3 research outputs found
Oksidacijski stres uzrokovan opÄom intravenskom i inhalacijskom anestezijom
Oxidative stress occurs when reactive oxygen species (ROS) production overwhelms cell protection by antioxidants. This review is focused on general anaesthesia-induced oxidative stress because it increases the rate of complications and delays recovery after surgery. It is important to know what effects of anaesthetics to expect in terms of oxidative stress, particularly in surgical procedures with high ROS production, because their either additive or antagonistic effect may be pivotal for the outcome of surgery. In vitro and animal studies on this topic are numerous but show large variability. There are not many human studies and what we know has been learned from different surgical procedures measuring different endpoints in blood samples taken mostly before and after surgery. In these studies most intravenous anaesthetics have antioxidative properties, while volatile anaesthetics temporarily increase oxidative stress in longer surgical procedures.Ovo je pregledni rad o oksidacijskom stresu uzrokovanom opÄim anesteticima zbog toga Å”to uzrokuje komplikacije nakon operacije i usporava oporavak. Oksidacijski stres nastaje kada je stvaranje reaktivnih kisikovih spojeva (ROS) veÄe od staniÄne zaÅ”tite antioksidansima. Poznavanje uÄinka anestetika na oksidacijski stres posebice je važno pri planiranju kirurÅ”kih zahvata kod kojih je poznato da uzrokuju nastanak veÄe koliÄine ROS-a. Naime, antagonistiÄki ili aditivni uÄinak anestetika na oksidacijski stres može kod takvih kirurÅ”kih zahvata biti kljuÄan za ishod operacije. Brojna su istraživanja o toj temi, no protokoli pokusa na staniÄnim kulturama i pokusnim životinjama vrlo su razliÄiti. U istraživanjima na ljudima anestetici su upotrebljavani tijekom vrlo raznorodnih kirurÅ”kih zahvata, Äesto uz primjenu viÅ”e anestetika, mjereni su razliÄiti parametri oksidacijskoga stresa, a uzorci (najÄeÅ”Äe krvi) uzimani su obiÄno prije zahvata i u razliÄitim intervalima nakon njega. Zbog svega je toga ponekad teÅ”ko razluÄiti kakav je uÄinak nekog anestetika na oksidacijski stres. OpÄenito intravenozni anestetici imaju antioksidacijsko djelovanje, imaju ga i plinoviti anestetici ā uglavnom nakon kratkotrajne anestezije, a dugotrajna anestezija uzrokuje privremeni porast oksidacijskoga stresa
Zbrinjavanje otežanog diÅ”nog puta ā vjeÄni izazov: prikaz bolesnika
Introduction: Obtaining a secured airway is a vital aspect during reconstructive surgery in patients with extensive post-burn mentosternal
scar contractures. Such contractures can potentially lead to a ācanāt intubate, canāt ventilateā scenario, otherwise rare but
life-threatening situation. We present a case of successful management of a paediatric case of anticipated difficult airway due to
burn injury.
Case description: A 14-year-old boy presented for repair of an extensive skin contracture of the neck, thorax and face due to mutilating
scarring. The boy was treated for 80% burn caused by gasoline flame 14 months prior to this surgery. Burn healing and scarring
resulted in massive distortion of the facial and cervical anatomy, all implying difficult airway with a high probability of ācanāt intubate,
canāt ventilateā situation. Flexible fiberoptic bronchoscope with loaded cuffed endotracheal tube NĀ° 6.0 was used for visualisation
of vocal cords through the mouth in light sedation with spontaneous breathing. After visualisation of the vocal cords, fentanyl
(Fentanyl, GlaxoSmithKline) and thiopental (Thiopental, Rotexmedica) were administered and the trachea was intubated at the first
attempt. Balanced general anaesthesia was initiated and planned surgical procedure was successfully completed. The trachea was
extubated on the first postoperative day without any complication.
Conclusion: Difficult paediatric airway and particularly ācanāt intubate, canāt ventilateā situation is a problem associated with significant
risks and complications. Anticipating a difficult airway, having a structured approach with appropriate preparation, and
understanding of difficult airway management algorithms are essential for success.Uvod: Zbrinjavanje diÅ”nog puta od vitalne je važnosti za bolesnika kod kojeg je indiciran rekonstruktivni zahvat nakon opsežnihopeklina lica i vrata. Kontrakture koje nastaju nakon takvih ozljeda mogu dovesti do nemoguÄnosti intubacije i ventilacije, Å”to predstavljarijetku ali životno ugrožavajuÄu situaciju. Prikazati Äemo uspjeÅ”no zbrinjavanje pedijatrijskog bolesnika sa oÄekivano otežanimzbrinjavanjem diÅ”nog puta.Prikaz sluÄaja: ÄetrnaestogodiÅ”nji djeÄak sa opsežnom opeklinom lica, vrata i prsnog koÅ”a bio je predviÄen za rekonstruktivni zahvat.Cijeljenje opekline, koja je nastala 14 mjeseci prije planiranog zahvata, rezultiralo je opsežnom kontrakturom i promjenom anatomijelica i vrata. Radi promijenjenih anatomskih odnosa bilo je oÄekivano da Äe zbrinjavanje diÅ”nog puta biti otežano. Za vizualizacijuglasnica koriÅ”ten je fleksibilni fiberoptiÄki bronhoskop s pripremljenim endotrahealnim tubusom dok je bolesnik bio u plitkoj sedacijii disao spontano. Nakon vizualizacije glasnica bolesnik je dobio fentanil (Fentanyl, GlaxoSmithKline) i tiopental (Thiopental, Rotexmedica)te je potom intubiran iz prvog pokuÅ”aja. Nastavljena je balansirana opÄa anestezija, planirani zahvat je uspjeÅ”no dovrÅ”en.Bolesnik je ekstubiran prvi postoperativni dan bez ikakvih komplikacija.ZakljuÄak: Otežani diÅ”ni put u pedijatrijskih bolesnika je problem povezan s brojnim rizicima i komplikacijama. Prepoznavanje otežanogdiÅ”nog puta uz adekvatnu pripremu i poznavanje algoritama za zbrinjavanje otežanog diÅ”nog puta kljuÄno je za sigurnostbolesnika
Y chromosome azoospermia factor region microdeletions are not associated with idiopathic recurrent spontaneous abortion in a Slovenian population: association study and literature review
Objective To investigate the potential association of Y chromosome microdeletions with idiopathic recurrent spontaneous abortion (IRSA) in a Slovenian population and compare our results with those of previously published studies in different populations, with the intention of clarifying the potential impact of Y chromosome microdeletions on IRSA. Design Caseācontrol and association study. Setting Departments of gynecology and obstetrics and university-based research laboratory. Patient(s) Male partners of 148 couples with at least three spontaneous pregnancy losses of unknown etiology, and 148 fertile men. Intervention(s) Multiplex polymerase chain reactions. Main Outcome Measure(s) Azoospermia factor (AZF) regions were tested for Y chromosome microdeletions according to European Academy of Andrology/European Molecular Genetics Quality Network guidelines. The PubMed database was searched to retrieve articles linking Y chromosome microdeletions and susceptibility to IRSA. Result(s) None of the IRSA or control men had microdeletions in the AZFa, AZFb, or AZFc regions. A total of nine previous studies examined the relationship between Y chromosome microdeletions and IRSA, yielding contradictory results, which we discuss in detail. Conclusion(s) On the basis of our comparisons, it is unlikely that Y chromosome microdeletions contribute to IRSA and are therefore currently not recommended for the routine evaluation of IRSA couples