Short Recovery Period Research Articles

A comparative study of laparoscopic appendicectomy versus open appendicectomy

Background: Open appendicectomy has been safe and effective for acute appendicitis for more than a century. Recently, several authors proposed that the new technique of laparoscopic appendicectomy should be the treatment for acute appendicitis. Therefore, the aim of this study is to evaluate and compare laparoscopic appendicectomy with open appendicectomy in general surgical practice. Methods: This prospective randomized controlled study was carried out over a period from October 2012 to October 2015 in the department of general surgery K.P.C. Medical College and Hospital, Kolkata. Patients between 18 years and 60 years of age were candidates for randomization. The total population group included 144 patients with a mean age of 39 years. Results: Comparative studies of laparoscopic and open appendicectomy shows that hospital stay and wound infection rates are significantly lower after laparoscopic appendicectomy. As compared to laparoscopic appendicectomy prevalence of intra-abdominal abscess was less in open appendicectomy. Similarly, shorter operating time was found in patients randomized to open appendicectomy compared with laparoscopic appendicectomy. There were shorter period of convalescence and better cosmesis observed in the laparoscopic group. However, no single case of pneumonia was reported in the post-operative period in both appendicectomy. Conclusions: From the present study, we can conclude that laparoscopic appendicectomy has been shown to be both feasible and safe in comparison with open appendicectomy. However, because of the competition of laparoscopic and open appendicectomy, open appendicectomy has improved greatly. The benefit of laparoscopic appendicectomy over the open appendicectomy will be a question.

Producción más Limpia y Eficiencia Energética en una Industria de Lácteos

Dentro del proyecto del Centro Ecuatoriano de Eficiencia de Recursos y Producción más Limpia propuesto por el Ministerio de Industrias y Productividad, en convenio con la Organización de Naciones Unidas para el Desarrollo Industrial (ONUDI) y el Programa de Naciones Unidas para el Medio Ambiente (PNUMA) se realizó el proyecto de “Producción más Limpia y Eficiencia Energética en una Industria de Lácteos” durante el año 2014 con el propósito de analizar e implementar soluciones de mejora aplicando Producción más Limpia con la metodología de la ONUDI, donde se identificó oportunidades de optimización del uso de energía eléctrica y disminución del consumo de diésel. Se utilizó las siguientes metodologías: -Línea-base de la planilla eléctrica; manejo de DP y energía horas pico; aislamiento de tuberías de vapor; análisis termodinámico para retorno de condesado de yoguteras, marmita y pasteurizador; evaluación termodinámica de una cámara de refrigeración. Se logró identificar operaciones unitarias donde se cuantificó los parámetros que la caracterizan, desde el punto de vista económico, ambiental y tecnológico. Se propone mejoras con incidencia en el consumo eficiente de energía eléctrica, y consumo de diésel. Se demostró que con poca inversión se obtiene considerables ahorros anuales con un periodo corto de recuperación de la inversión.

Sleep Deprivation and Recovery Sleep Prior to a Noxious Inflammatory Insult Influence Characteristics and Duration of Pain.

Insufficient sleep and chronic pain are public health epidemics. Sleep loss worsens pain and predicts the development of chronic pain. Whether previous, acute sleep loss and recovery sleep determine pain levels and duration remains poorly understood. This study tested whether acute sleep deprivation and recovery sleep prior to formalin injection alter post-injection pain levels and duration. Male Sprague-Dawley rats (n = 48) underwent sleep deprivation or ad libitum sleep for 9 hours. Thereafter, rats received a subcutaneous injection of formalin or saline into a hind paw. In the recovery sleep group, rats were allowed 24 h between sleep deprivation and the injection of formalin. Mechanical and thermal nociception were assessed using the von Frey test and Hargreaves' method. Nociceptive measures were performed at 1, 3, 7, 10, 14, 17 and 21 days post-injection. Formalin caused bilateral mechanical hypersensitivity (allodynia) that persisted for up to 21 days post-injection. Sleep deprivation significantly enhanced bilateral allodynia. There was a synergistic interaction when sleep deprivation preceded a formalin injection. Rats allowed a recovery sleep period prior to formalin injection developed allodynia only in the injected limb, with higher mechanical thresholds (less allodynia) and a shorter recovery period. There were no persistent changes in thermal nociception. The data suggest that acute sleep loss preceding an inflammatory insult enhances pain and can contribute to chronic pain. The results encourage studies in a model of surgical pain to test whether enhancing sleep reduces pain levels and duration.

