Search

Ketamine and propofol are the general anesthetics that also have antimicrobial and microbial growth-promoting effects, respectively. Although these agents are frequently applied together during clinical use, there is no data about their total effect on microbial growth when combined. In this study, we investigated some organisms’ growth in a ketamine and propofol mixture.

La Cetamina y el propofol son los anestésicos generales que también tienen efectos antimicrobianos y son los promotores del crecimiento microbiano, respectiva- mente. Aunque esos agentes sean frecuentemente aplicados en combinación durante el uso clínico, no hay datos sobre su efecto total en el crecimiento microbiano en la administración combinada. En ese estudio, investigamos el crecimiento de algunos microrganismos en una mezcla de cetamina y propofol.

Cetamina e propofol são os anestésicos gerais que também exibem efei- tos antimicrobianos e promotores do crescimento microbiano, respectivamente. Embora esses agentes sejam frequentemente aplicados em combinação durante o uso clínico, não há dados sobre seu efeito total no crescimento microbiano na administração combinada. Nesse estudo, investigamos o crescimento de alguns microrganismos em uma mistura de cetamina e propofol.

In this paper, we first construct a model for free surface flows that takes into account the air entrainment by a system of four partial differential equations. We derive it by taking averaged values of gas and fluid velocities on the cross surface flow in the Euler equations (incompressible for the fluid and compressible for the gas). The obtained system is conditionally hyperbolic. Then, we propose a mathematical kinetic interpretation of this system to finally construct a two-layer kinetic scheme in which a special treatment for the “missing” boundary condition is performed. Several numerical tests on closed water pipes are performed and the impact of the loss of hyperbolicity is discussed and illustrated. Finally, we make a numerical study of the order of the kinetic method in the case where the system is mainly non hyperbolic. This provides a useful stability result when the spatial mesh size goes to zero.

We compared the effectiveness of three anaesthetic regimens (propofol alone, propofol with remifentanil and sevoflurane alone), with respect to seizure duration and seizure quality in patients undergoing electroconvulsive therapy.Thirty-nine patients underwent a total of 234 electroconvulsive therapy treatments in this prospective, observer blinded, crossover study. Each patient received either propofol 1 mg/kg alone (Group P), propofol 0.5 mg/kg and remifentanil 1 μg/kg (Group R), or sevoflurane alone 6% (Group S) for their initial electroconvulsive therapy session. The patients subsequently received an alternative regimen in their next session, such as from propofol 1 mg/kg alone to propofol 0.5 mg/kg and remifentanil 1 μg/kg, from propofol 1 mg/kg alone to propofol 0.5 mg/kg and remifentanil 1 μg/kg to sevoflurane alone 6%, or from sevoflurane alone 6% to a continuing alternation between drugs at each session, until their sixth session. Muscle paralysis was achieved with 1 mg/kg succinylcholine. Seizure duration, postictal suppression index, early and midictal amplitude were recorded. The mean motor and electroencephalogram seizure durations were significantly longer in Groups P and R compared to Group S (P<0.001). The postictal suppression index and early and midictal amplitude values were not significantly different among the groups.These findings indicate that the three anaesthetic regimens had similar effects on seizure quality parameters, although sevoflurane was associated with shorter seizure durations than propofol or propofol-remifentanil.

The aim of this study was to evaluate the effect of a ketamine:propofol combination (‘ketofol’) for electroconvulsive therapy on seizure activity, haemodynamic response and recovery parameters, and to compare with these with the effects of propofol alone. Twenty-four patients underwent a total of 144 electro-convulsive therapy sessions, allocated in this prospective, double-blind, crossover study. Patients were randomly assigned to receive 1 mg/kg ketofol (0.5 mg/kg propofol plus 0.5 mg/kg ketamine) or 1 mg/kg propofol 1% for anaesthesia induction. Seizure duration and quality, haemodynamic data, recovery parameters and side-effects were recorded and analysed between groups. Both motor and electroencephalography seizure durations in the ketofol group (29±17 and 41±17 seconds, respectively) were similar to that in the propofol group (28±13 and 38±16 seconds, respectively). Postictal suppression index was higher in the ketofol group (89.63±7.88) than in the propofol group (79.74±14.6) (P P <0.05). There were no untoward psychological reactions following ketofol. Although no superiority to propofol in terms of seizure duration, haemodynamic or recovery parameters was found, the ketofol mixture selected in our study provided better seizure quality than propofol. We conclude that ketofol can be an alternative strategy to enhance the seizure quality and clinical efficiency of electroconvulsive therapy.

