173 research outputs found
Current trends in vasopressor use to the operating room : a pharmacoepidemiologic study in French teaching and military hospitals
Objectives:
Phenylephrine, ephedrine and norepinephrine are the vasopressors most commonly used in the operating room to treat anaesthesia-induced hypotension. Two new diluted forms of phenylephrine were released in 2011 (500 μg/10 mL and 500 μg/5 mL). We initiated a study to evaluate trends in the use of vasopressors in the operating room in French hospitals over the period 2011–2014.
Methods:
We conducted a longitudinal, retrospective, observational study between 2011 and 2014 in French teaching and military hospitals. A questionnaire was sent in February 2015 to hospital pharmacists of each centre to retrospectively collect the consumption of each type of vasopressor. Yearly numbers of vasopressor ampoules were divided by the yearly numbers of anaesthetics recorded. For each vasopressor, we calculated the number of ampoules per 100 anaesthetics recorded (/100A).
Results:
Thirty-two hospitals (82%) completed the questionnaire. One hundred per cent of hospitals had registered the diluted form of phenylephrine (61% had chosen the dilution 500 μg/10 mL), whereas concentrated ampoules were available in 68% of hospitals. Over the period, an exponential increase in the use of diluted phenylephrine was observed (from 1.0 ampoule/100A in 2012 to 31.7 in 2014), the use of ephedrine remained stable (26 ampoules and 17 prefilled syringe/100A), and use of norepinephrine trended upwards (from 6.7 to 8.2 ampoules/100A).
Conclusions:
The use of diluted phenylephrine has exponentially increased without reducing consumption of other vasopressors. This trend might be secondary to practice changes in hypotension treatment following the release of French guidelines in 2013 related to fluid management, the restriction of indications of hydroxylethyl-starch solutions in 2013, and a better knowledge of the benefit of blood pressure optimisation to reduce postoperative morbidity
Imaging the essential role of spin-fluctuations in high-Tc superconductivity
We have used scanning tunneling spectroscopy to investigate short-length
electronic correlations in three-layer Bi2Sr2Ca2Cu3O(10+d) (Bi-2223). We show
that the superconducting gap and the energy Omega_dip, defined as the
difference between the dip minimum and the gap, are both modulated in space
following the lattice superstructure, and are locally anti-correlated. Based on
fits of our data to a microscopic strong-coupling model we show that Omega_dip
is an accurate measure of the collective mode energy in Bi-2223. We conclude
that the collective mode responsible for the dip is a local excitation with a
doping dependent energy, and is most likely the (pi,pi) spin resonance.Comment: 4 pages, 4 figure
Diamagnetism above Tc in underdoped Bi2.2Sr1.8Ca2Cu3O10+d
Single crystals of (Bi2223) with were grown by a traveling solvent floating
zone method in order to investigate the superconducting properties of highly
underdoped Bi2223.Grown crystals were characterized by X-ray diffraction, DC
susceptibility and resistivity measurements, confirming Bi2223 to be the main
phase.The crystals were annealed under various oxygen partial pressures to
adjust their carrier densities from optimally doped to highly underdoped.The
fluctuation diamagnetic component above the superconducting transition
temperature extracted from the anisotropic normal state
susceptibilities () and ()
was found to increase with underdoping, suggesting a decrease in the
superconducting dimensionality and/or increase in the fluctuating vortex liquid
region.Comment: 6 pages, 7 figures, corrected fig.4 and references, published in J.
Phys. Soc. Jpn. 79, 114711 (2010
Parasite infection is associated with Kaposi's sarcoma associated herpesvirus (KSHV) in Ugandan women
Background:
Immune modulation by parasites may influence susceptibility to bacteria and viruses. We examined the association between current parasite infections, HIV and syphilis (measured in blood or stool samples using standard methods) and antibodies against Kaposi's sarcoma herpesvirus (KSHV), measured by ELISA, in 1915 stored plasma samples from pregnant women in Entebbe, Uganda.<p></p>
Results:
Seroprevalence of KSHV was higher in women with malaria parasitaemia (73% vs 60% p = 0.01), hookworm (67% vs 56% p = 0.001) and Mansonella perstans (69% vs 59% p = 0.05); seroprevalence increased with increasing intensity of hookworm infection (p < 0.001[trend]). No associations were found for HIV, five other parasites or active syphilis. These effects were not explained by socioeconomic status or education.<p></p>
Conclusions:
Specific parasite infections are associated with presence of antibodies against KSHV, perhaps mediated via their effect on immune function.<p></p>
Suppression of circulating IgD+CD27+ memory B cells in infants living in a malaria-endemic region of Kenya
Background: Plasmodium falciparum infection leads to alterations in B cell subset distribution. During infancy,
development of peripheral B cell subsets is also occurring. However, it is unknown if infants living a malaria
endemic region have alterations in B cell subsets that is independent of an age effect.
Methods: To evaluate the impact of exposure to P. falciparum on B cell development in infants, flow cytometry
was used to analyse the distribution and phenotypic characteristic of B cell subsets in infant cohorts prospectively
followed at 12, 18 and 24 months from two geographically proximate regions in western Kenya with divergent
malaria exposure i.e. Kisumu (malaria-endemic, n = 24) and Nandi (unstable malaria transmission, n = 21).
Results: There was significantly higher frequency and absolute cell numbers of CD19+ B cells in Kisumu relative to
Nandi at 12(p = 0.0440), 18(p = 0.0210) and 24 months (p = 0.0493). No differences were observed between the
infants from the two sites in frequencies of naïve B cells (IgD+CD27-) or classical memory B cells (IgD-CD27+).
However, immature transitional B cells (CD19+CD10+CD34-) were higher in Kisumu relative to Nandi at all three
ages. In contrast, the levels of non-class switched memory B cells (CD19+IgD+CD27+) were significantly lower
overall in Kisumu relative to Nandi at significantly at 12 (p = 0.0144), 18 (p = 0.0013) and 24 months (p = 0.0129).
Conclusions: These data suggest that infants living in malaria endemic regions have altered B cell subset
distribution. Further studies are needed to understand the functional significance of these changes and long-term
impact on ability of these infants to develop antibody responses to P. falciparum and heterologous infections
Amiloride Enhances Antigen Specific CTL by Faciliting HBV DNA Vaccine Entry into Cells
The induction of relatively weak immunity by DNA vaccines in humans can be largely attributed to the low efficiency of transduction of somatic cells. Although formulation with liposomes has been shown to enhance DNA transduction of cultured cells, little, if any, effect is observed on the transduction of somatic tissues and cells. To improve the rate of transduction, DNA vaccine delivery by gene gun and the recently developed electroporation techniques have been employed. We report here that to circumvent requirement for such equipment, amiloride, a drug that is prescribed for hypertension treatment, can accelerate plasmid entry into antigen presenting cells (APCs) both in vitro and in vivo. The combination induced APCs more dramatically in both maturation and cytokine secretion. Amiloride enhanced development of full CD8 cytolytic function including induction of high levels of antigen specific CTL and expression of IFN-γ+perforin+granzymeB+ in CD8+ T cells. Thus, amiloride is a facilitator for DNA transduction into host cells which in turn enhances the efficiency of the immune responses
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