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Background: Ultrasound-guided Quadratus Lumborum block (QLB) has become an established modality for perioperative analgesia in lower abdominal surgeries. However, its efficacy in upper abdominal surgeries is still understudied. Objectives: The study aimed to determine QLB2 efficacy as a perioperative analgesic modality in upper abdominal surgeries, compared to caudal epidural block (CEB), regarding FLACC score, the time to the first rescue analgesia, the amount of fentanyl consumed intraoperatively, amount of rescue analgesia administered, parents' satisfaction, as well as the incidence of complications. Study design: A randomized, prospective, double-blind, and single-center study. Setting: Ain Shams University Hospitals Methods/patients/interventions/measurements: Fifty-two pediatric patients scheduled for upper abdominal surgeries under general anesthesia were assigned randomly to undergo CEB or ultrasound guided QLB 2. As assessed by FLACC, postoperative pain scores were the primary outcome. The secondary outcomes included the amount of fentanyl consumed intraoperatively, the time to first rescue analgesia, the amount of rescue analgesia given, parents' satisfaction, and the incidence of complications. Results: The QLB cohort demonstrated decreased FLACC scores than the CEB group. Total fentanyl consumption was significantly lower (33.4 ± 14.9 µg vs. 56.5 ± 17.0 µg, p-value of 0.003), time to first rescue analgesia was more prolonged (14.4 ± 1.3hrs vs. 1.8 ± 1.2 hr, p-value <0.001), and parents' satisfaction was significantly higher. Postoperative nausea incidence was significantly alleviated (11 (42.3%) vs. 22 (84.6%), p-value 0.002), whereas vomiting was substantially decreased (0 (0.0%) vs. 15 (57.7%), p-value <0.001). Conclusion: Perioperative analgesia in pediatric patients can be effectively achieved using QLB type 2. Compared to CEB, it provides more stable hemodynamics, lower FLACC scores, less need for rescue analgesia, and higher parent satisfaction. [ABSTRACT FROM AUTHOR]

Background: The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula. Aim: To determine the minimum effective caudal local anesthetic dose using ultrasound guidance. Methods: Study was performed at two centres and at each centre, 50 pediatric patients (Total 100 patients), aged 1 to 3 years, undergoing below umbilical surgeries were included and randomised into two groups of 25 each (Total 50) to receive ultrasound guided drug volume vs. Armitage formula based volume. The volume required to reach T10 level was assessed with ultrasound in one group. Also, maximum height achieved, cutaneous level achieved after 15 min, FLACC scores 30 min post extubation and parental satisfaction scores were noted. Results: The mean drug volume required to reach T10 level in Group U was 0.755 ± 0.053 ml/kg with a P value < 0.001. (Compared to the drug volume of 1 ml/kg using one sample t test). The highest level achieved in both groups were calculated as the mode value of T8 and T7 in Group U and Group A respectively. The highest cutaneous level achieved after 15 min was also calculated as the mode value of T4 in both groups. FLACC scores at 30 min were also comparable. Satisfaction scores were comparable in both groups. Conclusion: A volume of 0.7 ml/kg of local anaesthetic in pediatric caudal block is sufficient to achieve a target of T10 level for infraumblical surgeries. [ABSTRACT FROM AUTHOR]

Background: Postoperative pain management remains a significant challenge for patients undergoing posterior urethroplasty (PU). In a previous study, we proposed a novel technique of combined pudendal nerve (PN) and spermatic cord (SC) block to manage pain after PU. The present trial was conducted to test the hypothesis that this technique is effective for pain control after PU and provides longer-lasting analgesia than caudal epidural block (CB). Methods: Sixty patients undergoing PU were randomized into two groups: Group NB received combined PN and SC block, and Group CB received CB. General anesthesia with a laryngeal mask was performed. The primary outcome was the postoperative analgesic duration, and the secondary outcomes included the Numeric Rating Scale (NRS) scores for pain and the number of patients with different motor scores of the lower limb at 3, 6, 12, and 24 h postoperatively. Results: Two patients in Group CB were withdrawn due to block failure. The postoperative analgesic duration was statistically longer in Group NB compared with Group CB (mean difference [95% confidence interval], 115.78 min [17.80, 213.75]; P = 0.021). The NRS scores for pain at 12 and 24 h after surgery were statistically lower in Group NB compared with Group CB. Group NB had statistically more patients with motor score 0 at 3 h postoperatively than Group CB. Conclusions: PN combined with SC block is an effective technique for postoperative analgesia in PU. This technique can achieve a longer duration of analgesia and lower pain scores, especially 12 h after surgery, than a CB. Trial registration: This study was registered in the Chinese Clinical Trial Register (registration no. ChiCTR2100042971, registration date on 2/2/2021). [ABSTRACT FROM AUTHOR]

Background: Transforaminal and caudal epidural injections are two methods of steroid injection in lumbar radiculopathy. Using a targeted catheter with the possibility of accessing the involved spinal roots and steroid administration selectively next to them during the caudal procedure may achieve the benefits of both transforaminal and caudal procedures. The aim of this study was to investigate the clinical effects and physical examinations of transforaminal steroid injection compared to caudal through a targeted catheter in lumbar radiculopathy. Methods: Fifty patients with lumbar radiculopathy candidates for epidural steroid injection were divided into transforaminal (T) and caudal (C) groups. Steroid injection under fluoroscopic guidance was performed in group T with the transforaminal method and in group C with the caudal method using a targeted catheter for each involved spinal nerve root. Pain intensity visual analog scale (VAS), Oswestry Disability Index (ODI), daily analgesic consumption, and physical examinations on four follow‐ups (before injection, second week, first and third month) were evaluated. Results: Pain score (VAS) and functional disability index (ODI) were similar in both groups, and there was no significant difference between the two groups (p > 0.05). The positive Lasègue test was significantly higher in the caudal group than in the transforaminal group only in the third month (p < 0.05). Other physical examinations in both groups did not have significant differences in all the follow‐ups. Moreover, there was no difference in the amount of analgesic consumption in the two groups. No complications were observed in both groups. Conclusion: This study showed that transforaminal and caudal steroid injection (with a targeted catheter) in patients with lumbar radiculopathy had similar effects in controlling pain and improving functional disability of patients in the short term. Cases of recurrence of positive Lasègue test in physical examinations in the long term (third month) in the caudal group may indicate the preference of the transforaminal approach. Trial Registration: Iranian Registry of Clinical Trials (IRCT) number: IRCT20111102007984N31 [ABSTRACT FROM AUTHOR]

Abstract Background The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula. Aim To determine the minimum effective caudal local anesthetic dose using ultrasound guidance. Methods Study was performed at two centres and at each centre, 50 pediatric patients (Total 100 patients), aged 1 to 3 years, undergoing below umbilical surgeries were included and randomised into two groups of 25 each (Total 50) to receive ultrasound guided drug volume vs. Armitage formula based volume. The volume required to reach T10 level was assessed with ultrasound in one group. Also, maximum height achieved, cutaneous level achieved after 15 min, FLACC scores 30 min post extubation and parental satisfaction scores were noted. Results The mean drug volume required to reach T10 level in Group U was 0.755 ± 0.053 ml/kg with a P value

Abstract Background Postoperative pain management remains a significant challenge for patients undergoing posterior urethroplasty (PU). In a previous study, we proposed a novel technique of combined pudendal nerve (PN) and spermatic cord (SC) block to manage pain after PU. The present trial was conducted to test the hypothesis that this technique is effective for pain control after PU and provides longer-lasting analgesia than caudal epidural block (CB). Methods Sixty patients undergoing PU were randomized into two groups: Group NB received combined PN and SC block, and Group CB received CB. General anesthesia with a laryngeal mask was performed. The primary outcome was the postoperative analgesic duration, and the secondary outcomes included the Numeric Rating Scale (NRS) scores for pain and the number of patients with different motor scores of the lower limb at 3, 6, 12, and 24 h postoperatively. Results Two patients in Group CB were withdrawn due to block failure. The postoperative analgesic duration was statistically longer in Group NB compared with Group CB (mean difference [95% confidence interval], 115.78 min [17.80, 213.75]; P = 0.021). The NRS scores for pain at 12 and 24 h after surgery were statistically lower in Group NB compared with Group CB. Group NB had statistically more patients with motor score 0 at 3 h postoperatively than Group CB. Conclusions PN combined with SC block is an effective technique for postoperative analgesia in PU. This technique can achieve a longer duration of analgesia and lower pain scores, especially 12 h after surgery, than a CB. Trial registration This study was registered in the Chinese Clinical Trial Register (registration no. ChiCTR2100042971, registration date on 2/2/2021).

Background/Aim. Surgery for developmental dysplasia of the hip (DDH) often needs acetabuloplasty and femoral osteotomy. This type of operation is characterized by long duration, major trauma, and severe postoperative pain. The aim of the study was to compare the analgesic effects of the caudal block (CB) and epidural block (EB) on the DDH surgery in children. Methods. A total of 100 children undergoing DDH surgery in our hospital from May 2018 to December 2021 were selected and randomly divided into two groups: an ultrasound-guided CB group and an EB group (each group consisting of 50 children). The dosage of ropivacaine, changes in blood pressure, heart rate, and intraoperative dosage of fentanyl were recorded. In addition, we recorded the values of several parameters after the surgery: the modified Face, Legs, Activity, Cry, and Consolability (FLACC) scale score at 2, 4, 6, 12, 24, 36, and 48 hrs after surgery; the time point of first-time request for acetaminophen and proportion of patients using pethidine; the sedation degree within 12 hrs after the operation (assessed using the Ramsay Sedation Scale -- RSS); the incidence of nausea, vomiting, and urinary retention; the satisfaction degree of family members with the applied methods of postoperative analgesia in children. Results. The ropivacaine dosage used in the CB group exceeded that of the EB group (p < 0.05). The CB group had lower FLACC scores 12 and 24 hrs after the operation and a longer postoperative time until the first-time request for acetaminophen than the EB group (p < 0.05). No block-related complications occurred; the two groups had similar incidence rates of nausea, vomiting, and urinary retention. The RSS score within 12 hrs after operation was higher in the CB group than in the EB group, and the family members of the children in the CB group were more satisfied (p < 0.05). Conclusion. Both CB and EB can provide satisfactory intraoperative and postoperative analgesia for pediatric hip surgery. However, CB provides effective analgesia for 24 hrs after the operation and lasts longer than that accomplished by the EB. [ABSTRACT FROM AUTHOR]

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ABSTRACT Background Transforaminal and caudal epidural injections are two methods of steroid injection in lumbar radiculopathy. Using a targeted catheter with the possibility of accessing the involved spinal roots and steroid administration selectively next to them during the caudal procedure may achieve the benefits of both transforaminal and caudal procedures. The aim of this study was to investigate the clinical effects and physical examinations of transforaminal steroid injection compared to caudal through a targeted catheter in lumbar radiculopathy. Methods Fifty patients with lumbar radiculopathy candidates for epidural steroid injection were divided into transforaminal (T) and caudal (C) groups. Steroid injection under fluoroscopic guidance was performed in group T with the transforaminal method and in group C with the caudal method using a targeted catheter for each involved spinal nerve root. Pain intensity visual analog scale (VAS), Oswestry Disability Index (ODI), daily analgesic consumption, and physical examinations on four follow‐ups (before injection, second week, first and third month) were evaluated. Results Pain score (VAS) and functional disability index (ODI) were similar in both groups, and there was no significant difference between the two groups (p > 0.05). The positive Lasègue test was significantly higher in the caudal group than in the transforaminal group only in the third month (p

El estudio se enfoca en el desarrollo de un micro generador hidroeléctrico mediante el empleo de una turbina de flujo cruzado de admisión inferior que aprovecha el potencial hidráulico de los canales de riego. La metodología utilizada es cuantitativa y experimental, y se basa en un diagrama de flujo que describe las etapas desde la creación hasta la implementación del prototipo. Se tomaron en cuenta variables como la altura y el caudal del agua, así como las dimensiones del canal de riego, las cuales no podían modificarse debido a las actividades agrícolas que se llevan a cabo en el lugar. Los resultados obtenidos de la implementación en campo del prototipo diseñado demuestran que el generador tiene la capacidad de alcanzar un valor de potencia de 93 W con un porcentaje de eficiencia del 11.3% el mismo que produce energía de manera sostenible en áreas remotas. En conclusión, el estudio resalta la necesidad de explorar nuevas fuentes de energía renovales y sostenibles en respuesta a la crisis energética actual que afecta a la sociedad; se enfatiza la imprescindibilidad por adoptar alternativas energéticas más limpias que limite la dependencia por los recursos no renovables a la par de controlar los efectos negativos del cambio climático.

