Hemodynamic efficacy and safety of using modified gelatin solution and polyhydric alcohol solution for fluid resuscitation of patients with septic shock

Objective ‒ to compare the hemodynamic effects and safety of the infusion of succinylated gelatin solution, sorbitol-containing solution, and 0.9 % normal saline (0.9 % sodium chloride), analyze their effect on the treatment of septic shock and mortality.Materials and methods. A prospective randomized clinical trial that included 94 adult patients with an active surgical infection and septic shock was conducted. There were 34 (36.2 %) male and 60 (63.8 %) female patients aged between 19 and 96 years, mean age was (66.51 ± 17.06) years. An appropriate solution in a volume of 500 ml was used for resuscitation, then hemodynamic and other clinical and laboratory parameters were monitored.Results. There was no significant difference in mean arterial pressure (MAP) between the 3 groups until the 40th minute (p>0.05). At the 45th minute MAP in the NS group differed only from MAP in the Gel group (p=0.007). At the 50th minute MAP in the NS group did not differ from the baseline (p=0.139). From the 50th minute to 2 hours, MAP in the Gel and Sorb groups was higher than in the NS group in all measurements (p<0.05). There was no statistically significant difference in heart rate (HR) in any measurement (p>0.05). Cardiac output (CO) did not differ up to the 30th minute (p>0.05), at the 35th minute, CO differed only between Gel and NS groups (p=0.019), from the 40th minute to 2 hour CO in Gel and Sorb groups were significantly higher than in NS group in all measurements (p<0.05). Oxygen delivery (DO2) also did not differ up to the 30th minute (p>0.05), from the 35th minute to the 45th minute a significant difference was found only between Gel and NS groups (p<0.05), from the 50th minute to 2 hour DO2 in Gel and Sorb group was significantly higher than in NS group in all measurements (p<0.05). After infusion of the gelatin-containing solution and sorbitol-containing solution, the acid-base balance of the blood improved significantly. The dose of gelatin-containing and sorbitol-containing solutions applied in this study was safe for the renal function of the patients with septic shock. However, it is possible that a decrease in blood fibrinogen concentrations may be associated with the use of a gelatin-containing solution. Significant improvement in the Glasgow Coma Scale scores was observed only in patients in the group receiving the sorbitol-containing solution. The difference in 28-day mortality between the groups was not statistically significant (p=0.993).Conclusions. In our observations, when using these three types of solution in patients with septic shock, hemodynamic effects up to the 40th minute did not differ between groups. From the 40th minute to 2 hour, the volemic effect of 4 % succinylated gelatin solution and balanced polyionic solution with 6 % sorbitol was significantly better, compared to the 0.9 % sodium chloride solution. The volume of solutions used in these three groups did not affect renal function in patients with septic shock. The amount of balanced polyionic solution used with 6 % sorbitol and 0.9 % sodium chloride solution did not affect blood coagulation function. But the use of 4 % succinyl gelatin solution reduced the concentration of fibrinogen in the blood. After infusion of the gelatin-containing solution with buffer formulations and sorbitol-containing solution with buffer formulations, the acid-base status of the blood was significantly improved compared to 0.9 % sodium chloride solution. Infusion of the gelatin-containing solution and 0.9 % sodium chloride solution did not affect the Glasgow coma score in patients. After infusion of the sorbitol-containing solution, patients’ consciousness was improved by this scale. The 28-day mortality did not differ significantly between groups.

Effects of contact time of natural cu-zeolite on the growth of Streptococcus pyogenes and Pseudomonas aeruginosa

Infection of a surgical wound due to bacteria is a major problem for surgical patients. Cu-zeolite is a material that can suppress bacterial growth with reversible cation characteristics and adsorption to be developed into non-toxic disinfectants for humans. Packaging uses filter paper to keep disinfectant solutions or instruments that will be sterilized clean. This study aimed to observe the effects of contact time of natural Cu-zeolite on the growth of Streptococcus pyogenes (S. pyogenes) and Pseudomonas aeruginosa (P. aeruginosa) bacteria. An experimental research was simple randomized design. Cu-zeolite 10 grams were packaged in Whatman no 42 paper bags measuring 5 x 5 cm2, contacted for 15, 30 and 45 minutes in 99.5 ml of distilled water exposed to 0.5 x 108 CFU / ml of S. pyogenes and P. aeruginosa. Subsequently, bacterial growth was calculated using total plate count method. The average growth of S.pyogenes for 15, 30 and 45 minutes (1840 ± 571.236 CFU; 29 ± 16.33 CFU and 0 CFU) while P. aeruginosa was (2776 ± 725.277 CFU; 55 ± 23.214 CFU and 0 CFU) respectively. Based on the independent t-test on Cu-zeolite, the bacterial growth in the 15th and 30th minute contact between S. pyogenes and P. aeruginosa was significantly different (pth and 30th minute contact.