Supracostal Punctures for PCNL: Factors that Predict Safety, Success and Stone Free Rate in Stag Horn and Non-Stag Horn Stones: A Single Centre Experience and Review of Literature.

Supra-costal Percutaneous Nephrolithotomy (PCNL) procedure has now become an established standard of care in patients with renal stone disease, in terms of morbidity, stone clearance, duration of stay and shorter convalescence period. Gone are the days when supracostal punctures were considered to be associated with a high morbidity. With increased expertise gained in performing multiple punctures and further refinements in focusing techniques, more and more of these procedures are being performed with an intention to achieve a maximum stone clearance with least morbidity. To prospectively analyze the various factors that predict the safety, efficacy and stone clearance rate in patients who have undergo supracostal punctures for PCNL procedures. Three hundred seventy six patients underwent PCNL for renal stones. Ninety two (n=92) of them needed supra-costal puncture. All patients were subdivided into groups 1 and 2 based on the size, location of the stone and the stone burden. In all, 132 tracts were established. About 83% of patients achieved a complete stone free rate after initial PCNL. Stones more than 3 centimeters were found to be associated with significant residual stones. Radio opacity under image intensifier also had a significant impact on the ultimate stone free status. About 23% of those (n=5/22) who needed longer duration of surgery had a clinically significant residual stones, needing ancillary procedures. Fifteen patients (16%) had complications related to the procedure, of which 13 were in group 1 (87%). High percentage of complications in patients with larger stone burden was found to be statistically significant. In about 76% (n=70), the procedure required only less than 90 minutes. Also, in those 22 patients in whom the duration of procedure exceeded 90 minutes, 12 of them had complications, with a p-value of <0.0001. Supra-costal punctures are safe and effective options in a selected group of patients. The overall results are almost on par with that of the infra costal punctures, with an acceptable morbidity.

Usability of carbonated high-carbohydrate beverage during short term recovery period in athletes

Usability of carbonated high-carbohydrate beverage during short term recovery period in athletes

Pilonidal sinus disease can be treated with crystallized phenol using a simple three-step technique.

Pilonidal sinus disease can be treated with various surgical techniques. However, invasive surgical techniques harbor the risk of wound infection and require a long postoperative wound healing period. The treatment of pilonidal sinus disease with crystallized phenol is minimally invasive with a short postoperative recovery period. This article explains how to treat pilonidal sinus disease with crystallized phenol using a quick and easy three-step technique. Between August 2014 and January 2016, 43 male and 7 female patients with pilonidal sinus disease were treated with crystallized phenol. Hair was gently removed from the sinus openings with a mosquito clamp. Afterwards, the pilonidal sinus openings were gently filled with crystallized phenol. The closure of pilonidal sinus openings without any leakage after a single application of crystallized phenol was accepted as healing. The treatment failed in two of the female patients, who had had prior pilonidal sinus surgery, and in four of the male patients, who had a recurrence after wound site infection. The overall cure rate was 88%. Treatment of pilonidal sinus disease with crystallized phenol using the three-step technique is simple, fast, and comfortable. Therefore, crystallized phenol should be preferentially considered in the treatment of pilonidal sinus disease.

Influence of beetroot juice supplementation on intermittent exercise performance.

