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1.
Sci Rep ; 14(1): 9170, 2024 04 22.
Artículo en Inglés | MEDLINE | ID: mdl-38649700

RESUMEN

This study provides a comparative analysis of two state-of-the-art automatic mosquito pupae sex sorters currently available: the ORINNO and the WOLBAKI Biotech pupae sex separation systems, which both exploit the sexual size dimorphism of pupae. In Aedes aegypti, the WOLBAKI sex sorter and the ORINNO with a sieve mesh size of 1.050 mm achieved sex separation with female contamination rates below 1%, low pupae mortality rates and high male flight capacity. However, in Ae. albopictus, there was more variability, with female contamination rates above the 1% threshold and pupae mortality reaching 27% when using the ORINNO sorter. On the other hand, the WOLBAKI sorter achieved a male pupae recovery of 47.99 ± 8.81% and 50.91 ± 11.77% in Ae. aegypti and Ae. albopictus, respectively, while the ORINNO sorter with a smaller sieve size achieved male pupae recoveries of 38.08 ± 9.69% and 40.16 ± 2.73% in Ae. aegypti and Ae. albopictus, respectively. This study provides valuable information for researchers and practitioners in the field, assisting in the selection of the most suitable system for mosquito control, management and research programs depending on their specific requirements.


Asunto(s)
Aedes , Control de Mosquitos , Pupa , Animales , Masculino , Femenino , Aedes/fisiología , Control de Mosquitos/métodos
2.
Sci Rep ; 14(1): 4358, 2024 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-38388700

RESUMEN

In the last decade, the use of the sterile insect technique (SIT) to suppress mosquito vectors have rapidly expanded in many countries facing the complexities of scaling up production and procedures to sustain large-scale operational programs. While many solutions have been proposed to improve mass production, sex separation and field release procedures, relatively little attention has been devoted to effective mass sterilization of mosquitoes. Since irradiation of pupae en masse has proven difficult to standardise with several variables affecting dose response uniformity, the manipulation of adult mosquitoes appears to be the most promising method to achieve effective and reliable sterilization of large quantities of mosquitoes. A 3D-printed phase change material based coolable canister was developed which can compact, immobilize and hold around 100,000 adult mosquitoes during mass radio sterilization procedures. The mass irradiation and compaction treatments affected the survival and the flight ability of Aedes albopictus and Aedes aegypti adult males but the use of the proposed irradiation canister under chilled conditions (6.7-11.3 °C) significantly improved their quality and performance. The use of this cooled canister will facilitate adult mass irradiation procedures in self-contained irradiators in operational mosquito SIT programmes.


Asunto(s)
Aedes , Infertilidad , Animales , Masculino , Aedes/fisiología , Esterilización Reproductiva , Impresión Tridimensional , Control de Mosquitos/métodos
3.
Front Bioeng Biotechnol ; 10: 856780, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35586555

RESUMEN

The success of the sterile insect technique (SIT) relies on the achievement of high levels of sterility and mating success of the factory-reared sterile males and thus their biological quality, which can be enhanced by the reduction of stress factors encountered during rearing, handling, and irradiation procedures. The achievement of consistent sterility levels requires reliable and standard irradiation protocols. Additionally, mosquito adults require immobilization prior to, and during irradiation to increase processing efficiency and to avoid physical damage caused by movement in restricted space. Common methods for immobilization include chilling and anesthetics such as nitrogen. Here we assessed the effects of chilling and exposure to nitrogen on the irradiation dose-response of Aedes mosquitoes, and their downstream effects on some male quality parameters including longevity and flight ability. We found that chilling does not incur damage in the insects in terms of longevity and flight ability when chilling duration and temperature are carefully controlled, and a recovery phase is provided. Irradiation in nitrogen shows high radioprotective effects during irradiation, resulting in reduced induction of sterility. Overall, longevity of males can be improved by irradiating in anoxia, however the exposure to nitrogen itself comes with negative impacts on flight ability. The results reported here will assist in the standardization and optimization of irradiation protocols for the SIT to control mosquito populations of medical relevance.

4.
Sci Robot ; 5(43)2020 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-33022616

RESUMEN

Genetic control methods of mosquito vectors of malaria, dengue, yellow fever, and Zika are becoming increasingly popular due to the limitations of other techniques such as the use of insecticides. The sterile insect technique is an effective genetic control method to manage insect populations. However, it is crucial to release sterile mosquitoes by air to ensure homogeneous coverage, especially in large areas. Here, we report a fully automated adult mosquito release system operated from an uncrewed aerial vehicle or drone. Our system, developed and tested in Brazil, enabled a homogeneous dispersal of sterile male Aedes aegypti while maintaining their quality, leading to a homogeneous sterile-to-wild male ratio due to their aggregation in the same sites. Our results indicate that the released sterile males were able to compete with the wild males in mating with the wild females; thus, the sterile males were able to induce sterility in the native female population. The use of drones to implement the sterile insect technique will lead to improvements in areal coverage and savings in operational costs due to the requirement of fewer release sites and field staff.


Asunto(s)
Aedes/genética , Aedes/fisiología , Aeronaves/instrumentación , Control de Mosquitos/instrumentación , Mosquitos Vectores/genética , Mosquitos Vectores/fisiología , Robótica/instrumentación , Animales , Brasil , Simulación por Computador , Diseño de Equipo , Femenino , Humanos , Infertilidad Masculina , Masculino , Control de Mosquitos/métodos , Control de Mosquitos/estadística & datos numéricos , Robótica/estadística & datos numéricos , Programas Informáticos , Enfermedades Transmitidas por Vectores/prevención & control , Enfermedades Transmitidas por Vectores/transmisión
5.
Sci Rep ; 9(1): 7413, 2019 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-31092868

RESUMEN

To achieve consistent and standardized rearing for mosquito immature stages, it is crucial to control the initial number of larvae present in each larval tray. In addition, maintaining an optimal and synchronized development rate of larvae is essential to maximize the pupal production and optimize male sorting in a mass-rearing setting. Manual counting is labor intensive, time consuming and error prone. Therefore, this study aimed to investigate the use of a customized automated counter for the quantification of mosquito larvae. The present prototype of the mosquito larval counter uses a single counting channel consisting of three parts: a larvae dispenser, an electronic counting unit and computer control software. After the separation of the larvae from eggs and debris, batches of different numbers of Aedes aegypti first instar larvae were manually counted and introduced into the counter through the upper loading funnel and channeled out from the bottom of the counter by gravitational flow. The accuracy and repeatability of the mosquito larval counter were determined in relation to larval density and water quality. We also investigated its impact on larval survival. Results showed an impact of larval density and water quality on the accuracy of the device. A -6% error and a repeatability of +/- 2.56% average value were achieved with larval densities up to 10 larvae/mL of clean water. Moreover, the use of the mosquito larval counter did not have any effect on larval survival or development. Under recommended conditions, the mosquito larval counter can be used to enumerate the number of mosquito larvae at a given density. However, future developments involving the use of multiple channels or larger input larvae container would help to expand its use in large-scale facilities.


Asunto(s)
Aedes , Factores de Edad , Animales , Anopheles , Automatización/métodos , Femenino , Larva , Masculino , Reproducibilidad de los Resultados
6.
Hernia ; 19(2): 307-11, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24615504

RESUMEN

PURPOSE: High pressure peaks might be a risk factor for the development of abdominal hernia. The course of abdominal pressure during extubation remains unclear. This preliminary study assessed the impact of two established extubation techniques. METHODS: Twenty-four consecutive patients suffering from abdominal wall hernia with the indication for surgical treatment were included. Twelve patients were extubated directly after the intravenous anaesthesia was stopped, before they had spontaneous breathing (deep extubation). The other 12 were extubated after they had spontaneous breathing (awake extubation). Intra-abdominal pressure (IAP) was measured via bladder catheter continuously. RESULTS: The highest value during extubation as well as the main increase in IAP was significantly lower in patients who underwent deep extubation (p < 0.001). CONCLUSIONS: Therefore, this extubation technique might improve the outcome of hernia repair.


