Background/aim: The supratrochlear foramen (STF) is an important variation in the lower end of the humerus where the septum separating the coronoid and olecranon fossa is perforated. There are no studies in the literature on the STF of the Jining population. This study will make a contribution to anatomy and anthropology by adding new data. Materials and methods: STF was studied in detail in 262 adult dried humeri of unknown sex and age. The topographical anatomy of the STF was studied, morphometric measurements were taken, and the specimens were photographed with a digital camera. Results: The prevalence of the STF was 10.3%, with 18 cases on the left side and 9 cases on the right side. The STF occurred in 4 shapes: oval, 19 cases; round, 4 cases; triangular, 2 cases; and rectangular, 2 cases. The mean transverse diameter of STF was 4.47 mm and 3.26 mm on the left and right sides, respectively; the mean vertical diameter of STF was 5.07 mm and 3.56 mm on the left and right sides, respectively; and the average surface area of STF was 13.1 mm2 and 18.43 mm2 on the left and right sides, respectively. Conclusions: The STF of the Jining population was more common on the left side, with oval being the most common shape. The two sides did not show any statistically significant differences. The findings of this study may be of clinical significance to surgeons and osteologists and may have anthropological or forensic importance.
Background/aim: The aim of this study is to assess the Xpert MTB/RIF assay for diagnosis of the Mycobacterium tuberculosis complex in clinical samples and to compare the results by reference to the diagnostic method, Bactec MGIT 960. Materials and methods: A total of 7407 samples were included from patients not primarily suggesting pulmonary or extrapulmonary tuberculosis (TB), collected from patients required to be screened for TB and excluding TB diagnoses since it was a differential diagnosis. Also included were a total of 411 samples from patients primarily suggesting pulmonary or extrapulmonary TB. Results: In the first group, 152 of 7407 samples yielded positive results with the Bactec MGIT 960, 131 (1.77%) were found positive with Löwenstein-Jensen medium, and 295 (3.99%) were found positive with Ziehl-Neelsen staining. In the second group, 24 (5.8%), 17 (4.1%), and 28 (6.8%) of 411 samples were found positive. Xpert MTB/RIF [27 (6.6%) of 411 samples] detected 3 additional samples as positive, and these 3 cases were clinically compatible with TB. Conclusion: The Xpert MTB/RIF assay shows superior performance for the diagnosis of TB. Its usefulness in culture-negative patients and the best method for integrating this diagnostic method into current tuberculosis diagnostic algorithms both need further study.
Background/aim: Nosocomial bloodstream infection (BSI) increases mortality rates, duration of stay in hospital, and treatment costs. This study was conducted to determine the rate and the risk factors of BSIs among intensive care unit patients. Materials and methods: Sixty-four patients with BSIs (patient group) and 79 patients without a nosocomial infection (control group) were enrolled in the study. Centers for Disease Control and Prevention criteria were used for diagnosing BSIs. Potential risk factors were evaluated by multivariate logistic regression model. Results: The BSI development rate was 15.7% (64/407), with an incidence rate of 18.2/1000 patient days. Distribution of pathogens among BSI patients were as follows: gram-positive cocci, 42.18% (27/64); gram-negative cocci, 34.3% (22/64); and Candida spp., 23.4% (15/64). Risk factors were determined as intubation, arterial catheter, tracheostomy, duration of intubation, duration of catheter use, duration of nasogastric catheter, underlying diseases of chronic renal failure and diabetes mellitus, implemented treatments of sedation and enteral nutrition, and APACHE II score. Conclusion: BSIs are the leading cause of mortality and morbidity in intensive care unit patients. Determination of the local risk factors is important and necessary for decreasing the rate of BSIs and the mortality rates.
Background/aim: The aim of this study was to investigate the potential correlation between clinical characteristics and prognosis of patients with retinoblastoma (Rb). Materials and methods: This retrospective study included 314 Rb patients. Clinical data including laterality of eyes, sex, age, presenting signs, lag time, and survival were recorded and analyzed. Results: Leukocoria is the most common clinical presentation of Rb. Patients with isolated leukocoria had shorter lag time and exhibited a high survival rate (85%, 5 years). Patients with strabismus and blurred vision, and who were older and had longer lag time, exhibited an excellent survival rate (100% and 92.3%, respectively, 5 years). Patients with exophthalmos had the longest lag time and the lowest survival rate (17.8%, 5 years). The 5-year survival rate of patients with a lag time of ≤6 months was 84.7%, which was significantly higher than that of patients with a lag time of >6 months (64.7%). Conclusion: Leukocoria, strabismus, and blurred vision are mild clinical manifestations of Rb that are associated with better disease prognosis, whereas exophthalmos is an indicator of poor prognosis. Long lag time is a risk factor for the survival of Rb, which can be avoided. Early detection and treatment can greatly improve the survival of Rb patients.
