Postoperative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative)

The main remit of the European Society for Paediatric Anaesthesiology (ESPA) Pain Committee is to improve the quality of pain management in children. The ESPA Pain Management Ladder is a clinical practice advisory based upon expert consensus to help to ensure a basic standard of perioperative pain management for all children. Further steps are suggested to improve pain management once a basic standard has been achieved. The guidance is grouped by the type of surgical procedure and layered to suggest basic, intermediate, and advanced pain management methods. The committee members are aware that there are marked differences in financial and personal resources in different institutions and countries and also considerable variations in the availability of analgesic drugs across Europe. We recommend that the guidance should be used as a framework to guide best practice

Therapeutic ultrasound and effectiveness in knee osteoarthritis

In Turkey, ultrasound is one of the most commonly used methods for physical therapy of knee osteoarthritis. Therapeutic ultrasound affects the cells and tissues by thermal and nonthermal ways. As well as being used as an agent for deep heating, it has effects like stimulation of tissue regeneration, soft tissue repair, regulation of blood flow in chronic ischemic tissues, protein synthesis and bone repair.In this manuscript, detailed technical information on ultrasound is given and studies on knee osteoarthritis in recent years are reviewed. [Archives Medical Review Journal 2013; 22(2.000): 170-183

Prolonged apnea following electroconvulsive therapy in a patient with attempted organophosphate suicide: a case report

Organophosphate poisoning is a frequent used method of suicide attempt in Turkey. Organophosphates are irreversibly bound to cholinesterase enzyme, causing deactivation of the enzyme. As a result the of inhibition of plasma cholinesterase, increased sensitivity to drugs hydrolyzed by this enzyme can occur, e.g. neuromuscular blockers such as succinylcholine and mivacurium may be affected. Muscle paralysis continues if the action of these neuromuscular drugs is not terminated. In this case report we present a case of a 6-hour period of apnea and paralysis following anesthesia with a muscle relaxant for electroconvulsive therapy in a bipolar disorder patient with mixed episode who attempted suicide with organophosphate ten days prior. ÖZET Organofosfat içeren tar›m ilaçlar›yla intihar giri.imi ülkemizde s›krastlanan intihar yöntemlerinden birisidir. Organofosfatlar asetil-kolinesteraz enzimine dönü.ümsüz ba¤lanarak onu inaktif halegetirirler. Plazma asetilkolinesteraz›n›n inhibe edilmesi ile, bu en-zim taraf›ndan y›k›lan süksinilkolin ve mivaküryum gibi kas gev.e-ticilerin etkileri artmaktad›r. Bu kas gev.eticilerin etkileri sonlan-d›r›lamazsa tüm kaslarda paralizi geli.ir. Bu olgu sunumunda ongün öncesinde intihar amac›yla organofosfat alm›., iki uçlu duy-gudurum bozuklu¤u-mikst epizod tan›s› konulan bir olgunun, ge-nel anestezi alt›nda yap›lan kas gev.eticili elektrokonvulsif tedavisonras›nda 6 saat devam eden apne tablosu sunularak; organo-fosfat zehirlenmesi olan ki.ilerde elektrokonvulsif tedavi uygula-mas› tart›.›lm›.t›r

Fas/FasL gene polymorphism in patients with Hashimoto’s thyroiditis in Turkish population

PubMed ID: 27572459Objective: Hashimoto’s disease is a polygenic disorder with complex etiopathogenesis. Apoptosis is proposed as one of its mechanisms. The Fas/Fas ligand cascade represents a major pathway initiating apoptosis. This study aims to evaluate the influence of Fas and FasL gene polymorphism in Hashimoto’s thyroiditis in Turkish population. Materials and methods: A total of 112 patients with Hashimoto’s thyroiditis and 112 cases of healthy control people were included in this study. The evaluation of genotype for Fas -670 A/G and FasL 843 C/T gene polymorphism was performed by using PCR-RFLP method. Results: The FAS genotype and gene allele frequency distribution did differ between the control group (AA 36.6 %, AG 50.0 %, GG 13.4 %, A 61.6 %, G 38.4 %) and the Hashimoto’s thyroiditis patients (AA 21.4 %, AG 50.9 %, GG 27.7 %, A 46.9 %, G 53.1 %) (p  0.05). Conclusions: Gene polymorphism of Fas and G allele frequency may play a role in the regulation of apoptosis in thyroid autoimmune disorders. There is a need for further studies to clarify the genetic role of apoptosis in HT. © 2016, Italian Society of Endocrinology (SIE)

Genetic variations in interleukin 6 rs1800795 polymorphism and the association with susceptibility to Hashimoto's thyroiditis

WOS: 000418337000001Hashimoto's disease is a polygenic disorder with complex etiopathogenesis. The imbalance between pro- and anti-inflammatory cytokines may play a role in the etiology. We aimed to evaluate the relation between 174 promoter region of the interleukin 6 rs1800795 gene polymorphism in patients with Hashimoto's thyroiditis (HT). We studied 110 HT patients and 110 healthy controls. The evaluation of genotype for interleukin 6 rs1800795 gene polymorphism were performed by using PCR-RFLP method. The genotype of IL6 distribution did differ between the control group (CC 17.3%, GC 78.2%, GG 4.5%) and the HT patients (CC 29.1%, GC 46.4%, GG 24.5%) (p 0.05). Our results indicate that interleukin 6 rs1800795 polymorphism may be associated with susceptibility to HT in Turkish Patients. It is necessary to confirm the results and determine the underlying pathogenic mechanisms in further studies. (C) 2016 Elsevier B.V. All rights reserved