The effects of total intravenous and inhalation anesthesia maintenance on tissue oxygenation in coronary artery bypass graft surgery.

OBJECTIVE: The aim of this study is to evaluate the effect of total intravenous anesthesia (TIVA) and inhalational anesthesia techniques on tissue oxygenation in cardiac surgery. We compared the effects of midazolam-based TIVA and sevoflurane-based (SEVO) inhalation anesthesia maintenance on intraoperative central and regional tissue oxygenation parameters. PATIENTS AND METHODS: A total of 104 adult patients who were scheduled for elective isolated coronary bypass surgery were included in the study. All patients were divided into two groups: the TIVA group consisted of total intravenous anesthesia maintenance patients (n=52) and the SEVO group consisted of patients with inhalation anesthesia with sevoflurane maintenance (n=52). Tissue oxygenation values were observed with left-right cerebral and somatic left forearm Near-Infrared Spectroscopy (NIRS) sensors. The hemodynamic parameters, NIRS StO2, central (ScvO2) and peripheral venous oxygen saturations of the patients were recorded at six intraoperative time points. RESULTS: The effects of midazolam-based TIVA and sevoflurane-based inhalation anesthesia maintenance on intraoperative central and peripheral tissue oxygenation parameters were compared and it was found that in the left forearm NIRS StO2 and ScvO2 values were higher in the SEVO group than the TIVA group. Although not significantly different, forearm regional venous oxygen saturation was also higher in the SEVO group. CONCLUSIONS: The effects of anesthetic drugs on regional tissue oxygenation can become important in critical patients and challenging surgeries. Sevoflurane-based anesthesia provides better tissue oxygenation than TIVA in patients undergoing coronary bypass surgery.

Attitudes of Turkish Medical and Law Students towards the Organ Donation.

BACKGROUND: Attitudes of medical and law personnel towards organ donation are very important. OBJECTIVE: To compare the attitudes of the medical and law students towards organ donation. METHODS: 498 students in the 1(st) and 4(th) grades of the medical and law faculties of Erciyes University, Kayseri, Turkey, in 2011-12 academic year, were included in this study. A questionnaire consisting of 31 questions on socio-demographic characteristics of the students and their attitudes towards organ donation and transplantation was administered to the participants. RESULTS: The percentage of the students who donated organs was 1%. Approximately, 48% of the medical students and 34% of the law students stated that they think to donate organs. The percentage of the students with a positive attitude towards organ donation was found significantly higher among the medical students than the law students, and higher among the 4th grade compared to the 1(st) grade. CONCLUSION: The percentages of the students who have donated organs and think to donate are rather low. Medical students' attitude towards organ donation was more positive than the law students.

Primary healthcare professionals' knowledge, attitude and behavior regarding influenza immunization; 2006-2007 season adverse effect profile.

OBJECTIVE: The objective of this study was to assess primary healthcare professionals' knowledge, attitude and behavior regarding immunization, as well as to evaluate the adverse effect profile for the 2006-2007 influenza vaccines. BACKGROUND: Influenza vaccination has been proven to have clinical and epidemiological benefits. However, its uptake in the general population and among healthcare workers has generally been suboptimal. METHODS: Primary healthcare professionals of Kayseri were enrolled in the study. Of the 672 primary healthcare professionals in Kayseri, 552 (82 %) completed a questionnaire comprised of 19 questions. The study was performed in March 2007 following a campaign of the Ministry of Health of Turkey for influenza vaccination of primary healthcare workers. RESULTS: Of the health professionals, 67 % (370) were women and 33 % (182) were men. Overall, 420 (76.1 %; 95% confidence interval: CI = 72.3-79.5) health professionals reported that they had received influenza vaccine during the 2006-2007 influenza season. Adverse effects were reported by 157 (28.4 %) health professionals. The adverse effects reported were fever (n=57; 13.5 %), muscle pain (n=60; 14.2 %), joint pain (n=40; 9.5 %), loss of appetite (n=16; 3.8%), headache (n=41; 9.7 %), cough (n=29; 6.9 %), malaise (n=76; 18.0 %), tiredness (n=41; 9.7 %), stuffiness (n=49; 11.6 %), sneezing (n=54; 12.8 %), sore throat (n=33; 7.8 %) and others, namely erythema, edema and abscess at the vaccination site, and lymphadenopathy (n=14; 3.3 %). CONCLUSION: Our study demonstrated that primary health care professionals in our study group have been vaccinated with influenza vaccine in a reasonable percentage. There were no severe or serious adverse effects of the vaccine, the fact of which may be used to encourage both health professionals and patients of primary care (Tab. 3, Ref. 13).