PurposeThis study tested the hypothesis that nitrate (NO3−) supplementation would improve performance during high-intensity intermittent exercise featuring different work and recovery intervals. MethodTen male team-sport players completed high-intensity intermittent cycling tests during separate 5-day supplementation periods with NO3−-rich beetroot juice (BR; 8.2 mmol NO3− day−1) and NO3−-depleted beetroot juice (PL; 0.08 mmol NO3− day−1). Subjects completed: twenty-four 6-s all-out sprints interspersed with 24 s of recovery (24 × 6-s); seven 30-s all-out sprints interspersed with 240 s of recovery (7 × 30-s); and six 60-s self-paced maximal efforts interspersed with 60 s of recovery (6 × 60-s); on days 3, 4, and 5 of supplementation, respectively.ResultPlasma [NO2−] was 237 % greater in the BR trials. Mean power output was significantly greater with BR relative to PL in the 24 × 6-s protocol (568 ± 136 vs. 539 ± 136 W; P < 0.05), but not during the 7 × 30-s (558 ± 95 vs. 562 ± 94 W) or 6 × 60-s (374 ± 57 vs. 375 ± 59 W) protocols (P > 0.05). The increase in blood [lactate] across the 24 × 6-s and 7 × 30-s protocols was greater with BR (P < 0.05), but was not different in the 6 × 60-s protocol (P > 0.05).ConclusionBR might be ergogenic during repeated bouts of short-duration maximal-intensity exercise interspersed with short recovery periods, but not necessarily during longer duration intervals or when a longer recovery duration is applied. These findings suggest that BR might have implications for performance enhancement during some types of intermittent exercise.

Appropriate selection is essential for achieving satisfactory outcomes in laparoscopic colonic resections in emergency settings

Dear Editor: Laparoscopic colectomy is increasingly accepted as the standard of care in the elective setting for both benign and malignant colorectal diseases. The most recent National Bowel Cancer Audit reported an uptake of just over 40 %. The use of laparoscopy in colorectal resection for cancer has been recommended by the National Institute for Healthcare and Clinical Excellence (NICE), provided it is performed by appropriately trained surgeons. Many randomised prospective studies have demonstrated the short-term benefits of laparoscopic over open colectomy for elective surgery. These include short recovery periods, early regaining of bowel function and short hospital stay, with comparable morbidity, mortality and recurrence rates [1–3]. The role of laparoscopy for emergency colorectal resection and its potential benefits remain controversial. The available studies in the literature compare the outcomes of emergency laparoscopic procedures with emergency open procedures. To the best of our knowledge, there have been no publications comparing outcomes of emergency with elective laparoscopic colectomy. We conducted a study is to examine the use of minimally invasive laparoscopic techniques in carefully selected emergency colorectal procedures and to assess its safety and feasibility when compared with elective surgery, and to assess the outcome when compared with emergency open colectomy. This is a retrospective study of a prospectively collected database. Research ethics committee approval was waived. A literature search was performed to assess the current evidence in laparoscopic emergency colectomy. The entire Ovid database was searched with the keywords Blaparoscopic^, Bcolectomy^ and Bemergency , and these were combined with the set operator BAND^. The search was completed on 19 June 2015. Thirty-one results were found and screened. Papers that were case series, case-control, cohort or randomised controlled trials of the use of emergency laparoscopic colectomy in adults were included. Fourteen papers did not meet the inclusion criteria and 9 were duplicates. All patients who underwent emergency laparoscopic colectomy, performed by one surgeon in a single district general hospital, between 2008 and 2014 were identified. Emergency open colectomy data was collected retrospectively by searching the theatre electronic coding system for the terms Bcolectomy^ and/or BHartmann’s^. The selection criteria for emergency laparoscopic surgery were a stable patient, being fit for laparoscopic procedure and the availability of experienced surgical and nursing staff. Patients with marked small-bowel dilatation or severe sepsis were excluded. Patients who underwent laparoscopic appendicectomy and laparoscopic stoma were excluded from the database. Emergency colectomy included both lifethreatening cases, booked on the emergency list as soon as possible, and urgent surgery which was defined as needed to occur before discharge of the patient. Data collected included age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) score, admission date, operation date, operation type, ICU admission, re-operation, morbidity and mortality. Statistical analysis was performed using Fisher’s exact test for categorical data and Student t test for numerical data. A total of 347 laparoscopic colectomies were performed between 2002 and 2014, of which 321 were elective. Twenty-six emergency procedures were performed after * N. Naguib nadernaguib71@yahoo.com

