General anesthesia soon after dialysis may increase postoperative hypotension - A pilot study.

IntroductionPilot study associating hemodialysis-to-general-anesthesia time interval and post-operative complications in hemodialysis patients to better define a more optimal pre-anesthetic waiting period.MethodsPre-anesthetic and 48-hours post-anesthetic parameters (age, gender, body-mass-index, pre-operative ultrafiltrate, potassium, renal disease etiology, hemodialysis sessions per week, Acute Physiology and Chronic Health Evaluation-II score, Portsmouth-Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity, American Society of Anesthesiologists physical status, Johns Hopkins Surgical Classification System Category, surgical urgency, intra-operative fluids, estimated blood loss, post-operative complications) were collected on chronic hemodialysis patients between 11/2009-12/2010. Continuous data were analyzed by Analysis of Variance or t-test. Bivariate data were analyzed by Fisher's Exact Test. Relative Risks/Confidence Intervals were calculated for statistically significant comparisons (p=0.05). Exclusion criteria were incomplete records, peritoneal dialysis, intra-operative hemodialysis, liver transplant, and cardiopulmonary bypass.ResultsPatients were grouped by dialysis to anesthesia time interval: Group 1 >24 hours, Group 2 7-23.9 hours, Group 3 < 7 hours. Among Surgical Category 3-5 patients, hypotension was more common in Group 3 than Group 1 (63.6% vs 9.2%, p<0.0001, relative risk=6.9, confidence interval=3.0-15.7) or Group 2 (63.6% vs 17.3%, p=0.0002, relative risk=3.7, confidence interval=1.9-7.2). Other complications rates were not statistically significant. Disease and surgical severity scores, preoperative ultrafiltrate, and intra-operative fluids were not different.ConclusionsPost-anesthetic hypotension within 48 hours was more common in those with < 7 hours interval between dialysis and anesthesia. Therefore, if surgical urgency permits, a delay of ≥7 hours may limit postoperative hypotension. More precise associations should be obtained through a prospective study

Application of Factorial Design in Selective Laser Sintering

Selective Laser Sintering (SLS) is a complex process involving many process parameters. These parameters are not all independent. A factorial design technique is utilized to study the effects of three main process parameters, laser power, laser beam scanning speed, and powder packing density as well as their interactions on the sintering depth and fractional density. The results of this investigation provide useful information for the further experimental analysis of the process parameters and for selecting suitable parameters for SLS process.Mechanical Engineerin

Period halving of Persistent Currents in Mesoscopic Mobius ladders

We investigate the period halving of persistent currents(PCs) of non-interacting electrons in isolated mesoscopic M\"{o}bius ladders without disorder, pierced by Aharonov-Bhom flux. The mechanisms of the period halving effect depend on the parity of the number of electrons as well as on the interchain hopping. Although the data of PCs in mesoscopic systems are sample-specific, some simple rules are found in the canonical ensemble average, such as all the odd harmonics of the PCs disappear, and the signals of even harmonics are non-negative. {PACS number(s): 73.23.Ra, 73.23.-b, 68.65.-k}Comment: 6 Pages with 3 EPS figure