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Lance M Relland,1,2 Joseph D Tobias,1–3 David Martin,1,2 Giorgio Veneziano,1,2 Ralph J Beltran,1,2 Christopher McKee,1,2 Tarun Bhalla1,2 1Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, 2Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, 3Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA Background: Umbilical hernia repair is a common pediatric surgical procedure. While opioid analgesics are a feasible option and have long been a mainstay in the pharmacological intervention for pain, the effort to improve care and limit opioid-related adverse effects has led to the use of alternative techniques, including regional anesthesia. The current study prospectively compares the analgesic efficacy of three techniques, including caudal epidural blockade, peripheral nerve blockade, and local wound infiltration, in a double-blinded study.Patients and methods: A total of 39 patients undergoing umbilical hernia repair were randomized to receive a caudal epidural block (CDL), ultrasound-guided bilateral rectus sheath blocks (RSB), or surgical site infiltration (SSI) with local anesthetic. Intraoperative anesthetic care was standardized, and treatment groups were otherwise blinded from the intraoperative anesthesiology team and recovery nurses. Postoperatively, the efficacy was evaluated using Hannallah pain scores, Aldrete recovery scores, the need for intravenous fentanyl, and the time to discharge.Results: Each cohort was similar in terms of age, weight, premedication dosing, length of case, intraoperative and postoperative fentanyl requirements, and time to tracheal extubation. Among the three cohorts, there were no significant differences noted in terms of pain scores or time to recovery.Conclusion: All the three techniques provided effective analgesia following umbilical hernia repair. Our findings offer effective and safe analgesic options as alternatives to the neuraxial (caudal) approach. Keywords: caudal, pediatric, rectus sheath, regional anesthesia, umbilical hernia

Background: Co-administration of dexamethasone or neostigmine with local anesthetic solution for caudal block (CB) can prolong postoperative analgesia duration. We aimed to evaluate and compare the effectiveness of dexamethasone (0.1 mg/kg) versus neostigmine (2 μg/kg) when used as adjuvant to 0.25% bupivacaine for CB in children undergoing unilateral open inguinal hernia repair on the quality of postoperative analgesia. Methods: 105 children aged 1–6 years scheduled for unilateral open inguinal hernia repair were randomly allocated into three groups. Ultrasound guided CB was performed with 0.25% bupivacaine (0.75 ml/kg). 1 ml saline, dexamethasone (0.1 mg/kg) in 1 ml saline and neostigmine (2 μg/kg) in 1 ml saline were added in bupivacaine, bupivacaine-dexamethasone and bupivacaine-neostigmine respectively. Duration of postoperative analgesia, postoperative consumption of analgesic, the modified objective pain score, postoperative sedation and side effects were recorded. Results: Duration of postoperative analgesia was prolonged in bupivacaine-dexamethasone and bupivacaine-neostigmine groups as compared to the bupivacaine group (P

In developmental studies, inferring regulatory interactions of segmentation genetic network play a vital role in unveiling the mechanism of pattern formation. As such, there exists an opportune demand for theoretical developments and new mathematical models which can result in a more accurate illustration of this genetic network. Accordingly, this paper seeks to extract the meaningful regulatory role of the maternal effect genes using a variety of causality detection techniques and to explore whether these methods can suggest a new analytical view to the gene regulatory networks. We evaluate the use of three different powerful and widely-used models representing time and frequency domain Granger causality and convergent cross mapping technique with the results being thoroughly evaluated for statistical significance. Our findings show that the regulatory role of maternal effect genes is detectable in different time classes and thereby the method is applicable to infer the possible regulatory interactions present among the other genes of this network.

Background: Caudal analgesia for postoperative pain relief in paediatric day-case surgery has been found to be of short duration, hence the need for addition of adjuncts to prolong the analgesia. Objective: The objective of the study was to compare the analgesic effects of caudal block with or without low-dose intravenous dexamethasone in children undergoing day-case herniotomy. Patients and Methods: This was a prospective randomised controlled study conducted in male patients, aged between 1 and 7 years scheduled for herniotomy. A total of 94 patients were randomised into two groups. Group A received intravenous 0.25 mg/kg dexamethasone in 5 ml solution, whereas Group B received equivalent volume of intravenous normal saline. All the patients had a caudal block. Post-operative pain was assessed and recorded in post-anaesthesia care unit (PACU) using objective pain scale. Time to first analgesia request (TFA), pain scores and complications were documented. Data were analysed using Statistical Package for the Social Sciences version 21.0. Results: A total of 94 patients were analysed with a mean age of 3.30 ± 1.67 and 3.06 ± 1.50 years for Groups A and B, respectively. The TFA request was 654.18 ± 31.56 and 261.50 ± 10.82 min in Groups A and B, respectively, P = 0.0001. Postoperatively, in the PACU, there was statistically significant difference in pain score between the two groups at 0, 30, 60, 120, 180 and 240 min (P = 0.0001) all through. Conclusion: The use of low-dose intravenous dexamethasone (0.25 mg/kg) in combination with caudal block prolonged duration of analgesia, reduced pain scores and analgesic consumption postoperatively, in children undergoing day-case herniotomy.

Background and Aims: Caudal analgesia is a good, reliable, and easy method to provide intraoperative and postoperative analgesia for infra-umbilical surgeries in children. Many additives are being used in combination with local anesthetics in caudal block to prolong the postoperative analgesia (clonidine, midazolam, ketamine, fentanyl, and dexmedetomidine). The purpose of this study was to compare the intraoperative hemodynamics, postoperative analgesia, postoperative rescue analgesic requirement, postoperative sedation and side-effects of clonidine and midazolam used as adjuvants to bupivacaine for caudal analgesia. Material and Methods: Following approval from Institutional Ethical Research Committee, 75 American Society of Anesthesiologists I and II patients aged between 1 and 7 years undergoing various elective infra-umbilical surgical procedures were included in this study. The patients were randomly allocated into three groups of 25 patients each. Group B received 1 ml/kg 0.25% bupivacaine in normal saline, Group BC received 1 ml/kg 0.25% bupivacaine + 1 μg/kg clonidine in normal saline, and Group BM received 1ml/kg 0.25% bupivacaine + 30 μg/kg midazolam in normal saline. The various parameters studied were intraoperative hemodynamic changes, duration of postoperative analgesia, postoperative sedation, postoperative analgesic requirement, and incidence of side-effects. Results: All the groups were similar with respect to patient and block characteristics. The hemodynamic parameters before and after administering caudal analgesia were also comparable. The mean duration of analgesia was 724.80 ± 60.29 min in Group BC, 605.40 ± 82.37 min in Group BM and 295.00 ± 41.78 min in Group B. Thus, the duration of analgesia was significantly prolonged in Group BC compared to Groups BM and B. The FLACC pain score was higher in Group B at the end of 4th, 8th and 12th h compared with Group BC and Group BM. Furthermore at the end of 12th h, pain scores were significantly higher in Group BM compared to Group BC. Only 1 child in Group BC received three rescue medications compared to 15 (60%) children in Group B and 7 (28%) children in Group BM. None of the groups were treated for bradycardia or hypotension and no significant sedation was noted. Conclusion: This study showed that the addition of both clonidine (1 μg/kg) and midazolam (30 μg/kg) with bupivacaine administered caudally significantly increase the duration of postoperative analgesia with minimal side-effects in children. The use of clonidine as an additive to bupivacaine in caudal epidural is a superior choice to midazolam as it reduces the demand of postoperative rescue analgesics significantly.

Background: Multiple studies claim that caudal administration of ketamine causes effective postoperative analgesia. The aim of this study was to assess the clinical effectiveness of ketamine after caudal or topical administration in pediatric patients undergoing inguinal herniotomy. Patients and Methods: This randomized, comparative, double-blind study included eighty children (aged 6 months to 6 years) received either 1 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg for caudal analgesia (caudal group) or 0.3 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg sprayed by the surgeon around the spermatic cord and upon the ilioinguinal nerve before wound closure for topical analgesia (topical group). The duration of postoperative analgesia, pain scores, rescue analgesic consumption, sedation score, hemodynamic monitoring, and side-effects were evaluated 48 h postoperative. Results: Kaplan–Meier survival analysis of analgesia free time demonstrated a significant advantage of topical ketamine (TK) group over caudal ketamine (CK) group. The duration of postoperative analgesia was longer in TK group than in CK group (28.74 ± 2.88 vs. 21.43 ± 5.01 h, P < 0.000). Fewer children asked for oral analgesics in the topical group (24 of 36, 66.7%) than in the caudal one (28 of 32, 87.5%; P < 0.01). Postoperative pain scores at the 6th till 48th h were lower in topical group with comparable analgesic consumption between two groups. In the caudal group, four subjects suffered from retention of urine: Two presented with a residual motor block and two had photophobia. Conclusion: Wound instillation of bupivacaine/ketamine is a simple, noninvasive, and effective technique that could be a safe alternative to CK for postoperative analgesia in children undergoing inguinal hernia repair.

Background: Alpha-2 adenoreceptors as an adjuvant to local anesthetic during caudal analgesia in children prolongs the duration of analgesia. This study was designed to compare the analgesic efficacy and adverse effects of dexmedetomidine and clonidine when added to ropivacaine for caudal analgesia in children undergoing lower abdominal surgeries. Methods: In a prospective study, Seventy-eight children received block with either 0.2% ropivacaine 1.5 mg/kg (Group R; n = 26) or 0.2% ropivacaine 1.5 mg/kg + 1 mcg/kg clonidine (Group RC; n = 26) or 0.2% ropivacaine 1.5 mg/kg + dexmedetomidine 1 mcg/kg (Group RD; n = 26). Results: Duration of analgesia was 7.15 ± 1.00 h in Group R, 11.57 ± 1.27 h in Group R + C, and 14.73 ± 1.53 h in Group R + D (P < 0.0001). One patient in Group R + D had vomiting and 1 patient in Group R had urinary retention which was not statistically significant (P > 0.05). Conclusion: Addition of clonidine and dexmedetomidine to caudal ropivacaine significantly prolongs the duration of analgesia without adverse effects.

Caudal epidural steroid injection (CESI) is one of the most common interventions in management of lumbar radicular pain of the patients who fail to respond to conservative treatment. Complications related to caudal epidural injections are rare. However, occasional complications may become worrisome. This report presents the inadvertent dural puncture during caudal epidural injections in two patients who were suffering from spinal-related radicular pain.

