Effects of CO 2 pneumoperitoneum on nephrotoxicity of sevoflurane: An experimental study in rabbits

Background: The purpose of this study is to evaluate the nephrotoxicity of sevoflurane inhalation anesthesia applied during carbon dioxide pneumoperitoneum (CO 2-PNP) which is conducted for a laparoscopic surgery treatment. Materials and Methods: 14 New Zealand white rabbits were used in this study. Initially, anesthesia was induced using 3.7% concentrated sevoflurane + 50% O 2/N 2O. Then, a tracheotomy was performed, and the rabbits were mechanically ventilated. The first group (n = 7) was subjected to CO 2-PNP for 90 min with a constant intraabdominal pressure of 12 mm Hg, the second (control group) (n = 7) was exempted. The serum inorganic fluoride (IF -) concentration was measured. The rabbits were sacrificed after 72 h, and one kidney each was immediately extracted for histopathological examination. Results: Serum IF - concentrations were not different in both groups. Histopathologically, mild renal damage was found in one rabbit in each group. Conclusion: CO 2-PNP did not have any additional effect on the nephrotoxicity of sevoflurane. © 2006 S. Karger GmbH

The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study

Background It is uncertain whether the association of the intraoperative driving pressure (Delta P) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average Delta P (Delta P-TW) with PPCs. We also tested the association of Delta P-TW with intraoperative adverse events. Methods Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. Results The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. Delta P was lower in open abdominal surgery patients, but Delta P-TW was not different between groups. The association of Delta P-TW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of Delta P-TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001).Conclusions Delta P is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.Trial registrationLAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223)

The relationship between psychiatric patients' caregiver burden and anger expression styles

WOS: 000425733600054PubMed ID: 28881076Aims and objectivesTo examine the relationship between psychiatric patients' caregiver burden and anger expression styles. BackgroundIn the caregiving process, when coping with problems, caregivers may exhibit emotional and behavioural responses, which can produce distressful results. One of these responses is angry. Examining the relationship between psychiatric patients' caregiver burden and caregivers' anger expression styles is necessary for quality of care. DesignA descriptive and relational study. MethodsThe sample for study included 60 family caregivers who were stayed with patient in psychiatry clinic during the treatment of inpatient setting of a university hospital. Data for the study were collected using the Caregiver Burden Inventory and the Trait Anger and Anger Expression Scale. The analysis of variance, Mann-Whitney U test, Kruskal-Wallis and Pearson correlation analysis were used. ResultsThe caregivers' Caregiver Burden Inventory score was found to be 24.601.57. Gender, working status, level of intimacy with patient, status of whether or not caregiver was living with patient and status of whether or not caregiver experienced difficulties in providing care had a significant effect on the Caregiver Burden Inventory scale as a whole, as well as its subscales. This study found a positive relationship between caregiver burden and caregivers' anger expression styles (p<.05, p<.01). ConclusionThe total Caregiver Burden Inventory mean score of caregivers was concluded to be low, with some introductory characteristics and anger expression styles having an impact on the burden experienced by caregivers. Relevance to clinical practiceKnowing the anger expression styles of caregivers is important for reducing caregiver burden and improving quality of care

Older people’s views and expectations about the competences of health and social care professionals: a European qualitative study

Adapting and providing quality services for people as they age is a common challenge across Europe. The perspective of older people is fundamental in a person-centred care approach. Expanding research at the European level that explicitly includes their views can ofer a relevant contribution to the development of evidence-based guidelines that can be shared in education and training across health and social care professions. This study aimed to identify common meaningful dimensions of pro fessional competence in health and social care emphasised by older people from six countries in diferent regions of Europe according to their experiences. A qualitative approach was chosen with a total of 95 semi-structured interviews conducted in Austria, Finland, Lithuania, Portugal, Turkey and UK, following a common topic guide. Participants in this study were aged 60 and above, and recruitment considered age, gender, level of education and living arrangements. Results identifed a set of universal skills and practices that according to older people, health and social care professionals should meet. Competences at the interpersonal level were central in older people’s discourses, and its core dimensions are anchored in relational, com munication and socio-emotional skills of professionals. These fndings reinforce the aspiration of establishing best practices in care that relies on the harmonisation of a competence framework that can be shared in the training and education of health and social care professionals across Europe and that voices older people’s preferences, expectations and needs.info:eu-repo/semantics/publishedVersio