Anesthesia experience along with familial Mediterranean fever and celiac disease

(Anesthetic management in patient with Familial Mediterranean Fever and Celiac Disease) Familial Mediterranean Fever is an autosomal recessive transmitted disease which often seen at Mediterranean origin society and it goes by deterioration at inflammation control. Celiac disease is a proximal small intestine disease which develops gluten intolerance by autoimmune mechanism in sensitive people. Association of Familial Mediterranean Fever and Celiac disease is a rare situation. In this article we present our anesthesia experience on a bilateral septic arthritis case who also have Familial Mediterranean Fever and Celiac disease association

The effects of hemodialysis and peritoneal dialysis on serum homocysteine and C-reactive protein levels.

OBJECTIVES: In this study, we aimed to investigate plasma homocysteine (Hcy) and serum C-reactive protein (CRP) levels in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, and the relation among them. MATERIALS AND METHODS: This study was carriedout on 52 HD patients, 26 CAPD patients and a control group of 22 healthy persons. Blood samples were taken from the patients for Hcy and CRP measurements. RESULTS: Serum CRP level was found to be high in 48.1% of HD patients, 69.2% of CAPD patients and 4.5% of the healthy control group. Plasma Hcy level was found out to be above the normal limits in 73.1% of HD patients, 65.4% of CAPD patients and 9% of the healthy control group. There was a significant positive relation (r = 0.384, p < 0.001) between the levels of plasma Hcy and serum CRP in HD and CAPD patients. CONCLUSION: The high levels of Hcy and CRP were found out to be higher in HD and CAPD patients than in the control group. In order to determine the risk rate of Hcy and CRP for coronary artery disease, extensive investigations are required in patients with chronic renal failure that also have coronary artery disease

The effects of peritoneal dialysis and hemodialysis on serum tumor necrosis factor-alpha, interleukin-6, interleukin-10 and C-reactive-protein levels.

BACKGROUND: Markers of an acute phase reaction, such as C-reactive protein (CRP) or tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6, are predictive for cardiovascular morbidity and mortality in normal subjects and in chronic renal failure patients. In this study, we aimed to investigate serum TNF-alpha, IL-6, IL-10 and CRP levels in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients. MATERIALS AND METHODS: Serum levels of TNF-alpha, IL-6, IL-10 and CRP levels were measured in 30 patients who were just diagnosed with end-stage renal failure and treated, with 16 CAPD (nine female, seven male) and 14 HD (eight female, six male) patients, before CAPD or HD treatment and after 3 months from the beginning of CAPD or HD in patients with no clinical signs of infection. The control groups were 20 healthy persons of similar age and sex. Serum levels of TNF-alpha, IL-6, IL-10 and CRP were measured by enzyme-linked immunosorbent assay in stable CAPD and HD patients and in healthy persons. RESULTS: The mean serum levels of TNF-alpha, IL-6, IL-10 and CRP showed no significant differences between the CAPD and HD patients for the beginning values and the third month of treatment. However, serum TNF-alpha, IL-6, IL-10 and CRP levels were higher than the control group in the CAPD and HD patients regarding the beginning values and the third month of treatment (p < 0.001). CONCLUSIONS: CAPD and HD of the renal replacement therapy have no effects on serum CRP and cytokines

Use of caffeic acid phenethyl ester and cortisone may prevent proliferative vitreoretinopathy.

