Cardiac troponins and volatile anaesthetics in coronary artery bypass graft surgery: A systematic review, meta-analysis and trial sequential analysis.

BACKGROUND: Reports from animal studies indicate that volatile anaesthetics protect the myocardium against the effects of acute ischaemia-reperfusion injury by reducing infarct size. This cardioprotective effect in the clinical setting of coronary artery bypass graft (CABG) surgery, where the heart is subjected to global ischaemia-reperfusion injury, remains controversial. OBJECTIVE: The objective was to demonstrate that clinical studies investigating the cardioprotective effect of volatile anaesthetics on cardiac troponins in CABG are no longer warranted. We also investigated the effect of volatile anaesthetics on cardiac enzymes in off-pump cardiac surgery. DESIGN: Systematic review of randomised clinical trials, meta-analyses and trial sequential analysis (TSA). DATA SOURCES: Trials between January 1985 and March 2015 were obtained from electronic databases (Medline, Excerpta Medica Database (EMBASE), Cochrane Controlled Trial Register, abstracts from major anaesthesiology and cardiology journals and reference lists of relevant randomised trials and review articles. ELIGIBILITY CRITERIA: Relevant randomised clinical trials were included. We investigated the effect of volatile anaesthetics in both off-pump and on-pump CABG surgery with respect to troponin release [peak postoperative cardiac troponin I (cTnI) and cardiac troponin T (cTnT), cTnI/cTnT] and performed two separate meta-analyses. TSA was used to overcome the weakness of a type-1 error associated with repeated meta-analyses. RESULTS: From 30 studies, 2578 patients were pooled for the meta-analysis. The outcome significantly favours the use of peroperative volatile over non-volatile anaesthetics during on-pump CABG surgery with regard to peak postoperative cTnI (0.995 mg l-1; standard mean difference, 95% confidence interval, -1.316 to -0.673; P

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Early- and late-latency gamma auditory steady-state response in schizophrenia during closed eyes: does hallucination status matter?

The auditory steady-state response (ASSR) - a response to periodic stimulation - has been proposed to serve as one of the biological markers of schizophrenia, being consistently impaired in the disorder (O'Donnell et al., 2013). The response to gamma range stimulation has been employed both to evaluate global synchronization of neural activity with the external environment (Light et al., 2006; Koenig et al., 2012; Tada et al., 2014) and the integrity of auditory circuits (Teale et al., 2003; Brenner et al., 2009; Spencer et al., 2009; Hamm et al., 2011).

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RETROGRADE INTUBATION WITH SUCTION CATHETER: A CASE REPORT

2016-02-22T18-20-48Z
Source: Journal of Contemporary Medicine
AHMET SELİM ÖZKAN, AYTAÇ YÜCEL, MUSTAFA SAİD AYDOĞAN, MUSTAFA KADIOĞLU, TÜRKAN TOĞAL.
Tracheal intubation has become a necessary part in the management of general anesthesia for surgical patient. Anesthetic management of difficult intubation and difficult ventilation will encounter are the major complications and most common cause of mortality and morbidity related to anesthesia. We aimed to present a case of retrograde intubation with suction catheter connected to an electrical burn injury to the trachea.


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Major Depressive Disorder' Definition, Etiology and Epidemiology: A Review

2016-02-22T18-20-48Z
Source: Journal of Contemporary Medicine
Fatmagül Helvacı Çelik, Çiçek Hocaoğlu.
Depression is one of the most common psychiatric disorders influencing the all population. Untreated depression may lead to early death and worsening in general health. Depression has several clinically distinct subtypes which are sometimes difficult to diagnose. Diagnosis and treatment of these disorders are of concern to physicians other than psychiatrists, because of their effect on course and prognosis of general medical diseases. This is a concise and up to date overview of the epidemiology,etiology physiopathology and diagnosis of major depressive disorder.


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Acute Renal Failure Due To Ethyleneglycol Poisoning

2016-02-22T18-20-48Z
Source: Journal of Contemporary Medicine
İhsan Ateş, Nihal Ozkayar, Nergiz Bayrakci, Fatih Dede.
Ethylene glycol is a colorless, odorless, sweet, water-soluble substance from the group of dihydric alcohols. As a result of taking ethylene-containing material for suicide purpose or as an accident, serious metabolic acidosis, central nervous system depression and oliguric acute renal failure occur. Early diagnosis and treatment can reduce mortality at a significant level. We present a case with severe metabolic acidosis, coma and acute renal failure due to ethylene glycol intoxication after drinking antifreeze accidentally.


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Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio on the prediction of methotrexate treatment success in tubal ectopic pregnancy

2016-02-22T18-20-48Z
Source: Journal of Contemporary Medicine
Hatice Yılmaz Doğru, Çiğdem Kunt İşgüder, Asker Zeki Özsoy, İlhan Bahri Delibas, Bülent Cakmak, Akgul Arici.
Objective A %2 of all pregnancies composed of ectopic pregnancy, further more than 95% of cases localized on the fallopian tubes. The aim of this study is to assess the success of metotrexate treatment on tubal pregnancy, and the relation between the neutrophil-lymphocyte ratio and thrombocyte-lymphocyte ratio, and tubal ectopic pregnancy rupture. Materials and Methods This retrospective study was conducted in Gaziosmanpasa University, Department of Obstetrics and Gynecology between 2012 and 2014. Patients with a diagnosis of tubal ectopic pregnancy whose admitted to the Department of Obstetrics and Gynecology were enrolled in the study. The data was analyzed using the Statistical Package for Social Sciences (SPSS) software version 20 (SPSS Inc., Chicago, IL). A two-tailed p value


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THE EVALUATION OF THE PATIENTS OF THOSE OPERATED DUE TO THE OVARY CYST: RETROSPECTIVE ANALYSIS

2016-02-22T18-20-48Z
Source: Journal of Contemporary Medicine
Hatice Yılmaz Doğru, Asker Zeki Özsoy, Akgul Arici, Selim Gulucu, Fazlı Demirtürk.
Aim: Ovarian cyst, those can be seen in all ages of women, is a common gynecologic problem. The present study is aimed to retrospectively evaluate the clinical features of the operated patients due to ovarian cyst. Materials and Methods: A total of 50 cases with a diagnosis of ovarian mass whose admitted or referred to the Gaziosmanpasa University, Medical Faculty, Gynecology and Obstetrics outpatient unit with any complaint were retrospectively evaluated and included into this study. Results: The mean age of the patients were 33.75±11.70. The most complaint was found as pelvic pain by 79%. The hospital stay of the cases underwent laparoscopic surgery (3.62±0.57 days) was significantly lower than the laparotomy (5.48±2.58 days, p = 0.000392). A 57.2% of the cases were non-neoplastic tumor, where 47.3% were neoplastic. Conclusion: It is suggested that the physical examination of adnexial mass is the most important factor affecting the choice of the surgical type.


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