Search

Maintaining high indoor air quality in hospitals is important for protecting the health of both personnel and patients. In this study, the results of air quality monitoring carried out in the intensive care unit of a hospital in Bolu, Turkey, are discussed. Air disinfection devices were used to reduce the concentrations of bacteria. A 4-week sampling programme was implemented. In the first and the last weeks of the sampling, the disinfection devices were turned off, while in the second and third weeks, they were turned on. Bioaerosols were collected, and their indoor levels were determined by counting all plate colonies and bacterial types were identified by matrix-assisted laser desorption/ionisation–time of flight mass spectrometry. The highest levels of bacteria were measured in the mornings and before the air disinfection devices were turned on. Doctors did their rounds at approximately nine to ten o’clock. The dominant bacteria in the air samples examined were Staphylococcus hominis, Micrococcus luteus, Staphylococcus capitis, Staphylococcus epidermidis, Corynebacterium afermentans and Staphylococcus haemolyticus. The results showed that the air disinfection devices were effective in decreasing the concentration of microorganisms between 83.4 and 55% in the intensive care unit, which is very important for the healthcare staff and patients, particularly during pandemics.

People spend most of their time in enclosed spaces (e.g., hospital, houses, office buildings, public transportation, and schools). The coronavirus in late 2019 has rapidly spread throughout the world. After the pandemic, people started to spend more time in indoor environments, especially in hospitals. In this study, air quality monitoring was carried out in the Intensive Care Unit of a hospital in Bolu - Turkey. This is the first comprehensive study done in Turkey. In this study, PM2.5, PM10, temperature, and relative humidity parameters affecting indoor air quality were monitored instantly for one month with a Wireless Sensors Network-based system. By the results of the study, the maximum concentration of these parameters except relative humidity was higher than the limited by accepted values parameters by the United States Environmental Protection Agency (EPA), The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), and the World Health Organization (WHO).

Aim Systemic inflammation has a crucial role in the pathogenesis and mortality of Coronavirus disease 2019 (COVID-19). Multi-inflammatory index (MII) is a novel index related with systemic inflammation. In this study, we investigated the relationship between MII and in-hospital mortality in COVID-19 patients admitted to the intensive care unit (ICU). Methods We retrospectively analyzed the medical records of COVID-19 patients followed-up in the ICU of our institution between 01.04.2020 and 01.10.2021. Patients were classified into two groups according to mortality status as survivors and non-survivors. Various inflammatory parameters of the groups were compared and their efficacy in predicting mortality was investigated. Results Out of 348 study patients, 86 cases (24.7%) were in the survived group and 262 cases (75.3%) were in the dead group. The median age of the mortal group was significantly higher than that of the survived group (65.5 vs 76, P Conclusion MII, a new combination of Neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP), is a simple and practical biomarker that can help us in the prediction of mortality in COVID-19 patients followed-up in the ICU.

Objectives: Fiberoptic bronchoscopy (FOB) is a useful method for ventilator-associated pneumonia (VAP), aspiration, and atelectasis, especially in intensive care units. (ICU) We aimed to investigate the effect of FOB on intracranial pressure by ultrasonographic optic nerve sheath diameter (uONSD) during different sedation protocols in a tertiary ICU. Methods: Prospective randomized study included the patients with two groups as superficial (Group M; midazolam) and deep sedation (Group P; propofol). FOB was performed for VAP or aspiration and intracranial hypertension (ICH) was measured with uONSD, noninvasively. The values of uONSD were noted pre-procedure, on sedation, 1st – 5th, and 15th minute of the procedure. In addition, mean arterial pressures (MAP), oxygen saturation, and heart rate values were recorded from the monitor. Results: The mean age and indications of FOB for 33 patients as Group M (n=17) and Group P (n=16) were similar to each other. ONSD was increased with the procedure in both groups but in group P it was stabilized from the 5th minutes of FOB whereas became higher progressively in group M (p

The study aims to examine the effect on intracranial pressure by calculating the optic nerve sheath diameter (ONSD) using ultrasound in patients who underwent suspension direct laryngoscopy.Thirty-three patients who underwent suspension direct laryngoscopy were included in this prospective observational study. ONSD measurement was performed using a high-frequency linear probe. The ONSD basal (T0) value was determined using ultrasound in the supine position before the induction. Ultrasonography was used to record ONSD in the Boyce Jackson position (T1) just before inserting the laryngeal blade, in the Boyce Jackson position just before removing the laryngeal blade (T2), and in the supine position (T3) just before extubation.A statistically significant rise (p 0.001) was seen between the patients' baseline ONSD values and the values at T1, T2, and T3. The optic nerve sheat diameter level recorded prior to withdrawing the laryngeal blade (T2) was considerably greater than the ONSD level calculated instantly before insertion of the laryngeal blade (T1) (p 0.001). The ONSD value prior to extubation (T3) following the removal of the laryngeal blade was considerably smaller than the ONSD value prior removing the laryngeal blade (T2) (p 0.001).This study found that when the laryngeal blade is mounted during the suspension direct laryngoscopy surgery, there is a significant increase in ultrasonographically measured ONSD and increased the ONSD even further during the time the mouth gag was remained in situ. This is the first research to indicate that measuring ONSD with ultrasonography during suspension direct laryngoscopy raises intracranial pressure.

Aim: Abdominoplasty is a common cosmetic procedure that is one of the most painful aesthetic surgery and has been used increasingly in recent years. Ibuprofen is a non-steroidal anti-inflammatory (NSAID) with antipyretic and analgesic effects. In this study, we aimed to evaluate the effectiveness of the intravenous (IV) form of ibuprofen on postoperative pain control and opioid requirement in patients who underwent abdominoplasty. Methods: The patients were divided into 3 groups as Group 1 (Tramadol), Group 2 (Ibuprofen) and Group 3 (Tramadol HCL + Ibuprofen). Tramadol HCL was given continuous infusion at a concentration of 4mg / ml via IV Patient Controlled Analgesia to Group 1. Ibuprofen800 mg IV was administered to Group 2 at 30 minutes before the end of the operation. Patients were followed up by administering 800 mg IV every 6 hours for 24 hours. In Group 3, 30 minutes before the end of the operation, tramadol was administered via PCA with continuous infusion at a concentration of 4mg / ml and 800 mg IV ibuprofen was administered as 4x1. Results: VAS values ​​were found to be significantly lower in Group 3 compared to Group 2 at every hour and at the 4th hour compared to Group 1. Group 3 was found to be significantly lower than Group 1 in total analgesic consumption in all time zones. Conclusion: We think that IV ibuprofen, which will be given in addition to tramadol after abdominoplasty, can provide effective analgesia and reduce analgesic consumption.

