Relationship between labour analgesia modalities and types of anaesthetic techniques in categories 2 and 3 intrapartum caesarean deliveries

General anesthesia (GA) is typically recommended for category 1 emergency cesarean delivery (CD). For categories 2–4 emergencies, either regional or GA can be used. The factors influencing the choice of anesthetic technique in these categories remain poorly understood. We analyzed the association between the type of labor analgesia and subsequent anesthetic techniques employed for intrapartum categories 2 and 3 CD. In a prospective longitudinal cohort study, 300 women were consequently enrolled and categorized according to Lucas’s classification of CD urgency. The techniques of anesthesia (GA, spinal, and epidural anesthesia [EA]) employed for CD were analyzed with respect to labor analgesia methods (remifentanil patient-controlled analgesia [remifentanil-PCA], EA, and nitrous oxide [N2O]). EA was the most frequent analgesic option (43.8%), followed by remifentanil-PCA (20.7%) and N2O (5.1%), while 30.4% of parturient women received no analgesia. All anesthetic methods showed a significant relationship with analgesic modalities (P < 0.001). Remifentanil-PCA was associated with a higher incidence of GA. Contraindication to EA was the primary factor related to the transition from remifentanil-PCA to GA. Most parturients who received EA were successfully converted to EA. Spinal anesthesia was the most common technique in women using N2O and those without labor analgesia. GA was associated with lower 5-min Apgar scores. The method of labor analgesia was associated with the anesthesia technique employed for categories 2 and 3 CD. This finding may guide patient counseling and intrapartum anesthetic planning. However, the analysis should be cautiously interpreted as the selection of anesthesia is a complex decision influenced by several clinical considerations.

Duckweed Lemna minor as a tool for testing toxicity and genotoxicity of surface waters

In this investigation growth parameters and certain endpoints (pigment content, peroxidase activity, lipid peroxidation and alkaline comet assay) were used to detect the toxic and genotoxic effects of surface water samples on duckweed plants. The surface waters of different origin and pollutant burdens were collected monthly over a 3-month monitoring period at three sampling sites along the river Sava and its confluents (Croatia). Physicochemical characterization of the water samples included measurements of conductivity, chemical and biological oxygen demand, levels of total suspended solids, nitrate, nitrite, ammonium, Kjeldahl nitrogen and orthophosphate. Surface water samples collected from three stations caused reduction of duckweed growth rates, chlorophylls and carotenoid contents and peroxidase activity. In contrast, damage to membrane lipids (estimated by malondialdehyde content) and especially to DNA (estimated by tail extent moment) markedly increased in duckweed exposed to industrial wastewater samples. The results from the study indicate the ability of selected biomarkers to predict the phyto- and genotoxic effects of complex water mixtures on living organisms as well as the relevance of duckweed as a sensitive indicator of water quality.

[C-reactive protein as an indicator of the severity of war injuries]

During the general reaction to trauma, acute phase proteins are synthetized. The aim of the prospective study was to determine CRP concentrations in sera of war casualties during the first 14 posttraumatic days, and to establish the correlation between these changes and severity of trauma. Subjects were 79 war casualties.

CONTROLS

33 blood donors.

METHODS

Injury severity was determined according to ISS and CRP concentrations with immunonephelometric analysis. Blood samples were collected 12 hours after trauma, then on the 1st, 2nd, 5th and 14th posttraumatic day. In war casualties CRP values were significantly increased (56.257.53 mg/dl after 12 hrs, 107.0976.08 on 1st, 144.3570.23 on 2nd, 71.42558.66 on 5th and 37.656.14 on 14th posttraumatic day; p). Significant differences were observed between groups with ISS and ISS12 (p) in first two days and later between group with ISS24 (144.1766.94 mg/dl on 5th and 111.588.5 on 14th posttraumatic day) and others (p).

CONCLUSIONS

During the acute-phase response to trauma, significant changes in concentration of CRP occur in sera of war casualties. These changes are the most prominent during the first 48 hours, with tendency for normalization after the 5th day. Intensity of these changes depend on the severity of trauma. CRP is valid marker of war wound severity.

Cytogenetic damage in shallot ( Allium cepa) root meristems induced by oil industry "high-density brines"

Saturated water solutions of calcium chloride, calcium bromide (densities 1.30 kg x dm(-3) and 1.61 kg x dm(-3), respectively) and their 1:1 mixture have been commonly used as oil industry "high-density brines." In our experiment they were added to tap water in amounts appropriate to achieve concentrations of 0.025, 0.05, 0.075, and 0.1 mol x dm(-3) to study their cytotoxic effect on the root tip cells of shallot ( Allium cepa L. var. ascalonicum). All tested solutions in concentrations of 0.075 and 0.1 mol x dm(-3) caused significant inhibition of shallot root growth. CaBr (2) showed this effect in concentration 0.05 mol x dm(-3). The investigated solutions in all concentrations applied decreased mitotic activity in root tip cells. The most of mitotic abnormalities were the consequence of spindle failure and chromosome stickiness. Furthermore, the cell microtubules were investigated by indirect immunofluorescence to confirm that most abnormalities observed were the consequence of spindle failure. The present study, as well as previously done Lemna tests and Chlorella tests showed that investigated samples have certain effects on plants, so constant control of their presence in the environment is needed.

