Effects of pre-emptive pregabalin and multimodal anesthesia on postoperative opioid requirements in patients undergoing robot-assisted laparoscopic prostatectomy

Background: Previous findings indicate that pre-emptive pregabalin as part of multimodal anesthesia reduces opioid requirements compared to conventional anesthesia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). However, recent studies show contradictory evidence suggesting that pregabalin does not reduce postoperative pain or opioid consumption after surgeries. We conducted a register-based analysis on RALP patients treated over a 5-year period to evaluate postoperative opioid consumption between two multimodal anesthesia protocols. Methods: We retrospectively evaluated patients undergoing RALP between years 2015 and 2019. Patients with American Society of Anesthesiologists status 1-3, age between 30 and 80 years and treated with standard multimodal anesthesia were included in the study. Pregabalin (PG) group received 150 mg of oral pregabalin as premedication before anesthesia induction, while the control (CTRL) group was treated conventionally. Postoperative opioid requirements were calculated as intravenous morphine equivalent doses for both groups. The impact of pregabalin on postoperative nausea and vomiting (PONV), and length of stay (LOS) was evaluated. Results: We included 245 patients in the PG group and 103 in the CTRL group. Median (IQR) opioid consumption over 24 postoperative hours was 15 (8-24) and 17 (8-25) mg in PG and CTRL groups (p = 0.44). We found no difference in postoperative opioid requirement between the two groups in post anesthesia care unit, or within 12 h postoperatively (p = 0.16; p = 0.09). The length of post anesthesia care unit stay was same in each group and there was no difference in PONV Similarly, median postoperative LOS was 31 h in both groups. Conclusion: Patients undergoing RALP and receiving multimodal analgesia do not need significant amount of opioids postoperatively and can be discharged soon after the procedure. Pre-emptive administration of oral pregabalin does not reduce postoperative opioid consumption, PONV or LOS in these patients.</div

Latin American chronic urticaria registry (CUR) contribution to the understanding and knowledge of the disease in the region

Chronic urticaria (CU) has a widespread spectrum on causal or exacerbating factors, clinical manifestations, therapeutic response and quality of life affectation. Registries are useful tools in several real-life diagnosis and management approach. We aimed to evaluate the characteristics of CU patients living in Latin America through an original cross-sectional registry with data entered by regional allergologists. Results: Three hundred patients were included, being 72% female, with median age of 36 years (1\u201385) and 20 months of CU median evolution time. The cause of CU was reported as unknown in 72% of them. Thirty-nine percent of suspected cases presented positive serology for Mycoplasma, positive autologous serum skin test (ASST) was reported in 47%, and occasional presence of thyroid or antinuclear autoantibodies and parasites. The impact of pruritus in their quality of life was moderate to severe in 60% of patients, with almost 3 out of four patients having partial or lack of urticaria control with anti-histamines. Conclusions: Our registry provides retrospective data on the real-life assistance of a large number of patients from the region. Continuous search for associated conditions and better treatment possibilities are needed, in order to control the significant impact on quality of life and the length of disease

Time to establish an international vaccine candidate pool for potential highly infectious respiratory disease: a community's view.

In counteracting highly infectious and disruptive respiratory diseases such as COVID-19, vaccination remains the primary and safest way to prevent disease, reduce the severity of illness, and save lives. Unfortunately, vaccination is often not the first intervention deployed for a new pandemic, as it takes time to develop and test vaccines, and confirmation of safety requires a period of observation after vaccination to detect potential late-onset vaccine-associated adverse events. In the meantime, nonpharmacologic public health interventions such as mask-wearing and social distancing can provide some degree of protection. As climate change, with its environmental impacts on pathogen evolution and international mobility continue to rise, highly infectious respiratory diseases will likely emerge more frequently and their impact is expected to be substantial. How quickly a safe and efficacious vaccine can be deployed against rising infectious respiratory diseases may be the most important challenge that humanity will face in the near future. While some organizations are engaged in addressing the World Health Organization's "blueprint for priority diseases", the lack of worldwide preparedness, and the uncertainty around universal vaccine availability, remain major concerns. We therefore propose the establishment of an international candidate vaccine pool repository for potential respiratory diseases, supported by multiple stakeholders and countries that contribute facilities, technologies, and other medical and financial resources. The types and categories of candidate vaccines can be determined based on information from previous pandemics and epidemics. Each participant country or region can focus on developing one or a few vaccine types or categories, together covering most if not all possible potential infectious diseases. The safety of these vaccines can be tested using animal models. Information for effective candidates that can be potentially applied to humans will then be shared across all participants. When a new pandemic arises, these pre-selected and tested vaccines can be quickly tested in RCTs for human populations

Open-Source tools: Incidence in the wireless security of theTechnical University of Babahoyo

Computer security is a fundamental part of an organization, especially in Higher Education institutions, where thereis very sensitive information, capable of being vulnerable by different methods of intrusion, the most common being free accessthrough wireless points. The main objective of this research is to analyze the impact of the open source tools in charge of managingthe security information of the wireless network, such as OSSIM, a set of active and passive components used to manage events thatgenerate traffic within the network. net. This research exposes the use of free software as a viable option of low cost to solve theproblems that afflict student staff, such as lack of access to academic services, problems of wireless interconnectivity, with the purposeto restore confidence in students in the Use of the services offered by the institution for research-related development, guaranteeingfree and free access to the internet. The level of dissatisfaction on the part of the students confirms the problem presented atthe Technical University of Babahoyo, thus confirming the positive influence of the Open-Source tools for the institution’s wirelesssecurityLa seguridad informática es una parte fundamental de una organización, especialmente en Higher Instituciones educativas,donde hay información muy sensible, capaz de ser vulnerables por diferentes métodos de intrusión, siendo el acceso libre más comúna través de puntos inalámbricos. El objetivo principal de esta investigación es analizar el impacto de las herramientas de código abierto encargadas de administrar la información de seguridad de la red inalámbrica, como OSSIM, un conjunto de componentes activos y pasivos utilizados para administrar eventos que generan tráfico dentro de la red. red. Esta investigación expone el uso de software libre como una opción viable de bajo costo para resolver los problemas que afligen al estudiante personal, como la falta de acceso a servicios acad émicos, problemas de interconexión inalámbrica, con el propósito de restaurar la confianza en los estudiantes en el uso de los servicios. ofrecido por la institución para el desarrollo relacionado con la investigación, garantizando de forma gratuita y gratuita acceso a Internet. El nivel de insatisfacción por parte de los estudiantes confirma el problema presentado en la Universidad Técnica de Babahoyo, confirmando así la influencia positiva de las herramientas de c ódigo abierto para la seguridad inalámbrica de la institució

