Re-Evaluation of the Role of Antifibrinolytic Therapy with Lysine Analogs in Liver Transplantation in The Post-Aprotinin Era

Purpose of review: Hemorrhage, blood and blood product transfusions and the need for surgical re-exploration for bleeding can have a detrimental effect on patient outcome during liver surgery. Following the suspension of aprotinin from the market only the antifibrinolyticstranexamic acid (TA) and epsilon-aminocaproic acid (EACA) are left as pharmacological options to reduce hemostatic activation and associated bleeding complications. Considering the apparent usefulnes of aprotinin in liver surgery and transplantation, its loss has left a void within the armamentarium of drugs available to reduce blood loss. The need for large independent safety studies has become evident. The current review focuses on the drugs that are available, the safety and efficacydata that supports their use and the indications warranting further trailsRecent findings Both TA and EACA are effective in reducing blood loss and transfusion requirements in liver surgery. Analysis of data is complicated as the dosing regimens, especially for tranexamic acid, varies enormously and the agents are highly overdosed in most relevant trials. New data indicates that in a dose-dependent fashion, TA is associated with an increase in adverse events with transient renal failure highlighted as a particular problem. It appears that all the anti-fibrinolyticshave side effects that may impact on morbidity and mortality and it may be that aprotinin is no worse. The use of these agents needs to be balanced against benefitespecially in the management of high risk cases

Uso de las nuevas tecnologías en el proceso de enseñanza-aprendizaje de las asignaturas de estructuras

Mediante esta ponencia se pretende hacer hincapié en que las tradicionales clases presenciales de las asignaturas de Estructuras de la Edificación, I y II, se pueden complementar con el uso de programas informáticos: de simulaciones multimedia, y los de cálculo y/o dimensionamiento de elementos estructurales; los cuales permiten que la transmisión de contenidos teóricos y prácticos, a los alumnos, se realice de una forma más amena, concisa y clara. Es de destacar que el uso de las nuevas tecnologías, es una de las herramientas con las que podemos contar para reforzar el proceso de enseñanza-aprendizaje que nos demandará la nueva titulación de Ingeniero de Edificación; todo esto dentro del nuevo Espacio Europeo de Educación Superior, que estamos por iniciar.Consejo General de la Arquitectura Técnica de Españ

Power line electrocution as an overlooked threat to Lear's Macaw (Anodorhynchus leari)

Electrocution can pose a serious threat to large birds, particularly threatened species with low population sizes. However, few studies have focused on the impacts of electrocution on large parrots such as the Endangered Lear's Macaw Anodorhynchus leari, endemic to the Brazilian Caatinga. Here, we compile and describe 31 electrocution events, as reported by villagers, indicating that electrocution may be an important threat to Lear's Macaw. We suggest a research and monitoring agenda to better understand the spatial and temporal patterns of this impact and recommend some immediate mitigation measures for decreasing electrocutions.info:eu-repo/semantics/submittedVersio

Beaked whales respond to simulated and actual navy sonar

This article is distributed under the terms of the Creative Commons Public Domain declaration. The definitive version was published in PLoS One 6 (2011): e17009, doi:10.1371/journal.pone.0017009.Beaked whales have mass stranded during some naval sonar exercises, but the cause is unknown. They are difficult to sight but can reliably be detected by listening for echolocation clicks produced during deep foraging dives. Listening for these clicks, we documented Blainville's beaked whales, Mesoplodon densirostris, in a naval underwater range where sonars are in regular use near Andros Island, Bahamas. An array of bottom-mounted hydrophones can detect beaked whales when they click anywhere within the range. We used two complementary methods to investigate behavioral responses of beaked whales to sonar: an opportunistic approach that monitored whale responses to multi-day naval exercises involving tactical mid-frequency sonars, and an experimental approach using playbacks of simulated sonar and control sounds to whales tagged with a device that records sound, movement, and orientation. Here we show that in both exposure conditions beaked whales stopped echolocating during deep foraging dives and moved away. During actual sonar exercises, beaked whales were primarily detected near the periphery of the range, on average 16 km away from the sonar transmissions. Once the exercise stopped, beaked whales gradually filled in the center of the range over 2–3 days. A satellite tagged whale moved outside the range during an exercise, returning over 2–3 days post-exercise. The experimental approach used tags to measure acoustic exposure and behavioral reactions of beaked whales to one controlled exposure each of simulated military sonar, killer whale calls, and band-limited noise. The beaked whales reacted to these three sound playbacks at sound pressure levels below 142 dB re 1 µPa by stopping echolocation followed by unusually long and slow ascents from their foraging dives. The combined results indicate similar disruption of foraging behavior and avoidance by beaked whales in the two different contexts, at exposures well below those used by regulators to define disturbance.The research reported here was financially supported by the United States (U.S.) Office of Naval Research (www.onr.navy.mil) Grants N00014-07-10988, N00014-07-11023, N00014-08-10990; the U.S. Strategic Environmental Research and Development Program (www.serdp.org) Grant SI-1539, the Environmental Readiness Division of the U.S. Navy (http://www.navy.mil/local/n45/), the U.S. Chief of Naval Operations Submarine Warfare Division (Undersea Surveillance), the U.S. National Oceanic and Atmospheric Administration (National Marine Fisheries Service, Office of Science and Technology) (http://www.st.nmfs.noaa.gov/), U.S. National Oceanic and Atmospheric Administration Ocean Acoustics Program (http://www.nmfs.noaa.gov/pr/acoustics/), and the Joint Industry Program on Sound and Marine Life of the International Association of Oil and Gas Producers (www.soundandmarinelife.org)