Objectives: Total knee arthroplasty (TKA) is an operation that causes severe postoperative pain. Adductor canal block (ACB) is separated from the other peripheral blocks as a method that can provide analgesia by sensory blockade only. The aim of this study was to compare the analgesic effect of morphine-bupivacaine with pure bupivacaine in USGguided ACB after TKA. Methods: Sixty patients aged between 40-80 years with ASA I-III physical status who were scheduled for TKA surgery in our hospital were included in this prospective randomized study. Patients were randomly divided into two groups as Group BM (bupivacaine+morphine) and Group B (bupivacaine) by closed envelope method, and then the groups were compared with each other. Results: In Group BM, compared to Group B, there was a significant decrease in visual analogue scale (VAS) values during rest and movement at 8th hour, 12-24 hours time zone analgesic consumption and additional analgesia usage. Conclusion: We conclude that the morphine added to bupivacaine in the adductor canal block reduces the VAS value at 8th hour and analgesic consumption.

WOS:000476622500010 PubMed: 31310470 Objective: To investigate the effects of preoperative anxiety relieving on electrophysiological changes in patients undergoing off-pump coronary artery bypass surgery. Methods: A total of 61 patients at ASA III risk group in the age range of 18-65 years were enrolled in the present study. Patients were randomly divided into two groups. Group S (Sedation group) was administered 0.04 mg/kg lorazepam per os (PO) twice before the operation. Group C (control group) was not administered with any anxiolytic premedication. State Trait Anxiety Inventory (STAI-I) and Beck Anxiety Inventory (BAI) were used to evaluate the level of anxiety. Electrocardiography (ECG), pulse oximeter and standard monitoring were performed for each patient. QT and P dispersions in each derivation of all ECGs were calculated. Results: Preoperative STAI-I scores were significantly lower in sedation group compared to the controls. Mean values of QT dispersion measured before induction, at the 1st minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.024; P=0.027; P=0.001; P=0.033, respectively). The mean values of P dispersion measured before induction, at the 3rd minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.001; P=0.020; P=0.023; P=0.005, respectively). Conclusion: Elevated anxiety levels in patients undergoing coronary bypass surgery have a negative effect through prolonged QT and P-wave dispersion times. Anxiolytic treatment before surgery may be useful to prevent ventricular and atrial arrhythmias and associated complications through decreasing the QT and P-wave dispersion duration.

The aim of this study is to investigate the effects of bispectral index-controlled use of magnesium on propofol consumption, periprocedural hemodynamic response and patient comfort.A total of 60 patients were enrolled in the study. In Group 1 (magnesium), a single dose 50 mg/kg magnesium sulfate diluted with 100 mL 0.9% NaCl was administered 10 minutes before the beginning of the procedure. Initially bolus dose of 0.5 mg/kg propofol was applied. The maintenance dose of propofol was 60 mcg/kg/min. During the procedure, the propofol infusion was increased by titration until the bispectral index (BIS) value of 70 was achieved. In Group 2 (saline), 100 ml 0.9% NaCl was administered 10 minutes before the beginning of the procedure. The bolus and maintenance doses of propofol, and target BIS values were the same as those in Group 1.When BIS values were compared between the groups, the initial BIS values in the magnesium group (Group 1) were significantly higher than those of the saline group (Group 2) (p0.05). The time to reach BIS 70 was significantly shorter in the magnesium group (p0.05). Propofol consumption was greater in Group 2 than in Group 1 (p0.05). The time to reach BIS 70 was significantly shorter in Group 1 (p0.05). No significant difference was found between the groups in terms of patient- and endoscopist-satisfaction (p0.05).The use of magnesium in addition to propofol may be an efficient and reliable option to reduce the drug consumption during colonoscopic interventions.Bu çalışmanın amacı, bispektral indeks kontrollü magnezyum kullanımının propofol tüketimi, periprosedürel hemodinamik cevap ve hasta konforu üzerine etkilerini araştırmaktır.Çalışmaya toplam 60 hasta dahil edildi. Grup I’de (magnezyum), işlem başlamadan 10 dakika önce tek bir doz 50 mg/kg magnezyum sülfat (100 mL %0,9 NaCl ile seyreltilmiş) verildi. İşlem başlangıcında 0,5 mg/kg propofol bolusu uygulandı. Propofolün idame dozu 60 mcg/kg/dk. idi. İşlem sırasında propofol infüzyonu bispektral indeks (BIS) değeri 70 olana kadar titrasyonla arttırıldı. Grup 2 de (salin), işlem başlamadan 10 dk. önce 100 ml %0,9 NaCl uygulandı. Propofol bolus ve idame dozları ve hedef BIS değerleri Grup 1’deki ile aynıydı.BIS değerleri gruplar arasında karşılaştırıldığında, Magnezyum grubundaki (Grup 1) ilk BIS değerleri salin grubundan (Grup 2) anlamlı derecede yüksek idi (p0,05). BIS 70’e ulaşma süresi Magnezyum grubunda anlamlı derecede düşüktü (p 0,05). Propofol tüketimi Grup 2’de grup 1’den daha fazlaydı (p0,05). BIS 70’e ulaşma süresi Grup 1’de anlamlı derecede düşüktü (p0,05). Gruplar arasında hasta ve endoskopist memnuniyeti açısından anlamlı fark bulunmadı (p0,05).Propofole ilaveten magnezyum kullanımı kolonoskopik müdahalelerde ilaç tüketimini azaltmak için etkili ve güvenilir bir seçenek olabilir.

Aim: To investigate the protective efficacy of magnesium sulphate in a model of rat liver ischemia-reperfusion (I/R) injury. Method: 32 adult female Wistar-Albino rats (250 to 350 g) were used in this experimental study. Rats were divided into 4 groups according to liver ischemia and magnesium sulfate application methods. Group 1 (C); control, group 2 (M); magnesium sulphate, group 3 (I/R); liver I/R, group 4 (I/R+M); I/R + magnesium sulphate treated. The blood samples were centrifuged for the study of aspartate aminotransferase (AST), alanine aminotransferase, prothrombin time (PT), international normalized ratio (INR) troponin I, total antioxidant status (TAS), total oxidant status (TOS) assays. The livers of the animals were removed at the end of the study and samples were taken for histopathological examination. Results: AST and INR values were significantly decreased in I/R+M group compared to I/R group. There was no significant difference in ALT values of the groups. Although not statistically significant, the TAS values were increased in I/R + M group compared to I/R group rats. In addition, the value of TOS was found to be lower in I/R + M group rats. In the histopathological examination, the mean values of apoptosis and necrosis were lower in the IR+M group compared to the IR group. Conclusion: The main finding of the present study suggested that magnesium sulphate pretreatment moderately decreased the liver damage through its anti-inflammatory and anti-oxidant effects in a rat model of liver I/R.

Background: Olfactory and taste sensations have a high impact on the quality of life. Impaired olfactory and taste functions may have a negative effect on physical and mental well-being, personal hygiene, and nutritional satisfaction, leading to the occurrence of depressive symptoms and impaired quality of life. Therefore, the recovery period of patients with disturbed olfactory and taste functions may be prolonged, and return to active life may be delayed. We designed this study to determine whether on-pump and off-pump coronary artery bypass grafting (CABG) surgeries have any effects on olfactory and taste functions and compare these functions between the surgical groups. Methods: A total of 60 patients, who underwent elective isolated first-time CABG, were included in this study. Patients were divided into two groups as Off-Pump and On-Pump CABG groups with 30 patients in each group. In addition to patients' primary clinical and laboratory data, olfactory and taste functions were evaluated pre- and postoperatively in both groups separately, and then these functions were compared between the groups. Olfactory functions were evaluated by the Brief Smell Identification Test, while taste functions by the Burghart Taste test. Results: Olfactory functions significantly were disrupted in the postoperative period in patients undergoing on-pump CABG (P value < .05), while these functions significantly were not affected in patients undergoing off-pump CABG (P value > .05). During the preoperative period, advanced age and smoking were detected to be independent predictors of impaired olfactory function for the study population. During the postoperative period, smoking, amount of postoperative bleeding and serum low-density lipoprotein (LDL) level were found to be independent predictors of impaired olfactory function for just the On-Pump CABG Group. In both groups, no significant deterioration in taste functions occurred during the postoperative period (P value > .05). Conclusion: Our study demonstrated that olfactory function was impaired in patients, who underwent on-pump CABG in the postoperative period, and significant impairment in taste function was present in neither off-pump nor on-pump CABG patients. However, the results of our study should be supported by more comprehensive, prospective, randomized controlled trials with more extensive patient series and by further tests.

Objectives: To compare the effects of low and high flow desflurane anaesthesia on hemogram parameters in lower abdominal surgeries. Methods: Sixty female patients who underwent lower abdominal surgery under general anaesthetic were included in this prospective study. Patients were randomly divided into two groups, as Group I (low flow) and Group II (high flow), and then compared with each other according to their demographic features and hemogram parameters. Results: Groups were statistically similar, and there were no significant differences in terms of demographic data between the groups (p>0.05). The comparisons of hemogram parameters within the groups showed that there were significant differences in plateletcrit, platelet-lymphocyte ratio and neutrophil-lymphocyte ratio values in Group I (p

Objective We aimed to evaluate the effect of an increase in intracranial pressure (ICP) due to sympatho-adrenergic response caused by mouth gag and tongue depressor during adenotonsillectomy by measuring the optic nerve sheath diameter (ONSD) by ultrasonographic method. Methods Forty patients (age range 3–12 years) who underwent adenotonsillectomy were included in the study. All patients underwent surgery under general anesthesia with endotracheal intubation. Boyle-Davis mouth gag was used during the procedure. ONSD measurement was performed and a high-frequency linear probe. All ONSD measurements were performed by a single investigator experienced in the use of ultrasound. Ultrasonographically measured ONSD before induction was accepted as baseline (T0) value. Immediately after insertion of the mouth gag (T1), just before removal of the mouth gag (T2), and just before extubation (T3), ultrasonographic measurements of ONSD were recorded. Results When patients' baseline ONSD values were compared with the values obtained in T1, T2, T3, and a statistically significant increase was detected. The ONSD value measured before removing the mouth gag (T2) was significantly higher than the ONSD value measured immediately after the insertion of the mouth gag (T1). The ONSD value measured just before extubation (T3) and after removal of the mouth gag was significantly lower than the ONSD value (T2) measured just before removal of the mouth gag. When heart rate, mean arterial pressure (MAP), peripheral oxygen saturation (SpO2) values of T0, T1, T2, T3 were compared, any statistically significant difference was not observed. When end-tidal carbon dioxide level (etCO2) and peak inspiratory pressure (PIP) values of T1, T2, T3 were compared, any statistically significant difference was not observed. Conclusion This study showed that the Boyle-Davis mouth gag used during the adenotonsillectomy operation resulted in a significant increase in the diameter of the optic nerve sheath measured ultrasonographically and increased the ONSD even further during the time the mouth gag was remained in situ. In children with intracranial pathologies who will undergo adenotonsillectomy or those with increased ICP-related risk factors, the risks that may arise from the effect of the Boyle-Davis mouth gag on ICP should be considered.

Aim: Inflammatory markers, such as the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), derived from a complete blood count have recently attracted attention as potential markers of morbidity and mortality in various diseases. The aim of the present study was to assess the usefulness of the NLR and PLR as markers of hospital stay and mortality of patients in intensive care units (ICUs). Methods: Patients treated in the ICU of our institution between October 2016 and August 2017 were enrolled in the study. After obtaining approval from the institutional committee, patient data were sourced from the institution’s computerized database and retrospectively analyzed. The patients were assigned to 2 groups according to the outcomes: survivors and deceased. Results: The NLR of survivors and deceased patients was 2.06 (1.18-21.68) and 10.42 (2.85-48.2), respectively. The NLR was significantly elevated in deceased patients as compared with that of survivors ( P < .001). Similarly, the median PLR of patients in the deceased group (268.9 [150-3000]) was significantly higher than that of patients in the survivor group (55.7 [11.8-152.5]). The difference in the PLR between groups was significant ( P < .001). Conclusion: Both the NLR and PLR, as well as C-reactive protein, predicted mortality in this critically ill population. The PLR and NLR are easy-to-measure, inexpensive markers. Physicians should be aware of elevations in PLR and NLR in patient care in ICUs.

Background and objectives: Even a small amount of bleeding during endoscopic sinus surgery can corrupt the endoscopic field and complicate the procedure. Various techniques, including induced hypotension, can minimize bleeding during endoscopic sinus surgery. The aim of this study was to compare the surgical vision quality, haemodynamic parameters, postoperative pain, and other effects of magnesium, a hypotensive agent, with that of dexmedetomidine, which was initially developed for short-term sedation in the intensive care unit but also is an alpha 2 agonist sedative. Method: 60 patients between the ages of 18 and 45 years were divided into either the magnesium group (Group M) or the dexmedetomidine group (Group D). In Group M, magnesium sulphate was given at a pre-induction loading dose of 50 mg kg−1 over 10 min and maintained at 15 mg kg−1 h−1; in Group D, dexmedetomidine was given at 1 mcg kg−1 10 min before induction and maintained at 0.6 mcg kg−1 h−1. Intraoperatively, the haemodynamic and respiratory parameters and 6-point intraoperative surgical field evaluation scale were recorded. During the postoperative period, an 11-point numerical pain scale, the Ramsay sedation scale, the nausea/vomiting scale, the adverse effects profile, and itching parameters were noted. Results: Group D showed a significant decrease in intraoperative surgical field evaluation scale scale score and heart rate. The average operation time was 50 min, and Group M had a higher number of prolonged surgeries. No significant difference was found in the other parameters. Conclusions: Due to its reduction of bleeding and heart rate in endoscopic sinus surgery and its positive impacts on the duration of surgery, we consider dexmedetomidine to be a good alternative to magnesium. Resumo: Justificativa e objetivo: Uma quantidade, mesmo pequena, de sangramento durante a cirurgia endoscópica pode alterar o campo endoscópico e dificultar o procedimento. Várias técnicas, incluindo hipotensão induzida, podem minimizar o sangramento durante a cirurgia endoscópica. O objetivo deste estudo foi comparar a qualidade da visibilidade cirúrgica, os parâmetros hemodinâmicos, a dor no período pós-operatório e outros efeitos do sulfato de magnésio, um agente hipotensor, com os da dexmedetomidina, inicialmente desenvolvida para sedação em curto prazo em unidade de terapia intensiva, mas que também é um sedativo agonista alfa-2. Métodos: Foram alocados 60 pacientes entre 18 e 45 anos em dois grupos: Grupo M (magnésio) e Grupo D (dexmedetomidina). No Grupo M, sulfato de magnésio foi administrado pré-indução a uma dose de carga de 50 mg kg−1 por 10 minutos e mantida com 15 mg kg−1 h−1; no Grupo D, dexmedetomidina foi administrada a uma dose de 1 mcg kg−1 10 minutos antes da indução e mantida com 0,6 mcg kg−1 h−1. No período intraoperatório, foram registrados os parâmetros hemodinâmicos e respiratórios e a avaliação do campo cirúrgico com uma escala de seis pontos. Durante o período pós-operatório foram registrados os valores da escala numérica de 11 pontos para avaliar a dor, a escala de sedação de Ramsay, a escala de avaliação de náusea/vômito, o perfil dos efeitos adversos e pruridos. Resultados: O Grupo D apresentou redução significativa da frequência cardíaca e do escore na escala de avaliação do campo cirúrgico intraoperatório. A média do tempo cirúrgico foi de 50 minutos e o Grupo M apresentou um número maior de cirurgias prolongadas. Não houve diferença significativa em outros parâmetros. Conclusão: Por causa da redução da taxa de sangramento e da frequência cardíaca em cirurgia endoscópica e dos impactos positivos sobre a duração da cirurgia, consideramos dexmedetomidina como melhor opção que o sulfato de magnésio. Keywords: Endoscopic sinus surgery, Magnesium, Dexmedetomidine, Hypotension, Palavras-chave: Cirurgia endoscópica sinusal, Sulfato de Magnésio, Dexmedetomidina, Hipotensão

ResumenIntroducción y objetivoUna cantidad, aunque sea pequeña, de sangrado durante la cirugía endoscópica puede alterar el campo endoscópico y dificultar el procedimiento. Varias técnicas que incluyen hipotensión inducida pueden minimizar el sangrado durante la cirugía endoscópica. El objetivo de este estudio fue comparar la calidad de la visibilidad quirúrgica, los parámetros hemodinámicos, el dolor en el período postoperatorio y otros efectos del sulfato de magnesio, que es un agente hipotensor, con los de la dexmedetomidina, inicialmente desarrollada para la sedación a corto plazo en la unidad de cuidados intensivos, pero que también es un sedante agonista alfa-2.Método60 pacientes con edades entre 18 y 45 años se dividieron en 2 grupos: grupo M (magnesio) y grupo D (dexmedetomidina). En el grupo M, el sulfato de magnesio fue administrado antes de la inducción en dosis de carga de 50mgkg−1 por 10min y se mantuvo con 15mgkg−1h−1; en el grupo D, la dexmedetomidina fue administrada con una dosis de 1μgkg−1 durante 10min antes de la inducción y se mantuvo con 0,6μgkg−1h−1. En el período intraoperatorio se registraron los parámetros hemodinámicos y respiratorios y la evaluación del campo quirúrgico con una escala de 6 puntos. Durante el postoperatorio también se registraron la escala numérica de 11 puntos para evaluar el dolor, la escala de sedación de Ramsay, la escala de evaluación de náuseas/vómito, el perfil de los efectos adversos y los pruritos.ResultadosEl grupo D tuvo una reducción significativa de la frecuencia cardíaca y de la puntuación en la escala de evaluación del campo quirúrgico intraoperatorio. La media del tiempo quirúrgico fue de 50min, y el grupo M tuvo un número mayor de cirugías prolongadas. No hubo diferencia significativa en otros parámetros.ConclusiónDebido a la reducción de la tasa de sangrado y de la frecuencia cardíaca en la cirugía endoscópica y a los impactos positivos sobre la duración de la cirugía, consideramos la dexmedetomidina como una buena alternativa para el magnesio.AbstractBackground and objectivesEven a small amount of bleeding during endoscopic sinus surgery can corrupt the endoscopic field and complicate the procedure. Various techniques, including induced hypotension, can minimize bleeding during endoscopic sinus surgery. The aim of this study was to compare the surgical vision quality, haemodynamic parameters, postoperative pain, and other effects of magnesium, a hypotensive agent, with that of dexmedetomidine, which was initially developed for short-term sedation in the intensive care unit but also is an alpha 2 agonist sedative.Method60 patients between the ages of 18 and 45 years were divided into either the magnesium group (Group M) or the dexmedetomidine group (Group D). In Group M, magnesium sulphate was given at a pre-induction loading dose of 50mgkg−1 over 10min and maintained at 15mgkg−1h−1; in Group D, dexmedetomidine was given at 1μgkg−1 10min before induction and maintained at 0.6μgkg−1h−1. Intraoperatively, the haemodynamic and respiratory parameters and 6-point intraoperative surgical field evaluation scale were recorded. During the postoperative period, an 11-point numerical pain scale, the Ramsay sedation scale, the nausea/vomiting scale, the adverse effects profile, and itching parameters were noted.ResultsGroup D showed a significant decrease in intraoperative surgical field evaluation scale score and heart rate. The average operation time was 50min, and Group M had a higher number of prolonged surgeries. No significant difference was found in the other parameters.ConclusionsDue to its reduction of bleeding and heart rate in endoscopic sinus surgery and its positive impacts on the duration of surgery, we consider dexmedetomidine to be a good alternative to magnesium.

