Utjecaj intenziteta prorjeda na rast azijske bukve (Fagus orientalis Lipsky) u plantažama u Trabzonu na sjeveroistoku Turske

In this study, the effects of first thinnings having different intensities in oriental beech (Fagus orientalis Lipsky) plantation areas were investigated in terms of diameter and height growth of trees. Sample plots were chosen from oriental beech plantation areas which are within the boundaries of Maçka–Yeşiltepe and Vakfıkebir districts of Trabzon province, Turkey. With removing of 0%, 10%, 25% and 40% of basal area in a hectare of stands which are in sapling stage, sample plots were established by applying thinnings which are in four different intensities (control, light, moderate, strong). After the thinning applications, basal areas were calculated by measuring diameters and heights of trees in established sample plots in order to reveal stand growth. The effects of thinnings were revealed related to some stand characteristics (average diameter, basal area, average height, relative diameter increment, etc.) and determined chosen trees. The effect of thinning intensity on average diameter, basal area, and volume values is statistically important in every two plantations. 2-year results showed that thinning increased the diameter increment significantly, and the increase in diameter increment was positively correlated with the thinning intensity in both experiments. Moreover, increments of diameter, height, basal area, and volume were higher in Maçka-Yeşiltepe experiment than in Vakfıkebir experiment. But, the values of moderate and strong thinning intensities applied in Vakfıkebir were close to each other. When all the results are evaluated, application of strong thinning intensity for Yeşiltepe sample plot, the moderate thinning intensity for Vakfıkebir sample plot is seen appropriate by us in terms of both stand development.U ovom su istraživanju proučavani učinci prve prorjede različitih intenziteta u plantažnim područjima azijske bukve (Fagus orientalis Lipsky) vezano za povećanje promjera i visine stabala. Odabrane su primjerne plohe u plantažnim područjima azijske bukve unutar granica okruga Maçka–Yeşiltepe i Vakfıkebir u pokrajini Trabzon, Turska. Primjerne plohe utvrđene su prorjedom u četiri različita intenziteta (kontrolni, slaba, umjereni, jaka), uklanjanjem 0%, 10%, 25% i 40% temeljnice po hektaru sastojine u fazi mladika. Nakon prorjeđivanja, temeljnica je izračunata mjerenjem promjera i visine stabala u utvrđenim primjernim plohama kako bi se utvrdio rast sastojine. Utvrđeni su učinci prorjede povezani s određenim karakteristikama sastojine (prosječni promjer, temeljnica, prosječna visina, relativni debljinski prirast, itd.) i određenim odabranim stablima. Učinak intenziteta prorjede na prosječni promjer, vrijednost temeljnice i volumena pokazao se kao statistički važan u svakoj od dvije plantaže. Dvogodišnji rezultati pokazali su da je prorjeda značajno povećala debljinski prirast, a povećanje debljinskog prirasta je u pozitivnoj korelaciji s intenzitetom prorjede u oba eksperimenta. Štoviše, prirast promjera, visine, temeljnice i volumena bio je veći u eksperimentu u Maçka-Yeşiltepeu nego u eksperimentu u Vakfıkebiru. Međutim, vrijednosti umjerenog i jakog intenziteta prorjede u Vakfıkebiru bile su bliske. Nakon procjene svih rezultata, smatramo da je primjena jakog intenziteta prorjede u primjernoj plohi u Yeşiltepeu i umjerenog intenziteta prorjede u primjernoj plohi u Vakfıkebiru prikladna u smislu razvoja sastojine

Anesthetic Management of a Pediatric Patient with Leigh Syndrome

Background and objectives: Leigh syndrome (LS) is a rare disease caused by abnormalities of mitochondrial energy generation. The central nervous system is most frequently affected, with psychomotor underdevelopment, seizures, nystagmus, ophthalmoparesis, optic atrophy, ataxia, dystonia, or respiratory failure. Surgical and anesthetic procedures stimulate the tracheal irritability, and could exacerbate risks of aspiration, wheezing, breathing difficulties, gasping, hypoventilation, and apnea. Case Report: We present the anesthetic management for a six-year-old boy with severe form of LS, involving repair of a femur fracture. Propofol and remifentanil were infused for general anesthesia. The patient was closely monitored during anesthesia and in the intensive care unit in the early postoperative period. Conclusions: Close intraoperative monitoring of patients, including invasive arterial blood pressure monitoring and frequently measuring the levels of blood gases, glucose, and lactate, made this procedure run smoothly. Intensive care and breathing support for the patient with LS, under sedation with an analgesic combination during the early postoperative period, minimized the stress response due to pain after surgery. Keywords: Leigh Disease, Anesthesia, General, Monitoring, Physiologic, Intensive Car

Abordagem anestésica em paciente pediátrico com síndrome de Leigh Abordaje anestésico en paciente Pediátrico con el síndrome de Leigh Anesthetic management of a pediatric patient with Leigh syndrome

JUSTIFICATIVA E OBJETIVOS: A síndrome de Leigh (SL) é uma doença rara causada por anomalias na produção de energia mitocondrial. O sistema nervoso central é afetado com mais frequência, com retardo psicomotor, convulsões, nistagmo, oftalmoparesia, atrofia óptica, ataxia, distonia ou insuficiência respiratória. Os procedimentos cirúrgicos e anestésicos provocam irritabilidade traqueal e podem exacerbar os riscos de aspiração, sibilação, dificuldade respiratória, respiração ofegante, hipoventilação e apneia. RELATO DE CASO: Apresentamos uma abordagem anestésica usada em um menino de seis anos com a forma grave de SL que envolve reparação de uma fratura de fêmur. Propofol e remifentanil foram infundidos para anestesia geral. O paciente foi atentamente monitorado durante a anestesia e sua permanência na unidade de terapia intensiva no período pós-operatório inicial. CONCLUSÕES: Uma atenta monitoração intraoperatória dos pacientes, que inclui pressão arterial invasiva e mensurações frequentes da gasometria, glicose e lactato, faz esse procedimento transcorrer sem problemas. A terapia intensiva e a assistência respiratória ao paciente com SL sob sedação, com uma combinação de analgésicos durante o período pós-operatório inicial, minimizaram a resposta ao estresse causado pela dor pós-cirúrgica.<br>JUSTIFICATIVA Y OBJETIVOS: El síndrome de Leigh (SL) es una enfermedad rara causada por anomalías en la producción de energía mitocondrial. El sistema nervioso central está afectado más a menudo, con el retardo psicomotor, convulsiones, nistagmo, oftalmoparesia, atrofia óptica, ataxia, distonía o insuficiencia respiratoria. Los procedimientos quirúrgicos y anestésicos provocan irritabilidad traqueal y pueden exacerbar los riesgos de aspiración, sibilancias, dificultad respiratoria, respiración extenuante, hipoventilación y apnea. RELATO DE CASO: Presentamos un abordaje anestésico usado en un niño de 6 años, con la forma grave de SL que nos ocupa con la reparación de una fractura de fémur. El propofol y el remifentanilo se infundieron para la anestesia general. El paciente fue monitoreado con mucho cuidado durante la anestesia y durante su permanencia en la unidad de cuidados intensivos en el período postoperatorio inicial. CONCLUSIONES: Una meticulosa monitorización intraoperatória de los pacientes, que incluye monitorización de presión arterial invasiva y mensuraciones frecuentes de la gasometría, glucosa y lactato, posibilita el perfecto transcurso del procedimiento. Los cuidados intensivos y la asistencia respiratoria al paciente con SL bajo sedación con una combinación de analgésicos durante el período postoperatorio inicial, minimizaron la respuesta al estrés causado por el dolor postquirúrgico.<br>BACKGROUND AND OBJECTIVES: Leigh syndrome (LS) is a rare disease caused by abnormalities of mitochondrial energy generation. The central nervous system is most frequently affected, with psychomotor underdevelopment, seizures, nystagmus, ophthalmoparesis, optic atrophy, ataxia, dystonia, or respiratory failure. Surgical and anesthetic procedures stimulate the tracheal irritability, and could exacerbate risks of aspiration, wheezing, breathing difficulties, gasping, hypoventilation, and apnea. CASE REPORT: We present the anesthetic management for a six-year-old boy with severe form of LS, involving repair of a femur fracture. Propofol and remifentanil were infused for general anesthesia. The patient was closely monitored during anesthesia and in the intensive care unit in the early postoperative period. CONCLUSIONS: Close intraoperative monitoring of patients, including invasive arterial blood pressure monitoring and frequently measuring the levels of blood gases, glucose, and lactate, made this procedure run smoothly. Intensive care and breathing support for the patient with LS, under sedation with an analgesic combination during the early postoperative period, minimized the stress response due to pain after surgery

