A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery

BACKGROUND: We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations. METHODS: One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively. RESULTS: The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P = 0.001, P = 0.01, P = 0.008, and P = 0.029, respectively; and for VAS-C, P = 0.035, P = 0.023, P = 0.002, and P = 0.037, respectively). Total 24-hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P = 0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P = 0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P = 0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P = 0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P = 0.03) were lower in the TEA group in comparison to the LEA group. CONCLUSIONS: TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile

The Role of Chlamydia pneumoniae in the Atherosclerotic Process of Patients under 50 Years of Age Who Underwent Coronary Artery Bypass Graft Surgery

ABSTRACT Background: To evaluate the presence of C. pneumoniae DNA in the tissues and C. pneumoniae DNA antibodies in the blood samples of patients who underwent CABG surgery. Material and Methods: Fifty-one patients <50 years of age were included in the study, and analyzed in two groups according to the intimal thickness of aorta. C. pneumoniae DNA was evaluated in the tissues collected from the atrium, left internal thoracic artery and ascending aorta of patients. Results: Although, C. pneumoniae DNA was negative in the atrial and left internal thoracic artery tissues of all patients, it was positive in the tissues obtained from the ascending aortas of twelve patients. C. pneumoniae DNA positivity was significantly higher in patients with increased aortic intimal thickness compared to those without increased aortic thickness. Conclusion: The question whether C. pneumoniae is triggering atherosclerosis or is involved as a superinfection could not be clarified

Preoperative Embolization in Surgical Treatment of a Primary Hemangiopericytoma of the Rib : A Case Report

Primary hemangiopericytoma of the rib is extremely rare and only a few cases have been reported. A 62-yr-old man presented with an aching chest pain and dyspnea. Thoracic computed tomography revealed a homogenous mass expanding the right seventh rib. A diagnosis of hemangiopericytoma was established by percutaneous needle biopsy. Preoperative embolization of the feeding vessels of the tumor was performed in order to prevent perioperative bleeding. There was no significant bleeding during the surgery, where complete resection of the tumor with 7th to 9th ribs with a surgical margin of 5 cm was performed. Postoperative course was uneventful and there has been no recurrence for thirteen months. To our knowledge, there has been no report to apply a preoperative embolization of a primary hemangiopericytoma of the rib

The effects of different egg yolk concentrations used with soy bean lecithin-based extender on semen quality to freeze bull semen

Özet Sarıözkan S, Tuncer PB, Bucak MN, Büyükleblebici S, Kinet H, Bilgen A. Boğa spermasının dondurulmasında soya lesitin temelli sulandırıcı ile birlikte kullanılan farklı yumurta sarısı konsantrasyonlarının sperma kalitesi üzerine etkileri. Eurasian J Vet Sci, 26, 1, 45-49 Amaç: Boğa spermasını dondurmak için soya lesitin temelli sulandırıcıya (Bioxcell ® ) %5 ve 10 konsantrasyonlarında santrifüj edilmiş yumurta sarısı (SYS) katıldı ve bunların çözüm sonu sperm motilite, morfolojik anormallikler ve membran bütünlüğü üzerindeki sinerjistik etkileri değerlendirildi. Gereç ve Yöntem: Her bir Simental boğadan alınan ejakulatlar (n=12) üç eşit miktara ayrıldı ve sırasıyla %5 (B5), %10 (B10) SYS eklenmiş ve hiç SYS (B0) içerme-yen soya lesitin temelli sulandırıcı ile sulandırıldı. Ardın-dan standart protokollere göre donduruldu ve çözdürül-dü. Spermatozoa kryocanlılığı, in vitro çözüm sonu motilite (CASA), akrozomal ve diğer anormallikler ve plasma membran bütünlüğü (HOST) yönünden değerlendirildi. Bulgular: Simental boğalarda, dondurma ve çözdürme sonrası B5 ile sulandırılan grupta, diğer sulandırıcılar-la sulandırılan gruplardan önemli derecede daha yüksek CASA motilite ve CASA progresif motilite oranı elde edilmiştir (p<0.001). Gruplar arasında, VAP, VCL ve ALH yö-nünden önemli bir farklılık bulunmamıştır (p>0.05). En yüksek VSL (p<0.01) ve LIN değeri (p<0.001) B10 grubundan elde edilmiştir. Membran bütünlüğü oranı, B5 grubunda, diğer gruplara göre önemli derecede yüksek bulunmuştur (p<0.001). Öneri: Soya lesitinle kombine olarak sulandırıcıya %5 SYS eklenmesi boğa spermasının dondurulabilirliğini önemli derecede artırmıştır. Abstract Sariozkan S, Tuncer PB, Bucak MN, Buyukleblebici S, Kinet H, Bilgen A. The effects of different egg yolk concentrations used with soy lecithin-based extender on semen tuality to freeze bull semen. Eurasian J Vet Sci, 26, 1, 45-49 Aim: The centrifuged egg yolk (CEY) was added at concentrations of 0.5 or 10% to a defined soy lecithin-based extender (Bioxcell ® ) used to freeze bull semen and their synergistic effects on post-thaw sperm motility, morphological abnormalities and membrane integrity assessed. Materials and Methods: Ejaculates obtained from each Simmental bull (n:12) divided in three equal aliquots and diluted in CEY 5% (B5), 10% (B10) supplemented, and without any CEY (B0) in soy bean lecithin -based extender, respectively. Thereafter, they were frozen and thawed following a standart protocol. Sperm cryosurvival was evaluated in vitro by microscopic assessments of post-thaw sperm motility (by means of the CASA), acrosomal and other abnormalities (head, mid-pieces, and tail) and plasma membrane integrity (evaluated by HOST). Results: In Simmental bulls, semen extended with B5 had significantly higher CASA motility and CASA progressive motility than those extended with the rest of extenders after freezing and thawing (p<0.001). There was no significant difference in VAP, VCL, and ALH among the three groups (p>0.05). For VSL (p<0.01) and LIN (p< 0.001), the highest values were obtained from B10 group. The highest percentages of acrosomal and other abnormalities were found in semen diluted in B10 (p<0.001). In the group frozen B5, the percentage of membrane integrity was significantly higher than that of the other groups (p<0.001). Conclusion: The use of CEY 5% in combination with soy bean lecithin significantly improved bull semen freezability

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

Post COVID-19 irritable bowel syndrome

Objectives: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection. Design: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires. Results: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p&lt;0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls. Conclusion: Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls. Trial registration number: NCT04691895

An Improved Quality and Security of LSB Based Steganography Technique Using XOR Bitwise Operation in 24 Bit Color Image

Information privacy has become the overborne issue today with the increasing use and efficiency of electronic data processing. The main purpose on privacy of communication is to provide secure connection with target without being captured by the third persons or by bringing them in such a way that they cannot understand. In the most general sense, steganography is the study and practice of concealing information to provide security of communication. The classic LSB (least significant bit) technique and methods which are derived from classic lsb, are used in steganography techniques on spatial domains. For the case of security, the classic LSB technique is very weak because it is very simple and predictable. Also, it causes distortion of image. In this paper, we propose an improved LSB Steganography technique to increase security and decrease the distortion of image. The proposed method is based on hiding two bits of secret data in one color (rgb) pixel with only one least significant bit change in one of the layers. LSB value of red layer is used in XOR operation with both LSB values of green and blue layers respectively. Only with one LSB bit change, 2 bits of secret data can be hidden, because nature of XOR bitwise operation. XOR operation provide the more secure and unpredictable communication than classic LBS. This method performed on to different images. Furthermore, it observed that the improved method reveals good result as the "Peak Signal to Noise Ratio (PSNR)" and "Mean Square Error (MSE)" than classic LSB method

Investigation the Success of Semidefinite Programming for the Estimating of Fuel Cost Curves in Thermal Power Plants

Accurate estimation of fuel cost curve parameters in thermal power plants is of great importance because these parameters directly influence the economic dispatch calculations. In this paper, a semidefinite programming (SDP) approach was proposed for the estimation of fuel cost functions' parameters in thermal power plants. The parameter estimation problem was designed as a minimization problem, where the objective function was accepted as the total absolute error (TAE) in the study. Also, linear, quadratic, and cubic fuel cost functions were used to estimate the fuel cost parameters. Different fuel types such as coal, oil and gas were preferred for simulation studies. The results achieved from the semidefinite programming method were compared with that of particle swarm optimization (PSO), artificial bee colony (ABC), crow search algorithm (CSA) and least error square (LES) methods, respectively. The performance of the methods were compared according to the TAE parameter. Simulation results showed that SDP method is more successful than other methods considered in this paper. Clearly, the present paper showed that SDP has a higher potential to solve parameter estimation problems