Effects of recurrent sevoflurane anesthesia on cognitive functions with streptozotocin induced Alzheimer disease.

OBJECTIVE: We aimed to investigate the effects of recurrent sevoflurane anesthesia on cognitive functions in Alzheimer Disease. MATERIALS AND METHODS: Rats were divided into 4 groups as followed: control (Group C), sevoflurane (Group S), Alzheimer's (Group A) and Alzheimer's + sevoflurane (Group AS)]. Cognitive functions were evaluated with Radial Arm Maze Test (RAMT). Alzheimer model was created by administering 3 mg/kg (10 µl) STZ. Sevoflurane was administered to S and AS groups. Serum samples and hippocampus tissues were analyzed. RESULTS: In RAM test, the entry-exit data were significantly decreased in A and AS groups. After the 2nd and 3rd administration of anesthesia, the numbers were significantly decreased in Group S. Glial-fibrillary-acidic protein levels were significantly higher in AS compared to the C and S groups. The brain tissue caspase 3 activity was less than 1% in all rats in the Group C, 3 % in 2 rats and 1 % in 1 rat in the Group AS. In A and AS group, serum catalase, myeloperoxidase and ferroxidase activities were found to be higher than in the other groups and myeloperoxidase activity was higher in the AS than in the A Group. Serum native thiol, total thiol and disulfide levels were found to be significantly different in the A and AS groups. CONCLUSION: Sevoflurane anesthesia negatively affected the cognitive functions (Tab. 5, Fig. 10, Ref. 51).

Effects of apelin-13 on myocardial ischemia reperfusion injury in streptozotocine induced diabetic rats.

AIM: We want to investigate the protective effects of apelin-13 on myocardial ischemia reperfusion (I/R) injury. MATERIAL AND METHODS: 30 Wistar Albino rat were divided into 5 groups (n:6), namely control group (C), diabetes group (D), diabetes+apelin-13 group (DA), diabetes+I/R group (DIR) and diabetes I/R+apelin-13 group (DIR-A). Rats were subjected to 30­min ischemia and 90­min reperfusion. Biochemical and histopathological parameters were measured. RESULTS: Caspase-3 enzyme activity was significantly higher in the DIR group than in the C, DA, and DIR-A groups. The intensity of caspase 3 enzyme activity was significantly higher in the I/R group than in all other groups. Inflammation and vascular dilatation were found significantly higher in the DIR group than in all other groups. Congestion was significantly higher in the DIR group than in the C and D groups. TOS enzyme activity was significantly higher in the DIR group than in the C, DA and DIR-A groups. TAS enzyme activity was significantly lower in the DIR group than in the C and DIR-A groups. CONCLUSION: We believe that the protective effects of apelin-13 in ischemia-reperfusion injury and its use indications can be demonstrated in detail as long as the findings we have reached in our study are supported by other studies (Tab. 2, Fig. 10, Ref. 43).

Effects of thoracic epidural or intravenous analgesia on the neutrophil-to-lymphocyte ratio in thoracotomy cases.

BACKGROUND AND PURPOSE: Postoperative pain is a significant problem in thoracotomy patients. Our aim in this study was to investigate the relationship between postoperative pain and neutrophil-to-lymphocyte ratio (NLR) which is a marker of acute inflammatory response. MATERIALS AND METHODS: Thoracic epidural or intravenous analgesia was administered to thoracotomy patients who elected to undergo a planned surgery. Patients were divided into two groups according to the analgesia method applied postoperatively. Thoracic epidural analgesia was recorded as Group 1 and intravenous analgesia as Group 2. Whole blood counts were recorded from preoperative and postoperative 24th- and 48th-hour routine blood samples, and NLRs were recorded as retrospective file scanning. Postoperative 24th- and 48th-hour NLRs and preoperative NLR values were recorded. RESULTS: Demographic data of the patients included in the study were similar except for age. Preoperative NLR was significantly higher in Group 1 at 3.50 (P = 0.004) than in Group 2 at 2.51. Postoperative NLRs were similar among both groups. Postoperative NLR values at both the 24th- and 48th-hour increased by4.9 times in Group 1 and 9.23 times in Group 2 from the 24th-hour preoperative period, when the preoperative NLRs were evaluated. The rate of increase in Group 1 was significantly lower than in Group 2 (P = 0.006). CONCLUSION: Postoperative NLR alterations when compared with preoperative values were related to the analgesic regimen used.

Comparison of C-MAC vs. McGrath video laryngoscopes on glottic exposure and endotracheal intubation success with stylet usage in obese patients.

OBJECTIVE: Cases of obesity are rising in parallel with the number of obese patients scheduled for anesthesia in which difficult airway is encountered. Video laryngoscopes (VL) have emerged as a popular device for the management of patients with difficult airway. The present study compares the success rate of intubation in obese patients using stylet in the ramped position using either a McGrath or C-MAC VLs. PATIENTS AND METHODS: Class II/III obese patients who were intubated with either McGrath (Group M, n=50) or C-MAC (Group C, n=50) laryngoscopes were assessed for the presence of difficult airway using the Difficult Airway Assessment tool, the Airway Difficulty Score and the Total Airway Score. The intubation attempts were made after the best glottic view, direct and indirect Cormack-Lehane (CL) score, and intubation time were recorded. In the event of failure, a further intubation attempt was made using a styled, and the intubation time was again recorded. If the intubation failed again, a third attempt was made using a C-MAC D-Blade. The Intubation Difficulty Scale score was recorded after the intubation. RESULTS: There was no statistically significant difference between groups in terms of demographic data, the number of patients with decreased CL score, the number of attempts required for intubation, or the first and second intubation time. The ADS Score, TAS Score, CL Score DL, and CL Score IN were found to be important risk factors for a second intubation requirement, and the cut-off value was found to be 8.50 for the ADS Score and 4.50 for the TAS Score in these patients. In the 38 patients who required a second intubation attempt, the procedure was successful in all, but one patient required a third attempt of intubation with C-MAC D-blade. CONCLUSIONS: Both McGrath and C-MAC were effective and comparable for best glottic view with no failed intubation. It was concluded that regardless of the type of video laryngoscope used, the use of a stylet in the first intubation attempt increases the success of intubation.