Fragmented marine plastics as the prevalent litter type on a small island beach in the Adriatic.

The issue of plastic pollution has dramatically intensified in the recent years. Our study investigates extensive plastic contamination of a sandy beach on a small Adriatic island. The beach was sampled on three occasions, in 2013, 2020 and 2022, using 1 m2 quadrats placed along the lower and upper strandlines, resulting in average litter concentrations of 385 ± 106, 1095 ± 522 and 129 ± 37 item m-2, respectively. The lower size limit of collected litter was 1 mm, thus including large microplastics. Plastic fragments (49-74 %) and plastic pellets (15 %-37 %) were predominant litter categories. The proportion of fragments is significantly higher during the tourist season with a more intensive cleaning regime (April-October), as opposed to the off-season (November-March). Fisheries and aquaculture litter was identified as a relevant source of pollution. More research is needed in the future into the microplastics smaller than 1 mm.

Microplastic pollution in the intertidal and subtidal sediments of Vava'u, Tonga.

Plastic pollution research on a global scale intensified considerably in the current decade; however, research efforts in the South Pacific are still lagging. Here, we report on microplastic contamination of intertidal and subtidal sediments in the Vava'u archipelago, Tonga. While providing the first baseline data of its type in Tonga, the study also advances methods and adjusts them for low-budget research. The methods were based on density separation of microplastics from the sediment using CaCl2, a high-density salt which due to its high solubility, low cost and availability. Once separated, microplastics were quantified by microscopic analysis and polymers characterized via FTIR spectroscopy. Microplastics in intertidal and subtidal sediments were found in concentrations of 23.5 ± 1.9 and 15.0 ± 1.9 particles L-1 of sediment, respectively. The dominant type of microplastics in both intertidal (85 %) and subtidal sediments (62 %) were fibres.

Microplastic pollution in the surface waters of Vava'u, Tonga.

Marine plastic pollution, particularly microplastics, has been recognised as a global issue in the recent years, but research efforts in the Pacific are lagging. We carried out research on microplastics contamination of surface waters of the Vava'u archipelago, Tonga. Since microplastics smaller than the standard mesh size (333-335 µm) are readily reported in the literature on microplastics, we used a finer plankton net (100 µm) to determine the proportion of captured microplastics smaller than 300 µm. Isolated microplastics were counted and measured using stereomicroscope with polymer identification performed by FTIR spectroscopy. The analysis revealed high microplastics concentrations (329,299.7 ± 40,994.2 pcs km-2 or 1.05 ± 0.13 pcs m-3). The proportion of particles smaller than 300 µm was 40 %. The predominant type of microplastics in surface waters were small bits of white film, which we associated with cement-filled white bags used to construct docks throughout Vava'u, often heavily eroded.

Double trouble in the South Pacific subtropical gyre: Increased plastic ingestion by fish in the oceanic accumulation zone.

Fish are an important food source for South Pacific (SP) island countries, yet there is little information on contamination of commercial marine fish species by plastic. The aim of our study was to perform a broad-scale assessment of plastic ingestion by fish common in the diet of SP inhabitants. We examined 932 specimens from 34 commercial fish species across four SP locations, and some of the prey they ingested, for the presence of marine plastics. Plastic was found in 33 species, with an average ingestion rate (IR) of 24.3 ±â€¯1.4% and plastic load of 2.4 ±â€¯0.2 particles per fish. Rapa Nui fish exhibited the greatest IR (50.0%), significantly greater than in other three locations. Rapa Nui is located within the SP subtropical gyre, where the concentration of marine plastics is high and food is limited. Plastic was also found in prey, which confirms the trophic transfer of microplastics.

Thoracic epidural analgesia for radical cystectomy improves bowel function even in traditional perioperative care: a retrospective study in eighty-five patients.

Radical cystectomy is associated with significant morbidity and mortality due to complex surgery and comorbidities associated with advanced age of patients. In contrast to the surgery, which is clearly the procedure of choice for patients with invasive bladder cancer, the opti- mal anesthesiologic method is still under debate. Therefore, we retrospectively analyzed 85 patients having undergone radical cystectomy at our institution, either under combined epidural-general anesthesia (CEGA) or opioid based general anesthesia (GA). The intraoperative blood loss was significantly lower in CEGA group (497.37 ± 354.13) than in GA group (742.31 ± 403.69; p = 0.006), due to induced hypotension. Consequently, blood transfusion requirements were lower in CEGA group (107.20 ± 263.92) than in GA group (388.18 ± 321.32; p = 0.001). The incidence of postoperative ileus was also lower in CEGA group (p = 0.024). There was no difference in analgesic efficacy, but a trend towards lower incidence of venous thrombosis and infection was noticed. The results of our study suggest that epidural anesthesia might have specific advantages in patients undergoing radical cystectomy.

Estimates of marine debris accumulation on beaches are strongly affected by the temporal scale of sampling.

