Growth and metabolic responses of orange spotted grouper Epinephelus coioides (Hamilton, 1822) fingerlings at different salinity regimes

A feeding trial was conducted for 60 days to delineate the effect of different salinities on growth and metabolic responses in fingerlings of orange spotted grouper Epinephelus coioides (Hamilton, 1822). The grouper fingerlings (N=1050; Av. wt. 2.0±0.01 g) were distributed equally into seven treatments of varying salinities viz., 5±1‰ (T1), 10±1‰ (T2), 15±1‰ (T3), 20±1‰ (T4), 25±1‰ (T5), 30±1‰ (T6) and 35±1‰ (T7) in triplicates. Fingerlings were fed with commercial diet containing 45% crude protein and 10% lipid. Results from the experiment concluded that growth performance of fingerlings of T4 group was better with minimum metabolic enzyme activity. The liver glycogen was significantly lower (p<0.05) in T4 group. Oxygen consumption rate (OCR) was recorded maximum at 15±1‰ and was significantly reduced for the fingerlings maintained at high salinity (p<0.05) from 20±1 to 35±1‰. Orange spotted grouper fingerlings maintained at salinity of 20±1‰ confirmed that, the animal spent less metabolic energy for maintaining the ionic balance at this optimum salinity compared to other salinities and it was reflected in better growth performance with minimum OCR and metabolic enzyme activities.

Synthesis, crystal structure, and magnetic properties of a nitronyl nitroxide biradical-coordinated copper(II) complex

A coordination compound constructed from a nitronyl nitroxide biradical NITPh(3-NIT) and CuII(hfac)2(H2O)2 building blocks [NITPh(3-NIT) = 1,3-bis(1′-oxyl-3′-oxido-4′,4′, 5′, 5′-tetramethyl-4,5-dihydro-1 H-imidazol-2-y1)-benzene, hfac = hexafluoroacetylacetonato] is successfully synthesized. The crystal structure is determined by X-ray single-crystal diffraction. The asymmetric complex {[(NITPh(3-NIT)]Cu(hfac)2} consists of one Cu(II) ion and two >N–O• groups and adopts a distorted triangular bipyramid with a penta-coordinated central copper(II) atom and three hfac oxygen atoms at the base and a >N–O• oxygen atom and one hfac oxygen atom at the apices. Intramolecular O. . .O bonding and π–π stacking interactions are observed between molecules. A magnetic susceptibility study of the coordination compound shows antiferromagnetic interactions between Cu(II) ions and >N–O• groups and very weak ferromagnetic interactions between Cu(II) ions and the free >N–O• group through O. . .O bonding between the nitroxide group oxygen atom and the oxygen atom of hfac.

Apneic laryngeal oxygenation during elective fiberoptic intubation – a technical simulation

Background Sedation during elective fiberoptic intubation for difficult airway can cause respiratory depression, apnea and periods of desaturation. During apneic episodes, hypoxemia can be prevented by insufflation of oxygen in the deep laryngeal space. The aim of this study was to evaluate an oropharyngeal oxygenation device (OOD) designed for deep laryngeal insufflation during fiberoptic intubation. Methods The OOD is split in the front to form a path for the bronchoscope. An external lumen delivers oxygen in the deep laryngeal space. In this experimental study, air application (as control group), oxygen application via nasal prongs, oxygen application via the OOD, and oxygen application via the working channel of a bronchoscope were compared in a technical simulation. In a preoxygenated test lung of a manikin, decrease of the oxygen saturation was measured over 20 min for each method. Results Oxygen saturation in the test lung dropped from 97 ± 1% (baseline in all groups) to 58 ± 3% in the control-group (p < 0.001 compared to all other groups) and to 78 ± 1% in the nasal prong group (p < 0.001 compared to all other groups). Oxygen saturation remained at 95 ± 2% in both the OOD group and the bronchoscopy group (p = 0.451 between those two groups). Conclusion Simulating apneic laryngeal oxygenation in a preoxygenated manikin, both oxygen insufflation via the OOD and the bronchoscope kept oxygen saturation in the test lung at 95% over 20 min. Both methods significantly were more effective than oxygen insufflation via nasal prongs.

