Computational Simulations of Magnetic Particle Capture in Arterial Flows

The aim of Magnetic Drug Targeting (MDT) is to concentrate drugs, attached to magnetic particles, in a specific part of the human body by applying a magnetic field. Computational simulations are performed of blood flow and magnetic particle motion in a left coronary artery and a carotid artery, using the properties of presently available magnetic carriers and strong superconducting magnets (up to B ≈ 2 T). For simple tube geometries it is deduced theoretically that the particle capture efficiency scales as \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\eta \sim \sqrt{{Mn}_{\rm p}}$$\end{document}, with Mnp the characteristic ratio of the particle magnetization force and the drag force. This relation is found to hold quite well for the carotid artery. For the coronary artery, the presence of side branches and domain curvature causes deviations from this scaling rule, viz. η ∼ Mnpβ, with β > 1/2. The simulations demonstrate that approximately a quarter of the inserted 4 μm particles can be captured from the bloodstream of the left coronary artery, when the magnet is placed at a distance of 4.25 cm. When the same magnet is placed at a distance of 1 cm from a carotid artery, almost all of the inserted 4 μm particles are captured. The performed simulations, therefore, reveal significant potential for the application of MDT to the treatment of atherosclerosis

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The first report of massive infestation with Lipoptena Cervi ( Diptera: Hippoboscidae ) in Roe Deer ( Capreolus Capreolus ) in Iasi county, N-E of Romania

ABSTRACT Investigations of four roe deer corpses were carried out from May until October 2014, in the Veterinary Forensic Laboratory and in the Parasitic Diseases Clinic, in the Iasi Faculty of Veterinary Medicine. The roe deer were harvested by shooting during the trophy hunting season. The clinical examination of the shot specimens revealed the presence of a highly consistent number of extremely mobile apterous insects, spread on the face, head, neck, lateral body parts, abdominal regions, inguinal, perianal and, finally, all over the body. The corpses presented weakening, anemia and cutaneous modification conditions. Several dozen insects were prelevated in a glass recipient and preserved in 70º alcoholic solution in order to identify the ectoparasite species. The morphological characteristics included insects in the Diptera order, Hippoboscidae family, Lipoptena cervi species. These are highly hematophagous insects that by severe weakening are affecting the game health and trophy quality. Histological investigations of the skin revealed some inflammatory reactions caused by ectoparasite Lipoptena cervi. Lipoptena cervi was identified for the first time in Iasi County, Romania

Management practices for postdural puncture headache in obstetrics: a prospective, international, cohort study

Background: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP. © 2020 British Journal of Anaesthesi