European Association of Cardiothoracic Anesthesiology and Intensive Care (EACTAIC) Fellowship Curriculum: Second Edition.

International audienceThis document represents the first update of the Cardiothoracic and Vascular Anaesthesia Fellowship Curriculum of the European Association of Cardiothoracic Anaesthesiology and Intensive Care. After obtaining feedback from exit interviews with fellows in training, graduate fellows, and program directors, 2 modified online Delphi procedures with questionnaires were conducted. A consensus was reached when two-thirds of responding committee members gave green or yellow ratings on a traffic light system, and >70% indicated strong agreement or agreement on a 5-point Likert scale. The new regulations include the following: (1) more flexibility in the fellows` rotation, as long as the total number of days, rotations, and cases are completed during the training year; (2) recommendation for strict compliance with national working-time guidelines; (3) no extension of fellowship training to compensate for annual and/or sick leave, unless the required minimum number of cases and rotations are not reached; (4) interruption of fellowship training for >12 months is allowed for personal or medical reasons; (5) introduction of a checklist for quantitative assessment of standard clinical skills; (6) recommendations for a uniform structure of exit interviews; (7) possibility of a 1-month training rotation in a postanesthesia care unit instead of an intensive care unit; and (8) provided all other requirements have been met, the allowance of progression from the basic training year to the advanced fellowship training year without first passing the transesophageal echocardiography examination

The Significance of a Triple Flexion Reflex in the Acute Spinal Cord Injured Patient: A Case Report and Review of the Literature

The TFR is a sign of upper motor neuron impairment. It does not typically appear for several days after an injury but in patients with pre-existing myelopathy, an early onset exaggerated Babinski response exhibited as a TFR may occur. It is important not to misinterpret such responses as volitional movements, particularly in patients with cognitive dysfunction where the history and physical examination may be limited. Failure to immobilize the spine and to administer adjunct steroid therapy may be detrimental to the patient. Education of initial response physicians may prevent overlooking an acute SCI

دراسة بتروجرافية لدولوميت العلمين ( الكريتاوى السفلى ) في حقل الرزاق، الصحراء الغربية - مصر

The origin and environment of deposition of the Alamein Dolomite in the El-Razzak Oil Field have been investigated by means of petrographic, chemical and X-ray analysis. The studied rocks are composed of dolomite with variable amounts of calcite, with anhydrite and iron oxide as minor minerals. Alamein Dolomite has been formed by replacement of limestones under a variety of conditions either penecontemporaneously or soon after deposition, or later through the action of ascending solution of either meteoric water or by hydrothermal solutions. Dolomitization took place in shallow, warm, Mg-rich environment under favourable pH, Eh, salinity, and temperature conditions. The low SiOs content, absence of fossils, and the association of anhydrites with dolomites reflect a restricted, shallow-marine, low energy environment, interrupted in parts, by high-energy level environment in which microsparites and sparites were formed.يتضمن هذا البحث دراسة اصل وظروف الترسيب لدولوميت العلمين بحقل بترول الرزاق وذلك عن طريق التحاليل البتروجرافيه والكيميائية وكذلك الأشعه السينه . ‏ولقد تم استنتاج أن الصخور قيد الدراسة تتكون من الدولوميت كما أن صخور دولوميت العلمين هي صخور جيريه متدلمته تحت ظروف مختلفه تمتد من تغير متزامن مع الترسيب إلى تغير متأخر بعد الترسيب كما توجد في صخور الدولوميت بقايا مختلفة الأحجام من الصخور الجيريه غير المتدلمته . وأمكن تحديد النسيج المميز لهذه الصخور وتأثيره على الخواص البتروفيزيائية لها ، والاستدلال على المسام الموجوده داخل تلك الصخور وأحجامها وطرق توزيعها وتأثير عملية الدلمته والضغط والمادة اللاحمه واعادة التبلور عليها ، هذا بالاضافة إلى التوصل إلى العديد من الاستنتاجات الخاصة ببيئه الترسيب والظروف غير الملائمة لنمو الاحياء البحرية . ‏كما تمت دراسة كيميائية لصخور الدولوميت في الحقل قيد الدراسة حيث أمكن استنتاج بيئة الترسيب ومعرفة المناخ السائد أثناء الترسيب ودرجة الحراره والمؤثرات الكيميائيه في بيئة الترسيب وعملية اعادة التبلور والتغيرات اللاحقة للترسيب . ‏وقد تبين أن نتائج التحاليل بواسطة الأشعة السينيه للمعادن غير الطينيه تؤيد الدراسات الصخرية والكيميائيه من خلال معرفة المعادن المكونه لتكوين العلمين واستنتاج نوع الصخور والتغيرات اللاحقة للترسيب وبعض الدلائل على بيئة الترسيب

Preparation, Characterization of New Antimicrobial Antitumor Hybrid Semi-Organic Single Crystals of Proline Amino Acid Doped by Silver Nanoparticles

Proline is water soluble amino acid extensively used in drug delivery systems. Compounds of cobalt (Co) transition metal have potent antimicrobial and anticancer activities. However, a drug delivery system combining proline cobalt is not reported yet. For the first time, new hybrid semi-organic single crystals of proline cobalt chloride (PCC) are prepared. The novelty of the article is also that single crystal proline cobalt chloride showed potent antimicrobial and antitumor activity. Doping of PCC by Ag0NPs significantly increased these biological activities. The anisotropic magnetic properties of single crystals can mitigate the cytotoxicity of Ag0NPs on normal cells. Silver nanoparticles (Ag0NPs) improved the crystal habits and physicochemical properties. Ag0NPs showed the best performance, paramagnetic materials n-type semiconductors due to delocalized excess electrons of Ag0NPs incorporated in the crystal lattice interstitially. Crystals have high absorptivity for UV-radiation electromagnetic radiation. Ag0NPs enhanced AC electrical conductivity up to 2.3 × 104 Ω cm−1 due to high electron density. Proline doped crystals are obtained in good purity as triclinic unit cell with having anisotropic magnetism. PCCAg0NPs crystal exhibited: high antimicrobial activities to various bacterial and fungal species, inhibition zone (mm): 21, 25, 24, 26, 30, 28, 12, and 46 for S. aureus, E. faecalis, S. typhi, E. coli, P. aerugino, K. pneumoniae, A. braselienses, and C. albicans, respectively, in comparison to ciprofloxacin antibiotic (23, 0, 26, 26, 25, 0, 0, 0) for the same tested species, respectively; higher cytotoxicity against breast cancer cells (IC50 22.1 μM) than the reference drug cisplatin (IC50 11.7 μM); and lower cytotoxicity to normal healthy lung cells MRC-5, (IC50 145.5 μM) than cisplatin (IC50 30.2 μM). Hence, this crystal is a candidate for chemotherapy of breast cancer