Marine debris is a global issue with impacts on marine organisms, ecological processes, aesthetics and economies. Consequently, there is increasing interest in quantifying the scale of the problem. Accumulation rates of debris on beaches have been advocated as a useful proxy for at-sea debris loads. However, here we show that past studies may have vastly underestimated the quantity of available debris because sampling was too infrequent. Our study of debris on a small beach in eastern Australia indicates that estimated daily accumulation rates decrease rapidly with increasing intervals between surveys, and the quantity of available debris is underestimated by 50% after only 3 days and by an order of magnitude after 1 month. As few past studies report sampling frequencies of less than a month, estimates of the scale of the marine debris problem need to be critically re-examined and scaled-up accordingly. These results reinforce similar, recent work advocating daily sampling as a standard approach for accurate quantification of available debris in coastal habitats. We outline an alternative approach whereby site-specific accumulation models are generated to correct bias when daily sampling is impractical.

Paraneoplastic limbic encephalitis in a patient with adenocarcinoma of the colon: a case report.

Paraneoplastic limbic encephalitis is a rare clinical entity characterized by the development of neuropsychiatric symptoms associated with malignancies. A case of a woman who presented to the Emergency Department with abdominal pain, hyperglycemia, and altered mental status is presented. After initial stabilization and correction of hyperglycemia the patient underwent emergency surgery. Laparotomy showed marked dilatation and gangrenous changes of the colon and tumor in the sigmoid colon. She was mechanically ventilated and remained ventilator-dependent for 42 days. Most of the time she was febrile; fever persisted with peaks up to 40° C despite various antibiotic treatments. On neurological examination, the patient was somnolent with left-sided hemiparesis. Magnetic resonance imaging (MRI) showed hyperintensities in both hippocampal areas, and electroencephalography (EEG) showed sharp-wave activity in the temporal lobes. Cerebrospinal fluid (CSF) examination showed slightly elevated protein levels, and laboratory assessments showed an elevated titer of anti-Yo antibodies. Although we do not have pathological confirmation of limbic encephalitis, the diagnosis of paraneoplastic limbic encephalitis was presumed on the basis of MRI findings, EEG abnormality, elevated CSF protein, positive anti YO antibodies, and neurological findings.

Extubation strategy following difficult intubation.

Airway management relates to the period of tracheal intubation, maintenance of endotracheal tube in situ, and finally extubation. Problems related to difficult extubation still pose significant challenge for both anesthesiologists and intensivists. This article reviews current approach to extubation strategy following difficult intubation. Guidelines and algorithm may be helpful in order to ensure safe management of the patient during this delicate period of airway management.

The effect of spinal versus general anesthesia on postoperative pain and analgesic requirements in patients undergoing peripheral vascular surgery.

The optimal anesthetic technique for peripheral vascular surgery remains controversial. The purpose of this study was to evaluate the effect of spinal versus general anesthesia on postoperative pain, analgesic requirements and postoperative comfort in patients undergoing peripheral vascular surgery. A total of 40 patients scheduled for peripheral vascular surgery were randomly assigned to two groups of 20 patients each to receive general anesthesia (GA) or spinal anesthesia (SA). In GA group, anesthesia was induced using thiopental and fentanyl. Vecuronium was used for muscle relaxation. Anaesthesia was maintained with isoflurane and nitrous oxide. In the SA group, hyperbaric 0.5% bupivacaine was injected into the subarachnoid space. Postoperative pain was assessed for 24 hours by a visual analog scale during three assessment periods: 0-4, 4-12 and 12-24 h as well as analgesic requirements. Patients were also asked to assess their postoperative state as satisfactory or unsatisfactory with regard to the pain, side effects and postoperative nausea and vomiting. Visual analogue scale (VAS) pain score was significantly lower in the group SA compared with group GA. This effect was mainly due to the lower pain score during the first study period. The patients received general anesthesia also reported a significantly higher rate of unsatisfactory postoperative comfort than those receiving spinal anesthesia. We conclude that spinal anesthesia is superior to general anesthesia when considering patients' satisfaction, side effects and early postoperative analgesic management.

[Laparoscopic cholecystectomy in patients with ventriculoperitoneal shunt]. / Laparoskopsko odstranjenje zucnog mjehura u bolesnika s ventrikuloperitonealnim kateterom.

Because of development of laparoscopic surgery and by knowing of its pathophysiological effects on organism, indications for laparoscopic surgery have become more extensive, so this method is today used for therapeutic and diagnostic procedures. Although ventriculoperitoneal shunt is not normally considered a contraindication for laparoscopic surgery, pneumoperitoneum is described as a cause of raised intracranial pressure. Since 1992 when the first laparoscopic cholecystectomy was done at the University Department of Surgery of Sveti Duh Clinical Hospital in Zagreb, three patients with implanted ventriculoperitoneal shunt were managed successfully laparoscopically. In all three patients, there were no complications during and after the surgery. In this paper we present our experience of three cases and short review of the literature.