Background/aim: To investigate the influence of thiopental (85 mg/kg, intraperitoneally (ip)), and ketamine+xylazine (ketamine 75 mg/kg and xylazine 8 mg/kg, ip) anesthesia on the incidence and duration of ischemia/reperfusion-induced arrhythmias. Materials and methods: Myocardial ischemia was induced by a 6-min ligation of the left anterior descending coronary artery, followed by a 6-min reperfusion. Measurements were taken of the incidence and duration of ventricular arrhythmias, the mean arterial blood pressure and heart rate, and the pressure rate-product (as an index of myocardial oxygen consumption). Results: The arrhythmia score and the incidence of ventricular fibrillation and tachycardia were significantly decreased in the ketamine+xylazine-anesthetized rats compared with the thiopental-anesthetized group (arrhythmia score: 2.0 ± 2.1 versus 3.7 ± 1.2, P < 0.05). The heart rate was significantly lower in the ketamine+xylazine group during the entire experiment, whilst the pressure-rate product was also significantly lower in the ketamine+xylazine group at different time points of the ischemia and reperfusion periods. Conclusion: Ketamine+xylazine anesthesia has a strong antiarrhythmic effect and an apparent depressive action on the heart rate and the myocardial oxygen consumption index. Therefore, ketamine+xylazine anesthesia is not appropriate for the evaluation of possible antiarrhythmic agents. Thiopental anesthesia is preferable to ketamine+xylazine anesthesia in the in vivo ischemia-reperfusion arrhythmia model.
Background/aim: The question of whether body mass index (BMI) affects semen quality and male fertility is controversial. The purpose of this research was to determine whether there is a correlation between BMI and semen analysis parameters. Materials and methods: A total of 617 male infertility patients were recruited and separated into 3 groups according to BMI values as follows: normal weight group (n = 334), overweight group (n = 220), and obese group (n = 63). Height and weight were measured and a routine semen analysis was performed for all patients. Results: Significant differences existed in BMI, age, and sperm motility (progressive motility) among the 3 groups. BMI and abstinence period were negatively correlated with sperm motility (P < 0.05 and P < 0.01), although they did not correlate with semen volume, total sperm number, concentration, and rate of sperm with normal morphology (P > 0.05). Abstinence, BMI, and age had a linear correlation with sperm motility (P < 0.01) in that order of influence. Conclusion: Sperm motility, an important semen parameter with respect to male fertility, is reduced in men with increased BMI, and BMI is one of the risk factors that influence semen quality.
Background/aim: Premature infants experience more respiratory problems after surgical procedures. We aimed to compare general anesthesia with sedation regarding the need for postoperative mechanical ventilation in infants undergoing retinopathy of prematurity (ROP) surgery. Materials and methods: Sixty patients who underwent laser surgery for ROP were included in this study. This study was performed between October 2010 and December 2012. The sedation group (Group S, n = 30) received 1 mg/kg ketamine and 1 mg/kg propofol as a bolus for induction. The patients then received an infusion of 100-150 μg kg-1 min-1 propofol and 0.25 mg kg-1 h-1 ketamine for maintenance. In the general anesthesia group (Group G, n = 30), anesthesia was induced using 8% sevoflurane by inhalation with 50% nitrous oxide in oxygen. Anesthesia was maintained with sevoflurane (2%) and 50% nitrous oxide in oxygen. Results: There was no difference in gestational age, birth weight, current age, or current body weight between the two groups. Preoperative medical histories of the groups were similar. Two patients in Group S and 11 patients in Group G required postoperative mechanical ventilation (P = 0.010). Blood pressures and heart rates were similar. Conclusion: In premature infants, sedoanalgesia administration reduced the need for postoperative mechanical ventilation after surgery for ROP.
Background/aim: To determine the prevalence and awareness of diabetes and to evaluate associated factors in a population aged 30 and over in the Balçova district of İzmir, Turkey. Materials and methods: In this cross-sectional study data from 12,915 people who participated in Balçova's Heart Project were evaluated. Diabetes was defined using fasting blood glucose levels according to ADA criteria. Results: Diabetes prevalence was 13.0% and 87.7% of the patients were aware of the condition. Diabetes prevalence was 1.32 times higher in males, 1.31 times higher in individuals with primary school or lower level of education, 1.37 times higher in individuals who perceived their economic status as bad, 1.20 times higher in those who had quit smoking, 2.84 times higher in individuals who had chronic disease, 1.78 times higher in overweight or obese individuals, and 1.65 times higher in individuals with high blood pressure. Diabetes awareness was 1.78 times higher in women, 1.94 times higher in individuals with social security, 2.62 times higher in individuals with a chronic disease, and 3.55 times higher in individuals who perceived their economic level as poor. Conclusion: Diabetes prevention policies and programs that aim for early diagnosis, treatment, and prevention of complications in patients should be developed and implemented for the public.
