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Selected AbstractsHydrophobic pervaporation for environmental applications: Process optimization and integrationENVIRONMENTAL PROGRESS & SUSTAINABLE ENERGY, Issue 4 2002Frank Lipnizki The focus of this paper is on the design of pervaporation units for wastewater treatment taking into account technical, economic, and environmental aspects. Two different sized industrial wastewater streams of water-chloroform, and of water-methyl-isobutylketone (MIBK) are considered. Based on a wastewater stream of 1,500 kg/d, a semi-batch process combining pervaporation with a decanter recycle loop is developed. Using this process, it is possible to recover over 99% of the organic components at concentrations of more than 98 wt. %. The treatment costs are between 0.11 to 0.16 $/kg wastewater. For the treatment of a wastewater stream of 1,000 kg/h, pervaporation combined with a decanter and recycling loop, as well as integrated in a hybrid process with adsorption, is considered. For MIBK, pervaporation with a decanter is the most attractive option taking economic and environmental aspects into account, while, for chloroform, the hybrid process is the better option. Treatment costs in all cases are about 0.03 $/kg wastewater. The recovery rate of the organic compounds is over 99% at concentrations over 98 wt. %. The authors concluded that pervaporation as a stand-alone unit, or integrated into hybrid processes, offers significant advantages over conventional alternatives. [source] Biocompatibility of various formula root filling materials for primary teethJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2007Tsui-Hsien Huang Abstract The aim of this study was to compare the effects of different materials used in primary root canal fillings on the cell viability of human osteosarcoma cell lines. The experimental group contained six different types of root canal filling materials, including zinc oxide (ZnO) + eugenol + formocresol (FC), Ca(OH)2 + FC, Ca(OH)2 + Iodoform, Ca(OH)2 + Iodoform + camphorated parachlorophenol (CPC), Ca(OH)2 + CPC, and Vitapex. Cell viability tests were performed using tetrazolium bromide colorimetric (MTT) assay on human osteosacorma cell lines (U2OS). The results were analyzed using one-way analysis of variance (ANOVA) and Student,Newman,Keul's test with p < 0.05 showed statistical differences. The ZnO + eugenol + FC group and Ca(OH)2 + FC group showed the lowest survival rates (p < 0.05). The Ca(OH)2 + Iodoform + CPC group and Ca(OH)2 + CPC group showed significantly lower survival rates at concentrations above 6 ,L/mL (p < 0.05). The Ca(OH)2 + Iodoform group and Vitapex group showed the highest survival rates (p < 0.05). We concluded that the use of calcium hydroxide with iodoform as a root filling base material is a better option than other medications. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2007 [source] Performance and trade-offs in Microfinance Organisations,Does ownership matter?JOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 5 2008Roy Mersland Abstract Policy advocates argue for the transformation of non-government Microfinance Organisations (MFOs) into shareholder owned firms (SHFs). This paper investigates whether the proposed superiority of shareholder owned MFOs is empirically supported. The findings indicate that the difference between shareholder owned MFOs and non-government MFOs is minimal. Our results contradict established paradigms and policy guidelines in the industry. However, the results are not necessarily surprising since ownership theories support our findings. So do also studies from the general banking markets as well as historical studies. Adaptation of legal frameworks allowing well-performing NGOs to mobilise savings appears to be a better option than transformation. Copyright © 2008 John Wiley & Sons, Ltd. [source] Alternative concept for SOFC with direct internal reforming operation: Benefits from inserting catalyst rodAICHE JOURNAL, Issue 6 2010Pannipha Dokamaingam Abstract Mathematical models of direct internal reforming solid oxide fuel cell (DIR-SOFC) fueled by methane are developed using COMSOL® software. The benefits of inserting Ni-catalyst rod in the middle of tubular-SOFC are simulated and compared to conventional DIR-SOFC. It reveals that DIR-SOFC with inserted catalyst provides smoother temperature gradient along the system and gains higher power density and electrochemical efficiency with less carbon deposition. Sensitivity analyses are performed. By increasing inlet fuel flow rate, the temperature gradient and power density improve, but less electrical efficiency with higher carbon deposition is predicted. The feed with low inlet steam/carbon ratio enhances good system