Inhaled nitric oxide as rescue therapy in severe ARDS cases due to COVID-19 pneumonia: a single center experience.

OBJECTIVE: Inhaled NO (iNO) has been recommended as rescue therapy in acute respiratory stress syndrome (ARDS) cases. In this study, we aimed to demonstrate the efficacy of iNO as a rescue therapy in patients with severe ARDS due to COVID-19. PATIENTS AND METHODS: This retrospective study included patients with ARDS due to COVID-19 who were treated with iNO between March 2020 and January 2022 in the intensive care unit (ICU) of Inonu University. Patients' files were reviewed retrospectively, and demographic data, APACHE II and Sequential Organ Failure Assessment (SOFA) scores, initiation day of iNO and duration of iNO treatment, length of stay in hospital/ICU, blood biochemistry values, complete blood counts, inflammatory parameters, arterial blood gas values, lactate, PaO2/FiO2 ratios, anti-inflammatory drugs and outcome were recorded. RESULTS: Data from 16 patients were reached. iNO was given at a dose of 20 ppm continuously. The mean duration of treatment with iNO was 3.5 days. All patients took the prone position except a single patient. While all patients received steroid therapy, four patients received anti-cytokine therapy, and five patients received intravenous immunoglobulin therapy. All patients were in severe ARDS with a mean PaO2/FiO2 ratio of 58 before iNO therapy. A significant increase in PaO2/FiO2 values was detected with the use of iNO (p<0.05). While three patients (19%) were discharged from the ICU, thirteen patients died. CONCLUSIONS: In our study, it was determined that iNO applied as a rescue treatment in patients with severe ARDS improved oxygenation. Although the effect of iNO on survival was low, it may be interpreted as clinically significant considering the severity of the general clinical condition of the patients.

The results of inspiratory muscle training on cardiac, respiratory, musculoskeletal, and psychological status in patients with stable angina: a randomized controlled trial.

PURPOSE: To determine the effect of inspiratory muscle training (IMT) on respiratory and peripheral muscle strength, functional exercise capacity, health-related quality of life (HRQoL), fatigue, depression, and cardiac functions in patients with stable angina. METHODS: A randomized, controlled, single-blinded study. Twenty patients (59.95 ± 7.35 y, LVEF = 58.77 ± 7.49) with stable angina received IMT at the lowest load (10 cmH2O), and 20 patients (55.85 ± 7.60 y, LVEF = 62.26 ± 7.75) received training at 30% of maximal inspiratory pressure (MIP) seven days/8 weeks. Respiratory muscle strength (MIP; maximal expiratory pressure, MEP), peripheral muscle strength, pulmonary functions, functional exercise capacity (6-min walking test; exercise test), fatigue, HRQoL, depression, and cardiac functions were evaluated before and after. RESULTS: A statistical difference was found between groups in terms of respiratory and peripheral muscle strength, pulmonary functions, functional exercise capacity (p < 0.05). The results of fatigue, depression, HRQoL, and cardiac functions were similar between the groups (p > 0.05). CONCLUSIONS: This study is the first to demonstrate the positive effects of IMT in patients with stable angina. IMT is a safe and effective method and is recommended to be added to cardiopulmonary rehabilitation programs and guidelines, as it results in increased peripheral muscle strength and functional exercise capacity in stable angina patients.Implications for rehabilitationInspiratory muscle training (IMT) is a safe and effective method for coronary artery disease (CAD) patients with stable angina.IMT improved respiratory and peripheral muscle strength, functional exercise capacity, pulmonary functions, and health-related quality of life in CAD patients with stable angina.Perception of depression and fatigue were decreased with IMT in CAD patients with stable angina.

Comparison of Different Fixation Confi gurations in Different Types of High Pediatric Supracondylar Humerus Fractures: a Finite Element Analysis.

