Turk J Med Sci
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Ventriculoperitoneal shunt infections remain an important problem and result mainlyfrom perioperative colonization of shunt components by skin flora. Antibiotic-impregnated shunts have been designed to prevent such colonization. T'his study evaluates the incidence of shunt infection after the insertion of antibiotic-impregnated shunts in a population of children with hydrocephalus. ⋯ The antibiotic-impregnated catheters significantly reduced the incidence of shunt infection in children with hydrocephalus during the postoperative period. Antibiotic-impregnated catheters are effective devices to prevent perioperative colonization of shunt components.
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Extracorporeal membrane oxygenation (ECMO) is a unique life-support modality offered to patients unresponsive to optimal medical therapy. The aim of this study was to evaluate early experiences with ECMO support in 2 tertiary Turkish pediatric intensive care units (PICUs). ⋯ Initial experiences build the learning curve of institutions, and our early results are encouraging. Giving time to heal to the right patient at the right time is the key to success.
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Review
Folate and homocysteine metabolisms and their roles in the biochemical basis of neuropsychiatry.
The term 'one-carbon metabolism' is commonly used to describe 3 separate metabolic processes: folate metabolism, the homocysteine remethylation cycle, and the transsulfuration pathway. Folate metabolism concerns the biochemical reactions in which endogenous and exogenous one-carbon units are transferred to tetrahydrofolates. The remethylation cycle is used for the synthesis of methionine from homocysteine with one-carbon units that come from folate. ⋯ An elevated homocysteine level is the most important marker of folate and vitamin B12 deficiencies, and also the most reliable biochemical sign of functional insufficiency. Some neurological and neuropsychiatric diseases, such as psychosis, Alzheimer's disease, and autism, have been found to be related to disorders of one-carbon metabolism. This review aims to summarize both one-carbon metabolism and its relationships with neuropsychiatric disorders.
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Comparative Study
Comparison of intraarticular bupivacaine and levobupivacaine injection in rat synovial inflammation.
Both bupivacaine and levobupivacaine are local anesthetics with strong analgesic efficacy that can be used intraarticularly. The aim of this study was to compare the effects of intraarticular bupivacaine and levobupivacaine injection on inflammation in articular cartilage and the synovium of the rat knee joint. ⋯ Careful usage of bupivacaine and levobupivacaine is recommended in intraarticular applications since they cause inflammation shortly after injection and fibrosis at later time points.
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Cardiac toxicity due to the administration of local anesthetics may be fatal. In this study, we evaluated the efficacy of a 20% lipid solution combined with epinephrine in a levobupivacaine-induced cardiac arrest model. ⋯ We found that adding a lipid solution to epinephrine for the resuscitation of rabbits that underwent levobupivacaine- induced cardiac arrest increased recovery rates of circulation and therefore the likelihood of survival. Further studies are needed to develop clinical therapies for the systemic toxicity of local anesthetics.