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Copyright of Mersin University School of Medicine Lokman Hekim Journal of History of Medicine & Folk Medicine is the property of Mersin University School of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Wilson’s disease is an autosomal recessive inherited chronic disease that occurs as a result of the deposition of copper in organs and tissues with impaired biliary excretion. With this case report, we aimed to share our experience in cesarean anesthesia in a pregnant woman with Wilson disease who had irregular medical follow-up and underwent chelation therapy. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study aims to demonstrate whether using scoring systems effects postoperative complications of patients in the recovery room as well as its contribution to patients’ safety Method: We examined files of patients operated in our Hospital between 2010 and 2017. In the recovery room after anesthesia, complications developed in the recovery room and in the early period were recorded in patients who were followed up by the Modified Aldrete Scoring System (MASS) (MASG) and without using the scoring system (CG). We used Statistica 13.3 program for statistical analyses. Results: The duration of stay in the recovery room was longer in MASG than CG. The minor complication rate was close in both groups. In the control group , one patient had a cardiac arrest, as a major complication, which responded to cardiopulmonary resuscitation. Conclusions: We determined that more serious complication developed in patients for whom the scoring system was not used in the recovery room than patients followed up with the scoring system. Safety of patients during their transfer to the service depends on having an advanced infrastructure in anesthesia recovery rooms, employing trained health personnel and using algorithms such as MASS. [ABSTRACT FROM AUTHOR]

Objective: Central venous catheterization (CVC) is an invasive procedure used in intensive care units with various indications. Malposition of the catheter has been reported in the literature ranging from 3.6-14% in practice. In this study, we aimed to determine the preference of catheter placement and malposition rates in CVC applications performed by specialist physicians in our intensive care units without using ultrasonography. Method: After the approval of the ethics committee, medical files of 1710 patients who were applied to the Mersin City Training and Research Hospital in 2017-2019 were reviewed. Permanent port catheter, dialysis catheter and catheters placed in pediatric patients under 18 years of age were excluded from the study. All catheterization procedures were performed by a specialist physician using 7 F catheters with Seldinger technique without the use of ultrasound. Results: Of the 1463 patients included in the study, the catheters were inserted intointernal jugular vein in 842, subclavian vein in 467,and femoral vein in 154 patients. When femoral catheterization was excluded from assessments, malposition was found in 1309 patients with a rate of 1.68%. There were 14 malpositioned catheters in the right internal jugular vein, 6 in the right subclavian vein and 2 in the left subclavian vein. Conclusion: In conclusion, it has been reported that ultrasound-guided catheter placement may prevent malposition and reduced complication rate when performed by experienced clinicians. However,when the ultrasound is not available, we believe that performing the procedure by experienced clinicians and confirming the accuracy of the catheter position with lung x-ray after the procedure may reduce malposition rates. [ABSTRACT FROM AUTHOR]

Substance abuse is a social problem and may increase morbidity with additional risks to the administration of anesthesia in patients requiring surgery. When it comes to cesarean section, the choice and management of a good anesthetic technique is mandatory for both the baby and the mother. A 30-year-old multiparous patient weighing 50 kg, in her 34 gestational week with a history of cesarean section but without routine follow-up presented with a sudden onset of active cervical hemorrhage and preterm labour. The patient’s vital signs were stable, laboratory values were within normal limits. It was learnt that she used heroin 4 hours previously, and she was not hungry. She underwent caesarean section under emergency conditions. A baby weighing 1500 g was delivered under general anesthesia. The infant was diagnosed with newborn withdrawal syndrome and phenobarbital treatment was performed in the neonatal intensive care unit. Maternal withdrawal syndrome and other complications did not occur. On the postoperative 5th day, the mother and baby were discharged. [ABSTRACT FROM AUTHOR]

Objective: One of the most frequently studied parameters in terms of outcome estimation in cardiac surgery is HbA1c. Several studies in literature suggest that high HbA1c value increases mortality and morbidity, but there is no relation between them. The primary aim of the present study is to investigate whether HbA1c value in diabetic patients undergoing coronary bypass graft surgery is an independent predictor for post-operative mortality and morbidity, and our secondary goal was to determine independent risk factors that cause mortality and morbidity in the same patient population. Methods: 380 diabetic patients diagnosed with diabetes who underwent coronary surgery with cardiopulmonary bypass in Mersin State hospital between July 2014 to December 2016 after the approval of the Mersin University Faculty of medicine ethics committee were included in this retrospective, observational, and cross-sectional study. Patient demographic and perioperative information were obtained from the electronic information operating system and from anesthesia-intensive care follow-up forms. The HbA1c threshold was accepted as 7%, which was reported to be more appropriate for evaluating high-risk groups. Results: Three hundred and fifty-four patients with complete access to the data were included in the study. The mean age of the patients was 60.8±9.4 years. 37% of the patients (131 patients) were female. The number of patients with HbA1c=7 was 194 (54,8%) in the entire patient population. In this study, high HbA1c (=7) values in diabetic patients undergoing isolated coronary bypass graft surgery were not found to be independent predictors of post-operative mortality and morbidity. Mortality was seen in 28 patients (7.9%). ejection fraction (EF) was found to be an independent predictor factor for pre-operative factors in logistic regression models constructed according to mortality predictors (OR:0.94; 95% CI: 0.90-0.99; p=0.016). Complications were seen in 50 patients (14.1%). In the models formed from the point of view of the complication predicators, only EF was found to be independent predictor (OR:0.95; 95% CI: 0.92-0.98; p=0.004). It was found that HbA1c was not predictive in all models for mortality and complication (p>0.05). Conclusion: There are reports in the literature that mortality increases 4-fold when HbA1c value is higher than 8.6% in coronary surgery. However, there is a view that HbA1c alone cannot predict mortality in coronary surgery if diabetes associated factors are excluded. In this study, high HbA1c (=7) values in diabetic patients undergoing isolated coronary bypass graft surgery were not found to be independent predictors of post-operative mortality and morbidity. Pre-operative low ejection fraction was found as an independent risk factor for post-operative mortality and morbidity in the general patient population. [ABSTRACT FROM AUTHOR]

Transfusion-related acute lung injury (TRALI) is the second leading cause of transfusion-associated mortality in high-risk patients undergoing major surgery. TRALI presenting with acute hypoxia and non-cardiac edema is a vital clinical entity which must be considered in the differential diagnosis in transfusion-associated patients. Fresh frozen plasma, erythrocyte suspension and thrombocyte suspension transfusion were performed during perioperative and postoperative periods to the patient undergoing supracoronary graft interposition due to ascending aortic aneurysm. Respiratory support treatment with positive pressure mechanical ventilation was initiated for acute hypoxia and bilateral pulmonary edema developed immediately after the procedure. The patient thought to have delayed TRALI was extubated on postoperative 5. day. Noninvasive mechanical respiratory support treatment was maintained. On postoperative 10. day the patient did not need any oxygen and ventilatory support. TRALI should be considered in patients with acute onset of hypoxia, ARDS especially in cases undergoing major surgery and transfusion of large amounts of ES, FFP, platelet suspension. Noninvasive mechanical ventilation should be considered as a treatment option. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the factors that affects the postperfusion syndrome in cadaveric liver transplantations and the effect of the postperfusion syndrome on discharge from the hospital. Methods: Patients who underwent cadaveric liver transplantations between 2007 and 2013 were scanned retrospectively. Intraoperative anaesthesia records, intensive care unit follow-up forms and discharge reports were examined from patient files. Overall, 43 patients having complete data were included in the study. The postperfusion syndrome is defined as asystoli or a decrease in mean arterial pressure of more than 30%, which occurred in the first 5 min of reperfusion and continued for 1 min. Patients were divided into two groups: those who had the postperfusion syndrome and those who did not. Results: The number of patients who had the postperfusion syndrome was 25 of 43 (58.1%). The MELD score of patients without the postperfusion syndrome was calculated as 16.9±3.2 and that of patients with the postperfusion syndrome was 19.7±3.6. A statistically significant relationship was detected between the postperfusion syndrome occurrence and a high MELD score (p=0.013). The diastolic blood pressure just before reperfusion was statistically lower in the group with the postperfusion syndrome than in the other group (p=0.023, 50±8 vs. 58±11). According to the logistic regression analysis, the MELD score and the decrease in diastolic blood pressure before reperfusion were defined as independent predictive factors. Conclusion: According to the study, the ratio for having the postperfusion syndrome was found to be 58.1%. The independent predictor factors affecting the postperfusion syndrome were detected as the MELD score and the decrease in diastolic blood pressure before reperfusion. The postperfusion syndrome during orthotropic liver transplantation is an important issue for anaesthesiologists. The awareness of the related factors with the postperfusion syndrome may help in the development of various preventive strategies. [ABSTRACT FROM AUTHOR]

Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Transient neurologic dysfunction is common after aortic surgery. Major causes of postoperative complications followed by cardiac surgery are due to hypoperfusion states such as selective cerebral perfusion, embolic debris during cardiopulmonary bypass and ulcerated plaque emboli originated from carotid arteries. Neurologic complications prolong periods of intensive care unit and hospital stay, worsens quality of life and unfortunately they are an important cause of morbidity. Anaesthesia during a carotid and aortic surgery constitutes of providing adequate brain perfusion pressure, attenuating cerebral metabolism by anaesthetic agents and monitoring the cerebral metabolic supply and demand relationship during the intraoperative period. We present a monitoring approach with an intraoperative 16-channel electroencephalography and bilateral near infrared spectroscopy during redo aneurysm of the sinus of Valsalva surgery. [ABSTRACT FROM AUTHOR]

Introduction. Postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy operations still continue to be a serious problem. Intravenous fluid administration has been shown to reduce PONV. Some patients have higher risk for PONV described byAPFEL score. In this study, our aim was to determine the effects of preoperative intravenous hydration on postoperative nausea and vomiting in high Apfel scored patients undergoing laparoscopic cholecystectomy surgery. Patients and Methods. This study is performed with 50 female patients who had APFEL score 3-4 after ethics committee approval and informed consent was taken from patients. The patients were divided into 2 groups: group 1 (P1): propofol + preoperative hydration and group 2 (P2): propofol + no preoperative hydration. Results. When the total nausea VAS scores of groups P1 and P2 to which hydration was given or not given were compared, a statistically significant difference was detected at 8th and 12th hours (ρ = 0.001 and ρ = 0.041). It was observed that in group P1, which was given hydration, the nausea VAS score was lower. When the total number of patients who had nausea and vomiting in P1 and P2, more patients suffered nausea in P2 group. Discussion. Preoperative hydrationmay be effective in high Apfel scored patients to prevent postoperative nausea. [ABSTRACT FROM AUTHOR]