En conducciones naturales y canales artificiales, es frecuente encontrar que la característica física del agua trasegada se vea alterada por la presencia de sedimento en el flujo; el depósito de dichas partículas sobre el fondo y paredes de la conducción, provoca que se modifique el valor de rugosidad del perímetro mojado. Determinar la velocidad o caudal de estos flujos con ecuaciones empíricas como la de Chezy-Manning, requiere considerar cambios físicos al momento de calcular el coeficiente de rugosidad «n» de la sección transversal del cauce. El objetivo fue calcular el coeficiente de rugosidad en un canal con presencia de sedimento. El trabajo fue realizado en el canal trapezoidal del laboratorio hidráulico, campus Universidad Nacional de Loja; se dividió en tres secciones; la primera, sin sedimento (inicio); la segunda, con sedimento (parte media) y una de control, mediante vertedero de 90o (parte final). Se aplicaron dos metodologías: i) el coeficiente de rugosidad ponderado, aplicando la ecuación de Horton-Einsten y ii) método gráfico, con la relación entre función (R/k) y el valor del diámetro de las partículas (k). Se determinó que n se puede expresar en función del diámetro de partículas de sedimento. Con el nuevo valor de n en las ecuaciones de Nanning, los valores de velocidad y caudal fueron más cercanos a los medidos con el correntómetro.

El tomillo (Thymus vulgaris) es una planta utilizada en medicina tradicional. Sus propiedades, se deben a su aceite esencial. Es importante destacar que el timol, el aceite esencial y la hoja seca, están catalogados por la FDA de los EEUU como aditivos alimentarios aptos para el consumo humano. El artículo muestra los resultados para el proceso de secado del tomillo, cuyo objetivo principal es establecer la incidencia de la temperatura y velocidad del aire sobre el contenido de humedad final, eligiendo el rango óptimo de secado. Se utilizaron dos métodos para determinar la densidad del tomillo, el primero fue por desplazamiento en probeta, el segundo por destilación azeotropica, encontrándose que el mas recomendado es este último. Se determinó por el segundo método la humedad en base húmeda, la cual fue del 80%. Por otro lado, mediante un diseño experimental por superficie de respuesta, se encontró que la temperatura se presenta como el factor más significativo sobre la humedad final del tomillo con valor p=0,0124 con un nivel de significancia del 90%. A las condiciones de temperatura halladas se observa que el mejor caudal se ajusta a la región entre 2050 – 2100 rpm, que corresponden con la mejor región de temperaturas de 52– 53ºC.

Background: The partial cutting and suture technique is a modification of the cutting and suture technique that overcomes the limitations and simplifies the procedure of the cutting and suture technique. Objective: We describe the partial cutting and suture technique and evaluate its effectiveness of correcting caudal septal deviation. Methods: We retrospectively reviewed the medical records of patients who underwent anterior septoplasty using the partial cutting and suture technique. The patients were evaluated with the Nasal Obstructive Symptoms Evaluation (NOSE) scale scores and the acoustic rhinometry preoperatively and 3 months postoperatively. Results: Thirty-one patients underwent caudal septoplasty by our novel technique. The NOSE scale score changed from 43.5 to 11.0 (P =.000). The minimal cross-sectional area (MCA) on the convex side changed from 0.49 cm2 to 0.65 cm2 (P =.006). Conclusion: The partial cutting and suture technique is relatively easy and is very effective in correcting caudal septal deviation without any complications. [ABSTRACT FROM AUTHOR]

Caudal block is most popular regional anesthetic technique used in children. It provides excellent analgesia during surgery as well as in postoperative period in subumblical surgeries. In this study, we compared the analgesic efficacy and safety of caudal dexmedetomidine added to caudal ropivacaine for postoperative analgesia in children. 60 patients aged 1 to 8 years scheduled for subumblical surgeries were randomly allocated into two groups of 30 patients each. Group RD received 1ml/kg of 0.2% ropivacaine with dexmedetomidine 2ìg/Kg in normal saline 1 ml. Group R received 1ml/kg of 0.2% ropivacaine with normal saline 1ml. Hemodynamic parameters, duration of analgesia, pain scores using observational pain scoring (OPS), requirement of rescue analgesia, and various complications were recorded. The duration of analgesia in group R was 8.4± 1.4 hours while in group RD the duration was 10.4 ± 2 hours. Maximum OPS scores were lower in group RD compared to group R.It was concluded that caudal dexmedetomidine when added to ropivacaine as an adjuvant increases the efficacy and duration of analgesia, reducing the need of post operative rescue analgesia with no additional side effects. [ABSTRACT FROM AUTHOR]

The research was developed in "La Cuchilla" farm, located in the community of Sabicú, "Primero de Enero" Municipality, Ciego de Ávila Province, with the objective of characterizing the wind speed to design a sprinkler irrigation system with pumping wind. The results showed that the value of average monthly speed in the series obtained at "Camilo Cienfuegos" Meteorological Station was greater than 5.50 m s-1 in all months of the year, except in September and October, which was between 3.00 and 3.50 m s-1,. The highest wind frequency corresponded to the range of 0-6 m s-1, which represents 72.39%. The wind speed at "La Cuchilla" farm reached an arithmetic mean value of 9.53 m s-1,, and a weighted average value of 11.25 m s-1,, according to the wind frequency in the months of January, February and March. The wind pumping provided flows between 0.06 and 0.77 L s-1, which allowed storing a total daily volume of 17,640 L in the months of January, February and March. [ABSTRACT FROM AUTHOR]

