Pain relief following day case laparoscopic tubal ligation with intra-peritoneal ropivacaine: a randomised double blind control study

Summary: The aim of this study was to examine the effectiveness of ropivacaine administered by a simple intraperitoneal technique in relieving pain following laparoscopic application of Filshie clips. Nineteen patients were randomised to receive either ropivacaine (200 mg) or normal saline through the umbilical port following clip application. Using a visual analogue scale women receiving ropivacaine had significantly lower pain scores 2 hours post operatively (0.97 vs 2.03 p < 0.05). The mean total postoperative fentanyl use was also significantly lower on the ropivacaine group (40 μg vs 104 μg p < 0.02). Only 10% (1/10) of the women in the ropivacaine group complained of nausea compared with 44o (4/9) in the control group. Furthermore, 80% (8/10) of women in the ropivacaine group were either very or totally satisfied with their pain relief. Only 56% (5/9) of the women in the control group were very or totally satisfied with their pain relief. Ropivacaine administered by a simple intraperitoneal technique following laparoscopic sterilisation significantly reduces postoperative pain and parenteral analgesic requirements. It would be reasonable to consider this method as standard practice following laparoscopic tubal ligation.JK Dreher, D Nemeth, and R Lim

Relationship of left main coronary artery disease significance with carotid and renal artery disease

WOS: 000208702606221

A risk assessment tool for the ship recycling industry

Ship recycling operations expose workers to a wide range of hazards that can cause a large number of incidents and accidents resulting in ill health, injuries and even death. In order to facilitate effective risk reduction within ship recycling yards, there is a need to develop an appropriate risk assessment method that is supportive and simple to use. In addition, the utilised method should involve end-user participation which is very important in assisting the realisation and acceptance of required health and safety measures. In this paper, a new bespoke risk assessment methodology for ship recycling, ‘The Three Step Risk Assessment Method for Ship Recycling’ (Three Step Method) will be presented which fulfils the criteria’s mentioned above. This paper will document the Three Step Method’s development and explain its various steps of implementation before introducing a case study and feedback of a practical application of the method. Finally, the conclusions that the Three Step Method provides a proven useful dialogue in the identification, assessment and mitigation of hazards and that the method can be easily implemented in the ship repair industry will be made

The impact of TFPI on coronary atherosclerotic burden

WOS: 000436626500011PubMed ID: 29947240OBJECTIVES: We aimed to associate a coronary artery disease (CAD) presence and severity with endothelial dysfunction (ED), carotid intima media thickness (CIMT) and Tissue Factor Pathway Inhibitor (TFPI). BACKGROUND: ED has a central role in atherosclerosis. CIMT and TFPI activity are also related with atherosclerosis and CAD. METHODS: In our prospective observational study, 50 patients had CAD and 30 had normal coronary arteries. Endothelial function was evaluated by endothelium-dependent flow-mediated dilatation (FMD) and nitroglycerinemediated dilatation (NMD) measurements. CIMT and Serum TFPI levels were also measured. RESULTS: TFPI was a statistically significant determinant between the two groups with an increased level in CAD (+) group (84.9 +/- 19.3 vs 70.2 +/- 14.7, p = 0.001). There was a positive correlation between CIMT and Gensini (r = 0.34, p = 0.014). There was a strong negative correlation between Gensini and FMD-NMD, statistically significant (FMD: r =-0.715, p < 0.001; NMD: r = -0.718, p < 0.001). CONCLUSION: We observed that ED, increased CIMT and TFPI levels were associated with CAD. Additionally, increased CIMT measurements and decreased FMD and NMD values had a positive correlation with GSS (Tab. 4, Fig. 6, Ref. 50). Text in PDF www.elis.sk

Effects of alendronate and pamidronate on apoptosis and cell proliferation in cultured primary human gingival fibroblasts

Dagdeviren, Attila/0000-0001-8990-8282; Senel, Firdevs/0000-0002-4475-0861WOS: 000363214300004PubMed: 25636638Data arising from the recent literature directed the researchers to study on the degree and extent of bisphosphonate toxicity on oral mucosa in further detail. the aim of this study is to determine the half maximal inhibitory concentration of pamidronate (PAM) and alendronate (ALN) on human gingival fibroblasts in vitro using 3-[4.5-thiazol-2-yl]-2.5-diphenyltetrazolium bromide (MTT) assay and to evaluate the effects of both agents on the proliferation and apoptotic indices. Cells used in the study were generated from human gingival specimens and divided into alendronate (n = 240), PAM (n = 240), and control groups (n = 60). Based on the MTT assay results, 10(-4), 10(-5), 10(-6), and 10(-7) M concentrations of both drugs were administered and the effects were evaluated for 6, 12, 24, 48, or 72 h periods. An indirect immunofluorescence technique was used to evaluate apoptotic (anti-caspase 3) and proliferation (anti-Ki67) indices. Toxicity of both PAM and ALN was found to be the most potent at 10(-4)-10(-5) M range. the apoptotic index of PAM group was found to be significantly higher than ALN group for all concentrations especially at 24 h incubation time (p < 0.05). the decrease in the proliferation index was found similar in first 48 h for both drugs; however, after 72 h of incubation decrease in proliferation index in PAM group was found to be significantly higher (p < 0.05). Micromolar concentrations of not only PAM but also ALN rapidly affect cells generated from human oral gingival tissue by inducing apoptosis together with inhibition of proliferation. Cytotoxic effects of both ALN and PAM on primary human gingival fibroblasts, which cause significant changes in apoptotic and proliferative indices as shown in this in vitro study, suggests that the defective epithelialization of oral mucosa is possibly a major factor on the onset of bisphosphonate-related osteonecrosis of the jaw cases.Baskent University Institutional Review BoardBaskent University [D-KA 10/09]; Baskent University Research FundBaskent UniversityThis study was approved by Baskent University Institutional Review Board (Project no: D-KA 10/09) and supported by Baskent University Research Fund