Clinical efficacy of combined spinal and epidural anesthesia with isobaric bupivacaine in older adult patients undergoing artificial femoral head replacement / 中国基层医药

Objective:To investigate the clinical efficacy of combined spinal and epidural anesthesia with isobaric bupivacaine in older adult patients undergoing artificial femoral head replacement.Methods:The clinical data of 50 older adult patients who underwent artificial femoral head replacement in Zhuji Third People's Hospital between January 2016 and January 2020 were retrospectively analyzed. The patients were divided into a control group ( n = 22) and a combined anesthesia group ( n = 28) according to different anesthesia methods. The control group was subjected to epidural anesthesia with bupivacaine. The combined anesthesia group underwent combined spinal and epidural anesthesia with isobaric bupivacaine. The excellent and good rate of anesthesia as well as heart rate and mean arterial pressure measured before and 10 minutes after anesthesia, at 1 hour of surgery and at the end of surgery were compared between the two groups. Time to anesthesia onset and time to block completion were recorded in each group. Results:The excellent and good rate of clinical efficacy in the combined anesthesia group was significantly higher than that in the control group [85.71% (24/28) vs. 59.09% (13/22), χ2 = 4.54, P < 0.05]. There were no significant differences in heart rate and mean arterial pressure between the two groups before and 10 minutes after anesthesia, at 1 hour of surgery and at the end of surgery ( t = 0.83, 0.60, 1.13, 1.21; 0.98, 0.60, 0.85, 0.88, P > 0.05). The time to anesthesia onset and the time to block completion in the combined anesthesia group were shorter than those in the control group ( t = 4.99, 2.29, both P < 0.05). Conclusion:Combined spinal and epidural anesthesia with isobaric bupivacaine can increase the excellent and good rate of anesthesia effects and has no obvious effect on hemodynamics in patients undergoing artificial femoral head replacement. Combined spinal and epidural anesthesia takes a shorter time to anesthesia onset and a shorter time to block completion than spinal or epidural anesthesia.

Fluid intake, hydration status and body mass changes in U-15 judo athletes during a training day

Despite numerous studies related to dehydration there is still a lack of scientific literature presenting hydration status and fluid intake of judo athletes during different periods. Therefore, the aim of this study was to investigate, fluid intake, hydration status and body weight changes of young judo athletes during a typical day of training in preparation period. Twenty-two young judo athletes (age: 12 ± 0.7 y, experience: 3.5 ± 1.1) voluntarily participated in this study. Hydration status and weight were examined in the morning, before and immediately after the training. All athletes trained 90 min and they consumed fluids ad libitum during the exercise. According to morning urine specific gravity (USG) values, 81.2% of the athletes were dehydrated while only 18.8% of the athletes were euhydrated. Pre-training urine measurements showed that 63.64% of the athletes presented dehydration and 77.27% of the athletes completed the training in dehydrated condition despite fluid availability during the training. Mean body weight loss during training was -0.64 ± 0.66%. It can be concluded that young judo athletes presented high prevalence of dehydration as indicated by USG values. Most of the athletes were dehydrated during a typical training day and completed the training in more dehydrated conditions compared to pre training values despite ad libitum fluid intake. It is of great importance to evaluate hydration status of the athletes before training to refrain from common practice of fluid restriction for weight loss and adverse effects of a persistent state of fluid deficit on physical and health related state.

The Hydration Status of Female Collegiate Soccer Players Over Consecutive Training and Match Days / Estado de Hidratación de Jugadoras de Fútbol Universitarias Durante Días de Entrenamiento y Partidos Consecutivos

Abstract Purpose: Hydration has been shown to play a pivotal role in sport. Soccer is a team sport in which the integrity of all players is vital for team performance; thus, individual player hydration status is important. The primary aim of this study was to investigate the hydration status of female collegiate soccer players during regular season. Methods: Sixteen collegiate female soccer players (age: 20.4 ± 0.8 years; height: 163.6 ± 6.9 cm; weight: 65.3 ± 12 kg) provided urine over 9 days to monitor their hydration status. Hydration was determined by urine specific gravity (Usg). Usg was analyzed in the morning (AM) and in the afternoon before practice/game (PM). Results: All 16 players were at least minimally hypohydrated (Usg > 1.010) in the AM on 5 of the 9 days tested. Players had significantly higher Usg values in the AM as compared to PM (F(1,250) = 23.09; p < 0.0001); however, there was no significant time*day interaction (F(1,250) = 1.98; p = 0.16). Conclusion: Data show a high prevalence of hypohydration occurring in this specific population. This sub-optimal hydration status could be a cause for concern in terms of overall performance. Efforts should be made to integrate hydration interventions and daily monitoring to minimize hypohydration in players.

