22 research outputs found
Chronic abdominal pain in a patient with Escobar Syndrome
No full textErdivanli, Basar/0000-0002-3955-8242Escobar syndrome is characterized with multiple pterygia or webs of the skin and multiple congenital anomalies. We present a 15-year-old patient with Escobar syndrome who complained of persistent blunt abdominal pain for 1 year. Preoperative evaluation confirmed the diagnosis of imperforate hymen, and the patient underwent hymenectomy under intravenous sedation. the patient's postoperative course was uneventful and her complaints resolved completely. After a 3-month follow-up, she reported having normal menstrual bleeding intervals each month without any complications. Patients with Escobar syndrome may suffer from abdominal pain due to imperforate hymen. Careful evaluation of these patients must include a complete gynaecological assessment and, if indicated, surgical treatment must be performed without delay. (C) 2014 S. Karger AG, Base
Effect of cooled hyperbaric bupivacaine on unilateral spinal anesthesia success rate and hemodynamic complications in inguinal hernia surgery
No full textCooling of hyperbaric bupivacaine to 5 A degrees C increased the density and viscosity of the solution and the success rate of unilateral spinal anesthesia, and decreased the hemodynamic complication rate
Comparison of the Effects of Minimal and High-Flow Anaesthesia on Cerebral Perfusion During Septorhinoplasty
No full textComparison of King Vision video laryngoscope and Macintosh laryngoscope: a prospective randomized controlled clinical trial
No full textUltrasound evaluation of gastric emptying and comparison with patient-reported risk factors in elective surgical patients
No full textBackground/Objectives: Despite standard preoperative fasting guidelines, residual gastric content can persist in some patients, increasing the risk of aspiration pneumonitis. Multiple patient-specific factors may predict gastric content retention, but their predictive accuracy is limited. We hypothesized that ultrasound would more reliably identify residual gastric content compared to a comprehensive questionnaire and aimed to determine the most practical approach for risk assessment in elective surgical patients. Methods: We conducted a prospective, observational study in adult patients scheduled for elective surgery at a single center. All participants adhered to an 8 h fasting period. The primary outcome was the incidence of a “full stomach” on ultrasound. Secondary outcomes included the Perlas risk classification, comparisons of established volume estimation formulas, correlations with self-reported fasting duration, agreement between questionnaire-based predictions and ultrasound findings, and the time efficiency of each method. Multivariable logistic regression and Cohen’s kappa were used for analyses. Results: Data from 404 patients were analyzed. Despite prolonged fasting, 16.3% had a full stomach by ultrasound, suggesting incomplete gastric emptying. Early satiety and cholelithiasis significantly predicted a full stomach; prolonged fasting duration and female sex were protective. Questionnaire-based predictions demonstrated fair agreement with ultrasound (kappa = 0.327). The Michiko formula often yielded negative volumes, highlighting limitations in volume estimations. Ultrasound examination (3 min median) was faster than questionnaire completion (5 min). Conclusions: Ultrasound accurately detects residual gastric content, outperforming questionnaire-based assessments. Integrating it into routine preoperative evaluation may improve patient safety, although research is needed to refine volume estimation formulas and expand feasibility for patients with positioning limitations
The Effect of Thyroid Lobe Volume on the Common Carotid Artery Blood Flow in Thyroidectomy Position
No full textBackground/Objectives: This study investigates the effect of thyroid lobe size on common carotid artery hemodynamics during thyroidectomy. While prior research has reported reduced carotid blood flow during the procedure, the impact of thyroid size remains unclear. We hypothesized that larger thyroid lobes may influence carotid flow dynamics via external compression. Methods: Adult patients undergoing elective thyroidectomy were prospectively included. Doppler ultrasonography measured carotid artery diameters and flow characteristics at three time points: before anesthesia induction, after induction, and after surgical positioning. Regional cerebral oximetry was recorded. Each carotid artery was analyzed separately. Results: Data from 202 carotid arteries (132 patients) were analyzed. Baseline carotid diameters and flow velocities were similar between patients with normal and large thyroid lobes. Anesthesia induction reduced flow velocities in all patients. After surgical positioning, patients with large thyroid lobes had significantly increased peak systolic velocity, leading to an overestimation of carotid blood flow, when using formula-based calculations. Manually traced Velocity Time Integral confirmed the increase in peak systolic velocity and a shortened systolic/diastolic ratio in these patients. Receiver operating characteristic analysis identified a thyroid lobe volume cutoff of 19.7 mL (AUC: 0.93, Sensitivity: 85%, Specificity: 98%). Regional cerebral oxygen saturation remained unchanged (p > 0.05). Conclusions: Larger thyroid lobes are associated with altered carotid flow dynamics during thyroidectomy, emphasizing diastolic flow. While these findings provide insight into thyroid-related hemodynamic changes, their applicability to patients with pre-existing carotid stenosis or peripheral artery disease remains uncertain, as our study population did not include such cases
Avaliação in vitro das propriedades antimicrobianas de vasopressores
No full textResumoJustificativa e objetivoos medicamentos administrados como perfusão intravenosa podem ser contaminados durante as várias etapas de produção ou preparação. No entanto, estudos sobre os efeitos antibacterianos de vasopressores são muito raros. Este estudo investiga a atividade antimicrobiana in vitro das formas de vasopressores usados clinicamente.Materiais e métodosatividades antimicrobianas in vitro de substâncias vasopressoras de diferentes concentrações foram investigadas com o uso da técnica de microdiluição. Os microrganismos empregados no teste foram: Escherichia coli ATCC 25922, Yersinia pseudotuberculosis ATCC 911, Pseudomonas aeruginosa ATCC 10145, Listeria monocytogenes ATCC 43251, Enterococcus faecalis ATCC 29212, Staphylococcus aureus ATCC 25923, Bacillus cereus 702 Roma, Mycobacterium smegmatis ATCC607, Candida albicans ATCC 60193 e Saccharomyces cerevisiae RSKK 251. Os ensaios antibacterianos foram feitos em caldo de cultura Mueller‐Hinton (pH 7,3) e os ensaios antifúngicos em solução tampão de base nitrogenada para levedura (pH 7,0).Resultadosduas preparações diferentes de dopamina mostraram atividade antimicrobiana. Nenhuma outra substância do estudo mostrou qualquer atividade antimicrobiana.Conclusõesem nossa opinião, os efeitos antibacterianos da dopamina podem ser vantajosos para inibir a propagação de contaminação bacteriana durante a preparação das soluções para perfusão. Contudo, salientamos a importância do seguimento rigoroso das diretrizes de esterilização dos equipamentos e de assepsia durante todos os procedimentos feitos em unidades de terapia intensiva
In vitro evaluation of antimicrobial features of vasopressors
No full textAbstractBackgroundDrugs administered as intravenous infusion may be contaminated during several stages of production or preparation. However studies focusing on antibacterial effects of vasopressor drugs are very rare. This study investigates the in vitro antimicrobial activity of the clinically used forms of vasopressors.Materials and methodsIn vitro antimicrobial activities of vasopressor drugs of different concentrations were investigated by using the micro dilution technique. Microorganisms used in the test were Escherichia coli ATCC 25922, Yersinia pseudotuberculosis ATCC 911, Pseudomonas aeruginosa ATCC 10145, Listeria monocytogenes ATCC 43251, Enterococcus faecalis ATCC 29212, Staphylococcus aureus ATCC 25923, Bacillus cereus 702 Roma, Mycobacterium smegmatis ATCC607, Candida albicans ATCC 60193, and Saccharomyces cerevisiae RSKK 251. Antibacterial assays were performed in Mueller-Hinton broth at pH 7.3 and antifungal assays were performed in buffered Yeast Nitrogen Base at pH 7.0.ResultsTwo different dopamine preparations showed antimicrobial activity. No other study drug showed any antimicrobial activity.ConclusionsIn our opinion, dopamine's antibacterial effects may be advantageous for inhibiting the spread of bacterial contamination during the preparation of the infusion solutions. However, it is important that strict guidelines regarding the need for sterile equipment and deliverables be adhered to during all procedures performed in the intensive care units
Effect of sugammadex on rocuronium induced changes in pancreatic mast cells
No full textErdivanli, Basar/0000-0002-3955-8242; yilmaz, adnan/0000-0003-4842-1173Mast cells play a vital role in hypersensitivity reactions. Rocuronium is known to cause mast cell mobilization, hypersensitivity, and pancreatitis. the aim of this study was to investigate the effects of sugammadex on pancreatic changes due to rocuronium. A total of 42 Sprague-Dawley male rats were divided into six equal groups to receive either rocuronium 1mg/kg intravenously (i.v., R group), rocuronium 1mg/kg+sugammadex 16mg/kg i.v. (RS16 group), rocuronium 1mg/kg+sugammadex 96mg/kg i.v. (RS96 group), sugammadex 16mg/kg (S16), sugammadex 96mg/kg i.v. (S96 group), or 0.9% sodium chloride (control group). Sugammadex was administered 5s later following rocuronium. in R group, mast count was higher, and the distribution rate of granules and nuclear changes were different compared with other groups. Distribution rate of granules in groups S16 and S96 were similar to the control group and lower compared with other groups. the amount of mast cells and granule density in groups RS16 and RS96 was lower compared with R group. the amount of mast cells in groups RS16 and RS96 was significantly lower compared with other treatment groups. These results suggest that sugammadex may have an inhibitory effect on mobilization and morphological changes in pancreatic mast cells induced by administration of rocuronium and sugammadex in rats.Department of Histology and Embryology, Medical Faculty of Recep Tayyip Erdogan University, TurkeyRecep Tayyip Erdogan UniversityThis work was financially supported by all authors. No external funding was obtained. the animals, materials, and drugs were obtained by the first author as research fund from his institution (Department of Histology and Embryology, Medical Faculty of Recep Tayyip Erdogan University, Turkey)
