Evaluation of the synergism between ketorolac and morphine in the treatment of postoperative pain

BACKGROUND: The aim of the study is to determine what concentration of ketorolac and morphine administered together i.v. achieve best synergic effect between NSAID antiinflammatory and opioids analgesic properties. DESIGN: Randomized comparative study was carried out on 180 patients, ASA II-IV, undergoing major general surgery, in an University Clinic. METHODS: Postoperative pain therapy by i.v. PCA: group 1 morphine 0.75 mg.ml + ketorolac 0.75 mg.ml; group 2 morphine 0.50 mg.ml + ketorolac 1.50 mg.ml; group 3 morphine 0.25 mg.ml + ketorolac 1.50 mg.ml; in saline solution. Initial bolus: 2 ml. Continuous infusion 1.5 ml.h. Demand bolus: 0.2 ml. Lockout time: 30 minutes. Evaluations included: pain intensity (T0, T3, T18); total amount of infused drugs (T18); number of valid demands and attempts (T18); amount of autoadministered analgesic drugs in percent of highest available amount (T18); side effects (T18); patient's judgment. DATA ANALYSIS: ANOVA and Student's "t"-test. RESULTS: A statistically significant reduction of pain intensity was found after 3 and 18 hours in the three groups, no differences were found among the groups. Group 2 required an amount of autoadministered drugs significantly lower than other groups. Rare side effects. Patient's judgment was generally positive. CONCLUSIONS: Results suggest a greater synergetic effect between morphine and ketorolac in concentrations used in group 2.     

Mesh plug repair and groin hernia surgery

Since the mid-1980s, dramatic progress has been made in the evolution of hernia surgery, highlighted by the increasing use of prosthetic mesh. Among the mesh-based "tension-free" hernioplasties, the use of mesh plugs has garnered a large number of spirited enthusiasts, and plug herniorrhaphy has become the fastest growing hernia repair currently employed by the American surgeon. To demonstrate the simplicity and effectiveness of mesh plugs, a 9-year experience with almost 3300 patients is reported. Technical details are discussed and presentation of a literature search serves to further emphasize the utilitarian nature of this elegantly unsophisticated surgical operation.     

Minimally invasive cardiac surgery

In a short period of time, tremendous progress has been made in the field of minimally invasive cardiac surgery. The goal of true "minimally invasive" cardiac surgery should be a totally thoracoscopic or transvascular procedure that allows a very short hospital stay and prompt patient recovery at acceptable costs. To accomplish this goal, efforts to miniaturize and refine instrumentation/cannulae/visualization and the development of innovative new techniques must be pursued. The concept of performing intracardiac repair of a variety of pathologies on the beating heart is under investigation and will require a new generation of technology, which will include through-blood imaging, such as blood displacement videoscopes, and task-specific instruments. Robotics may offer additional assistance in the performance of complex and fine maneuvers.     

Human immunodeficiency virus infection, Part II

The acceptance of highly active antiretroviral therapy (HAART) among patients and health care providers has had a dramatic impact on the epidemiology and clinical characteristics of many opportunistic infections associated with human immunodeficiency virus (HIV). Previously intractable opportunistic infections and syndromes are now far less common. In addition, effective antibiotic prophylactic therapies have had a profound impact on the risk of patients developing particular infections and on the incidence of these infections overall. Most notable among these are Pneumocystis carinii, disseminated Mycobacterium avium complex, tuberculosis, and toxoplasmosis. Nevertheless, infections continue to cause significant morbidity and mortality among patients who are infected with HIV. The role of HAART in many clinical situations is unquestioned. Compelling data from clinical trials support the use of these therapies during pregnancy to prevent perinatal transmission of HIV. HAART is also recommended for health care workers who have had a "significant" exposure to the blood of an HIV-infected patient. Both of these situations are discussed in detail in this article. In addition, although more controversial, increasing evidence supports the use of HAART during the acute HIV seroconversion syndrome. An "immune reconstitution syndrome" has been newly described for patients in the early phases of treatment with HAART who develop tuberculosis, M avium complex, and cytomegalovirus disease. Accumulating data support the use of hydroxyurea, an agent with a long history in the field of myeloproliferative disorders, for the treatment of HIV. Newer agents, particularly abacavir and adefovir dipivoxil, are available through expanded access protocols, and their roles are being defined and clarified.     