Asunto(s)
Extubación Traqueal/efectos adversos , Hernia Abdominal/etiología , Hipertensión Intraabdominal/etiología , Adulto , Anciano , Extubación Traqueal/métodos , Femenino , Hernia Abdominal/fisiopatología , Humanos , Hipertensión Intraabdominal/fisiopatología , Masculino , Persona de Mediana Edad , Presión , Factores de Riesgo
7.
J Biotechnol ; 162(1): 75-80, 2012 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-22749908

RESUMEN

Synechocystis sp. PCC 6803 is a model organism for the study of photosynthetic processes. Methods to genetically manipulate this bacterium are essential to investigate these processes and to evaluate potential biotechnological applications. We developed a vector for controllable expression of proteins using a platform for stable integration of the expression cassette into the genome. The respective gene is translationally fused to the promoter of the petJ gene encoding cytochrome c(553) that is repressed by copper. Maximal expression from this promoter is achieved under copper depletion, whereas normal copper concentrations in standard medium lead to low expression rates. We show here the application of this system for construction of a conditional knockout mutant for the ferrochelatase, which is an essential enzyme in heme biosynthesis. Using different amounts of copper in the medium we were able to control the amount of ferrochelatase in the cell resulting in a varying expression of the phenotype.


Asunto(s)
Ferroquelatasa/genética , Técnicas de Inactivación de Genes/métodos , Proteínas Recombinantes/metabolismo , Synechocystis/genética , Synechocystis/metabolismo , Biotecnología/métodos , Clonación Molecular/métodos , Cobre/metabolismo , Ferroquelatasa/metabolismo , Vectores Genéticos , Fenotipo , Ficocianina/análisis , Ficocianina/metabolismo , Plásmidos/genética , Regiones Promotoras Genéticas , Proteínas Recombinantes/genética , Synechocystis/enzimología
8.
J Plant Physiol ; 168(12): 1380-6, 2011 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-21388705

RESUMEN

Hypothetical chloroplast open reading frames (ycfs) are highly conserved and interspecifically occurring genes in plastomes of plants and algae with significant functions in gene expression and photosynthesis. However, the function of many ycfs is still in vain so that attention is directed to other chloroplast functions such as metabolism of co-factors, protein translocation and protection against abiotic stress. We provide a comprehensive functional description of ycf53 and ycf59, two genes involved in chlorophyll biosynthesis. While ycf59 encodes an essential enzymatic component of Mg protoporphyrin monomethylester cyclase, ycf53 encodes a posttranslational regulator of chlorophyll biosynthesis. Their roles in tetrapyrrole biosynthesis were compared by using cyanobacterial and plant mutants with modulated expression of these two genes. Our work provides indications for diverse effects of these homologous gene products in plants and cyanobacteria on tetrapyrrole biosynthesis and photosynthesis.


Asunto(s)
Clorofila/biosíntesis , Cloroplastos/genética , Sistemas de Lectura Abierta/genética , Plantas/genética , Synechocystis/genética , Vías Biosintéticas , Ésteres/metabolismo , Técnicas de Inactivación de Genes , Modelos Biológicos , Filogenia , Proteínas de Plantas/química , Proteínas de Plantas/metabolismo , Plantas/enzimología , Subunidades de Proteína/metabolismo , Protoporfirinas/metabolismo , Tetrapirroles/biosíntesis
9.
Acta Anaesthesiol Scand ; 48(10): 1287-91, 2004 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-15504190

RESUMEN

BACKGROUND: The study assessed the efficacy and safety of dixyrazine, an alternative neuroleptic drug to droperidol, in the prophylaxis of postoperative nausea and vomiting (PONV). METHODS: A total of 197 patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomized to receive either dixyrazine 10 mg or placebo double-blinded at the end of surgery. Scores pertaining to PONV episodes, analgetic supply, rescue medication, adverse events and patient satisfaction were collected over the first 2 h in the PACU and the next 22 h in the ward. RESULTS: The incidence of PONV over the entire 24-h period was reduced from 32% in the placebo group to 13% in the dixyrazine group (P< or =0.004). The incidence of nausea in the first 2 h was reduced from 15% in the placebo group to 4% in the dixyrazine group (P< or =0.02) and from 12% to 5% in the next 22 h. The incidence of emetic episodes was not different between the two groups. Postoperative shivering was significantly less prevalent in the dixyrazine than in the placebo group (2% vs. 13%; P< or =0008), and opioid analgesics were required significantly less often (61% vs. 75%; P< or =0.01). No significant adverse effects were observed. Patient satisfaction was similar in both groups. CONCLUSION: Prophylactic dixyrazine is an effective, safe, and cheap antiemetic drug for laparoscopic cholecystectomy without involving any significant adverse events.


Asunto(s)
Antieméticos/uso terapéutico , Colecistectomía Laparoscópica/efectos adversos , Fenotiazinas/uso terapéutico , Náusea y Vómito Posoperatorios/prevención & control , Analgésicos Opioides/uso terapéutico , Periodo de Recuperación de la Anestesia , Anestesia General , Antieméticos/efectos adversos , Método Doble Ciego , Femenino , Humanos , Masculino , Dolor Postoperatorio/epidemiología , Fenotiazinas/efectos adversos
10.
Br J Anaesth ; 84(3): 341-5, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10793593

RESUMEN

We have evaluated the intra- and postoperative analgesic efficacy of preservative-free S(+)-ketamine compared with bupivacaine for caudal block in paediatric hernia repair. After induction of general anaesthesia, 49 children undergoing hernia repair were given a caudal injection (0.75 ml kg-1) of S(+)-ketamine 0.5 mg kg-1 (group K1), S(+)-ketamine 1.0 mg kg-1 (group K2) or 0.25% bupivacaine with epinephrine 1:200,000 (group B). No additional analgesic drugs were required during operation in any of the groups. Haemodynamic and respiratory variables remained stable during the observation period. Mean duration of analgesia was significantly longer in groups B and K2 compared with group K1 (300 (SD 96) min and 273 (123) min vs 203 (117) min; P < 0.05). Groups B and K2 required less analgesics in the postoperative period compared with group K1 (30% and 33% vs 72%; P < 0.05). Postoperative sedation scores were comparable between the three groups. We conclude that S(+)-ketamine 1.0 mg kg-1 for caudal block in children produced surgical and postoperative analgesia equivalent to that of bupivacaine.


Asunto(s)
Anestesia Caudal/métodos , Anestésicos Disociativos , Ketamina , Anestésicos Locales , Bupivacaína , Niño , Preescolar , Método Doble Ciego , Femenino , Hemodinámica/efectos de los fármacos , Herniorrafia , Humanos , Lactante , Masculino , Dolor Postoperatorio/tratamiento farmacológico , Estudios Prospectivos , Estereoisomerismo
11.
Orthopedics ; 23(2): 121-7, 2000 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10688288

RESUMEN

Three hundred seventy-six patients with peritrochanteric fractures treated over a 10-year period were reviewed. In 85 patients treated with Ender nailing, the most frequent complications were leg shortening (34), external rotation failure (21), and postoperative distal gliding of the nails (7). In 183 patients treated with dynamic hip screws or a 95 degree condylar or a 130 degree blade plate, 3 presented with infection, 5 with instability, and 4 with femoral head necrosis. In 105 patients treated with Gamma nailing, the most serious complications were infections (3), inward rotation failure (2), postoperative bleeding at the insertion site (2), and shaft fracture (1). Because of its inherent instability, Ender nailing is no longer used. The implantation technique for the dynamic hip screw is safer and simpler than the various models of the ASIF blade plate. However, the dynamic hip screw has been superseded by the Gamma nail because of its absolute stability. In the beginning, Gamma nailing was technically more demanding with a higher number of intraoperative complications. In this study, the number of malalignments did not differ significantly between the dynamic hip screw (14) and the Gamma nail (11), but was high with Ender nailing (56).


Asunto(s)
Clavos Ortopédicos , Tornillos Óseos , Fijación Interna de Fracturas/instrumentación , Fracturas de Cadera/cirugía , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Humanos , Complicaciones Intraoperatorias , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos
12.
Anesthesiology ; 90(5): 1339-44, 1999 May.
Artículo en Inglés | MEDLINE | ID: mdl-10319782

