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Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

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Open Journal of Anesthesiology 2014年第7期4卷 167-176页

作者： José Pomares Gustavo Mora-García Roberto Palomino Yéssika De León Claudio Gómez-Alegría Doris Gómez-Camargo Anesthesiology and reanimation department Faculty of Medicine University of Cartagena Cartagena de Indias Colombia Faculty of Medicine University of Cartagena Cartagena de Indias Colombia Pharmacy department Faculty of Sciences National University of Colombia Bogotá Colombia Tropical Medicine Doctorate Program Faculty of Medicine University of Cartagena Cartagena de Indias Colombia

Background: Metabolic syndrome (MS) is a constellation of factors associated with increased risk of developing cardiovascular diseases and Diabetes Mellitus. Despite of the many studies related to MS, little is known about its impact on scenarios such as surgical anesthesia. Objective: To examine the correlation between demographic and metabolic variables with the occurrence of perioperative complications in patients with MS undergoing scheduled surgeries using a spinal anesthesia technique in the surgery department at the University Clinic San Juan de Dios in Cartagena de Indias, Colombia. Methods: Observational, analytical, cross-sectional, single-center study of 150 subjects with MS and 150 control subjects. Perioperative complications, socio-demographic, hemodynamic and respiratory variables were registered. Groups were compared using t test, Fisher’s exact test or Chi-square, as appropriate. We applied a logistic multiple regression model, adjusted by backward stepwise at 0.25 and forward at 0.05, to find possible incompatible associations. p value < 0.05 was considered significant. Results: There were significant differences between groups in age, American Society of Anesthesiologists physical status classification, frequency of diseases associated to MS and perioperative complications. There were no cases of mortality among patients. There was statistically significant difference between the two groups for intraoperative hypotension and hypertension with p values of <0.0001 and 0.034. Among postoperative complications there was statistically significant difference in pain (13.3% vs 5.3% in patients without MS) and nausea and/or postoperative vomiting (8% vs 2% in patients without MS) with a p value of 0.027 and 0.015 (by Fisher) respectively. Conclusions: Metabolic abnormalities in MS are a risk factor for developing complications in the perioperative period of patients scheduled for surgeries using the subarachnoid anesthesia technique. Accordingly, it is ap

关键词： Metabolic Syndrome X Insulin Resistance Spinal Anesthesia Abdominal Obesity Perioperative Period

Prognostic Signification of Admission Hyperglycemia among Acute Stroke Patients in Intensive Care Units in Kinshasa,the Democratic Republic of the Congo

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World Journal of Cardiovascular Diseases 2019年第9期9卷 665-680页

作者： Josée K.Tshituta Francois B.Lepira Francois P.Kajingulu Jean Robert R.Makulo Ernest K.Sumaili Pierre Z.Akilimali Aliocha N.Nkodila Freddy M.Mbuyi Angele I.Masewu Stephane Mutombo Eric B.Amisi Jean Pierre M.Ilunga Wilfrid B.Mbombo Patrick M.Mukuna Adolphe M.Kilembe department of Anesthesiology and reanimation University of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo Division of Nephrology Department of Internal MedicineUniversity of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo department of Epidemiology&Biostatistics Kinshasa School of Public HealthUniversity of Kinshasa School of MedicineKinshasaThe Democratic Republic of the Congo Centre medical cite des Aveugles KinshasaThe Democratic Republic of the Congo

BACKGROUND AND AIM: Although admission hyperglycemia has been reported to be associated with unfavorable outcomes in acute stroke, little is known about this association in sub-Saharan Africa. Therefore, the aim of the present study was to assess the prognostic significance of admission hyperglycemia in the acute phase of stroke in Congolese patients. METHODS: In a multicenter prospective cohort study, consecutive patients with acute stroke were examined in 5 Emergency Rooms or Intensive Care Units of Kinshasa between July 15th, 2017 and March 15th, 2018. The severity of stroke was assessed at admission using the Glasgow Coma Scale. Stress hyperglycemia was defined as random blood glucose levels at admission > 140 mg/dL in patients without known type 2 diabetes mellitus (T2DM). The endpoint was 10-day all-cause in-hospital mortality. Survival (time-to-death) curves were built using the Kaplan Meier methods. Cox proportional analysis was used to identify predictors of 10-day all-cause in-hospital mortality. The predictive performance of blood glucose level to predict 10-day all-cause in-hospital mortality was assessed using ROC curve analysis. RESULTS: Out of 194 patients (mean age 58.7 ± 13.1 years;64% males, 74.7% light to moderate stroke severity;63.4% ischemic stroke) enrolled, 106 (54.6%) had admission hyperglycemia with 77 (72.6%) having stress hyperglycemia. Ninety four deaths (48.5%);mortality rate of 6 deaths per 100 person-days (95%CI 2.7 - 9.3) occurred during a median follow up time 6 (5 - 7) days equivalent to 1542 person-days. Independent predictors of 10-day all-cause in-hospital mortality were admission hyperglycemia regardless of diabetes status (aHR 3.77;95%CI 1.92 - 7.42;p < 0.001), GCS - 5.23;p = 0.001) and non-use of mechanical ventilation (aHR 1.97;95%CI 1.05 - 3.70;p = 0.034). Blood glucose concentrations (AUC 0.743;95%CI 0.672 - 0.814) had a better predictive performance for 10-day all-cause in-hospital mortality with an optimal value of 154 m

