Spinal Anesthesia In Kartagener'S Syndrome

Kartagener's syndrome, an autosomal recessive disorder is a combination of dextrocardia (situs inversus), bronchiectasis and sinusitis. We report a 22-year-old woman with this syndrome scheduled for appendectomy. Spinal anesthesia was preferred for the patient with this rare disorder due to the relative advantages of the regional technique over general anesthesia.Wo

Airtraq, LMA CTrach and Macintosh Laryngoscopes in Tracheal Intubation Training: A Randomized Comparative Manikin Study

WOS: 000382992900004PubMed ID: 27366562Objective: Training students on simulators before allowing their direct contact with patients is well accepted. There is no clinical or manikin-based simulation study in the literature comparing tracheal intubation with Airtraq, laryngeal mask airway (LMA) CTrach and Macintosh laryngoscopes performed by medical students having no prior intubation experience. Methods: After obtaining written informed consents, 123 participants were included in the study. The participants were asked to intubate the manikin five times with each device randomly. After all the participants had completed their fifth intubations, the measurements were performed. The primary outcome variables were the first-attempt success rate and the time for a successful intubation, while the secondary outcome variables were to determine the scores of dental trauma, the difficulty visual analogue scale and the optimization manoeuvres. Results: The LMA CTrach group revealed a significantly higher number of intubation attempts. The mean time for a successful intubation was the longest in the LMA CTrach group (17.66 +/- 8.22 s, p<0.05). Students defined the Airtraq as the easiest to use and the Macintosh laryngoscope as the most difficult device to use and learn. Dental trauma severity was significantly lower in the Airtraq group than in the other groups (p<0.05), and it was found to be 0 in 81.1% in the Airtraq group. The head extension optimization manoeuvre rate was significantly higher with the Macintosh laryngoscope than with the Airtraq laryngoscope (p<0.05). Conclusion: This study, in which different types of laryngoscopes were compared, revealed that the Airtraq laryngoscope has advantages, such as shorter intubation duration, less additional optimization manoeuvres, less dental trauma intensity and is easier to learn compared with the LMA CTrach and Macintosh laryngoscopes

Comparative Assessment Of Induction Efficacy Of Propofol Preparations

Objectives: 10 compare the hypnotic effects (using Bispectral Index [BIS]), hemodynamic parameters, injection pain and quality of anesthesia during induction of anesthesia of the 3 commercial propofol preparations (Abbott Propofol, Abbott Laboratories), Pofol (Dongkook Pharm. Co. Ltd.), and Propofol 1% Fresenius (Fresenius Kabi). Methods: After Ethics Committee Approval, a prospective, randomized, double-blind study was designed in Hacettepe University Hospitals Operating Theaters in 2005. The patients aged 18-65 years, American Society of Anesthesiologists (ASA) grades I and 11 scheduled for elective surgery under general anesthesia with orotracheal intubation. Ninety patients were randomized into 3 groups with 30 patients in each group. Propofol infusion rate was 2.5 mg. seconds(-1). Induction time and doses to reach BIS level of 50 10, injection pain, BIS values and hemodynamic parameters were recorded every minutes for the first 7 minutes and than every 2 minutes for 15 minutes. We used a special chart to assess the induction quality. Results: Demographical parameters and ASA Physical status were similar in all groups. There were no significant differences in induction quality, induction time and doses, injection pain, BIS values and hemodynamic parameters. Conclusion: Abbott Propofol, Pofol and Propofol 1% Fresenius have similar effects on anesthesia induction quality and the cost should be taken into consideration when choosing the type of commercial formulation propofol emulsions.Wo

Effect of Hypotensive Anesthesia on Cognitive Functions - A Comparison of Esmolol and Remifentanil During Tympanoplasty

Objective: To compare the effects of esmolol and remifentanil, used as adjuncts for induced hypotension on surgical conditions and short-term cognitive functions, during tympanoplasty. Methods: The study was conducted in Hacettepe University, School of Medicine, Ankara, Turkey between January 2005 and December 2006 following Institutional Ethical Committee approval, 40 ASA I-II patients, between 18 and 60 years of age were included in this study. With the induction of anesthesia, for group E, an esmolol infusion of 50-250 mu g.kg(-1).min(-1) was titrated, following a bolus of 0.5 mg.kg(-1); for group R, a remifentanil infusion of 0.2-0.5 mu g.kg(-1).min(-1) was titrated; to achieve a mean blood pressure (BP) of 55-65 mm Hg. Arterial BP were recorded continuously throughout the operation. Mini Mental State Test (MMS) was performed at the preoperative 30th minute (MMSP), postoperative 30th minute (MMS30), 60th minute (MMS60) and 24th hour (MMS24). Surgical field was evaluated by the blinded surgeon, using a 6 point category scale. Results: Patient demographics were similar in both groups. Sustained controlled hypotension was sufficient in A of the groups throughout surgery. Surgical field scores were lower in group R (p<0.05), although the scores were <= 2 in both groups, which was regarded as adequate for tympanoplasty. Four patients in group R (20%) and one patient in group E (5%) showed cognitive function decline between MMSP and MMS30. Within both groups, there were statistically significant differences between MMS60 and MMSP, MMS24 and MMSP, MMS60 and MMS30, MMS24 and MMS30, but the results were similar between the groups. Conclusion: Remifentanil or esmolol provided adequate induced hypotension and similar operating conditions and their effects on cognitive functions in the short postoperative period are similar for tympanoplasty.Wo

