Comparison of sedation with dexmedetomidine/atipamezole administered subcutaneously at GV20 acupuncture point with usual routes of administration in dogs presented for orthopaedic radiographs.

OBJECTIVES: To evaluate the efficacy of subcutaneous administration of dexmedetomidine/atipamezole at the Governing Vessel 20 (GV20) acupuncture point compared with other administration routes (intramuscular and intravenous) in dogs presented for orthopaedic radiographs. MATERIALS AND METHODS: Prospective, randomised, blinded, controlled clinical study. Sixty-four client-owned dogs were randomly injected with 200 µg/m2 of dexmedetomidine intramuscular (lumbar muscles) (n=20), intravenous (n=23) or subcutaneous at the GV20 point (n=21). Following radiographs, dogs received 2000 µg/m2 of atipamezole intramuscular (n=31), or subcutaneous at the GV20 point (n=27). Degree and time to sedation and recovery were assessed using a sedation scale and a Dynamic and Interactive Visual Analog Scale (DIVAS). Clinical physiological variables and adverse events were used. Statistical linear mixed-effect models (analysis of variance) and Cox models were performed. Significance was set at P-value <0.05. RESULTS: Sedation was insufficient to perform orthopaedic radiographs in six dogs in the intramuscular group. The time to sedation was significantly longer, and sedation scale and DIVAS scores were significantly lower in the intramuscular group. The intravenous group had significantly higher sedation scale and DIVAS scores than the GV20 group. No significant differences were observed between the intramuscular and GV20 recovery groups, although the time effect was significantly more pronounced in the GV20 recovery group. CLINICAL SIGNIFICANCE: Subcutaneous administration of dexmedetomidine and atipamezole at GV20 provided effective sedation and recovery in dogs undergoing orthopaedic radiographic studies. GV20 administration provided a clinically similar level of sedation to the intravenous route, and greater and faster sedation and similar recovery to intramuscular.

Atom Probe Tomography of Encapsulated Hydroxyapatite Nanoparticles.

Hydroxyapatite nanoparticles (HAP NPs) are important for medicine, bioengineering, catalysis, and water treatment. However, current understanding of the nanoscale phenomena that confer HAP NPs their many useful properties is limited by a lack of information about the distribution of the atoms within the particles. Atom probe tomography (APT) has the spatial resolution and chemical sensitivity for HAP NP characterization, but difficulties in preparing the required needle-shaped samples make the design of these experiments challenging. Herein, two techniques are developed to encapsulate HAP NPs and prepare them into APT tips. By sputter-coating gold or the atomic layer deposition of alumina for encapsulation, partially fluoridated HAP NPs are successfully characterized by voltage- or laser-pulsing APT, respectively. Analyses reveal that significant tradeoffs exist between encapsulant methods/materials for HAP characterization and that selection of a more robust approach will require additional technique development. This work serves as an essential starting point for advancing knowledge about the nanoscale spatiochemistry of HAP NPs.

Meditaciones de la técnica / A meditation on technique

No disponible

Effects of dexmedetomidine administered at acupuncture point GV20 compared to intramuscular route in dogs.

OBJECTIVE: To compare the sedative effects produced by dexmedetomidine in dogs, administered either intramuscularly or into the Governing Vessel 20 acupuncture point. MATERIALS AND METHODS: Six dogs were sedated with 125 µg/m2 dexmedetomidine injected either intramuscularly in the gluteal muscles or subcutaneously into the acupuncture point and in random order. Sedation and analgesia were assessed blindly before and after treatments at regular intervals for 90 minutes or until the dogs fully recovered. Duration and quality of sedation were assessed with a numerical sedation rating scale and a dynamic and interactive visual analogue scale. Analgesia was also assessed with a numerical rating scale. Heart and respiratory rates and rectal temperatures were recorded. RESULTS: Sedative and analgesic scores were significantly increased when dexmedetomidine was administered at the Governing Vessel 20 acupuncture point compared with the routine intramuscular route. Duration of sedation was longer in the acupuncture site injection group compared to the intramuscular group (93 ±38 and 41 ±16 minutes). Bradycardia was significantly more pronounced in the acupuncture site group than the intramuscular group, whereas respiratory rates and rectal temperatures did not differ between administration routes. CLINICAL SIGNIFICANCE: Administration at the Governing Vessel 20 acupuncture point increased the duration and degree of sedation and analgesic effects of dexmedetomidine compared with the intramuscular route.

Epidemiology of asthma exacerbations and their relation with environmental factors in the Basque Country.

BACKGROUND: Asthma is a highly prevalent chronic inflammatory disease characterised by reversible airflow obstruction and hyperreactivity and inflammation of the airways. Factors that cause and/or trigger asthma attacks include host-related factors (genetic predisposition, obesity and sex) and environmental factors (allergens, infections, occupational sensitisation, smoking status, pollution and diet). OBJECTIVE: To describe the epidemiology of asthma exacerbations (AEs) in the Basque Country and to explore its relationship with potentially associated environmental variables. We studied a total of 31,579 emergency department (ED) visits and 28,189 hospitalisations due to asthma. We describe the trends, incidence, seasonality and the influence of age and sex, as well as of exposure to NO2 , CO, PM, O3 , and pollen, temperature, relative humidity and flu status. We calculated the Pearson's R correlation coefficient for the study variables. RESULTS: The incidence was 486 and 88.9 cases per 100,000 people for ED visits and hospitalisations, respectively. Slightly over half (53.5%) of the ED cases were male, while females represented 62.6% of the hospital admissions. Hospitalisations are tending to decrease in children and increase in over 64-year-olds. Peaks in cases occur at the beginning of autumn in children and in winter in adults. AEs were correlated positively with exposure to NO2 , CO and to the influenza virus and negatively with temperature and exposure to O3 . These relationships vary, however, with age and season. CONCLUSIONS AND CLINICAL RELEVANCE: Rates of hospitalisation for AEs and trends in these rates over time are different in adults and children with the patterns varying by sex, season and environmental conditions.

Osteoporosis y fractura de cadera. Modelo asistencial / No disponible

La osteoporosis y, secundariamente, la fractura de cadera son dos entidades inseparables que acontecen en la mayoría de los casos en individuos de edad avanzada, principalmente mujeres, y con otros problemas de salud. La elevada prevalencia de síndromes geriátricos en los pacientes con fractura de cadera requiere un abordaje integral, e integrado, entre los diferentes profesionales y niveles asistenciales que priorice la continuidad asistencial y los resultados en salud a largo plazo. Las herramientas clave en este abordaje son la valoración geriátrica integral, el trabajo en equipo interdisciplinar, la atención centrada en el paciente y las guías de práctica clínica. Los modelos de atención integrada emergen como una respuesta más adecuada en la atención a la fractura de cadera porque los diferentes agentes implicados comparten objetivos comunes, colocan al paciente en el centro de la atención, eliminan barreras y permiten racionalizar los recursos(AU)

Osteoporosis and hip fracture are two inseparable conditions in most cases in older female patients with other health problems. A comprehensive-multidisciplinary integrated approach is required because of high prevalence of geriatric syndromes in hip fracture patients. Care continuum and long-term results must be enhanced. Comprehensive geriatric assessment, multidisciplinary teamwork, patientfocused care, and evidenced-based practices are the management key tools for these patients. Integrated care models seems to be the best answer in hip fracture because common targets are shared between all implicated agents, patient is sited in the center of care, barriers are suppressed, and resources rationalized(AU)

The excesive intake of macronutrients: does it influence the sports performances of young cyclists?

UNLABELLED: The purpose was to determine whether 34 young Spanish males belonging to a cyclist team, follows the optimal macronutrients intake based on the recommended dietary guidelines. The deficits in nutrition jeopardise the sportive performances, but what about the diets with excessive intake of macronutrients? Furthermore, is there an association between their sports achievements and the psychological profile? Surely, but the problem is to determine which psychological variables are involved. METHOD: Nutritional evaluation based on Nutrients intake questionnaire of 7 consecutive days. RESULTS: Cyclists consume an excessive quantity of proteins and lipids in their diets. The average consumption of proteins is 16,36% of their caloric intake (the recommended quantity is less than 10%). The average consumption of fats is 38,71% (the recommended is less than 30%). The same tendency is found in the homologous Spanish young people of the enKID study, where the percentage of energy from fat and saturated fat is much higher than the recommended one. The cyclists consume insufficient quantities of carbohydrates (average is 44, 94% of their caloric intake, the recommended is more than 60%), therefore the reload of their glycogen stores may not be complete on each competition stage. No association has been found between the excessive intake of referred macronutrients and the achieved sports performances. CONCLUSION: This work contributes to the knowledge of the diets of very active young cyclists. Excessive intake of proteins and fats do not jeopardise their sportive performances. The commonly studied psychological variables in sport, are not determinant of sports achievements of young cyclists; additional work is needed to determine the psychological profile playing a determinant role in success of young cyclists.

