The Benefits of Opioid Free Anesthesia and the Precautions Necessary When Employing It.

The use of opioids in the perioperative period is associated with respiratory depression, impaired gastrointestinal function, post-operative nausea and vomiting (PONV), pruritus, urinary retention, delirium and the potential for developing opioid addiction. Currently the United States is experiencing an epidemic of prescription opioid abuse and deaths from overdose. Many addicts develop their addiction during a routine surgical admission to hospital. More people now die from overdose of synthetic prescription opioids than from heroin and other street drugs. Public education campaigns teaching family members of addicts to reverse opioid induced respiratory depression with naloxone are currently underway. Preventing the development of addiction in the first place during and after the surgical admission however will be more successful at saving lives. Primary prevention of opioid addiction is possible when non-opioid analgesic drugs are used. Employing alternative analgesic drugs in the peri-operative period that have a lower addiction potential and less respiratory depression has therefore become a matter of great national importance. Many powerful non-opioid analgesics are currently available that have more favorable side effect profiles and a lower potential for developing addiction. However, these medications are currently not used as often in routine clinical practice as they should be. Replacing opioids with other analgesics will not only reduce the development of opioid addiction but will also lead to better perioperative outcomes and enhanced patient recovery. This article briefly reviews the opioid alternatives that can significantly reduce or even entirely eliminate the perioperative use of opioids in the majority of surgical procedures.

Mixed-charge pseudo-zwitterionic mesoporous silica nanoparticles with low-fouling and reduced cell uptake properties.

The design of drug delivery systems needs to consider biocompatibility and host body recognition for an adequate actuation. In this work, mesoporous silica nanoparticles (MSNs) surfaces were successfully modified with two silane molecules to provide mixed-charge brushes (-NH3⊕/-PO3⊝) and well evaluated in terms of surface properties, low-fouling capability and cell uptake in comparison to PEGylated MSNs. The modification process consists in the simultaneous direct-grafting of hydrolysable short chain amino (aminopropyl silanetriol, APST) and phosphonate-based (trihydroxy-silyl-propyl-methyl-phosphonate, THSPMP) silane molecules able to provide a pseudo-zwitterionic nature under physiological pH conditions. Results confirmed that both mixed-charge pseudo-zwitterionic MSNs (ZMSN) and PEG-MSN display a significant reduction of serum protein adhesion and macrophages uptake with respect to pristine MSNs. In the case of ZMSNs, this reduction is up to a 70-90% for protein adsorption and c.a. 60% for cellular uptake. This pseudo-zwitterionic modification has been focused on the aim of local treatment of bacterial infections through the synergistic effect between the inherent antimicrobial effect of mixed-charge system and the levofloxacin antibiotic release profile. These findings open promising future expectations for the effective treatment of bacterial infections through the use of mixed-charge pseudo-zwitterionic MSNs furtive to macrophages and with antimicrobial properties. STATEMENT OF SIGNIFICANCE: Herein a novel antimicrobial mixed-charge pseudo-zwitterionic MSNs based system with low-fouling and reduced cell uptake behavior has been developed. This chemical modification has been performed by the simultaneous grafting of short chain organosilanes, containing amino and phosphonate groups, respectively. This nanocarrier has been tested for local infection treatment through the synergy between the antimicrobial effect of mixed-charge brushes and the levofloxacin antibiotic release profile.

Adding value to cocoa (Theobroma cacao L.) germplasm information with domestication history and admixture mapping.

A sound understanding of crop history can provide the basis for deriving novel genetic information through admixture mapping. We confirmed this, by using characterization data from an international collection of cocoa, collected 25 years ago, and from a contemporary plantation. We focus on the trees derived from three centuries of admixture between Meso-American Criollo and South American Forastero genomes. In both cacao sets of individuals, linkage disequilibrium extended over long genetic distances along chromosome regions, as expected in populations derived from recent admixture. Based on loose genome scans, genomic regions involved in useful traits were identified. Fifteen genomic regions involved in seed and fruit weight variation were highlighted. They correspond to ten previously identified QTLs and five novel ones. Admixture mapping can help to add value to genetic resources and thus, help to encourage investment in their conservation.

Prevalencia e importancia de la miocardiopatia chagasica en 88 varones de 18 años con diagnóstico serológico de enfermedad de chagas / Prevalence and importance of the chagasic myocardiopathy in 88 males of 18 years-old with serologic diagnosis of Chagas disease

En este trabajo se estudia la prevalencia de miocardiopatía en 88 jovenes chagásicos (serología positiva) de 18 años, provenientes de la revisión médica para Servicio Militar de la Clase 1970 del Distrito Tucumán. De ellos 25 pacientes de cardiopatía. De ellos 20 (22%) pueden incluírse en el grupo I de Kushnir (serología + y anomalías electrocardiográficas) y 5(6%) al grupo II de Kushnir (serología +, anomalías electrocardiográficas y cardiomegalia). Se hacen consideraciones sobre la patogenia de los hallazgos electrocardiográficos y se plantean los problemas que dichos hallazgos provocan. Se comparan los resultados con los de otros trabajos argentinos similares y se hacen consideraciones sobre la patogenia de la miocardiopatía crónica (inmunología) y su posible importancia futura (AU)

Estudio epidemiológico y de evaluación de la lucha contra el mal de chagas en Tucumán / Epidemiologic study and evaluation of struggie aginst the Chagas disease in Tucumán

Se estudian 88 jóvenes de 18 años de la clase 1970 con pruebas positivas para Chagas, mediante historia clínica protocolizada, electrocardiograma y Rx. de Tórax. Se determino la procedencia de los pacientes; de los mismos, 76 provenian de la provincia de Tucumán y los 12 restantes de las otras provincias del N.D.A. La distribución por departamentos de los pacientes tucumanos confirmó nuestra impresión clínica previa y los estudios realizados por la Lucha Contra el Chagas. Se confirmó asimismo la mayor incidencia en clases socio-económicas bajas. La investigación de conocimientos acerca de la enfermedad, el agente transmisor y sus hábitos, la forma de transmisión, se encontro que los mismos eran escasos o nulos, lo cual plantea la necesidad de intensificar la propaganda para una adecuada profilaxis de esta grave endemia (AU)

Prevalencia e importancia de la miocardiopatia chagasica en 88 varones de 18 años con diagnóstico serológico de enfermedad de chagas / Prevalence and importance of the chagasic myocardiopathy in 88 males of 18 years-old with serologic diagnosis of Chagas disease

En este trabajo se estudia la prevalencia de miocardiopatía en 88 jovenes chagásicos (serología positiva) de 18 años, provenientes de la revisión médica para Servicio Militar de la Clase 1970 del Distrito Tucumán. De ellos 25 pacientes de cardiopatía. De ellos 20 (22%) pueden incluírse en el grupo I de Kushnir (serología + y anomalías electrocardiográficas) y 5(6%) al grupo II de Kushnir (serología +, anomalías electrocardiográficas y cardiomegalia). Se hacen consideraciones sobre la patogenia de los hallazgos electrocardiográficos y se plantean los problemas que dichos hallazgos provocan. Se comparan los resultados con los de otros trabajos argentinos similares y se hacen consideraciones sobre la patogenia de la miocardiopatía crónica (inmunología) y su posible importancia futura

Estudio epidemiológico y de evaluación de la lucha contra el mal de chagas en Tucumán / Epidemiologic study and evaluation of struggie aginst the Chagas disease in Tucumán

Se estudian 88 jóvenes de 18 años de la clase 1970 con pruebas positivas para Chagas, mediante historia clínica protocolizada, electrocardiograma y Rx. de Tórax. Se determino la procedencia de los pacientes; de los mismos, 76 provenian de la provincia de Tucumán y los 12 restantes de las otras provincias del N.D.A. La distribución por departamentos de los pacientes tucumanos confirmó nuestra impresión clínica previa y los estudios realizados por la Lucha Contra el Chagas. Se confirmó asimismo la mayor incidencia en clases socio-económicas bajas. La investigación de conocimientos acerca de la enfermedad, el agente transmisor y sus hábitos, la forma de transmisión, se encontro que los mismos eran escasos o nulos, lo cual plantea la necesidad de intensificar la propaganda para una adecuada profilaxis de esta grave endemia