Preferences of Mexican anesthesiologists for vecuronium, rocuronium, or other neuromuscular blocking agents: a survey

BACKGROUND: Several neuromuscular blocking (NMB) agents are available for clinical use in anesthesia. The present study was performed in order to identify preferences and behaviors of anesthesiologists for using vecuronium, rocuronium or other NMB agents in their clinical practice. MATERIAL AND METHODS: The cross-sectional survey was applied at the Updated Course of the Colegio Mexicano de Anestesiología performed last year. Of 989, 282 (28.5%) surveys were returned. RESULTS: Most anesthesiologists were working at both public and private hospitals, performed anesthetic procedures for hospitalized and ambulatory patients, and anesthetized children as well as adults. Respondents did not consider mechanomyography as the gold standard method for neuromuscular monitoring. The T(25) was not recognized as a pharmacodynamic parameter that represents the clinical duration of the neuromuscular block. Most answered that vecuronium induces less histamine release than rocuronium, had never used any neuromuscular monitor, did not know the cost of vecuronium and rocuronium, and preferred rocuronium in multiple-sampling vials and vecuronium in either a vial for single or multiple sampling. Rocuronium was preferred for emergency surgery in patients with full stomach only. Almost all of anesthesiologists that conserve the unused drug did it without refrigeration and more than 30% conserve the unused drug in one syringe for further use. CONCLUSION: Vecuronium was preferred for most clinical situations, and the decision for this choice was not based on costs. Storage of unused drugs without refrigeration in a single syringe for purpose of future use in several patients represented a dangerous common practice

Effect of a DC Electric field on the melting temperature, nucleation and ice growth rate of the TIP4P/ICE water model

Understanding the effect of electric fields on the thermal stability and phase transitions of water could have potential applications in the food industry, cryopreservation, and environmental science. In this work, we investigate the effect of a static electric field on the melting temperature (Tm), ice nucleation and ice growth rate of two phases of ice, hexagonal ice (Ih) and ferroelectric cubic ice (Icf), for the TIP4P/ICE water model. By means of direct coexistence simulations, we establish that Tm of Ice Ih is shifted toward lower values, whereas Tm of Ice Icf grows, becoming the most stable ice phase for sufficiently largevalues of the applied electric field. We also investigate ice nucleation for both ice phases under an external electric field and find that, for a given supercooling with respect to Tm, while the field slows down the nucleation rate of ice Ih significantly, it barely affects that of ice Icf, due to the enhanced ability of water molecules to orient favorably along the direction of the field in the latter phase. In terms of absolute temperature, overall ice formation is promoted by the electric field because it increases the melting point of ice Icf. Finally, we show how the electric field slows down the crystal growth of Ice Ih and increases that of Ice Icf by a factor of about two

Variation in the Extraction Efficiency of Estradiol and Progesterone in Moist and Lyophilized Feces of the Black Howler Monkey (Alouatta pigra): Alternative Methods

Several fecal steroid extraction techniques have been developed to measure the ovary function in different species of mammals. However, regardless of the method of extraction and the sample type chosen, it has been observed that they can yield results with different percentages of recuperation. The objective of this study was to determine whether the type of substratum, solvent and extraction method used have any influence on the extraction efficiency in the feces of Alouatta pigra (black howler monkey). For this purpose we used two methods: agitation and ebullition. With each method, we utilized moist and lyophilized feces. The validation of radioimmunoassay method was accurate and precise for quantify estradiol and progesterone in lyophilized feces of A. pigra. To both of which ethanol and methanol, absolute and at 80%, were added, besides the hormones 125I-Estradiol and 125I-Progesterone. The extraction efficiency for 125I-Estradiol was from 87.72 ± 3.97 to 41.24 ± 2.67%, and for 125I-Progesterone from 71.15 ± 4.24 to 42.30 ± 1.19% when we used the agitation method. Whereas with the ebullition method, the extraction efficiency for 125I-Estradiol ranged from 86.89 ± 2.66 to 71.68 ± 3.02% and for 125I-Progesterone from 98.31 ± 1.26 to 85.40 ± 1.98%. Due to the differences found in these assays, which depend on the method used, the type of feces employed and the type of solvent added to them, we recommend the ebullition method and the lyophilized feces of A. pigra for extracting the hormones, since in moist feces there may exist variables which might interfere in the quantification of 125I-Estradiol and 125I-Progesterone

Functional capacity evaluation in a clinical and ambulatory setting: new challenges of accelerometry to assessment balance and muscle power in aging population

Dentro de cualquier población de individuos mayores de 65 años, una proporción sustancial (entre el 6% y el 25%) sufre diferentes síntomas del síndrome de fragilidad. A pesar de la complejidad del termino fragilidad y de las imprecisiones en cuanto a su definición existe un consenso sobre sus síntomas y signos. Las personas que poseen este síndrome presentan pérdidas de fuerza muscular, fatiga, disminución de la actividad física, con un aumento del riesgo de padecer anorexia-pérdida de peso, delirium, hospitalización, declive funcional, deterioro cognitivo, mortalidad, ingreso en residencias, caídas e inestabilidad. Bajo este contexto, surge la necesidad de desarrollar tests que sean capaces de predecir de la forma más precoz posible la fragilidad y la discapacidad. La acelerometría es una herramienta adecuada para la monitorización de movimientos humanos de una forma objetiva y fiable, aplicable en la vida diaria de los sujetos sin implicar grandes costes. Los acelerómetros están siendo utilizados en la monitorización de diferentes movimientos. Se pueden obtener una amplio abanico de medidas como: clasificación de movimientos, valoración del nivel de actividad física, estimación del gasto de energía metabólica, medida del equilibrio, ritmo de marcha y control al levantarse-sentarse. Combinando la acelerometría con giróscopos y magnetómetros se podrá añadir información relacionada con la orientación y los cambios de posición. Esta revisión analiza las herramientas y tecnologías existentes que puedan llegar a detectar de manera precoz posibles signos y síntomas de la fragilidad y permitan a los individuos vivir autónomamente de forma más prolongada y en condiciones de mayor seguridad.If we consider a population of free-living individuals, who are 65 years old and even older, a substantial proportion (in the range of 6% to 25%) suffers from many of the elements of the syndrome of frailty Although the syndrome is complex and still lacks a standard definition, there is a growing consensus about its signs and symptoms. Patients who are afflicted with frailty typically exhibit losses of muscle strength, fatigue easily, are physically inactive, with all increased risk (and fear) of failing, have undergone a recent, unintentional loss of weight, experience impaired cognition and depression, all of which is frequently complicated by a variety of coexistent illnesses. In this context, functional tests to predict disability and frailty are needed. Accelerometry offers a practical and low cost method of objectively monitoring human movements, and has particular applicability to the monitoring of disability in all aging population. Accelerometers have been used to monitor a range of different movements, including gait, sit to stand transfers and postural sway. This review focuses on methodological concepts in the evaluation of skeletal muscle function and monitoring systems (accelerometers and gyroscopes) in each of these areas. An integrated approach is described in which a combination of accelorometry and gyroscopy can be used to monitor a range of different parameters (muscle power, gait and balance) in all aging population in a clinical or out-patient setting.Este trabajo se ha realizado en parte gracias a una beca de investigación de la Fundación MAPFRE Medicina y una ayuda para la realización de proyectos de investigación por el Departamento de Salud del Gobierno de Navarra y a las ayudas destinadas a financiar Redes Temáticas de Investigación (Red Envejecimiento y Fragilidad) en el marco del Plan Nacional de Investigación 2004-2007

