Comparación entre los efectos de la dexmedetomidina, el fentanilo y el esmolol en la prevención de la respuesta hemodinámica a la intubación

ResumenJustificación y objetivosLa laringoscopia y la intubación pueden causar una respuesta hemodinámica. Varios medicamentos pueden ser usados para controlar esa respuesta. En este estudio, nuestro objetivo fue comparar los efectos de la dexmedetomidina, el fentanilo y el esmolol sobre la respuesta hemodinámica.MétodosNoventa pacientes programados para cirugías electivas con intubación endotraqueal, estado físico ASA I-II, y edades entre 21 y 65 años, se incluyeron en el estudio prospectivo, aleatorizado y doble ciego. Las presiones arteriales medias, sistólicas, diastólicas y las frecuencias cardíacas se midieron cuando los pacientes llegaron al quirófano y se registraron como valores basales. Los pacientes fueron aleatorizados en 3 grupos: el grupo i (n=30) recibió 1μg/kg de dexmedetomidina con infusión en 10min; el grupo ii (n=30) recibió 2μg/kg de fentanilo; el grupo iii recibió 2mg/kg de esmolol 2min antes de la inducción. Los pacientes fueron intubados en 3min. Las presiones medias, sistólicas y diastólicas y las frecuencias cardíacas fueron medidas antes de la inducción, antes de la intubación y durante los minutos 1, 3, 5 y 10 después de la intubación.ResultadosCuando los niveles basales fueron comparados entre los grupos, verificamos que en los minutos 5 y 10 la postintubación, las frecuencias cardíacas en el grupo i y las presiones arteriales medias, sistólicas y diastólicas en el grupo iii eran más bajas que en otros tiempos medidos (p<0,05).ConclusionesLa dexmedetomidina fue superior en la prevención de la taquicardia. El esmolol previno el aumento de las presiones arteriales medias, sistólicas y diastólicas después de la intubación. Concluimos que son necesarios algunos estudios adicionales para descubrir una estrategia que prevenga tanto el aumento de la presión arterial sistémica como la frecuencia cardíaca.AbstractBackground and objectivesLaryngoscopy and intubation can cause hemodynamic response. Various medications may be employed to control that response. In this study, we aimed to compare the effects of dexmedetomidine, fentanyl and esmolol on hemodynamic response.MethodsNinety elective surgery patients who needed endotracheal intubation who were in American Society of Anesthesiology I–II group and ages between 21 and 65 years were included in that prospective, randomized, double-blind study. Systolic, diastolic, mean arterial pressures, heart rates at the time of admittance at operation room were recorded as basal measurements. The patients were randomized into three groups: Group I (n = 30) received 1 μg/kg dexmedetomidine with infusion in 10 min, Group II (n = 30) received 2 μg/kg fentanyl, Group III received 2 mg/kg esmolol 2 min before induction. The patients were intubated in 3 min. Systolic, diastolic, mean arterial pressures and heart rates were measured before induction, before intubation and 1, 3, 5, 10 min after intubation.ResultsWhen basal levels were compared with the measurements of the groups, it was found that 5 and 10 min after intubation heart rate in Group I and systolic, diastolic, mean arterial pressures in Group III were lower than other measurements (p < 0.05).ConclusionsDexmedetomidine was superior in the prevention of tachycardia. Esmolol prevented sytolic, diastolic, mean arterial pressure increases following intubation. We concluded that further studies are needed in order to find a strategy that prevents the increase in systemic blood pressure and heart rate both

The Effect of Different Harvest Stages on Chemical Composition and Antioxidant Capacity of Essential Oil from Artemisia annua L.

Chemical composition of the essential oils obtained by hydro-distillation from Artemisia annua L. (Asteraceae) harvested before flowering (BF), 50% of flowering (50%F), full flowering (FF), and after flowering (AF) stages were determined using GC and GC/MS analysis. The essential oil contents were 0.8%, 0.96%, 1.22% and 1.38% in BF, 50% F, FF and AF, respectively. In total, 20 compounds were identified, with artemisia ketone (28.30%-37.15%), camphor (18.00%23.30%), and 1,8-cineole (9.00%-10.39%) as main components. The highest amounts of the three main components were recorded in the essential oils of the plants harvested in the FF stage. Also, the free radicals scavenging activity of the essential oils, tested by using DPPH method, were found to be in order of FF&gt;50% F&gt;AF&gt;B

Detection of CMV DNA in intraocular fluid samples in patients clinically diagnosed with viral uveitis by molecular methods