Continuous i.v. infusion of remifentanil and intraosseous lidocaine provide better analgesia than intraosseous lidocaine alone in percutaneous vertebroplasty of osteoporotic fractures

Editor—Several methods have been reported for providing anaesthesia for percutaneous vertebroplasty (PV). These include local anaesthesia alone, 1 local anaesthesia and sedation, 2 3 and general anaesthesia. 4 Sesay and colleagues 5 reported that intraosseous lidocaine provides effective analgesia in 84% of patients undergoing PV and the addition of i.v. boluses of propofol was required in about 10% of patients. Target-controlled infusions (TCI) of remifentanil in conscious sedation regimes is reported in other settings, 6 but conscious sedation with remifentanil infusion during the PV with local anaesthesia has not been evaluated. Our objectives were to evaluate the safety and efficacy of analgesia with intraosseous lidocaine associated with TCI remifentanil i.v. (ILR), compared with intraosseous lidocaine (IL) alone during PV for osteoporotic fractures

Correlating military sonar use with beaked whale mass strandings: What do the historical data show?

There have been several incidents in which U.S. Navy sonar operations at sea coincided in time and location with a mass stranding of marine mammals, particularly beaked whales. Although a conclusive cause-and-effect relationship has not been established, there is strong evidence and scientific concern that use of military sonar has resulted in beaked whale mass strandings. Most previous attempts to determine whether military sonar use and whale strandings are correlated have looked at mass stranding records of beaked whales and have singled out those instances in which military operations appear to coincide in time and location with a mass stranding event. In this study, historical data on beaked whale mass strandings and military exercises that were likely to include active sonar use were compiled, and statistical analyses were performed to determine the level of correlation between these events for four geographic regions. Strandings were significantly correlated with naval activity in the Mediterranean and Caribbean Seas, but not off the coasts of Japan and southern California

Pheromone of the banana-spotting bug, Amblypelta lutescens lutescens Distant (Heteroptera: Coreidae): identification, synthesis, and field bioassay

The banana-spotting bug, Amblypelta lutescens lutescens Distant (Heteroptera: Coreidae), is one of the principal pests of tree fruits and nuts across northern and eastern Australia. Apart from visual damage assessment, there are currently no reliable methods for monitoring bug activity to aid management decisions. An attractant pheromone for this species that could be used as a trap lure could potentially fill this void. Earlier, two male-specific compounds were identified in airborne extracts from A. lutescens lutescens, (E,E)-α-farnesene and (R,E)-nerolidol; an unknown compound with a molecular weight 220 was also detected. We now report the identification of this hitherto unknown compound as (R,E,E)-α-farnesene-10,11-oxide. Synthesis of this epoxide was conducted using a regioselective asymmetric dihydroxylation of a sulfolene. A blend mimicking the natural proportions of (E,E)-α-farnesene, (R,E)-nerolidol, and (R,E,E)-α-farnesene-10,11- oxide attracted male and female A. lutescens lutescens as well as nymphs in the field, verifying that the aggregation pheromone comprises or is contained within this group of compounds. Copyrigh