The Change in Facial Emotion Recognition Ability in Inpatients with Treatment Resistant Schizophrenia After Electroconvulsive Therapy.

People with schizophrenia have impairments in emotion recognition along with other social cognitive deficits. In the current study, we aimed to investigate the immediate benefits of ECT on facial emotion recognition ability. Thirty-two treatment resistant patients with schizophrenia who have been indicated for ECT enrolled in the study. Facial emotion stimuli were a set of 56 photographs that depicted seven basic emotions: sadness, anger, happiness, disgust, surprise, fear, and neutral faces. The average age of the participants was 33.4 ± 10.5 years. The rate of recognizing the disgusted facial expression increased significantly after ECT (p < 0.05) and no significant changes were found in the rest of the facial expressions (p > 0.05). After the ECT, the time period of responding to the fear and happy facial expressions were significantly shorter (p < 0.05). Facial emotion recognition ability is an important social cognitive skill for social harmony, proper relation and living independently. At least, the ECT sessions do not seem to affect facial emotion recognition ability negatively and seem to improve identifying disgusted facial emotion which is related with dopamine enriched regions in brain.

The impacts of super obesity versus morbid obesity on respiratory mechanics and simple hemodynamic parameters during bariatric surgery.

BACKGROUND: This study was designed to determine the impact of the degree of obesity on respiratory mechanics and simple hemodynamic parameters at laparoscopic bariatric surgery. METHODS: The patients were divided into two groups, each of which included 24 patients (a morbidly obese group and a super obese group) undergoing laparoscopic bariatric surgery. Dynamic respiratory compliance, respiratory resistance, and peak inspiratory pressures were measured at four time points: 10 min after anesthesia induction (T1: induction), 10 min after pneumoperitoneum (T2: pneumoperitoneum), 10 min after terminating pneumoperitoneum (T3: end-pneumoperitoneum), and before extubation (T4: extubation). The systolic, diastolic, and mean arterial pressures and the heart rate values were measured noninvasively in T0 (10 min before operation). RESULTS: Obesity was found to cause a statistically significant increase in respiratory resistance and a peak inspiratory pressure and a decrease in dynamic respiratory compliance. In the morbidly obese group, the lowest dynamic respiratory compliance was 37 ± 12 mL/cm H(2)O, but it was 33 ± 13 mL/cm H(2)O in the super obese group. The systolic pressure, diastolic pressure, and mean arterial pressure were found to decrease significantly in both groups. CONCLUSIONS: Morbid obesity and super obesity have negative effects on hemodynamics and respiratory mechanics.

Efficacy of tigecycline and vancomycin in experimental catheter-related Staphylococcus epidermidis infection: microbiological and electron microscopic analysis of biofilm.

Central venous catheters are frequently used. The commonest cause of catheter-related bloodstream infections (CRBSI) is coagulase-negative staphylococci (CoNS) associated with adherent biofilm. Tigecycline, a derivative of tetracycline, acts against strains producing biofilm. In this study, we aimed to determine the effect of tigecycline in a CRBSI model. A single dose of 10(8) colony-forming units (CFU)/mL of slime-producing Staphylococcus epidermidis was given through polyethylene catheters inserted into 24 rabbits. After 72 h, groups of eight rabbits were treated with heparin, vancomycin/heparin or tigecycline/heparin. Blood obtained from peripheral veins and the catheter lumen as well as catheter tips were cultured, and three catheters from each group were studied using electron microscopy. Surfaces were randomly subdivided and areas with ≥50 bacteria were compared. Blood cultures were positive from all heparin-treated rabbits but were negative from those receiving either antibiotic (P<0.001). Catheter tip cultures revealed growth from six, two and one rabbit(s) given heparin, vancomycin and tigecycline, respectively. Electron microscopy showed that catheters from heparin-treated rabbits were most heavily colonised (more areas with ≥50 CFU) compared with catheters from animals treated with vancomycin or tigecycline (P<0.003 and P<0.001, respectively). In conclusion, this study shows that tigecycline and vancomycin are both effective for treating CRBSI due to CoNS. Electron microscopy of catheters themselves suggests that tigecycline is superior to vancomycin (P<0.001). Tigecycline may be useful for the treatment of CRBSI.

Effect of intravenous administration of paracetamol on morphine consumption in cancer pain control.

OBJECTIVE: The present study aimed to examine the effectiveness of intravenous administration of paracetamol added to morphine in the control of cancer pain and its possible contribution as reduction of opioid consumption and opioid-related side effects. MATERIALS AND METHODS: A total of 43 patients with chronic cancer pain without neuropathic origin aged between 18 and 76 years and receiving step 2 treatment according to the World Health Organization analgesic ladder were included. Patients were randomized to receive intravenous administration of saline (control) or 1 g of paracetamol on top of morphine. Visual analog scale (VAS), patient rating index (PRI), Eastern Cooperative Oncology Group (ECOG) status, patient satisfaction, and safety were evaluated. MAIN RESULTS: Both treatments resulted in improved VAS and PRI scores compared to baseline. However, groups did not differ in terms of VAS and PRI scores, morphine consumption, side-effect frequencies, laboratory values, ECOG status, and patient satisfaction. CONCLUSIONS: Although safe and there are signals for a true analgesic efficacy, our results failed to confirm any benefits of add-on treatment with intravenous administration of paracetamol. However, the study was underpowered, and future studies in this important area need to be wary of background noise and the risk of a type II error.

Comparison of the electrothermal vessel-sealing system versus endoclip in laparoscopic appendectomy.

BACKGROUND: Various techniques have been used for the division of mesoappendix, such as endoloops, endoscopic linear cutting staplers, an electrothermal vessel-sealing system (LigaSure), the Harmonic Scalpel, clips, and bipolar coagulation. In the present study, LigaSure and an endoclip were compared in laparoscopic appendectomy (LA). MATERIALS AND METHODS: This study included patients who underwent LA for acute appendicitis at Istanbul University, Cerrahpasa Medical Faculty, Emergency Unit (Istanbul, Turkey) between May 2003 and April 2007. The patients were assigned to two groups according to the mesoappendix dissection device: LigaSure and endoclip groups. The main outcome measures (e.g., operating time, conversion rate, hospital stay, postoperative complications, etc.) were then compared. RESULTS: LA was performed in 280 patients with acute appendicitis. LigaSure and endoclips were used in 127 and 153 patients, respectively. The mean operative times were 41 and 54 minutes in the LigaSure and endoclip groups, respectively. Conversions to open rates were found to be 9.4% (12 patients) in the LigaSure and 11.1% (17 patients) in endoclip groups. No statistically significant differences regarding hospital stay or complications were found, whereas significant differences were observed in surgical time and conversion rate. CONCLUSION: The use of LigaSure facilitates the dissection of mesoappendix and shortens the operation time in LA. We believe that LigaSure is a safe, useful tool for mesoappendix dissection.

Electrocardiographical P wave changes after electroconvulsive therapy in patients with schizophrenia: a preliminary study.

OBJECTIVE: Cardiac ventricular conduction has been studied in patients with schizophrenia who have undergone electroconvulsive therapies while they were drug-naive or drug-free or on drug regimens; however, atrial conduction has not been studied in this setting. We aimed to measure atrial and ventricular conduction changes in hospitalized patients with schizophrenia after convulsive therapy. METHODS: Fifteen people with schizophrenia and 15 healthy people enrolled in the study. The participants were assessed for fasting blood glucose and electrolyte levels before the study. All patients were receiving atypical antipsychotics. The electrocardiography records were obtained before the first convulsive therapy and after the third session. RESULTS: The baseline P minimum duration in the patient group was significantly smaller than healthy controls. There was a significant increase in patients' P maximum duration after the third convulsive therapy session (P < 0.05). The differences in P Wave Dispersion, QTc, and QT Dispersion between baseline and after the third session in patients were not statistically significant (P > 0.05). CONCLUSIONS: The lower P wave duration minimum may be related to autonomic nervous system dysregulation in schizophrenia because an acute episode of the illness and/or antipsychotic drugs. In addition, we propose that electroconvulsive therapy alone or in combination with atypical antipsychotics may influence atrial conduction as evidenced by the significantly prolonged P wave maximum.