Background: Latent Cytomegalovirus (CMV) infections may be reactive in consequence of immunosuppression. Recently, CMV-associated uveitis cases have also been reported in immunocompetent individuals. Aim: The aim of this study was to obtain epidemiological data by evaluating CMV DNA PCR results, clinical characteristics and risk factors of patients diagnosed with viral uveitis. Methods: Between the years 2011-2017, anterior chamber fluid samples of 35 patients with viral uveitis sent from the ophthalmology clinic to the Virology Laboratory were included in this study. CMV DNA real-time PCR results were evaluated. Results: CMV DNA positivity was detected in 9 (26%) of the 35 patients. CMV DNA positivity was highest (13%) in over 60 years (p=0.02). Acute recurrent uveitis in 44% (4/9) of patients, single eye involvement in 78% (7/9) and anterior uveitis in 44% (4/9) were found. Conclusion: In this study, CMV DNA positivity was detected in 26% of the patients with viral uveitis. Considering the presentations of a small number of cases related to CMV uveitis in our country, this study is important due to being the most comprehensive study in our country

Effects of Aminoguanidine on Glomerular Basement Membrane Thickness and Anionic Charge in a Diabetic Rat Model

We investigated the effect of aminoguanidine (AG) administration on GBM thickness, glomerular heparan sulfate (HS) content, and urinary albumin and HS excretion in diabetic rats. After induction of diabetes, female Wistar rats were divided into 2 groups: Group AGDM (n=11) received 1g/L aminoguanidine bicarbonate in drinking water, group DC (n=12) was given only tap water. Control rats received AG (group AGH, n=8) or tap water (group HC, n=8). At the end of a period of 8 weeks, urinary albumin and glycosaminoglycan (GAG) excretion was detected. GBM heparan sulfate distribution and count was determined under the electron microscope. The AGDM group had lower urinary albumin and GAG excretion than diabetic controls. GBM thickness was increased in diabetic rats compared to groups of AGDM and HC. In AGDM group alcian blue stained particle distribution and count in the GBM was similar to healthy controls. In conclusion AG prevents the decrease of anionic charged molecules in the GBM and GBM thickening. This can be one of the mechanisms by which AG decreases albuminuria in diabetic rats

Omentum adiposity is linked with resistin gene expression

Background: This study demonstrated site-specific adipose tissue resistin gene expression differences in individuals with and without type 2 diabetes mellitus. The relationship between conventional drug therapy and adipose tissue resistin gene expression was also determined. Paired omental and subcutaneous adipose tissues were excised during elective surgery from morbidly obese and obese patients. Methods: Resistin mRNA expressions were determined by qPCR. All tissue sections also were also analyzed for their resistin and CD68 protein expressions by immunohistochemistry. Results: No significant difference for omental and subcutaneous adipose tissue resistin mRNA expression levels were found among morbidly obese and obese study groups. The omental adipocytes resistin mRNA expressions increased with macrophage number both in the omental and subcutaneus fat. Resistin mRNA expressions of the omental and subcutaneous fat were in positive correlation. As the omental adipocytes radius decreased, the macrophage number increased in subcutaneous fat. In the omentum the adipocytes diameter and areas increased, in correlation with macrophage number. The antidiabetic drug use was found to increase adipocyte size both in the omentum and subcutaneous fat. Conclusions: The higher resistin gene expression in the omental fat may induce the increase in size and number of adipocytes, thus leading to elavation in omental fat mass

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Esnek Çalışma ve Örgütsel Bağlılık İlişkisi: Sağlık Profesyonelleri Üzerinde Bir Uygulama - Correlation Between Flexible Working and Organizational Commitment: An Application On Health Professionals

Today’s businesses have developped different strategies to get them maximum efficiency their working. One of them is the flebxible working. In this study, the personnel working in the Health sector, The correlation between these two structures with Flexible working models perspectives and commitment to the organization was investigated. Araştırma anket yöntemi ile gerçekleştirilmiştir.The research has been conducted by survey method. Questionnaire consists of three sections. In the first part, demographic variables of the participantsare determined. In these condand the third sections, the questions about the concepts of flexibleworking and Organizational Commitment are asked, respectively. The qustions about Organizational Commitment have been prepare dusing the scale of Organizational dedication developed by Allen and Meyer in 1991. The survey was distributed to 228 employees working in Health sector. The survey results were entered and runusing the software package of SPSS 22.0. The study, a meaningful weak and positive directed correlation between Flexible working and Organizational commitment has been obtaine