PLASMA INTERLEUKIN-6 LEVELS MAY BE ASSOCIATED WITH THE LENGTH OF STAY TIME OF ADULT HYPERGLYCEMIC PATIENTS IN AN INTENSIVE CARE UNIT.

CONTEXT: Estimation of intensive care unit (ICU) length of stay time (LOS) may be challenging, and pro-inflammatory cytokines can be used as a marker for this purpose. OBJECTIVE: The current study aimed to investigate the association between pro-inflammatory cytokine levels and LOS in hyperglycemic patients admitted to adult ICU. DESIGN: This is a prospective observational study. SUBJECTS AND METHODS: All adult ICU patients with a blood glucose level higher than 250 mg/dL, during the study period were included. Hospitalization day demographics were recorded, and plasma IL-6, IL1-ß, and TNF-α concentrations were measured. RESULTS: A total of 74 patients were enrolled in the study. Diabetic ketoacidosis (DKA) was positive in 31 patients, and the remaining 43 were in the non-DKA (NDKA) group. There was no difference between the two groups in terms of age, gender, LOS, hemoglobin, hematocrit, lactate levels, and platelets count. IL-6, IL-1ß, and TNF-α levels did not show any difference between DKA and NDKA groups (p=0.784, 0.413, and 0.288, respectively). There was a positive correlation between IL-6 levels and LOS (n=74, Pearson correlation=0.330; p=0.004). CONCLUSIONS: Among pro-inflammatory cytokines, IL-6 showed a better performance for the prediction of LOS than IL-1ß, TNF-α, and CRP.

Treatment outcomes of archwise distraction osteogenesis in mandibular dentoalveolar retrognathia cases.

The aim of this study was to describe the treatment of class II malocclusion by sagittal advancement of the alveolar bone in the symphyseal area using an intraoral archwise distractor device and to determine the effects of this method on the dentoalveolar complex. Fifteen patients (10 female, five male) aged 16-20 years with a class II division 2 malocclusion, characterized by mandibular dentoalveolar retrusion and a prominent chin, underwent archwise alveolar distraction in the anterior mandible. Lateral cephalometric radiographs were obtained before distraction (T0), after 6 weeks of consolidation (T1), and after debonding (T2). Linear and angular skeletal, dental, and soft tissue measurements were performed. Forty-seven parameters were measured for each of the 15 subjects on pre- and postoperative lateral cephalometric radiographs (T0, T1, and T2). The distraction protocol was successful in all patients. Skeletally, the mandible showed a clockwise rotation. B-point moved forward significantly (P<0.05). Overjet decreased significantly (P<0.001). The total profile angle was unaffected, and the improvement in the submental fold was highly significant (P<0.001). The intraoral archwise distraction force that is applied through brackets and archwires is sufficiently effective for alveolar advancement. This procedure is simple and effective in the treatment of specific adult patients with a class II division 2 malocclusion, characterized by a prominent chin and severe mandibular dentoalveolar retrusion.

Effects of benzodiazepine on neuromuscular activity performance in archers.

AIM: The aim of the study was to investigate the effects of benzodiazepine on shooting performance and its components in archers. In order to evaluate the possible effects of benzodiazepine, performance related parameters of body sway, mechanical clicker reaction time, aiming behavior and heart rate values were measured. METHODS: Subjects were 24 (10 females and 14 males) archers competing at international events and trained at least 4 years. Each archer was requested to perform under normal, placebo, and the influence of benzodiazepine (diazepam 5 mg, oral). Thus, each archer competed as control, placebo and benzodiazepine under double blind crossover design. The competition was especially designed to simulate competition environment by having archers shooting in doubles each time, on a specifically designed platforms. One platform was mounted on two force plates, where all the data related to shooting and body swaying was collected. The second platform was a dummy platform, to provide the second subject with similar feelings as the subject on the first platform. With this set of data collection, the archers were asked to compete 6 times each in changing rounds, where they had 24 shots in each competition. Repeated measure of ANOVA was used to compare the differences between control, placebo and benzodiazepine shots. RESULTS: Results showed that there was no difference in shooting scores, resting heart rate, shooting heart rate, aiming behavior (aiming displacement in x and y axis on the target), the amount of changes in the center of pressure both in terms of displacement and velocity (front and rear foot), clicker reaction time between control, placebo and 5 mg diazepam administration shots. CONCLUSION: It can be concluded that the use of 5 mg diazepam has no effect on shooting performance and related parameters on archers in an artificially conducted competition environment.

Autoimmune complications associated with hepatitis A virus infection in children.

Hepatitis A virus infection is usually a self-limited disease during childhood. Autoimmune manifestations are rarely reported among patients. We describe two children with acute hepatitis A infection who developed immune thrombocytopenia and hepatic venous thrombosis during the course of acute infection. Antiphospholipid antibodies were increased in both of them during the thrombocytopenic and thrombotic complications and decreased during the resolution of these events.

Blue rubber bleb nevus syndrome.

Blue rubber bleb nevus syndrome is a rare disorder characterized by distinctive cutaneous and gastrointestinal venous malformations that usually cause massive or occult gastrointestinal hemorrhage and iron deficiency anemia secondary to the bleeding episodes. It is even a rare cause of gastrointestinal hemorrhage during childhood. We describe a 6-year-old boy who had multiple venous malformations all over his body. He also suffered from several episodes of melena, chronic anemia, and growth retardation. The endoscopic examination of the gastrointestinal tract revealed multiple bluish-black sessile and polypoid venous malformations in various sizes. It was possible to remove the largest venous malformations causing massive bleeding during colonoscopy.

Congenital microvillus atrophy in a 4-month-old girl.

Congenital microvillus atrophy is a severe generalized enteropathy with ultrastructural abnormalities of the intestinal brush border. It is a rather new clinicopathological entity which needs to be differentiated from other enteropathies within the spectrum of intractable diarrhea of infancy. The presented case was a four-month-old girl with a chronic, intractable diarrhea, beginning at birth. The diagnosis was established only after the electron microscopic examination of small intestinal mucosa which revealed the characteristic features of the disease. Congenital microvillus atrophy is a rare autosomal recessively inherited disorder and bowel transplantation becomes a realistic option of treatment. Therefore, it should be specifically considered in the differential diagnosis of chronic intractable diarrhea of infancy.

Ultrasonographic scoring system: an auxiliary to differential diagnosis of gastric pathologies.

In a prospective clinical study, 64 patients with gastric pathologies (27 malignant and 37 benign) were examined ultrasonographically. Gastric wall layer changes, gastric wall thickness, lesion length, and protrusion into the lumen were evaluated. A scoring system was defined based on the distribution of these parameters and the score of each patient was calculated retrospectively. Six of the malignant cases had scores in the benign range and 3 of the benign cases had scores in the malignant range. Sensitivity of this scoring system in terms of detecting malignancy was 78% and specificity 92%. The positive predictive value was 88%, the negative predictive value was 85%, and overall diagnostic accuracy was 86%. This scoring system was considered to be a useful aid in the differential diagnosis of gastric pathologies.