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This study aimed to assess the effectiveness of two clarifying procedures and their effects on some properties in thermally or microwave-pasteurized pomegranate juices. The experiment consisted in combining pectinase and protease as well as chitosan and gelatin once they were being stored in the refrigerator. The experiment consisted in three parts, being the first one a fresh juice without any clarification treatment, whereas, the second one was the fresh juice treated with clarifying agent consisted of pectinase and protease mixture ratio (2:1) at 0.75 v/v,and 50 °C for 20 min. Finally, the third one was fresh juice treated with chitosan and gelatin mixture at 0.4 and 0.8) g/L, respectively, at 50 °C for (20) min. The pasteurization of all three experiments was done by using two techniques, i.e., one with thermal water bath at 85 °C for two min and the microwave at 400 Watts for two min. All pomegranate juice bottles were stored at 4 °C for three months. The results showed a significant effect of the clarification method variable on the properties studied, especially turbidity, polyphenol and anthocyanin values. Moreover, the juice clarified with the enzymatic clarification method had better characteristics than the traditional ones during storage, what has therefore a better commercial appeal. The area of significance was founded with the use of traditional clarification with concentration at (0.4 and 0.8) g/l, and microwave pasteurization with 400 watts and zero month of storage at 4 °C, respectively, which is provided a minimum turbidity value.

Abstract Objective To evaluate whether there is an effect of the physician who transfers the embryos on pregnancy rates in in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) treatment. Methods A total of 757 participants were analyzed between 2012 and 2017. Participants were classified according to 3 physicians who transferred the embryos: ([group 1=164 patients]; [group 2=233 patients]; [group 3=360 patients]). Baseline parameters and IVF-ICSI outcomes were compared between the groups. Results No differences were determined between the groups regarding the baseline parameters (age, age subgroups [20-29, 30-39, and ≥ 40 years old)], body mass index (BMI), smoking status, infertility period, cause of infertility, baseline follicle stimulating hormone, luteinizing hormone, estradiol (E2), thyroid stimulating hormone, prolactin levels, antral follicle count, duration of stimulation, stimulation protocol, gonadotropin dose required, maximum E2 levels, progesterone levels, endometrial thickness on human chorionic gonadotropin (hCG) administration and transfer days (p>0.05). The numbers of oocytes retrieved,metaphase II (MII), 2 pronucleus (2PN), transferred embryo, fertilization rate, day ofembryo transfer, the catheter effect and embryo transfer technique, and clinical pregnancy rates (CPRs) were also comparable between the groups (p>0.05). Conclusion Our data suggests that the physician who transfers the embryos has no impact on CPRs in patients who have undergone IVF-ICSI, but further studies with more participants are required to elucidate this situation.

BACKGROUND AND OBJECTIVES: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. METHODS: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline); 10 min after intubation (Supine 1); 10 (Prone 1), 60 (Prone 2), 120 (Prone 3) min after prone position; and just after postoperative supine position (Supine 2). RESULTS: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p = 0.009 and p = 0.003, respectively). We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. CONCLUSIONS: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery.

ABSTRACTBACKGROUND AND OBJECTIVES:Tenoxicam is widely used in osteoarthritis treatment and we aimedto compare the effectivity of oral and intra-articular administration of tenoxicam in osteoarthri-tis treatment.METHODS: This study was performed between 2011 and 2012 by retrospectively analyzing andcomparing the findings of 60 patients who were clinically and radiologically diagnosed with kneedegenerative osteoarthritis in Bünyan state hospital pain policlinic. 60 patients included in thestudy were divided into two groups. The first group (tenoxicam IA, n = 30) included patientfindings of those subjected to intra-articular injection of 20 mg tenoxicam to the knee oncea week for three weeks and the second group (oral tenoxicam, n = 30) included patients whowere administered 20 mg oral tenoxicam once a day for three weeks. All patients were clini-cally evaluated pre-treatment and in the 1st week, 1st month and 3rd month post-treatmentaccording to specified criteria.RESULTS AND CONCLUSIONS: Twenty two of 60 patients included in the study were male and 38were female. In both groups significant improvements were detected in all of the observedparameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physicalactivity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week,1st month and 3rd month with respect to pre-treatment values. Besides, a better complianceto treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed.Intra-articular tenoxicam administration could be thought as an alternative treatment methodin patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemicgastrointestinal system side effects and those who have difficulties in adapting to treatment.

BACKGROUND AND OBJECTIVES: It has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. The purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. METHODS: 220 patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n = 110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20 G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. RESULTS: The demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31 ± 1.56 and 1.65 ± 1.23, respectively (p < 0.001). CONCLUSION: Pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients.

Justificativa e objetivo: os medicamentos administrados por via intravenosa podem ser contaminados durante as várias fases de produção ou preparação. Sugamadex é uma gama-ciclodextrina modificada. Embora muitas pesquisas sobre os efeitos antibacterianos de uma variedade de ciclodextrinas estejam disponíveis, não há estudos dos efeitos antibacterianos de sugamadex. Este estudo investigou a atividade antimicrobiana in vitro de sugamadex. Materiais e métodos: a atividade antimicrobiana in vitro de sugamadex foi investigada pelo método de microdiluição em meio de cultura. O pH da solução de ensaio foi determinado com o uso de um medidor de pH. Os microrganismos-teste analisados incluíram Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 e Pseudomonas aeruginosa ATCC 27853. Na segunda fase do estudo, 100 mg/mL de sugamadex (50 μg) foram contaminados com microrganismos-teste (50 μg), incluindo S. aureus ATCC 29213, E. fecalis ATCC 29212, E. coli ATCC 25922 e P. aeruginosa ATCC 27853, incubados por 24 horas e, em seguida, a produção bacteriana foi avaliada. Resultados: o pH das soluções da análise variaram entre 7,25 e 6,97. Com o uso do método de microdiluição, sugamadex não apresentou efeito antibacteriano contra S. aureus, E. fecalis, E. coli e P. aeruginosa em qualquer concentração. Na segunda fase do estudo, a produção bacteriana foi observada após 24 horas em 100 mg/mL de sugamadex contaminados com os microrganismos-teste S. aureus, E. fecalis, E. coli e P. aeruginosa.

FUNDAMENTO: A função endotelial braquial tem sido associada ao fluxo lento coronário (FLC). O aumento do fluxo sanguíneo para a artéria braquial faz com que o endotélio libere óxido nítrico (ON), com subsequente vasodilatação. Além de sua atividade com betabloqueador, o nebivolol provoca vasodilatação, aumentando a liberação endotelial de ON. OBJETIVO: Avaliar os efeitos do nebivolol na função endotelial vascular em pacientes com FLC. MÉTODOS: 46 pacientes com FLC e 23 indivíduos com artérias coronárias epicárdicas normais foram examinados com ecocardiografia transtorácica e ultrassonografia da artéria braquial. Os pacientes foram reavaliados dois meses após o tratamento com aspirina ou aspirina e nebivolol. RESULTADOS: Os pacientes com FLC apresentaram maior índice de massa corporal (26,5 ± 3,3 vs. 23,8 ± 2,8, p < 0,001), tempo de relaxamento isovolumétrico (TRIV) de influxo mitral (114,9 ± 18,0 vs. 95,0 ± 22,0 mseg, p < 0,001), menor fração de ejeção do ventrículo esquerdo (FEVE) (63,5 ± 3,1% vs. 65,4 ± 2,2, p = 0,009), colesterol HDL (39,4 ± 8,5 vs. 45,8 ± 7,7 mg/dL, p = 0,003) e dilatação fluxo-mediada da artéria braquial (DFM) (6,1 ± 3,9% vs. 17,6 ± 4,5%, p BACKGROUND: Brachial endothelial function has been associated with coronary slow flow (CSF). Increasing blood flow to brachial artery provokes endothelium to release nitric oxide (NO) with subsequent vasodilatation. Besides its β1-blocker activity, nebivolol causes vasodilatation by increasing endothelial NO release. OBJECTIVE: To assess the effects of nebivolol on vascular endothelial function in patients with CSF. METHODS: Forty-six patients with CSF and 23 individuals with normal epicardial coronary arteries were examined with transthoracic echocardiography and brachial artery ultrasonography. The patients were reevaluated two months after treatment with aspirin or aspirin plus nebivolol. RESULTS: Patients with CSF had higher body mass index (26.5 ± 3.3 vs. 23.8 ± 2.8, p < 0.001), mitral inflow isovolumetric relaxation time (IVRT) (114.9 ± 18.0 vs. 95.0 ± 22.0 msec, p < 0.001) and lower left ventricular ejection fraction (LVEF) (63.5 ± 3.1% vs. 65.4 ± 2.2, p = 0.009), HDL-cholesterol (39.4 ± 8.5 vs. 45.8 ± 7.7 mg/dL, p = 0.003) and brachial flow-mediated dilatation (FMD) (6.1 ± 3.9% vs. 17.6 ± 4.5%, p < 0.001). There were significant correlations between FMD and the presence of CSF (r = 0.800, p < 0.001) and HDL-cholesterol (r = 0.349, p = 0.003). Among Patients with CSF, although pretreatment mean FMD values were similar (6.1 ± 4.3% vs. 6.0 ± ,6%, p = 0.917) compared to aspirin alone group, posttreatment FMD was significantly higher in patients treated with aspirin plus nebivolol (6.0 ± 3.5% vs. 8.0 ± 2.9%, p = 0.047). Treatment with nebivolol was associated with a significant increase in FMD (6.0 ± 3.6 to 8.0 ± 2.9 %, p = 0.030) whereas treatment with aspirin alone was not. CONCLUSION: Endothelial function may be impaired in both coronary and brachial arteries in patients with CSF and nebivolol may be effective in the improvement of endothelial function in patients with CSF.

FUNDAMENTO: A variabilidade da frequência cardíaca (VFC) está associada com aumento do fator de risco cardíaco em várias condições. As concentrações de ferro apresentadas por um indivíduo podem ter um papel importante na saúde cardiovascular. OBJETIVO: Avaliar a VFC em pacientes com anemia ferropriva. MÉTODOS: Vinte e três pacientes com anemia ferropriva (hemoglobina (Hb) média = 8,6±2,2 g/dl) e 10 indivíduos saudáveis ( Hb média = 13,9±1,2 g/dl) foram avaliados através de monitoramento ambulatorial por 24 horas (Sistema Holter) durante estadia hospitalar com atividade física limitada. RESULTADOS: Embora a frequência cardíaca (FC) média tenha sido significantemente mais alta em pacientes com anemia, não houve diferença significativa em relação aos parâmetros da VFC quando comparados ao grupo saudável. CONCLUSÃO: Não há diferença significativa nos parâmetros da VFC entre pacientes com anemia ferropriva e indivíduos saudáveis.FUNDAMENTO: La variabilidad de la frecuencia cardiaca (VFC) está asociada al aumento del factor de riesgo cardiaco en varias condiciones. Las concentraciones de hierro presentadas por un individuo pueden ejercer un rol importante para la salud cardiovascular. OBJETIVO: Evaluar la VFC en pacientes con anemia ferropriva. MÉTODOS: Se evaluaron a 23 pacientes con anemia ferropriva (hemoglobina [Hb] media = 8,6±2,2 g/dL) y a 10 individuos sanos (Hb media = 13,9±1,2 g/dL) por medio de monitoreo ambulatorio por 24 horas (Sistema Holter) durante estadía hospitalaria con actividad física limitada. RESULTADOS: Aunque la frecuencia cardiaca (FC) media fue significantemente más alta en pacientes con anemia, no hubo diferencia significante respecto a los parámetros de la VFC en comparación con el grupo de individuos sanos. CONCLUSIONES: No hay diferencia significante en los parámetros de la VFC entre pacientes con anemia ferropriva e individuos sanos.BACKGROUND: Heart rate variability (HRV) is associated with increased cardiac risk factor in several conditions. The iron status of an individual may play an important role in cardiovascular health. OBJECTIVE: To evaluate heart rate variability in patients with iron deficiency anemia. METHODS: Twenty-three patients with iron deficiency anemia (mean hemoglobin (Hb) 8.6±2.2 g/dl) and 10 healthy people (mean Hb 13.9±1.2 g/dl) were assessed with 24-hour ambulatory Holter recordings during in hospital course having limited physical activity. RESULTS: Although mean heart rate was significantly higher in patients with anemia, there was no significant difference regarding HRV parameters compared to the healthy group. CONCLUSION: There was no significant difference in HRV parameters between patients with iron deficiency anemia with limited physical activity and healthy ambulatory people.

FUNDAMENTO: Devido à sobreposição de sintomas e inadequada capacidade de exercícios, o diagnóstico não-invasivo da doença arterial coronariana (DAC) pode ser sub ou superestimado em pacientes com doença pulmonar obstrutiva crônica (DPOC). OBJETIVO: Avaliar os resultados de angiografias coronarianas em pacientes com DPOC dependendo das características clínicas basais. MÉTODOS: Os registros médicos de 157 pacientes com DPOC e 157 pacientes sem DPOC pareados por características clínicas basais, que haviam sido submetidos a angiografia coronariana diagnóstica pela primeira vez, foram revisados, retrospectivamente. RESULTADOS: A frequência de DAC era significantemente mais baixa em pacientes com DPOC do que no grupo controle (52,8% vs. 80,2%, pFUNDAMENTO: A causa de la superposición de síntomas e inadecuada capacidad de ejercicios, el diagnóstico no-invasivo de la enfermedad arterial coronaria (EAC) se puede sub o superestimar en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). OBJETIVO: Evaluar los resultados de angiografías coronarias en pacientes con EPOC dependiendo de las características clínicas basales. MÉTODOS: Se revisaron retrospectivamente los registros médicos de 157 pacientes con EPOC y 157 pacientes sin EPOC distribuidos en grupos según características clínicas basales, que se habían sometido a angiografía coronaria diagnóstica por primera vez. RESULTADOS: La frecuencia de EAC era significantemente más baja en pacientes con EPOC que en el grupo control (52,8% vs. 80,2%, pBACKGROUND: Due to overlapping symptoms and inadequate exercise capacity, noninvasive diagnosis of coronary artery disease (CAD) may be under- or overestimated in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: To assess outcomes of coronary angiography in COPD patients depending on baseline clinical characteristics. METHODS: Medical records of 157 patients with COPD and 157 patients without COPD matched for baseline clinical characteristics who had undergone diagnostic coronary angiography for the first time were reviewed retrospectively. RESULTS: The frequency of significant CAD was significantly lower in COPD patients than in the control group (52.8% vs. 80.2%, p

Resumo Justificativa e objetivos As alterações de perfusão ocular desempenham um papel importante na patogênese da neuropatia óptica isquêmica. A pressão de perfusão ocular é igual à pressão arterial média menos a pressão intraocular. O objetivo deste estudo foi avaliar as alterações da pressão intraocular e da espessura da camada de fibras nervosas da retina em pacientes submetidos à cirurgia da coluna vertebral em pronação. Métodos Este estudo prospectivo incluiu 30 pacientes submetidos à cirurgia da coluna vertebral. A espessura da camada de fibras nervosas da retina foi medida um dia antes e um depois da cirurgia, com o uso da tomografia de coerência óptica. A pressão intraocular foi medida seis vezes com o Tonopen e o tempo de duração em posições diferentes: em supinação (basal), 10 minutos após a intubação (Supinação 1); após a pronação aos 10 minutos (Pronação 1), 60 minutos (Pronação 2) e 120 minutos (Pronação 3) e logo após a supinação no período pós‐operatório (Supinação 2). Resultados Nosso estudo envolveu 10 pacientes do sexo masculino e 20 do feminino, com média de 57 anos. No pós‐operatório, quando as medidas da espessura da camada de fibras nervosas da retina foram comparadas com os valores do pré‐operatório, um afinamento estatisticamente significativo da retina foi observado nos quadrantes nasais e inferiores (p = 0,009 e p = 0,003, respectivamente). Observamos uma diminuição da pressão intraocular estatisticamente significante em Supinação 1 e um aumento em ambos momentos Pronação 2 e Pronação 3, em comparação com os valores basais. A pressão arterial média e a pressão de perfusão ocular foram significativamente mais baixas em Pronação 1, Pronação 2 e Pronação 3, em comparação com os valores basais. Conclusões Nosso estudo mostrou aumento da pressão intraocular durante a cirurgia da coluna vertebral em pronação. Um afinamento estatisticamente significante da espessura da camada de fibras nervosas da retina foi observado nos quadrantes nasais e inferiores um dia após a cirurgia da coluna vertebral. Background and objectives Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. Methods This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time‐duration: supine position (baseline); 10 min after intubation (Supine 1); 10 (Prone 1), 60 (Prone 2), 120 (Prone 3) min after prone position; and just after postoperative supine position (Supine 2). Results Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants ( p = 0.009 and p = 0.003, respectively). We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. Conclusions Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery. [ABSTRACT FROM AUTHOR]

Resumo Justificativa e objetivos Tenoxicam é amplamente usado no tratamento da osteoartrite (OA) e o nosso objetivo foi comparar a eficácia de tenoxicam administrado por via oral (VO) e intra‐articular (IA) no tratamento da OA. Métodos Este estudo foi conduzido entre 2011 e 2012 por meio de análise retrospectiva e comparação dos resultados de 60 pacientes que foram clínica e radiologicamente diagnosticados com OA degenerativa de joelhos na Policlínica de Tratamento da Dor do Hospital Estadual de Bünyan. Os 60 pacientes incluídos no estudo foram alocados em dois grupos. O primeiro grupo (tenoxicam IA, n = 30) incluiu resultados de pacientes submetidos à injeção nos joelhos por via IA de 20 mg de tenoxicam uma vez por semana durante três semanas e o segundo grupo (tenoxicam VO, n = 30) incluiu pacientes que receberam 20 mg de tenoxicam por VO uma vez por dia durante três semanas. Todos os pacientes foram avaliados clinicamente na fase basal pré‐tratamento e em uma semana, um mês e três meses pós‐tratamento, de acordo com os critérios especificados. Resultados e conclusões Dos 60 pacientes, 22 eram do sexo masculino e 38 do sexo feminino. Em ambos os grupos, melhorias significativas foram detectadas em todos os parâmetros da escala visual analógica, do índice Western Ontario and MacMaster (Womac – dor, atividade física e rigidez dos joelhos) e do índice de Lequesne nas avaliações feitas em uma semana, um mês e três meses e comparadas aos valores basais. Além disso, uma melhor adesão ao tratamento e tolerabilidade ao sistema gastrointestinal no grupo tenoxicam IA também foram observadas. A administração de tenoxicam IA pode ser considerada como um método opcional de tratamento em pacientes com OA de joelhos que não podem usar tenoxicam por VO, especialmente por causa dos efeitos colaterais sobre o sistema gastrintestinal, e naqueles com dificuldades de adaptação ao tratamento. Background and objectives Tenoxicam is widely used in osteoarthritis treatment and we aimed to compare the effectivity of oral and intra‐articular administration of tenoxicam in osteoarthritis treatment. Methods This study was performed between 2011 and 2012 by retrospectively analyzing and comparing the findings of 60 patients who were clinically and radiologically diagnosed with knee degenerative osteoarthritis in Bünyan state hospital pain policlinic. 60 patients included in the study were divided into two groups. The first group (tenoxicam IA, n = 30) included patient findings of those subjected to intra‐articular injection of 20 mg tenoxicam to the knee once a week for three weeks and the second group (oral tenoxicam, n = 30) included patients who were administered 20 mg oral tenoxicam once a day for three weeks. All patients were clinically evaluated pre‐treatment and in the 1 st week, 1 st month and 3 rd month post‐treatment according to specified criteria. Results and conclusions 22 of 60 patients included in the study were male and 38 were female. In both groups significant improvements were detected in all of the observed parameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physical activity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1 st week, 1 st month and 3 rd month with respect to pre‐treatment values. Besides, a better compliance to treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed. Intra‐articular tenoxicam administration could be thought as an alternative treatment method in patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemic gastrointestinal system side effects and those who have difficulties in adapting to treatment. [ABSTRACT FROM AUTHOR]

