Building two-dimensional metal-organic networks with tin

We show that Sn atoms combined with organic ligands can be used to build 2D coordination networks on Au(111) surfaces.

Loss of lipid material during the dehulling of oilseeds with different structural characteristics

The loss of lipid material by migration to the hull during the dehulling of oilseeds with different structural characteristics was evaluated. The samples selected -three sunflower hybrids and a safflower cultivar- were processed under optimal dehulling operating conditions and with two passes through a dehuller. From the SEM micrographs of the samples it was possible to observe structural differences which affect the mechanical properties of the pericarps and, consequently, the dehulling process. The black-hull sunflower hybrid exhibited residual hull percentages lightly above those recommended by the industry after one pass through the dehuller, therefore, this hybrid should not be further processed to avoid oil losses due to migration to the hull. On the other hand, the safflower cultivar and the high stearic high oleic sunflower hybrid and the traditional striped-hull sunflower require two passes through the dehuller, but this resulted in an oil loss due to migration to the hull of over 0.9 % per gram of grains processed. These results suggest the need to reach 'compromise' decisions based on economic impact studies in the face of the variables that originate simultaneously both positive and negative effects.

[Analysis of factors conditioning admission at the critical care unit of surgical patients. Prospective study of 764 patients operated for 1 year at a university and reference hospital]

OBJECTIVE

Assess what factors determine the income of surgical patients in critical care unit after surgery.

MATERIAL AND METHODS

It included a survey of the 10% of all patients operated by the services of General Surgery, Thoracic Surgery, Maxillofacial Surgery, Vascular Surgery, Urology and Otolaryngology during 2012. We performed a prospective, observational study. Pre-, intra-, and post-operative variables were analyzed. Comparisons were made between patients operated under elective and emergency surgery, and between patients admitted in critical care and admitted directly in the ward, using χ(2) of Pearson correlation with a confidence interval of 95%.

RESULTS

Seven hundred and sixty-four patients were included into the study, 304 were admitted in critical care after surgery and 460 were admitted in the ward. The medical history showed a statistically significant association with intensive care unit admission, well as the fact of being labeled with a high risk for the risk scales. Complexity and duration of the surgery showed a statistically significant association with intensive care unit admission, as well as the fact of present intra-operative complications. Emergency surgery was not significantly associated with intensive care unit admission of surgical patients, although these patients had significantly higher numbers of intra- and post-operative complications, and more exitus than those undergoing elective surgery.

CONCLUSIONS

A greater incidence of intensive care unit admission of patients undergoing emergency surgery should significantly reduce morbimortality rate. The existence of specific protocols for intensive care unit admission for urgent surgery, and greater availability of beds could be useful in this regard.

[Distal radius fracture: clinico-radiographic correlation after fixation with volar plate]

The purpose of the study was to assess and correlate the clinical and radiographic results of patients with distal radius fracture treated with a volar approach and plate osteosynthesis thus identifying the factors that determine or contribute to functional results in these patients.

METHODS

All patients who underwent surgical treatment for distal radius fracture with a volar approach and plate osteosynthesis from May 2010 to May 2011 were identified. They were radiographically assessed with measurements of the volar and radial angle and clinically with the Mayo Wrist Score; the correlation coefficient was used to obtain the results.

RESULTS

A total of 35 patients met the selection criteria; 23 females and 12 males; mean age was 40 years (18-62); the right extremity was predominant (25:10) and was the dominant limb in 57% of cases. The assessment using the MWS was done at postoperative year one; mean score was 81 (50-100): 37% were excellent, 31% good, 26% satisfactory, and 6% poor. The correlation showed that the MWS-radial angle and the MWS-volar angle had statistically significant values with p values of 0.0001 and 0.0008 respectively, both with a 95% confidence interval.

CONCLUSION

The clinical and radiographic correlation showed that the radial and volar angles are determining factors for a satisfactory course. Age, sex, the dominant limb, the number of days elapsed and the AO classification did not show statistically significant values for patient course.

[Anesthetic management of coagulation factor V deficiency]

Factor V deficiency, or Owren's disease, is a rare inherited recessive autonomic disorder that is congenital. The bleeding in patients with this disease depends on plasma levels of factor V. Anesthetic management is similar to that used for patients with other coagulation disorders. On the one hand, it is useful to initiate infusion of plasma if purified concentrates are not available. On the other hand, it is important to monitor hemostasis carefully so that bleeding during postoperative recovery can be prevented. Plasma and antifibrinolytic drugs such as tranexamic acid should continue to be administered in the first few days after surgery. We report the case of a man with homozygotic factor V deficiency who underwent surgery for colon cancer. This article reviews the main aspects of anesthetic management of this coagulation disorder.