PURPOSE: To investigate whether caffeic acid phenethyl ester (CAPE) and cortisone prevent proliferative vitreoretinopathy (PVR). METHODS: Twenty pigmented rabbits were used in this study. All rabbits except controls received an intravitreal injection of 0.15 ml (75,000 U) of platelet-rich plasma into their left eye. The animals were divided into four groups: group I was treated with intraperitoneal injection of 0.5 ml (15 micromol/kg) of CAPE for 3 days, group II received 0.15 ml (4 mg/kg) of intravitreal cortisone, group III received nothing (blank group), and group IV (control group) received only 1 ml of 1% ethanol intraperitoneally daily for 3 days. Proliferative changes were graded in a masked fashion by indirect ophthalmoscopy for a 15-day follow-up period. The malondialdehyde (MDA), reduced glutathione (GSH) and total nitrite (NO) levels were measured in the vitreous humor. RESULTS: The grades of PVR were B-C in group I, and C-D in group II. The PVR grade in the control group was C-D. The mean MDA level in group I (4.0+/-0.8 micromol/l) was significantly lower than in the blank group (6.0 micromol/l) (p < 0.05). The mean GSH level in group I (71.0+/-11.2 micromol/l) was significantly different than in the blank group (p < 0.05). The MDA and GSH levels in group II were 4.7+/-0.6 micromol/l and 53.8+/-7.8 micromol/l, respectively. Both these levels were not significantly different from the blank group (p > 0.05). The NO levels in both treatment groups were significantly lower than in the blank group (p < 0.001). CONCLUSION: These findings suggest an inhibitory effect of CAPE on PVR. The inhibitory effect was supported by lower MDA and NO with higher GSH levels in treatment groups than in the blank group. There was no detected significant effect of cortisone for preventing PVR experimentally

Atypical Cogan’s Syndrome: A Case Report

Cogan’s Syndrome is a rare autoimmune disease that presents with multi-system involvement including the eyes and ears. It is typically characterized by attacks of vertigo resembling Meniere, sensorineural hearing loss and interstitial keratitis. Ocular findings may vary widely, other than interstitial keratitis in the manner of atypical form which is less frequently seen and has a less favourable prognosis. Here, a 52-year-old male patient with atypical Cogan’s Syndrome is reported. In Cogan’s Syndrome, especially if diagnosis is delayed, hearing diminishes progressively and deafness usually occurs despite therapy, while ocular findings usually respond to topical therapy and persistent blindness does not occur. Persistent sensorineural hearing loss can be prevented by early diagnosis and immediate high dose systemic steroid administration with other immunosuppressive agents if required

Results of Cataract Surgery in the Very Elderly Population

Purpose: The aim of this study was to retrospectively evaluate the effect of cataract surgery on visual acuity (VA) and daily living activities in participants aged over 80 years. Methods: For eighty-three eyes from eighty three eligible patients aged 80 or above who had undergone cataract surgery between 2000 and 2005, preoperative and postoperative best-corrected visual acuity (BCVA), satisfaction score for daily living activities, surgical complications, and retinal pathologies affecting vision were recorded from the patient's file. Results: The mean age of the patients was 86.80±5.24 years (range, 80-98). VA improved in the operated eye for patients aged 80 to 89 and for those over 90 years. Postoperative VA of 0.5 or better was more frequently observed in those aged 80 to 89 than in those aged over 90 years (90.6% and 73.4%, respectively). Mean postoperative scores for the daily living activities scale were significantly better in both groups as compared to preoperative levels, and were better in the 80 to 89-year age group than for those older than 90. Intraoperative posterior capsule perforation occurred in two participants, cystoid macular edema in one, iridodialysis in one and postoperative refractory stromal edema occurred in one case. Conclusions: Our results showed that better VA levels for daily living activities can be obtained after cataract surgery in elderly patients aged over 80 years, thereby suggesting that cataract removal is effective removal in this population

A Pregnancy Case with Idiopathic Intracranial Hypertension that Improved with Diet

Idiopathic intracranial hypertension is a syndrome characterized by an increase in intracranial pressure, without hydrocephaly or a mass lesion. It is most commonly encountered in obese adolescent girls, young women, and pregnant women. Its prevalence rate in all 3 groups is the same. Herein we present a pregnancy case with idiopathic intracranial hypertension and an evaluation of the effects of idiopathic intracranial hypertension during any trimester and the effects of its treatment on pregnancy, as well as the correlation bet- ween idiopathic intracranial hypertension and pregnancy. Moreover, treatment options are assessed in light of the literatur

Developing bone cement implantation syndrome under regional anesthesia: case report

