Practical Guidelines for Perioperative Hypersensitivity Reactions

Perioperative hypersensitivity reactions constitute a first-line problem for anesthesiologists and allergists. Therefore, hospitals should have a consensus protocol for the diagnosis and management of these reactions. However, this kind of protocol is not present in many hospitals, leading to problems with treatment, reporting of incidents, and subsequent etiological diagnosis. In this document, we present a systematic review of the available scientific evidence and provide general guidelines for the management of acute episodes and for referral of patients with perioperative hypersensitivity reactions to allergy units. Members of the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) have created this document in collaboration with members of the Spanish Anesthesia Society (SEDAR). A practical algorithm is proposed for the etiologic diagnosis, and recommendations are provided for the management of hypersensitive patients

Effect of nucleon exchange on projectile multifragmentation in the reactions of 28Si + 112Sn and 124Sn at 30 and 50 MeV/nucleon

Multifragmentation of quasiprojectiles was studied in reactions of 28Si beam with 112Sn and 124Sn targets at projectile energies 30 and 50 MeV/nucleon. The quasiprojectile observables were reconstructed using isotopically identified charged particles with Z_f <= 5 detected at forward angles. The nucleon exchange between projectile and target was investigated using isospin and excitation energy of reconstructed quasiprojectile. For events with total reconstructed charge equal to the charge of the beam (Z_tot = 14) the influence of beam energy and target isospin on neutron transfer was studied in detail. Simulations employing subsequently model of deep inelastic transfer, statistical model of multifragmentation and software replica of FAUST detector array were carried out. A concept of deep inelastic transfer provides good description of production of highly excited quasiprojectiles. The isospin and excitation energy of quasiprojectile were described with good overall agreement. The fragment multiplicity, charge and isospin were reproduced satisfactorily. The range of contributing impact parameters was determined using backtracing procedure.Comment: 11 pages, 8 Postscript figures, LaTeX, to appear in Phys. Rev. C ( Dec 2000

Thermal excitation of heavy nuclei with 5-15 GeV/c antiproton, proton and pion beams

Excitation-energy distributions have been derived from measurements of 5.0-14.6 GeV/c antiproton, proton and pion reactions with $^{197}$Au target nuclei, using the ISiS 4$\pi$ detector array. The maximum probability for producing high excitation-energy events is found for the antiproton beam relative to other hadrons, $^3$He and $\bar{p}$ beams from LEAR. For protons and pions, the excitation-energy distributions are nearly independent of hadron type and beam momentum above about 8 GeV/c. The excitation energy enhancement for $\bar{p}$ beams and the saturation effect are qualitatively consistent with intranuclear cascade code predictions. For all systems studied, maximum cluster sizes are observed for residues with E*/A $\sim$ 6 MeV.Comment: 14 pages including 5 figures and 1 table. Accepted in Physics Letter B. also available at http://nuchem.iucf.indiana.edu

Immunomodulatory effect of gut microbiota-derived bioactive peptides on human immune system from healthy controls and patients with inflammatory bowel disease

Bioactive peptides secreted by probiotic Bifidobacterium longum (peptide B7) and opportunistic pathogen Bacteroides fragilis (peptide B12) modulate the intestinal cytokine milieu in health. Here, we characterized their capacity to modulate both the mucosal cytokine production and the phenotype of circulating antigen presenting cells (APCs) in active inflammatory bowel disease (IBD). The IBD mucosa produced higher levels of pro-inflammatory cytokines referred to healthy controls (HCs). Peptides B7 and B12, however, did not ameliorate the mucosal cytokine milieu in IBD. Human circulating APCs (B-cells, monocytes, plasmacytoid dendritic cells (pDCs), and conventional dendritic cells (cDCs)) were characterized by flow cytometry in presence/absence of the peptides. Circulating B-cells, monocytes, and cDCs from IBD patients were more activated than those from HCs. Peptide B7, but not B12, decreased CCR2 expression on all APC subsets from HC, but not IBD patients. Moreover, both peptides tend to further increase their pro-inflammatory profile in IBD. In summary, IBD patients display mucosal and circulating APC pro-inflammatory properties. Peptide B7 immunomodulatory capacity elicited over circulating APCs from HC, but not IBD patients, suggests the presence of disrupted modulatory mechanisms for this peptide in IBD. Future studies should address the effect of bacteria-derived immunomodulatory peptides in non-inflamed (quiescent) IBD patientsThis work was supported by the Spanish Ministry of Economy (SAF2014-56642-JIN), the Spanish Ministry of Health (PIE13/00041), GETECCU (Grupo Español de Trabajo en Enfermedad Crohn y Colitis Ulcerosa), and the Community of Madrid (Consejería de Educación, Juventud y Deporte, Programa de Garantía Juvenil 2015 and 2016)

Inhomogeneous isospin distribution in the reactions of 28Si + 112Sn and 124Sn at 30 and 50 MeV/nucleon

We have created quasiprojectiles of varying isospin via peripheral reactions of 28Si + 112Sn and 124Sn at 30 and 50 MeV/nucleon. The quasiprojectiles have been reconstructed from completely isotopically identified fragments. The difference in N/Z of the reconstructed quasiprojectiles allows the investigation of the disassembly as a function of the isospin of the fragmenting system. The isobaric yield ratio 3H/3He depends strongly on N/Z ratio of quasiprojectiles. The dependences of mean fragment multiplicity and mean N/Z ratio of the fragments on N/Z ratio of the quasiprojectile are different for light charged particles and intermediate mass fragments. Observation of a different N/Z ratio of light charged particles and intermediate mass fragments is consistent with an inhomogeneous distribution of isospin in the fragmenting system.Comment: 5 pages, 4 Postscript figures, RevTe

Nationalism, resistance, and patriarchy: the poetry of Saharawi women

The arts, and in particular poetry, have been swords of resistance for the Saharawis since the 1975 Moroccan and Mauritanian invasion and subsequent occupation of their country. In this article, I aim to investigate whether Saharawi women writers go further than the more common objects of Saharawi resistance and fight against patriarchy. Firstly, I focus on the work of the Saharawi 'Friendship Generation' of writers, exploring the Generation's collective (nationalist) aims. Secondly, I look at the construction of gender in Saharawi poetry, analysing how gender, particularly the idea of woman and femininity, are imagined according to the sex-identification of the author

Signals for a Transition from Surface to Bulk Emission in Thermal Multifragmentation

Excitation-energy-gated two-fragment correlation functions have been studied between 2 to 9A MeV of excitation energy for equilibrium-like sources formed in $\pi^-$ and p + $^{197}$Au reactions at beam momenta of 8,9.2 and 10.2 GeV/c. Comparison of the data to an N-body Coulomb-trajectory code shows a decrease of one order of magnitude in the fragment emission time in the excitation energy interval 2-5A MeV, followed by a nearly constant breakup time at higher excitation energy. The observed decrease in emission time is shown to be strongly correlated with the increase of the fragment emission probability, and the onset of thermally-induced radial expansion. This result is interpreted as evidence consistent with a transition from surface-dominated to bulk emission expected for spinodal decomposition.Comment: 11 pages including 3 postscript figures (1 color

Optimal stomatal behaviour around the world

© 2015 Macmillan Publishers Limited. All rights reserved. Stomatal conductance (g s) is a key land-surface attribute as it links transpiration, the dominant component of global land evapotranspiration, and photosynthesis, the driving force of the global carbon cycle. Despite the pivotal role of g s in predictions of global water and carbon cycle changes, a global-scale database and an associated globally applicable model of g s that allow predictions of stomatal behaviour are lacking. Here, we present a database of globally distributed g s obtained in the field for a wide range of plant functional types (PFTs) and biomes. We find that stomatal behaviour differs among PFTs according to their marginal carbon cost of water use, as predicted by the theory underpinning the optimal stomatal model and the leaf and wood economics spectrum. We also demonstrate a global relationship with climate. These findings provide a robust theoretical framework for understanding and predicting the behaviour of g s across biomes and across PFTs that can be applied to regional, continental and global-scale modelling of ecosystem productivity, energy balance and ecohydrological processes in a future changing climate

A Primary Prevention Clinical Risk Score Model for Patients With Brugada Syndrome (BRUGADA-RISK)

OBJECTIVES: The goal of this study was to develop a risk score model for patients with Brugada syndrome (BrS). BACKGROUND: Risk stratification in BrS is a significant challenge due to the low event rates and conflicting evidence. METHODS: A multicenter international cohort of patients with BrS and no previous cardiac arrest was used to evaluate the role of 16 proposed clinical or electrocardiogram (ECG) markers in predicting ventricular arrhythmias (VAs)/sudden cardiac death (SCD) during follow-up. Predictive markers were incorporated into a risk score model, and this model was validated by using out-of-sample cross-validation. RESULTS: A total of 1,110 patients with BrS from 16 centers in 8 countries were included (mean age 51.8 ± 13.6 years; 71.8% male). Median follow-up was 5.33 years; 114 patients had VA/SCD (10.3%) with an annual event rate of 1.5%. Of the 16 proposed risk factors, probable arrhythmia-related syncope (hazard ratio [HR]: 3.71; p < 0.001), spontaneous type 1 ECG (HR: 3.80; p < 0.001), early repolarization (HR: 3.42; p < 0.001), and a type 1 Brugada ECG pattern in peripheral leads (HR: 2.33; p < 0.001) were associated with a higher risk of VA/SCD. A risk score model incorporating these factors revealed a sensitivity of 71.2% (95% confidence interval: 61.5% to 84.6%) and a specificity of 80.2% (95% confidence interval: 75.7% to 82.3%) in predicting VA/SCD at 5 years. Calibration plots showed a mean prediction error of 1.2%. The model was effectively validated by using out-of-sample cross-validation according to country. CONCLUSIONS: This multicenter study identified 4 risk factors for VA/SCD in a primary prevention BrS population. A risk score model was generated to quantify risk of VA/SCD in BrS and inform implantable cardioverter-defibrillator prescription