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1.
J Econ Psychol ; 1012024 Mar.
Article in English | MEDLINE | ID: mdl-38617819

ABSTRACT

Negative emotions have been shown to influence financial risk-taking. However, how receiving salient information about prior outcomes interacts with a decision-maker's emotional state is not well known. In a laboratory experiment, we induced a fearful emotional state to investigate its effects on financial investment when outcome probabilities are unknown but decision-makers observe prior outcomes. The effects of fear on investment depended on whether the sequence of previous outcomes was favorable or unfavorable and contained weak or strong information. Our findings suggest that fear affected investment, at least in part, through changes in expectations of success.

2.
Medicina (B Aires) ; 84(2): 347-350, 2024.
Article in Spanish | MEDLINE | ID: mdl-38683522

ABSTRACT

Very early onset inflammatory bowel disease (VEOIBD) is a rare entity in pediatrics. Its association with primary immunodeficiencies of monogenic origin is known. We present the case of a patient diagnosed with VEOIBD who underwent massive paralleled exome sequencing. The result of the study showed a pathogenic variant in the RET proto-oncogene, associated with multiple endocrine neoplasia type 2A disease. There are no previous reports of association of RET proto-oncogene variants with VEOIBD. The presence of these two clinical entities cannot be attributed to a single genetic cause.


La enfermedad inflamatoria intestinal de inicio muy temprano (VEOIBD) es una entidad rara en pediatría. Es conocida su asociación con inmunodeficiencias primarias de origen monogénico. Presentamos el caso de una paciente con diagnóstico de VEOIBD a quien se le realizó una secuenciación masiva del exoma. El resultado del estudio permitió identificar una variante patogénica en el proto oncogen RET, asociada con enfermedad neoplasia endocrina múltiple tipo 2A. No hay reportes de asociación de variantes en el proto oncogen RET con VEOIBD. No se puede adjudicar la presencia de estas dos entidades clínicas a una única causa genética.


Subject(s)
Inflammatory Bowel Diseases , Proto-Oncogene Mas , Proto-Oncogene Proteins c-ret , Female , Humans , Age of Onset , Exome Sequencing , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/genetics , Multiple Endocrine Neoplasia Type 2a/genetics , Mutation , Proto-Oncogene Proteins c-ret/genetics , Infant
3.
Neotrop Entomol ; 53(3): 469-479, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38347319

ABSTRACT

Pastoralism is a dominant agricultural activity in arid and semi-arid ecosystems. The interaction between coprophagous insects and livestock is a key but an undervalued topic in rangeland management decisions. The objective was to identify similarities and differences in the composition of coprophagous insects and nesting strategies, associated with different climatic conditions within these regions. We performed a literature review of research articles available in the Scopus database which resulted in 17 articles. We examined the taxonomic diversity of dung beetles and their nesting strategies in relation to temperature and precipitation at the study sites. Results revealed a rich and varied interaction between dung beetles and livestock in arid and semi-arid environments, with 364 species from the Scarabaeoidea superfamily documented worldwide. The greatest diversity of dung beetles was reported in hot arid and semi-arid conditions with dry winters and in cold semi-arid ones with no marked annual precipitation cycle. These insects displayed diverse nesting strategies, with endocoprid strategies predominating in colder and drier settings, and paracoprid and telecoprid strategies in warmer, more humid environments. Domestic animal species are currently key components in promoting this interaction, which indicates that the ecological processes involving coprophagous fauna are occurring in production systems, which are under the influence of human decisions. We discuss the design and planning of livestock and rangeland management in arid and semi-arid environments, emphasizing in a more formalized manner the inclusion of this kind of interaction.


Subject(s)
Coleoptera , Livestock , Animals , Coleoptera/physiology , Coleoptera/classification , Desert Climate , Nesting Behavior
4.
Sci Total Environ ; 912: 168783, 2024 Feb 20.
Article in English | MEDLINE | ID: mdl-38013094

