A comparative study on the effectiveness of bupivacaine and ropivacaine for supraclavicular block

Background: Bupivacaine and Ropivacaine have been extensively studied &their properties with respect to onset, duration and quality of block. This study aims to detect whether addition of clonidine to both of them changes their properties. This study also aims to use lower than usual dosages for both the local anesthetics to prevent adverse effects of local anesthetics.Methods: After obtaining ethical approval, the study was carried out on patients undergoing elective upper limb surgeries. They were randomly divided into two Groups: Group B and Group R. The onset and duration of sensory and motor blockade and other parameters were assessed.Results: The onset of blockade, both sensory & motor was earlier in Ropivacaine as compared to Bupivacaine group. Mean duration of blockade, both sensory & motor, was more in the Bupivacaine group.  Conclusions: Addition of Clonidine enabled the use of low concentrations (0.25%) of both the anesthetics. Also, Ropivacaine (0.25%) has faster onset of sensory and motor blockade, shorter duration of action and less motor blockade compared to Bupivacaine

Miocene Volcaniclastic Sequence Within the Xiyu Formation from Source to Sink: Implications for Drainage Development and Tectonic Evolution in Eastern Pamir, NW Tibetan Plateau

©2018. American Geophysical Union. All Rights Reserved. The formation of the Pamir salient and the Tashkorgan-Yarkand River is highly debated with the ages ranging from pre-Cenozoic to late Miocene. One approach to resolve these issues is to draw support from the sedimentary record in the surrounding basins. A volcaniclastic sequence, which divides into Lower and Upper Members, was identified in the southwestern Tarim Basin. The Lower Member was transported by dilute streamflows, which likely flowed during or soon after eruptions, while the Upper Member was formed by a syneruptive volcanic debris flow. Chronological, petrologic, and geochemical data consistently indicate that the sequence was derived from the Central Pamir at ~11 Ma. The ~11 Ma emplacement of the volcaniclastic sequence provides unique constraints for the evolution of the Tashkorgan-Yarkand River and the Pamir salient. Provenance data indicate a multistage evolutionary history of the Tashkorgan-Yarkand River. The paleo-Tashkorgan River was initially formed in the piedmont of the Pamir marginal range before ~15 Ma. This river cut back into the Tashkorgan region at ~15 Ma, after which it has eroded the Central Pamir by ~11 Ma. The N-S trending upper reaches of the Tashkorgan River and the Yarkand River were established after ~11 Ma. The emplacement of the volcanic debris flow, together with regional deformation evidence, indicates limited strike-slip motion between Pamir and the Tarim at least since ~11 Ma, which refutes hundreds of kilometers offset between the Pamir and the Tarim after this time and supports an earlier indention of the Pamir salient

Evolution of infectious bronchitis virus in the field after homologous vaccination introduction

International audienceAbstractDespite the fact that vaccine resistance has been typically considered a rare phenomenon, some episodes of vaccine failure have been reported with increasing frequency in intensively-raised livestock. Infectious bronchitis virus (IBV) is a widespread avian coronavirus, whose control relies mainly on extensive vaccine administration. Unfortunately, the continuous emergence of new vaccine-immunity escaping variants prompts the development of new vaccines. In the present work, a molecular epidemiology study was performed to evaluate the potential role of homologous vaccination in driving IBV evolution. This was undertaken by assessing IBV viral RNA sequences from the ORF encoding the S1 portion of viral surface glycoprotein (S) before and after the introduction of a new live vaccine on broiler farms in northern-Italy. The results of several biostatistics analyses consistently demonstrate the presence of a higher pressure in the post-vaccination period. Natural selection was detected essentially on sites located on the protein surface, within or nearby domains involved in viral attachment or related functions. This evidence strongly supports the action of vaccine-induced immunity in conditioning viral evolution, potentially leading to the emergence of new vaccine-escape variants. The great plasticity of rapidly-evolving RNA-viruses in response to human intervention, which extends beyond the poultry industry, is demonstrated, claiming further attention due to their relevance for animal and especially human health

Evaluation of receptor and chemical transport models for PM10 source apportionment

