The use of an ostial stent does not increase the success rate of endoscopic dacryocystorhinostomy.

OBJECTIVE: This prospective, controlled study assessed how placing a stent into a newly formed ostium affects ostial patency, success and complication rates in endoscopic dacryocystorhinostomy patients. METHODS: In group 1 (40 eyes of 36 patients), both silicone tube intubation and tube stenting were performed. In group 2 (36 eyes of 34 patients), only silicone tube intubation was performed. Success, operative time and post-surgical complications were investigated two months post-operatively in each group. RESULTS: The success rates were 92.5 per cent and 83.3 per cent for groups 1 and 2 respectively, but the difference was not statistically significant (p = 0.294). The complication rates also differed between the two groups, but this was again insignificant. CONCLUSION: Compared with the use of a silicone tube alone, the addition of an ostial stent did not significantly increase the success rate of endoscopic dacryocystorhinostomy.

Long-term effects of allergen-specific subcutaneous immunotherapy for house dust mite induced allergic rhinitis.

BACKGROUND: Allergic rhinitis is strongly associated with the presence of house dust mites. This study investigated the long-term effects of allergen-specific immunotherapy. Allergen-specific immunotherapy was applied over three years. The study was based on a 10-year follow up of patients with allergic rhinitis. METHODS: The study was conducted between 2001 and 2015. Skin prick test results and symptom scores were evaluated before (26 patients) and after 3 years (20 patients) of allergen-specific immunotherapy (using data from a previously published study), and 10 years after allergen-specific immunotherapy had ended (20 of 26 patients). RESULTS: The symptom scores before allergen-specific immunotherapy were significantly higher than those obtained after 3 years of allergen-specific immunotherapy and 10 years after allergen-specific immunotherapy (p 0.0175). CONCLUSION: Subcutaneous immunotherapy is an effective treatment for house dust mite induced allergic rhinitis.

Oxidative stress status in congenital hypogonadism: an appraisal.

Patients with hypogonadism are at increased risk of cardiac and metabolic diseases. However, the pathogenesis of increased cardiometabolic risk in patients with hypogonadism is not clear. Oxidative stress plays an important role in the pathogenesis of cardiometabolic diseases. This study aimed to investigate possible differences in oxidative stress conditions between patients with hypogonadism and healthy controls. In this study, 38 male patients with congenital hypogonadotropic hypogonadism (CHH) (mean age: 21.7 ± 1.6 years) and 44 healthy male controls (mean age: 22.3 ± 1.4 years) with almost equal body mass index were enrolled. The demographic parameters, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total and free testosterone, homeostatic model assessment of insulin resistance (HOMA-IR) and oxidative stress parameters, such as superoxide dismutase, catalase (CAT), glutathione peroxidase (GPx) and malondialdehyde (MDA), were compared between both groups. Compared to the healthy controls, triglycerides (p = .02), insulin levels, HOMA-IR values, CAT activities and MDA levels (p < .001 for all) were significantly higher and HDL cholesterol (p = .04), total and free testosterone, FSH, LH levels and GPx activity were significantly lower (p < .001 for all) in patients with CHH. There were significant correlations between total testosterone levels and CAT activity (r = -.33 p = .01), GPx activity (r = .36 p = .007) and MDA (r = -.47 p < .001) levels. The results of this study showed that young and treatment-naïve patients with congenital hypogonadism had an increased status of oxidative stress.

Comparison of the effects of nasal steroids and montelukast on olfactory functions in patients with allergic rhinitis.

OBJECTIVE: Olfactory dysfunction is one of the comorbidities associated with allergic rhinitis (AR) and AR is one of the common causes of olfactory problems. We aimed to evaluate by the Sniffin' Sticks test the effects on olfactory functions of nasal steroids and leukotriene antagonists used for allergic rhinitis. METHODS: Thirty patients with seasonal rhinitis were included in this study. Patients were randomly divided into three groups of 10 patients; group 1 received montelukast sodium and mometasone furoate (MF) therapy, group 2 received only montelukast, and group 3 only MF. Patients' olfactory functions were determined using the Sniffin' Sticks olfactory test before and after a month treatment. RESULTS: Threshold, discrimination, identification, and the sum of threshold, discrimination, and identification (TDI) values were not significantly different among the groups before treatment. For Group 1 and Group 3 patients, there were statistically significant differences in threshold, discrimination, identification, and TDI values before and after treatment (P<0.05) (Wilcoxon signed ranks analysis). For Group 2 patients, the before and after treatment values of threshold, discrimination, identification, and TDI showed no significant difference (P>0.05). CONCLUSION: According to the findings of our study, MF is superior to montelukast in improving olfactory function. Although montelukast has been shown to be effective against AR symptoms, its effect on olfactory function was not demonstrated in this study.

The impact of ethical climate types on nurses' behaviors in Bosnia and Herzegovina.

BACKGROUND: The performance of nurses has become vital in hospitals. Some studies have suggested that nurses' perceptions of the ethical climate in their hospitals are related to higher job satisfaction and organizational commitment and in turn lessen the issue of nursing shortage. HYPOTHESIS: (1) The ethical climate types "caring," "independent," "law and code," and "rules" have a significant positive impact on overall job satisfaction. (2) The ethical climate types and overall job satisfaction have significant positive influences on normative and affective and significant negative influences on continuance commitment. RESEARCH DESIGN: The study uses path analysis to understand which types of ethical climate impact overall job satisfaction. It also tries to find the effect of different types of ethical climate and overall job satisfaction on the components of organizational commitment. The relationships between variables were evaluated using factor analysis, reliability, descriptive statistics, correlations, and regression in this study. Participants and research context: A total of 171 useful questionnaires were collected from nurses working in public and private hospitals in Bosnia and Herzegovina. Ethical considerations: Formal research approval was obtained from the administration of each study hospital. Questionnaires with a cover letter were mailed to the hospitals that agreed to participate in the study. In the cover letter, the researchers explained the study purpose, encouraged nurses' voluntary participation, and guaranteed the anonymity of participants. FINDINGS: In the first path analyses, "rules" and "caring" climates significantly and positively affected overall job satisfaction. In the second one, while overall job satisfaction and "rules" climate significantly influenced normative commitment, "caring" climate and overall job satisfaction significantly affected affective commitment. DISCUSSION: The findings of the study have been convenient with the literature. CONCLUSION: Public and private hospitals can enhance overall job satisfaction and organizational commitment by altering the ethical climate of organizations. Hospital administrations should nurture caring and rule types of ethical climate which influence overall satisfaction. By this way, they could reduce nursing shortage.

Evaluation of halitosis using OralChroma™ in patients with allergic rhinitis.

OBJECTIVE: The objective of this study was to evaluate the occurrence of halitosis in patients with allergic rhinitis (AR). MATERIALS AND METHODS: In this study, we enrolled 53 patients with AR and 34 participants as controls. Halitosis was evaluated by measuring volatile sulphur compound (VSC) levels. VSCs, which consist of hydrogen sulphide (HS), methyl mercaptan (MM), and dimethyl sulphide (DMS), were measured using a portable gas chromatograph (OralChroma™; AbiMedical, Osaka, Japan). RESULTS: Patients with AR exhibited significantly higher levels of MM and DMS that did control subjects. Specifically, MM levels showed a greater increase than DMS levels in patients with AR than in controls. We observed no significant changes in the levels of HS between the groups. CONCLUSION: This study demonstrated that AR is likely to result in halitosis. Several studies have overlooked the relationship between halitosis and AR. In light of our results, we suggest that halitosis should be further investigated in patients with AR.

Thiol/disulphide homeostasis as a novel indicator of oxidative stress in sudden sensorineural hearing loss.

OBJECTIVES: To investigate a novel oxidative stress marker, thiol/disulphide literature homeostasis, in patients with idiopathic sudden sensorineural hearing loss, and to compare the results with healthy controls for the first time. METHODS: Thirty-two patients with idiopathic sudden sensorineural hearing loss and 30 healthy individuals were included in the study. Serum native thiol, total thiol and disulphide levels were measured, and disulphide/native thiol and disulphide/total thiol ratios were determined in all subjects. RESULTS: Serum native thiol and total thiol levels were significantly lower in patients with sudden sensorineural hearing loss compared with controls (p < 0.05). Of the 32 patients, 25 had lower native thiol levels than controls (333.2 ± 73.9 vs 381.8 ± 35.6 µmol/l, p = 0.002) and 24 had lower total thiol levels (375.1 ± 74.3 vs 426.1 ± 39.3 µmol/l, p = 0.002). CONCLUSION: The changes in oxidative markers evident in a significant number of patients may be associated with oxidative stress, which may, in turn, have caused sudden sensorineural hearing loss in those patients.

