bluuebunny/crossref_metadata_2025 huggingface dataset:
Reference Values of Umbilical Cord and Third-Day Cystatin C Levels for Determining Glomerular Filtration Rates in Newborns
Authors: Bahar A , Yilmaz Y , Unver S , Gocmen I , Karademir F
Published: February 2013

The aim of this study was to determine reference values for serum cystatin C at, and 3 days after, birth, and to determine if the concentration was influenced by gender, gestational age or bilirubin level. Umbilical cord and peripheral venous blood was taken, and serum cystatin C, creatinine, and total and direct bilirubin levels were measured. The mean concentration of cystatin C was not significantly different between cord blood and blood taken on day 3 (1.36 ± 0.35 mg/l and 1.35 ± 0.33mg/l, respectively). Comparison of subgroups, divided by gender, duration of gestation and bilirubin levels, using the Mann-Whitney U-test and Wilcoxon analysis, showed no effect of these parameters on cystatin C levels.
Brugada-Like Electrocardiographic Changes during Influenza Infection
Authors: Kusaka K , Yamakawa J , Kawaura K , Itoh T , Takahashi T , Ishii R , Kanda T
Published: February 2013

We describe a 32-year-old man with electrocardiographic (ECG) changes consistent with Brugada syndrome and influenza virus infection. The ECG pattern changed after 1 week to one of early repolarization in V1 and V2. This case suggests an association between Brugada syndrome and viral infection.
Re-Operation after Lumbar Disc Surgery: Results in 85 Cases
Authors: Kayaoglu CR , Calikoğlu C , Binler S
Published: February 2013

In this retrospective study, 85 patients previously operated on for lumbar disc herniation who had undergone reoperation due to persistent pain or recurrence of the symptoms were investigated. The surgical findings were: recurrent herniation (20%), epidural fibrosis alone (36.4%), small recurrent herniation with epidural fibrosis (28.2%), herniation at another level (10.6%), spinal stenosis (2.4%), lumbar pseudomeningocele (1.2%) and adhesive arachnoiditis (1.2%). The overall success rate of re-operation was 60%. The best results were obtained in recurrent disc herniation (47.1% excellent and 35.3% good results) and in herniation at another level (77.8% excellent and 22.2% good). Re-operation in epidural fibrosis had less-satisfactory results (29.1% excellent and 12.9% good).
A Clinical Study of Oral Mucous Membrane Pemphigoid
Authors: Alkan A , Günhan Ö , Alkan A , Otan F
Published: February 2013

We present 13 cases of oral mucous membrane pemphigoid (MMP) and review the literature. The cases were retrieved from the archives of Ondokuz Mayis University and Gülhane Military Medical Academy, Turkey, between 1997 and 2002. Inclusion criteria were clinical findings of oral MMP verified by histological and immunofluorescent examination. Thirteen patients (two males and 11 females), aged 16–72 years, were identified. Involvement was confined to the mouth in all cases except one, in which the conjunctiva was also affected. Two individuals in the study were < 20 years old, an age group rarely affected. The oral mucosa is often the initial site of MMP lesions, so it is important that dentists as well as physicians are aware of the symptoms and signs. A swift diagnosis, made in consultation with other specialists such as ophthalmologists and dermatologists, is needed in order to prevent a delay in treatment.
Demographics, Treatment Regimens and the Use of Angiotensin-Receptor Blockers in Heart Failure: Findings from the Valsartan Heart Failure Trial
Authors: Majahalme S
Published: February 2013

Heart failure is the only major cardiovascular disease with an incidence and prevalence that continue to increase in the developed world. Early identification and correct treatment of the condition are of paramount importance. In recent years, there has been growing interest in identifying the differences between patients in terms of their risk of heart failure and response to treatment. Differences between men and women, different age groups, patients with varying aetiologies or co-morbidities and differences between ethnic groups are only some of the factors that have been identified. This review surveys the available data on differences in responses to treatment, and discusses the use of angiotensin-receptor blockers in heart failure in light of the recent Valsartan Heart Failure Trial (Val-HeFT).

Conclusion: Heart failure is a complex syndrome, a fact that is reflected in the wide spectrum of patient characteristics and breadth of treatments available to physicians. Recommendations will keep evolving as we learn more about the changing aetiology and manifestations of the disease, and as new data become available on old and emerging treatments. The recent addition of ARBs (or at least valsartan) to the list of drugs of benefit in HF is a welcome development. Perhaps the most important message from Val-HeFT is that valsartan significantly reduced the risk of a first morbid event, irrespective of most underlying physiological and demographic parameters. This implies that valsartan will be beneficial in most patients, whether they are old or young, male or female and whatever the aetiology of their HF. As polypharmacy will continue to be the therapy of choice in HF and as no wonder-drug seems to be on the horizon to make the concept obsolete, further blocking the RAS by adding a well-tolerated agent would seem a very welcome expansion of our current treatment options.
Adhesion Preventive Effect of a Novel Hyaluronic Acid Gel Film in Rats
Authors: Himeda Y , Yanagi S , Kakema T , Fujita F , Umeda T , Miyoshi T
Published: February 2013

