Premedication with midazolam in low-risk surgery in children does not reduce postoperative delirium. Prospective cohort study

Introduction: Pediatric postoperative delirium is a frequent complication for which preventive pharmacological measures have been suggested. The use of midazolam as a prophylactic strategy has not yet been thoroughly assessed. Notwithstanding the fact that it is used in pediatric presurgical separation anxiety, its role in delirium is yet to be established. Objective: To quantify the incidence of pediatric postoperative delirium in patients undergoing low risk surgical interventions, exposed to oral midazolam-based premedication and to explore the protective and risk factors associated with the development of delirium. Methods: Prospective, analytical observational study with a cohort design. Children were conveniently selected in accordance with the daily list of surgical procedures in the operating rooms. The inclusion criteria were children between 2 and 10 years old, ASA I-II, undergoing low risk surgeries. Concurrent and longitudinal follow-up was then conducted upon admission to the post-anesthesia care unit (PACU) for the first hour. Results: A total of 518 children were included. The overall incidence of delirium was 14.4 % (95 % CI: 11.4 %-17.5 %). In the subgroup exposed to midazolam, 178 children were analyzed, with an incidence of delirium of 16.2% (95% CI of 10,8 %-21,7). These patients exhibited a higher tendency to delirium with the use of sevoflurane or fentanyl, and/orwhen presenting with severe postoperative pain. Patients exposed to propofol and/or remifentanil showed lower incidences. Conclusions: No reduction in the incidence of emergency pediatric delirium associated with the use of pre-surgical oral midazolam in low risk surgical procedures. Prospective controlled trials and additional research are required to study the effectiveness and safety of this intervention.

Introducción: El delirio pediátrico posoperatorio es una complicación frecuente para la cual se han sugerido medidas farmacológicas de prevención. El uso de midazolam como estrategia profiláctica aún no ha sido suficientemente evaluado. A pesar de que se emplea para la ansiedad de separación pediátrica prequirúrgica, su papel en delirio aún no se ha establecido. Objetivo: Cuantificar la incidencia de delirio pediátrico posoperatorio en pacientes sometidos a cirugías de bajo riesgo quirúrgico, expuestos a premedicación basada en midazolam oral y adicionalmente, explorar los factores protectores y de riesgo asociados a la ocurrencia. Materiales y métodos: Estudio observacional analítico prospectivo con un diseño de cohorte. Se seleccionaron niños por conveniencia de acuerdo con la lista quirúrgica diaria en salas de cirugía. Como criterios de inclusión se tomaron sujetos entre 2 y 10 años de edad, ASA 1-11, sometidos a cirugías de bajo riesgo quirúrgico. Posteriormente se realizó seguimiento concurrente y longitudinal al ingreso a la unidad de recuperación posanestésica (UCPA) durante la primera hora de estancia. Resultados: Se incluyeron 518 niños. La incidencia global de delirio fue del 14,4 % (IC 95 %;11,4 %-17,5 %). En el subgrupo expuesto a midazolam se analizaron 178 niños, quienes presentaron una incidencia de delirio del 16,2 % (IC 95 %;10,8 %-21,7 %). Estos pacientes presentaron una mayor tendencia a delirio con el uso de sevofluorano o fentanilo, y/o cuando presentaron dolor severo posoperatorio. Pacientes con exposición a propofol y/o remifentanilo exhibieron incidencias inferiores. Conclusiones: No se encontró una reducción en la incidencia de delirio pediátrico de emergencia asociada al empleo de midazolam oral prequirúrgico en cirugías de bajo riesgo. Se requieren estudios prospectivos controlados e investigación adicional para el estudio de la efectividad y seguridad de esta intervención.

Single-bolus dexmedetomidine in prevention of emergence delirium in pediatric ophthalmic surgeries: A randomized controlled trial

Purpose: Emergency delirium (ED), a common postoperative neurologic complication, causes behavioral disturbances leading to self?traumas and also has long?term adverse effects in children. Our aim was to investigate the efficacy of a single?bolus dose of dexmedetomidine in reducing the incidence of ED. Additionally, pain relief, number of patients who needed rescue analgesia, hemodynamic parameters, and adverse events were assessed. Methods: One hundred and one patients were randomly allocated into two groups: 50 patients received 15 mL of dexmedetomidine 0.4 ?g/kg (group D) and 51 patients received volume?matched normal saline (group C). Hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were monitored regularly throughout the procedure. ED was assessed with Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and pain was measured using the modified Objective Pain Score (MOPS). Results: The incidences of ED and pain were higher in group C than group D (P < 0.0001 and P < 0.0001, respectively). Group D showed significant decrease in MOPS and PAEDS values at 5, 10, 15, and 20 min (P < 0.05), HR at 5 min (P < 0.0243), and SBP at 15 min (P < 0.0127). There was no significant difference in DBP between the two groups at any time point. The mean blood pressure (MBP) at 10 min was significantly less in group D than group C (P < 0.001). Conclusion: Dexmedetomidine 0.4 ?g/kg as a single bolus over 10 min immediately after intubation is effective for the prevention of ED and significantly reduces the need of rescue analgesia without compromising the hemodynamic parameters in children undergoing ophthalmic surgery.

The impact of emergence delirium on hospital length of stay for children who underwent tonsillectomy/adenotonsillectomy: an observational retrospective study

Abstract Background Emergence Delirium (ED) is a combination of disturbance of perception and psychomotor agitation that is common in pediatric patients after general anesthesia, especially at preschool age. Since the effect of ED on the length of stay has been studied in adults but infrequently in children, the aim of this study was to investigate the relationship between ED and length of stay in this population. Methods A single center, retrospective, observational study was carried out in children who underwent tonsillectomy or adenotonsillectomy. The Pediatric Anesthesia Emergence Delirium (PAED) scale was used to assess ED. In addition to the time to hospital discharge (time frame 24 hours), drugs used, comorbidities, early postoperative complications, and pain were investigated if potentially associated with the complication. Results Four hundred sixteen children aged from 1.5 to 10 years (183 female, 233 male) were included. ED occurred in 25.5% of patients (n = 106). Patients were divided into the ED group and the No-ED group. The discharge time was similar in both groups. No significant differences were observed in the frequency of postoperative complications. The use of fentanyl or dexmedetomidine did not affect ED occurrence. The frequency of pain was greater in the ED group, both in the recovery room and in the ward (p= 0.01). Conclusions The occurrence of ED in children after tonsillectomy/adenotonsillectomy did not extend the length of stay.

The SARS-CoV-2 variants around us: A literature review

ABSTRACT@#The SARS-CoV-2 outbreak in Wuhan (China) has become a global pandemic. Various variants of SARS-CoV-2 have been detected and the variant number of the virus continues to grow. A particular SARS-CoV-2 variant can be detected in a country that was never infected before by the virus. Furthermore, a specific SARS-CoV-2 variant, which has been detected before in a country, can be detected too in another country. The emergence of SARS-CoV-2 variants is mainly caused by mutations and recombinations. The emergence of a SARS-CoV-2 variant in a country (which was never infected before by the virus), of course, can be explained easily as it is caused by the effect of the viral spread among countries, although there may be another explanation. On the other hand, the emergence of a SARS-CoV-2 variant (which has been previously detected in a country) in another country, always has been explained only as it is caused by the effect of the viral spread between countries. However, maybe it is caused by another factor. A literature review was performed to look for the explanation related to the emergence of a certain SARS-Cov-2 variant (which is already detected before in another country) in a country. Based on the literature review results related to the RNA virus genome and its mutation as well as its recombination, it is easy to explain the cause/agent of the emergence of a SARS-CoV-2 variant (which has been previously detected elsewhere) in another country. In this case, the emergence of a SARS-CoV-2 variant (which has been previously detected elsewhere) in a country may be caused by mutations and/or recombinations in addition to the probability that it may also occur due to the spread of the virus among countries; so the emergence of SARS-CoV-2 variant that has been previously detected elsewhere in other countries does not only occur due to the spread of the virus.

Espíritos, afetos e biologia: o cuidado em saúde mental à luz do emergentismo de Terrence Deacon / Spirits, affects and biology: mental health care in the light of Terrence Deacon's emergentism / Esprits, affects et biologie: les soins de santé mentale à la lumière l'émergentisme de Terrence Deacon / Espíritus, afectos y biologia: el cuidado en la salud mental a la luz del emergentismo de Terrence Deacon

Apesar de carregar "mental" em seu nome, no que concerne aos profissionais inseridos em serviços de atenção diária a portadores de transtornos mentais, não há tanto questionamento sobre os pressupostos teóricos que implicam a caracterização que qualifica e delimita o campo da saúde mental. O que é o "mental" da saúde mental? Com vistas a contribuir para a interdisciplinaridade dessa área de atuação, faremos uma análise da teoria de Terrence Deacon, biólogo evolutivo contemporâneo que estuda a emergência da vida e da mente, propondo essa discussão como um aspecto formativo essencial e pouco consolidado nas práticas em saúde mental Como conclusão, veremos como a visão do autor implica, para a saúde mental, uma abordagem na qual esta não pode ser pensada como ausente de aspectos normativos, subjetivos e ambientais.

Resumos Despite having "mental" in its name, as far as professionals engaged in daily services for persons with mental disorders are concerned, there is not much scrutiny about the theoretical assumptions involved in characterizing and delimiting the field of mental health. What is "mental" in mental health? In order to strengthen the interdisciplinary aspects of this field, we will carry out an analysis of the theory by Terrence Deacon, a contemporary evolutionary biologist who studies the emergence of life and mind, and will offer this discussion as an essential formative aspect as yet neglected in mental health practice. In conclusion, we will consider how Deacon's view entails an approach to mental health in which cannot be conceived devoid of normative, subjective and environmental aspects..

Bien que son nom contienne le mot « mental ¼, les professionnels qui travaillent dans les services de soins quotidiens pour les patients atteintes de troubles mentaux ne s'interrogent pas tellement sur les présupposés théoriques qui impliquent la caractérisation qui qualifie et délimite le domaine de la santé mentale. Qu'est-ce que le « mental ¼ de la santé mentale ? Afin de contribuer à l'interdisciplinarité de ce champ d'expertise, nous analyserons la théorie de Terrence Deacon, biologiste évolutionniste contemporain qui étudie l'émergence de la vie et de l'esprit, en proposant cette discussion comme un aspect formatif essentiel et peu consolidé dans les pratiques de santé mentale. Nous verrons comment la vision de l'auteur implique, pour la santé mentale, une approche dans laquelle elle ne peut être pensée comme absente des aspects normatifs, subjectifs et environnementaux.

A pesar de llevar "mental" en su nombre respecto de los profesionales que realizan servicios de atención diaria a las personas con trastornos mentales, no se cuestiona tanto los supuestos teóricos que implican la caracterización que califica y delimita el campo de la salud mental. ¿Qué es lo "mental" de la salud mental? Para contribuir a la interdisciplinariedad de esta área de especialización, haremos un anàlisis de la teoría de Terrence Deacon, biólogo evolutivo contemporáneo que estudia el surgimiento de la vida y de la mente, proponiendo esta discusión como un aspecto formativo esencial y poco consolidado en las prácticas de salud mental. En la conclusión, veremos cómo el autor da a la salud mental un enfoque en el que no se puede pensarlo sin tener en cuenta los aspectos normativos, subjetivos y ambientales..

Treatment with insecticide and fungicide on the physiological quality of lentil seeds / Tratamento com inseticida e fungicida na qualidade fisiológica de sementes de lentilha

The low Brazilian productive index and the high demand have aroused interest in the cultivation of lentils, however the legume is little known and needs further studies. The objective of this study was to analyze and identify the effects of treatments with insecticides and fungicides on the physiological quality of lentil seeds, CA-1512 strain. The experiments were conducted in the seed laboratory in a completely randomized design with seven treatments and four replicates. Seed treatment with Thiophanate-methyl; Fluazinam® (180 ml) + Pyraclostrobin; Thiophanate-methyl; Fipronil® (150 ml) promoted higher levels of germination under accelerated aging, lower number of abnormal seedlings and longer lengths of shoot and radicle for the emergence in paper. Treatment with Carboxin; Thiram® (250 ml) + Imidacloprid® (150 ml) allowed a higher value in the first count of germination in sand, lower number of dead seeds under accelerated aging and longer root length, in the emergence in sand. Shoot length in the emergence in sand increased after seed treatment with Metalaxyl-M; Fludioxonil® (75 ml) + Pyraclostrobin; Thiophanate-methyl; Fipronil® (150 ml). Treatments with fungicides and insecticides considerably improved the physiological properties of the seeds, thus being able to guarantee greater phytosanitary qualities in the field, generating healthier seedlings and with protection against possible pests and diseases, and consequently guaranteeing greater productivity.

O baixo índice produtivo brasileiro e a alta demanda têm despertado o interesse no cultivo da lentilha, porém a leguminosa é pouco conhecida e necessita maiores estudos. Objetivou-se neste trabalho analisar e identificar tratamentos com inseticidas e fungicidas na qualidade fisiológica das sementes de lentilha, linhagem CA-1512. Os experimentos foram conduzidos no laboratório de sementes em delineamento inteiramente casualizado com sete tratamentos e quatro repetições. O tratamento de semente com Tiofanato-metílico; Fluazinam® (180 ml) + Piraclosrobina; Tiofanato-metílico; Fipronil® (150 ml) proporcionou índices mais elevados de germinação no envelhecimento acelerado, menor número de plântulas anormais e maior comprimento de parte aérea e radícula, na emergência em papel. O tratamento com Carboxina; Tiram® (250 ml) + Imidacloprido® (150 ml) possibilitou maior índice na primeira contagem de germinação em areia, menor número de sementes mortas no envelhecimento acelerado e maior comprimento de raiz, na emergência em areia. Já o comprimento da parte aérea, na emergência em areia, aumentou com o tratamento de semente Metalaxil-M; Fludioxonil® (75 ml) + Piraclosrobina; Tiofanato-metílico; Fipronil® (150 ml). Os tratamentos com fungicidas e inseticidas melhoraram consideravelmente as propriedades fisiológicas das sementes, podendo assim, garantir maiores qualidades fitossanitárias à campo, gerando plântulas mais sadias e com proteção para possíveis pragas e doenças, e consequentemente garantindo maiores produtividades.

Treatment with insecticide and fungicide on the physiological quality of lentil seeds

Abstract The low Brazilian productive index and the high demand have aroused interest in the cultivation of lentils, however the legume is little known and needs further studies. The objective of this study was to analyze and identify the effects of treatments with insecticides and fungicides on the physiological quality of lentil seeds, CA-1512 strain. The experiments were conducted in the seed laboratory in a completely randomized design with seven treatments and four replicates. Seed treatment with Thiophanate-methyl; Fluazinam® (180 ml) + Pyraclostrobin; Thiophanate-methyl; Fipronil® (150 ml) promoted higher levels of germination under accelerated aging, lower number of abnormal seedlings and longer lengths of shoot and radicle for the emergence in paper. Treatment with Carboxin; Thiram® (250 ml) + Imidacloprid® (150 ml) allowed a higher value in the first count of germination in sand, lower number of dead seeds under accelerated aging and longer root length, in the emergence in sand. Shoot length in the emergence in sand increased after seed treatment with Metalaxyl-M; Fludioxonil® (75 ml) + Pyraclostrobin; Thiophanate-methyl; Fipronil® (150 ml). Treatments with fungicides and insecticides considerably improved the physiological properties of the seeds, thus being able to guarantee greater phytosanitary qualities in the field, generating healthier seedlings and with protection against possible pests and diseases, and consequently guaranteeing greater productivity.

Resumo O baixo índice produtivo brasileiro e a alta demanda têm despertado o interesse no cultivo da lentilha, porém a leguminosa é pouco conhecida e necessita maiores estudos. Objetivou-se neste trabalho analisar e identificar tratamentos com inseticidas e fungicidas na qualidade fisiológica das sementes de lentilha, linhagem CA-1512. Os experimentos foram conduzidos no laboratório de sementes em delineamento inteiramente casualizado com sete tratamentos e quatro repetições. O tratamento de semente com Tiofanato-metílico; Fluazinam® (180 ml) + Piraclosrobina; Tiofanato-metílico; Fipronil® (150 ml) proporcionou índices mais elevados de germinação no envelhecimento acelerado, menor número de plântulas anormais e maior comprimento de parte aérea e radícula, na emergência em papel. O tratamento com Carboxina; Tiram® (250 ml) + Imidacloprido® (150 ml) possibilitou maior índice na primeira contagem de germinação em areia, menor número de sementes mortas no envelhecimento acelerado e maior comprimento de raiz, na emergência em areia. Já o comprimento da parte aérea, na emergência em areia, aumentou com o tratamento de semente Metalaxil-M; Fludioxonil® (75 ml) + Piraclosrobina; Tiofanato-metílico; Fipronil® (150 ml). Os tratamentos com fungicidas e inseticidas melhoraram consideravelmente as propriedades fisiológicas das sementes, podendo assim, garantir maiores qualidades fitossanitárias à campo, gerando plântulas mais sadias e com proteção para possíveis pragas e doenças, e consequentemente garantindo maiores produtividades.

Distribution characteristics of emerging and reemerging Oncomelania hupensis in China from 2015 to 2021 / 中国血吸虫病防治杂志

Objective To analyze the distribution characteristics of emerging and reemerging Oncomelania hupensis snails after the criteria for transmission control of schistosomiasis were achieved in China, so as to provide insights into assessment of schistosomiasis transmission risk and formulation of snail control strategies during the elimination phase. Methods O. hupensis survey data in China from 2015 to 2021 were collected from the National Schistosomiasis Pevention and Control Information Management System, and the distribution characteristics of emerging and reemerging O. hupensis snails were descriptively analyzed. Results Emerging and reemerging O. hupensis snails were identified in China each year from 2015 to 2021, with relatively larger areas with emerging and reemerging O. hupensis snail habitats in 2016 and 2021, and relatively higher numbers of counties (districts) where emerging and reemerging O. hupensis snails were detected in 2016 and 2021. A total of 4 586.30 hm2 of emerging O. hupensis snail habitats were found in 10 schistosomiasis-endemic provinces of China (except Fujian and Yunnan Provinces) from 2015 to 2021, with 96.80% in Anhui, Hunan and Hubei provinces, where marshland and lake endemic foci were predominant. A total of 21 023.90 hm2 of reemerging O. hupensis snail habitats were found in 12 schistosomiasis-endemic provinces of China from 2015 to 2021, with 97.67% in six provinces of Hubei, Sichuan, Jiangxi, Jiangsu, Yunnan and Anhui, where marshland and lake and hilly endemic regions were predominant. Emerging snail habitats were found in 15.08% of all schistosomiasisendemic counties (districts) in China from 2015 to 2021, and 78.75% of all emerging snail habitats were identified in 11 schistosomiasis-endemic counties (districts), with the largest area of emerging snail habitats found in Lixian County, Hunan Province (645.00 hm2). Reemerging snail habitats were found in 47.67% of all schistosomiasis-endemic counties (districts) in China from 2015 to 2021, and 43.29% of all reemerging snail habitats were identified in 11 schistosomiasis-endemic counties (districts), with the largest area of reemerging snail habitats found in Weishan Li and Hui Autonomous County of Hunan Province (1 579.70 hm2). Conclusions Emerging and reemerging O. hupensis snails were identified in China each year from 2015 to 2021, with much larger areas of reemerging snail habitats than emerging snail habitats, and larger numbers of schistosomiasis-endemic provinces and counties (districts) with reemerging snails were found that those of provinces and counties (districts) with emerging snails. Specific snail control interventions are required tailored to the causes of emerging and reemerging snail habitats. Both emergence and reemergence of O. hupensis snails should be paid attention to in marshland and lake endemic areas, and Guangxi Zhuang Autonomous Region, Shanghai Municipality and Zhejiang Province where schistosomiasis had been eliminated, and reemergence of O. hupensis snails should be given a high priority in hilly areas. In addition, monitoring of O. hupensis snails should be reinforced in snail-free areas after flooding.

Effects of Dolutegravir (DTG) on Survival, Pupariation and Emergence in Drosophila melanogaster: The Rescue Role of Brassica oleracea

The study aimed at determining the protective role of Brassica oleracea on dolutegravir-induced changes in Pupariation and Emergence of Drosophila melanogaster. D. melanogaster aged 3-5 days old were exposed to different concentrations (0.5 to 4 mg/ 5 g diet) of dolutegravir and B. oleracea extract (7.5–1000 mg/5 g diet) for 7 days to determine the lethal concentration (LC50). D. melanogaster were then exposed to the extract (50, 100, 200, and 400 mg/5 g diet) and controls (diet alone and vitamin C) to assess their effects on pupariation and emergence. A 14-day assay was also performed to evaluate the effect of the extract and toxicant (dolutegravir) on fly survival. The result showed a dose-dependent significant decrease (P < 0.05) and a dose-dependent significant increase (P < 0.05) in survival for D. melanogaster exposed to dolutegravir and the extract respectively, when compared to the control group. Results showed a delay in pupariation and decrease in mean pupariation in flies exposed to dolutegravir alone. An improvement in the same parameters was observed in D. melanogaster pre-treated with the extract before exposure to dolutegravir. D. melanogaster pre-treated with 200 and 400 mg extract per 5 g diet showed emergence that was comparable to those in the control groups. A significant decrease (P < 0.05) was observed in the groups exposed to 50 and 100 mg extract per 5 g diet, suggesting no protection at these doses. This study concludes that B. oleracea leaf extract, at certain concentrations, is able to protect against dolutegravir-induced changes in pupariation and emergence in D. melanogaster.

OMICRON (B.1.1.529) SARS-CoV-2 variant-Latest addition in the battle ground!!!

Background: Fungal colonisation of airways in Post TB patients, can lead to a spectrum of diseases based on the immune response of the host. This study was aimed at studying the different entities of this spectrum. Methods: A cross sectional observational study was conducted over 100 patients of post TB patients to make an observation of the diseases of the spectrum of Aspergillus infections. Results: Of the 100 patients who were studied, IPA was found in 24 (48%), ABPA in 13 (26%), CPA in 5 (10%) patients out of the 50 diabetics. ABPA in 23 (46%) patients, Simple colonization, CPA in 11 (22%) and 4 (8%) patients showed IPA out of the 50 non-diabetics. Conclusion: Chronic pulmonary Aspergillosis was the most common disease from Aspergillus among Post TB patients. Diabetes was associated with invasive forms of Aspergillosis, Invasive Pulmonary Aspergillosis (IPA) and subacute invasive pulmonary aspergillosis (SAIA).

Seed size and presence of thorns in Caryocar brasiliense on seedling emergence

Commercial propagation of pequizeiro, which stands out among the main native fruits of the Cerrado region for its high economic potential, has been done by seeds, despite their erratic germination. The objective of this study was to evaluate the effect of seed size and presence of thorns on the endocarp on seedling emergence of pequizeiro in the field. Seeds were collected in a pequizeiro commercial area in Canarana-MT, Brazil. Due to availability, 2,353 thorny seeds (3 sizes) and 106 seeds without thorns (medium sized) were tested. Thorny seeds were classified as large ­ longer than 50 mm; medium ­ between 40 and 50 mm; small ­ less than 40 mm. Seedling emergence started after 50 days in all seed categories, extending up to 100 days in the large seeds and to about 1 year after sowing in the small and medium sized ones. Small seeds showed a lower rate and speed of emergence compared to the others. Large seeds showed higher emergence speed compared to the medium ones. The presence of thorns did not affect seedling emergence. These results indicate the advantages of pequizeiro seed classification for sowing purposes.

A comparison of binocular and monocular surgery on the effect of eye-covering pretreatment on emergence delirium after general anesthesia in pre-school aged children / 中国实用护理杂志

Objective:To evaluate the effect of eye-covering pretreatment on acute delirium in ophthalmology preschool-age children who underwent binocular and monocular surgery by general anesthesia.Methods:The 300 preschool-age children who underwent general anesthesia of elective ophthalmic surgery in the Second Affiliated Hospital, Zhejiang University School of Medicine, from August 2019 to February 2021 were selected as the research object. They were divided into control group and blindfold group with 150 cases each by random number-table. Children in the control group received regular education on cartoon animation videos before surgery; children in the blindfold group received eye-covering pretreatment on the basis of cartoon animation videos(monocular surgery with monocular cover, binocular surgery with binocular cover). The Modified Yale Preoperative Anxiety Scale (m-YPAS) , the Nursing Delirium Screening Scale(NU-DESC), the incidence rate of delirium and the score of postoperative nursing difficulty were compared between two groups.Results:The 271 cases were completed in this study, including 129 cases(monocular surgery 66 cases, binocular surgery 63 cases) in the blindfold group and 142 cases (monocular surgery 73 cases, binocular surgery 69 cases) in the control group. The preoperative m-YPAS score, the postoperative NU-DESC score, the incidence rate of acute delirium and postoperative nursing care difficulty score of monocular surgery in the blindfold group , monocular surgery was (40.28 ± 15.02) points, 1.00 (0.00, 2.00) points, 27.3%(18/66), 1.00 (1.00, 2.00) points,and binocular surgery was (41.69 ± 16.35) points, 1.00 (0.00, 2.00), 39.7%(25/63), 1.00(1.00, 2.00); in the control group, monocular surgery was (46.28 ± 15.76) points, 2.00 (1.00, 3.00) points, 67.1% (49/73), 2.00 (1.00, 3.00) points, and binocular surgery was (47.77 ± 14.82) points, 3.00 (2.00, 4.00) points, 82.6% (57/69) and 2.00 (1.50, 3.00) points respectively. The difference between the two groups was statistically significant ( t= -2.29, -2.24, Z values were -5.74 - -2.95, χ2= 32.94, 25.78, all P<0.05). The preoperative m-YPAS score, the postoperative NU-DESC score, the incidence rate of acute delirium and postoperative nursing care difficulty score of monocular surgery patients in the blindfold group had no significantly statistical difference with that of binocular surgery patient (all P>0.05) . Conclusions:Monocular/ binocular eye-covering pretreatment can effectively decrease the preoperative m-YPAS score, the postoperative NU-DESC score, incidence rate of acute delirium and the postoperative nursing care difficulty in preschool-age children who underwent general anesthesia both monocular or binocular surgery. There was no difference in the application effect of monocular or binocular surgery.

The effect of visual preconditioning on emergence agitation of preschool children during ophthalmologic anesthesia / 中国实用护理杂志

Objective:To investigate the effect of visual preconditioning on emergence agitation in ophthalmic surgery among preschool children.Methods:A total of 156 preschool children who underwent elective ophthalmic surgery in Qilu Hospital of Shandong University from February to September 2021 were selected as the research subjects, and they were divided into the control group and the intervention group by random number table method, there were 78 cases in each group. The control group was given normal nursing 1 hour before surgery while the intervention group accepted visual preconditioning by covering the affected eye. Chinese Version of the Modified Yale Preoperative Anxiety Scale (Cm-YPAS) was used to evaluate the grade of anxiety for the patients during the process of anesthesia induction. Pediatric Anesthesia Emergence Delirium (PAED) was used to compare the score of emergence agitation and the incidence rate of emergence agitation of the two groups.Results:Finally, 75 cases were included in the intervention group and 75 cases in the control group. During anesthesia induction, the intervention group scored (39.78±4.84) and the control group scored (41.07±5.09) with Cm-YPAS, and there was no statistical difference between the two groups ( P>0.05). Furthermore, compared the PAED score of the intervention group 5(4,8) with the control group 8(5, 11), there were statistically significant differences between the two groups ( Z=-3.07, P<0.01). Emergence agitation incidence in the intervention group was 14.67%(11/75), which was lower than that in the control group 38.67%(29/75), the difference was significant ( χ2=11.05, P<0.01). Conclusions:Visual preconditioning can effectively improve recovery quality after general anesthesia and decrease the incidence rate of emergence agitation in ophthalmic surgery among preschool pediatric patients. It′s well worthy of application and dissemination of visual preconditioning clinically.

Effects of fast-track surgery combined with acupuncture at Neiguan acupoint on stress indicators and recovery quality during anesthesia of craniocerebral surgery / 国际中医中药杂志

Objective:To explore the effects of fast-track surgery (FTS) combined with acupuncture at Neiguan acupoint on stress indicators and recovery quality in patients during anesthesia of craniocerebral surgery.Methods:According to block randomization method, 120 patients with craniocerebral trauma meeting inclusion criteria in the hospital were divided into three groups between January 2018 and December 2020, 40 in each group. The control group was given routine awakening intervention, intervention 1 group was given routine awakening intervention and acupuncture at Neiguan acupoint, and intervention 2 group was given FTS and treatment of intervention 1 group. At 10 min after entering the room, immediately after tracheal intubation and immediately after extubation, level of serum cortisol (COR) was detected by electrochemical luminescence apparatus. The level of serum dopamine was detected by ELISA. The blood pressure and heart rates were recorded. The recovery quality during anesthesia was compared, including recovery time, recovery time of spontaneous breathing, extubation time and recovery time of orientation. The cognitive function of patients was evaluated by Neurobehavioral Cognitive Status Examination (NSCE). The incidence of intestinal paralysis, nausea and vomiting, and hospitalization time were observed and recorded during treatment.Results:Immediately after tracheal intubation and extubation, systolic blood pressure in intervention 2 group, intervention 1 group and control group were significantly decreased ( F=12.03, 13.96), levels of serum COR ( F=91.40, 53.76), and dopamine ( F=29.72, 69.39) were significantly decreased ( P<0.01). The recovery time of orientation during anesthesia [(39.09±3.12)min vs. (41.57±3.54)min, (43.84±3.28)min, F=34.65] in intervention 2 group was significantly shorter than that of the intervention 1 group and control group ( P<0.01), and hospitalization time [(9.36±1.78)d vs. (10.92±1.81)d, (12.10±1.95)d, F=1.44] was significantly shorter than that of the intervention 1 group and control group ( P<0.05). Conclusion:The FTS combined with acupuncture at Neiguan acupoint can reduce stress level during anesthesia, improve recovery quality and relieve postoperative cognitive dysfunction in patients undergoing craniocerebral surgery.

Report of autochthonous cases of localized cutaneous leishmaniasis caused by Leishmania (Leishmania) mexicana in vulnerable, susceptible areas of Southeastern Mexico

ABSTRACT Localized cutaneous leishmaniasis (LCL) is an endemic disease in several Mexican States with the main endemic areas located in the South-Southeast region of the country, where 90% of Leishmania (Leishmania) mexicana cases are registered. The Southeast region is located in the Yucatan Peninsula, including Campeche, Quintana Roo and Yucatan States. Campeche and Quintana Roo register more than 60% of the cases in the country each year, while in Yucatan the reports are of imported cases due to residents traveling to endemic areas. However, since 2015, autochthonous cases have been diagnosed by health authorities in municipalities with no previous transmission records. We aimed to identify Leishmania parasite species involved in autochthonous cases by means of the PCR technique. The present study included 13 autochthonous cases of LCL with clinical and parasitological diagnoses during 2018 and 2019 by health authorities, without specific identification of the causal agent. Tissue samples were taken by scraping the margins of active lesions and then they were spotted onto an FTATM Elute Microcard. Next, DNA was eluted and used for PCR amplification of specific Leishmania genus and L. (L.) mexicana species-specific fragments. Molecular analysis showed evidence that L. (L.) mexicana was the causal agent of LCL in 12 of the 13 patients; in one patient, PCR was not performed due to the patient's refusal to participate in the study. Identifying Leishmania species that cause LCL is necessary to define efficient treatment schemes and control strategies for the disease in vulnerable and susceptible areas of the Yucatan State's municipalities.

Effects of transcutaneous electrical acupoint stimulation on emergence agitation in patients undergoing thoracoscopic surgery / 中华麻醉学杂志

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on emergence agitation in the patients undergoing thoracoscopic surgery.Methods:Eighty patients of both sexes, aged 25-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, undergoing elective thoracoscopic surgery under general anesthesia, were divided into 2 groups ( n=40 each) by a random number table method: TEAS group (group T) and control group (group C). In group T, the Hegu (L14), Zusanli (ST36) and Sanyinjiao (SP6) were stimulated starting from 30 min before induction of anesthesia until the end of operation, with a frequency of 2/100 Hz and disperse-dense waves.The intensity of stimulation was the maximum current that patients could tolerate.In group C, stimulating electrodes were placed at the same acupoints before induction, but no electrical stimulation was applied.Ramsay sedation score and VAS score were recorded.and emergence agitation was assessed using RSS agitation score.Blood samples from the median cubital vein or internal jugular vein were collected before anesthesia induction (T 1), at the end of surgery (T 2), immediately after removal of tracheal tube (T 3) and at 15 min after removal of tracheal tube (T 4) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The intraoperative consumption of propofol, remifentanil and sufentanil was recorded.Adverse reactions such as tachycardia, bradycardia, hypertension, hypotension, respiratory depression, delay of awakening and nausea and vomiting were recorded after operation. Results:Compared with group C, the amount of intraoperative remifentanil consumed was significantly decreased, serum IL-6 concentrations were decreased, and the serum IL-10 concentration was increased T 2-4, Ramsay sedate score was increased, and the incidence of agitation was decreased in group T ( P<0.05). There was no significant difference in VAS score and incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:TEAS can reduce the development of emergence agitation in the patients undergoing thoracoscopic surgery, which is related to inhibition of inflammatory responses.

Effect of local infiltration of ropivacaine in gallbladder triangle on agitation and postoperative pain in patients undergoing laparoscopic cholecystectomy / 中国医师杂志

Objective:To study the effect of local infiltration of ropivacaine in gallbladder triangle on agitation and postoperative pain in patients undergoing laparoscopic cholecystectomy (LC).Methods:108 patients with LC who met the requirements of this study treated in Yunnan Cancer Hospital from March 2018 to March 2021 were randomly divided into two groups, 54 cases in each group. Both groups received routine LC under general anesthesia. The observation group received ropivacaine for local infiltration in the gallbladder triangle, and the control group received the same amount of normal saline for local infiltration in the gallbladder triangle. The anesthesia indexes, agitation during awakening and postoperative pain were compared between the two groups.Results:There was no significant difference in extubation, anesthesia and recovery time between the observation group and the control group (all P>0.05); The scores of static and dynamic visual analogue scale (VAS) in the two groups reached the highest value at 6 h after operation, and then decreased gradually, with significant differences between the two groups ( F=15.28, 4.26, 11.06, 3.21, all P<0.05). The dynamic and static VAS scores of the observation group were lower than those of the control group at the time of awakening, 6 h, 12 h and 24 h after operation, with statistically significant difference (all P<0.05). Compared with the control group, the Riker sedation agitation score (SAS) and the incidence of agitation in the observation group were significantly lower (all P<0.05), and the effective times of analgesic pump pressing 24 hours after operation were significantly less ( P<0.05); There was no significant difference in SpO 2 level between the observation group and the control group ( P>0.05); The levels of heart rate (HR) and mean arterial pressure (MAP) in the two groups were significantly higher than those before anesthesia, and the rising degree in the observation group was significantly lower than that in the control group (all P<0.05); The levels of norepinephrine (NE), C-reactive protein (CRP) and cortisol in the two groups were significantly higher than those before anesthesia, and the rising degree in the observation group was significantly lower than that in the control group (all P<0.05). Conclusions:Local infiltration of gallbladder triangle with ropivacaine during LC can reduce the degree of postoperative pain, the use of PCIA pump and the occurrence of agitation during awakening, so as to maintain hemodynamic stability.

Age and sequence of emergence of permanent teeth in a population of Costa Rican school children / Edad y secuencia de erupción de la dentición permanente en una población de niños escolares en Costa Rica

ABSTRACT: The aim of this study was to determine the average age and sequence of eruption of permanent dentition in the school population of the province of Cartago, Costa Rica. Methods: A cross-sectional observational study included children between the ages of 5 and 12 from public and private schools. Clinical examination was performed, and the presence or absence of permanent teeth recorded. Statistical analysis: An estimation of means of eruption was used through binary variables, building the probabilities of the presence of a dental piece through a logistic regression. Results: 833 children were examined: 433 (51.90%) girls and 400 (48.10%) boys. The permanent teeth erupt first in the female sex; however, this difference is not statistically significant. The maxilla eruption sequence for girls was 6-1-2-4-3-5-7 on both sides; for boys, the sequence of eruption was 6-1-2-4-5-3-7 for the right side and 6-1-2-4-3-5-7 for the left side. In the jaw, the sequence in boys was 6-1- 2-3-4-5-7, and in girls, 1-6-2-3-4-5-7. Conclusions: For the first time, at the Central American Level, the pattern of permanent dentition eruption could be established. The age of permanent dental eruption does not vary according to sex in this population.

RESUMEN: El objetivo de este estudio fue determinar la edad promedio y la secuencia de erupción de la dentición permanente en la población escolar de la provincia de Cartago, Costa Rica. Metodología: se realizó un estudio transversal que incluyó niños con edades comprendidas entre los 5 y 12 años provenientes de escuelas públicas y privadas. Se realizó un examen clínico y se registró la presencia o ausencia de dientes permanentes. Análisis estadístico: se utilizó una estimación de las medias de erupción a través de variables binarias, construyendo las probabilidades de la presencia de una pieza dental por medio de una regresión logística. Resultados: se examinaron 833 sujetos: 433 (51,90%) niñas y 400 (48,10%) niños. Los dientes permanentes erupcionaron primero en el sexo femenino, sin embargo, esa diferencia no fue estadísticamente significativa. La secuencia de erupción maxilar para las niñas fue 6-1-2-4-3-5-7 en ambos lados; para los niños la secuencia fue 6-1-2-4-5-3-7 para el lado derecho y 6-1-2-4-3-5-7 para el lado izquierdo. En la mandíbula, la secuencia en los niños fue de 6-1-2-3-4-5-7-, y en las niñas fue de 1-6-2-3-4-5-7. Conclusiones: por primera vez a nivel de Centroamérica se pudo establecer el patrón de erupción de la dentición permanente. La edad de erupción dental permanente no varía según el sexo en esta población.

Light, temperature and sowing depth on germination of garden spurge / Efeito da luz, temperatura e profundidade de semeadura na germinação de erva-de-santa-luzia

ABSTRACT: Knowledge on weed biology and ecology is fundamental to provide suitable control practices in weed management systems. The objective of this research was to understand the effect of light and temperature on germination of Chamaesyce hirta, as well as to evaluate the effect of depth of seed placement in the soil in the emergence of the plant. Two experiments were conducted. In the first one, in the laboratory, the seeds were placed to germinate in plastic boxes and kept in a B.O.D. germination chamber, under constant temperatures of 20, 25, 30 and 35 ºC, either in the dark or under continuous light. Daily germination assessments were performed. The percentage of germinated seeds in the 10-day period and the germination speed index (GSI) were calculated. In the second trial, carried out in greenhouse conditions, 100 seeds were planted, under six levels of seeding depth (0, 1, 2, 3, 4 and 5 cm) and three soil cover conditions: no straw, under black oats (Avena strigosa) straw and under corn (Zea mays) straw. Daily plant emergence was counted along 30 days and total emergence and GSI were calculated. Germination of C. hirta seeds occurs both in the presence and absence of light. For the highest temperature, both increased germination and GSI were reported in the presence of light. The highest levels of emergence were obtained with the absence of plant cover and under corn straw at 0 cm depth. The presence of black oat straw on the soil reduced the emergence of C. hirta.

RESUMO: O conhecimento a respeito da biologia e ecologia das plantas daninhas é fundamental para a adoção de práticas de controle adequadas dentro dos sistemas de manejo. O objetivo do trabalho foi avaliar o efeito da luz e da temperatura na germinação de Chamaesyce hirta, e o efeito de profundidade de semeadura na emergência das plantas, com a presença e ausência de cobertura vegetal no solo. Foram instalados dois experimentos. No primeiro, conduzido em laboratório, as sementes foram colocadas para germinar em caixas plásticas, do tipo "gerbox", e mantidas em câmara de germinação do tipo B.O.D., sob temperaturas constantes de 20, 25, 30 e 35 ºC no escuro ou sob luz contínua. Foram realizadas avaliações diárias de germinação. Calculou-se a porcentagem total de sementes germinadas no período de 10 dias e o índice de velocidade de germinação (IVG). No segundo, conduzido em casa-de-vegetação, 100 sementes foram colocadas em vasos com solo, sob seis níveis de profundidade de semeadura (0, 1, 2, 3, 4 e 5 cm) e três condições de cobertura do solo: sem palhada, com palha de aveia-preta (Avena strigosa) e com palha de milho (Zea mays). A emergência das plântulas foi registrada diariamente por um período de 30 dias, calculando-se a porcentagem total de emergência para cada tratamento e o índice de velocidade de emergência (IVE). A germinação das sementes de C. hirta ocorreu tanto na presença quanto na ausência de luz. Para a temperatura mais elevada houve maior porcentagem de germinação, bem como maior IVG, na presença de luz. Os maiores níveis de emergência ocorreram na ausência de cobertura vegetal e sob palhada de milho na profundidade de 0 cm. A presença de palha de aveia-preta sobre o solo reduziu a emergência de C. hirta, mostrando-se como uma boa medida de controle cultural.

Effect of prophylactic use of propofol on emergence agitation following sevoflurane anesthesia in pediatric patients: a meta-analysis / 中华麻醉学杂志

Objective:To systematically review the effect of prophylactic use of propofol on emergence agitation (EA) following sevoflurane anesthesia in pediatric patients.Methods:Databases such as Pubmed, Web of Scince, Embase, Cochrane Library, ClinicalTrials.gov, CNKI, Wanfang Data and VIP were searched for randomized controlled trials involving the comparison of effects of propofol (1 mg/kg) versus normal saline on EA following sevoflurane anesthesia in pediatric patients using computers from inception to December 1, 2020.Evaluation indexes included incidence of agitation, Pediatric Anesthesia Emergence Delirium (PAED) scale, awakening time, postanesthesia care unit (PACU) stay time and incidence of adverse events.The Cochrane Collaboration′s tool for assessing risk of bias was used to evaluate the quality of the included trials.The meta-analysis was conducted using the RevMan 5.3 and Stata 12.0 softwares.Results:Sixteen randomized controlled clinical trials involving 1 061 patients were included in this meta-analysis.The patients were divided into 2 groups: propofol group ( n=531) and normal saline group ( n=530). Compared with group normal saline, incidence of EA and PAED score were significantly decreased in group propofol ( P<0.05), and there was no significant difference in the incidence of postoperative nausea and vomiting, incidence of other adverse events and PACU stay time between the 2 groups ( P>0.05). Conclusion:Prophylactic dose of propofol (1 mg/kg) for sevoflurane-based anesthesia can reduce the degree of EA and decrease its incidence without increasing the occurrence of adverse reactions in pediatric patients.