Anesthesia management for ALS and WPW

WOS: 000435650500021Epidural anesthesia can provide anesthesia and analgesia for unilateral or bilateral lower extremity surgery and is associated with a low complication rate. We present our epidural anaesthetic management of a patient with both Amyotrophic lateral sclerosis (ALS) and Wolff-Parkinson-White (WPW) syndrome after intertrochanteric femur fracture surgery. It should be kept in mind that the choice of correct anaesthetic method in such patients with complicated neurological, pulmonary, and cardiac symptoms will significantly reduce postoperative mortality and morbidity

Comparison of the Effects of Pharyngeal Packing and Gastric Aspiration with an Orogastric Tube on Postoperative Nausea, Vomiting and Sore Throat in Septorhinoplasty

Introduction:We compared the effects of pharyngeal packing and gastric decompression with orogastric tube application on the incidence of nausea/vomiting, sore throat, and dysphagia. As a secondary objective, we assessed the effect of the selected method on the postoperative pain score and patient satisfaction.Methods:In this randomized, prospective study were 60 patients aged 18-50 years who underwent elective septorhinoplasty. Nasopharyngeal packing was performed in group 1 and gastric decompression with an orogastric tube in group 2, and both procedures were terminated by the practitioner before extubation. Between-group demographic data, duration of operation/anesthesia, hemodynamic parameters, nausea, vomiting, additional antiemetic requirement, pain/dysphagia during swallowing, visual analogue scale (VAS), and patient satisfaction were measured at 24 h, and the group findings were compared.Results:The demographic findings and durations of anesthesia/operation were not statistically different between the groups, and there was no difference in postoperative nausea and vomiting, VAS, and satisfaction scores. In contrast, sore throat was twice as common in the nasopharyngeal pack group but decreased over time.Conclusion:The routine packing approach should be abandoned by anesthesiologists. Because pharyngeal packing is not a completely risk-free procedure, we do not recommend intraoperative packing during nasal surgery. If indicated for surgical reasons, however, protocols, checklists, and observation forms pre-prepared with the participation of the surgical and anesthesia teams should be used. All materials should be included in the surgical (scrub) count, and it should be ensured that all materials are removed before extubation with a matching count. Regardless of the method used, it should not be forgotten that the anesthesiologist is responsible for the examination of the oral cavity and throat via direct laryngoscopy and, if necessary, aspiration before extubation

Effect of genotypic differences on mineral nutritions of strawberry

The aim of this study was to examine leaf and fruit nutrient concentrations of some strawberry varieties. For this aim, samples were collected from Selva, Osmanlı, Yalova-15, Cavendish, Camarosa, Arnavutkoy, Rapella, Seascape and their crosses. Results showed that nutrient concentrations of leaf and fruit significantly changed with varieties and lines

Liver transplantation in a child with kartagener syndrome: A case report

Background: Kartagener syndrome (KS) is a rare genetic disorder consisting of the triad of situs inversus, chronic sinusitis, and bronchiectasis. Although there are previous reports regarding the anaesthetic considerations in KS, none have included liver transplantation. Case Presentation: An 11-year-old boy with a diagnosis of KS underwent liver transplantation due to extrahepatic biliary atresia. Previous diagnostic imaging confirmed situs inversus and the absence of an inferior vena cava. The patient's peak airway pressure intermittently increased intraoperatively from 15 to 30 cm H2O due to increased pulmonary secretions, which required frequent suctioning of the endotracheal tube. Intraoperative volume resuscitation included 200 mL of 5% albumin, 5 units of erythrocyte suspension and 3 units of fresh frozen plasma. Intermittently, a norepinephrine infusion was required to maintain the MAP. Coagulation function was monitoring using the thromboelastogram to guide the use of blood products including fresh frozen plasma. At the end of the surgery, the patient was transferred to the intensive care unit. He was discharged from the intensive care unit on postoperative day 5, and from the hospital on postoperative day 28. He continues to do well with normal liver function 23 months after surgery. Conclusion: Despite the risk of pulmonary related to airway secretions and exacerbation of hemodynamic instability related to anatomical variations in the inferior vena cava anatomy, KS patients can be safely anesthetized with careful planning and attention of the disease process, even for complex surgical procedures such as liver transplantation

Anaphylactoid Reactions Following Red Blood Cell Transfusion in a Patient with Previously Undiagnosed Immunoglobulin A Deficiency: Case Report

A 73-year-old, 104 kg female patient was hospitalised for debulking and low anterior colon resection operations. Anaphylactoid symptoms devel-oped when administering erythrocyte suspension and fresh frozen plasma. Through the immediate haematology department consultation, it was found that the patient might possibly have immunoglobulin A deficiency. Immunoglobulin A level was found to be very low in the patient’s blood sample, which was sent intraoperatively to verify the diagnosis. This case report discusses a sudden anaphylactic reaction that occurred as a result of a blood transfusion in a previously undiagnosed immunoglobulin A deficiency

Prevalence and clinical features of chronic critical illness in the elderly population in Turkey

Objectives: The definition of chronic critical illness in the elderly has not yet been determined. The aim of the study is to determine the prevalence and clinical features of chronic critical illness in the elderly population in Turkey.Materials and Methods: Data from 16 intensive care units of public and private hospitals in Turkey were evaluated. Patients staying in the intensive care units for at least eight days between 2015 and 2017 and having at least one of the additional criteria were accepted as chronic critical illness and they were divided into two groups by age, those 65 and older and those under 65.Results: The chronic critical illness patient rate in the intensive care units was 10.7%. Of chronic critical illness patients in the intensive care units, 60.9% were 65 years of age and older, and the mortality rate of patients 65 years and older was 70%. The frequencies of ischemic stroke and sepsis, the number of patients with comorbidities, and the mortality rate were higher in patients over 65 years of age, while the frequency of traumatic brain injury, presence of a major wound, tracheostomy, length of hospital stay and cost of care were higher in patients under 65 years of age.Conclusion: We determined that prolonged mechanical ventilation, traumatic brain injury, tracheostomy and major wound presence in intensive care units patients 65 years and older increased hospital stay and costs. More work is needed to define chronic critical illness more clearly in elderly