A Case of Swyer-James-Macleod Syndrome Associated with Middle Lobe Hypoplasia and Arteriovenous Malformation

A 58-year-old female patient presented to the hospital with hearing loss. In the chest radiography obtained before her ear surgery, volume decrease in the right hemithorax, elevation of the right diaphragm, and increase of ventilation in the right lung were detected. At the thorax CT-CT angiography, hypoplasia of the main pulmonary artery and its branches and arteriovenous malformation localized in the middle lobe of the right lung were detected. Thus, diagnosis of Swyer-James-Macleod syndrome associated with right lung middle lobe hypoplasia and arteriovenous malformation was made. This kind of association has not been reported earlier, so we are presenting it in the light of the literature knowledge

The Effects of Different Diet Models on Oocyte Quality, Oocyte Maturation and in Vitro Fertilization Outcomes in Mice

Nutritional quality affects fertility in both men and women. Nutrition should be considered in the prevention and treatment of infertility in men and women. In this study, we evaluated IVF rates, oocyte maturation and oocyte quality in a female animal model feding ketogenic, western and standard type diet. Female BALB / c mice were allocated to three groups: (a) control; (b) Western and (c) Ketogenic. After feeding female mice with these 3 feeding groups for 4 weeks, IVF was administered before sacrification of the mice. The number of collected oocytes and oocyte quality, fertilization rates and embryo quality were evaluated.The number of total oocytes was the highest in the ketogenic diet and the least in the western diet. MII stage oocytes in the ketogenic group were statistically significantly higher than the control group and western groups. Fertilized oocyte count was significantly lower in the western group compared to the other two groups. When the two-cell zygote stage was evaluated, it was found that the results were better in the ketogenic diet group and worse in the western diet group. The worst results in terms of the number of zygotes reaching the blastocyst stage were observed in the western type nutrition group, and the best results were observed in the group on the keteogenic diet. The results of our study show that western nutritional models negatively affect IVF results, while ketogenic diet has a positive effect. Keywords: Fertility, ketogenic diet, oocyte, ovulation, western diet DOI: 10.7176/JMPB/72-02 Publication date: January 31st 202

Evaluation of factors that affect skin to subarachnoid space distance

Introduction: Lumbar puncture is a procedure frequently used in anesthetic practice. For the success of the procedure, prediction of skin to subarachnoid space distance (SSD) is valuable. In this study, we aimed to evaluate the relationship between SSD with age and body mass index (BMI). Methods: Two hundred and fifty patients, ASA physical status I, II, and III scheduled to undergo elective surgery under spinal anesthesia, were studied. Spinal anesthesia was induced in the sitting position at the L3–4 vertebral level using a midline approach. Furthermore, the level of L3–L4 was identified by palpation, using Tuffier’s line as a guide. Following an intrathecal injection, the spinal needle was grasped between the thumb and the index finger during its removal from the patient’s back. From the grasping point, SSD was measured using rulers. Results: Mean values of SSD at the L3-4 interspace were 55.43±6.47 mm (range 35-74). Statistically significant correlations were observed between SSD with BMI and body weight (ρ=0.650, P<0.001 and ρ=0.651, P<0.001, respectively). Statistically significant correlation was not found between SSD with age, gender and body height (ρ=0.120, P=0.058; ρ=-0.047, P=0.4568 and ρ=0.089, P=0.159, respectively). Conclusions: SSD is affected by BMI and body weight but not by age, gender and body height

Effects of Storage Temperature and Time on Stability of Serum Tacrolimus and Cyclosporine A Levels in Whole Blood by LC-MS/MS

Tacrolimus and cyclosporine A are immunosuppressant drugs with narrow therapeutic windows. The aim of this study was to investigate the stability of tacrolimus and cyclosporin A levels in whole blood samples under different storage conditions. Whole blood samples were obtained from 15 patients receiving tacrolimus and 15 patients receiving cyclosporine A. Samples were immediately analyzed and then stored at different conditions (room temperature (24°C−26°C) for 24 hours, +4°C for 24 and 48 hours, and −20°C for one month) and then analyzed again. For tacrolimus, there was a significant difference between samples analyzed immediately and those kept 24 hours at room temperature (P=0.005) (percent change 32.89%). However, there were no significant differences between the other groups. For cyclosporine A, there was a significant difference between samples analyzed immediately and those kept 24 hours (P=0.003) (percent change 19.47%) and 48 hours (P=0.002) (percent change 15.38%) at +4°C and those kept 24 hours at room temperature (P=0.011) (percent change 9.71%). Samples of tacrolimus should be analyzed immediately or stored at either +4°C or −20°C, while samples of cyclosporine A should be analyzed immediately or stored at −20°C

Efficacy of the erector spinae plane block for quality of recovery in bariatric surgery: A randomized controlled trial

Background: Postoperative pain management after bariatric surgery is difficult due to different physiological properties and high sensitivity toward opioids in patients with obesity. It has been reported that erector spinae plane block (ESPB) contributes to postoperative analgesia when applied together with multimodal analgesia. Methods: Eighty patients were randomized either bilateral ESPB (group E) each side or no block (group C). Our primary aim was to evaluate the effects of ESPB on the quality of recovery 24 h postoperatively in bariatric surgery by using 40-item Quality of Recovery-40 (QoR-40) questionnaire. Postoperative pain assessed using a numerical rating scale (NRS), time of additional analgesic requirement, analgesic consumption, side effects, sedation, mobilization time, and postoperative complications were evaluated as secondary outcomes. Results: Postoperative mean QoR-40 scores were found to be higher in group E (175.02 ± 11.25) than in group C (167.78 ± 18.59) at the postoperative 24th hour (P < 0.05). Pain scores at rest and during movement were higher in group C than in group E. At the postoperative 24th hour, NRS mean SD scores at rest for group C and group E were 3.25 ± 1.32 and 2.40 ± 0.96, respectively. NRS mean SD scores during movement for groups C and E were 3.88 ± 1.49 and 3.12 ± 1.30, respectively. The total amount of tramadol consumed in the first 24 h in group C and group E were mean SD: 86.40 ± 69.60 and 40.00 ± 46.96, respectively; P < 0.05. Conclusions: ESPB improved postoperative quality of recovery, reduced NRS scores, and total analgesic consumption in patients with obesity undergoing bariatric surgery. Clinical Trial Registration: NCT05020379. Graphical Abstract: [Figure not available: see fulltext.]

Comparison of the effects of ketamine-midazolam and ketamin-propofol anesthesia on recovery of circumcision operations

To compare the effects of ketamine+midazolam or ketamine+propofol on analgesia, sedation and recovery time in children premedicated with midazolam for circumcision operations. Eighty American Society of Anesthesiologists physical status I-II, 5-12 years old children who undergone circumcision operations were included in the study. Both groups were administered of midazolam 0.04 mg/kg intravenously in the presence of besides their parents in the pre-operative holding area. Patients were induced with midazolam-ketamine in Group I or ketamine+propofol in Group II. There were no differenses observed between the groups according to sedation and analgesia. None of patients needed additional hypnotic agent doses. Recovery was faster in ketamine-midazolam group. Midazolam+ketamine provided faster recovery than ketamine-propofol in pediatric circumcision operations. No complication was observed during sedation. It is observed that ketamine+midazolam has provided a faster recovery in circumcision operation. [Med-Science 2018; 7(4.000): 834-6

The effect of the use of a stylet and/or McGrath videolaryngoscope on intubation time in obese patients: A randomized clinical trial

WOS:001007003000001Obese people have low oxygen reserves because of low functional capacity. For this reason, the time for airway manipulation before intubation is reduced and airway management may be difficult in obese population. Aim: The purpose of the present study was to investigate whether videolaryngoscope or stylet or both, shorten the intubation time in obese patients. Methods: A total of 120 obese patients scheduled for surgery under general anesthesia were included in the study, 30 in each group; Group DL utilizing a standardized Macintosh blade, Group DLS: DL utilizing a standardized Macintosh blade + Stylet, Group VL: McGrath VL (Series 5), Group VLS: McGrath VL (Series 5) + Stylet. Intubation time was investigated as the primary outcome. Results: Intubation times were found to be significantly different between the study groups (P 0.05). Conclusions: The intubation times of obese patients were shorter with direct laryngoscopy, with or without a stylet when compared to those with a McGrath videolaryngoscope, with or without a stylet. Among the same type of laryngoscopy groups, the use of stylet did not change the intubation time. The rate of first-pass intubation was lower with the stylet-free McGrath videolaryngoscope when compared to direct laryngoscopy and direct laryngoscopy plus stylet groups