A Review of Pain Control in Pediatric Cardiac Bypass Surgery

Background: Children undergoing cardiac surgery with cardiopulmonary bypass receive high dose opioids for analgesia and to reduce the neurohormonal stress response. While opioids have excellent pharmacodynamics profiles adverse effects include: respiratory depression, bradycardia, nausea, vomiting, and tolerance. Additionally, opioids with short half-lives like fentanyl require several boluses to be administered during surgery causing fluctuating levels analgesia. Several strategies to advance pain control incorporate regional and neuraxial anesthetic techniques, however anticoagulation preclude its routine use. Alternatively using opioids with longer half-lives for analgesia may improve pain control and reduce adverse effects. Objective: The objective of this study is to quantify postoperative opioid requirements in pediatric patients following cardiac bypass surgery. Methods: Electronic medical records were retrospectively reviewed for 64 pediatric patients following cardiac bypass surgery at Children’s National Health System from June of 2014 through February of 2016. Intraoperative and postoperative opioid class and dose was recorded for outpatients with designation ASA class 2-4. The data was compiled and analyzed to obtain a mean and standard deviation for future study. Results: 64 cardiac surgery patients (mean age 4.3±1.7, mean weight 17.1±7.5 kg) receiving between 10-30mcg/kg of fentanyl, the mean total dose of morphine in the first 24-hour postoperative period was 0.363mg/kg, with a standard deviation of 0.239. Conclusions: The data from this internal case review of pain control in pediatric cardiac bypass surgery will be used delineate the appropriate sample size for studying postoperative pain control. This is applicable to our study that compares intraoperatively administered fentanyl to methadone on postoperative opioid requirement. This internal case review of 64 cardiac surgery patients (mean age 4.3±1.7, mean weight 17.1±7.5 kg) receiving between 10-30 mcg/kg of fentanyl showed a mean total dose of morphine in the first 24-hour postoperative period was 0.363 mg/kg, with a standard deviation of 0.239. Assuming no difference between the two treatment strategies in the population, a total sample size of 76 in each group will provide 80% power to detect a difference of 0.109 in means, using a two-sample t-test at the 0.05 significance level. The high amount of postoperative morphine required, as determined by this study, reveals the need to find alternative pain control strategies such as opioids with longer half-lives and regional techniques. Exploring the effectiveness of methadone, a long acting opioid, to reduce postoperative adverse effects is an area of future study

Treatment of chronic pain in oncology: cooperation between the oncologist and psychooncologist

The aim of this work is to present the problem of chronic pain in neoplastic disease as a situation requiring diagnosis and interdisciplinary treatment. The phenomenon of chronic pain, its types, and causes are discussed. A discussion was held on appropriate scales for measuring pain intensity. Pharmacotherapy and psychotherapy were primarily presented among the discussed treatment methods, and issues related to other methods of interactions related to the treatment of patients with chronic pain in the course of neoplastic disease were discussed. The key aspect of the article is to draw attention to the implementation of multi-specialist treatment of chronic pain, including personalised solutions and the accommodation of the most favourable form of therapy and the methods of its implementation.Celem pracy jest przedstawienie holistycznego modelu diagnostyki i leczenia bólu przewlekłego w chorobie nowotworowej. Omówiono zjawisko bólu przewlekłego, jego rodzaje oraz przyczyny. Specyfikę tematyki uzupełniono o dyskusję nad metodologią oceny natężenia bólu. Wśród metod leczenia zaprezentowano przede wszystkim farmakoterapię i psychoterapię oraz przedstawiono zagadnienia wymagające postępowania interdyscyplinarnego. Kluczowym aspektem artykułu jest zwrócenie uwagi na konieczność wdrożenia wielopłaszczyznowego sposobu leczenia bólu przewlekłego z uwzględnieniem rozwiązań spersonalizowanych oraz dostosowania optymalnej terapii do możliwości jej realizacji

Tax Burden of Russian Oil Companies after Tax Consolidation

This article takes studying the impact of tax consolidation on oil companies' tax burden as its focus. Oil companies are crucial for the Russian economy while oil and gas money are as well important for the Russian budget. Besides, a lot of oil companies being major taxpayers have had the opportunity to consolidate corporate profit tax since 2012. The article's goal is to analyze the results of creating consolidated groups of taxpayers for tax burden in terms of corporate profit tax exemplified by oil companies in order to assess the importance of profit tax consolidation as a way of reducing corporate profit tax. Upon analyzing the data provided by the Federal Tax Service of Russia and 2010-2015 oil companies' financial reports, it is possible to conclude that the largest tax burden falls on fossil fuel industry in comparison with other industries what can be explained first of all by the mineral extraction tax. Corporate profit tax burden for most oil companies in 2014 accounted for 5% of revenue. At the same time, profit tax burdens on consolidated groups of taxpayers producing oil vary a lot; in 2012, the general trend was falling, but then it started to grow again. Thus, it is impossible to state that tax obligations and corporate profit tax burden have significantly decreased as a result of creating consolidated groups of taxpayers for oil producers. Quantitative analysis of money spent for paying the profit tax might be interestingfor describing consequences of creating consolidated groups of taxpayers

