Dental anxiety and oral health-related quality of life in children following dental rehabilitation under general anesthesia or intravenous sedation: A prospective cross-sectional study.

PURPOSE: The study aimed to investigate dental anxiety and oral health-related quality of life among children undergoing dental rehabilitation under general anesthesia (GA) and intravenous sedation (IVS). MATERIALS AND METHODS: Participants were 99 healthy children aged 3-5 or 6-12 years operated under GA or IVS. Dental anxiety before treatment and 1 month postoperatively were measured using the Frankl behavior scale (FBS), the venham picture test (VPT), the early childhood oral health impact scale (ECOHIS), and the children's fear survey schedule-dental subscale (CFSS-DS). Data were analyzed using Student's t-test and Mann-Whitney U-test. RESULTS: ECOHIS scores decreased in all groups. VPT scores increased in the 3-5-year-olds treated under GA (P = 0.003). Postoperative CFSS-DS anxiety scores were lower in IVS groups. FBS scores were significantly higher for both age groups (P < 0.001). There was no effect of numbers of extracted or treated teeth. CONCLUSIONS: Dental rehabilitation under GA and IVS improved the quality of life and dental behavior. In the 6-12-year-olds, there was no statistically significant difference between children undergoing dental operations under GA and those undergoing dental operations under IVS. Dental anxiety decreased in 3-5-year-olds after treatment under GA but not after IVS.

The evaluation of hemodynamic changes during the reperfusion phase in adult living donor liver transplantations: the role of cardiovascular problems.

OBJECTIVE: This study sought to evaluate the hemodynamic changes of and to analyze the effects of coronary artery disease (CAD) as well as its risk factors on hemodynamic parameters during the reperfusion phase (RP) in adult living donor liver transplantation (ALDLT). PATIENTS AND METHODS: This single-center retrospective study evaluated 154 adult patients being assessed from January 2001 to December 2013 for orthotopic liver transplantation (OLT). The patients were divided into separate groups according to the presence or absence of CAD and its risk factors, including diabetes, hypertension, dyslipidemia, smoking, sex, and age. The hemodynamic parameters were noted during the RP with respect to the patient files. The comparison of the groups and the effects of cardiovascular problems on hemodynamic parameters were statistically analyzed. RESULTS: A decrease of more than 20% in systolic arterial pressure was seen in 16 (16.7%), 7 (43.8%), and 17 (40.5%) patients without CAD, with CAD, and with its high risk factors (>2), respectively (P < .05). Moreover, diastolic hypotension was seen in 59 (38.3%) patients during RP; of those, 10 (62.5%) had CAD and 19 (45.2%) had CAD high-risk factors. The decline in both systolic and diastolic arterial pressure was significantly correlated with the increased number of risk factors (P < .05). CONCLUSIONS: RP in ALDLT remains an issue not only for the surgeons but also for the anesthesiologists. Clinicians should be aware of CAD and its risk factors before OLT and successful management of such problems are mandatory for hemodynamic stability during this formidable process.

Early-onset posterior reversible encephalopathy syndrome after solid organ transplantation in pediatric patients: a report of 2 cases.

Posterior reversible encephalopathy syndrome (PRES) is a neurological disturbance that occurs due to different reasons and presents with different clinical symptoms. It can be a devastating situation, but, timely treatment may lead to complete recovery. We report 2 cases of PRES, which developed and fully recovered in the early period after solid organ transplantation in pediatric patients.

Successful treatment of a child with fulminant liver failure and coma due to Amanita phalloides poisoning using urgent liver transplantation.

Intoxication due to eating wild mushrooms presents with a variety of signs, ranging from mild diarrhea to severe organ failure. We present the case of an 11-year-old boy with fulminant liver failure and hepatic coma due to Amanita phalloides poisoning treated with an urgent pediatric orthotopic liver transplantation. Successful treatment of patients with fulminant liver failure and hepatic coma caused by Amanita phalloides poisoning is possible using urgent orthotopic liver transplantation when conservative medical treatment modalities are ineffective.

Syringe pumps take too long to give occlusion alarm.

BACKGROUND: The aim of this study was to assess the time needed to trigger an occlusion alarm, and the influence of the type of infusion pump, type and size of the syringe, and the set infusion rate. METHODS: Forty syringe pumps (20 JMS SP-100 and 20 JMS SP-500 machines) were tested using two types (JMS and Hayat) and two sizes (20 and 50 ml) of syringes at four infusion rates (0.5, 1, 2 and 5 ml x h(-1)). Syringes filled with saline were occluded with a stopcock, and times to activation of the occlusion alarm were recorded. Statistical analysis was performed with Wilcoxon and Mann-Whitney U-tests, P < 0.05 was considered significant. RESULTS: The mean time to alarm activation was longer with lower infusion rates and larger syringes (P < 0.05). We recorded delays up to 117.3 +/- 9.4 min with 50 ml syringe at 0.5 ml x h(-1) and 15.0 +/- 7.1 min at 5 ml x h(-1). Syringe type had no effect on time to alarm activation (P > 0.05). The alarm on the JMS SP-500 pump was activated faster than the JMS SP-100 pump (P < 0.05). CONCLUSION: Our results showed that activation of occlusion alarms on both pumps takes a considerable time, and that the mean time to alarm activation was longer with low infusion rates and larger syringes. To reduce occlusion alarm delays smaller sized syringes with low compliance should be used and staff be alerted when using low flow rates with highly concentrated potent drugs.

Early postoperative complications of pediatric liver transplantation: experience at one center.

To evaluate the postoperative complications within the first month among 20 pediatric liver transplant recipients between April 1990 and March 2003 we retrospectively studied their medical charts to gather demographic data; primary diagnosis; operative duration; perioperative transfusions; time to extubation; length of intensive care unit (ICU) stay; mortality; perioperative laboratory values; and postoperative complications including respiratory, infections, renal, neurological, cardiovascular, and gastrointestinal tract (GIT) complications. Ten male and ten female patients of mean age 8 +/- 4 years had a mean operative duration, time to extubation, and length of stay in the ICU of 12.1 +/- 2.3 hours, 11.1 +/- 15.0 hours, and 7.2 +/- 5.5 days, respectively. The most frequent postoperative complication was respiratory (n = 14, 70%), followed by infections (n = 13, 65%), renal (n = 8, 40%), neurological (n = 7, 35%), cardiovascular (n = 4, 20%), and GIT (n = 4, 20%) infections. The overall mortality rate was 25% (n = 5). Compared with patients who survived, those who died displayed significantly lower perioperative platelet counts (P <.05), as well as a significantly higher incidence of postoperative neurological disorders (P =.031), and cardiovascular complications (P =.032).

Inactivation of Escherichia coli by photocatalytic oxidation.

The inactivation of Escherichia coli (E.coli) was studied in presterilized surface water sample using titanium dioxide as the photocatalyst under irradiation of BLF Fluorescent lamps. Inactivation of E.coli (10(3) CFU/mL) was achieved in 60 min in the presence of 1.0 mg TiO2/mL. Photocatalytic inactivation data was evaluated in terms of first order rate equation N/N0 = e (-kIt). The reaction rate constant k, 1.22*10(-2)(mW min/cm2)-1 was calculated.