PURPOSE OF THE STUDY: The purpose of this study is to compare the stability of different fi xation methods in high pediatric supracondylar humerus fractures with a fi nite element analysis method. MATERIAL AND METHODS Transverse, lateral oblique, and medial oblique fracture models were created in a ten years old boy's distal humerus. Eight different fi xation methods were applied to each fracture model. Displacement of the fracture models was measured under the translational and torsional forces. RESULTS In the transverse fracture model; the 6th method provided the best stability in internal rotation, external rotation, and extension loading. In varus 7th method, valgus 8th, and fl exion the 5th and 2nd methods had the best stability. In the lateral oblique fracture model; the 7th method had the best stability in all loading directions except fl exion and the 6th method had the best stability in fl exion and had acceptable values in all other directions except valgus and external rotation. In the medial oblique fracture model; the 6th method had the best stability in all directions except varus. 3rd method was the best fi xation type against varus and the second stable fi xation type in all other directions. CONCLUSIONS Combining lateral antegrade with lateral retrograde wire and lateral condylomedullary wire provides strong stability in the lateral oblique fracture. Two condylomedullary Kirchner wires and one antegrade lateral wire results in a strong stability in the medial oblique fracture. Medial-lateral condylomedullary and lateral antegrade wires provided the best stability against varus in transverse and lateral oblique fractures. KEY WORDS: high pediatric supracondylar humerus fracture, percutaneous fi xation method, metaphyseal-diaphyseal junction, fi nite element analysis.

The effect of HA330 hemoperfusion adsorbent method on inflammatory markers and end-organ damage levels in sepsis: a retrospective single center study.

OBJECTIVE: In this study, we aimed at evaluating the impact of HA330 hemoperfusion adsorbent application on inflammatory markers and end-organ damage markers in patients with sepsis/septic shock. PATIENTS AND METHODS: Patients who were diagnosed with sepsis/septic shock and treated with HA330 hemoperfusion adsorbent in addition to the standard treatment were included in this retrospective study conducted at Inonu University Turgut Ozal Medical Center between January 1, 2019 and January 1, 2021. RESULTS: A total of 150 patients were included in the study. The mean±SD age of the patients was 51.9±17.7 years. 102 patients (68%) were in septic shock. Mean±SD APACHE II scores were 15.3±4.8. The need for mechanical ventilation was noted in 64 patients (42.7%). WBC, neutrophil count, hemoglobin, platelet count, BUN, creatinine, AST, ALT, CRP and procalcitonin levels were measured before and after the procedure. Overall, 104 patients (69.3%) died median (min-max) 2.5 (1-114) days after the cytokine adsorption, while 46 patients (30.7%) recovered from sepsis and were discharged. The increase in BUN levels and decrease in platelet count after the procedure were statistically significant (p≤0.001, 0.041, respectively) in the overall study population. The laboratory findings in 46 survivors indicated significantly decreased AST and ALT levels after cytokine adsorption compared to baseline pre-treatment levels. WBC, neutrophil count, CRP, procalcitonin, BUN and creatinine values were also decreased after cytokine adsorption in survivors, whereas the change was not statistically significant. There was also a non-significant tendency for an increase in platelet count and hemoglobin levels after cytokine adsorption compared to pre-treatment values in these patients. CONCLUSIONS: Although no effect of HA330 hemoperfusion application on inflammatory markers and end-organ damage markers was demonstrated in our study, we used the HA330 hemoperfusion adsorbent method as a last resort in terminal patients with a mortality rate of approximately 90% and for whom antibiotic treatment did not benefit. Therefore, multicenter, prospective studies are needed to clarify the effect of early HA330 hemoperfusion use in the treatment of sepsis.

Tracheomediastinal emphysema after tracheostomy in a post-COVID-19 patient: a case report.

