Continuous rate infusion of dexmedetomidine vs subcutaneous administration in anaesthetized horses undergoing MRI examination

Up to 2005, dexmedetomidine use had not been reported in equine. Since then, several experimental and clinical studies have been published. The main reason for this increase relies on its beneficial pharmacological profile, including short half-life and rapid redistribution (1). The aim of the study is to compare the clinical effects and recovery quality after continuous rate infusion (CRI) or subcutaneous administration of dexmedetomidine in horses undergoing general anaesthesia. Fourteen horses scheduled for MRI examination were included. All horses were sedated with acepromazine 0.03 mg kg-1 intravenously (IV) and detomidine 10 \ub5g kg-1 (IV). Anaesthesia was induced with ketamine 3 mg kg-1 (IV) and diazepam 0.04 mg kg-1 (IV) and maintained with isofluorane in 60% oxygen; end-tidal isoflurane concentration was maintained between 1.3-1.4 %. Horses were randomly divided in two groups. Group \u201cDex CRI\u201d received dexmedetomidine intravenously at 1 \ub5g kg-1 hour-1, group \u201cDex SC\u201d received 2 \ub5g kg-1 of dexmedetomidine subcutaneously every 60 minutes. If nystagmus or incessant fighting against ventilator occurred, ketamine rescue at 0.1 mg kg-1 was given. In case of sudden movements, thiopental 0.5-1.0 mg kg-1 IV was given. Ringer\u2019s lactate was given at 3 mL kg-1 hour-1, dobutamine was administered IV and the rate adjusted to maintain MAP>70 mmHg. Controlled mechanical ventilation using intermittent positive pressure ventilation was adjusted to maintain arterial carbon dioxide partial pressure between 38-45 mmHg. Heart rate, invasive arterial blood pressure, arterial blood gases, total dose of dobutamine administered, ketamine rescue needed, urine production were recorded. Time required until extubation and time to attain sternal and standing position were noted. The main anaesthesiologist assessed recovery quality graded on a standard scoring 5-point scale with a score of 1 representing the best recovery (2). Mann-Whitney U test was applied for non-parametric data and T-test for parametric data (p 640.05). There was no statistically differences in physiological intra-anaesthetic parameters, in body weight (kg) (CRI 521\ub153; SC 506\ub176), age (years) (CRI 10.7\ub12.1; SC 10.8\ub14.1), anaesthesia duration (min) (CRI 139\ub19.,7; SC 144\ub116.2), number of ketamine rescue needed (CRI 1\ub11.15; SC 0.5\ub11.13), recovery score (CRI 1.8\ub11,2; SC 1.5\ub10,5). Also time until extubation (min) (CRI 11.5\ub15.0; SC 9.7\ub12.6), time to attain sternal (min) (CRI 41.5\ub112.2; SC 49.7\ub16.0) and standing position (min) (CRI 50.7\ub114.6; SC 57.2\ub16.,0) were not statistically different. There was statistical significance in urine production (L) (CRI 8.0\ub13.5; SC 11.1\ub14.4) and total dobutamine mcg/kg/min (CRI 0.89\ub10.35; SC 0.56\ub10.18). Subcutaneous administration of dexmedetomidine has product similar clinical effects to those achieved with CRI. It has permitted a significative reduction in dobutamine administration and a more stable depth of anaesthesia confirmed by the lower number of rescue ketamine boluses required even if not statistically different. Further studies are required to evaluate different dosages both in CRI and subcutaneous administration

Decaying shock studies of phase transitions in MgOSiO2 systems: implications for the Super-Earths interiors

We report an experimental study of the phase diagrams of periclase (MgO), enstatite (MgSiO3) and forsterite (Mg2SiO4) at high pressures. We investigated with laser driven decaying shocks the pressure/temperature curves of MgO, MgSiO3 and Mg2SiO4 between 0.2-1.2 TPa, 0.12-0.5 TPa and 0.2-0.85 TPa respectively. A melting signature has been observed in MgO at 0.47 TPa and 9860 K, while no phase changes were observed neither in MgSiO3 nor in Mg2SiO4. An increasing of reflectivity of MgO, MgSiO3 and Mg2SiO4 liquids have been detected at 0.55 TPa -12 760 K, 0.15 TPa - 7540 K, 0.2 TPa - 5800 K, respectively. In contrast to SiO2, melting and metallization of these compounds do not coincide implying the presence of poor electrically conducting liquids close to the melting lines. This has important implications for the generation of dynamos in Super-earths mantles

Signatures of synchrotron emission and of electron acceleration in the X-ray spectra of Mrk 421

