Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

Purpose: Both intrathecal sufentanil (ITS) and intrathecal morphine (ITM) improve analgesia in obstetrical or cardiac procedures. From a pharmacokinetic standpoint, combining these two opioids may improve perioperative analgesia. We performed a prospective randomized double-blind study to compare the analgesic efficacy of ITM alone vs a mixture of a low dose of ITS plus ITM for perioperative pain relief in colorectal surgery. Methods: Eighty adult patients undergoing colorectal surgery were randomly allocated to receive either 0.4 mg ITM alone or 10 µg ITS plus 0.4 mg ITM before general anesthesia. Intraoperative intravenous sufentanil consumption, postoperative morphine consumption delivered with a patient controlled analgesia device, pain scores, patient satisfaction and adverse effects were recorded for the first 48 hr postoperatively. Results: No differences were observed between groups with respect to intraoperative sufentanil consumption (39 ± 23 µg in group ITM and 40 ± 25 µg in group ITS plus ITM, P = 0.85) and in postoperative morphine consumption in postanesthesia care unit (6 ± 5 mg vs 6 ± 5 mg, P = 0.59), at 24 hr (26 ± 17 vs 24 ± 15 mg, P = 0.59) and at 48 hr (47 ± 31 vs 44 ± 22 mg, P = 0.58). Similarly, no differences were observed in regards to pain relief, patient satisfaction and incidence of adverse effects. Conclusions: These results do not support the addition of 10 µg ITS to 0.4 mg ITM for colorectal surgery, as low dose sufentanil dœs not improve intraoperative and postoperative analgesia in this settin

Prenatal and Postnatal Exposure to DDT by Breast Milk Analysis in Canary Islands

The use of p,p' -dichlorodiphenyltrichloroethane (DDT) has been banned since the late 1970s due to its toxicity. However, its long half-life makes it persistent in the environment and, consequently, almost everyone has DDT residues in the body. Human milk constitutes an ideal non-conventional matrix to investigate environmental chronic exposure to organochlorine compounds (OCs) residues. The study aimed to identify potential population risk factors of exposure to DDT due to the proximity to countries where it is still used. Seventy-two consecutive lactating women were prospectively included in Tenerife, Canary Islands (Spain). A validated questionnaire was used to obtain socioeconomic, demographics data, and daily habits during pregnancy. DDT levels in breast milk were measured by gas chromatography with-electron capture detector (GC-ECD). Anthropometrics measurements in newborns were obtained. Thirty-four out of 72 (47.2%) of the analysed milk samples presented detectable levels of DDT (mean: 0.92 ng/g), ranging between 0.08 to 16.96 ng/g. The socio-demographic variables did not significantly differ between detectable DDT and non-detectable DDT groups. We found positive association between DDT levels and vegetables (OR (95%CI): 1.23 (1.01-1.50)) and poultry meat (OR (95%CI): 2.05 (1.16-3.60)) consumption, and also between the presence of DDT in breast milk and gestational age (OR (95%CI): 0.59 (0.40-0.90)). DDT is present in breast milk of women at the time of delivery. Residual levels and the spread from countries still using DDT explain DDT detection from vegetables and from animal origin food. The presence of this compound in breast milk represents a pre- and postnatal exposure hazard for foetuses and infants due to chronic bioaccumulation and poor elimination, with possible deleterious effects on health. This data should be used to raise awareness of the risks of OCs exposure and to help establish health policies in order to avoid its use worldwide and thus, to prevent its propagation

Clonidine as an adjuvant to intrathecal local anesthetics for surgery: systematic review of randomized trials

BACKGROUND AND OBJECTIVES: Clonidine is added to intrathecal local anesthetics to improve intraoperative analgesia and to increase the duration of sensory and motor block. The aim of this systematic review is to quantify beneficial and harmful effects of clonidine when used as an adjuvant to intrathecal local anesthetics for surgery. METHODS: We included data from 22 randomized trials (1,445 patients) testing a large variety of doses of clonidine, added to intrathecal bupivacaine, mepivacaine, prilocaine, or tetracaine. RESULTS: Clonidine 15 to 150 microg prolonged in a linear, dose-dependent manner, the time to 2 segment regression (range of means, 14 to 75 minutes) and the time to regression to L2 (range of means, 11 to 128 minutes). The time to first analgesic request (median 101 minutes, range 35 to 310) and of motor block (median 47 minutes, range 6 to 131) was prolonged without evidence of dose-responsiveness. Time to achieve complete sensory or motor block, and extent of cephalic spread remained unchanged. There were fewer episodes of intraoperative pain with clonidine (relative risk, 0.24; 95% confidence interval [CI], 0.09-0.64; number needed to treat, 13) but more episodes of arterial hypotension (relative risk, 1.81; 95% CI 1.44-2.28; number needed to harm, 8) without evidence of dose-responsiveness. The risk of bradycardia was unchanged. CONCLUSIONS: This study may serve as a rational basis to help clinicians decide whether or not to combine clonidine with an intrathecal local anesthetic for surgery. The optimal dose of clonidine, however, remains unknown