OBJECTIVE: There are no reports of tracheomediastinal fistula development after tracheostomy. CASE REPORT: A 72-year-old female patient with post acute COVID-19 was transferred to our intensive care unit. After two unsuccessful weaning attempts, a tracheostomy was performed at hospitalization on day 32. The patient's body mass index was 35 kg/m2 and she had a narrow neck anatomy. A percutaneous tracheostomy was performed using the Griggs method without any problems. Pneumothorax, pneumomediastinum, subcutaneous emphysema, and hemorrhage were not observed. Twenty-two days after the tracheostomy, the patient developed subcutaneous emphysema and experienced a sudden decrease in oxygen saturation. Bedside anterior-posterior chest X-ray did not detect pneumothorax and a tracheoesophageal fistula was found via esophageal endoscopy. A tracheomediastinal fistula was observed just below the cannula distal end via computed tomography. CONCLUSIONS: There are multiple reasons why a tracheomediastinal fistula could develop after tracheostomy. Therefore, this condition should be considered in cases of sudden subcutaneous emphysema and oxygen deterioration following tracheostomy.

Molecular and morphological description of Myxidium parvum (Cnidaria) from Salaria pavo (Blenniidae) in the Black Sea.

Members of the predominantly coelozioc genus Myxidum Bütschli, 1882 with more than 232 species have been reported from a wide variety of marine and freshwater fish species worldwide. In this study, 25 specimens of peacock blenny, Salaria pavo, were collected from Sinop on the Turkish Black Sea coast. The gills, fins, skin, urinary bladder, gal bladder, kidney, liver, gonads and smooth muscle tissue of the collected samples were investigated for myxosporean parasites. Myxidium parvum Yurakhno, 1991 was the only myxosporean found in the gall bladder of host fishes. Based on spore morphology, M. parvum had mostly overlapping measurement data of original description in spore length and width, polar capsule length but differed slightly in width; however, they were within the ranges previously reported from other blenniid host fish species in the Black Sea. Moreover, in this study, molecular analysis of the 18S rDNA gene of M. parvum isolates from S. pavo was done for the first time and our M. parvum genotypes appeared as sister to Myxidium incurvatum within the "Lineage II" of the marine Myxidium clade.

Management of mechanical ventilation in a morbidly obese patient with COVID-19-induced ARDS.

Coronavirus disease 2019-induced acute respiratory distress syndrome (ARDS) is more severe in morbidly obese patients. Mechanical ventilation differs between obese and non-obese patients. We examined these differences in an obese (body mass index = 47 kg/m2) 32-year-old patient followed up in our clinic. The patient was admitted to the intensive care unit due to respiratory failure. Recruitment maneuvers were performed in pressure-controlled ventilation mode. The optimal positive end-expiratory pressure was 25 cm H2O. The inspiratory pressure was adjusted to 45 cm H2O to provide a tidal volume of 6 ml/kg and driving pressure ≤ 15. The patient was discharged with full recovery.

The effect of gamma and microwave radiation sterilization on periodontological grafts for microbiological evaluation.

Periodontological grafts are materials used in dentistry to regenerate lost gingival soft tissues or bone parts. In the case of direct contact with blood, the possibility of disease transmission from the source to the patient is high. This source can be an animal or a human. Therefore, the sterilization of grafts before implanting to the patient is of significant importance. The purpose of this study was to evaluate gamma radiation and microwave sterilization processes from microbiological and sterility perspectives and to compare the effectiveness of these two sterilization methods. Grafts were irradiated with 2, 4, 5, 10, 25 and 50 kGy doses of gamma radiation. Another group of same materials was irradiated by microwave for 1, 2, 3 and 4 min at 24,500 MHz and 900 W. Gamma radiation and microwave sterilization methods were evaluated as successful at minimum doses as 5 kGy and 3 min, respectively. Both gamma and microwave sterilization successfu lly sterilized periodontological grafts coded as PBG1, HBG1, HL1, PDG1, MBG3, MDG2 and PDG3. Moreover, microwave sterilization can be used as an alternative novel method to gamma radiation sterilization.

Diagnostic and therapeutic evaluation of folate-targeted paclitaxel and vinorelbine encapsulating theranostic liposomes for non-small cell lung cancer.

