Group GA Research Articles

PWE-131 Propofol deep sedation for small bowel enteroscopy in elderly patients in a world gastroenterology organising endoscopy training center in Thailand

IntroductionThe aim of the study is to compare and evaluate the clinical efficacy of propofol deep sedation (PDS) for small bowel enteroscopy (SBE) procedure in elderly patients in a teaching...

Esterilização em gatas mediante salpingectomia parcial (incluindo prenhes) versus ovariossalpingohisterectomia

A ligadura ou laqueadura das tubas uterinas é uma forma de contracepção bastante utilizada na medicina humana. Ela consiste na oclusão mecânica e/ou ressecção parcial desta estrutura (salpingectomia parcial). Nesta pesquisa, procurou-se utilizar uma técnica de contracepção definitiva em gatas prenhes, que não comprometesse a gestação em curso, o parto, nem os conceptos, tendo em vista a frequência da visualização de útero gravídico nas campanhas de castração. Avaliou-se também o ganho de peso e mudanças de comportamento das gatas submetidas à salpingectomia parcial, comparando-as com as submetidas à ovariossalpingohisterectomia (OSH), além de comparar o tempo cirúrgico entre os dois procedimentos. Para tal, foram utilizadas 40 gatas, distribuídas em dois grupos de 20 animais, GA: salpingectomia parcial, e GB: OSH; sendo o primeiro subdividido em GA1 contendo 10 gatas prenhes e GA2 contendo 10 não prenhes. Todos os animais foram reavaliados com sete, 60, 180 e 365 dias. O tempo cirúrgico apresentou diferença estatisticamente significativa entre os grupos, sendo o GB mais demorado. Nas gatas do grupo GA1, o curso gestacional e o parto foram normais. No total, foram visualizadas 51 vesículas embrionárias, nasceram 49 fetos vivos e ocorreram duas reabsorções fetais. Dentre os 49 fetos, sete (14,28%) apresentaram a anormalidade genu recurvatum. Quanto à fertilidade, os animais do grupo A que ciclaram e copularam não engravidaram. Apenas o grupo B apresentou aumento de peso médio (20,34%) estatisticamente significativo. Com relação aos parâmetros comportamentais, o grupo B apresentou maiores alterações quanto ao aumento na ingestão de alimentos, aumento da letargia e diminuição do período de vigília. Concluiu-se que a técnica de salpingectomia parcial realizada em gatas é um método contraceptivo 100% eficaz, de rápida execução, que pode ser empregado durante a identificação transcirúrgica do estado de prenhez, com mínimo efeito prejudicial aos conceptos e sem alterações significativas de conduta e ganho de peso, mas com características indesejáveis quanto à aceitação dos proprietários.

$${\mathbb{G}_a^ M}$$ degeneration of flag varieties

Let \({\mathcal{F}_\lambda}\) be a generalized flag variety of a simple Lie group G embedded into the projectivization of an irreducible G-module Vλ. We define a flat degeneration \({\mathcal{F}_\lambda^a}\) , which is a \({\mathbb{G}^M_a}\) variety. Moreover, there exists a larger group Ga acting on \({\mathcal{F}_\lambda^a}\) , which is a degeneration of the group G. The group Ga contains \({\mathbb{G}^M_a}\) as a normal subgroup. If G is of type A, then the degenerate flag varieties can be embedde‘d into the product of Grassmannians and thus to the product of projective spaces. The defining ideal of \({\mathcal{F}_\lambda}\) is generated by the set of degenerate Plucker relations. We prove that the coordinate ring of \({\mathcal{F}_\lambda^a}\) is isomorphic to a direct sum of dual PBW-graded \({\mathfrak{g}}\) -modules. We also prove that there exists bases in multi-homogeneous components of the coordinate rings, parametrized by the semistandard PBW-tableux, which are analogs of semistandard tableaux.

Trace Elements in Thai Oxisols on Limestone in Relation to Rainfall

Trace element concentrations of 7 profiles of Oxisols derived from calcareous sedimentary rocks under tropical monsoonal and the tropical savanna environments have been investigated using XRD, SXRD, XRF, and ICP–OES analytical techniques so as to provide baseline values for estimating environmental contamination of soils with heavy metals. Kaolinite was the dominant mineral of the clay fraction with moderate amounts of goethite and hematite. Gibbsite was only present in Ak1 profile under more humid conditions contributing to high anion exchange capacity (AEC). Trace element concentrations in these soils conform to those for worldwide normal soils. However, the extraordinary high arsenic (As) concentration in Ak1 soil represents a hazardous concentration (313mg kg-1), which may have been inherited from the parent rock. Arsenic in this soil is probably not toxic because it is immobile in an oxidized environment, and is sorbed onto soil constituents particularly sesquioxides. Factor analysis showed that for soils under various rainfalls were deficient. For the whole soil samples, three main groups of similar geochemical behavior existed. Different concentrations of elements of the Ca group (Ca, Ni, Cr, Mg, Ba, Be, Gd, Rb, K, Co, Mn, Zn, La, Cu, V, Ce, P, Cd, Sc, Pb, clay, SSA and CEC) and the Si group (Si and sand), resulted in soils developed under the tropical monsoonal and the tropical savanna climates being clearly different. The Fe group (Fe, Ti, Al, Mo, Ge, Se, Sr, Ga, Th, Hf, U, As and Sb) separated the soils developed of under a tropical monsoonal into two groups based on the very high concentrations of Fe, Al and As in Ak1 profile.

Niveles séricos del antígeno prostático específico en varones expuestos y no expuestos al arsénico en el agua de bebida en Tucumán, Argentina

There is an association between arsenic exposure and prostatic cancer mortality.To analyze and to compare the serum levels of total prostatic specific antigEn (TPSA) in asymptomatic men of a rural zone, exposed and not exposed to high concentrations of arsenic (As) in drinking water.The study included 161 men that were subjected to a clinical evaluation, serum TPSA determination and a trans rectal ultrasonography. Exposed and non-exposed subjects were divided in groups GA, GB and GC according to TPSA levels (<4 ng/ml, 4.1-10 ng/ml and >10.1 ng/ml respectively).Exposed and non-exposed subjects had similar TPSA levels. Among exposed subjects, 88.2, 8,8 and 3% were ascribed to groups GA, GB and GC respectively. The figures for non-exposed subjects were 90. 6, 6,3 and 3,1%. The area under the receiver operating characteristic (ROC) curve for TPSA in exposed and non-exposed subjects was 0.64 (95% confidence intervals (CI) 0.40-0.9) and 0.71 (95% CI 0.6-0.8) respectively.No differences in TPSA levels between subjects exposed and non-exposed to arsenic were observed in this study.

Total prostatic specific antigen levels among subjects exposed and not exposed to arsenic in drinking water

There is an association between arsenic exposure and prostatic cancer mortality. To analyze and to compare the serum levels of total prostatic specific antigEn (TPSA) in asymptomatic men of a rural zone, exposed and not exposed to high concentrations of arsenic (As) in drinking water. The study included 161 men that were subjected to a clinical evaluation, serum TPSA determination and a trans rectal ultrasonography. Exposed and non-exposed subjects were divided in groups GA, GB and GC according to TPSA levels (<4 ng/ml, 4.1-10 ng/ml and >10.1 ng/ml respectively). Exposed and non-exposed subjects had similar TPSA levels. Among exposed subjects, 88.2, 8,8 and 3% were ascribed to groups GA, GB and GC respectively. The figures for non-exposed subjects were 90. 6, 6,3 and 3,1%. The area under the receiver operating characteristic (ROC) curve for TPSA in exposed and non-exposed subjects was 0.64 (95% confidence intervals (CI) 0.40-0.9) and 0.71 (95% CI 0.6-0.8) respectively. No differences in TPSA levels between subjects exposed and non-exposed to arsenic were observed in this study.

Influence of Gestational Age and Nutritional Status on Neurodevelopment of Very Low Birth Weight Infants

Background: Developmental evaluation of VLBWI after hospital discharge is important to assess the effectiveness of management during hospitalization. Objective: Compare neurodevelopment at 24 months corrected age of VLBWI according to adequacy for gestational age at birth and at discharge. Methods: A prospective cohort including VLBWI in the follow-up. They were rated SGA or AGA at birth and at discharge. Data of birth, maternal age and education, family income and neurodevelopment (Bayley III) were evaluated. Results: 125 infants were sequentially included: 15 had GA≤27 weeks, 73 GA 28-31 weeks, 37 GA>31 weeks. Maternal age, education and income were similar among groups. Infants GA≤27 weeks had more ROP (III and IV), lower head circumference at birth, longer duration of mechanical ventilation and hospitalization (all p 31 weeks; Language: 90.8±9 group GA≤27 weeks, 92.8±14.9 group GA 28-31 weeks and 94±9.6 group GA>31 weeks; Motor: 81.9±13.6 group GA≤27 weeks, 94.9±17.4 group GA 28-31 weeks and 95±13 group GA>31 weeks. There were no statistically significant differences for language. The differences were statistically significant in cognitive and motor scales (p=0.020 and p=0.016, respectively). The most impaired group was GA≤27 weeks. Conclusion: Our data suggest that GA is more important for VLBWI neurodevelopment than nutritional status at birth or at discharge.

The spherical Hecke algebra for affine Kac-Moody groups I

We dene the spherical Hecke algebra for an (untwisted) ane KacMoody group over a local non-archimedian eld. We prove a generalization of the Satake isomorphism for this algebra, relating it to integrable representations of the Langlands dual ane Kac-Moody group. In the next publication we shall use these results to dene and study the notion of Hecke eigenfunction for the group Ga .

A comparative study of the mortality rate of rats receiving a half lethal dose of fat intravenously: Under general anaesthesia versus under spinal anaesthesia

BackgroundThere is no data that demonstrates what anaesthesia is suitable for patients who have a high risk of fat embolism syndrome (FES). We investigated the mortality rates of rats that received a half lethal dose (LD50) of fat by intravenous injection after induction of general or spinal anaesthesia. MethodsAn LD50 of fat for rats was determined by using a toxicological method. Three hundred and seventy five rats were randomly assigned to receive general anaesthesia (group GA, n=125), or spinal block (group SA, n=125), or no anaesthesia (group C, n=125). The rats were injected with the LD50 of fat at 20min after anaesthesia induction. The mortality rates were recorded at 2, 8, 12, and 24h after fat injection. ResultsThe LD50 of fat was 0.706ml/kg and its 95% CI was 0.622ml/kg–0.801ml/kg. The mortality rate was lower in the group GA than in the group SA (p<0.01), whilst there was no statistical difference between the group SA and the group C (p=0.442). ConclusionIt is feasible to assess the efficacy of various treatments for FES by comparing the mortality rates of animals after injection of an LD50 of fat. The mortality rate of rats was lower when FES was induced under general anaesthesia than under spinal anaesthesia which implies that general anaesthesia is superior to spinal anaesthesia for patients who have a high risk of FES.

On enveloping type-definable structures

AbstractWe observe simple links between equivalence relations, groups, fields and groupoids (and between preorders, semi-groups, rings and categories), which are type-definable in an arbitrary structure, and apply these observations to the particular context of small and simple structures. Recall that a structure is small if it has countably many n-types with no parameters for each natural number n. We show that a ∅-type-definable group in a small structure is the conjunction of definable groups, and extend the result to semi-groups, fields, rings, categories, groupoids and preorders which are ∅-type-definable in a small structure. For an A-type-definable group GA(where the set A may be infinite) in a small and simple structure, we deduce that(1) if GA is included in some definable set X such that boundedly many translates of GA cover X, then GA is the conjunction of definable groups.(2) for any finite tuple ḡ in GA, there is a definable group containing ḡ.

Role of thoracic epidural block in improving post-operative outcome for septic patients: a preliminary report

Sepsis is considered a relative contraindication for epidural blockade. Recent evidence indicates that thoracic epidural blockade may be of benefit during sepsis by improving gut perfusion. This study was planned to evaluate whether combining thoracic epidural blockade with general anaesthesia could decrease the post-operative mortality and morbidity in patients with sepsis due to perforation peritonitis. This randomised non-blinded study included consenting adult patients of the American Society of Anesthesiologists grade II-III, undergoing emergency laparotomy for small intestinal perforation peritonitis. Severity of illness was evaluated using Mannheim Peritonitis Index, Acute Physiology and Chronic Health Evaluation III score and clinical indicators of systemic inflammatory response syndrome. Patients were randomised into two groups depending on the anaesthetic technique [general anaesthesia combined with thoracic epidural block (group GT) and general anaesthesia (group GA), n = 33 each. The thoracic block was extended from T5 to T10 using 0.125% bupivacaine in aliquots of 2-3 ml, with 50 μg fentanyl. Post-operatively, patients were followed for occurrence of any major morbidity till discharge from hospital, and 30-day mortality. 'Major morbidity' included development of organ failure. Post-operative markers for gut motility and perfusion, that is, time to passage of flatus, stools, resumption of oral feeds and occurrence of anastomotic leak were also observed. Sample size was calculated at power of 80% and α error of 0.05, aiming to detect a decrease of 50% in the incidence of post-operative major morbidity or mortality. Patients in the two groups were similar with respect to demographic profile and severity of sepsis. The number of patients with major morbidity or 30-day mortality were statistically similar between the two groups (group GT, 0/33; group GA 4/33; P = 0.114). A significantly shorter time to pass stools and resume oral feeds in group GT (4 ± 2 vs. 3 ± 1 days) (P = 0.006 and 0.012, respectively) and lesser incidence of anastomotic leak (0/33 vs. 4/33; P = 0.114) showed earlier recovery of gut motility and perfusion in that group. Use of intra-operative segmental thoracic epidural blockade performed in addition to general anaesthesia suggested some benefit in improving post-operative mortality or major morbidity, but the trend was not significant, perhaps due to the small sample size. There was, however, a significantly earlier return of bowel motility and earlier discharge from hospital.

Standard blood flow rates of cardiopulmonary bypass are adequate in awake on-pump cardiac surgery☆

Standard blood flow rates for cardiopulmonary bypass have been assumed to be the same for awake cardiac surgery with thoracic epidural anesthesia (TEA) as for general anesthesia. However, compared with general anesthesia, awake cardiac surgery with epidural anesthesia may be associated with higher oxygen consumption and may result in lactic acidosis when standard blood flow rates were used. The aim of our study was to investigate if standard blood flow rates are adequate in awake cardiac surgery. Forty-five patients undergoing elective on-pump cardiac surgery were assigned to receive either epidural (Group TEA, n=15), combined (Group TEA-GA, n=15) or general (Group GA, n=15) anesthesia. To monitor the adequacy of standard blood flow rates, arterial lactate, acid base parameters, and central venous and jugular bulb saturation were measured at six time points (before, during, and after the surgery) in all groups. Blood flow rates were adjusted when needed. No lactic acidosis has developed in any group (p=NS). TEA as compared with TEA-GA and GA groups had lower central venous (67±4%, 75±11%, and 72±13%, respectively, p<0.05) and jugular bulb oxygen saturations during cardiopulmonary bypass (60±7%, 68±9%, and 75±12%, respectively, p<0.05) during the post-cardiopulmonary bypass period. The TEA group as compared with the TEA-GA and GA groups also had mild hypercapnic respiratory acidosis (56±10, 42±8, and 37±4 mmHg, respectively, p<0.05) and mild decrease of arterial oxygen saturation (93±4%, 97±2%, and 96±1%, respectively, p<0.05) at the end of surgery without any clinical consequences. Thus, no additional blood flow rates adjustments in any study group and no ventilatory support in TEA group were required. Under careful monitoring, the use of standard blood flow rates is adequate for patients undergoing awake on-pump normothermic cardiac surgery.

The application of combined spinal-epidural anesthesia and combined Midazolam used for laparoscopic gynecology Operation

Objective To evaluate the safety and feasibility of combined spinal-epidural anesthesia and Combined Midazolam used for laparoscopic gynecology Operation.Methods 500 patients of ASA grade Ⅰ-Ⅱundergoing laparoscopic gynecology surgery were randomly devided into combined spinal-epidural anesthesia group(group CSEA,n=250)and general anesthesia group(group GA,n=250),The variation of peri-anesthesia mean heart rate(HR),respiration rate(RR),arterial pressure(MAP),pulse oxygen saturation(SpO2)were tested and recorded.The wake time and the post-operative(in24hour)complications were observed.Results Referring to all patients,there were not any significant differences in BP,HR,RR,SpO2(P>0.05).The wake time was significantly shorter in Group CSEA than in Group GA(P<0.01),The incidence of postoperative complication(nausea,vomiting,restlessness)was significantly lower in Group CSEA than in Group GA(P<0.05).Conclusion The combined spinal-epidural anesthesia and combined Midazolam used for laparoscopie gynecology Operation is safe and feasible,and easier and more economical general anesthesia. Key words: Combined spinal-epidural anesthesia; Midazolam,Laparoscopic gynecology Operation

The influence of various anesthesia techniques on postoperative recovery and discharge criteria among geriatric patients

OBJECTIVE:We aim to compare selective spinal anesthesia and general anesthesia with regard to postoperative recovery and fast‐track eligibility in day surgeries.MATERIALS AND METHOD:Sixty geriatric outpatient cases, with ASA II‐III physical status and requiring short‐duration transurethral intervention, were enrolled in the study. The cases were split into 2 groups: as general anesthesia (Group GA) and selective spinal anesthesia (Group SSA). Group GA (n = 30) received propofol 2 mg kg‐1 (until loss of eyelash reflex), remifentanil induction 0.5‐1 µg kg‐1, and laryngeal mask. Maintenance was achieved by 4‐6% desflurane in 60% N2O and 40% O2 along with remifentanil infusion at 0.05 µg /kg‐1 /min‐1. Drugs were discontinued after the withdrawal of the ureteroscope, and extubation was carried out with 100% O2. Group SSA (n = 30) received 0.5% spinal anesthesia via L4‐5 space by 0.5% hyperbaric bupivacaine 5 mg. Anesthesia preparation time, time to surgical anesthesia level, postoperative fast‐tracking, and time to White‐Song recovery score of 12, were noted. In the operating room, we evaluated hemodynamics, nausea/vomiting, surgeon and patient satisfaction with anesthesia, perioperative midazolam‐fentanyl administration, postoperative pain, and discharge time.RESULTS:Anesthesia preparation time, length of surgery, anesthesia‐related time in the operating room, time to sit, and time to walk were significantly low in Group GA (p<0.05), whereas time to fast‐track eligibility, length of stay in the PACU, discharge time, and other parameters were similar in both of the groups.CONCLUSION:While anesthesia preparation time, length of surgery, start time of surgery, time to sit, and time to walk were shorter in the General Anesthesia group, time to fast‐track eligibility, phase 1 recovery time, and discharge time were similar among patients subjected to selective spinal anesthesia.

Effect of all-trans retinoic acid on renal expressions of matrix metalloproteinase-2, matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in rats with glomerulosclerosis

In kidney injury the accumulation of extracellular matrix (ECM) plays an important role and precedes the development of glomerulosclerosis (GS). There is great interest in agents that may interfere with such accumulation of ECM. Therefore, a rat model of GS was established to investigate the effect of all-trans retinoic acid (ATRA) on the renal expressions of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1). Eighty Wistar rats were randomly divided into four groups: sham operation group (SHO), GS model group without treatment (GS), GS model group treated with benazepril (GB) and GS model group treated with ATRA (GA), n = 20, respectively. The disease was established in the GS rats by uninephrectomy and adriamycin (5 mg/kg) injection through the tail vein. Serum creatinine (Scr), blood urea nitrogen (BUN) and urine protein (Upro) were measured. Renal abnormality was evaluated at the end of 12 weeks. Immunohistochemical analysis was performed on renal tissue to detect the expression of collagen IV (Col-IV), fibronectin (FN), MMP-2, MMP-9 and TIMP-1 protein. MMP-2 and MMP-9 activity was detected by gelatin zymography. Real-time reverse transcription polymerase chain reaction (real-time RT-PCR) was used to detect the expression of MMP-2, MMP-9, and TIMP-1 mRNA. In comparison with group GS, group GA and group GB exhibited levels of BUN and 24 h urinary protein and a glomerulosclerosis index (GSI) that were significantly reduced (P < 0.05); the level of Scr in group GA was reduced too (P < 0.05). ATRA and benazepril also significantly down-regulated Col-IV, FN expression and TIMP-1 expression (protein and mRNA) (P < 0.05). In contrast, the expressions of MMP-2, MMP-9 mRNA and protein, and activity in groups GA and GB were enhanced (P < 0.05). However, there were no significant differences in MMP-2, MMP-9 mRNA and protein expression, or activity, between the ATRA and GB groups (P > 0.05). In conclusion, ATRA may protect renal function and step down the progression of GS by reducing the expression of TIMP-1, enhancing the expression and activity of MMP-2 and MMP-9, and regulating the ratio of MMPs/TIMPs to dynamic balance, so as to reduce the accumulation of ECM.

Caudal epidural sufentanil and bupivacaine decreases stress response in paediatric cardiac surgery

Surgery and anaesthesia are known to cause stress response. Attenuation of stress response can decrease morbidity, postoperative hospital length of stay and, thus, cost. Intrathecal and epidural techniques produce reliable analgesia in patients undergoing surgery along with stress response attenuation. The present study was undertaken to evaluate the efficacy of caudal sufentanil and bupivacaine combination on perioperative stress response in paediatric patients undergoing open heart surgery. Thirty patients (ASA grade II-III) undergoing elective corrective cardiac surgery for acyanotic congenital heart disease, were randomly allocated to two groups. In group GA (n = 15), patients received balanced general anaesthesia. In group GC (n = 15), in addition to general anaesthesia, caudal block with bupivacaine and sufentanil combination was given after endotracheal intubation. Monitoring included electrocardiography, invasive arterial pressure, end-tidal carbon dioxide, pulse oximetry, arterial blood gases including serum electrolytes, blood glucose, serum cortisol, urine output, central venous pressure and temperature. Haemodynamic responses in both groups were statistically similar. Serum cortisol levels were significantly lower in GC group than GA group (P < 0.05) after sternotomy (9.8+/-7.5 vs. 34.74+/-27.35), on cardiopulmonary bypass (CPB) (12.17 +/- 6.2 vs. 35.36 +/- 24.15), after sternal closure (14.03 +/- 5.1 vs. 37.62 +/- 20.69), 4 hours (26.64 +/- 14.61 vs. 37.62 +/- 9.13) and 24 hours (14.30 +/- 8.11 vs. 28.12 +/- 16.31) after intubation. Blood glucose levels were significantly higher in GA group as compared to GC group at sternal closure (277.46 +/- 77.25 vs.197.73 +/- 42.17) and 4 hours (255.26 +/- 73.73 vs. 185.26 +/- 57.41) after intubation (P < 0.05). To conclude, supplementation of caudal epidural bupivacaine and sufentanil could effectively attenuate the stress response in paediatric patients undergoing cardiac surgery under CPB in acyanotic congenital heart anomaly.

Early postnatal renal growth in premature infants

To assess postnatal kidney volume development and to compare the intrauterine and extrauterine kidney growth curves of premature infants. One hundred neonates were enrolled in this study, and all infants had their kidney volumes measured by renal ultrasound examination. Group GA consisted of 44 neonates who were evaluated within 48 h after birth, and their gestational ages were used in the analysis. Group CA included 56 premature infants born before 34 weeks of gestation and was evaluated 14-96 days after birth, and their conceptional ages were used in the analysis. Left kidney volume, body weight, body height and age were used in the correlation analysis. There was a better kidney growth rate for Group GA infants than for Group CA infants (P = 0.001). Kidney volumes in Group CA infants were thus apparently larger than those of the Group GA infants before 31 weeks of age, but they were smaller after 31 weeks of age. Group GA infants had a significantly faster growth in body weight (P = 0.001) and body height (P < 0.001). However, a larger kidney volume was noted in Group CA infants with the same body weight (P < 0.001). A chart is presented of the postnatal growth of normal kidney volume before 40 weeks conceptional age in premature infants. These data suggest that intrauterine growth may have a regulatory influence on kidney growth, and the reduced kidney volume in premature infants may result from the early extrauterine period.

Avaliação da função pulmonar após colecistectomias laparoscópicas e convencionais

OBJETIVO: Avaliar a função pulmonar pós-colecistectomias laparoscópicas e subcostais abertas. MÉTODOS: Tratou-se de um ensaio randomizado, onde se avaliaram espirometrias pós-operatórias de dois grupos, cada qual com 15 pacientes. O grupo GL foi submetido a colecistectomia laparoscópica. O grupo GA foi submetido a colecistectomia por via subcostal, por meio de mini-laparotomia e abreviado tempo anestésico-cirúrgico. As variáveis dos dois grupos foram comparadas entre si por meio da ANOVA. Entre um mesmo grupo, antes e depois das operações, utlizou-se do teste t-Student emparelhado. Um valor de p &lt; 0,05 foi considerado estatisticamente significativo. RESULTADOS: Todas as pacientes, dos dois grupos, apresentaram distúrbios ventilatórios restritivos pós-operatórios, com normalização espirométrica mais rápida nas pacientes operadas por laparoscopia. Grupos GL X GA, no pós-operatório imediato: Capacidade vital forçada (p &lt; 0,001) e Volume Expiratório forçado em 1 segundo (p &lt; 0,001). CONCLUSÕES: O prejuízo pós-operatório da função pulmonar foi significativamente menor nas colecistectomias laparoscópicas do que nas abertas, mesmo por meio de mini-laparotomia e abreviado tempo anestésico-cirúrgico.

Influência de diferentes comprimentos de onda da laserterapia de baixa intensidade na regeneração tendínea do rato após tenotomia

Influence of different low-intensity laser therapy wavelengths for rat tendon regeneration following tenotomy Objective: The aim of this study was to compare the effect of the low level laser therapy in the organization of the collagen fibers with 3 J/cm² of dose in two wavelengths (670nm and 904nm) and in the combination of both on the tissue repair of the calcaneus tendon. Methods: We used 37 female Wistar rats divided in 5 groups which had been submitted to the total tenotomy. Group GA (n= 8) was submitted to the laser irradiation in λ= 904nm, GaAS diode, pulsated emission, peak power 15W and dose of 3J/cm², group GB (n= 8) was submitted to laser irradiation λ= 670nm AlGaInP diode, continuous emission, power 30 mW and dose 3J/cm², group GAB (n= 8) was submitted to association of both of lasers and group GCL (n= 7) which the calcaneum tendon was submitted to placebo treatment. The group GP (n= 6) was a standard group without lesion and treatment. The animals received 12 sessions of lasertherapy and submitted to euthanasia on 14 th day after surgery. The tendons were submitted to histological procedure and were analyzed to evaluate the optic retardation (in nm) for the birefringence measurement. Results: The statistic analysis showed that the irradiated groups have higher values of optic retardation statistically significant than placebo group (p= 0,00001). It indicates that all the treated groups show better organization of collagen fibers in the longitudinal axis of the tendon, evidencing better quality in the tissue repair. The group GAB was that shown best results (p= 0,00001) when compared to another groups.

Population Pharmacokinetics of Mycophenolic Acid in Senile Chinese Kidney Transplant Recipients

To explore the pharmacokinetic characteristics of mycophenolic acid (MPA) among elderly Chinese kidney transplant recipients, we enrolled 24 patients over 60 years old (65.6 ± 3.6) as the (Gs) group and 24 patients of 39.6 ± 14.3 years old as a control group (Ga). Venous blood samples were taken at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, and 12 hours after the morning dose of mycophenolate mofetil at 10 to 12 weeks posttransplant. Plasma MPA concentrations were measured by a validated high-performance liquid chromatography method. Within 6-month posttransplant follow-up, there had not been an acute rejection episode when five elderly and one other adult experienced severe adverse events (SAEs), such as pneumonia and leukocytopenia. MPA area under the curve (AUC) in Gs was significantly lower than that among Ga ( P < .05), while there was no significant difference in predose, peak concentrations, or peak times ( P > .05). The concentration-time curve of Gs showed a bipeak pattern in five patients (20.8%) during the early stage (2 to 4 hours postdose). AUC in the subgroup of Gs with SAEs ( n = 5) was significantly higher than that of elderly subjects without SAEs ( n = 19) ( P = .042). When Gs were subdivided at a cutting AUC point of 25 μg/mL, the SAE incidence was significantly higher in the subgroup with a higher AUC than than those with the lower AUC ( P = .047). Through multiple stepwise regression, we obtained a minimal model to estimate MPA AUC of elderly recipients: AUC = 3.0410 + 9.8588 × C 0 + 0.5963 × C 0.5 + 2.5612 × C 3 ( R 2 = .893).