A double-blinded randomized clinical trial for pain perception: The efficacy and safety of topical cold saline solution anesthesia in phacoemulsification

Purpose: To compare the efficacy and safety of cold saline solution (0.9% NaCl) with topical ophthalmic proparacaine for maintaining topical anesthesia of patients undergoing phacoemulsification surgery. Methods: The prospective, double?blinded, and randomized clinical study was randomly assigned to two groups that underwent phacoemulsification surgery due to cataracts. The cold saline group included 86 eyes of 86 patients with topical anesthesia of cold saline solution alone. The proparacaine group included 84 eyes of 84 patients with topical ophthalmic proparacaine (room temperature) anesthesia alone. The patients were scored according to a pain survey questionnaire of Visual Analog Scale (VAS) ranked between 0 and 10. The surgeon scored surgical experience by a Surgeon Questionnaire Scale (SQS) in three parameters, each of which was ranked from 1 to 3 based on questions regarding ease and comfort during the surgery. Results: The mean VAS scores were 1.29 ± 0.65 and 1.22 ± 0.66 for the cold saline and proparacaine groups, respectively (P = 0.182). The mean scores of SQS (lower values represented favorable results) were 4.11 ± 0.76 and 3.97 ± 0.74 in the cold saline and proparacaine groups, respectively (P = 0.163). Ten patients in the proparacaine group experienced corneal epitheliopathy in the postoperative period. Conclusion: As an easily accessible and cost?effective method, cold saline solution alone might be an alternative to topical ophthalmic proparacaine alone with comparable safe and effective results. The absence of allergic or toxic effects also provided a significant advantage in the cold saline application

Performance of the Pandemic Medical Early Warning Score (PMEWS), Simple Triage Scoring System (STSS) and Confusion, Uremia, Respiratory rate, Blood pressure and age ≥ 65 (CURB-65) score among patients with COVID-19 pneumonia in an emergency department triage setting: a retrospective study

ABSTRACT BACKGROUND: Healthcare institutions are confronted with large numbers of patient admissions during large-scale or long-term public health emergencies like pandemics. Appropriate and effective triage is needed for effective resource use. OBJECTIVES: To evaluate the effectiveness of the Pandemic Medical Early Warning Score (PMEWS), Simple Triage Scoring System (STSS) and Confusion, Uremia, Respiratory rate, Blood pressure and age ≥ 65 years (CURB-65) score in an emergency department (ED) triage setting. DESIGN AND SETTING: Retrospective study in the ED of a tertiary-care university hospital in Düzce, Turkey. METHODS: PMEWS, STSS and CURB-65 scores of patients diagnosed with COVID-19 pneumonia were calculated. Thirty-day mortality, intensive care unit (ICU) admission, mechanical ventilation (MV) need and outcomes were recorded. The predictive accuracy of the scores was assessed using receiver operating characteristic curve analysis. RESULTS: One hundred patients with COVID-19 pneumonia were included. The 30-day mortality was 6%. PMEWS, STSS and CURB-65 showed high performance for predicting 30-day mortality (area under the curve: 0.968, 0.962 and 0.942, respectively). Age > 65 years, respiratory rate > 20/minute, oxygen saturation (SpO2) < 90% and ED length of stay > 4 hours showed associations with 30-day mortality (P < 0.05). CONCLUSIONS: CURB-65, STSS and PMEWS scores are useful for predicting mortality, ICU admission and MV need among patients diagnosed with COVID-19 pneumonia. Advanced age, increased respiratory rate, low SpO2 and prolonged ED length of stay may increase mortality. Further studies are needed for developing the triage scoring systems, to ensure effective long-term use of healthcare service capacity during pandemics.

