Intrathecal analgesia and restrictive perioperative fluid management within enhanced recovery pathway: hemodynamic implications.

BACKGROUND: Intrathecal analgesia and avoidance of perioperative fluid overload are key items within enhanced recovery pathways. Potential side effects include hypotension and renal dysfunction. STUDY DESIGN: From January 2010 until May 2010, all patients undergoing colorectal surgery within enhanced recovery pathways were included in this retrospective cohort study and were analyzed by intrathecal analgesia (IT) vs none (noIT). Primary outcomes measures were systolic and diastolic blood pressure, mean arterial pressure, and heart rate for 48 hours after surgery. Renal function was assessed by urine output and creatinine values. RESULTS: One hundred and sixty-three consecutive colorectal patients (127 IT and 36 noIT) were included in the analysis. Both patient groups showed low blood pressure values within the first 4 to 12 hours and a steady increase thereafter before return to baseline values after about 24 hours. Systolic and diastolic blood pressure and mean arterial pressure were significantly lower until 16 hours after surgery in patients having IT compared with the noIT group. Low urine output (<0.5 mL/kg/h) was reported in 11% vs 29% (IT vs noIT; p = 0.010) intraoperatively, 20% vs 11% (p = 0.387), 33% vs 22% (p = 0.304), and 31% vs 21% (p = 0.478) for postanesthesia care unit and postoperative days 1 and 2, respectively. Only 3 of 127 (2.4%) IT and 1 of 36 (2.8%) noIT patients had a transitory creatinine increase >50%; no patients required dialysis. CONCLUSIONS: Postoperative hypotension affects approximately 10% of patients within an enhanced recovery pathway and is slightly more pronounced in patients with IT. Hemodynamic depression persists for <20 hours after surgery; it has no measurable negative impact and therefore cannot justify detrimental postoperative fluid overload.

Vacancy and interstitial depth profiles in ion-implanted silicon

An experimental method of studying shifts between concentration-versus-depth profiles of vacancy- and interstitial-type defects in ion-implanted silicon is demonstrated. The concept is based on deep level transient spectroscopy measurements utilizing the filling pulse variation technique. The vacancy profile, represented by the vacancy¿oxygen center, and the interstitial profile, represented by the interstitial carbon¿substitutional carbon pair, are obtained at the same sample temperature by varying the duration of the filling pulse. The effect of the capture in the Debye tail has been extensively studied and taken into account. Thus, the two profiles can be recorded with a high relative depth resolution. Using low doses, point defects have been introduced in lightly doped float zone n-type silicon by implantation with 6.8 MeV boron ions and 680 keV and 1.3 MeV protons at room temperature. The effect of the angle of ion incidence has also been investigated. For all implantation conditions the peak of the interstitial profile is displaced towards larger depths compared to that of the vacancy profile. The amplitude of this displacement increases as the width of the initial point defect distribution increases. This behavior is explained by a simple model where the preferential forward momentum of recoiling silicon atoms and the highly efficient direct recombination of primary point defects are taken into account.

Produtividade e nutrição de mamona cultivada em área de reforma de canavial tratada com lodo de esgoto

A utilização de lodo de esgoto (LE) em solos agrícolas é uma das maneiras mais viáveis de destinação desse resíduo. O objetivo deste trabalho foi avaliar o efeito da aplicação de LE na nutrição e na produtividade da mamona cultivada em área de reforma de canavial, num Argissolo Vermelho-Amarelo distrófico textura argilosa. Os tratamentos testados constaram de quatro doses de lodo de esgoto: 0, 5, 10 e 20 t ha-1 (base seca), calculadas para fornecer N equivalente a 0, 37,5, 75 e 150 kg ha-1; um tratamento com fertilização mineral N-P2O5-K2O (75-40-80 kg ha-1respectivamente) e um controle sem qualquer fertilização. Os tratamentos com LE também receberam 40 kg ha-1 de P2O5 e 80 kg ha-1 de K2O. A mamoneira, cultivar IAC-Guarani, foi cultivada por cerca de 180 dias entre novembro de 2004 e maio de 2005. A aplicação de LE resultou em incremento estatisticamente significativo (p < 0,05) na produtividade e em outras características biométricas da mamona. A aplicação da dose equivalente a 10 t ha-1 de lodo resultou em um índice de eficiência agronômica de 85 %, em relação à adubação mineral. A disponibilidade de N foi o fator mais limitante no crescimento e na produtividade da mamona, e a taxa de mineralização do N utilizada subestimou o fornecimento de N pelo lodo em campo. Houve aumento significativo de Cu e Zn no solo com a aplicação das doses de lodo, mas tanto os teores no solo quanto na planta estiveram dentro dos limites aceitos pela legislação ambiental.

