Preoperative preparation and postoperative care in children in thoracic surgery.

Anesthesia for pediatric patients undergoing thoracic surgery continues to be distinctive due to differing anatomical and physiological characteristics compared to adults. Adequate preoperative preparation, appropriate tool selection for providing one-lung ventilation, perioperative pain management, and a multidisciplinary approach can ensure higher quality postoperative care. In this review, the perioperative anesthesia management for pediatric patients undergoing thoracic surgery will be discussed, starting from the preoperative preparation phase. Additionally, the issues related to the application and management of one-lung ventilation will also be assessed.

The effect of 24-hour sleep deprivation on subjective time perception.

In this study, we investigated the effect of 24-h total sleep deprivation on subjective time perception. Twenty-five participants aged 18-35 years (13 female and 12 male) were recruited. Time perception and cognitive assessments were performed twice: after a regular night's sleep and following a 24-h sleep deprivation. The retrospective and prospective tasks were used to measure time perception. In order to prevent order effect, the test orders were randomized. The Stroop test and the Wechsler Memory Scale-III were used to evaluate attention, processing speed, and memory. The repeated measures ANOVA was used to examine gender-by-sleep deprivation interactions on time perception. We found that retrospective time perception was significantly prolonged after sleep deprivation (p < 0.05). Women had a shorter prospective time estimation rate after adequate sleep than men, but this difference disappeared after sleep deprivation. The Stroop test showed improvement in cognitive flexibility after sleep deprivation (p < 0.05), and short-term or working memory appeared unaffected by one night of sleep deprivation. There was a negative correlation between sleepiness rate and working memory function in female subgroup. The results suggest that even short-term sleep deprivation can significantly affect time perception, which may have important implications in critical situations.

Comparison of Different Local Anesthetic Volumes for Saddle Block Anesthesia in Ambulatory Surgery: A Prospective Randomized Trial.

INTRODUCTION: Saddle block anesthesia (SBA) is a frequently preferred method for ambulatory anorectal surgery. This study aimed to observe the effects of two different dose SBAs on discharge times and perioperative block characteristics in patients undergoing ambulatory anorectal surgery. METHODS: The study was conducted as a prospective, randomized controlled study. Patients over the age of 18 who were scheduled for ambulatory anorectal surgery and had American Society of Anaesthesiologists (ASA) physical status I and II were included in the research. Patients were divided into two groups: 5 mg hyperbaric bupivacaine 0.5% (Group I; n=34) and 3 mg hyperbaric bupivacaine 0.5% (Group II; n=34). The primary outcome was discharge time. Characteristics of the spinal block like time to reach S4 blockade, maximum blocked dermatome, regression time of sensorial, first analgesic need time, voiding time, mobilization time, and side effects were the secondary outcomes. RESULTS: Sixty-eight patients were included in the study. The groups were similar in terms of demographic and surgical characteristics (p > 0.05). In Group II, S4 sensory dermatome blockade time was statistically longer (p: 0.007) and the time to the disappearance of the sensory block was statistically shorter (p < 0.001). Also, voiding time and discharge times were statistically shorter in Group II (p: 0.049, p < 0.001, respectively). CONCLUSION: SBA provided adequate anesthesia, and the complication rates were limited. Saddle block can be considered an advantageous technique because of conditions that adversely affect recoveries, such as postoperative cognitive problems, nausea, and vomiting due to general anesthesia. In addition, better recovery results and optimal surgical condition with 3 mg hyperbaric bupivacaine in our study suggest that this dose may be a good alternative.

Validity and reliability of the Turkish version of Sleep Disturbance Scale for Children.

