Internal Jugular Vein Cannulation: An Ultrasound-Guided Technique Versus a Landmark-Guided Technique

OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications

Vascular anomaly in bilateral ectopic kidney: a case report

Ectopic kidney occurs as a result of a halt in migration of kidneys to their normal locations during embryonal period. While kidneys ascend through pelvis, they receive new branches from vessels (iliac and aorta) close to them. When they reach the highest point, they receive new branches from aorta and the former branches degenerate. Renal vessels do not degenerate in the ectopic caudal kidney, more than one accessory and polar arteries may arise. In various studies, a possibility of association between presence of multiple renal arteries and hypertension, has been reported. We aimed to present a case with bilateral ectopic kidney and vascular anomaly associated with hypertension and renal dysfunction

Rare use of twin Solitaire® stents in the double waffle-cone technique for endovascular treatment of a wide-necked bifurcation aneurysm

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Ultrasound biomicroscopic evaluation of anterior segment cysts as a risk factor for ocular hypertension and closure angle glaucoma

AIM:To investigate the relationship between the ultrasound biomicroscopic (UBM) features of anterior-segment cysts (ASCs) and increased intraocular pressure (IOP) as a risk factor for closed-angle glaucoma (CAG).METHODS:Totally 24 eyes with recently diagnosed ASCs were divided into two groups . First group with ASC and ocular normotension (n=13), second group with ASC and ocular hypertension (n=11). An ophthalmologic examination, including tonometry, slit-lamp biomicroscopy (SLBM), gonioscopy, fundoscopy, pentacam, and UBM, was performed. The features of the ASCs were compared with the IOP.RESULTS:ASCs were accurately diagnosed and delineated in 24 eyes using UBM. IOP was elevated in those ASCs with a secondary aetiology (P=0.027), iridociliary location (P=0.006), deformed shape (P=0.013), increased size (P=0.001) and elongated pupillary aperture (P=0.009). However, the count (P=0.343) of ASCs, anterior chamber depth (ACD; P=0.22) and axial lenght (AL; P=0.31) were not associated with ocular hypertension. Correlations were found between the IOP and ASC size (r=-0.712; P=0.003), anterior chamber angle (ACA; r=-0.985; Pr=0.885; Pr=-0.776, Pr =-0.655, P=0.002).CONCLUSION:Ocular hypertension in some eyes with ASC might be associated with various mechanisms, including secondary aetiology, iridociliary location, deformed shape, increased size and elongated pupill, which can be determined by UBM

Carcass traits of improved and indigenous lamb breeds of North-Western Turkey under an intensive production system

The aim of study was to investigate the carcass quality of Turkish Merino, Ramlic, Kivircik, Chios and Imroz breeds in north-western Turkey under an intensive production system. After weaning at approximately 85 days of age, 46 lambs from Turkish Merino, Ramlic, Kivircik, Chios and Imroz breeds were fattened for 56 days. Slaughter weights were 47.39, 45.68, 47.27, 31.08 and 29.82 kg and chilled carcass weights were 23.35, 22.33, 23.51, 14.33 and 13.75 kg, respectively (P<0.001). Improved Turkish Merino and Ramlic and indigenous Kivircik lambs had higher carcass measurements than indigenous Chios and Imroz lambs. Chios lamb carcasses had the highest tail root fat yellowness and tail percentage while having the lowest fatness score, omental and mesenteric fat percentage and kidney knob and channel fat percentage. Turkish Merino lambs had higher shoulder percentage, lean percentage and lean/total fat ratio in the hind leg and produced less total fat in the hind leg than Ramlic and Kivircik lambs. These results indicate that improved Turkish Merino might be used to produce high quality lamb carcasses in north-western Turkey. Among indigenous breeds Kivircik showed an outstanding carcass production performance

Serum N-Desmethylcitalopram Concentrations are Associated with the Clinical Response to Citalopram of Patients with Major Depression.

Citalopram (CITA) is a widely used and well-tolerated selective serotonin reuptake inhibitor. The aim of the study was to evaluate the possible influences of serum concentrations of CITA and its major metabolite n-desmethylcitalopram (NDCITA) on the efficacy and tolerability of CITA in patients with major depressive disorder

Serum N-Desmethylcitalopram Concentrations are Associated with the Clinical Response to Citalopram of Patients with Major Depression

Objective Citalopram (CITA) is a widely used and well-tolerated selective serotonin reuptake inhibitor. The aim of the study was to evaluate the possible influences of serum concentrations of CITA and its major metabolite n-desmethylcitalopram (NDCITA) on the efficacy and tolerability of CITA in patients with major depressive disorder. Methods The study included 46 outpatients with major depressive disorder who received CITA. The efficacy and tolerability were assessed for 6 weeks. Serum CITA and NDCITA levels were measured at the 4th week. Results The HDRS17 total scores of the patients with high NDCITA and CITA \& NDCITA concentrations showed a more significant reduction compared to the patients with expected and low serum NDCITA and CITA \& NDCITA concentrations. However, we did not observe a correlation between the serum concentrations and the side effects of CITA, NDCITA, and CITA \& NDCITA. Conclusion Our results suggested the potential contribution of NDCITA to the antidepressant effect of CITA. Further studies involving larger clinical samples are required to confirm the impact of serum NDCITA concentrations on the efficacy of CITA