Pediatric burns affect approximately 15-20 patients per 100 000 hospital admissions, but unfortunately there is a lack of evidence to guide optimal strategies for acute pain control. The aim of this study was to evaluate whether caudal analgesia with single injection of local anesthetics reduced pain medication consumption in pediatric patients who required surgical intervention for burn injuries. Retrospective data from patients

Background & Aim: Caudal block has been commonly used by the anaesthesiologists in pediatric surgery to relieve postoperative pain. This study compared the use of bupivacaine alone with bupivacaine plus tramadol for a single shot caudal block to find out whether tramadol can be an effective adjuvant to bupivacaine for providing better postoperative analgesia in children undergoing lower extremity surgery. Material and methods: A total of 60 children undergoing lower extremity surgery were randomly allocated into two groups; 30 children in group BT were treated with bupivacainewith tramadol, and 30 patients in Group B were treated with bupivacaine only. Caudal epidural block was performed immediately after induction of anaesthesia. Study outcomes were monitored in terms of duration of analgesia and total rescue analgesia (paracetamol) required in 1st 24 hrs. Results: Mean duration of analgesia was significantly high in group BT compared to group B and total rescue analgesia required was more in group B compared to group BT which was statistically significant. Conclusion: Tramadol when administered caudally with bupivacaine provided prolonged analgesia without any side effects in children undergoing lower extremity surgery. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed to evaluate the mid-term effectiveness and safety of a combined ultrasound (US) and fluoroscopy (FL)-guided approach in comparison to US-guided and FL-guided caudal epidural steroid injections (CESI) for treating unilateral lower lumbar radicular pain. Materials and Methods: A total of 154 patients who underwent CESI between 2018 and 2022 were included. Patients were categorized into three groups based on the guidance method: combined US and FL (n = 51), US-guided (n = 51), and FL-guided (n = 52). The study design was retrospective case-controlled, utilizing patient charts and standardized forms to assess clinical outcomes, adverse events, complications during the procedures. Results: In all groups, Oswestry Disability Index and Verbal Numeric Scale scores improved at 1, 3, and 6 months after the last injection, with no significant differences between groups (p < 0.05). The treatment success rate at all time points was also similar among the groups. Logistic regression analysis showed that injection method, cause, sex, age, number of injections, and pain duration did not independently predict treatment success. Blood was aspirated before injection in 2% (n = 1), 13.5% (n = 7), and 4% (n = 2) of patients in the combined US and FL groups, FL-guided groups, and US-guided groups, respectively. Intravascular contrast spread was detected in one patient in the combined method groups and seven in the FL-guided groups. Conclusions: When comparing pain reduction and functional improvement, there was no significant difference between the three methods. The combined method took less time compared to using FL alone. The combined approach also showed a lower occurrence of intravascular injection compared to using FL alone. Moreover, blood vessels at the injection site can be identified with an ultrasound using the combined method. Given these advantages, it might be advisable to prioritize the combined US- and FL-guided therapy when administering CESI for patients with unilateral lumbar radicular pain. [ABSTRACT FROM AUTHOR]

Background/Aim. Surgery for developmental dysplasia of the hip (DDH) often needs acetabuloplasty and femoral osteotomy. This type of operation is characterized by long duration, major trauma, and severe postoperative pain. The aim of the study was to compare the analgesic effects of the caudal block (CB) and epidural block (EB) on the DDH surgery in children. Methods. A total of 100 children undergoing DDH surgery in our hospital from May 2018 to December 2021 were selected and randomly divided into two groups: an ultrasound-guided CB group and an EB group (each group consisting of 50 children). The dosage of ropivacaine, changes in blood pressure, heart rate, and intraoperative dosage of fentanyl were recorded. In addition, we recorded the values of several parameters after the surgery: the modified Face, Legs, Activity, Cry, and Consolability (FLACC) scale score at 2, 4, 6, 12, 24, 36, and 48 hrs after surgery; the time point of first-time request for aceta-minophen and proportion of patients using pethidine; the sedation degree within 12 hrs after the operation (assessed using the Ramsay Sedation Scale – RSS); the incidence of nausea, vomiting, and urinary retention; the satisfaction degree of family members with the applied methods of post-operative analgesia in children. Results. The ropivacaine dosage used in the CB group exceeded that of the EB group (p < 0.05). The CB group had lower FLACC scores 12 and 24 hrs after the operation and a longer postoperative time until the first-time request for acetaminophen than the EB group (p < 0.05). No block-related complications occurred; the two groups had similar incidence rates of nausea, vomiting, and urinary retention. The RSS score within 12 hrs after operation was higher in the CB group than in the EB group, and the family members of the children in the CB group were more satisfied (p < 0.05). Conclusion. Both CB and EB can provide satisfactory intraoperative and postoperative analgesia for pediatric hip surgery. However, CB pro-vides effective analgesia for 24 hrs after the operation and lasts longer than that accomplished by the EB.

Background: Pain after lumbosacral spine surgeries is due to activation of various pain mechanisms like inflammatory, nociceptive and neuropathic. Also, by handling structures like vertebrae, intervertebral disc, dura and nerve root sleeves, facet joint capsules, muscles, fascia and ligaments. Several studies have shown that caudal epidural injections are relatively safe, simple, and effective in relieving postoperative pain. Regional blockade can be prolonged by adding different adjuvants. Methodology-The study was conducted in the Anesthesiology department, at the tertiary care hospital for a period of 18 months. 40 patients selected for lumbar spine surgery were included in this study. Further the patients were divided into two groups consisting of 20 patients in each. Group 1 received 0.2% Ropivacaine and Group 2 received 0.2% Ropivacaine + 8mg Dexamethasone. Patients were further monitored for hemodynamic changes such as for Heart rate (HR), Respiratory rate (RR), Non-invasive Blood pressure (NIBP), arterial oxygen saturation (SpO2). Changes were noted and analyzed. Results- The mean of group 1 (N=25) was recorded as 80.96 ± 703 with the range between minimum 65 and maximum 95, whereas the mean of group 2 was recorded as 82.36 ± 9.92 for OPHR. OPSBP mean of group 1 (N=25) was recorded as 112.92 ± 10.27 with the range between minimum 90 and maximum 130, whereas the mean of group 2 was recorded as 118.84 ± 11.82 with the range between minimum 90 and maximum 138.Conclusion-Pre-emptive caudal block with 0.2% Ropivacaine and 8 mg Dexamethasone provides longer and better analgesia for lumbosacral spine surgeries with no hemodynamic side effects. [ABSTRACT FROM AUTHOR]

The study was carried out at the Tío Pedro farm in the municipality of Venezuela, in the province of Ciego de Ávila, with the objective of proposing mathematical models to estimate the hydraulic parameters of a pumping system using the furrow irrigation technique for the cultivation of black bean. The results showed expected fluctuations in hydraulic parameters such as flow rate, head, hydraulic power, pumping time, and pumped volume. Functional relationships were found between flow and pumping head, as well as between hydraulic power, flow and pumping head. These ratios can improve pump system performance, save energy, and increase pump efficiency. In addition, functions were developed to predict the characteristic curves of the load, the efficiency of the pump and the system in general. These results can improve energy efficiency and water management in agriculture. [ABSTRACT FROM AUTHOR]

Caudal epidural blockade is one of the most frequently administered regional anesthesia techniques in children. It is a supplement during general anesthesia and for providing postoperative analgesia in pediatrics for sub-umbilical surgeries, especially for genitourinary surgeries. However, the duration of the analgesic effect is occasionally unsatisfactory. In this review, we discuss the main advantages and disadvantages of different techniques to prolong postoperative analgesia for single-injection caudal blockade in children. A literature search of the keywords “caudal”, “analgesia”, “pediatric”, and “children” was performed using PubMed and Web of Science databases. We highlight that analgesic quality correlates substantially with the local anesthetic's type, dose, the timing relationship between caudal block and surgery, caudal catheterization, and administration of epidural opioids or other adjuvant drugs.

ABSTRACTBackground We hypothesized that adding nalbuphine to bupivacaine would prolong the duration of caudal epidural anaesthesia (CEA) in pediatric patients undergoing hypospadias repair surgery.Methods 60 children scheduled for elective hypospadias surgery under general anesthesia combined with CEA were divided into two equal groups: the control group received caudal bupivacaine 0.25% 1 ml/kg plus 2 ml normal saline. The Nalbuphine group received caudal bupivacaine 0.25% 1 ml/kg plus nalbuphine 0.1 mg/kg in 2 ml normal saline. Intraoperative and postoperative rescue analgesia was managed by giving intravenous paracetamol 15 mg/kg and/or 100mcg nalbuphine. The Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, and the Richmond AgitationSedation Scale (RASS) score were measured. Pre-operative and postoperative blood samples were collected for a subgroup of patients for cortisol analysis.Results The duration of postoperative analgesia was significantly longer in the nalbuphine group (p

Yifan Qin, Huiyu She, Wenrui Peng, Xiaofeng Zhou, Yiting Wang, Peng Jiang, Jin Wu Department of Anesthesiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of ChinaCorrespondence: Jin Wu, Department of Anesthesiology, Affiliated Hospital of Jiangsu University, 438 Jie Fang Road, Zhenjiang, Jiangsu, 212001, People’s Republic of China, Email wujin914@hotmail.comPurpose: Multiple regional nerve blocks proved no additional benefit in total laparoscopic hysterectomy in multimodal analgesia, as postoperative pain may mainly originate from the vaginal cuff. Theoretically, caudal block can relieve pain from the vaginal cuff by a sacral spinal nerve block. We aimed to verify whether a caudal block with ropivacaine and morphine can achieve an analgesic effect without additional adverse effects after a total laparoscopic hysterectomy.Patients and Methods: Forty-eight patients undergoing total laparoscopic hysterectomy were randomly allocated to receive preoperative caudal block with 20 mL of mixture including 0.25% ropivacaine and 2 mg morphine (caudal block group) or sham block (sham group). The primary outcome was the postoperative 24 h cumulative sufentanil consumption.Results: Median (IQR) sufentanil consumption in the first 24 postoperative hours of the caudal block group and the sham group was 0.00 (0.00 to 0.05) μg/kg vs 0.13 (0.04 to 0.21) μg/kg, respectively, p < 0.001. The majority of patients felt that visceral pain was more intense than incisional pain at 1, 6, 12, and 24 h post-surgery in the sham group (95.8% at 1 h, 95.8% at 6 h, 95.8% at 12 h, and 75% at 24 h post-surgery). Compared to the sham group, the caudal block reduced visceral pain scores at rest and during movement at 1 h (p < 0.001), 6 h (p < 0.001), 12 h (p < 0.001), and 24 h (p < 0.001) post-surgery. Intraoperative remifentanil consumption was significantly lower in the caudal block group than in the sham group (p = 0.004). There were no significant differences in other secondary outcomes between the two groups.Conclusion: A caudal block with ropivacaine and morphine could provide a satisfactory analgesic effect for 24 h postoperatively without additional adverse effects after total laparoscopic hysterectomy.Keywords: anesthesia, caudal, visceral pain, hysterectomy, pain, postoperative, postoperative nausea and vomiting, gynecologic surgical procedures

Caudal epidural block is a simple and safe technique with a low complication rate commonly used for pediatric anesthesia and treatment of chronic lumbosacral pain. However, it is not exempt from some risks that, although infrequent, should be known. We describe the case of a 48-year-old female with chronic lumbosacral radicular pain who underwent caudal epidural infiltration. During the withdrawal of the catheter, accidental breakage and retention of a fragment at the level of the anterior epidural space of the sacrum occurred. We choose to have an expectant management with regular controls and a radiological lumbosacral computed tomography (CT) scan. Since the catheter was placed under sterile conditions, no prophylactic antibiotic treatment was considered. The patient showed no adverse events during the 6 months following catheter rupture. To our knowledge, there are no reports of epidural catheter breakage at the caudal level in adults. This is why there is no standardized protocol on how to proceed in these cases, and the handling of this situation must be individualized. [ABSTRACT FROM AUTHOR]

El conocimiento global de las consecuencias del cambio de vegetación y uso de suelo en las fases del ciclo hidrológico y la calidad del suelo aún está en ciernes. Esta tarea es particularmente desafiante en las regiones tropicales donde las tasas de deforestación alcanzan los niveles máximos reportados y el monitoreo es limitado. Tal es el caso de México, donde el cambio de cobertura y la erosión hídrica afectan a más de la mitad del territorio nacional. En este contexto, se usó el modelo SWAT para estudiar la erosión hídrica asociada con las variaciones en el caudal condicionadas por la trayectoria de cambio de la cobertura vegetal en seis periodos entre 1986 y 2018 en dos subcuencas del río Papaloapan. Basados en la evaluación combinada de tres estadísticos de eficiencia y dos de incertidumbre, 6 de los 10 periodos calibrados mostraron buenos ajustes en la simulación de la descarga con KGE > 0.70 y P-factor > 0.70. Los resultados mostraron a mediano plazo una disminución en la producción de sedimentos en las dos subcuencas estudiadas, posiblemente relacionada con la recuperación de los bosques en las cabeceras de las cuencas. A pesar de los buenos resultados de las simulaciones, el análisis detallado de las fuentes de incertidumbre en regiones con monitoreo limitado es tan importante como la validación con datos medidos de buena calidad para mejorar el desempeño y la confianza de los modelos y soportar de forma adecuada la toma de decisiones.