This study evaluated the efficacy of a novel hyaluronic acid (HA) gel for preventing adhesions in a rat caecal model. The gel was manufactured from an acidic HA solution using a freezing procedure. HA gel films with four different half-lives (50-200 h) in physiological buffered saline at 37 °C were prepared, by regulating the freezing time, and tested. The HA gel film was applied as a barrier on the injured caecal surface after standardized treatment with a rotary abrasion apparatus. A control group of 20 animals were abraded in the same way but not treated. Seven days after the initial operation, the incidence and severity of any adhesions were recorded. Application of the HA gel film significantly reduced the incidence and severity of adhesion formation in all treatment groups compared with the control group. This novel HA gel film is effective for reducing post-operative adhesions in this rat model and the resorption rate is optimum for adhesion prevention on the caecal surface.
An Open-Label Study Investigating the Efficacy and Safety of 12–96 Weeks of Telmisartan Treatment in Patients with Hypertension
Authors: Ingino C , Farsang C , Laucevicius A , Bergovec M
Published: February 2013

This open-label, multicentre, multinational trial evaluated the efficacy and safety of telmisartan used alone or as add-on therapy in 2121 adults with mild-to-moderate essential hypertension. Patients received telmisartan 40-80 mg once daily for 12 weeks and could participate in the study for up to 96 weeks, or until a marketed supply of telmisartan became available. Mean change from baseline in mean seated trough diastolic blood pressure (DBP) after 12 weeks' treatment, the primary endpoint, was −11.8 mmHg in the intent-to-treat population. The corresponding mean change in mean seated trough systolic blood pressure (SBP) was −20.2 mmHg. Both changes were statistically significant. Mean DBP and SBP reductions were apparent from week 4 and maintained throughout the treatment period. Telmisartan was well tolerated; the most common adverse events were headache (6%) and dizziness (3%), and 10% of adverse events were considered drug-related. In conclusion, telmisartan is an effective and well-tolerated drug when used as monotherapy or add-on treatment in this broad population of patients.
Protein C Inhibitor and Serum Amyloid a in Immune Thrombocytopaenic Purpura
Authors: Sayinalp N , Haznedaroğlu IC , Büyükaşik Y , Göker H , Aksu S , Koçoğlu H , Özcebe OI , Koşar A , Kirazli Ş , Dündar SV
Published: February 2013

In immune thrombocytopaenic purpura (ITP), phagocytic cells prematurely destroy platelets opsonized by anti-platelet auto-antibodies, while residual platelets rescued from these autoimmune attacks are hyperfunctioning. The exact pathobiological basis of this phenomenon is unknown. Protein C inhibitor (PCI), a platelet α-granule pro-coagulant molecule, is released on activation of platelets. Serum amyloid A (SAA; an acute phase protein), however, inhibits platelet aggregation and modulates platelet adhesion. We aimed to assess circulating soluble plasma PCI and SAA concentrations in 17 patients with newly diagnosed ITP and ten healthy volunteers. Plasma PCI concentrations tended to be higher in ITP patients, despite absolute thrombocytopaenia, than in normal controls. SAA levels were significantly higher in ITP patients compared with the control group. We conclude that secretion of the α-granule PCI content of platelets could result from platelet activation, and that PCI may be the link between platelet microparticles and haemostatically active ITP platelets. Increased concentrations of SAA and PCI may interfere with the disordered and compensatory pro-coagulant mechanisms of ITP.
Histopathological Safety Evaluation of Polyethylene Glycol Applied Subcutaneously in Mice
Authors: Kawakami T , Mizoguchi T , Matsuura S , Shimizu T , Kurihara S , Ito M , Kawai T
Published: February 2013

Polyethylene glycol is used as a nonaqueous solvent for a variety of medical agents. We believe it could also be used as a base component in root canal filling material and aimed to test the histological safety of subcutaneously injected polyethylene glycol. We injected polyethylene glycol subcutaneously into the dorsal area of 30 6-week-old anaesthetized male ddY mice. An equal number of mice were injected with propylene glycol as controls. One week, 3 weeks and 9 weeks after injection, the tissue surrounding the injection site was removed from 10 mice in each group and examined. We found no histopathological changes, degeneration, necrosis, foreign body reactions or granulation tissue proliferation in either group. Some inflammatory cell infiltration was observed in both groups. Based on these results, we believe that polyethylene glycol could be used safely as a base component of biomaterials for internal medical use, such as in root canal filling material.
Effect of the Serotonin Blocker Sarpogrelate on Circulating Interleukin-18 Levels in Patients with Diabetes and Arteriosclerosis Obliterans
Authors: Yamakawa J , Takahashi T , Saegusa S , Moriya J , Itoh T , Kusaka K , Kawaura K , Wang XQ , Kanda T
Published: February 2013

We aimed to evaluate the effect of treatment with sarpogrelate, a serotonin 2A receptor antagonist, on circulating interleukin (IL)-18 levels in patients with diabetes and arteriosclerosis obliterans. Patients received sarpogrelate (100 mg 3 times daily) for 2 months. We evaluated the degree of cryaesthesia (a feeling of cold in the foot and toes) as the clinical outcome, and measured circulating IL-18, IL-6 and lipid protein concentrations. An improvement in clinical outcome occurred after initiation of sarpogrelate therapy;a significant decrease in IL-18 levels was observed after 2 months of therapy. Levels of IL-6 and lipid proteins, including triglyceride, total cholesterol and high-density lipoprotein cholesterol, were not significantly altered by treatment. Our data suggest that by reducing circulating IL-18 levels, sarpogrelate treatment may contribute to the inhibition of arteriosclerosis obliterans progression in patients with diabetes.
Antioxidant Effect of a New Calcium Antagonist, Azelnidipine, in Cultured Human Arterial Endothelial Cells
Authors: Shinomiya K , Mizushige K , Fukunaga M , Masugata H , Ohmori K , Kohno M , Senda S
Published: February 2013

Azelnidipine is a novel dihydropyridine-type calcium antagonist with long-acting anti-hypertensive action and a low reported incidence of tachycardia. We aimed to evaluate its antioxidant activity in cultured human arterial endothelial cells under oxidative stress. Endothelial cells were exposed to 1 mM H2O2 and treated with 100 μM α-tocopherol, 1 nM, 10 nM or 100 nM azelnidipine, 100 nM nifedipine or 100 nM amlodipine. After 3 h, the cell number and level of lipid peroxidation were evaluated by measuring the total protein and 8-iso-PGF2α concentrations, respectively. The total protein concentration was similar with each treatment. Inhibition of 8-iso-PGF2α was greatest with 10 nM azelnidipine (compared with the other drugs); the difference between 10 nM and 100 nM azelnidipine was not significant. We conclude that azelnidipine has a potent antioxidative effect that could be of significant clinical benefit when combined with its long-lasting anti-hypertensive action and low incidence of tachycardia.
The Efficacy and Tolerability of Barnidipine Hydrochloride in Thai Patients with Hypertension
Authors: Buranakitjaroen P , Koanantakul B , Phoojaroenchanachai M , Chawantanpipat C
Published: February 2013

This open-label, blinded study was performed to evaluate the efficacy and tolerability of barnidipine at a titrated dose of 10 − 15 mg once daily for 8 weeks in the treatment of essential hypertension in 40 Thai patients. ‘Office’ blood pressure (BP) and 24-h ambulatory BP measurements were recorded. A systolic BP/ diastolic BP (SBP/DBP) reduction of 18.0 ± 13.6/9.1 ± 6.6 mmHg was obtained. The full response rate among patients with systolic and diastolic hypertension was 63% using either SBP or DBP criteria, and 54% using both SBP and DBP criteria. One of the two patients with isolated systolic hypertension had a full response, and the BP in two of the three patients with isolated diastolic hypertension was normalized. The trough-to-peak ratio and smoothness index for SBP/DBP were acceptable (0.76 ± 0.63/0.55 ± 0.26 and 1.2 ± 0.4/1.2 ± 0.3, respectively). In conclusion, once-daily barnidipine monotherapy provides effective 24-h BP control and is generally well tolerated in ambulatory patients.
A New Treatment Modality for Fibromyalgia Syndrome: Hyperbaric Oxygen Therapy
Authors: Yildiz Ş , Kiralp MZ , Akin A , Keskin I , Ay H , Dursun H , Cimsit M
Published: February 2013

Fibromyalgia syndrome (FMS) is characterized by longstanding multifocal pain with generalized allodynia/hyperalgesia. There are several treatment methods but none has been specifically approved for this application. We conducted a randomized controlled study to evaluate the effect of hyperbaric oxygen (HBO) therapy in FMS (HBO group: n = 26; control group: n = 24). Tender points and pain threshold were assessed before, and after the first and fifteenth sessions of therapy. Pain was also scored on a visual analogue scale (VAS). There was a significant reduction in tender points and VAS scores and a significant increase in pain threshold of the HBO group after the first and fifteenth therapy sessions. There was also a significant difference between the HBO and control groups for all parameters except the VAS scores after the first session. We conclude that HBO therapy has an important role in managing FMS.
Relationship between Cardiovascular Risk Indicators and Types of Obesity in Overweight and Obese Women
Authors: Cikim AS , Ozbey N , Orhan Y
Published: February 2013

We aimed to evaluate the relationship between different types of obesity and cardiovascular risk indicators. A total of 623 overweight (body mass index [BMI] > 25 kg/m2), and 2559 obese (BMI > 30 kg/m2) women were divided into four groups according to their BMI and waist-to-hip ratio (WHR): simple overweight (BMI 25-30 kg/m2 and WHR < 0.8, n = 371), abdominal adiposity (BMI 25-30 kg/m2 and WHR > 0.8, n = 252), peripheral (pure) obesity (BMI > 30 kg/m2 and WHR < 0.8, n = 918) and central obesity (BMI > 30 kg/m2 and WHR > 0.8, n = 1641). The levels of the risk indicators measured (clinical, anthropometric and laboratory) were significantly higher in the central obesity group. Total body fat and abdominal fat accumulation seems to result in more serious hyperinsulinaemia and insulin resistance in central obesity. Measuring BMI and WHR in obese patients may reveal their risk for coronary heart disease.
A Comparison of Colour Duplex Ultrasonography after Transurethral Alprostadil and Intracavernous Alprostadil in the Assessment of Erectile Dysfunction
Authors: Ahn HS , Lee SW , Yoon SJ , Hann HJ , Hong JM
Published: February 2013

This study aimed to investigate whether transurethral alprostadil could be used for the diagnosis of erectile dysfunction using colour duplex ultrasound. The ultrasonography results were compared after transurethral and intracavernous alprostadil administration in 20 patients with erectile dysfunction. There were no significant differences in the mean peak systolic velocities (PSVs) between the two routes of administration, but the mean end diastolic velocities (EDVs) showed significant differences, with patients treated with transurethral alprostadil having higher EDVs. Linear regression analysis of the PSVs reached following the two routes of administration showed a moderate relationship, but linear regression analysis of the EDVs showed no relationship. We concluded that transurethral alprostadil was an inappropriate vasoactive drug to use with colour duplex ultrasonography for the evaluation of patients with erectile dysfunction because it required a longer scan time and it was less effective and less reliable than intracavernous alprostadil at stimulating complete corporeal smooth muscle relaxation.
Low Frequency of bcl-2 Expression in Large Non-Polypoid Colonic Neoplasms
Authors: Yamada H , Hasegawa H , Iino H , Eguchi H , Fujii H
Published: February 2013

