The influence of propofol, remifentanil and lidocaine on the tone of human bronchial smooth muscle.

Bronchoscopy is generally a safe procedure, but the induction of anaesthesia can induce bronchospasm. Consequently we investigated the influence of propofol, remifentanil and lidocaine on the tone of the human bronchial smooth muscle. Materials and methods: The influence of propofol, remifentanil and lidocaine on the contractile response of human bronchial smooth muscle to electrical field stimulation (EFS) has been evaluated. The role of capsaicin-sensitive sensory nerves and of inducible nitric oxide synthase has also been assessed. Furthermore, the interaction between these three dugs has been measured by Bliss Independence (BI) theory. Statistical significance (P < 0.05) was assessed by Student's t test or ANOVA. Results: Propofol (1.3 μg ml-1) and lidocaine (1 mg ml-1) reduced the baseline tone of bronchial rings (-14.45 ± 4.53% and -33.40 ± 1.07%, respectively, P < 0.05), whereas remifentanil had not such effect. Aminoguanidine prevented the relaxant effect of propofol. Propofol did not alter the bronchial contractile response to EFS following 30 min of treatment, whereas remifentanil enhanced the bronchial tension (133.83 ± 9.38%, control 101.93 ± 6.82%, P < 0.05 P < 0.05) and lidocaine completely abolished the contractility at 1 mg ml-1 (P < 0.05). The desensitization of capsaicin-sensitive sensory nerves normalized the hyperresponsiveness induced by remifentanil (-26.77 ± 1.68%, P < 0.05). Significant BI antagonism (P < 0.001) was detected for propofol and lidocaine on the bronchial hyperresponsiveness induced by remifentanil. Conclusion: Propofol and remifentanil may be used safely for bronchoscopy, although remifentanil should be associated with propofol or lidocaine to prevent the potential opioid-mediated bronchospasm

Early induction of bedside pneumoperitoneum in the management of residual pleural space and air leaks after pulmonary resection

Background: The pneumoperitoneum to treat prolonged air leaks or pleural space problems after pulmonary resection has been successfully used for decades. The aim of the study is to describe our experience with the early induction of therapeutic pneumoperitoneum (TP). Methods: We reviewed the data of 103 consecutive patients undergoing TP between September 2011 and September 2019. Patients were divided into two groups according to the time of the induction of TP: early application (≥72&nbsp;h) and standard application (&gt;72&nbsp;h). Results: In total, 52 early TP and 51 standard TP were analyzed. The median time of TP induction was 2 (1–3) versus 8 (5–11) postoperative days (POD) (p &lt; 0.001). The time for obliteration of the residual pleural space (7 vs.9&nbsp;days, p = 0.805) and the time of resolution of the air leaks (14 vs. 16&nbsp;days, p = 0.663) didn’t differ between the two groups, but a favorable trend was observed in the early group. The hospital stay was lower for patients undergoing early pneumoperitoneum: 9 versus 18&nbsp;days (p &lt; 0.001). The multivariate analysis showed that POD of induction of TP (p &lt; 0.001), time of resolution of the air leak (p &lt; 0.001) and Heimlich valve (p = 0.002) were independent variables associated with the hospital stay. Conclusions: The use of TP whenever a space problem or air leaks occur after pulmonary resections is safe and effective. Its early use (≤72&nbsp;h) accelerates the hospital stay, eventually reducing the time of resolution of the air leak and residual pleural space

Venous thromboembolism in covid-19 compared to non-covid-19 cohorts: A systematic review with meta-analysis

Background: A high incidence of venous thromboembolism (VTE) is reported in hospitalized COVID-19 patients, in particular in patients admitted to the intensive care unit (ICU). In patients with respiratory tract infections, including influenza A (H1N1), many studies have demonstrated an increased incidence of thromboses, but evidence is lacking regarding the risk difference (RD) of the occurrence of VTE between COVID-19 and non-COVID-19 patients. Methods: In this systematic review with meta-analysis, we evaluated the RD of the occurrence of VTE, pulmonary embolism (PE), and deep venous thrombosis (DVT) between COVID-19 and other pulmonary infection cohorts, in particular H1N1, and in an ICU setting. We searched for all studies comparing COVID-19 vs. non-COVID-19 regarding VTE, PE, and DVT. Results: The systematic review included 12 studies and 1,013,495 patients. The RD for VTE in COVID-19 compared to non-COVID-19 patients was 0.06 (95% CI 0.11–0.25, p = 0.011, I2 = 97%), and 0.16 in ICU (95% CI 0.045–0.27, p = 0.006, I2 = 80%). The RD for PE between COVID-19 and non-COVID-19 patients was 0.03 (95% CI, 0.006–0.045, p = 0.01, I2 = 89%). The RD for PE between COVID-19 and non-COVID-19 patients was 0.021 in retrospective studies (95% CI 0.00–0.04, p = 0.048, I2 = 92%) and 0.11 in ICU studies (95% CI 0.06–0.16, p < 0.001, I2 = 0%). Conclusions: The growing awareness and understanding of a massive inflammatory response combined with a hypercoagulable state that predisposes patients to thrombosis in COVID-19, in particular in the ICU, may contribute to a more appropriate strategy of prevention and earlier detection of the thrombotic events