performances but also results in high potential for carbon formation; this gains great benefit of DIR-SOFC with inserted catalyst because the rate of carbon deposition is remarkably low. Compared between counter- and co-flow patterns, the latter provides smoother temperature distribution with higher efficiency; thus, it is the better option for practical applications. © 2009 American Institute of Chemical Engineers AIChE J, 2010 [source] High divorce rates in Corsican blue tits: how to choose a better option in a harsh environmentOIKOS, Issue 3 2000Jacques Blondel We investigate which hypothesis, the "better mate hypothesis" or the "better territory hypothesis" best explains the unusually high divorce rate (59%) in a population of blue tits (Parus caeruleus) living in a sclerophyllous habitat characterised by severe environmental constraints (trophic, parasitic, climatic) on the island of Corsica, France. Using data from the breeding seasons 1985,1998 and from a brood size experiment (1990,1993) we examined the causes of divorce and their consequences on breeding performance, mate assortment and territory choice. Breeding performance had no significant effect on whether birds re-united or divorced in the next breeding season. Re-uniting pairs did better than divorced females and the latter improved their breeding performance compared to prior to divorce, but this was mainly due to age and territory effects. There were no differences in male performance depending on whether they re-united or divorced. The age combination of pairs did not differ between re-uniting and divorcing pairs, but mate assortment changed after divorce with males re-mating more often with older partners than females. Manipulation of brood size showed a trend for birds with enlarged broods to divorce more. Pairs responded significantly to territory quality by divorcing more often in poor than in good breeding sites. Both faithful pairs and male divorcees had shorter breeding dispersal distances than female divorcees. Divorce rates were determined by the large differences in quality among breeding sites. Males, whatever their status, usually retained their previous territory whereas divorced females moved significantly longer distances and improved their breeding site. Moving to a better territory after divorce benefits only females which appear to be the choosing sex in the decision to divorce. This study strongly supports the "habitat mediated hypothesis" and we suggest that the large observed intraspecific variation in the magnitude of divorce rates in many species of birds is mostly determined by habitat characteristics. [source] Beyond Tropical Forests Adoption: Contextualizing Conservation StrategiesBIOTROPICA, Issue 6 2009Claudia Romero ABSTRACT The complexity of factors driving tropical deforestation demand integrated approaches from concerned researchers and policy makers. Strict protection is sometimes the most appropriate mode of conservation, but conservation through management is often the better option. In either case, this essay highlights the importance of considering the social/cultural, economic, and political contexts in which these forests are threatened. By attempting to understand the cultural settings, institutional architectures and dynamics, and local expectations, and then by combining the concepts and tools of a range of disciplines, researchers will be more likely to forge lasting partnerships and increase their potential for sustained improvement in resource management and overall forest conservation. [source] Electrosurgery, Pacemakers and ICDs: A Survey of Precautions and Complications Experienced by Cutaneous SurgeonsDERMATOLOGIC SURGERY, Issue 4 2001Hazem M. El-Gamal MD Background. Minimal information is available in the literature regarding the precautions implemented or complications experienced by cutaneous surgeons when electrosurgery is used in patients with pacemakers or implantable cardioverter-defibrillators (ICDs). The literature pertinent to dermatologists is primarily based on experiences of other surgical specialties and a generally recommended thorough perioperative evaluation. Objective. To determine what precautions are currently taken by cutaneous surgeons in patients with pacemakers or ICDs, and what types of complications have occurred due to electrosurgery in a dermatologic setting. Methods. In the winter of 2000, a survey was mailed to 419 U.S.