Resumen Propósito: Se ha demostrado que la hidratación juega un papel fundamental en el deporte. El fútbol es un deporte de equipo en el que la integridad de todos los jugadores es vital para su rendimiento; por lo tanto, el estado de hidratación de cada jugador es importante. El objetivo principal de este estudio fue investigar el estado de hidratación de las jugadoras universitarias de fútbol durante la temporada regular. Métodos: Dieciséis jugadoras universitarias de fútbol (edad: 20.4 ± 0.8 años; estatura: 163.6 ± 6.9 cm; peso: 65.3 ± 12 kg) proporcionaron muestras de orina durante 9 días para controlar su estado de hidratación, la cual se determinó por la gravedad específica de la orina (Usg). La Usg se analizó en la mañana (AM) y en la tarde antes del entrenamiento o el juego (PM). Resultados: Las 16 jugadoras estaban al menos mínimamente hipohidratadas (Usg > 1.010) en la AM en 5 de los 9 días medidos. Las jugadoras tuvieron valores Usg significativamente más altos en AM en comparación con PM (F (1,250) = 23.09; p < 0.0001); sin embargo, no hubo interacción significativa de tiempo * día (F(1,250) = 1.98; p = 0.16). Conclusión: los datos muestran una alta prevalencia de hipohidratación en esta población específica. Este estado de hidratación subóptimo podría ser motivo de preocupación en términos de rendimiento general. Se deberían hacer esfuerzos para integrar las intervenciones de hidratación y el monitoreo diario para reducir al mínimo la hipohidratación en las jugadoras.

Resumo Objetivo: Foi demonstrado que a hidratação desempenha um papel fundamental no esporte. O futebol é um esporte coletivo no qual a integridade de todos os jogadores é vital para o desempenho da equipe; portanto, o estado de hidratação de cada jogador é importante. O objetivo principal deste estudo foi investigar o estado de hidratação de universitárias jogadoras de futebol do sexo feminino durante a temporada regular. Métodos: Dezesseis universitárias jogadoras de futebol (idade: 20,4 ± 0,8 anos; altura: 163,6 ± 6,9 cm; peso: 65,3 ± 12 kg) forneceram amostras de urina por 9 dias para monitorar seu estado de hidratação. A hidratação foi determinada pela gravidade específica da urina Usg. Sua Usg foi analisado pela manhã (matutino) e à tarde (vespertino) antes do treino ou jogo. Resultados: As 16 jogadoras estavam minimamente hipohidratadas (Usg > 1.010) no período matutino em 5 dos 9 dias medidos. As jogadoras apresentaram valores de Usg significativamente maiores no período matutino em comparação ao vespertino (F (1.250) = 23,09; p <0,0001); no entanto, não houve interação tempo * dia significativa (F (1.250) = 1,98; p = 0,16). Conclusão: os dados mostram uma alta prevalência de hipohidratação nesta população específica. Este estado de hidratação abaixo do ideal pode ser uma preocupação em termos de desempenho geral. Devem ser feitos esforços para integrar intervenções de hidratação e monitoramento diário para minimizar a hipohidratação em jogadoras.

Urine Analysis Revisited: A Review

Analysis of urine represents a basic test in the diagnostic battery for most of the systemic disorders and renal diseases in particular. Significant informations can be obtained by urinalysis as many disease processes invariably display urinary abnormalities. It offers a simple, often quick way of following response to treatment in these diseases, without putting the patient under much distress. For urinalysis to be maximally useful as a diagnostic tool, attention to details is necessary in the methodology of urine collection, timely sample processing and most importantly, a thorough knowledge on the various abnormalities that can be detected during the analysis. This article is a comprehensive review on urinalysis, including the intricacies of sample collection, various normal and abnormal physical and chemical parameters with an emphasis on the importance of a meticulous microscopic examination of urine sample to arrive at a diagnosis.

Sub-morbid dehydration-associated glomerular hyperfiltration: An emerging reality?

BACKGROUND: Severe dehydration decreases renal perfusion. However, it is unclear whether sub-morbid dehydration affects kidney function similarly. Although there have been numerous animal and human studies that have suggested mild dehydration is associated with glomerular hyperfiltration, it has not been confirmed on a large-scale in the general population. Therefore, we aimed to identify the relationship between hydration status and kidney function. METHODS: We reviewed the data of 28,342 adults who participated in the Korea National Health and Nutrition Examination Surveys. Urine specific gravity unit (SGU) was the primary variable that indicated hydration status, and the estimated glomerular filtration rate (eGFR) was used as the primary outcome. RESULTS: Multivariate linear regression analysis showed urine SGU was positively associated with eGFR, which was J-shaped in the multivariate generalized additive model plot. In the penalized spline curve analysis, the odds ratio for high eGFR was steadily increased. Although increased urine SGU was associated with decreased blood pressure and pulse rate, it had no effect on increased fasting glucose and total cholesterol, suggesting conflicting cardio-metabolic dehydration effects. CONCLUSION: Dehydration, presumably sub-morbid in an ambulatory community-dwelling general population, is associated with higher kidney function. The clinical significance of sub-morbid dehydration-associated glomerular hyperfiltration needs further investigation.

Dynamic analysis of iodine nutritional status and rationality of urine specific gravity correction for urinary iodine of focused groups in Fujian Province / 中华地方病学杂志