The potential for mass trapping Lygus rugulipennis and Anthonomus rubi; trap design and efficacy

Cross vane funnel bucket traps with water and detergent captured significantly more A. rubi than sticky traps. L. rugulipennis catches were higher in the cross vane traps, but catches were impeded by the bee excluder grid. There were fewer of the target pest species captured on sticky traps and these devices tended to capture significantly more by-catch (e.g. Diptera) including beneficial insects, e.g. spiders and Carabidae. In the second experiment, the height of the green cross vane had no effect on the numbers of male L. rugulipennis trapped in the funnel traps. However, the higher cross vanes captured more coccinelids and opiliones. In the A. rubi trials there were significantly more individuals in the full height cross vane compared to the half-height or no cross vane treatments. Hence, the most effective trap for A. rubi and L. rugulipennis is a green Unitrap with no bee excluder grid. We are currently testing this device for mass trapping of both pests

Diet and primary prevention of stroke: Systematic review and dietary recommendations by the ad hoc Working Group of the Italian Society of Human Nutrition

Abstract Background and aims To systematically review the latest evidence on established and emerging nutrition-related risk factors for incidence of and mortality from total, ischemic and haemorrhagic strokes. The present review was conducted in the framework of the work carried out through 2015 and 2016 for the preparation of the Italian Guidelines for the Prevention and Treatment of Stroke, 8th Edition, by ISO-SPREAD (Italian Stroke Organization and the Stroke Prevention and Educational Awareness Diffusion). Methods and results Systematic review of articles focused on primary prevention of stroke published between January 2013 to May 2016 through an extensive search of the literature using MEDLINE/PUBMED, EMBASE and the Cochrane Library. Articles were ranked according to the SIGN methodology while the GRADE system was used to establish the strength of recommendations. As a result of our literature search, we examined 87 meta-analyses overall (mainly of prospective studies), a few isolated more recent prospective studies not included in the meta-analyses, and a smaller number of available randomized controlled trials and case–control studies. Based on the analysis of the above articles, 36 Syntheses of the available evidence and 36 Recommendations were eventually prepared. The present document was developed by organizing the available evidence into three individual areas (nutrients, food groups and dietary patterns) to provide a systematic and user-friendly overview of the available evidence on the relationship between nutrition and primary prevention of stroke. Yet analysis of foods and food patterns allowed translating the information about nutrients in a tool more amenable to use in daily life also in the light of the argument that people eat foods rather than nutrients. Conclusions The present literature review and dietary recommendations provide healthcare professionals and all interested readers with a useful overview for the reduction of the risk of total, ischemic and haemorrhagic stroke through dietary modifications

Suicide inhibition of alpha-oxamine synthases:structures of the covalent adducts of 8-amino-7-oxononanoate synthase with trifluoroalanine

The suicide inhibition of the α-oxamine synthases by the substrate analog, L-trifluoroalanine was investigated. The inhibition resulted in the formation of a complex with loss of all three fluorine atoms. Decarboxylation and loss of fluoride occurred immediately after aldimine formation. The inherent flexibility could allow the difluorinated intermediate complex to adopt a suitable conformation. Decarboxylation in the normal mechanism occurs after formation of the ketoacid intermediate.link_to_subscribed_fulltex

Biodisponibilidad de plomo y cadmio en sedimentos dragados del río Matanza y evaluación de métodos geoquímicos para su estimación

p.49-55En este trabajo se determinó la biodisponibilidad de cadmio y plomo en sedimentos dragados del río Matanza midiendo la acumulación de estos metales en los tejidos de la lombriz Eisenia foetida. Se evaluó la aplicación de métodos simples de extracción de cadmio y plomo, como medidas indirectas de su biodisponibilidad. La concentración de ambos metales aumentó en los tejidos de Eisenia fetida acorde con las mayores concentraciones en el sedimento; sin embargo, los coeficientes de bioacumulación sólo fueron mayores que la unidad para los tratamientos con adición de 5, 10 y 25 mg de Cd/kg de sedimento. El fraccionamiento de los metales por el método de Tessier mostró que la principal forma de cadmio presente en el sedimento fue la intercambiable para todos los tratamientos, mientras que las formas de plomo, variaron según la dosis del metal agregada. Las concentraciones de los metales extractados del sedimento con MgCi2, EDTA y DTPA se relacionaron con la bioacumulación en los tejidos de Eisenia ferida, indicando que pueden utilizarse como indicadores de la fracción biodisponible de Cd y Pb en los sedimentos