Resumo Justificativa e objetivos Sabe‐se que o tabagismo aumenta a percepção de dor; porém, o efeito do tabagismo sobre a percepção da dor durante o cateterismo venoso não é conhecido. O objetivo deste estudo foi determinar se o tabagismo tem ou não algum efeito sobre a percepção da dor durante a punção venosa periférica. Métodos Foram incluídos no estudo 220 pacientes agendados para cirurgia eletiva randomicamente alocados em dois grupos: Grupo S (n = 110) e Grupo C (n = 110), de acordo com seus hábitos tabagísticos. Os pacientes foram instruídos sobre o uso da escala numérica de classificação da dor e, em seguida, a punção venosa periférica foi feita no dorso da mão com um cateter de calibre 20G (Intracath ® ). A percepção de dor dos pacientes foi posteriormente registrada de acordo com os escores da escala numérica. Resultados As características demográficas dos grupos eram idênticas. Os escores da escala numérica de dor dos grupos S e C foram 3,31 ± 1,56 e 1,65 ± 1,23, respectivamente (p < 0,001). Conclusão A percepção da dor por causa da punção venosa periférica é maior em fumantes. Estudos futuros sobre o tratamento da dor devem considerar os hábitos tabagísticos dos pacientes. Background and objectives It has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. The purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation. Methods 220 patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n = 110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20 G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning. Results The demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31 ± 1.56 and 1.65 ± 1.23, respectively ( p < 0.001). Conclusion Pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients. [ABSTRACT FROM AUTHOR]

Resumo Justificativa e objetivo os medicamentos administrados por via intravenosa podem ser contaminados durante as várias fases de produção ou preparação. Sugamadex é uma gama‐ciclodextrina modificada. Embora muitas pesquisas sobre os efeitos antibacterianos de uma variedade de ciclodextrinas estejam disponíveis, não há estudos dos efeitos antibacterianos de sugamadex. Este estudo investigou a atividade antimicrobiana in vitro de sugamadex. Materiais e métodos a atividade antimicrobiana in vitro de sugamadex foi investigada pelo método de microdiluição em meio de cultura. O pH da solução de ensaio foi determinado com o uso de um medidor de pH. Os microrganismos‐teste analisados incluíram Staphylococcus aureus ATCC 29213, Enterococcus fecalis ATCC 29212, Escherichia coli ATCC 25922 e Pseudomonas aeruginosa ATCC 27853. Na segunda fase do estudo, 100 mg/mL de sugamadex (50 μg) foram contaminados com microrganismos‐teste (50 μg), incluindo S. aureus ATCC 29213, E. fecalis ATCC 29212, E. coli ATCC 25922 e P. aeruginosa ATCC 27853, incubados por 24 horas e, em seguida, a produção bacteriana foi avaliada. Resultados o pH das soluções da análise variaram entre 7,25 e 6,97. Com o uso do método de microdiluição, sugamadex não apresentou efeito antibacteriano contra S. aureus , E. fecalis , E. coli e P. aeruginosa em qualquer concentração. Na segunda fase do estudo, a produção bacteriana foi observada após 24 horas em 100 mg/mL de sugamadex contaminados com os microrganismos‐teste S. aureus, E. fecalis, E. coli e P. aeruginosa . Conclusões sugamadex não apresentou efeito antimicrobiano sobre os microrganismos‐teste S. aureus, E. fecalis, E. coli e P. aeruginosa. Cuidados devem ser tomados para que as condições estéreis sejam mantidas na preparação de sugamadex, para que a mesma preparação não seja usada em mais de um paciente e para que as condições de armazenamento sejam observadas após a colocação de sugamadex em injetor. [ABSTRACT FROM AUTHOR]

