Evaluation of Intraperitoneal and Incisional Bupivacaine or Levobupivacaine for Postoperative Analgesia in Ovariohysterectomized Dogs

Background: Ovariohysterectomy (OHE) is the most commonly performed elective surgical procedure in companion animals. OHE offers benefits of control of population and decreased risk of potentially life-threatening diseases such as mammarian tumours and pyometra.  Traditional OHE intervention causes inflammation and pain due to trauma during organ manipulation. The purpose of this study was to compare the effect of intraperitoneal and incisional administration of bupivacaine (BP) or levobupivacaine (LP) on postoperative analgesia in dogs undergoing the OHE procedure.Materials, Methods & Results: A total of 24 mix-breed bitches aged between 1 - 3 years and weighed 19 - 20 kg were used in this study. The animals were divided into three groups as control (n = 8), BP (n = 8) and LP group (n = 8). The animals were kept under surveillance at the hospitalisation unit of the animal hospital for one day before the elective OHE. The dogs were fasted for 12 h before the surgery, with adlib water consumption. Atropine sulphate 0.045 mg/kg was administered subcutaneously approximately 30 min before general anaesthesia. Midazolam (0.3 mg/kg) was intravenously injected into all dogs for pre-anaesthetic medication. After sedation, anaesthesia was induced with propofol (4 mg/kg, IV) and then the dogs were orotracheally intubated using cuffed endotracheal tubes. General anaesthesia was maintained by administration of 2% isoflurane. The ventral abdomen was prepared aseptically for OHE following the general anaesthesia. All animals were operated on by the same surgeon. During surgery, sprayed bupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in BP group, levobupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in LP were then applied over the ovaries, uterine broad ligaments and cervix uteri. After removal of the uterine body, either LP or BP was sprayed to left and right, or cranial and caudal parts of the abdominal cavity. Finally, the incision line was sprayed before closing the skin. The control group received only sprayed saline.  The pain evaluation was carried out with modified Melbourne pain scoring scale. To determine cortisol concentrations, blood samples were taken before anaesthesia induction (baseline) and postoperative 0, 0.5, 1, 2, 4, 6, 12 and 24 h. Postoperative pain scores were higher in the control group than BP and LP groups following surgery at 30 min, 1st, 4th, and 6th h. In all groups, cortisol levels increased postoperatively, whereas they decreased more rapidly in BP and LP groups. There was a steady increase at postoperative 0 min, 30 min, 1st, 2nd, 4th and 6th h in the control group and at postoperative 0 min, 30 min and 1 h in BP and LP groups (P < 0.05).Discussion: Intraperitoneal and incisional bupivacaine shows significantly superior postoperative pain management benefits after the closure of skin, compared to untreated dogs and it is also superior to lidocaine treatment at 0.5 h following the visual analogy pain assessment system. In the present study, the observation of lower pain scores in BP group at 0.5, 1, 4 and 6 h as compared to the control group was similar to findings of other studies. LP group also showed decreased pain scores at above-mentioned h without any significant difference. However, only in LP group, pain scores at 24 h were lower than postoperative pain scores. In conclusion, it is suggested that sprayed intraperitoneal and incisional BP and LP are very effective for preventing postoperative pain ovariohysterectomized dogs

Evaluation of Inner Ear Damage by Using Otoacoustic Emissions in Patients Who Underwent Mastoidectomy and Tympanoplasty Operations in the Early Period

Objective:We aim to demonstrate inner ear damage caused by drilling in the early period. Healthy contralateral ears of patients who underwent mastoidectomy using drill or tympanoplasty without using drill were compared.Methods:A total of 38 patients (mastoidectomy: 22, tympanoplasty: 16) who were diagnosed as chronic otitis media and were scheduled for surgery were included. Distortion product (dp) otoacoustic emissions measurements were performed on healthy contralateral ears of patients on pre- and post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day.Results:In mastoidectomy group, dp otoacoustic emission values on post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day at a frequency of 4000 Hz were significantly lower than in tympanoplasty group (p<0.05). In mastoidectomy group, dp values on post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day at 4000 Hz significantly decreased in comparison with pre-operative period (p<0.05). In comparison with pre-operative period, decrease in dp values on post-operative 1. hour, 1. day, and 2. day at 4000 Hz in mastoidectomy group is significantly higher than those in tympanoplasty group (p<0.05). In tympanoplasty group, dp values on post-operative 1. hour at 4000 Hz significantly decreased in comparison with pre-operative period (p<0.05).Conclusion:Drilling used in mastoidectomy operation damage healthy contralateral ears by causing acoustic trauma. This damage can be determined by otoacoustic emissions in the early period. According to our study, hearing loss is temporary and more distinct at higher frequencies

Long-Term, High-Frequency Tympanometry and Audiometry Results after Cartilage and Fascia Tympanoplasty