-based members of the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO). Results. A total of 166 (40%) surveys were returned. Routine precautions included utilizing short bursts of less than 5 seconds (71%), use of minimal power (61%), and avoiding use around the pacemaker or ICD (57%). The types of interference reported were skipped beats (eight patients), reprogramming of a pacemaker (six patients), firing of an ICD (four patients), asystole (three patients), bradycardia (two patients), depleted battery life of a pacemaker (one patient), and an unspecified tachyarrhythmia (one patient). Overall there was a low rate of complications (0.8 cases/100 years of surgical practice), with no reported significant morbidity or mortality. Bipolar forceps were utilized by 19% of respondents and were not associated with any incidences of interference. Conclusions. Significant interference to pacemakers or ICDs rarely results from office-based electrosurgery. No clear community practice standards regarding precautions was evident from this survey. The use of bipolar forceps or true electrocautery are the better options when electrosurgey is required. These two modalities may necessitate fewer perioperative precautions than generally recommended, without compromising patient safety. [source] Combining scenario planning and multi-criteria decision analysis in practiceJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 1-3 2006Gilberto Montibeller Abstract The integrated use of scenario planning and multi-criteria decision analysis (MCDA) has been advocated as a powerful combination for providing decision support in strategic decisions. Scenario planning helps decision makers in devising strategies and thinking about possible future scenarios; while MCDA can support an in-depth performance evaluation of each strategy, as well as in the design of more robust and better options. One of the frameworks proposed recently, by Goodwin & Wright, suggests the use of scenario planning with multi-attribute value theory, a mathematically simple, yet extensively researched and widely employed multi-criteria method. However, so far, such framework has been presented only using hypothetical problems. In this paper, we describe two case studies where this approach was used to support real-world strategic decisions. We discuss the challenges and limitations we encountered in applying it and suggest some possible improvements that could be made to such framework. Copyright © 2007 John Wiley & Sons, Ltd. [source] Review article: pain and chronic pancreatitisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2009J. G. LIEB II Summary Background, Pain in chronic pancreatitis chronic pancreatitis is a frustrating and challenging symptom for both the patient and clinician. It is the most frequent and most significant symptom. Many patients fail the currently available conservative options and require opiates or endoscopic/surgical therapy. Aim, To highlight the pathophysiology and management of chronic pancreatitis pain, with an emphasis on recent developments and future directions. Methods, Expert review, utilizing in addition a comprehensive search of PubMed utilizing the search terms chronic pancreatitis and pain, treatment or management and a manual search of recent conference abstracts for articles describing pain and chronic pancreatitis. Results, Pancreatic pain is heterogenous in its manifestations and pathophysiology. First-line medical options include abstinence from alcohol and tobacco, pancreatic enzymes, adjunctive agents, antioxidants, and non-opiate or low potency opiate analgesics. Failure of these options is not unusual. More potent opiates, neurolysis and endoscopic and surgical options can be considered in selected patients, but this requires appropriate expertise. New and better options are needed. Future options could include new types of pancreatic enzymes, novel antinociceptive agents nerve growth factors, mast cell-directed therapy, treatments to limit fibrinogenesis and therapies directed at the central component of pain. Conclusions, Chronic pancreatitis pain remains difficult to treat. An approach utilizing conservative medical therapies is appropriate, with more invasive therapies reserved for failure of this conservative approach. Treatment options will continue to improve with new and novel therapies on the horizon. [source] A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS-ES Task ForceEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2006A. Albanese chairman To review the literature on primary dystonia and dystonia plus and to provide evidence-based recommendations. Primary dystonia and dystonia plus are chronic and often disabling conditions with a widespread spectrum mainly in young people. Computerized MEDLINE and EMBASE literature reviews (1966,1967 February 2005) were conducted. The Cochrane Library was searched for relevant citations. Diagnosis and classification of dystonia are highly relevant for providing appropriate management and prognostic information, and genetic counselling. Expert observation