The management of postoperative pain in children with caudal blocks

Background: The aim of this study was to evaluate the pre-emptive analgesic effect and duration of postoperative analgesia after caudal blocks in children. Method: Forty-five children undergoing distal hypospadias surgery were assigned to group 1 (n = 23), and received caudal 0.25% bupivacaine 0.5 mg/kg and midazolam 0.05 mg/kg before the surgical incision. Group 2 (n = 22) received caudal 0.25% bupivacaine 0.5 mg/kg and midazolam 0.05 mg/kg at the end of surgery. Anaesthesia was induced with propofol and fentanyl and maintained with sevoflurane and nitrous oxide. Postoperative pain was rated on an objective paediatric pain scale. Results: The analgesic requirement was greater in the second group. Conclusion: Pre-emptive analgesia with caudal blocks may prevent the intensity and frequency of postoperative wound pain.South Afr J Anaesth Analg, 2011;17(6):376-37

Cumulant based parametric multichannel FIR system identification methods

Cataloged from PDF version of article.In this paper, ''least squares'' and recursive methods for simultaneous identification of four nonminimum phase linear, time-invariant FIR systems are presented. The methods utilize the second- and fourth-order cumulants of outputs of the four FIR systems of which the common input is an independent, identically distributed (i.i.d.) non-Gaussian process. The new methods can be extended to the general problem of simultaneous identification of three or more FIR systems by choosing the order of the utilized cumulants to be equal to the number of systems. To illustrate the effectiveness of our methods, two simulation examples are included

Long-term effects of neoadjuvant chemoradiotherapy followed by sphincter-preserving resection on anal sphincter function in relation to quality of life among locally advanced rectal cancer patients: a cross-sectional analysis

BACKGROUND: There is growing recognition for the consequences of rectal cancer treatment to maintain an adequate functional sphincter in the long-term rather than preserving the anal sphincter itself. This study aims to evaluate long-term effects of neoadjuvant chemoradiotherapy (nCRT) followed by sphincter-preserving resection on anal sphincter function in relation to quality of life (QoL) among locally advanced rectal cancer patients. METHODS: Twenty-nine patients treated with nCRT followed by low anterior resection surgery were included in this study. Data on patient demographics, tumor location and symptoms of urgency and fecal soiling were recorded and evaluated with respect to Wexner Fecal Incontinence Scoring Scale, European Organization for Research and Cancer (EORTC) cancer-specific (EORTC QLQ-C30) and colorectal cancer-specific (EORTC QLQ-CR38) questionnaires and anorectal manometrical findings. Correlation of manometrical findings with Wexner Scale, EORTC QLQ-CR38 scores and EORTC QLQ-C30 scores was also evaluated. RESULTS: Median follow-up was 45.6 months (ranged 7.5–98 months. Higher scores for incontinence for gas (p = 0.001), liquid (p = 0.048) and solid (p = 0.019) stool, need to wear pad (p = 0.001) and alteration in life style (p = 0.004) in Wexner scale, while lower scores for future perspective (p = 0.010) and higher scores for defecation problems (p = 0.001) in EORTC QLQ-CR38 were noted in patients with than without urgency. Manometrical findings of resting pressure (mmHg) was positively correlated with body image (r = 0.435, p = 0.030) and sexual functioning (r = 0.479, p = 0.011) items of functional scale, while rectal sensory threshold (RST) volume (mL) was positively correlated with defecation problems (r = 0.424, p = 0.031) items of symptom scale in EORTC QLQ-CR38 and negatively correlated with social function domain (r = −0.479, p = 0.024) in EORTC QLQ-C30. RST volume was also positively correlated with Wexner scores including incontinence for liquid stool (r = 0.459, p = 0.024), need to wear pad (r = 0.466, p = 0.022) and alteration in lifestyle (r = 0.425, p = 0.038). CONCLUSION: The high risk of developing functional anal impairment as well as the systematic registration of not only oncological but also functional and QoL related outcomes seem important in rectal cancer patients in the long-term disease follow-up

Resveratrol-loaded solid lipid nanoparticles versus nanostructured lipid carriers: evaluation of antioxidant potential for dermal applications