OBJECT: This study examines the validity and reliability of the Sleep Disturbance Scale for Children (SDSC) in the Turkish language. METHOD: This scale was translated into the Turkish language by applying the translation-back translation method and content validity analysis. A total of 1903 participants aged 5-15 years were included in the study. A sociodemographic data form, SDSC, and the Children's Sleep Habits Questionnaire (CSHQ) were filled by the parents. Internal consistency analysis, correlation analysis, test-retest analysis, and confirmatory factor analysis were applied to evaluate the reliability and validity of the applied scale. RESULTS: The internal consistency of the scale was high (Cronbach α = 0.84). Test-retest reliability was found to be high as well. According to the confirmatory factor analysis, the Turkish version of the scale was compatible with the model of the original scale. According to the T-score evaluation, the frequency of sleep disorders was determined to be 4.15%, and the most common sleep disorder was sleep hyperhidrosis. Correlations between the scores of the SDSC and CSHQ were at a satisfactory level. CONCLUSIONS: These results revealed that the SDSC is a valid and reliable scale that can be used in children aged 5-14 years in Turkey to question sleep disorder symptoms.

Blood pressure, autonomic stress, and inflammatory markers during sleep deprivation and recovery in healthy men.

OBJECTIVE: Recent community-based studies have identified sleep deprivation (SD) as an important modifiable risk factor for hypertension However, the underlying mechanisms linking SD to hypertension remain elusive. Thus, this study investigates blood pressure (BP) responses to cardiac autonomic stress tests in the presence of SD. Furthermore, we analyzed vascular inflammatory biomarkers as a possible underlying factor linking SD to increased BP. METHODS: Ten healthy male volunteers (age, 21.6±1.2 years) underwent repeated autonomic stress tests for three consecutive days (baseline, SD, and recovery). The autonomic stress tests included the Valsalva maneuver, mental arithmetic, isometric handgrip, and cold pressor tests. Each day, resting BPs were measured, venous blood samples were collected for intercellular adhesion molecule 1, vascular cell adhesion molecule 1, and E-selectin measurements, and stress tests were performed between 0900 and 1100. Ambulatory BP was recorded during the entire SD period (24 h). RESULTS: One-night SD abolished BP reactivity to the Valsalva maneuver, isometric hand grip, and cold pressor tests, which returned after recovery sleep. Ambulatory BP monitoring showed that the mean systolic and diastolic BPs were 121.1±8.5 mm Hg and 72.8±6.3 mm Hg, respectively, between 0700 and 2300 and 120.3±9.6 mm Hg and 74.1±6.1 mm Hg, respectively, between 2300 and 0700 during the SD day (p>0.05 for both). Vascular inflammatory markers seemed unrelated to BP changes. CONCLUSION: Acute SD altered BP responses to cardiac autonomic stress tests in healthy men without affecting resting BP levels. SD led to a non-dipping pattern in BP oscillation. Collectively, these findings highlight the importance of sleep in regulating BP.

Repeated Doses of Ketamine Affect the Infant Rat Urogenital System.

AIM: Long-term ketamine use is known to create an interstitial cystitis-like problem in the bladder. It is known that long-term intermittent ketamine is applied to the children receiving radiotherapy for sedation. This study was planned to investigate whether this effect seen in the bladder causes similar changes in the kidneys, testicles, epididymis and ductus deferens. MATERIALS AND METHODS: A total of 12 male Wistar Albino rats for 3 weeks were used in the study. Rats were divided equally into 2 groups as, ketamine and saline. 50 mg/kg ketamine was administered intraperitoneally during 21 days to ketamine (K) groups. 1mL/kg saline was administered intraperitoneally during 21 days to saline (S) groups. At the end of 21 days kidney and testicular tissues were taken for biochemical and histopathological evaluations. RESULTS: Histological assessment of kidney tissue showed that tubule epithelial congestion increased significantly in the ketamine group. Epididymis congestion and distortion in the epididymal gland were found to be different in the ketamine group when testicular tissue was examined. Thiobarbituric acid reactive substances (TBARS) level in testicular and kidney tissue was found to be significantly higher in the ketamine group according to the saline group. Catalase (CAT) enzyme activity was significantly lower in the ketamine group compared to the saline group in both tissues. Paraoxonase-1 (PON-1) enzyme activity was significantly higher in the ketamine group compared to the saline group. CONCLUSION: We think that the results we have achieved in this study will provide guidance on ketamine, which is repeated in daily anesthesia applications, especially in radiation oncology. But these findings should be supported by clinical and experimental studies that will be conducted in a more detailed and broad series.

