L'exposition aux gaz anesthésiques. À propos d'une campagne de mesure au bloc opératoire d'un hôpital universitaire suisse

Des gaz anesthésiques sont souvent administrés dans le cadre de l'anesthésie générale. Cet article décrit les résultats d'une campagne de mesures de l'exposition du personnel à ces gaz. Les résultats des mesures effectuées démontrent une situation acceptable du point de vue des normes suisses. Certaines activités sont néanmoins responsables d'une exposition plus importante selon le type d'anesthési

Injuries in the Martial Arts Judo, Taekwondo and Wrestling – A Systematic Review

Hintergrund: Kampfsportarten wie Judo, Taekwondo und Ringen sind reglementierte, in der Regel sportliche Zweikämpfe, bei denen es darum geht, entweder mehr Punkte zu erreichen als der Gegner, oder zu gewinnen. Wie in jeder anderen Sportart werden auch hier kleinere und größere Verletzungen beobachtet, was für den Sportler viele negative Konsequenzen haben kann. Zudem verursachen Sportverletzungen und deren Rehabilitation hohe Kosten für das Gesundheitssystem. Im Gegensatz zum FIFA 11 + Aufwärmprogramm, gibt es in diesen Kampfsportarten keine Präventivprogramme zur Verletzungsprophylaxe. Daher war das Ziel dieser Arbeit, den aktuellen Forschungsstand zusammenzufassen, um zu evaluieren, ob erste Empfehlungen für die Kampfsportarten Judo, Ringen und Taekwondo zur Reduktion der Verletzungen ausgesprochen werden können. Methoden: Um einen Überblick über den aktuellen Forschungsstand zu erhalten, wurden in den Datenbanken PEDro, PubMed, Cochrane sowie in der Internetsuchmaschine Google scholar nach Übersichtsarbeiten zu den drei Kampfsportarten Judo, Taekwondo und Ringen gesucht. Deren methodologische Qualität wurde mittels Critical Appraisal Tool for a Systematic Review (CASP) bewertet, sowie die Daten zu Verletzungsrisiken, Verletzungslokalisation und Verletzungstyp extrahiert. Ergebnisse: Es zeigte sich, dass alle drei untersuchten Übersichtsarbeiten eine niedrige bis mittlere methodologische Qualität aufweisen. Bei der Verletzungslokalisation wurde ersichtlich, dass in allen drei Kampfsportarten besonders die Extremitäten gefährdet sind. Als häufigster Verletzungstyp wurde der Erguss beobachtet. Schlussfolgerung: Aufgrund der mäßigen methodologischen Qualität und dem Verletzungstyps Erguss ist es nicht möglich, Empfehlungen zur Prävention von Verletzungen auszusprechen. Des Weiteren sollte an einer einheitlichen Definitionsbeschreibung von Sportverletzungen gearbeitet werden.Background: Martial arts such as judo, taekwondo and wrestling are regulated, usually athletic duels. The aim is to score better than your opponent or to win. As with any type of sport, athletes in martial arts sustain minor and major injuries, which may have many negative consequences. In addition, sports injuries and their rehabilitation generate high costs to the healthcare system. In contrast to the FIFA 11+ warm-up program, no preventive programs have been postulated for injury prevention in these martial arts. Therefore, the aim of this systematic review was to summarise the latest research findings and to evaluate whether initial recommendations can be given for the reduction of injuries in the martial arts judo, wrestling and taekwondo. Methods: To gain an overview of the latest research findings, we searched for systematic reviews in PEDro, PubMed, Cochrane and the internet search engine Google Scholar. The methodological quality of these reviews was assessed using the Critical Appraisal Tool for a Systematic Review (CASP), and data was extracted on the risk of injury, injury location and injury type. Results: It was found that all three review articles are of low to moderate methodological quality. Regarding injury location, it became evident that the extremities are particularly vulnerable to injury in all three martial arts. Effusion was observed to be the most common type of injury. Conclusion: Due to the moderate methodological quality and the injury type of effusion, it is not possible to formulate recommendations for injury prevention. Moreover, uniform definitions should be developed to describe sports injuries

Anaesthesia for electroconvulsive therapy: time for a change?

Introduction: Electroconvulsive therapy (ECT) may be used to treat severe depression and needs a specific general anaesthesia. Important cardiovascular changes occur during the ECT with a parasympathetic induced bradycardia followed by a sympathetic response. A dedicated protocol was designed 6 years ago. The goal of this study was to analyse the management of anaesthesia for ECT in our institution, the adherence to the protocol and the occurrence of adverse events during anaesthesia. Methods: After Institutional Ethics Committee approval, we conducted a retrospective analysis of our anaesthesia protocol for patients scheduled for electroshock therapy during a five years period (2004- 2008). The protocol includes administration of atropine subcutaneously 30 minutes before the procedure, followed by general anaesthesia induced with etomidate (0.2 mg/kg). Suxamethonium (1 mg/kg) is administered after the inflation of a pneumatic tourniquet on the opposite arm, in order to observe the electroshocks convulsive effects. The psychiatrist initiates the convulsive crisis once curarisation is achieved. Face mask ventilation is then applied during the post-ictal phase with closed blood pressure monitoring. : 228 ECT were performed in 25 patients. The median dosage of etomidate was 0.37 mg/kg and suxamethonium 1.20 mg/kg. Hypertension during the ECT procedure was present in 62.7% of cases, tachycardia 23.2% and bradycardia 10.5%. Esmolol was administered in 73.4% of hypertensive patients in a range of 0 to 30 mg. The protocol was followed in half of the cases in regards to atropine administration (50.4%). We observed a significant increase of hypertension (73.9%, p = 0.001) after atropine administration, without effect on heart rate. Conclusions: The management of anaesthesia for ECT is specific and follows a predefined protocol in our institution. Adherence to our protocol was poor. Adverse events are frequent and significant association between the administration of atropine and the incidence of hypertension as well as poor protocol adherence implies reconsideration of our anaesthesia protocol for electroconvulsive therapy and better quality control of the clinical practice