El presente artículo, tiene por objetivo principal realizar un análisis comparativo entre diversos métodos hidrológicos para estimar el Caudal Ecológico en la Bocatoma El Brazo en la Cuenca del Rio Camaná-Majes-Colca, Perú, en este caso se trata de un rio que nace de los Andes peruanos y discurre hasta desembocar en la Hoya Hidrográfica del Pacífico. Para estimar el Caudal Ecológico para el tramo en estudio se analizaron diversos métodos hidrológicos empleando una serie histórica de 20 años de datos de caudales en el rio. La fuente de información fue la Estación Hidrológica de Huatiapa. La especie indicadora para estimar el Caudal Ecológico es el Camarón de Rio cuyo nombre científico es el Cryphiops caementarius, que presenta importancia económica debido a que se distribuye en grandes poblaciones en la cuenca. Finalmente, es de resaltar, que la importancia de este artículo radica en que la metodología y resultados alcanzados aportará directrices de fácil manejo y aplicación; la cual pueda servir de guía para determinar el Caudal Ecológico en otros tramos en la cuenca y en cuencas con similares características geomorfológicas en el Perú.

Introduction: Caudal anesthesia is a standard procedure in pediatric anesthesia because of its excellent safety and success rate. Usually, it is administered after general anesthesia, but in selected neonatal populations, awake caudal anesthesia is a method of choice. Prematurely born, low birth weight neonates are more prone to complications from general anesthesia than term neonates, even after simple surgery. Among these complications, post-operative apnea is the most common. Caudal epidural anesthesia in awake neonates is a recognized technique that enables the avoidance of general anesthesia and the complications associated with it. In skilled hands, it is also theoretically easier to perform consistent caudal anesthesia than an awake subarachnoid block. In our case, we report a successful awake caudal anesthesia in an ex-premature baby in the emergency setting for incarcerated inguinal hernia repair. To our knowledge, this case report on this topic has yet to be published in Armenia. Conclusion: Neuraxial (spinal, epidural, caudal) awake anesthesia is the method of choice for lower abdominal surgery in preterm infants. Both spinal and caudal anesthesia are effective methods; awake caudal anesthesia is a method of choice because of the success rate and lower analgesic requirements in the post-operative period.

Background: Erector spinae plane block (ESPB) is a relatively new type of regional anesthesia that has demonstrated efficacy in pain management. The study uses ultrasound (US) guidance to perform the ESPB and evaluates its efficacy and safety compared to the traditional caudal block (CB) in managing postoperative pain in children undergoing lower limb surgeries. Methods: This randomized controlled double-blind trial enrolled 50 pediatric cases aged 2-15 years planned for lower limb surgeries. Cases were classified into two equal groups that were administered 0.25% bupivacaine (0.5 ml/Kg) via CB (group C) or lumbar ESPB at the side of operation (group E). The blocks were US guided after induction of anesthesia before skin incision. Results: Heart rate and mean arterial pressure at 45, 60, and 75 min, and at the end of surgery were reduced in group C contrasted to group E (P < 0.05). Pain scores at 6 h and 8 h were reduced significantly in group E (P < 0.001 and 0.049 respectively). The time of block performance was significantly lower in group C compared to group E. The number of patients who required intraoperative fentanyl was comparable between groups. Group E had prolonged analgesia and less postoperative pethidine doses. Neither group exhibited local anesthetic toxicity or hematoma with lower incidence of postoperative nausea and vomiting (PONV) in Group E (P = 0.042). Conclusion: In pediatric cases undergoing lower limb surgeries, US-guided ESPB provided adequate analgesia (better pain score and prolonged analgesia with lower postoperative analgesic doses) with stable hemodynamic and lower incidence of PONV. [ABSTRACT FROM AUTHOR]

Background: We hypothesized that adding nalbuphine to bupivacaine would prolong the duration of caudal epidural anaesthesia (CEA) in pediatric patients undergoing hypospadias repair surgery. Methods: 60 children scheduled for elective hypospadias surgery under general anesthesia combined with CEA were divided into two equal groups: the control group received caudal bupivacaine 0.25% 1 ml/kg plus 2 ml normal saline. The Nalbuphine group received caudal bupivacaine 0.25% 1 ml/kg plus nalbuphine 0.1 mg/kg in 2 ml normal saline. Intraoperative and postoperative rescue analgesia was managed by giving intravenous paracetamol 15 mg/kg and/or 100mcg nalbuphine. The Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, and the Richmond AgitationSedation Scale (RASS) score were measured. Pre-operative and postoperative blood samples were collected for a subgroup of patients for cortisol analysis. Results: The duration of postoperative analgesia was significantly longer in the nalbuphine group (p < 0.001). The number of patients who needed postoperative supplemental analgesia was significantly lower in the nalbuphine group (p < 0.001). Total paracetamol consumption was significantly higher in the control group (p < 0.001). The FLACC and RASS were significantly lower in the nalbuphine group. Postoperative cortisol levels were lower in the nalbuphine group compared to the control group. Conclusions: Adding caudal nalbuphine 0.1 mg/kg to bupivacaine 0.25% provides better postoperative pain control than bupivacaine alone in children undergoing hypospadias repair. [ABSTRACT FROM AUTHOR]

La cuenca del río Ayuquila-Armería se clasifica como cuenca hidrográfica prioritaria de México por su alta diversidad y también por la presión ecosistémica a la que es sometida. El objetivo de este estudio fue determinar las concentraciones de metales pesados (As, Cd, Cr, Hg, Pb y Zn) en agua y macroinvertebrados acuáticos, además de parámetros físicos y químicos (pH, C.E y caudal) en las subcuencas tributarias y el cauce principal. La presente investigación se llevó a cabo con muestreos en la temporada lluviosa en 2015, y en la temporada seca en 2016, en 18 sitios de la cuenca. En cada sitio de muestreo se realizaron determinaciones de metales pesados, parámetros físicos y químicos, colecta de macroinvertebrados acuáticos y estimación del caudal de los afluentes. En el agua superficial solo el Hg y el Pb superaron los límites permisibles para aguas naturales (0.02 y 0.0015 mg L-1 respectivamente) en el 60% de los sitios, en cuanto a las concentraciones en macroinvertebrados los seis metales superaron los límites permisibles en el 65% de los sitios con concentraciones de 0.33 a 7.07 mg kg-1, de estos el Hg (7.07 mg kg-1) y el metaloide As (5.19 mg kg-1) fueron los que presentaron las mayores concentraciones.

