Auditory and Histopathological Effects of Topical Mercurochrome Treatment in Rats with Tympanic Membrane Perforation.

OBJECTIVES: Topical treatment is first choice in the treatment of uncomplicated chronic otitis media. It was intended to assess auditory and histopathological safety of ototopical use of mercurochrome solution in rats with induced tympanic membrane perforation. MATERIALS AND METHODS: The study was conducted on 21 female Wistar-Albino rats which were randomly assigned into 3 groups. In all rats, perforation was performed at right tympanic membrane. Distortion product otoacoustic emissions (DPOAEs) measurements were performed at frequencies of 2000, 3000 and 4000 Hz (with L1/L2: 70 /70 dB at 2f1-f2 frequency; f2/f1 ratio: 1:22) before recovery from anesthesia and signal-to-noise ratio (SNR) were recorded. Normal saline, 2% mercurochrome and gentamicin were given to group 1, 2 and 3 twice daily over a week, respectively. Rats were sacrificed after DPOAE measurements on day 14. Right temporal bone specimens were examined under light microscope after processing. RESULTS: Based on DPOAE results, there was no significant difference among groups before treatment. On day 14, significant differences were found in DPOAE measurements at 3000 and 4000 Hz, and in mean SNR values in 2% mercurochrome and gentamicin groups when compared to normal saline group while no significant difference was detected at 2000 Hz among groups. In addition, significant degeneration was detected in Corti organs, spiral ganglions and stria vascularis in groups 2 and 3. CONCLUSION: In this study, it was observed that mercurochrome use in external otitis and otitis media with tympanic membrane perforation could cause ototoxicity and concluded that the solution should be used cautiously.

Audiological Results of Total Ossicular Replacement Prosthesis with Cartilage Shoe Technique.

OBJECTIVE: The aim of this study was to investigate functional results of total ossicular replacement prosthesis (TORP) shaft stabilization with a cartilage shoe in chronic otitis media patients with cholesteatoma who had undergone canal wall down tympanomastoidectomy (CWDT). In addition, it was determined whether the presence of granular and edematous mucosa in middle ear altered functional outcomes. METHODS: Sixty patients, who had undergone CWDT with the use of TORP for the reconstruction of ossicular chain, were divided into two groups. Patients with cartilage shoe were classified as Group 1 (n=30) and those without the shoe were classified as Group 2 (n=30). Patients in both groups were classified into "A" and "B" subgroups according to the middle ear risk index (MERI). Air conduction (AC) and bone conduction thresholds were evaluated preoperatively and postoperatively. RESULTS: There was no statistically significant change between preoperative AC thresholds of the groups and subgroups (p>0.05). There were statistically significant differences regarding AC thresholds and air-bone gap (ABG) values between Groups 1 and 2 at the postoperative 12th month (p<0.05). Postoperative AC thresholds and ABG values of Group 1B patients with a high MERI score were statistically significant at all frequencies than those of Group 2B patients (p<0.05). When ABG values were compared, it was observed that functional results were better in Group 1B, but a statistically significant difference was observed only at 2000 Hz (p<0.01). CONCLUSION: The cartilage shoe method for titanium TORP stabilization that is used for ossicular reconstruction during CWDT has been found to have a beneficial effect on auditory outcomes. Cartilage shoe application increases positive effects on hearing outcomes, particularly if the middle ear mucosa is granular and edematous.

Falsely Elevated Glucose Concentrations in Peritoneal Dialysis Patients Using Icodextrin.

BACKGROUND: Peritoneal dialysis (PD) is used as an alternative to hemodialysis in end-stage renal disease (ESRD). Icodextrin has been used as a hyperosmotic agent in PD. The aim of the study was to assess two different point-of-care testing (POCT) glucose strips, affected and not affected by icodextrin, with serum glucose concentrations of the patients using and not using icodextrin. METHODS: Fifty-two chronic ambulatory peritoneal dialysis (CAPD) patients using icodextrin (Extraneal®) and 20 CAPD patients using another hyperosmotic fluid (Dianeal®) were included in the study. Duplicate capillary and serum glucose concentrations were measured with two different POCT glucose strips and central laboratory hexokinase method. Assay principles of glucose strips were based on glucose dehydrogenase-pyrroloquinoline quinone (GDH-PQQ) and a mutant variant of GDH (Mut Q-GDH). The results of both strips were compared with those of hexokinase method. RESULTS: Regression equations between POCT and hexokinase methods in icodextrin group were y = 2.55x + 1.12 mmol/l and y = 1.057x + 0.16 mmol/l for the GDH-PQQ and Mut Q-GDH methods, respectively. The mean difference between the results of hexokinase and those of GDH-PQQ and Mut Q-GDH in icodextrin group was 3.41 ± 1.56 and 0.72 ± 0.64 mmol/l, respectively. However, the mean differences were found much lower in the control group; 0.64 mmol/l for GDH-PQQ and 0.52 mmol/l for Mut Q-GDH. CONCLUSION: Compared to GDH-PQQ, glucose strips of Mut Q-GDH correlated better with hexokinase method in PD patients using icodextrin.

Can routine automated urinalysis reduce culture requests?

OBJECTIVES: There are a substantial number of unnecessary urine culture requests. We aimed to investigate whether urine dipstick and microscopy results could accurately rule out urinary tract infection (UTI) without urine culture. DESIGN AND METHODS: The study included a total of 32,998 patients (11,928 men and 21,070 women, mean age: 39 ± 32 years) with a preliminary diagnosis of UTI and both urinalysis and urinary culture were requested. All urine cultures were retrospectively reviewed; association of culture positivity with a positive urinalysis result for leukocyte esterase (LE) and nitrite in chemical analysis and pyuria (WBC) and bacteriuria in microscopy was determined. Diagnostic performance of urinalysis parameters for detection of UTI was evaluated. RESULTS: In total, 758 (2.3%) patients were positive by urine culture. Out of these culture positive samples, ratios of positive dipstick results for LE and nitrite were 71.0% (n=538) and 17.7% (n=134), respectively. The positive microscopy results for WBC and bacteria were 68.2% (n=517) and 78.8% (n=597), respectively. Negative predictive values for LE, nitrite, bacteriuria and WBC were very close to 100%. CONCLUSIONS: Most of the samples have no or insignificant bacterial growth. Urine dipstick and microscopy can accurately rule out UTI. Automated urinalysis is a practicable and faster screening test which may prevent unnecessary culture requests for majority of patients.