Effects of homeopathic medications Eupatorium perfoliatum and Arsenicum album on parasitemia of Plasmodium berghei-infected mice.

Malaria is one of the most important parasitic diseases in the world and a major public health problem because of emerging drug-resistant strains of Plasmodium. A number of synthetic and natural compounds are now being analysed to develop more effective antimalarial drugs. We investigated the effect of homeopathic preparations of Eupatorium perfoliatum and Arsenicum album on parasitemia using a rodent malaria model. We found significant inhibitory effect on parasite multiplication with both medications with a level of 60% for Eupatorium perfoliatum at a 30 CH potency. Arsenicum album 0/6 gave 70% inhibition but this was less stable than Eupatorium perfoliatum. The number of schizonts was higher in animals treated with homeopathic medications. Although the mechanism of action is unknown, these agents would be good candidates as alternative or complementary medications in the treatment of malaria.

Valoración geriátrica: visión desde el Hospital de Día / Geriatric assessment: the Day Hospital View

La Valoración Geriátrica Integral es la herramienta básica y fundamentalen la priorización de problemas e intervención en la atención alanciano frágil. Independientemente de cuál sea el nivel asistencial,permite realizar un análisis exhaustivo de las capacidades físicas,funcionales, del estado nutricional, de los órganos de los sentidos, delestado de ánimo y del entorno sociofamiliar que envuelve a cadapaciente. De la misma manera, tiene en cuenta las necesidades, lavoluntad y los deseos del paciente. Por este motivo, sólo a través deella, podemos coordinarnos entre los diferentes profesionales de lasalud y niveles asistenciales para priorizar el abordaje de los problemasde salud y ofrecer una asistencia integral de calidad

Integral Geriatric Assessment is the basic and fundamental tool in theprioritization of problems and supervision in the care of the frail elderly.Independent of whatever the level of care is, it permits the realization ofan exhaustive analysis of the physical and functional capabilities, thenutritional state, the sense organs, the state of mind and the social andfamily environment that surrounds each patient. In the same way, theneeds, the will and the wishes of the patient are taken into account.Therefore, only through it can we coordinate between the differenthealth professionals and levels of care to prioritise the broaching of thehealth problems and offer quality integral care

Tratamiento de la disfunción eréctil mediante el implante de prótesis de pene. Análisis de nuestra serie / Treatment of erectile dysfunction with penile prothesis. Our experience

INTRODUCCIÓN Y OBJETIVOS: El objetivo de este estudio fue revisar la situación actual de las prótesis de pene en el tratamiento de la disfunción eréctil; así como analizar las indicaciones, el grado de aceptabilidad y las complicaciones en nuestra experiencia. MATERIAL Y MÉTODOS: Entre 1984 y 2003 implantamos 48 prótesis de pene en varones con edad media de 55 años. Los antecedentes patológicos más frecuentes fueron: enfermedad vascular, diabetes mellitus y cirugía pélvica. El tipo de prótesis utilizada fue inactiva maleable en 7 casos (14,58%), Jonas6, Acu-form1. Activa inflable o hidráulica de 3 componentes en 19 casos (39,58%), AMS 700 plus17, Alpha2. Activa inflable, integrada o autocontenida en 5 casos (10,41%), Hydroflex4, Dynaflex1. Activa inflable de 2 piezas en 17 casos (35,4%), Ambicor2, Mark II15. RESULTADOS: El 6,25% presentó infección protésica que obligó a retirar el implante, y el 4,16% complicaciones mecánicas. El 80% de los pacientes se mostraron satisfechos con la prótesis. CONCLUSIONES: Las prótesis peneanas continúan siendo una alternativa válida y eficaz en el tratamiento del varón con disfunción eréctil, presentando un bajo índice de complicaciones

INTRODUCTION AND OBJETIVES: The aim of this study was to review the current situation of penile prosthesis in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in oir experience. MATERIAL AND METHODS: From 1984 to 2003, 48 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 55 years. Vascular disease, Diabetes and pelvic surgery were the most common pathologies recorded. The type of prothesis inserted were malleable inactive in 7 cases (14.58%), Jonas6, Acu-form1. Inflable active with 3 components in 19 cases (39.58%), AMS 700 plus17, Alpha2. Inflable active integrated in 5 cases (10.41%) Hydroflex4, Dynaflex1. Inflable active with 2 components in 17 cases (35.4%), Ambicor2, Mark II15. RESULTS: Infection of the prosthesis was observed in 6.25% of the cases. This infectious complication required removal of the prosthesis. 4.16% of the cases complained of mechanical failure that required change of the prosthesis. 80% of the patients were satisfied with the results. CONCLUSIONS: Penile prostheses continue to be an effective and valid therapeutic alternative in impotent. Although the complication rate is low, adequate information must be provided to the patient

Electrophysiologic cardiac effects of the new local anesthetic IQB-9302 and of bupivacaine in the anesthetised dog.

