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Quantum networks have the potential to transform secure communication via quantum key distribution and enable novel concepts in distributed quantum computing and sensing. Coherent quantum light generation at telecom wavelengths is fundamental for fibre-based network implementations, but Fourier-limited emission and subnatural linewidth photons have so far only been reported from systems operating in the visible to near-infrared wavelength range. Here, we use InAs/InP quantum dots to demonstrate photons with coherence times much longer than the Fourier limit at telecom wavelength via elastic scattering of excitation laser photons. Further, we show that even the inelastically scattered photons have coherence times within the error bars of the Fourier limit. Finally, we make direct use of the minimal attenuation in fibre for these photons by measuring two-photon interference after 25 km of fibre, demonstrating finite interference visibility for photons emitted about 100,000 excitation cycles apart.
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BACKGROUND: Data demonstrate the benefit of blood product administration near point-of-injury (POI). Fresh whole blood transfusion from a pre-screened donor provides a source of blood at the POI when resources are constrained. We captured transfusion skills data for medics performing autologous blood transfusion training. METHODS: We conducted a prospective, observational study of medics with varying levels of experience. Inexperienced medics were those with minimal or no reported experience learning the autologous transfusion procedures, versus reported experience among special operations medics. When available, medics were debriefed after the procedure for qualitative feedback. We followed them for up to 7 days for adverse events. RESULTS: The median number of attempts for inexperienced and experienced medics was 1 versus 1 (interquartile range 1-1 for both, p = .260). The inexperienced medics had a slower median time to needle venipuncture access for the donation of 7.3 versus 1.5 min, needle removal after clamping time of 0.3 versus 0.2 min, time to bag preparation of 1.9 versus 1.0 min, time to IV access for reinfusion of 6.0 versus 3.0 min, time to transfusion completion of 17.3 versus 11.0 min, and time to IV removal of 0.9 versus 0.3 min (all p < .05). We noted one administrative safety event in which an allogeneic transfusion occurred. No major adverse events occurred. Qualitative data saturated around the need for quarterly training. CONCLUSIONS: Inexperienced medics have longer procedure times when training autologous whole blood transfusion skills. This data will help establish training measures of performance for skills optimization when learning this procedure.
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Transfusión de Sangre Autóloga , Personal Militar , Humanos , Estudios Prospectivos , Transfusión Sanguínea , Donantes de TejidosRESUMEN
During cataract surgery, diseased lenses in the eye are surgically removed and replaced with polymeric artificial intraocular lenses (IOLs). Patients can experience a complication called posterior capsular opacification (PCO) that is corrected through the removal of part of the posterior capsule using a neodymium: yttrium-aluminum-garnet (Nd-YAG) laser to restore the optical path. These interventions have increased costs and can damage the retina and the IOL. PCO develops when lens epithelial cells (LECs) proliferate, migrate, and undergo epithelial-to-mesenchymal transition. Neutrophils involved in the immune response triggered during implantation impact LEC behavior and produce damaging neutrophil extracellular traps (NETs). In this research, poly(2-hydroxyethyl methacrylate) (PHEMA) -based disks were synthesized with varying amounts of comonomer (HEMA with 0, 2, and 12 mol% MMA) and functionalized with carboxyl and amine groups, yielding nine different hydrogels. Material and chemical properties of the disks were characterized, and neutrophil-like HL60 cells and B3 LECs were incubated with the disks. HL60 cell behavior was more strongly influenced by chemical functionalization than by mechanical properties with increases in adherence and NET accumulation. Conversely, the behavior and viability of B3 LECs were more strongly influenced by mechanical properties with increases in cell adhesion and α-SMA expression with increasing compressive moduli. Interestingly, B3 LECs had decreased viability and increased α-SMA expression when cultured on PHEMA2 disks pretreated with isolated NETs. Critical to the understanding of PCO and its prevention are both surface chemistry and mechanics as well as the inflammatory response.
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Catarata , Cápsula del Cristalino , Lentes Intraoculares , Humanos , Neutrófilos/metabolismo , Catarata/etiología , Catarata/metabolismo , Catarata/prevención & control , Cápsula del Cristalino/metabolismo , Cápsula del Cristalino/cirugía , Lentes Intraoculares/efectos adversos , Células Epiteliales/metabolismoRESUMEN
BACKGROUND: The MARCH (Massive hemorrhage, Airway, Respirations, Circulation, and Hypothermia/Head injuries) algorithm taught to military medics includes interventions to prevent hypothermia. As possible sequelae from major trauma, hypothermia is associated with coagulopathy and lower survival. This paper sought to define hypothermia within our combat trauma population using an outcomes-based method, and determine clinical variables associated with hypothermia. METHODS: This is a secondary analysis of a previously described dataset from the Department of Defense Trauma Registry focused on casualties who received prehospital care. A receiver operating curve was constructed and Youden's index was used to define hypothermia within the predetermined population based on mortality risk. A multivariable regression model was used to identify associations. RESULTS: There were 23,243 encounters that met the inclusion criteria for this study with patients having received prehospital care and documentation of at least one emergency department temperature. An optimal threshold of 36.2° C was found to predict mortality; 3,159 casualties had temperatures below this threshold (14%). Survival to discharge was lower among casualties with hypothermia (91% versus 98%). Hypothermic casualties were less likely to undergo blanket application (38% versus 40%). However, they had higher proportions with Hypothermia Prevention and Management Kit application (11% versus 7%) and radiant warming (2% versus 1%). On multivariable regression modeling, none of the hypothermia interventions were associated with a decreased likelihood of hypothermia. Non-hypothermia interventions associated with hypothermia included prehospital intubation (OR 1.57, 95% CI 1.45-1.69) and blood product administration. CONCLUSIONS: Hypothermia, including a single recorded low temperature in the patient care record, was associated with worse outcomes in this combat trauma population. Prehospital intubation was most strongly associated with developing hypothermia. Prehospital warming interventions were not associated with a reduction in hypothermia risk. Our dataset suggests that current methods for prehospital warming are inadequate.
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Traumatismos Craneocerebrales , Servicios Médicos de Urgencia , Hipotermia , Heridas y Lesiones , Humanos , Hipotermia/prevención & control , Servicios Médicos de Urgencia/métodos , Servicio de Urgencia en Hospital , Hemorragia , Sistema de Registros , Heridas y Lesiones/terapiaRESUMEN
INTRODUCTION: Uncontrolled hemorrhage remains the leading cause of preventable death in the prehospital, combat setting. Treatment guidelines emphasize immediate hemorrhage control and early resuscitation with whole blood or blood products. Current methods for the delivery of blood products are often insufficient to provide trauma resuscitation. The novel LifeFlow device is a hand-powered device that can rapidly infuse fluids, including blood products. However, successful use of this device in the hands of the intended end user has not been demonstrated. MATERIALS AND METHODS: We conducted a pilot study to assess how quickly and effectively medics could set up the LifeFlow device and infuse mock blood products into a casualty. They were provided with a brief block of instruction (<10 min) and the opportunity to handle the device. The time to set up the device and proportion of successful completion were recorded. Participants were surveyed regarding the use of the device including post-study interview. RESULTS: Forty medics, who were recruited and eligible to participate, completed the study procedures. All medics were able to successfully set up the device and perform the infusion. We had two instances of fluid leakage owing to malfunctions with the simulation arm, not the LifeFlow device. The mean time to device setup was 112 s (95% confidence interval [CI], 101-124). The mean time for infusion of 500 mL of fluid was 94 s (95% CI, 83-105). The mean time for all procedures was 197 s (95% CI, 178-213). On product feedback, they generally found it easier to use, easy to manipulate, possessing a useful grip, easily set up, and requiring minimal training. CONCLUSIONS: The medics were able to reliably assemble and use the LifeFlow rapid infusion device. However, there were concerns about the packaging and the single indication for the device.
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Hemorragia , Resucitación , Humanos , Proyectos Piloto , Resucitación/métodos , Hemorragia/terapiaRESUMEN
BACKGROUND: Military helicopter mishaps frequently lead to multiple casualty events with complex injury patterns. Data specific to this mechanism of injury in the deployed setting are limited. We describe injury patterns associated with helicopter crashes. MATERIALS AND METHODS: This is a secondary analysis of a Department of Defense Trauma Registry (DODTR) dataset from 2007 to 2020 seeking to describe prehospital care within all theaters in the registry. We searched within the dataset for casualties injured by helicopter crash. A serious injury was defined by an abbreviated injury scale of =3 by body region. RESULTS: We identified 120 casualties injured by helicopter crash within the dataset. Most were Army (64%), the median age was 30 (interquartile range [IQR] 26-35), and most were male (98%), enlisted service members made up the largest cohort (47%), with most injuries occurring during Operation Enduring Freedom (69%). Only 2 were classified as battle injuries. The median injury severity score was 9 (IQR 4-22). Serious injuries by body region are the following: thorax (27%), head/neck (17%), extremities (17%), abdomen (11%), facial (3%), and skin/superficial (1%). The most common prehospital interventions focused on hypothermia prevention/management (62%) and cervical spine stabilization (32%). Most patients survived to hospital discharge (98%). CONCLUSIONS: Serious injuries to the thorax were most common. Survival was high, although better data capture systems are needed to study deaths that occur prehospital that do not reach military treatment facilities with surgical care to optimize planning and outcomes. The high proportion of nonbattle injuries highlights the risks associated with helicopters in general.
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Personal Militar , Heridas y Lesiones , Accidentes de Tránsito , Adulto , Campaña Afgana 2001- , Aeronaves , Femenino , Humanos , Guerra de Irak 2003-2011 , Masculino , Sistema de Registros , Estudios Retrospectivos , Heridas y Lesiones/epidemiología , Heridas y Lesiones/terapiaRESUMEN
BACKGROUND: Video laryngoscopy (VL) is shown to improve first-pass success rates and decrease complications in intubations, especially in novice proceduralists. However, the currently fielded VL devices are cost-prohibitive for dispersion across the battlespace. The novel i-view VL is a low-cost, disposable VL device that may serve as a potential solution. We sought to perform end-user performance testing and solicit feedback. METHODS: We prospectively enrolled Special Operations flight medics with the 160th Special Operations Aviation Regiment at Hunter Army Airfield, Savannah, Georgia. We asked them to perform an intubation using a synthetic cadaver model while in a mobile helicopter simulation setting. We surveyed their feedback afterward. RESULTS: The median age of participants was 30 and all were male. Of those, 60% reported previous combat deployments, with a median of 20 months of deployment time. Of the 10, 90% were successful with intubation, with 60% on first-pass success with an average of 83 seconds time to intubation. Most had a grade 1 view. Most agreed or strongly agreed that it was easy to use (70%), with half (50%) reporting they would use it in the deployed setting. Several made comments about the screen not being bright enough and would prefer one with a rotating display. CONCLUSIONS: We found a high proportion of success for intubation in the mobile simulator and a high satisfaction rate for this device by Special Operations Forces medics.
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Laringoscopios , Aeronaves , Estudios de Factibilidad , Humanos , Intubación Intratraqueal , Laringoscopía , Masculino , Estudios ProspectivosRESUMEN
INTRODUCTION: Airway obstruction is the second leading cause of potentially preventable death on the battlefield during the recent conflicts. Previous studies have noted challenges with enrolling medics using quantitative methods, with specific challenges related to limited prior experience with the devices presented. This limited the ability to truly assess the efficacy of a particular device. We sought to implement a qualitative methods design for supraglottic airway (SGA) device testing. METHODS: We performed prospective, qualitative-designed studies in serial to discover emerging themes on interview. We obtained consent and demographic information from all participants. Medics were presented 2-3 airway devices in the same session with formal training by a physician with airway expertise to include practice application and troubleshooting. Semi-structured interviews were used after the training to obtain end-user feedback with a focus on emerging themes. RESULTS: Of the 77 medics surveyed and interviewed, the median age was 24, and 86% were male. During the interview sessions, we noted five emerging themes: (1) insertion, which pertains to the ease or complexity of using the devise; (2) material, which pertains to the tactile features of the device; (3) versatility, which pertains to the conditions in which the device can be used as well as with which other devices it can be used; (4) portability, which refers to how and where the device is stored and carried; and (5) training, which refers to the ease and frequency of initial and ongoing training to sustain medics' technical capability when using the device. CONCLUSIONS: In our preliminary analysis after enrolling 77 medics, we noted 5 emerging themes focused on insertion material, versatility, portability, and training methodology. Our results will inform the future enrollment sessions with a goal of narrowing the market options from themes to ideal device or devices or modifications needed for the operational environment.
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Obstrucción de las Vías Aéreas , Personal Militar , Adulto , Obstrucción de las Vías Aéreas/terapia , Diseño de Equipo , Humanos , Masculino , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: Hemorrhage is the leading cause of death in trauma patients with most fatalities occurring before reaching a higher level of care-this applies to both the civilian setting and the military combat setting. Hemostatic resuscitation with increased emphasis on blood transfusion while limiting use of crystalloids has become routine in trauma care. However, the prehospital setting-especially in combat-presents unique challenges with regard to storage, transport, and administration. We sought to evaluate available technology on the market for storage and administration technology that is relevant to the prehospital setting. STUDY DESIGN AND METHODS: We conducted a market review of available technology through subject-matter expert inquiry, reviews of published literature, reviews of Federal Drug Administration databases, internal military publications, and searches of Google. RESULTS: We reviewed and described a total of 103 blood transporters, 22 infusers, and 6 warmers. CONCLUSIONS: The risk of on-scene fatality in trauma patients and recent developments in trauma care demonstrate the need for prehospital transfusion. These transfusions have been logistically prohibited in many operations. We have reviewed the current commercially available equipment and recommended pursuit of equipment that improves accessibility to field transfusion. Current technology has limited applicability for the prehospital setting and is further limited for the military setting.
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Almacenamiento de Sangre , Transfusión Sanguínea , Transportes , Animales , Almacenamiento de Sangre/métodos , Transfusión Sanguínea/instrumentación , Transfusión Sanguínea/métodos , Hospitales , Humanos , Transportes/instrumentaciónRESUMEN
This study describes the screening of 13 commercially-available plant extracts for pharmacological activity modulating vascular function using an endothelial cell model. A French maritime pine bark extract (FMPBE) was found to have the greatest effect upon nitric oxide availability in control (181% ± 36% of untreated cells) and dysfunctional cells (132% ± 8% of untreated control cells). In healthy volunteers, the FMPBE increased plasma nitrite concentrations 8 h post-consumption compared to baseline (baseline corrected median 1.71 ± 0.38 (25% IQR) and 4.76 (75% IQR) µM, p < 0.05). This was followed by a placebo-controlled, healthy volunteer study, which showed no effects on plasma nitrite. It was confirmed that different batches of extract had been used in the healthy volunteer studies, and this second batch lacked bioactivity, assessed using the in vitro model. No difference in plasma catechin levels was seen at 8 h following supplementation between the studies (252 ± 194 nM versus 50 ± 64 nM, p > 0.05), however HPLC-UV fingerprinting showed that the new batch had a 5-15% in major constituents (including procyanidins A2, B1 and B2) compared to the original batch. This research describes a robust mechanism for screening bioactive extracts for vascular effects. It also highlights batch variability as a significant limitation when using complex extracts for pharmacological activity, and suggests the use of in vitro systems as a tool to identify this problem in future studies.
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Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Pinus/química , Corteza de la Planta/química , Extractos Vegetales/farmacología , Polifenoles/farmacología , Adolescente , Adulto , Catequina/análisis , Catequina/sangre , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Femenino , Voluntarios Sanos , Células Endoteliales de la Vena Umbilical Humana/citología , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Nitratos/sangre , Óxido Nítrico/metabolismo , Nitritos/sangre , Extractos Vegetales/administración & dosificación , Extractos Vegetales/aislamiento & purificación , Polifenoles/administración & dosificación , Polifenoles/aislamiento & purificación , Adulto JovenRESUMEN
INTRODUCTION: The Accreditation Council for Graduate Medical Education stipulates that residents should participate in scholarly activity. As of 2019 that verbiage will be changed to, "Residents must participate in scholarship." However, scholarly activity is not clearly defined. We set out to define our graduation research requirement in a measurable way and structure a research curriculum that better prepared residents to conduct scholarly activity. MATERIALS AND METHODS: This study compares resident scholarly output in several categories before and after the initiation of a revised research curriculum and graduation requirement. Scholarly activity was measured by comparing the production of Pubmed Indexed (PMID) publications, online publications, and conference presentations of two Emergency Medicine Residency classes. The intervention class was represented by the class of 2018 which exposed 16 residents to the new curriculum and graduation requirement for the full three years of their residency. The comparison class was represented by the class of 2015 which exposed 16 residents to the old curriculum and old graduation requirement. The old graduation requirement and curriculum were undefined. The new requirement involved two options, participate in original research starting from the process of question formulation and carried through manuscript drafting or publishing at first author PMID of any kind. The new curriculum involved monthly journal clubs, two annual deep dives, and an 8-day Intern Research Course modeled after the Emergency Medicine Basic Research Skills workshop sponsored by the American College of Emergency Physicians. In addition to the new curriculum, several new leadership positions were created at both the staff and resident level that solely focused on the promotion of scholarly activity. In addition to creating a culture within the department that encouraged scholarship, these overlapping leadership positions also helped create continuity in a program that could easily be hampered by frequent staff turnover due to new military assignments and military deployments. RESULTS: Resident scholarly activity in the form of PMIDs increased from 4 to 22. The production of online publications was 0 and 12, respectively. There were 2 and 11 conference presentations, respectively. CONCLUSION: Resident scholarly activity increased following the institution of a new research curriculum and graduation requirement.
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Medicina de Emergencia/tendencias , Internado y Residencia/tendencias , Personal Militar/estadística & datos numéricos , Investigación/educación , Educación de Postgrado en Medicina/métodos , Educación de Postgrado en Medicina/tendencias , Medicina de Emergencia/educación , Medicina de Emergencia/métodos , Humanos , Internado y Residencia/métodos , Personal Militar/psicología , Estados UnidosRESUMEN
BACKGROUND: Infantile haemangiomas (IH) are the most common vascular tumours of infancy. Despite their frequency and potential complications, there are currently no unified U.K. guidelines for the treatment of IH with propranolol. There are still uncertainties and diverse opinions regarding indications, pretreatment investigations, its use in PHACES (posterior fossa malformations-haemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe) syndrome and cessation of treatment. OBJECTIVES: To provide unified guidelines for the treatment of IH with propranolol. METHODS: This study used a modified Delphi technique, which involved an international treatment survey, a systematic evidence review of the literature, a face-to-face multidisciplinary panel meeting and anonymous voting. RESULTS: The expert panel achieved consensus on 47 statements in eight categories, including indications and contraindications for starting propranolol, pretreatment investigations, starting and target dose, monitoring of adverse effects, the use of propranolol in PHACES syndrome and how to stop treatment. CONCLUSIONS: These consensus guidelines will help to standardize and simplify the treatment of IH with oral propranolol across the U.K. and assist in clinical decision-making.
