The Interaction of Oxidative Stress Response with Cytokines in the Thyrotoxic Rat: Is There a Link?

Oxidative stress is regarded as a pathogenic factor in hyperthyroidism. Our purpose was to determine the relationship between the oxidative stress and the inflammatory cytokines and to investigate how melatonin affects oxidative damage and cytokine response in thyrotoxic rats. Twenty-one rats were divided into three groups. Group A served as negative controls. Group B had untreated thyrotoxicosis, and Group C received melatonin. Serum malondialdehyde (MDA), glutathione (GSH), glutathione reductase (GR), glutathione peroxidase (GPx), and nitric oxide derivates (NO•x), and plasma IL-6, IL-10, and TNF-alpha were measured. MDA, GSH, NO•x, IL-10, and TNF-alpha levels increased after L-thyroxine induction. An inhibition of triiodothyronine and thyroxine was detected, as a result of melatonin administration. MDA, GSH, and NO•x levels were also affected by melatonin. Lowest TNF-alpha levels were observed in Group C. This study demonstrates that oxidative stress is related to cytokine response in the thyrotoxic rat. Melatonin treatment suppresses the hyperthyroidism-induced oxidative damage as well as TNF-alpha response

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Interval Distinction on Melody Perception for Music Information Retrieval

The problem of musical query processing can be envisioned as a sub-string-matching problem when the melody is represented as a sequence of notes associated with a set of attributes. In comparison of two musical sequences, one of the important problems is to determine the weights of each operation. This paper presents an alternate weighting-scheme which is based on diatonic distinctions on melody perception. To achieve this, we run a cognitive experimentation applying Probe-Tone method. The results showed that perceptional hierarchy of pitches changes according to the interval distinction on melody, whether it has more disjunt interval than conjunct intervals, vice versa. Consequently, if the new weighting-scheme created in this study are used in sequenced-based melody comparison, melodies retrieved to user would have a more credible ranking. The details of experimentations and the results we reach are also presented in detail

The Effects of Preoperative Acupuncture Needle and Capsicum Plaster Applications of Extra 1, Pericardium 6 and Large Intestine 4 Points on Preoperative Anxiety, Postoperative Nausea-Vomiting and Analgesic Consumption

WOS: 000272651300003Objective: The acupuncture points pericardium 6 (P 6), extra I (E 1), and large intestine 4 (Li 4) are known to reduce postoperative nausea and vomiting, and to provide sedation and analgesia, respectively. We investigated the effects of preoperative application of acupuncture needle or capsicum plaster on these points on preoperative anxiety, postoperative nausea and vomiting, and analgesic consumption. Material and Methods: Sixty cases undergoing laparoscopic gynecological operations were divided into four groups. The day before the operation, State Trait Anxiety Inventory (STAI) was given to all cases. The participants were divided into four groups regarding the preoperative application of the following: dry needle at points P 6, Li 4 and El in group 1; capsicum plaster application at the same points in group II; 0.07 mg kg(-1) midazolam im and plasebo plaster application at different non acupunctural points (sham) in group III and only placebo plaster usage at sham points in group IV. STAI was repeated immediately before the operation. After standard general anesthesia, tramadol was administered with postoperative patient controlled analgesia method. Postoperative visual pain score (VAS), analgesic consumption, and nausea and vomiting were recorded. Results: The decrease in the preoperative day 1 STAI scores compared to immediate preoperative scores in group I and group II was significantly higher than the decrease in group III (p < 0.05). Nausea and vomiting rates were lower in group I and II (p < 0.05). The postoperative analgesic consumption of group I and group IV were lower than that of group 11 and group III (p < 0.05). There was no significant difference between the study groups regarding VAS scores. Conclusion: Preoperative acupuncture needle and capsicum plaster application at P 6, El, and Li 4 points were found to be effective in reducing preoperative anxiety and postoperative nausea and vomiting, but thought to be non effective on postoperative analgesic consumption. Noninvasive capsicum plasters are concluded to be a good alternative method for needles that may cause side effects

Crystal structure of 1,3-bis(4-methylbenzyl)-1H-1,3-benzimidazol-3-ium bromide monohydrate

In the title hydrated symetrically substituted 1,3-bis(4-methyl-benzyl) benzimidazolium salt, C23H23N2+center dot Br-center dot H2O, the dihedral angles between the benzimidazole ring system (r.m.s. deviation = 0.003 angstrom) and the pendant benzene rings are 73.18 (16) and 77.52 (16)degrees. Both benzene rings lie to the same side of the benzimidazole ring system, giving the cation an overall U-shape. In the crystal, the cation is linked to the water molecule by a short C-H center dot center dot center dot O hydrogen bond and the water molecule forms O-H center dot center dot center dot Br hydrogen bonds. Together, these interactions lead to [010] chains. The packing is consolidated by C-H center dot center dot center dot Br hydrogen bonds and aromatic pi-pi stacking interactions [centroid-centroid distances = 3.5401 (17) and 3.8815 (18) angstrom], generating a three-dimensional network

The ongoing debate in thyroid surgery: Should frozen section analysis be omitted?

WOS: 000253083200006PubMed ID: 17429155Controversies concerning the role of frozen section (FS) have been a matter of debate. The aim of this study was to identify the role of FS analysis in intraoperative decision making and analyze the effect of the cost in detecting thyroid malignancies in Turkey. Out of 214 consecutive patients who had been operated on for thyroid cancer between January 1996 and August 2004, 178 patients were evaluated retrospectively. All 178 patients were subjected to FS. Intraoperative FS correctly identified the pathology as malignant in 58.4% of patients. A true-positive FS result changed the surgical strategy in 30 (27.6%) cases False negative FS lesions were defined histologically as papillary microcarcinoma in 54%, follicular variant of papillary cancer in 18% and follicular cancer in 8% of cases. The sensitivities of FNAB and intraoperative FS in thyroid cancer patients were 22.5% and 58.4%, respectively. False negative FS results increased the cost for each informative FS from (sic)25 to (sic)42.7. Despite limitations, results of this Study reject the idea that the role of FS is becoming limited. We recommend routine frozen section in the operative assessment of thyroid nodules. Omitting FS may be suggested only in cases with a FNAB revealing malignancy

Management of Cushing's disease using cavernous sinus sampling: Effectiveness in tumor lateralization

Objective: The aim of this study was to determine the accuracy of bilateral cavernous sinus sampling (CSS) in preoperative tumor lateralization (right/left) within the pituitary in patients with Cushing's disease (CD)