Background/aim: To determine the color alterations of natural teeth associated with different orthodontic composites used in comprehensive short-term treatment. Materials and methods: Twenty-two patients were treated with ?xed appliances and 22 untreated subjects were also evaluated. Lower incisors were bonded with different orthodontic composites: 42 with Grengloo, 41 with Light Bond, 31 with Kurasper F, and 32 with Transbond XT. The color parameters of the Commission Internationale de l'Eclairage (CIE) were measured for each tooth with a spectrophotometer. Color assessment in relation to time, adhesive material, and their interaction was made with 2-way mixed analysis of variance (ANOVA) and 1-way ANOVA for the color differences (?E*). Further analyses were done using Tukey's honestly significant difference tests and paired-samples t-tests. Results: The color of teeth was affected by treatment. The mean L* and a* values increased, whereas the mean b* values decreased. Total color differences of teeth demonstrated visible color changes clinically after treatment, ranging from 1.12 to 3.34 ?E units. However, there were no significant differences for color of enamel. Conclusion: Teeth may be discolored with fixed appliances during treatment. Moreover, contemporary orthodontic composites have similar effects of enamel discoloration.
Background/aim: The aim of this study was to examine the theory that oxidative stress might have an important mediating effect on the deleterious results of vitamin B12 metabolism deficiency seen throughout the body. Materials and methods: Forty patients with vitamin B12 deficiency and 40 healthy controls were included in the study. Venous blood samples were collected from all participants to evaluate serum vitamin B12, homocysteine, methylmalonic acid, total antioxidant status (TAS), and total oxidant status (TOS) levels in the pre- and posttreatment periods. Results: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) levels between the pretreatment patient and control groups, and there were no significant differences in TAS or TOS levels between the posttreatment and control groups. In addition, there were no significant differences between the pre- and posttreatment TAS, TOS, and OSI levels of the patients. Conclusion: These findings are remarkable in that cyanocobalamin treatment had no direct effect on oxidant and antioxidant status in patients with vitamin B12 deficiency. The fact that there were no differences in oxidant and antioxidant status between the patients and the controls might suggest that oxidative stress does not play a role in the systemic negative effects of vitamin B12 deficiency.
Background/aim: In order to determine elderly people's capabilities in daily activities, we evaluated the factors that may affect their daily instrumental activities. Materials and methods: We performed an observational, analytical, and cross-sectional study on 101 patients above 60 years of age in 2008 and 2009. We applied the Lawton Instrumental Activity of Daily Living (IADL) scale, the Standardized Mini-Mental State Examination (SMMSE), and the Geriatric Depression Scale (GDS) during one-on-one interviews with the patients. Demographic data and disability levels were also recorded. These data were used to evaluate the possible effects of factors on the IADL scale. Results: Statistical analyses indicated that total scores of instrumental activities are affected negatively by increased age, female sex, and literacy (P < 0.001, P = 0.005, and P = 0.021), whereas scores are affected positively by educational level (P = 0.047). Conclusion: Our findings suggest that increased age, sex, literacy, and education levels influence elderly people's daily instrumental activities. Daily functional activities and factors influencing these activities should be determined in order to increase elderly people's quality of life and independence. It is important to evaluate elderly people's capabilities in daily activities.
Background/aim: Familial Mediterranean fever (FMF) is diagnosed by fever episodes with sterile peritonitis, arthritis, pleurisy, and erysipelas-like erythema. The relationship between phenotype and genotype in FMF has not been adequately explained. The aim of this study was to characterize the phenotype and genotype correlation in FMF. Materials and methods: Clinical diagnosis of FMF was conducted according to the Tel Hashomer criteria. Pras scoring was used to determine clinical severity. FMF strip assay analysis was used, and the hotspot regions were observed with PCR amplification and automatic DNA sequence analysis method. Results: We showed commonly seen mutations (most frequently M694V) in a study group of 191 patients. The disease severity score of patients with M694V mutation was high on the Pras scoring system. Patients with M694V mutation needed high colchicine dosages to control disease activity. R202Q was the most commonly seen polymorphism in 70 patients. The coexpression of R314R single nucleotide polymorphism on third exon was shown in our study. Moreover, D102D, G138G, and A165A subhaplotypes and E474E, Q476Q, and D510D subhaplotypes were also shown. Conclusion: DNA sequence analysis should be a commonly used method for progress in the field of molecular genetics and for the better understanding of the FMF phenotype and genotype relationships in all populations.