is suggested. DYT-1 gene testing in conjunction with genetic counselling is recommended for patients with primary dystonia with onset before age 30 years and in those with an affected relative with early onset. Positive genetic testing for dystonia (e.g. DYT-1) is not sufficient to make diagnosis of dystonia. Individuals with myoclonus should be tested for the epsilon-sarcoglycan gene (DYT-11). A levodopa trial is warranted in every patient with early onset dystonia without an alternative diagnosis. Brain imaging is not routinely required when there is a confident diagnosis of primary dystonia in adult patients, whereas it is necessary in the paediatric population. Botulinum toxin (BoNT) type A (or type B if there is resistance to type A) can be regarded as first line treatment for primary cranial (excluding oromandibular) or cervical dystonia and can be effective in writing dystonia. Actual evidence is lacking on direct comparison of the clinical efficacy and safety of BoNT-A vs. BoNT-B. Pallidal deep brain stimulation (DBS) is considered a good option, particularly for generalized or cervical dystonia, after medication or BoNT have failed to provide adequate improvement. Selective peripheral denervation is a safe procedure that is indicated exclusively in cervical dystonia. Intrathecal baclofen can be indicated in patients where secondary dystonia is combined with spasticity. The absolute and comparative efficacy and tolerability of drugs in dystonia, including anticholinergic and antidopaminergic drugs, is poorly documented and no evidence-based recommendations can be made to guide prescribing. [source] Present and future therapeutic strategies for idiopathic oligozoospermiaINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 6 2000Dimitrios A. Adamopoulos The effectiveness of medical treatment for idiopathic oligozoospermia (IO) has been at best doubtful until now and a logical consequence of this unsatisfactory situation has been the partial displacement of this approach by assisted reproduction techniques. This state of affairs has resulted from insufficient investigation, inappropriately designed clinical trials and consistent disregard for the principles of evidence-based medicine. Protocol-related shortcomings and wrong interpretation of the data available have also been some of the all too frequent problems encountered in this therapeutic approach. In this rather misty situation, it appears that, of the therapeutic agents used so far, follicle stimulating hormone (FSH) (mainly FSH-secretagogues) may exert some beneficial effects on a number of biological endpoints related to spermatogenesis and sperm maturation. The short and medium term prospects of medical treatment for IO rest mainly with improvement of investigative procedures to a higher degree of sophistication, with emphasis placed on identifying the causes rather than the results of dysfunction so that a better selection of candidates can be made. Moreover, the introduction of prognostic indices for evaluation of the beneficial effects of a therapeutic agent may be of paramount importance. Finally, a better assessment of the preparations available and, possibly, the introduction of new more specific agents may also be an important step forward in this field. This type of large-scale effort should not be left to individual investigators or special centres working independently, but it may come under the auspices of a central regulating agency so that undisputed results from large, multicentre and uniform studies might be obtained, if medical treatment is to remain a good option. In this context, it may also be emphasized that andrology's main task should always be to treat the male with the problem rather than his healthy female partner, whenever this is possible. [source] Mechanical and thermal properties of poly(butylene succinate)/plant fiber biodegradable compositeJOURNAL OF APPLIED POLYMER SCIENCE, Issue 6 2010Zhichao Liang Abstract Biodegradable polymeric composites were fabricated from poly(butylene succinate) (PBS) and kenaf fiber (KF) by melt mixing technique. The mechanical and dynamic mechanical properties, morphology and crystallization behavior were investigated for PBS/KF composites with different KF contents (0, 10, 20, and 30 wt %). The tensile modulus, storage modulus and the crystallization rate of PBS in the composites were all efficiently enhanced. With the incorporation of 30% KF, the tensile modulus and storage modulus (at 40°C) of the PBS/KF composite were increased by 53 and 154%, respectively, the crystallization temperature in cooling process at 10°C/min from the melt was increased from 76.3 to 87.7°C, and the half-time of PBS/KF composite in isothermal crystallization at 96 and 100°C were reduced to 10.8% and 14.3% of that of the neat PBS, respectively. SEM analysis indicates that the adhesion between PBS and KF needs further improvement. These results signify that KF is efficient in improving the tensile modulus, storage modulus and the crystallization rate of PBS. Hence, this study provides a good option for preparing economical biodegradable composite. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2010 [source] Bioprocesses for the removal of nitrogen oxides from polluted airJOURNAL OF CHEMICAL TECHNOLOGY & BIOTECHNOLOGY, Issue 5 2005Yaomin Jin Abstract Nitrogen oxides (NOx) of environmental concern are nitrogen monoxide (NO) and nitrogen dioxide (NO2). They are hazardous air pollutants that lead to the formation of acid rain and tropospheric ozone. Both pollutants are usually present simultaneously and are, therefore, called NOx. Another compound is N2O which is found in the stratosphere where it plays a role in the greenhouse effect. Concern for environmental and health issues coupled with stringent NOx emission standards generates a need for the development of efficient low-cost NOx abatement technologies. Under such circumstances, it becomes mandatory for each NOx-emitting industry or facility to opt for proper NOx control measures. Several techniques are available to control NOx emissions: selective catalytic reduction (SCR), selective non-catalytic reduction (SNCR), adsorption, scrubbing, and biological methods. Each process offers specific advantages and limitations. Since bioprocesses present many advantages over conventional technologies for flue gas cleaning, a lot of interest has recently been shown for these processes. This article reviews the major characteristics of conventional non-biological technologies and recent advances in the biological removal of NOx from flue gases based on the catalytic activity of either eucaryotes or procaryotes, ie nitrification, denitrification, the use of microalgae, and a combined physicochemical and biological process (BioDeNOx). Relatively uncomplicated design and simple operation and maintenance requirements make biological removal a good option for the control of NOx emissions in stationary sources. Copyright © 2005 Society of Chemical Industry [source] Mezzanine Financing: Is It for You?JOURNAL OF CORPORATE ACCOUNTING & FINANCE, Issue 2 2008LuAnn Bean Companies that want to finance a leveraged buyout (LBO) should consider mezzanine financing. This can fill the gap between low-risk collateralized debt, obtained from traditional lenders, and higher-risk equity interests. But what are the pros and cons of this kind of financing? Is it a good option for your company? The author reveals what you should know before committing to this financial arrangement. © 2008 Wiley Periodicals, Inc. [source] Profiling of polar metabolites in biological extracts using diamond hydride-based aqueous normal phase chromatographyJOURNAL OF SEPARATION SCIENCE, JSS, Issue 13 2009Damien L. Callahan Abstract Highly polar metabolites, such as sugars and most amino acids are not retained by conventional RP LC columns. Without sufficient retention low concentration compounds are not detected due ion suppression and structural isomers are not resolved. In contrast, hydrophilic interaction chromatography (HILIC) and aqueous normal phase chromatography (ANP) retain compounds based on their hydrophilicity and therefore provides a means of separating highly polar compounds. Here, an ANP method based on the diamond hydride stationary phase is presented for profiling biological small molecules by LC. A rapid separation system based upon a fast gradient that delivers reproducible chromatography is presented. Approximately 1000 compounds were reproducibly detected in human urine samples and clear differences between these samples were identified. This chromatography was also applied to xylem fluid from soyabean (Glycine max) plants to which 400 compounds were detected. This method greatly increases the metabolite coverage over RP-only metabolite profiling in biological samples. We show that both forms of chromatography are necessary for untargeted comprehensive metabolite profiling and that the diamond hydride stationary phase provides a good option for polar metabolite analysis. [source] Live donor/split liver grafts for adult recipients: When should we use them?LIVER TRANSPLANTATION, Issue S2 2005Peter Neuhaus Key Points 1Split liver transplantation for a child and an adult recipient is standard today. Living donor liver transplantation for small children should only be necessary in exceptional situations in a country with a well-organized organ donation program. 