Maladies et incapacites, allocations et modes de transports: correlations chez les membres d'une association de patients avec maladies neuromusculaires. Pour l'Association Suisse Romande contre la Myopathie. [Correlation of diseases and disabilities and allocation and modes of transport among the members of an association of patients with neuromuscular diseases. For the Association Suisse Romande contre la Myopathie]

Seventy-nine patients with various chronic neuromuscular disorders returned a questionnaire. We analyzed the linkage between demographic and socio-economic data, type of disease and disability, and types of transportation used. This study shows that whatever type of disability, all patients attach a significant priority to the use of their private vehicle, and that (i) there is a significant correlation between severity of disability and use of disabled people transportation system but not with revenue nor with type of professional activity, and (ii) satisfaction rate is inversely proportional to severity of disability. The relationship between disability and disabled people transportation system appears as logical, but those between revenue and type of transportation is rather complex (role of family, of special refunds from insurance industry, possibility of special loans from the patient organization). The absence of correlation between severity of disability and professional activity must be explained by our choice concerning the scale of disability, which appears too simplistic according to the complexity of the different neuromuscular disorders. It is concluded that (i) co-operation and consultation are needed to give patients better access to disabled people transportation system and to improve technical aids to drive private vehicle and (ii) a more appropriated scale to quantitate disability in neuromuscular disorder patients is needed

Low pt thin cathode layer catalyst layer by reactive spray deposition technology

National Research Council Canada's Institute for Fuel Cell Innovation, NRC-IFCI, has been developing the Reactive Spray Deposition Technology (RSDT) process to optimize composite electrode layer formation and develop novel electrocatalysts and catalyst layers. The RSDT process provides the means necessary to develop the next generation of thin, low platinum or alloy catalyst layers for PEM MEA's. In order to best manage water distribution, mass transport and conductivity, the structure should be a gradient with controlled porosity and controlled distribution of both platinum and ionomer across the catalyst layer. The RSDT process allows good control of the platinum particle size as they are created directly from metal vapors, which prevents agglomeration in the catalyst layer. Additionally, it has the flexibility to build a gradient layer structure across a very thin film catalyst layer (<1 um). In our design, a platinum sub-layer (100 nm) was deposited directly on a Nafion\uae 117 membrane as a columnar structure. After the sub-layer, the platinum loading was reduced in a co-deposited layer of Pt-Nafion (ionomer)-carbon with the lowest loading closest to the GDL. The combined loading of both layers was <0.05mg/cm2 Pt with this approach. The manufactured catalyst layer has a performance of 0.65V at 1 A/cm2 with 0.05mg/cm2 Pt loading using pure oxygen.Peer reviewed: YesNRC publication: Ye

Antioxidant, antimicrobial and cytotoxic properties as well as the phenolic content of the extract from Hancornia speciosa Gomes

Hancornia speciosa Gomes (Apocynaceae) is a fruit tree, popularly known as mangabeira, and it is widely distributed throughout Brazil. Several parts of the plant are used in folk medicine, and the leaf and bark extracts have anti-inflammatory, antihypertensive, antidiabetic, and antimicrobial properties. In this study, we investigated the chemical composition of the ethanolic extract of Hancornia speciosa leaves (EEHS) and its antioxidant, antimicrobial, and cytotoxic activities as well as the mechanisms involved in cell death. The chemical compounds were identified by liquid chromatography coupled to mass spectrometry (LC-MS/MS). The antioxidant activity of the EEHS was investigated using the method that involves the scavenging of 2,2-diphenyl-1-picrylhydrazyl free radicals as well as the inhibition of oxidative hemolysis and lipid peroxidation induced by 2,2’-azobis (2-amidinopropane) in human erythrocytes. The antimicrobial activity was determined by calculating the minimum inhibitory concentration, minimum bactericidal concentration, minimum fungicidal concentration, and zone of inhibition. Kasumi-1 leukemic cells were used to assess the cytotoxic activity and mechanisms involved in cell death promoted by the EEHS. The chemical compounds identified were quinic acid, chlorogenic acid, catechin, rutin, isoquercitrin, kaempferol-rutinoside, and catechin-pentoside. The EEHS demonstrated antioxidant activity via the sequestration of free radicals, inhibition of hemolysis, and inhibition of lipid peroxidation in human erythrocytes incubated with an oxidizing agent. The antimicrobial activity was observed against American Type Culture Collection (ATCC) and hospital strains of bacteria and fungi, filamentous fungi and dermatophytes. The cytotoxic activity of the EEHS was induced by apoptosis, reduction of the mitochondrial membrane potential, and activation of cathepsins. Together, these results indicate the presence of phenolic compounds and flavonoids in the EEHS and that their antioxidant, antimicrobial, and cytotoxic activities in acute myeloid leukemia cells are mediated by apoptosis.This work was supported by grants from Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (FUNDECT, Brazil), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil) and PRODER, (24.073 – Â, Portugal). E.L.S.; E.J.P.G e C.A.L.C., were recipient of felowship from CNPq, Brazil. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript