Methemoglobinemia presenting in a circumcised baby following application of prilocaine: a case report

<p>Abstract</p> <p>Introduction</p> <p>Local anesthesia with prilocaine has become a routine part of ambulatory circumcision procedures. Methemoglobinemia is a rare but potentially lethal complication of local anesthetics.</p> <p>Case presentation</p> <p>We report the case of a 40-day-old Turkish boy who presented with cyanosis after receiving local anesthesia with prilocaine. His methemoglobin level revealed severe methemoglobinemia (methemoglobin = 44%). His cyanosis resolved after intravenous administration of methylene blue.</p> <p>Conclusion</p> <p>Although the association between prilocaine use and methemoglobinemia has generally restricted the use of prilocaine in babies, it is still widely used in ambulatory procedures, especially during circumcision in the neonatal period. Prilocaine should not be used in babies who are less than 3 months old because of the risk of methemoglobinemia; other local anesthetics may be used for this age group. Furthermore, general anesthesia by mask ventilation may be favored for babies less than 3 months of age instead of local anesthetics.</p

Influence Of Sevoflurane And Desflurane On Neurological And Adaptive Capacity Scores In Newborns

Objectives: To evaluate maternal and neonatal effects of desflurane compared with the sevoflurane for general anesthesia for cesarean section. Methods: The study was conducted as a prospective randomized blind study between January 2003 to January 2004 at the Hacettepe University, Ankara, Turkey. One hundred and two American Society of Anesthesiologists (ASA) I patients aged between 20-35 at 37-42 weeks of pregnancy were randomly allocated into 2 groups. All patients received thiopental and succinylcholine for induction. Patients assigned to the first group received desflurane 2.5%, and the second group sevoflurane 1.5% combined with 50% nitrous oxide and oxygen. Maternal blood loss, umbilical arterial blood gas values, delivery intervals, Apgar scores, and neurologic and adaptive capacity score (NACS) on the fifteenth minute, second hour, and twenty-fourth hour of age were evaluated to assess the neonatal status. Results: One hundred and two (52 sevoflurane group, 50 desflurane group) parturients were included in the study. In the desflurane group, NACS were significantly better on the fifteenth minute and second hour evaluations. There were no statistically significant differences in twenty-fourth hour NACS evaluations, Apgar scores, umbilical arterial blood gas values, delivery times, and maternal blood loss between the groups. Conclusion: Desflurane anesthesia offers more favorable results compared to sevoflurane in newborns delivered by elective cesarean section under general anesthesia in the early hours after delivery.Wo

Acute effects of various antibiotic combinations on acetoclastic methanogenic activity

Pharmaceutical production industries are one of the main sources of antibiotics, and they release considerable amounts of antibiotics to ecosystem. Antibiotics usually present as mixtures in treatment plants and have negative effect on biological processes. In this study, batch acute tests were performed to assess the inhibitory impacts of selected antibiotic combinations of sulfamethoxazole and tetracycline (ST), erythromycin and sulfamethoxazole (ES), and erythromycin and tetracycline (ET) on acetoclastic methanogenic activity. Each antibiotic was equally applied, making the total concentrations in the mixtures 0 (control), 2, 20, 50, 100, 250, and 500 mg/L. Results showed decline characteristic on methane production with increasing antibiotic concentrations. EC50 values were calculated as 275 mg/L for ES, 219 mg/L for ST, and 130 mg/L for ET. Mixture inhibition of ST and ET combinations were accurately predicted using the concept of independent action, while ES combination resulted in almost the same inhibition with that of single antibiotic response. Inhibition on acetate utilization followed similar trend with methane production inhibition

Genes That Affect Brain Structure And Function Identified By Rare Variant Analyses Of Mendelian Neurologic Disease

Development of the human nervous system involves complex interactions among fundamental cellular processes and requires a multitude of genes, many of which remain to be associated with human disease. We applied whole exome sequencing to 128 mostly consanguineous families with neurogenetic disorders that often included brain malformations. Rare variant analyses for both single nucleotide variant (SNV) and copy number variant (CNV) alleles allowed for identification of 45 novel variants in 43 known disease genes, 41 candidate genes, and CNVs in 10 families, with an overall potential molecular cause identified in >85% of families studied. Among the candidate genes identified, we found PRUNE, VARS, and DHX37 in multiple families and homozygous loss-of-function variants in AGBL2, SLC18A2, SMARCA1, UBQLN1, and CPLX1. Neuroimaging and in silico analysis of functional and expression proximity between candidate and known disease genes allowed for further understanding of genetic networks underlying specific types of brain malformations.WoSScopu

Genes that Affect Brain Structure and Function Identified by Rare Variant Analyses of Mendelian Neurologic Disease

Development of the human nervous system involves complex interactions among fundamental cellular processes and requires a multitude of genes, many of which remain to be associated with human disease. We applied whole exome sequencing to 128 mostly consanguineous families with neurogenetic disorders that often included brain malformations. Rare variant analyses for both single nucleotide variant (SNV) and copy number variant (CNV) alleles allowed for identification of 45 novel variants in 43 known disease genes, 41 candidate genes, and CNVs in 10 families, with an overall potential molecular cause identified in >85% of families studied. Among the candidate genes identified, we found PRUNE, VARS, and DHX37 in multiple families and homozygous loss-of-function variants in AGBL2, SLC18A2, SMARCA1, UBQLN1, and CPLX1. Neuroimaging and in silico analysis of functional and expression proximity between candidate and known disease genes allowed for further understanding of genetic networks underlying specific types of brain malformations. VIDEO ABSTRACT.publisher: Elsevier articletitle: Genes that Affect Brain Structure and Function Identified by Rare Variant Analyses of Mendelian Neurologic Disease journaltitle: Neuron articlelink: http://dx.doi.org/10.1016/j.neuron.2015.09.048 content_type: article copyright: Copyright © 2015 Elsevier Inc. All rights reserved.status: publishe