Background: Recent publications from the United States, India, and Korea report that children undergoing hypospadias repair with caudal regional anesthesia/analgesia could have increased postoperative surgical complications. Aims: The purpose of this retrospective cohort study was to assess the impact between caudal regional anesthesia, other regional anesthesia, and no regional anesthesia on complications after hypospadias repair at a tertiary care children's hospital in Ottawa, Canada, with an expectation to changing practices if a link was found. Method: We reviewed the health records of 827 children with hypospadias undergoing penile surgery from January 1991‐June 2017. The final sample size for the analysis consisted of 764 patients and 825 procedures. Results: The overall complications were almost identical when considering anesthesia effects, and this similarity persisted when we assessed specifically for only surgical complications. We had 716, 94, and 15 subjects who had a caudal block, penile block, and general anesthesia only, respectively, and their complication rates were 28, 31, and 27%, respectively, and their fistula formation rates were 10, 6, and 0%, respectively, and their stricture formation rates were 8, 7, and 20%,, respectively. Hypospadias type and surgical repair technique were marked predictors of complications in the postoperative period. Conclusion: Anesthesia technique appears to have minor impact on complications after hypospadias repair, while surgical technique and type of hypospadias impact complications after hypospadias surgery in children. Based upon these results, we will not change our current practice of using a variety of regional anesthesia techniques for children undergoing hypospadias repair. [ABSTRACT FROM AUTHOR]

Environmental flow determination is important for the management of rivers and reservoirs. This parameter allows us to calculate the water supply of basins and minimize environmental impacts associated with water harvesting. In the past, research has been performed to determine environmental flows in rivers of Antioquia. However, the results did not include annual weather variation. M ean environmental flows, evapotranspiration and infiltration in the area have been calculated with the rainfall data registered in the Olaya station during 20 years and the basin morphometric parameters. The collected data were used to build a mathematical model in MATLAB and determine the environmental flows with the Range of Variability Approach (RVA) method for each month of the year and ENSO periods. The model can be used to determine environmental flows in similar basins using new rainfall data and morphometric parameters. [ABSTRACT FROM AUTHOR]

The present work was developed in areas of the Agroindustrial Company of Ceballos, Ciego de Avila, with the objective of carrying out a comparative study of two irrigation tape models, the self-compensating Aqua Traxx and the non-compensating one. The tapes used were the existing models in the company, which were acquired from foreign firms that commercialize components of irrigation systems in Cuba. The samples of the irrigation tapes used were obtained from a universe of 500 emitters for each model, choosing 20 emitters of each tape model. The evaluations carried out were the determination of the hydraulic characteristics and quality of the tapes, determination of the coefficient of variation of manufacture and of the variation of the flow, determination of the flowpressure curve and determination of the variation of the flow product of the water temperature. The study showed the best quality, resistance, constancy in the variations of the flow, pressure and coefficient of variation of manufacture of the compensating Aqua Traxx tape in relation to the noncompensating one. [ABSTRACT FROM AUTHOR]

Four isolated sauropod axial elements from the Oxford Clay Formation (Callovian, Middle Jurassic) of Peterborough, UK, are described. Two associated posterior dorsal vertebrae show a dorsoventrally elongated centrum and short neural arch, and nutrient or pneumatic foramina, most likely belonging to a non-neosauropod eusauropod, but showing ambiguous non-neosauropod eusauropod and neosauropod affinities. An isolated anterior caudal vertebra displays a ventral keel, a 'shoulder' indicating a wing-like transverse process, along with a possible prespinal lamina. This, together with an overall high complexity of the anterior caudal transverse process (ACTP) complex, indicates that this caudal could have belonged to a neosauropod. A second isolated middle-posterior caudal vertebra also shows some diagnostic features, despite the neural spine and neural arch not being preserved and the neurocentral sutures being unfused. The positioning of the neurocentral sutures on the anterior one third of the centrum indicates a middle caudal position, and the presence of faint ventrolateral crests, as well as a rhomboid anterior articulation surface, suggest neosauropod affinities. The presence of possible nutrient foramina are only tentative evidence of a neosauropod origin, as they are also found in Late Jurassic non-neosauropod eusauropods. As the caudals from the two other known sauropods from the Peterborough Oxford Clay, Cetiosauriscus stewarti and an indeterminate non-neosauropod eusauropod, do not show the features seen on either of the new elements described, both isolated caudals indicate a higher sauropod species diversity in the faunal assemblage than previously recognised. An exploratory phylogenetic analysis using characters from all four isolated elements supports a basal neosauropod placement for the anterior caudal, and a diplodocid origin for the middle caudal. The dorsal vertebrae are an unstable OTU, and therefore remain part of an indeterminate eusauropod of uncertain affinities. Together with Cetiosauriscus, and other material assigned to different sauropod groups, this study indicates the presence of a higher sauropod biodiversity in the Oxford Clay Formation than previously recognised. This study shows that it is still beneficial to examine isolated elements, as these may be indicators for higher species richness in deposits that are otherwise poor in terrestrial fauna. [ABSTRACT FROM AUTHOR]

Thyme (Thymus vulgaris) is a plant used in folk medicine. Its properties, are due to its essential oil. It is important to note that thymol, essential oil and dried leaf are classified by the US FDA as food suitable for human consumption. The article shows the results for the drying process of the thyme, whose main objective is to establish the incidence of the temperature and air speed on the final humidity, choosing the optimum drying range. Two methods were used to determine the density of thyme, the first was by displacement in a test tube, the second by azeotropic distillation, finding that the most recommended is the latter one. The wet method was determined by the second method, which was 80%. On the other hand, by means of an experimental design by response surface, it was found that temperature is the most significant factor on the final moisture of thyme with p-value = 0,0124 with a level of significance of 90%. To the temperature conditions found, it is observed that the best flow rate is adjusted to the region between 2050 - 2100 rpm, which corresponds to the best temperature region of 52-53°C. [ABSTRACT FROM AUTHOR]