Background and objectives: Even a small amount of bleeding during endoscopic sinus surgery can corrupt the endoscopic field and complicate the procedure. Various techniques, including induced hypotension, can minimize bleeding during endoscopic sinus surgery. The aim of this study was to compare the surgical vision quality, haemodynamic parameters, postoperative pain, and other effects of magnesium, a hypotensive agent, with that of dexmedetomidine, which was initially developed for short-term sedation in the intensive care unit but also is an alpha 2 agonist sedative. Method: 60 patients between the ages of 18 and 45 years were divided into either the magnesium group (Group M) or the dexmedetomidine group (Group D). In Group M, magnesium sulphate was given at a pre-induction loading dose of 50 mg kg−1 over 10 min and maintained at 15 mg kg−1 h−1; in Group D, dexmedetomidine was given at 1 mcg kg−1 10 min before induction and maintained at 0.6 mcg kg−1 h−1. Intraoperatively, the haemodynamic and respiratory parameters and 6-point intraoperative surgical field evaluation scale were recorded. During the postoperative period, an 11-point numerical pain scale, the Ramsay sedation scale, the nausea/vomiting scale, the adverse effects profile, and itching parameters were noted. Results: Group D showed a significant decrease in intraoperative surgical field evaluation scale scale score and heart rate. The average operation time was 50 min, and Group M had a higher number of prolonged surgeries. No significant difference was found in the other parameters. Conclusions: Due to its reduction of bleeding and heart rate in endoscopic sinus surgery and its positive impacts on the duration of surgery, we consider dexmedetomidine to be a good alternative to magnesium. Justificativa e objetivo: Uma quantidade, mesmo pequena, de sangramento durante a cirurgia endoscópica pode alterar o campo endoscópico e dificultar o procedimento. Várias técnicas, incluindo hipotensão induzida, podem minimizar o sangramento durante a cirurgia endoscópica. O objetivo deste estudo foi comparar a qualidade da visibilidade cirúrgica, os parâmetros hemodinâmicos, a dor no período pós-operatório e outros efeitos do sulfato de magnésio, um agente hipotensor, com os da dexmedetomidina, inicialmente desenvolvida para sedação em curto prazo em unidade de terapia intensiva, mas que também é um sedativo agonista alfa-2. Métodos: Foram alocados 60 pacientes entre 18 e 45 anos em dois grupos: Grupo M (magnésio) e Grupo D (dexmedetomidina). No Grupo M, sulfato de magnésio foi administrado pré-indução a uma dose de carga de 50 mg kg−1 por 10 minutos e mantida com 15 mg kg−1 h−1; no Grupo D, dexmedetomidina foi administrada a uma dose de 1 mcg kg−1 10 minutos antes da indução e mantida com 0,6 mcg kg−1 h−1. No período intraoperatório, foram registrados os parâmetros hemodinâmicos e respiratórios e a avaliação do campo cirúrgico com uma escala de seis pontos. Durante o período pós-operatório foram registrados os valores da escala numérica de 11 pontos para avaliar a dor, a escala de sedação de Ramsay, a escala de avaliação de náusea/vômito, o perfil dos efeitos adversos e pruridos. Resultados: O Grupo D apresentou redução significativa da frequência cardíaca e do escore na escala de avaliação do campo cirúrgico intraoperatório. A média do tempo cirúrgico foi de 50 minutos e o Grupo M apresentou um número maior de cirurgias prolongadas. Não houve diferença significativa em outros parâmetros. Conclusão: Por causa da reducção da taxa de sangramento e da frequência cardíaca em cirurgia endoscópica e dos impactos positivos sobre a duração da cirurgia, consideramos dexmedetomidina como melhor opção que o sulfato de magnésio Introducción y objetivo: Una cantidad, aunque sea pequeña, de sangrado durante la cirugía endoscópica puede alterar el campo endoscópico y dificultar el procedimiento. Varias técnicas que incluyen hipotensión inducida pueden minimizar el sangrado durante la cirugía endoscópica. El objetivo de este estudio fue comparar la calidad de la visibilidad quirúrgica, los parámetros hemodinámicos, el dolor en el período postoperatorio y otros efectos del sulfato de magnesio, que es un agente hipotensor, con los de la dexmedetomidina, inicialmente desarrollada para la sedación a corto plazo en la unidad de cuidados intensivos, pero que también es un sedante agonista alfa-2. Método: 60 pacientes con edades entre 18 y 45 años se dividieron en 2 grupos: grupo M (magnesio) y grupo D (dexmedetomidina). En el grupo M, el sulfato de magnesio fue administrado antes de la inducción en dosis de carga de 50 mg kg−1 por 10 min y se mantuvo con 15 mg kg−1 h−1; en el grupo D, la dexmedetomidina fue administrada con una dosis de 1 µg kg−1 durante 10 min antes de la inducción y se mantuvo con 0,6 µg kg−1 h−1. En el período intraoperatorio se registraron los parámetros hemodinámicos y respiratorios y la evaluación del campo quirúrgico con una escala de 6 puntos. Durante el postoperatorio también se registraron la escala numérica de 11 puntos para evaluar el dolor, la escala de sedación de Ramsay, la escala de evaluación de náuseas/vómito, el perfil de los efectos adversos y los pruritos. Resultados: El grupo D tuvo una reducción significativa de la frecuencia cardíaca y de la puntuación en la escala de evaluación del campo quirúrgico intraoperatorio. La media del tiempo quirúrgico fue de 50 min, y el grupo M tuvo un número mayor de cirugías prolongadas. No hubo diferencia significativa en otros parámetros. Conclusión: Debido a la reducción de la tasa de sangrado y de la frecuencia cardíaca en la cirugía endoscópica y a los impactos positivos sobre la duración de la cirugía, consideramos la dexmedetomidina como una buena alternativa para el magnesio.

Objectives. The aim of this study was to explore effect of a combination of pregabalin and dexamethasone on pain control after septoplasty operations. Methods. In this study, 90 patients who were scheduled for septoplasty under general anesthesia were randomly assigned into groups that received either placebo (Group C), pregabalin (Group P), or pregabalin and dexamethasone (Group PD). Preoperatively, patients received either pregabalin 300 mg one hour before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain treatment included tramadol and diclofenac sodium 30 minutes before the end of the operation. Numeric rating scale (NRS) for pain assessment, side effects, and consumption of tramadol, pethidine, and ondansetron were recorded. Results. The median NRS score at the postoperative 0 and the 2nd h was significantly higher in Group C than in Group P and Group PD ( for both). The 24 h tramadol and pethidine, consumptions were significantly reduced in Groups P and PD compared to Group C (). The incidence of blurred vision was significantly higher in Group PD compared to Group C within both 0–2 h and 0–24 h periods (, resp.). Conclusions. We conclude that administration of 300 mg pregabalin preoperatively may be an adequate choice for pain control after septoplasty. Addition of dexamethasone does not significantly reduce pain in these patients.

To evaluate the efficacy of intraarticular injection of ketamine or ketamine plus levobupivacaine on post-operative analgesia in patients undergoing arthroscopic meniscectomy.A prospective, randomized, double-blind study was performed on 60 patients aged 18-65 years who planned to undergo elective arthroscopic meniscectomy. The patients were divided into three groups: the ketamine group (n = 20) received 1.0 mg/kg of intraarticular ketamine in 20 ml of normal saline, the ketamine-levobupivacaine group (n = 20) received 0.5 mg/kg of intraarticular ketamine plus 50.0 mg of 0.25 % levobupivacaine in 20 ml of normal saline, and the control group (n = 20) received 20 ml of intraarticular normal saline. A visual analogue scale (VAS) was used to determine the efficacy of analgesia at 1, 2, 4, 6, 8, 12, and 24 h post-operatively.There were statistically significant differences in the median VAS scores among the three groups according to Bonferroni adjustment at all time points (p0.01), with the exception of 6 and 24 h post-operatively. The median VAS scores at 1, 2, and 4 h post-operatively were higher in the control group than in the two treatment groups (p0.001). The median VAS scores in the control group at 1, 2, 4, 6, 8, and 12 h post-operatively and those in the ketamine group at 4, 8, and 12 h post-operatively were significantly higher than those in the ketamine-levobupivacaine group (p0.05).Intraarticular ketamine provides effective post-operative analgesia. Addition of intraarticular levobupivacaine to ketamine may provide better amelioration of pain after outpatient arthroscopic meniscectomy.

Introduction: This study determined whether coronary artery bypass grafting (CABG) surgery has any effect on olfactory function, employing the Brief Smell Identification Test (B-SIT). Material and methods: All the participants were informed preoperatively about the B-SIT test and the mode of its application. The test was performed by each patient preoperatively (d0) as well as 1 (d1) and 3 (d3) days following the surgery. C-reactive protein (CRP) levels were recorded at the same time as the smell test. Results: This prospective study included 45 patients. The mean age was 67 ± 7.55, and the group was 29% male. The mean durations of cross clamping and cardiopulmonary bypass were 54 ± 32 min and 62.5 ± 37.0 min, respectively. Eleven different odors were tested. Significant differences were observed for several odors: leather between d0 and d3, pine between d0 and d3, onion between d0 and d1, onion between d0 and d3, and soap between d0 and d1. The postoperative CRP levels were significantly higher than the preoperative levels. The correlation analysis determined that the postoperative CRP levels were negatively correlated with the B-SIT score (r = –0.48, p = 0.001). Conclusions: Our findings suggest that patients after CABG are prone to develop olfactory dysfunction in the early postoperative period and that olfactory dysfunction is associated

We investigated the effect of a combination of pregabalin and dexamethasone, when used as part of a multimodal analgesic regimen, on pain control after rhinoplasty operations. Sixty patients were enrolled in this study. They were randomly assigned into three groups: Group C (placebo + placebo), Group P (pregabalin + placebo), and Group PD (pregabalin + dexamethasone). Patients received either pregabalin 300 mg orally 1 h before surgery, dexamethasone 8 mg intravenously during induction, or placebo according to their allocation. Postoperative pain was treated with intravenous patient-controlled analgesia (tramadol, 20-mg bolus dose, 45-min lockout time). The numeric rating scale (NRS), side effects, and consumption of tramadol, pethidine, and ondansetron were assessed. The median NRS scores at 0, 1, and 6 h after surgery were significantly higher in Group C than in Group PD (p

Topikal anestezi, saydam kornea kesisinden yapilan fa- koemulsifikasyon katarakt cerrahisi icin genellikle yeterli ve etkin okuler anestezi saglamaktadir. Ancak asiri endiseli, kaygili ve kooperasyonu guc olan olgularda intraoperatif problemlerle karsilasma hic de azimsanmayacak kadar cok- tur. Bu olgularda uygulanan oral veya intravenoz sedasyon, bu problemleri buyuk oranda ortadan kaldirmaktadir. Bu derlemenin amaci, saydam kornea kesisinden yapilan fa- koemulsifikasyon katarakt cerrahisinde sedasyonun rolu ve olasi sedasyon alternatiflerinin degerlendirilmesidir. Topical anesthesia for clear corneal phacoemulsification cataract surgery usually provides adequate and effective ocular anesthesia. However, the possibility of intraoperative complications is not rare in anxious, distressed and uncoop- erative patients. In these cases, oral or intravenous sedation largely eliminates these problems. The purpose of this re- view is to evaluate the role of sedation in cataract surgery and possible sedation alternatives.