The investigation of tannic acid effects on removal of heavy metals and some biochemical values in the rat toxicity induced by cadmium

AMAÇ: Endüstriyel alanda yoğun bir şekilde kullanılan, önemli çevre kirleticilerden biri olan kadmiyum (Cd), günlük hayattaki maruziyetimiz nedeniyle yaşamsal bir takım tehditlere sebep olabilmektedir. Uzun bir yarılanma ömrüne sahip olan Cd, solunum, üriner, kardiovasküler, gastrointestinal, sinir sistemi ve kemiklerde direkt veya dolaylı olarak toksisiteye neden olmaktadır. Vücutta biriken Cd’un osteoporoz, anemi, eozinofili, anozmi ve kronik rinit gibi birçok hastalığa neden olduğu bilinmektedir. Çalışmamızda, flavonoid içeriği oldukça yüksek, ağır metal şelatlayıcı özelliğe sahip ve antioksidan tannik asidin (TA) Cd toksikasyonundan korunmadaki rolünü araştırmak amaçlandı. GEREÇ VE YÖNTEM: Bu amaçla, 28 adet 200-300 gram ağırlığında sağlıklı 3-4 aylık Spraque-Dawley soyu erkek sıçanlar kullanıldı. Deney hayvanlarına ön tedavi amaçlı intraperitonal (i.p) enjeksiyon ile 5 gün boyunca TA 50mg/kg/gün olarak uygulandıktan sonra, intragastrik (i.g) enjeksiyon tek doz 35mg/ kg CdCl2 uygulandı. BULGULAR: CdCl2 uygulaması ile azalan hemolizat, karaciğer ve böbrek süperoksit dismutaz (SOD) değerlerini TA’nın artırdığı gözlendi. Benzer şekilde artan hemolizat ve karaciğer malondialdehit (MDA) değerlerini TA’nın azalttığı belirlendi. Karaciğer, böbrek, akciğer, testis ve dalakta CdCl2 uygulaması ile artan birikimi azaltma yönünde, TA etkili olmazken, kalpteki birikimi azaltma yönünde TA’nın etkili olduğu analiz edildi. CdCl2 uygulaması ile artan demir birikimini azaltma yönünde böbrek, dalak ve kalpte TA etkili olmazken, karaciğer, akciğer ve testiste etkili olduğu tespit edildi. SONUÇ: Günlük diyette kullanılan yiyecek ve içeceklerin, toksik ajanlara maruz kalma sonucu gelişebilecek bazı hastalıkları erken dönemde önlenmesiyle, bireylerin yaşam kalitesi yükselebilecektir. Çalışmamızda günlük yaşantımızda tüketilen TA içeren yiyeceklerin, çeşitli şekillerde maruz kaldığımız ağır metallerden korunma üzerine olan etkileri gözlemlendi. Elde edilen sonuçlara göre farklı dokularda farklı sonuçlara ulaşılabileceği belirlenirken, genel olarak değerlendirildiğinde, Cd’un zararlı etkilerine ya da en azından bazı dokulardaki birikimini azaltma yönünde TA’nın etkili olabileceği sonucuna ulaşıldı.OBJECTIVE: Cadmium (Cd), one of the major environmental pollutants used intensively in the industrial field and could causes a variety of vital threats due to our exposure in our daily lives. Having a long half-life, Cd causes direct or indirect toxicity to respiratory, urinary, cardiovascular, gastrointestinal, nervous system and bones. It is known that Cd that accumulates in the body causes many diseases such as osteoporosis, anemia, eosinophilia, anosmia and chronic rhinitis. In our study, we aimed to investigate the role of tannic acid (TA), an antioxidant substance with a high content of flavonoids and heavy metal chelating agents, in order to investigate its role in protecting from Cd toxicity. MATERIALS AND METHODS: In this study, it was used 28 Spraque-Dawley, 200-300 gr, 3-4 monthly male rats. For pre-treatment, TA (50 mg/kg/day) was administered by intraperitoneal (i.p) injection to the experimental groups for 5 days. And then a single dose CdCl2 (35 mg/kg) was was administered by intragastric (i.g). RESULTS: It was observed that superoxide dismutase (SOD) values decreased in hemolysate, liver and kidney by CdCl2 administration; but increased with TA. Malondialdehyde (MDA) values increased with CdCl2 administration whereas decreased with TA the hemolysate and liver. TA was found to be effective in decreasing heart accumulation, while TA was not effective in reducing accumulation with CdCl2 administration in liver, kidney, lung, testis and spleen. TA is not effective in reducing increased iron accumulation with CdCl2 administration in the kidney, spleen and heart, but in liver, lung and testis it could be effective. CONCLUSIONS: Food and drinks used in the daily diet may increase the quality of life of individuals by early prevention of certain diseases that may result in exposure to toxic agents. In our study, it has been shown that TA, which is consumed in our daily lives, may be effective in protecting substances from heavy metal toxicity. According to the results obtained, different results could be reached in different tissues; but when assessed in general, the harmful effects of Cd, or at least the result that TA have been achieved to reduce the accumulation of some tissues