In this study, the performance of two types of source apportionment models was evaluated by assessing the results provided by 40 different groups in the framework of an intercomparison organised by FAIRMODE WG3 (Forum for air quality modelling in Europe, Working Group 3). The evaluation was based on two performance indicators: z-scores and the root mean square error weighted by the reference uncertainty (RMSEu), with pre-established acceptability criteria. By involving models based on completely different and independent input data, such as receptor models (RMs) and chemical transport models (CTMs), the intercomparison provided a unique opportunity for their cross-validation. In addition, comparing the CTM chemical profiles with those measured directly at the source contributed to corroborate the consistency of the tested model results. The most commonly used RM was the US EPA- PMF version 5. RMs showed very good performance for the overall dataset (91% of z-scores accepted) while more difficulties were observed with the source contribution time series (72% of RMSEu accepted). Industrial activities proved to be the most difficult sources to be quantified by RMs, with high variability in the estimated contributions. In the CTMs, the sum of computed source contributions was lower than the measured gravimetric PM10 mass concentrations. The performance tests pointed out the differences between the two CTM approaches used for source apportionment in this study: brute force (or emission reduction impact) and tagged species methods. The sources meeting the z-score and RMSEu acceptability criteria tests were 50% and 86%, respectively. The CTM source contributions to PM10 were in the majority of cases lower than the RM averages for the corresponding source. The CTMs and RMs source contributions for the overall dataset were more comparable (83% of the z-scores accepted) than their time series (successful RMSEu in the range 25% - 34%). The comparability between CTMs and RMs varied depending on the source: traffic/exhaust and industry were the source categories with the best results in the RMSEu tests while the most critical ones were soil dust and road dust. The differences between RMs and CTMs source reconstructions confirmed the importance of cross validating the results of these two families of models

Systematic review of the evidence relating FEV1 decline to giving up smoking

<p>Abstract</p> <p>Background</p> <p>The rate of forced expiratory volume in 1 second (FEV₁) decline ("beta") is a marker of chronic obstructive pulmonary disease risk. The reduction in beta after quitting smoking is an upper limit for the reduction achievable from switching to novel nicotine delivery products. We review available evidence to estimate this reduction and quantify the relationship of smoking to beta.</p> <p>Methods</p> <p>Studies were identified, in healthy individuals or patients with respiratory disease, that provided data on beta over at least 2 years of follow-up, separately for those who gave up smoking and other smoking groups. Publications to June 2010 were considered. Independent beta estimates were derived for four main smoking groups: never smokers, ex-smokers (before baseline), quitters (during follow-up) and continuing smokers. Unweighted and inverse variance-weighted regression analyses compared betas in the smoking groups, and in continuing smokers by amount smoked, and estimated whether beta or beta differences between smoking groups varied by age, sex and other factors.</p> <p>Results</p> <p>Forty-seven studies had relevant data, 28 for both sexes and 19 for males. Sixteen studies started before 1970. Mean follow-up was 11 years. On the basis of weighted analysis of 303 betas for the four smoking groups, never smokers had a beta 10.8 mL/yr (95% confidence interval (CI), 8.9 to 12.8) less than continuing smokers. Betas for ex-smokers were 12.4 mL/yr (95% CI, 10.1 to 14.7) less than for continuing smokers, and for quitters, 8.5 mL/yr (95% CI, 5.6 to 11.4) less. These betas were similar to that for never smokers. In continuing smokers, beta increased 0.33 mL/yr per cigarette/day. Beta differences between continuing smokers and those who gave up were greater in patients with respiratory disease or with reduced baseline lung function, but were not clearly related to age or sex.</p> <p>Conclusion</p> <p>The available data have numerous limitations, but clearly show that continuing smokers have a beta that is dose-related and over 10 mL/yr greater than in never smokers, ex-smokers or quitters. The greater decline in those with respiratory disease or reduced lung function is consistent with some smokers having a more rapid rate of FEV₁decline. These results help in designing studies comparing continuing smokers of conventional cigarettes and switchers to novel products.</p

The hypercoagulable states in anaesthesia and critical care

Hypercoagulable disorders are now diagnosed more frequently than before. These patients are, usually, managed with multiple anticoagulant and antiplatelet medications. Left unmonitored and unevaluated, there can be disastrous haemorrhagic or thrombotic complications. Appropriate perioperative and anaesthetic management of these patients will invite an aetiological diagnosis, severity analysis and the on-going treatment review. Different assays, thromboelastography and molecular cytogenetics have helped to diagnose these conditions precisely and thus guide the long-term management. Besides this, there are varieties of clinical conditions that will predispose to the hypercoagulability. These need to be defined and classified in order to offer a suitable therapeutic option. Pregnancy is one such important condition and can have more than one responsible factor favouring hypercoagulability. With such diverse kinds of disorders, it would be essential to note the anaesthetic implications, to avoid adverse perioperative outcomes. Available evidence based guidelines will help to make the therapeutic approach more precise. Selection of the appropriate technique of anaesthesia, offering the appropriate anticoagulation bridging as necessary and defining an appropriate interval and time for the intervention will help to minimise the complications