BACKGROUND: Local anesthetics are not free from potentially fatal complications. Therefore every new local anesthetic should be tested to demonstrate a lower, or at least similar, degree of toxicity over clinically used analogs. Most toxic effects from local anesthetics affect the cardiac electrophysiologic function, so the aim of this study was to characterize the electrophysiologic effects of a new long-acting local anesthetic (IQB-9302, Ciprocaine), and compare them with those of bupivacaine in the anesthetized dog. METHODS: Eight Beagle dogs received three increasing infusion doses of either IQB-9302 or bupivacaine. Under isoflurane anesthesia, dogs were instrumented to monitor cardiovascular (cardiac output, arterial and venous blood pressures) and cardiac electrophysiologic data (sinus and atrioventricular (AV) node function, atrial, nodal and ventricular conduction times, and refractoriness). RESULTS: Only the highest dose of both drugs induced hemodynamic or electrophysiologic alterations: cardiac output and heart rate were reduced while blood pressures remained unchanged. Atrial and intranodal conduction times and atrial refractoriness increased similarly with both anesthetics, but to a slightly lesser extent with IQB-9302. Significant increases in His-Purkinje and intraventricular conduction times were the most severe noxious effects and occurred only with large doses of either drug. IQB-9302 was slightly less toxic than bupivacaine and, unlike this latter drug, potentially fatal arrhythmias were not induced. CONCLUSION: IQB-9302 has hemodynamic and cardiac electrophysiologic effects similar to those caused by bupivacaine. Nevertheless, slightly less toxic effects were derived from IQB-9302 administration than with bupivacaine, and, unlike the latter, the former might be less proarrhytmogenic. The new long-acting local anesthetic IQB-9302 may offer clinical advantages compared with bupivacaine.

Synthesis and evaluation of calystegine B2 analogues as glycosidase inhibitors.

A practical synthesis of polyhydroxylated 6-oxa-nor-tropanes incorporating the essential structural features of calystegine B(2) from 5-deoxy-5-thioureido and 5-ureido-L-idofuranose precursors is presented. The methodology relies on the ability of pseudoamide-type nitrogen atoms (thiourea, urea, and carbamate) to undergo nucleophilic addition to the masked aldehyde group of the monosaccharide. The generated hemiaminal functionality may further undergo in situ intramolecular glycosidation to give the bicyclic aminoacetal compounds, the whole process being favored by the anomeric effect. A series of derivatives bearing different substituents at nitrogen has been prepared and screened against several glycosidases in comparison with xylonojirimycin-type piperidine analogues. Interestingly, strong and highly specific inhibition of bovine liver beta-glucosidase was observed for 6-oxacalystegine B(2) analogues incorporating aromatic pseudoaglyconic groups. On the basis of these data, a 1-azasugar inhibition mode is proposed for this family of glycomimetics.

Spanish toxic oil syndrome: ten years after the disaster.

Toxic oil syndrome (TOS), a previously undescribed disease that occurred in Spain in epidemic form in 1981, has been associated with ingestion of a reprocessed denatured rapeseed oil illegally marketed. However, the association between the syndrome and the adulterated rapeseed oil rests exclusively on epidemiological data because of the absence of toxicologic confirmation and the inability to reproduce the disease in animals. An analysis of the epidemiological evidence available on TOS is carried out in this paper, in an attempt to elucidate the aetiological role of the purported toxic oil. The adulterated oil was found to be highly statistically associated with the syndrome, such an association being extremely unlikely to be due to the effects of bias and/or confounders. The association is very strong, as the estimated relative risk shows (odds ratio = 30), and a dose-response relationship was found. Likewise, the specificity of the association is very high. The temporal sequence of events, although not entirely clear, also helps to support the hypothesis of causality. No other criterion was met, but none of these unmet criteria stands against this hypothesis. From these findings, the adulterated rapeseed oil can be considered a necessary cause for the syndrome to have occurred. Further toxicologic investigations are required to elucidate the precise toxic agent.