The response of bispectral index to laryngoscopy, comparison between hemispheres in patients with a brain tumour versus a healthy control group

Background and Goal of Study: Electroencephalogram during anaesthesia may be affected by brain tumour.(1) We studied whether patients with a brain tumour have different BIS responses after laryngoscopy (LAR). We compared tumour patients with healthy control patients. Materials and Methods: After EC approval, 40 ASA 1 or 2 patients (control) and 41 intracranial tumour patients(tumour) received standardized anaesthesia while measuring bilateral BIS (BIS VISTAXP4 with bilateral sensor).(Covidien, Dublin, Ireland) Remifentanil was randomized to 3 or 5ng/ml effect‐site concentration (Minto) and maintained throughout the study. Propofol effect‐site concentration(CePROP)(Schnider) was set at 2 μg/ml and increased with incremental steps of 0.5 μg/ml until loss of consciousness was observed. After 3 minutes, laryngoscopy was performed and BIS was monitored during one minute. The median BIS of 1 minute before LAR is subtracted from the median BIS one minute after LAR to obtain delta BIS for each hemisphere. We tested if delta BIS is significantly different between hemispheres in control, between healthy and diseased hemispheres in tumour and between ipsilateral control and tumour hemispheres. Statistical significance was set at p< 0.05. Results and Discussion: No demographic differences were present except for age.(table 1) Delta BIS is not statistically different, neither between hemispheres in control, nor between healthy and diseased hemispheres in tumour groups.(table 2) No significant difference was found in delta BIS between ipsilateral control and pathological hemispheres. Conclusion(s): Bilateral BIS does not provide additional information on responsiveness to a standardized stimulus. We could not observe major differences in bilateral BIS response between control and brain tumour patients. Unilateral BIS monitoring seems to be equally informative in healthy and brain tumour patients compared to bilateral monitoring

Ambient air pollution and the prevalence of rhinoconjunctivitis in adolescents: A worldwide ecological analysis

Whether exposure to outdoor air pollution increases the prevalence of rhinoconjunctivitis in children is unclear. Using data from Phase Three of the International Study of Asthma and Allergies in childhood (ISAAC), we investigated associations of rhinoconjunctivitis prevalence in adolescents with model-based estimates of ozone, and satellite-based estimates of fine (diameter < 2.5 μm) particulate matter (PM2.5) and nitrogen dioxide (NO2). Information on rhinoconjunctivitis (defined as self-reported nose symptoms without a cold or flu accompanied by itchy watery eyes in the past 12 months) was available on 505,400 children aged 13–14 years, in 183 centres in 83 countries. Centre-level prevalence estimates were calculated and linked geographically with estimates of long-term average concentrations of NO2, ozone and PM2.5. Multi-level models were fitted adjusting for population density, climate, sex and gross national income. Information on parental smoking, truck traffic and cooking fuel was available for a restricted set of centres (77 in 36 countries). Between centres within countries, the estimated change in rhinoconjunctivitis prevalence per 100 children was 0.171 (95% confidence interval: − 0.013, 0.354) per 10% increase in PM2.5, 0.096 (− 0.003, 0.195) per 10% increase in NO2 and − 0.186 (− 0.390, 0.018) per 1 ppbV increase in ozone. Between countries, rhinoconjunctivitis prevalence was significantly negatively associated with both ozone and PM2.5. In the restricted dataset, the latter association became less negative following adjustment for parental smoking and open fires for cooking. In conclusion, there were no significant within-country associations of rhinoconjunctivitis prevalence with study pollutants. Negative between-country associations with PM2.5 and ozone require further investigation

A Protein Inventory of Human Ribosome Biogenesis Reveals an Essential Function of Exportin 5 in 60S Subunit Export

A systematic search for human ribosome biogenesis factors shows conservation of many aspects of eukaryotic ribosome synthesis with the well-studied process in yeast and identifies an export route of 60S subunits that is specific for higher eukaryotes