Large non-polypoid colorectal adenomas that spread over the mucosa and morphologically flat lesions are included in a group called granule-aggregating tumours. These are uncommon in the West. We aimed to clarify the biological differences between granule-aggregating tumours and colorectal polypoid adenomas. We evaluated the extent of apoptotic cell loss and expression of bcl-2 and p53 oncoproteins in 26 granule-aggregating tumours and 19 polypoid adenomas. The mean apoptosis index value of granule-aggregating tumours was significantly higher than that of polypoid adenomas. Only two (7.7%) granule-aggregating tumours and 13 (68.4%) polypoid colorectal adenomas expressed bcl-2, while 12 (46.2%) granule-aggregating tumours and six (31.6%) polypoid colorectal adenomas were p53-positive. Our results show that the higher apoptosis index and frequent expression of bcl-2 oncoprotein differentiates granule-aggregating tumours from polypoid colorectal adenomas. We propose that large non-polypoid granule-aggregating tumours of the colorectum are a biologically distinct entity.
Histopathological Evaluation of Subcutaneous Tissue Reaction in Mice to a Calcium Hydroxide Paste Developed for Root Canal Fillings
Authors: Shimizu T , Kawakami T , Ochiai T , Kurihara S , Hasegawa H
Published: February 2013

We aimed to evaluate the subcutaneous tissue reaction to a new calcium hydroxide paste for root canal fillings developed by Neo Dental Chemical Products Co., Tokyo, Japan. We injected calcium hydroxide paste and a water-based control subcutaneously into the dorsal area of 6-week-old anaesthetized male ddY mice. The tissue surrounding the injection sites was removed from mice in each group, 2 days, 1 week, 3 weeks and 12 weeks after the injection, and histopathologically examined. We found necrotic and degenerative changes, as well as foreign body reaction or proliferation of granulation tissue in specimens from both groups until 3 weeks after the injection. Some lymphocyte infiltration was observed in the 12-week specimens of the control group only. We conclude that calcium hydroxide paste is safe to use as a root canal filling material.
Rapid Identification of the Candida Species from Direct Blood Cultures by CHROMagar™ Candida
Authors: Birinci A , Akkurt L , Acuner C , Unlu M , Durupinar B
Published: February 2013

We evaluated the ability of CHROMagar™ Candida to identify Candida species isolated directly from blood cultures. A total of 50 clinical isolates of Candida were incubated at 35°C, and once growth was established, an aliquot of each was plated onto CHROMagar™ Candida medium. A control specimen was plated directly from Sabouraud's dextrose agar. Following incubation at 30°C, all yeast isolates were identified by colony morphology and colour. We were able to identify all isolates of C. albicans ( n = 20), C. tropicalis ( n = 14), C. glabrata ( n = 6), and C. krusei ( n = 5), which were isolated from blood or from control cultures. This study demonstrated that CHROMagar™ Candida reliably isolated and identified yeast taken directly from blood cultures. We conclude that this rapid and easy method of identifying Candida species will enable clinicians to quickly choose the appropriate antifungal agent. This should decrease patient morbidity and mortality.
Immunogenicity and Tolerability of a Trivalent Virosomal Influenza Vaccine in a Cohort of HIV-Infected Children
Authors: Zuccotti GV , Zenga A , Durando P , Massone L , Bruzzone B , Sala D , Riva E
Published: February 2013

Twenty-three children infected with the human immunodeficiency virus (HIV) were vaccinated with a trivalent inactivated virosomal influenza vaccine. Serum haemagglutinin inhibition antibody titres were determined for the three viral strains at the time of vaccination and 1 month later. CD4 cell counts and HIV viral loads were measured to evaluate the effect of vaccination on HIV status. Adverse reactions were monitored during the first hour following vaccination by an investigator and then on a continuous basis by the parents. Seroconversion rates against the three viral strains A/H3N2, A/H1N1 and B were 73.9%, 56.5% and 52.2%, respectively. Geometric mean antibody titres increased after 1 month compared with baseline values (A/H3N2: 70.9 versus 13.5; A/H1N1: 24.7 versus 5.8; B: 34.4 versus 9.1). No significant changes were observed in either HIV viral load or CD4 cell count following vaccination. Vaccination was well tolerated with only a few mild, transient symptoms.
The Effect of Melatonin on Plasma Oxidant-Antioxidant Skeletal Muscle Reperfusion Injury in Rats
Authors: Halici M , Narin F , Turk CY , Saraymen R , Baykan A , Kabak S
Published: February 2013

We investigated the effects of melatonin administration on skeletal muscle ischaemia-reperfusion injury (IRI) by assessing plasma malondialdehyde (MDA), superoxide dismutase (SOD), total glutathione (GSSH), glutathione peroxidase (GPX) and myeloperoxidase (MPO) concentrations. Male Sprague-Dawley rats ( n = 32) were randomized into four groups: group 1 served as time controls; group 2 were the test animals; group 3 received melatonin (30 mg/kg) intraperitoneally prior to the induction of ischaemia; and group 4 received melatonin (30 mg/kg) intraperitoneally prior to the reperfusion period. Administration of melatonin prior to reperfusion significantly decreased the elevated MDA concentration caused by IRI, and significantly elevated GSSH concentrations, which had been reduced by IRI. Ischaemia-reperfusion injury significantly increased activities of GPX, SOD and MPO, and melatonin administration reversed this effect. In conclusion, a pharmacological dose of melatonin showed significant protective effects against IRI by decreasing lipid peroxidation, MPO, SOD and GPX enzyme activities and regulating glutathione content.
Promotion of Fracture Healing by Vitamin E in Rats
Authors: Turk CY , Halici M , Guney A , Akgun H , Sahin V , Muhtaroglu S
Published: February 2013

