CEREBROVASCULAR CARBON DIOXIDE REACTIVITY DURING EXPOSURE TO EQUIPOTENT ISOFLURANE AND ISOFLURANE IN NITROUS OXIDE ANAESTHESIA

We have studied the effects of hypocapnia on cerebrovascular changes in two MAC-equivalent anaesthetic regimens, using the transcranial Doppler technique as an index of cerebral blood flow (CBF) in 24healthy ASA I patients undergoing spinal surgery. Eight of the patients were subjected to carbon dioxide reactivity challenges in the awake state. Before surgery, the other 16 patients received, in random order, either 1.15% isoflurane in oxygen or 0.5% isoflurane with 70% nitrous oxide. Carbon dioxide reactivity was calculated for each group as the increase in flow velocity per kPa change in PÉCO2 (cm s−1 kPa−1). It was significantly greater for the isoflurane group (14.09 (SD 2.44) cm s−1 kPa−1) and significantly less for the isoflurane—nitrous oxide group (7.95 (1.32) cm s-−1 kPa−1) compared with the awake group (11.24 (0.95) cm s−1 kPa−1). We conclude that cerebrovascular responsiveness to changes in arterial carbon dioxide concentration is influenced markedly by the anaesthetic procedure. Hyperventilation is more likely to affect CBF during isoflurane anaesthesia than during an MAC-equivalent isoflurane—nitrous oxide anaesthesi

Transformation of 2,4, 6-Trinitrotoluene (TNT) by Immobilized and Resting Cells of Arthrobacter SP.

Arthrobacter sp. transformed 2,4,6-trinitrotoluene (TNT) into two isomeric monoaminodinitrotoluenes viz, 4-amino-2,6-dinitrotoluene (4-ADNT), 2-amino- 4,6 –dinitrotoluene (2-ADNT) and also 2,4- diamino-6- nitrotoluene (2,4-DANT) under aerobic resting cell conditions. Experiments were carried out at 30° C (±1°C) in phosphate buffer with 60 mg per liter TNT at a pH of 7.2 (±0.2). Complete transformation of TNT occurred within 36 hours, yielding a mixture of monoaminodinitrotoluenes and diaminonitrotoluene. The major component was found to be 4-ADNT. Under the same experimental conditions, transformations were studied using barium alginate immobilized cells of Arthrobacter sp. Appropriate controls were run simultaneously. In both the cases, reactions were monitored every six hours by thin-layer chromatography (TLC) and gas chromatography (GC). The products were identified by gas chromatography coupled with mass spectrometry (GC-MS). Immobilization of Arthrobacter sp. in barium alginate resulted in more efficient TNT transformations, which were complete in 24 hours. The immobilized cells could be utilized at least for eight cycles and a decrease in rate of transformation was observed with each cycle

Polymerization shrinkage and spherical glass mega fillers: Effects on cuspal deflection

Purpose. The Authors analyzed the effect of spherical glass mega fillers (SGMF) on reducing contraction stress in dental composite resins, by means of a cavity model simulating the cuspal deflection which occurs on filled tooth cavity walls in clinical condition. Materials and methods. 20 stylized MOD cavities (C-factor = 0.83) were performed in acrylic resin. The inner surface of each cavity was sand blasted and adhesively treated in order to ensure a valid bond with the composite resin. Three different diameter of SGMF were used (i.e. 1, 1,5, 2 mm). The samples were divided in 4 groups of 5 each: Group 1 samples filled with the composite only; Group 2 samples filled with composite added with SGMFs, Ø1mm (16 spheres for each sample); Group 3 samples filled with composite added with SGMFs, Ø1,5 mm (5 spheres for each sample); Group 4 samples filled with composite added with SGMFs, Ø2 mm (2 spheres for each sample). Digital pictures were taken, in standardized settings, before and immediately after the polymerization of the composite material, placed into the cavities. With a digital image analysis software the distances from the coronal reference points of the cavity walls were measured. Then the difference between the first and second measurement was calculated. The data were analyzed by means of the ANOVA test. Results. A significative reduction on cavity walls deflection, when the composite resin is used in addiction with the SGMFs was observed. The SGMFs of smallest diameter (1mm) showed the better outcome. Conclusion. The SGMFs are reliable in reducing contraction stress in dental composite resins

Fixture-abutment connection surface and micro-gap measurements by 3D micro-tomographic technique analysis

X-ray micro-tomography (micro-CT) is a miniaturized form of conventional computed axial tomography (CAT) able to investigate small radio-opaque objects at a-few-microns high resolution, in a non-destructive, non-invasive, and tri-dimensional way. Compared to traditional optical and electron microscopy techniques, which provide two-dimensional images, this innovative investigation technology enables a sample tri-dimensional analysis without cutting, coating or exposing the object to any particular chemical treatment. X-ray micro-tomography matches ideal 3D microscopy features: the possibility of investigating an object in natural conditions and without any preparation or alteration; non-invasive, non-destructive, and sufficiently magnified 3D reconstruction; reliable measurement of numeric data of the internal structure (morphology, structure and ultra-structure). Hence, this technique has multi-fold applications in a wide range of fields, not only in medical and odontostomatologic areas, but also in biomedical engineering, materials science, biology, electronics, geology, archaeology, oil industry, and semi-conductors industry. This study shows possible applications of micro-CT in dental implantology to analyze 3D micro-features of dental implant to abutment interface. Indeed, implant-abutment misfit is known to increase mechanical stress on connection structures and surrounding bone tissue. This condition may cause not only screw preload loss or screw fracture, but also biological issues in peri-implant tissues