RESUMEN

BACKGROUND: Ropivacaine, a new local anesthetic, is less cardiotoxic in adults and is less likely to cause motor blockade than is bupivacaine. The authors evaluated the clinical effectiveness and hemodynamic effects of ropivacaine compared with bupivacaine and the pharmacokinetics of ropivacaine when given for caudal blocks in 56 children 4.1 +/- 1.2 yr old (mean +/- SD). METHODS: Patients scheduled for inguinal hernia repair were randomly given a caudal injection (0.75 ml/kg) of ropivacaine, 0.25% (R0.25 group); ropivacaine, 0.5% (R0.5 group); or bupivacaine, 0.25% (B0.25 group). Postoperative measurements included the duration of analgesia, which was our primary outcome variable, and hemodynamic and respiratory monitoring for 4 h in the recovery room. Thereafter, analgesic requirements for the following 24 h were assessed by an independent observer on the ward using an observational pain-discomfort scale, which gives a cumulative score from 5 to 15 to estimate the quality of analgesia by assessment of behavioral objective parameters. Plasma levels of ropivacaine were measured before the procedure was started and 5, 10, 15, 20, 25, 30, and 45 min and 1, 2, 4, 6, 8, and 24 h after caudal block. RESULTS: A significantly longer (P < 0.0001) duration of analgesia (median [range]) was observed in the R0.5 group (1,440 [335-1,440] min), whereas the R0.25 group (208 [175-340] min) and the B0.25 group (220 [100-390] min) were comparable. All groups showed a significant decrease in mean arterial blood pressure and heart rate from baseline values, but differences between groups were not observed. CONCLUSION: Ropivacaine is well tolerated and provides effective analgesia when given for caudal blockade in small children for inguinal hernia repair.


Asunto(s)
Amidas/farmacología , Anestesia Caudal , Anestésicos Locales/farmacología , Amidas/sangre , Bupivacaína/farmacología , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Hemodinámica/efectos de los fármacos , Humanos , Lactante , Estudios Prospectivos , Ropivacaína , Factores de Tiempo
13.
Anesth Analg ; 88(4): 925-9, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10195550

RESUMEN

UNLABELLED: The National Institute for Occupational Safety and Health-recommended exposure levels for nitrous oxide exposure are 25 ppm as a time-weighted average over the time of exposure. The exposure limit for halogenated anesthetics (without concomitant nitrous oxide exposure) is 2 ppm. Inhaled sevoflurane provides an alternative to i.v. induction of anesthesia. However, the inadvertent release of anesthetic gases into the room is likely to be greater than that with induction involving i.v. anesthetics. We therefore evaluated anesthesiologist exposure during four different induction techniques. Eighty patients were assigned to one of the induction groups to receive: 1) sevoflurane and nitrous oxide from a rebreathing bag, 2) sevoflurane and nitrous oxide from a circle circuit, 3) propofol 3 mg/kg, and 4) thiopental sodium 5 mg/kg. Anesthesia was maintained with sevoflurane and nitrous oxide via a laryngeal mask. Trace concentrations were measured directly from the breathing zone of the anesthesiologist. During induction, peak concentrations of sevoflurane and nitrous oxide with the two i.v. methods rarely exceeded 2 ppm sevoflurane and 50 ppm nitrous oxide. Concentrations during the two inhalation methods were generally <20 ppm sevoflurane and 100 ppm nitrous oxide. During maintenance, median values were near 2 ppm sevoflurane and 50 ppm nitrous oxide in all groups. Sevoflurane concentrations during inhaled induction frequently exceeded the National Institute for Occupational Safety and Health-recommended exposure ceiling of 2 ppm but mostly remained <20 ppm. Exposure during the maintenance phase of anesthesia also frequently exceeded the 2-ppm ceiling. We conclude that operating room anesthetic vapor concentrations are increased during inhaled inductions and remain increased with laryngeal mask ventilation. IMPLICATIONS: We compared waste gas concentrations to sevoflurane and nitrous oxide during four different induction methods. During inhaled induction with a rebreathing bag or a circle circuit system, waste gas concentrations frequently exceed National Institute for Occupational Safety and Health limits of 2 ppm sevoflurane and 50 ppm nitrous oxide. Therefore, we recommend that people at risk (e.g., women of child-bearing age) should pay great attention when using this technique.