Trace Element Levels in Congenital Hypogonadotrophic Hypogonadism.

Cardiometabolic diseases are prevalent in hypogonadism. The pathophysiologic mechanism of increased cardiometabolic risk in hypogonadal patients is not clear. Recently, trace elements have been linked to the development of chronic disease especially cardiovascular disease. We investigated the trace element levels in an unconfounded population of congenital hypogonadotrophic hypogonadism (CHH) and also searched for the relationship with metabolic risk factors. A total of 89 patients with CHH (mean age 21.8 ± 2.0 years) and 80 healthy control subjects (mean age 21.3 ± 1.1 years) were enrolled. The demographic parameters, homeostatic model assessment of insulin resistance (HOMA-IR) levels and plasma zinc, copper, and selenium levels, were measured in patients and healthy controls. The patients had higher waist circumferences (p = 0.014), triglyceride (p = 0.04), insulin (p = 0.004), HOMA-IR levels (p = 0.001), and lower selenium (p = 0.049), zinc (p = 0.004), and copper (p = 0.012) levels when compared to the healthy controls. There was a significant relationship between zinc levels and HOMA-IR levels (p = 0.015). In the regression analysis, zinc levels were independently associated with the calculated HOMA-IR levels (p = 0.015). The results of the present study show that plasma selenium, zinc, and copper levels are decreased in patients with CHH. Also, plasma zinc levels are independently associated with insulin resistance in patients with hypogonadism. Long-term follow-up studies are warranted to investigate the effect of trace elements on the increased cardiometabolic risk in hypogonadism.

Inhibitor-assisted synthesis of silica-core microbeads with pepsin-imprinted nanoshells.

A novel approach for molecularly imprinting proteins, i.e. inhibitor-assisted imprinting, onto silica microspheres is discussed, which provides advanced functional materials addressing prevalent challenges in the field of protein purification and isolation from biotechnologically relevant media. Pepstatin-assisted surface-imprinted core-shell microbeads for the acidic protease pepsin were synthesized serving as selective sorbent materials for solid phase extraction (SPE) applications. The inorganic core, i.e. amino-functionalized silica spheres (AFSS), is prepared by the co-condensation of tetraethylorthosilicate (TEOS) and (3-aminopropyl) trimethoxysilane (APTMS) in water-in-oil (W/O) emulsion, which is then reacted with pepstatin, a selective inhibitor of pepsin, onto the surface of the AFSS via an amide bond. 3-Aminophenylboronic acid (APBA) serves as the functional monomer for establishing nanothin imprinted polymer films, i.e. poly(3-aminophenylboronic acid) (pAPBA) at the surface of the pepstatin-immobilized AFSS via oxidation by ammonium persulfate in aqueous solution in the presence (molecularly imprinted polymer, MIP) and absence (non-imprinted polymer; NIP) of pepsin. Thus obtained core-shell microbeads are packaged into SPE cartridges for evaluating the selectivity for pepsin. Each individual synthesis step is thoroughly characterized using x-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and BET methods. Finally, the imprinted core-shell microbeads indeed provide specific binding.

Analysis of lung metastases in patients with primary extremity sarcoma.

PURPOSE: To investigate the incidence, radiographic findings, and the time course for the appearence of lung metastases from primary extremity sarcoma. PATIENTS AND METHODS: Four-hundred patients with extremity sarcoma were evaluated retrospectively for lung metastases. Multiple clinical factors were analyzed for possible influence on the metastases-free interval and subsequent metastases development. Radiographic findings of metastases were also reviewed. RESULTS: Ninety of 400 patients (23%) developed lung metastases. Median time from presentation to detection of metastasis was 8.0 +/- 1.1 months (95% CI: 6.02-9.98). More than 75% of patients developed metastases within 1 year after presentation of the primary sarcoma. As disease grade increased, the metastases-free intervals shortened significantly. Histologically, synoviosarcoma and osteogenic sarcoma were more often associated with the development of lung metastases. In this subgroup, 54 patients (60%), the presence of solitary (11) or multiple (43) nodular metastases was the only radiological finding. In 36 of 90 patients (40%), parenchymal mass, pleural effusion, hilar lymphadenopathy and pneumothorax were found. CONCLUSIONS: Twenty-three percent of patients in our study developed lung metastases. As the grade of the disease increased, metastases-free intervals are shortened. Although it has been reported that lung metastases in patients with extremity sarcomas may present as solitary or multiple nodules in earlier trials with radiographic screening methods, the current review of 400 patients found that a substantial number of patients may present radiological appearances other than nodular formations.

Decreased osteocalcin levels in patients with chronic obstructive pulmonary disease using long-term inhaled beclomethasone dipropionate.

Inhaled corticosteroids have been used in the treatment of chronic obstructive pulmonary disease (COPD) for many years. However the adverse effects of corticosteroids on bone formation may require special consideration in these patients. This study was undertaken to investigate the effects of long-term inhaled beclomethasone dipropionate treatment on the biochemical markers of bone formation. For this purpose, serum osteocalcin, alkaline phosphatase, free calcium, and inorganic phosphate levels were measured in 65 male COPD patients. Patients in the control group (n = 30) had not taken oral or inhaled corticosteroids for at least 1 year. Only those patients using beclomethasone with metered-dose inhalers were included in the treatment group (n = 35). The mean age of the control group was 61.63 +/- 1.84 (mean +/- SEM). In the treatment group, the mean age was 59.10 +/- 2.29 and patients in this group had taken beclomethasone for an average time of 23.94 +/- 2.72 months (for at least 12 months) at an average concentration of 1,142.0 +/- 79.64 microg/d. The mean serum osteocalcin levels in the control group and treatment group were 7.03 +/- 0.19 ng/mL and 3.74 +/- 0.12 ng/mL, respectively. Comparison of values between groups indicates that serum osteocalcin levels in patients using beclomethasone were significantly lower than that of patients in the control group. Serum alkaline phosphatase levels were 167.96 +/- 1.49 U/L and 168.17 +/- 1.60 U/L for the control and treatment groups, respectively. There was no statistically significant difference among these values (Student's t test; P >.05). The mean values of total serum calcium and inorganic phosphate were not statistically different between the groups (P >.05). These results indicate that long-term inhaled beclomethasone treatment in COPD patients may induce significant changes in osteocalcin levels and require close monitoring for osteoporotic changes.

Effects of (+) and (-) enantiomers of calcium channel agonist, Bay K 8644, on mechanical and electrical responses of frog skeletal muscle.

The effects of (+) and (-) enantiomers of Bay K 8644, a Ca2+ channel agonist, on the mechanical and electrical properties of frog skeletal muscle fibers were investigated. In the concentration range of 10(-6) to 10(-5) M, both (+) and (-) enantiomers of Bay K 8644 significantly increased the maximum amplitudes of twitch responses. Both (+) and (-) enantiomers of Bay K 8644, at higher concentrations such as 10(-4) M, greatly depressed the amplitudes of twitches. Potentiating and depressing effects of (-) enantiomer of Bay K 8644 on twitch responses were significantly greater than those of the (+) enantiomer. At all concentrations used, both (+) and (-) enantiomers of Bay K 8644 significantly decreased the area under the tetanic force x time curve. In intracellular recordings, it was found that the depressing effects of both (+) and (-)-Bay K 8644 on tetanic contractions and twitch responses were due to the inhibition of action potentials. The inhibitory effect of (-) enantiomer of Bay K 8644 on action potentials also was significantly greater than that of the (+) enantiomer. In conclusion, present results suggest that, in contrast with cardiac muscle fibers, (+) and (-) enantiomers of Bay K 8644 have similar inhibitory effects on the electrical and mechanical properties of frog skeletal muscle fibers.

The role of extracellular calcium in the pathophysiology of myotonic dystrophy.

Increased intracellular calcium levels in myotonic dystrophy have been repeatedly reported in many studies. In our recent investigations, the entrance of extracellular calcium ions through voltage sensitive calcium channels (VSCCS) during repetitive action potentials and late after potentials (LAPs) in tetanic responses were found. Since there is an increased amplitude of LAPs and after-discharges in muscle fibers of myotonic dystrophy, we suggest that this pathological increase in the electrical properties of the muscle could also be responsible for this elevated intracellular calcium level.