Feed Composition Differences Resulting from Organic and Conventional Farming Practices Affect Physiological Parameters in Wistar Rats-Results from a Factorial, Two-Generation Dietary Intervention Trial.

Recent human cohort studies reported positive associations between organic food consumption and a lower incidence of obesity, cancer, and several other diseases. However, there are very few animal and human dietary intervention studies that provide supporting evidence or a mechanistic understanding of these associations. Here we report results from a two-generation, dietary intervention study with male Wistar rats to identify the effects of feeds made from organic and conventional crops on growth, hormonal, and immune system parameters that are known to affect the risk of a number of chronic, non-communicable diseases in animals and humans. A 2 × 2 factorial design was used to separate the effects of contrasting crop protection methods (use or non-use of synthetic chemical pesticides) and fertilizers (mineral nitrogen, phosphorus and potassium (NPK) fertilizers vs. manure use) applied in conventional and organic crop production. Conventional, pesticide-based crop protection resulted in significantly lower fiber, polyphenol, flavonoid, and lutein, but higher lipid, aldicarb, and diquat concentrations in animal feeds. Conventional, mineral NPK-based fertilization resulted in significantly lower polyphenol, but higher cadmium and protein concentrations in feeds. Feed composition differences resulting from the use of pesticides and/or mineral NPK-fertilizer had a significant effect on feed intake, weight gain, plasma hormone, and immunoglobulin concentrations, and lymphocyte proliferation in both generations of rats and in the second generation also on the body weight at weaning. Results suggest that relatively small changes in dietary intakes of (a) protein, lipids, and fiber, (b) toxic and/or endocrine-disrupting pesticides and metals, and (c) polyphenols and other antioxidants (resulting from pesticide and/or mineral NPK-fertilizer use) had complex and often interactive effects on endocrine, immune systems and growth parameters in rats. However, the physiological responses to contrasting feed composition/intake profiles differed substantially between the first and second generations of rats. This may indicate epigenetic programming and/or the generation of "adaptive" phenotypes and should be investigated further.

Consequences of FFP3 mask usage on venous blood gases.

OBJECTIVES/HYPOTHESIS: To investigate the effect of FFP3 mask usage on venous blood gases (VBG) and some subjective symptoms METHODS: VBG analyses and subjective symptom questionary were obtained from 15 healthcare proffesionals before and after 4-h FFP3 mask usage. RESULTS: Wearing an FFP3 mask for 4 hours did not change any venous blood gas parameters between pre- and post-values, statistically. According to an 8-symptom questionary, only nausea did not show any significance. Headache, lightheadedness, visual difficulties, shortness of breath, palpitation, confusion, and difficult communication showed statistically significant difference between pre and post values. CONCLUSION: Four-hour use of FFP3 mask did not cause any significant VBG change. Although the participants complained about some subjective symptoms, this study indicated that long-term use of FFP3 mask did not cause any significant discomforts, and it was well tolerated.

The effect of one-night sleep deprivation on cognitive functions in healthy young adults.

INTRODUCTION: The effects of acute sleep deprivation on cognitive function have not been clearly elucidated. The purpose of this study was to evaluate changes in cognitive function in healthy adults after one night of sleep deprivation. MATERIAL AND METHODS: Twenty-one healthy young adults (aged 18-30 years) underwent assessment of cognitive functions before and after one night of total sleep deprivation and an age- and gender-matched control group was assessed before and after a normal night sleep. Cognitive functions were assessed using the Montreal cognitive assessment (MOCA) and trail making test (TMT) parts A and B. RESULTS: General linear model repeated measures demonstrated an insignificant effect for time × group (sleep deprivation) interaction for MOCA, TMT Part A, and TMT Part B scores after one-night sleep deprivation (p>.05 for all). CONCLUSION: A single night of sleep deprivation, which can be inevitable in modern society, had no significant effect on cognitive performance in healthy adults.