Background/aim: Reduction mammoplasty is a common surgical procedure. We report the incidence of nonproliferative and proliferative breast lesions in breast reduction specimens from a single institution over a 6-year period. Materials and methods: The histopathology reports of all patients were analyzed. The clinical and histopathological findings of the patients were recorded. Results: Between 2004 and 2010, 106 patients underwent breast reduction. Fifty-six patients (52.8%) had proliferative breast lesions, 84 patients (79.2%) had nonproliferative lesions, 8 patients (7.5%) had columnar cell lesions without atypia, 61 patients (57.5%) had columnar cell lesions with atypia, 5 patients (4.7%) had atypical ductal hyperplasia, and 6 patients (5.6%) had lobular carcinoma in situ. No invasive breast cancer was identified. Conclusion: In Turkey, there is limited evidence regarding the role of histopathological analysis in reduction mammoplasty. Moreover, none of the previous studies determined columnar cell lesion rates in reduction mammoplasty patients. The detection of significantly elevated columnar cell lesions, with or without atypia, especially in patients under the age of 40, increases the importance of screening tests, especially in Turkey, which has a high incidence of breast cancer in early ages, and addresses the need to starting screening tests early in these patients.
Background/aim: Several authorities advocate the use of hypogastric artery ligation (HAL) in the treatment of cases of obstetrical hemorrhage related to uterine atony or placenta accreta. We assessed the morbidity and mortality of patients who underwent HAL as a component of emergency procedures to control life-threatening uterine bleeding in a tertiary-care university hospital. Materials and methods: In this retrospective study, the clinical data of 24 eligible patients who underwent HAL between 2010 and 2013 in a university hospital to prevent or control severe uterine bleeding were collected and analyzed with regard to intraoperative and postoperative findings. Results: In the study population, there were nine patients with uterine atony managed without hysterectomy after HAL and there were 15 patients with placenta previa complicated with placenta accreta after HAL. Of these 15 patients, seven underwent hysterectomy and eight were managed without hysterectomy. Overall, the clinical features of the patients managed with or without hysterectomy were similar for patients with uterine atony and placenta previa. Conclusion: We suggest that if HAL is performed in a surgical setting as mentioned in this study, it may be a life-saving and fertility-sparing procedure.
Background/aim: The uptake of the ferric-acinetobactin complex into the periplasmic space relies on the baumannii acinetobactin utilization (BauA) protein. BauA is composed of cork and the β-barrel domains. We constructed a recombinant protein from conserved antigenic domains of cork and the β-barrel of BauA to evaluate their immunogenic role in an animal model. Materials and methods: The selected bauA domains were amplified from a purified genome of Acinetobacter baumannii ATCC 19606. The domains were then cloned into pET28a and the proteins expressed in E. coli BL21 (DE3) were purified using nickel nitrilotriacetic acid chromatography. Mice and rabbits were immunized with an intraperitoneal injection of the recombinant BauA (rBauA). Results: The highest immune response was achieved after the third booster injection while hyperimmunity was achieved after the second booster injection in rabbits. Immunized mice challenged with live A. baumannii survived, whereas all unimmunized mice in the control group died after 24 h. Mice injected with 109 colony forming units of A. baumannii preincubated with pure immune rabbit sera survived. Bacterial cultures from mice spleen and liver specimens revealed the absence of bacterial growth in the immunized groups. Conclusion: The rBauA could be used as a prophylactic agent and further tests should be carried out to see if it may be useful in a clinical setting against A. baumannii infections.
Background/aim: To investigate the diagnostic value of bacterial artificial chromosome (BAC)-based array comparative genomic hybridization (CGH) and chromosome analysis in prenatal diagnosis. Materials and methods: This study included the chromosome analysis and BAC-based array CGH analysis of 140 amniocentesis samples with prenatal diagnosis indications. Results: Karyotype analysis showed trisomy 21 in 4 patients, trisomy 18 in 5 patients, monosomy X in 1 patient, and other anomalies in 3 patients. The BAC-based array CGH analysis showed 4 patients with trisomy 21, 4 patients with trisomy 18, and 1 patient with monosomy X as a numerical chromosome anomaly, while partial duplication was observed in chromosome 14 in 1 case as a structural anomaly. Conclusion: The array CGH is the most effective method available to complement cases where chromosome analysis, a gold standard in prenatal diagnosis, proves to be insufficient. Considering the inherent limitations of both methods, complementary features should be introduced in order to be able to give the most accurate data at the right time.
Background/aim: In the present study, the protective effect of erdosteine against cyclosporine-induced injury in rat liver was investigated with histological and biochemical methods. Materials and methods: Thirty-two Wistar albino male rats were randomly divided into 4 groups: control (n = 8), cyclosporine (n = 8, 20 mg kg-1 day-1 i.p.), cyclosporine + erdosteine (n = 8, erdosteine 12 mg kg-1 day-1 orally), and erdosteine (n = 8). At the end of day 12, liver tissues were removed for histological and biochemical analysis. After liver tissues were fixed in 10% buffered neutral formalin, routine histological processes were applied and tissue sections were stained with hematoxylin and eosin, periodic acid-Schiff, and elastic fiber stain methods. One hundred lobules of liver were examined for each group and evaluated statistically. The levels of malondialdehyde and glutathione peroxidase, as well as the activities of superoxide dismutase, were determined. Results: The cyclosporine group showed significant histopathological changes compared to the control. In the cyclosporine + erdosteine group, histopathological changes of hepatic damage were markedly reduced. Histological findings were supported by biochemical results. Conclusion: Erdosteine could attenuate cyclosporine-induced liver injury.
