Showing papers by "Trakya University published in 2004"

A factorial trial of six interventions for the prevention of postoperative nausea and vomiting.

Abstract: background Untreated, one third of patients who undergo surgery will have postoperative nausea and vomiting. Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown. methods We enrolled 5199 patients at high risk for postoperative nausea and vomiting in a randomized, controlled trial of factorial design that was powered to evaluate interactions among as many as three antiemetic interventions. Of these patients, 4123 were randomly assigned to 1 of 64 possible combinations of six prophylactic interventions: 4 mg of ondansetron or no ondansetron; 4 mg of dexamethasone or no dexamethasone; 1.25 mg of droperidol or no droperidol; propofol or a volatile anesthetic; nitrogen or nitrous oxide; and remifentanil or fentanyl. The remaining patients were randomly assigned with respect to the first four interventions. The primary outcome was nausea and vomiting within 24 hours after surgery, which was evaluated blindly. results Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26 percent. Propofol reduced the risk by 19 percent, and nitrogen by 12 percent; the risk reduction with both of these agents (i.e., total intravenous anesthesia) was thus similar to that observed with each of the antiemetics. All the interventions acted independently of one another and independently of the patients’ baseline risk. Consequently, the relative risks associated with the combined interventions could be estimated by multiplying the relative risks associated with each intervention. Absolute risk reduction, though, was a critical function of patients’ baseline risk. conclusions Because antiemetic interventions are similarly effective and act independently, the safest or least expensive should be used first. Prophylaxis is rarely warranted in low-risk patients, moderate-risk patients may benefit from a single intervention, and multiple interventions should be reserved for high-risk patients.

Antioxidant Effects of Sulfur-Containing Amino Acids

Abstract: Sulfur is an essential element for the entire biological kingdom because of its incorporation into amino acids, proteins and other biomolecules. Sulfur atoms are also important in the iron-containing flavoenzymes. Unlike humans, plants can use inorganic sulfur to synthesize sulfur-containing amino acids. Therefore, plants are an important source of sulfur for humans. Sulfur-containing compounds are found in all body cells and are indispensable for life. Some of sulfur-containing antioxidant compounds are, cysteine, methionine, taurine, glutathione, lipoic acid, mercaptopropionylglycine, N-acetylcysteine, and the three major organosulfur compounds of garlic oil, diallylsulfide, diallyldisulfide and diallyltrisulfide. In a comparison of the structure-function relationship among these sulfur-containing antioxidant compounds, dihydrolipoic acid (the reduced form of LA) is the most effective antioxidant. Dihydrolipoic acid contains two sulfhydryl groups and can undergo further oxidation reaction to form lipoic acid. The antioxidative activities of sulfur-containing compounds follow a general trend, the more highly reduced forms are stronger antioxidants and the number of sulfur atoms determine, at least in part, their modulatory activites on the glutathione related antioxidant enzymes. In this article, the antioxidant effects and the antioxidative activities, of sulfur-containing amino acids, are reviewed. In addition, the general antioxidant effects and the structure-function relationship of some sulfur-containing compounds are also reviewed.

Analgesic effects of gabapentin after spinal surgery.

Abstract: Background: A combination of opioid and nonopioid analgesic drugs may improve the quality of postoperative analgesia as well as reduce opioid requirements and their associated side effects. Studies have shown synergism between gabapentin and morphine in animal and human experiments and in the treatment of incisional pain. Therefore, the authors investigated, in a randomized, placebo-controlled, double-blind study, the effects of gabapentin on acute postoperative pain and morphine consumption in patients undergoing spinal surgery. Methods: After standard premedication, 25 patients in the control group received oral placebo, and 25 patients in the gabapentin group received 1,200 mg of gabapentin, 1 h before surgery in a randomized fashion. Anesthesia was induced with propofol and cisatracurium and was maintained with sevoflurane and remifentanil. The total intraoperative remifentanil consumption by each patient was noted. All patients postoperatively received patient-controlled analgesia with morphine (1 mg/ml) with an incremental dose of 2 mg, a lockout interval of 10 min, and a 4-h limit of 40 mg. The incremental dose was increased to 3 mg, and the 4-h limit to 50 mg, if analgesia was inadequate after 1 h. Patients were questioned for the first 1 h in the PACU and were later evaluated in the ward at 1, 2, 4, 6, 12, and 24 h. Pain scores, heart rate, oxygen saturation measured by pulse oximetry, mean blood pressure, respiratory rate, sedation, morphine use, and total dose of morphine were recorded. Results: Overall, pain scores at 1, 2, and 4 h were significantly lower in the gabapentin group when compared with the placebo group. Total morphine consumption in the gabapentin group was 16.3 +/- 8.9 mg (mean +/- SD) versus 42.8 +/- 10.9 mg in the placebo patients. The incidence of vomiting and urinary retention was significantly (P < 0.05) higher in the placebo group, but there was no difference in incidence of other adverse effects between the groups. Conclusions: Preoperative oral gabapentin decreased pain scores in the early postoperative period and postoperative morphine consumption in spinal surgery patients while decreasing some morphine-associated side effects.

Adding Dexmedetomidine to Lidocaine for Intravenous Regional Anesthesia

Abstract: Dexmedetomidine is approximately 8 times more selective toward the -2-adrenoceptors than clonidine. It decreases anesthetic requirements by up to 90% and induces analgesia in patients. We designed this study to evaluate the effect of dexmedetomidine when added to lidocaine in IV regional anesthesia (IVRA). We investigated onset and duration of sensory and motor blocks, the quality of the anesthesia, intraoperative-postoperative hemodynamic variables, and intraoperative-postoperative pain and sedation. Thirty patients undergoing hand surgery were randomly assigned to 2 groups to receive IVRA. They received 40 mL of 0.5% lidocaine and either 1 mL of isotonic saline (group L, n 15) or 0.5 g/kg dexmedetomidine (group LD, n 15). Sensory and motor block onset and recovery times and anesthesia quality were noted. Before and after the tourniquet application at 5, 10, 15, 20, and 40 min, hemodynamic variables, tourniquet pain and sedation, and analgesic use were recorded. After the tourniquet deflation, at 30 min, and 2, 4, 6, 12, and 24 h, hemodynamic variables, pain and sedation values, time to first analgesic requirement, analgesic use, and side effects were noted. Shortened sensory and motor block onset times, prolonged sensory and motor block recovery times, prolonged tolerance for the tourniquet, and improved quality of anesthesia were found in group LD. Visual analog scale scores were significantly less in group LD in the intraoperative period and 30 min, and 2, 4, and 6 h after tourniquet release. Intra-postoperative analgesic requirements were significantly less in group LD. Time to first analgesic requirements was significantly longer in group LD in the postoperative period. We conclude that the addition of 0.5 g/kg dexmedetomidine to lidocaine for IVRA improves quality of anesthesia and perioperative analgesia without causing side effects. (Anesth Analg 2004;98:835–40)

The analgesic effects of gabapentin after total abdominal hysterectomy.

Abstract: UNLABELLED: We investigated, in a randomized, placebo-controlled, double-blind study, the efficacy and safety of gabapentin on pain after abdominal hysterectomy and on tramadol consumption in patients. The 50 patients were randomized to receive either oral placebo or gabapentin 1200 mg 1 h before surgery. Anesthesia was induced with propofol and maintained with sevoflurane in 50% N(2)O/O(2) with a fresh gas flow of 2 L/min (50% N(2)O in O(2)) and fentanyl (2 microg/kg). All patients received patient-controlled analgesia with tramadol with a 50 mg initial loading dose, 20 mg incremental dose, 10-min lockout interval, and 4-h limit of 300 mg. The incremental dose was increased to 30 mg if analgesia was inadequate after 1 h. Patients were studied at 4, 8, 12, 16, 20, and 24 h for visual analog (VAS) pain scores, heart rate, peripheral oxygen saturation, mean arterial blood pressure, respiratory rate, sedation, and tramadol consumption. The VAS scores in the sitting and supine position at 1, 4, 8, 12, 16, and 20 h were significantly lower in the gabapentin group when compared with the placebo group up to 20 h after surgery. The tramadol consumption at 12, 16, 20, and 24 h and total tramadol consumption were significantly less in the gabapentin group when compared with placebo group. Sedation scores were similar at all the measured times. There were no differences between groups in adverse effects. Preoperative oral gabapentin decreased pain scores and postoperative tramadol consumption in patients after abdominal hysterectomy. IMPLICATIONS: This randomized, controlled trial examined the effects of preoperative oral gabapentin 1200 mg on postoperative pain and tramadol consumptions. We conclude that preoperative oral gabapentin is effective in reducing postoperative pain scores and tramadol consumption in patients after abdominal hysterectomy.

Electrophysiological evaluation of phrenic nerve injury during cardiac surgery--a prospective, controlled, clinical study.

Abstract: Background According to some reports, left hemidiaphragmatic paralysis due to phrenic nerve injury may occur following cardiac surgery. The purpose of this study was to document the effects on phrenic nerve injury of whole body hypothermia, use of ice-slush around the heart and mammary artery harvesting.

Prevalence of underweight, overweight and obesity in Turkish adolescents.

Abstract: BACKGROUND: The aim of this study was to determine underweight, overweight and obesity prevalence in a representative sample of adolescents living in urban and rural area of central Edirne, Turkey, and to compare the 95th percentile BMI curve to the curves of other countries. MATERIAL AND METHODS: Data concerning the height and weight of 989 adolescents, aged between 12 and 17 years were collected. The prevalence of underweight was defined as the percentage of adolescents below the 5th percentiles of the American adolescents' age and gender specific BMI; prevalence of overweight and obesity were based on the cut off points of the International Obesity Task Force values (excess of the 85th and 95th percentiles), respectively. RESULTS: This study demonstrated that the prevalence of underweight, overweight and obesity among adolescent girls was 11.1%, 10.6% and 2.1%, respectively, while it was 14.4%, 11.3% and 1.6% for adolescent boys. In the urban area the prevalence of underweight, overweight and obesity among adolescent girls was 10.0%, 10.3% and 2.1%, while it was 14.4%, 11.6% and 1.6% for boys, respectively. In the rural area; the prevalence of underweight, overweight and obesity among adolescent girls was 15.7%, 12.4% and 2.2%, while it was 14.5%, 9.6% and 1.2% for boys, respectively. DISCUSSION: Analyses of data collected during these studies support that adolescents living in the city of Edirne carry relatively lower further risk of overweight and obesity than adolescents in other countries do.

The analgesic effects of gabapentin in monitored anesthesia care for ear-nose-throat surgery.

Abstract: ‡Departments of *Anaesthesiology, †Ear-Nose-Throat Surgery, and ‡Biostatistics, Trakya University Medical Faculty,Edirne, TurkeyWeinvestigatedtheefficacyandsafetyofgabapentinin rhinoplasty or endoscopic sinus surgery patients.Patients received either oral placebo or gabapentin1200 mg 1 h before surgery. After standard premedi-cation, 25 patients in each group received propofol,fentanyl, and local anesthesia at the operative site.Sedation was maintained by a continuous infusion ofpropofol adjusted according to the Ramsay scale. Se-dation and pain scores were obtained at 5, 15, 30, 45,and 60 min during surgery and 30 min and 2, 4, 6, 8,12, 16, 20, and 24 h after the procedure. Diclofenac75 mg IM was administered as a rescue analgesic.Postoperative pain scores and intraoperative painscoresat45and60minweresignificantlylowerinthegabapentin group. Fentanyl (122 40 g versus 148 42 g;

Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome

Abstract: Subacromial corticosteroid injection is one of the most frequently used management tools in subacromial impingement syndrome (SIS) despite controversial reports on the efficacy. Our purpose, in this single blinded, randomised and controlled study was to clarify whether the corticosteroid injection provides additional benefit when used with other conservative treatment modalities in 48 patients with stage 2 SIS. The patients were randomly divided into three groups according to the two therapeutic injections applied with a 10-day interval: group 1: 10 cc of 1% lignocaine + 40 mg of methylprednisolone for the first and second injections, group 2: 10 cc of 1% lignocaine + 40 mg of methylprednisolone for the first injection and only 10 cc of 1% lignocaine for the second injection, group 3: only 10 cc of 1% lignocaine for the first and second injections. All the patients were prescribed 500 mg of naproxen sodium to use two times daily, instructed to rest and perform Codman's pendulum exercises during the first 15 days. Shoulder pain during rest, activity, and causing disturbance of sleep was evaluated using a visual analogue scale and shoulder function was investigated by total Constant score and its subsectional parameters which are pain, daily living activities, active range of motion and strength before the therapy and 1 and 3 months after the therapy onset. Significant improvements from the baseline values in all pain and function parameters were observed at the first and second evaluation in all groups. Group 1 patients had more favourably improved values in pain causing sleep disturbance and daily living activity parameters than group 2 and 3 patients only in the 1st month after therapy onset. We found that subacromial corticosteroid injections in the acute or subacute phase of SIS provided additional short-term benefit without any complication when used together with nonsteroidal anti-inflammatory drugs (NSAIDs) and exercise.