Objective: Propofol has been widely used for anaesthesiology, although about 60%-70% of patients experience pain on injection. The aim of our study was to compare two storage patterns of propofol, namely room temperature versus refrigeration, in terms of their effect on incidence and severity of pain caused by its injection. Methods: Two hundred patients referred to gastrointestinal or urologic surgery with general anaesthesiology were included in a prospective randomized, double-blind study. After routine monitoring, 5 mL of propofol at room temperature and 5 mL of propofol kept in the fridge was administered within 10 seconds to patients in Group 1 and Group 2, respectively. An investigator assessed pain intensity. Propofol temperature-pH were measured by another researcher. Results: The overall incidence of pain on injection of propofol was 73.7% in Group 1, and 83.2% in Group 2. There was no significant difference between groups regarding the incidence of pain. There was a significant difference between groups in terms of pain severity based on a 6-point verbal rating scale. While the median VRS value for Group 1 was 2, it was 3 in Group 2. Conclusion: Cold application has a local anesthetic effect of its own. In the present study it was observed that cold application of propofol caused pain more frequently, although it was statistically not significant; moreover, it was found that it statistically significantly increased the severity of pain. These findings indicate that propofol should be kept at room temperature instead of in the refrigerator in order to reduce injection pain. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Anesthesia & Reanimation is the property of Turkish Society of Anaesthesiology & Reanimation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: One of the most frequently studied parameters in terms of outcome estimation in cardiac surgery is HbA1c. Several studies in literature suggest that high HbA1c value increases mortality and morbidity, but there is no relation between them. The primary aim of the present study is to investigate whether HbA1c value in diabetic patients undergoing coronary bypass graft surgery is an independent predictor for post-operative mortality and morbidity, and our secondary goal was to determine independent risk factors that cause mortality and morbidity in the same patient population., Methods: 380 diabetic patients diagnosed with diabetes who underwent coronary surgery with cardiopulmonary bypass in Mersin State hospital between July 2014 to December 2016 after the approval of the Mersin University Faculty of medicine ethics committee were included in this retrospective, observational, and cross-sectional study. Patient demographic and perioperative information were obtained from the electronic information operating system and from anesthesia-intensive care follow-up forms. The HbA1c threshold was accepted as 7%, which was reported to be more appropriate for evaluating high-risk groups., Results: Three hundred and fifty-four patients with complete access to the data were included in the study. The mean age of the patients was 60.8±9.4 years. 37% of the patients (131 patients) were female. The number of patients with HbA1c≥7 was 194 (54,8%) in the entire patient population. In this study, high HbA1c (≥7) values in diabetic patients undergoing isolated coronary bypass graft surgery were not found to be independent predictors of post-operative mortality and morbidity. Mortality was seen in 28 patients (7.9%). Ejection fraction (EF) was found to be an independent predictor factor for pre-operative factors in logistic regression models constructed according to mortality predictors (OR:0.94; 95% CI: 0.90-0.99; p=0.016). Complications were seen in 50 patients (14.1%). In the models formed from the point of view of the complication predicators, only EF was found to be independent predictor (OR:0.95; 95% CI: 0.92-0.98; p=0.004). It was found that HbA1c was not predictive in all models for mortality and complication (p>0.05)., Conclusion: There are reports in the literature that mortality increases 4-fold when HbA1c value is higher than 8.6% in coronary surgery. However, there is a view that HbA1c alone cannot predict mortality in coronary surgery if diabetes associated factors are excluded. In this study, high HbA1c (≥7) values in diabetic patients undergoing isolated coronary bypass graft surgery were not found to be independent predictors of post-operative mortality and morbidity. Pre-operative low ejection fraction was found as an independent risk factor for post-operative mortality and morbidity in the general patient population., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objective: To evaluate the factors that affects the postperfusion syndrome in cadaveric liver transplantations and the effect of the postperfusion syndrome on discharge from the hospital., Methods: Patients who underwent cadaveric liver transplantations between 2007 and 2013 were scanned retrospectively. Intraoperative anaesthesia records, intensive care unit follow-up forms and discharge reports were examined from patient files. Overall, 43 patients having complete data were included in the study. The postperfusion syndrome is defined as asystoli or a decrease in mean arterial pressure of more than 30%, which occurred in the first 5 min of reperfusion and continued for 1 min. Patients were divided into two groups: those who had the postperfusion syndrome and those who did not., Results: The number of patients who had the postperfusion syndrome was 25 of 43 (58.1%). The MELD score of patients without the postperfusion syndrome was calculated as 16.9±3.2 and that of patients with the postperfusion syndrome was 19.7±3.6. A statistically significant relationship was detected between the postperfusion syndrome occurrence and a high MELD score (p=0.013). The diastolic blood pressure just before reperfusion was statistically lower in the group with the postperfusion syndrome than in the other group (p=0.023, 50±8 vs. 58±11). According to the logistic regression analysis, the MELD score and the decrease in diastolic blood pressure before reperfusion were defined as independent predictive factors., Conclusion: According to the study, the ratio for having the postperfusion syndrome was found to be 58.1%. The independent predictor factors affecting the postperfusion syndrome were detected as the MELD score and the decrease in diastolic blood pressure before reperfusion. The postperfusion syndrome during orthotropic liver transplantation is an important issue for anaesthesiologists. The awareness of the related factors with the postperfusion syndrome may help in the development of various preventive strategies.