A systematic review of therapeutic interventions to reduce acute and chronic post-surgical pain after amputation, thoracotomy or mastectomy

BACKGROUND: Perioperative neuropathic pain is under-recognized and often undertreated. Chronic pain may develop after any routine surgery, but it can have a far greater incidence after amputation, thoracotomy or mastectomy. The peak noxious barrage due to the neural trauma associated with these operations may be reduced in the perioperative period with the potential to reduce the risk of chronic pain. DATABASES AND DATA TREATMENT: A systematic review of the evidence for perioperative interventions reducing acute and chronic pain associated with amputation, mastectomy or thoracotomy. RESULTS: Thirty-two randomized controlled trials met the inclusion criteria. Gabapentinoids reduced pain after mastectomy, but a single dose was ineffective for thoracotomy patients who had an epidural. Gabapentinoids were ineffective for vascular amputees with pre-existing chronic pain. Venlafaxine was associated with less chronic pain after mastectomy. Intravenous and topical lidocaine and perioperative EMLA (eutectic mixture of local anaesthetic) cream reduced the incidence of chronic pain after mastectomy, whereas local anaesthetic infiltration appeared ineffective. The majority of the trials investigating regional analgesia found it to be beneficial for chronic symptoms. Ketamine and intercostal cryoanalgesia offered no reduction in chronic pain. Total intravenous anaesthesia (TIVA) reduced the incidence of post-thoracotomy pain in one study, whereas high-dose remifentanil exacerbated chronic pain in another. CONCLUSIONS: Appropriate dose regimes of gabapentinoids, antidepressants, local anaesthetics and regional anaesthesia may potentially reduce the severity of both acute and chronic pain for patients. Ketamine was not effective at reducing chronic pain. Intercostal cryoanalgesia was not effective and has the potential to increase the risk of chronic pain. TIVA may be beneficial but the effects of opioids are unclear

Temperature and gravity of the pulsating extreme helium star LSS 3184 (BX Cir) through its pulsation cycle

We report the analysis of optical spectra of the extreme helium star LSS 3184 (BX Cir) to determine its effective temperature and gravity throughout its pulsation cycle. The spectra were also used to measure its chemical abundances. We report rest gravity, log g = 3.38 +/- 0.02, and a chemical abundance mixture consistent with those reported earlier in a study using an optical spectrum with lower spectral resolution and a lower signal to noise ratio. Our analysis decreases the upper limit for the H abundance to H < 6.0 (mass fraction < 7.1 x 10^-7). Our gravity corresponds to stellar mass M = 0.47 +/- 0.03 M_sun. We find that the effective log g varies through the pulsation cycle with an amplitude of 0.28 dex. The effective gravity is smaller than the rest gravity except when the star is very near its minimum radius. The change in effective gravity is primarily caused by acceleration of the stellar surface. Based on the optical spectra, we find the temperature varies with an amplitude of 3450 K. We find a time averaged mean temperature, 23390 +/- 90 K, consistent with that found in the earlier optical spectrum study. The mean temperature is 1750 K hotter than that found using combined ultraviolet spectra and V and R photometry and the variation amplitude is larger. This discrepancy is similar to that found for the extreme helium star V652 Her.Comment: 7 pages, 6 figures, LaTeX, to be published in A&

NIMBUS-5 sounder data processing system. Part 2: Results

The Nimbus-5 spacecraft carries infrared and microwave radiometers for sensing the temperature distribution of the atmosphere. Methods developed for obtaining temperature profiles from the combined set of infrared and microwave radiation measurements are described. Algorithms used to determine (a) vertical temperature and water vapor profiles, (b) cloud height, fractional coverage, and liquid water content, (c) surface temperature, and (d) total outgoing longwave radiation flux are described. Various meteorological results obtained from the application of the Nimbus-5 sounding data processing system during 1973 and 1974 are presented

Variability in the extreme helium star LSS 5121

We report a photometric and spectroscopic study of the hot extreme helium star LSS 5121. We found photometric variability, but no period was evident in its periodogram. This is consistent with the previous proposal, based on spectral line variations, that LSS 5121 is a non-radial pulsator similar to other hot extreme helium stars.Comment: 5 pages, 6 figure

Data specifications for INSPIRE

In Europe a major recent development has been the entering in force of the INSPIRE Directive in May 2007, establishing an infrastructure for spatial information in Europe to support Community environmental policies, and policies or activities which may have an impact on the environment. INSPIRE is based on the infrastructures for spatial information established and operated by the 27 Member States of the European Union. The Directive addresses 34 spatial data themes needed for environmental applications, with key components specified through technical implementing rules. This makes INSPIRE a unique example of a legislative ¿regional¿ approach. One of the requirements of the INSPIRE Directive is to make existing spatial data sets with relevance for one of the spatial data themes available in an interoperable way, i.e. where the spatial data from different sources in Europe can be combined to a coherent result. Since INSPIRE covers a wide range of spatial data themes, the first step has been the development of a modelling framework that provides a common foundation for all themes. This framework is largely based on the ISO 19100 series of standards. The use of common generic spatial modelling concepts across all themes is an important enabler for interoperability. As a second step, data specifications for the first set of themes has been developed based on the modelling framework. The themes include addresses, transport networks, protected sites, hydrography, administrative areas and others. The data specifications were developed by selected experts nominated by stakeholders from all over Europe. For each theme a working group was established in early 2008 working on their specific theme and collaborating with the other working groups on cross-theme issues. After a public review of the draft specifications starting in December 2008, an open testing process and thorough comment resolution process, the draft technical implementing rules for these themes have been approved by the INSPIRE Committee. After they enter into force they become part of the legal framework and European Member States have to implement these rules. The next step is the development of the remaining 25 spatial data themes, which include many themes of interest for the Earth Sciences including geology, meteorological and oceanographic geographic features, atmospheric conditions, habitats and biotopes, species distribution, environmental monitoring facilities, and land cover to name a few. The process will follow in general the same steps as for the first themes and the working groups are expected to start their work in March/April 2010. The first draft specifications for public comment are expected at the end of 2010 and the work is scheduled to be completed in 2012.JRC.DDG.H.6-Spatial data infrastructure

The Hot R Coronae Borealis Star DY Centauri is a Binary

The remarkable hot R Coronae Borealis (RCB) star DY Cen is revealed to be the first and only binary system to be found among the RCB stars and their likely relatives, including the extreme helium stars and the hydrogen-deficient carbon stars. Radial velocity determinations from 1982 to 2010 have shown that DY Cen is a single-lined spectroscopic binary in an eccentric orbit with a period of 39.67 days. It is also one of the hottest and most H-rich member of the class of RCB stars. The system may have evolved from a common envelope to its current form.Spanish Ministry of Economy and Competitiveness AYA-2011-27754McDonald Observator