Anaesthesia for bariatric surgery.

Although many smaller studies have addressed anaesthetic care for bariatric surgical patients, comprehensive systematic literature reviews have yet to be compiled, and much evidence includes expert panel opinion. This review summarises study results in bariatric surgical patients regarding pre-anaesthesia evaluation, the perioperative impact of sleep-disordered breathing, airway management at anaesthetic induction and emergence, maintenance of anaesthesia, postoperative pain management, utility of clinical-care pathways and feasibility of outpatient bariatric surgery. The 'ramped' upper-body, reversed Trendelenburg position at anaesthetic induction and manual application of positive end-expiratory pressure (PEEP) is recommended.

Genetic variation of TLR4 influences immunoendocrine stress response: an observational study in cardiac surgical patients.

Introduction: Systemic inflammation (for example, following surgery) involves Toll-like receptor (TLR) signaling and leads to an endocrine stress response. This study aims to investigate a possible influence of TLR2 and TLR4 single nucleotide polymorphisms (SNPs) on perioperative adrenocorticotropic hormone (ACTH) and cortisol regulation in serum of cardiac surgical patients. To investigate the link to systemic inflammation in this context, we additionally measured 10 different cytokines in the serum.

Pores of the inner limiting membrane in flat-mounted surgical specimens.

Purpose: To demonstrate the incidence of pores in the inner limiting membrane (ILM) in flat-mounted ILM specimens and to show the immunocytochemical properties of cellular proliferation associated with them.

Methods: One hundred and twelve ILM specimens from patients with idiopathic macular holes were flat mounted and screened for pores. The ILM was assessed by phase-contrast and interference microscopy.

Availability of anesthetic effect monitoring: utilization, intraoperative management and time to extubation in liver transplantation.

Titration of volatile anesthetics to anesthetic effect monitoring using the bispectral index (BIS) has been shown to decrease anesthetic requirements and facilitate recovery from anesthesia unrelated to liver transplantation (OLT). To determine whether availability of such monitoring influences its utilization pattern and affect anesthetic care and outcomes in OLT, we conducted a retrospective analysis in recipients with and without such monitoring. We evaluated annual BIS utilization over a period of 7 years, and compared 41 BIS-monitored patients to 42 controls.

Adjusting the pH of lidocaine for reducing pain on injection.

Background: Lidocaine administration produces pain due to its acidic pH.

Objectives: The objective of this review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children. We tested the hypothesis that adjusting the pH of lidocaine solution to a level closer to the physiologic pH reduces this pain.

Bacterial activity and bacterioplankton diversity in the eutrophic River Warnow--direct measurement of bacterial growth efficiency and its effect on carbon utilization.

The influence of bacterial activity and diversity on bacterial growth efficiency was investigated in a flatland river. Eutrophic River Warnow drains predominantly agricultural land and is heavily loaded with nutrients, dissolved and particulate organic matter (DOM and POM), especially humic substances. Although the water column bacterial community consists of many inactive or damaged cells, bacterioplankton sustained a high bacterial secondary production of 0.

Sequential epiretinal membrane removal with internal limiting membrane peeling in brilliant blue G-assisted macular surgery.

Purpose: To assess the selectivity of brilliant blue G (BBG) staining by analysing the morphological components of unstained and stained tissue obtained during epiretinal membrane (ERM) removal with internal limiting membrane (ILM) peeling in BBG-assisted macular surgery.

Methods: Twenty-six surgical specimens were removed from 13 eyes with epiretinal gliosis during vitrectomy using BBG for ERM and ILM peeling. We included eyes with idiopathic macular pucker, idiopathic macular hole and vitreomacular traction syndrome.

[Laryngeal and pharyngeal actinomycosis].

Cervicofacial actinomycosis is an uncommon infection and in most cases odontogenic in origin. Pharyngeal and/or laryngeal lesions, usually occurring secondary to mucosal trauma, are very rare and may mimic a malignant tumor. In such cases, which represent less than 1% of all cases, the differential diagnosis with upper aerodigestive tract malignancy remains challenging.

Influence of genetic variations in TLR4 and TIRAP/Mal on the course of sepsis and pneumonia and cytokine release: an observational study in three cohorts.

Introduction: It has been proposed that individual genetic variation contributes to the course of severe infections and sepsis. Recent studies of single nucleotide polymorphisms (SNPs) within the endotoxin receptor and its signaling system showed an association with the risk of disease development. This study aims to examine the response associated with genetic variations of TLR4, the receptor for bacterial LPS, and a central intracellular signal transducer (TIRAP/Mal) on cytokine release and for susceptibility and course of severe hospital acquired infections in distinct patient populations.

The toll-like receptor 1 variant S248N influences placental malaria.

In malaria-endemic regions, Plasmodium falciparum infection in pregnancy is a predominant cause of maternal and infant morbidity and mortality. Primiparae are relatively immune-naïve and particularly prone. Innate immune recognition of P.

[Incidence and severity of retinopathy of prematurity and its association with morbidity and treatments instituted at Hospital Antonio Pedro from Universidade Federal Fluminense, between 2003 and 2005].

Purposes: To evaluate the incidence and the severity of retinopathy of prematurity (ROP) in preterm infants (PTI), its association with morbidity, and the treatments instituted at Antonio Pedro Hospital from the Universidade Federal Fluminense, between the years of 2003 and 2005.

