The comparison of preemptive analgesic effectiveneas of epidural and intravenous fentanil

Bu çalışmada, total abdominal histerektomilerde epidural ve intravenöz olarak uygulanan fentanilin preemptif analjezik etkinliğinin karşılaştırılması amaçlandı. ASA I-II grubu, total abdominal histerektomi yapılacak 54 hasta çalışmaya alındı ve randomize olarak üç gruba ayrıldı. Bütün hastalara standart genel anestezi uygulandı. Kontrol grubuna (Grup K, n18), sadece genel anestezi verildi. Epidural analjezi grubuna (Grup E, n18), preoperatif olarak L2-3 veya L3-4 aralıklarından yerleştirilen epidural kateterden 10 mL % 0.9 NaCl içinde 4 µg kg-1 fentanil, insizyondan 30 dakika önce uygulandı. İntravenöz analjezi grubuna (Grup İ, n18), insizyondan 5 dakika önce 4 µg kg-1 İV fentanil uygulandı. Postoperatif ağrı, 1.,2., 4., 6., 12. ve 24. saatlerde VAS ağrı skalası ile değerlendirildi. İlk analjezik istem zamanları ve 24 saatlik toplam analjezik tüketimleri kaydedildi. Ayrıca insizyon öncesi ve postoperatif 4. saatteki kan glukoz ve kortizol düzeylerine bakıldı. Postoperatif bütün evrelerdeki VAS skorları ve toplam analjezik gereksinimi Grup E'de diğer iki gruba göre anlamlı derecede düşük bulundu (p0.05). İlk analjezik istem zamanı da Grup E'de belirgin olarak uzundu (p0.05). Preinsizyonel kan glukoz ve kortizol değerlerinde gruplar arasında farklılık yok iken, postoperatif 4. saatte Grup E'de diğer iki gruba göre anlamlı derecede düşük bulundu (p0.05). Ancak bütün grupların postoperatif 4. saatteki değerleri preinsizyonel değerlerle karşılaştırıldığında, anlamlı bir artış tespit edildi (p0.05). Sonuç olarak total abdominal histerektomi ameliyatlarında preemptif epidural fentanilin akut postoperatif ağrı ve cerrahi stres yanıtın kontrolünde intravenöz fentanilden daha etkili olduğunu düşünmekteyiz.In this study, we aimed to compare the preemptive analgesic effect of fentanyl, which is used by intravenous or epidural route, in total abdominal hysterectomy (TAH). Fifty-four ASA I-II patients who admitted for total abdominal hysterectomy were included to this study and patients were randomly separated into three groups. All patients were given standard general anesthesia. General anesthesia alone was given in control group (Group K). In epidural analgesia group (Group E), epidural catheter was inserted preoperatively through L2-3 interspace and 4 µg kg-1 fentanyl in 10 mL0.9 % NaCl was administered 30 min. before incision. In intravenous analgesia group (Group I), fentanyl 4 µg kg-1 was administered intravenously 5 min. before skin incision. Pain scores were assessed with visual analogue scale (VAS) at 1st, 2nd, 4th, 6th, 12th and 24th hours postoperatively. First analgesic requirement time and total analgesic consumption were also recorded. Surgical stress response was evaluated with the blood glucose and plasma cortisol levels of patients whom were obtained before the incision and postoperative 4th hour. Compared to the other two groups, we observed that remarkable lower VAS pain scores and total analgesic consumption was provided in Group E (p<0.05). First analgesic requirement time was also significantly prolonged in Group E (p<0.05). The blood glucose and plasma cortisol levels at 4th hour postoperatively were significantly lower in Group E when compared to the other two groups (p<0.05). As a result we suggested that preemptive epidural fentanyl administration was more effective than preemptive intravenous fentanyl in postoperative acute pain and surgical stress response control at total abdominal hysterectomy

Intraventricular albumin: an optional agent in experimental post-traumatic brain edema

MENGI, MURAT/0000-0003-1688-814X; Uzan, Mustafa/0000-0001-7214-380XWOS: 000226701300012PubMed: 15829162Hypothesis: Human albumin may be effective in the treatment of posttraumatic brain edema due to its hyperoncotic features. Therefore, the aim of the experimental stud presented in this paper has two points: the first is to evaluate the efficacy of intraventricular hyperoncotic human albumin on post-traumatic brain edema and the second is to try to show the appropriate posttraumatic time window for albumin administration. Method: Traumatic brain injury and subsequent edema was formed by a model of impact acceleration injury in rats. Human albumin was administered via intraventricular route by using a stereotactic head holder. All animals in each roup were decapitated 24 hours after the procedure and the effect of albumin was evaluate by measurement of tissue specific gravity. Results: Tissue specific gravity decreased in edematous tissue (trauma indicator), increased after albumin administration at the 12th (p<0.001), and both at the 1st and 12th hour of the trauma (edema treatment; p<0.001). On the other hand, albumin administered at the 12th, and at both the 1st and 12th hours in the rats without trauma has caused the formation of the brain edema. Conclusion: We conclude that human albumin is effective in cytotoxic, but not in vasogenic edema and exerts its best anti-edematous effect at the 12th hour of severe head trauma and this study may help future studies that will try to show the effects of albumin with different time modalities after severe head injury

Microbiological and Nutrient Analysis of Spiriluna platensis Produced in Poultry Manure Enriched Medium

Spirulina platensis is an interesting source of important protein for both human and animal consumption, which is cyanobacteria, is a crucial functional food additive. Spirulina platensis which is a photosynthetic micro algae, contains high crude protein content (62-70%) as well as precious metabolites (Fox, 1996). Recent studies have propound that dry chicken manure can be used as low-cost nitrogen source in cultivation of Spirulina platensis (Ungsethaphand at al., 2007). Dry chicken manure(DCM) contains most of elements particularly nitrogen (N) and phosphorus (P) which microalg need for growth and flourish. In Turkey, about 7 million tons of poultry manure creates environmental problems per year(Eleroğlu at al., 2013). The aim of study, cell density was counted and dry biomass were analyzed (DCM medium) was to compare the microbiological quality of Spirulina platensis cultured in standart medium and DCM medium.Çukurova University Scientific Research Project Commission (Project Number: CUBAP-09/2017-9767)

Clinical and molecular aspects of Turkish familial hemophagocytic lymphohistiocytosis patients with perforin mutations

The aim of this study was to elucidate the pathologic sequence changes and associated clinical phenotypes in 9 new patients showing homozygosity for perforin gene among a total of 37 (24%) Turkish FHL families studied by linkage analysis. These 9 unrelated patients (5M/4F) were coming from consanguineous families and their presentation ages of systemic symptoms were ranged from birth to 15 years. Direct sequencing of coding exons of the perforin gene led to the identification of five different homozygous alterations. The nonsense W374X mutation was identified in three patients while four different missense mutations namely G149S, V50M, A91V and novel A523D were detected in the rest six patients. (c) 2007 Elsevier Ltd. All rights reserved