Operating room fire: Should we mistrust alcoholic antiseptics?

Surgical site infections are a challenge for public health. One of the keystones of prevention is the skin preparation of the patient. Alcoholic antiseptics are presented as the best solution. But the adverse effects attributed to them must not be overshadowed by the exclusive benefit of their microbiological performance. The authors report four cases of severe burn having occurred in the operating room after skin antisepsis performed with an alcoholic antiseptic. The mechanisms of these accidents and preventive measures are reviewed. It concerns the restriction of ignition factors during use and the strict conformity to drying time. These potentially dramatic complications can and should be avoided. Probably underestimated, burns due to ignition of alcoholic antiseptics should appear more clearly in the evaluation of the risk-benefit balance.

Effects of branched-chain amino acids supplementation on physiological and psychological performance during an offshore sailing race.

The aim of the present study was to investigate the effect of protein diets, rich in branched chain amino acids (BCAA) on perceived exertion, mental and physical performance during an offshore sailing race that lasted 32 h. Twelve sailors were randomly allocated into one of two groups [Control (CON) and BCAA: n = 6/group]. The BCAA group consumed a standard diet of 11.2 MJ day(-1) (58% carbohydrate, 30% fat, 12% Protein) along with a high-protein supplement of 1.7 MJ day(-1) (40% carbohydrate, 35% protein, 25% fat) and 1.7 MJ day(-1) composed of 50% valine, 35% leucine, and 15% isoleucine. CON was given a standard diet of 14.5 MJ day(-1) (58% carbohydrate, 30% fat and 12% protein). During the race, heart rate was monitored. Subjects self-evaluated their feeling of fatigue every 3 h, and 12 samples of saliva from each subject were collected to perform cortisol assays. Before and after the race a vertical jump and a handgrip test were performed, and mental performance was evaluated with a standardized battery of tests. A significant increase in the feeling of fatigue was noted on the second day (D2) of race in both groups; the increase was higher in CON (P < 0.05). For both groups, salivary cortisol concentration followed a nycthemeral rhythm, with an alteration during the race as evidenced by high midnight cortisol levels between D1 and D2, and significantly decreased cortisol levels observed on D2 (P < 0.05). There was no change in physical performance at the end of the race in both groups. As a significant decrease (P < 0.05) in short-term memory performance was observed only in the CON group. These data indicate that an offshore sailing race enhances the feeling of fatigue, and decreases short-term memory performance. These detrimental consequences are reduced by a high-protein diet with BCAA.

Energy expenditure of horse riding.

Oxygen consumption (VO2), ventilation (VE) and heart rate (HR) were studied in five recreational riders with a portable oxygen analyser (K2 Cosmed, Rome) telemetric system, during two different experimental riding sessions. The first one was a dressage session in which the rider successively rode four different horses at a walk, trot and canter. The second one was a jumping training session. Each rider rode two horses, one known and one unknown. The physiological parameters were measured during warm up at a canter in suspension and when jumping an isolated obstacle at a trot and canter. This session was concluded by a jumping course with 12 obstacles. The data show a progressive increase in VO2 during the dressage session from a mean value of 0.70 (0.18) l x min(-1) [mean (SD)] at a walk, to 1.47 (0.28) l x min(-1) at a trot, and 1.9 (0.3) l x min(-1) at a canter. During the jumping session, rider VO2 was 2 (0.33) l x min(-1) with a mean HR of 155 beats x min(-1) during canter in suspension, obstacle trot and obstacle canter. The jumping course significantly enhanced VO2 and HR up to mean values of 2.40 (0.35) l x min(-1) and 176 beats x min(-1), respectively. The comparison among horses and riders during the dressage session shows differences in energy expenditure according to the horse for the same rider and between riders. During the jumping session, there was no statistical difference between riders riding known and unknown horses. In conclusion these data confirm that riding induces a significant increase in energy expenditure. During jumping, a mean value of 75% VO2max was reached. Therefore, a good aerobic capacity seems to be a factor determining riding performance in competitions. Regular riding practice and additional physical training are recommended to enhance the physical fitness of competitive riders.

Local muscular fatigue and attentional processes in a fencing task.

Study of the effects of brief exercise on mental processes by Tomporowski and Ellis (1986) has shown that moderate muscular tension improves cognitive performance while low or high tension does not. Improvements in performance induced by exercise are commonly associated with increase in arousal, while impairments are generally attributed to the effects of muscular or central fatigue. To test two hypotheses, that (1) submaximal muscular exercise would decrease premotor time and increase would increase the attentional and preparatory effects observed in premotor time 9 men, aged 20 to 30 years, performed an isometric test at 50% of their maximum voluntary contraction between blocks of a 3-choice reaction-time fencing task. Analysis showed (1) physical exercise did not improve postexercise premotor time, (2) muscular fatigue induced by isometric contractions did not increase motor time, (3) there was no effect of exercise on attentional and preparatory processes involved in the postexercise choice-RT task. The invalidation of hypotheses was mainly explained by disparity in directional effects across subjects and by use of an exercise that was not really fatiguing.

Effect of smoking cessation on lipoprotein A-I and lipoprotein A-I:A-II levels.

Cigarette smoking is associated with low plasma high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (apo) A-I levels, which may explain, in part, its deleterious effects on coronary heart disease (CHD). In a group of ex-smokers, we assessed the influence of smoking cessation on apo A-I particle levels. Plasma lipid, apolipoprotein, and lipoparticle concentrations of 58 subjects who had completely stopped smoking (ex-smokers) were compared with those of 37 subjects who had continued smoking (smokers) before and after a smoking cessation counseling program. Nutritional intake was recorded before and after the program to adjust for potential interaction with plasma lipid variables. Smokers and ex-smokers were similar in gender distribution, age, body mass index (BMI), social status, and nutrient intake. There were significantly greater increases in total cholesterol (P < .04), HDL-C (P < .005), HDL2-C (P < .008), and lipoprotein (Lp) A-I:A-II (P < .04) in ex-smokers than in smokers. After smoking cessation, ex-smokers consumed more vegetable protein (P < .02) and polysaccharides (P < .04) and had higher plasma levels of HDL-C (P < .0004), apo A-I (P < .001), Lp A-I (P < .007), and Lp A-I:A-II (P < .01) than smokers. Adjustments on nutritional variables did not show any additional difference between ex-smokers and smokers, suggesting that smoking per se effects Lp A-I and Lp A-I:A-II levels. In conclusion, HDL particles including Lp A-I and Lp A-I:A-II are higher in ex-smokers than in smokers.