Neuromuscular Blockade Agents Reversal with Sugammadex Compared to Neostigmine in the Living Kidney Donors

Backround: The reversation of NMBA (neuromuscular blocking agents) prevents numerous postoperative complications, increases quality of recovery and decreases the time, expenditure spending in hospital. The choice of medicine used to reverse NMBA depends  considered as a key fators to gain the best outcome and to avoid the side effects. Aim: To evaluate the postoperative effect on muscle relaxation reversal and side effects of sugammadex 2 mg/kg versus the combination of  neostigmine and atropine sulfate in the living kidney donors. MethodS: A randomised controlled trial on 70 patients undergoing living kidney donation surgery were allocated to 2 groups. Patients in group I (SUGA) were reversed with sugammadex 2 mg/kg and in group II (NEO/ATR) with the combination of neostigmine and atropine sulfat. Results: With 35 patients in each group, the study results showed that after 3 mintutes of reversal patients reaching TOF value ≥ 0.9 in group SUGA is 91.4%, after 5 minutes 100% of patients in group SUGA reached TOF value ≥ 0.9 . In group NEO/ATR after 3 minutes 28.6% patients reached TOF ≥ 0.9 and 40% patients reached TOF≥ 0.9 after 5 minutes. The difference in percentage of patients reaching TOF ≥ 0.9 after 3 minutes, 5 minutes of reversal between two groups is significant (p<0.05). After 10 minutes, 100% patients in both group got TOF ≥ 0.9. Time to exutubation of group SUGA was 249.43 ± 81.75 seconds and it was 456.29 ± 146.45 seconds in group NEO/ATR. Nausea, bradycardia, and increased phlegm production in group NEO/ATR was 22.9%; 28.5%; 25.7% respectively; while those side effects were not met in group SUGA, the difference was significant (p<0.05). Conclusion: The muscle relaxation reversal effect of sugammadex was faster than that of neostigmine, the duration TOF ≥ 0.9 and the time to extubation was significantly faster. Sugammadex did not cause hemodynamic changes before and after muscle relaxation reversal, neostigmine resulted in the bradycardia, increased phlegm secreting and other side effects. The renal function after 24 hours postoperatively of two groups was similar

Optimizing the ratios of standardized ileal digestible (SID) methionine plus SID cystine and SID threonine to SID lysine in low-protein diets for working boars

This study aimed to optimize the ratios of standardized ileal digestible (SID) methionine (Met) plus cystine (Cys), and threonine (Thr) to SID lysine (Lys) in low-protein diets for working boars. Forty-eight working Duroc boars were randomly allocated to one of 12 dietary treatments in a 3x4 factorial experimental design in which factor 1 was the ratios of SID Met plus Cys to SID Lys (50, 60, 70%), factor 2 was the ratios of SID Thr to SID Lys (40, 50, 60, 70%). Semen was collected at a 4 days interval for 6 weeks for 10 ejaculates. Semen volume (V), percentage of sperm with progressive motility (A), sperm concentration (C), and the total number of motile sperm per ejaculate (VAC) were measured. The results of the study revealed that the ratios of SID Met plus Cys to SID Lys in the diets affected the C and VAC. Values of C and VAC were highest at the ratios of SID Met plus Cys to SID Lys of 70% and lowest at 50% (P<0.05). Similarly, the ratios of SID Thr to SID Lys affected the C and VAC. Further, the values of C and VAC were highest at the ratio of SID Thr to SID Lys of 60% and lowest at 40% (P<0.05). There was no interaction effect between the two factors. In conclusion, the ratios of SID Met plus Cys to SID Lys of 70% and SID Thr to SID Lys of 60% in a 13.5% CP diet are optimal for working boars

Transport Jc in Bulk Superconductors: A Practical Approach?

The characterisation of the critical current density of bulk high temperature superconductors is typically performed using magnetometry, which involves numerous assumptions including, significantly, that Jc within the sample is uniform. Unfortunately, magnetometry is particularly challenging to apply where a local measurement of Jc across a feature, such as a grain boundary, is desired. Although transport measurements appear to be an attractive alternative to magnetization, it is extremely challenging to reduce the cross-sectional area of a bulk sample sufficiently to achieve a sufficiently low critical current that can be generated by a practical current source. In the work described here, we present a technique that enables transport measurements to be performed on sections of bulk superconductors. Metallographic techniques and resin reinforcement were used to create an I-shaped sample of bulk superconductor from a section of Gd-Ba-Cu-O containing 15 wt % Ag2O. The resulting superconducting track had a cross-sectional area of 0.44 mm2. The sample was found to support a critical current of 110 A using a field criterion in the narrowed track region of 1 μV cm-1. We conclude, therefore, that it is possible to measure critical current densities in excess of 2.5 x 108 A m-2 in sections of a bulk superconductor.This work was supported by the Engineering and Physical Sciences Research Council, via a Doctoral Training Award (grant number is EP/L504920/1) and funding from grant number EP/K02910X/1. This work was also supported by the Boeing Company. All data are provided in full in the results section of this paper.This is the author accepted manuscript. The final version is available from IEEE via http://dx.doi.org/10.1109/TASC.2016.253764

Streptococcus suis, an Important Cause of Adult Bacterial Meningitis in Northern Vietnam