Abordagem anestésica em paciente pediátrico com síndrome de Leigh

JUSTIFICATIVA E OBJETIVOS: A síndrome de Leigh (SL) é uma doença rara causada por anomalias na produção de energia mitocondrial. O sistema nervoso central é afetado com mais frequência, com retardo psicomotor, convulsões, nistagmo, oftalmoparesia, atrofia óptica, ataxia, distonia ou insuficiência respiratória. Os procedimentos cirúrgicos e anestésicos provocam irritabilidade traqueal e podem exacerbar os riscos de aspiração, sibilação, dificuldade respiratória, respiração ofegante, hipoventilação e apneia. RELATO DE CASO: Apresentamos uma abordagem anestésica usada em um menino de seis anos com a forma grave de SL que envolve reparação de uma fratura de fêmur. Propofol e remifentanil foram infundidos para anestesia geral. O paciente foi atentamente monitorado durante a anestesia e sua permanência na unidade de terapia intensiva no período pós-operatório inicial. CONCLUSÕES: Uma atenta monitoração intraoperatória dos pacientes, que inclui pressão arterial invasiva e mensurações frequentes da gasometria, glicose e lactato, faz esse procedimento transcorrer sem problemas. A terapia intensiva e a assistência respiratória ao paciente com SL sob sedação, com uma combinação de analgésicos durante o período pós-operatório inicial, minimizaram a resposta ao estresse causado pela dor pós-cirúrgica

Using dynein heavy chain 5 and creatine kinase levels in cervical fluid and blood for early diagnosing of ectopic pregnancy

Uygun, Zihni Onur/0000-0001-9045-7271WOS:000599522600001PubMed: 33336538Aim Ectopic pregnancy is a life-threatening problem in reproductive ages. Diagnosing ectopic pregnancy in the early period provides to reducing mortality and morbidity and gives an opportunity for medical treatment to preserve fallopian tubes. Evaluation of cervical fluid for determining ectopic pregnancy with new promising markers provided different aspects for diagnosing ectopic pregnancy in the present study. Methods in this prospective clinical study, ectopic pregnant patients as ectopic pregnancy group (n = 46), intrauterine pregnant patients as intrauterine pregnancy group (n = 29) and not-pregnant patients as nonpregnancy group (n = 10) participated to study. Cervical fluid samples were collected with using merocel sponge. in addition, serum samples were obtained from patients. Dynein heavy chain 5 (DNAH5) and creatine kinase (CK) levels were determined by enzyme-linked immunosorbent assay kits in samples. Results Reduced cervical fluid DNAH5 levels was diagnosed in ectopic pregnancy group compared to intrauterine pregnancy group (median 3.42 ng/mL; 25-75% percentile 0-9.56 ng/mL vs median 6.14 ng/mL; 1.40-8.31 ng/mL; P < 0.001). on the other hand, DNAH5 protein was not detected in nonpregnant patients' samples. in addition, statistical significant increased cervical fluid CK levels were diagnosed in ectopic pregnancy group compared to intrauterine pregnancy group (median 4477.61 IU/L; 0-64 925.37 IU/L vs 0 IU/L; 0-6832.30 IU/L; P = 0.006). Conclusion Measuring of CK and DNAH5 in cervical fluid could be promising markers for early diagnosing of ectopic pregnancy. Decreased DNAH5 levels in cervical fluid might be result from abnormal cilia function in ectopic pregnant patients. ClinicalTrials.gov ID. NCT02995356