General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Apple post-harvest preservation is linked to phenolics and SOD activity

The postharvest preservation of apples indicated that well-preserved varieties of apples had increased superoxide dismutase (SOD) activity initially, and the activity declined during later storage as apples deteriorated. The increased SOD activity linked to better preservation correlated with higher phenolic content and free-radical scavenging-linked antioxidant activity. Well-preserved varieties were able to maintain a more stable pentose phosphate pathway (measured by the activity of glucose-6-phosphate dehydrogenase) throughout the storage period. Proline content increased with proline dehydrogenase (PDH) activity in the initial storage period, indicating proline catabolism supporting potential adenosine 5′-triphosphate (ATP) synthesis. During later storage, succinate dehydrogenase activity increased, while PDH activity declined indicating a shift to tricarboxylic acid cycle and likely nicotinamide adenine dinucleotide hydrogen (NADH) generation for ATP synthesis. This shift, coupled with the declining SOD activity, coincides with rapid deterioration. The guaiacol peroxidase activity generally declined in late stages, indicating postharvest deterioration

Influence of cultivar, harvest time, storage conditions, and peeling on the antioxidant capacity and phenolic and ascorbic acid contents of apples and pears."

Apple and pear fruits are important sources of secondary plant metabolites and one of the major sources of dietary phenolics consumed all year round. The aim of this work was to identify the main variables influencing phenolic content and antioxidant capacity in apples. Higher phenolic and antioxidant contents were observed in some varieties (such as the Delbar Estival apple and Durondeau pear). Storage conditions were important. Our results also showed that fruits should be consumed rapidly after purchase and with their peel. After one week of domestic storage, the ascorbic acid content was found to decrease by 75%. Peeling led to a more than 25% decrease in total phenolics and ascorbic acid. The harvest time (at normal ripeness) had only a limited impact, but significant year-to-year variations were observed. In conclusion, well-chosen and well-stored apples and pears may contribute to an antioxidant-rich diet if consumed rapidly and with their peel

Polyphenolic profiles in lettuce (Lactuca sativa L.) after CaCl2 treatment and cold storage

Lettuce (Lactuca sativa L.) is a popular vegetable with the health-enhancing properties determined by high levels of antioxidant polyphenols as chlorogenic acids and other derivatives of caffeic acid or flavonoids. In this study, changes in the phenolic compound profiles in the lettuce leaves induced by application of CaCl2 before harvest and cold storage were studied. For the first time quantitative analysis of individual phenolic compounds on the basis of standards isolated from lettuce leaves was performed. Compounds were identified using HPLC, LC-MS, 1H and 13CNMR techniques. The dominant compounds were 2,3-dicaffeoyltartaric (2,3-diCTA), 5-O-caffeoylquinic (5-OCQA) and caffeoyltartaric (CTA) acids, with content of 5.7, 2.5 and 0.981 mg/g DM, respectively. The levels of individual phenolic compounds, total phenolics and antioxidant activity (DPPH assay) in plants treated by CaCl2 were determined throughout the storage period (7 and 14 days) at 4 °C. To ascertain the relationship between the content of individual compounds, total phenols, antioxidant activities and storage time, Pearson’s correlation analysis was used. The best correlation between the storage length and compound concentration was observed for 2,3-diCTA (R2 = 0.866) and caffeoylmalic acid (CMA) (R2 = 0.750). Application of CaCl2 (0.05M) on lettuce resulted in an increase in the levels of CTA, 2.3-diCTA and 5-OCQA about 120, 65 and 57%, respectively, compared to the control stored for 7 days in the same conditions and had a favourable effect on the antioxidant activity (R2 = 0.985). The present paper shows that CaCl2 may be used as an agent that influences the stability of health-promoting compounds of cold-stored lettuce