Moral Hazard in Monday Claim Filing: Evidence from Spanish Sick Leave Insurance

Abstract The Monday effect on workers’ compensation insurance shows that there is a higher proportion of hard-to-diagnose injuries the first day of the week. The aim of this paper is to test whether the physiological hypothesis or the economic explanation is more satisfactory to understand this Monday effect and, if both are correct, to obtain an estimation of the magnitude of each of them. To do this, we exploit the singular legal regulation of Spanish sick leave benefits and use this country as a “laboratory”. Our econometric analysis detects and measures a hard-to-diagnose reporting gap on Mondays by about 6.5 percentage points due to physiological reasons and up to 1.4 percentage points attributable to moral hazard for those injuries with a short recovery period.

Using a multi-criteria approach to assess post-release recovery periods in behavioural studies: study of a fish telemetry project in the Seine Estuary

Biotelemetry has many advantages for monitoring fish behaviour. However, the accuracy of results can be impacted by changes in fish behaviour following tagging and other forms of human intervention. Different fish take different amounts of time to return to normal behaviour patterns. This recovery period is often difficult to assess. In many studies, it is simply ignored, while in others an assumed duration is used. This assumption is rarely based on objective criteria. To address this challenging aspect of fish telemetry, a multi-criteria stepwise approach was developed based on complementary criteria obtainable through prior knowledge of the normal behaviour of studied species (home range, diel rhythm, homing, shoaling, migration…). It was applied to the case study of an acoustic telemetry project in the Seine Estuary (France) for three estuarine species exhibiting contrasted ecological traits: European eel Anguilla anguilla (Linnaeus 1758), thin lipped grey mullet Liza ramada (Risso 1827) and bream Abramis brama (Linnaeus 1758). Taking into account the particular traits of the species studied, we used the following three criteria: time to return to core area of activity, time to return to rhythmic activity, and time to return to site of capture. Post-release periods of recovery varied greatly between species. The median value was 10 days for eel, 25 days for mullet, and 1 day for bream. During this period, eels moved very little and the schedule pattern presented a diel rhythm with most detections occurring at night. All mullet exhibited rapid downstream trajectories after release, with larger distances covered during the ebb. Only five individuals returned later to the study site. This behaviour turns out to be not only an effect of post-release stress, but also the result of normal shifts in feeding habitat use by large shoals of mullet. Common bream exhibit very short periods of recovery with strong site fidelity. Most of the individuals of the different species (72%) return to their site of capture. The approach allows the identification of individual periods of recovery specific to the species and environment being studied. It maximises the amount of conserved data representing normal behaviour and can be implemented with various types of tracking data. Analysis of this period provides additional information about the stress response of species and their associated behaviour.

Effects of seated lumbar extension postures on spinal height and lumbar range of motion during prolonged sitting

Prolonged sitting during sedentary work has been reported as a potential risk factor for low back pain. Furthermore, prolonged sitting can result in both reduced spinal height (SH) and lumbar range of motion (LROM). This study compared the effects of no intervention (control) with two recovery postures on SH and LROM (flexion and extension) during prolonged sitting. Twenty-four participants were randomly assigned to three interventions for three consecutive days. The interventions comprised two seated lumbar extension recovery postures (unsupported sustained and supported dynamic lumbar extension postures) and a control. Both interventions facilitated a relatively short recovery period for both SH and LROM. Supported dynamic lumbar extension conditions significantly helped SH recovery, as compared with control condition, after the first recovery posture intervention, and both postures have potential to maintain LROM. However, both postures failed to induce SH recovery over an extended time.