2True split liver transplantation for two adults is still not very common. In the United States between April 2000 and May 2001, 89 surgical teams transplanted only 15 left lobes and 13 right lobes. Especially left lobes from deceased donors have a poor outcome; in Europe the ELTR shows a 1-year graft survival of 47%. 3While in Asia left lobes, right lateral segments, and dual left lateral segments are more frequently used, living donor liver transplantation for adults in Europe and the United States is predominantly performed with right lobes.7, 8 This carries a significant morbidity and mortality risk for the donor. Outcome compared to deceased donor liver transplantation (DDLTx) is similar with a trend towards more short-term and long-term biliary complications. 4Living donor and split liver transplantation should be used mainly in an elective situation. Candidates are tumor patients, patients with cholestatic liver disease, and elective patients with bile disease. 5Urgent liver transplantation is not a good option for living donor and split liver transplantation. Hepatic assist devices may change the picture in the future. 6Living donor liver transplantation for metabolic disorders like Alpha-1-Antitrypsin deficiency, Hyperoxaluria, and others cannot be recommended at present since the genetically related donor and the patient may carry an unknown risk. (Liver Transpl 2005;11:S6,S9.) [source] Reconstruction of anterior through and through oromandibular defects following oncological resections,MICROSURGERY, Issue 2 2010Bernardo Bianchi M.D. Background: Resections of oromandibular squamous cell carcinoma involving anterior mandible, floor of the mouth, and the skin, lead to composite oromandibular defects that can be approached in several ways depending on the extension of the bone defect, of the soft tissue and cutaneous resection, the patient's general status, and the prognosis. Methods: A retrospective evaluation of 27 patients has been performed. The techniques described included single osseous or soft tissues free flap reconstruction, two free flaps or free and locoregional flap association. Results: Postoperative follow-up ranged from 12 to 120 months. Final results were evaluated with regards to deglutition, speech, oral competence, and esthetic outcome. Conclusion: Reconstruction of the anterior mandible is strongly indicated whenever possible. When the defect involves the tongue, the best results are provided by the association of two free flaps. Finally, the association of free and locoregional flaps ia a good option for external coverage reconstruction. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. [source] Evaluation and donor site morbidity of tibial bone graft in sinus lift operationORAL SURGERY, Issue 3 2008S.L. Miranda Abstract Aim:, The use of autologous bone is a good option for bone grafts in implantology. The purpose of this study was to present advantages in harvesting the proximal tibial cancellous bone as an alternative in the sinus floor lifting procedure, seeking future installation of osseointegraded implants. Materials and methods:, Between 2002 and 2006, 19 patients were attended, with age between 41 and 77, being 9 males and 10 females, in order to lift the maxillary sinus floor. The approach to the donor site was medial, because of the fact that this method brings minor risk of injury to anatomical structures. Results:, All cases allowed the installation of osseointegraded implants. Only minor complications occurred, such as local ecchymosis and ecchymosis extending to foot. In all cases, ambulation was immediate. Conclusions:, A good amount of bone could be harvested; scarce pain symptomatology was detected, and risk of complications could be considered very low in the donor site. [source] Audiological Application Criteria for Implantable Hearing Aid Devices: A Clinical Experience at the Nijmegen ORL Clinic,THE LARYNGOSCOPE, Issue 9 2008Veronique J. O. Verhaegen MD Abstract Objectives/Hypothesis: To define audiological application criteria for different implantable hearing aid devices. Study Design: Retrospective study. Methods: Comparisons were made between aided speech recognition scores obtained at conversational level (65 dB) in patients with the Vibrant Soundbridge (VSB) (n = 22), the Otologics middle ear transducer (MET) (n = 10), conventional hearing aids (behind-the-ears) (n = 47), and cochlear implants (CIs) (n = 123). Results: In relation to hearing loss, only for mild hearing loss, speech recognition scores with VSB were comparable to that with conventional hearing aids. In the Otologics MET users, speech recognition scores were comparable with those of the conventional hearing aid users until a mean hearing loss of about 75 dB HL. At a sensorineural hearing loss of about 65 dB HL or more, the Otologics MET users have better speech recognition