Objective To understand the iodine nutritional status of children aged 8 to 10 years old and pregnant women in the new standard iodized salt pilot areas of Fujian Province,and to analyze the rationality of urine specific gravity correction for urinary iodine.Methods In the 3rd,6th,9th,12th,15th and 21th months after supplying of new standard iodized salt in March 2012,the first to sixth phases' assessment were conducted in Xindian Town of Xiang'an District,Xiamen City and Yongfu Town,Xinqiao Town of Zhangping City,Longyan City.Totally 200 children aged 8 to 10 years old and 50 pregnant women were selected from each town,home salt samples and urine samples were collected,salt iodine,urinary iodine and urine specific gravity were tested.Salt iodine was detected by "General Test Method in Salt Industry-Determination of Iodine" (GB/T 13025.7-2012);urinary iodine was detected by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" (WS/T 107-2006);urine specific gravity was detected by digital refractometer.Results From the first to sixth phases' assessment,the iodized salt coverage rates of children aged 8 to 10 years old and pregnant women were ＞ 95％,the edible rates of qualified iodized salt were ＞ 90％.The measured medians of urinary iodine of children aged 8 to 10 years old were 216.7,219.5,188.1,206.7,209.2,and 201.0 μg/L,respectively;except the third phase's assessment,which was in the iodine appropriate level (100-199 μg/L),the other five phases/ assessment were all higher than the iodine appropriate level (200-299 μg/L);the medians of urinary iodine of children aged 8 to 10 yearsold after urine specific gravity correction were 215.0,213.6,197.3,202.9,204.3,and 197.7 μg/L,respectively;there were no significant differences in urinary iodine between the measured and urine specific gravity correction (Z =-0.131,-0.183,-1.052,-1.180,-0.311,-0.368,P ＞ 0.05).The measured medians of urinary iodine of pregnant women were 134.0,132.2,120.9,115.6,113.3,and 123.3 μg/L,respectively,which were in the iodine deficiency level (＜ 150 μg/L);the medians of urinary iodine of pregnant women after urine specific gravity correction were 207.3,197.1,168.8,158.3,171.8,and 181.7 μg/L,respectively;there were significant differences in urinary iodine between the measured and urine specific gravity correction (Z =-6.419,-6.406,-5.990,-6.648,-7.008,-8.034,P ＜ 0.01).Conclusions The iodine nutrition of children aged 8 to 10 years old is appropriate in the new standard iodized salt pilot areas of Fujian Province,while that of pregnant women is mild iodine deficiency.Further research is needed to use urine specific gravity to calibrate the concentration of urinary iodine to assess the iodine nutritional level of the focused populations in the regions.

Comparación entre hidratación con leche chocolatada descremada y bebida deportiva posterior al ejercicio físico en militares / Comparison between hydration with chocolate skim milk and sports drink after physical exercise in militaries

Introducción: dos factores importantes han sido descritos como contribuyentes en la aparición de fatiga durante el ejercicio físico: la disminución de las reservas de glucógeno muscular y la pérdida de agua con electrolitos a través del sudor, que favorecen la deshidratación. Debido a esto, la reposición de líquidos y electrolitos posterior al ejercicio físico se transforma en la prioridad para restablecer la homeostasis corporal alterada durante el ejercicio físico. Por su composición nutricional, la leche parece ser una buena alternativa natural como bebida rehidratante posterior al ejercicio físico. Objetivo: comparar la efectividad como bebida de rehidratación de la leche descremada chocolatada contra una bebida deportiva artificial en militares, a partir de la hipótesis de que la leche descremada chocolatada tiene iguales o mejores efectos sobre la hidratación post ejercicio, que una bebida deportiva artificial. Método: 30 militares (23,0 ± 3,2 años) se dividieron en 2 grupos: 1) rehidratación con bebida deportiva con 6 pòr ciento de carbohidratos y relación de Na/K 2:1 (grupo ISO). Rehidratación con leche descremada chocolatada (grupo LECHE). Se evaluó la retención de fluidos a través del peso corporal y la gravedad específica de la orina (GEO) antes y después del ejercicio físico y posterior a las 2 horas de rehidratación. Resultados: se encontraron diferencias significativas (p< 0,05) en la retención de fluidos en el grupo LECHE comparado con el grupo ISO. No hubo diferencias significativas entre la GEO de ambos grupos. Conclusión: Los resultados muestran que la rehidratación con leche descremada es más efectiva en la retención de fluidos y recuperación del peso previo al ejercicio que la bebida deportiva(AU)

ntroduction: Two important factors have been described as contributing to the onset of fatigue during physical exercise: Decreased muscle glycogen stores and the loss of water with electrolytes through sweating, favoring dehydration. Because of this, fluid and electrolyte replacement after physical exercise becomes the priority to restore altered body homeostasis during physical exercise. Due to its nutritional composition, milk appears to be a good natural alternative as a rehydration beverage after exercise. Objective: To compare the effectiveness chocolate skim milk as pots-exercise rehydration beverage with an artificial sports drink in the military, based on the hypothesis that chocolate skim milk has equal or better effects on post-exercise hydration than an artificial sports drink. Method: 30 soldiers (23.0 ± 3.2 years) were divided into 2 groups: 1) rehydration with sports drink with 6 percent carbohydrates and ratio of Na / K 2: 1 (ISO group). Rehydration with chocolate skim milk (LECHE group). Fluid retention was assessed through body weight and the specific gravity of urine (GEO) before and after physical exercise and after 2 hours of rehydration. Results: significant differences were found (p < 0.05) in fluid retention in the LECHE group compared to the ISO group. There were no significant differences between the GEO of both groups. Conclusion: The results show that rehydration with skim milk is more effective in fluid retention and weight recovery prior to exercise than sports drink(AU)

Predictors of early neurological deterioration in patients with acute ischaemic stroke with special reference to blood urea nitrogen (BUN)/creatinine ratio & urine specific gravity.