Vagus nerve stimulation for the treatment of refractory epilepsy

Abstract Vagus nerve stimulation (VNS) represents one of the main surgical options for the treatment of the refractory epilepsy in pediatric and adult patients. There are several mechanism involved in vagal nerve stimulation which could influence the pathophysiology of seizures like neuromodulation of the thalamic and subthalamic nuclei involved in seizure initiation and the modulation of the neurotransmitters pattern norepinefrin, GABA, and serotonin. The VNS system is composed of the implanted components (the generator, the lead with the electrodes attached) and the programming system components (programming wand and handheld computer). The authors present their experience with 81 patients diagnosed with refractory epilepsy, investigated, selected and implanted with vagal neurostimulators between December 2012 and January 2015 in Neurosurgery Clinic, "Bagdasar-Arseni" Emergency Hospital. The surgical technique and the potential pitfalls are described in detail. There were 20 children (24,7%) and 61 (75,3%) adults in this series. There was no death in this series and no intraoperative incidence. One patient presented dysphagia postoperatively which completely remitted after two months of follow-up. The outcome in term of seizure frequency and severity was better for patients under 30 years compared with patients older than 30 years. VNS represents now a safe, quick and efficient surgical procedure with a minimum period of hospitalization and a short recovery period. The good results on long term improve the quality of life of the patients and facilitate the social and professional reinsertion

Blood lactate removal after a rowing all-out test depends on the active protocol proposed

Summary Aims In sports competition recovery is considered fundamental, especially in those modalities that require competing repeatedly within one contest. One of the main concerns regarding the short recovery period during repeated-based competitions is the accumulation of blood lactate, which may impair muscle function on a metabolic basis. Therefore, the aim of this study was to compare the lactate concentration ([Lac]) removal rate with different recovery active protocols after an all-out rowing test. Materials and methods The participants were chosen at random from the Naval School and subjected to four removal protocols (rowing, cycling, running and complete rest). Blood lactate samples were taken at rest and subsequent to the all-out test (0, 5, 10, 15, 20, 25 and 30 min). Results and conclusion At minute 20, the running protocol presented similar blood [Lac] values as resting sample, whereas rowing reached it on 25, and cycling on 30 min. Additionally, a passive 30 min rest after the last blood sampling indicated that all protocols were able to reduce the blood [Lac] to rest values, including the resting group. In this sense, this study indicates that different active protocols induce a faster blood [Lac] removal after high-intensity rowing. Finally, treadmill running may be a feasible tool to boost blood [Lac] removal after rowing trials within the same competition.

Short-term Changes In Dietary Pattern Following Glycogen Depletion And Post-exercise Supplementation

Post-exercise chocolate milk consumption has been shown to improve subsequent endurance exercise performance following a short recovery period with limited food availability, presumably due to added carbohydrate (CHO) and protein (PRO). It is unclear how post-exercise nutrition strategies affect subsequent dietary intake when the duration of recovery is prolonged and diet is not restricted. PURPOSE: To examine the influence of post-exercise supplementation of CHO and PRO on the quantity and timing of macronutrient consumption during a 30-h recovery period. METHODS: Twelve trained, male cyclists (21.7 ± 1.8 y, 63.0 ± 4.1 ml·kg-1·min-1) carried out a glycogen-depleting exercise bout followed by a 2-h supplementation period and 28 h of free-living recovery. During 2-h supplementation, subjects consumed equal volume of reduced-fat chocolate milk (CM; 2.0 g of CHO·kg-1, 0.5 g of PRO·kg-1) or a sports beverage (SB; 0.8 g of CHO·kg-1, 0 g of PRO·kg-1) in a single-blind, randomized design. Following supplementation, individuals’ food log was recorded during the remaining 28-h recovery. Two-way repeated measures ANOVA was performed to examine the effects of treatment and time on the voluntary food intake. If a significant interaction effect was detected, paired t-test was used to compare the treatments at each time point. RESULTS: Total food intake over the 28-h free-living recovery did not differ (CM: 63.6 ± 2.9 kcal·kg-1, 8.0 ± 0.5 g CHO·kg-1, 2.4 ± 0.1 g fat·kg-1, 2.6 ± 0.2 g PRO·kg-1, SB: 68.3 ± 4.3 kcal·kg-1, 8.5 ± 0.5 g CHO·kg-1, 2.5 ± 0.2 g fat·kg-1, 2.9 ± 0.3 g PRO·kg-1). However, a significant interaction effect (treatment × time) revealed that eating patterns were different between the two treatments during the initial 12 h of the free-living recovery period, indicating that the SB group consumed a relatively large portion of food in the early phase of recovery and gradually reduced their intake to the end of the day. By contrast, the modified pattern was not observed during remaining recovery period. CONCLUSIONS: Athletes’ dietary behavior can be altered by ingesting supplements following strenuous exercise for hours but this effect does not last long enough to change the daily food intake as a whole.

Reliability of VEP Recordings Using Chronically Implanted Screw Electrodes in Mice.

Visual evoked potentials (VEPs) are widely used to objectively assess visual system function in animal models of ophthalmological diseases. Although use of chronically implanted electrodes is common in longitudinal VEP studies using rodent models, reliability of recordings over time has not been assessed. We compared VEPs 1 and 7 days after electrode implantation in the adult mouse. We also examined stimulus-independent changes over time, by assessing electroencephalogram (EEG) power and approximate entropy of the EEG signal. Stainless steel screws (600-μm diameter) were implanted into the skull overlying the right visual cortex and the orbitofrontal cortex of adult mice (C57Bl/6J, n = 7). Animals were reanesthetized 1 and 7 days after implantation to record VEP responses (flashed gratings) and EEG activity. Brain sections were stained for glial activation (GFAP) and cell death (TUNEL). Reliability analysis, using intraclass correlation coefficients, showed VEP recordings had high reliability within the same session, regardless of time after electrode implantation and peak latencies and approximate entropy of the EEG did not change significantly with time. However, there was poorer reliability between recordings obtained on different days, and a significant decrease in VEP amplitudes and EEG power. This amplitude decrease could be normalized by scaling to EEG power (within-subjects). Furthermore, glial activation was present at both time points but there was no evidence of cell death. These results indicate that VEP responses can be reliably recorded even after a relatively short recovery period but decrease response peak amplitude over time. Although scaling the VEP trace to EEG power normalized this decrease, our results highlight that time-dependent cortical excitability changes are an important consideration in longitudinal VEP studies. This study shows changes in VEP characteristics over time in chronically implanted mice. Thus, future preclinical longitudinal studies should consider time in addition to amplitude and latency when designing and interpreting research.

Сравнительная оценка влияния ремаксола и адеметионина на клиническое течение и динамику показателей углеводного и белкового обмена у больных с острыми отравлениями этанолом на фоне алкогольных поражений печени

Целью настоящей работы явилась сравнительная оценка результатов использования метионинсодержащих гепатопротекторов ремаксола и адеметионина при лечении пациентов с острыми отравлениями этанолом на фоне алкогольных поражений печени. В исследование включены 92 больных. Полученные результаты свидетельствуют о более высокой эффективности гепатопротекторных препаратов, действующих комплексно, на функциональное состояние печени и одновременно снижающих степень метаболических расстройств. Данные эффекты, в свою очередь, сказываются на более благоприятном течении острых отравлений этанолом, что реализуется снижением частоты развития осложнений, а также сокращением сроков лечения.

Transcatheter aortic valve implantation: emerging role in poor left ventricular function severe aortic stenosis?

Surgical aortic valve replacement (AVR) has long been recognized as the gold standard treatment for symptomatic severe aortic stenosis improving symptoms, survival and functional class. Recently, transcatheter aortic valve implantation (TAVI) has also become an established procedure for the treatment of higher risk patients with symptomatic severe aortic stenosis.1 These include the frail, elderly patient with multiple co-morbidities and disabilities. TAVI has been shown to successfully reduce aortic valve gradients to a similar degree as conventional AVR but the incidence of paravalvular aortic regurgitation (AR) is significantly higher.2, 3 Compared to conventional AVR, TAVI has a shorter recovery period, avoids a sternotomy and cardiopulmonary bypass, and has a lower risk of bleeding, acute kidney injury, atrial fibrillation and early mortality, but the risk of vascular complications, pacemaker implantations and cardiac perforations are higher.1, 3 Stroke rates were initially reported to be higher following TAVI compared to conventional AVR but recent studies suggest no difference in stroke rates.3

Patterns of late spring frost leaf damage and recovery in a European beech (Fagus sylvatica L.) stand in south-eastern Germany based on repeated digital photographs.