Protective role of intramuscularly administered vitamin E on the levels of lipid peroxidation and the activitiesof antioxidant enzymes in the lens of rats made cataractous with gamma-irradiation.

PURPOSE: To determine the antioxidant role of vitamin E (VE) (10 mg/kg/day) against radiation-induced cataract in lens after total-cranium irradiation of rats with a single dose of 5 Gy. METHODS: Sprague-Dawley rats were divided into three groups. Group 1 did not receive VE or irradiation but received both 0.1 ml physiologic saline intraperitoneally and sham irradiation (control group). Group 2 received to total cranium 5 Gy of gamma irradiation as a single dose (RT group) plus 0.1 ml physiologic saline intraperitoneally. Group 3 received irradiation to total cranium plus 10 mg/kg/day VE (RT+VE group). The rats were irradiated using a cobalt-60 teletherapy unit. Chylacks cataract classification (1) was used in this study. At the end of 10 days, the rats were killed and their eyes were enucleated to measure the antioxidant enzymes (the activity of superoxide dismutase [SOD], glutathione peroxidase [GSH-Px]) and lipid peroxidation level (malondialdehyde [MDA]). RESULTS: While grade 1 cataract development was detectable in seven rats in the RT group, it was detectable only in two rats in the RT+VE group, whereas none of the rats in the control group exhibited any biomicroscopic change in their lenses. MDA level and GSH-Px activity in the rat lens in the RT group was significantly higher than in the control group. SOD activity in the RT group was lower than in the control group. The activity of SOD and GSH-Px enzymes was higher in the RT+VE group, but MDA level was lower in the RT+VE group when compared with the RT group. CONCLUSIONS: Vitamin E has a protective effect on radiation-induced cataract by decreasing oxidative stress. (Eur J Ophthalmol 2004; 14: 478-85).

Protective role of intramuscularly administered vitamin E on the levels of lipid peroxidation and the activities of antioxidant enzymes in the lens of rats made cataractous with gamma-irradiation.

PURPOSE: To determine the antioxidant role of vitamin E (VE) (10 mg/kg/day) against radiation-induced cataract in lens after total-cranium irradiation of rats with a single dose of 5 Gy. METHODS: Sprague-Dawley rats were divided into three groups. Group 1 did not receive VE or irradiation but received both 0.1 ml physiologic saline intraperitoneally and sham irradiation (control group). Group 2 received to total cranium 5 Gy of gamma irradiation as a single dose (RT group) plus 0.1 ml physiologic saline intraperitoneally. Group 3 received irradiation to total cranium plus 10 mg/kg/day VE (RT+VE group). The rats were irradiated using a cobalt-60 teletherapy unit. Chylack's cataract classification (1) was used in this study. At the end of 10 days, the rats were killed and their eyes were enucleated to measure the antioxidant enzymes (the activity of superoxide dismutase [SOD], glutathione peroxidase [GSH-Px]) and lipid peroxidation level (malondialdehyde [MDA]). RESULTS: While grade 1 cataract development was detectable in seven rats in the RT group, it was detectable only in two rats in the RT+VE group, whereas none of the rats in the control group exhibited any biomicroscopic change in their lenses. MDA level and GSH-Px activity in the rat lens in the RT group was significantly higher than in the control group. SOD activity in the RT group was lower than in the control group. The activity of SOD and GSH-Px enzymes was higher in the RT+VE group, but MDA level was lower in the RT+VE group when compared with the RT group. CONCLUSIONS: Vitamin E has a protective effect on radiation-induced cataract by decreasing oxidative stress.