Background and Objectives: Tenoxicam is widely used in osteoarthritis treatment and we aimed to compare the effectivity of oral and intra-articular administration of tenoxicam in osteoarthritis treatment., Methods: This study was performed between 2011 and 2012 by retrospectively analyzing and comparing the findings of 60 patients who were clinically and radiologically diagnosed with knee degenerative osteoarthritis in Bünyan state hospital pain policlinic. 60 patients included in the study were divided into two groups. The first group (tenoxicam IA, n=30) included patient findings of those subjected to intra-articular injection of 20mg tenoxicam to the knee once a week for three weeks and the second group (oral tenoxicam, n=30) included patients who were administered 20mg oral tenoxicam once a day for three weeks. All patients were clinically evaluated pre-treatment and in the 1st week, 1st month and 3rd month post-treatment according to specified criteria., Results and Conclusions: 22 of 60 patients included in the study were male and 38 were female. In both groups significant improvements were detected in all of the observed parameters: visual analog scale, Western Ontario McMaster Osteoarthritis Index (pain, physical activity, knee stiffness) and Lequesne index scores and in the evaluations performed in 1st week, 1st month and 3rd month with respect to pre-treatment values. Besides, a better compliance to treatment and gastrointestinal system tolerability in tenoxicam IA group was also observed. Intra-articular tenoxicam administration could be thought as an alternative treatment method in patients with knee osteoarthritis who cannot use oral tenoxicam especially due to systemic gastrointestinal system side effects and those who have difficulties in adapting to treatment., (Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background and Objectives: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position., Methods: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline); 10min after intubation (Supine 1); 10 (Prone 1), 60 (Prone 2), 120 (Prone 3)min after prone position; and just after postoperative supine position (Supine 2)., Results: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p=0.009 and p=0.003, respectively). We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline., Conclusions: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery., (Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background and Objectives: It has been demonstrated that smoking increases pain perception; however the effect of smoking on perception of pain during venous cannulation is not known. The purpose of this study is to determine whether or not smoking has an effect on pain perception due to peripheral venous cannulation., Methods: 220 patients scheduled to have elective surgery were enrolled in the study and were divided into two groups (Group S and C, n=110 for each) according to their smoking habits. Numerical rating scale was introduced to the patients and then peripheral venous cannulation at the dorsum of the hand was made with a 20G intracath. Pain perception of the patients was scored by subsequent numerical rating scale questioning., Results: The demographic characteristics of the groups were identical. Numerical rating scale scores in Group S and C were 3.31±1.56 and 1.65±1.23, respectively (p<0.001)., Conclusion: Pain perception due to peripheral venous cannulation is higher in smokers. Future studies on pain treatment should consider the smoking habits of patients., (Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background: Brachial endothelial function has been associated with coronary slow flow (CSF). Increasing blood flow to brachial artery provokes endothelium to release nitric oxide (NO) with subsequent vasodilatation. Besides its β1-blocker activity, nebivolol causes vasodilatation by increasing endothelial NO release., Objective: To assess the effects of nebivolol on vascular endothelial function in patients with CSF., Methods: Forty-six patients with CSF and 23 individuals with normal epicardial coronary arteries were examined with transthoracic echocardiography and brachial artery ultrasonography. The patients were reevaluated two months after treatment with aspirin or aspirin plus nebivolol., Results: Patients with CSF had higher body mass index (26.5 ± 3.3 vs. 23.8 ± 2.8, p < 0.001), mitral inflow isovolumetric relaxation time (IVRT) (114.9 ± 18.0 vs. 95.0 ± 22.0 msec, p < 0.001) and lower left ventricular ejection fraction (LVEF) (63.5 ± 3.1% vs. 65.4 ± 2.2, p = 0.009), HDL-cholesterol (39.4 ± 8.5 vs. 45.8 ± 7.7 mg/dL, p = 0.003) and brachial flow-mediated dilatation (FMD) (6.1 ± 3.9% vs. 17.6 ± 4.5%, p < 0.001). There were significant correlations between FMD and the presence of CSF (r = 0.800, p < 0.001) and HDL-cholesterol (r = 0.349, p = 0.003). Among Patients with CSF, although pretreatment mean FMD values were similar (6.1 ± 4.3% vs. 6.0 ± ,6%, p = 0.917) compared to aspirin alone group, posttreatment FMD was significantly higher in patients treated with aspirin plus nebivolol (6.0 ± 3.5% vs. 8.0 ± 2.9%, p = 0.047). Treatment with nebivolol was associated with a significant increase in FMD (6.0 ± 3.6 to 8.0 ± 2.9 %, p = 0.030) whereas treatment with aspirin alone was not., Conclusion: Endothelial function may be impaired in both coronary and brachial arteries in patients with CSF and nebivolol may be effective in the improvement of endothelial function in patients with CSF.