Prosthesis-socket volume imbalance and dermofat graft rehabilitation in patients with an anophthalmic socket / Os problemas causados pelo desequilíbrio do volume da cavidade da prótese, nos casos de cavidades anoftálmicas, e a sua reabilitação com o enxerto de dermofat

ABSTRACT Purposes: To identify problems caused by prosthesis-socket volume imbalances in anophthalmic sockets; and to evaluate rehabilitation with dermofat graft as a solution. Methods: We retrospectively reviewed medical records of patients operated in our clinic (between May 2011 and June 2016) with dermofat grafts to treat anophthalmic socket-related problems. During the preoperative examinations, ophthalmologists recorded the presence of eyelid problems due to the socket volume deficit, upper and lower fornix deficiency, deepening in the upper eyelid sulcus, epiphora and secretion, lower eyelid laxity, ptosis, entropion, and ectropion. Following the surgical repair, new prosthesis suitable for the resulting socket area were implemented for all the patients. The mean follow-up period was 27.42±16 months (ranging from 10-62 months). On the last control examinations, ophthalmologists recorded solved and unsolved socket problems that were present preoperatively. Results: We included 16 men and 5 women in this study. The mean age was 38.3 ± 18.4 years (range, 5-75 years). The mean duration of preoperative prosthesis use was 9.4 ± 6.8 years (range, 1-30 years). Preoperatively, 7 patients had only orbital volume deficits, and 14 had socket volume displacements in addition to the volume deficits. After the dermofat graft implantations, the remaining deficits were corrected during another surgical session: 6 patients underwent ptosis corrections, 5 lateral canthal suspensions, 5 lower fornix with mucosal graft formations, and 2 upper fornix formations with mucosal grafts. All patients were able to use prosthesis postoperatively. Conclusion: The use of dermofat grafts to correct anophthalmic socket problems caused by orbital volume deficits or volume displacements is an effective, reliable, and reproducible surgical method.

RESUMO Objetivos: Identificar os problemas causados pelo desequilíbrio do volume da cavidade da prótese em cavidades anoftálmicas, e avaliar a reabilitação com enxerto de dermofato como solução. Métodos: Revisamos retrospectivamente os prontuários de pacientes operados em nossa clínica (entre maio de 2011 e junho de 2016) com enxertos de dermofato para tratar problemas relacionados a cavidades anoftálmicas. Durante os exames pré-operatórios, os oftalmologistas registraram a presença de problemas palpebrais devido ao déficit de volume, deficiência de fórnice superior e inferior, aprofundamento no sulco palpebral superior, a epífora e secreção, flacidez palpebral inferior, ptose, entrópio e ectrópio. Após a cirurgia, novas próteses adequadas para a área de encaixe foram implementadas em todos os pacientes. O tempo médio de acompanhamento foi de 27,42 ± 16 meses (variando de 10 a 62 meses). Nos últimos exames de controle, os oftalmologistas registraram problemas corrigidos e não corrigidos da cavidade que estavam presentes no pré-operatório. Resultados: Foram incluídos 16 homens e 5 mulheres neste estudo. A média de idade foi de 38,3 ± 18,4 anos (variação de 5-75 anos). A duração média do uso de prótese pré-operatória foi de 9,4 ± 6,8 anos (variação de 1 a 30 anos). No pré-operatório, 7 pacientes apresentavam apenas déficit orbitais e 14 tinham desvios de volume, além dos déficits de volume. Após os implantes de enxerto de dermoadipação, os déficits remanescentes foram corrigidos durante outra sessão cirúrgica: 6 pacientes foram submetidos a correção de ptose, 5 suspensões de cantal lateral, 5 fórnix inferior com enxerto de mucosa e 2 formações de fórnice superior com enxerto de mucosa. Todos os pacientes foram capazes de usar prótese no pós-operatório. Conclusão: A utilização de enxertos de dermofato para corrigir problemas de anoftalmia causados por déficits de volume orbital ou deslocamento de volume é um método cirúrgico eficaz, confiável e reprodutível.

Comparison of 1α-25-dihydroxyvitamin D3 and IgE Levels between Allergic Rhinitis Patients and Healthy People

Abstract Introduction Allergic rhinitis is one of the most common allergic diseases that cause a decrease in quality of life. Over the last decades, the increase in the number of cases is supposed to be a result of industrialization and lifestyle changes. Vitamin D, which is a steroid hormone, has a significant immunomodulatory and antioxidant role in the human body. Objective The objective of the present study is to investigate the role of 1α-25-dihydroxyvitamin D3 levels in allergic rhinitis patients and to compare them to the levels found in the healthy population. Methods A total of 256 participants were included in the present study. Allergic rhinitis is diagnosed with the help of the Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines confirmed through skin prick tests. Control subjects were selected among people without allergy history, which was also confirmed through skin prick tests. The levels of 1α-25-dihydroxyvitamin D3, immunoglobulin E (IgE), and eosinophil counts were measured in blood samples from both groups. Results The mean value of serum levels of 1α-25-hydroxyvitamin D3 was 25.5 ± 3.74 in the allergic rhinitis group, and 31.58 ± 3.85 in the control subjects. This difference reveals statistically-decreased levels in the allergic rhinitis group (p< 0.05). The total IgE levels are increased in the allergic rhinitis group (p< 0.05) and negatively correlated with the serum levels of 1α-25-hydroxyvitamin D3 (r = - 0.259, p< 0.05). Conclusion Lower serum levels of 1α-25-hydroxyvitamin D3 were detected in the allergic rhinitis population. This data is also correlated to the IgE response in the study group. A supplement of 1α-25-hydroxyvitamin D3 in deficient patients might be helpful to relieve symptoms and signs of allergic rhinitis, but further studies are needed.

Evaluation of apoptosis indexes in currently used oral alpha-blockers in prostate: a pilot study

ABSTRACT Objectives: Apoptosis effect of oral alpha-blockers is known in the prostate. Apoptosis index of silodosin has not been proved, yet. Aims are to present apoptosis index of silodosin in prostate and to compare this with other currently used alpha-blocker's apoptosis indexes together with their clinical effects. Materials and Methods: Benign prostatic hyperplasia (BPH) patients were enrolled among those admitted to urology outpatient clinic between June 2014 and June 2015. Study groups were created according to randomly prescribed oral alpha-blocker drugs as silodosin 8mg (Group 1; n=24), tamsulosin 0.4mg (Group 2; n=30), alfuzosin 10mg (Group 3; n=25), doxazosin 8mg (Group 4; n=22), terazosin 5mg (Group 5; n=15). Pa- tients who refused to use any alpha-blocker drug were included into Group 6 as control group (n=16). We investigated apoptosis indexes of the drugs in prostatic tissues that were taken from patient's surgery (transurethral resection of prostate) and/or prostate biopsies. Immunochemical dyeing, light microscope, and Image Processing and Analy- sis in Java were used for evaluations. Statistical significant p was p<0.05. Results: There were 132 patients with mean follow-up of 4.2±2.1 months. Pathologist researched randomly selected 10 areas in each microscope set. Group 1 showed statisti- cal significant difference apoptosis index in immunochemical TUNEL dyeing and im- age software (p<0.001). Moreover, we determined superior significant development in parameters as uroflowmetry, quality of life scores, and international prostate symptom score in Group 1. Conclusions: Silodosin has higher apoptosis effect than other alpha-blockers in prostate. Thus, clinic improvement with silodosin was proved by histologic studies. Besides, static factor of BPH may be overcome with creating apoptosis.