Background and Objectives: This study aimed to evaluate the mid-term effectiveness and safety of a combined ultrasound (US) and fluoroscopy (FL)-guided approach in comparison to US-guided and FL-guided caudal epidural steroid injections (CESI) for treating unilateral lower lumbar radicular pain. Materials and Methods: A total of 154 patients who underwent CESI between 2018 and 2022 were included. Patients were categorized into three groups based on the guidance method: combined US and FL (n = 51), US-guided (n = 51), and FL-guided (n = 52). The study design was retrospective case-controlled, utilizing patient charts and standardized forms to assess clinical outcomes, adverse events, complications during the procedures. Results: In all groups, Oswestry Disability Index and Verbal Numeric Scale scores improved at 1, 3, and 6 months after the last injection, with no significant differences between groups (p < 0.05). The treatment success rate at all time points was also similar among the groups. Logistic regression analysis showed that injection method, cause, sex, age, number of injections, and pain duration did not independently predict treatment success. Blood was aspirated before injection in 2% (n = 1), 13.5% (n = 7), and 4% (n = 2) of patients in the combined US and FL groups, FL-guided groups, and US-guided groups, respectively. Intravascular contrast spread was detected in one patient in the combined method groups and seven in the FL-guided groups. Conclusions: When comparing pain reduction and functional improvement, there was no significant difference between the three methods. The combined method took less time compared to using FL alone. The combined approach also showed a lower occurrence of intravascular injection compared to using FL alone. Moreover, blood vessels at the injection site can be identified with an ultrasound using the combined method. Given these advantages, it might be advisable to prioritize the combined US- and FL-guided therapy when administering CESI for patients with unilateral lumbar radicular pain.

Background: The use of local anesthetics as part of multimodal analgesia is an attractive concept in pediatric patients, since the evaluation and management of pain is a challenge in children under 7 years of age. Despite having guidelines and multiple studies on volume calculation, no safe and effective recommendation has been issued. Objective: To demonstrate that ultrasound-guided caudal block with a dose of 0.75 mL/kg of 0.2% ropivacaine has the same analgesic effect as a dose of 1.2 mL/kg. Material and methods: Randomized, prospective, longitudinal, comparative equivalence clinical trial. One hundred patients 0-7 years of age scheduled for elective or emergency infraumbilical surgery were enrolled between April 2021 and January 2022. Children were randomized 1:1 to be assigned to ultrasound-guided caudal block. Results: 100 patients divided into two groups with 0.2% ropivacaine volumes (0.75 mL vs. 1.2 mL). Both groups demonstrated the trans-anesthetic and post-anesthetic sedoanalgesia variables without significant differences for both groups on the FLACC pain scale after surgery and in recovery (p > 0.5), in the pain reassessment on the FLACC scale in the office called chronic pain (p > 0.5) in both groups. No complications were reported in the follow-up consultations and no arrhythmias were reported in both groups during surgery. Conclusions: The results of both groups did not show differences between a volume of 0.75 mL and 1.2 mL, the administration of 0.2% ropivacaine is favored with the use of ultrasound, which allows effective administration of lower doses of local anesthetic with reduced risk of complications. [ABSTRACT FROM AUTHOR]

Copyright of Tecnología y Ciencias del Agua is the property of Instituto Mexicano de Tecnologia del Agua (IMTA) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Pediatric burns affect approximately 15–20 patients per 100 000 hospital admissions, but unfortunately there is a lack of evidence to guide optimal strategies for acute pain control. The aim of this study was to evaluate whether caudal analgesia with single injection of local anesthetics reduced pain medication consumption in pediatric patients who required surgical intervention for burn injuries. Retrospective data from patients

Background and Aims: Caudal block provides good perioperative analgesia for pediatric infraumbilical surgeries but has a short duration of action after a single injection. To overcome this limitation, we evaluated the effect of magnesium sulfate added to caudal bupivacaine on postoperative analgesia in pediatric patients undergoing infraumbilical surgeries. Materials and Methods: In this prospective randomized double-blind comparative study, 60 American Society of Anesthesiologists Grade I, II children aged 1–5 years, of either gender, undergoing infraumbilical elective surgeries were randomly divided into 2 Groups (Group M [Magnesium sulfate] and Group C [control]) and received caudal block with magnesium sulfate 50 mg (upto 1 ml with saline) and 1 ml saline, respectively, added to 1 ml/kg of 0.25% bupivacaine. Hemodynamic parameters were recorded at predefined time intervals. Postoperative pain by Face, Legs, Activity, Cry and Consolability (FLACC) scale and level of sedation by Ramsay Sedation Score was assessed postoperatively. Duration of analgesia and number of rescue analgesic doses received in 24 h were recorded. Quantitative and qualitative variables were analyzed using Mann–Whitney U test, Chi-Square test, and Kruskal–Wallis test where deemed appropriate. P ≤ 0.05 was considered statistically significant. Results: The mean duration of analgesia was significantly higher in Group M with reduced requirement of rescue analgesic doses. FLACC scores were higher in control Group C at all time intervals. Patients in the magnesium group were sedated for a longer period. Both groups had comparable hemodynamic parameters throughout the study. Conclusion: Magnesium sulfate as an adjuvant to bupivacaine in caudal block prolongs the duration of analgesia with a reduction of postoperative rescue analgesic requirement in pediatric patients.

Rabab SS Mahrous,1 Amin AA Ahmed,2 Aly Mahmoud Moustafa Ahmed1 1Department of Anaesthesia and Surgical Intensive Care Alexandria University Alexandria Egypt; 2Department of Orthopedic Surgery and Traumatology Alexandria University Alexandria EgyptCorrespondence: Rabab SS Mahrous, Department of Anaesthesia and Surgical Intensive Care Faculty of Medicine Alexandria University, Alexandria, Egypt, Tel +201223497339, Email roba98@hotmail.comBackground and Aim: Ultrasound (US) guided regional analgesia is a safe and effective method in providing perioperative analgesia in pediatrics with a high success rate rapid onset and fewer side effects. The aim of this study was to compare the efficacy of US-guided caudal block versus US-guided peripheral nerve blocks (femoral and sciatic nerve blocks) in providing perioperative analgesia in pediatrics undergoing unilateral lower limb surgery.Methods: Children aged 1– 12 years scheduled for unilateral lower limb surgery during the period from January 2020 to December 2021 were randomly allocated into two groups. Group C where pediatrics received US-guided caudal block, while in group P, pediatrics received US-guided femoral and sciatic nerve blocks after the induction of general anesthesia (GA). The primary aim was to compare the postoperative pain (evaluated by the COMFORT pain score) between the two groups. Secondary aims were to compare perioperative opioids used parents’ satisfaction and occurrence of side effects.Results: Pediatrics who underwent unilateral lower limb surgeries were allocated into two groups (group C and group P). There was no significant difference between patients’ baseline characteristics and the postoperative pain score at 2, 4, 16, and 20 h.’ However there was a statistical significance at 6, 8, 12, and 24 h postoperatively, frequency of analgesia as well as the total postoperative dose of opiates (nalbuphine). Time to first analgesic (nalbuphine) requirement was significantly less in group C with a mean of (9.6± 2.9 h) than in group P with a mean of (15.1± 3.5 h). Parents of children in group P were more satisfied than those in group C with no recorded complications for both techniques.Conclusion: US-guided lower limb peripheral nerve block is a simple and safe method to provide adequate and more prolonged analgesia compared to US-guided caudal block for lower limb surgeries in pediatrics.Keywords: caudal, analgesia, peripheral nerve, block, lower limb surgeries, pediatrics