Detection of DNA damage in haemocytes of zebra mussel using comet assay

The aim of the study was to use the comet assay on haemocytes of freshwater mussel, Dreissena polymorpha Pallas, for detection of possible DNA damage after exposure to pentachlorophenol (PCP) and to evaluate the potential application of the comet assay on mussel haemocytes for genotoxicity monitoring of freshwater environment. Zebra mussels were exposed for seven days to different concentrations (10, 80, 100, 150 microg/l) of PCP and in the river Sava downstream from Zagreb municipal wastewater outlet. Significant increase in DNA damage was observed after exposure to PCP at doses of 80 microg/l and higher and after in situ exposure in the river Sava as well. This study confirmed that the comet assay applied on zebra mussel haemocytes may be a useful tool in determining the potential genotoxicity of water pollutants.

The cytotoxic effect of wastewater from the phosphoric gypsum depot on common oak (Quercus robur L.) and shallot (Allium cepa var. ascalonicum)

The effect of wastewater from a phosphoric gypsum depot on common oak, Quercus robur L., at cytogenetical level was studied. Allium-test was used as a control. The treatment of common oak seedlings with wastewater under laboratory conditions caused mitodepressive effect. Chromosome aberrations and mitotic irregularities were found. Cytogenetic analysis of common oak seedlings grown from acorns collected near the depot did not show changes in mitotic activity in comparison to control but the number of aberrations was higher than in control. In comparison to Alliumtest common oak was found to be more tolerant to wastewater from the phosphoric gypsum depot.

Symptomatic aniseikonia in unilateral and bilateral pseudophakia. A projection space eikonometer study

PURPOSE

To determine the incidence of aniseikonia and aniseikonic symptoms in pseudophakia (intraocular lens implantation after cataract extraction).

METHOD

Aniseikonia, stereoacuity, and clinical symptoms were evaluated in patients with unilateral and bilateral pseudophakia. Aniseikonia was determined with the Essilor projection space eikonometer. Eight-seven cases were studied, fifty-four of unilateral pseudophakia and thirty-three of bilateral pseudophakia. Nine of the 87 patients had insufficient stereopsis to be examined or measured for aniseikonia with the Essilor instrument, and were studied with the "Double-D", a two dimensional "direct comparison eikonometer" device programmed and viewed on a computer. Stereoacuity was determined with the Titmus Stereo Test.

RESULTS

Thirty-five (40.2%) of all pseudophakes had ophthalmic complaints referable to aniseikonia. The mean aniseikonia in the unilateral pseudophakia group was 4.1%, SD=3.41, while the mean aniseikonia in the bilateral group was 3.2%, SD=2.6.

CONCLUSION

Symptomatic aniseikonia is common in pseudophakia. Unilateral pseudophakia has the higher degrees of aniseikonia, and is at a greater risk of loss of binocularity and of asthenopia.

Detection of micronuclei in haemocytes of zebra mussel and great ramshorn snail exposed to pentachlorophenol

The frequency of micronuclei (MN) induced by pentachlorophenol (PCP) in haemocytes of zebra mussel, Dreissena polymorpha Pall. and great ramshorn snail, Planorbarius corneus L. was determined over a 14 days of exposure (sampling after 4, 7 and 14 days) under laboratory conditions. PCP doses for zebra mussel ranged from 10 to 150 microg/l, and for ramshorn snail from 10 to 450 microg/l. Micronuclei were detected after bisbenzimide fluorescent staining. Positive responses were observed in both species. The mean MN frequencies in treated mussels ranged between 0.69 and 7.50 per thousand, and between 2.07 and 13.80 per thousand in treated snails. The spontaneous MN levels in mussels averaged from 0.5 to 2.75 per thousand, and in snails from 1.56 to 2.00 per thousand. Our results suggest that haemolymph of both species represent an appropriate test tissue in environmental genotoxicity assessment.

[Temperature of the skin in microvascular flaps]

Transferred free flaps by their defined vascular net improve the perfusion of the recipient region. Skin temperature depends on the skin perfusion, temperature conduction of the visceral organs, muscles and blood vessels, as well as on the heat loss by the evaporation and air convection in the environment. At the Clinic for Plastic Surgery and Burns and at the Institute of Hygiene of the Military Medical Academy, skin temperature of the transferred free flaps and the recipient region surrounding were analyzed and measured in controlled microclimate conditions. The analysis was performed in 31 subjects, 20.23 months after the free tissue transfer. The aim of the study was to determine the differences between the skin temperature of the transferred free flaps and the recipient region surrounding, as wall as of the donor's region surrounding. The results of the investigation revealed that skin temperature of the transferred free flaps was lower in 28 (90.3%) patients than the temperature of the donor's region surrounding. Skin temperature of the transferred free flaps was higher in 25 subjects (80.6%) than the temperature of the recipient region surrounding. Skin temperature of free flaps transferred to the foot and the lower leg was higher than the skin temperature of the recipient region surrounding but was also lower in the flaps transferred on the head. The temperature of the recipient region surrounding influenced the skin temperature of the transferred free flaps, besides the flap tissue perfusion.

Environmental factors, health-related habits, and serum selenium levels in cancer patients and healthy controls

Previous studies conducted in Yugoslavia indicated that the concentration of selenium in soil, food items, and serum of the population is very low. The aim of the study was to investigate the possible relationship among environmental, health-related habits, nutrition, and selenium serum levels in cancer patients and the healthy population. The case-control study included a group of cancer patients and a matched group of healthy controls: 57 cancer patients and 41 healthy controls living in Stari Grad (an urban area of Belgrade), as well as 17 cancer patients and 13 healthy controls living in Barajevo (a rural community in the vicinity of Belgrade). The healthy controls were matched to cancer patients in sex and age; they were not blood related. The selenium serum levels were measured by atomic absorption spectrophotometry. Health-related habits and relevant dietary factors ("food frequency" method) that may influence the selenium serum levels were assessed by questionnaires. The differences in average values of selenium serum levels between the cancer patients and healthy controls were not significantly different, but both were below the lowest recorded in referential studies. A significant difference between the values obtained from urban and rural subgroups was noted. The most important factors that influenced the level of selenium included the residence place in the region with selenium deficiency (Barajevo), age, associated chronic diseases, and some dietary factors potentially related to the intake of selenium. The results obtained in this investigation pointed out that use of selenium supplementation in this area should be seriously considered.

[Gas-mass spectrometry in the identification and determination of ethanol in blood]

A contemporary analytical method for positive identification and quantitative toxicological--chemical analysis of ethanol in blood samples using the methods of gas extraction, thermal adsorption/desorption and gas-mass spectrometry, was developed. Maximal sensitivity of ethanol detection was 0.27 mmol/l.

Genotoxicity of dithiocarbamates and their metabolites

Dithiocarbamate fungicides are widely used in agriculture for protection of vegetable crops and seeds. The mutagenicity spectra of ziram, thiram, zineb S-65 and ETU were determined by employing a battery of test systems included the bacterium Salmonella typhimurium (strains TA98, TA100, TA102, TA104, TA1535, TA1538), the yeast Saccharomyces cerevisiae (strain D61.M) and the shallot Allium ascalonicum somatic cells. Plate incorporation assay with S. typhimurium demonstrated direct mutagenicity of ziram in TA100 and thiram in TA100 and TA98 whereas zineb S-65 and ETU were ineffective. Tests for mitotic chromosome malsegregation in S. cerevisiae D61.M gave positive results with thiram, zineb S-69 and ETU. In shallot somatic root-tip cells ziram, thiram and ETU induced different genetic damages e.g. mitotic disturbance, polyploidy and micronuclei.

Effects of benzyladenine on prokaryotic and eukaryotic cells

Comparative studies of the effect of benzyladenine (BA) on the yeast Saccharomyces cerevisiae, the bacterium Salmonella typhimurium, the shallot Allium ascalonicum and Chinese hamster fibroblast cells were performed. The tested substance had no mutagenic activity on yeast, bacteria and cultured fibroblast cells. Changes in mitotic activity and cell division abnormalities were observed after BA treatment in shallot root-tip cells.

2,4-Dichlorophenoxyacetic acid causes chromatin and chromosome abnormalities in plant cells and mutation in cultured mammalian cells

The cytotoxic and mutagenic effects of the synthetic auxin 2,4-dichlorophenoxyacetic acid (2,4-D) on shallot root tip cells and on V79 Chinese hamster fibroblast cells were examined and compared. In shallot root tips 2,4-D caused changes in mitotic activity, as well as changes in chromosome and chromatin structure, and also changes during the cell cycle. 2,4-D also showed mutagenic and cytotoxic effects on V79 cells in culture in concentrations higher than 10 micrograms/ml. The results in both systems (plant and mammalian cells) were in agreement showing mutagenic activity of 2,4-D in the concentration range higher than usually used in establishing plant tissue culture (greater than 5 micrograms/ml).

[The effect of a 3-day fast on psychophysical functions in young people]

Presented are results of the effect of a complete three-day fasting with permitted optional water intake on some anthropometric, biochemical-metabolic and functional parameters significant in the assessment of psychophysical fitness of healthy, well-developed and normally-nourished young men aged 19.5 years in average. It was found that a three-day complete fasting with average daily energy expenditure of 14.89 MJ resulted in significant body mass reduction, significant glycemia and respiratory quotient decrease, significant blood urea, keto-bodies and triglyceride levels increase and in significantly reduced endurance at strenuous physical work performance.

[Nutritional status, physical development and physical fitness of soldiers before and after training]

Results of nutritional status, physical development and fitness examination in 414 infantrymen from 4 garrisons have been presented. Examinations have been undertaken in two phases: immediately after entering the army and at the end of the military service. Somatometric values and physical fitness results suggest the positive effect of training and nutrition on nutritional status, physical development and fitness of soldiers.