Effects of intraocular rifampicin on retinal ganglion cell structure: a stereological and histopathological study.

AIM: To determine the histopathological changes of rifampicin applied intravitreally on retinal ganglion cells by means of stereological and histopathological methods. METHODS: For this study twenty-four New Zealand adult rabbits were divided into four groups (n=6 for each group). 50µg/0.1mL (group 1), 100µg/0.1mL (group 2), 150µg/0.1mL (group 3) and 200µg/0.1mL (group 4), rifampicin were injected into the vitreous of the right eyes of animals, their left eyes were used as control (group 5). After the 28(th) day of application, animals were anesthetised with xylazine (8mg/kg, IM) and then their eyes were enucleated immediately. Patterns were taken away and eyes were prepared for both stereological and electromicroscopic observation. RESULTS: Depending on the high dose of rifampicin, some histopathological changes such as cytoplasmic dilatation and damaged membrane were observed on the electromicroscopic level. Using quantitative examination, which was done at the light microscopic level, it was shown that the number of neurons decreased linearly as rifampicin dose increased when compared with the control group. CONCLUSION: Based on these findings, low-dose rifampicin (50µg/0.1mL) may be useful for treatment of the ocular diseases.

[Evaluation of carotis intima media thickness in chronic obstructive pulmonary disease patients]. / Kronik obstrüktif akciger hastaliginda karotis intima mediya kalinliginin degerlendirilmesi.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) and atherosclerosis may occur due to similar risk factors and have a significant cause of morbidity and mortality. In this study to assess the relationship between COPD and atherosclerosis; carotid intima media thickness (CIMT) of COPD patients and adult healthy individuals with normal body mass index and metabolic parameters compared. MATERIALS AND METHODS: 2298 participants aged between 18-92; 46 patients diagnosed with COPD according to clinical features and pulmonary function tests the study, 47 healthy controls who do not have exclusion criteria were evaluated. Doppler ultrasound was performed for the assessment of CIMT to all participants. p values < 0.05 were considered to be significant. RESULTS: Mean CIMT in COPD group and control group were 0.79 ± 0.16 mm and 0.616 ± 0.1 mm, respectively (p< 0.001). In multiple linear regression analysis that made to determine the atherosclerotic risk parameters affecting CIMT; it was found that CIMT was related to age with direct proportion (p= 0.002) and to FEV(1)% with inversely proportion (p= 0.04). In multivariate logistic regression analysis that made to determine the parameters affecting atherosclerosis; we found that any parameters were related with atherosclerosis. CONCLUSION: Persistent low-grade systemic inflammation in COPD and atherosclerotic disease may possibly have been reported a factor in both pathologies. Early atherosclerosis and cardiovascular risks in adults with COPD increase independent of risk factors. CIMT which shows direct proportion with age and inverse proportion with FEV(1)% is a non-invasive, easily applicable and cheap method that can be used in determining the risk of atherosclerosis.

Is obstructive sleep apnea syndrome a risk factor for pulmonary thromboembolism? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In many studies, obstructive sleep apnea (OSA) has been shown to be an independent risk factor for cardiovascular disease. Conversely, there are few reports establishing possible relation between OSA and venous thromboembolism (VTE). In this study, the aim is to evaluate OSA via polysomnography in patients with pulmonary embolism and drawing the attention of clinicians to the presence of obstructive sleep apnea syndrome (OSAS) may be a risk factor for pulmonary embolism.</p><p><b>METHODS</b>Fifty consecutive patients who were diagnosed with pulmonary embolism (PE) were evaluated prospectively for OSAS. Polysomnographic examination was conducted on 30 volunteer patients. The frequency of OSAS in PE was determined and PE cases were compared to each other after being divided into two groups based on the presence of a major risk factor.</p><p><b>RESULTS</b>The study consisted of a total of 30 patients (14 females and 16 males). In 56.7% of the patients (17/30), OSAS was determined. The percent of cases with moderate and severe OSAS (apnea hipoapnea index > 15) was 26.7% (8/30). Patients who had pulmonary thromboembolism (PTE) without any known major VTE risk (n = 20), were compared to patients with VTE risk factors (n = 10), and significantly higher rates of OSAS were seen (70% and 30% respectively; P = 0.045). The mean age of the group with major PE risk factors was lower than the group without major PE risk factors (52 years old and 66 years old, respectively; P = 0.015), however, weight was greater in the group with major PE risk factors (88 kg and 81 kg, respectively; P = 0.025). By multivariate Logistic regression analysis, in the group without any visible major risk factors, the only independent risk factor for PE was OSAS (P = 0.049).</p><p><b>CONCLUSIONS</b>In patients with PTE, OSA rates were much higher than in the general population. Moreover, the rate for patients with clinically significant moderate and severe OSA was quite high. PTE patients with OSA symptoms (not syndromes) and without known major risk factor should be examined for OSA. There seems to be a relationship between OSA and PTE. However, whether this relationship is a causal relationship or a relationship due to common risk factors or long-term complications of OSA is not clear. Further comprehensive studies on those special topics are needed to clarify these points.</p>

The evaluation of Pat-Pat related injuries in the Western Black Sea region of Turkey.

BACKGROUND: Accidents caused by motorized vehicle in the agricultural sector are frequently observed. In Turkey; accidents arising from motorized vehicles, named Pat-Pat, which are used by farmers in the Western Black Sea region is not unusual. METHODS: One hundred five patients who were brought into the Emergency Department of Duzce University, Medical Faculty Hospital between September 2009 and August 2010 due to Pat-Pat related accidents were evaluated. RESULTS: The cases consisted of 73 (69.5%) males and 32 (30.5%) females, ranging from 2 to 73 years of age. In the 10-39 age group, a total of 63 (60.0%) cases were determined. The months when the greatest rate of cases applied to the hospital consisted of July, August, September and the season is summer. The cases were exposed to trauma in roads in 54 (51.4%), and 51 (48.6%) occurred in agricultural area without roads. Eighty seven (82.9%) cases were injured due to the overturning of vehicle. The patients were brought to the hospital using a private vehicle in 54 (51.4%) of the cases and in 51 (48.6%) cases, 112 ambulance system was used. The cases were determined to apply to the hospital most frequently between 6 pm-12 am. The injuries frequently consisted of head-neck and spine traumas, thorax traumas and upper extremity traumas. In 55 (52.4%) cases, open wound-laceration was determined. Seventy five (71.4%) cases were treated in the Emergency Department, and 28 (26.7%) were hospitalized. Three (2.9%) cases were deceased. CONCLUSIONS: Serious injuries can occur in Pat-Pat related accidents, and careful systematic physical examination should be conducted. In order to prevent these accidents, education of farm operators and engineering studies on the mechanics and safety of these vehicles should be taken and legal regulations should be created.

Prevention of pulmonary complications of pneumoperitoneum in rats.

BACKGROUND: Carbon dioxide (CO2) pneumoperitoneum facilitates the visualization of abdominal organs during laparoscopic surgery. However, the associated increase in intra-abdominal pressure causes oxidative stress, which contributes to tissue injury. OBJECTIVE: We investigated the ability of the antioxidant and anti-inflammatory drug Erdosteine to prevent CO2 pneumoperitoneum-induced oxidative stress and inflammatory reactions in a rat model. METHODS: Fourteen female adult Wistar albino rats were divided into a control group (Group A, n = 7) and an Erdosteine group (Group B, n = 7). Group A received 0.5 cc/day 0.9% NaCl, and Group B received 10 mg/kg/day Erdosteine was administered by gavage, and maintained for 7 days prior to the operation. During the surgical procedure, the rats were exposed to CO2 pneumoperitoneum with an intra-abdominal pressure of 15 mmHg for 30 min. The peritoneal gas was then desufflated. The rats were sacrificed following 3 h of insufflation. Their lungs were removed, histologically evaluated, and scored for intra-alveolar hemorrhage, alveolar edema, congestion, and leukocyte infiltration. The results were statistically analyzed. A value of P < 0.05 was considered statistically significant. RESULTS: Significant differences were detected in intra-alveolar hemorrhage (P < 0.05), congestion (P < 0.001), and leukocyte infiltration (P < 0.001) in Group A compared with Group B. However, the differences in alveolar edema were not statistically significant (P = 0.698). CONCLUSIONS: CO2 pneumoperitoneum results in oxidative injury to lung tissue, and administration of Erdosteine reduces the severity of pathological changes. Therefore, Erdosteine may be a useful preventive and therapeutic agent for CO2 pneumoperitoneum-induced oxidative stress in laparoscopic surgery.

Poor-quality sleep score is an independent predictor of nondipping hypertension.

OBJECTIVE: We aimed to investigate whether there was any association between the nondipping status and sleep quality in relatively young patients with an initial diagnosis of hypertension. METHODS: One hundred and thirty-three consecutive patients, diagnosed to have stage 1 hypertension by their primary physicians, were referred to our study. Patients with a history of use of any antihypertensive medication were excluded. Eligible patients underwent the Pittsburgh Sleep Quality Index (PSQI) survey, which has an established role in evaluating sleep disturbances. All patients underwent ambulatory blood pressure monitoring. RESULTS: There were 71 nondipper patients (mean age 44.3+/-5.3 years, 33 male/38 female) and 62 dipper hypertensive patients (mean age 43.3+/-6.3 years, 27 male/35 female). The PSQI scores, globally, were significantly higher in the nondippers compared with the dippers. It was noticed that all the components of the PSQI (sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction) were significantly higher in the nondippers. Correlation analysis showed that systolic blood pressure fall at night was inversely and significantly related with the PSQI (r=-0.46, P<0.001). Logistic regression analysis showed that the PSQI score is an independent determinant for nondipping hypertension (HT) {odds ratio=0.842 [95% confidence interval (CI)=0.748-0.947; P=0.004]}. CONCLUSION: We showed that poor sleep quality was related with a nondipping pattern, and furthermore, it was an independent predictor of nondipping in newly diagnosed stage 1 hypertensive patients.

Echocardiographic manifestations of pandemic 2009 (H1N1) influenza a virus infection.

UNLABELLED: SUMMARY AIM: The prevalence of myocardial involvement in influenza infection ranges from 0% to 12% depending on the diagnostic criteria used to define myocarditis. Whether such an association holds for the novel influenza A strain, pandemic-2009-H1N1, remains unknown. The aim of this present study is to evaluate the cardiovascular manifestations of pandemic (H1N1) 2009 influenza A (pH1N1) by using standard echocardiography and tissue Doppler imaging (TDI). METHODS: Twenty-eight young patients who had been hospitalized for at least 24 h due to an influenza-like illness and tested positive for pH1N1 by real-time polymerase chain reaction were included in the study. All patients underwent echocardiographic studies during the first 72 h of admission. Echocardiographic studies of thirty gender and age matched control subjects were performed and the results were compared. RESULTS: Heart rate was significantly higher in patients infected with pH1N1 virus. Other clinical variables were similar between the two groups (p > 0.05). Echocardiographic variables were also similar except left ventricular end-systolic dimension, which was significantly increased in the patient group (P = 0.042). Left ventricular tissue Doppler assessment at mitral annulus showed that mean systolic velocities of pH1N1 infected patients and control group were statistically similar. However, early diastolic velocity was decreased and late diastolic velocity was increased in the patient group. Therefore early diastolic/late diastolic velocity ratio was significantly decreased in pH1N1 infected patients. Also, isovolumetric contraction time and isovolumetric relaxation time were prolonged and ejection time was significantly shortened in pH1N1 infected patients. As a result, global myocardial performance index was significantly higher in pH1N1 infected patients (p < 0.001). Right ventricular tissue Doppler assessment at tricuspid annulus showed similar results with the left ventricular measurements. CONCLUSION: The results of the study suggest an association between hospitalized pH1N1 and subclinical cardiac dysfunction as measured by tissue Doppler echocardiography.