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Positive Matrix Factorization-PMF was applied to hourly resolved elemental composition of fine (PM0.15-1.15) and coarse (PM1.15-10) aerosol particles to apportion their sources in the airshed of residential district, Ostrava-Radvanice and Bartovice in winter 2012. Multiple-site measurement by PM2.5 monitors complements the source apportionment. As there were no statistical significant differences amongst the monitors, the source apportionment derived for the central site data is expected to apply to whole residential district. The apportioned sources of the fine aerosol particles were coal combustion (58.6%), sinter production-hot phase (22.9%), traffic (15%), raw iron production (3.5%), and desulfurization slag processing (<0.5%) whilst road dust (47.3%), sinter production-cold phase (27.7%), coal combustion (16.8%), and raw iron production (8.2%) were resolved being sources of the coarse aerosol particles. The shape and elemental composition of size-segregated aerosol airborne-sampled by an airship aloft presumed air pollution sources helped to interpret the PMF solution.

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Peripheral neuropathic pain (PNP) poses a significant clinical challenge. The long-term efficacy of delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray was investigated in this 38-week open-label extension study. In total, 380 patients with PNP associated with diabetes or allodynia entered this study from two parent randomised, controlled trials. Patients received THC/CBD spray for a further 38 weeks in addition to their current analgesic therapy. Neuropathic pain severity was the primary efficacy measure using a pain 0-10 numerical rating scale (NRS). Additional efficacy, safety and tolerability outcomes were also investigated. In total, 234 patients completed the study (62 %). The pain NRS showed a decrease in score over time in patients from a mean of 6.9 points (baseline in the parent studies) to a mean of 4.2 points (end of open-label follow-up). The proportion of patients who reported at least a clinically relevant 30 % improvement in pain continued to increase with time (up to 9 months); at least half of all patients reported a 30 % improvement at all time points. Improvements were observed for all secondary efficacy outcomes, including sleep quality 0-10 NRS scores, neuropathic pain scale scores, subject global impression of change and EQ-5D questionnaire scores. THC/CBD spray was well tolerated for the study duration and patients did not seek to increase their dose with time, with no new safety concerns arising from long-term use. In this previously difficult to manage patient population, THC/CBD spray was beneficial for the majority of patients with PNP associated with diabetes or allodynia.

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BACKGROUND: Peripheral neuropathic pain (PNP) associated with allodynia poses a significant clinical challenge. The efficacy of Δ(9) -tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray, a novel cannabinoid formulation, was investigated in this 15-week randomized, double-blind, placebo-controlled parallel group study. METHODS: In total, 303 patients with PNP associated with allodynia were screened; 128 were randomized to THC/CBD spray and 118 to placebo, in addition to their current analgesic therapy. The co-primary efficacy endpoints were the 30% responder rate in PNP 0-10 numerical rating scale (NRS) score and the mean change from baseline to the end of treatment in this score. Various key secondary measures of pain and functioning were also investigated. RESULTS: At the 30% responder level, there were statistically significant treatment differences in favour of THC/CBD spray in the full analysis (intention-to-treat) dataset [p = 0.034; 95% confidence interval (CI): 1.05-3.70]. There was also a reduction in mean PNP 0-10 NRS scores in both treatment groups that was numerically higher in the THC/CBD spray group, but which failed to reach statistical significance. Secondary measures of sleep quality 0-10 NRS score (p = 0.0072) and Subject Global Impression of Change (SGIC) (p = 0.023) also demonstrated statistically significant treatment differences in favour of THC/CBD spray treatment. CONCLUSIONS: These findings demonstrate that, in a meaningful proportion of otherwise treatment-resistant patients, clinically important improvements in pain, sleep quality and SGIC of the severity of their condition are obtained with THC/CBD spray. THC/CBD spray was well tolerated and no new safety concerns were identified.

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The bilinear receptor model positive matrix factorization (PMF) was used to apportion particulate matter with an aerodynamic diameter of 1-10 microm (PM1-10) sources in a village, Brezno, situated in an industrial region of northern Bohemia in Central Europe. The receptor model analyzed the data sets of 90- and 60-min integrations of PM1-10 mass concentrations and elemental composition for 27 elements. The 14-day sampling campaigns were conducted in the village in summer 2008 and winter 2010. Also, to ensure seasonal and regional representativeness of the data sets recorded in the village, the spatial-temporal variability of the 24-hr PM10 and PM1-10 within 2008-2010 in winter and summer across the multiple sites was evaluated. There were statistically significant interseasonal differences of the 24-hr PM data, but not intrasummer or intrawinter differences of the 24-hr PM1-10 data across the multiple sites. PMF resolved seven sources of PM1-10. They were high-temperature coal combustion; combustion in local heating boilers; marine aerosol; mineral dust; primary biological/wood burning; road dust, car brakes; and gypsum. The main summer factors were assigned to mineral dust (38.2%) and primary biological/wood burning (33.1%). In winter, combustion factors dominated (80%) contribution to PM1-10. The conditional probability function (CPF) helped to identified local sources of PM1-10. The source of marine aerosol from the North Sea and English Channel was indicated by the Hybrid Single Particle Lagrangian Integrated Trajectory Model (HYSPLIT).

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Results of field tests with explosive dispersal of a radioactive substance (RaS) are presented. The paper deals with tests exploiting artificial obstacles as a continuation and expansion of the tests used in this study performed in free area described previously. The essential goal of the tests was to estimate the distribution of the released RaS in the case of intentional abuse of radioactive sources and to get a set of data applicable to testing physical or mathematical models of propagation. Effects of different geometrical and meteorological conditions on the distribution of dispersed RaS were studied via the assessment of dose rate, surface and volume activities, aerosol mass and activity aerodynamic diameters. The principal results can be summarised as follows: the prevalent proportion of the activity of the radionuclide dispersed by an explosion (born by the blast wave and by air convection) is transferred to the detection system/collecting pads essentially within the first minute. Enhanced aerosol mass concentrations were also detected within the same period. The RaS carried by the blast wave passed through the polygon (50 m) within <1 s. An expected crucial impact of meteorological conditions at the moment of the explosion and shortly after was proved by the tests.

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During recent years, the assessment of possible radiological consequences of a terrorist attack associated with a release of radioactive substances (RaS) has been in the focus of interest of emergency preparedness and radiation protection specialists, as well as experts dealing with the dispersion of harmful substances in the atmosphere. Suitable tools for these analyses are applications of mathematical and physical models and simulation of this attack under 'realistic' conditions. The work presented here summarises the results of four tests, in which a RaS (a Tc-99 m solution) was dispersed over a free area with the use of an industrial explosive. Detection methods and techniques employed in these tests are described and values characterising the RaS dispersion--dose rates, surface activities in horizontal and vertical directions, volume activities, their space and time distributions and mass concentrations of aerosols produced after the explosion are presented and compared. These data will be applied to a comparison of outcomes of models used for the assessment of radiation accidents as well as in future field tests carried out under conditions of more complex geometry (indoor environment, terrain obstacles, etc.).

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UNLABELLED: We performed this randomized, double-blind, placebo-controlled study to determine whether reversal of neuromuscular block with neostigmine increases the incidence and severity of postoperative nausea and vomiting (PONV). We studied 162 women undergoing abdominal hysterectomy and randomly allocated them into two groups. In Group A, neuromuscular block produced with mivacurium was antagonized with neostigmine 2.0 mg and glycopyrrolate 0.4 mg intravenously, whereas Group B received no drugs to facilitate antagonism of blockade. The incidence and severity of PONV was assessed up to 27 h after the operation. There was no difference in PONV between the groups (in Group A 35% had nausea and 33% vomited; in Group B 28% nauseated and 40% vomited) or in the amount of antiemetics given. We had a 75% chance to find a 30% difference in PONV. We conclude that the administration of neostigmine and glycopyrrolate at the end of anesthesia to reverse neuromuscular block does not increase the incidence or severity of PONV. IMPLICATIONS: Neostigmine may increase postoperative nausea and vomiting. In this study, omission of reversal of neuromuscular block with neostigmine failed to decrease the incidence or severity of postoperative nausea and vomiting.

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Excitatory synapses were studied in the dentate gyrus ipsilateral to stimulated entorhinal cortex in fully kindled rats 2 weeks after the last (3rd) stage 5 seizure. In previous studies of the same model marked redistribution of synaptic vesicles to a 'strategic position' in the vicinity of the synaptic cleft and a significant enlargement of postsynaptic element were described. In this study the size and shape of synaptic vesicles were evaluated in three zones parallel to the presynaptic membrane of the synaptic cleft. The first zone (0.1 micron) directly adjoined the active zone of presynaptic membrane, the second was from 0.1 to 0.2 micron and the third from 0.2 to 0.3 micron from the presynaptic membrane. The vesicles of both the experimental and control animals were significantly smaller in zone I than in zone II and III and, in the control animals there was a tendency of vesicles to diminish towards the active zone. Such a tendency was not observed in the experimental animals, the largest vesicles were in the middle of zone II and were significantly more rounded in comparison to the vesicles in the controls. On the contrary, the vesicles in zone I and III were more elongated in the experimental animals than in controls. Our results may be taken as a sign of active reconstruction of synaptic apparatus in relation to increased functional readiness of the synapses. Possible mechanisms as well as significance for the kindling and epileptogenesis are discussed.

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Ninety women undergoing elective caesarean section under epidural anaesthesia were double blindly randomised into three groups to receive either 2 ml of saline or 50 or 100 micrograms of fentanyl in 2 ml volume added to 0.5% bupivacaine. Both doses of fentanyl intensified the epidural anaesthesia and reduced patient discomfort during the operation. In both fentanyl groups the epidural blockade more often reached the 5th thoracic segment (P = 0.0258), the patients had significantly less pain (P = 0.0256), needed less intravenous diazepam medication during the operation (P = 0.0005) and the operating conditions were were better when compared to the saline group (P = 0.0416). There was no difference between the groups in the condition of the neonates as assessed by the Apgar score and cord blood pH. The postoperative time until treatment for pain was requested by the patients was more than 1 h longer in the fentanyl groups, but there was no difference in the total amount of postoperative analgesics needed during the first 24 h when compared to the saline group. Mild pruritus not requiring treatment was more common in fentanyl groups than in the saline group (P = 0.0187). The results suggest that 50 micrograms of fentanyl added to 0.5% bupivacaine increases patient comfort and improves the quality of epidural anaesthesia for caesarean section, and that adding 100 micrograms does not give further advantage.

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Diclofenac sodium, 100 mg, or saline was given intravenously after the induction of anaesthesia to 169 patients undergoing outpatient gynaecological diagnostic laparoscopy or laparoscopic sterilization by tubal ligation. Propofol was used as the main anaesthetic agent and fentanyl and paracetamol were given for post-operative pain relief. In the post-anaesthesia care unit the amount of analgesics given and the incidence of nausea and vomiting were recorded. The time until oral intake, voiding and walking without assistance were recorded as parameters of recovery and guidelines for discharging the patient. In the diagnostic laparoscopy group, the patients given diclofenac needed significantly (P < 0.05) less fentanyl (25 +/- 33 micrograms, mean +/- SD) and paracetamol (230 +/- 40 mg) for post-operative pain than the patients given saline (fentanyl 47 +/- 53 micrograms and paracetamol 690 +/- 100 mg), which was not the case in the tubal ligation group. However, patients in the tubal ligation group needed significantly more post-operative analgesia than patients in the laparoscopy group. Diclofenac had no influence on the rapidity of recovery or home readiness in either group. It is concluded that diclofenac has no influence on home readiness, but prevents postoperative pain in patients undergoing diagnostic laparoscopies, whereas it was not a potent enough analgesic to prevent pain after laparoscopic tubal ligation.

PIP: At Helsinki University Central Hospital in Finland, clinical researchers divided 169 women into two groups (group 1: diagnostic laparoscopies; group 2: laparoscopic sterilizations) as part of a study to evaluate the effect of intravenous diclofenac on postoperative pain, nausea, and recovery after outpatient gynecological laparoscopy. After induction of anesthesia (propofol infusion, total dose = about 370 mg), the patients randomly received, in a double-blind approach, either 100 mg diclofenac sodium (Voltaren, Ciba-Geigy) diluted in 10 ml saline or 10 ml saline alone. Patients in the saline group needed much more fentanyl and paracetamol for pain relief than those in the diclofenac group (47 vs. 25 mcg and 0.69 vs. 0.23 g, respectively; p 0.05). Even though a higher proportion of diclofenac patients experienced postoperative nausea and vomiting (17% vs. 6%) and thus were more likely to receive droperidol (9% vs. 2%), the differences were not statistically significant. Laparoscopic sterilization patients experienced more pain and required more pain relievers postoperatively than diagnostic laparoscopy patients. Specifically, sterilization patients receiving saline received 2.8 times more fentanyl and 1.9 times more paracetamol than diagnostic laparoscopy patients. As for diclofenac patients, these figures were 4.9 and 5.5, respectively. Sterilization patients had more nausea and vomiting than diagnostic laparoscopy patients (34% vs. 11%; p 0.001). Diclofenac did not influence the rapidity of recovery or home readiness in either group. These findings show that diclofenac significantly reduced the need for postoperative analgesia in diagnostic laparoscopy patients but not laparoscopic sterilization patients.

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In a previous study of a kindling model using stimulation of the entorhinal cortex we found a redistribution of synaptic vesicles into the close vicinity of the active zone of synapses of Type I (Gray 1959) in the hippocampal gyrus dentatus. In this paper, ultrastructural studies of the same model are being continued using planimetry of the synaptic apparatus. A significant increase of the postsynaptic apparatus, area enlargement by 53%, increase of the perimeter by 28% and shape irregularity are being reported. No changes in shape or in size have been demonstrated in presynaptic structures or in the morphology of presynaptic mitochondria. These findings are discussed in relation to increased functional readiness of the synapses as signs of active reconstruction of the synaptic apparatus.

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Postoperative nausea and vomiting were compared in 68 women with regular menstrual periods undergoing gynaecological laparoscopy. The patients were divided into four group on the basis of the phase of the menstrual cycle as follows: premenstrum-menstrum (pre + menstrum) (Pd 25-6), early follicular phase (Pd 8-12), ovulatory phase (Pd 13-15) and luteal phase (Pd 20-24). The overall incidence of nausea and vomiting was 46%. Statistically significant differences in the incidence of nausea and retching were found among the groups by regression analysis. The incidence of nausea and vomiting was highest in women undergoing laparoscopy during the luteal phase (77%), which was greater than during the follicular phase (32%) or during pre + menstruation (18%). The need for antimetic was highest in women undergoing laparoscopy during the luteal phase (69%) and this was different from the follicular (18%, P less than 0.01) and pre + menstrum (19%, P less than 0.01) phases. It is concluded that the highest incidence of postoperative nausea and vomiting after gynaecological laparoscopy occurs during the luteal phase.

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The sensorimotor area of the cerebral cortex of the laboratory rat was repeatedly stimulated by electric current after 10-minute intervals which led to the development a gradual prolongation of self-sustained after-discharges (SSAD). One and 10 minutes after termination of the third SSAD the authors analyzed under the electron microscope synapses type I after to Gray from the second cortical homotopic area of the unstimulated hemisphere. They evaluated the curvature of the active zone of synapses. Evidence was provided that one minute after termination of the fit the number of negatively curved synapses increased and the number of synapses with a straight active zone decreased. The number of synapses with a positively curved active zone does not change. Ten minutes after termination of SSAD in the experimental animals the number of positively curved elements declines and the number of negatively curved synapses increases. There is no significant difference in the number of synapses with a straight active zone. The authors discuss possible functional consequences of the mentioned changes.

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This study was designed to compare the ease of performing laryngoscopy and endotracheal intubation without muscle relaxants after the induction of anaesthesia with either thiopentone or propofol in 106 patients scheduled for elective surgery. Thiopentone (5 mg/kg) or propofol (2.5 mg/kg), supplemented with lidocaine (1.5 mg/kg) and alfentanil (30 micrograms/kg), were used in random order for the induction of anaesthesia. Jaw tone, visualisation of the larynx, position of vocal cords, ease of intubation and tolerance of the tracheal tube were assessed. The jaw was relaxed and the vocal cords were immobile/open in most patients in both groups. Visualisation of the larynx was good in 60 and 46% and intubation was easy in 48 and 22% of the patients given thiopentone and propofol, respectively (P less than 0.05 between groups for intubation). After induction of anaesthesia with thiopentone or propofol, endotracheal intubation is not recommended without the use of muscle relaxants.