ABSTRACT

This study compares the performance of different wave overtopping estimation models at urban beaches. The models selected for comparison are the Mase et al. (2013) and EurOtop parametric models and the XBeach process-based model in surfbeat and non-hydrostatic mode. Seven energetic storms are selected between 2015 and 2022 with offshore significant wave height ranging between 3 m and 8 m and peak period between 12 s and 20 s to perform the model comparison. The information required to run and validate the models (beach slope, shoreface shape, absence/presence of overtopping) was collected for each storm from coastal videometry. To account for the uncertainties derived from the incident waves randomness and the bathymetry shape when using the process-based model, a series of simulations with random seed boundary conditions were run over two different realistic profile shapes for each storm. The present study is a pilot study on the beach of Zarautz; however, it can be extended to other beaches of the Basque coast. Results indicate that while Mase et al. (2013) and EurOtop tend to reasonably predict the absence or presence of overtopping events, they tend to underestimate the hazard level at the beach of Zarautz. Additionally, the beach underwater profile shape can affect the process-based model performance at intermediate intensity storms and to a lesser extend during moderate storms. Finally, the hazard level at the beach of Zarautz varies significantly alongshore due to the configuration of the seawall, highlighting the need for local adaptation measures. Considering that there is no model that systematically performs better than others, it might be reasonable to use model assemble techniques to draw conclusions from a probabilistic perspective.

5.
Pain ; 165(3): 573-588, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-37751532

ABSTRACT

ABSTRACT: Dysregulation of voltage-gated sodium Na V 1.7 channels in sensory neurons contributes to chronic pain conditions, including trigeminal neuropathic pain. We previously reported that chronic pain results in part from increased SUMOylation of collapsin response mediator protein 2 (CRMP2), leading to an increased CRMP2/Na V 1.7 interaction and increased functional activity of Na V 1.7. Targeting this feed-forward regulation, we developed compound 194 , which inhibits CRMP2 SUMOylation mediated by the SUMO-conjugating enzyme Ubc9. We further demonstrated that 194 effectively reduces the functional activity of Na V 1.7 channels in dorsal root ganglia neurons and alleviated inflammatory and neuropathic pain. Here, we used a comprehensive array of approaches, encompassing biochemical, pharmacological, genetic, electrophysiological, and behavioral analyses, to assess the functional implications of Na V 1.7 regulation by CRMP2 in trigeminal ganglia (TG) neurons. We confirmed the expression of Scn9a , Dpysl2 , and UBE2I within TG neurons. Furthermore, we found an interaction between CRMP2 and Na V 1.7, with CRMP2 being SUMOylated in these sensory ganglia. Disrupting CRMP2 SUMOylation with compound 194 uncoupled the CRMP2/Na V 1.7 interaction, impeded Na V 1.7 diffusion on the plasma membrane, and subsequently diminished Na V 1.7 activity. Compound 194 also led to a reduction in TG neuron excitability. Finally, when intranasally administered to rats with chronic constriction injury of the infraorbital nerve, 194 significantly decreased nociceptive behaviors. Collectively, our findings underscore the critical role of CRMP2 in regulating Na V 1.7 within TG neurons, emphasizing the importance of this indirect modulation in trigeminal neuropathic pain.


Subject(s)
Chronic Pain , Intercellular Signaling Peptides and Proteins , Nerve Tissue Proteins , Trigeminal Neuralgia , Ubiquitin-Conjugating Enzymes , Animals , Rats , Chronic Pain/drug therapy , Chronic Pain/metabolism , Ganglia, Spinal , Rats, Sprague-Dawley , Sensory Receptor Cells/metabolism , Trigeminal Neuralgia/drug therapy , Trigeminal Neuralgia/metabolism , Ubiquitin-Conjugating Enzymes/antagonists & inhibitors , Administration, Intranasal , Nerve Tissue Proteins/antagonists & inhibitors
6.
bioRxiv ; 2023 Jul 17.
Article in English | MEDLINE | ID: mdl-37502910

ABSTRACT

Dysregulation of voltage-gated sodium Na V 1.7 channels in sensory neurons contributes to chronic pain conditions, including trigeminal neuropathic pain. We previously reported that chronic pain results in part from increased SUMOylation of collapsin response mediator protein 2 (CRMP2), leading to an increased CRMP2/Na V 1.7 interaction and increased functional activity of Na V 1.7. Targeting this feed-forward regulation, we developed compound 194 , which inhibits CRMP2 SUMOylation mediated by the SUMO-conjugating enzyme Ubc9. We further demonstrated that 194 effectively reduces the functional activity of Na V 1.7 channels in dorsal root ganglia neurons and alleviated inflammatory and neuropathic pain. Here, we employed a comprehensive array of investigative approaches, encompassing biochemical, pharmacological, genetic, electrophysiological, and behavioral analyses, to assess the functional implications of Na V 1.7 regulation by CRMP2 in trigeminal ganglia (TG) neurons. We confirmed the expression of Scn9a , Dpysl2 , and UBE2I within TG neurons. Furthermore, we found an interaction between CRMP2 and Na V 1.7, with CRMP2 being SUMOylated in these sensory ganglia. Disrupting CRMP2 SUMOylation with compound 194 uncoupled the CRMP2/Na V 1.7 interaction, impeded Na V 1.7 diffusion on the plasma membrane, and subsequently diminished Na V 1.7 activity. Compound 194 also led to a reduction in TG neuron excitability. Finally, when intranasally administered to rats with chronic constriction injury of the infraorbital nerve (CCI-ION), 194 significantly decreased nociceptive behaviors. Collectively, our findings underscore the critical role of CRMP2 in regulating Na V 1.7 within TG neurons, emphasizing the importance of this indirect modulation in trigeminal neuropathic pain.

7.
Neurobiol Pain ; 12: 100109, 2022.
Article in English | MEDLINE | ID: mdl-36531612

ABSTRACT

The voltage-gated sodium NaV1.7 channel sets the threshold for electrogenesis. Mutations in the gene encoding human NaV1.7 (SCN9A) cause painful neuropathies or pain insensitivity. In dorsal root ganglion (DRG) neurons, activity and trafficking of NaV1.7 are regulated by the auxiliary collapsin response mediator protein 2 (CRMP2). Specifically, preventing addition of a small ubiquitin-like modifier (SUMO), by the E2 SUMO-conjugating enzyme Ubc9, at lysine-374 (K374) of CRMP2 reduces NaV1.7 channel trafficking and activity. We previously identified a small molecule, designated 194, that prevented CRMP2 SUMOylation by Ubc9 to reduce NaV1.7 surface expression and currents, leading to a reduction in spinal nociceptive transmission, and culminating in normalization of mechanical allodynia in models of neuropathic pain. In this study, we investigated whether NaV1.7 control via CRMP2-SUMOylation is conserved in nodose ganglion (NG) neurons. This study was motivated by our desire to develop 194 as a safe, non-opioid substitute for persistent pain, which led us to wonder how 194 would impact NaV1.7 in NG neurons, which are responsible for driving the cough reflex. We found functioning NaV1.7 channels in NG neurons; however, they were resistant to downregulation via either CRMP2 knockdown or pharmacological inhibition of CRMP2 SUMOylation by 194. CRMP2 SUMOylation and interaction with NaV1.7 was consered in NG neurons but the endocytic machinery was deficient in the endocytic adaptor protein Numb. Overexpression of Numb rescued CRMP2-dependent regulation on NaV1.7, rendering NG neurons sensitive to 194. Altogether, these data point at the existence of cell-specific mechanisms regulating NaV1.7 trafficking.

8.
J Equine Vet Sci ; 104: 103701, 2021 09.
Article in English | MEDLINE | ID: mdl-34416984

ABSTRACT

The objective of the present study was to compare, using accelerometry, the gait changes produced after administration of a dose of 0.2 mg/kg of morphine at the walk in healthy horses. Six mature horses were used, and all animals received two different treatments with, at least, two weeks interval in between. Treatments administered consisted of a single dose of 10 ml of saline solution or a total of 0.2 mg/kg of morphine diluted in 10 ml of saline solution. A three-dimensional accelerometric device was used to collect data continuously while horses were walking. The walking test was performed 10 min prior to injection, and then at 5, 10, 15 and 20 min after injection and then every 10 min for 3 h. Eight variables were calculated including stride kinematic, coordination and energetic parameters. Additionally, the force of acceleration and three components of the power were calculated. Significant interaction was only observed for stride length, propulsion power and the propulsive part of the total power with a reduction in values after morphine administration. Compared to baseline values, stride length values were significantly reduced for 80 min and again 110 min after injection of the opioid and at 5, 15, 20, 30 and 40 min in the case of propulsion power values. For the propulsion component of power, these differences were observed for 20 min when compared to baseline values. The administration of 0.2 mg/kg of morphine to conscious healthy horses produces limited effects on the gait pattern of horses and the effects on locomotor activity are minimal at this dose, not being an important concern for the administration of analgesia in a clinical setting.


Subject(s)
Accelerometry , Morphine , Acceleration , Accelerometry/veterinary , Animals , Gait , Horses , Locomotion , Morphine/pharmacology
9.
Energy Policy ; 148: 111964, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33071429

ABSTRACT

Electricity demand and its typical load pattern are usually affected by many endogenous and exogenous factors to which the generation system must accordingly respond through utility operators. Lockdown measures to prevent the spread of COVID-19 imposed by many countries have led to sudden changes in socioeconomic habits which have had direct effects on the electricity systems. Therefore, a detailed analysis of how confinement measures have modified the electricity consumption in Spain, one of the countries most affected by this pandemic, has been performed in this work. Its electricity consumption has decreased by 13.49% from March 14 to April 30, compared to the average value of five previous years. Daily power demand profiles, especially morning and evening peaks, have been modified at homes, hospitals, and in the total power demand. These changes generate a greater uncertainty for the System Operator when making demand forecasts, but production deviations have increased by only 0.1%, thanks to the presence of a diversified generation mix, which has been modified during this period, increasing the proportion of renewable sources and decreasing CO2 emissions.

10.
Environ Monit Assess ; 192(8): 488, 2020 Jul 04.
Article in English | MEDLINE | ID: mdl-32623574

ABSTRACT

The current problem related to the supply of drinking water for the metropolitan area of Monterrey, which comprises of five million inhabitants, and the important role played by the El Cuchillo Dam, found downstream of the Santa Catarina River basin as a surface source of drinking water for the city, renders this river an interesting site for assessment. This work evaluates the degree to which the surface water and the subsoil of the river are affected by emerging organic pollutants due to their existence, even at low concentrations, representing a toxic risk enhanced by the absence of stricter standards for regulating these substances. Based on fieldwork, three discharge points that could affect the quality of the surface water were selected: two points on the river stream, and three groundwater wells. Gas chromatography results showed the presence of BisPhenol A (BPA) and bis(2-EthylHexyl) Phthalate (DEHP) in both the surface water and subsoil at different seasons of the year. The highest concentration levels in the samples taken from both types of water were 0.9 and 60 µg L-1 for BPA and DEHP, respectively. Results of this research did not reveal the level at which the aquifer is affected by these substances.


Subject(s)
Benzhydryl Compounds , Phenols , Phthalic Acids , Water Pollutants, Chemical , Cities , Environmental Monitoring , Mexico
11.
An. sist. sanit. Navar ; 42(1): 79-82, ene.-abr. 2019. ilus
Article in Spanish | IBECS | ID: ibc-183050

ABSTRACT

Según la evidencia científica, la trombosis venosa profunda (TVP) se trata con anticoagulación, variando el tiempo según la causa. Ocasionalmente aparecen recidivas en la misma localización, siendo el síndrome de May-Thurner o síndrome de Cockett una de las causas, debido a la compresión del sistema venoso ilio-cava entre los cuerpos vertebrales y el sistema arterial. El tratamiento varía respecto al resto de causas de TVP: aunque la anticoagulación debe mantenerse el mismo tiempo, en estos casos está recomendada la trombectomía, con o sin la colocación de stent venoso para evitar la recidiva. No existe consenso en la literatura respecto a la indicación o no de antiagregación tras el periodo de anticoagulación. Presentamos un caso de síndrome de May-Thurner tratado con trombectomía y colocación de stent venoso, que resultó un manejo óptimo de la enfermedad


According to scientific evidence, deep venous thrombosis (DVT) is treated with anticoagulation therapy, involving different periods of time depending on the cause. Occasionally, recurrences appear in the same location, with May-Thurner syndrome or Cockett syndrome as one reason, due to compression of the ilio-cava venous system between the vertebral bodies and the arterial system. In these cases, anticoagulation therapy must be maintained during the same time as in the rest of DVT, but as opposed to them, thrombectomy is recommended, with or without the implant of a venous stent in order to avoid recurrence. There is no consensus in the literature regarding the indication of antiaggregation therapy after the anticoagulation therapy period. We present a case of May-Thurner syndrome treated with thrombectomy and the implant of a venous stent, which yielded an optimum management of the disease


Subject(s)
Humans , Female , Adult , May-Thurner Syndrome/diagnosis , Venous Thrombosis/therapy , Thrombectomy/methods , Anticoagulants/therapeutic use , Angioplasty, Balloon/methods , May-Thurner Syndrome/therapy , Stents , Treatment Outcome
12.
An Sist Sanit Navar ; 42(1): 79-82, 2019 Apr 25.
Article in Spanish | MEDLINE | ID: mdl-30706907

ABSTRACT

According to scientific evidence, deep venous thrombosis (DVT) is treated with anticoagulation therapy, involving different periods of time depending on the cause. Occasionally, recurrences appear in the same location, with May-Thurner syndrome or Cockett syndrome as one reason, due to compression of the ilio-cava venous system between the vertebral bodies and the arterial system. In these cases, anticoagulation therapy must be maintained during the same time as in the rest of DVT, but as opposed to them, thrombectomy is recommended, with or without the implant of a venous stent in order to avoid recurrence. There is no consensus in the literature regarding the indication of antiaggregation therapy after the anticoagulation therapy period. We present a case of May-Thurner syndrome treated with thrombectomy and the implant of a venous stent, which yielded an optimum management of the disease.


Subject(s)
Anticoagulants/administration & dosage , May-Thurner Syndrome/therapy , Stents , Thrombectomy/methods , Adult , Combined Modality Therapy , Female , Humans , May-Thurner Syndrome/physiopathology , Treatment Outcome , Venous Thrombosis/etiology , Venous Thrombosis/therapy
14.
Colorectal Dis ; 20 Suppl 1: 43-48, 2018 05.
Article in English | MEDLINE | ID: mdl-29878681

ABSTRACT

Professor Nagtegaal has already highlighted that lymph nodes are probably not responsible for the development of liver metastases. If they are not, then is there another mechanism? Professor Haboubi addresses the question of extranodal deposits - their frequency and their importance in the development of metastatic disease. The experts review the evidence and discuss whether this information will alter treatment decisions and staging systems in the future.


Subject(s)
Colorectal Neoplasms/pathology , Liver Neoplasms/secondary , Lymph Nodes/pathology , Neoplasm Recurrence, Local/pathology , Vascular Neoplasms/secondary , Colorectal Neoplasms/mortality , Colorectal Neoplasms/surgery , Expert Testimony , Female , Humans , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Lymphatic Metastasis/pathology , Male , Neoplasm Invasiveness/pathology , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/surgery , Neoplasm Staging , Risk Assessment , Survival Analysis , Vascular Neoplasms/pathology
15.
Colorectal Dis ; 20 Suppl 1: 39-42, 2018 05.
Article in English | MEDLINE | ID: mdl-29878686

ABSTRACT

The traditional view of progression of disease in cancer is the sequential spread of tumour to locoregional lymph nodes and then to distant metastases. However, this view may need to be challenged and modern pathology techniques such as immunohistochemistry and tumour profiling can provide us with a greater insight into the pathways and mechanisms of distant spread. Professor Nagtegaal discusses the evidence for reconsidering the current paradigm and reflects on the need for further investigation into mechanisms of distant metastatic spread.


Subject(s)
Cause of Death , Colorectal Neoplasms/pathology , Liver Neoplasms/secondary , Lymph Nodes/pathology , Colorectal Neoplasms/mortality , Colorectal Neoplasms/surgery , Disease Progression , Female , Humans , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Lymphatic Metastasis , Male , Neoplasm Invasiveness , Neoplasm Staging , Prognosis , Risk Assessment , Survival Analysis
16.
Rev Invest Clin ; 66(6): 490-4, 2014.
Article in Spanish | MEDLINE | ID: mdl-25729865

ABSTRACT

INTRODUCTION: Surveillance is necessary for bloodstream infection control. Daily monitoring of the central venous catheter (CVC) use, a time-demanding process, is the standard denominator to calculate the infection rate; surveillance of only one day per week has been proposed as alternative. OBJECTIVE: To determine whether surveillance of one day per week is similar to daily monitoring in a second-level hospital. MATERIAL AND METHODS: Daily monitoring of CVC utilization ratio was done during nine weeks in four locations of a second-level hospital. For each day, proportional differences respect to the global CVC utilization ratio was estimated. An ANOVA test was done to find differences between each weekday. RESULTS: CVC usage surveillance was performed for 9 weeks, so nine determinations were obtained for each weekday. No significant differences were found between each day (F = 2.20, p = 0.056). The lowest sampling discrepancy was found on Wednesdays. CONCLUSIONS: According to previous studies, and our own data, monitoring the CVC use one day per week is a reasonable alternative to the daily surveillance.


Subject(s)
Catheter-Related Infections/diagnosis , Catheterization, Central Venous/adverse effects , Cross Infection/diagnosis , Sepsis/diagnosis , Analysis of Variance , Catheter-Related Infections/prevention & control , Cross Infection/prevention & control , Hospitalization , Humans , Longitudinal Studies , Prospective Studies , Sepsis/etiology , Time Factors
17.
Vet J ; 193(1): 212-6, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22082509

ABSTRACT

The aim of the present study was to verify the efficacy and sensitivity of an accelerometric device in detecting and quantifying the degree of movement alteration produced in horses sedated with xylazine. Horses (n=6) were randomly administered either xylazine or a control by intravenous injection, with at least 1 week between each treatment. A triaxial accelerometric device was used for the accelerometric gait assessment 15 min before (baseline) and 5, 15, 30, 45, 60, 75, 90, 105 and 120 min after each treatment. Eight different accelerometric parameters were calculated, including speed, stride frequency, stride length, regularity, dorsoventral power, propulsion power, mediolateral power and total power, with the force of acceleration and the dorsoventral, mediolateral and craniocaudal (propulsive) parts of the power then calculated. Administration of xylazine decreased many of the parameters investigated, with significant differences for speed, stride frequency, dorsoventral power, propulsion power and total power at 5, 15, 30 and 45 min after injection. There were no significant differences in stride length values at any time point. Decreases in regularity values were evident with significant differences at every time point from 5 to 120 min following xylazine injection. Force values were also significantly reduced from 5 to 30 min after treatment and a redistribution of the total power was observed 5 min after injection as the mediolateral power increased significantly, while the dorsoventral power decreased. Accelerometry offers a practical, accurate, easy to use, portable and low cost method of objectively monitoring gait abnormalities at the walk in horses after sedation with xylazine.


Subject(s)
Actigraphy/methods , Adrenergic alpha-2 Receptor Agonists/adverse effects , Gait , Horses/physiology , Hypnotics and Sedatives/adverse effects , Xylazine/adverse effects , Acceleration , Actigraphy/veterinary , Animals , Female , Injections, Intravenous/veterinary , Male , Random Allocation
18.
Equine Vet J ; 43(6): 721-6, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21668490

ABSTRACT

REASONS FOR PERFORMING STUDY: Lidocaine and ketamine are administered to horses as a constant rate infusion (CRI) during inhalation anaesthesia to reduce anaesthetic requirements. Morphine decreases the minimum alveolar concentration (MAC) in some domestic animals; when administered as a CRI in horses, morphine does not promote haemodynamic and ventilatory changes and exerts a positive effect on recovery. Isoflurane-sparing effect of lidocaine, ketamine and morphine coadministration has been evaluated in small animals but not in horses. OBJECTIVES: To determine the reduction in isoflurane MAC produced by a CRI of lidocaine and ketamine, with or without morphine. HYPOTHESIS: Addition of morphine to a lidocaine-ketamine infusion reduces isoflurane requirement and morphine does not impair the anaesthetic recovery of horses. METHODS: Six healthy adult horses were anaesthetised 3 times with xylazine (1.1 mg/kg bwt i.v.), ketamine (3 mg/kg bwt i.v.) and isoflurane and received a CRI of lidocaine-ketamine (LK), morphine-lidocaine-ketamine (MLK) or saline (CTL). The loading doses of morphine and lidocaine were 0.15 mg/kg bwt i.v and 2 mg/kg bwt i.v. followed by a CRI at 0.1 mg/kg bwt/h and 3 mg/kg bwt/h, respectively. Ketamine was given as a CRI at 3 mg/kg bwt/h. Changes in MAC characterised the anaesthetic-sparing effect of the drug infusions under study and quality of recovery was assessed using a scoring system. RESULTS: Mean isoflurane MAC (mean ± s.d.) in the CTL, LK and MLK groups was 1.25 ± 0.14%, 0.64 ± 0.20% and 0.59 ± 0.14%, respectively, with MAC reduction in the LK and MLK groups being 49 and 53% (P<0.001), respectively. No significant differences were observed between groups in recovery from anaesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of lidocaine and ketamine via CRI decreases isoflurane requirements. Coadministration of morphine does not provide further reduction in anaesthetic requirements and does not impair recovery.


Subject(s)
Isoflurane/pharmacokinetics , Ketamine/pharmacology , Lidocaine/pharmacology , Morphine/pharmacology , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/adverse effects , Analgesics, Opioid/pharmacology , Anesthesia Recovery Period , Anesthetics, Dissociative/administration & dosage , Anesthetics, Dissociative/adverse effects , Anesthetics, Dissociative/pharmacology , Anesthetics, Inhalation/administration & dosage , Anesthetics, Inhalation/pharmacokinetics , Anesthetics, Inhalation/pharmacology , Anesthetics, Local/administration & dosage , Anesthetics, Local/adverse effects , Anesthetics, Local/pharmacology , Animals , Cross-Over Studies , Dose-Response Relationship, Drug , Female , Horses , Isoflurane/administration & dosage , Isoflurane/pharmacology , Ketamine/administration & dosage , Ketamine/adverse effects , Lidocaine/administration & dosage , Lidocaine/adverse effects , Male , Morphine/administration & dosage , Morphine/adverse effects , Pulmonary Alveoli/metabolism
19.
An Sist Sanit Navar ; 33 Suppl 1: 89-96, 2010.
Article in Spanish | MEDLINE | ID: mdl-20508681

ABSTRACT

The increase in demand and the normal situations of overload of the Hospital Emergency Department (HED) make continuous organisational changes compulsory in the search for optimum working and greater quality of care. The main changes have been based on the implementation of different triage systems, with the aim of structuring care according to urgency, and adaptive change in the medical service through different formulae, such as referrals without consultation, fast-track areas and specific care circuits, such as units for thoracic pain, stoke code or sepsis code, amongst the most widespread in HED. On the other hand, HEDs have been forced to seek and use methods that favour the discharge of patients, often hindered by poor management of hospital beds by the health administrations. Hence, different alternatives to hospitalisation are suggested, such as: observation units, short stay units, day hospitals and hospitalisation at home.


Subject(s)
Emergencies/epidemiology , Emergency Service, Hospital/organization & administration , Hospitalization , Humans , Patients/classification , Triage/organization & administration
20.
An. sist. sanit. Navar ; 33(supl.1): 89-96, ene.-abr. 2010.
Article in Spanish | IBECS | ID: ibc-88208

ABSTRACT

El incremento de la demanda y las habituales situacionesde colapso de los Servicios de UrgenciasHospitalarios (SUH) obliga a continuos cambios organizativosen busca de un óptimo funcionamiento y unaasistencia de mayor calidad.Los principales cambios se han basado en la implantaciónde diferentes sistemas de triaje, a fin deestructurar la atención en función de la urgencia, y elcambio adaptativo en la asistencia médica mediantediferentes fórmulas, como la derivación sin visita, lasáreas de visita rápida (fast-track areas) y los circuitosasistenciales específicos, como las unidades de dolortorácico, de código ictus o de código sepsis, entre lasmás extendidas en los SUH.Por otro lado, los SUH se han visto obligados a buscary utilizar métodos que favorezcan el flujo de salidade los pacientes desde los propios servicios, la mayorparte de las veces entorpecida por la mala gestión decamas hospitalarias por parte de las administracionessanitarias. Para ello se utilizan diferentes alternativas ala hospitalización convencional como son: unidades deobservación, unidades de estancia corta, hospitales dedía y hospitalización domiciliaria(AU)


The increase in demand and the normal situationsof overload of the Hospital Emergency Department(HED) make continuous organisational changes compulsoryin the search for optimum working and greaterquality of care.The main changes have been based on the implementationof different triage systems, with the aim ofstructuring care according to urgency, and adaptivechange in the medical service through different formulae,such as referrals without consultation, fast-trackareas and specific care circuits, such as units for thoracicpain, stoke code or sepsis code, amongst the mostwidespread in HED.On the other hand, HEDs have been forced to seekand use methods that favour the discharge of patients,often hindered by poor management of hospital bedsby the health administrations. Hence, different alternativesto hospitalisation are suggested, such as: observationunits, short stay units, day hospitals and hospitalisationat home(AU)


Subject(s)
Humans , Emergency Medical Services/organization & administration , Emergency Treatment/classification , Civil Codes/methods , Health Priorities/organization & administration , Specialization , Hospitalization
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