关键词： Admission Hyperglycemia Stroke Prognostic Significance Black Africans

Acupuncture at Tàichōng(太冲 LR 3) for dysmenorrhea

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World Journal of Acupuncture-Moxibustion 2018年第3期28卷 224-226,I0008页

作者： ABDURACHMAN Krisnawan Andy PRADANA HAMZAH Hendy HENDARTO Traditional Medicine Study Program (BATFRA) Faculty of Vocational Studies Airlangga University Surabaya 60231 Indonesia department of Anatomy and Histology Airlangga University Surabaya 60231 Indonesia department of Molecular Biology University of Surabaya Surabaya 60231 Indonesia department Anesthesiology and reanimation Soetomo Hospital Airlangga University Surabaya 60231 Indonesia department of Obstetrics and Gynecology Soetomo Hospital Airlangga University Surabaya 60231 Indonesia

The patient with dysmenorrhea was treated by needling at Tàichōng（太冲 LR 3）, 4 times of treatment was given and the nausea, migraine and pain scale of the patient were alleviated and finally *** the next two menstrual period, patient did not have similar complaints. The author recommended for other acupuncturists to utilize LR 3 as complementary therapy for relieving pain at primary dysmenorrhea.

关键词： Acupuncture Tàichōng(太冲 LR 3) Dysmenorrhea

Cerebral Venous Thrombosis: A Rare Complication of Spinal Anesthesia

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World Journal of Neuroscience 2021年第1期11卷 1-7页

作者： Raphael M. Kabore Habib A. K. Ouiminga Labodi Lompo H. Desire Sankara Anselme Dabilgou Alassane Drave Svetlana Barro Cherban Christian Napon Athanase Millogo Jean Kabore department of Neurology CHU Tengandogo Ouagadougou Burkina Faso department of Neurosurgery CHU Tengandogo Ouagadougou Burkina Faso Deparement of Imagery CHU Tengandogo Ouagadougou Burkina Faso department of Neurology CHU Yalgado OUEDRAOGO Ouagadougou Burkina Faso department of Neurology CHU Ouahigouya Ouahigouya Burkina Faso department of Anesthesia-reanimation CHU Tengandogo Ouagadougou Burkina Faso department of Neurology CHU Bogodogo Ouagadougou Burkina Faso department of Neurology CHU-Souro SANOU Bobo-Dioulasso Burkina Faso

Introduction: Cerebral venous thrombosis (CVT) is a rare complication of spinal anesthesia. The diagnosis is difficult when it occurs by isolated headache, following post spinal puncture headache (PSPH). We report a case of cerebral venous thrombosis complicating PSPH, following a spinal anesthesia. Observation: A 23-year-old man was admitted to the emergency room for PSPH appeared 6 hours after a spinal aesthesia for removal of osteosynthesis equipment from the right tibial plateau. The headache was fronto-occipital, relieved by lying down. Six days later, headache became permanent, not relieved by morphine, associated with vomiting. The neurological examination was normal. Brain magnetic resonance Magnetic venography showed superior sagittal sinus and right transverse sinus thrombosis. After administration of low molecular weight heparin at curative dose, and warfarin under INR control, the evolution was marked by a rapid regression of headaches on the same day. After a 1-year setback, the patient was asymptomatic. Conclusion: CVT is a rare complication of spinal anesthesia and potentially severe if diagnosed lately. Urgent brain imaging must be performed for any atypical headache or the onset of neurological disorders so as not to misunderstand cerebral vein thrombosis. Controlling the spine anesthesia would reduce the inadvertent perforation of the dura-mother that would lead to CVT complicating post spinal puncture headaches.

关键词： Spinal Anesthesia Post Spinal Puncture Headache Cerebral Venous Thrombosis

Epidemiologic Profile of Maternal Deaths in Two Referral Hospitals in Cameroon

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Open Journal of Obstetrics and Gynecology 2016年第6期6卷 365-372页

作者： Philip Njotang Nana Felix Essiben Julius Dohbit Sama Elisabeth Medoua Koh Koh Morfaw Lifanji Filbert Eko Eko Jeanne Fouedjio Agnes Esiene Robinson Enow Mbu department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon department of Obstetrics and Gynecology Yaoundé Central Hospital Yaoundé Cameroon department of Obstetrics and Gynecology Yaoundé Gyneco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon department of Obstetrics and Gynecology Bamenda Regional Hospital Bamenda Cameroon department of Anesthesia and reanimation Faculty of Medicine and Biomedical Sciences (FMBS) The University of Yaoundé I Yaoundé Cameroon

Introduction: Our objective was to compare the epidemiologic profile of maternal mortality in two structures serving as referral levels of care in Cameroon. Methodology: This cross-sectional, comparative study took place at the maternities of the Yaoundé Central Hospital (YCH) and the Bamenda Regional Hospital (BRH) from December 1st 2014 to May 31st 2015, a 6 months’ period. The medical records of deceased women over 5 years, from January 2010 to December 2014, were collected. We calculated the MMR (Maternal mortality rate) and studied the causes and risk factors associated with maternal death. The Epi info software 3.5.4 was used to analyze data with a significance level of P < 0.05. Results: The maternal mortality ratio (MMR) was 964 and 247 per 100,000 live births for YCH and BRH, respectively. More deaths occurred within the aged group range 20 to 34 years, 76.8% at YCH and 64.7% at BRH. At YCH, 70.7% of these patients were referrals versus 32.4% at BRH. Complication from abortion was often implicated at BRH (P = 0.007;OR = 0.31;CI = 0.13 - 0.74). Others causes were hemorrhage (YCH = 43.4%;BRH = 35.5%), hypertensive diseases (YCH = 17.2%;BRH = 14.7%) and infections (YCH = 8.1%;BRH = 17.6%). At YCH time elapsed from admission to death was <3 h (P = 0.005;OR = 6.63;CI = 1.49 - 29.5). Conclusion: Both hospitals have similar causes of maternal deaths, differing only in the context within which the deaths occurred. Improving access to good quality health care, satisfying unmet needs for family planning, availability of blood products and the establishment of health insurance could decrease the maternal mortality rate.

关键词： Maternal Mortality Causes Maternal Death Referral Hospital Cameroon

Hepato Splenic Tuberculosis in Acute Cholecystitis

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International Journal of Clinical Medicine 2014年第14期5卷 871-874页

作者： Mountassir Moujahid Hicham Iraqui Mohamed Ghari Issam Serghini Khalid Chekoura Moulay Hassan Tahiri Departement of Radiology 5th Military Hospital Guelmim Morroco Departement of reanimation 5th Military Hospital Guelmim Morroco Departement of Surgery 5th Military Hospital Guelmim Morroco

Background: The tuberculosis is an endemic disease in our country;it remains a major public health problem. Liver and splenic tuberculosis is a classic disease which represents 1.5% of all gastrointestinal tuberculosis. Patients and Methods: We reported the case of a fifty-six years old patient admitted in the department of surgery for acute cholecystitis, and the biological balance showed a hyperleukocytosis at 16,000 elements/mm3 and a CRP at 25 with a light cholestasis. The abdominal scanner showed a micronodular splenomegaly with coelio mesenteric ganglions. We discovered a tuberculosis location in the liver and the spleen and we realized a cholecystectomy with a hepatic biopsy and a splenectomy. Results: A gallbladder ablation associated with an enlarged spleen and liver biopsy was diagnosed with liver and splenic tuberculosis. The patient was put under anti tubercular treatment with the good clinical and radiological evolution. Conclusion: The diagnosis of tuberculosis should always be considered especially in endemic countries.

关键词： Tuberculosis Endemic Liver Spleen Diagnosis Treatment

Role of serological rapid antibody test in the management of possible COVID-19 cases

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World Journal of Experimental Medicine 2021年第4期11卷 44-54页

作者： Fatma Yıldırım Pinar Yildiz Gulhan Ozlem Ercen Diken Aylin Capraz Meltem Simsek Berna Botan Yildirim Muhammet Ridvan Taysi Sakine Yilmaz Ozturk Nurcan Demirtas Julide Ergil Adem Dirican Tugce Uzar Irem Karaman Sevket Ozkaya department of Pulmonary and Critical Care Medicine University of Health Sciences Diskapi Yildirim Beyazit Research and Education HospitalAnkara 06110Turkey department of Pulmonary Medicine Düzce UniversityFaculty of MedicineDüzce 81100Turkey department of Chest Diseases Adana Research and Education HospitalUniversity of Health SciencesAdana 01230Turkey department of Pulmonary Medicine Amasya University Sabuncuoglu Serefeddin Research and Education HospitalAmasya 05200Turkey Medical Intensive Care Unit University of Health Sciences Diskapi Yildirim Beyazit Research and Education HospitalAnkara 06110Turkey department of Pulmonology Research and Education Hospital of Baskent UniversityKonya 42030Turkey department of Infectious and Clinical Microbiology University of Health Sciences Diskapi Yildirim Beyazit Research and Education HospitalAnkara 06110Turkey department of Pulmonary Medicine Vezirkopru State HospitalSamsun 55090Turkey department of Pulmonary Medicine Kumluca State HospitalAntalya 07070Turkey department of Anaesthesiology and reanimation Diskapi Yildirim Beyazit Research and Education HospitalUniversity of Health SciencesAnkara 06110Turkey department of Pulmonary Medicine Samsun Medicalpark HospitalSamsun 55090Turkey Irem Karaman Medical Student/InternBahcesehir University Faculty of MedicineIstanbul 34734Turkey department of Pulmonary Medicine Bahcesehir UniversityFaculty of MedicineIstanbul 34734Turkey

Although the detection of viral particles by reverse transcription polymerase chain reaction(RT-PCR)is the gold standard diagnostic test for coronavirus disease 2019(COVID-19),the false-negative results constitute a big *** To examine a group of patients diagnosed and treated as possible COVID-19 pneumonia whose multiple nasopharyngeal swab samples were negative for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)by RT-PCR but then serological immunoglobulin M/immunoglobulin G(IgM/IgG)antibody against SARS-CoV-2 were detected by rapid antibody *** Eighty possible COVID-19 patients who had at least two negative consecutive COVID-19 RT-PCR test and were subjected to serological rapid antibody test were evaluated in this *** The specific serological total IgM/IgG antibody against SARS-CoV-2 was detected in twenty-two *** mean age of this patient group was 63.2±13.1-yearsold with a male/female ratio of 11/*** was the most common symptom(90.9%).The most common presenting chest computed tomography findings were bilateral ground glass opacities(77.2%)and alveolar consolidations(50.1%).The mean duration of time from appearance of first symptoms to hospital admission,to hospital admission,to treatment duration and to serological positivity were 8.6 d,11.2 d,7.9 d,and 24 d,*** with reference laboratory values,serologically positive patients have shown increased levels of acute phase reactants,such as C-reactive protein,ferritin,and procalcitonin and higher inflammatory markers,such as erythrocyte sedimentation rate,lactate dehydrogenase enzyme,and fibrin end-products,such as D-dimer.A left shift on white blood cell differential was observed with increased neutrophil counts and decreased *** Our study demonstrated the feasibility of a COVID-19 diagnosis based on rapid antibody test in the cases of patients whose RT-PCR samples were *** of antibodies against SARS-CoV-2 with

关键词： COVID-19 Rapid antibody test Reverse transcription polymerase chain reaction High resolution computed tomography Serology Pneumonia

Comparison between intrathecal hyperbaric bupivacaine and levobupivacaine for ambulatory knee arthroscopy

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World Journal of Anesthesiology 2013年第3期2卷 18-25页

作者： Ozlem Sagir Sabri Ozaslan Mehmet Erduran Yucel Meric Ismail Aslan Ahmet Koroglu department of Anesthesiology and reanimation Faculty of Medicine Balikesir University 10145 Balikesir Turkey department of Anesthesiology and reanimation Erpa Hospital 20010 Denizli Turkey department of Orthopedics and Traumatology 9 Eylul University Faculty of Medicine 35340 Izmir Turkey

AIM: To compare the effect of hyperbaric levobupivacaine and bupivacaine on the quality of the block, patient satisfaction, and discharge time in patients undergoing arthroscopic knee surgery under unilateral spinal ***: One hundred and thirty-two patients, American Society of Anaesthesiologists Ⅰ or Ⅱ, scheduled for elective ambulatory knee arthroscopy were randomly assigned to four double-blind groups. To achieve a unilateral spinal block, Group BF received 5 mg of hyperbaric bupivacaine plus 20 μg of fentanyl intrathecally, Group LF received 5 mg of hyperbaric levobupivacaine plus 20 μg of fentanyl intrathecally, Group B received 5 mg of hyperbaric bupivacaine intrathecally, and Group L received 5 mg of hyperbaric levobupivacaine intrathecally. The level and duration of the sensory block, the intensity and duration of the motor block, the time to first analgesic requirement, and the time elapsed until the patient's discharge were recorded. Hemodynamic values and adverse effects were also recorded. RESULTS: The duration of time needed to reach the T12 dermatome level was significantly longer in Group L [7(3-20) min] than in Group B [6(3-12) min](P = 0.006). The maximum sensory level reached on the side undergoing the operation was significantly higher in Group BF than in Group B(P < 0.05). The intensity of the motor blockade was greater in Group BF than in Group LF and L. Complete recovery from motor blockade occurred earlier in Groups LF [75(45-165) min] and L [63(35-120) min] than in Group BF [115(60-180) min](P < 0.05). The length of time needed for the sensory block to regress to the level of S2 was shorter in Group L(154 ± 50) than in Group BF(192 ± 66)(P < 0.05). The quality of the block was significantly lower in Group L than in Groups BF, LF and B(P = 0.012, P = 0.003, and P < 0.001, respectively). The time elapsed until Visual Analog Scale ≥ 4 was significantly shorter in Group L(110 ± 48) than in Groups BF(200 ± 60), LF(156 ± 61) and B(162

关键词： Spinal anesthesia Knee arthroscopy Outpatient surgery Bupivacaine Levobupivacaine

Plasma Concentrations of Some Trace Element and Heavy Metals in Patients with Metastatic Colon Cancer

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Journal of Cancer Therapy 2013年第6期4卷 1085-1090页

作者： Ozgur Emre Halit Demir Erkan Dogan Ramazan Esen Tugba Gur Canan Demir Edip Gonullu Nedim Turan Mehmet Fatih Ozbay Division of Biochemistry Department of ChemistryScience FacultyYuzuncu Yil UniversityVanTurkey department of Medical Oncology Medical FacultyYuzuncu Yil UniversityVanTurkey department of Hematology Medical FacultyYuzuncu Yil UniversityVanTurkey Division of Biochemistry Health FacultyYuzuncu Yil UniversityVanTurkey department of Biostatics Faculty of MedicineYuzuncu Yil UniversityVanTurkey department of Anesthesiology and reanimation Regional Training and Research Hospital of VanVanTurkey department of Medical Oncology Faculty of MedicineGazi UniversityAnkaraTurkey department of Internal Medicine Regional Training and Research Hospital of VanVanTurkey

Purpose: It is well known that trace elements and heavy metals play a significant role in human health and disease. These elements play an important role in different metabolic pathways of cells and tissues. Trace element deficiency or excess is implicated in the development or progression of some cancers. We present a study which investigates serum/ plasma levels of trace-heavy elements in metastatic colon cancer patients and healthy subjects. Methods: Blood samples were collected from 29 healthy subjects and 40 patients with metastatic colon cancer in Oncology department of Medical School of Yuzuncu Yil University. In both groups, the serum levels of copper (Cu), magnesium (Mg), lead (Pb), chromium (Cr), zinc (Zn) selenium (Se), manganese (Mn), and cadmium (Cd) were determined. Results: Higher levels of Cu, Mg, Pb, Cr, Zn, Mn and Cd were seen in patients with metastatic colon cancer compared to healthy subjects and these findings were statistically significant (p 0.05). Se levels were noted to be lower in patients with colon cancer in comparison to healthy subjects and this finding was also statistically significant (p 0.05). Conclusions: According to our findings there was significant diffence in trace elements and heavy metals levels between healthy subjects and metastatic colon cancer patients. Therefore heavy metal and trace elements may have prognostic significance in complex disorders including colon cancer. However, further comprehensive studies are needed in order to advance our understanding of the relationship between heavy metal and trace elements and their role in cancers.

关键词： Colon Cancer Trace Element Heavy Metal Essential Element