Background/aim: Heat shock proteins (HSPs) are expressed in human spermatozoa and play a role in sperm function. MicroRNAs (miRNAs) regulate gene expression, and the possible involvement of miRNAs in the regulation of HSP gene expression in sperm was investigated in this study. Materials and methods: miRNAs differentially expressed in 8 copies of an oligoasthenozoospermic semen group (OA) were identified by comparison with a normal male semen control group (NC) using microarray technology. Potential targets of HSP proteins among the differentially expressed miRNAs were further investigated. Results: HSP40, HSP60, HSP70, and HSP90 were all found to be expressed in human ejaculated spermatozoa. A total of 32 miRNAs showed significant differences in expression between the OA and NC groups. Ten of these miRNAs encoded potential targets of HSPs. Conclusion: These results show that specific miRNAs are expressed in human ejaculated spermatozoa. These miRNAs appear to be involved in regulating the expression of HSP40, HSP70, and HSP90, and this in turn affects sperm function.
Background/aim: In recent years, the increase in the prevalence of carbapenem-resistant Enterobacter cloacae (CREC) has been significant and has become a global problem. The aim of this study is to characterize CREC extended spectrum β-lactamases (ESBLs) and CREC carbapenemase genes and evaluate the risk factors for CREC infections in a university hospital in China. Materials and methods: The identification and assessment of the antimicrobial susceptibility of CREC isolates were performed using a VITEK-2 compact system. Clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE). β-Lactamase genes were examined using polymerase chain reaction and nucleotide sequencing. Results: A total of 64 CREC isolates were included in the study. The rate of CREC infections significantly increased between 2009 and 2012. Among the CREC isolates, 39 (60.9%) isolates possessed ESBL genes, and 49 (76.6%) carried carbapenemase genes; blaSHV-12 and blaKPC-2 were the most common genes, respectively. PFGE showed that there were no obvious clonal associations between these CREC isolates, except for 3 isolates. A univariate analysis demonstrated that prior treatment with antibiotics, intravascular catheterization, urinary catheterization, mechanical ventilation, and parenteral nutrition were significant risk factors for CREC infections. Conclusion: The emergence and increase of CREC infections is worrisome. Effective measures should be taken to control the spread of CREC.
Background/aim: Spinocerebellar ataxias (SCAs) are complex clinical and genetically heterogeneous, mostly autosomal dominant neurodegenerative diseases. At present, more than 30 hereditary SCA types have been associated with different gene mutations. In this study, the frequency distribution of the 6 SCA types 1, 2, 3, 6, 7, and 17 in the Turkish population was investigated with respect to clinical features. Materials and methods: 159 patients who received a diagnosis of SCA and 42 healthy controls from Adana, Mersin, Gaziantep, Hatay, and Osmaniye provinces were included in the study. DNA samples were isolated from 2 mL blood samples and the number of trinucleotide repeats (TNRs) for each SCA type was detected using PCR-RFLP technique and sequencing. Results: Of the 6 SCA types that were studied, 4 types, SCA 1, 3, 7, and 17, were positive and all heterozygous for expansions. SCA types 1 and 17 had higher frequencies, 4.4% and 3.8%, respectively, than SCA types 3 and 7. The clinical data of patients were also evaluated to correlate with the increased TNR numbers. Conclusion: This study, being the first mutation record of SCAs in this area, indicated that 9.4% of cases belonged to 4 types, SCA 1, 3, 7, and 17.
Background/aim: Urticaria is a vascular skin reaction characterized with papules and plaques. Neopterin is accepted as an immunologic marker and an indicator of activation of the immune system. Homocysteine and asymmetric dimethylarginine (ADMA) are the markers of increased vascular resistance. Alteration in vascular resistance has a role in the pathogenesis of urticaria. We aimed to investigate whether there is a relationship between urticaria and neopterin, homocysteine, or ADMA. Materials and methods: The study is designed as a prospective descriptive study and patients with a diagnosis of urticaria in the emergency department were included in the study. Demographic data and characteristics of the disease were recorded. Neopterin, homocysteine, and ADMA levels were measured both during and after urticaria attacks. All data were statistically analyzed. Results: The differences between neopterin levels measured during and after urticaria attacks were statistically significant (P < 0.001). The differences between homocysteine and ADMA levels measured during and after urticaria attacks were not statistically significant (P > 0.05). Conclusion: Our results indicate that neopterin levels in patients with urticaria attacks are increased and the level of neopterin is also a useful parameter in acute urticaria. Further studies should clarify whether homocysteine levels contribute to diagnosis of acute urticaria. However, no relation was found between ADMA and urticaria.