The Effect of the Cholesterol Levels on Noise-Induced Hearing Loss

Abstract Introduction Noise-induced hearing loss (NIHL), which is one of the most common occupational diseases among industrialized populations, is associated with longstanding exposure to high levels of noise. The pathogenesis of NIHL is not clear, but some genes and their activity at the tissue level have been investigated. Hypercholesterolemia, which can disturb the microcirculation, can be one of the underlying pathologies in hearing loss. Objective To investigate the relationship between NIHL and hypercholesterolemia. Methods The study group was selected among workers who had an occupational exposure of 85 dB of noise for at least 10 years. The audiologic assessment was recorded at seven frequencies (500 Hz, 1,000 Hz, 2,000 Hz, 3,000 Hz, 4,000 Hz, 6,000 Hz and 8,000 Hz). A total of 456 workers were included in the study and divided into two groups: the control group (252 patients) and the NIHL group (204 patients). After the audiologic measurement, blood samples were taken and investigated for blood cholesterol levels. According to these results, the groups were compared. Results Both groups were similarly distributed regarding age and occupational exposure time (p > 0.05). We could not detect any association between cholesterol levels and noise-induced hearing loss (p < 0.05). According to logistic regression analyses, the odds ratios are not significant for both hypercholesterolemia and hypertriglyceridemia (p > 0.05). Conclusion Noise-induced hearing loss is still a common occupational problem that can be prevented by hearing conservation programs and occupational health and safety training. Still, we know little about the relationship between NIHL and hypercholesterolemia. According to our findings, we cannot detect any relationship. Controlled studies and studies with human individuals can be made possible in the future with diagnostic innovations in tissue imaging and tissuemicrocircular sampling.

Anterior tarsal flap rotation combined with anterior lamellar reposition in the repair of cicatricial upper eyelid entropion / Rotação anterior de retalho tarsal combinada com reposição laminar anterior no reparo do entrópio cicatricial das pálpebras superiores

ABSTRACT Purpose: This study aimed to share the results of patients who underwent anterior tarsal flap rotation combined with anterior lamellar reposition because of cicatricial upper eyelid entropion, and to determine the effectiveness and reliability of this surgical technique. Methods: Fifteen eyes of 11 patients (2 right eyes; 5 left eyes; and 4 bilateral eyes) on whom we performed anterior tarsal flap rotation surgery combined with anterior lamellar reposition because of cicatricial entropion were included in this study. The medical records of the patients were analyzed retrospectively, and the causes of cicatricial entropion as well as the preoperative and postoperative ophthalmic examination findings were recorded. Normal anatomical appearance and function of eyelid were considered to have been achieved. Results: The mean age was 59.81 ± 18 years. The mean follow-up period was 21.72 ± 14 months (range, 5-43 months). The causes of cicatricial entropion were postoperative cicatrices development due to multiple electrolyzes for trichiasis and/or distichiasis in 7 eyes, trachoma in 6 eyes, and trauma in 2 eyes. Irritation and watering were detected in all patients preoperatively, whereas corneal opacity and erosion were detected in 10 patients and epithelial erosion was detected in one patient. Full anatomical and functional success was achieved for all patients. Conclusion: Anterior tarsal flap rotation combined with anterior lamellar reposition in the repair of cicatricial entropion was found to be an effective and reliable alternative surgical procedure.

RESUMO Objetivo: Compartilhar os resultados dos pacientes submetidos à rotação de retalho tarsal anterior, combinados com a reposição lamelar anterior devido à entrópio cicatricial da pálpebra superior e determinar a eficácia e a confiabilidade desta técnica cirúrgica. Métodos: Foram incluídos neste estudo quinze olhos de 11 pacientes em quem realizamos cirurgia de rotação de retalho tarsal anterior combinada com reposição lamelar anterior devido ao entrópio cicatricial. Os registros médicos dos pacientes foram analisados retrospectivamente e as causas da entrópio cicatricial, bem como os achados do exame oftalmológico pré-operatório e pós-operatório foram registrados. A integridade anatômica e funcional da pálpebra foi considerada como sucesso cirúrgico. Resultados: A idade média foi de 59,81 ± 18 anos. O período médio de seguimento foi de 21,72 ± 14 meses (intervalo 5-43 meses). As causas da entrópio cicatricial foram o desenvolvimento de cicatrizes pós-operatórias devido a eletrólises múltiplas para triquíase e/ou distiquiase em 7 olhos, tracoma em 6 olhos e trauma em 2 olhos. Todos os pacientes foram tiveram irritação e lacrimejamento pré-operatório, enquanto que 10 pacientes apresentavam opacidade e erosão da córnea e 1 paciente apresentava apenas erosão epitelial. O sucesso total anatômico e funcional foi alcançado em todos os casos. Conclusão: A rotação do retalho tarsal anterior combinada com a reposição lamelar anterior no reparo da entrópio cicatricial é um procedimento cirúrgico alternativo efetivo e confiável.

Macular hemorrhage after roller coaster riding in a single-eyed patient with congenital glaucoma / Hemorragia macular após passeio em montanha russa em paciente monocular com glaucoma congênito

ABSTRACT A 21-year-old female presented with a 4-day history of decreased vision in her only functional eye (right eye, OD). She had a history of multiple ocular surgeries in both eyes because of congenital glaucoma and had lost light perception in her left eye several years prior. Ophthalmological examination revealed 0.15 Snellen visual acuity, and fundoscopy revealed nearly total cupping and pallor of the optic disc and multiple retinal hemorrhagic foci in the macula in OD. Lesions spontaneously resolved over a few months. Gravitational forces during a roller coaster ride may have caused this macular hemorrhage.

RESUMO Uma paciente de 21 anos de idade se apresentou com perda de visão há quatro dias em seu único olho com visão útil. Ela tinha uma história de cirurgias oculares múltiplas nos dois olhos devido a um glaucoma congênito e perda de percepção luminosa em olho esquerdo há muitos anos. O exame oftalmológico revelou acuidade visual de Snellen de 0,15 e na fundoscopia foi observada escavação do nervo óptico quase total e palidez de papila, assim como focos hemorrágicos múltiplos na região macular. As lesões se resolveram espontaneamente em alguns meses. Acreditamos que essas hemorragias maculares tenham sido causadas pelas forças gravitacionais geradas durante o passeio na montanha russa.

A Review of Helicobacter pylori Infection in Patients with Diabetes Mellitus.

Gastrointestinal symptoms, such as abdominal discomfort, chronic abdominal pain, dysphagia, heartburn, nausea, vomiting, diarrhea and constipation are more common in patients with Diabetes Mellitus (DM) than in the general population. Studies published in the past two decades have suggested a link between Helicobacter pylori (H. pylori) infection and DM in many aspects. These include; higher H. pylori infection prevalence however the data on the prevelance of H. pylori infection in patients with DM are scanty and contradictory, the eradication rate of H. pylori seems to be lower in DM patients than in non-diabetic controls, control of dyspeptic symptoms with eradication as well as association with late complications in DM patients. The aim of the present review is to gain a better understanding of H. pylori infection in DM patients.

The localization of the asterion according to the anatomical landmarks of posterior cranial fossa in newborns: clinical implications / Localización del asterión de acuerdo con los puntos anatómicos de la fosa craneal posterior en recién nacidos: implicaciones clínicas

The purpose of this study was to determine the localization of the asterion according to the anatomical landmarks of posterior cranial fossa and its relation with sinuses for posterolateral surgical approaches in newborns. On 70 head-halves, a needle about 2 mm with diameter was placed on the centre point of asterion (posterolateral fontanel) by inserting into the whole cranial bony tissue by forming an right angle with the bony surface. Various localizations of asterion and its measurements from the internal and external anatomical landmarks were investigated on term neonatal cadavers. The localization of asterion was found as on the sigmoid-transverse sinus junction (STJ) (5., 6., 7., 8. squares) in 40% of cases on right side and in 34%, on left side. Additionally, it was located below the STJ (9., 10., 11., 12. squares) in 60% of cases, on right side and in 63% of cases on left side. We determined that the most frequent localization of asterion as the 11. square both for the right and left sides 12 (34%) cases for the right side and 11 (31,4%) cases for the left side. The asterion was not located on 1., 2., 3., 4., 5. and 12. squares on right side and 1., 3., 4., 8. and 9. squares on left side. It has been found that the region of asterion has an average distance value of 19.9 mm to internal acoustic meatus (MI), 31.7 mm to posterior clinoid process (PC), 34.4 to dorsum sellae (DS), 19.2 mm to jugular foramen (FJ), 23.0 mm to hypoglossal canal (HC), internally. The distance of asterion as 28.8 mm to zygoma root (ZR) and 22.3 mm to Henle's spine (HS) and 15.8 mm to mastoid tip (MT) and 35.9 mm to external occipital protuberance (PE) were observed. By the guide of point asterion on newborns the area of 1cm2 on this point which was placed on superior 4 squares of our scale diagram is suggested as a safe area of placement of first burr hole to avoid from the risk of bleeding of sigmoid and transverse sinuses on craniotomies of posterior fossa.

El propósito de este estudio fue determinar la localización del asterion de acuerdo con los puntos anatómicos de la fosa craneal posterior y su relación con los senos de abordajes quirúrgicos posterolaterales en los recién nacidos. Fueron utilizadas 70 hemicabezas y se colocó una aguja de alrededor de 2 mm de diámetro en el punto central del asterion (fontanela posterolateral) en todo el tejido óseo craneal produciéndose la formación de un ángulo recto con la superficie ósea. La localización del asterion y las mediciones de los puntos de referencia anatómicos internos y externos fueron investigados en cadáveres de neonatos a término. La localización del asterion se encontró en la unión sinusal transverso sigmoide (STJ) (cuadrados 5., 6., 7., 8.) en el 40% de los casos en el lado derecho y en el 34%, en el lado izquierdo. Además, se encontró por debajo del STJ (cuadrados 9., 10., 11., 12.) en un 60% de los casos en el lado derecho y en el 63% de los casos en el lado izquierdo. Se determinó que la localización más frecuente del asterion fue 11., tanto para los lados derecho e izquierdo, 12 casos (34%) para el lado derecho y 11 casos (31,4%) para el lado izquierdo. El asterion no se encuentra en los cuadrados 1., 2., 3., 4., 5. y 12. del lado derecho y 1., 3., 4., 8. y 9. del lado izquierdo. Se determinó que la región del asterion tiene una distancia promedio de 19,9 mm al meato acústico interno, 31,7 mm al proceso clinoides posterior, 34,4 mm al dorso selar, 19,2 mm al foramen yugular y 23,0 mm al canal hipogloso, internamente. La distancia del asterion a la raíz del hueso cigomático fue 28,8 mm y 22,3 mm a la columna vertebral, siendo de 15,8 mm al proceso mastoides y 35,9 mm a la protuberancia occipital externa. En los recién nacidos, se sugiere un área de 1cm2 y se colocan en 4 casillas superiores de nuestro diagrama a escala, como una zona segura para la realización de la primera trepanación para evitar el riesgo de sangrado de los senos sigmoide y transverso en craneotomías de fosa posterior.

Effect of bevacizumab, which remain after withdrawal of the first dose/s from a single-use vial on diabetic macular edema.

Background: The objective of this study was to investigate the effect of bevacizumab remaining after withdrawal of the first dose/s from a single-use vial in diabetic macular edema (DME) secondary to diabetic retinopathy. Methods: Patients were divided into four groups according to duration of storage of the single-use vial of bevacizumab in the refrigerator: Group 1 received IVB when the vial was first opened, and Groups 2, 3, and 4 received IVB after 3, 7, and 15 days, respectively, after the first dose or doses had been withdrawn with an insulin (27-gauge) needle from the single-use vial. The Wilcoxon test was used to compare the results in four groups. p<0.05 was considered as statistically significant. Results: Mean age, mean glycosylated hemoglobin, severe of retinapathy and status of the lens were similar in all groups (p>0.05). Preinjection mean best corrected visual acuity (BCVA) was 0.41±0.2; 0.39±0.2; 0.39±0.2 and 0.34±0.2 logMAR Group 1, 2, 3 and 4, respectively. Preinjection mean central macular thickness (CMT) was 503±88; 502±99; 565±63 and 491±107 μm in Group 1, 2, 3 and 4, respectively. After injection mean BCVA was 0.30±0.16; 0.28±0.20; 0.29±0.19 and 0.25±0.20 logMAR and mean CMT was 321±75; 315±97; 360±83 and 279±82 in Group 1, 2, 3 and 4, respectively. The mean BCVA increased significantly, and CMT decreased significantly after injection in all groups. No observed serious ophthalmologic or systemic side effects. Conclusion: Bevacizumab which remain in the single use vial after first dose/s is safe and effective for treatment of DME. These results are useful for poor countries.