Congrès AFMED 2017 : Co-infection VIH-Helminthiases intestinales à Kinshasa (RD Congo) : fréquence et facteurs associés: HIV-Helminthiasis co-infection in Kinshasa (DR Congo): frequency and associated factors

Objectifs. Montrer l‟ampleur des helminthiases intestinales chez les PVVs adultes en milieu de soins à Kinshasa et en identifier les facteurs associés.Méthodes. Étude transversale à visée analytique réalisée dans 8 structures de prise en charge des PVVs à Kinshasa choisies de manière aléatoire. Quatre cent vingt-deux PVVs adultes ont été incluses dans l‟étude selon une approche probabiliste. Un questionnaire pré-testé leur a été administré. Chaque patient avait remis un échantillon de selle conservé dans du formol à 10% pour examen par la méthode de RITCHIE. Les données ont été analysées l‟aide du logiciel SPSS version 21. La régression logistique a servi à identifier les facteurs associés à l‟infection helminthique chez les PVVs.Résultats. Sur 422 PVV, 324 étaient des femmes, soit un sex ratio de 1H/3,3F ; soit 10 H pour 33 F. L‟âge moyen était de 42 ans (ET =10 ans).La fréquence globale des helminthiases intestinales était de 22% (93/422). L‟helminthe le plus retrouvé était Ascaris lumbricoides 44/422 (10,4%) suivi de Trichuris trichiura (Trichocéphale) 33/422 (7,8%), et de Strongyloides stercoralis (Anguillule) 14/422 (3,3%). Ce dernier helminthe était associé à un taux de LT CD4 bas. Aucune infection helminthique mixte n‟a été détectée. Le taux de lymphocytes T CD4 médian était de 388 éléments/mm3 (EIQ : 342-412) pour toutes les PVVs de l‟étude, et 425 éléments/mm3 (EIQ : 373-456) pour les co-infectées, avec comme extrêmes : 13-1421 éléments/mm3. Plus de 70% de PVV étaient atteints d‟infections à faible intensité. Après ajustement, l‟utilisation d‟eau de robinet [OR ajusté 3,62 IC95% (1,04-12,58), p=0,018], la consommation des légumes crus ou fruits frais [OR ajusté 1,80 IC95% (1,11-2,92), p=0,018], la non consommation d‟eau traitée [OR ajusté 2,84 IC95% (1,81-4,72), p=0,018], le non lavage hygiénique des mains après usage de toilettes [OR ajusté 2,65 IC95% (1,14-8,21), p=0,010] et avant de manger [OR ajusté 2,01 IC95% (1,09-6,73), p=0,004] étaient les facteurs associés à l‟helminthiase intestinale.Conclusion. La co-infection VIH-helminthiasiase intestinale est fréquente à Kinshasa. Ascaris lumbrocoides est l‟helminthe le plus retrouvé. L‟immunodépression avancée favorise la strongyloïdose. Les campagnes de sensibilisation sur l‟éducation sanitaire et le déparasitage intermittent de masse chez les PVVs devraient être à envisagés

The high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) in a large Zambian prison: a public health alert.

BACKGROUND: Tuberculosis (TB) and human immunodeficiency virus (HIV) represent two of the greatest health threats in African prisons. In 2010, collaboration between the Centre for Infectious Disease Research in Zambia, the Zambia Prisons Service, and the National TB Program established a TB and HIV screening program in six Zambian prisons. We report data on the prevalence of TB and HIV in one of the largest facilities: Lusaka Central Prison. METHODS: Between November 2010 and April 2011, we assessed the prevalence of TB and HIV amongst inmates entering, residing, and exiting the prison, as well as in the surrounding community. The screening protocol included complete history and physical exam, digital radiography, opt-out HIV counseling and testing, sputum smear and culture. A TB case was defined as either bacteriologically confirmed or clinically diagnosed. RESULTS: A total of 2323 participants completed screening. A majority (88%) were male, median age 31 years and body mass index 21.9. TB symptoms were found in 1430 (62%). TB was diagnosed in 176 (7.6%) individuals and 52 people were already on TB treatment at time of screening. TB was bacteriologically confirmed in 88 cases (3.8%) and clinically diagnosed in 88 cases (3.8%). Confirmed TB at entry and exit interventions were 4.6% and 5.3% respectively. Smear was positive in only 25% (n = 22) of bacteriologically confirmed cases. HIV prevalence among inmates currently residing in prison was 27.4%. CONCLUSION: Ineffective TB and HIV screening programs deter successful disease control strategies in prison facilities and their surrounding communities. We found rates of TB and HIV in Lusaka Central Prison that are substantially higher than the Zambian average, with a trend towards concentration and potential transmission of both diseases within the facility and to the general population. Investment in institutional and criminal justice reform as well as prison-specific health systems is urgently required