Background/aim: The aim of this study was to investigate the availability of osteoprotegerin (OPG) as a marker of atherosclerosis and compare serum OPG levels with ankle-brachial index (ABI) in diabetic patients. Materials and methods: A total of 31 type 1 and 31 type 2 diabetic patients without macrovascular complications and 20 healthy volunteers were included. Serum OPG levels and ABI were measured. Results: The duration of diabetes was significantly higher in type 1 diabetics than in type 2, although there was no significant difference between mean HbA1c levels. There was a weak and inverse correlation between OPG and atherosclerosis in type 1 diabetics only (P = 0.046, r = -0.360). There was a weak, positive correlation between ABI and HbA1c in all participant groups (P = 0.047, r = 0.220), and a weak-medium correlation in type 2 diabetics (P = 0.021, r = 0.414). After the adjustment of OPG levels to atherosclerosis risk factors, only the age factor was found to be effective on OPG. Conclusion: The inverse correlation of serum OPG with atherosclerosis in type 1 diabetics suggests that atherosclerosis may be related to increased duration of diabetes. Since the study participants did not show macrovascular complications, future prospective studies on the development of diabetic complications and correlation with OPG might give further information about the availability of OPG as a marker of atherosclerosis.
Background/aim: The purpose of this study was to investigate and compare the pharmacokinetic behavior and tissue distribution of paclitaxel, delivered as commercial preparation Taxol or through Span 40 niosomes, after intravenous injection to rats. Materials and methods: Paclitaxel-loaded Span 40 niosomes were prepared using the thin-film method. An HPLC method was developed and validated for paclitaxel determination in rat plasma and tissues. Results: The area under the curve value of the niosome-recipient group (3.22 ± 0.255 μg h/mL) was significantly higher compared to that of the Taxol group (0.725 ± 0.163 μg h/mL). The mean residence time and the elimination half-life of paclitaxel were 1.66 ± 0.133 h and 1.15 ± 0.085 h for Taxol administration, respectively. The elimination half-life (7.63 ± 0.380 h) and the mean residence time (11.0 ± 0.6 h) of paclitaxel were significantly increased, and a pronounced delay was observed in general excretion of paclitaxel from plasma (0.0925 ± 0.00490 h-1) after niosomal administration. The spleen was the main tissue that accumulated paclitaxel from both niosomes and Taxol. Conclusion: The findings of this study show that niosomal formulation might be a useful drug delivery system for intravenous administration of paclitaxel.
Background/aim: Staphylococcus aureus colonization is a determiner of disease activation in psoriasis patients. Here we evaluate the presence of genes encoding Panton-Valentine leukocidin (PVL), enterotoxins, TSST-1, exfoliative toxins, and the accessory gene regulatory locus by polymerase chain reaction (PCR) in S. aureus isolates obtained from healthy and diseased skin regions and anterior nares of psoriasis patients and healthy controls. Materials and methods: The presence of PVL and toxin genes was investigated, and agr typing was performed by PCR. Results: Eighteen of the isolated strains carried the sei, 1 carried the seb-sec, and 1 carried the seg1397645907enterotoxin gene. Eight of the strains carrying enterotoxin genes were isolated from nasal swabs, 6 from diseased skin swabs, and 4 from healthy skin swabs. None of the strains isolated from the control group carried the agr locus. On the other hand, 11 of the S. aureus strains isolated from the patients carried type 1, 7 carried type 1 + 3, 4 carried type 2, 4 carried type 3, and 1 carried type 1 + 2 agr loci. Conclusion: Enterotoxin production and the carried accessory gene regulatory locus may be important in the aggravation of psoriasis.
Background/aim: The annual Hajj pilgrimage to Mecca, which attracts more than 3 million Muslim pilgrims from around the world, has played a role in the global spread of meningococcal infection. We aimed to compare pharyngeal carriage of Neisseria meningitidis in Hajj pilgrims before departure and after returning to Iran, Zahedan. Materials and methods: This prospective and cross-sectional study was conducted among Hajj pilgrims in Zahedan (southeast Iran) in 2012. We studied all pilgrims who agreed to participate in this study and who met the inclusion criteria. Sampling was done by swabbing the posterior pharyngeal wall through the mouth with direct plating or keeping transport time to below 5 h. Specific culture, oxidase test, and carbohydrates tests were done on the positive samples. Results: Among 422 pilgrims (42.2% male, 57.8% female; with age range 21-95 years), 6 (1.4%) were positive for N. meningitidis after the Hajj pilgrimage. Nobody was positive before departure. During the Hajj 58.5% of the participants received antibiotics. Conclusion: According to the results of our study, the prevalence of pharyngeal carriage of N. meningitidis in pilgrims after returning to Zahedan was low (1.4%). The quadrivalent meningococcal vaccine and antibiotic therapy were effective in reducing the number of carriers among pilgrims after travel.