Вплив природних та штучних радіонуклідів на стан здоров'я людини (огляд)

Здійснено огляд основних етапів досліджень з впливу природних та штучних радіонуклідів на стан здоров'я людини. Розглянуто методи профілактики захворювань спровокованих радіоактивним випромінюванням. На основі узагальнення наукової літератури про вплив радіонуклідів на людину запропоновано можливі шляхи розширення лікувальних процедур з використанням водних розчинів, які містять іони калію і мають радіоактивність в діапазоні 20-400 Бк/л, що спричинено радіонуклідом 40К і залежить від концентрації іонів калію

Response of Lactobacillus casei BL23 to phenolic compounds

2 tables, 2 figures.-- Article first published online: 17 OCT 2011.-- The definitive version is available at www3.interscience.wiley.comAims:  To determine the inhibitory effect of phenolic compounds on Lactobacillus casei BL23, the role of two component signal transduction systems (TCS) and the response of Lact. casei BL23 to p-coumaric acid. Methods and Results:  Growth of Lact. casei BL23 and 17 derivative strains defective in each TCS harboured by this strain in the presence of p-coumaric acid, ferulic acid, caffeic acid or methyl gallate was monitored. Furthermore, changes in the protein content of Lact. casei BL23 when exposed to p-coumaric acid were evaluated by 2D-SDS-PAGE. Eleven proteins differentially expressed in the presence of p-coumaric acid were detected. Six of them could be identified: ClpP and HtrA, involved in protein turnover and folding, acetyl-CoA carboxylase, involved in lipid metabolism, and an arginyl-tRNA synthetase were more abundant, whereas PurL and PurN, involved in purine biosynthesis, were less abundant. Conclusions:  No significant differences were observed between the parental strain and the TCS-defective mutants. p-Coumaric acid elicited a response against membrane and cytoplasmic damages. Significance and Impact of the Study:  The inhibitory effect of phenolic compounds on Lact. casei BL23 has been determined. For the first time, cytoplasmic proteins presumably involved in the response of Lact. casei BL23 against p-coumaric acid have been identified.This work was financed by AGL2010-15679 and Consolider Fun-C-Food CSD2007-00063 funds from the Spanish Ministry of Science and Innovation (MICINN) and FEDER. J.M. Landete enjoyed a postdoctoral contract of the programme ‘Juan de la Cierva’ (MICINN).Peer reviewe

Using A High-Temperature Flue Gases in the Technology of Combustion Neutralization of Wastewater

This paper provides an analysis of composition of typical polluting contaminants of industrial wastewater. The study suggest industry branches, wastewater of which contains the greatest amount of organic flammable substanses (petroleum и oil). The present study was conducted to analyze an opportunity to replace fuel torch by the high-temperature flow of flue gases in the realization thermal treatment method (combustion neutralization)

Влияние полиненасыщенных жирных кислот на биохимическую активность комбинированной закваски

В данной работе представлены результаты культивирования комбинированнойзакваски, соотношение культур Lactobacillus helveticus 35-1 и Propionibakterium freudenreichii subsp. shermanii АС 2503 в которой 40:60, на обезжиренном молоке, с добавлением рыжикового масла. Подобрана оптимальная доза внесения рыжикового масла, обеспечивающая более высокую кислотообразующую способность и количество жизнеспособных клеток в комбинированной закваске

Leczenie bólu przewlekłego w onkologii — współpraca onkologa z psychoonkologiem

Celem pracy jest przedstawienie holistycznego modelu diagnostyki i leczenia bólu przewlekłego w chorobie nowotworowej. Omówiono zjawisko, rodzaje i przyczyny bólu przewlekłego oraz uzupełniono temat o dyskusję nad metodami klasyfikowania bólu. Wśród metod leczenia zaprezentowano przede wszystkim farmakoterapię i psychoterapię oraz przedstawiono zagadnienia wymagające postępowania interdyscyplinarnego. Kluczowym aspektem artykułu jest zwrócenie uwagi na konieczność wdrożenia wielopłaszczyznowego leczenia chorych z bólem przewlekłym z uwzględnieniem rozwiązań spersonalizowanych oraz dostosowania optymalnej terapii do możliwości jej realizacji