Background & objectives: Early neurological deterioration (END) occurs in about 20 to 40 per cent of patients with acute ischaemic stroke and results in increased mortality and functional disability. In recent studies relative dehydration has been found to be associated with END in patients with acute ischaemic stroke. This study was conducted to identify factors useful for predicting END and to assess the role of blood urea nitrogen/creatinine ratio (BUN/creatinine) and urine specific gravity (USG) as predictors of END in patients with acute ischaemic stroke. methods: The present study was an observational prospective study. Various parameters comprising demographic, clinical, laboratory and radiological variables along with stroke severity were assessed and studied as predictors of early neurological deterioration in 114 consecutive patients presenting to the Emergency department during 2012. BUN/creatinine >15 and USG >1.010 were studied as markers of relative dehydration contributing to END. results: of the 114 patients enrolled in the study, END was observed in 25 (21.9%) patients. National Institutes Health Stroke Scale score (NIHSS) ≥ 12 at admission was found to be an independent risk factor for END. Amongst markers of relative dehydration, BUN/creatinine >15 at admission was found to be an independent risk factor for END, as also USG >1.010. Also, cerebral oedema and size of hypodensity >1/3rd of the middle cerebral artery territory on cranial CT were observed to be independent risk factors for END. Interpretation & conclusions: Our study findings highlighted a possible association of relative dehydration, as indicated by BUN/creatinine ratio >15, with END along with other parameters like stroke severity at presentation, extent of hypodensity >1/3rd of the middle cerebral artery (MCA) territory and cerebral oedema. Dehydration being a treatable condition, the use of BUN/creatinine >15 as a marker of relative dehydration, can be helpful in detecting patients with dehydration early and thus play a role in preventing END.

A study of rationality of correcting urinary iodine concentration by using urine specific gravity / 中华地方病学杂志

Objective To explore the rationality of correcting urinary iodine (UI) concentration by using urine specific gravity (U-SG).Methods Weighing method and refractometer method were used respectively to measure specific gravity of 10-30 g/L mass concentration of different inorganic salts (sodium chloride,sodium sulfate,ammonium biphosphate) and organic matters(urea,glucose,glycine) aqueous solution,and urine plus 10-30 g/L sodium chloride or urea.UI concentrations in urine samples of 27 pregnant women respectively were expressed by direct method,weighing method U-SG correction and refractometer method U-SG correction.One random urine sample was collected for six batches in different seasons from children aged 8-10 and pregnant women for determination of U-SG and UI concentration.UI concentration was determined by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Results ①Measured by weighing method,specific gravity of inorganic salt (sodium chloride,sodium sulfate,ammonium biphosphate) aqueous solution was significantly greater than that of organic matters (urea,glucose,glycine) aqueous solution which had the same mass concentration.The specific gravity of 10 g/L sodium chloride aqueous solution was 1.008,and that of 30 g/L urea solution was 1.006.②Measured by weighing method,10 g/L sodium chloride was added to 3 urine samples separately.Accordingly the increases of USG were 0.006,0.008 and 0.007,respectively.Otherwise,the increases of U-SG were 0.003,0.002 and 0.004,respectively,when adding 10 g/L urea.~he median results of UI concentrations in urine samples from 27 pregnant women were 106.4,165.2 and 211.8 μg/L,respectively,expressing obtained by direct method,weighing method USG correction and refractometer method U-SG correction.④The determination results of six batches urine collected from children aged 8-10 in different seasons,the median results of U-SG measured by refractometer method were 1.019 0-1.021 2,the median UI concentration results obtained by direct method and refractometer method U-SG correction were 134.5-181.7 μg/L and 157.7-190.4 μg/L.The determination results of six batches urine samples of pregnant women in different seasons,the median results of U-SG measured by refractometer method were 1.013 4 -1.017 1,the median UI concentration results obtained by direct method and refractometer method U-SG correction were 96.2-138.9 μg/L and 135.2-181.6 μg/L.Conclusions The change of sodium chloride concentration in urine is the most important reason for the change of U-SG.In China,the main source of UI is the intake of edible iodized salt.Iodized salt intakes directly affect the U-SG and UI concentration.If the U-SG is used to correct the UI concentration,there will be a phenomena that the lower intake of iodized salt the lower U-SG.So the UI concentration was falsely increased significantly after correction.Conversely higher intakes of iodized salt caused higher U-SG.The UI concentration was falsely reduced significantly after correction.Therefore,U-SG cannot be used to correct the UI concentration.

Clinical significance of cystatin C to early renal damage in puerperae / 国际检验医学杂志

Objective To investigate the serum concentration of cystatin C in puerperae and the relationship of cystatin C with e-rythrocyte count,leukocyte count,urine microalbumin and specific gravity.Methods The serum cystatin C,Cr,BUN and urine e-rythrocyte count,leukocyte count,urine microalbumin and specific gravity were detected in 232 puerperae and 200 healthy women. Multiple linear regression analysis was performed to analyze the relationship of cystatin C with urine erythrocyte count,leukocyte count,urine microalbumin and specific gravity.Results The concentration of cystatin C in the puerperal group was significantly higher than that in the normal control group(P <0.05).The concentrations of Cr,BUN in the puerperal group were significantly lower than that in the normal control group (P <0.05).The erythrocyte count and the leukocyte count,in the puerperal group were higher than those in the control group(P <0.05).The urine microalbumin was higher in the puerperal group than that in the con-trol group(P <0.05).There was no significant difference of specific gravity between them.In multiple linear regression analysis,a regression relationship was found between cystatin C(Y)and urine microalbumin(X1 )and specific gravity(X2 ).Regression relation-ship was not found between cystatin C and other indices.Conclusion Elevated serum cystatin C,together with urine microalbumin suggests early renal function change.They can be used to monitor renal function for the puerperae.