Author Correction: Mapping QTLs conferring salt tolerance and micronutrient concentrations at seedling stage in wheat.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Effects of cannabinoid modulation on hypothalamic nesfatin-1 and insulin resistance.

Both nesfatin-1 and cannabinoid systems involved in the regulation of sleep, metabolism, and food intake. The relationship between cannabinoid system and nesfatin-1 levels remains to be elucidated. This study investigated nesfatin-1 and insulin resistance in 72-h rapid eye movement (REM) sleep-deprived mice under the effects of cannabinoid, and cannabinoid receptors CB1R and CB2R blocking. Sixty mice were exposed to 72-h sleep deprivation. Groups and drug administrations were as follows: Group 1 (control) received injection of vehicle. Group 2 received WIN 55,212,2. Group 3 received AM251 (CB1R antagonist) followed by WIN 55,212,2 injection. Group 4 received SR144528 (CB2R antagonist) followed by WIN 55,212,2 injection. Group 5 received only AM251. Group 6 received only SR144528. Blood samples were collected 1 h after drug administration and prepared for biochemical measurements. Glucose levels were measured by glucometer, whereas insulin and nesfatin-1 levels were measured by ELISA. Central nesfatin-1 was also assessed using immunohistochemistry. One-way analysis of variance together with post hoc Tukey's test was used for inter-group comparisons. Serum nesfatin-1 levels were comparable in all study groups. Brain nesfatin-1 immune-positive cell count was lower in WIN group compared to controls. The administration of CB1R or CB2R antagonist prevented reduction in nesfatin-1-positive cell count. Insulin resistance was higher in WINCB2 and CB2 groups than in control and WINCB1 groups. Cannabinoid treatment reduced nesfatin-1 immunoreactivity in the central nervous system and this effect was prevented by either CB1R or CB2R antagonist pretreatment. Insulin resistance might be related to CB2 receptor activation which was independent from central nesfatin-1 immunoreactivity.

Comparison of the Effects of Sevoflurane and Desflurane on Thiol-Disulfide Homeostasis in Patients Undergoing Laparoscopic Cholecystectomy.

OBJECTIVE: This study aims to compare the effects of different inhalation anesthetics on oxidative status by measuring thiol-disulfide homeostasis in laparoscopic cholecystectomy surgeries. The effect of inhaler agents on thiol-disulfide homeostasis that shows the oxidative status in laparoscopic cholecystectomy is unknown. MATERIALS AND METHODS: In this study, 71 patients planned to undergo laparoscopic cholecystectomy under general anesthesia were included. They were divided into two groups: desflurane (group D, n: 35) and sevoflurane (group S, n: 36). Blood samples were taken before induction (T1), at 30th minute of insufflation (T2) (30th min of ischemia), and at 30th min postdeflation (T3) (30th min of reperfusion). The native thiols (-SH) and total thiols (-SH+ -SS) were determined. The amounts of disulfide (-SS), disulfide/native thiol percent ratios (-SS/-SH), disulfide/total thiol percent ratios (-SS/-SH+-SS), and native thiol/total thiol percent ratios (-SH/-SH+ -SS) were calculated. RESULTS: In the sevoflurane group, preoperative values and intraoperative 30th-minute SS-SH ratio were significantly reduced (p=0.017). In the desflurane group, intraoperative native thiol values and postdeflation levels significantly decreased compared to those in the preoperative values (p<0.001). CONCLUSION: We think that the usage of sevoflurane was more protective in terms of the oxidative damage occurring during laparoscopic surgery.

Effects of Agronomic Management and Climate on Leaf Phenolic Profiles, Disease Severity, and Grain Yield in Organic and Conventional Wheat Production Systems.

Agricultural intensification over the last 40 years has increased cereal yields, but there is very limited information on the effects of intensification practices (e.g., nondiverse rotations, mineral NPK fertilizer, and pesticides) on crop health and quality. Results from the study reported here suggest that the use of mineral NPK fertilizers reduces phenolic acid and flavonoid concentrations in leaves and increases the susceptibility of wheat to lodging and powdery mildew, when compared to composted FYM inputs. In contrast, the use of herbicides, fungicides, and growth regulators reduces lodging and foliar disease severity but had no effect on phenolic acid and flavonoid concentrations. The use of composted FYM inputs also resulted in a significant grain yield reduction and not substantially reduced the severity of opportunistic pathogens such as Septoria, which remain a major yield limiting factor unless fungicides are used and/or more Septoria resistant varieties become available.

Quantitative trait loci associated with soybean seed weight and composition under different phosphorus levels.

Seed size and composition are important traits in food crops and can be affected by nutrient availability in the soil. Phosphorus (P) is a non-renewable, essential macronutrient, and P deficiency limits soybean (Glycine max) yield and quality. To investigate the associations of seed traits in low- and high-P environments, soybean recombinant inbred lines (RILs) from a cross of cultivars Fiskeby III and Mandarin (Ottawa) were grown under contrasting P availability environments. Traits including individual seed weight, seed number, and intact mature pod weight were significantly affected by soil P levels and showed transgressive segregation among the RILs. Surprisingly, P treatments did not affect seed composition or weight, suggesting that soybean maintains sufficient P in seeds even in low-P soil. Quantitative trait loci (QTLs) were detected for seed weight, intact pods, seed volume, and seed protein, with five significant QTLs identified in low-P environments and one significant QTL found in the optimal-P environment. Broad-sense heritability estimates were 0.78 (individual seed weight), 0.90 (seed protein), 0.34 (seed oil), and 0.98 (seed number). The QTLs identified under low P point to genetic regions that may be useful to improve soybean performance under limiting P conditions.

DNA methylation of the prestin gene and outer hair cell electromotileresponse of the cochlea in salicylate administration

Background/aim: Activity of the prestin gene may have a role in the pathogenesis of salicylate-induced ototoxicity. We investigated DNA methylation for prestin gene exon 1 in salicylate-injected guinea pigs.Materials and methods: Fifteen guinea pigs (30 ears) underwent audiological evaluation including 1000 Hz probe-tone tympanometry and a distortion product otoacoustic emission (DPOAE) test. The animals were randomly divided into three groups. Groups 2 (8 ears) and 3 (14 ears) were injected with intramuscular saline and sodium salicylate (200 mg/kg), respectively twice daily for 2 weeks. Group 1 (8 ears) received no injection. DPOAE measurements were performed at baseline; after 1, 2, 4, and 8 h (acute effect); and after 1 and 2 weeks (chronic effect). After audiological measurements, the animals were sacrificed for DNA isolation.Results: While a significant decrease (P < 0.01) was found for the acute effect in all frequencies in Group 3 according to baseline measurements, there was no difference in terms of chronic effect. DNA methylation increased during the acute phase of salicylate administration, whereas it returned to initial levels during the chronic phase.Conclusion: Salicylate-induced changes in DPOAE responses may be related to prestin-gene methylation. These results may have important implications for salicylate ototoxicity.

Mapping QTLs conferring salt tolerance and micronutrient concentrations at seedling stagein wheat.

Soil salinization and degradation is one of the consequences of climate change. Identification of major salt tolerance genes and marker assisted selection (MAS) can accelerate wheat breeding for this trait. We genotyped 154 wheat F2 lines derived from a cross between salt tolerant and susceptible cultivars using the Axiom Wheat Breeder's Genotyping Array. A high-density linkage map of 988 single nucleotide polymorphisms (SNPs) was constructed and utilized for quantitative trait loci (QTL) mapping for salt tolerance traits and mineral concentrations under salinity. Of 49 mapped QTLs, six were for Na+ exclusion (NAX) and two QTLs (qSNAX.2 A.1, qSNAX.2 A.2) on chromosome 2 A coincided with a reported major NAX QTL (Nax1 or HKT1;4). Two other major NAX QTLs were mapped on 7 A, which contributed 11.23 and 18.79% of the salt tolerance respectively. In addition to Ca+2 and Mg+2 QTLs, twenty-seven QTLs for tissue Phosphorus, Zinc, Iron, Manganese, Copper, Sulphur and Boron concentrations under salinity were also mapped. The 1293 segregating SNPs were annotated/located within genes for various ion channels, signalling pathways, transcription factors (TFs), metabolic pathways and 258 of them showed differential expression in silico under salinity. These findings will create new opportunities for salt tolerance breeding programs.