Retinal nerve fiber layer and ganglion cell complex thickness in patients with type 2 diabetes mellitus.

Aim: The aim of the following study is to evaluate the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness in patients with type 2 diabetes mellitus (DM). Materials and Methods: Average, inferior, and superior values of RNFL and GCC thickness were measured in 123 patients using spectral domain optical coherence tomography. The values of participants with DM were compared to controls. Diabetic patients were collected in Groups 1, 2 and 3. Group 1 = 33 participants who had no diabetic retinopathy (DR); Group 2 = 30 participants who had mild nonproliferative DR and Group 3 = 30 participants who had moderate non‑proliferative DR. The 30 healthy participants collected in Group 4. Analysis of variance test and a multiple linear regression analysis were used for statistical analysis. Results: The values of RNFL and GCC in the type 2 diabetes were thinner than controls, but this difference was not statistically significant. Conclusions: This study showed that there is a nonsignificant loss of RNFL and GCC in patients with type 2 diabetes.

Comparison of the effects of intravitreal bevacizumab and triamcinolone acetonide in the treatment of macular edema secondary to central retinal vein occlusion.

Aim: To compare the effects of intravitrealbevacizumab (IVB) and intravitreal triamcinolone acetonide (IVT) in the treatment of macular edema (ME) secondary to central retinal vein occlusion (CRVO). Materials and Methods: There were 20 patients treated with IVB (1.25 mg/0.05 mL) and 16 treated with IVT (4 mg/0.1 mL). The two groups were compared with regard to best-corrected visual acuity (BCVA), central macular thickness (CMT) on optical coherence tomography (OCT), slit-lamp biomicroscopy and fundus fluorescein angiography results, intraocular pressure (IOP), numbers of injections, and adverse events. Results: The mean follow-up times in the IVB and IVT groups were 17.45±8.1 months (range: 8–33 months) and 19.94±10.59 months (range: 6–40 months), respectively (P = 0.431). Visual acuity increased and CMT decreased significantly within both groups, but no differences were observed between the groups (P = 0.718). The percentages of patients with increased IOP and iatrogenic cataracts were significantly higher in the IVT group than in the IVB group. Conclusions: Treatment with IVB and IVT both resulted in significant improvement in visual acuity and a decrease in CMT in patients with ME secondary to nonischemic CRVO, with no difference between the two treatments. The incidence of adverse events, however, was significantly greater in the IVT group than in the IVB group. IVB may be preferred over IVT for the treatment of ME in patients with non-ischemic CRVO.

Evaluation of plasma eosinophil count and mean platelet volume in patients with coronary slow flow

OBJECTIVE: The pathophysiology of coronary slow flow has not been clearly defined, although multiple abnormalities including arteritis, endothelial dysfunction, and atherothrombosis, have been reported. It is known that eosinophils play an important role in inflammation, endothelial dysfunction, and thrombosis. We aimed to compare the eosinophil counts of coronary slow flow patients versus healthy controls. METHODS: This study included 50 coronary slow flow patients (19 males, mean age 65.6±13.7 years) and 30 healthy controls (10 males, mean age 57.86±11.6 years). These participants were evaluated using concurrent routine biochemical tests as well as neutrophil, lymphocyte, and eosinophil counts and mean platelet volume (MPV), which were obtained from the whole blood count. These parameters were compared between groups. RESULTS: The baseline characteristics of the study groups were comparable. The coronary slow flow patients had a higher mean platelet volume and eosinophil count than the control group (8.38±0.86 vs 6.28±1.6 fL and 0.31±0.42 vs 0.09±0.05; p<0.001 and 0.008, respectively). CONCLUSION: Our study demonstrated a relationship between eosinophil count and MPV in patients with coronary slow flow. .