Damage by late spring frost is a risk deciduous trees have to cope with in order to optimize the length of their growing season. The timing of spring phenological development plays a crucial role, not only at the species level, but also at the population and individual level, since fresh new leaves are especially vulnerable. For the pronounced late spring frost in May 2011 in Germany, we studied the individual leaf development of 35 deciduous trees (mainly European beech Fagus sylvatica L.) at a mountainous forest site in the Bayerischer Wald National Park using repeated digital photographs. Analyses of the time series of greenness by a novel Bayesian multiple change point approach mostly revealed five change points which almost perfectly matched the expected break points in leaf development: (i) start of the first greening between day of the year (DOY) 108–119 (mean 113), (ii) end of greening, and (iii) visible frost damage after the frost on the night of May 3rd/4th (DOY 123/124), (iv) re-sprouting 19–38 days after the frost, and (v) full maturity around DOY 178 (166–184) when all beech crowns had fully recovered. Since frost damage was nearly 100%, individual susceptibility did not depend on the timing of first spring leaf unfolding. However, we could identify significant patterns in fitness linked to an earlier start of leaf unfolding. Those individuals that had an earlier start of greening during the first flushing period had a shorter period of recovery and started the second greening earlier. Thus, phenological timing triggered the speed of recovery from such an extreme event. The maximum greenness achieved, however, did not vary with leaf unfolding dates. Two mountain ashes (Sorbus aucuparia L.) were not affected by the low temperatures of -5°C. Time series analysis of webcam pictures can thus improve process-based knowledge and provide valuable insights into the link between phenological variation, late spring frost damage, and recovery within one stand.

Comparison of Dexmedetomidine Versus Ketamine-Propofol Combination for Sedation in Cataract Surgery.

The aim of this study is to compare the sedative properties and haemodynamic and respiratory effects of dexmedetomidine and a ketamine-propofol combination (ketofol), which are expected to have minimal effects on spontaneous breathing. Sixty patients were enrolled in this prospective randomised study. Patients were divided into 2 groups according to the administration of dexmedetomidine (Group D) and ketofol (Group K). Target sedation level was determined as a Ramsay Sedation Score of 3. In Group D, 0.5 mcg kg(-1) dexmedetomidine was administered via intravenous route in 10 minutes versus 0.125 mL kg(-1) of a solution containing 200 mg propofol and 100 mg ketamine in Group K. Haemodynamic and respiratory effects, postoperative awakening time, analgesic properties and satisfaction levels of the patients and surgeon were assessed. There was a statistically significant decrease in mean arterial pressures following drug administration compared to initial measurements in both groups. However, there was a statistically significant decrease in heart rate only in Group D. There was no significant difference between the two groups regarding respiratory rate and protection of spontaneous respiration. Although the time for Aldrete score to be 9 was 16.1 minutes for Group K, it was 24.9 minutes for Group D, and this difference was statistically significant (p<0.01). There was no significant difference between the two groups regarding adverse effects, pain scores and satisfaction levels of the patients and surgeon. Compared to dexmedetomidine, at similar sedation levels, sedation provided by ketofol enables satisfactory analgesia. Moreover, ketofol has a more rapid onset of action and a shorter recovery period from anaesthesia without causing significant haemodynamic or respiratory adverse effects.

Can analysis of performance and neuromuscular recoveries from repeated sprints shed more light on its fatigue-causing mechanisms?

Can analysis of performance and neuromuscular recoveries from repeated sprints shed more light on its fatigue-causing mechanisms?