BackgroundThe caudal block and transversus abdominis plane block (TAP) are commonly used in combination with general anesthesia for pediatric lower abdominal, inguinal, and genitourinary surgeries. There is limited data directly comparing the impact of these techniques on recovery. In this meta-analysis, we compare the duration of postoperative analgesia between these two techniques.ObjectiveThis review examined the duration of analgesia in pediatric patients (age 0–18 years) undergoing surgery who received caudal or TAP block after induction of general anesthesia. The primary outcome was duration of analgesia, defined as the time to first rescue analgesic dose. Secondary outcomes included number of rescue analgesic doses, acetaminophen usage within 24 h postoperatively, 24 h pain score area under the curve, and postoperative nausea and vomiting.Evidence reviewWe systematically searched Pubmed, Central, EMBASE, CINAHL, Google Scholar, Web of Science citation index, the US clinical trials register, and abstracts from prominent 2020–2022 anesthesia conferences for randomized controlled trials that compared these blocks and reported analgesia duration.FindingsTwelve RCTs inclusive of 825 patients were identified. TAP block was associated with longer analgesia duration (Mean difference = 1.76 h, 95% CI: 0.70–2.81, p = 0.001) and reduced doses of rescue analgesic within 24 h (Mean difference = 0.50 doses, 95% CI: 0.02–0.98, p = 0.04). No statistically significant differences were detected in other outcomes.ConclusionThis meta-analysis suggests that TAP block provides greater duration of analgesia than caudal block after pediatric surgeries. TAP block was also associated with fewer rescue analgesic doses in the first 24 h without increased pain scores.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=380876, identifier: CRD42022380876.

Copyright of Terra Latinoamericana is the property of Sociedad Mexicana de la Ciencia del Suelo A.C. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims: Caudal block provides good perioperative analgesia for pediatric infraumbilical surgeries but has a short duration of action after a single injection. To overcome this limitation, we evaluated the effect of magnesium sulfate added to caudal bupivacaine on postoperative analgesia in pediatric patients undergoing infraumbilical surgeries. Materials and Methods: In this prospective randomized double-blind comparative study, 60 American Society of Anesthesiologists Grade I, II children aged 1--5 years, of either gender, undergoing infraumbilical elective surgeries were randomly divided into 2 Groups (Group M [Magnesium sulfate] and Group C [control]) and received caudal block with magnesium sulfate 50 mg (upto 1 ml with saline) and 1 ml saline, respectively, added to 1 ml/kg of 0.25% bupivacaine. Hemodynamic parameters were recorded at predefined time intervals. Postoperative pain by Face, Legs, Activity, Cry and Consolability (FLACC) scale and level of sedation by Ramsay Sedation Score was assessed postoperatively. Duration of analgesia and number of rescue analgesic doses received in 24 h were recorded. Quantitative and qualitative variables were analyzed using Mann--Whitney U test, Chi-Square test, and Kruskal--Wallis test where deemed appropriate. P ≤ 0.05 was considered statistically significant. Results: The mean duration of analgesia was significantly higher in Group M with reduced requirement of rescue analgesic doses. FLACC scores were higher in control Group C at all time intervals. Patients in the magnesium group were sedated for a longer period. Both groups had comparable hemodynamic parameters throughout the study. Conclusion: Magnesium sulfate as an adjuvant to bupivacaine in caudal block prolongs the duration of analgesia with a reduction of postoperative rescue analgesic requirement in pediatric patients. [ABSTRACT FROM AUTHOR]

Copyright of Ingenius, Revista Ciencia y Tecnología is the property of Universidad Politecnica Salesiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El objetivo del estudio fue estimar los escurrimientos promedio mensuales de una cuenca para el desarrollo de una pico central hidroeléctrica en un área rural-montañosa de la selva (Satipo) del Perú. Debido a la ausencia de datos hidrometeorológicos en cuencas montañosas y remotas en el Perú, una estimación hidrológica resulta indispensable para determinar el potencial hidroenergético en la cuenca de estudio. Primero se determinaron los parámetros geomorfológicos (de forma y de relieve) de la cuenca y, posteriormente, se realizó un análisis de precipitación tomando en cuenta los datos de 17 estaciones meteorológicas. Para verificar la homogeneidad de los registros pluviométricos, se realizó un análisis de consistencia mediante un análisis de dobles acumulaciones. Para estimar los caudales de la cuenca de estudio, a falta de información hidrométrica, se utilizó el método de transposición de caudal, en el cual se transportaron los caudales de la cuenca Ourohuari. Asimismo, se comprobó que las características geomorfológicas e hidrometeorológicas resultaran similares, para ello se realizó una prueba t-test para muestras independientes, con el fin de verificar la similitud en la precipitación anual entre ambas cuencas. Finalmente, se puede concluir, las características geomorfológicas y el caudal regular durante todo el año en la cuenca Cashingari favorece el desarrollo de una pico central hidroeléctrica.

The initial mechanical damage of a spinal cord injury (SCI) triggers a progressive secondary injury cascade, which is a complicated process integrating multiple systems and cells. It is crucial to explore the molecular and biological process alterations that occur after SCI for therapy development. The differences between the rostral and caudal regions around an SCI lesion have received little attention. Here, we analyzed the differentially expressed genes between rostral and caudal sites after injury to determine the biological processes in these two segments after SCI. We identified a set of differentially expressed genes, including Col3a1, Col1a1, Dcn, Fn1, Kcnk3, and Nrg1, between rostral and caudal regions at different time points following SCI. Functional enrichment analysis indicated that these genes were involved in response to mechanical stimulus, blood vessel development, and brain development. We then chose Col3a1, Col1a1, Dcn, Fn1, Kcnk3, and Nrg1 for quantitative real-time PCR and Fn1 for immunostaining validation. Our results indicate alterations in different biological events enriched in the rostral and caudal lesion areas, providing new insights into the pathology of SCI.

En este trabajo se aplica el principio de generación hidroeléctrica, utilizado a gran escala en nuestro país. El sistema construido representa una herramienta didáctica de laboratorio en los cursos de docencia sobre energías renovables. El objetivo de este artículo es la construcción de un microgenerador hidráulico de carácter didáctico que permita aprovechar la energía cinética del agua para la producción de energía eléctrica. Además, disponer dicho sistema en una institución educativa ayuda a enseñar conceptos de energías renovables como la microhidráulica y potenciar sus aplicaciones en zonas rurales a través de proyectos de vinculación con la sociedad. Se han considerado aspectos de diseño importantes como potencia de generación, uso del modelo tornillo de Arquímedes, suministro del recurso hídrico, costo de materiales para la elaboración, instalación del generador, entre otros. Esta propuesta ofrece una solución didáctica de bajo costo fácil de reproducir, que genera una potencia máxima de 8 (W) con un caudal de 10 (l/s), lo que permite abastecer una determinada demanda eléctrica, principalmente de iluminación. A través de un modelo validado en laboratorio gracias al sistema desmontable que posee para ser utilizado en un entorno real, se realizaron pruebas, utilizando un tanque de almacenamiento de agua y una bomba. Con estos resultados se concluye que el sistema construido aprovecha un caudal de agua reducido para producir energía limpia y renovable.