Objective:Fascia or cartilage can be used as grafts in tympanoplasty; however, the disadvantage of cartilage is that it causes stiffness and rigidity in the newly formed tympanic membrane. The aim of this study was to compare the long-term high-frequency tympanometry and audiometry outcomes of tympanoplasty using cartilage and fascia.Methods:Forty patients in whom tragal cartilage was used in type 1 tympanoplasty and 40 patients in whom temporal muscle fascia was used were included in the study. The preoperative and postoperative audiometries of the two groups were compared. Postoperative high-frequency tympanometry (224, 668, 800, and 1000 Hz) and air volume, compliance, and pressure differences of the two groups were also compared.Results:The mean age of the patients was 31.3±4.5 year. The success rates were 96% in the cartilage group and 92% in the fascia group. In the fascia group, the preoperative mean air bone gap was 27.9±97 decibels (dB), and the postoperative mean air bone gap was 19.1±7.6 dB. The postoperative mean air bone gap improvement was 8.8±9.9 dB; the difference was statistically significant. In the cartilage group, the preoperative mean air bone gap was 28.2±9.6 dB, and the postoperative mean air bone gap was 17.2±10.5 dB. The postoperative mean air bone gap improvement was 10.9±10.3 dB; the difference was statistically significant. When postoperative mean air bone gap improvement was compared, there was no statistical difference between the two groups. When high-frequency tympanogram values were compared, there were no significant differences between the two groups at 224, 668, 800, or 1000 Hz frequencies in terms of air volume, compliance, or pressure values.Conclusion:The use of temporal muscle fascia and cartilage in tympanoplasty is statistically similar when compared in terms of tympanic membrane repair, hearing gain, air volume, pressure, and compliance. For this reason, cartilage graft can easily be preferred in tympanoplasty, especially in revision cases and adhesive otitis media, without fear of stiffness or rigidity effects

The Impact of Pressure Dressing on Post-Thyroidectomy Hypocalcemia: Prospective Randomized Controlled Clinical Study

Objective:The aim of the study was to evaluate the efficacy of pressure dressing on complications after total thyroidectomy and its correlation with serum calcium levels.Methods:The study involved 112 patients who underwent total thyroidectomy. Patients were randomized into two groups-with and without pressure dressing-and followed prospectively. The calcium levels were measured at 6, 24, and 48 hours postoperatively, respectively. Hypocalcemia was diagnosed when patients were symptomatic or calcium level was below 8.0 mg/dL. Dressing and drain were removed at the 48th hour of postoperatively.Results:No statistically significant difference was found between the two groups in terms of age; gender; thyroid gland weight; calcium concentrations at the 6th, 24th, and 48th hours; total drain liquid; and hypocalcemia rates. Postoperative hematoma developed in 7.1% of the cases and was statistically higher in the without-dressing group compared to with-dressing group. Thyroid gland weight was correlated positively with total drain liquid. There was no correlation between thyroid gland weight and total drain liquid level and 6th-, 24th-, and 48th-hour calcium levels.Conclusion:Pressure dressing after total thyroidectomy significantly reduces postoperative hematoma. Postoperative serum calcium levels were slightly higher in the pressure dressing group but not statistically significant

Correlation Between Tumor Volumes and Serum S100B Values in High Grade Glioma Patients.

TEZ9469Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2014.Kaynakça (s. 43-53) var.viii, 54 s. : tablo ; 29 cm.Amaç: Yüksek gradeli glial tümörlerin tanı ve operasyon sonrası takip aşamalarında serum S100B değerlerinin mevcut görüntüleme yöntemlerine ek katkısının değerlendirilmesi ve S100B proteinin yüksek gradeli glial tümörler için bir tümör belirteci veya prognostik faktör olarak kullanılabilirliğinin değerlendirilmesi. Gereç ve yöntem: Aralık 2013 – Ağustos 2014 tarihleri arasında beyin ve sinir cerrahisi kliniğinde yüksek gradeli glial tümör tanısı ile cerrahi uygulanan 14 olguluk hasta grubu ve sağlıklı bireylerden oluşan 14 kişilik kontrol grubu çalışmaya alınmıştır. Hasta grubundan operasyon öncesi, operasyondan sonraki 1. gün ve 5. günler olmak üzere 3 kez, kontrol grubundan 1 kez olmak üzere venöz kan örnekleri alınmıştır. Hasta grubundakilerin ayrıntılı nörolojik muayeneleri değerlendirilmiş ve nörolojik hasar olup olmadığı tespit edilmiştir. Serumda S100B protein değerleri çalışılıp hasta grubundaki olguların görüntüleme yöntemleri ile tümör hacimleri ölçülmüştür. Operasyon öncesi ve sonrasındaki serum S100B değerleri karşılaştırılmıştır. Bulgular: Hasta grubu ile kontrol grubunun S100B değerlerinin karşılaştırılması yapıldığında hasta grubunda S100B değerleri anlamlı oranda daha yüksek bulunmuştur. (p0,05) Ancak total rezeksiyon uygulanan olgularda postop 5. gün yapılan ölçümlerde S100B değerlerinde anlamlı bir düşüş saptanmıştır. (p0,05) But a significant reduction of S100B values is determined in the postoperative 5. day measurements of the patients in whom total resection were performed. (p<0,05) Conclusion: A significant correlation isn’t determined as the assesment of tumor volumes and serum S100B values. However rise of the serum S100B values in the high grade glioma patients is defined but a definitive conclusion isn’t determined because of the false negative values and the minority of the patient group (n=14). We think that more significant and directive conclusions shall be defined with the more comprehensive studies in the oncoming periods

