Indurative Edema of the Prepuce Mimicing Phimosis, an Atypical Manifestation of Primary Syphilis

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PHYTOTHERAPEUTIC ACTIVITY OF EUPHORBIA CYPARISSIAS EXTRACTS ON IXODIDAE (ACARI) FEMALE TICKS

Background: Given its numerous biologically active components, Euphorbiaceae has been found to be a large plant family and polyvalent with quite interesting therapeutic activity that can be studied. Materials and Methods: The ixodicidal activity of Euphorbia cyparissias extracts was studied in vitro and in vivo. Tested concentrations were 10, 5, 2, 1, 0.5 and 0.25%. Results: For the in vitro study, conducted on field-collected female specimens of Dermacentor marginatus and Haemaphysalis punctata, the efficacy results showed that the ticks died after exposure in the case of 10, 5, and 2% tincture concentrations. The effects appeared after 30 minutes and became more visible 120 minutes after each exposure. The statistical differences regarding the used concentrations were found to be: F = 6.51, df = 5, P < 0.001. The in vivo study of the efficacy of E. cyparissias concentrations was performed on 35 naturally infested sheep and on 30 bovines parasitized with Ixodes ricinus, sprayed with tincture and glycerinate dilutions (bovines) on days 0 and 7. The results revealed detrimental effects on the survivability of female ticks, the most prominent being the reduction of their movement capacity. In sheep in vivo efficiency observed within 24 hrs varied, between 1 and 23% for D. marginatus and between 7 and 27% for H. punctata and respectively between 2 and 53% after 24 hrs, for I. ricinus, comparable effects being also found 72 hrs after the second administration of Euphorbia extracts. Conclusion: Extracts from E. cyparissias may be used, with results, as an ecologic alternative tick control management method, being a cheap solution, with a sizeable role in reducing the use of synthetic and/or other harming and resistance source ixodicidal conditionings

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Abdominal Radical Trachelectomy Performed During Pregnancy — Case Series

Introduction: Abdominal radical trachelectomy (ART) for tumors of the uterine cervix can be performed while the pregnancy is ongoing, but the success rates so far are reduced

Experimental Investigation of the Porous Free Zone of Silicon Cemented Layer Obtained through Pack Cementation

The development of a porous free zone of the silicon cemented layer represents a scientific and technical challenge. The limitation of the effects of the Kirkendall–Frenkel phenomena requires the right control of the thermochemical processing parameters (temperature, time, and chemical) and thorough knowledge of the related interaction with the specific elements of the metallic matrix of the thermochemically processed product. Through the experimental programming method, the individual and cumulated effects of the thermochemical processing parameters on (Fe-Armco) high-purity iron cemented by silicon in ferrosilicon (FeSi75C) powdered solid media have been quantified. It was concluded that ferrosilicon with silicon concentrations higher than 60% (FeSi75C) represents a redoubtable active component, especially in a temperature range higher than 1100 °C. In the layer cemented with silicon, the presence of nitrogen was also observed, as a direct consequence of the composition of the medium used for cementation. The presence of this element is the predominant result of the manifestation of the ionic phenomenon of adsorption. The correlations between these parameters and the dimension of the porous free zone of the silicon cemented layer in the vicinity of the thermochemically processed surface have been determined

Previously undiagnosed serotonin toxicity: from pre-anaesthetic assessment to postoperative management – a case report

Serotonin syndrome (SS), also known as serotonin toxicity, is a life-threatening condition induced by certain drugs that affect serotonin metabolism. We report a case of SS, induced by a combination of three drugs encountered in a patient with a previously suspected allergy to metoclopramide and pitofenone discovered as an "anaesthetic incident”. In the immediate postoperative period, following the administration of antiemetic and analgesic treatment, the patient presented generalized myoclonus and intense abdominal pain. The diagnosis of SS was established using the Hunter Criteria. After the discontinuation of potentially triggering medication and anticonvulsant therapy, the patient was discharged from the ICU with complete resolution within six days. Given the increased use in clinical practice of drugs that may interfere with serotonin metabolism, the rising prevalence of mental health and the increasing use of illicit drugs, it is essential for anaesthetists to be aware of the potential for SS occurrence. Continue..