The relationship between serum bilirubin level with interleukin.6, interleukin.10 and mortality scores in patients with sepsis

Context: Bilirubin has been shown to influence the mechanisms of both apoptosis and inflammation.Aims: The aim of the following study is to investigate the relationship between the serum bilirubin level with sepsis progression.Settings and Design: A total of 20 patients from intensive care unit were included for this study.Materials and Methods: Patients were divided into two groups: Patients diagnosed with sepsis according to the American College of Chest  Physicians/Society of Clinical Care Medicine consensus conference criteria (n = 10) and patients treated for various other diagnoses (n = 10). Blood samples were collected for both groups at the time of origin (defined as the time of diagnosis) and 24 and 48 h after diagnosis. Serum interleukin (IL).6, IL.10 and bilirubin levels were analyzed and compared. Acute physiology and chronic health evaluation (APACHE) II and sepsis related organ failure (SOFA) scores of the patients were also evaluated. Statistical Analysis Used: We used Statistical Package for Social Sciences (SPSS for Windows, version 17.0, SPSS Inc. 233 South Wacker Drive, Chicago) for statistical analysis.Results: At all.time intervals, serum IL.6, IL.10 and total, direct and  indirect serum bilirubin levels were significantly higher in the sepsis group (P < 0.05); APACHE II and SOFA scores were also significantly higher. Both SOFA scores and serum IL.10 levels were positively correlated with bilirubin levels 24 h after diagnosis (P < 0.05, r = .0.76).Conclusions: Although levels of bilirubin and other associated parameters were higher for the sepsis group, only SOFA score and bilirubin levels were correlated. Because bilirubin is already a SOFA parameter, this correlation was not considered as clinically significant.Key words: Acute physiology and chronic health evaluation, bilirubin, interleukin.6, interleukin.10, sepsi

Comparison of anaesthetic cost in open and laparoscopic appendectomy

Context: Appendectomy is generally conducted as open or by laparoscopic surgical techniques under general anesthesia.Aims: This study aims to compare the anesthetic costs of the patients, who underwent open or laparoscopicappendectomy under general anesthesia.Settings and Design: The design is retrospective and records of 379 patients who underwent open or laparoscopicappendectomy under general anesthesia, falling under the category of I‑III risk group according to the American Societyof Anesthesiologists (ASA) classification between the years 2011 and 2013, and aged 18-77.Subjects and Methods: Open (Group I) or laparoscopic (Group II) appendectomy operation under general anesthesiawere evaluated retrospectively by utilizing hospital automation and anesthesia observation records. This study evaluatedthe anesthesia time of the patients and total costs (Turkish Lira ₺, US dollar $) of anesthetic agents used (induction,maintenance), necessary medical materials (connecting line, endotracheal tube, airway, humidifier, branule, aspirationprobe), and intravenously administered fluids were evaluated.Statistical Analysis Used: We used Statistical Package for the Social Sciences software (SPSS version 17.0) forstatistical analysis.Results: Of the patients, 237 were males (62.53$) in Group I and 83.09 ± 26.85₺ (41.29 ± 13.34$) inGroup II (P > 0.05). A correlation was observed between cost and operation times (P = 0.002, r = 0.158).Conclusions: Although a statistical difference was not established in this study in terms of time and costs inappendectomy operations conducted as open and laparoscopically, changes may occur in time in market conditionsof drugs, patent rights, legal regulations, and prices. Therefore, we believe that it would be beneficial to update andrevise cost analyses from time to time.Keywords: Cost, cost comparison laparoscopic appendectomy, open appendectom

Does aprotinin reduce lung reperfusion damage after cardiopulmonary bypass?

Objective: The role of aprotinin in the prevention of lung reperfusion injury was investigated in the patients undergoing cardio-pulmonary bypass (CPB) for coronary artery bypass grafting (CABG) operations. Methods: The study was planned randomly and prospectively. Two hundred milliliters of physiological saline solution was added to the prime solution of patients in group I (n = 10) whereas, 200 mi aprotinin (Trasylol. Bayer AG) was given to patients in group II(n = 10). In order to measure lung tissue malondialdehyde (MDA) levels, glutathion peroxidase (GSH-Px) activity levels and polymorphonuclear leukocytes (PMNs) numbers, lung tissue samples were taken before CPB and 5 min after removing the cross clamp. In addition, alveolo-arterial oxygen difference (AaDO(2)) for tissue oxygenation was calculated by obtaining arterial blood gas samples. Results: MDA levels before CPB increased from 41.72 +/- 21.00 nmol/g tissue to 66.71 +/- 13.44 nmol/g tissue in group I and from 43.44 +/- 5.16 nmol MDA/g tissue to 53.22 +/- 10.95 nmol MDA/g tissue in group II after cross clamp removal (P = 0.001 and P = 0.021, respectively). The increase in group LI was found to be significantly lower than group I (P = 0.048). With the initiation of reperfusion. GSH-Px activity decreased in group I from 3.05 +/- 0.97 to 2.31 +/- 0.46 U/mg protein (P = 0.015) whereas GSH-P,: activity in group II decreased from 3.18 +/- 1.01 to 2.74 +/- 0.81 U/mg protein (P = 0.055). This decrease in the group II was less than group I (P = 0.049), AaDO(2) significantly increased in the group I and II (P = 0.012 and P = 0.020, respectively), but elevation in the group I was significant than in the Group IT (P = 0.049). In histopathological examination: it was observed that neutrophil counts in the lung parenchyma rose significantly following removal of cross clamp in both groups (P = 0.001). The increase in group I was significantly larger than in group II (P = 0.050). Conclusion: Results represented in our study indicate that addition of aprotinin (2 million units) into the prime solution during CPB can reduce lung reperfusion injury. (C) 2000 Elsevier Science B.V. All rights reserved

Reconstruction of the vena cava with the peritoneum: The effect of temporary distal arteriovenous fistula on patency - (An experimental study)

Objective: To determine the effect of increasing inferior vena cava blood flow by means of distal arteriovenous fistula on the patency of a peritoneal tube graft

Comparative Investigation of Protective Effects of Metyrosine and Metoprolol Against Ketamine Cardiotoxicity in Rats

Ahiskalioglu, Ali/0000-0002-8467-8171; ALP, Hamit Hakan/0000-0002-9202-4944; Ahiskalioglu, Ali/0000-0002-8467-8171; AKSOY, Mehmet/0000-0003-0867-8660WOS: 000361605900005PubMed: 25503950This study investigated the effect of metyrosine against ketamine-induced cardiotoxicity in rats and compared the results with the effect of metoprolol. in this study, rats were divided into groups A, B and C. in group A, we investigated the effects of a single dose of metyrosine (150 mg/kg) and metoprolol (20 mg/kg) on single dose ketamine (60 mg/kg)-induced cardiotoxicity. in group B, we investigated the effect of metyrosine and metoprolol, which were given together with ketamine for 30 days. in group C, we investigated the effect of metyrosine and metoprolol given 15 days before ketamine and 30 days together with ketamine on ketamine cardiotoxicity. By the end of this process, we evaluated the effects of the levels of oxidant-antioxidant parameters such as MDA, MPO, 8-OHGua, tGSH, and SOD in addition to CK-MB and TP I on cardiotoxicity in rat heart tissue. the experimental results show that metyrosine prevented ketamine cardiotoxicity in groups A, B and C and metoprolol prevented it in only group C