Fire in the Operating Room During Hypospadias Repair

Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery

Feasibility, safety and outcome of inguinal hernia repair under spinal versus general anesthesia in preterm and term infants

Background: Inguinal hernia repair (IHR) is a common operation in preterm and term infants. Recently, spinal anesthesia (SA) has been proposed as an alternative to avoid exposure to general anesthesia (GA) during early life. The aim of this study was to compare surgical outcomes of open IHR performed under SA versus GA in neonates and infants, and to detect criteria to predict the success or failure of SA. Materials and methods: This is a 6-year, single center, nonrandomized interventional study (2013–2019). SA was performed with 0.5% bupivacaine. GA was given using propofol, fentanyl, sevoflurane, and laryngeal mask. Patient demographics, operative time, intraoperative events related to surgery or anesthesia, and complications were analyzed at short and long-term follow-up. Results: 68 infants (78 IHR) and 37 infants (44 IHR) received SA and GA at the discretion of the anesthesiologist, respectively. SA failure rate was 9%, and positively correlated with weight at surgery (p = 0.001; rp = 0.38). Conversion from SA to GA occurred in 4 (6%) patients owing to prolonged operative time (43.75 ± 4.8 vs 23.02 ± 11.3 min; p = 0.0006). There were no differences regarding operative time and intra- and postoperative complications among the two groups at mean follow-up of 18.53 ± 21.9 months. Conclusions: This pilot study confirms that SA is safe, effective and not detrimental to surgical outcome of neonates and infants undergoing IHR. Additionally, it may help further define what patients may have a successful SA. Our experience suggests that SA is especially suitable in infants weighing < 4000 g, and conversion to GA correlates with prolonged operative time. Level of evidence: Level II

Sea ice diatom contributions to Holocene nutrient utilization in East Antarctica

Combined high-resolution Holocene δ30Sidiat and δ13Cdiat paleorecords are presented from theSeasonal Ice Zone, East Antarctica. Both data sets reflect periods of increased nutrient utilization by diatomsduring the Hypsithermal period (circa 7800 to 3500 calendar years (cal years) B.P.), coincident with a higherabundance of open water diatom species (Fragilariopsis kerguelensis), increased biogenic silica productivity(%BSi), and higher regional summer temperatures. The Neoglacial period (after circa 3500 cal years B.P.) isreflected by an increase in sea ice indicative species (Fragilariopsis curta and Fragilariopsis cylindrus,upto50%) along with a decrease in %BSi and δ13Cdiat(< 18‰ to 23‰). However, over this period, δ30Sidiatdata show an increasing trend, to some of the highest values in the Holocene record (average of +0.43‰).Competing hypotheses are discussed to account for the decoupling trend in utilization proxies including ironfertilization, species-dependent fractionation effects, and diatom habitats. Based on mass balance calculations,we highlight that diatom species derived from the semi-enclosed sea ice environment may have a confoundingeffect upon δ30Sidowncorecompositions of the seasonal sea ice zone. A diatom composition, with approximately28% of biogenic silica derived from the sea ice environment (diat-SI) can account for the increased averagecompo sition of δ30Sidiatduring the Neoglacial. These data highlight the significant role sea ice diatoms can playwith relation to their export in sediment records, which has implications on productivity reconstructions fromthe seasonal ice zone

Hydrophobically directed aldol reactions: polystyrene-supported L-proline as a recyclable catalyst for direct asymmetric aldol reactions in the presence of water

A simple synthetic methodology for the preparation of a polystyrene- supported L-proline material is reported, and this material has been used as catalyst in direct asymmetric aldol reactions between several ketones and arylaldehydes to furnish aldol products in high yields and stereoselectivities. Screening of solvents showed that these reactions take place only in the presence of water or methanol, at lower levels of conversion in the latter case. This solvent effect, coupled with the observed high stereoselectivities, has been ex- Introduction In the last decade organocatalysis has became a field of great interest.[1] Organocatalysts are metal-free small organic molecules that are able to function as efficient and selective catalysts for a large variety of enantioselective transformations. In this context, -proline and its derivatives have emerged as powerful organocatalysts.[2] -Proline can be regarded as the simplest “enzyme” and it has been successfully applied in many reactions, such as Robinson annulations,[3] aldol reactions,[4] Mannich reactions,[5] Michael reactions,[6] direct electrophilic α-aminations,[7] Diels– Alder reactions,[8] Baylis–Hillman reactions,[9] aza-Morita- Baylis–Hillman reactions,[10] α-selenenylation,[11] oxidation,[ 12] chlorination,[13] and others.[14] Among all these processes, -proline-mediated aldol reactions affording β-hydroxy ketones have been investigated in great depth. Indeed, the aldol reaction is one of the most important C–C bond-formation methods in organic synthesis.[ 15] Proline and its derivatives operate by bifunctional catalysis and play the role of a simplified version of the type I [a] Dipartimento di Chimica Organica “E.Paternò”, Università di Palermo, Viale delle Scienze, Pad. 17, 90128 Palermo, Italy Fax: +39-091-596825 E-mail: [email protected] © 2007 Wiley-VCH Verlag GmbH 4688 & Co. KGaA, Weinheim Eur. J. Org. Chem. 2007, 4688–4698 plained in terms of the formation of a hydrophobic core in the inner surface of the resin, whereas the hydrophilic proline moiety lies at the resin/water interface. Such a microenvironment both promotes the aldol reaction and increases the stereoselectivity. Recycling investigations have shown that this material can be reused, without loss in levels of conversion and stereoselectivity, for at least five cycles

A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas : the PERSEUS experience

PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional research themes targeting research topics that are requested to the achievement of GES. 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license.peer-reviewe