THE EFFECT OF ETHNICITY ON THE INCIDENCE OF POSTOPERATIVE NAUSEA AND VOMITING IN MODERATE TO HIGH RISK PATIENTS UNDERGOING GENERAL ANESTHESIA IN SOUTH AFRICA: A CONTROLLED OBSERVATIONAL STUDY

BACKGROUND

We conducted this prospective controlled observational study to compare the effect of ethnicity on the risk of postoperative nausea and vomiting (PONV) between moderate to high-risk African and non-African patients undergoing general anesthesia.

METHODS

Using Apfel score risk factors and predicted length of surgery (>30 minutes), 89 moderate to high risk patients undergoing general anesthesia were recruited in a university hospital between March 2009 and November 2010. Thirty patients in the non-African group and 59 patients in the African group were allocated using an ethnicity self identification questionnaire. Intraoperative anesthesia was standardized. PONV was assessed at 0 minutes, 15 minutes, 90 minutes, 180 minutes, and 24 hours. Generalized linear mixed effects models was used to determine the effect of ethnicity on PONV.

RESULTS

Despite similar Apfel scores, cumulative incidence of postoperative nausea was higher in the non-African group at 0 minutes (46.67% vs 22.03%, P = 0.019), 15 minutes (70% vs 23.73%, p<0.001) and 90 minutes (36.67% vs 16.95%, P = 0.04). The non-African group had more episodes of vomiting over 24 hours (13.33% vs 1.69%, P = 0.055). Non-Africans had a 25 times higher reported nausea incidence than Africans over 24 hours.

CONCLUSION

The incidence of PONV in non-Africans is significantly higher than in Africans. Non-African ethnicity is an independent risk factor for PONV. Current risk prediction models may be limited in multi-ethnic populations and further investigations are warranted to examine ethnicity as a risk factor.

SiO2-CaO-P2O5 (58S) sol gel glass applied onto surgical grade stainless steel by spray technique: morphological characterization by digital image processing

AISI 316L stainless steel is commonly used as a low-cost material for permanent implants. It can be protected for degradation and corrosion by applying a hybrid silica based coating. Also the bioactive response of the implant can only be achieved by functionalizing the coated implant surface. The aim of this work is to synthesize and characterize a sol-gel made glass particles from the system SiO2-CaO-P2O5 with potential as bone inductive material, with and without an aging treatment of the precursor solution. The glass was synthesized by sol-gel technique that, comparing with melt glasses, generates an open net structure that could lead to particle dissolution and apatite deposition for biological purposes. The synthesized glass is dispersed by spray onto AISI 316L protected by a hybrid silica based coating, generating deposits with different size and morphology. To characterize the particles composition, microRaman spectroscopy was applied. It showed that no significant changes were reached after aging or thermal treatment of the deposited particles. Image processing techniques based on Mathematical Morphology were used to analyze morphology and sizes of the deposits obtain with the different sols (aged and no aged). Aproximately 50% of the surface was covered with particles made with a glass aged, and a 25% of covered area was reached with no aged one. When no aged glass particles were deposited, the particle size distribution shows the presence of many big particles with a roundness factor between 0.8 and 1 in a high percentage, meaning that they are spherical due to the presence of solvent and with a more open glass structure in the no aged glass. The Digital Image Processing and Raman spectroscopy tools help to analyze, characterize and quantify the bioactive particles deposited onto coated surgical grade stainless steel in terms of morphology, distribution and composition.

Evaluation of Stain Penetration by Beverages in Demineralized Enamel Treated With Resin Infiltration

PURPOSE

To evaluate stain penetration by different beverages in artificially demineralized human teeth treated with resin infiltration.

METHODS AND MATERIALS

Sixty extracted human permanent molars were demineralized, treated with resin infiltration (Icon), and immersed in four different beverages (coffee, grape juice, iced tea, and distilled water; N=15) for four weeks. After aging, teeth in the distilled water group were stained with 2% methylene blue for 24 hours. All teeth were sectioned, and stain penetration was evaluated under light microscopy. Chi-square test, independent and paired sample t-test, analysis of variance with the Fisher least significant difference post hoc test, and the Kruskal-Wallis test were used to analyze the results (p<0.05).

RESULTS

Resin infiltration-treated surfaces (Icon surfaces) had statistically significant fewer samples with presence of stain penetration compared to untreated surfaces (control surfaces) (p<0.001). There was also a significant decrease in depth of stain penetration in Icon surfaces compared to the control surfaces (p<0.001). Among tested beverage groups, iced tea showed significantly greater depth of stain penetration (0.134±0.029 mm), followed by grape juice (0.118±0.047 mm), methylene blue (0.022±0.019 mm), and coffee (0.008±0.017 mm; p<0.001).

CONCLUSION

Both Icon and control surfaces exhibit stain penetration by different beverages (iced tea, grape juice, and coffee). However, resin-infiltrated enamel surfaces allow significantly less depth of stain penetration compared to untreated surfaces. The iced tea group presents greatest depth of stain penetration, followed by grape juice, methylene blue, and coffee.

Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder

AIM

To assess dental caries experience and periodontal treatment needs among Libyan children diagnosed with autistic spectrum disorder (ASD).

MATERIALS AND METHODS

A cross-sectional, comparative case-control study was used, in which dental caries experience of 50 children with ASD was compared with that of 50 controls. The children with ASD were recruited from Benghazi Centre of Children with ASD, Libya. Controls were recruited from school children and matched for age, gender and socioeconomic status. DMFT, dmft for dental caries experience and CPITN for periodontal treatment needs were calculated according to WHO criteria by a calibrated examiner. Scores for DMFT as well as CPITN indices were compared using bivariate analysis.

RESULTS

The data analysed for this study comprised observations from a group of children (cases = 50) diagnosed with ASD matched with healthy children (controls = 50). Consequently, each group consisted of 40 males and 10 females aged between 3 and 14 years (mean 7.29 ± 3.11). The ASD children showed significantly lower means for DMFT and dmft teeth as well as higher periodontal treatment needs (p > 0.05).

CONCLUSION

Children with ASD were found to be more likely caries-free and have lower DMFT scores and higher unmet periodontal treatment needs than did the unaffected control children.

Search for gravitational waves associated with γ-ray bursts detected by the interplanetary network

We present the results of a search for gravitational waves associated with 223 γ-ray bursts (GRBs) detected by the InterPlanetary Network (IPN) in 2005-2010 during LIGO's fifth and sixth science runs and Virgo's first, second, and third science runs. The IPN satellites provide accurate times of the bursts and sky localizations that vary significantly from degree scale to hundreds of square degrees. We search for both a well-modeled binary coalescence signal, the favored progenitor model for short GRBs, and for generic, unmodeled gravitational wave bursts. Both searches use the event time and sky localization to improve the gravitational wave search sensitivity as compared to corresponding all-time, all-sky searches. We find no evidence of a gravitational wave signal associated with any of the IPN GRBs in the sample, nor do we find evidence for a population of weak gravitational wave signals associated with the GRBs. For all IPN-detected GRBs, for which a sufficient duration of quality gravitational wave data are available, we place lower bounds on the distance to the source in accordance with an optimistic assumption of gravitational wave emission energy of 10(-2)M⊙c(2) at 150 Hz, and find a median of 13 Mpc. For the 27 short-hard GRBs we place 90% confidence exclusion distances to two source models: a binary neutron star coalescence, with a median distance of 12 Mpc, or the coalescence of a neutron star and black hole, with a median distance of 22 Mpc. Finally, we combine this search with previously published results to provide a population statement for GRB searches in first-generation LIGO and Virgo gravitational wave detectors and a resulting examination of prospects for the advanced gravitational wave detectors.