OBJECTIVE:This paper reports the first-ever description of a clinical eating disorder population from Turkey. The aim of this study was to examine the socio-demographic and clinical characteristics of individuals with diagnosis of eating disorders (IDED) referred to a university psychiatry clinic in Istanbul between 2003 and 2009. METHOD:The diagnoses and subtype of 111 IDEDs, the referral type to the hospital, setting of treatment, and state of involuntary hospitalization were evaluated by interview and semi-structured questionnaire. RESULTS:The clinical sample included 64 individuals with anorexia nervosa (AN), 38 with bulimia nervosa (BN), and 9 with eating disorder not otherwise specified (EDNOS), including only one male. Younger individuals and those with a lower BMI were significantly more likely to be family referred and hospitalized involuntarily. DISCUSSION:The overall socio-demographic features of the sample are generally consistent with data collected in other communities. However, aspects of the clinical features, referral types of eating disorders and subtypes exhibit some characteristics peculiar to our sample.

This randomised controlled study evaluated the effects of fentanyl and dexmedetomidine on emergence characteristics of children having adenoidectomy and anaesthetised with sevoflurane.Ninety children, two to seven years of age and ASA physical status I, were studied. Children were randomly assigned to one of three groups of 30 children, with the study intervention injection given intravenously after intubation. Children in Group F received fentanyl 2.5 μg.kg−1children in Group D received dexmedetomidine 0.5 μg.kg−1and children in Group C received saline solution. Anaesthesia was induced with 50% N2O and 8% sevoflurane in O2by mask and atracurium 0.6 mg.kg−1was administered for tracheal intubation. All children received paracetamol 40 mg/kg rectally one hour preoperatively and dexamethasone 0.5 mg.kg−1intravenously.The time to extubation was shorter in Group D than Group F. The eye-opening time was longer in Group F (16.1∓5.3 minutes) than in Groups C (12.0∓4.2 minutes) and D (12.7∓3.2 minutes). The proportion of pain-free children in early recovery was significantly higher in Groups D (47%) and F (43%) than Group C (13%) (P <0.05). The proportion of children with agitation scores >3 was lower in Groups D 17% (5/30) and F 13% (4130) than in Group C 47% (14/30) (P <0.05). Fentanyl 2.5 μg.kg−1and dexmedetomidine 0.5 μg.kg−1had similar haemodynamic effects and emergence characteristics. Fentanyl has been safely used in children for many years. Further studies of dexmedetomidine safety and its interaction with other anaesthetic agents are required before recommending its routine use during general anaesthesia in children.

Background: Laryngospasm is the most common cause of upper airway obstruction after tracheal extubation. Magnesium has a central nervous system depressant property, which contributes to the depth of anaesthesia. It also has calcium antagonist properties, which provide muscle relaxation. In this study, we aimed to determine the effect of magnesium on preventing laryngospasm.

AIM: A comparative radiologico-anatomical study of the cochlear aqueduct (CA) was performed.

BACKGROUND: The pterion, the most commonly used neurosurgical landmark, is defined as the junction of frontal, parietal, and greater wing of the sphenoid and the squamous part of temporal bones. Our aim was to identify the variations of the pterion which may be a potential surgical pitfall.[nl] METHODS: Both sides of 300 adult skulls were examined but 110 sides were eliminated since their pterion could not be identified owing to a damage. The shortest distance between the lateral orbital rim and the most anterior junction of the four bones forming the pterion was measured on all sides.[nl] RESULTS: Out of 490 sides the pterion was found to contain epipteric bones in 44 (9 %), and in these skulls the most anterior junction of the bones may be as close as 16 mm to the lateral orbital rim.[nl] CONCLUSION: In skulls with an epipteric bone variation, particularly the anterius and proprium types; the pterion can mistakenly be assessed to be at the most anterior junction of bones and a burr hole placed over there may cause inadvertent penetration into the orbit.

Background. We evaluated the sedative, haemodynamic and respiratory effects of dexmedetomidine and compared them with those of midazolam in children undergoing magnetic resonance imaging (MRI) procedures. Methods. Eighty children aged between 1 and 7 yr were randomly allocated to receive sedation with either dexmedetomidine (group D, n=40) or midazolam (group M, n=40). The loading dose of the study drugs was administered for 10 min (dexmedetomidine 1 µg kg−1 or midazolam 0.2 mg kg−1) followed by continuous infusion (dexmedetomidine 0.5 µg kg−1 h−1 or midazolam 6 µg kg−1 min−1). Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during MRI. The children who were inadequately sedated were given a single dose of rescue midazolam and/or propofol intravenously. Mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Spo2) and ventilatory frequency (VF) were monitored and recorded during the study. Results. The quality of MRI was significantly better and the rate of adequate sedation was higher in group D than in group M (P<0.001). In group D, the requirement for rescue drugs was lower and the onset of sedation time was shorter than in group M (P<0.001). MAP, HR and VF decreased from baseline during sedation in both groups (P<0.001). Conclusions. Dexmedetomidine provided adequate sedation in most of the children aged 1–7 yr without haemodynamic or respiratory effects during MRI procedures.