A new regression based software cost estimation model using power values

8th International Conference on Intelligent Data Engineering and Automated Learning -- DEC 16-19, 2007 -- Birmingham, ENGLANDWOS: 000252394900034The paper aims to provide for the improvement of software estimation research through a new regression model. The study design of the paper is organized as follows. Evaluation of estimation methods based on historical data sets requires that these data sets be representative for current or future projects. For that reason the data set for software cost estimation model the International Software Benchmarking Standards Group (ISBSG) data set Release 9 is used. The data set records true project values in the real world, and can be used to extract information to predict new projects cost in terms of effort. As estimation method regression models are used. The main contribution of this study is the new cost production function that is used to obtain software cost estimation. The new proposed cost estimation function performance is compared with related work in the literature. In the study same calibration on the production function is made in order to obtain maximum performance. There is some important discussion on how the results can be improved and how they can be applied to other estimation models and datasets

Criteria for Preferring Anterior Approach in Surgical Treatment of Cervical Spondylotic Myeloradiculopathy

Servikal spondilosis; servikal intervertebral diskte başlayıp, daha sonra çevre kemik ve yumuşak dokularda devam eden, ilerleyici, süreğen ve sinsi bir dejeneratif hastalıktır. Bu dejeneratif değişikliklere bağlı omurilik ve sinir kökü tutulumu olur ise servikal spondilotik myeloradikülopati (SSMR) olarak isimlendirilir ve 50 yaş üzerinde myelopatinin en sık sebebidir.İlerleyici ve fonksiyonel nörolojik defisite sahip olan olgular ile uzun süreli tanı almış ve konservatif tedaviye yanıt vermeyen yakınmaları bulunan olguların cerrahi olarak tedavi edilmeleri gerekir. Cerrahi tedavinin amacı omurilik ve sinir kökleri üzerindeki basıyı ortadan kaldırmak, servikal omurganın dizilimini korumak veya bozulmuş ise bunu yeniden oluşturmak, hastanın nörolojik bulgularını ve yakınmalarını ortadan kaldırarak yaşam kalitesini artırmak ve bunları yaparken de mümkün olduğu kadar komplikasyona neden olmamaktır. Bu hedefler servikal omurgaya anterior veya posterior cerrahi yaklaşım yolları ile sağlanabilir.Cerrahi yaklaşımın şekline ancak hastanın klinik ve radyolojik olarak çok ayrıntılı değerlendirilmesi ile karar verilebilir.Cerrahi yaklaşımın en büyük amacı olan yeterli nöral dekompresyon ve servikal dizilimin korunması/sağlanması en iyi anterior yaklaşımlar ile sağlanabilir.Bu çalışmamızda SSMR'nin cerrahi tedavisinde anterior yaklaşımın tercih edilme sebepleri özetlenecektir.Cervical spondylosis is a progressive, chronic and insidious degenerative disease, which origins from the cervical intervertebral disc and then diffuses to surrounding bony and soft tissues. If the spine and nerve roots are involved due to degenerative changes, this is called as cervical spondylotic myeloradiculopathy (CSMR) and it is the most frequent cause of myelopathy over age of 50. Cases with progressive character and functional neurological deficits and cases with a prolonged course refractory to conservative therapy shall be treated surgically. The aim of the surgical treatment is to relieve the pressure on the spinal cord and nerve roots, to preserve the proper anatomical alignment of the cervical vertebrae or to reestablish correct anatomical positioning if it is distorted and lastly to increase the life quality by relieving patients neurological signs and complaints. While achieving these goals, complications shall be avoided as much as possible. These goals can be accomplished by anterior or posterior surgical approaches to the cervical vertebrae. The style of the surgical approach can only be decided by a detailed evaluation of the patient's clinical and radiological features. The utmost aim of the surgical procedure, which is to achieve sufficient neurological decompression and to preserve/establish proper cervical vertebral alignment, can be provided best by anterior approaches. In our current study, the criteria to prefer anterior approach in surgical treatment of CSMR will be reviewed