Search for gravitational waves associated with γ-ray bursts detected by the interplanetary network

We present the results of a search for gravitational waves associated with 223 γ-ray bursts (GRBs) detected by the InterPlanetary Network (IPN) in 2005-2010 during LIGO's fifth and sixth science runs and Virgo's first, second, and third science runs. The IPN satellites provide accurate times of the bursts and sky localizations that vary significantly from degree scale to hundreds of square degrees. We search for both a well-modeled binary coalescence signal, the favored progenitor model for short GRBs, and for generic, unmodeled gravitational wave bursts. Both searches use the event time and sky localization to improve the gravitational wave search sensitivity as compared to corresponding all-time, all-sky searches. We find no evidence of a gravitational wave signal associated with any of the IPN GRBs in the sample, nor do we find evidence for a population of weak gravitational wave signals associated with the GRBs. For all IPN-detected GRBs, for which a sufficient duration of quality gravitational wave data are available, we place lower bounds on the distance to the source in accordance with an optimistic assumption of gravitational wave emission energy of 10(-2)M⊙c(2) at 150 Hz, and find a median of 13 Mpc. For the 27 short-hard GRBs we place 90% confidence exclusion distances to two source models: a binary neutron star coalescence, with a median distance of 12 Mpc, or the coalescence of a neutron star and black hole, with a median distance of 22 Mpc. Finally, we combine this search with previously published results to provide a population statement for GRB searches in first-generation LIGO and Virgo gravitational wave detectors and a resulting examination of prospects for the advanced gravitational wave detectors.

Urinary creatine at rest and after repeated sprints in athletes: a pilot study

Creatine plays a key role in muscle function and its evaluation is important in athletes. In this study, urinary creatine concentration was measured in order to highlight its possible significance in monitoring sprinters. The study included 51 sprinters and 25 age- and sex-matched untrained subjects as a control group. Body composition was measured and dietary intake estimated. Urine samples were collected before and after standardized physical exercise. Creatine was assessed by gas chromatography mass spectrometry. Basal urinary creatine (UC) was significantly lower in sprinters than controls (34±30 vs. 74±3 µmol/mmol creatinine, p < 0.05). UC was inversely correlated with body mass (r = -0.34, p < 0.01) and lean mass (r = -0.30, p < 0.05), and positively correlated with fat mass (r = 0.32, p < 0.05). After acute exercise, urinary creatine significantly decreased in both athletes and controls. UC is low in sprinters at rest and further decreases after exercise, most likely due to a high uptake and use of creatine by muscles, as muscle mass and physical activity are supposed to be greater in athletes than untrained subjects. Further studies are needed to test the value of urinary creatine as a non-invasive marker of physical condition and as a parameter for managing Cr supplementation in athletes.

Partial sequencing of the VP2 capsid gene for direct enterovirus genotyping in clinical specimens

Typing of human enterovirus (EV) remains a major goal for diagnostic and epidemiological purposes. Whereas sequencing of the VP1 coding region is the reference standard for EV typing, a method relying on sequencing of the VP2 coding region has been proposed as an alternative; however, this has been validated only on cell culture supernatants. To avoid the selection of cultivable strains and to quicken the identification step, a new semi-nested PCR method targeting the VP2 region was developed by use of the CODEHOP strategy. After validation of the method on reference and clinical strains, a total of 352 clinical specimens found to be positive for EV RNA (138 with the GeneXpert EV kit and 214 with the Enterovirus R-gene kit) during a 3-year period (2010-2012) were analysed prospectively for VP2 genotyping. Overall, 204 (58%) specimens were typeable. A higher proportion of throat swab/stool specimens than of cerebrospinal fluid (CSF) specimens was found to be typeable (94 of 142 (66.2%) vs. 83 of 169 (49.1%), respectively, p <0.01 by the chi-square test). Moreover, the median Ct value obtained was lower for typeable specimens than for untypeable specimens (32.20 vs. 33.01, p <0.05, and 25.96 vs. 31.74, p <0.001, for the GeneXpert and R-gene tests, respectively, by the Mann-Whitney-Wilcoxon test). These results suggest that, in cases of EV meningitis, a peripheral specimen (i.e. throat swab or stool) that is susceptible to exhibiting a higher viral load should be used in preference to CSF for identifying the causative EV genotype by use of the VP2 typing method without cell culture isolation.