Streptococcus suis can cause severe systemic infection in adults exposed to infected pigs or after consumption of undercooked pig products. S. suis is often misdiagnosed, due to lack of awareness and improper testing. Here we report the first fifty cases diagnosed with S. suis infection in northern Viet Nam.In 2007, diagnostics for S. suis were set up at a national hospital in Hanoi. That year there were 43 S. suis positive cerebrospinal fluid samples, of which S. suis could be cultured in 32 cases and 11 cases were only positive by PCR. Seven patients were blood culture positive for S. suis but CSF culture and PCR negative; making a total of 50 patients with laboratory confirmed S. suis infection in 2007. The number of S. suis cases peaked during the warmer months.S. suis was commonly diagnosed as a cause of bacterial meningitis in adults in northern Viet Nam. In countries where there is intense and widespread exposure of humans to pigs, S. suis can be an important human pathogen

Priorities for Pig Research in Southeast Asia and the Pacific to 2010

Livestock Production/Industries, Research and Development/Tech Change/Emerging Technologies,

Multi-drug resistant Vibrio cholerae O1 variant El Tor isolated in northern Vietnam between 2007 and 2010

Since 2007, there has been a re-emergence of cholera outbreaks in northern Vietnam. To understand the molecular epidemiological relatedness and determine the antibiotic susceptibility profiles of responsible V. cholerae O1 outbreak strains, a representative collection of 100 V. cholerae O1 strains was characterized. V. cholerae O1 strains isolated from diarrhoeal patients in northern Vietnam between 2007 and 2010 were investigated for antibiotic susceptibility and characterized by using phenotypic and genotypic tests, including PFGE analysis. Ten clinical V. cholerae O1 isolates from Bangladesh and Zimbabwe were included for comparison. The results revealed that all isolates were resistant to co-trimoxazole and nalidixic acid, 29 % were resistant to tetracycline and 1 % were resistant to azithromycin. All strains were susceptible to ampicillin–sulbactam, doxycycline, chloramphenicol and ciprofloxacin and 95 % were susceptible to azithromycin. MIC values did show reduced susceptibility to fluoroquinolones and 63 % of the strains were intermediately resistant to tetracycline. The isolates expressed phenotypic traits of both serogroup O1 Ogawa and El Tor and harboured an rstR El Tor and ctxB classical biotype. Among the outbreak isolates, only a single PFGE pattern was observed throughout the study period. This study shows that multi-drug resistant V. cholerae altered El Tor producing classical CT strains are now predominant in northern Vietnam

Long‐term viral suppression and immune recovery during first‐line antiretroviral therapy: a study of an HIV‐infected adult cohort in Hanoi, Vietnam

Abstract Introduction: Achieving viral suppression is key in the global strategy to end the HIV epidemic. However, the levels of viral suppression have yet to be described in many resource‐limited settings. Methods: We investigated the time to virologic failure (VF; defined as a viral load of ≥1000 copies/ml) and changes in CD4 counts since starting antiretroviral therapy (ART) in a cohort of HIV‐infected adults in Hanoi, Vietnam. Factors related to the time to VF and impaired early immune recovery (defined as not attaining an increase in 100 cells/mm3 in CD4 counts at 24 months) were further analysed. Results: From 1806 participants, 225 were identified as having VF at a median of 50 months of first‐line ART. The viral suppression rate at 12 months was 95.5% and survival without VF was maintained above 90% until 42 months. An increase in CD4 counts from the baseline was greater in groups with lower baseline CD4 counts. A younger age (multivariate hazard ratio (HR) 0.75, vs. <30), hepatitis C (HCV)‐antibody positivity (HR 1.43), and stavudine (d4T)‐containing regimens (HR 1.4, vs. zidovudine (AZT)) were associated with earlier VF. Factors associated with impaired early immune recovery included the male sex (odds ratio (OR) 1.78), HCV‐antibody positivity (OR 1.72), d4T‐based regimens (OR 0.51, vs. AZT), and nevirapine‐based regimens (OR 0.53, vs. efavirenz) after controlling for baseline CD4 counts. Conclusion: Durable high‐rate viral suppression was observed in the cohort of patients on first‐line ART in Vietnam. Our results highlight the need to increase adherence support among injection drug users and HCV co‐infected patients

Incidence of AIDS-Defining Opportunistic Infections and Mortality during Antiretroviral Therapy in a Cohort of Adult HIV-Infected Individuals in Hanoi, 2007-2014

Background: Although the prognosis for HIV-infected individuals has improved after antiretroviral therapy (ART) scale-up, limited data exist on the incidence of AIDS-defining opportunistic infections (ADIs) and mortality during ART in resource-limited settings. Methods: HIV-infected adults in two large hospitals in urban Hanoi were enrolled to the prospective cohort, from October 2007 through December 2013. Those who started ART less than one year before enrollment were assigned to the survival analysis. Data on ART history and ADIs were collected retrospectively at enrollment and followed-up prospectively until April 2014. Results: Of 2,070 cohort participants, 1,197 were eligible for analysis and provided 3,446 person-years (PYs) of being on ART. Overall, 161 ADIs episodes were noted at a median of 3.20 months after ART initiation (range 0.03–75.8) with an incidence 46.7/1,000 PYs (95% confidence interval [CI] 39.8–54.5). The most common ADI was tuberculosis with an incidence of 29.9/1,000 PYs. Mortality after ART initiation was 8.68/1,000 PYs and 45% (19/45) died of AIDS-related illnesses. Age over 50 years at ART initiation was significantly associated with shorter survival after controlling for baseline CD4 count, but neither having injection drug use (IDU) history nor previous ADIs were associated with poor survival. Semi-competing risks analysis in 951 patients without ADIs history prior to ART showed those who developed ADIs after starting ART were at higher risk of death in the first six months than after six months. Conclusion: ADIs were not rare in spite of being on effective ART. Age over 50 years, but not IDU history, was associated with shorter survival in the cohort. This study provides in-depth data on the prognosis of patients on ART in Vietnam during the first decade of ART scale-up