Effect of hyperbaric factor on lidocaine-induced apoptosis in spinal neurons in rats with diabetic neuropathic pain / 中华麻醉学杂志

Objective To evaluate the effect of hyperbaric factor on lidocaine-induced apoptosis in spinal neurons in rats with diabetic neuropathic pain.Methods Healthy male Sprague-Dawley rats,weighing 220-300 g,were used in the study.Diabetic neuropathic pain was induced by high-sugar high-fat diet + intraperitoneal 1％ streptozotocin (STZ) 30 mg/kg and confirmed by blood glucose level ＞ 16.65 mmol/L at 3 days after STZ injection and then intrathecal catheter was placed.Twenty-four rats with diabetic neuropathic pain in which IT catheters were successfully implanted were randomly divided into 3 groups (n =8 each):hyperbaric lidocaine group (group HL),isobaric lidocaine group (group IL),and glucose group (group G).Another 8 rats in which IT catheters were successfully inserted served as control group (group C).2％ hyperbaric lidocaine 10 μl (in C and HL groups),2％ isobaric lidocaine 10 μl (in group IL),or 10％ glucose 10 μl (in group G) was injected intrathecally once a day for 3 consecutive days.The duration of motor block was recorded at 2 min after each administration.The paw withdrawal threshold to von Frey filament stimulation (PWT) was measured before STZ injection (T1),before IT injection (T2),at 30 min after administration on 1st,2nd and 3rd days and on day 5 after the end of administration (T3-6).All the rats were sacrificed at T6 and their L4,5 segments of the spinal cord were removed for microscopic examination.The apoptosis in spinal neurons was detected using TUNEL assay.Results Compared with the baseline value at T1,PWT was significantly decreased at T2-5 in HL,IL and G groups.PWT was significantly higher at T6 than at T2-5 in group HL.Compared with group C,the duration of motor block was significantly prolonged and the apoptotic index was increased in group HL.Compared with group IL,the duration of motor block was significantly prolonged and the apoptotic index was increased in group HL.Conclusion Hyperbaric factor can promote lidocaine-induced apoptosis in spinal neurons in rats with diabetic neuropathic pain.

Ropivacaína para raquianestesia unilateral: hiperbárica ou hipobárica? / Ropivacaine for unilateral spinal anesthesia; hyperbaric or hypobaric? / Ropivacaína para raquianestesia unilateral: ¿hiperbárica o hipobárica?

JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi comparar a unilateralidade do bloqueio subaracnoide obtido com ropivacaína hiperbárica e hipobárica. MÉTODOS: Estudo prospectivo aleatorizado conduzido em centro cirúrgico ortopédico. No total, 60 pacientes (ASA I-III) programados para cirurgia eletiva de artroplastia total do joelho foram incluídos no estudo. O grupo hipo (n = 30) recebeu 11,25 mg de ropivacaína (7,5 mg.mL-1) + 2 mL de água destilada (a densidade em temperatura ambiente foi 0,997) e o grupo hiper (n = 30) recebeu 11,25 mg de ropivacaína + 2 mL (5 mg.mL-1) de dextrose (a densidade em temperatura ambiente foi 1,015). Os pacientes no grupo hiperbárica foram posicionados com o lado operado para baixo e na posição de Fowler a 15º e os pacientes do grupo hipobárica foram posicionados com o lado operado para cima e na posição de Trendelenburg a 15º. O bloqueio combinado de raquianestesia e anestesia peridural (ACRP) foi realizado na linha mediana do interespaço lombar em L3 e L4. Foram avaliados os parâmetros hemodinâmicos e de bloqueio da coluna vertebral, tempo de regressão, sucesso da raquianestesia unilateral, conforto do paciente, do cirurgião e da cirurgia, tempo até a primeira requisição analgésica e efeitos adversos. RESULTADOS: O tempo necessário para atingir o nível de dermátomo T10 no lado operado foi menor no grupo hiper (612,00 ± 163,29 segundos) comparado ao grupo hipo (763,63 ± 208,35 segundos) (p < 0,05). O tempo para a regressão de dois segmentos do nível de bloqueio sensorial nos lados operado e não operado foi menor no grupo hipo do que no grupo hiper. CONCLUSÃO: A ropivacaína tanto hiperbárica quanto hipobárica (11,25 mg) proporcionou anestesia adequada e confiável para artroplastia total do joelho (ATJ), com um alto nível de conforto para o paciente e cirurgião. As soluções anestésicas hipobáricas locais fornecem um alto nível de anestesia unilateral, com rápida recuperação dos bloqueios sensitivo e motor e, portanto, pode ser preferível em regime ambulatorial.

BACKGROUND AND OBJECTIVES: The aim of this study was to compare the unilaterality of subarachnoid block achieved with hyperbaric and hypobaric ropivacaine. METHODS: The prospective, randomized trial was conducted in an orthopedics surgical suite. In all, 60 ASA I-III patients scheduled for elective total knee arthroplasty were included in the study. Group Hypo (n = 30) received 11.25 mg of ropivacaine (7.5 mg.mL-1) + 2 mL of distilled water (density at room temperature was 0.997) and group Hyper (n = 30) received 11.25 mg of ropivacaine (7.5 mg.mL-1) + 2 mL (5 mg.mL-1) of dextrose (density at room temperature was 1,015). Patients in the hyperbaric group were positioned with the operated side down and in the 15º Fowler position, versus those in the hypobaric group with the operated side facing up and in the 15º Trendelenburg position. Combined spinal epidural anesthesia was performed midline at the L3-4 lumbar interspace. Hemodynamic and spinal block parameters, regression time, success of unilateral spinal anesthesia, patient comfort, surgical comfort, surgeon comfort, first analgesic requirement time, and adverse effects were assessed. RESULTS: Time to reach the T10 dermatome level on the operated side was shorter in group Hyper (612.00 ± 163.29 s) than in group Hypo (763.63 ± 208.35 s) (p < 0.05). Time to 2-segment regression of the sensory block level on both the operated and non-operated sides was shorter in group Hypo than in group Hyper. CONCLUSION: Both hyperbaric and hypobaric ropivacaine (11.25 mg) provided adequate and dependable anesthesia for total knee replacement surgery, with a high level of patient and surgeon comfort. Hypobaric local anesthetic solutions provide a high level of unilateral anesthesia, with rapid recovery of both sensory and motor block, and therefore may be preferable in outpatient settings.

JUSTIFICATIVA Y OBJETIVOS: El objetivo de este estudio fue comparar la unilateralidad del bloqueo subaracnoideo logrado con la ropivacaína hiperbárica y con la ropivacaína hipobárica. MÉTODOS: El estudio randomizado y prospectivo fue llevado a cabo en una sala quirúrgica ortopédica. En total, 60 pacientes ASA I-III seleccionados para artoplastia electiva total de rodilla fueron incluidos en el estudio. El grupo Hipo (n = 30) recibió 11,25 mg de ropivacaína (7.5 mg.mL-1) + 2 mL de agua destilada (la densidad en la temperatura ambiente era de 0,997) y el grupo Hiper (n = 30) recibió 11,25 mg de ropivacaína + 2 mL (5 mg.mL-1) de dextrosa (la densidad en la temperatura ambiente era de 1,015). Los pacientes del grupo hiperbárica fueron colocados con el lado operado hacia abajo y en la posición de Fowler a 15º, y los pacientes del grupo hipobárica fueron colocados con el lado operado hacia arriba en la posición de Trendelenburg a 15º. El bloqueo combinado de raquianestesia y de anestesia epidural (CRP) fue realizado en la línea media del interespacio lumbar en L3 y L4. Se evaluaron los parámetros hemodinámico y de bloqueo de la columna vertebral, el tiempo de regresión, el éxito de la raquianestesia unilateral, la comodidad del paciente, la tranquilidad en la cirugía y la comodidad del cirujano, así como el tiempo requerido para la primera analgesia y los efectos adversos. RESULTADOS: El tiempo necesario para alcanzar el nivel del dermatoma T10 en el lado operado fue más corto en el grupo Hiper (612,00 ± 163,29 segundos) que en el grupo Hipo (763,63 ± 208,35 segundos) (p < 0,05). El tiempo para la regresión de los dos segmentos del nivel de bloqueo sensorial tanto en el lado operado como en el no operado, fue más corto en el grupo Hipo que en el grupo Hiper. CONCLUSIONES: Tanto la ropivacaína hiperbárica como la hipobárica (11,25 mg) han demostrado una anestesia adecuada y confiable para la artoplastia total de rodilla (ATR), con un alto nivel de comodidad tanto para el paciente como para el cirujano. Las soluciones anestésicas hipobáricas locales suministran un alto nivel de anestesia unilateral con una rápida recuperación de los bloqueos sensorial y motor, y por tanto, puede ser preferible en un régimen ambulatorial.

Avaliação da qualidade do colostro e transferência de imunidade passiva em animais mestiços Holandês Zebu / Colostrum quality evaluation and passive immunity transfer in crossbred Holstein Zebu cattle

O objetivo desta pesquisa foi avaliar a qualidade do colostro de vacas mestiças Holandês Zebu e a transferência de imunidade a seus bezerros. Efeitos de ordem de parto, sexo do bezerro, estação do ano e grupo genético foram estudados em vacas distribuídas em quatro grupos genéticos. Amostras de sangue dos bezerros foram coletadas aos três dias de vida. Foi avaliada a concentração de proteína total no soro (PT) por refratometria e espectrofotometria. As amostras de colostro apresentaram alta qualidade, com concentração média de Ig de 78,5mg/mL. Houve adequada transferência de imunidade passiva, com 88,3% dos bezerros com PT acima de 5,5g/dL. Não houve efeito de ordem de parto, sexo do bezerro, estação do ano e grupo genético da vaca na qualidade do colostro e na PT (P>0,05). Vacas F1 produziram, em média, colostro de alta qualidade e houve sucesso na transferência de imunidade passiva.

The objective of this paper was to evaluate crossbred Holstein Zebu cows colostrum quality and passive immunity transfer to their calves. Parity, calf sex, season of the year and cow genetic group effects in both responses were analyzed. Quality (immunoglobulin - Ig - concentration) was measured in colostrum samples of 186 crossbred cows from four different genetic groups with a colostrometer. Calf’s blood samples were collected on the third day of life. Serum total protein concentration (PT) was measured through refractometry and spectrophotometry. Colostrum samples were classified as high quality and showed mean Ig concentrations of 78.5mg/mL. Passive immunity transfer was successful, since 88.3% of calves had PT higher than 5.5g/dL. There was no effect of parity, calf sex, season of the year or cow genetic group in colostrum quality or serum total protein concentration (P>0.05). Crossbred Holstein Zebu cows produced high quality colostrums. There was success in passive immunity transfer to the calves.

The Effect of Water Exercise Program for Treating the Gestational Edema / 대한주산의학회잡지

PURPOSE: To confirm the effect of water exercise program for treating the gestational edema. METHODS: Both low leg volume, body weight and urine specific gravity were measured in thirty women with gestational edema before and after water exercise program. Fetal heart rate, maternal heart rate and maternal blood pressure were measured before and after water exercise program. RESULTS: Right leg volume was decreased by 286 ml from 1714 to 1428 mL (P<.0001), left leg volume was decreased by 267 mL from 1,644 to 1,377 mL (P<0.0001), and total leg volume was decreased by 553 mL from 3,359 to 2,805 mL (P<0.0001). Urine specific gravity was decreased by 0.0047 from 1.0197 to 1.0150 (P=0.004). Maternal body weight, heart rate, blood pressure, and fetal heart rate were showed no significant change. CONCLUSION: Water exercise program is effective and safe method for treating the gestational edema.

Diferentes relações cálcio:fósforo disponíveis e fitase em dietas de poedeiras UFSM-V: desempenho produtivo, qualidade dos ovos e tecido ósseo / Different calcium relations: available phosphorus and phytase in diets of UFSM-V laying hens: productive performance, egg quality and bone tissue

O estudo teve como objetivo determinar os efeitos das diferentes relações cálcio:fósforo disponíveis (Ca:Pd) e fitase em dietas à base de milho e farelo de soja sobre a qualidade dos ovos e o desempenho produtivo de poedeiras de ovos marrons. Foram utilizadas 144 poedeiras UFSM-V de 28 a 36 semanas de idade. O delineamento experimental foi o inteiramente casualizado, com os tratamentos distribuídos em esquema fatorial 3x2, em que foram testadas três diferentes relações Ca:Pd (8:1; 11:1; 14:1) e dois níveis de fitase (0 e 300FTU kg-1 de dieta), com seis repetições de quatro aves cada. Os parâmetros avaliados foram: peso corporal, consumo de dieta, conversão alimentar por massa de ovos, produção de ovos, altura de albúmen, massa de ovos, gravidade específica dos ovos, unidade Haugh e percentagem de cálcio e fósforo na tíbia. Os índices produtivos não foram afetados pelas relações Ca:Pd e nem pela utilização da enzima, sendo que o peso corporal das aves variou entre 1,927kg e 2,118kg, e o consumo de ração foi em média de 120g de ração ave-1 dia-1. A qualidade interna dos ovos também não apresentou diferenças significativas, a altura de albúmen média foi de 8,78mm e a unidade Haugt de 94,66 em média. Dietas com relação Ca:Pd de 8:1 apresentaram interação com a enzima, melhorando o nível de Ca das tíbias das aves (Ca na tíbia=20,63 por cento). Com relação Ca:Pd igual ou superior a 11:1, não houve interação com a fitase, porém as aves apresentam percentagem de Ca superior na tíbia (Ca na tíbia ±22 por cento).

The study aimed to determine the effects of different calcium relations: phosphorus (Ca:Pd) and phytase in diets based on corn and soybean meal on egg quality and production on the performance of brown egg layers. It was used 144 UFSM-V layers, aging from 28th to 36th weeks. The experiment was a completely randomized design with treatments arranged in a 3x2 factorial arrangement, and three different Ca relations were tested: Pd (8:1, 11:1, 14:1) and two phytase levels (0 and 300FTU kg-1 diet) with six replicates of four layers each. The parameters evaluated were: body weight, feed intake, feed conversion by egg mass, egg production, albumen height, egg mass, egg specific gravity, Haugh units and percentage of calcium and phosphorus in the tibia. The production indices were not affected by the Ca:Pd relation or by the use of the enzyme, and the weight of the birds ranged from 1.927kg and 2.118kg, and feed intake averaged 120g of feed bird-1 day-1. Internal egg quality also showed no significant differences, the average albumen height was 8.78mm and the unit Haugt average was of 94.66. Diets with Ca:Pd of 8:1 showed interaction with the enzyme, improving the level of Ca in the Hens' tibia (Ca in tibia=20.63 percent), with a Ca: Pd greater than or equal to 11:1. There was no interaction with phytase, but there was higher percentage of Ca in the tibia (Ca in tibia ±22 percent).

Median effective dose of intrathecal hyperbaric and hypobaric ropivacaine for cesarean section / 中华麻醉学杂志

ObjectiveTo determine the median effective dose (ED50) of intrathecal (IT) hyperbaric and hypobaric ropivacaine for elective cesarean section.MethodsForty parturients aged 20-40 yr at full term undergoing elective cesarean section under combined spinal-epidural anesthesia were randomized to receive IT 0.5 ％ hyperbaric (group HR) and hypobaric ropivacaine (group LR) ( n =20 each).The initial dose was 9 mg and the dose was increased/decreased by 1 mg in the next parturient using an up-and-down sequential allocation technique.Analgesia was considered acceptable if adequate analgesia reached T7 or higher in response to pin prick until 20 min after IT ropivacaine and no supplemental epidural analgesic was required during the operation.ED50 and 95％confidence interval (CI) were calculated.ResultsThe ED50 and 95 ％ CI were 9.34 mg (95 ％ CI 8.34-10.46mg) for 0.5％ hyperbaric ropivacaine and 9.64 mg (95％ CI 8.90-10.44 mg) for 0.5％ hypobaric ropivacaine.ConclusionBaricity has no effect on the efficacy of IT ropivacaine for cesarean section.

Propriedades físico-mecânicas da madeira de canafístula aos 10 anos de idade / Physical and mechanical properties of 10 years old wood trees of canafístula

A presente pesquisa objetivou caracterizar as propriedades físico-mecânicas da madeira de canafístula (Peltophorum dubium (Spreng.) Taub.) proveniente de árvores com 10 anos, por meio da determinação da massa específica básica, da retratibilidade, do módulo de elasticidade e do módulo de ruptura em flexão estática, do módulo de elasticidade em compressão perpendicular, da resistência máxima à compressão paralela à grã, da dureza de Janka, da resistência máxima ao cisalhamento e da resistência ao choque. A determinação da massa específica básica e da retratibilidade seguiu as normas COPANT 30:1-004 (1971) e 30:1-005 (1971), respectivamente, e os ensaios mecânicos seguiram as normas ASTM D 143-94 (2000) e NF B 51-009 (1942). A massa específica básica e o coeficiente de anisotropia encontrado para a espécie permitiram classificar sua madeira como leve e medianamente estável, respectivamente; já os valores médios das propriedades mecânicas encontradas definem a madeira como de resistência fraca a média. As características tecnológicas determinadas indicam que sua madeira, quando proveniente de plantios jovens, deve ser utilizada com cautela em situações que exijam elevada estabilidade dimensional e resistência mecânica, sendo, portanto, aconselhável seu corte em idades mais avançadas.

This research aimed to characterize the physic-mechanical properties of the canafístula wood (Peltophorum dubium (Spreng.) Taub.) from 10 years' old trees. There was determined the specific gravity, shrinkage, modulus of elasticity and modulus of rupture in static bending, modulus of elasticity in compression perpendicular to the grain, compression strength parallel to the grain, hardness, shear and impact resistance. Specific gravity and shrinkage determination were conducted according to COPANT 30:1:004 (1971) and 30:1-005 (1971), respectively, and the mechanical tests followed ASTM D 143-94 (2000) and NF B51-009 (1942). The specific gravity and the ratio of tangential to radial shrinkage observed, ranked the wood as light and moderately stable, respectively, since the average values of mechanical properties classified the wood as weak to average strength. The technological characteristics observed indicate that when the wood is originated from short rotation plantation, it should be used with caution in situation which requires high dimensional stability and mechanical strength, suggesting the need of older trees.

Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients

PURPOSE: We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. METHODS: Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none( or =50%) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. RESULTS: Parameters mentioned above showed no significant relation to the treatment outcome. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3%(2/151), partial in 29.6%(47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73)(P<0.05). CONCLUSION: We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.

Research of pH and specific gravity of urine on 3724 healthy children aged from 2 months to 6 years old

Background: Research of pH and specific gravity of urine in healhty children is nessecary in order to evaluate urine in children with neurology. Objectives:This study aims to estimate pH and specific gravity in healthy children aged from 2 months to 6 years old. Subjects and method: 3724 healthy children ( boy: 52,6% and girl: 47.4%) aged from 2 months to 6 years old located in 3 districts: Kien Thuy, Thuy Nguyen, Kien An of Hai Phong were enrolled in the descriptive and cross-sectional study using urianalysis of midstream urine samples in the morning by analyzer Model 101-Teco from USA. The data was collected and analysed bysocial statistic SPSS software. Results: - pH mean in boys was 5.38\xb10.62, in girls: 5.40\xb10.61, and both sexes: 5.39\xb10.62. In general, urine pH decreased according to age groups but there were no sex differences significantly. - Specific gravity mean of healthy boys was 1.018\xb10.007, of girls: 1.018\xb10.006 and both sexes: 1.018\xb10.007. Conclusion: In general, specific gravity increased according to age groups but no sex differences may significantly be found.

Effects of primary cerebral injury with hypotension on the development and severity of brain edema in rats / 中华急诊医学杂志

Objective To study the effects of traumatic brain injury with or without hypotension on the development and severity of brain edema using the impact- acceleration model.Methods Brain tissue water content (BWC) was measured by the gravimetric technique in the cortex and striatum following traumatic brain injury (TBI) . The hypotension was induced by the combination of α - chloralose and pavulon after TBI.Results The mortality of this improved model of TBI was 48.6 %, but the rate of skull fracture was 6.4 %. Within the first 24 hours after TBI, the BWC of cortex and striatum in the survival rats showed a slight decrease at first, and then an increase. There appeared no difference in BWC between the two groups of TBI and the control. Nevertheless, the BWC in the area of parietal cortex at 24 hours after impact injury slightly increased by 0.5 % in comparison with that at 8 hours after impact [ (79.1 ± 0.5) % vs. (78.6 ± 0.5) %, P ＜ 0.05]. Meanwhile,the BWC of striatum didn't show the difference. However, while TBI was associated with hypotension, the BWC of both parietal cortex [ (81.5±0.9)% vs. (78.6±0.5)%, P＜0.001] and striatum [ (78.5±0.9)% vs. (75.5±0.9)%, P＜0.001) were significantly increased, by comparison with survival rats at 8 hours after impact. Moreover, the amplitude of increase in BWC achieved about 2.9 %.Conclusion The rats, suffering TBI without hypotension, presented the slight brain edema at the relatively late stage; by contrast, the rats,suffering from TBI with hypotension, had severe brain edema at the early stage.