Transversus abdominis plane TAP block abdominal field blocks used in the treatment of acute postoperative pain after lower abdominal surgery. TAP block is a procedure in which local anesthetic agents are applied to the anatomic neurofacial space between the internal oblique and transversus abdominis muscle to block anterior branches of thoracic T7-T12 and first lumbar L1 nerves. TAP block may be a better method in postoperative pain control.In this review, the latest datas have been collect on TAP block., Transversus abdominis plan TAP bloğu, alt abdominal cerrahi sonrası, akut postoperatif ağrı tedavisinde kullanılan abdominal saha bloklarından birisidir. Karnın antero-lateral bölgesinde yer alan internal oblik ve transversus abdominis kas arasındaki anatomik nörofasiyal boşluğa, torakal interkostal T7-T12 ve birinci lomber L1 sinirlerin ön dallarını bloke etmek için lokal anestezik ajanların uygulanması işlemidir. TAP blok, postoperatif ağrı kontrolünde iyi bir yöntem olabilir. Bu yazıda TAP blok ile ilgili son bilgiler derlenmiştir.

Atropa Belladonna poisoning may lead to anticholinergic syndrome. Ingestion of high amounts of the plant may cause lethargy, coma, and even a serious clinical picture leading to death. In this case report, we aimed to present a case with anticholinergic syndrome that developed after ingestion of the fruit called "Deadly Nightshade" in our country.

Two patients, aged 18 and 28 years, with maxillofacial trauma due to motor vehicle accident, were operated upon by a team of plastic surgeons. In this report we aimed to present our experience with submental intubation procedure in these cases, in which orotracheal or nasotracheal intubation was impossible due to panfacial fracture.

Objective: We aimed to evaluate the attitudes of doctors about cardiopulmonary resuscitation (CPR) in this research. Methods: Overall, 234 doctors who were working in Abant İzzet Baysal University Health Research and Application Center and who accepted to participate in this research were included. Research data were obtained by a questionnaire containing questions about demographic characteristics of doctors and their knowledge about CPR. Questionnaires were applied between 27.02.2012 and 04.06. 2012. The chi-square test was used for categorical variables. A value of p

Umit Yasar Tekelioglu1*, Abdullah Demirhan1, Tulay Ozlu2 and Hasan Kocoglu1 1Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey 2Department of Obstetrics and Gynecology, Abant Izzet Baysal University Medical School, Bolu, Turkey *Corresponding author: Umit Yasar Tekelioglu, MD, Department of Anesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkey, Tel: +90 505 3131292; Fax: +90 374 2534615; E-mail: drtekelioglu@yahoo.com

Transversus abdominis plane (TAP) block is one of the abdominal field block. The TAP block is used for both anaesthetic management and post-operative pain therapy in lower abdominal surgery. TAP block is a procedure in which local anaesthetic agents are applied to the anatomic neurofacial space between the internal oblique and the transversus abdominis muscle. TAP block is a good method for post-operative pain control as well as allows for short operations involving the abdominal area. In this article, a case of colostomy under TAP block is presented. © 2015 by Turkish Anaesthesiology and Intensive Care Society.

Neonatal compartment syndrome is a rare condition mainly involving the upper extremity associated with necrotic lesions. It is often initially misdiagnosed because the skin lesions mimic several other conditions of the newborn. Early diagnosis and timely intervention are of paramount importance to achieve the best outcome. In the present case, we describe a newborn with forearm compartment syndrome owing to being stuck in the birth canal.

Intra-arterial catheterization is used for continuous pressure monitoring and blood gas analysis in intensive care units. Especially it is used routinely in patients that take inotropic agents. Radial artery is frequently preferred because of adequate collateral circulation and easy cannulation. During this procedure, risks of complication and failure are high. Catheterization may lead to complications such as peripheral neuropathy and cerebral embolization which can increase morbidity and mortality. Ultrasonography [USG]-guided arterial cannulation can prevent potential complications with an increased success. In this report, we aimed to present the USG-guided catheterization of radial artery in intensive care patients.

OBJECTIVE Researchers use a large number of information technology tools from the beginning until the publication of a scientific study. The aim of the study is to investigate the technology and data processing tool usage preferences of academics who produce scientific publications in the field of anaesthesiology. METHODS A multiple-choice survey, including 18 questions regarding the use of technology to assess the preferences of academicians, was performed. RESULTS PubMed has been the most preferred article search portal, and the second is Google Academic. Medscape has become the most preferred medical innovation tracking website. Only 12% of academicians obtain a clinical trial registration number for their randomized clinical research. In total, 28% of respondents used the Consolidated Standards of Reporting Trials checklist in their clinical trials. Of all participants, 21% was using Dropbox and 9% was using Google-Drive for sharing files. Google Chrome was the most preferred internet browser (32.25%) for academic purposes. English language editing service was obtained from the Scribendi (21%) and Textcheck (12%) websites. Half of the academics were getting help from their specialist with a personal relationship, 27% was doing it themselves, and 24% was obtaining professional assistance for statistical requirements. Sixty percent of the participants were not using a reference editing program, and 21% was using EndNote. Nine percent of the academics were spending money for article writing, and the mean cost was 1287 Turkish Liras/year. CONCLUSION Academics in the field of anaesthesiology significantly benefit from technology and informatics tools to produce scientific publications.

Background: Nausea and vomiting are frequently seen in patients undergoing cesarean section (CS) under regional anesthesia. We aimed to compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the use of each agent alone to decrease the incidence of post-delivery intraoperative nausea and vomiting (IONV) during CS under spinal anesthesia. Objective: To compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the single use of each agent to decrease the incidence of postdelivery IONV during CS under spinal anesthesia.Methods: A randomized, prospective, double blind study was performed on 90 patients undergoing planned CS under spinal anesthesia. Patients received 4mg ondansetron in Group O, 8mg dexamethasone in GroupD, 4mg ondansetron+8mg dexamethasone in Group OD intravenously within 1-2 minutes after the umbilical cord was clamped. Frequency of postdelivery IONV episodes was recorded.Results: A total of 86 eligible patients were included in the study. There were 29 patients in Group O, 29 patients in Group D and 28 patients in Group OD. There were no statistically significant difference between the groups in terms of baseline characteristics and intraoperative managements. Frequency of intraoperative nausea, retching and vomiting experiences were similar between the groups(p>0.05).Conclusion: Single dose 4mg ondansetron, 8mg dexamethasone, or combined use of 8mg dexamethasone+4mg ondansetron, given intravenously is all effective agents for the control of postdelivery IONV. Combined use of dexamethasone and ondansetron for the same indication does not seem to increase the antiemetic efficacy. Keywords: Emesis, nausea and vomiting, intraoperative; ondansetron, 5-HT3 antagonists, dexamethasone