Iatrogenic Horner’s Syndrome Associated with Branchial Cleft Cyst Surgery.

Aim: To report a case of right-sided iatrogenic Horner's syndrome developed after branchial cleft cyst surgery. Presentation of the Scope: An 8 year-old boy presented with right-sided eyelid ptosis and enophthalmos, and diagnosed as having Horner’s syndrome. Discussion: Ophthalmic examination yielded miosis in the affected eye. Medical history revealed branchial cleft cyst surgery 4 years ago and mild ptosis was identified in the first postoperative day. Conclusion: Iatrogenic Horner syndrome may follow the cleft cyst surgery in on neck.

Evaluation of oxidative stress parameters and metabolic activities of nurses working day and night shifts / Avaliação de parâmetros de estresse oxidativo e as atividades metabólicas das enfermeiras trabalhando em turnos diurnos e noturnos / Evaluación de parámetros de estrés oxidativo y actividades metabólicas de enfermeras trabajando en turnos diurnos y nocturnos

O objetivo deste estudo foi avaliar o estresse oxidativo e as atividades metabólicas das enfermeiras em turnos diurnos e noturnos. Enfermeiras da Unidade de Tratamento Intensivo (UTI) (n=70) e do serviço comum (SC) (n=70) participaram do estudo. Logo no início e ao final dos turnos, amostras de sangue foram obtidas para medir parâmetros de estresse oxidativo. Atividades metabólicas também foram analisadas com o uso da braçadeira SenseWear. Parâmetros de estresse oxidativo aumentaram no fim dos turnos de todas as enfermeiras SC e UTI quando comparados ao início dos turnos. Comparados às enfermeiras SC, os níveis de TAS, TOS e OSI das enfermeiras de UTI não eram significativamente diferentes no final dos turnos diurnos e noturnos. Além disso, as atividades metabólicas das enfermeiras de SC e UTI se revelaram como sendo similares. Assim, os parâmetros de estresse oxidativo e as atividades metabólicas das enfermeiras SC e UTI não eram diferentes, e todas as enfermeiras sofrem efeitos semelhantes dos turnos, tanto no dia quanto na noite.

The aim of this study was to evaluate the oxidative stress and metabolic activities of nurses working day and night shifts. Intensive care unit (ICU) (n=70) and ordinary service (OS) nurses (n=70) were enrolled in the study. Just before and the end of the shifts, blood samples were obtained to measure the participants' oxidative stress parameters. Metabolic activities were analyzed using the SenseWear Armband. Oxidative stress parameters were increased at the end of the shifts for all OS and ICU nurses compared to the beginning of the shifts. Compared to the OS nurses, the ICU nurses' TAS, TOS, and OSI levels were not significantly different at the end of the day and night shifts. The metabolic activities of the OS and ICU nurses were found to be similar. As a result, the OS and ICU nurses' oxidative stress parameters and metabolic activities were not different, and all of the nurses experienced similar effects from both the day and night shifts.

Se objetivó evaluar estrés oxidativo y actividades metabólicas de enfermeras en turnos diurnos y nocturnos. Participaron enfermeras de Unidad de Terapia Intensiva (UTI, n=70) y del servicio común (SC, n=70). Se obtuvieron muestras sanguíneas al inicio y al final de los turnos para medir parámetros de estrés oxidativo. Las actividades metabólicas también fueron analizadas utilizando brazaletes SenseWear. Los parámetros de estrés oxidativo aumentaron hacia el final de los turnos de todas las enfermeras SC y UTI, comparados con la medida de inicio. Los niveles de TAS, TOS y OSI no eran significativamente diferentes entre enfermeras SC y UTI al cierre de los turnos diurnos y nocturnos. Las actividades metabólicas de enfermeras SC y UTI se mostraron similares. Consecuentemente, los parámetros de estrés oxidativo y las actividades metabólicas de enfermeras SC y UTI no resultaron diferentes, y todas las enfermeras sufren efectos semejantes en sus turnos, tanto diurnos como nocturnos.