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INTRODUCTION: Orofacial clefts are the most common craniofacial abnormalities, affecting approximately one in 700 newborns each year. The anaesthetic management of these patients is challenging, including difficulties in airway approach and respiratory complications that have direct implications in the final outcome. AIM: The present study aimed to characterize the anesthetic approach to paediatric patients undergoing cleft palate or lip surgical repair and review the perioperative anesthetic complications in a tertiary Portuguese hospital. METHODS: Data were collected from a retrospective review of the patient records which included anaesthesia perioperative notes of paediatric patients submitted to cleft surgery repair during a five-year period (2016 to 2021). Demographic, pre-anaesthetic characteristics, anaesthetic management and perioperative complications were recorded. RESULTS: A total of 102 patients were included, with a median age of 1.5 years. Congenital syndromes were present in 14 (13.7%) of the children included. Inhalational induction of anaesthesia with sevoflurane was the preferred approach in 86 cases (84.3%), with neuromuscular blockade being used in 59 cases (57.8%). Intubation was achieved at first attempt in 91 (89.2%) cases with four (3.9%) patients needing three or more attempts. Intraoperative respiratory-related complications were the most frequent, occurring in 22 (21.6%) cases. These include multiple attempts to intubation, desaturation due to bronchospasm or laryngospasm. The average length of stay was two days. Postoperative complications were recorded in 17 (16.7%) of patients. DISCUSSION: The predominance of airway and respiratory complications occurring in cleft is consistent with previous studies. Care must be taken in order to avoid such complications in the perioperative period by following protocols, having skilled personnel, appropriate monitoring equipment and airway devices available during cleft surgeries to minimise morbidity.
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: Parkinson's disease is a movement disorder characterized by a progressive degeneration of dopaminergic neurons that has been object of study by the scientific community through the last decades. However, nowadays there is still no treatment to cure it, although there are drugs available, with limited efficacy, to relieve the symptoms or replenish the cells with dopamine to supply the lack of dopaminergic neurons. This work was structured in two parts. In the first one, binary aqueous solutions of L-dopa and cyclodextrins were studied. In the second part, ternary aqueous solutions of L-dopa were studied with each of the selected cyclodextrins. In all cases, thermodynamic properties (density, partial molar volume and thermodynamic transfer functions for temperatures between 294.15 ± 0.01 K and 312.15 ± 0.01 K) and transport properties (mutual diffusion coefficients, viscosity, transfer viscosity at 298.15 ± 0.01 K and 310.15 ± 0.01 K) were studied. Using theoretical models to adjust the experimental data obtained for the diffusion coefficients and for the apparent molar volumes, in the ternary aqueous solutions, it was possible to estimate the values to the L-dopa-cyclodextrin association constant. For the aqueous ternary solutes, the partial molar volume of transfer of levodopa in the presence of the cyclodextrins, the partial molar expansibility at infinite dilution and from this, the Hepler constant, were determined. Also, the values of Gibbs free energy (ΔG°), enthalpy (ΔH°) and entropy (ΔS°) were determined. From the obtained information, it was possible to characterize the molecular interactions, as well as to identify some structural characteristics of the controlled drug delivery systems under study and to estimate the influence of the cyclodextrin substituent groups, and, also, the temperature effect in the interaction levodopa-cyclodextrin. It is our intent to attain information about the mechanism of possible new systems for controlled drug delivery systems, throughout an alternative perspective, which could allow to increase its effectiveness in the Parkinson's treatment.
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Ciclodextrinas/metabolismo , Enfermedad de Parkinson/patología , Difusión , Humanos , Levodopa/metabolismo , Modelos Teóricos , Enfermedad de Parkinson/metabolismo , Temperatura , Termodinámica , ViscosidadRESUMEN
The side chain effect on transport in ionic aqueous salt solutions was investigated for [Formula: see text]-amino acids glycine, alanine, [Formula: see text]-amino butyric acid, norvaline, and norleucine --that together define a chemical homologous series based on the length of the characteristic side chain which increases from zero to four carbons, respectively. Binary mutual diffusion coefficients at infinitesimal concentration in aqueous solutions of NaCl (0.15 mol kg -1) are measured by means of Taylor dispersion technique for this series and significant differences were found against previous published results for identical systems in pure water. In this way, NaCl effect on the transport of each amino acid is thus assessed and discussed in terms of salting-out effects. Also, solvated Stokes hydrodynamic radii were computed for the series showing comparable results in water and NaCl solution. The new information should prove useful in the design and characterization of transport-controlled systems in physiological and pharmacological studies.
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Alanina/química , Glicina/química , Norleucina/química , Valina/análogos & derivados , Ácido Butírico/química , Difusión , Interacciones Hidrofóbicas e Hidrofílicas , Concentración Osmolar , Valina/químicaRESUMEN
Mutual diffusion coefficients, D, were determined for aqueous solutions of sodium hyaluronate (NaHy) at 25 °C and concentrations ranging from 0.00 to 1.00 g·dm(-3) using the Taylor dispersion technique. From these experimental data, it was possible to estimate some parameters, such as the hydrodynamic radius Rh, and the diffusion coefficient at infinitesimal concentration, D0, of hyaluronate ion, permitting us to have a better understanding of the structure of these systems of sodium hyaluronate in aqueous solutions. The additional viscosity measurements were done and Huggins constant, kH, and limiting viscosity number, [η], were computed for interaction NaHy/water and NaHy/NaHy determination.
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Ácido Hialurónico/análisis , Hidrodinámica , Soluciones , Difusión Térmica , Termodinámica , ViscosidadRESUMEN
Mutual diffusion coefficients, D, densities, ρ, and viscosities, η, are reported for aqueous solutions of L-3,4-dihydroxyphenylalanine (L-Dopa) at 298.15K and 310.15K at concentrations from (0.00025 to 0.0075) moldm(-3). The aim of this study is to contribute to a better understanding of the structure of these systems and the thermodynamic behaviour of L-Dopa in solution. Thus, from these experimental data it was possible to estimate some parameters, such as the hydrodynamic radius, Rh, apparent molar volumes, ÏV, and diffusion coefficients at infinitesimal concentration, D(0), essential for a better understanding of disperse systems. From the measured diffusion coefficients, activity coefficients, γ, for aqueous L-Dopa solutions were also estimated by using Nernst-Hartley equation. The effect of the viscosity on the estimated hydrodynamic radius was also studied.