Phosphoprotein gene of peste des petits ruminants virus: unsuitable for lineage determination

The aim of this study was to investigate the effect of isoflurane (ISO) and sevoflurane (SEVO) anesthesia on coagulation parameters in dogs. A total of 12 dogs were used in the study in two groups as ISO(n = 6) and SEVO(n = 6), which were brought to the clinic for ovariohysterectomy. Premedication was performed by the intravenous administration of 0.3 mg/kg midazolam, followed by 5 mg/kg intravenous bolus propofol infusion. This was followed by 1.5% ISO administration in the ISO group and 2% sevoflurane administration in the SEVO group for anesthesia maintenance. Before anesthesia, prothrombin time (PT), active partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB) level were measured at the 0th minute before anesthesia, at the 15th and 30th minutes during anesthesia, and at the 0th minute and the 1st hour after anesthesia. It was observed that the changes in TT, PT, APTT, and FIB level with time were not significant in the ISO and SEVO groups. It was determined that the changes in TT between the measurements in groups at the 30th minute during anesthesia and 0th minute after anesthesia were statistically significant (P less than 0.05)

Effect of isoflurane and sevoflurane anesthesia on coagulation parameters in dogs**

The aim of this study was to investigate the effect of isoflurane (ISO) and sevoflurane (SEVO) anesthesia on coagulation parameters in dogs. A total of 12 dogs were used in the study in two groups as ISO(n = 6) and SEVO(n = 6), which were brought to the clinic for ovariohysterectomy. Premedication was performed by the intravenous administration of 0.3 mg/kg midazolam, followed by 5 mg/kg intravenous bolus propofol infusion. This was followed by 1.5% ISO administration in the ISO group and 2% sevoflurane administration in the SEVO group for anesthesia maintenance. Before anesthesia, prothrombin time (PT), active partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB) level were measured at the 0th minute before anesthesia, at the 15th and 30th minutes during anesthesia, and at the 0th minute and the 1st hour after anesthesia. It was observed that the changes in TT, PT, APTT, and FIB level with time were not significant in the ISO and SEVO groups. It was determined that the changes in TT between the measurements in groups at the 30th minute during anesthesia and 0th minute after anesthesia were statistically significant (P less than 0.05)

Influence of dibornol-HES on electrophysiological parameters in the period of restoration of blood flow in rabbit myocardium

Objective. Dibornol-HES, a water-soluble drug based on the derivative of 2,6-diisobornyl-4-methylphenol Dibornol conjugated with hydroxyethyl starch, can reduce the occurrence and severity of arrhythmias by preventive intravenous administration, but it is unknown whether the drug could reduce the myocardial arrhythmogenicity once ischemia has developed at the developed ischemia.Materials and methods. In the model of acute ischemia / reperfusion of the rabbit heart, the effect of Dibornol-HEC (80 mg/kg body weight of the animal) on the electrophysiological indices characterizing myocardial arrhythmogenicity (global and border dispersion of repolarization) was studied during the restoration of blood flow. In the model of acute ischemia / reperfusion with 64 unipolar epicardial leads, the activation-recovery intervals were measured and global and border dispersion of repolarization in the native rabbits (control group, n = 9) and in the rabbits treated by Dibornol-HES (on the 25th minute of occlusion, the experimental group, n = 6).Results. The introduction of Dibornol-HES did not lead to a change in the electrocardiographic parameters of rabbits. By the 30th minute of the coronary occlusion on the ECG in the animals of the control and the experimental groups, the intervals RR, QT, QTc were shortened (p < 0.05). In the animals of both groups by the 30th minute of coronary occlusion, the global dispersion of repolarization increased (p < 0.05), the boundary dispersion of repolarization also increased (p < 0.05), due to the decrease in the duration of the activation-recovery intervals in the ischemic zone (p < 0.05). During the 30-minute reperfusion the magnitude of the global dispersion of repolarization did not change in animals of the both groups, and the magnitude of the border dispersion of repolarization in the control rabbits decreased (p < 0.05), while in the rabbits treated by Dibornol-HES the border dispersion of repolarization did not changed.Conclusion. In rabbits of the experimental group, the values of the global and border dispersions of repolarization did not differ from those of the animals in the control group. Therefore, the administration to Dibornol-HES just prior to reperfusion does not lead to the decrease in the dispersion of repolarization increased as a result of acute ischemic myocardial damage.

Effect of Phosphate Addition and Exposure of Micro Waves on Comparatives Ca/F in Gipsum Waste: Preliminary Study of Hydroxyappatite Synthesis (HAp) from Ceramics Gypsum Industry Waste

This study aims to conduct an initial study of hydroxyapatite synthesis from ceramic gypsum waste. The parameters of the synthesis process carried out were variations in the time of the hydrothermal process namely 10, 20, 30, 40 and 50 minutes. The time variation was studied to study the effect of time on the hydroxyapatite character of gypsum waste. The initial synthesis process was conducted by looking at the comparison of Phosphate and Calcium levels in gypsum. In this study the results of the highest Phosphate levels obtained were 0.607% in the 10th minute, while the largest Calcium levels were obtained in the 30th minute which was 0.171%. The treatment in the 30th minute gave the most optimal difference in effect which was 0.413. FTIR results showed the emergence of hydroxyapatite peaks namely –OH, PO43- and Ca-O, as well as the increase in the intensity of the peak of gypsum powder before treatment and after treatment. While the XRD results strengthened the presence of hydroxyapatite in gypsum with the presence of high peaks at 2θ = 31.08°; 32.14° and 33.45° respectively which indicated the presence of hydroxyapatite. While the main impurities in the synthesized hydroxyapatite are carbonates identified from FTIR results.

Investigating the heart rate and oxygen saturation values of u13 category footballers at competition occasion who stand in different Uphill citiesFarklı yükseltideki illerde bulunan u13 kategorisi futbolcuların müsabaka ortamında nabız ve oksijen saturasyon değerlerinin incelenmesi

The aim of this study is to investigate the heart rate and oxygen saturation values of U13 footballers at competition occasion who stand in different cities. 34 footballers participated to the study totally who are playing U13 teams of Ankara Keçiören Bağlum Sport Club and Isparta Iyaş Youth and Sport Club. Height, weight, heart rate and oxygen saturation measurements were taken from research groups. In analyzing handled datas, Independent t Test was used at SPSS 18.0 for Windows. Research Groups’ height means found in Isparta Iyaş Youth and Sport Club 156.1±6,1 cm, found in Ankara Bağlum Sport Club 152,7±5,6 cm; weight means found in Isparta Iyaş Youth and Sport Club 47,0±3,7 kg, Ankara Bağlum Sport Club 48,4±4,0 kg. As comparing the heart rate values pre and during competition, differences found insignificiant too (p>0.05). While comparing the oxygen saturation measurements in pre and 30th minute, differences were found statistically significiant (p<0.05); No significant difference was found in the comparison of the oxygen saturation measurements before the competition and at the 10th, 20th and 40th minutes (p>0.05). Based on the obtained data, we think that studying with more higher areas and groups will be useful for sharpening some differences and similarities. Extended English abstract is in the end of PDF (TURKISH) file.ÖzetBu araştırmanın amacı, farklı yükseltideki illerde bulunan U13 kategorisi futbolcuların müsabaka şartlarında nabız ve oksijen saturasyon değerlerinin incelenmesidir.Araştırmaya Ankara Keçiören Bağlum Spor (n 17) ve Isparta Iyaş Gençlik Sporun (n:17) U13 futbol takımında oynayan toplam 34 futbolcu gönüllü (izinli) olarak katıldı. Araştırma grubundan boy, vücut ağırlığı, kalp atım sayısı ve O2 saturasyonu ölçümleri alındı. Elde edilen verilerin tanımlayıcı istatistikleri ile gruplar arasında farkları belirlemek için Independent t testi kullanıldı. Araştırmaya katılan sporcuların boy ortalaması Isparta Iyaş Gençlik ve Spor Kulübünde 156,1±6,1 cm, Ankara Bağlum Spor Kulübünde 152,7±5,6 cm iken; vücut ağırlıkları ortalaması Isparta Iyaş Gençlik ve Spor Kulübünde 47,0±3,7 kg, Ankara Bağlum Spor Kulübünde 48,4±4,0 kg olarak tespit edildi. Sporcuların müsabaka başlangıcında ve esnasında kalp atım sayılarının karşılaştırılmasında da fark anlamsız bulunmuştur (p>0.05). Sporcuların müsabaka öncesi ve müsabakanın 30. dakikasında oksijen saturasyonu ölçümlerinin karşılaştırılması sonucunda istatistiksel açıdan anlamlı fark bulunurken (p<0.05), müsabakının öncesi ve 10., 20., 40. dakiklardaki oksijen saturasyonu ölçümlerinin karşılaştırılması sonucunda ise fark istatistiksel açıdan anlamlı fark bulunamamıştır (p>0.05). Elde edilen verilere dayanarak bazı farklılıkların veya benzerliklerin daha da netleşebilmesi için daha fazla yükseltiye sahip olan bölgeler ve gruplar üzerinde çalışılmasının yararlı olacağı düşünmekteyiz.

Effects of prophylactic ozone therapy on general anesthesia and surgical stress response: Neutrophil/lymphocyte ratio and ischemia modified albumin

Background:General anesthesia and surgical stress cause an acute endocrine, metabolic, and immunological inflammatory response in organisms and an increase in neutrophil lymphocyte ratio (NLR) and ischemia modified albumin (IMA) levels. Ozone, other than inhalation administration, reduces the release of antioxidants and some proinflammatory cytokines and has been shown to have an anti-inflammatory effect. Our aim is to research how the NLR and IMA response is affected in rabbits undergoing surgical intervention with general anesthesia given prophylactic with ozone therapy. Methods: Twelve New Zealand rabbits were divided into two groups: GroupO was given 70 µg/ml 10 ml ozone by the rectal route in 6 sessions on alternate days, and GroupC was given air by the rectal route.The rabbits underwent surgical intervention under general anesthesia.Blood samples were taken at basal, preoperative, 30th minute of operation, and 24 hour postoperative times and were examined for hemogram and IMA. Results:In the postoperative 24th hour an increase in NLR was observed in both groups, more clearly in GroupC (p&lt;0.05). In both groups, comparisons within the groups showed a significant increase in NLR only in the postoperative 24th hour compared to other times (p&lt;0.05).When IMA values were compared, differences between the groups were observed between preoperative values and those at the 30th minute of anesthesia and 24 hours postoperative (p&lt;0.05). Conclusions:When General anesthesia and surgical stress response was evaluated using inflammatory parameters of both NLR and IMA, there was significantly less of an increase in levels in rabbits given ozone compared to the control group.

Technical Errors And The Venue Of The Match In Handball

Introduction. In sports success depends on how well the players are prepared for the match in terms of their technical, tactical and motor skills, as well as their mental attitude. The training process is focused on improving the players' capabilities and eliminating their errors. The aim of the study was to describe the errors made in handball matches taking into account their timing and quantity.Material and methods. The material consisted of recordings of 50 matches of men's handball held in the EHF Champions League in 2012-2013. The study included 8 teams that took part in the tournament. The following matches were analysed for each team: 4 matches in the knockout stage (2 played at home and 2 away) and 4 in the group stage (2 at home and 2 away). The errors were determined based on EHF regulations.Results. A difference was found between the errors committed in matches at home and away in the knockout stage. The most errors (35) in this stage of the tournament were made between the 25th and 30th minute, and the fewest (18) between the 30th and 35th minute, in both cases in matches played at home. In the group stage the most errors (36) were made between the 40th and 45th minute away, and the fewest (15) between the 10th and 15th minute at home. In the knockout stage the four teams made a total of 632 errors, including 71 errors made by the winner of the tournament, who committed the smallest number of errors. The smallest number of errors (53) in the group stage were made by HC Metalurg Skopje.Conclusions. The number of errors made did not have a direct influence on a team's position in the tournament, but the winner made the least errors in the knockout stage. The differences between the numbers of errors made in the knockout stage may indicate that the players were more comfortable when playing at home. The support of fans may be one of the factors which contribute to the fact that players commit fewer errors in this stage of the tournament. The rise in the number of errors made towards the end of the match, on the other hand, is most likely due to an increased level of physical and emotional fatigue, particularly considering the risk of being eliminated from the tournament.

Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress

Objective. To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2(ETCO2), arterial blood gases (ABG), and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF) during laparoscopic cholecystectomy (LC) by using lung-protective ventilation strategy.Materials and Methods. Forty-six patients undergoing LC and abdominal wall hernia (AWH) surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and at the end of surgery. BALF samples were obtained after anesthesia induction and at the end of surgery.Results. Peak inspiratory pressure, ETCO2, and pCO2values at the 30th minute were significantly increased, while there was a significant decrease in dynamic lung compliance, pH, and pO2values in LC group. In BALF samples, total oxidant status (TOS), arylesterase, paraoxonase, and malondialdehyde levels were significantly increased; the glutathione peroxidase levels were significantly decreased in LC group. The serum levels of TOS and paraoxonase were significantly higher at the end of surgery in LC group. In addition, arylesterase level in the 30th minute was increased compared to baseline. Serum paraoxonase level at the end of surgery was significantly increased when compared to AWH group.Conclusions. Our study showed negative effects of pneumoperitoneum in both lung and systemic levels despite lung-protective ventilation strategy.