Laparoscopic Excision of Omental Infarction Mass: A Case Report

Omental infarction is a very rare cause of an acute abdomen in children. Symptoms, in particular, display a great similarity to those of appendicitis. A 10-year-old boy with omental infarction was successfully treated by laparoscopic excision. The authors have demonstrated that laparoscopic excision is a technically feasible and safe method associated with a shorter hospital stay, no requirement for analgesics and a good cosmetic outcome. [Arch Clin Exp Surg 2014; 3(4.000): 247-250

Spinal anaesthesia for a caesarean section in a patient with paraneoplastic cerebellar ataxia

Paraneoplastic cerebellar ataxia (PCA) is most frequently observed in gynaecological cancers, small cell lung cancer, breast cancer, Hodgkin's lymphoma, cancer testis or malignant thymoma. In the literature, there is no data related to the effects of PCA during pregnancy or reports on the effects of anaesthesia in patients with PCA. We present management of a pregnant woman with PCA who was suddenly unable to walk with PCA and for whom effective spinal anaesthesia was performed for an elective caesarean section with no complications

Anesthetic Techniques in Octogenarians and Older Undergoing Orthopedic Surgery for Hip Fracture

Objectives: Hip fracture is common orthopedic problems for patients aged 80 years and older. Because of their decreased cardiopulmonary capacity, an optimal anesthetic technique should be chosen by anesthesiologists. The purpose of the present study is to analyze anesthetic techniques and related postoperative mortality in octogenarians and older who underwent hip fractures surgery. Patients and Methods: We analyzed hip fracture surgeries and identified patients aged 80 years and older between January 2012 and December 2013. Patient age, gender, coexisting diseases, American Society of Anesthesiologists (ASA) Physical Status classification, anesthetic technique, hematocrit, hemoglobin, total lymphocyte count (TLC), the length of surgery, intraoperative blood transfusion requirements, postoperative discharge ward, the length of postoperative hospital stay, and postoperative status were recorded. Results: We retrospectively identified 106 patients aged 80 years and older underwent hip fracture surgeries. Six (5.6%), 36 (34.0%), 2 (1.9%), 53 (50.0%), and 9 (8.5%) of procedures were performed under general anesthesia (GA), spinal anesthesia (SA), epidural anesthesia, combined spinal-epidural anesthesia (CSEA), and peripheral nerve block (PNB), respectively. The postoperative 7 and 30-day mortality were 6.6% and 10.4%, respectively. Age, gender, ASA, hematocrit, hemoglobin, TLC, discharge to the ward, the length of postoperative hospital stay, and the postoperative mortality rates were similar between the GA, SA, CSEA, and PNB. There was no relationship between postoperative mortality and anesthetic technique. Conclusion: In octogenarians and older, the postoperative mortality is higher after hip fracture and is not associated with the anesthetic technique

Effects of fullerene C60 on liver tissue in liver ischemia reperfusion injury in rats undergoing sevoflurane anesthesia

This study aimed to investigate the effects of fullerene C60 on rat liver tissue in a liver ischemia reperfusion injury (IRI) model under sevoflurane anesthesia to evaluate the ability of nanoparticles to prevent hepatic complications. A total of 36 adult female Wistar Albino rats were divided into six groups, each containing six groups as follows: sham group (Group S), fullerene C60 group (Group FC60), ischemia-reperfusion group (Group IR), ischemia-reperfusion-sevoflurane group (Group IR-Sevo), ischemia-reperfusion-fullerene C60 group (Group IR-FC60), and ischemia-reperfusion-fullerene C60-sevoflurane group (Group IR-FC60-Sevo). Fullerene C60 100 mg/kg was administered to IR-FC60 and IR-FC60-Sevo groups. In the IR group, 2 h of ischemia and 2 h of reperfusion were performed. At the end of reperfusion, liver tissues were removed for biochemical assays and histopathological examinations. Hepatocyte degeneration, sinusoidal dilatation, prenecrotic cells, and mononuclear cell infiltration in the parenchyma were significantly higher in Group IR than in all other groups. Thiobarbituric acid reactive substances levels were significantly higher in Group IR than in the other groups, and the lowest thiobarbituric acid reactive substances level was in Group IR-FC60 than in the other groups, except for Groups S and FC60. Catalase and Glutathione-S-transferase activities were reduced in the IR group compared to all other groups. Fullerene C60 had protective effects against liver IR injury in rats under sevoflurane anesthesia. The use of fullerene C60 could reduce the adverse effects of IRI and the associated costs of liver transplantation surgery

Management practices for postdural puncture headache in obstetrics : a prospective, international, cohort study

Background: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19-1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score <= 3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP