Regional Versus General Anesthesia: Effect of Anesthetic Techniques on Clinical Outcome in Lumbar Spine Surgery: A Prospective Randomized Controlled Trial.

Background: There are only a few prospective clinical trials investigating the effects of different anesthetic techniques on clinical outcomes after lumbar spine surgery. The purpose of this study was to evaluate clinical outcomes in patients receiving general (GA) and regional anesthesia (RA) for lumbar spine surgery.

Methods: This was a single-center, 2-arm, trial in which 100 patients undergoing lumbar spine surgery were randomized to receive either RA or GA (50 per group).

Preemptive volume therapy to prevent hemodynamic changes caused by the beach chair position: hydroxyethyl starch 130/0.4 versus Ringer's acetate-a controlled randomized trial.

Background: Hemodynamic instability frequently occurs in beach chair positioning for surgery, putting patients at risk for cerebral adverse events. This study examined whether preoperative volume loading with crystalloids alone or with a crystalloid-colloid combination can prevent hemodynamic changes that may be causative for unfavorable neurologic outcomes.

Methods: The study randomly assigned 43 adult patients undergoing shoulder surgery to 3 study groups.

LMA Protector™ Airway: first experience with a new second generation laryngeal mask.

Background: The LMA Protector™ Airway (The Laryngeal Mask Company Ltd., Teleflex Incorporated, Athlone, Ireland) is a new supraglottic airway promising a better seal, an improved drainage of gastric secretions and the opportunity of a simplified fiberscopy-guided tracheal intubation. The aim of this study was to present a primary evaluation of the LMA Protector in a clinical setting.

Relationship between dynamic expiratory time constant tau(edyn) and parameters of breathing cycle in pressure support ventilation mode.

Study of the relationship between ventilation parameters: monitored expiratory time constant - tau(edyn) and breathing - trigger frequency (f(trig)) and time of breathing cycle (T(cy)) are main goals of this article. Parameters were analyzed during last 4+/-2 h before weaning from ventilation in 66 patients ventilated in pressure support mode (PSV). We have found out, that there exist mathematical relationships, observed during adequate gas exchange, yet not described.

Effect of a combined brief narrative exposure therapy with case management versus treatment as usual in primary care for patients with traumatic stress sequelae following intensive care medicine: study protocol for a multicenter randomized controlled trial (PICTURE).

Background: Traumatic events like critical illness and intensive care are threats to life and bodily integrity and pose a risk factor for posttraumatic stress disorder (PTSD). PTSD affects the quality of life and morbidity and may increase health-care costs. Limited access to specialist care results in PTSD patients being treated in primary care settings.

Underestimated Role in the Organ Donation Pathway-Paramedics' Attitudes and Knowledge About Donation After Circulatory Death.

Background: Healthcare staff working in emergency medical services (EMS) and hospital emergency departments serve a key role in identifying potential donors after cardiac death in Maastricht category II.

Methods: An anonymous survey available via electronic resources for emergency medical technicians (EMTs) was conducted. The questionnaire included questions about attitudes and knowledge about donation regarding cardiac death (DCD) and organ donation in general.

Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacteremia?

Background: Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet count (MPV/PC) ratio are readily available parameters that might have discriminative power regarding outcome. The aim of our study was to assess prognostic value of these biomarkers regarding outcome in critically ill patients with secondary sepsis and/or trauma.

Methods: A total of 392 critically ill and injured patients, admitted to surgical ICU, were enrolled in a prospective observational study.

Fentanyl and naloxone effects on glutamate and GABA release rates from anterior hypothalamus in freely moving rats.

Fentanyl, a μ-opioid receptor agonist, has been studied for its neuro/psycho-pharmacological effects since its first clinical use; however, its effect on the release rate of the Central Nervous System (CNS) neurotransmitters has not been yet elucidated. In the present study the influence of fentanyl on the release rates of glutamate and GABA is investigated. Specifically, we examined the effects of intravenous (10 μg/kg) as well as intrahypothalamic (0.

Interscalenic versus suprascapular nerve block: can the type of block influence short- and long-term outcomes? An observational study.

Background: While interscalenic nerve block (INB) is still considered the gold standard for shoulder arthroscopy, its postoperative analgesic effectiveness has recently been called into question. Meanwhile, in light of its high-quality postoperative pain relief, a renewed interest has emerged in suprascapular nerve block (SNB). The first aim of our study was to compare the postoperative analgesia effects of these two types of block at two, four and six hours after surgery.

Elucidation of chemical modifier reactivity towards peptides and proteins and the analysis of specific fragmentation by matrix-assisted laser desorption/ionization collision-induced dissociation tandem mass spectrometry.

Rationale: Matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) analysis of covalent 5-lipoxygenase inhibitors is challenging due to unknown amino acid specificity and low posttranslational modification (PTM)-identification rates. The analysis of the amino-acid specificity and of the characteristic fragmentation of chemically modified peptides is considered to improve knowledge for the analysis of chemically modified peptides and proteins by MALDI-MS.

Methods: Various compounds were used to investigate the modification of synthetic peptides carrying reactive amino acid residues.

Does preemptive gabapentin modulate cytokine response in total knee arthroplasty? A placebo controlled study.

