bluuebunny/crossref_metadata_2025 huggingface dataset:
Rate of Eating and Body Weight in Patients with Type 2 Diabetes or Hyperlipidaemia
Authors: Takayama S , Akamine Y , Okabe T , Koya Y , Haraguchi M , Miyata Y , Sakai T , Sakura H , Sasaki T
Published: February 2013

This preliminary investigation, involving 422 patients, tested the hypothesis that rate of eating is associated with obesity in patients with type 2 diabetes or hyperlipidaemia at all ages. The patients' eating habits were determined using a questionnaire, and the patients were classified as quick, normal or slow eaters. The body mass indices of the three groups were compared. The body mass indices of the male patients who ate quickly (25.4 ± 0.2 kg/m2) were significantly higher than those of the patients who ate at a normal rate (24.4 ± 0.3 kg/m2) or slowly (24.1 ± 0.5 kg/m2). No difference between body mass indices in the female groups was found. It was speculated that rate of eating affects body weight in male patients with type 2 diabetes or hyperlipidaemia.
Detection of Antimicrobial Resistance and Extended-Spectrum β-Lactamase Production in Klebsiella Pneumoniae Strains from Infected Neonates
Authors: Aktas E , Yigit N , Yazgi H , Ayyildiz A
Published: February 2013

The present study was designed to determine the antimicrobial resistance and extended-spectrum β-lactamase (ESBL) activities of Klebsiella pneumoniae strains isolated from the neonatal intensive care unit of Atatürk University Hospital, Erzurum, Turkey. Antibiotic susceptibility of 40 isolates was detected by the standard disk diffusion method according to the National Committee for Clinical Laboratory Standards Guidelines. The double-disk synergy method was used to determine ESBL activity, which is associated with resistance to β-lactam antibiotics. Twenty-four (60%) of 40 K. pneumoniae strains were found to produce ESBL. Of the antibiotics tested, meropenem was found to be the most effective (100%), and ampicillin the least effective (0%). With the increasing incidence of antimicrobial resistance, which poses a clinically significant risk to vulnerable patients, it is important that clinical microbiology laboratories have accurate and timely information concerning the strains of bacteria present to enable them to predict which antibiotics are likely to be effective in treating the infections they may cause.
Retrospective Study of Febrile Seizures: Subsequent Electroencephalogram Findings, Unprovoked Seizures and Epilepsy in Adolescents
Authors: Piperidou HN , Heliopoulos IN , Maltezos ES , Stathopoulos GA , Milonas IA
Published: February 2013

A retrospective questionnaire to determine the prevalence of febrile seizures was given to adolescents (16- and 17-year-olds) in the final 2 years of secondary school at the five schools in Alexandroupolis, Greece. Parents were interviewed, and clinical and electroencephalographic examinations were performed in all adolescents with a history of febrile seizures. Of 1708 adolescents, 56 (3.3%) had experienced at least one febrile seizure. Of these, 44 (78.6%) were simple and 12 (21.4%) were complex febrile seizures. Recurrent seizures occurred in 22 cases (39.3%), and the mean age at onset was 25.1 months. There was a positive first-degree family history in eight cases (14.3%) and this increased to 27.3% in cases with recurrent seizures. Two of the adolescents (3.6%) had had one unprovoked seizure before the age of 3 years, and another two children developed epilepsy. Epileptiform electroencephalogram discharges were observed in only one case (1.8%) with generalized tonic-clonic epilepsy.
Comparison of Tamsulosin and Finasteride for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia in Korean Patients
Authors: Lee E
Published: February 2013

Tamsulosin (0.2 mg) and finasteride (5 mg) once daily for 24 weeks were compared in a single-blind, randomized study as initial treatments for lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH) in 205 Korean patients. Symptom and quality of life (QOL) assessment by the International Prostatic Symptom Score (I-PSS), maximum urinary flow rate ( Qmax) and adverse events were analysed at 4 weeks and 24 weeks. On intention-to-treat analysis, both drugs showed similar efficacy at endpoint (decreased I-PSS, increased Qmax and improved QOL score; 34.7%, 23.9% and 34.1% for tamsulosin, and 30.5%, 22.2% and 23.1% for finasteride, respectively). However, tamsulosin produced significant improvements in I-PSS and Qmax at 4 weeks compared with finasteride (17.6% versus 10.0% and 10.9% versus 3.1%, respectively), and a superior QOL score improvement during the study. Adverse events were observed significantly more frequently among finasteride than tamsulosin patients (23 versus four). Both were equally effective in long-term treatment of urinary outflow obstruction symptoms associated with BPH in Korean patients, but tamsulosin was more effective for short-term treatment, with a better safety profile.
Experience with Ampicillin/Sulbactam in Severe Infections
Authors: Kanra G
Published: February 2013

The emergence of beta-lactamase-mediated resistance to established beta-lactam antibiotics prompted the development of beta-lactamase inhibitors for co-administration. Ampicillin has been combined with sulbactam for both parenteral and oral (as the mutual pro-drug sultamicillin) administration. The combination is active in vitro against a wide variety of Gram-positive and Gram-negative pathogens, including aerobic and anaerobic organisms. In clinical trials, ampicillin/sulbactam has proved clinically and bacteriologically effective against a variety of frequently encountered pediatric infections, including mild-to-moderate upper respiratory tract infections (acute otitis media, sinusitis, pharyngitis, and tonsillitis), severe postoperative and intra-abdominal infections, periorbital infections (which, left untreated, can lead to blindness, brain abscess, or death), acute epiglottitis, bacterial meningitis, and brain abscess. Ampicillin/sulbactam has also proved effective in the prevention of post-operative surgical infections in pediatric patients. The clinical efficacy profile of ampicillin/sulbactam and sultamicillin, combined with their excellent tolerability profile, make these agents attractive options for the management of many life-threatening infections in pediatric patients.
The Efficacy of Non-Contrast Helical Computed Tomography in the Prediction of Urinary Stone Composition In Vivo
Authors: Demirel A , Suma S
Published: February 2013