BL Lac objects undergo strong flux variations involving considerable changes in their spectral shapes. We specifically investigate the X-ray spectral evolution of Mrk 421 over a time span of about nine years. We aim at statistically describing and physically understanding the large spectral changes in X rays observed in Mrk 421 over this time span. We perform a homogeneous spectral analysis of a wide data set including archived observations with ASCA, BeppoSax, RXTE, as well as published and unpublished XMM-Newton data. The presence of uncertainties is taken into account in our correlation analysis. The significance of the correlations found and possible spurious effects are studied with Monte Carlo simulations. We find that the Mrk421 spectral energy distribution (SED) has a lower peak at energies that vary in the range, 0.1-10 keV while its X-ray spectrum is definitely curved. Parameterizing the X-ray spectra with a log-parabolic model, we find a positive correlation between the position and the height of the SED peak. In addition, we find a negative trend of the spectral curvature parameter vs. the SED peak energy. We show that these relations between the spectral parameters are consistent with statistical or stochastic acceleration of the emitting particles, and provide insight into the physical processes occurring in BL Lac nuclei.Comment: 11 pages, 5 fiures, Accepted for publication in A&

Wide band X-ray and optical observations of the BL Lac object 1ES 1959+650 in high state

The blazar 1ES 1959+650 was observed twice by BeppoSAX in September 2001 simultaneously with optical observations. We report here the X-ray data together with the optical, R_C magnitude, light curve since August 1995. The BeppoSAX observations were triggered by an active X-ray status of the source. The X-ray spectra are brighter than the previously published X-ray observations, although the source was in an even higher state a few months later, as monitored by the ASM onboard RossiXTE, when it was also detected to flare in the TeV band. Our X-ray spectra are well represented by a continuosly curved model up to 45 keV and are interpreted as synchrotron emission, with the peak moving to higher energies. This is also confirmed by the slope of the X-ray spectrum which is harder than in previous observations. Based on our optical and X-ray data, the synchrotron peak turns out to be in the range 0.1-0.7 keV. We compare our data with non simultaneous radio to TeV data and model the spectral energy distribution with a homogeneous, one-zone synchrotron inverse Compton model. We derive physical parameters that are typical of low power High Energy peaked Blazar, characterised by a relatively large beaming factor, low luminosity and absence of external seed photons.Comment: 12 pages, 6 figures, accepted by A&

The BL Lac objects OQ 530 and S5 0716+714. Simultaneous observations in the X-rays, radio, optical and TeV bands

We present the results of the BeppoSAX observations of two BL Lacs, OQ 530 and S5 0716+714, as part of a ToO program for the simultaneous observation at radio, optical, X-ray and TeV energies. Both sources are detected in the LECS and MECS, with S5 0716+714 visible also in the PDS band, up to about 60 keV. The X-ray spectra of both sources are better fitted by a double power-law model, with a steep soft X-ray component flattening at harder energies, with breaks at 0.3 and 1.5 keV, respectively. The concave shape of the spectra in both objects is consistent with soft X-rays being produced by the synchrotron and harder X-rays by the inverse Compton processes. Also the X-ray variability properties confirm this scenario, in particular for S5 0716+714 our observation shows variations by about a factor 3 over one hour below 3 keV and no variability above. Their simultaneous broad band energy spectral distributions can be successfully interpreted within the frame of a homogeneous synchrotron and inverse Compton model, including a possible contribution from an external source of seed photons with the different spectral states of S5 0716+714 being reproduced by changing the injected power. The resulting parameters are fully consistent with the two sources being intermediate objects within the "sequence" scenario proposed for blazars.Comment: 10 pages, 8 figures, accepted by A&

The clinical management of children with achondroplasia in Italy: results of clinician and parent/caregiver surveys

Purpose: This study aimed to assess the real-world management of achondroplasia in Italy. Methods: Two online surveys addressed to (1) parents/caregivers of individuals with achondroplasia and (2) Italian clinicians managing individuals with achondroplasia were conducted to assess real-world perspectives on achondroplasia management. Both surveys collected data on either patient or clinician demographics, details on diagnoses and referrals, disease complications, and views/experiences with limb lengthening surgery. Results: In total, 42 parents/caregivers and 19 clinicians (from 18 hospitals) completed the surveys. According to parents/caregivers, achondroplasia diagnosis was most commonly made in the third trimester of gestation (55% of respondents), with a genetic test performed to confirm the diagnosis in all but one case. In contrast, the clinicians indicated that, while achondroplasia was typically suspected during the prenatal period (78%), diagnosis was more frequently confirmed postnatally (72%). Parents/caregivers reported that the greatest impact of achondroplasia-related complications occurred in their children between the ages of 2-5 years. The most significant complications were otitis, sleep apnoea, stenosis of the foramen magnum or pressure on the spinal cord, and hearing difficulties. Lengthening surgery had been presented as a treatment option to 92% of responding parents/caregivers, with 76% of clinicians viewing surgery favourably. Typically, clinicians' reasons for suggesting limb lengthening surgery were to improve patient quality of life, increase patient autonomy and self-acceptance, improve trunk-limb disproportion, short stature and walking, and ensure that all possible treatment options had been presented to the parents/caregivers. Conclusion: This survey provides insight into the real-world management of individuals with achondroplasia in Italy