scores than the VSB users. For comparison with CI users, we followed a more conservative approach. In 90% of the users of a CI, speech recognition scores were better than those in: 1) patients with a conventional hearing aid and a mean hearing loss of about 95 dB HL or worse; 2) patients with an Otologics MET and a mean hearing loss of 85 dB HL or worse. Conclusions: Patients fitted with a VSB or an Otologics MET middle ear implant do not demonstrate better speech recognition scores than patients fitted with today's conventional hearing aids. Results might even been worse. However, the VSB and Otologics MET are a good option in patients with moderate (VSB) to severe (Otologics MET) sensorineural hearing loss and external otitis. [source] Sulfur hexafluoride (SF6) versus perfluoropropane (C3F8) gas tamponade for macular hole surgeryACTA OPHTHALMOLOGICA, Issue 2009M STEFANIOTOU Purpose In Macular Hole surgery gas tamponade is hypothesized to enhance macular hole closure after removal of tangential force. Sulfur hexafluoride (SF6) was described in the initial report of Macular Hole surgery (MHS). Long lasting gas (such as C3F8) may offer more extensive tamponade . To compare outcomes of Macular Hole Surgery using SF6 gas versus C3F8 gas for idiopathic macular hole repair. Methods A consecutive group of patients undergoing MHS with SF6 group A (24 eyes of 24 patients) and a consecutive comparison group B with S3F8 was used (19 eyes of 19 patients). All patients had PP Vitrectomy, ILM peeling, using Kenacort or Blue and two different gases for internal tamponade. Results The macular hole closure rate was similar in both groups. Conclusion Macular Hole surgery using SF6 gas yields similar results as with C3F8 gas and may be a good option. [source] Remifentanil in neonatal intensive care and anaesthesia practiceACTA PAEDIATRICA, Issue 10 2010Márcia Gomes Penido Abstract Remifentanil is a relatively new ultrashort action synthetic opioid. Studies on the use of remifentanil in neonatology have emerged demonstrating its effectiveness and safety in neonates. The present study describes the use of remifentanil in both full-term and premature newborns, highlighting the theoretical benefits for this population in terms of both neonatal intensive care and anaesthesia. A Medline search was undertaken of all reviews and reports about the use of remifentanil in neonates published between 1996 and 2009 using MeSH search terms ,remifentanil', ,analgesia', ,anaesthesia', ,newborn' and ,neonate'. The review points that remifentanil has been used with advantages in newborns including preterm neonates and even for foetal anaesthesia. It proved to be a good option to attenuate the hemodynamic/endocrine markers of stress related to surgery. Owing to its unique pharmacokinetic profile, shorter extubation times can be achieved what makes the drug also a good option for short duration invasive procedures in NICUs (InSurE). A concern on its use is that the hemodynamic response (hypotension) may become significant when the drug is associated to other drugs like sevoflurane. Conclusion:, Remifentanil seems to be an effective and safely used opioid for neonatal intensive care and anaesthesia practice. [source] Laparoscopy in the management of closed loop sigmoid volvulusCOLORECTAL DISEASE, Issue 4 2008T. Cartwright-Terry Abstract Objective, To investigate the feasibility and surgical outcome of elective laparoscopic surgery for acute closed loop sigmoid volvulus. Method, A prospectively electronic database of colorectal laparoscopic procedures identified nine consecutive patients with sigmoid volvulus managed by colonoscopic decompression followed by same admission laparoscopic recto-sigmoidectomy. Results, Between January 2001 and February 2007, nine patients, ASA I (one), II (four), III (four) with sigmoid volvulus were treated: seven were women. Their age distribution was 37,87 years (median 64). The volvulus was the first episode in one patient, the second episode for four and the third (or more) for the remainder. The median operation time was 115 min (45,145). No anastomosis was de-functioned. Postoperative analgesia was parenteral paracetamol (eight) supplemented by 10 mg oral morphine in one case; a ninth patient received patient controlled parenteral morphine for 36 h. Complications included: ileus (one), myocardial infarct (one) and wound infection (one). There was one death on day 32 from a brainstem infarct. Seven had an uncomplicated recovery. The median postoperative stay was 4 days (2,32). Conclusion, Laparoscopic recto-sigmoidectomy postcolonoscopic decompression is a good option for patients with sigmoid volvulus. Surgical complications are minimal and recovery is quick. [source] | |||||||||||||||||||||||||