Local anesthetic infiltration vs. nervous blocks in face’s skin lesions: what’s new

Skin tumors are the most common type of cancer. They are localized throughout the body, more frequently in those regions chronically exposed to sun, like face, scalp and neck, compromising aesthetic appearance. The optimization of day hospital surgical procedures is mandatory, to avoid erroneous indications, insufficient intra operative comfort and prolonged recovery. New guidelines should be discussed and shared. Patients were divided in two groups: i. Group A of 50 patients, 21 male and 29 female, age 65 ±9, ASA I – III (10/19/21), weight 68±11 kg, height 160±8, with anesthetic Local Infiltration (LI); ii. Group B of 50 patients, 16 male, 34 female, age 68 ±10, ASA I – III (9/22/19), weight 64 ± 9 kg, height 158 ±11, with nerve block (NB). The purpose of our study is to evaluate the analgesia level, compliance and complication rate after LI or selective NB with alkalinised mepivacaine cloridrate 2%, Guardant®. Demographic data, ASA physical stauts, size of lesions, surgery, anesthesia durations and volume of LA injected were analyzed. Fisher’s exact test and Student’s t test were used; P ≤ 0.05 was considered statistically significant. No differences in age (65 ± 9 vs 68 ± 10 years), weight (68 ± 11 vs 64 ± 9), height (160 ± 8 vs 158 ± 11 cm), size of lesion (23 ± 11 vs 25 ± 14 mm), duration of surgery (47 ± 18 vs 51 ± 23 minutes) were detected in two groups (p > 0.05). Both anesthetic techniques ensured good analgesia, but only nerve’s blocks were be able to determine satisfactory intra operative patient’s comfort, a bloodless wound and weak risk for nervous lesions and toxic reaction to local anesthetic

Fast glycorrhachia and cerebrospinal fluid protein as predictors of sensory block in anesthesia with subarachnoid Ropivacaine

BACKGROUND: Identify if glycorrhachia and cerebrospinal fluid protein could influence the time of sensory block to T10, the duration and the metameric block's level, after a standard dose of Ropivacaine. METHODS: 80 patients, ASA I - III undergoing to transurethral prostate resection with spinal anesthesia in a prospected open study were recruited. A 0.2 ml liquor's sample was taken; glycorrhachia, by glycemic stix and CSF protein, by urinary stix, were got, before Ropivacaine 0.5% 15 mg injection (0.10 - 0.15 mlsec). After anti-trendelemburg, with 30 ° tilting for 15 min, the onset of sensory block to T10, the maximum metameric level to 15' and the time of sensory block were reported. The data collection were analyzed using the software language R. RESULTS: A significant correlation liquor specific weigh preoperative glycemia (0.749), liquoral specific weigh glycorrhachia (rho = 0.751; R2 = 0.564; P 0.05) and specific weigh CSF protein (rho = 0.684; R2 = 0.468; P 0.05) were reported. Inverse relation CSF weightsensory block level (rho -0.789, P 0.05, R2 0.621) was evidenced. Inverse relation onset time to T10 glycorrhachia (84%) and cephalic block glycorrhachia (76%) were found. Inverse correlation onset time to T 10 CSF protein and cephalic block proteinorrachia was respectively 84% and 67%. A rho of 0.712 with R2 of 51% BMI onset to T10 and rho of 0.681 with R2 of 51% BMI maximum cephalic block with P 0.05 were reported. CONCLUSIONS: The predictability of a iso-hypobaric local anesthetic could reduce the risk of procedure failure and adverse events by further cephalic spread

modeling the influence of stress triaxiality on the failure strain of nodular cast iron microstructures

Abstract In this study the fracture behavior of different cast iron microstructures subjected to tensile loading under different triaxialities is simulated by a finite element, 3-D Reference Volume Element approach. Three ferritic/pearlitic heterogeneous matrixes are considered which are representative of the class material grades for strength and ductility. Isotropic ductile and shear damage models are considered for the matrix constituents as concurrent damage mechanisms at the microscale, while graphite nodules are considered as voids acting as stress concentrators. Numerical results confirm experimental findings about local strain distribution and damage accumulation, and reproduce the engineering macroscopic behavior. The stress triaxiality is found to play a strong effect on the failure strain, extending the potentialities of this RVE modeling approach

Coherent Dynamics in Solutions of Colloidal Plexcitonic Nanohybrids at Room Temperature

The increasing ability to prepare systems with nanoscale resolution and address their optical properties with ultrashort time precision is revealing quantum phenomena with tremendous potential in quantum nanotechnologies. Colloidal plexcitonic materials promise to play a pivotal role in this scenario. Plexcitons are hybrid states originating from the mixing of the plasmon resonances of metal nanostructures with molecular excitons. They allow nanoscale confinement of electromagnetic fields and the establishment of strong couplings between light and matter, potentially giving rise to controllable and tunable coherent phenomena. However, the characterization of the ultrafast coherent and incoherent dynamics of colloidal plexciton nanohybrids remains highly unexplored. Here, two dimensional electronic spectroscopy (2DES) is employed to study the quantum coherent interactions active after the photoexcitation of these systems. By comparing the response of the nanohybrids with the one of the uncoupled systems, the nonlinear photophysical processes at the base of the coherent dynamics are identified, allowing a step forward toward the effective understanding and exploitation of these nanomaterials

influence of material and manufacturing technology on the failure behavior of composite laminate bonded joints

Abstract The purpose of this work is to evaluate the influence of co-lamination vs. co-bonding on the failure behavior, and namely the fracture toughness, of carbon fibre reinforced (CFR) composite laminate joints in order to assess comparatively their performance. Since the strength of the laminate and ply texture are parameters affecting the strength of the joint, the comparison is extended to two different types of CFR pre-preg fibers, a satin T1100 with 2573 Nanoalloy® epoxy resin supplied by Toray and a twill T700 with ER450 toughened epoxy resin supplied by CIT, Toray group, representative of two different fields of application, racing and automotive, respectively

Coherent electronic and nuclear dynamics in a rhodamine heterodimer-DNA supramolecular complex

Elucidating the role of quantum coherences in energy migration within biological and artificial multichromophoric antenna systems is the subject of an intense debate. It is also a practical matter because of the decisive implications for understanding the biological processes and engineering artificial materials for solar energy harvesting. A supramolecular rhodamine heterodimer on a DNA scaffold was suitably engineered to mimic the basic donor-acceptor unit of light-harvesting antennas. Ultrafast 2D electronic spectroscopic measurements allowed identifying clear features attributable to a coherent superposition of dimer electronic and vibrational states contributing to the coherent electronic charge beating between the donor and the acceptor. The frequency of electronic charge beating is found to be 970 cm-1 (34 fs) and can be observed for 150 fs. Through the support of high level ab initio TD-DFT computations of the entire dimer, we established that the vibrational modes preferentially optically accessed do not drive subsequent coupling between the electronic states on the 600 fs of the experiment. It was thereby possible to characterize the time scales of the early time femtosecond dynamics of the electronic coherence built by the optical excitation in a large rigid supramolecular system at a room temperature in solution. © 2017 the Owner Societies.Multi valued and parallel molecular logi

Impact of SARS-CoV-2 on elective surgical volume in Tuscany: effects on local planning and resource prioritization

No abstract availabl