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One hundred and ninety-eight patients undergoing elective abdominal hysterectomy were anaesthetized with isoflurane in nitrous oxide and oxygen. Ventilation before endotracheal intubation was carried out either by an experienced senior or by an inexperienced junior member of the anaesthetic team. The incidence and severity of emesis (none, nausea, retching or vomiting) were assessed five times during the first 24 h after operation. Patients whose lungs had been ventilated by experienced members of staff had significantly less (P less than 0.05 to 0.01) postoperative emesis in the recovery room (incidence of emesis 35%) and 2-6 h after operation (incidence 27%) when compared to patients whose lungs had been ventilated by inexperienced members of staff (incidence of emesis 54% and 40% in the recovery room and after 2 to 6 h, respectively). The results suggest that the experience of the person ventilating the lungs is associated with postoperative nausea and vomiting.

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Two hundred and one women undergoing elective abdominal hysterectomy were anaesthetised with isoflurane in nitrous oxide and oxygen. At the end of anaesthesia the stomach was aspirated in half of the patients, selected in random order. In the other half no aspiration was performed. Incidence and severity of emesis (none, nausea, retching or vomiting) was assessed during the first 24 hours after operation. Emesis was similar after the operation regardless of aspiration of the stomach (overall emesis, 79% and 70% for those whose stomach had and had not been aspirated, respectively). The incidence at all times during the 24 hours was similar in both groups. The results suggest that gastric aspiration at the end of anaesthesia has no major effect on the incidence or severity of postoperative emesis in patients undergoing abdominal hysterectomy.

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Excitatory synapses were studied in the hippocampal dentate gyrus ipsilateral to the stimulated entorhinal cortex in fully kindled rats 2 weeks after the last (3rd) stage 5 seizure. No change was observed in the absolute number of synaptic vesicles. On the other hand, marked redistribution of the vesicles in the synaptic apparatus was found, with a shift to a strategic position in the vicinity of the synaptic cleft. This redistribution evidently makes it possible to increase the supply of neurotransmitter needed for hyperfunction of the synaptic apparatus in kindling.

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The incidence of helminthozoonoses in the Slovak Socialist Republic over the years 1981--1987 was assessed on the basis of reports submitted by health and veterinary organizations. The incidence of taeniases exhibited a decreasing trend over the period studied. The occurrence rate of cysticercosis in slaughter cattle was irregularly increasing from 0.65% to 0.90%. Echinococcosis in humans was established only sporadically (4 cases). In animals its extensity was decreasing and dropped to 0.22% in slaughter pigs and to 0.70% in sheep and goats. Trichinosis showed an endemic occurrence (13 cases). Larval toxocariasis increased from 6 to 129 seropositive cases. Hymenolepiasis was diagnosed only in the East Slovakian Region (0.06 to 1.46 cases per 100,000 inhabitants). (Fig. 5, Ref. 3.)

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The effect of three different anaesthetic techniques on the incidence and severity of postoperative emesis (nausea, retching and vomiting) was studied in 150 patients undergoing gynaecological laparoscopy. Patients were anaesthetized with isoflurane in nitrous oxide and oxygen (Group A), enflurane in nitrous oxide and oxygen (Group B) or with isoflurane in air and oxygen (Group C). Groups had been predetermined by date of birth. During the first 24 hours after the operation no difference was found at any time in the incidence or severity of emesis among the groups. The overall incidence of emesis during the first 24 hours postoperatively was 54, 48 and 52 per cent, in groups A, B and C, respectively. It is concluded that nitrous oxide does not increase the incidence of emesis after isoflurane anaesthesia and that isoflurane and enflurane anaesthesia are associated with similar incidences of nausea and vomiting after gynaecological laparoscopy.

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