Effect of clonidine on the target dose of propofol: bispectral index evaluation

Background: The increasing evidence associating general anaesthetics with neurotoxicity and post-operative cognitive disturbances, mainly with deeper levels of anaesthetics, has led to more frequent use of adjuvants. This study aimed to analyse the effect of clonidine on the target dose of propofol in total intravenous anaesthesia. Methods: A randomised, double-blind clinical trial was performed in a large hospital located in the southern region of Ceará, Brazil. Fifty-one patients from the anaesthesia outpatient clinic were enrolled. Patients were divided into two groups: one group received 100 mL of 0.9% sterile saline, and the other group received 100 mL of 0.9% sterile saline with clonidine at a dose of 3 µg/kg. A target-controlled infusion pump was used to administer propofol, following the modified Marsh pharmacokinetic model and aiming for a bispectral index (BIS) score of approximately 40 for intubation and 45 for anaesthesia maintenance. The anaesthesiologist was informed which group the patient belonged to after completion of surgery and data recording. Results: The chi-squared test was used to evaluate the distribution of the samples with respect to gender, and the Student’s t-test was used to evaluate the parametric variables. There was no statistically significant difference between the samples. A significant difference was observed in the target dose of propofol between the two groups during the maintenance and awakening phases, but not at the time of intubation. Conclusions: Clonidine pre-operatively administered at a dose of 3 µg/kg significantly reduced the target dose of propofol needed to maintain adequate levels of anaesthesia as measured by BIS

Auditory stimulation and cardiac autonomic regulation

Previous studies have already demonstrated that auditory stimulation with music influences the cardiovascular system. In this study, we described the relationship between musical auditory stimulation and heart rate variability. Searches were performed with the Medline, SciELO, Lilacs and Cochrane databases using the following keywords: "auditory stimulation", "autonomic nervous system", "music" and "heart rate variability". The selected studies indicated that there is a strong correlation between noise intensity and vagal-sympathetic balance. Additionally, it was reported that music therapy improved heart rate variability in anthracycline-treated breast cancer patients. It was hypothesized that dopamine release in the striatal system induced by pleasurable songs is involved in cardiac autonomic regulation. Musical auditory stimulation influences heart rate variability through a neural mechanism that is not well understood. Further studies are necessary to develop new therapies to treat cardiovascular disorders

Labyrinthine fístulae in chronic otitis media with cholesteatoma

The chronic otitis media with cholesteatoma (COMC) may evoluate to intracranial and extra cranial complications, including the labyrithine fístulae. In this study, we present the evolution of our patients with labyrinthine fístulae. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: Ten out 82 patients with COMC had labyrinthine fístulae and underwent surgery from January/2001 to April/2002. They were assessed by clinical exam, computed tomography scans, and pre and postoperative audiogram. RESULTS: Hearing loss, otorrhea, tinnitus and dizziness were present in 100%, 90%,80%, and 40% of the cases. In one patient the fístulae was seen only in the coronal CT-scan, in another patient the fístulae was not seen neither in coronal nor axial images. Among the patients who had tinnitus, 66% referred improvement of this complaint after surgery. DISCUSSION: in the cases without invasion of the perilymphatic space, we noticed a tendency of improvement of the postoperative audiogram pattern and clinical outcome. In the extensive fístulae, on the other hand, there were no clinical changes. CONCLUSION: The CT-scan remains the best exam to assess the COMC with 90% of sensitivity for labyrinthine fístulae. In the stage II we had a good postoperative outcome.A otite média crônica colesteatomatosa (OMCC) pode cursar com complicações intra e/ou extracranianas, entre elas a fístula labiríntica. Neste trabalho, mostramos a incidência e a evolução dos casos de fístula labiríntica decorrentes da OMCC em nosso serviço. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Dez pacientes com fístula labiríntica, do total de 82 pacientes com OMCC, foram submetidos à cirurgia no período de janeiro de 2001 a abril de 2002 e avaliados através de exame otorrinolaringológico completo, tomografia computadorizada e audiometria pré e pós-operatória. RESULTADOS: Perda auditiva, otorréia, zumbido e vertigem estavam presentes em 100%, 90%, 80% e 40% dos casos respectivamente na avaliação clínica pré-operatória. Em um paciente a fístula aparecia apenas nos cortes tomográficos coronais e tivemos um caso de falso-negativo. Dos pacientes com zumbido, 66% apresentaram melhora deste quadro no pós-operatório. DISCUSSÃO: Nos casos de fístula sem invasão do espaço perilinfático (até grau II), notamos uma tendência de melhora dos quadros clínico e audiométrico após a cirurgia. Nas fístulas extensas, por outro lado, o resultado audiométrico se manteve inalterado. CONCLUSÃO: A tomografia continua sendo o exame de escolha para os quadros de OMCC com sensibilidade de 90% para fístulas labirínticas. Nas fístulas grau II a cirurgia apresenta bom resultado funcional.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Otorrinolaringologia e Distúrbios da Comunicação HumanaUNIFESP, EPM, Depto. de Otorrinolaringologia e Distúrbios da Comunicação HumanaSciEL