NSCLC is the most common type of lung cancer. However, non-specific contrast agents, radiopharmaceuticals, and treatment methods are insufficient in early diagnosis and eradication of all tumor tissue. Therefore, the formulation of a novel, targeted, specific theranostic agents possess critical importance. In our previous study, paclitaxel and vinorelbine encapsulating, Tc-99m radiolabeled, folate targeted, nanosized liposomes were formulated and found promising due to characterization properties, high cellular uptake, and cytotoxicity. In this study, in vivo therapeutic and diagnostic efficacy of liposomal formulations were tested by biodistribution study, evaluation of tumor growth inhibition, and histopathologic examination after in vitro assays on LLC1 cells. Both actively and passively targeted liposomal formulations exhibited high cellular uptake, and co-drug encapsulating liposomes showed a greater cytotoxicity profiles than free drug combination in LLC1 cells. By the results of biodistribution studies performed in NSCLC tumor-bearing C57BL/6 mice, the uptake of radiolabeled, actively folate targeted, co-drug encapsulating liposomal formulation was found to be higher in tumor tissue when compared to non-actively targeted one. Also, more effective treatment was achieved by using folate-targeted, co-drug encapsulating liposomal formulation when compared to free drugs combination according to changes in tumor size of mice. Furthermore, liposomal formulations showed lower toxicity compared to free drug combinations in the toxicity study considering body weight. Moreover, according to the histopathological study, folate targeted, co-drug encapsulating liposomes not only inhibited the tumor growth effectively but also restricted the lung metastasis entirely.

Morphological and molecular descriptions of Sphaeromyxa sevastopoli (Cnidaria) from host fishes from Sinop on the Black Sea coast.

Members of the genus Sphaeromyxa Thélohan, 1892 have been reported from a wide variety of fish species worldwide. In the present study, specimens of rusty blenny, Parablennius sanguinolentus, collected from Sinop on the Turkish Black Sea coast were investigated for myxosporean parasites by using both conventional and molecular methods. Sphaeromyxa sevastopoli Naidenova 1970 was the only myxosporean parasite found in the gall bladder of host fishes. The morphology peculiarities of obtained S. sevastopoli spores are in good agreement with those of original description and the morphometric data overlapped in spore length and width but differed in polar capsule length and width; however, they were within the ranges previously reported from 18 host fish species. Moreover, in the present study, molecular analysis of the 18S rDNA gene of S. sevastopoli isolate in our P. sanguinolentus as well as isolates from shore rockling Gaidropsarus mediterraneus and knout goby Mesogobius batrachocephalus which were previously morphologically identified and reported by Okkay and Özer (Acta Zool Bulg 72(1):123-130, 2020) was done for the first time and our three S. sevastopoli genotypes were allocated to the "balbianii" group which is characterized by straight or slightly curved and fusiform or ovoid spores with ovoid polar capsules.

Targeted Alpha Therapy and Nanocarrier Approach.

The rates of cancer incidence and mortality are increasing day by day. Although several conventional methods including surgery, chemotherapy, and radiotherapy (RT) exist for cancer treatment, they are insufficient in the eradication of all tumor tissues and have some side-effects such as narrow therapeutic index and serious side-effects to healthy tissues. Moreover, it may probably recur in time due to the survival and spreading of cancerous cells or any possible metastases. Targeted radionuclide therapy is a promising alternative. α particles are ideal for localized cell killing because of their high linear energy transfer and short ranges. However, upon emission of α particles, the daughter nuclides induce a recoil energy to lead decoupling from any chemical bond that may accumulate in normal tissues. Targeted α therapy can also be performed by targeted delivery systems apart from mAb, mAb fragments, peptides, and small molecules for selective tumor therapy. Targeted drug delivery systems have been developed to overcome the limitations of α therapy. Moreover, drug delivery systems are one of the most searched applications in cancer imaging and/or treatment due to their targeting ability to tumor or biocompatibility properties. The aim of this article is to summarize tumor therapy applications, targeted α RT approach, and to review the role of drug delivery systems in the delivery of α particles for cancer therapy and some instances of targeted α-emitting drug delivery systems from the literature.

Which one predicts mortality better? Hemogram and ST elevation myocardial infarction.

