Comparison of the maternal and neonatal effects of bupivacaine plus fentanyl and ropivacaine plus fentanyl during cesarean delivery

Purpose: The aim of the present study was to compare the anesthetic efficacy, and fetal and maternal effects of 7.5 mg (1 ml) intrathecal 0.75% hyperbaric ropivacaine + 25 ìg (0.5 ml) fentanyl versus 5 mg (l ml) intrathecal 0.5% hyperbaric bupivacaine + 25 ìg (0.5 ml) fentanyl in elective cesarean delivery.Materials and Methods: The study included 40 ASA I–II cases scheduled for cesarean delivery that were randomized into two groups of 20 cases each. Cases in the RF group were administered 0.75% hyperbaric ropivacaine + 25 ìg (0.5 ml) fentanyl and those in the BF group were administered 5 mg (l ml) hyperbaric bupivacaine + 25 ìg (0.5 ml)fentanyl into the spinal space. The time until spinal anesthesia in the T4 dermatome, overall duration of analgesia, hemodynamic parameters, Apgar score of newborns at 1–5 min, fetal blood gas values (pH, PO2, PCO2, HCO3., and BE), maternal side effects, the degree of motor block, maternal need for ephedrine, objective pain scale score, and patient satisfaction were recorded in each group.Results: There were no significant differences between the groups in terms of the parameters evaluated (P > 0.05).Conclusion: In elective cesarean delivery, the combinations of bupivacaine + fentanyl or ropivacaine + fentanyl exhibited similar anesthetic efficacy, and fetal and maternal effects.Key words: Bupivacaine, cesarean, opioid, ropivacain

Resource uptake and host tissue chemistry: Implications for competition and disease

Maintenance of optimal nutrient supplies is fundamental to the functioning of vertebrate, invertebrate, bacterial and plant physiology. Organisms on this planet compete with each other primarily to fulfill nutritional needs in order to maximize their health, wellbeing, and reproductive success. Here we examine nutrient concentrations in several different grass species within the context of the causes and effects of infection by barley yellow dwarf viruses, a common and economically important pathogen of grasses worldwide. Here we examine whether there is evidence that nutrient concentration motivates the vector to seek and feed on particular grasses. We selected grass species for which we knew aphid fecundity from a previous experiment. We analyzed tissue from these plants to determine their carbon to nitrogen ratios. We found that perennial grasses contained more tissue carbon than annuals, regardless of fertilization, and fertilized annual grasses increased more in tissue nitrogen than did the perennial grass species. These results are concordant with previous findings: aphids preferred and produced more offspring on the lower carbon annual grasses, suggesting that aphid vector preference and performance may be controlled by nutrition

Driving calmodulin protein towards conformational shift by changing ionization states of select residues

Proteins are complex systems made up of many conformational sub-states which are mainly determined by the folded structure. External factors such as solvent type, temperature, pH and ionic strength play a very important role in the conformations sampled by proteins. Here we study the conformational multiplicity of calmodulin (CaM) which is a protein that plays an important role in calcium signaling pathways in the eukaryotic cells. CaM can bind to a variety of other proteins or small organic compounds, and mediates different physiological processes by activating various enzymes. Binding of calcium ions and proteins or small organic molecules to CaM induces large conformational changes that are distinct to each interacting partner. In particular, we discuss the effect of pH variation on the conformations of CaM. By using the pKa values of the charged residues as a basis to assign protonation states, the conformational changes induced in CaM by reducing the pH are studied by molecular dynamics simulations. Our current view suggests that at high pH, barrier crossing to the compact form is prevented by repulsive electrostatic interactions between the two lobes. At reduced pH, not only is barrier crossing facilitated by protonation of residues, but also conformations which are on average more compact are attained. The latter are in accordance with the fluorescence resonance energy transfer experiment results of other workers. The key events leading to the conformational change from the open to the compact conformation are (i) formation of a salt bridge between the N-lobe and the linker, stabilizing their relative motions, (ii) bending of the C-lobe towards the N-lobe, leading to a lowering of the interaction energy between the two-lobes, (iii) formation of a hydrophobic patch between the two lobes, further stabilizing the bent conformation by reducing the entropic cost of the compact form, (iv) sharing of a Ca+2 ion between the two lobes

Patterns of medical management of overactive bladder (OAB) and benign prostatic hyperplasia (BPH) in the United States

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142147/1/nau23276.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142147/2/nau23276_am.pd

Hard Photodisintegration of a Proton Pair

We present a study of high energy photodisintegration of proton-pairs through the γ + 3He → p + p + n channel. Photon energies, Eγ , from 0.8 to 4.7 GeV were used in kinematics corresponding to a proton pair with high relative momentum and a neutron nearly at rest. The s−11 scaling of the cross section, as predicted by the constituent counting rule for two nucleon photodisintegration, was observed for the first time. The onset of the scaling is at a higher energy and the cross section is significantly lower than for deuteron (pn pair) photodisintegration. For Eγ below the scaling region, the scaled cross section was found to present a strong energy-dependent structure not observed in deuteron photodisintegration

Extraction of the Nuetron Electric Form Factor from Measurements of Inclusive Double Spin Asymmetries

Background: Measurements of the neutron charge form factor, GnE , are challenging because the neutron has no net charge. In addition, measurements of the neutron form factors must use nuclear targets which require accurately accounting for nuclear effects. Extracting GnE with different targets and techniques provides an important test of our handling of these effects. Purpose: The goal of the measurement was to use an inclusive asymmetry measurement technique to extract the neutron charge form factor at a four-momentum transfer of 1(GeV/c)2 . This technique has very different systematic uncertainties than traditional exclusive measurements and thus serves as an independent check of whether nuclear effects have been taken into account correctly. Method: The inclusive quasielastic reaction 3→He(→e,e′) was measured at Jefferson Laboratory. The neutron electric form factor, GnE , was extracted at Q2=0.98(GeV/c)2 from ratios of electron-polarization asymmetries measured for two orthogonal target spin orientations. This Q2 is high enough that the sensitivity to GnE is not overwhelmed by the neutron magnetic contribution, and yet low enough that explicit neutron detection is not required to suppress pion production. Results: The neutron electric form factor, GnE , was determined to be 0.0414 ± 0.0077 (stat) ± 0.0022 (syst) , providing the first high-precision inclusive extraction of the neutron\u27s charge form factor. Conclusions: The use of the inclusive quasielastic 3→He(→e,e′) with a four-momentum transfer near 1(GeV/c)2 has been used to provide a unique measurement of GnE . This new result provides a systematically independent validation of the exclusive extraction technique results and implies that the nuclear corrections are understood. This is contrary to the proton form factor where asymmetry and differential cross section measurements have been shown to have large systematic differences

Measurement of Double-Polarization asymmetries in the Quasi-Elastic He→ 3 (e→, e′ p) Process

We report on a precise measurement of double-polarization asymmetries in electron-induced breakup of 3He proceeding to pd and ppn final states, performed in quasi-elastic kinematics at Q2 = 0.25 (GeV/c)2 for missing momenta up to 250 MeV/c. These observables represent highly sensitive tools to investigate the electromagnetic and spin structure of 3He and the relative importance of two- and three-body effects involved in the breakup reaction dynamics. The measured asymmetries cannot be satisfactorily reproduced by state-of-the-art calculations of 3He unless their three-body segment is adjusted, indicating that the spin-dependent part of the nuclear interaction governing the three-body breakup process is much smaller than previously thought