Dipotassium tetra­aqua­bis­[3,5-bis­(dicyano­methyl­ene)cyclo­pentane-1,2,4-trionato(1−)-κN]cobaltate(II)

The title structure, K2[Co(C11N4O3)2(H2O)4], is isotypic with K2[Fe(C11N4O3)2(H2O)4]. The CoII atom is in a distorted octa­hedral CoN2O4 geometry, forming a dianionic mononuclear entity. Each dianionic unit is associated with two potassium cations and inter­acts with adjacent units through O—H⋯N and O—H⋯O hydrogen bonds

Changes in the biochemical and immunological components of serum and colostrum of overweight and obese mothers

Abstract\ud \ud Background\ud Obesity in pregnancy is associated with systemic inflammation, immunological changes and adverse maternal-fetal outcomes. Information on the association between maternal obesity and breast milk composition is scarce. This study describes changes and relationships between biochemical and immunological parameters of colostrum and serum of overweight and obese women.\ud \ud \ud Methods\ud Colostrum and blood samples were collected from 25 normal weight, 24 overweight and 19 obese women for determination of glucose, total protein, triglycerides, cholesterol, immunoglobulins, complement proteins (C3 and C4), fat and calorie content and C-reactive protein (CRP).\ud \ud \ud Results\ud Glucose was higher in colostrum of obese women (p = .002). In normal weight and obese women, total protein content was higher in colostrum than in serum (p = .001). Serum triglycerides (p = .008) and cholesterol (p = .010) concentrations were significantly higher in overweight and obese women than in their normal weight counterparts, but in colostrum their concentrations were similar across the three groups. Secretory IgA (sIgA) in colostrum and IgA in serum concentrations were significantly higher (p = .001) in overweight and obese mothers, whereas IgG and IgM concentrations did not vary among the groups (p = .825). Serum C3 (p = .001) and C4 (p = .040) concentrations were higher in obese women. No differences in colostrum complement proteins were detected among the groups. Calorie content (p = .003) and fat (p = .005) concentrations in colostrum and serum CRP (p = .002) were higher in obese women.\ud \ud \ud Conclusions\ud The results corroborate the hypothesis that colostrum of overweight and obese women undergoes biochemical and immunological changes that affect its composition, namely increasing glucose concentrations, calorie content, fat and sIgA concentrations.Fundação de Amparo a Pesquisa de São Paulo (FAPESP-No 2012-17843-8; No 2012-16662-0)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-No 308702/2013-1; No 475238/2013-3

Efeito do gengibre no poder anaeróbico de membros inferiores de ginastas da seleção brasileira