Background/aim: There have been conflicting results in the literature regarding the relationship between functional system involvement, the expanded disability status scale (EDSS), and the presence of restless legs syndrome (RLS) in patients with multiple sclerosis (MS). Materials and methods: Ninety-one patients with MS and 40 patients in a control group (headache, essential tremor, and benign positional paroxysmal vertigo) were studied. The patients underwent a complete neurological examination and Kurtzke functional system scores were calculated. In order to assess the temporal relation between the onset of RLS and MS, a semistructured interview guided by a questionnaire about RLS was applied to all of the patients. Results: Sixteen (17.6%) of the patients with MS and 1 (2.5%) patient in the control group had RLS. The prevalence of RLS was higher in patients with MS, compared to the control group (P = 0.018). Among the patients with MS, none of them suffered from RLS before the onset of MS, whereas sixteen patients (16%) suffered RLS after the onset of MS. There was no significant relationship between functional system involvement and the presence of RLS. Conclusion: The prevalence of RLS was higher in MS patients than it was in the control group. No association was found between RLS and functional system involvement in MS patients.
Background/aim: Treating animals repeatedly with intermittent and increasing morphine doses has been suggested to allow some withdrawal during each dosing interval, which causes repeated stress. The present study aimed to test this hypothesis and assess sex-related differences in withdrawal signs and their suppression by clonidine. Materials and methods: Male and female rats and mice were administered with increasing doses of morphine twice daily at different dosing intervals. Rats were given clonidine in drinking water (5 μg/mL). Spontaneous and naloxone-precipitated withdrawal signs and novelty-induced grooming were evaluated. Results: Male rats and male and female rats displayed manifestations of morphine withdrawal at the end of 14-h and 24-h dosing intervals, respectively. Clonidine attenuated the severity of the withdrawal signs. Male but not female mice displayed withdrawal signs at the end of 12-h and 17-h dosing intervals. Female mice exhibited less pronounced naloxone-precipitated withdrawal syndrome. Grooming did not reflect a "stress-like state" in morphine-treated animals. Conclusion: These findings indicate intermittent morphine treatment-induced spontaneous withdrawal in rats and mice and sex-related differences in spontaneous and naloxone-precipitated withdrawal signs in mice. Since the treatment protocol closely parallels the drug use pattern in opioid addicts, further experiments are needed to clarify the stress associated with the treatment and the efficacy of sedatives.
Background/aim: To compare the effects of tramadol-only treatment and tramadol + gabapentin treatment in patients who had received an epidural steroid injection. Materials and methods: Forty patients with hernia disc-originated acute lumbar discogenic pain were evaluated. All patients received a single dose of steroid and local anesthesia mixture epidurally via the lumbar approach. In both groups, Group T (tramadol, n = 20) and Group TG (tramadol + gabapentin, n = 20), the injection dose was adjusted to 4 mL of triamcinolone acetonide and 0.25% bupivacaine mixture. Orally, 75 mg/day tramadol or 75 mg/day tramadol + 900 mg/day gabapentin were added to the treatment. Leukocyte, erythrocyte sedimentation rate, C-reactive protein, and urine serotonin levels were measured prior to and after treatment. The effectiveness of the treatment was evaluated by visual analog scale (VAS), Oswestry Disability Index (ODI), and straight leg elevation test (SLET). Results: Similar improvements in VAS, ODI, and SLET values were observed in both groups in the second week. The inflammation markers were not different after treatment, neither within the groups nor between the groups. Conclusion: This study revealed that tramadol + gabapentin treatment was not superior to tramadol treatment.
Background/aim: A randomized, placebo-controlled, double-blind study was designed to investigate the effectiveness of ultrasound therapy in primary knee osteoarthritis. Materials and methods: Ninety patients between 40 and 65 years of age having grade 2 and 3 bilateral knee osteoarthritis enrolled in the study were randomly assigned into 3 groups: continuous ultrasound, pulsed ultrasound, and placebo ultrasound. All patients were given a home exercise program. Patients were evaluated at baseline, at the end of the treatment, and at the second month after the treatment by a range of motion measurement, visual analog scale, Lequesne index for knee osteoarthritis, and Short Form-36 quality of life scale. Results: The increase in the knee range of motion was similar in both ultrasound groups, while the change in the placebo group was not statistically significant. Visual analog scale scores and Lequesne scores of the placebo group at the second month were significantly greater than both ultrasound groups' scores (P < 0.01 and P < 0.05, respectively). Conclusion: Significant improvements in terms of pain, function, and quality of life scales were noted in both ultrasound groups in comparison with the placebo group. No statistically significant difference was found in terms of efficacy between the continuous and pulsed ultrasound.