A New Hypothesis on the Frequency Discrimination of the Cochlea.

OBJECTIVE: Medial olivocochlear efferent (MOCE) neurons innervate outer hair cells (OHCs) of the cochlea, which in turn leads to basilar membrane motion. We hypothesized that MOCE-induced alterations in basilar membrane motion, independent of traveling waves, is responsible for the cochlear frequency discrimination of sound. MATERIALS AND METHODS: Eleven guinea pigs underwent bilateral otoscopic and audiologic evaluations under general anesthesia. The study comprised two parts. Part I (n=11) included spontaneous otoacoustic emission (SOAE) recordings with or without contralateral pure-tone acoustic stimuli (1 and 8 kHz) at 60 dB sound pressure level (SPL). Part II involved pure-tone (1 or 8 kHz) acoustic trauma in the right ears of two randomly selected subgroups (G1: 1 kHz; n=4 and G8: 8 kHz; n=4). The remaining three animals served as controls. After frequency-specific deafness was confirmed by distortion product otoacoustic emission (DPOAE), SOAEs were recorded in the left ears in the presence of a contralateral pure-tone (1 and 8 kHz) stimulus of 60 dB SPL. Furthermore, the surface of the organ of Corti was examined by scanning electron microscopy (SEM). RESULTS: The contralateral pure tone led to frequency-specific activation in SOAEs in part I (without trauma) and part II (with trauma) measurements. SEM showed heterogeneous OHC damage along the cochlea in traumatized ears with pure tone. CONCLUSION: We suggest that MOCEs convey acoustic information from traumatized ears to intact ears. Traumatized ears can show frequency-specific activation in the presence of diffuse damage in OHCs that excludes the passive transmission of the pressure wave from the perilymph to the basilar membrane.

Bispectral index-guided general anaesthesia in combination with interscalene block reduces desflurane consumption in arthroscopic shoulder surgery: a clinical comparison of bupivacaine versus levobupivacaine.

BACKGROUND: The goal of this study was to compare the influence of an interscalene brachial plexus block (ISB) performed with either bupivacaine or levobupivacaine in conjunction with general anaesthesia (GA) on desflurane consumption, which was titrated to maintain the recovery profiles and postoperative analgesia while also keeping the bispectral index score (BIS) between 40 and 60 in patients undergoing arthroscopic shoulder surgery. METHODS: Sixty patients undergoing arthroscopic shoulder surgery were prospectively randomized to receive GA with desflurane alone (group C) or in combination with a preoperative ISB by either bupivacaine 0.25 % (group B) 40 ml or levobupivacaine 0.25 % (group L) 40 ml. BIS scores or respiratory and hemodynamic parameters during the operation, recovery characteristics, consumed doses of desflurane and pain intensities were evaluated. RESULTS: The eye opening time was 4.0 ± 2.5 minutes for group B, 4.6 ± 2.4 minutes for group L, and 6.2 ± 2.1 minutes for group C (p < 0.05). Group B and group L saved 36 % and 25 % desflurane per unit time respectively when compared with group C (p < 0.001and p < 0.05) while the mean pain scores and analgesic requirements the first day after surgery were higher in group C (p < 0.05). CONCLUSIONS: Because of lower desflurane consumption, a superior recovery profile, and a high degree of patient acceptance, general anaesthesia in combination with interscalene block may be preferred in arthroscopic shoulder surgery. TRIAL REGISTRATION: The trial registration number is ACTRN12613000381785.