Background: Gabapentin, as a structural analogue of γ-aminobutyric acid, has been investigated to provide pain relief in the early postoperative period following various surgical interventions.

Objectives: The objective of this study was to investigate whether preemptive oral administration of gabapentin 800 mg can reduce postoperative pain and modulate the inflammatory cytokine response in comparison to placebo in patients undergoing total knee arthroplasty under general anesthesia.

Material And Methods: Fifty-two patients were randomly divided into 2 groups before surgery, either to receive peroral gabapentin 800 mg or placebo drug, 1 h before surgery.

Serum S100B Levels Can Predict Computed Tomography Findings in Paediatric Patients with Mild Head Injury.

Introduction: Traumatic brain injuries (TBIs) are very common in paediatric populations, in which they are also a leading cause of death. Computed tomography (CT) overuse in these populations results in ionization radiation exposure, which can lead to lethal malignancies. The aims of this study were to investigate the accuracy of serum S100B levels with respect to the detection of cranial injury in children with mild TBI and to determine whether decisions regarding the performance of CT can be made based on biomarker levels alone.

Validity and Reliability of the Turkish Chronic Pain Acceptance Questionnaire.

Background: Pain acceptance is the process of giving up the struggle with pain and learning to live a worthwhile life despite it. In assessing patients with chronic pain in Turkey, making a diagnosis and tracking the effectiveness of treatment is done with scales that have been translated into Turkish. However, there is as yet no valid and reliable scale in Turkish to assess the acceptance of pain.

Neuroinflammation markers and methyl alcohol induced toxic brain damage.

Methyl alcohol intoxication is a global problem with high mortality and long-term visual sequelae and severe brain damage in survivors. The role of neuroinflammation in the mechanisms of methyl alcohol-induced toxic brain damage has not been well studied. We measured the acute concentrations and dynamics of lipoxins LxA4 and LxB4 and the interleukins IL-4, IL-5, IL-9, IL-10, and IL-13 in the serum of patients treated with methyl alcohol poisoning and the follow-up concentrations in survivors two years after discharge from the hospital.

Accuracy of Computed Tomographic Perfusion in Diagnosis of Brain Death: A Prospective Cohort Study.

BACKGROUND This study was designed to determine diagnostic accuracy of computed tomographic perfusion (CTP) compared to computed tomographic angiography (CTA) for the diagnosis of brain death (BD). MATERIAL AND METHODS Whole-brain CTP was performed in patients diagnosed with BD and in patients with devastating brain injury with preserved brainstem reflexes. CTA was derived from CTP datasets.

Double-arterial cannulation: a strategy for whole body perfusion during aortic arch reconstruction.

Objectives: Double-arterial cannulation enables cerebral perfusion and lower body perfusion during aortic arch reconstruction. The aim of this study was to analyse and report our experience of using this cannulation and perfusion technique on paediatric patients.

Methods: A retrospective single-centre study was carried out on 407 consecutive paediatric patients who underwent an aortic arch reconstruction under double-arterial cannulation between 2003 and 2015.

Levosimendan in patients with low ejection fraction undergoing cardiac surgery.

Introduction: Significant impairment of left ventricular function causes low cardiac output syndrome in the immediate postoperative period in 3-14% of patients undergoing surgery, increasing the mortality 15-fold.

Aim: To assess the use of levosimendan in patients undergoing cardiac surgery in 2016.

Material And Methods: The analysis included 14 patients: 3 (21.

RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Follow-Up.

Background: Remote ischemic preconditioning (RIPC) has been suggested to protect against certain forms of organ injury after cardiac surgery. Previously, we reported the main results of RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study, a multicenter trial randomizing 1403 cardiac surgery patients receiving either RIPC or sham-RIPC.

Methods And Results: In this follow-up paper, we present 1-year follow-up of the composite primary end point and its individual components (all-cause mortality, myocardial infarction, stroke and acute renal failure), in a sub-group of patients, intraoperative myocardial dysfunction assessed by transesophageal echocardiography and the incidence of postoperative neurocognitive dysfunction 5 to 7 days and 3 months after surgery.

Hyperbaric oxygenation and glucose/amino acids substitution in human severe placental insufficiency.

In the first case, the AA and glucose were infused through a perinatal port system into the umbilical vein at 30 weeks' gestation due to severe IUGR. The patient received daily hyperbaric oxygenation (HBO, 100% O ) with 1.4 atmospheres absolute for 50 min for 7 days.

Optical molecular imaging of corpora amylacea in human brain tissue.

Label-free multiphoton imaging constitutes a promising technique for clinical diagnosis and therapeutic monitoring. Corpora amylacea (CoA) are starch-like structures often found in the diseased brain, whose origin and role in nervous pathologies are still a matter of debate. Recently, CoA in the diseased human hippocampus were found to be second harmonic generation (SHG) active.

Compatibility of common IV drugs with 6% hydroxyethyl starch 130/0.42 and 4% gelatin.

Background: Acetate-containing colloid infusion solutions are recommended to recover normovolemia during pediatric anesthesia. Until now, no studies investigating the compatibility with common anesthetic drugs were available.

Aims: This in vitro study was conducted to reveal possible incompatibilities between common anesthetic drugs and the acetate-containing colloid infusion solutions 6% hydroxyethyl starch and 4% gelatin with normal saline as control.