Prevalence of Enterococci and Vancomycin Resistance in the Throat of Non-Hospitalized Individuals Randomly Selected in Central Italy

Enterococci are commonly found in the environment and humans as a part of the normal microbiota. Among these, Enterococcus faecalis and Enterococcus faecium can convert into opportunistic pathogens, making them a major cause of nosocomial infections. The rapid diffusion of vancomycin-resistant strains and their impact on nosocomial settings is of considerable concern. Approximately one-third of the E. faecium infections in Italy are caused by vancomycin-resistant strains. This study explored the hypothesis that the oral cavity could represent a silent reservoir of virulent enterococci. A sample of 862 oral flora specimens collected from healthy human volunteers in Central Italy was investigated by real-time PCR to detect E. faecalis and E. faecium, as well as the genetic elements that most frequently determine vancomycin resistance. The prevalence of E. faecalis was 19%, a value that was not associated with alcohol consumption, tobacco smoking, or age of the subjects. Less frequently detected, with an overall prevalence of 0.7%, E. faecium was more common among people older than 49 years of age. The genes conferring vancomycin resistance were detected in only one sample. The results indicate that the oral cavity can be considered a reservoir of clinically relevant enterococci; however, our data suggest that healthy individuals rarely carry vancomycin-resistant strains

Degradation of 2,4,6-trichlorophenol by a specialized organism and by indigenous soil microflora: bioaugmentation and self-remediability for soil restoration

A selected mixed culture and a strain of Alcaligenes eutrophus TCP were able to totally degrade 2,4,6-TCP with stoichiometric release of Cl-. In cultures of Alc. eutrophus TCP, a dioxygenated dichlorinated metabolite was detected after 48 h of incubation. Experiments conducted with soil microcosms gave evidence that: the degradative process had a biotic nature and was accompanied by microbial growth; the soil used presented an intrinsic degradative capacity versus 2,4,6-TCP; the specialized organism used as inoculum was effective in degrading 2,4,6-TCP in a short time. These results could be utilized for the adoption of appropriate remediation techniques for contaminated soil

Management of pregnant women infected with Ebola virus in a treatment centre in Guinea, June 2014

We report two cases of confirmed Ebola virus disease in pregnant women, who presented at the Médecins Sans Frontières Ebola treatment centre in Guéckédou. Despite the very high risk of death, both pregnant women survived. In both cases the critical decision was made to induce vaginal delivery. We raise a number of considerations regarding the management of Ebola virus-infected pregnant women, including the place of amniocentesis and induced delivery, and whether certain invasive medical acts are justified

Le terapie alternative e le infezioni respiratorie

Attualmente, la pi\uf9 recente classifi cazione delle medicine e delle pratiche non convenzionali \ue8 molto ampia e include molti tipi di medicine e terapie estremamente diverse tra loro, dall\u2019agopuntura alla medicina ayurvedica/antroposofi ca, dalla fi toterapia alla medicina tradizionale cinese, dall\u2019omeopatia alla chiropratica. In Italia il ricorso a terapie non convenzionali in et\ue0 pediatrica (<14 anni), secondo un\u2019indagine dell\u2019ISTAT del 1999, non risulta elevato, attestandosi in media intorno al 9%: da questa indagine \ue8 emerso che l\u2019omeopatia e la fi toterapia sono le terapie non convenzionali pi\uf9 seguite. In realt\ue0, nel nostro Paese esistono, comunque, grandi differenze loco regionali nella pratica della medicina non convenzionale. Nella realt\ue0 del nostro ambulatorio, tra il 2004 e il 2006, circa i 2/3 dei bambini giunti in osservazione per infezioni delle alte vie respiratorie hanno ricevuto una o pi\uf9 terapie alternative, sia di tipo medico (omeopatia, fi toterapia) che non medico (osteopatia, agopuntura)

Detection of poliovirus-infected macrophages in thymus of patients with myasthenia gravis

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Next-Generation Sequencing in Clinical Practice. Is It a Cost-Saving Alternative to a Single-Gene Testing Approach?

Objectives: This study aimed to compare the costs of a next-generation sequencing-based (NGS-based) panel testing strategy to those of a single-gene testing-based (SGT-based) strategy, considering different scenarios of clinical practice evolution. Methods: Three Italian hospitals were analysed, and four different testing pathways (paths 1, 2, 3, and 4) were identified: two for advanced non-small-cell lung cancer (aNSCLC) patients and two for unresectable metastatic colon-rectal cancer (mCRC) patients. For each path, we explored four scenarios considering the current clinical practice and its expected evolution. The 16 testing cases (4 scenarios × 4 paths) were then compared in terms of differential costs between the NGS-based and SGT-based approaches considering personnel, consumables, equipment, and overhead costs. Break-even and sensitivity analyses were performed. Data gathering, aimed at identifying the hospital setup, was performed through a semi-structured questionnaire administered to the professionals involved in testing activities. Results: The NGS-based strategy was found to be a cost-saving alternative to the SGT-based strategy in 15 of the 16 testing cases. The break-even threshold, the minimum number of patients required to make the NGS-based approach less costly than the SGT-based approach, varied across the testing cases depending on molecular alterations tested, techniques adopted, and specific costs. The analysis found the NGS-based approach to be less costly than the SGT-based approach in nine of the 16 testing cases at any volume of tests performed; in six cases, the NGS-based approach was found to be less costly above a threshold (and in one case, it was found to be always more expensive). Savings obtained using an NGS-based approach ranged from €30 to €1249 per patient; in the unique testing case where NGS was more costly, the additional cost per patient was €25. Conclusions: An NGS-based approach may be less costly than an SGT-based approach; also, generated savings increase with the number of patients and different molecular alterations tested