Evren H Gokce1, Emrah Korkmaz1, Eleonora Dellera2, Giuseppina Sandri2, M Cristina Bonferoni2, Ozgen Ozer11Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey; 2Department of Drug Sciences, University of Pavia, Pavia, ItalyBackground: Excessive generation of radical oxygen species (ROS) is a contributor to skin pathologies. Resveratrol (RSV) is a potent antioxidant. Solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) can ensure close contact and increase the amount of drug absorbed into the skin. In this study, RSV was loaded into SLN and NLC for dermal applications.Methods: Nanoparticles were prepared by high shear homogenization using Compritol 888ATO, Myglyol, Poloxamer188, and Tween80. Particle size (PS), polydispersity index (PI), zeta potential (ZP), drug entrapment efficiency (EE), and production yield were determined. Differential scanning calorimetry (DSC) analysis and morphological transmission electron microscopy (TEM) examination were conducted. RSV concentration was optimized with cytotoxicity studies, and net intracellular accumulation of ROS was monitored with cytofluorimetry. The amount of RSV was determined from different layers of rat abdominal skin.Results: PS of uniform RSV-SLN and RSV-NLC were determined as 287.2 nm ± 5.1 and 110.5 nm ± 1.3, respectively. ZP was –15.3 mV ± 0.4 and –13.8 mV ± 0.1 in the same order. The drug EE was 18% higher in NLC systems. TEM studies showed that the drug in the shell model was relevant for SLN, and that the melting point of the lipid in NLC was slightly lower. Concentrations below 50 µM were determined as suitable RSV concentrations for both SLN and NLC in cell culture studies. RSV-NLC showed less fluorescence, indicating less ROS production in cytofluorometric studies. Ex vivo skin studies revealed that NLC are more efficient in carrying RSV to the epidermis.Conclusion: This study suggests that both of the lipid nanoparticles had antioxidant properties at a concentration of 50 µM. When the two systems were compared, NLC penetrated deeper into the skin. RSV-loaded NLC with smaller PS and higher drug loading appears to be superior to SLN for dermal applications.Keywords: solid lipid nanoparticles, nanostructured lipid carriers, resveratro

Fattori di emissione dalla combustione di legna e pellet in piccoli apparecchi domestici

The aim of this study was to report emission factors of pollutants (i.e., carbon monoxide, nitrogen oxides, non-methane hydrocarbons, particulate matter, polycyclic aromatic hydrocarbons, dioxins) from biomass burning residential heating appliances. The influence of several factors such as biomass type, appliance and combustion cycle was investigated. Four manually fed (6-11 kW) firewood burning and two automatic wood pellets (8.8-25 kW) appliances were tested under real-world operating conditions in order to determine the actual environmental performance of the appliance. The experimental EFs were also compared with the values proposed by the European emission inventory guidebook used in the local inventory in order to evaluate their representativeness of real world emissions. The composite macropollutant EFs for manually fed appliances are: for CO 5858 g GJ-1, for NOx 122 g GJ-1, NMHC 542 g GJ-1, PM 254 g GJ-1, whereas emissions are much lower for automatic pellets appliances: CO 219 g GJ-1, for NOx 66 g GJ-1, NMHC 5 g GJ-1, PM 85 g GJ-1. The open fireplace appears to have very high emission factors, however traditional and advanced stoves show the highest overall CO EFs. Especially for the advanced stove real-world emissions are far worse than those measured under cycles used for type testing of residential solid fuel appliances. No great difference is observed for different firewood types in batch working appliances, diversely the quality of the pellets is observed to influence directly the emission performance of the automatic appliances. Benzo(b)fluoranthene is the PAH with the highest contribution (110 mg GJ-1 for manual appliances and 2 mg GJ-1 for automatic devices) followed by benzo(a)pyrene (77 mg GJ-1 for manual appliances and 0,8 mg GJ-1 for automatic devices)

New FIP resources to advance pharmacy education and early career development

During the COVID-19 pandemic, FIP Education (FIPEd) continued to produce reports, guidance documents, toolkits, and virtual programmes to advance pharmacy education and early career development.peer-reviewe