OBJECTIVE: The aim of this study was to determine the effectiveness of hematological parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cut-off values of strongly predictive values. SUBJECTS AND METHODS: The study began with approval of the ethics committee. In total, 1,929 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width, mean platelet volume, and ratio of neutrophils to lymphocytes (NLR) values were determined and recorded. CK-MB and high-sensitive Troponin T values were recorded as cardiac markers. For statistical analysis, "SPSS for Windows Version 21" package program was used. FINDINGS: About 71.7% (n = 1384) of the patients were male and 28.3% (n = 545) of the patients were female. About 92.5% of the patients (n = 1785) were discharged from the hospital, whereas the remaining 144 patients (7.5%) were exitus in the hospital. When the efficacy of hematological parameters and cardiac markers in predicting mortality was examined by receiver operating charecteristics analysis, NLR was found to be the strongest predictor (area under the curve [AUC], 0.772, standard deviation [SD] = 0.022, 95% confidence interval [CI]). It was found that the WBC value came in second place after NLR as a strong predictor of mortality (AUC, 0.749, SD = 0.024, % 95 CI). CONCLUSION: The use of predictors for the prediction of mortality for ST elevation myocardial infarction patients is of great importance for faster implementation of treatment modalities. We found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.

Hepatic Arterial Reconstruction Using Right Gastroepiploic Artery in Living Donor Liver Transplantation.

BACKROUND: Hepatic artery (HA) anastomosis is still a challenge in living donor liver transplantation due to the short- and small-caliber graft artery. PATIENTS AND METHODS: If the recipient HA is damaged, reconstruction of HA is a significant problem. This paper reports on the results of using our alternative artery source in patients who had HA depredation for a variety of reasons, including transarterial chemoembolization. We used the right gastroepiploic hepatic artery for HA reconstruction in 5 patients. RESULTS: None of the patients experienced HA thrombosis. Only one patient who underwent retransplantation due to chronic rejection had biliary leakage. The mean follow-up time was 7.4 months; no graft loss or patient mortality was observed. The right gastroepiploic hepatic artery can be used securely for HA reconstruction in patients with a damaged HA.

Effects of dexmedetomidine and thymoquinone on erythrocyte deformability in lower limb ischemia reperfusion injury in streptozotocin-induced diabetic rats.

OBJECTIVE: In this study we aimed to evaluate the effect of dexmedetomidine and thymoquinone on erythrocyte deformability in lower limb ischaemia-reperfusion (IR) injury in streptozotocin-induced diabetic rats. MATERIAL AND METHODS: Thirty Wistar albino rats were equally divided into 5 groups (n = 6); randomized control group (Group C), diabetes control group (Group DC), DIR group (Group DIR), DIR group with thymoquinone 25 mg.kg‒1 intraperitoneally (Group DIRT) and Group DIR with dexmedetomidine 100 µg.kg‒1 intraperitoneally (Group DIRD). Erythrocyte packs were prepared from heparinized blood samples and deformability measurements were performed. RESULTS: IR significantly increased the relative resistance, a marker of erythrocyte deformability when compared to control group (p < 0.05). There were significant differences among the groups in comparisons with ANOVA test (p < 0.0001). Comparisons of the groups DIRD and DIRT revealed similar results (p = 0.824). The values of Group DIR were significantly higher than those of the control, DC, DIRD and DIRT groups (p < 0.0001, p = 0.001, p = 0.004, p = 0.002, respectively). The values of the DC, DIR, DIRD and DIRT groups were significantly higher than those of the control group (p < 0.0001, all). CONCLUSION: Erythrocyte deformability may cause more problems in microcirculation. Dexmedetomidine and thymoquinone may be useful in reducing the adverse effects of this type of injury (Fig. 1, Ref. 41).

Theranostic polymeric nanoparticles for NIR imaging and photodynamic therapy.

Near-Infrared (NIR) dyes forming some of the photosensitizer agents show imaging and therapy features by themselves. NIR dyes show photodynamic therapy by formation of reactive oxygen species and imaging by NIR Fluorescence light. Photodynamic therapy occurs from irradiation of laser or light to photosensitizer matters and following by the formation of reactive oxygen species diseased tissues or cells can be killed effectively. NIR dyes have advantages such as stability, high specificity and sensitivity when compared with the other photosensitizer and imaging agents. Drug delivery systems are getting attention for either diagnosis or therapy of almost all of the diseases. Theranostic nanoparticles comprise the substances which shows the imaging and treatment features together. Besides, the combination of active substance and the imaging agent can also be encapsulated in theranostic nanoparticles. Many researchs are performed to evaluate the efficacy of theranostic drug delivery systems particularly polymeric nanoparticles in order to enhance targeting properties, specificity and bioavailability. Polymeric nanoparticles give advantages because of easier degradation properties when compared with the others. Theranostic polymeric nanoparticles can be used for NIR imaging and photodynamic therapy of several diseases especially cancers.

Two novel myxosporean parasites in Black Sea fishes: Kudoa niluferi sp. nov. and Kudoa anatolica sp. nov. (Cnidaria: Myxosporea).

Members of the genus Kudoa are typically histozoic and only a few are coelozoic parasites, mainly in marine fishes. In the present study, 2 novel Kudoa species were recovered and described as Kudoa niluferi sp. nov. in the musculature of Neogobius melanostomus and Kudoa anatolica sp. nov. in the musculature, urinary bladder and kidney of Atherina hepsetus collected from the coast of Sinop on the Black Sea. Means ± SD (ranges) of mature spores of K. niluferi sp. nov. were 5.9 ± 0.1 (5.7-6.1) µm in length, 9.2 ± 0.2 (8.8-9.5) µm in width and 7.5 ± 0.3 (7.0-8.1) µm in thickness, while those of K. anatolica sp. nov. were 4.1 ± 0.3 (3.5-4.1) µm in length, 7.1 ± 0.2 (6.7-7.2) µm in width and 5.7 ± 0.2 (5.3-6.0) µm in thickness. In both parasite species, length and width of the 4 polar capsules were not equal and formed 3 distinct size classes, largest (1), intermediate (2) and smallest (1) in size. The prevalence and intensity of infection by K. niluferi sp. nov. were 12.8% and 20-29 parasites (per field-of-view, at 200× magnification), respectively, in the musculature of N. melanostomus. These values for K. anatolica sp. nov. were 32.1% and 10-19 parasites in the musculature as well as 2.9% and 20-29 parasites jointly in the kidney and urinary bladder of A. hepsetus. Phylogenetic analysis based on nuclear small subunit rDNA also suggested K. niluferi and K. anatolica as 2 novel species. These species appeared in the same lineage with K. nova and formed a Black Sea lineage.

Sugammadex Improves Neuromuscular Function in Patients Receiving Perioperative Steroids.

CONTEXT: Sugammadex has steroid-encapsulating effect. AIM: This study was undertaken to assess whether the clinical efficacy of sugammadex was altered by the administration of steroids. SETTING AND DESIGN: Sixty patients between 18 and 60 years of age with the American Society of Anesthesiologists I-IV and undergoing elective direct laryngoscopy/biopsy were included in this study. MATERIALS AND METHODS: Patients were assigned to two groups based on the intraoperative steroid use: those who received steroid (Group S) and who did not (Group C). After standard general anesthesia, patients were monitored with the train of four (TOF) monitoring. The preferred steroid and its dose, timing of steroid administration, and TOF value before and after sugammadex as well as the time to recovery (TOF of 0.9) were recorded. STATISTICAL ANALYSIS USED: SPSS software version 17.0 was used for statistical analysis. RESULTS: There is no statistically significant difference between groups in terms of age, gender, preoperative medication use, and TOF ratio just before administering sugammadex. The reached time to TOF 0.9 after sugammadex administration was significantly shorter in Group S than Group C (P < 0.05). A within-group comparison in Group S showed no difference in TOF ratio immediately before sugammadex as well as the dose of sugammadex in those who received prednisolone; time to TOF 0.9 was higher in prednisolone receivers as compared to dexamethasone receivers (P < 0.05). CONCLUSION: In patients receiving steroids, and particularly dexamethasone, an earlier reversal of neuromuscular block by sugammadex was found, in contrast with what one expect. Further studies are required to determine the cause of this effect which is probably due to a potential interaction between sugammadex and steroids.

Gabapentin pretreatment for propofol and rocuronium injection pain: A randomized, double-blind, placebo-controlled study.

AIM: This prospectively-planned, randomized, double-blind and placebo-controlled study aims to evaluate the effect of 1200 mg gabapentin premedication on the incidence and severity of propofol and rocuronium injection pain. METHOD: One hundred patients, between 18-60 years of age and ASA I-II for elective surgery planned under general anaesthetic, were randomized and divided into two groups. Two hours before the operation, the patients were given either a placebo tablet (Group P, n = 50) or 1200 mg gabapentin tablet (Group G, n = 50). On the back of the non-dominant hand, a vein was opened using a 20 G cannula , 0.9% NaCl was begun and preoxygenation was provided. For anaesthesia induction, 1% propofol at 800 ml/hr infusion rate was administered for 20 s. Propofol injection pain was evaluated up to the 20th second and recorded using a scale between 0 and 3 developed by McCrirrick and HunteR The remaining propofol dose (2.5 mg/kg), 5 ml saline and 0.6 mg/kg rocuronium were injected in that order over 10 seconds and rocuronium injection pain response was evaluated with a four point scale. RESULTS: Pain after propofol infusion average score (degree ≥ 1) (Group G = 0.5; Group P = 1.0) and incidence (Group G = 46%; Group P = 68%); and average withdrawal movements response score linked to rocuronium injection pain (≥ 1 response) (Group G = 0.3; Group P = 1.2) and incidence (Group G = 20%; Group P = 80%) were detected to be significantly lower in the gabapentin group compared to the placebo group (p < 0.001). CONCLUSION: Premedication with 1200 mg gabapentin 2 hours before propofol and rocuronium injection reduced the incidence and severity of injection pain.

Morphology and molecular phylogeny of Ortholinea mullusi sp. nov. (Myxozoa) in Mullus barbatus from the Black Sea.

Myxosporeans of the genus Ortholinea have a worldwide distribution and infect organs and tissues of exclusively marine fishes. Here we describe the morphological and molecular characteristics of Ortholinea mullusi sp. nov. parasitizing the urinary bladder and kidney tubules of red mullet Mullus barbatus collected from the coastal zone of Sinop in the Black Sea, Turkey. Polysporic plasmodia with immature spores were either elongate, 37.0 ± 4.5 SD (30-50) µm long and 45.0 ± 3.8 (40-55) µm wide, or were round, up to 100.0 µm in diameter. Mature, free spores were spherical in the frontal view and measured 9.3 ± 0.2 (9.0-9.7) µm in length, 8.7 ± 0.3 (8.2-9.3) µm in width and 7.7 ± 0.1 (7.5-7.9) µm in thickness. We observed 2 polar capsules of equal size, which measured 3.1 ± 0.1 (3.0-3.2) µm long by 2.5 ± 0.1 (2.4-2.6) µm wide, and the tips of the polar capsules were open towards the sutural line. The prevalence of infection by O. mullusi sp. nov. was 24.5%. Phylogenetic analysis based on nuclear small subunit ribosomal DNA (SSU rDNA) clearly suggested O. mullusi to be a new species, clustered within a lineage comprising O. labracis and O auratae. Pairwise nucleotide similarities and DNA distance values between O. mullusi sp. nov. and sister Ortholinea species also supported this suggestion.

Takotsubo Cardiomyopathy Resulting in Cardiac Arrest in a Patient Undergoing Liver Transplantation.

Cardiac complications during and after liver transplantation are a common cause of death. Although considered to be uncommon, takotsubo cardiomyopathy, which is characterized by reversible left ventricular akinesis without coronary artery obstruction, is becoming increasingly reported. Herein we have presented a case of reversible stress-induced takotsubo cardiomyopathy resulting in cardiac arrest in a patient undergoing liver transplantation.