[Anesthesia in intrahepatic cholestasis: Alagille syndrome]

A 42-year-old patient, diagnosed with Alagille syndrome when he was 1 month old, was admitted to the general surgery department to undergo right hepatectomy for right lobe carcinoma. Alagille syndrome, also known as biliary duct hypoplasia, is an extremely rare genetic condition with multiorganic implications. Liver and heart dysfunction will play key roles in the course of the disease and its prognosis. An exhaustive preoperative assessment of liver and heart function, blood chemistry and the skeleton will be essential for managing these patients. This article reviews the main principles underlying the anesthetic management of patients with Alagille syndrome.

[Exchanging and maintaining the airway in hyoid surgery: using a flexible exchanger during new surgical treatments for obstructive sleep apnea syndrome]

OBJECTIVE

To assess the level of intubation difficulty and anatomical changes after hyoid surgery. To evaluate the difficulty of switching from nasotracheal to orotracheal intubation after hyoid and palatopharyngeal surgery using an exchanger.

MATERIAL AND METHODS

Prospective study enrolling 30 patients undergoing surgery for obstructive sleep apnea syndrome (OSAS) in 2 consecutive phases. Anatomical features suggesting risk of difficult intubation, anatomical changes caused by surgery, the incidence of failure to intubate upon first attempt during the first surgical session, and upon switching from nasal to oral intubation, and the time required to intubate were recorded. The rate of complications during and after surgery was also noted.

RESULTS

The incidence of difficult intubation was 15% and no complications developed in the switch from nasotracheal to orotracheal intubation (100% success rate).

CONCLUSION

New surgical treatments for the OSAS patient require new anesthetic maneuvers such as nasotracheal-orotracheal intubation exchange after hyoid surgery. The exchanger used in the present study offers a valid way to achieve airway management in this situation.

[Anesthetic management in mastocytosis]

Mastocytosis is a heterogeneous grouping of entities characterized by proliferation of mast cells in one or more organs or tissues. The skin is the most frequently affected organ, followed by bone marrow. The relevance of this disease to anesthesia lies in the fact that many drugs used can trigger massive release of chemical mediators of mast cells. We report the case of a patient diagnosed with cutaneous mastocytosis who underwent testicular biopsy with intradural anesthesia. We review the fundamental aspects of the disease and the principles of anesthetic management.

Proteocephalus brooksi n. sp. (Cestoda:Proteocephalidae) in the neotropical freshwater fish Rhamdia guatemalensis (Siluriformes: Pimelodidae) from Lake Catemaco, Veracruz, Mexico

Proteocephalus brooksi n. sp. is described from the neotropical pimelodid fish Rhamdia guatemalensis from Lake Catemaco, Veracruz, México. The new species is characterized by the "paramuscular" position of vitellaria, the cortical origin of uterine stem with development of medullar lateral branches, the alternated position of vagina (anteriorly and posteriorly to cirrus sac), and the absence of apical organ and vaginal sphincter. Proteocephalus brooksi most closely resembles Nomimoscolex matogrossensis from which it differs in a series of characters. The probable paraphyletic nature of both Proteocephalus and Nomimoscolex and the convergent evolution of the "paramuscular" location of vitellaria among proteocephalideans are suggested, and the need for a phylogenetic analysis of the group is emphasized. The new species is assigned to Proteocephalus pending such an analysis.

Induction of ventricular fibrillation predicts sudden death in patients treated with amiodarone because of ventricular tachyarrhythmias after a myocardial infarction

OBJECTIVE

To examine the value of programmed electrical stimulation of the heart in predicting sudden death in patients receiving amiodarone to treat ventricular tachyarrhythmias after myocardial infarction.

DESIGN

Consecutive patients; retrospective study.

SETTING

Referral centre for cardiology, academic hospital.

PATIENTS

106 patients with ventricular tachycardia (n = 77) or ventricular fibrillation (n = 29) late after myocardial infarction.

INTERVENTIONS

Programmed electrical stimulation was performed while on amiodarone treatment for at least one month.

MEASUREMENTS AND MAIN RESULTS

In 80/106 patients either ventricular fibrillation (n = 15) or sustained monomorphic ventricular tachycardia (n = 65) was induced. After a mean follow up of 50 (SD 40) months (1-144), 11 patients died suddenly and two used their implantable cardioverter debfibrillator. By multivariate analysis two predictors for sudden death were found: (1) inducibility of ventricular fibrillation under amiodarone treatment (P << 0.001), and (2) a left ventricular ejection fraction of < 40% (P < 0.05). The survival rate at one, two, three, and five years was 70%, 62%, 62%, and 40% respectively for patients in whom ventricular fibrillation was induced, and 98%, 96%, 94%, 94% for patients with induced sustained monomorphic ventricular tachycardia. Where there was no sustained arrhythmia, five year survival was 100%.

CONCLUSIONS

In patients receiving amiodarone because of life threatening ventricular arrhythmias after myocardial infarction, inducibility of ventricular fibrillation, but not of sustained monomorphic ventricular tachycardia, indicates a high risk of sudden death.

