Polymorphisms of the DNA repair gene XPD (751) and XRCC1 (399) correlates with risk of hematological malignancies in Turkish population

Polymorphisms that occur in DNA repair genes affect DNA repair capacity and constitute a risk factor in hematological malignancies. This study, was aimed to investigate whether xeroderma pigmentosum complementation group D (XPD) and x-ray repair cross-complementing group 1 (XRCC1) gene polymorphisms were involved in the susceptibility to different hematological malignancies. The genotype and allele frequencies were obtained by analyzing XPD gene codon 751 in a total of 80 patients and XRCC1 gene codon 399 polymorphism in a total of 100 patients with hematological malignancies and 100 healthy controls. Mean age was 45 (range: 16 to 75) and 46 (range: 16 to 82) in the patients groups and 39.5 (range: 18 to 67) in the control group, respectively. Additionally, distribution of genotypes and alleles were compared in the patient and control groups. In the comparison of genotype and allele frequencies in hematological malignancies and healthy controls, XPD-751Gln variant was arranged and compared according to age and sex and Gln/Gln genotype was reported to be a protector, which was decreased significantly in acute myeloblastic leukemia (AML) (p = 0.042). No relationship was determined between allele frequencies (p = 0.054). In XRCC1-399, it was shown that Gln/Gln genotype was decreased significantly in AML (p = 0.014) plus all hematological malignancies (p = 0.033) and that Gln allele was present at a lower ratio in AML (p = 0.046). The distribution of polymorphism of both genes was not statistically significant in terms of age and sex. In leukemia with early relapse, XPD 751 Lys/Lys genotype was determined at a statistically higher ratio (p = 0.042). In the evaluation of both genes together, a decrease was noted in Gln/Gln + Lys/Gln haplotype frequency in hematological malignancies (p = 0.048). In this study, it was demonstrated that a decrease in Gln/Gln genotype and Gln allele acted as a protector in XPD codon 751 and XRCC1 codon 399 polymorphisms in acute myeloblastic leukemia (AML) and that an increase in Lys/Lys genotype in acute leukemia was associated with early relapse

New anticoagulant agents and spinal/epidural anesthesia

A special attention is needed in terms of spinal and epidural techniques which are frequently used in anesthesia practice, due to the high increase in the usage of anticoagulant and antitrombocyt drugs in patients who require surgical treatment. The institutional on the treatment of anticoagulant and the management of those patients in preoperative and postoperative periods to avoid potential severe complications

Effects of epidural metoprolol and verapamil on the quality of blockade induced by lidocaine

Inadequaecy of block quality in epidural anaesthesia is a challenging problem in clinical practice. It has been shown that intrathecal calcium channel blocker, verapamil, potentiates spinal anaesthesia with local anaesthetics. However, it has not been investigated the effects of epidural verapamil. It is also unknown whether epidural beta adrenergic receptor blockers which have local anaesthetic-like action, affect quality of block with local anaesthetics. In this study, we aimed to determine the effects of epidural verapamil or beta blocker, metoprolol, on the quality of block induced by lidocaine. Fourty male Wistar rats were chronically implanted with lomber epidural catheter. Tail flick (TF) and mechanical paw pressure (MPP) tests were used to assess thermal and mechanical antinociceptive thresholds, respectively. Motor function was assessed using a modified Langerman's scale. Although epidural verapamil (75 μg) or metoprolol (30 μg) alone showed neither sensory and motor block, the combination of lidocaine (100, 200, 400 ve 800 μg) and verapamil or metoprolol produced more potent sensory and motor block when compared with lidocaine alone. We concluded that epidural metoprolol and verapamil increase quality of block induced by lidocaine, and further experimental studies are needed to be used in human

The resuscitation greats. Cemil Topuzlu Pasha: one of the forgotten pioneers in the history of open chest cardiac massage.

One of the pioneers of open chest cardiac massage was Cemil Topuzlu Pasha, in Turkey. He presented his experience in open heart cardiac massage in several papers published in Ottoman and French and German. On 27 August 1903 one of his patients undergoing external urethrotomy under chloroform anaesthesia developed cardiac arrest and he performed open chest cardiac massage. He reported his approach to this event and discussed the literature regarding resuscitation available at the beginning of 20th century. Meanwhile he had defined "Do Not Resuscitate" code in cases involving serious heart disease and other diseases where life expectancy is very short. The Ottoman version of his report is translated in this paper

Assessing propofol induction of anesthesia dose using bispectral index analysis.