We investigated the effects of the antioxidant α-tocopherol on early- and late-phase fracture healing in a rat model. Sixty male Sprague-Dawley rats were randomized into two groups. The right tibia of each rat was fractured manually under anaesthesia, and fracture sites fixed with intramedullary Kirschner wires. The α-tocopherol group received 20 mg/kg α-tocopherol intraperitoneally; the control group received intraperitoneal saline injections. Ten rats from each group were sacrificed on day 15, day 45 and day 60. In the α-tocopherol group, malondialdehyde concentrations, a measure of lipid peroxidation associated with oxygen free radicals, were significantly decreased on day 15 and day 45 compared with the control group, but had regained the 15-day value on day 60. On histopathological and radiological assessment, fracture healing on day 60 was significantly more advanced in the α-tocopherol group. We conclude that α-tocopherol has a positive effect on both early and late-phase fracture healing, and may be beneficial in clinical fracture cases.
Chronotropic Effect of the Antithrombotic Agent Cilostazol in a Patient with Sick Sinus Syndrome and Syncope
Authors: Moriya J , Takahashi T , Nomura Y , Kawaura K , Kusaka K , Yamakawa J , Fujioka N , Okubo S , Itoh T , Kanda T
Published: February 2013

In this case report we describe an 80-year-old man with sick sinus syndrome (SSS) who developed syncope attacks. The diagnosis of SSS was based on electrocardiographic evidence of markedly prolonged sinus arrests associated with syncope attacks while in hospital. The patient was given cilostazol, an anti-thrombotic agent that selectively inhibits cyclic nucleotide phosphodiesterase type 3, at a dose of 100 mg twice daily. The syncope attacks ceased, and an electrocardiogram obtained 1 week after the start of cilostazol administration showed no evidence of sinus arrest. The outcome of this case suggests that cilostazol may be useful in patients with syncope attacks due to SSS, although the long-term chronotropic effects of cilostazol need to be evaluated.
Comparison of Central Venous Catheterization Sites in Infants
Authors: Han SH , Kim SD , Kim CS , Kim WH , Lim C , Park YS , Bahk JH
Published: February 2013

This study aimed to compare the rates of success and complications between different sites of central venous catheterization in infants. A total of 272 infants were randomized to four groups: right subclavian group (G-RSCV), right internal jugular group (G-RIJV), left subclavian group (G-LSCV) and left internal jugular vein group (G-LIJV). In 77.2% of the patients, we successfully introduced a catheter at the first attempt. The rate of successful catheter placement was highest in the RIJV (RIJV 89.7%, LIJV 79.4%, RSCV 66.2% and LSCV 55.9%). With regard to complications, the rate of arterial puncture, guide wire advancement failure and malpositioning of the catheter were all significantly more frequent during SCV catheterization (SCV versus IJV: 10.1% versus 2.1%, 12.4% versus 0% and 13.4% versus 0.6%, respectively). Our results imply that IJV, especially RIJV, should be the first choice for central venous catheterization in infants.
The Effects of Calcitriol Therapy on Serum Interleukin-1, Interleukin-6 and Tumour Necrosis Factor-α Concentrations in Post-menopausal Patients with Osteoporosis
Authors: Inanir A , Özoran K , Tutkak H , Mermerci B
Published: February 2013

Seventy post-menopausal women with osteoporosis were randomized into two groups: 40 patients received calcitriol (0.5 μg/day) and calcium (1000 mg/day); and 30 control patients received calcium (1000 mg/day) alone. Thirty healthy women formed the healthy control group. Bone mineral density (BMD) and serum interleukin (IL)-1, IL-6 and tumour necrosis factor-α (TNF-α) concentrations were measured at baseline and after 6 months of treatment. Calcitriol treatment for 6 months significantly increased BMD and reduced serum IL-1 and TNF-α concentrations compared with no significant changes in patients treated with calcium alone. Both treatments increased serum calcium and decreased parathyroid hormone concentrations. The healthy control group had a significantly lower IL-6 concentration than the post-menopausal women with osteoporosis. We have shown that calcitriol was an effective treatment for osteoporosis. Significant reductions in serum IL-1 and TNF-α concentrations suggest that, in addition to increasing the absorption of calcium, calcitriol may directly affect bone metabolism via cytokines.
Cell Wall-Deficient Bacteria as a Cause of Infections: A Review of the Clinical Significance
Authors: Onwuamaegbu ME , Belcher RA , Soare C
Published: February 2013

Cell wall-deficient bacteria (CWDB) are pleomorphic bacterial forms. These atypical organisms may occur naturally or they can be induced in the laboratory. Their presence has been known about for over a century, but a definite link to clinical disease outcomes has not been demonstrated. A number of case reports and laboratory studies suggest some disease associations, however. Considerable controversy surrounds the true relevance of CWDB to disease; there is a widespread belief that they may represent a response by the walled organism to adverse extracellular conditions like antibiotic pressure. This review looks at studies published between 1934 and 2003, which were identified by Dialog DataStar using the key words ‘cell wall deficient bacteria and clinical significance and infections’ and by further scanning the reference list at the end of the papers retrieved. We conclude that the evidence for the clinical significance of CWDB in disease is not compelling.
Efficacy of Lumiracoxib in Osteoarthritis: A Review of Nine Studies
Authors: Berenbaum F , Grifka J , Brown JP , Zacher J , Moore A , Krammer G , Dutta D , Sloan VS
Published: February 2013

Lumiracoxib is a cyclooxygenase-2 selective inhibitor in development for the treatment of osteoarthritis (OA), rheumatoid arthritis and acute pain. We reviewed nine clinical studies of 1 − 52 weeks' duration demonstrating the efficacy of lumiracoxib in OA. Male and female patients aged ≥ 18 years with primary OA of the hand, hip or knee received lumiracoxib, placebo or active comparators (diclofenac, celecoxib or rofecoxib). Lumiracoxib provided consistent reductions in OA pain intensity and improvements in the patient's global assessment of disease activity and functional status (assessed using the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire or the Australian/Canadian OA Hand Index). These results were superior to placebo and similar to the active comparators tested. In addition, lumiracoxib was consistently superior to placebo and generally similar to active comparators in terms of the new Outcome Measures in Clinical Trials and Osteoarthritis Research Society International criteria. These were used to provide a single measure of response to treatment, taking into account pain, the patient's global assessment of disease activity and functional status.
Effect of Anti-Hypertensive Drug Dose Frequency on the Clinic-Home Blood Pressure Difference in Patients with Stage 1 Treated Hypertension
Authors: Huang H-C , Lin M-S , Kudo K , Chang N-C , Lee T-M
Published: February 2013

Clinic blood pressure (CBP) is generally used for diagnosis and treatment monitoring in hypertension, but target organ damage correlates more closely with home blood pressure (HBP). Eliminating the clinic-home blood pressure difference (CHBPD) would make conventional CBP a more accurate alternative to HBP. This prospective, randomized, open trial compared the effect of a once-daily versus a twice-daily regimen of anti-hypertensive therapy on CHBPD. After a 2-week wash-out period, 85 confirmed stage 1 hypertensive patients were randomized to receive 2 mg tri-chlormethiazide daily in one (40 subjects) or two (45 subjects) daily doses for 3 weeks. CBP and HBP measurements were taken during the third week of treatment and the CHBPD calculated. After treatment, the systolic and diastolic CHBPD values were significantly greater in the once-daily regimen than in the twice-daily regimen. Conventional CBP should not be used as an alternative to HBP for evaluating prognosis and monitoring anti-hypertensive therapy when using a once-daily regimen.
Pre-emptive Effects of Ibuprofen Syrup and Lidocaine Infiltration on Postoperative Analgesia in Children Undergoing Adenotonsillectomy
Authors: Kedek A , Derbent A , Uyar M , Bilgen C , Uyar M , Kirazli T , Certug A
Published: February 2013

We aimed to compare the effects of lidocaine and adrenaline with ibuprofen syrup (administered before adenotonsillectomy) on post-operative analgesia and initiation of oral feeding. One group of 20 children received 100 g/5 ml ibuprofen suspension (10 mg/kg) 1 h before anaesthesia; bleeding control was provided by pre-incisional administration of 1:200000 adrenaline solution (10 ml). The same amount of 0.5% lidocaine solution plus 1:200000 adrenaline was applied pre-incisionally in a similar manner in a second group of 20 children. No significant differences were observed between the two groups in terms of the duration of operation and anaesthesia, post-operative pain scores, paracetamol requirements, times to initiation of liquid and solid food intake, or adverse side-effects. We conclude that ibuprofen syrup applied pre-incisionally and local infiltration with lidocaine are equally effective for post-operative analgesia.
Effects of N-acetylcysteine Treatment on Oxidative Stress in Acetic Acid-induced Experimental Colitis in Rats
Authors: Akgun E , Çaliskan C , Celik HA , Ozutemiz AO , Tuncyurek M , Aydin HH
Published: February 2013

We assessed the possible protective effects of N-acetylcysteine (NAC) against toxic damage in the rat colon. Two doses of NAC (20 mg/kg and 100 mg/kg) given for 2 days and 7 days after acetic acid administration (to induce colitis) were tested. NAC was dissolved in saline and administered locally (intracolonic), systemically (intraperitoneal) or in a combination (intracolonic and intraperitoneal). Several parameters, including macroscopic and histopathological scores and myeloperoxidase, glutathione and nitric oxide concentrations were measured using standard assay procedures. Treatment with 100 mg/kg NAC for 7 days significantly decreased tissue myeloperoxidase, glutathione and nitric oxide concentrations. The 20 mg/kg dose had no protective effects. The data indicate that NAC substantially reduced the degree of colonic injury, probably by regulating free radical production and inhibiting inflammation. It may, therefore, have a role in the treatment of inflammatory bowel disease.
Adiponectin Replacement Therapy Attenuates Myocardial Damage in Leptin-deficient Mice with Viral Myocarditis
Authors: Takahashi T , Saegusa S , Sumino H , Nakahashi T , Iwai K , Morimoto S , Kanda T
Published: February 2013

The effects of adiponectin replacement therapy on myocardial damage were studied in leptin-deficient (OB) mice with acute viral myocarditis. Encephalomyocarditis virus was injected intraperitoneally into OB and wild-type (WT) mice. One subgroup of OB mice received no intervention and another subgroup received daily adiponectin replacement, simultaneously with viral inoculation. Differences in heart weight, cardiac histological score, numbers of infiltrating or apoptotic cells in the myocardium and the immunoreactivity of adiponectin receptors in myocytes were determined.