Background/aim: We aimed to define the optimal SUVmax cut-off value in determination of mediastinal-hilar lymph node metastasis, by comparing positive PET/CT results with the results of endobronchial ultrasound guided transbronchial needle aspiration biopsy (EBUS-TBNA). Materials and methods: Thirty-one patients with malignancy whose PET/CT imaging revealed a hypermetabolic mediastinal and/or hilar lymph node and who had undergone EBUS-TBNA were evaluated retrospectively. Histopathology was regarded as the gold standard. The diagnostic role of PET/CT in mediastinal/hilar lymph node metastasis was investigated and compared with the results of contrast-enhanced CT. Results: When a SUVmax value of 2.5 was used, the sensitivity, positive predictive value (PPV), and diagnostic accuracy of the PET/CT were 100%, 65.4%, and 65.4% respectively. In the ROC analysis, the SUVmax cut-off value with the highest diagnostic accuracy (75%) was calculated as 6.3, and when this value was considered, the sensitivity, specificity, PPV, negative predictive value, and diagnostic accuracy of the PET/CT were determined as 70.6%, 83.3%, 88.9%, 60%, and 75% respectively (AUC: 0.779). The sensitivity, PPV, and diagnostic accuracy of the thorax CT were calculated as 91.1%, 72%, and 71.1%, respectively. Conclusion: When determining mediastinal-hilar lymph node metastasis via PET/CT, although a SUVmax cut-off value of 6.3 increases specificity and diagnostic accuracy, we think that a SUVmax cut-off value of 2.5 and above give more optimal results in routine practice.
Background/aim: Data about contact allergen sensitization (CAS) in children with atopic dermatitis (AD) are limited. The purpose of this study was to identify the frequency and patterns of CAS in children with AD by using a ready-to-use patch test system. Materials and methods: After receiving the history of CAS in the patients, the severity of AD and IgE-mediated allergen sensitization were determined. Results: Of 134 children with AD, 33.8% (n = 45) had at least 1 positive reaction. The most frequent positive reaction was to nickel sulfate (NS) (37.8%, 17/45), followed by methylchloroisothiazolinone (20.0%, 9/45) and thimerosal (15.6%, 7/45). The total Scoring Atopic Dermatitis (SCORAD) score was significantly higher in the NS-sensitized group (P = 0.036). The patients with NS sensitization had moderate-severe AD more frequently than those without any reaction (P = 0.020). When the SCORAD score was evaluated in detail, extent of eczema, score of sleep loss, and pruritus were significantly higher in the patients with NS sensitization than those without any reaction (P = 0.002, P = 0.001, and P = 0.002, respectively). Conclusion: Our study confirms the necessity of CAS in the management of AD. In particular, NS sensitization should be considered for children with severe AD or larger extent of eczema and trunk involvement.
Background/aim: Systemic sclerosis (SSc) is an autoimmune disease characterized by microvascular injury, excessive extracellular matrix deposition, and fibrosis in the skin and internal organs. Bacterial and viral infectious agents have been suspected to be contributing factors in the development and progression of the pathologic features of SSc. Materials and methods: In this study, 30 SSc patients who were admitted to the rheumatology unit of the Konya Training and Research Hospital and 30 healthy controls were included. The presence of 9 different antibodies (IgM and IgG) against Helicobacter pylori, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and parvovirus B19 were investigated in sera samples obtained from the 60 participants using an enzyme-linked immunosorbent assay method. The characteristics of current and past infections with H. pylori, CMV, EBV, and parvovirus B19 were evaluated by determining the seropositivity of the tested bacterial and viral agents. Results: The prevalences of H. pylori, CMV, EBV, and parvovirus B19 were determined to be higher in patients with SSc than in the control group. Conclusion: SSc is associated with a higher rate of certain infections, which deserves further investigation in order to assess the role of infections in disease etiology/pathogenesis.
Background/aim: Vitamin B12 plays an important role in the development of mental, motor, cognitive, and social functions via its role in DNA synthesis and nerve myelination. Its deficiency in infants might cause neuromotor retardation as well as megaloblastic anemia. The objective of this study was to investigate the effects of infantile vitamin B12 deficiency on evoked brain potentials and determine whether improvement could be obtained with vitamin B12 replacement at appropriate dosages. Materials and methods: Thirty patients with vitamin B12 deficiency and 30 age-matched healthy controls were included in the study. Hematological parameters, visual evoked potentials, and brainstem auditory evoked potentials tests were performed prior to treatment, 1 week after treatment, and 3 months after treatment. Results: Visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) were found to be prolonged in 16 (53.3%) and 15 (50%) patients, respectively. Statistically significant improvements in VEP and BAEP examinations were determined 3 months after treatment. Three months after treatment, VEP and BAEP examinations returned to normal in 81.3% and 53.3% of subjects with prolonged VEPs and BAEPs, respectively. Conclusion: These results demonstrate that vitamin B12 deficiency in infants causes significant impairment in the auditory and visual functioning tests of the brain, such as VEP and BAEP.
Background/aim: The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. Materials and methods: This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. Results: The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. Conclusion: We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.