Sedation and Analgesia in Intensive Care: A Comparison of Fentanyl and Remifentanil

Optimal sedation and analgesia are of key importance in intensive care. The aim of this study was to assess the quality of sedoanalgesia and outcome parameters in regimens containing midazolam and either fentanyl or remifentanil. A prospective, randomized, open-label, controlled trial was carried out in the ICU unit of a large teaching hospital in Istanbul over a 9-month period. Thirty-four patients were randomly allocated to receive either a remifentanil-midazolam regimen (R group, n = 17) or a fentanyl-midazolam regimen (F group, n = 17). A strong correlation between Riker Sedation-Agitation Scale (SAS) and Ramsey Scale (RS) measurements was observed. Comparatively, remifentanil provided significantly more potent and rapid analgesia based on Behavioral-Physiological Scale (BPS) measurements and a statistically nonsignificantly shorter time to discharge. On the other hand, remifentanil also caused a significantly sharper fall in heart rate within the first six hours of treatment

Core Outcome Set for IgE ‐mediated food allergy clinical trials and observational studies of interventions: International Delphi consensus study ‘ COMFA ’

Background: IgE‐mediated food allergy (FA) is a global health concern with substantial individual and societal implications. While diverse intervention strategies have been researched, inconsistencies in reported outcomes limit evaluations of FA treatments. To streamline evaluations and promote consistent reporting, the Core Outcome Measures for Food Allergy (COMFA) initiative aimed to establish a Core Outcome Set (COS) for FA clinical trials and observational studies of interventions. Methods: The project involved a review of published clinical trials, trial protocols and qualitative literature. Outcomes found as a result of review were categorized and classified, informing a two‐round online‐modified Delphi process followed by hybrid consensus meeting to finalize the COS. Results: The literature review, taxonomy mapping and iterative discussions with diverse COMFA group yielded an initial list of 39 outcomes. The iterative online and in‐person meetings reduced the list to 13 outcomes for voting in the formal Delphi process. One more outcome was added based on participant suggestions after the first Delphi round. A total of 778 participants from 52 countries participated, with 442 participating in both Delphi rounds. No outcome met a priori criteria for inclusion, and one was excluded as a result of the Delphi. Thirteen outcomes were brought to the hybrid consensus meeting as a result of Delphi and two outcomes, ‘allergic symptoms’ and ‘quality of life’ achieved consensus for inclusion as ‘core’ outcomes. Conclusion: In addition to the mandatory reporting of adverse events for FA clinical trials or observational studies of interventions, allergic symptoms and quality of life should be measured as core outcomes. Future work by COMFA will define how best to measure these core outcomes

A Survey on Awareness, Knowledge, and Attitudes toward Epilepsy in an Urban Community in Turkey

Background and Aim: Epilepsy is one of the most common chronic neurological disorders with a high prevalence. Epileptic people and their family members suffer more from social stigma than the disorder itself. Among various complex reasons knowledge and awareness about epilepsy are the two important factors underlying discriminatory attitudes towards epileptic people. Community pharmacists play a major role in the care of these patients. In this study we mainly aimed to gain insights into the knowledge and awareness of and attitudes (AKA) towards epilepsy both in epileptic and healthy individuals in an urban community. To this end we also aimed at developing a reliable and valid measurement tool to assess AKA levels. Materials and Methods: This study was conducted in 13 community pharmacies with 219 respondents. Factor analysis yielded three clear subscales. Results: It was found that a vast majority of the participants were familiar with epilepsy; yet only 18 of them had detailed information. The community pharmacists were indicated as a main source of information about epilepsy at the same rate to that of physicians. Although most of the respondents knew that epilepsy was not a form of mental illness only about one forth of them knew the real cause. More than half of the respondents supported the epileptics’ socialization in the community. Conclusion: We believe that the questionnaire developed in the study is a promising instrument for determining educational needs and offering guidance to healthcare professionals in developing standardized educational tools and programs.Keywords: Attitude, awareness, community pharmacist, epilepsy, knowledg

The effects of calorie restriction and exercise on age-related alterations in corpus cavernosum