In this study we sought to determine the propofol requirement and hemodynamic effects as guided by bispectral index (BIS) analysis during induction of anesthesia. Sixty patients were enrolled in this study. Propofol, 2 mg/kg, was given to Group I for induction. Propofol was administered for induction until loss of response to verbal commands and until BIS values were around 50 to Groups II and III. After induction, the smallest BIS value was different in Group I. Decreases in total propofol dose were 36% and 43% in Groups II and III respectively as compared with Group I. The dose of propofol assessed by BIS analysis results in an important reduction of propofol requirement without side effects. IMPLICATIONS: Hypotension during induction of anesthesia with propofol is common. This study has shown that propofol requirement assessed by bispectral index analysis during anesthesia induction may decrease the dose and side effects and provide for satisfactory depth of anesthesia

open chest cardiac massage

One of the pioneers of open chest cardiac massage was Cemil Topuzlu Pasha, in Turkey. He presented his experience in open heart cardiac massage in several papers published in Ottoman and French and German. On 27 August 1903 one of his patients undergoing external urethrotomy under chloroform anaesthesia developed cardiac arrest and he performed open chest cardiac massage. He reported his approach to this event and discussed the literature regarding resuscitation available at the beginning of 20th century. Meanwhile he had defined "Do Not Resuscitate" code in cases involving serious heart disease and other diseases where life expectancy is very short. The Ottoman version of his report is translated in this paper. (c) 2005 Elsevier Ireland Ltd. All rights reserved.C1 Pamukkale Univ, Fac Med, Dept Hist Med & Deontol, TR-20070 Denizil, Turkey.Pamukkale Univ, Fac Med, Dept Anesthesiol & Reanimat, TR-20070 Denizil, Turkey.Istanbul Univ, Cerrahpasa Med Fac, Dept Anesthesiol & Reanimat, TR-34098 Istanbul, Turkey

Comparison of epidural tramadol, tramadol - Droperidol and tramadol-clonidine in the postoperative pain management

In this study, tramadol alone and the combinations of tramadol - clonidine and tramadol - droperidol were compared with regard to their effectiveness and side effects. Epidural catheters were placed to 90 ASA I-II group adult patients undergoing lower abdominal surgery, preoperatively through the L3-4 by using loss of resistance method. The first group received 75 mg tramadol (T), the second group received 75 mg tramadol - 2.5 mg droperidol (TD) and the third group received 75 mg tramadol-150 μg clonidine (TK) in a total volume of 10 ml via epidural route. The time point of initiation and duration of analgesia, visual pain, sedation, nausea scores, blood pressure, heart rate, SpO2 values, respiration rate and side effects were recorded. The durations of analgesia were similar in groups TD and TK and both were significantly longer than group T (p<0.001). Group TK exhibited significant increase in sedation and decrease in blood pressure and heart rate compared to other groups (p<0.01). No side effect was observed in group TD, while significant nausea - vomiting scores were evident in groups T and TK (p<0.001). No significant differences were found between the study groups with regard to the VAS scores, respiration rates, and SpO2 values. In conclusion, it may be suggested that addition of droperidol or clonidine to epidural tramadol may prolong analgesia and when side effects as well as the antiemetic effect were considered, droperidol seems to be a better choice

analysis

In this study we sought to determine the propofol requirement and hemodynamic effects as guided by bispectral index (BIS) analysis during induction of anesthesia. Sixty patients were enrolled in this study. Propofol, 2 mg/kg, was given to Group I for induction. Propofol was administered for induction until loss of response to verbal commands and until BIS values were around 50 to Groups II and III. After induction, the smallest BIS value was different in Group I. Decreases in total propofol dose were 36% and 43% in Groups II and III respectively as compared with Group I. The dose of propofol assessed by BIS analysis results in an important reduction of propofol requirement without side effects.C1 Pamukkale Univ, Sch Med, Dept Anesthesiol, Denizli, Turkey