The reactivity of adiponectin receptor 1 in myocytes from OB mice on day 4 and day 8 after viral inoculation was significantly decreased compared with that in myocytes from WT mice; the OB mice also had elevated cardiac weights and severe inflammatory myocardial damage. Adiponectin replacement in OB mice inhibited the development of severe myocarditis by augmenting myocyte adiponectin receptor 1 reactivity. Exogenously administered adiponectin may inhibit the progression of viral myocarditis through binding to the adiponectin receptor 1 in leptin-deficient conditions.
Reliability and Validity of the Modified Dental Anxiety Scale in Turkish Patients
Authors: İlgüy D , İlgüy M , Dinçer S , Bayirli G
Published: February 2013

We aimed to determine dental anxiety among Turkish patients and assess the sensitivity, specificity, positive/negative predictive values and reliability of the Modified Dental Anxiety Scale (MDAS) and Corah's Dental Anxiety Scale (DAS). Patients referred to our clinic for dental treatment who had a history of dental anxiety were included in the study. 294 randomly selected patients (mean age 38.8 years) completed a questionnaire combining Corah's DAS and MDAS. They were retested 15 days later. The prevalence of dental anxiety was found to be 9.9% (29/294) for Corah's DAS at the cut-off point ≥ 15 and 8.8% (26/294) for the MDAS at the cut-off point ≥ 19. Both dental anxiety scales gave acceptable sensitivity, specificity, positive and negative predictive values at these cut-off points.
The Haemodynamic Effects of Propranolol and Atenolol Medication on Dobutamine Infusion in Patients with Coronary Artery Obstructive Disease
Authors: Oh YJ , Lee JH , Kim JY , Song JW , Hong YW , Kwak YL
Published: February 2013

We compared the haemodynamic effects of β-blockers on dobutamine infusion in 60 patients undergoing coronary artery bypass graft surgery. All patients had been taking propranolol (n = 30) or atenolol (n = 30) pre-operatively for at least 1 month. After sternotomy, dobutamine was infused at 2 μg/kg per min, and the dose increased to 4 μg/kg per min and then 8 μg/kg per min, at 15-min intervals. In both groups, dobutamine infusion did not increase the cardiac index or the heart rate, but was associated with an increase in mean arterial pressure, systemic vascular resistance index and mean pulmonary arterial pressure in a dose-dependent manner. The haemodynamic responses to dobutamine infusion were similar in the two groups. We conclude that pre-operative medication with β-blockers reduced the inotropic and chronotropic effects of dobutamine infusion. There was no difference between the modification produced by propranolol, a non-selective β -blocker, and that produced by atenolol, a selective β1-blocker, however.
Patterns of Macrolide Resistance Determinants among S. pyogenes and S. pneumoniae Isolates in Saudi Arabia
Authors: Shibl AM
Published: February 2013

In the study we characterized the macrolide sensitivity of recent clinical isolates of Streptococcus pyogenes and S. pneumoniae collected from major Saudi Arabian hospitals. Susceptibility testing was performed using standard National Committee for Clinical Laboratory Standards methodology on 335 S. pyogenes and 350 S. pneumoniae isolates. Macrolide resistance mechanism phenotypes were identified using double-disk diffusion. All S. pyogenes were penicillin sensitive, while 6.3% were macrolide resistant, the main mechanism of which was of M phenotype (96%). Approximately 51% of S. pneumoniae were penicillin non-susceptible. Macrolide resistance in S. pneumoniae accounted for 18.8%, the majority of which were M phenotype (91%). Low-level resistance mediated by mef-bearing strains predominated. Newer macrolides, including azithromycin, are still considered drugs of choice for empirical treatment of respiratory infection in such circumstances.
Myelofibrosis Associated with Severe Vitamin D Deficiency Rickets
Authors: Balkan C , Ersoy B , Nese N
Published: February 2013

Myelofibrosis is a rare disorder in childhood. In this report, we present the case of a 6-month-old infant with myelofibrosis due to severe vitamin D deficiency rickets. The characteristic clinical and laboratory findings of myelofibrosis improved rapidly after vitamin D therapy. In developing countries, nutritional rickets is still an important health problem. Rickets is not only a skeletal system-related disorder, it is also a systemic disorder. Rickets should be considered, therefore, as one of the conditions that can lead to severe haematological disorders in infants.
Effect of Analgesia Administration Timing on Early Post-operative Period Characteristics: A Randomized, Double-blind, Controlled Study
Authors: Mavioğlu Ö , Özkardełler S , Tałdöğen A , Akan M , Candüz B
Published: February 2013

This study investigated the effect of time of analgesia administration in 64 patients undergoing total abdominal hysterectomy. Patients received standard general anaesthesia and were divided randomly into two equal groups. At the time of fascia closure, patients in the intra-operative (Iop) group received 0.5 mg/kg pethidine intravenously. On arrival in the post-anaesthesia care unit, the same dose of pethidine was given to patients in the post-operative (Pop) group. All patients then used a patient-controlled analgesia pump to administer pethidine analgesia as required. Times to extubation, response to verbal stimulation and orientation, post-operative pain scores and analgesic consumption were recorded. Times to extubation and response to verbal stimulation were significantly longer in the Iop group. Pain scores, analgesic consumption and additional analgesic requirements were significantly higher in the Pop group in the first 2 h post-operatively. In conclusion, intra-operative administration of pethidine provided better pain management than post-operative administration.
Effectiveness of a 23-valent Polysaccharide Vaccine in Preventing Pneumonia and Non-invasive Pneumococcal Infection in Elderly People: A Large-scale Retrospective Cohort Study
Authors: Ansaldi F , Turello V , Lai P , Bastone G , De Luca S , Rosselli R , Durando P , Sticchi L , Gasparini R , Delfino E , Icardi G
Published: February 2013

