Investigation of the effect of postoperative early-term high-flow oxygen use on new-onset atrial fibrillation in high-risk patient groups after isolated coronary artery bypass graft operations.

OBJECTIVE: Postoperative atrial fibrillation (PoAF) is a significant complication that may occur after coronary artery bypass graft (CABG) surgeries. High-flow nasal oxygen (HFNO) therapy has recently been used in adult patients. In this current study, we aimed to investigate the effect of early HFNO treatment after extubation on the development of postoperative atrial fibrillation, in patient groups at risk for PoAF. PATIENTS AND METHODS: Patients who underwent isolated CABG surgery in our clinic between October 2021 and January 2022 and had a preoperative HATCH score of above 2, were retrospectively included in this study. After the extubation, patients who were followed-up with HFNO were defined as Group 1, and patients who were followed-up with a standard oxygen treatment were determined as Group 2. RESULTS: Group 1 consisted of thirty-seven patients with a median age of 56 (ranging between 37 and 75) years, while Group 2 had seventy-one patients with a median age of 58 (ranging between 41 and 71) years (p=0.357). The groups were similar in terms of gender, hypertension, diabetes mellitus, hypercholesterolemia, smoking, body mass index, and ejection fraction. The need for positive inotropic support and incidence of PoAF was significantly higher in Group 2 (p=0.022, p=0.017, respectively). CONCLUSIONS: In this study, we showed that HFNO treatment can reduce the rates of PoAF in high-risk patient groups.

The second wave of desaturation in coronavirus disease 2019.

After a complete symptomatic recovery from coronavirus disease 2019 pneumonia, the second phase of desaturation is a new phenomenon that is being increasingly observed. Two possible mechanisms behind it can be a continued subclinical infection and lung fibrosis. We have presented a case with the former mechanism, who responded well to steroids.

Effect of oral gabapentin on the intraocular pressure and haemodynamic responses induced by tracheal intubation.

BACKGROUND: Laryngoscopy and tracheal intubation may cause undesirable increases in blood pressure, heart rate (HR) and intraocular pressure (IOP). Gabapentin has been used effectively to attenuate the pressor response to laryngoscopy and tracheal intubation. We investigated whether the pre-treatment with gabapentin attenuates the IOP in addition to a haemodynamic response to tracheal intubation. METHODS: Sixty ASA I-II patients were randomly allocated into two groups who received either gabapentin (800 mg) or placebo 2 h before surgery. IOP, mean arterial pressure (MAP) and HR were measured before and after the induction of anaesthesia as well as at 0, 1, 3, 5, 10 and 15 min following intubation. RESULTS: IOP and MAP increased from baseline immediately after intubation in the placebo group (P=0.001 and 0.002, respectively). When compared with the placebo group, IOP values of the gabapentin group were significantly lower for the first 15 min after tracheal intubation (P=0.002 at 0 min, P=0.006 at 1 min, P<0.001 at 3 min, P<0.001 at 5 min, P<0.001 at 10 min and P=0.003 at 15 min) while MAP was lower in the first 10 min (P=0.001 at 0 min, P=0.002 at 1 min, P<0.001 at 3 min, P<0.001 at 5 min and P=0.028 at 10 min). These results showed that gabapentin effectively suppresses the increase in IOP secondary to endotracheal intubation and attenuates the increases in MAP. CONCLUSION: It is suggested that gabapentin is a useful adjuvant in order to prevent an increase in the IOP in response to laryngoscopy and tracheal intubation.

Studies on the response of ewes to live chlamydiae adapted to chicken embryos or tissue culture.

Ewes infected before gestation with chicken embryo or tissue culture adapted chlamydial strain B-577 were challenge inoculated with the homologous strain at four to 18 weeks of gestation. The ewes responsed with group specific complement fixing antibody titers of 1:8 to 1:256 by the second week after initial infection. A secondary antibody response in the surviving challenge inoculated ewes occurred at the time of lambing and reached titers of 1:32 to 1:256 by the second week after parturition. Group specific complement fixing antibodies did not appear to play a significant role in resistance to chlamydial infection. Ewes infected with the chicken embryo adapted strain B-577 excreted chlamydiae in their feces 60 days after inoculation. However, chlamydiae were not recovered from feces of ewes infected with the tissue culture adapted strain B-577. Placentas of ewes challenge inoculated by the intravenous route were consistently infected. Chlamydiae were recovered from placentas, some fetuses and lambs. In two instances when challenge inoculation was given by the intramuscular route, infection was detected only by the direct fluorescent antibody method.

Inapparent respiratory infection of inbred Swiss mice with sulfadiazine-resistant, iodine-negative Chlamydiae.

Three chlamydial strains were isolated from the lungs of three different strains of mice that were inbred for over 30 years. These chlamydial strains were resistant to sulfadiazine and did not induce iodine-positive, glycogen-like material in the inclusions of infected L cells which characterizes them as Chlamydia psittaci.