Gastric bypass and On-Q pump: effectiveness of Soaker Catheter system on recovery of bariatric surgery patients

BackgroundThe continuous infusion of ropivacaine is effective in controlling pain for a wide variety of surgical procedures and reducing opioid adverse effects and dependency. The present study assessed the efficacy of ropivacaine infusion using the I-Flow dual Soaker Catheter system at the surgical site for bariatric surgery recovery at the Dallas Veterans Affairs Medical Center Hospital (Dallas, TX). We hypothesized that patients receiving ropivacaine would report lower levels of morphine requirement and pain, would have shorter hospital stays, and would return to ambulating faster than patients in the control group.MethodsA total of 45 patients undergoing Roux-en-Y gastric bypass surgery were randomized to 1 of 2 treatment groups, with a target study population of 50 patients, receiving either .2% ropivacaine (n = 24) or saline solution (n = 21). Before incision closure, the surgeon infiltrated the surrounding tissues with 30 mL of ropivacaine (.5%) or saline solution. The catheter was then placed in both the subfascial space and subcutaneously. Next, the infusion pump was connected to the Soaker Catheters to complete the system design and deliver solution to the surgical site.ResultsNo significant differences were found in the pain scores, morphine requirement, or length of stay between the 2 groups. The ropivacaine group interval to sitting up was one half day shorter than that of patients receiving saline (P = .038).ConclusionsPatients receiving ropivacaine were found to ambulate much more quickly than did the control group patients. This could be very beneficial in reducing the complications from blood clots and improving patient recovery and overall well-being after surgery by assisting with a quicker return to activities of daily living and reducing the dependence on the nursing staff.     

Analysis of the in vitro antibacterial action of a fluoridated amalgam

To a conventional silver amalgam alloy was added 1% of stanous fluoride, to prove in vitro, if it presents any antibacteria actions against S. mutans and Lactobacillus acidophilus. Thirteen Petri plate were seeded with S. mutans and 12 Petri plate with Lactobacillus, in both cases, was disposited fluoride containing amalgam and conventional amalgam. The average of inhibition signs in the Petri plates with S. mutans was 1.7 mm in the Petri plates with Lactobacillus the average was 2.4 mm. Is demonstrated that the fluoride containing amalgam has in vitro antibacteria action in comparison with conventional amalgam, that has none.     

Effects of sprint and endurance training on passive stress-strain relation of fast- and slow-twitch skeletal muscle in Wistar rat.

We investigated the effects of endurance and sprint training on the passive mechanical properties of fast-twitch (FT) and slow-twitch (ST) skeletal muscles. Eight-week-old male Wistar rats (n=18) were divided into three groups: control (C), sprint-trained (S) and endurance-trained (E). The trained animals exercised for 10 weeks on a treadmill. Under anaesthesia, Plantaris and Soleus muscles were deformed cyclically in vivo at 0.33 mm x s(-1) with length increments of 1 mm in successive cycles until rupture. The rupture of muscle occurs at belly. Stress-strain relation were constructed using the maximum stress and maximum strain in each cycle. The data were fitted to an S-shaped curve. The curve-fitting parameters for trained and untrained muscles showed significant statistical differences. Stress and strain at rupture and maximum deformation energy were statistically greater for trained ST muscles (both groups) than for the controls. The changes induced by the present training protocols were not significant in Plantaris. The above results suggest the plasticity of passive structure caused by activity-demands.     

Study of ventricular function by means of echocardiographic quantification of the thickness/radius (h/r) ratio of the left ventricle in healthy subjects

We studied 72 healthy subjects; 31 of them were adults and 41 children. By means of two-dimensional echocardiography we obtained a short axis view at the papillary muscle level of the ratio of the thickness (h) of the ventricular wall and the radius (r) of the cavity. We analysed ventricular performance determinants (pre-load, after-load and contractility). This non-invasive method gives information similar to pressure-volume curves. Thus, we propose it for the study of left ventricular overloads.     

Oxidation of methylamine and ethylamine on Pt single crystal electrodes in acid medium

Cyclic voltammetry (CV) and Fourier transform infrared reflection-absorption spectroscopy (FT-IRRAS) have been combined to analyse the oxidation of methylamine and ethylamine on platinum single crystal electrodes in an acidic medium. The oxidation of both amines on Pt(hkl) electrodes gives rise to the formation of adsorbed cyanide ad-layers, which have been detected by in situ infrared spectroscopy. In the case of Pt(111) the resulting adsorbed cyanide is rather stable but, on the contrary, the adsorbed CN-like species is highly reactive on Pt(100). It yields either adsorbed NO and CO₂ when the electrode is polarised above 0.7 V or adsorbed CO below 0.4 V. The detection of adsorbed cyanide is difficult to achieve at the Pt(110) surface. In the case of ethylamine, these adsorbed species are present in lower coverage than for methylamine. The substitution of one hydrogen atom by a methyl group in the methylamine makes the amine molecule more stable. So, the behaviour of ethylamine provides evidence for its lower electrochemical reactivity when compared with that of the methylamine molecule.     

Anxiety and depression as risk factors for oral lichen planus.

BACKGROUND: Stress and anxiety have frequently been mentioned as possible factors related to the development of oral lichen planus (OLP), although this association remains controversial. OBJECTIVE: To determine whether anxiety and depression constitute risk factors in the development of OLP. MATERIAL AND METHODS: Eighty patients diagnosed as having OLP were studied: anxiety was evaluated by the Hamilton Anxiety Scale and depression with the Montgomery-Asberg Depression Rating Scale. The results were contrasted with those obtained in a control series of the same number of subjects (n = 80) matched for age and sex. RESULTS: Significantly greater anxiety and depression were observed among patients with OLP than in the control group. Odds ratios of 2.8 and 4.4 were obtained for anxiety and depression, respectively. CONCLUSION: Our findings suggest that anxiety and depression constitute risk factors that could influence the development of OLP.     

The role of maintenance therapy in the treatment of large-cell non-Hodgkin's lymphoma.

Eighty-one patients with large-cell non-Hodgkin's lymphoma achieving complete restaging verified remission after induction chemotherapy (CHOP-Bleo or m-BACOD) were randomized to the following 3 arms: 1. No further treatment (observation). 2. Early consolidation therapy with 6 courses of CVP (cyclophosphamide, vincristine, prednisone) given monthly. 3. Maintenance therapy with cyclophosphamide and prednisone given every 6 weeks for 2 years. The relapse-free survival was better in the maintenance and consolidation arms than in the observation arm. The additional therapy given after the initial complete remission produced lasting disease control in a considerable number of patients and with acceptable toxicity. The authors feel that patients with large-cell lymphoma do not need more aggressive and toxic initial management because the use of maintenance therapy can increase the number of patients remaining in complete remission by more conventional, less toxic chemotherapy.