Preliminary findings for preemptive analgesia with inhaled morphine: efficacy in septoplasty and septorhinoplasty cases.

OBJECTIVE: The aim of this study was to assess the efficacy of inhaled morphine for preemptive analgesia in patients who undergo septoplasty or septorhinoplasty. STUDY PLAN AND METHODS: Eighty ASA I-II patients scheduled for septoplasty or septorhinoplasty were recruited and randomly divided into 2 groups that received different treatments 10 minutes prior to induction. The preemptive analgesia group (Group P, n = 40) received 65 mug kg(-1) morphine sulphate (a 3-mL volume) via an oral nebulizer, and the control group (Group C, n = 40) received 3 mL 0.9% sodium chloride (physiological saline) via the same type of nebulizer. Blood pressure, oxygen saturation, heart rate, time to first requirement for analgesia, and occurrence of nausea/vomiting were recorded. RESULTS: There were no significant differences between Groups P and C with respect to age, body weight, sex distribution, or duration of surgery. There was also no significant difference between the group frequencies of postoperative nausea/vomiting. The time to first requirement for analgesia was significantly longer in Group P than Group C. CONCLUSION: The results of this preliminary study suggest that a single dose of inhaled morphine administered preemptively prior to septoplasty or septorhinoplasty provides effective postoperative analgesia. EBM rating: B-3b.     

Iatrogenic injuries to ureter, bladder and urethra during abdominal and pelvic operations

Abdominal and pelvic operations at Departments of Obstetrics and Gynaecology, and General Surgery play an important role in ureteral, bladder and rarely urethral injuries. Fifty-nine patients with iatrogenic ureteral, bladder and urethral injuries were treated at the Department of Urology, Atatürk University Research Hospital, between 1985 and 1995. These injuries were urinary vaginal fistulas in 43 patients (vesicovaginal 33, ureterovaginal 7, urethrovaginal 2 and vesicovaginal plus urethrovaginal 1), ureteric ligation in 9, bladder laceration in 7. These injuries were treated by different methods. All patients were followed up by intravenous urography (IVU) and urine culture three months later. It must be borne in mind that iatrogenic urinary tract injuries are not rare. Bladder and ureteral catheterization must be performed to prevent these complications.     

Case report: Osseous metaplasia of the endometrium: a rare cause of infertility and its hysteroscopic management

This case report presents a very rare and long-standing causeof infertility, osseous metaplasia of the endometrium, and describesits successful management by hysteroscopy. A woman with a historyof induced abortion 12 years ago, failed to conceive from thattime on. The infertility work-up was unrevealing except forthe presence of intracavitary calcification on ultrasonography.After diagnostic hysteroscopy, solid bony spicules coveringthe posterior wall of the endometrial cavity were removed bywire loop resectoscope. Histology established the diagnosisof osseous metaplasia of the endometrium. The patient conceivedin her second spontaneous cycle and has an ongoing pregnancyat the time of writing. Hysteroscopy was an effective meansof extracting this heterotopic tissue, thereby re-establishingfertility even after a long period of infertility.     

Effect of combined supplementation with vitamin E and alpha-lipoic acid on myocardial performance during in vivo ischaemia-reperfusion

Reactive oxygen species (ROS) contribute significantly to myocardial ischaemia-reperfusion (I-R) injury. Recently the combination of the antioxidants vitamin E (VE) and alpha-lipoic acid (alpha-LA) has been reported to improve cardiac performance and reduce myocardial lipid peroxidation during in vitro I-R. The purpose of these experiments was to investigate the effects of VE and alpha-LA supplementation on cardiac performance, incidence of dysrhythmias and biochemical alterations during an in vivo myocardial I-R insult. Female Sprague-Dawley rats (4-months old) were assigned to one of the two dietary treatments: (1) control diet (CON) or (2) VE and alpha-LA supplementation (ANTIOXID). The CON diet was prepared to meet AIN-93M standards, which contains 75 IU VE kg-1 diet. The ANTIOXID diet contained 10 000 IU VE kg(-1) diet and 1.65 g alpha-LA kg(-1) diet. After the 14-week feeding period, significant differences (P<0.05) existed in mean myocardial VE levels between dietary groups. Animals in each experimental group were subjected to an in vivo I-R protocol which included 25 min of left anterior coronary artery occlusion followed by 10 min of reperfusion. No group differences (P>0.05) existed in cardiac performance (e.g. peak arterial pressure or ventricular work) or the incidence of ventricular dysrhythmias during the I-R protocol. Following I-R, two markers of lipid peroxidation were lower (P<0.05) in the ANTIOXID animals compared with CON. These data indicate that dietary supplementation of the antioxidants, VE and alpha-LA do not influence cardiac performance or the incidence of dysrhythmias but do decrease lipid peroxidation during in vivo I-R in young adult rats.     

Synthesis and Characterization of Activated Carbon from Biowaste-Peanut Shell and Application to Preconcentration/Removal of Uranium

This study aims to synthesize and characterize an economical and ecological adsorbent with high adsorption capacity. For this purpose, the peanut shells (Pistacia vera L.) were modified chemically. After the synthesis of activated carbon (AC), the optimum conditions for enrichment steps were performed using parameters: pH and contact time for uranium in the model solutions. The measurements were carried out by inductively coupled plasma-mass spectrometry (ICP-MS). From the shapes of the BET isotherms, the AC obtained exhibits type I. The study indicated that the surface area and total pore volume of the AC were found to be 679.9 m² g⁻¹ and 0.31 cc g⁻¹, respectively. The adsorption capacity was found to be 260 mg g⁻¹. The optimum pH was found to be 6.0 for enrichment using the AC obtained by sulfuric acid as a chemical-modifier. The optimized method was applied to enrichment of U at ppb levels in the model solutions.

     

2D:4D Digit Ratios in Adults with Gender Dysphoria: A Comparison to Their Unaffected Same-Sex Heterosexual Siblings,Cisgender Heterosexual Men,and Cisgender Heterosexual Women

Archives of Sexual Behavior - We compared gender dysphoria (GD) patients and their same-sex siblings in terms of their 2D:4D ratios, which may reflect prenatal exposure to androgen, one of the...     

Application of Rhenium-186 Radiosynovectomy in Elbow Diffuse Pigmented Villonodular Synovitis. - A Case Report with Multiple Joint Involvement

After surgical therapy of diffuse pigmented villonodular synovitis (DPVNS), recurrence is seen in almost half of the patients. The effectiveness of radiosynovectomy (RSV) in preventing recurrence and complaints of DPVNS is well known. Elbow involvement in DPVNS is a very rare condition; therefore, RSV in elbow hasn’t been experienced widely. The aim of this case report is to show the effectiveness of RSV with rhenium-186 (Re-186) sulfide colloid. We applied Re-186 sulfide colloid to the elbow joint of DPVNS patients six weeks after arthroscopic synovectomy. As a result, the patient did not have any complaints, and our findings are compatible with residue or recurrence on magnetic resonance imaging (MRI) in sixth and twentieth month controls after administration. We concluded that Re-186 is an effective adjuvant therapy for the prevention of recurrence and complaints.     

Does hyaluronan affect inflammatory cytokines in knee osteoarthritis?

Our aim was to investigate the effects of hyaluronan on inflammatory cytokines in the synovial fluid of patients with knee osteoarthritis. The study was single blind, placebo-controlled, and randomized. We administered hyaluronan to 22 patients in the study group and placebo to 19 in the control group. Enzyme-linked immunosorbent assay was used to determine the levels of cytokines. Both HA and placebo caused a significant decrease in interleukin (IL)-6 levels (P=0.0001 and P=0.04, respectively). But it was more significant in the study group. However, IL-8 and tumor necrosis factor alpha (TNF-) levels did not change in either group (P>0.05). The amount of effusion decreased significantly in the study group (P=0.001) but not in the control group (P=0.133). It can be concluded that hyaluronan considerably decreased IL-6 levels, which correlated with clinical improvement, but had no effect on IL-8 and TNF- levels in synovial fluid. However, larger studies with longer follow-up periods are needed to explain the effect of hyaluronan on cytokines.