CO2, CH4 and N2O fluxes in an Ultisol treated with sewage sludge and cultivated with castor bean

Organic residue application into soil alter the emission of gases to atmosphere and CO2, CH4, N2O may contribute to increase the greenhouse effect. This experiment was carried out in a restoration area on a dystrophic Ultisol (PVAd) to quantify greenhouse gas (GHG) emissions from soil under castor bean cultivation, treated with sewage sludge (SS) or mineral fertilizer. The following treatments were tested: control without N; FertMin = mineral fertilizer; SS5 = 5 t ha-1 SS (37.5 kg ha-1 N); SS10 = 10 t ha-1 SS (75 kg ha-1 N); and SS20 = 20 t ha-1 SS (150 kg ha-1 N). The amount of sludge was based on the recommended rate of N for castor bean (75 kg ha-1), the N level of SS and the mineralization fraction of N from SS. Soil gas emission was measured for 21 days. Sewage sludge and mineral fertilizers altered the CO2, CH4 and N2O fluxes. Soil moisture had no effect on GHG emissions and the gas fluxes was statistically equivalent after the application of FertMin and of 5 t ha-1 SS. The application of the entire crop N requirement in the form of SS practically doubled the Global Warming Potential (GWP) and the C equivalent emissions in comparison with FertMin treatments.

Madot tappoivat suden Hämeessä : kuolemaan johtanut Alaria sp. -imumatoinfektio sudella

Summary: Alaria sp. causing fatal enteritis in a wolf

Male body size and breeding tubercles are both linked to intra-sexual dominance and reproductive success in the minnow

Male dominance hierarchies are usually linked to relative body size and to weapon size, that is, to determinants of fighting ability. Secondary sexual characters that are not directly used as weapons could still be linked to dominance if they reveal determination or overall health and vigour and hence, indirectly, fighting ability. We studied the mating behaviour of the minnow, Phoxinus phoxinus, a cyprinid fish in which males develop breeding tubercles during the spawning season. The function of these breeding tubercles is still not clear. Using microsatellite markers, we determined male reproductive success under controlled conditions. The minnows were territorial and quickly established a dominance hierarchy at the beginning of the spawning season. Dominance was strongly and positively linked to fertilization success. Although body size and number of breeding tubercles were not significantly correlated in our sample, both large males and males with many breeding tubercles were more dominant and achieved higher fertilization success than small males or males with few tubercles. We found multimale fertilization in most clutches, suggesting that sperm competition is important in this species. Females showed behaviour that may be linked to spawning decision, that is, male dominance might not be the only determinant of male reproductive success in minnows

Place de la laparoscopie dans le traitement du cancer de l'endomètre [Laparoscopy in the management of endometrial cancer]

Les récents progrès de la laparoscopie ont modifié l'approche chirurgicale des patientes atteintes d'un cancer de l'endomètre. Le centre Swissendos Fribourg en collaboration avec l'AGO (Groupe de travail pour la gynécologie oncologique) et l'AGE (Groupe de travail pour la gynécologie endoscopique) ont entrepris d'élaborer un consensus basé sur l'évidence pour la pratique de la laparoscopie dans le traitement du cancer de l'endomètre. L'objectif a été de définir une approche propre à la Suisse en fournissant aux praticiens une aide à la prise en charge. Recent advance in laparoscopy have changed the surgical approach of endometrial cancer patients. The Swissendos Center, Fribourg, in collaboration with AGO (Groupe de travail pour la gynécologie oncologique) and AGE (groupe de travail pour la gynécologie endoscopique) have established a consensus based on the available evidence for the use of laparoscopy in the management of patients with endometrial cancer The main objective was to define Swiss clinical practice guidelines appropriate to the country and consistent with the needs of the physicians.

Gonadal alterations in male whitefish Coregonus fatioi: no evidence for genetic damage reducing viability in early life stages.

In recent years, numerous cases of morphological gonadal alterations in fish have been recorded throughout the world and across a wide range of species. In the whitefish Coregonus fatioi from the pre-alpine Lake Thun (Switzerland), the frequency of gonadal alterations is particularly high and the variety of alteration types large. Little is known about the proximal causes and the direct consequences of these morphological features on population persistence. In particular, the potential for the observed alterations to be the phenotypic expression of reduced genetic quality has not yet been addressed. In this study, we used offspring survival during embryogenesis as a proximate indicator of male genetic quality and tested whether the presence of gonadal alterations in males is an indicator of reduced quality. Embryos resulted from in vitro fertilizations of gametes from 126 males and females. We found no significant correlation between embryo survival and gonadal alteration in adults. Our findings suggest that in C. fatioi of Lake Thun, alterations in gonad morphology are not a phenotypic expression of variation in genetic quality.