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Coartación Aórtica/tratamiento farmacológico , Dermatología/normas , Anomalías del Ojo/tratamiento farmacológico , Hemangioma/tratamiento farmacológico , Síndromes Neurocutáneos/tratamiento farmacológico , Pediatría/normas , Propranolol/administración & dosificación , Neoplasias Cutáneas/tratamiento farmacológico , Administración Oral , Toma de Decisiones Clínicas , Consenso , Técnica Delphi , Humanos , Lactante , Sociedades Médicas/normas , Resultado del Tratamiento , Reino UnidoRESUMEN
INTRODUCTION: Our goal was to determine if heated gel for emergency department (ED) bedside ultrasonography improves patient satisfaction compared to room-temperature gel. METHODS: We randomized a convenience sample of ED patients determined by their treating physician to require a bedside ultrasound (US) study to either heated gel (102.0° F) or room-temperature gel (82.3° F). Investigators performed all US examinations. We informed all subjects that the study entailed investigation into various measures to improve patient satisfaction with ED US examinations but did not inform them of our specific focus on gel temperature. Investigators wore heat-resistant gloves while performing the examinations to blind themselves to the gel temperature. After completion of the US, subjects completed a survey including the primary outcome measure of patient satisfaction as measured on a 100-mm visual analogue scale (VAS). A secondary outcome was patient perceptions of sonographer professionalism measured by an ordinal scale (1-5). RESULTS: We enrolled 124 subjects; 120 completed all outcome measures. Of these, 59 underwent randomization to US studies with room-temperature gel and 61 underwent randomization to heated US gel. Patient 100-mm VAS satisfaction scores were 83.9 among patients undergoing studies with room-temperature gel versus 87.6 among subjects undergoing studies with heated gel (effect size 3.7, 95% confidence interval -1.3-8.6). There were similarly no differences between the two arms with regard to patient perceptions of sonographer professionalism. CONCLUSION: The use of heated ultrasound gel appears to have no material impact on the satisfaction of ED patients undergoing bedside ultrasound studies.
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Geles/administración & dosificación , Satisfacción del Paciente , Ultrasonografía/métodos , Administración Tópica , Adulto , Servicio de Urgencia en Hospital , Femenino , Calor , Humanos , Masculino , Persona de Mediana Edad , Sistemas de Atención de Punto , Encuestas y CuestionariosRESUMEN
The major role of the Oncology Registrars' Forum (ORF) of the Royal College of Radiologists is to voice the opinions of the clinical oncology trainee body and work towards improving all aspects of clinical oncology training in the UK. In order to provide data to support these efforts, the ORF undertakes a biennial survey of all trainees. As with the previous surveys, this year's ORF survey produced data that highlight areas of good training as well as new and ongoing areas of concern. This summary highlights the key survey results and provides recommendations for improving the delivery of clinical oncology training in the UK.
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Oncología Médica/educación , Actitud del Personal de Salud , Personal de Salud , Humanos , Encuestas y Cuestionarios , Reino UnidoRESUMEN
We assessed a population-based cohort of patients diagnosed with oropharyngeal squamous cell carcinoma in Southeast Scotland over 13â months. p16 and human papilloma virus (HPV) expression were determined, and correlated with stage, treatment, smoking and alcohol history, and disease outcomes. Retrospective analysis was performed on 60 patients. p16 immunohistochemistry and HPV genotyping were performed on formalin-fixed paraffin-embedded tissues. HPV infection (as defined by p16 positivity and/or HPV PCR positivity) was identified in 57% of samples, while dual positives were detected in 45% of cases. HPV16 was most prevalent of the HPV types and was associated with 90% of positive samples. Cause-specific 1-year and 2-year survivals were 82.5% and 78.2%, respectively. The p16-positive and HPV-positive groups demonstrated significantly increased cause-specific survival in comparison with their negative counterparts.