Effect of Intraarticular Injection of Lornoxicam on the Articular Cartilage & Synovium in Rat

Background & objectives: Intraarticular (i.a) drug application is consider to be a new therapeutic approach for the treatment of postoperative pain after arthroscopic knee surgery without any systemic adverse effects. Lornoxicam, a nonsteroid anti-inflammatory drug is a short acting agent, and its anti-inflammatory and analgesic activity may be effective in the postoperative pain management in minor surgery. In this study, the effects of intraarticular administration of lornoxicam on the synovium and articular cartilage in the rat knee joint were investigated. Methods: Lornoxicam (0.25 ml) was given as an injection into the right knee joint and 0.25 ml of 0.9 per cent saline solution by injection into the left knee joint as a control in 25 rats. Groups of five rats were sacrificed by a lethal injection of ketamine 1(st), 2(nd), 7(th), 14(th) and 21(th) days after lornoxicam administration. Knee joints were detached, fixed in 10 per cent buffered formalin and decalcified. Serial sections of 5 mu m were stained with haematoxylin-eosin and evaluated for the presence of inflammation in the articular, periarticular regions and synovium. Inflammatory changes in the joints were graded according to a five-point scale, histologically. Results: There were no significant differences in inflammation and cartilage degeneration, between control and lornoxicam applied knees. Grade 3 inflammatory changes occurred only in one knee in lornoxicam group, at 24 h after injection. No pathological changes were observed in both groups at any time point. Interpretation & conclusions: Lornoxicam did not show significant effect on inflammation on rat synovia in knee joint. Further studies including in human need to be done before any recommendations are made for La. administration of lornoxicam.Wo

Major Ayak Cerrahisi Uygulanan Çocuklarda Postoperatif Analjezi İçin Devamlı Siyatik Sinir Bloğu ve İntravenöz Hasta Kontrollü Analjezi Yöntemi ile Morfin Kullanımının Karşılaştırılması

Objective: Peripheral nerve catheter for postoperative analgesia is new method in children. In this study, we aimed to compare the efficacy of systemic opioid use with continuous sciatic nerve blocks after foot surgery in children. Material and Methods: A total of 32 patients aged between 2-8 years were randomized into two groups prospectively. After general anesthesia, Group I (n= 16): Patients in the systemic opioid group were administered patient controlled analgesia (PCA) 30 minutes before the end of surgery and were administered 0.5 ml.mg.(-1) of morphine with a rate of 0.02 mg.kg.(-1) hour(-1). Bolus dose was adjusted as 0.01 mg.kg.(-1), lock out time was determined as 15 minutes and four hour limit was determined as 4 mg. Group II (n= 15): The sciatic nerve catheter was inserted using nerve stimulator under ultrasound and 0.4 ml.kg.(-1) of %0.5 bupivacain was injected and 0.2% bupivacain with a rate of 0.1 ml.kg.(-1) hour(-1) was administered with PCA at recovery through sciatic nerve catheter. Visual pain scale (VPS) (0-100 mm 0= no pain, 100= the worst pain) was used for evaluation of postoperative pain in children and CHIPPS (children and infants postoperative pain score) was used for children under 7 years for evaluation of pain When VAS>40 and CHIPPS >3, 15 mg.kg.(-1) paracetamol IV was administered, and if this was not enough to decrese the scores, 0.02 mg.kg.(-1) morphine was given. Pain scores, rescue analgesics, adverse effects and family satisfaction were recorded. Results: A statistically significant difference was not found between study groups when compared for demographic features, VPS and CHIPPS scores. Rescue analgesic administration, nausea, vomiting, pruritus and urinary retention was found higher in group I and the difference was statistically significant. Parent satisfaction was statistically significantly higher in PNC group. Conclusion: Sciatic nerve catheter is as effective as opioid use with PCA for children after appropriate operations and has fewer adverse effects, less need for rescue analgesics and better parent satisfaction.WoSScopu

Novel alterations of CC2D1A as a candidate gene in a Turkish sample of patients with autism spectrum disorder

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