A microprogramming animation

This paper describes a successful project using computer animation to teach the concepts of microprogramming to lower division computer science majors. The students write a simulator for the Mic-1 horizontal microcontroller described in the book Structured Computer Organization by Tanenbaum. The simulation is enhanced by the use of a graphical representation of the machine to animate the simulation. This creative use of computer animation enables the students to see the results of their simulation without having to write an extensive user interface. They can concentrate on implementing the instruction cycle, an activity that directly enhances their understanding of microprogramming and the conventional machine level. The XTango animation package is used, making the animation facility portable to any Unix system with an X display. The user interface and additional instructional material are available via the web     

Identification of the female-produced sex pheromone of the scarab beetle,Hoplia equina

Hoplia equina LeConte (Coleoptera: Scarabaeidae: Melolonthinae) is a beetle pest of cranberry beds in Massachusetts. Larvae feed on the roots of the cranberry plant, reducing yield as well as vine density. The female sex pheromone was identified as 2-tetradecanone. There were eight compounds found in the airborne volatiles collected from females that elicited antennal responses from males. Of the eight compounds tested (nonanal, decanal, dodecanal, 2-dodecanone, 2-tridecanone, 2-tetradecanone, 2-pentadecanone, and 2-hexadecanone), 2-tetradecanone was the only one that attracted male beetles in the field. Combining any of the other seven antennally active compounds with 2-tetradecanone did not increase male capture.     

Diversity and distribution of free-living and particle-associated bacterioplankton in Sandusky Bay and adjacent waters of Lake Erie Western Basin

Studies on the bacterial communities in Lake Erie have been largely focused on cyanobacteria. To characterize the community structure of the other bacteria, we examined the 16S rRNA gene content of free-living (FL) and particle-associated (PA) bacterioplankton populations in Sandusky Bay (SD) and adjacent waters in the Western Basin (WB) of Lake Erie. A comprehensive survey of nutrients and other limnological variables was also performed in parallel. A total of 18,569 of 16S rRNA V6 pyrotag sequences were recovered, which were affiliated with 64 unique bacterial orders within 14 phyla. FL bacteria were composed differently from PA ones and contained significantly more Actinomycetales. In addition, FL bacteria were taxonomically more diverse. Despite the distinct environmental conditions, compositional variation was insignificant between bacteria in the SD and WB samples.     

Condom Use Among High-Risk Adolescents: Testing the Influence of Alcohol Use on the Relationship of Cognitive Correlates of Behavior.

The goal of this study was the exploration of distal effects of alcohol use on condom use. Criminally involved adolescents completed an initial measure of attitudes, beliefs, and prior behavior. Of the 300 who completed the initial measurement, 267 (89%) completed a behavioral assessment 6 months later. Analyses validated a theoretical model of condom use intentions and indicated that intentions and attitudes measured at baseline were significant predictors of condom use behavior 6 months later. Neither alcohol use nor alcohol problems moderated relationships among model variables or the influence of intentions and attitudes on behavior. The findings do not support a distal role for alcohol use in altering the cognitive correlates of condom use intentions and behavior among high-risk adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between dairy food intake and cognitive function: The Maine-Syracuse Longitudinal Study

Diet modification to alter the course of age-related cognitive decline is becoming increasingly important. Few observational findings suggest that dairy food intake may be positively related to cognitive function, but research in this novel area is limited. The aim of this study was to investigate whether dairy food intake is associated with cognitive function, before and after adjustment for cardiovascular, lifestyle and dietary factors. To do this, a cross-sectional analyses of a subset of the community-based Maine-Syracuse Longitudinal Study (MSLS) sample (N = 972) was undertaken. It was determined that participants who consumed dairy products at least once per day had significantly higher scores on multiple domains of cognitive function compared with those who never or rarely consumed dairy foods, adjusting for cardiovascular risk factors, lifestyle and dietary factors. Frequent dairy food intake is associated with better cognitive performance but underlying causal mechanisms are still to be determined.