Fine particulate matters less than 2.5 µm (PM2.5) in the ambient atmosphere are strongly associated with adverse health effects. However, it is unlikely that all fine particles are equally toxic in view of their different sizes and chemical components. Toxicity of fine particles produced from various combustion sources (diesel engine, gasoline engine, biomass burning (rice straw and pine stem burning), and coal combustion) and non-combustion sources (road dust including sea spray aerosols, ammonium sulfate, ammonium nitrate, and secondary organic aerosols (SOA)), which are known major sources of PM2.5, was determined. Multiple biological and chemical endpoints were integrated for various source-specific aerosols to derive toxicity scores for particles originating from different sources. The highest toxicity score was obtained for diesel engine exhaust particles, followed by gasoline engine exhaust particles, biomass burning particles, coal combustion particles, and road dust, suggesting that traffic plays the most critical role in enhancing the toxic effects of fine particles. The toxicity ranking of fine particles produced from various sources can be used to better understand the adverse health effects caused by different fine particle types in the ambient atmosphere, and to provide practical management of fine particles beyond what can be achieved only using PM mass which is the current regulation standard.
The clinical usefulness of vitamin D for treatment of hypogonadism or LUTS/BPH varies according to metabolic status.
Objectives: To determine the cardiovascular, autonomic, and neuromuscular effects of an IV infusion of tetrodotoxin (TTX) when ventilation is supporte'd.Methods: TTX was infused in 18 anesthetized beagles during conventional mechanical ventilation. TTX infusion continued at a rate of 9.3 p.g/kg/hr until apnea occurred with 1 minute of ventilator disconnection. Measurements included intravascular pressures, heart rate (HR), cardiac output, blood gases, displacements of the rib cage and abdomen, 0, delivery, and responses to train-of-four and tetanic peripheral nerve stimulation. Results are expressed as mean 2 SD. Results: During TTX infusion, all the dogs had discoordinate movements of the rib cage, abdomen, and limbs. Vomiting, urination, defecation, and increased salivation occurred. Nicotinic and muscarinic effects, neuromuscular blockade, and cardiovascular depression were produced by TTX. Apnea occurred in 72.0 2 17.0 minutes when a total of 119.0 ? 17.4 pg of TTX was infused. At apnea, decreases in arterial pressure, cardiac index, HR, 0, delivery, and systemic vascular resistance occurred, while pulmonary artery pressure and pulmonary vascular resistance increased. Loss of response to tetanic stimulation was closely correlated with the dose of TTX that produced apnea. Conclusion:The clinical symptoms and signs of TTX poisoning are similar to those of anticholinesterase poisons, and TTX dosing as described by this model may serve as a surrogate for organophosphorus poisoning.The model may be useful to determine optimum therapies for 'ITX poisoning and, since TTX prevents sodium influx into cells, to investigate enhanced survival in animals suffering from ischemia. Key words: tetrodotoxin; organophosphorus poisoning; simulation; overdose; toxicology; airway management. I Tetrodotoxin (TTX) is a neurotoxin found in the puffer fish. TTX produces apnea and cardiovascular depression'-' by selectively blocking axonal conduction and by preventing the increase in permeability to sodium (Na') ions associated with an action ~otential.~.' Precipitous hypotension, bradycardia, and a fall in cardiac output are reported to occur when TTX is given in bolus IV or intraperitoneal (Ip) doses sufficient to produce respiratory muscle paralysis and a~n e a .~.~. "Over a 68-year period there has been a 59% mortality rate among 6,386 people who suffered TTX poisoning after eating puffer fish liver, roe, and testes,'.* yet systematic study of TTX effects during a more clinically relevant dosing regimen remains undescribed. Gradual changes would be expected to occur following overdose with TTX after ingestion and absorption through the skin. However, respiratory failure masks the other effects of TTX.The neuromuscular blockade that results from TTX causes a similar pathologic state (by a different pharmacologic mechanism) to those of potent long-acting anticholinesterases (AChEs), which are widely used as insecticides in agriculture and used in chemical warfare.'-'' Both TTX and AChE overdoses produce vomiting, excess sal...
PurposeWe investigated the correlations of serum total testosterone (TT) levels with body composition and physical fitness parameters in patients with erectile dysfunction (ED) to know the best exercise for testosterone deficiency.Materials and MethodsEighty-seven ED patients underwent serum TT assessment as well as body composition and basic exercise testing. The bioelectrical impedance analysis was used to assess body composition. Seven types of basic exercise tests were used to determine physical fitness. Correlations between serum TT levels and body composition/physical function parameters were evaluated using partial correlation analyses. A serum TT cut-off value was obtained for the parameters significantly correlated with serum TT levels.ResultsThe subjects had a mean serum TT level of 342.1 ng/dL. Among the body composition parameters, body and abdominal fat percentages showed statistically significant negative correlations with serum TT levels. Among the basic exercise test parameters, only the cycle ergometer test for cardiorespiratory fitness showed a statistically significant positive correlation with serum TT levels.ConclusionsSerum TT levels in patients with ED, may be increased by reducing fat percentage and improving cardiorespiratory fitness via aerobic exercise.
The objective of this study was to determine whether routine preoperative type and screen blood testing is cost effective and medically warranted for benign diagnosis in healthy patients undergoing robotic hysterectomy. The study was designed as a cross sectional retrospective descriptive study. Four hundred and twenty two medical records of American Society of Anesthesiologists (ASA) Classifications I and II patients undergoing robotically-assisted laparoscopic hysterectomy between 1 June 2011 and 31 May 2014 at a 211 bed regional medical center were analysed. The results from this study paralleled the findings of other published research. Preoperative type and screen testing was performed on 249 (59%) of the patients in the study. Ten patients (2.4% of the group) converted to open laparotomy. Mean estimated blood loss was 59.59ml. No perioperative transfusions were required. The results indicate that preoperative type and screen testing is not warranted for patients meeting the inclusion criteria.
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