Effect of a low sodium diet on urinary elimination of cystine in cystinuric children

Restriction of sodium intake has been shown to decrease urinary elimination of cystine in adult subjects with cystinuria. This simple therapeutic recommendation may be particularly useful in pediatric patients whose compliance with high fluid ingestion and repeated doses of alkali is usually poor. We studied the effect of sodium intake in 5 cystinuric children (3 males) aged 5.9-9.3 years. Urinary excretion of cystine (means +/- SD) was determined at the end of two sequential 1-week periods in which sodium content of diet was modified. Reduction of sodium intake brought about significant decreases in natriuresis (6.0 +/- 2.1 vs. 1.5 +/- 0.5 mEq/kg/day, p < 0.03) and urine cystine concentration (328.0 +/- 190.7 vs. 14.1 +/- 7.4 mg/l, p < 0.02) while urine volume output remained unchanged (58.0 +/- 36.0 vs. 70.3 +/- 33.0 ml/kg/day). These findings confirm that elimination of cystine is highly influenced by sodium intake in cystinuric children and suggest that a low sodium diet may play a key-role in the treatment of pediatric patients with cystinuria.

Clinical and electrophysiologic characteristics of exercise-related idiopathic ventricular tachycardia

In 37 (70%) of 53 patients with idiopathic ventricular tachycardia (VT), episodes were mainly related to exercise (group 1). These patients were younger (33 +/- 14 vs 44 +/- 18 years, p = 0.015) and more often had dizziness during VT (71 vs 40%, p = 0.003) than the 16 patients in whom VT was not exercise-related (group 2). Patients in group 1 needed cardioversion less often to terminate the arrhythmia (4 (11%) vs 6 (40%), group 2 [p = 0.04]). VT was initiated during exercise testing in 62% of patients in group 1 but in only 1 patient in group 2 (p = 0.0004). Induction of clinical VT during programmed stimulation was observed in a similar percentage in group 1 (49%) and group 2 (50%) patients. Isoproterenol infusion facilitated the induction of VT in 9 of 20 (45%) group 1 and in 2 of 8 (25%) group 2 patients (p = not significant). After a mean follow-up of 2.9 +/- 2.5 years, 8 (22%) group 1 patients and 5 (31%) group 2 had at least 1 episode of symptomatic VT. Only 1 patient died suddenly. Class III drugs were the most useful in preventing recurrences. Beta-blocking agents were of little value in both groups. Patients with VT and a structurally normal heart have a good prognosis despite recurrences of their arrhythmia. The relation of the arrhythmia to exercise has no prognostic implications.

The syndrome of renal tubular acidosis and nerve deafness. Discordant manifestations in dizygotic twin brothers

The syndrome of renal tubular acidosis (RTA) and nerve deafness is a distinct nosological entity that is inherited as an autosomal recessive trait. We studied a pair of dizygotic twin brothers both with nerve deafness but only one with RTA. Distal RTA was diagnosed in twin A because of inappropriately high urinary pH (6.9) and low net acid excretion (40.0 muEq/min per 1.73 m2) in the presence of hyperchloraemic metablic acidosis, and fractional bicarbonate excretion of 1.6% at a normal serum bicarbonate concentration. The urine minus blood PCO2 differences (U-B PCO2) during a neutral sodium phosphate load and in alkaline urine induced by bicarbonate supplementation were: 11 and 0 mm Hg, respectively. Twin A developed nephrocalcinosis and, after a 9.5-year follow-up period, was 5.3 cm taller than his brother. Twin B remained asymptomatic. Periodic determinations of blood pH and serum bicarbonate were normal and urine pH decreased to 4.6 in the face of ammonium chloride-induced metabolic acidosis. The U-B PCO2 assessed in alkaline urine was 33.5 mm Hg. Audiograms demonstrated bilateral nerve deafness in both brothers. The presence of deafness without RTA has not been previously reported in this syndrome. This report also shows that a primary distal acidification defect is responsible for the RTA observed in this syndrome.

Tracheal versus pulmonary deposition and clearance of inhaled Pasteurella haemolytica or Staphylococcus aureus in mice

The aim of this investigation was to do a comparative study on the deposition and clearance of inhaled bacteria between the lungs and tracheae of mice exposed to aerosols of bacteria. Two hundred and eighty-eight mice were divided into four groups (n = 72) and exposed to aerosols of Pasteurella haemolytica or Staphylococcus aureus in four replicates. The numbers of bacteria were determined in the trachea and lungs of mice sacrificed 0, 2, 4, 8, 12, 24, 48 and 72 hours postexposure. Results indicated that bacterial deposition was greater in lungs than in tracheae. No significant (p greater than 0.05) difference was observed between P. haemolytica and S. aureus clearance rates. Although bacteria were rapidly eliminated from the whole respiratory tract, bacterial clearance was significantly (p less than 0.002) faster in tracheae than lungs. A significant (p less than 0.05) replicate effect was also observed.