Utility of oxygen insufflation through working channel during fiberoptic intubation in apneic patients: a prospective randomized controlled study

Background: Airway management is a part of routine anesthetic procedures; however, serious complications, including hypoxia and death, are known to occur in cases of difficult airways. Therefore, alternative techniques such as fiberoptic bronchoscope-assisted intubation (FOB intubation) should be considered, although this method requires more time and offers a limited visual field than does intubation with a direct laryngoscope. Oxygen insufflation through the working channel during FOB intubation could minimize the risk of desaturation and improve the visual field. Therefore, the aim of this prospective randomized controlled study was to evaluate the utility and safety of oxygen insufflation through the working channel during FOB intubation in apneic patients. Methods: Thirty-six patients were randomly allocated to an N group (no oxygen insufflation) or an O group (oxygen insufflation). After preoxygenation, FOB intubation was performed with (O group) or without (N group) oxygen insufflation in apneic patients. The primary outcome was the velocity of decrease in the partial pressure of oxygen (PaO2) during FOB intubation (VPaO2, mmHg/sec) defined as the difference of PaO2 before and after intubation divided by the time to intubation. The secondary outcomes included the success rate for FOB intubation, time to intubation, visual field during FOB intubation, findings of arterial blood gas analysis, and occurrence of FOB intubation-related complications. Results: We found that VPaO2 was significantly greater in the N group than in the O group (1.0 ± 0.4 vs. 0.4 ± 0.4; p < 0.001), while the visual field was similar between groups. There were no significant intergroup differences in the secondary outcomes. Conclusions: These findings suggest that oxygen insufflation through the working channel during FOB intubation aids in extending the apneic window during the procedure.Trial registration: ClinicalTrials.gov, NCT02625194, registered at December 9, 2015

Utility of oxygen insufflation through working channel during fiberoptic intubation in apneic patients: a prospective randomized controlled study

Background Airway management is a part of routine anesthetic procedures; however, serious complications, including hypoxia and death, are known to occur in cases of difficult airways. Therefore, alternative techniques such as fiberoptic bronchoscope-assisted intubation (FOB intubation) should be considered, although this method requires more time and offers a limited visual field than does intubation with a direct laryngoscope. Oxygen insufflation through the working channel during FOB intubation could minimize the risk of desaturation and improve the visual field. Therefore, the aim of this prospective randomized controlled study was to evaluate the utility and safety of oxygen insufflation through the working channel during FOB intubation in apneic patients. Methods Thirty-six patients were randomly allocated to an N group (no oxygen insufflation) or an O group (oxygen insufflation). After preoxygenation, FOB intubation was performed with (O group) or without (N group) oxygen insufflation in apneic patients. The primary outcome was the velocity of decrease in the partial pressure of oxygen (PaO2) during FOB intubation (VPaO2, mmHg/sec) defined as the difference of PaO2 before and after intubation divided by the time to intubation. The secondary outcomes included the success rate for FOB intubation, time to intubation, visual field during FOB intubation, findings of arterial blood gas analysis, and occurrence of FOB intubation-related complications. Results We found that VPaO2 was significantly greater in the N group than in the O group (1.0 ± 0.4 vs. 0.4 ± 0.4; p < 0.001), while the visual field was similar between groups. There were no significant intergroup differences in the secondary outcomes. Conclusions These findings suggest that oxygen insufflation through the working channel during FOB intubation aids in extending the apneic window during the procedure. Trial registration ClinicalTrials.gov, NCT02625194, registered at December 9, 2015.

Utility of oxygen insufflation through working channel during fiberoptic intubation in apneic patients: a prospective randomized controlled study

Background: Airway management is a part of routine anesthetic procedures; however, serious complications, including hypoxia and death, are known to occur in cases of difficult airways. Therefore, alternative techniques such as fiberoptic bronchoscope-assisted intubation (FOB intubation) should be considered, although this method requires more time and offers a limited visual field than does intubation with a direct laryngoscope. Oxygen insufflation through the working channel during FOB intubation could minimize the risk of desaturation and improve the visual field. Therefore, the aim of this prospective randomized controlled study was to evaluate the utility and safety of oxygen insufflation through the working channel during FOB intubation in apneic patients. Methods: Thirty-six patients were randomly allocated to an N group (no oxygen insufflation) or an O group (oxygen insufflation). After preoxygenation, FOB intubation was performed with (O group) or without (N group) oxygen insufflation in apneic patients. The primary outcome was the velocity of decrease in the partial pressure of oxygen (PaO2) during FOB intubation (VPaO2, mmHg/sec) defined as the difference of PaO2 before and after intubation divided by the time to intubation. The secondary outcomes included the success rate for FOB intubation, time to intubation, visual field during FOB intubation, findings of arterial blood gas analysis, and occurrence of FOB intubation-related complications. Results: We found that VPaO2 was significantly greater in the N group than in the O group (1.0 ± 0.4 vs. 0.4 ± 0.4; p < 0.001), while the visual field was similar between groups. There were no significant intergroup differences in the secondary outcomes. Conclusions: These findings suggest that oxygen insufflation through the working channel during FOB intubation aids in extending the apneic window during the procedure.Trial registration: ClinicalTrials.gov, NCT02625194, registered at December 9, 2015

Utility of oxygen insufflation through working channel during fiberoptic intubation in apneic patients: a prospective randomized controlled study

Background: Airway management is a part of routine anesthetic procedures; however, serious complications, including hypoxia and death, are known to occur in cases of difficult airways. Therefore, alternative techniques such as fiberoptic bronchoscope-assisted intubation (FOBI) should be considered, although this method requires more time and offers a limited visual field than does intubation with a direct laryngoscope. Oxygen insufflation through the working channel during FOBI could minimize the risk of desaturation and improve the visual field. Therefore, the aim of this prospective randomized controlled study was to evaluate the utility and safety of oxygen insufflation through the working channel during FOBI in apneic patients. Methods: Thirty-six patients were randomly allocated to an N group (no oxygen insufflation) or an O group (oxygen insufflation). After preoxygenation, FOBI was performed with (O group) or without (N group) oxygen insufflation in apneic patients. The primary outcome was the velocity of decrease in the partial pressure of oxygen (PaO2) during FOBI (VPaO2, mmHg/sec) defined as the difference of PaO2 before and after intubation divided by the time to intubation. The secondary outcomes included the success rate for FOBI, time to intubation, visual field during FOBI, findings of arterial blood gas analysis, and occurrence of FOBI-related complications. Results: We found that VPaO2 was significantly greater in the N group than in the O group (1.01 ± 0.39 vs. 0.42 ± 0.42; p < 0.001), while the visual field was similar between groups. There were no significant intergroup differences in the secondary outcomes. Conclusions: These findings suggest that oxygen insufflation through the working channel during FOBI aids in extending the apneic window during the procedure.Trial registration: ClinicalTrials.gov, NCT02625194, registered at December 9, 2015

Utility of Oxygen Insufflation Through Working Channel During Fiberoptic Intubation: a Prospective Randomized Controlled Study

Background: Airway management is a part of routine anesthetic procedures; however, serious complications, including hypoxia and death, are known to occur in cases of difficult airways. Therefore, alternative techniques such as fiberoptic bronchoscope-assisted intubation (FOBI) should be considered, although this method requires more time and offers a limited visual field than does intubation with a direct laryngoscope. Oxygen insufflation through the working channel during FOBI could minimize the risk of desaturation and improve the visual field. Therefore, the aim of this prospective randomized controlled study was to evaluate the utility and safety of oxygen insufflation through the working channel during FOBI. Methods: Thirty-six patients were randomly allocated to an N group (no oxygen insufflation) or an O group (oxygen insufflation). After preoxygenation, FOBI was performed with (O group) or without (N group) oxygen insufflation. The primary outcome was the velocity of decrease in the partial pressure of oxygen during FOBI (VPaO2), while secondary outcomes included the success rate for FOBI, time to intubation, visual field during FOBI, findings of arterial blood gas analysis, and occurrence of FOBI-related complications. Results: We found that VPaO2 was significantly greater in the N group than in the O group (1.01 ± 0.39 vs. 0.42 ± 0.42; p < 0.001), while the visual field was similar between groups. There were no significant intergroup differences in the secondary outcomes. Conclusions: These findings suggest that oxygen insufflation through the working channel during FOBI aids in extending the apneic window during the procedure.Trial registration: ClinicalTrials.gov, NCT02625194, registered at December 9, 2015