The present investigation was carried out in the upper basin of the Pindo River, Mera canton, Pastaza province. The objective was to evaluate the influence of the type of cover on the edaphological and hydrological characteristics that influence the variability of the Pindo River flow. Data were collected using the simple infiltrometer cylinder method. The infiltration behavior in the forest and grass cover was compared, additionally a soil sample was extracted using the cylinder method (MC), to determine the apparent density, soil texture and root density. The results showed that the infiltration speed and longitudinal density of roots do not present significant differences between forest and grass. From the analysis of the apparent density, the grasses presented the highest average values. [ABSTRACT FROM AUTHOR]

Background: the control of postoperative pain is important in children, and poor pain control leads to organ dysfunction and behavioral problem. Aim of study: we compare the analgesic effect of bupivacaine by caudal block root and acetaminophen suppository on postoperative pain in pediatric inguinal hernial repair surgery. Patient and Methods: A prospective, randomized, controlled trail of 40 children, aged between (1-7 years), ASA grade I-II, scheduled for elective day case unilateral inguinal surgery. For all the patients included in this study, a standardized controlled anesthetic protocol was used. Preoperatively the patients were randomized into two groups according to the operation waiting lists. group 1 included (18) patients who received single - shot caudal block with (1ml/kg) of 25% bupivacaine preoperatively after induction of anesthesia by the anesthetist, group 2 included (22) patients who received (15-20 mg/kg) acetaminophen suppository. Results: The number of patients (who had first three hours free of pain); was significantly higher in the Caudal group than those of the other group. Patients of the Caudal group; needed significantly a longer duration of time for the first analgesic drug. Patients of the Caudal group; had significantly a lower (Face, Legs, Activity, Cry, Consolability scale) in (1/2, 1, and 2 hours) time intervals of the study. Conclusion: Caudal anesthesia with bupivacaine has better painless period postoperatively. [ABSTRACT FROM AUTHOR]

El objetivo de este trabajo fue establecer la influencia que ejerce la granulometría del lecho del río, la forma de la pila de un puente y los parámetros hidrológicos en la profundidad de socavación, a partir de un modelo físico. Para el desarrollo experimental se empleó un suelo granular proveniente de río al que se le realizaron ensayos de laboratorio para determinar la distribución del tamaño de las partículas, empleando materiales cuya clasificación, según el sistema unificado de clasificación de suelos (USCS, por sus siglas en inglés) es SP (arena mal gradada), SW (arena bien gradada), SP-SC (arena mal gradada con arcilla). Adicionalmente, se realizó un análisis estadístico con el fin de determinar las diferencias significativas entre cada una de las variables y su influencia en dicho proceso. Se encontró que existe una fuerte relación entre la forma de la pila, el caudal y la granulometría, con las características hidrodinámicas del flujo cuando pasa por las pilas, así como en la profundidad de socavación.

Background: Although sepsis is one of the leading causes of mortality in hospitalized patients, information regarding early predictive factors for mortality and morbidity is limited. The main objective of this study was to identify the outcome of patients with sepsis and septic shock. Methods: A prospective observational study was done in a surgical ICU over a period of one year. We included all adult patients admitted to ICU with features of sepsis and septic shock. Data related to demography, co-existing illnesses, parameters to assess Sequential Organ Failure Assessment (SOFA) scores, other relevant laboratory data, source of infection, organ failures and supportive measures instituted were recorded. Patients were followed till discharge or death from the ICU. Results: 160 patients were included in this study. The mortality rate was significantly higher among females compared with males. The most common co-existing illnesses were hypertension and type II diabetes mellitus. The SOFA scores at admission were high among non-survivors. Older age, presence of anaemia (defined as haemoglobin less than 13 g/dL in males and 12 g/dL in females), renal dysfunction (creatinine level more than 1.3 g/dL), and acute respiratory distress syndrome (ARDS) were associated with higher mortality. Haematocrit, total leucocyte count, serum bilirubin and SOFA scores were significantly higher among non-survivors. Conclusion: Our findings suggest that septic shock occurs frequently in ICU patients and mortality remains high. Several critical scoring systems are useful for the early prediction of mortality. A sepsis mortality based on SOFA scores and haemoglobin has greater predictive power.

La presente investigación fue realizada en la cuenca alta del río Pindo, cantón Mera, provincia de Pastaza. El objetivo fue evaluar la influencia del tipo de cobertura en las características edafológicas e hidrológicas que influyen en la variabilidad del caudal del Río Pindo. Los datos se recolectaron, utilizando el método de cilindro infiltrómetro simple. Se comparó el comportamiento de la infiltración en la cobertura de bosque y pasto, adicionalmente se extrajo una muestra de suelo mediante el método del cilindro (MC), para determinar la densidad aparente, textura del suelo y densidad de raíces. Los resultados mostraron que, la velocidad de infiltración y densidad longitudinal de raíces no presentan diferencias significativas entre bosque y pasto. Del análisis de la densidad aparente los pastos presentaron los mayores valores promedio.

The economic development of the country establishes among its priorities, the achievement of the efficient use of energy in the pumping of water, which constitutes one of the fundamental links for Agriculture. In recent years, various solar pumps have been introduced in Cuba in order to economically empower various companies. Its evaluation allows obtaining information for decision-making with a view to its possible introduction into the country for these purposes. This work was developed at the Experimental Station of the Agricultural Engineering Research Institute with the aim of determining the technical and operating characteristics of the photovoltaic system and the Lorentz PS2-150-C- SJ5-8 Solar Pump. The methodology used consisted of measuring the electrical and hydraulic characteristics of the system at the time of its start-up, in addition to calculating the daily volume of water pumping. The results found showed that the average power obtained from the panels was 0,3 kW, the maximum pressure reached by the pump was 20 m.c.a. when the discharge was 1,52 m³/h and the maximum flow rate was 4,00 m³/h in 2 m.c.a. The daily volume of water in 7 hours of pumping was 28,02; 18,20 and 10,64 m³/day for heights of 2, 11 and 20 m.c.a. respectively. It was concluded that the behavior of the evaluated equipment is acceptable with respect to the characteristics provided by the manufacturer. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia e Ingenieria Neogranadina is the property of Ciencia e Ingenieria Neogranadina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)