Introduction: Aerobic gymnastics is a sport that has consistently grown over the previous decades, and its practice demands its athletes to perform complex and high-intensity movements. Objective: The study was to analyze whether ginger supplementation had an ergogenic effect on the anaerobic power of limbs (PAMI) in aerobic gymnastic athletes. Methods: A randomized double-blind placebo-controlled trial was conducted with nine athletes (23.11 + 4.14 years, 1.63 + 0.09 m, 60.51 + 7.38 kg) from the Brazilian National Team of Aerobic Gymnastics. After ingesting 400 mg of Zingiber officinale or placebo for seven days, the subjects underwent an anaerobic power test (RAST). Peak Velocity and Peak power (m/s and W), average and minimum power (W), and fatigue index (W/s and %) data were obtained from the RAST. Results: After verifying the no normality of the sample, the Mann-Whitney was applied, but no significant differences were found in the peak velocity of the ginger supplementation (6.28 ± 0.41 m/s; 445.28 ± 117.15 W) compared to placebo (6.22 ± 0.45 m/s; 425.95 ± 130.39 W). Conclusions: It is concluded that ingesting 400 mg of Z. officinale does not have an ergogenic effect on the anaerobic power of the lower limbs of aerobic gymnastic athletes.Introdução: a ginástica aeróbica é um esporte que tem crescido consistentemente nas últimas décadas, e sua prática exige que seus atletas realizem movimentos complexos e de alta intensidade. Objetivo: analisar se a suplementação com gengibre tem efeito ergogênico no poder anaeróbico dos membros (PAMI) em atletas de ginástica aeróbica. Métodos: foi realizado um estudo randomizado, duplo-cego, controlado por placebo, com nove atletas (23,11 + 4,14 anos, 1,63 + 0,09 m, 60,51 + 7,38 kg) da Seleção Brasileira de Ginástica Aeróbica. Após a ingestão de 400 mg de Zingiber officinale ou placebo por sete dias, os indivíduos foram submetidos a um teste de potência anaeróbica (RAST). Os dados de Velocidade de pico e Potência de pico (m/s e W), potência média e mínima (W) e índice de fadiga (W/s e %) foram obtidos no RAST. Resultados: Após verificar a não normalidade da amostra, foi aplicado o Mann-Whitney, mas não foram encontradas diferenças significativas na velocidade de pico da suplementação de gengibre (6,28 ± 0,41 m / s; 445,28 ± 117,15 W) em comparação ao placebo (6,22 ± 0,45 m / s; 425,95 ± 130,39 W). Conclusões: conclui-se que a ingestão de 400 mg de Z. officinale não exerce efeito ergogênico no poder anaeróbico dos membros inferiores de atletas de ginástica aeróbica

Avocado (Persea americana) pulp improves cardiovascular and autonomic recovery following submaximal running: a crossover, randomized, double-blind and placebo-controlled trial

Previous studies have demonstrated that regular avocado consumption presents advantageous effects on cardiovascular system. However, little attention has been paid to the use of avocado as a dietary supplement, in particular, for individuals involved in physical exercise training. Therefore, this study aims to evaluate the effect of acute avocado pulp intake on cardiovascular and autonomic recovery subsequent to moderate exercise. Using a crossover, randomized, double-blind and placebo-controlled trial design, 16 healthy female adults underwent two protocols: Avocado pulp (600 mg in capsule) and placebo (600 mg starch in capsule). After the ingestion of Avocado pulp or placebo, the subjects were seated for 60 min at rest, followed by running on a treadmill at a submaximal level and then remained seated for 60 min during recovery from the exercise. Heart rate (HR), heart rate variability (HRV) [rMSSD, SD1, HF (ms2)] and skin conductance were evaluated before and during exercise, as well as during recovery. HR, systolic blood pressure, HRV and skin conductance recovered faster when subjects were given avocado pulp prior to exercise. In conclusion, avocado pulp improved cardiovascular and autonomic recovery after exercise, suggesting a reduced risk of cardiovascular events after exertion. The current results support the beneficial effects of ingestion of avocado prior to submaximal treadmill running