This retrospective cohort study evaluated the effectiveness of a 23-valent pneumococcal polysaccharide vaccine in reducing hospital admission for pneumonia, otitis media and exacerbation of asthma or other syndromes due to Streptococcus pneumoniae in 9170 high-risk individuals. Cohort members were followed from 1 January 1998 to 31 December 2002. With regard to preventing hospitalization due to pneumonia, we observed a decrease in the incidence of 1/10 000 person-months and a reduction in the relative risk of 38% in the vaccinated cohort compared with the non-vaccinated subjects. A decrease in the risk of hospital admission for asthma, acute otitis media, chronic obstructive pulmonary disease and other respiratory infections was also observed in vaccinated compared with non-vaccinated subjects. The specificity of these findings was confirmed by the lack of a protective effect from vaccination for those outcomes, such as hospitalization ‘for all causes’ and ‘other otorhinolaryngological diagnoses’, that were not directly related to pneumococcal disease.
Electromagnetic Fields Inhibit Endothelin-1 Production Stimulated by Thrombin in Endothelial Cells
Authors: Morimoto S , Takahashi T , Shimizu K , Kanda T , Okaishi K , Okuro M , Okuro M , Nishimura Y , Nomura K , Tsuchiya H , Ohashi I , Matsumoto M
Published: February 2013

Electromagnetic field (EMF) radiation has been found to induce arteriolar dilatation, but the mechanism of action remains largely unknown. This study investigated the effect of EMF radiation on the production of endothelin-1 (ET-1), a potent vasoconstrictor, by cultured endothelial cells. EMF radiation reduced ET-1 basal levels in human umbilical vein and microvascular endothelial cells, but failed to reduce ET-1 basal levels in bovine and human aortic endothelial cells. EMF radiation significantly inhibited thrombin-stimulated ET-1 production in all four endothelial cell types in a dose-dependent manner. EMF radiation significantly inhibited thrombin-induced endothelin-1 mRNA expression in all four cell types. The inhibitory effect of EMF radiation on ET-1 production was abolished by the nitric oxide synthase inhibitor NG-monomethyl-L-arginine (10−3 mol/l). These results demonstrate that EMF radiation modulates ET-1 production in cultured vascular endothelial cells and the inhibitory effect of EMF radiation is, at least partly, mediated through a nitric oxide-related pathway.
Gamma/Delta T-cell Receptor Type Granular Lymphocyte Proliferative Disorder Associated with Rheumatoid Arthritis
Authors: Zenibayashi M , Saigo K , Chayahara N , Sakamoto Y , Inujima K , Imamura Y , Takada M , Kawano S , Tatsumi E , Kumagai S
Published: February 2013

We present here a case report of a 69-year-old female patient with T granular lymphocyte proliferative disorder (T-GLPD) expressing the γ/δ T-cell receptor. The patient had been treated for rheumatoid arthritis for 25 years, and presented with mild anaemia. Cell-surface marker analysis was carried out using flow cytometry and natural killer function was determined using a chromium release assay. The case report is followed by a summary of the 21 other γ/δ T-GLPD cases reported in the literature and a comparison of their clinical characteristics with those of T-GLPD cases expressing the α/β T-cell receptor. The clinical symptoms and the frequency of association with rheumatoid arthritis are similar in γ/δ and α/β T-GLPD, but a prevalence of the CD8- cell-surface marker and enhanced natural killer function appear to be characteristics of γ/δ T-GLPD.
Seroprevalence of Hepatitis C Virus Infection and Evaluation of Serum Aminotransferase Levels among Haemodialysis Patients in Izmir, Turkey
Authors: Olut AI , Ozsakarya F , Dilek M
Published: February 2013

The seroprevalence of hepatitis C virus (HCV) infection was investigated among haemodialysis (HD) patients. Mean serum aminotransferase levels were also compared over 3 months in HCV-seropositive patients with and without viraemia, as well as in HCV-seronegative HD patients and HCV-seropositive, non-uraemic, viraemic patients. Seroprevalence of HCV infection was 19% among the 437 HD patients tested. Of the 61 HD HCV-seropositive, hepatotoxic medication- and alcohol-free patients, 38 (62%) were found to be viraemic, using quantitative HCV-RNA, on at least one occasion. Mean serum aminotransferase levels were significantly higher in viraemic HD patients (compared with non-viraemic patients), suggesting that HCV-RNA positivity is an important predictor of increased enzyme activity in these patients. As expected, aminotransferase levels in HCV-seropositive HD patients tended to be lower than levels in HCV-seropositive non-uraemic patients.
Left Ventricular Hypertrophy – the Problem and Possible Solutions
Authors: Gosse P
Published: February 2013

Left ventricular hypertrophy (LVH), which describes pathological changes in cardiac structure, is a powerful and reversible predictor of cardiovascular risk. There is a continuous relationship between left ventricular mass (LVM) and the likelihood of cardiovascular events, with no cut-off between the absence of such events and heightened risk. A correlation between LVH and blood pressure is well established. There is a paradox, however, that the structural changes to the heart as a result of increased workload due to high blood pressure appear to promote cardiovascular disease. This may be partially explained by the fact that ambulatory blood pressure measurements correlate more closely with LVH than resting blood pressure. Blood pressure variation throughout the day is also emerging as an important correlate of LVH, and a strong association has been identified between an early morning rise in blood pressure and increased LVM. Use of anti-hypertensive agents not only lowers blood pressure, but can also bring about LVH regression. The pathological role of angiotensin II in LVH and target-organ damage within the cardiovascular continuum suggest that agents targeting the renin – angiotensin - aldosterone system (RAAS), such as the angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, may prove particularly effective and may confer beneficial effects in addition to the lowering of blood pressure. The angiotensin II receptor blockers may be very appropriate treatment options because of their placebo-like tolerability and the possibility of more complete blockade of the RAAS. Within this class of anti-hypertensive agents, pharmacological differences may mean that some agents afford greater cardioprotection than others.