Objective: Risk factors of cranial migration were investigated in patients with lumbar disc herniation (LDH) that migrated in the cranial direction and the long-term outcomes are discussed in this study. Materials and Methods: Patients who underwent surgery for LDH at four different centers between 2012 and 2017 were studied. Extraligamentous discs were located in the lateral part of the posterior longitudinal ligament (PLL) within the spinal canal of the axial plane, and subligamentous discs were located under the PLL. The extent of cranial migration was calculated as a percentage of the height of the migrated corpus. Based on the extent of cranial migration, partial hemilaminectomy or hemilaminectomy was performed at different rates in each patient and the amount of laminectomy performed was recorded. During surgery, all free fragments were attempted to be removed. The appropriate technique was decided intraoperatively, and the surgery was performed on an individual patient basis. Results: Of 1289 patients who underwent surgery for LDH, 654 (50.73%) had caudal migration, 576 (44.68%) had migration at the level of the disc, and 59 (4.57%) had cranial migration. Analysis of 59 patients with cranial migration according to the localization of the disc fragment revealed that 31 had extraligamentous and 28 had subligamentous fragments (P = 0.024). Conclusions: Extraligamentous intervertebral disc fragments migrate more cranially than subligamentous intervertebral fragments. The anatomy of the PLL that varies along the corpus is the main reason for the weakness of the resistance of the disc material to the dorsolateral region, direction of discrete force vectors, and orientation of the disc fragment due to torsional vertebral movements. [ABSTRACT FROM AUTHOR]

La cuenca del río Tecka – Gualjaina se localiza al Noroeste de la provincia de Chubut, Argentina y desarrolla una superficie de 5.318 km2. El trabajo explora los forzantes del sistema atmósfera-océano asociados a la variabilidad interanual del caudal para la temporada de máximo caudal (de junio a noviembre), que representa el 80% del total anual, y de mínimo caudal (de diciembre a mayo). El balance hídrico de la cuenca arrojó condiciones de aridez, por lo que el comportamiento temporal del caudal depende del de la precipitación. En el registro disponible 1956-2013 la serie de máximo caudal presentó tendencia negativa, con un cambio de régimen en las anomalías de caudal a comienzos de los 80, pasando de un predominio positivo antes a otro negativo después. La serie de mínimo caudal mostró ser más estacionaria, sin tendencia significativa. Los ciclos dominantes en ambas series temporales sólo se observaron en la alta frecuencia interanual ( 2 años y 4-5 años). Las teleconexiones y forzantes asociados a las series de caudal se analizaron para el período 1979-2013 mediante el reanálisis del ERA-Interim. Las variaciones interanuales del caudal máximo estuvieron asociadas a teleconexión troposférica de baja frecuencia (interanual) simétrica respecto del Ecuador, posiblemente asociada a variaciones en la convección tropical entre aproximadamente 10oN-10oS y 150oE-180oE, inducidas por variaciones de temperatura superficial del mar en el Pacífico occidental ecuatorial (entre 180oO-150oO). La teleconexión afectó la posición e intensidad de las corrientes en chorro subtropical y polar, alterando la trayectoria de sistemas baroclínicos invernales que precipitan en la región. Las variaciones interanuales del mínimo caudal estuvieron asociadas a una variabilidad de altas latitudes simétricamente anular, modulada por un tren de onda 3 en latitudes medias sobre el Pacífico Sur y el Atlántico Sur. Estas características pudieron haber favorecido cambios dinámicos en el transporte de humedad dando lugar a cambios en la precipitación hacia el centro-oeste y sur de la Patagonia, afectando la cuenca del río Tecka-Gualjaina. Los resultados muestran que al menos en el período 1979-2013, el río Tecka-Gualjaina tuvo como forzante principal teleconexiones trópico-extratrópico asociadas a variaciones en el calentamiento de las temperaturas de la superficie del mar del Pacífico central ecuatorial, en parte debido a la actividad de El Niño – Oscilación del Sur (ENOS). Palabras clave: río Tecka-Gualjaina, Caudal, Dinámica fluvial, Teleconexiones troposféricas

Context: Caudal analgesia is a reliable and an easy method to provide intraoperative and postoperative analgesia for infraumbilical surgeries in pediatric population but with the disadvantage of short duration of action after single injection. Many additives were used in combination with local anesthetics in the caudal block to prolong the postoperative analgesia. Aim: We compared the analgesic effects and side effects of dexmedetomidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries. Settings and Design: Double-blinded randomized controlled trial. Materials and Methods: Sixty patients (2-10 years) were evenly and randomly assigned into two groups in a double-blinded manner. After sevoflurane in oxygen anesthesia, each patient received a single caudal dose of ropivacaine 0.25% (1 ml/kg) combined with either dexmedetomidine 2 μg/kg in normal saline 0.5 ml, or corresponding volume of normal saline according to group assignment. Hemodynamic variables, end-tidal sevoflurane, and emergence time were monitored. Postoperative analgesia, requirement of additional analgesic, sedation, and side effects were assessed during the first 24 h. Results: The duration of postoperative analgesia was significantly longer (P = 0.001) and total consumption of rescue analgesic was significantly lower in Group RD compared with Group R (P < 0.05). Group RD have better quality of sleep and prolonged duration of sedation (P = 0.001). No significant difference was observed in the incidence of hemodynamic changes or side effects. Conclusion: Addition of dexmedetomidine to caudal ropivacaine significantly prolongs analgesia in children undergoing lower abdominal surgeries without an increase in the incidence of side effects.