Response to Tocilizumab in Severe COVID-19

Background: Since the COVID-19 pandemic began in December 2019 no specific therapy for managing severe complications of infection has emerged, although this is under intensive investigation. Progressive pneumonia and multi-organ complications are managed with supportive care and COVID-19 has a mortality of &gt;50% when ventilatory support is needed.Methods: We implemented a compassionate use protocol for tocilizumab, a humanised monoclonal anti-Il-6 receptor antibody. Patients with severe COVID-19 requiring oxygen or ventilation, and complicated by hyperinflammation and the cytokine release syndrome (CRS) received tocilizumab (8 mg/kg up to a maximum of 800 mg, with the option of a second dose given after 12-24 hours). CRS was defined as having at least three of: D-dimer above the upper limit of normal (ULN), rising C-reactive protein (CRP), ferritin &gt;1000 ng/mL and lactate dehydrogenase (LDH) greater than the ULN.Oral consent for prescription of an off-label medicine was obtained from patients, their next of kin or representative, whenever possible. The treatment protocol adhered to the Monitored Emergency Use of Unregistered and Investigational Interventions of the WHO.Findings: Of seventeen patients with severe COVID-19 seen between 3-12th April 2020, eleven patients (seven ventilated and four receiving high flow oxygen) were treated with tocilizumab. Treatment normalised temperatures within 48 hours and was associated with a significant fall in CRP from 311 (138-332) (median, IQR mg/L) to 110 (58-184) (p = 0·001). For the group, oxygen requirements fell by 60±32% (95% CI 38-81) over 1 week (p&lt;0·001). Two of seven patients on intensive care died, five have been extubated and two discharged. All four ward patients have also been discharged.Interpretation: Following tocilizumab treatment, we observed improvement in clinical and laboratory abnormalities in this small series. Compassionate use of tocilizumab can provide valuable information to support clinical trials in patients with severe COVID-19.

Polypyridines, Picrates, Lanthanides: A Plethora of Stacks?

Reactions of the lanthanide(iii) picrates (picrate=2,4,6-trinitrophenoxide=pic) with 1,10-phenanthroline (phen) and 2,2′:6′,2′′-terpyridine (terpy) in a 1:2 molar ratio have provided crystals suitable for X-ray structure determinations in instances predominantly involving the lighter lanthanides. In all, the aza-aromatic ligands chelate the lanthanide ion, none being found as ‘free’ ligands within the lattice. The complexes of 1,10-phenanthroline have been characterised in two forms, one unsolvated (Ln=La, Sm, Eu; monoclinic, C2/c, Z 8), one an acetonitrile monosolvate (Ln=Gd; monoclinic, P21/a, Z 4), the latter being the only previously known form (with Ln=La). In both forms, the LnIII is nine-coordinate, in an approximately tricapped trigonal-prismatic environment, with two picrate ligands chelating through phenoxide and 2-nitro group oxygen atoms, the third being bound through phenoxide-O only. The 2,2′:6′,2′′-terpyridine complexes, all acetonitrile monosolvates defined for Ln=La, Gd, Er, and Y (monoclinic, C2/c, Z 4), are ionic, one picrate having been displaced from the primary coordination sphere. For Ln=La, the two bound picrates are again chelating, making the LaIII 10-coordinate in a distorted bicapped square-antiprismatic environment but in the other species they are bound through phenoxide-O only, making the LnIII ions eight-coordinate in a distorted square-antiprismatic environment. Stacked arrays of the ligands can be found in both series of complexes, with intramolecular picrate–picrate and picrate–aza-aromatic stacks being prominent features.