PENTAZOCINE IN SEQUENTIAL ANALGESIC ANAESTHESIA

SUMMARY The technique of sequential analgesic anaesthesia, a new approach to balanced anaesthesia using fentanyl and pentazocine, is described. Elderly patients who were particularly at risk during orthopaedic surgery were studied and measurements made of blood pressure, pulse rate, central venous pressure, respiratory minute volume; arterial and venous Po2, Pco2 and pH were also measured. The results showed that good cardiovascular stability was achieved during the operation and in the postoperative period. Pentazocine reversed the respiratory depression produced by fentanyl and the patients were conscious and co-operative very soon after the operation. Excellent analgesia, on average lasting for 10 hours, was provided by the use of the two drugs. Side effects were infrequent and of no clinical importance. It was concluded that the technique of sequential analgesic anaesthesia was particularly useful for the elderly high-risk patients and that it could represent a valuable alternative anaesthetic technique for this grou

Tensile Testing of Polyurea Crosslinked Silica Aerogel Impregnated Silicone and Amine Functionalized Polyoligomeric Silsesquioxane Crosslinked Polyimide Aerogel for Cryogenic Tank Applications.

Polymer-based thermally insulating vessels are an attractive option for future space exploratory missions as well as energy conserving terresterial applications as an alternative to the conventional metal-based structures. Aerogel due to its unique set of material properties, such as superior thermal insulation and light weight, makes it an attractive for future space applications. Room Temperature (RT) and Low Temperature (LT)evaluation of the mechanical properties of Polyurea Crosslinked Silica Aerogel (PCSA) impregnated RTV655 was performed under increasing concentrations of PCSA. The effect of PCSAparticles size on the tensile behavior of RTV655 was also assessed and compared with the tensile behavior of neat RTV655 at both RT and LT. Incorporated PCSAparticles ranges were varied from 90-425µm and the concentrations tested were 25%, 50%, and 75% weight to the RTV655. The tensile properties of amine functionalized Polyoligomeric Silsesquioxane (POSS) crosslinked polyimide (PI)aerogel strips were also evaluated at both RT and LT and the effect of geometry and flexibility of PI-based aerogels was compared with the results obtained from PCSAimpregnated RTV 655 samples

COMPARISON OF EXTRADURAL ADMINISTRATION OF SUFENTANIL, MORPHINE AND SUFENTANIL-MORPHINE COMBINATION AFTER CAESAREAN SECTION

We have studied postoperative analgesia and unwanted side effects of a single dose of a mixture of morphine and sufentanil administered extradurally with the effects produced by extradural injection of each opioid alone in 64 patients after Caesarean delivery. The patients were allocated randomly to receive morphine 4 mg (n = 21), sufentanil 50 μg (n = 22) or morphine 2 mg with sufentanil 25 μg (n = 21) via an extradural catheter in a double-blind design. Intensity of pain was measured using a linear visual analogue scale. Compared with the effect produced by morphine alone, the morphine-sufentanil combination produced more rapid onset of pain relief (19 (SD 5) min vs 79 (23) min for a 75% reduction of pain; P < 0.01), whereas the duration and quality of analgesia assessed during 12 h was similar for these two groups. In contrast, patients receiving sufentanil alone required significantly more supplementary analgesia 4 h after administration than with morphine alone or morphine combined with sufentanil. There were no significant changes in cardiorespiratory variables in any group. Side effects consisted mainly of pruritus and nausea and did not differ between groups, with the exception of early and transient dizziness which was observed only in patients given sufentanil either alone or in combination with morphine. We conclude that a single extradural injection of morphine and sufentanil combines the short onset time produced by sufentanil and the long duration of analgesia attributable to morphine, thus providing excellent and prolonged analgesia after Caesarean deliver

Single-particle HIV-1 capsid uncoating analysis to elucidate the role of the cofactor IP6 and the mode of action of the capsid-targeting drug Lenacapavir

The process and factors that trigger HIV-1 capsid uncoating remain an area of active research. Our group has previously reported an in-vitro single particle capsid uncoating assay using Total Internal Reflection Fluorescence (TIRF) microscopy. While the assay provided a unique advantage for investigating capsids at a single particle level, the method was constrained by two sample limitations caused by the necessity to include GFP within the Gag polyprotein: (1) the presence of a foreign insertion can affect maturation and reduce virus titre; and (2) availability of only a single proviral clone (WT) with GFP embedded in the sequence. Consequently, any alternative virus or mutant to be studied must be carefully engineered which would require extensive amount of cloning let alone validation prior to uncoating experimentation. To overcome above limitations, I have developed two different independent approaches with a motivation to broaden the capabilities of our uncoating assay so that it could be deployed to investigate various HIV groups, subgroups and their respective mutants. In the first method (CypA paint assay), I have fluorescently labelled capsid binding protein ‘CypA’ and utilised it to monitor capsid disassembly process. In the second method (GFP Vpr assay), I have loaded fluorescent protein (GFP/mScarlet) as a fluid marker inside virions by tagging it along with the viral accessory protein R (Vpr) and used the fluid marker to monitor the loss of capsid integrity. I have utilised the assays to elucidate the role of host factor inositol hexakisphosphate (IP6) in multiple stages of HIV-1 lifecycle. I show that IP6 is an important cofactor that (1) packages into immature lattice via a positively charged interface in the immature lattice and (2) drives the assembly and formation of a stable matured capsid via a positively charged interface in the matured capsid that is capable maintaining proper stability required for a successful infection. Furthermore, I have investigated the effect of various capsid targeting antivirals including newly reported ultrapotent GS-6207 and a peptide derived from host cofactor CSPF6. I show that drugs and CSPF6 peptide although they occupy a shared interface on HIV-1 capsid have differential effects on the capsid integrity and stability

Ko-infeksi asimptomatik helminthiasis pada pasien tuberkulosis paru di Surabaya kota: studi pendahuluan

BACKGROUNDPulmonary tuberculosis (TB) is a leading cause of morbidity and mortality, and East Java province is the second largest contributor of co-infection in Indonesia. Asymptomatic helminth infection among pulmonary tuberculosis patients causes another public health problem. Few data relate to helminth infection based on clinical and immunological outcomes of pulmonary TB in highly endemic areas. METHODSThis study was designed as a preliminary study and aimed to determine helminth co-infection among TB patients with a macroscopic assessment. This cross-sectional study was conducted in June-August 2017. RESULTSAmong 16 treated active TB patients from TB cohort data of Tanakali Kedinding health center found that 56% were stool smear-positive for Trichuris trichiura eggs, but had no clinical symptoms. CONCLUSIONWhether or not the helminth infection may have an impact on the diagnosis and treatment of active TB remains to be further investigated. Co-infection could be inhibited by the host immune response and improve the prognosis of TB treatment.LATAR BELAKANGPenyakit tuberculosis paru (TB) hingga saat ini masih menjadi penyebab utama tingginya angka morbiditas dan mortalitas, dan propinsi Jawa Timur termasuk penyumbang penderita kedua terbanyak di Indonesia. Hanya sedikit data informasi diketahui terkait infeksi kecacingan yang terjadi pada penderita TB baik secara klinis dan imunologi pada daerah endemis.&nbsp;METODEStudi ini di desain sebagai studi awal dan bertujuan untuk menilai ko-infeksi kecacingan diantara penderita TB. Studi potong-lintang ini dilakukan pada bulan Juni-Agustus 2017.HASILEnam belas penderita aktif TB berdasarkan data kohort tuberkulosis Puskesmas Tanakali Kedinding, didapatkan 56%-nya positif kecacingan dengan ditemukannya telur Trichuris trichiura.KESIMPULANWalaupun efek dari infeksi kecacingan tidak berdampak terhadap diagnosis dan pengobatan tuberkulosis, akan tetapi sebaiknya penderita yang terdeteksi sebagai tuberkulosis aktif, dilakukan skrining kecacingan terlebih dahulu. Ko-infeksi dapat dihampat oleh respon imun penderita dan meningkatkan prognosis pengobatan tuberkulosis.&nbsp

Sex-Specific Impacts of Exercise on Cardiovascular Remodeling

Cardiovascular diseases (CVD) remain the leading cause of death in men and women. Biological sex plays a major role in cardiovascular physiology and pathological cardiovascular remodeling. Traditionally, pathological remodeling of cardiovascular system refers to the molecular, cellular, and morphological changes that result from insults, such as myocardial infarction or hypertension. Regular exercise training is known to induce physiological cardiovascular remodeling and beneficial functional adaptation of the cardiovascular apparatus. However, impact of exercise-induced cardiovascular remodeling and functional adaptation varies between males and females. This review aims to compare and contrast sex-specific manifestations of exercise-induced cardiovascular remodeling and functional adaptation. Specifically, we review (1) sex disparities in cardiovascular function, (2) influence of biological sex on exercise-induced cardiovascular remodeling and functional adaptation, and (3) sex-specific impacts of various types, intensities, and durations of exercise training on cardiovascular apparatus. The review highlights both animal and human studies in order to give an all-encompassing view of the exercise-induced sex differences in cardiovascular system and addresses the gaps in knowledge in the field

Differences in research funding for women scientists: a systematic comparison of UK investments in global infectious disease research during 1997–2010

Objectives: There has not previously been a systematic comparison of awards for research funding in infectious diseases by sex. We investigated funding awards to UK institutions for all infectious disease research from 1997 to 2010, across disease categories and along the research and development continuum. Design: Systematic comparison. Methods: Data were obtained from several sources for awards from the period 1997 to 2010 and each study assigned to—disease categories; type of science (preclinical, phases I–III trials, product development, implementation research); categories of funding organisation. Fold differences and statistical analysis were used to compare total investment, study numbers, mean grant and median grant between men and women. Results: 6052 studies were included in the final analysis, comprising 4357 grants (72%) awarded to men and 1695 grants (28%) awarded to women, totalling £2.274 billion. Of this, men received £1.786 billion (78.5%) and women £488 million (21.5%). The median value of award was greater for men (£179 389; IQR £59 146–£371 977) than women (£125 556; IQR £30 982–£261 834). Awards were greater for male principal investigators (PIs) across all infectious disease systems, excepting neurological infections and sexually transmitted infections. The proportion of total funding awarded to women ranged from 14.3% in 1998 to 26.8% in 2009 (mean 21.4%), and was lowest for preclinical research at 18.2% (£285.5 million of £1.573 billion) and highest for operational research at 30.9% (£151.4 million of £489.7 million). Conclusions: There are consistent differences in funding received by men and women PIs: women have fewer funded studies and receive less funding in absolute and in relative terms; the median funding awarded to women is lower across most infectious disease areas, by funder, and type of science. These differences remain broadly unchanged over the 14-year study period

The Global Alliance for Infections in Surgery: Defining a Model for Antimicrobial Stewardship-Results From an International Cross-Sectional Survey

BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p \u3c 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal