Minutes In Adults Research Articles

Impact of neighbourhood walkability on weekly walking minutes among adults with visual impairments: A preliminary study

Weekly and consistent physical activity can help minimize the risk of preventable disease and improve mental health and cognitive function among adults. Despite these benefits, adults with visual impairments tend to not meet physical activity recommendations. The purpose of this preliminary study was to examine how neighbourhood walk score (walkability) is associated with weekly walking minutes in adults with visual impairments. Participants were recruited from two visual impairment–related listservs in the United States. A total of 88 participants (aged 22–85 years; 78% female) were included. Participants completed an online survey including demographic, walking duration, and zip code questions. Linear regression analyses were performed to determine whether there were significant associations between walkability and weekly walking minutes. Walkability scores were not significantly related to walking minutes per week ( p = .84), but age was negatively associated with walking minutes per week (β = −.16), holding other factors constant. Neighbourhood walkability was not significantly associated with walking minutes per week among adults with visual impairments in this study. As these adults age, the amount of walking decreased. Future research in this line of inquiry should expand to include other variables that may influence the relationship between walkability and walking minutes per week and examine the barriers to physical activity among individuals with visual impairments.

Pharmacokinetic and Pharmacodynamic Target Attainment in Adult and Pediatric Patients Following Administration of Ceftaroline Fosamil as a 5-Minute Infusion.

The key pharmacokinetic/pharmacodynamic (PK/PD) efficacy index for β‐lactam antibiotics is the percentage of time that free drug concentrations exceed the minimum inhibitory concentration (MIC) of bacteria during each dosing interval (fT>MIC). Ceftaroline fosamil, the prodrug of the β‐lactam ceftaroline, was initially approved for administration as 60‐minute intravenous (IV) infusions. Population PK analyses comparing exposure and PK/PD target attainment for 5‐minute and 60‐minute IV infusions, described here, have supported ceftaroline fosamil labeling updates to include variable infusion durations of 5 to 60 minutes in adults and children aged ≥2 months. A 2‐compartment disposition PK model for ceftaroline fosamil and ceftaroline was used to predict steady‐state ceftaroline exposures (maximum plasma concentrations [Cmax,ss] and area under the plasma concentration–time curve over 24 hours [AUCss,0‐24]) and probability of target attainment in simulated adult and pediatric patients with various degrees of renal function receiving standard doses of ceftaroline fosamil as 5‐minute or 60‐minute IV infusions. Across age groups and renal function categories, median ceftaroline AUCss,0‐24 values were similar for 5‐minute and 60‐minute infusions, whereas Cmax,ss was up to 42% higher for 5‐minute infusions. Both infusion durations achieved >99% probability of target attainment based on PK/PD targets for Staphylococcus aureus (35% fT>MIC) and Streptococcus pneumoniae (44% fT>MIC) at European Committee on Antimicrobial Susceptibility Testing/Clinical and Laboratory Standards Institute MIC breakpoints (1 mg/L and 0.25/0.5 mg/L, respectively). These findings support administration of standard ceftaroline fosamil doses over 5 to 60 minutes for adults and children aged ≥2 months, providing added flexibility to clinicians and patients.

Predictive and protective factors in suicidal behavior among males diagnosed with postural tachycardia syndrome

Background: Postural orthostatic tachycardia syndrome (POTS) is a chronic invisible illness characterized by orthostatic intolerance and increased heart rate upon standing (>30 beats per minute in adults and >40 beats per minute in adolescents). This study seeks to characterize the psychological distress in males who have been diagnosed with POTS. Males are diagnosed at much lower rates than females and are underrepresented in the literature. Methods: Forty-one male POTS patients responded to an online survey including the following instruments: acquired capability for suicide—fearlessness about death, beck depression inventory-II, interpersonal needs questionnaire-15, and the suicide behaviors questionnaire-revised. Results: In this study, 58.5% of men surveyed scored in high-risk group for suicide on the suicide behaviors questionnaire-revised. In a multiple linear regression analysis, perceived burdensomeness (β = 0.72; p = 0.001), age (β = –0.41; p = 0.001), changes in health due to chronic illness (β = –0.39; p = 0.05) and fearlessness about death (β = 0.35; p = 0.01) explained 50.7% of their suicidal behavior. Conclusions: In this small sample of men, perceived burdensomeness was the greatest predictor of suicidal behavior followed by fearlessness about death. Age and changes in health due to chronic illness seem to be protective against suicidal behavior. Therapeutic interventions, both medical and psychological, to decrease perceived burdensomeness could decrease the overall risk of suicide in men with postural orthostatic tachycardia syndrome. Fearlessness about death and increased changes in health due to chronic illness as indicators for suicidal behavior may provide an alternative approach for intervention for some men with postural orthostatic tachycardia syndrome.

Accuracy of a 14-Day Factory-Calibrated Continuous Glucose Monitoring System With Advanced Algorithm in Pediatric and Adult Population With Diabetes.

In this study, we evaluated the analytical performance of the second-generation factory-calibrated FreeStyle Libre Flash Glucose Monitoring (FreeStyle Libre 2) System compared to plasma venous blood glucose reference, Yellow Springs Instrument 2300 (YSI). The study enrolled participants aged four and above with type 1 or type 2 diabetes at seven sites in the United States. Adult participants (18+ years) participated in three in-clinic sessions and pediatric participants (4-17 years) participated in up to two in-clinic sessions stratified to provide data for days 1, 2, 3, 7, 8, 9, 12, 13, or 14 of sensor wear. Participants aged 11+ underwent supervised glycemic manipulation during in-clinic sessions to achieve glucose levels across the measurement range of the System. Performance evaluation included accuracy measures such as the proportion of continuous glucose monitoring (CGM) values that were within ±20% or ±20 mg/dL of reference glucose values, and bias measures such as the mean absolute relative difference (MARD) between CGM and reference values. Data from the 144 adults and 129 pediatric participants were analyzed. Percent of sensor results within ±20%/20 mg/dL of YSI reference were 93.2% and 92.1%, and MARD was 9.2% and 9.7% for the adults and pediatric participants, respectively. The System performed well in the hypoglycemic range, with 94.3% of the results for the adult population and 96.1% of the data for pediatric population being within 15 mg/dL of the YSI reference. The time lag was 2.4 ± 4.6 minutes for adults and 2.1 ± 5.0 minutes for pediatrics. The System demonstrated improved analytical accuracy performance across the dynamic range during the 14-day sensor wear period as compared to the previous-generation device.NCT#: NCT03607448 and NCT03820050.

Comparison Of Total MVPA Versus MVPA In Bout Of At Least 10 Minutes In Adults With Obesity.

INTRODUCTION: The 2008 Physical Activity Guidelines for Americans recommended adults engage in >150 min/week of moderate-to-vigorous intensity physical activity (MVPA) in bouts of >10 minutes to elicit numerous health benefits. However, the 2018 Physical Activity Guidelines recommends that all MVPA, regardless of bout length, contribute to the desired MVPA goal as this also elicits health benefits. PURPOSE: This study examined whether the number of adults meeting the public health recommendation of 150 min/week of MVPA differed based on the criteria that considered all minutes or minutes that were only accumulated in bouts of >10 minutes. METHODS: Baseline data from 377 adults with obesity (age=45.5±8.0 years; BMI=32.2±3.8 kg/m2) who enrolled in a behavioral weight loss program were analyzed. Participants reported not engaging in regular structured exercise that exceeded 60 min/week. Participants were instructed to wear an activity monitor (SenseWear Armband) for 7 days while maintaining their regular activity prior to initiating the intervention. Data were considered valid if the activity monitor was worn for >10 hours per day on at least 4 days. These data from the activity monitor were used to identify total minutes of MVPA that met the criteria of >3 METs regardless of bout length and total minutes of MVPA that was accumulated in bouts >10 minutes. RESULTS: Median minutes of total MVPA was 244 (25th, 75th percentiles: 118.0, 458.0) min/week. Median minutes of MVPA in bouts >10 minutes was 103 (25th, 75th percentiles: 27.5, 232.5) min/week. Both total MVPA (-0.327, p<0.001) and MVPA in bouts >10 minutes (-0.275m p<0.001) were correlated with BMI using the Spearman Rank Order procedure. The proportion of adults engaging in >150 min/week meeting was 67.4% when total minutes of MVPA was considered and 39.8% when minutes of MVPA in bouts >10 minutes was considered. CONCLUSION: The proportion of adults with overweight or obesity meeting the recommended 150 minutes per week of MVPA will vary based on whether total MVPA or MVPA in bouts >10 minutes is used to determine engagement. However, both total MVPA and MVPA resulting from bout >10 minutes may contribute to a lower BMI. These findings may have implications for evaluation of and recommendations for MVPA that may impact body weight regulation.

Early diagnosis and treatment for burn complicated with severe paroxysmal sympathetic hyper-activity

Objective: To investigate the early diagnosis and treatment for burn complicated with severe paroxysmal sympathetic hyperactivity (PSH). Methods: Medical records of patients with burn complicated with severe PSH, admitted to our department from April 2016 to March 2019 and meeting the inclusion criteria were analyzed retrospectively. There were 4 males and 1 female, aged 17 months to 39 years, with an average of (21±16) years. During occurrence of PSH, the vital signs of patients were routinely monitored and oxygen were given. Other treatment included central venous catheterization and infusion of electrolyte solution, infusion of plasma according to patients' condition, use of opioid analgesics and benzodiazepine sedatives, physical cooling and drug cooling, and establishment or maintenance of artificial airway and use of ventilator. Heart rate was controlled below 120 beats per minute in adults and 140 beats per minute in children with comprehensive treatment dominated by analgesia and sedation. Besides, single or multiple vasoactive agents, even in large doses were used to maintain normal blood pressure of patients. The occurrence characteristics, time, and treatment outcome of PSH were analyzed. Results: PSH happened rapidly, with a sharp increase in several minutes to dozens of minutes. Five patients were with symptoms such as high body temperature, shortness of breath, very fast heart rate, normal or elevated systolic blood pressure, hyperhidrosis, and dystonia at the onset. The symptoms occurred simultaneously or successively. According to the Clinical Feature Scale, the above-mentioned 6 indexes achieved the highest score of 3 points except of systolic blood pressure. Four patients showed dilated pupils and impaired consciousness. Among the patients, PSH occurred in the acute exudation stage in 3 patients, in the fluid reabsorption stage in 1 patient, and in the late repair stage in 1 patient. PSH of patients lasted for 3 hours to 12 days. The symptoms of 4 patients were effectively controlled, and 1 patient died of deterioration. No PSH occurred in the cured patients during follow-up of 3 to 14 months. Conclusions: Burn complicated with PSH can occur at any time before wound repair and in patients with different injury conditions. The causes of PSH include sudden burn, persistent pain, fright and fear, strange environment, low blood volume, and other adverse stimuli, and PSH is more likely to occur in children with underdeveloped brain function. Intravenous infusion of analgesics sedatives, physical therapy and medication to lower body temperature, stabilizing blood pressure and respiration are effective measures to treat PSH. PSH should be distinguished from the common complications of burns, such as sepsis, cerebral edema, hyperpyretic convulsion, transfusion response, stress disorder, etc.

A correlation exists between normal breathing rate and watching horror movies

The reason of present research was to estimate somewhat relation between normal breathing rate and watching horror movies. Total 135 subjects were the participants of this project. The breathing rate is expressed as the total number of breaths a person receiving in 1 minute. The normal rate is 12 to 20 breaths per minute in adults. The respiration rate underneath 12 and overhead 25 is regarded as abnormal and it points to grim health problems. The situations that can vary normal respiratory rate are anxiety, fever, flu, air pollution, asthma, pneumonia, heart failure, lung disorder, drug overdosing and usage of narcotics. Now a days, number of people love viewing horror movie while some hatred them. There is an elongated list of such movies on internet. Scary movies have the physical and psychological effects on one’s mind. The most evident are anxiety and stress that can lead to high pulse rate and sweating. Such physical effects result in increase of respiration rate. In such situations, we inhale more oxygen and exhale more carbon dioxide. The member of the audience spots high breathing like performing a light exercise. The thrill of unknown and abrupt appearance of any terror initiates the body to groom against that fear. After-all above procedure, it was summarized that there was a significant interaction between normal breathing rate and watching horror movies.

Influence of aminergic and peptidergic substances on heart beat frequency in the stick insect Carausius morosus (Insecta, Phasmatodea).

The dorsal heart of the Indian stick insect, Carausius morosus, is responsible for the anterograde flow of hemolymph to the aorta and into the body cavity. The contraction frequency of the insect heart is known to be influenced by several substances of neural source. Here, a semi-exposed heart assay was employed to study the effect of an aminergic substance (octopamine) and three neuropeptides (C. morosus hypertrehalosemic hormone [Carmo-HrTH], crustacean cardioactive peptide [CCAP], and proctolin) on heart contraction. The contraction frequency was measured as beats per minute in adults ligated between the head and the prothorax. All three investigated neuropeptides had a stimulatory effect on heart contraction that lasted approximately 6min, after which the normal heart beat rate was restored. Proctolin and CCAP stimulated the rate of heart beat also in unligated stick insects, whereas Carmo-HrTH was active only in ligated insects. The latter could suggest that when the stick insect is not ligated, a competing substance may be released from the head of C. morosus; the competing substance is, apparently, not physiologically active but it binds or blocks access to the receptor of Carmo-HrTH-II, thereby rendering the HrTH peptide "not active." In ligated stick insects, 6.7×10-8 M Carmo-HrTH-II significantly increased the heart beat rate; higher doses resulted in no further increase, suggesting the saturation of the HrTH receptor. Octopamine inhibited the rate at which the heart contracted in a dose-dependent manner; inhibition was achieved with 10-4 M of octopamine.

Optimization of door-to-electrocardiogram time within a critical pathway for the management of acute coronary syndromes at a teaching hospital in Colombia.

Door-to-electrocardiogram (D2E) time is recognized as one of the quality parameters in the attention of acute coronary syndromes. Electrocardiogram realization within periods below 10 minutes increases the possibility to achieve quick and effective reperfusion, which has an impact on outcomes. To describe the results of a strategy whose goal is to improve the fulfillment of the D2E deadline below 10 minutes in adults who attend the emergency service due to chest pain with clinical suspicion of acute coronary syndromes. Before-and-after study that assesses D2E time upon the implementation of actions for the reorganization of the process of attention of the patients with chest pain within the context of the implementation of a critical pathway. A total of 373 patients were assessed, 204 in the before stage and 169 in the after stage. The median D2E time was 16 minutes in the before stage, in 41% of the cases it was below 10 minutes; upon the implementation of the change in the process of attention of chest pain the median was 5 minutes, with 63% of the cases below 10 minutes, exhibiting a statistically significant difference. The actions taken led to a lower median of D2E time and a higher percentage of patients with times below 10 minutes. However, further interventions are required to assure a higher number of patients with D2E times below 10 minutes.

Transcatheter Closure of Persistent Ductus Arteriosus in Adults

To describe the technical aspects and outcome of duct occlusion in adults over a 12-year period. A single center review of all transcatheter duct closures performed between 2000 and 2012. Of 518 transcatheter duct closures performed, 31 patients were over the age of 16 at the time of procedure (6%). In 10 of the 31 cases, it was not possible to cross the duct from the pulmonary artery. In 4 of those, the duct was small enough to be closed with coils delivered from the aorta (although 1 required a second procedure for a residual shunt). In the remaining 6 cases, it was necessary to cross the duct from the aorta and create an arterio-venous "circuit" using a snare to deliver an Amplatzer device from the femoral vein. In none of the 487 children who underwent transcatheter duct closure during the same time period was it necessary to deliver the device using an arterio-venous wire circuit. The increased complexity of the procedure in adults compared with children was further reflected by longer procedure times (median of 37 minutes in adults vs. 24 minutes in children [P < 0.01]) and longer fluoroscopy times (median of 8.4 minutes in adults vs. 4.3 minutes in children [P < 0.025]). There were no major complications. Closure of the arterial duct in adults is safe and effective but ductal anatomy may differ from that seen in childhood, making transcatheter closure technically much more demanding than in children.

Molt and gastroliths inAustropotamobius pallipes(Lereboullet, 1858)

Knowledge of the molting cycle in crayfish may contribute (1) to improving a population analysis for monitoring and conservation purposes and (2) to imposing significant constraints on practices involved in culture. Two populations of Austropotamobius pallipes in central Italy were monitored from April to November for five years (2002–2006). Crayfish were collected, sexed, and the carapace length (CL) was measured. Molt cycle stages (premolt, molt, postmolt and intermolt) were identified depending on the exoskeleton hardness and color, and the abdomino-thorax splitting. The molt lasted for 6 minutes in juveniles, and maximally 16 minutes in adults in captivity. Males and females were treated separately, and divided into five age classes (0+; 1+; 2+; 3+; >4+). No significant differences were observed between females and males of the same age class. The molting event mainly occurred in April and May ongoing to November. The molting cycle occurred less frequently between July and August, and during the study period it was rarely observed between the last five days of July and the first week of August. Moreover, we measured and counted the gastrolith layers from a total of 124 crayfish (73 females + 51 males) collected twelve years ago, in order to discuss possible correlations between CL and gastrolith size.

Optimal vasopressor drug therapy during resuscitation

Optimal vasopressor support during resuscitation should theoretically enhance aortic diastolic and coronary perfusion pressure as well as coronary and cerebral blood flow/oxygen delivery without increasing cellular oxygen demand. Intravenous vasopressor support, using 1 mg doses of epinephrine every 5 minutes in adults or vasopressin 40 IU, is recommended by American Heart Association Advanced Cardiac Life Support Guidelines to maximize oxygen delivery to the heart and brain and increase cellular high energy phosphate levels. Vasopressin offers theoretical advantages over epinephrine in that it does not increase myocardial oxygen demand significantly and its receptors are relatively unaffected by acidosis. However, unlike epinephrine, it is not a myocardial stimulant. Despite these differences in physiologic actions, two large randomized clinical trials yielded virtually identical overall survival to hospital discharge when these agents were compared during inhospital or out-of-hospital resuscitation in Canada and Europe, respectively. More recent clinical and experimental evidence suggests that a combination of vasopressin and epinephrine used during resuscitation can improve hemodynamics and perhaps survival. The verdict on a combination vasopressor strategy may soon come from a large (>2,000 patients) prospective clinical trial that is underway in France to clarify the role of combination vasopressin/epinephrine therapy in out-of-hospital resuscitation.

Nasal mucociliary clearance in health and disease

"Standard saccharine test is used to detect nasal mucociliary clearance time in healthy individuals both adults and children. The length of the nose was measured radiologically and with the help of a soft malleable rubber catheter. For healthy individuals, mean nasal mucociliary clearance lime is 8.2 minutes in children and 9.5 minutes in adults. The mean nasal mucociliary clearance rates were 11.1 mm/min for children and 12.7 mm/min for adults.Deviated nasal septum, chronic sinusitis, allergic rhinitis, atrophic rhinitis, chronic smokers and patients with recent nasal packings were taken as diseased conditions in adults, whereas children with adenoid hyperplasia were taken for the study. In all of these, nasal mucociliary clearance was significantly prolonged."

Epinephrine versus Vasopressin in Adult Cardiac Arrest: Role of Agonal Respirations and Patient Age

A review of the literature regarding the use of vasopressin versus epinephrine in the treatment of out-of-hospital cardiac arrest recommends initially administering 1 mg of epinephrine, followed by alternating doses of vasopressin 40 IU and epinephrine 1 mg every 3 minutes in adults, regardless of the initial electrocardiographic rhythm. The American Heart Association—Emergency Cardiac Care Committee (AHA—ECCC) adopted this position in its recent recommendations. However, further research is required to determine whether epinephrine should always be the initial agent regardless of the initial cardiac rhythm or whether other factors need to be considered. A review of evidence that may have been overlooked by the AHA-ECCC argues for the need to consider the presence of spontaneous agonal (“gasping”) respirations and patient age before determining which vasopressor to use first.

Eyelid movements in health and disease. The supranuclear impairment of the palpebral motility

The eyelid movements are mediated mainly by the orbicularis oculi (OO) and the levator palpebrae superioris (LPS) muscles. Dissociated upper lid functions exhibit different counterbalanced action of these muscles, and in blinking they show a strictly reciprocal innervation. The disturbance of this close LPS–OO relationship likely leads to many of the central lid movement disorders. Three groups of supranuclear motor impairment of lid movements are considered: the disorders of the lid-eye movements’ coordination, the disturbances of blinking and lid “postural” maintenance, and the alteration of voluntary lid movements. Nuclei of the posterior commissure control the inhibitory modulation of LPS motor-neuronal activity and they are involved in the lid-eye coordination disorders such as lid retraction, which is observed in the Parinaud’s syndrome and also in parkinsonism and progressive supranuclear palsy. Spontaneous (SB) and reflex blinking consist of two components: the inhibition of the basal tonic LPS activity, which keeps the eyes open, and the concurrent activation of the OO muscles. LPS inhibition precedes and outlasts the OO activation. This normal configuration is impaired in parkinsonism and blepharospasm (BSP). SB shows a highly interindividual rate variation (among 10–20 per minute in adults) and abnormal blink rates occur in neurological diseases related to dopaminergic transmission impairments. Lid postural abnormalities include involuntary eyelid closure, which is usually associated with inability to open the eyes. Two major disorders share these two aspects: BSP and blepharocolysis (BCO). BSP consists of an involuntary overactivity of the OO, with LPS co-contraction activity, and is expressed as frequent and prolonged blinks, clonic bursts, prolonged tonic contraction or a blend of all of them. BCO (commonly named “so-called lid opening apraxia”) is an overinhibition of the LPS with no evidence of ongoing OO activity. BSP and BCO occur in many instances of idiopathic dystonias and basal ganglia diseases and, less frequently, in rostral brainstem lesions. Both may coincide in the same patient. Voluntary lid movement disorders comprise the impairment of Bell’s phenomenon, the voluntary eyelid closure palsy and the so-called cerebral ptosis, all related to lesions of frontal cortical areas and/or the corticospinal system.

Predicting recovery from deep neuromuscular block by rocuronium in children and adults

Study Objective: To compare the response to motor nerve stimulation at a rate of 1 Hz after 50 Hz tetanus [posttetanic count (PTC)] and 2 Hz for 2 seconds [train-of-four (TOF)] in children and adults during spontaneous recovery from blockade caused by rocuronium. Design: Prospective, clinical, observational, multicenter study. Setting: Operating rooms of two university hospitals. Patients: 22 children (ASA physical status I and II) aged 2 to 5 years, scheduled to undergo dental treatment and 20 adults aged 18 to 60 years, scheduled to undergo elective general or orthopedic surgery during general anesthesia with tracheal intubation. Measurements: Neuromuscular blockade was evaluated with accelerometry of the thumb, using PTC and TOF stimulation of the ulnar nerve, in patients who received rocuronium 1 mg · kg −1. Main Results: The first response to posttetanic and TOF nerve stimulation appeared earlier in children than in adults. The time from injection of rocuronium to appearance of the fourth response to TOF ranged from 27 to 62 minutes in children and from 37 to 94 minutes in adults. The average interval between the appearance of a posttetanic response and the first detectable response to TOF stimulation (T1) was also shorter in children, 7 minutes, than in adults, 16 minutes. The relationship between PTC and the time interval between a given PTC and the first detectable TOF response in both children and adults was exponential (R = −0.64 and R = −0.81, respectively). Conclusions: Children recover faster than adults from neuromuscular blockade after administration of 1 mg · kg −1 rocuronium. The relationship between PTC and time to first response to TOF is exponential both in children and adults during recovery from neuromuscular blockade caused by rocuronium.

Spinal muscular atrophy type II (intermediary) and III (Kugelberg-Welander). Evolution of 50 patients with physiotherapy and hydrotherapy in a swimming pool.

We added hydrotherapy to 50 patients with spinal muscular atrophy (SMA) who were being treated with individual conventional physiotherapy. Hydrotherapy performed at an approximate temperature of 30 degrees Celsius, twice a week, for thirty minutes in children and forty-five minutes in adults during a 2-year period. The outcome derived from this combined modality of treatment was rated according to physiotherapeutic evaluations, the MMT (Manual Muscular Test), and the Barthel Ladder. Patients were reevaluated at 2-month intervals. After two years of ongoing treatment, we were able to observe that the deformities in hip, knee and foot were progressive in all SMA Type II patients, and in some Type III. Muscle strength stabilized in most SMA Type III patients, and improved in some. MMT was not done in SMA Type II. In all patients we were able to detect an improvement in the Barthel Ladder scale. This study suggests that a measurable improvement in the quality of daily living may be obtained in patients with SMA Types II and III subjected to conventional physiotherapy when associated with hydrotherapy.

Xylazine hydrochloride-ketamine hydrochloride immobilization of free-living red foxes (Vulpes vulpes) in Spain.

A combination of xylazine hydrochloride-ketamine hydrochloride was used to immobilize 83 wild red foxes (Vulpes vulpes) (15 pups and 68 adults) at Doñana National Park (Spain). Mean ketamine hydrochloride doses were 17.1 mg/kg (SE = 1.53) and 12.3 mg/kg (SE = 0.4) for pups and adults, respectively, and mean xylazine hydrochloride doses for the same groups were 6.2 mg/kg (SE = 0.63) and 4.7 mg/kg (SE = 0.14), respectively. Mean induction times and first reaction times were 1.6 minutes and 22.5 minutes for pups and 3.8 minutes and 39.4 minutes for adults, respectively. Recommended doses for wild adult foxes of unknown weight are 75 mg of ketamine hydrochloride and 20 mg of xylazine hydrochloride.

Response to heparinization in adults and children undergoing cardiac operations

The activated clotting time is an unreliable index of anticoagulation status during cardiopulmonary bypass procedures. However, modem instrumentation (Hemotec Hepcon HMS) now allows the monitoring of free heparin levels via automated protamine titration. In the present study, the standard procedure of anticoagulation at Killingbeck Hospital, Leeds, was investigated. Twenty-two pediatric patients and 20 adult patients undergoing open heart procedures involving cardiopulmonary bypass were given empirical doses of heparin (3 mg/kg body weight bolus), and activated clotting time was maintained at a level greater than 450 seconds using the Hemochron Timer. Heparin neutralization was performed at the termination of the bypass period using an empirical equivalent (3 mg/kg) of protamine sulfate. Mean free heparin concentration (± standard deviation) fell from 2.26 (± 0.45) mg/kg to 1.39 (± 0.34) mg/kg over the period 10 to 40 minutes on bypass in children. In adults, free heparin level declined from 2.56 (± 0.58) mg/kg to 1.81 (± 0.58) mg/kg over the same period. The biological half-life for heparin was 60 minutes in adults and 35 minutes in pediatric patients. Empirical protamine dosing resulted in excess protamine administration when compared with Hepcon titrated dose requirements: for children: median (range), 80 (12 to 350) versus 33 (12 to 97) mg, p < 0.001; and for adults: 350 (200 to 500) versus 130 (61 to 237) mg, p < 0.001. In conclusion, empirical heparin administration (3 mg/kg) does not result in “steady-state” anticoagulation during cardiopulmonary bypass, and empirical administration of protamine takes no account of interindividual differences in heparin sensitivity and biological half-life, which may be assessed using the Hepcon HMS.

Ｃｅｆｍｉｎｏｘの口蓋へん桃組織内への移行

Tissue transfer concentration of cefminox (CMNX) in the tonsil was measured in 10 adults and 8 children after tonsillectomy. One gram of CMNX was injected intravenously before tonsillectomy, and its concentrations in the tonsil and in the serum were measured after tonsil had been removed.1. In adults, mean CMNX concentration in the tonsil was 15.8μg/mg 40 to 120 minutes after administration. Tonsillar concentration was 33.1% of serum concentration.2. In children, mean CMNX concentration in the tonsil was 20.9μg/mg 25 to 100 minutes after sdministration. Tonsillar concentration was 17.4% of serum concentration.3. The half-life of CMNX in the serum was 115 minutes in adults and 83 minutes in children.CMNX is effective against a variety of bacteria. The present study proved that the administration of one gram of CMNX was sufficient to treat tonsillitis and peritonsillar abscess, since its concentration in the tonsil was above the MIC80 of most bacterial.