The effect of thrombolytic therapy on QT dispersion in acute myocardial infarction and its role in the prediction of reperfusion arrhythmias

Purpose: We aimed to determine the effect of intravenous thrombolytic therapy on QT dispersion (QTd) and its role in the prediction of reperfusion arrhythmias.Materials and Methods: Twenty patients with acute myocardial infarction (MI) were enrolled in the study. Measurements of QTd were carried out  prior to thrombolytic therapy and before discharge. The patients were examined for ventricular arrhythmias with 24‑h Holter electrocardiography monitoring after treatment and the relationship between ventricular arrhythmias and the QTd values in the early phase of MI was investigated.Results: The values of QTd were significantly higher during the early phase of MI (60 ± 5.32 ms) than those in the late phase (53.35 ± 4.07 ms) (P = 0.032). There was no correlation between isolated, bigeminal, trigeminal and total ventricular premature beats, accelerated idioventricular rhythm (AIVR) with QTd values. However, the patients with sustained ventricular tachycardia (VT), prolonged VT and sustained AIVR had higher corrected QTd (92 ms1/2, 97.8 ms1/2, 81.7 ms1/2, respectively) than the patients without these arrhythmias (74 ms1/2, 56.3 ms1/2, 58.28 ms1/2,  respectively) (P = 0.022, 0.013, 0.018).Conclusion: The values of QTd may be significantly reduced in the 1st week of acute MI and measurement of QTd in the early phase of MI may have a correlation with the following reperfusion arrhythmias: Sustained VT, prolonged VT and AIVR.Key words: Arrhythmia, myocardial infarction, QT dispersion, reperfusion, thrombolytic therap

Effects of intrathecal bupivacaine and bupivacaine plus sufentanil in elderly patients undergoing transurethral resection

Introduction: The present study compared the effect of bupivacaine and bupivacaine + sufentanil on hemodynamic parameters and characteristics of spinal anesthesia in elderly patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia.Technical Considerations: The study included 40 American Society of Anesthesiologists (ASA) I‑III patients scheduled to undergo TURP. Patients were blindly and randomly divided into two groups. Group B (n = 20) received 10 mg of intrathecal bupivacaine and group BS (n = 20) received 7.5 mg of bupivacaine + 5 μg of sufentanil. Sensory and motor block characteristics, hemodynamic changes, side effects, and time to first analgesic requirement were recorded. No differences in mean arterial pressure or heart rate, time for sensory blockade to reach the T10 level, and maximum sensory level were observed between the two groups. The time to first analgesic request was longer in group BS (P < 0.05). Motor block was significantly higher in group B (P < 0.05). In terms of side effects, no statistically significant differences occurred between the groups.Conclusions: Similar hemodynamic stability and sufficient level of sensory blockade were provided by bupivacaine and bupivacaine + sufentanil used for spinal anesthesia in patients undergoing TUR. Due to the fact that less motor block was observed and the time to first analgesic request was longer, the combination of bupivacaine + sufentanil might be appropriate for patients undergoing TUR.Key words: Bupivacaine, intrathecal, opioid, spinal, sufentani

The effect of anesthesia type on stress hormone response: Comparison of general versus epidural anesthesia

Aim: The aim of this study was to investigate the effect of different types of anesthesia on stress hormones.Materials and Methods: The study was included 60 ASAI-II cases scheduled for major lower extremity surgery. The cases were randomized into 2  groups: The EA group was administered epidural anesthesia and the GA group was administered standard general anesthesia. In order to evaluate the surgical trauma - related stress response, CRP, TSH, cortisol, and fasting blood sugar(FBS) levels were measured preoperatively, 30 min after surgical incision, and 24 h post surgery.Results: Between-group comparisons; Preoperative values were not  significantly different between the groups.(P > 0,05) Pulse rate and cortisol values significantly higher in general group at 30 min. (P < 0,05), and the FBS values were significantly higher in the epidural group at 24 h.(P < 0,05) There were not found differences for other parameters at evaluation times.Conclusion: No differences were observed between the two anesthesia methods, in terms of minimizing the stress response due to surgical trauma during major low extremity surgery.Key words: Epidural anesthesia, general anesthesia, stress hormone

