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BackgroundDexamethasone has been reported to reduce postoperative symptoms after different surgical procedures. We evaluated the efficacy of preoperative dexamethasone in ameliorating postoperative nausea and vomiting (PONV), and pain after mastectomy.MethodsIn this prospective, double-blind, placebo-controlled study, 70 patients scheduled for mastectomy with axillary lymph node dissection were analyzed after randomization to treatment with 8 mg intravenous dexamethasone (n = 35) or placebo (n = 35). All patients underwent standardized procedures for general anesthesia and surgery. Episodes of PONV and pain score were recorded on a visual analogue scale. Analgesic and antiemetic requirements were also recorded.ResultsDemographic and medical variables were similar between groups. The incidence of PONV was lower in the dexamethasone group at the early postoperative evaluation (28.6% vs. 60%; p = 0.02) and at 6 h (17.2% vs. 45.8%; p = 0.03). More patients in the placebo group required additional antiemetic medication (21 vs. 8; p = 0.01). Dexamethasone treatment significantly reduced postoperative pain just after surgery (VAS score, 4.54 ± 1.55 vs. 5.83 ± 2.00; p = 0.004), at 6 h (3.03 ± 1.20 vs. 4.17 ± 1.24; p < 0.0005) and at 12 h (2.09 ± 0.85 vs. 2.54 ± 0.98; p = 0.04). Analgesics were required in more patients of the control group (21 vs. 10; p = 0.008). There were no adverse events, morbidity or mortality.ConclusionsPreoperative intravenous dexamethasone (8 mg) can significantly reduce the incidence of PONV and pain in patients undergoing mastectomy with axillary dissection for breast cancer.Trial registration numberNCT01116713

The aim of this study is to contribute to the knowledge about 2-Chlorophenol (2CP) mineralization and methanization in batch culture. This work was focused on evaluating the effect of: (i) the use of sludge with different periods of previous contact to 2CP, (ii) the electron donor addition in stoichiometric relation with 2CP and (iii) the presence of different initial oxygen concentrations. When compared with the control, 50 and 80 days of previous contact to 2CP resulted in a lag phase reduction of 57% and an increase in 2CP specific consumption rate (q(2CP)) of 114%. These results were obtained with no addition of an external electron donor. When acetate was used as an electron donor its consumption resulted independently of 2CP consumption. No lag phase and increase of 46% in q(2CP) was observed when phenol was used as an electron donor. In the third part when sludge without previous contact to 2CP was used, it was found that consumption efficiency (E(2CP)) and q(2CP) values did not increase in the presence of different oxygen concentrations. However, at the highest oxygen concentration, CH(4) yield (Y(CH(4))(-C/2CP-C)) and phenol yield (Y(phenol-C/2CP-C)) values decreased, while CO(2) yield value (Y(CO(2))(-C/2CP-C)) increased with regard to the methanogenic control. The use of sludge previously exposed to both 2CP and O(2) resulted in an increase in q(2CP) of 73%. However, among the different oxygen concentrations, no significant difference in E(2CP) or q(2CP) values was observed when compared to the control without oxygen. Therefore, previous contact to 2CP resulted in being a key factor for improving 2CP mineralization and methanization in batch culture.

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The possibility to produce lactic acid using mixed heterogeneous i.noculum found in cowdung has been demonstrated controlling physicochemical factors such as pH, temperature and the composition of the culture medium. At low pH values the principal final product was always ethanol while at higher pH values was always lactic acid, irrespective of the nitrogen source. Lactate production increased significantly when growth factors (.vitamins) were added to the culture media irrespective of the nitrogen source. The results indicate that mixed cultures could be grown on media with ammonium sulphate nitrogen source obtaining high yields of lactilc acid.