Olgu sunumuKemik sement implantasyon sendromu hipoksi, hipotansiyon, kardiyak aritmiler, pulmoner vasküler direnç artışı ve kardiyak arrest ile ilişkilidir ve sement kullanılan ortopedik hastalarda mortalite ve morbidite sebebidir. Nadir görülmesi ve iyi tanımlanamamış olması nedeniyle literatür bilgileri vaka sunumları ile sınırlıdır. Bu makalede kalça protezi için opere olan bir hastada gelişen kemik sement implantasyon sendromunu literatür eşliğinde sunulmuştur.Bone cement implantation syndrome is associated with hypoxia, hypotension, cardiac arrhythmias, increase in pulmonary vascular resistance and cardiac arrest and is a cause of mortality and morbidity in orthopedic patients when cement is used. Because it is rare and isn't well identified, literature is limited to case reports. In this article, bone cement implatation syndrome developed in a patient who had undergone surgery for hip replacementis reported with literature

Pain Perception in Phacoemulsification with Topical Anesthesia and Evaluation of Factors Related with Pain

Objectives: Evaluation of pain during and after phacoemulsification with topical anesthesia in patients with senile cataract and investigation of factors related with pain. Materials and Methods: Ninety-two adult patients scheduled for routine clear corneal phacoemulsification with topical anesthesia who had no previous cataract surgery in their fellow eyes were included in the study. Verbal pain scale and visual analog scale were used to measure pain intensity. Demographic characteristics, concomitant systemic diseases, drug consumption, need of additional anesthesia during surgery, surgical complications, duration of surgery and surgeon comfort were also evaluated for each patient. Results: Seventy-two patients (78.3%) reported pain during surgery and 68 patients (73.9%) reported pain in the period after the surgery. When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild, moderate and intense pain was 35.9%, 25.0% and 17.4%, respectively. The average verbal pain score during the surgery was 1.4±1.0 (0-3). Reported pain was not associated with age or gender (p>0.05). Diabetic patients and patients who consumed nonsteroidal anti-inflammatory drugs in the morning before operation reported less pain during and after the surgery (p0.05). Conclusion: Patients frequently experience pain during phacoemulsification with topical anesthesia. Although pain perception does not affect surgical success, preoperative administration of analgesics in suitable patients or giving additional anesthesia to patients reporting severe pain during surgery may increase patient comfort

Comparison of brimonidine-timolol and dorzolamide-timolol in the management of intraocular pressure increase after phacoemulsification

<b>AIM:</b> To compare the effectiveness of brimonidine/timolol fixed combination (BTFC) and dorzolamide/timolol fixed combination (DTFC) in the management of short-term intraocular pressure (IOP) increase after phacoemulsification surgery.<b>METHODS:</b> Eighty eyes of 80 patients undergoing phacoemulsification and intraocular lens (IOL) implantation were randomly assigned into three groups. Group 1 consisted of 28 eyes and represented the control group. Group 2 consisted of 25 eyes undergoing phacoemulsification surgery and BTFC was instilled at the end of surgery. Group 3 consisted of 27 eyes undergoing phacoemulsification surgery and DTFC was instilled at the end of surgery. IOP was measured preoperatively and 6, 24h and 1wk postoperatively.<b>RESULTS:</b> There was no statistically significant difference in preoperative baseline IOP among the three groups (<i>P</i>=0.84). However, IOP was significantly lower in groups 2 and 3 compared to the control group (<i>P</i>&lt;0.05 for all comparisons) at all postoperative visits. There was no significant difference between groups 2 and 3 at any visit. Eight eyes (28.6%) in the control group, two (8%) in Group 2 and one (3.7%) in Group 3 had IOP &gt;25 mm Hg at 6h after surgery (<i>P</i>=0.008). However, IOP decreased and was &gt;25 mm Hg in only one eye in each group at 24h after surgery.<b>CONCLUSION:</b> BTFC and DTFC have similar effects in reducing increases in IOP after phacoemulsification surgery and can both be recommended for preventing IOP spikes after such surgery