Spinal anesthesia in cesarean section with different combinations of bupivacaine and fentanyl

The use of opioids for spinal anesthesia increases the anesthetic quality, reduces side effects and also has advantages for the postoperative analgesia. The aim of this study was to evaluate the effects of subarachnoid % 0.5 hyperbaric bupivacaine (B) alone or combined with 10 or 20 mu g fentanyl (F) on the anesthetic properties for cesarean section and newborn. 45 patients were randomized to three groups to receive 1.8 ml anesthetic drug for spinal anesthesia. GI (n=15) received B, GII (n=15) 10 mu g F+B, GIII (n=15) 20 mu g F+B. The onset of sensory blok at T4 level, maximum anesthetic level and the onset time, the level of the motor block, duration of effective analgesia, use of total i.v. fluids and ephedrine, relaxation at the operative area, side effects, umblical cord blood gases, Apgar and neurological and adaptive capasity scores of the newborn were compared among the groups. We conclude that compared to control group, the addition of fentanyl to hyperbaric bupivacaine leads to a decrease in local anesthetic doses and so to a decrease in the incidence of side effects and postoperative analgesic consumption. 7 mu g B+20 mg F seems to be the preferable combination for that reasons

Effects of short-term hyperoxic ventilation on lung, kidney, heart, and liver in a rat model: A biochemical evaluation

BACKGROUND: Despite studies on the adverse effects of hyperoxia, its use is still recommended by the World Health Organization. The aim of this study was to test the possible harmful effects of hyperoxia on the lung, kidney, heart, and liver in a rat mechanical ventilation model

The frequency, risk factors, and complications of gastrointestinal dysfunction during enteral nutrition in critically ill patients

Background: Gastrointestinal (GI) motility disorders in intensive care patients remain relatively unexplored. Nowadays, the frequency, risk factors and complications of GI dysfunction during enteral nutrition (EN) become more questionable

The Treatment of Acute Liver Failure with Fractionated Plasma Separation and Adsorption System: Experience in 85 Applications

Introduction: Artificial liver support systems represent a potential useful option for the treatment of liver failure. The outcomes of patients treated with the fractionated plasma separation and adsorption (FPSA) system are presented. Patients and methods: FPSA was performed 85 times for 27 patients (median 3 treatments/patient) with liver failure [85.2% acute liver failure (ALF) and 14.8% acute-on-chronic liver failure] using the Prometheus 4008H (Fresenius Medical Care) unit. Citrate was used for anticoagulation. A variety of clinical and biochemical parameters were assessed. Comparisons between pretreatment and post-treatment data were performed using paired t-test. Results: The 85 sessions had a mean duration of 6 h. There were significant decreases in total bilirubin (13.18 +/- 9.46 mg/dL vs. 9.76 +/- 7.05 mg/dL; P < 0.0001), ammonia (167.6 +/- 75 mg/dL vs. 120 +/- 43.8 mg/dL; P < 0.0001), blood urea nitrogen (BUN; 12.55 +/- 13.03 mg/dL vs. 8.18 +/- 8.15 mg/dL; P < 0.0001), creatinine (0.54 +/- 0.47 mg/dL vs. 0.46 +/- 0.37 mg/dL; P = 0.0022) levels. and in pH (7.48 +/- 0.05 vs. 7.44 +/- 0.08; P = 0.0045). Four patients (14.8%) received liver transplantation after the treatments; in nine patients, transplantation was not necessary anymore (33%); the remaining 14 patients did not receive a transplantation because they were either not appropriate candidates or no organ was available. Overall survival was 48.1% (4 transplanted and 9 treated patients). No hematological complications related to FPSA were observed. Conclusions: FPSA system is a safe and effective detoxification method for patients with liver dysfunction, including ALF. The system is useful as a symptomatic treatment before liver transplantation; in up to 1/3 of the cases, it can even be used as a sole method of treatment. J. Clin. Apheresis 25:195-201, 2010. (C) 2010 Wiley-Liss, Inc

First evaluation of neustonic microplastics in Black Sea waters

The Black Sea has a high risk of plastic pollution given the high river discharge of several industrialized countries into this semi-enclosed sea. Here, for the first time, the occurrence and distribution of microplastics are reported for the Black Sea. Microplastics were assessed from zooplankton samples taken during two cruises along the south eastern coast of the Black Sea in the November of 2014 and February of 2015. In each cruise neuston samples were collected at 12 stations using a WP2 net with 200 μm mesh. Microplastics (0.2-5 mm) were found in 92% of the samples. The primary shapes were fibres (49.4%) followed by plastic films (30.6%) and fragments (20%), and no micro beads were found. Average microplastic concentration in November (1.2 ± 1.1 × 10(3) par. m(-3)) was higher than in February (0.6 ± 0.55 × 10(3) par. m(-3)). Reduced concentrations in February were possibly caused by increased mixing. The highest concentrations of microplastics were observed in offshore stations during November sampling. The heterogeneous spatial distribution (0.2 × 10(3)-3.3 × 10(3) par. m(-3) for all samples) and accumulation in some stations could be associated to transport and retention mechanisms linked with wind and the dynamics of the rim current, as well by different sources of plastic. There were no statistically significant differences in MP concentration between sampling stations and sampling periods (t-test, p < 0.05).The relatively high microplastic concentrations suggest that Black Sea is a hotspot for microplastic pollution and there is an urgency to understand their origins, transportation and effects on marine life.info:eu-repo/semantics/publishedVersio