Asunto(s)
Contaminación del Aire Interior/análisis , Anestesia Obstétrica/métodos , Anestésicos por Inhalación/análisis , Éteres Metílicos/análisis , Óxido Nitroso/análisis , Exposición Profesional/análisis , Anestesiología/métodos , Femenino , Humanos , Sevoflurano
14.
Anesth Analg ; 88(4): 930-5, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10195551

RESUMEN

UNLABELLED: We compared two conventional induction techniques (thiopental and propofol), an inhaled induction with sevoflurane using a circle system, and a rebreathing method. Fentanyl 1 microg/kg was given to women undergoing 10- to 20-min procedures. Anesthesia was induced (n = 20 each) with one of the following: 1) sevoflurane and N2O from a rebreathing bag (Sevo/Bag). A 5-L bag was prefilled with a mixture of sevoflurane 7% and N2O 60% in oxygen. The bag was connected between the normal circle system, separated by a spring-loaded valve; 2) sevoflurane 8% and N2O 60% from a circle system on a conventional anesthesia machine with a total fresh gas flow of 6 L/min (Sevo/Circle); 3) propofol 3 mg/kg as an i.v. bolus; 4) thiopental sodium 5 mg/kg as an i.v. bolus. Postoperative nausea and vomiting was treated with ondansetron. Induction times were comparable with each method. Recovery duration was shortest with sevoflurane, intermediate with propofol, and longest with thiopental. Induction drug costs were lowest with Sevo/Bag and thiopental, intermediate with Sevo/Circle, and highest with propofol. However, sevoflurane (by either method) caused considerable nausea and vomiting that required treatment. Consequently, total drug cost was least with thiopental, intermediate with Sevo/Bag and propofol, and greatest with Sevo/Circle. Thus, no single technique was clearly superior. IMPLICATIONS: Anesthetic induction techniques influence awakening time, recovery duration, and drug costs. We tested two i.v. methods and two inhaled techniques. However, none of the four tested methods was clearly superior to the others.


Asunto(s)
Anestesia General/métodos , Anestesia Obstétrica/métodos , Adulto , Anestesia General/economía , Anestesia Obstétrica/economía , Anestésicos por Inhalación/efectos adversos , Anestésicos por Inhalación/economía , Anestésicos Intravenosos/efectos adversos , Anestésicos Intravenosos/economía , Femenino , Humanos , Éteres Metílicos/efectos adversos , Éteres Metílicos/economía , Persona de Mediana Edad , Propofol/efectos adversos , Propofol/economía , Sevoflurano , Tiopental/efectos adversos , Tiopental/economía , Factores de Tiempo
15.
Reg Anesth Pain Med ; 23(6): 584-8, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-9840855

RESUMEN

BACKGROUND AND OBJECTIVES: Recently it has been demonstrated that the use of ultrasound (US) improves the onset time and the quality of sensory block for 3-in-1 blocks compared with conventional nerve stimulator (NS) techniques. The present study was designed to evaluate if US guidance for 3-in-1 blocks reduces the amount of local anesthetic compared to NS guidance. METHODS: After institutional approval and informed consent, 60 patients undergoing hip surgery following trauma were randomly assigned to three groups of 20 patients each. In group A, the 3-in-1 block was performed using US guidance with 20 mL 0.5% bupivacaine. Group B received 20 mL 0.5% bupivacaine, and group C received 30 mL 0.5% bupivacaine during NS guidance. The quality and the onset time was assessed by pinprick test in the central sensory region of each of the three targeted nerves and compared with the contralateral leg every 10 minutes for 1 hour by a blinded observer. The rating was undertaken using a scale from 100% (uncompromised sensibility) to 0% (no sensation). RESULTS: Overall success for the 3-in-1 block in group A was 95% and in groups B and C 80%. Onset time was significantly shorter in the US-guided group compared with both NS-guided groups (group A 13+/-6 minutes; group B 27+/-12 minutes; and group C 26+/-13 minutes; P < .01 to groups B and C). Quality of sensory block was significantly better in group A (4%+/-5% of initial value) compared with groups B and C (group B 21%+/-11% of initial value, P < .01 to group A; group C 22%+/-19%, P < .01 to group A). CONCLUSION: The amount of local anesthetic for 3-in-1 blocks can be reduced by using US guidance compared with the conventional NS-guided technique.


Asunto(s)
Anestésicos Locales/administración & dosificación , Bloqueo Nervioso/métodos , Ultrasonografía Intervencional , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Bupivacaína/administración & dosificación , Estimulación Eléctrica , Nervio Femoral/efectos de los fármacos , Estudios de Seguimiento , Fracturas de Cadera/cirugía , Humanos , Pierna/inervación , Persona de Mediana Edad , Nervio Obturador/efectos de los fármacos , Nervio Ciático/efectos de los fármacos , Sensación/efectos de los fármacos , Factores de Tiempo
16.
Anesth Analg ; 87(1): 206-10, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9661575

RESUMEN

UNLABELLED: In a randomized, double-blind study with two parallel groups, we assessed the analgesic effect of perioperative magnesium sulfate administration in 46 ASA physical status I or II patients undergoing arthroscopic knee surgery with total i.v. anesthesia. The patients received either magnesium sulfate 50 mg/kg preoperatively and 8 mg.kg-1.h-1 intraoperatively or the same volume of isotonic sodium chloride solution i.v. Anesthesia was performed with propofol (2 mg/kg for induction, 6-8 mg.kg-1.h-1 for maintenance), fentanyl (3 micrograms/kg for induction), and vecuronium (0.1 mg/kg for intubation). Intraoperative pain was defined as an increase of mean arterial blood pressure and heart rate of more than 20% from baseline values after the induction of anesthesia and was treated with bolus fentanyl (1-2 micrograms/kg). Postoperative analgesia was achieved with fentanyl (0.5 microgram/kg) and evaluated using the pain visual analog scale for 4 h. During the intraoperative and postoperative periods, patients in the magnesium group required significantly less fentanyl than those in the control group (control group 0.089 +/- 0.02 microgram.kg-1.min-1 versus magnesium group 0.058 +/- 0.01 microgram.kg-1.min-1; P < 0.05 and control group 0.021 +/- 0.013 microgram.kg-1.min-1 and magnesium group 0.0031 +/- 0.0018 microgram.kg-1.min-1; P < 0.01 for intraoperative and postoperative periods, respectively). We conclude that, in a clinical setting with almost identical levels of surgical stimulation, i.v. magnesium sulfate administration reduces intraoperative and postoperative analgesic requirements compared with isotonic sodium chloride solution administration. IMPLICATIONS: The perioperative administration of i.v. magnesium sulfate reduces intra- and postoperative analgesic requirements in patients with almost identical levels of surgical stimulus. Our results demonstrate that magnesium can be an adjuvant to perioperative analgesic management.


Asunto(s)
Analgésicos Opioides/administración & dosificación , Analgésicos/administración & dosificación , Fentanilo/administración & dosificación , Sulfato de Magnesio/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Adulto , Artroplastia de Reemplazo de Rodilla , Presión Sanguínea/efectos de los fármacos , Método Doble Ciego , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Cuidados Intraoperatorios , Magnesio/sangre , Masculino , Persona de Mediana Edad , Umbral del Dolor/efectos de los fármacos , Placebos
19.
Res Dev Disabil ; 9(2): 135-43, 1988.
Artículo en Inglés | MEDLINE | ID: mdl-3261435

RESUMEN

The statistics for 1983, issued by the Swedish National Board of Health and Welfare, show among other things, that the age structure among mentally retarded persons has undergone a striking change since 1973, but that the number and proportion of mentally retarded persons in the total population has not changed; there are fewer children and young persons and more adults. The author of this article considers that the reasons for the changes which have taken place during one single decade may preliminarily and hypothetically be attributed to prenatal diagnosis, improved techniques in obstetrics, the introduction of antibiotics in 1948, as well as further noticeable improvements in the medical and social care provided for mentally retarded persons. Apart from prenatal diagnosis, the measures mentioned were not intended to have exactly this result in each specific case, but if the hypotheses--totally or partly--are true, knowledge of the underlying factors will have consequences, first and foremost for future public health and medical services planning. Steps cannot be taken for the restriction or increase of the number of Caesarean sections or prenatal diagnosis, for example, with no thought of the consequences for the increase, respectively decrease in the number of mentally retarded persons. This means that the number of mentally retarded persons in society can be controlled.


Asunto(s)
Discapacidad Intelectual/epidemiología , Factores de Edad , Estudios Transversales , Predicción , Humanos , Suecia
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