Metales artificiales en aplicaciones escultóricas: matrices termoestables y cargas metálicas

[EN] Artificial metals are composites obtained from the mixture of thermoset resins with metallic fillers. They are used in pursuit of 3D prototypes, as well as in the making of sculptures and decorative objects, in areas such as industrial creation, fine arts, and conservation and restoration of cultural heritage. Although they are widespread materials known since the 1960¿s they have not been well studied for these applications, especially those concerning to artistic cold¿cast reproductions. Thus, there are no systematic studies about the type of fillers, particle mesh size and dosage to fit the various procedures of sculptural work. This article proposes a review of the forementioned parameters, using epoxy and polyester resins, and focusing in the proper proportions for obtaining composites witch a metallic appearance[ES] Los metales artificiales son materiales reforzados obtenidos a partir de la mezcla de resinas termoestables con cargas metálicas, que se utilizan en la consecución de prototipos tridimensionales, esculturas, y objetos ornamentales, en ámbitos industriales, artísticos y de conservación y restauración de bienes culturales. Aunque su uso se conoce desde la década de 1960 se trata de materiales que no han sido bien estudiados para este tipo de aplicaciones. Así, no existe una sistematización alusiva al tipo de cargas, tamaño de partícula y dosificación que se ajuste a los diversos procedimientos de trabajo escultórico. El presente artículo propone una revisión de los mencionados parámetros, utilizando como matrices una resina de epoxi y una resina de poliéster, y atendiendo a las proporciones idóneas de carga para la obtención de materiales compuestos de apariencia metálica.Herrero-Cortell, MÁ.; Culebras Rubio, M.; Mas-Barberà, X. (2017). Metales artificiales en aplicaciones escultóricas: matrices termoestables y cargas metálicas. Revista Iberoamericana de Polimeros. 18(1):21-37. http://hdl.handle.net/10251/110823S213718

Propofol increased cerebral perfusion as compared with isoflurane during a cerebral angiography in a child with moyamoya disease

We report the case of a child with Moyamoya disease during a cerebral angiography procedure in which the effects of propofol on the cerebral perfusion were seen to be different compared with isoflurane. We suggest propofol was associated with a better preservation of cerebral circulation compared to isoflurane in this case of Moyamoya, as it maintained blood supply to the watershed areas

Low-dose sufentanil does not potentiate intrathecal morphine for postoperative analgesia after major colorectal surgery

Both intrathecal sufentanil (ITS) and intrathecal morphine (ITM) improve analgesia in obstetrical or cardiac procedures. From a pharmacokinetic standpoint, combining these two opioids may improve perioperative analgesia. We performed a prospective randomized double-blind study to compare the analgesic efficacy of ITM alone vs a mixture of a low dose of ITS plus ITM for perioperative pain relief in colorectal surgery

Museum reproduction of metallic archaeological artefacts: from lost wax casting techniques to artificial metals

Reproductions of archaeological artefacts play a necessary role in our societies while allowing an induced multiplicity of the original, which supposes benefits for conservation, dissemination and promotion of our heritage. But the reproduction of metal objects has been a challenge for museums and institutions, due to the complexity of emulating metals, and thus, the implementation of traditional techniques such as lost wax casting or electrolytic processes have been set in many cases as the mainly solution. The aim of this paper is to propose an alternative procedure, based on the use of thermosetting resin composites with metallic fillers. A comparison between the solutions provided by artificial metal and artistic casting techniques is done for two cases of study, juxtaposing advantages and limitations of both procedures.As reproduções de peças arqueológicas cumprem uma necessária função nas nossas sociedades, uma vez que permitem uma multiplicidade induzida do original, que resulta em benefícios para a conservação, divulgação e promoção do nosso património. A reprodução de objetos metálicos tem sido um desafio para as instituições museológicas, dada a complexidade de emular metais, e assim se propôs, em muitos casos, a implementação de técnicas tradicionais como a fundição a cera perdida ou os processos eletrolíticos, limitando a investigação a outros materiais. O presente artigo propõe uma solução alternativa, fundamentada no uso de composites de resinas termo estáveis com cargas metálicas. Através de dois casos de estudo aborda-se uma comparação entre as soluciones obtidas pelo metal artificial e pelas técnicas de fundição artística no mesmo modelo, justapondo vantagens e limitações de ambos os processos.Las reproducciones de piezas arqueológicas cumplen una necesaria función en nuestras sociedades en tanto permiten una multiplicidad inducida del original, que redunda en beneficios para la conservación, divulgación y promoción de nuestro patrimonio. La reproducción de objetos metálicos ha supuesto un desafío para las instituciones museísticas, dada la complejidad de emular metales, y así se ha propuesto en muchos casos la implementación de técnicas tradicionales como la fundición a la cera perdida o los procesos electrolíticos, limitando la investigación en otros materiales El presente artículo propone una solución alternativa, fundamentada en el uso de composites de resinas termoestables con cargas metálicas. A través de dos casos de estudio se aborda una comparativa entre las soluciones aportadas por el metal artificial y por las técnicas de fundición artística ante un mismo modelo, yuxtaponiendo ventajas y limitaciones de ambos procesos