Searching for Extraterrestrial Amino Acids in a Contaminated Meteorite: Amino Acid Analyses of the Canakkale L6 Chondrite

Amino acids can serve as important markers of cosmochemistry, as their abundances and isomeric and isotopic compositions have been found to vary predictably with changes in parent body chemistry and alteration processes. Amino acids are also of astrobiological interest because they are essential for life on Earth. Analyses of a range of meteorites, including all groups of carbonaceous chondrites, along with H, R, and LL chondrites, ureilites, and a martian shergottite, have revealed that amino acids of plausible extraterrestrial origin can be formed in and persist after a wide range of parent body conditions. However, amino acid analyses of L6 chondrites to date have not provided evidence for indigenous amino acids. In the present study, we performed amino acid analysis on larger samples of a different L6 chondite, Canakkale, to determine whether or not trace levels of indigenous amino acids could be found. The Canakkale meteor was an observed fall in late July, 1964, near Canakkale, Turkey. The meteorite samples (1.36 and 1.09 g) analyzed in this study were allocated by C. Y. Ornek, along with a soil sample (1.5 g) collected near the Canakkale recovery site

The training needs of Turkish emergency department personnel regarding intimate partner violence

<p>Abstract</p> <p>Background</p> <p>Violence against females is a widespread public health problem in Turkey and the lifetime prevalence of IPV ranges between 34 and 58.7%. Health care workers (HCW) sometimes have the unique opportunity and obligation to identify, treat, and educate females who are abused. The objective of this study was to evaluate the knowledge, attitudes, and experiences of the emergency department (ED) staff regarding intimate partner violence (IPV) at a large university hospital in Turkey.</p> <p>Methods</p> <p>A cross-sectional study was conducted in a large university hospital via questionnaire. The study population consisted of all the nurses and physicians who worked in the ED during a two month period (n = 215). The questionnaire response rate was 80.5% (41 nurses and 132 physicians). The main domains of the questionnaire were knowledge regarding the definition of IPV, clinical findings in victims of IPV, legal aspects of IPV, attitudes towards IPV, knowledge about the characteristics of IPV victims and abusers, and professional and personal experiences and training with respect to IPV.</p> <p>Results</p> <p>One-half of the study group were females, 76.3% were physicians, and 89.8% had no training on IPV. The majority of the nurses (89.5%) and physicians (71.1%) declared that they were aware of the clinical appearance of IPV. The mean of the knowledge scores on clinical knowledge were 8.84 ± 1.73 (range, 0–10) for acute conditions, and 4.51 ± 3.32 for chronic conditions. The mean of the knowledge score on legal procedures and the legal rights of the victims was 4.33 ± 1.66 (range, 0–7). At least one reason to justify physical violence was accepted by 69.0% of females and 84.7% of males, but more males than females tended to justify violence (chi square = 5.96; p = 0.015). However, both genders accepted that females who experienced physical violence should seek professional medical help.</p> <p>Conclusion</p> <p>The study participants' knowledge about IPV was rather low and a training program is thus necessary on this issue. Attention must be given to the legal aspects and clinical manifestations of IPV. The training program should also include a module on gender roles in order to improve the attitudes towards IPV.</p

Retinal nerve fiber layer thickness in the acute phase of sildenafil treatment

Batislam, Ertan/0000-0002-7493-4573; Ornek, Nurgul/0000-0003-3068-1831WOS: 000355744400005PubMed: 26004593OBJECTIVE: To evaluate the early effect of sildenafil on the retinal nerve fiber layer (RNFL) thickness. PATIENTS AND METHODS: Sixty eyes of 60 patients were enrolled in the study. The patients underwent RNFL analysis by scanning laser polarimetry (Nerve Fiber Analyzer, GDx VCC: 5.3.3; Laser Diagnostic Technologies, San Diego, CA, USA) before and after a single 100 mg dose of sildenafil. Sixty eyes of 60 volunteers of similar age and sex distribution were taken as the control group. The RNFL thickness parameters evaluated included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average (SA), inferior average (IA), TSNIT standard deviation (SD), and nerve fiber index (NFI). RESULTS: The mean age of the patients was 53,52 +/- 9,26 years. The mean pre- and post-treatment TSNIT, SA, IA, TSNIT SD, and NFI of the patients were 57.46 +/- 4.94 mu versus 56.90 +/- 4.59 microns (mu), 68.93 +/- 6,12 mu versus 67,79 +/- 5,49 mu, 66,71 +/- 7.10 mu versus 66.31 +/- 6.82 mu, 24 +/- 3.86 mu versus 23.40 +/- 4.05 mu, and 16.50 +/- 6.08 mu versus 14.92 +/- 6.76 mu, respectively. There were no statistically significant differences between pre- and post-treatment RNFL thicknesses (p = 0.527, p = 0.281, p = 0.754, p = 0.416, p = 0.185, respectively). CONCLUSIONS: A single 100 mg dose of sildenafil seems to have no unfavorable effect on RNFL thickness in the acute phase of treatment

Prilling of aluminum sulfate hydrates

A prilling technique was used to produce droplets of aluminum sulfate hydrates in the size range of 2-2.5 mm. Production of spherical particles of aluminum sulfate hydrates by using a prilling technique has never been studied, nor carried out. The effects of the orifice geometry and hydrostatic head on drop formation were measured. The flow rates of hydrated aluminum sulfate melt through bores of 0.08 and 0.11 cm were measured for liquid heads of 10-100 cm. It was found that the break-up of a liquid jet produced particles in the size range 2.0-2.5 mm with a 0.8 mm orifice. The modified Meister and Scheele correlation, which is the first application on a high viscous fluid in air system, was found to be satisfactory for estimating the particle size obtained by the jet break-up mechanism. (C) 2000 Society of Chemical Industry

Comparison of dexmedetomidine and alfentanil during middle ear surgery

Background: We aimed to compare the effects of controlled hypotension with dexmedetomidine or alfentanil on hemodynamic parameters, surgeon satisfaction and bleeding in surgical field under N2O-free low-flow sevoflurane anesthesia in patients undergoing middle ear surgery. Materials and Methods: Forty patients, classified as ASA physical status I-II and candidates for middle ear surgery were randomly allocated into two groups by sealed-envelope method. Before induction Group D (n=20) received 0.1 µg/kg/min dexmedetomidine for 10 minutes and Group A (n=20) received 20 µg/kg alfentanil. Group D received 0.7 µg/kg/hour maintenance dose of dexmedetomidine and Group A 1 µg/kg/min alfentanil up until 30 minutes from the end of the surgery. All patients were had an induction with 6 mg/kg thiopental + 0.1mg/kg vecuronium bromide. Following intubation 3% sevoflurane was administered in a mixture of 2.0 L/min O2 + 2.0 L/min air and this was followed by low-flow anesthesia to deliver 0.5 L/min O2 + 0.5 L/min air. During the operation, controlled hypotension level was adjusted to have a systolic blood pressure of 80-90 mmHg and mean arterial pressure of 50-65 mmHg. Hemodynamic parameters were recorded with five minutes intervals. The surgeon, blinded to the study drugs, assessed amounts of bleeding in the operative field and surgeon satisfaction. Results: Achieving the desired hypotension levels happened later in Group D. At the stage of membrane placement, targeted mean arterial pressures were achieved in both groups. Three patients in Group D required short-term nitroglycerine infusion to reach the desired hypotension levels. The amounts of bleeding and surgeon satisfaction were equal in both groups. The return of hypotensive effect of dexmedetomidine was slower once it was stopped. In Group A, postoperative nausea and vomiting were frequently observed and 0.1 mg doses of naloxone were administered to four patients for two times after extubation. Conclusion: Although additional hypotensive agent required in dexmedetomidine group and desired hypotension levels were happened lately, there was no difference in the amount of bleeding, surgical view and surgeon satisfaction between dexmedetomidine and alfentanil. ©The Mediterranean Society of Otology and Audiology