A 23-year-old male patient with occipitocervical fixator was scheduled for surgery due to injury to the right forearm. The patient's thyromental distance was 5 cm, mouth opening grade II, sternomental distance 10 cm and Mallampati score 4. Loss of extension and rotation movements of the head was assessed as difficult intubation criteria. Anaesthetic procedures are almost always difficult in patients with occipitocervical fixation; the limited cervical extension complicated both intubation and ventilation. In this report, application of general anaesthesia using awake fibreoptic bronchoscopic intubation (FOB) is described. After routine monitoring of vital signs and premedication, hypopharyngeal topical anaesthesia was accomplished by instilling 10% lidocaine spray twice via the appropriate nostril. Superior laryngeal nerve block was performed with local anaesthetic infiltration of tissues 1 cm below the greater horns of the hyoid bone. Lingual and pharyngeal branches of the glossopharyngeal nerve were blocked. Transtracheal block was performed. Following completion of local anaesthesia, the patient was intubated using the awake FOB technique, on 5 L min(-1) of 100% O2. After muscle relaxation, the patient underwent a microsurgical operation to repair eight tendons, one artery, and one nerve. Surgery lasted for 5 hours. When the extubation criteria were met, the patient was extubated. In cases of occipitocervical fixation, which causes severe limitation of neck movements, the use of awake fibreoptic intubation should be considered.

Amaç: Çalışmadaki amacımız, çıkan aorta ve arkus aortayı (proksimal aorta) içine alan patolojilerinde yan greft tekniği ile yapılan sağ aksiller arter kanülasyonun (AAK) postoperatif erken dönem mortalite, morbidite sonuçları ve sağ AAK yerinde gelişen orta-geç dönem komplikasyonların araştırılmasıdır. Gereç ve Yöntemler: Kliniğimizde yan greft tekniği-sağ AAK ile proksimal aortaya müdahele edilen 45 hasta çalışmaya dâhil edildi. Hastaların postoperatif erken dönem mortalite, morbidite, aksiller arter, aksiller ven, brakial pleksus yaralanması retrospektif olarak araştırıldı. Toplam 32 hastanın sağ AAK bölgesindeki değişiklikler Doppler ultrasonografi ile incelendi. Bulgular: Hastaların, yaş ortalaması 59,25±13,7, 34’ü (%75,5) erkek idi. Erken dönem mortalite 7 (%15,55), geçici nörolojik disfonksiyon 2 (%4,44), erken inme 1 (%2,22), ortalama yoğun bakımda kalma süresi 3,35±1,61 gün, hastanede kalış süresi 13,44±4,5 gün olarak tespit edildi. Ortalama 24±18,5 (1-52) aylık orta dönem takiplerde, hastaların hiç birinde sağ AAK yerinde stenoza rastlanmazken, 4 (%16,66) hastada sağ AAK yerinde en büyüğü 4,6 mm, en küçüğü 1,4 mm olan sakküler anevrizma tespit edildi. Sonuç: Proksimal aorta patolojilerinde yan greft tekniği ile sağ AAK düşük morbidite ve mortalitesi nedeni ile güvenlidir. Dekanülasyon sonrası yan greftin kapatılması sırasında aksiller arterde anevrizmatik kese bırakılmamasına dikkat edilmelidir. Objective: To investigate both postoperative early-mid term mortality and morbidity results of right axillary artery cannulation (AAC) that is done with the side graft technique in the pathologies including ascending aorta, aortic arch (proximal aorta) and late term complications occuring in the place of AAC. Material and Methods: Forty-five patients whose proximal aorta was intervened by using side graft-right AAC. Injury of axillary vein and brachial plexus and early postoperative mortality and morbidity were retrospectively investigated via patient file. The changes in the place of right AAC were analyzed with Doppler ultrasonography after calling tha patients whose addresses were available. Results: We recruited 45 patients (34 males and 11 females; age, 59.2±13.7years) who underwent aortic surgery. Early postoperative mortality was 7 (15.55%), transient neurologic disfunction was 2 (4.44%), early stroke was 1 (2.22%), the average length of intensive care unit was 3.35±1.61 days, length of discharge was 13.44±4.5 days. While stenosis was not encountered in the place of right AAC in none of the patients at the averagely 24±18.5 (1-52) monthly follow-up, saccular enlargement of which the smallest was 1.4 mm and the biggest was 4.6 mm in the place of right AAC was detected in 4 (16.66%) patients. Conclusion: Right AAC with side graft technique in proximal aorta pathologies is safe because of low morbidity and mortality. Not to create aneurysmal sac in axillary artery while closing the side graft after decanulation is a remarkable matter.

Hyponatremia; a serious electrolyte disorder, frequently develops in the elderly and hospitalized patients with heart failure. Hyponatremia in patients with heart failure is usually in hypervolemic form characterized by increased total body sodium and water. However, rarely, hypovolemic hyponatremia associated with actual sodium loss may occur in the clinical course. We present an extremely hypovolemic hyponatremia case in a patient with severe heart failure. Serum sodium value of the patient was 101mEq/L; which is exceptionally compatible with life. J. Exp. Clin. Med., 2013; 30:89-91

We report a case of a 33-year-old woman who developed severe brain edema and pseudo-subarachnoid hemorrhage (SAH) at 36-hour follow-up after successful cardiopulmonary resuscitation for anaphylactic shock as a result of a bee sting. The patient died on the sixth day of the follow-up due to multiple organ failure and brain herniation. Our case suggests that the SAH-like findings on computed tomography scanning were not a new complication ("real" SAH) arising from the bee sting; rather, it was a pseudo-SAH related to prolonged cardiopulmonary resuscitation).

Postoperative atrial fibrillation (POAF) complicating coronary artery bypass grafting surgery (CABG) increases morbidity and stroke risk. Total atrial conduction time (PA-TDI duration) has been identified as an independent predictor of new-onset atrial fibrillation (AF). We aimed to assess whether PA-TDI duration is a predictor of AF after CABG. In 128 patients who had undergone CABG, preoperative clinical and echocardiographic data were compared between patients with and without POAF. The PA-TDI duration was assessed by measuring the time interval between the beginning of the P wave on the surface ECG and point of the peak A wave on TDI from left atrium (LA) lateral wall just over the mitral annulus. Patients with POAF (38/128, 29.6 %) were older (68.1 ± 11.1 vs. 59.3 ± 10.2 years; p