Background Aging is an important risk factor for erectile dysfunction (ED). Both calorie restriction (CR) and physical exercise (PE) have been established as a non-medical method for the improvement of detrimental changes in aging. It is well documented that both CR and PE influence on sympathetic and parasympathetic systems; however, there are few studies on non-adrenergic non-cholinergic pathways. This study aims to investigate the NO-mediated mechanisms of CR and PE on corpus cavernosum in aged rats. Materials and Methods 3 and 15 month-old rats were divided into five experimental groups: young rats fed ad libitum (Y-C), aged rats fed ad libitum (O-S), aged rats with CR (O-CR), aged rats with PE (O-PE), and aged rats with CR and PE (O-CR-PE). CR was applied to animals as a 40% reduction of daily food intake for 6 weeks. PE was moderate swimming at 30 min at 3 days/week. The effects of CR and PE were evaluated by histologic, biologic, and in-vitro tissue bath studies. Results The outcomes in CR and PE groups (characterized by decreased nitrosative damage together with increased antioxidant capacity) were improved in comparison to the O-S. Apoptotic biomarkers were also lower and both endothelial and smooth muscle cell' functions were preserved too. There was no statistical difference between apoptosis, antioxidant capacity, and nitrosative damage parameters. Contractile responses to phenylephrine and relaxation responses to carbachol were: O-CR > O-PE > O-CR-PE. In these groups, NOS protein levels determined by western-blot were: eNOS: O-CR = O-CR + PE > O-PE; iNOS: O-CR = O-PE > O-CR-PE; nNOS: O-PE > O-CR-PE > O-CR. Conclusion In our study, both CR and PE prevented age-related changes in the corpus cavernosum of rats. Reducing nitrosative damage in the neurovascular structure was the main mechanism. CR and exercise restored the endothelial and smooth muscle cells in corpus cavernosum by decreasing apoptosis. The mechanism of enhancing functional response in corpus cavernosum with CR was the improvement of endothelial function via eNOS activation however it involves increases in the NO-cGMP signaling pathway by an endothelium-independent mechanism with PE. This might be a direct stimulation of smooth muscle cells by NO, which released from the cavernous nerve endings via nNOS activation

(E)-N-[(2-Ethoxynaphthalen-1-yl)methylidene]-2-ethylaniline

In the title compound, C21H21NO, the dihedral angle between the naphthalene ring system and the benzene ring is 64.61(6)°. The molecular structure is stabilized by an intramolecular C-H?N hydrogen bond

(E)-3-Chloro-N-[(2-eth-oxy-naphthalen-1-yl)methyl-idene]aniline

In the title compound, C19H16ClNO, the dihedral angle between the naphthalene ring system and the chloro-benzene ring is 61.90 (10)°and the C-N-C-C torsion angle is 174.6 (2)°. The mol-ecular structure is stabilized by an intra-molecular C-H?N hydrogen bond. The crystal structure features ?-? stacking inter-actions [centroid-centroid distances = 3.7325 (17) and 3.8150 (17) Å]

Sweet cherry growing in Turkey - A brief overview

The sweet cherry (Prunus avium L.) is native to some parts of northern Turkey. Turkey is the leading worldwide cherry producer and exporter, followed by USA. Sweet cherry is grown in the Aegean, Marmara, Mediterranean and Black Sea Regions in Turkey. Despite the recent growing interest in high density planting cherry orchards, cherry production is still carried out by using predominantly traditional methods with tall trees and local cultivars, without regular training, pruning and modern irrigation systems. The Turkish sweet cherry industry mainly relies on '0900 |Ziraat' cultivar, known as the export cherry in Turkey. Turkey has a lot of valuable cherry gene resources because northern Anatolia is a center of origin. In Turkey, the most widely used rootstock is mazzard seedlings followed by 'Mahaleb'. Recently, modern orchards with high density have been established using the new cultivars, rootstocks, training systems and growing techniques. It seems that Turkey is changing from conventional to modern cherry production and will continue to be a leader in cherry production in the world

Electromagnetic Shielding and Electrical Properties of Polyurethane Acrylate/E- Glass Composites in the 3-13 GHz Frequency Range

Abstract The electromagnetic shielding effectiveness (EMSE) and surface resistivity of UV-cured polyurethane acrylate (PUA) / copper wire / E-glass fabric composites in the frequency range of 3-13 GHz were investigated using a free space measurement. The effect of polyvinyl butyral (PVB) binder on the shielding and electrical properties were searched by using a range of PVB concentrations 2.5, 5, 7.5 % and without PVB. The best EMSE value of 25 dB was obtained in the frequency range of 5-9 GHz by adding 2.5 % PVB. When the addition of PVB was more than 2.5 %, the shielding effect decreased. The sample which contains 2.5 % PVB was showed the least surface resistivity and the best EMSE value