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Biomarcadores de Tumor/análisis , Carcinoma de Células Escamosas/epidemiología , Inhibidor p16 de la Quinasa Dependiente de Ciclina/análisis , Neoplasias Orofaríngeas/epidemiología , Papillomaviridae/genética , Infecciones por Papillomavirus/epidemiología , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/virología , ADN Viral/genética , Femenino , Pruebas de ADN del Papillomavirus Humano , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Neoplasias Orofaríngeas/química , Neoplasias Orofaríngeas/mortalidad , Neoplasias Orofaríngeas/patología , Neoplasias Orofaríngeas/terapia , Neoplasias Orofaríngeas/virología , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/mortalidad , Infecciones por Papillomavirus/terapia , Infecciones por Papillomavirus/virología , Valor Predictivo de las Pruebas , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Escocia/epidemiología , Factores de Tiempo , Resultado del TratamientoRESUMEN
Storms containing hail are a common occurrence in Wisconsin, with a few or many cranberry (Vaccinium macrocarpon) growers being affected every year. Growers usually apply fungicides immediately following hail events to prevent fruit rot, despite a lack of research to support this practice. We conducted field trials in 2010 and 2011 to address the question of whether applying fungicides to injured fruit reduces fruit rot incidence (% rotten fruit). Hail damage was simulated by forcibly projecting pea gravel into cranberry beds using a mist-blower sprayer modified for this purpose, and the fungicides azoxystrobin or copper hydroxide were applied to fruit immediately after applying gravel. Fruit rot incidence and yield were evaluated within 2 weeks prior to commercial harvest in late September and early October. Fruit rot incidence was greater (P ≤ 0.05) and yield was lower (P < 0.05) in plots treated with gravel than in the nontreated control plots in six of seven trials. Fungicides did not reduce fruit rot incidence (P ≥ 0.05) in gravel-treated plots compared to the nontreated control in six of seven trials. However, in a trial conducted on relatively immature berries, fruit rot incidence in gravel-treated plots treated with azoxystrobin was less (P = 0.0103) than fruit rot incidence in gravel-treated plots receiving no fungicide treatment. In that same trial, fruit rot incidence was not reduced (P = 0.1243) in gravel-treated plots treated with copper hydroxide compared to gravel-treated plots that were not treated with fungicide. Results suggest that under most circumstances, if cranberries are damaged by hail, it is unlikely that an application of fungicide will reduce the amount of fruit rot at the time of harvest.
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INTRODUCTION: The purpose of this prospective, randomized, double-blind study was to determine ibuprofen versus ibuprofen/acetaminophen use for postoperative endodontic pain in symptomatic patients with a pulpal diagnosis of necrosis and an associated periapical radiolucency who were experiencing moderate to severe preoperative pain. We also recorded escape medication use. METHODS: Seventy-one adult patients presenting for emergency endodontic treatment with a symptomatic maxillary or mandibular tooth with a pulpal diagnosis of necrosis, periapical radiolucent area, and moderate to severe pain participated in this study. The patients were randomly divided into 2 groups by random assignment and numeric coding. An emergency debridement of the tooth was completed with hand and rotary instrumentation. At the end of the appointment, the patients randomly received capsules of either 600 mg ibuprofen or 600 mg ibuprofen combined with 1000 mg acetaminophen (blinded to both operator and patient). Patients also received a 6-day diary to be completed after anesthesia wore off and every morning for 5 days. Patients were asked to record pain, symptoms, and the number of capsules taken. Patients received escape medication (Vicodin) if the study medication did not control their pain. Postoperative data were analyzed by randomization test and step-down Bonferroni method of Holm. RESULTS AND CONCLUSIONS: There were decreases in pain levels and analgesic use over time for the ibuprofen and ibuprofen/acetaminophen groups. There was no statistically significant difference between the 2 groups for analgesic use or escape medication use. Approximately 20% of patients in both groups required escape medication to control pain.
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Acetaminofén/uso terapéutico , Analgésicos no Narcóticos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Necrosis de la Pulpa Dental/terapia , Ibuprofeno/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Acetaminofén/administración & dosificación , Adulto , Analgésicos no Narcóticos/administración & dosificación , Analgésicos Opioides/uso terapéutico , Antiinflamatorios no Esteroideos/administración & dosificación , Sulfato de Calcio/uso terapéutico , Cementos Dentales/uso terapéutico , Método Doble Ciego , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Hidrocodona/uso terapéutico , Ibuprofeno/administración & dosificación , Masculino , Registros Médicos , Enfermedades Periapicales/terapia , Polivinilos/uso terapéutico , Estudios Prospectivos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Óxido de Zinc/uso terapéuticoRESUMEN
Covalent modification of alginate with polyethylene glycol-conjugated anthracene molecules has the potential to both stabilize the alginate and act as a photosensitive crosslinker. Release studies with Coomassie Blue show lengthy release times from the alginate photogels that extend past 70 days with, for example, 17% versus 27% release at 1750 h (73 days) for photogels with and without 365-nm UV light treatment for 30 min at 10 mW/cm(2) in the initial release period. Photocrosslinking of the photogels after loading effectively "locks" in drug compounds to control their release. Effective crosslinking densities and controls of polyethylene glycol-crosslinked alginate and physically crosslinked calcium alginate gels suggest strong interactions between Coomassie Blue and both alginate and anthracene. Photogels containing anthracene-capped star-polyethylene glycol show increased photosensitivity with modified release profiles. Ultimately, the covalent modification of alginate with photoactive crosslinkers has the potential to produce a long-term, photosensitive, controlled release system.
Asunto(s)
Alginatos/química , Alginatos/efectos de la radiación , Antracenos/química , Antracenos/efectos de la radiación , Polietilenglicoles/química , Polietilenglicoles/efectos de la radiación , Reactivos de Enlaces Cruzados/química , Reactivos de Enlaces Cruzados/efectos de la radiación , Preparaciones de Acción Retardada , Sistemas de Liberación de Medicamentos/métodos , Hidrogel de Polietilenoglicol-Dimetacrilato/química , Hidrogel de Polietilenoglicol-Dimetacrilato/efectos de la radiación , Colorantes de Rosanilina/química , Rayos UltravioletaRESUMEN
BACKGROUND AND PURPOSE: The purinergic system through the A(2A) adenosine receptor regulates addiction induced by different drugs of abuse. The aim of the present study was to investigate the specific role of A(2A) adenosine receptors (A(2A)Rs) in the behavioural and neurochemical responses to morphine associated with its motivational properties. EXPERIMENTAL APPROACH: Mice lacking A(2A)Rs (A(2A) knockout (KO) mice) and wild-type littermates were used to evaluate behavioural responses induced by morphine. Antinociception was assessed using the tail-immersion and the hot-plate tests. Place-conditioning paradigms were used to evaluate the rewarding effects of morphine and the dysphoric responses of morphine withdrawal. Microdialysis studies were carried out to evaluate changes in the extracellular levels of dopamine in the nucleus accumbens of A(2A) KO mice after morphine administration. KEY RESULTS: The acute administration of morphine induced a similar enhancement of locomotor activity and antinociceptive responses in both genotypes. However, the rewarding effects induced by morphine were completely blocked in A(2A) KO mice. Also, naloxone did not induce place aversion in animals lacking the A(2A)Rs. CONCLUSIONS AND IMPLICATIONS: Our findings demonstrate that the rewarding and aversive effects associated with morphine abstinence were abolished in A(2A) KO mice, supporting a differential role of the A(2A) adenosine receptor in the somatic and motivational effects of morphine addiction. This study provides evidence for the role of A(2A)Rs as general modulators of the motivational properties of drugs of abuse. Pharmacological manipulation of these receptors may represent a new target in the management of drug addiction.