Background and Aims: Caudal block (CB) with adjuvants is routinely used in children for anaesthesia. We evaluated the efficacy of the α2 adrenergic agonist, dexmedetomidine at two different doses as an adjuvant to bupivacaine in CB. Methods: This study was conducted on ninety children. Control group BD0 received 0.25% bupivacaine 1 ml/kg, whereas, the study groups BD1 and BD2 received 1 μg/kg and 2 μg/kg dexmedetomidine, respectively, with 0.25% bupivacaine 1 ml/kg as a single shot CB. Adequacy of the block, haemodynamic changes, duration of analgesia and side effects were compared. Analysis of Variance was used for between-group comparisons of numerical variables. Student's t-test and Mann–Whitney U-test were used for quantitative data. Results: The demography was comparable. Anal sphincter 5 min after administration of the CB was relaxed in 89.3%, 82.1% and 75% of cases in BD0, BD1 and BD2 groups, respectively. The sphincter was relaxed at the end of surgery in all the cases. Comparable haemodynamics was noted with significantly prolonged duration of analgesia in the groups BD1 (964.2 ± 309 min) and BD2 (1152.6 ± 380.4 min) compared to control (444.6 ± 179.4 min). While no complications were encountered in groups BD0 and BD1, bradycardia was observed in four cases of BD2 group with accompanied hypotension in one of them. Conclusion: Dexmedetomidine as an adjuvant to bupivacaine improves the quality of CB, provides good operating conditions and increases the duration of post-operative analgesia. We conclude that 1 μg/kg is as effective as 2 μg/kg of dexmedetomidine and with a better safety profile.

Background: The study was conducted to evaluate the perioperative analgesic efficacy of the two doses of caudally administered tramadol versus bupivacaine in adult hemorrhoidectomy. Patients and Methods: A total of 90 patients, aged 20-50 years, undergoing hemorrhoidectomy were randomly scheduled to receive bupivacaine 0.25% in 20 ml (Group B; n = 30), tramadol 1 mg/kg in 20 ml (Group T 1 ; n = 30), tramadol 2 mg/kg in 20 ml (Group T 2 ; n = 30) through caudal route after induction of general anesthesia. Postoperative pain was assessed every hour until the visual analog scale was 6, which is 1 st time for rescue analgesia. Postoperative sedation, hemodynamic changes, serum cortisol, and epinephrine levels and incidence of side effects were also evaluated. Results: Duration of analgesia was longer in Group T 2 (20 [1.14] h] compared with the Group B (7 [1.2] h) or Group T 1 (12 [0.75] h); all P < 0.001. There were no significant hemodynamic changes. There were not incidences of side effects. Conclusion: Caudal tramadol 2 mg/kg provided a longer duration of postoperative analgesia with rapid onset and no incidence of complications or adverse effects in adult hemorrhoidectomy.

Unos de los aspectos significativos en la selección de plantas convencionales de tratamiento de agua potable son los costos de inversión, dado que interrelacionan la capacidad de la planta, el cumplimiento normativo y la tecnología a aplicar según el tipo de agua cruda. Mediante el análisis de regresión exponencial, en esta investigación se utilizaron datos de 44 proyectos de plantas convencionales de tratamiento de agua potable nuevas, en donde se obtuvieron antecedentes de elasticidad de costo de escala en un crecimiento lento, en comparación con el caudal de diseño, para cada una de las plantas analizadas.

Objective: Epidural blood patch is indicated to treat post-dural puncture headache (PDPH). When it was difficult to approach from lumbar area due to surgical wound or scar, we attempted to perform epidural blood patch from caudal hiatus. Case report: A 41-year-old woman had undergone spinal surgery because of L5-S1 spondylolisthesis. After surgery, she complained of posture-related headache and dizziness. Conservative management (fluid-supply, bed rest, and pain control) was attempted, but no improvement. Initially we did lumbar epidural autologous blood patch from the level of L3-4, but in vain. Because the lesion (dural tear) might be located at the level of L5-S1 according to statement of surgeon, we performed caudal epidural autologous blood patch to manage her PDPH under guidance with fluoroscopy. After this treatment, her symptoms dramatically improved. Conclusions: The results indicated that fluoroscopically guided caudal epidural blood patch could treat lower lumbar epidural tear after spinal surgery.

La calidad del agua para riego está condicionada por las sales (cantidad y tipo) y sedimentos que la constituyen. Las características del agua destinada al riego influyen en las propiedades edáficas, el rendimiento de los cultivos, las obras del sistema de riego y el funcionamiento de los equipos de riego presurizados. El objetivo de este trabajo fue comparar los datos actuales (2014-2017) y los de la serie histórica (1969-2007) de conductividad eléctrica (CE), total de sólidos disueltos (TSD) y pH en el Sistema de Aprovechamiento Múltiple del Río Colorado en 25 de Mayo (La Pampa). Estos parámetros se determinaron de forma periódica, en el canal matriz, el cual conduce el agua a la zona de regadío de 25 de Mayo. Se analizó el comportamiento anual e interanual de los parámetros en este período respecto a los valores medios mensuales de la serie histórica que pertenecen al Ente Provincial del Río Colorado (Gobierno de La Pampa). Los resultados analizados indican que la CE y el TSD medio mensual de los últimos tres años son superiores al promedio histórico mensual. El pH resultó superior al promedio histórico mensual durante el año 2014, a excepción de los meses de noviembre y diciembre. En 2015 y 2016 los valores registrados fueron inferiores a los históricos. Del análisis de los cambios observados se infiere que el aumento de la salinidad (CE y TSD) es debido, principalmente, a la disminución del caudal que se viene registrando en los últimos años.