Methods: Transversal and retrospective study performed with 73 PTI, with gestational age (GA) of 32 weeks or less and/or birth weight (BW) of less than 1,500 g. Ophthalmoscopic exam was accomplished between 4 and 6 weeks of chronologic age or within the 32nd to 36th week of postconceptional age.

In situ calcite formation in limestone-saturated water leaching of acid rock waste.

The result of leaching of a 75% acid rock/25% limestone column with limestone-saturated solution has shown that the pH of the effluent recovered from 2.5, after apparent loss of acid neutralizing capacity after 4 years with water leaching, to pH 7 in less than 3 years. Bulk assay results, XRD and SEM/EDS analyses of samples from the column at 384 weeks (pH 3.

[Safety aspects of novel foods].

Since 1997, novel foods and novel food ingredients have been subjected to Regulation (EC) No. 258/97, which established a notification or authorization procedure before novel foods could be placed on the market. This article reviews the scientific criteria for the safety assessment of novel foods and novel food ingredients.

Genetic variation in innate immunity pathways and their potential contribution to the SIRS/CARS debate: evidence from human studies and animal models.

The lack of a causal and successful treatment for sepsis has led to a re-evaluation of the condition's pathophysiology. The failure of anti-inflammatory strategies has implied compensatory immunosuppression to play a central part in fatal clinical cases. While searching for novel therapeutic strategies, the question arose whether pro-inflammation (systemic inflammatory response syndrome, SIRS) or anti-inflammation (compensatory anti-inflammatory response syndrome, CARS) are dominant in sepsis, and may be counteracted by therapeutic measures.

Persistence of full-length caspase-12 and its relation to malaria in West and Central African populations.

Background: The full-length (L-) variant of caspase-12 is believed to predispose to sepsis. It has been replaced in the genome of most human populations by the (S-) variant, which leads to premature termination of translation. Strikingly, the L-allele is still widely prevalent in African populations, presumably due to a counterbalancing selective force specific to this continent, for which malaria is a prime candidate.

Prevention of biofilm growth on man-made surfaces: evaluation of antialgal activity of two biocides and photocatalytic nanoparticles.

As algal growth on man-made surfaces impacts their appearance, biocides and surfaces with self-cleaning properties are widely used in the building and paint industries. The objective of this study was to evaluate the antialgal activity of two biocides (triazine and isothiazoline) and photocatalytic nanoparticles of zinc oxide (20-60 nm). An aeroterrestrial green, microalgal strain of the genus Stichococcus was chosen as the test organism.

A randomized comparison of right ventricular function after on-pump versus off-pump coronary artery bypass graft surgery.

Objectives: Right ventricular dysfunction occurs very soon after conventional coronary bypass surgery with cardiopulmonary bypass and might not recover within 1 year after the operation. It has been postulated that performing coronary surgery without cardiopulmonary bypass might preserve right ventricular function. We hypothesized that right ventricular global and overall systolic functions are better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery.

[Alkylphosphocholines inhibit lens epithelial cell proliferation and attachment].

Background: Posterior capsule opacification (PCO) is one of the major concerns in modern cataract surgery. Ten years after successful surgery, Nd:YAG capsulotomy is required in up to 42% of patients with an acrylic sharp-edged intraocular lens (IOL). Some accommodative and multifocal IOLs display even higher capsulotomy rates.

Different effects of sevoflurane, desflurane, and isoflurane on early and late left ventricular diastolic function in young healthy adults.

Background: Knowledge on the effects of volatile anaesthetics on left ventricular (LV) diastolic function in humans in vivo is limited. We tested the hypothesis that sevoflurane, desflurane, and isoflurane do not impair LV diastolic function in young healthy humans.

Methods: Sixty otherwise healthy subjects (aged 18-48 yr) undergoing minor procedures under general anaesthesia were studied.

Chemoenzymatic synthesis of a glycolipid library and elucidation of the antigenic epitope for construction of a vaccine against Lyme disease.

Lyme disease (LD) is the most common tick-borne disease in Europe, North America, and Asia. The etiologic agents of LD are spirochetes of the group Borrelia burgdorferi sensu lato, which possess a lipid content of 25-30% of the dry weight. The major glycolipid cholesteryl 6-O-acyl-beta-D-galactopyranoside (ACGal), present in B.

Methods for estimation of long-term non-carbonate neutralisation of acid rock drainage.

In the long-term phase of an acid rock drainage (ARD) evolution profile, after any short-term neutralisation capacity provided by carbonate minerals is exhausted, the net acid release is a product of a declining acid generation rate (AGR) and a slower, long-term acid neutralisation rate mainly provided by gangue silicate minerals. At some point, the AGR and the non-carbonate acid neutralisation rate (ANRnc) will be similar. Matching of the AGR and ANRnc near 10mg H(2)SO(4)/kg/week is demonstrated in data from 10-year columns.

Second-hand smoking and carboxyhemoglobin levels in children: a prospective observational study.

Aim: To establish baseline noninvasive carboxyhemoglobin (COHb) levels in children and determine the influence of exposure to environmental sources of carbon monoxide (CO), especially environmental tobacco smoke, on such levels.

Background: Second-hand smoking may be a risk factor for adverse outcomes following anesthesia and surgery in children (1) and may potentially be preventable.

Patients And Methods: Parents and their children between the ages of 1-12 were enrolled on the day of elective surgery.