Auscultation of velcro crackles is associated with usual interstitial pneumonia

Auscultation of Velcro crackles has been proposed as a key finding in physical lung examination in patients with interstitial lung diseases (ILDs), especially in idiopathic pulmonary fibrosis (IPF). However, no studies have been carried out to assess the association of Velcro crackles with other clinical variables. We evaluated a cohort of 132 patients, prospectively and consecutively included in our ILD diagnostic program at a tertiary referral center. All patients were auscultated during the physical examination. The patients were divided into 2 groups: "presence" or "nonpresence" of bilateral Velcro crackles. Of all patients assessed, 83 (63%) presented Velcro crackles in the respiratory auscultation. Patients with Velcro crackles usually had more frequently cough and dyspnea at the moment of diagnosis. Forced vital capacity (P = 0.002) and lung diffusion capacity for carbon monoxide (P = 0.04) was lower in these patients. The ILD-GAP index was higher in the group with Velcro crackles (P = 0.01). All patients with usual interstitial pneumonia (UIP) in high-resolution computed tomography and all patients with final IPF diagnosis presented Velcro crackles. In multivariate analysis, the presence of Velcro crackles was independently associated with an UIP pattern. In patients suspected of having ILD, the auscultation of Velcro crackles was associated with UIP, a possibility which must be taken into consideration in early ILD detection in primary care

Sensitivity to light sterile neutrino mixing parameters with KM3NeT/ORCA

[EN] KM3NeT/ORCA is a next-generation neutrino telescope optimised for atmospheric neutrino oscillations studies. In this paper, the sensitivity of ORCA to the presence of a light sterile neutrino in a 3+1 model is presented. After three years of data taking, ORCA will be able to probe the active-sterile mixing angles ¿¿¿, ¿¿¿, ¿¿¿ and the effective angle ¿µ¿, over a broad range of mass squared difference ¿m² ~ [10¿5, 10] eV2, allowing to test the eV-mass sterile neutrino hypothesis as the origin of short baseline anomalies, as well as probing the hypothesis of a very light sterile neutrino, not yet constrained by cosmology. ORCA will be able to explore a relevant fraction of the parameter space not yet reached by present measurements.The authors acknowledge the financial support of the funding agencies: Agence Nationale de la Recherche (contract ANR-15-CE31-0020), Centre National de la Recherche Scientifique (CNRS), Commission Europeenne (FEDER fund and Marie Curie Program), Institut Universitaire de France (IUF), LabEx UnivEarthS (ANR-10-LABX-0023 and ANR-18-IDEX-0001), Paris Ile-de-France Region, France; Shota Rustaveli National Science Foundation of Georgia (SRNSFG, FR-18-1268), Georgia; Deutsche Forschungsgemeinschaft (DFG), Germany; The General Secretariat of Research and Technology (GSRT), Greece; Istituto Nazionale di Fisica Nucleare (INFN), Ministero dell'Universita e della Ricerca (MIUR), PRIN 2017 program (Grant NAT-NET 2017W4HA7S) Italy; Ministry of Higher Education Scientific Research and Professional Training, ICTP through Grant AF-13, Morocco; Nederlandse organisatie voor Wetenschappelijk Onderzoek (NWO), the Netherlands; The National Science Centre, Poland (2015/18/E/ST2/00758); National Authority for Scientific Research (ANCS), Romania; Ministerio de Ciencia, Innovacion, Investigacion y Universidades (MCIU): Programa Estatal de Generacion de Conocimiento (refs. PGC2018-096663-B-C41, -A-C42, -B-C43, -B-C44) (MCIU/FEDER), Generalitat Valenciana: Prometeo (PROMETEO/2020/019), Grisolia (ref. GRISOLIA/2018/119) and GenT (refs. CIDEGENT/2018/034,/2019/043,/2020/049) programs, Junta de Andalucia (ref. A-FQM-053-UGR18), La Caixa Foundation (ref. LCF/BQ/IN17/11620019), EU: MSC program (ref. 101025085), Spain.Aiello, S.; Albert, A.; Alshamsi, M.; Alves Garre, S.; Aly, Z.; Ambrosone, A.; Ameli, F.... (2021). Sensitivity to light sterile neutrino mixing parameters with KM3NeT/ORCA. Journal of High Energy Physics (Online). 10:1-22. https://doi.org/10.1007/JHEP10(2021)1801221