El páramo es una zona biogeográfica de alta montaña que comúnmente se extiende entre el límite superior del bosque andino hasta por debajo de las nieves perpetuas. Hidrológicamente este ecosistema presenta una buena regulación de los caudales bases, como resultado de la interacción de los componentes precipitación, humedad del suelo y evapotranspiración, lo que permite el abastecimiento continuo del recurso hídrico para las poblaciones ubicadas en las cuencas medias y bajas de la región Andina. La presente investigación tiene como objetivo evaluar el comportamiento de los principales parámetros que caracterizan el balance hídrico en los páramos de Jatunsacha, con base en la recolección, análisis y procesamiento de la información hidroclimatologica de estaciones ubicadas en los páramos de Antisana, como mecanismo de apoyo en la toma de decisiones para el manejo y conservación de zonas de recarga hídrica de la parte norte del Ecuador. De acuerdo con los resultados, la dinámica del régimen hidrológico en la zona de estudio está determina por eventos de lluvia de baja intensidad, volumen y duración pero muy frecuentes, por un contenido de humedad del suelo entre capacidad de campo y punto de saturación, por una evapotranspiración relativamente baja, por un caudal muy variable que genera un coeficiente de escorrentía bajo y por una percolación alta típico en zonas con geología porosa.

La investigación demanda para su estudio el análisis de los diferentes caudales de producción de petróleo pesado con diferentes calidades API, por lo que para tal efecto se considera condiciones actuales de transporte de fluido por el oleoducto. El análisis se fundamenta en las simulaciones de estado dinámico. Para el caso base, motivo de estudio, se nota la presencia de una baja desviación en los parámetros simulados y se lo considera representativo, debido a las condiciones de frontera del oleoducto, las composiciones del fluido y su ajuste a las diferentes calidades API, datos de la tubería, condiciones ambientales y la máxima presión de operación del oleoducto. El estudio y las simulaciones llevadas a cabo, permiten concluir que el aseguramiento de flujo en el oleoducto en condiciones actuales de operación es de un caudal mayor a 14.000 bopd (barriles de petróleo por día) para no superar las presiones de operación permisibles, en tanto que para transportar flujos menores es necesario considerar otras alternativas de manejo de flujo: inyección de diluyente, mejoradores de flujo o puntos de calentamiento adicionales a lo largo del oleoducto.

Este trabajo estudia la influencia de la variación estacional de aguas residuales crudas en la eficiencia de remoción de contaminantes, tomando como caso de estudio la Planta de Tratamiento de Aguas Residuales de Juan Díaz, la cual es parte del Proyecto de Saneamiento de la Ciudad y Bahía de Panamá. Se seleccionaron seis sitios de muestreo en el sistema de colectoras que conduce las aguas residuales a la planta. En cada sitio de muestreo se midió el caudal, se determinaron valores de parámetros físicoquímico en campo y se tomaron muestras para análisis de parámetros físicoquímicos y biológicos en laboratorio. La mayoría de los resultados estuvieron dentro del rango especificado por las normas de aguas residuales de Panamá. Se encontró que los cambios en precipitación en la estación seca y lluviosa producen variaciones tanto en la cantidad como en la calidad de aguas residuales crudas y afecta la eficiencia de tratamiento o remoción de contaminantes en la Planta de Tratamiento de Aguas Residuales de Juan Díaz. Este estudio se realizó con la colaboración de la Empresa Degremont, encargada de la operación y mantenimiento de la planta.

La mayor de las cuencas hidrográficas íntegramente desarrolladas en el territorio argentino es la del río llamado sucesivamente Desaguadero-Salado-Chadileuvú-Curacó, que drena el frente oriental andino entre los 27º37 y los 38 50' de latitud sur, a lo largo de gran parte de la Diagonal Arida del país, y cubre casi un cuarto de millón de km². Aunque originalmente era un curso del orden de los 230 m³/s los aprovechamientos sobre los afluentes han secado los dos tercios inferiores, desertificando el entorno ya en zona pampeano-patagónica. Lo que hasta mediados del siglo XIX se pensaba como una vía fluvial para sacer los productos de la región de Cuyo al Atlántico hoy es, apenas, un hilo de agua hipersalina, imposible de cualquier aprovechamiento. Un análisis del desarrollo histórico de esos aprovechamientos de afluentes sumado a la consideración del balance hídrico integral permiten considerar la posibilidad de recuperación parcial de parte de las vastas zonas palustres de las confluencias, junto con el desarrollo de nuevos aunque reducidos oasis de regadío sobre la franja árida que divide al país. Contra esa posibilidad está la cerrada oposición de los estados arribeños, que desconocen la integralidad de la cuenca y, en un equivocado federalismo, consideran al agua como un recurso exclusivo. A BACIA DO RIO DESAGUADERO: Um caso de desertificação por ação antrópica Resumo A maior das bacias hidrográficas integralmente pertencente ao território argentino é a do rio chamado, sucessivamente, Desaguadero-Salado-Chadileuvú-Curacó, que drena a frente oriental andina entre os 27º37 e os 38 50' de latitude sul, que abrange grande parte da Diagonal Arida do país, e cobre quase um quarto de milhão de km². Embora originalmente possuísse um curso hídrico da ordem dos 230 m³/s, os aproveitamentos dos afluentes secaram dois terços inferiores, desertificando o ambiente da região pampeano-patagónica. O que até meados do século XIX se pensava como uma via fluvial que trazia os produtos da região de Cuyo até o Atlântico, hoje é, apenas, um fio de água hipersalina, impossível de qualquer aproveitamento. Uma análise do desenvolvimento histórico desses aproveitamentos de afluentes somado a consideração do balanço hídrico integral permitem considerar a possibilidade de recuperação parcial de parte das vastas regiões de pântanos das confluências, junto com o desenvolvimento de novos pequenos oásis de irrigação na faixa árida que divide o país. Contra essa possibilidade está à oposição dos estados arribeños, que desconhecem a integralidade da bacia e, em um federalismo equivocado, consideram a água como um recurso exclusivo.