Neuron-specific enolase as a marker of the severity and outcome of hypoxic ischemic encephalopathy.

Abstract: The aim of this study was to evaluate serum concentrations of neuron-specific enolase (NSE) as a marker of the severity of hypoxic ischemic encephalopathy (HIE) and to elucidate the relation among the concentrations of NSE, grade of HIE and short-term outcome. Forty-three asphyxiated full-term newborn infants who developed symptoms and signs of HIE (Group 1) and 29 full-term newborn infants with meconium-stained amniotic fluid but with normal physical examination (Group 2) were studied with serial neurological examination, Denver developmental screening test (DDST), electroencephalogram and computerized cerebral tomography (CT) for neurological follow-up. Thirty healthy infants were selected as the control group. In the patient groups, two blood samples were taken to measure NSE levels, one between 4 and 48 h and the other 5-7 days after birth. Serum NSE levels were significantly higher in infants with HIE compared to those infants in Group 2 and control group. The mean serum concentrations of the second samples decreased in all groups studied but they were significantly higher in Group 1 compared to those in Group 2. Serum NSE concentrations of initial samples were significantly higher in patients with stage III HIE than in those with stages II and I. The sensitivity and specificity values of serum NSE as a predictor of HIE of moderate or severe degree (cut-off value 40.0 microg/l) were 79 and 70%, respectively, and as a predictor of poor outcome (cut-off value 45.4 microg/l) were calculated as 84 and 70%, respectively. The predictive capacity of serum NSE concentrations for poor outcome seems to be better than predicting HIE of moderate or severe degree. However, earlier and/or CSF samples may be required to establish serum NSE as an early marker for the application of neuroprotective strategies.

Bone mineral metabolism changes in epileptic children receiving valproic acid.

Abstract: Objective: The aim of this study was to evaluate bone mineral density (BMD) in epileptic children receiving valproic acid (VPA) and to determine differences between osteopenic and non-osteopenic children. Methods: Thirty-three epileptic children, receiving VPA for at least 6 months, were compared with 33 healthy children for BMD. BMD was measured by dual-energy X-ray absorptiometry at lumbar vertebrae, femoral neck and greater trochanter. Serum calcium, phosphorus, alkaline phosphates, osteocalcin and VPA levels were also determined. Results: Patient's osteocalcin levels were significantly higher (P = 0.02) and femur and trochanter BMD values were significantly lower (P = 0.04 and P = 0.03, respectively). Duration of VPA therapy was significantly longer and doses of VPA were significantly higher in seven osteopenic patients compared with 26 non-osteopenic patients. Osteopenic patients (4.6 ± 2.4 years) were younger than non-osteopenic patients (7.8 ± 3.2 years) (P = 0.01). Conclusion: Long-term and high dose VPA therapy may cause osteopenia, primarily in younger epileptic children. These patients should be followed closely by BMD measurements.

Dynamic MRI in indirect estimation of microvessel density, histologic grade, and prognosis in colorectal adenocarcinomas

Abstract: The relations of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters to microvessel density (MVD), histologic grade, and presence of metastasis were evaluated to establish new prognostic indicators in colorectal cancer (CRC). Fast-low angle shot DCE-MRI parameters (time-intensity curves, TICs; maximal relative enhancement within the first minute, E(max/1); maximal relative enhancement of the entire study, Emax; steepest slope of the contrast enhancement curve; and time to peak enhancement) of 21 CRCs (seven Duke stage B, 12 Duke stage C, and two Duke stage D) were retrospectively evaluated and correlated with corresponding postoperative MVD measurements, histologic grades, and presence of metastasis at 2 years. TICs were classified as type A in nine (43%), type B in seven (33%), and type C in five cases (24%). There was a significant difference between TIC types with regard to MVD (p < 0.05-0.001). Time to peak enhancement, steepest slope of TIC, and E(max/1) were strongly correlated with MVD (r = -0.765, p < 0.01; r = 0.681, p < 0.01; r = 0.634, p < 0.01; respectively). MVD, steepest slope of the enhancement curve, E(max/1), and Emax strongly correlated with histologic grade (r = 0.475, p < 0.05; r = 0.683, p < 0.01; r = 0.687, p < 0.01; r = 0.791, p < 0.01; respectively). There was a significant difference between groups of patients with and without metastasis with regard to histologic grade (p < 0.05) and two of the DCE-MRI parameters (p < 0.005 for E(max/1) and p < 0.05 for time to peak enhancement). Discriminant analysis correctly predicted the metastatic occurrence at 2 years in 90.5% of cases using E(max/1) (p < 0.001). Histologic grade resulted in lower rates of discrimination (66.7%; p < 0.05). DCE-MRI parameters may help in the prediction of MVD and histologic grade in CRC and may be used to predict therapeutic outcome.

Prevalence of postpartum depression in Edirne, Turkey, and related factors.

Abstract: Objective To estimate the community prevalence of postpartum depression (PPD) in Edirne, Turkey, and the potential risk factors for it. Study design The study was performed on mothers during the 6-week postpartum visit at home. A questionnaire that was devised to collect data on basic demographic information on the mothers and the Edinburgh Postnatal Depression Scale (EPDS) were applied. A total of 210 mothers were interviewed between January and April 2002, and 178 of them whose data were complete were analyzed. We evaluated EPDS cutoff scores > or =12. Results With an EPDs cutoff score of > or =12, the prevalence of PPD was 40.4%. Such factors as the husband's unemployment and a low educational level, living in a rented house, and having psychological or other problems during a previous pregnancy were the most significant risk factors for PPD. In the logistic model, the family's preference for a male infant in the previous pregnancy, female infant in the previous delivery and unwanted pregnancy were associated with PPD. The OR for these 3 variables and their 95% CI are, respectively, OR = 3.10, 95% CI 1.57-6.12; OR = 2.18, 95% CI 1.09-4.37, and OR = 2.84, 95% CI 1.22-6.61). Conclusion The prevalence of PPD was high. Although the risk factors were similar to those in other studies, other family members' mention of wanting a son can cause depression in the mothers.

Cherry chlorotic rusty spot and Amasya cherry diseases are associated with a complex pattern of mycoviral-like double-stranded RNAs. I. Characterization of a new species in the genus Chrysovirus.

Abstract: Cherry chlorotic rusty spot (CCRS) and Amasya cherry disease (ACD) display similar symptoms and are associated with a series of dsRNAs. However, a direct comparison has been lacking. Here, a side-by-side analysis confirmed that both diseases were symptomatologically very similar, as were the number (10–12) and size of their associated dsRNAs. Sequence determination of four of these dsRNAs revealed that they were essentially identical for CCRS and ACD. The largest (3399 bp), which potentially encoded a protein of 1087 aa with the eight motifs conserved in RNA-dependent RNA polymerases of dsRNA mycoviruses, had the highest similarity to those coded by dsRNA 1 of viruses belonging to the genus Chrysovirus and was termed CCRS or ACD chrys-dsRNA 1. The three closely migrating dsRNAs had the properties of the other components of a chrysovirus and in CCRS and ACD versions, respectively, were chrys-dsRNA 2 (3125 and 3128 bp), chrys-dsRNA 3 (2833 bp) and chrys-dsRNA 4 (2499 and 2498 bp), potentially encoding the major capsid protein (993 and 994 aa) and two proteins (884 and 677 aa, respectively) of unknown function. The four 5′- and 3′-UTRs shared internal similarities and had conserved GAAAAUUAUGG and AUAUGC termini, respectively. The 5′-UTRs contained the ‘Box 1’ motif followed by a stretch rich in CAA, CAAA and CAAAA repeats, characteristic of chrysovirus dsRNAs. Because species of the genus Chrysovirus have only been described as infecting fungi, this suggests a fungal aetiology for CCRS and ACD, a proposal supported by the properties of two other CCRS- and ACD-associated dsRNAs (see accompanying paper by Coutts et al., 2004 , in this issue).

Reversible MR Angiographic Findings in a Patient with Autoimmune Graves Disease

Abstract: A 45-year-old woman presented with subacute encephalopathy due to autoimmune Graves disease. MR angiography (MRA) demonstrated stenosis of the major intracerebral arteries. After high-dose methylprednisolone therapy and plasmapheresis, her neurologic status improved dramatically, and the MRA findings resolved after 3 months. The angiographic findings in Graves disease that resemble those in Moyamoya disease are temporary.

An Outbreak of Tularemia in Western Black Sea Region of Turkey

Abstract: The aim of this study was to investigate the source and the size of a tularemia outbreak in a village located in a non-endemic area. Five patients from the same village were admitted to hospital with the same complaints all within one week of September 2001. Tularemia was suspected and a diagnosis was made after physical and anamnesis examinations. The village was visited the same week that the patients were admitted to the hospital, in the January and April 2002. The villagers were examined and screened serologically by microagglutination method and the water sources were investigated bacteriologically. A total of 14 people were found to be infected from the outbreak and the oropharyngeal form was the only clinical presentation. Antibody titers ranged between 1 : 80 and 1 : 640. The patients responded well to the aminoglycoside plus tetracycline therapy. Examination of the pipewater and three springs revealed that all the water sources were contaminated by coliforms, however, Francisella tularensis could not be isolated in glucose-cystine medium. Antibody levels stayed stable or decreased seven months after. Tularemia had not been reported in this area before, so the first patients were misdiagnosed. In conclusion tularemia should be considered in differential diagnosis of patients with fever, sore throat and cervical lymphadenopaties.

Assessment of feeding performance in patients with cerebral palsy.

Abstract: Patients with cerebral palsy (CP) frequently manifest oral-ingestive problems ranging from mild to severe. Drooling, rejection of solid foods, choking, coughing and spillage during eating may contribute to these problems. The aim of this study was to assess functional feeding skills of patients with CP, aged 4-25 years. They were assessed with the Modified Functional Feeding Assessment Scale (FFAm). Mothers had expressed concern regarding drooling and reluctance in accepting solid foods. None of the mothers thought that there was a major problem with adequate ingestion. However, the study revealed that patients had disabilities in spoon feeding, biting, chewing, cup drinking, straw drinking, swallowing and clearing.

Immobilized lipase-catalyzed ethanolysis of sunflower oil

Abstract: The ethanolysis of sunflower oil catalyzed by an immobilized 1,3-specific porcine pancreatic lipase in a medium composed solely of substrates was investigated. The effects of the oil/ethanol molar ratio, temperature, amount of added water, and amount of enzyme used [respectively, 1∶3, 45°C, 0% (vol/vol), and 0.5 g of lipase, i.e., 10% w/w of total substrate]. To investigate the reusability of the lipase, the four-step ethanolysis process was repeated by transferring the immobilized lipase to a substrate mixture. As a result, the percentage of conversion after the first usage decreased markedly.

Lipase-catalyzed esterification of glycerol and oleic acid

Abstract: The enzymatic synthesis of glycerides from glycerol and oleic acid in organic solvent was studied, and the optimal conditions for glyceride synthesis by lipases were established. Of the commercially available lipases that were investigated, Candida rugosa lipase and porcine pancreas lipase resulted in the highest extent of esterification. Iso-octane and hexane were particularly useful organic solvents in glyceride synthesis. The water content in the reaction mixture was of primary importance. For C. rugosa lipase and porcine pancreas lipase, the optimal water contents were 5 and 1%, respectively. Candida rugosa lipase and porcine pancreas lipase manifested contrasting positional specificities in glyceride synthesis.

Airborne Fungi and Actinomycetes Concentrations in the Air of Eskisehir City (Turkey)

Abstract: The present study investigated the isolation and identification of airborne fungi from three different urban stations located in Eskisehir (Turkey). Air samples were taken by exposing a Petri dish with Rose-Bengal streptomycin agar medium for 15 min and after incubation the number of growing colonies was counted. The sampling procedure for fungi was performed 35 times at the research stations weekly between March and November 2001. A total of 2518 fungal and 465 actinomycetes colonies were counted on 420 Petri plates over a nine-month period. In total, some 20 mould species belonging to 12 genera were isolated. Alternaria alternata, Cladosporium cladosporioides and Scopulariopsis brevicaulis were the most abundant species in the study area (13.66, 5.80 and 5.50% of the total, respectively). Relationships between fungal spore numbers, aerosol air pollutants (that is the particulate matter in the air) and sulphur dioxide together with the meteorological conditions were examined using statistical analysis. N...

An experimental study on friction welding of medium carbon and austenitic stainless steel components

Abstract: In the presented study, AISI 1040 medium carbon steel and AISI 304 austenitic stainless steel parts were joined by friction welding. The welding process was carried out under optimized conditions using statistical approach. Tension tests were applied to welded parts to obtain the strength of the joints. Fatigue properties were additionally obtained experimentally under fluctuated tensile loads. Finally, notch impact tests were applied to the joints. Microstructures using microphotographs were examined in the heat affected zone of welded parts. Hardness variations in welding zone were also obtained. Experimental results were compared with those of previous studies.

The use of intraarticular tramadol for postoperative analgesia after arthroscopic knee surgery: a comparison of different intraarticular and intravenous doses.

Abstract: We aimed to determine the optimal dose of tramadol when administered intraarticularly after arthroscopic knee surgery under general anesthesia in patients with an American Society of Anesthesiologists (ASA) physical status score of I-II. When the surgical procedure was completed, patients were assigned to one of seven groups (n=30 for each) in a double-blinded and randomized manner according to a table of random numbers. Group I received 100 mg tramadol, Group II received 50 mg tramadol, Group III received 20 mg tramadol and Group IV received 0.9% NaCl intraarticularly in 20 ml solutions. Group V received 100 mg tramadol, Group VI received 50 mg tramadol and Group VII received 20 mg tramadol intravenously. Pain was evaluated by using the Visual Analogue Scale (VAS) at 0 min (when the patient was cooperated after extubation), 30 min, 1 h, 4 h, 6 h, 12 h, 18 h and 24 h postoperatively. Patients were administered diclofenac sodium 75 mg intravenously (i.m.) when they experienced pain. The intraarticular tramadol groups had longer duration of analgesia than i.v. tramadol groups who were administered the same doses (I vs V; II vs VI; III vs VII; p <0.001). Group I had the longest duration of analgesia (p<0.001). Group II had a longer time to the first analgesic request than all other groups (p<0.001) except Group I. Consequently, Group I and II needed less analgesics than other groups (p<0.001). Pain scores were 0–3 on the VAS in Groups I, II and V at first assessment, in Groups I and II at 30 min and 1 h, and in Group I at 4 h and 6 h postoperatively (p<0.01). In Group V, vomiting was more a more frequent complication than with other groups (p<0.05). It is concluded that tramadol provides analgesia with a peripheral mechanism when administered intraarticularly. The side effects of intraarticular 100 mg tramadol were no more severe than those for intraarticular 50 mg tramadol. Moreover, intraarticular 100 mg tramadol provided excellent analgesia after arthroscopic surgery.

Effects of lornoxicam on the physiology of severe sepsis

Abstract: The purpose of the present study was to evaluate the effects of intravenous lornoxicam on haemodynamic and biochemical parameters, serum cytokine levels and patient outcomes in severe sepsis. A total of 40 patients with severe sepsis were included, and were randomly assigned (20 per group) to receive either lornoxicam (8 mg administered intravenously every 12 hours for six doses) or placebo. For both groups the following were recorded: haemodynamic parameters (heart rate, mean arterial pressure), nasopharyngeal body temperature, arterial blood gas changes (pH, partial oxygen tension, partial carbon dioxide tension), plasma cytokine levels (IL-1β, IL-2 receptor, IL-6, IL-8, tumour necrosis factor-α), biochemical parameters (lactate, leucocytes, trombocytes, creatinine, total bilirubin, serum glutamate oxalate transaminase), length of stay in the intensive care unit, duration of mechanical ventilation and mortality. All measurements were obtained at baseline (before the start of the study) and at 24, 48 and 72 hours from the start of lornoxicam/placebo administration. No significant differences were found between the intravenous lornoxicam and placebo groups in major cytokines, duration of ventilation and length of intensive care unit stay, and inspired fractional oxygen/arterial oxygen tension ratio (P > 0.05). In these patients with severe sepsis, we found intravenous lornoxicam to exert no effect on haemodynamic and biochemical parameters, cytokine levels, or patient outcomes. Because of the small number of patients included in the study and the short period of observation, these findings require confirmation by larger clinical trials of intravenous lornoxicam, administered in a dose titrated manner.