Background: Inguinal hernia is a common disease in preterm infants necessitating surgical repair. Despite the increased risk of postoperative apnea in preterm infants, the procedure was conventionally performed under general anesthesia. Recently, regional anesthesia approaches, including spinal and caudal blocks have been proposed as safe and efficient alternative anesthesia methods in this group of patients. The current study evaluates awake caudal and spinal blocks in preterm infants undergoing inguinal hernia repair. Materials and Methods: In a randomized clinical trial, 66 neonates and infants (weight

Caudal epidural block is one of the most commonly performed neuraxial block techniques with reliable peri-operative and post-operative analgesia in pediatric patients. In our randomized, prospective, double-blinded, open level, parallel group study, we have established the effect of caudal epidural block on maintenance requirement of intravenous (IV) propofol in targeted bispectral (BIS) monitored patients. Context: Neuraxial anesthesia exhibits sedative properties that may reduce the requirement for general anesthesia. TIVA with propofol has been administered as an established method of maintaining general anesthesia in children. Caudal analgesia being a type of neuraxial block, also seems to reduce the requirement of sedative hypnotics in pediatric patients. Numerous studies show that for patients, administered with caudal epidural block, they require reduced intra-operative volatile inhalation anesthetics. In the present study, we have established the anesthetic sparing effect of Caudal Epidural Analgesia in children undergoing infra-umbilical surgical procedure and calculated the efficacy of propofol-infusion in maintaining adequate depth of anesthesia. Aims: (1) To study and compare the dose requirements of propofol using caudal epidural analgesia. (2) To calculate the efficacy of propofol as maintenance anesthetic agent in both groups and to compare hemodynamic stability of patients in both the techniques. Settings and Design: In our study, after administering general anesthesia to pediatric patients, we have administered caudal analgesia and IV analgesia to monitor the requirement of intra-operative propofol infusion using BIS monitor with a target value of 40-60 in both groups. Materials and Methods: 82 patients (aged between 3 and 6 years) have been selected undergoing infra-umbilical surgery and randomly allocated into two groups containing 41 patients in each group. Both the groups group B and group A then intubated with glycopyrrolate, 2 mg/kg injection fentanyl, propofol till loss of verbal contact and atracurium at the rate of 0.5 mg/kg and group B has been administered caudal epidural blockade with 1 ml/kg 0.2% ropivacaine. Propofol infusion at the rate of 10 mg/kg/h is given as maintenance. BIS value has been recorded throughout and propofol requirement at the end of surgery has been calculated. Statistical Analysis Used: Numerical variables between groups have been analyzed using the Student′s t-test and the Mann-Whitney U-test as applicable. Categorical variables have been analyzed using the Pearson′s Chi-square test. P < 0.05 is considered statistically significant. Results: Consumption of propofol at the start of operation in the group A is 2.9 ± 0.17 and group B is 2.91 ± 0.17, which is not statistically significant (P > 0.05), whereas at the end of the operation in the group A is 11.33 ± 0.17 and group B is 7.83 ± 0.63, which is statistically significant (P < 0.05). Incidence of adverse effects is statistically insignificant between the two groups. The time for administration of rescue analgesic is 2.1 ± 0.88 in group A and 6.5 ± 0.17 in group B, which is statistically significant due to caudal analgesia. Conclusions: We conclude that in BIS-monitored patients (3-6 years) with infra-umbilical surgeries have shown a reduction in consumption of IV propofol due to caudal epidural blockade.

Objective: To describe a case of caudal duplication successfully operated with long-term follow-up., Animal: A 12-week-old female Chihuahua mix., Clinical Presentation, Progression, and Procedures: The dog of this report presented for evaluation of duplicate external organs, including 2 anuses, 2 vulvas, and 2 tails. The dog was clinically normal except for signs of cystitis. Contrast CT identified complete urogenital and anorectal duplication, characterized by duplication of the cecum, descending colon/rectum, urinary bladder, urethra, uterus, and ovaries, with left-sided rectovestibular fistula., Treatment and Outcome: Exploratory laparotomy was performed to remove the left cecum and colon, the left ureter was transected and implanted into the right urinary bladder, the left bladder and urethra were removed, and bilateral ovariohysterectomy removed 4 ovaries and 2 uteruses. Following abdominal closure, the left anus and vulva with remaining portions of distal rectum and urethra, respectively, were removed en bloc with both tails. Long-term follow-up at 5 years showed the dog to be clinically normal., Clinical Relevance: Caudal duplication is extremely rare in veterinary medicine, and this report details successful surgical correction with good long-term follow-up.