The composition of urinary stones was predicted on the basis of the differences in their Hounsfield unit (HU) densities as detected by in vivo non-contrast helical computed tomography (NCHCT). A total of 87 stones, which had been obtained from patients admitted to the emergency department with acute flank pain, were analysed biochemically. These stones had been visualized by NCHCT before spontaneous passage, ureteroscopic extraction or surgical removal, and their HU densities had been recorded. The HU densities of the stones were compared with the results of biochemical analysis. The mean HU densities of the stones composed of calcium oxalate ( n = 54), struvite ( n = 19) and uric acid ( n = 14) were 812 ± 135, 614 ± 121 and 413 ± 143, respectively. The differences between the mean HU densities of these three stone types were statistically significant. This initial clinical study demonstrated that in vivo NCHCT analysis may be used to predict the composition of urinary stones.
Epidemiological Features of Ulcerative Colitis in Trakya, Turkey
Authors: Tezel A , Dökmeci G , Eskiocak M , Ümit H , Soylu AR
Published: February 2013

To determine the epidemiological features of ulcerative colitis in the Trakya region of Turkey, southeast Europe, we conducted a descriptive, cross-sectional, hospital-based study. All subjects were followed, and age, sex, place of residence, family history, educational status, tobacco consumption and use of oral contraceptives were recorded. The study included 49 cases of ulcerative colitis. The incidence of the disease was 0.59 per 100 000 in 1998, 0.89 per 100 000 in 1999, 0.89 per 100 000 in 2000 and 0.69 per 100 000 in 2001. The overall prevalence of the disease was 4.9 per 100 000; it was 2.18 per 100 000 in rural areas and 5.87 per 100000 in urban areas. As in the Mediterranean countries, both the incidence and the prevalence of ulcerative colitis were found to be low. The incidence was significantly higher in urban areas than in rural areas.
Oral Telithromycin 800 mg Once Daily for 5 Days versus Cefuroxime Axetil 500 mg Twice Daily for 10 Days in Adults with Acute Exacerbations of Chronic Bronchitis
Authors: Zervos MJ , Heyder AM , Leroy B
Published: February 2013

The efficacy and safety of a 5-day regimen of 800 mg telithromycin once daily was compared with a standard 10-day regimen of 500 mg cefuroxime axetil twice daily in a multicentre, randomized, double-blind, parallel-group trial involving 376 patients with acute exacerbations of chronic bronchitis (AECB). In clinically evaluable patients ( n = 282), post-therapy clinical cure rates were 86.4% with telithromycin and 83.1% with cefuroxime axetil. In bacteriologically evaluable patients ( n = 53), eradication or presumed eradication of the pathogen was achieved in 76.0% and 78.6% of telithromycin and cefuroxime axetil patients, respectively. Adverse events were mostly mild; the most common were diarrhoea (12.8% versus 11.8%) and nausea (8.9% versus 3.2%) in telithromycin and cefuroxime axetil patients, respectively. The 5-day regimen of 800 mg telithromycin once daily was similar in efficacy and equally well tolerated as a 10-day regimen of 500 mg cefuroxime axetil twice daily in adults with AECB.
Magnesium-Flush Infusion into the Aortic Root Just before Reperfusion Reduces the Requirement for Internal Defibrillation and Early Post-Perfusion Arrhythmias
Authors: Beşoğul Y , Tünerir B , Özdemir C , Aslan R
Published: February 2013

Pre- and post-operative administration of magnesium has beneficial effects on post-operative ischaemia and reperfusion arrhythmias, but few studies have examined whether intra-operatively administered magnesium can prevent the effects of intra-operative arrhythmias. The aim of this randomized, double-blind study was to compare the effects of intra-operative magnesium or placebo on intra-operative arrhythmias in patients undergoing coronary bypass grafting. Patients received a flush infusion of magnesium or placebo into the aortic root before cross-clamp removal. The results showed that rate of spontaneous resumption of a cardiac rhythm was significantly higher, and number of shocks for defibrillation, energy requirement for defibrillation and rate of intra-operative ventricular tachyarrhythmias were significantly lower in the magnesium group, compared with the placebo group. The differences in need for temporary pacing, and in serum magnesium levels, were not significant. Intra-operative administration of magnesium has beneficial effects on the outcome of surgery. Larger, multicentre clinical investigations should now be undertaken.
Comparison of the Antiemetic Efficacy of Tropisetron and Droperidol with Patient-Given Tramadol
Authors: Öztekın S , Özzeybek D , Taşdöğen A , Kilercik H , Kara HC
Published: February 2013

We compared the antiemetic efficacy of tropisetron versus droperidol in women given tramadol after total hysterectomy. Forty patients were randomly allocated to group 1 ( n = 20, tropisetron 0.05 mg/kg intravenously) or group 2 ( n = 20, droperidol 15 μg/kg intravenously). Tramadol infusion (intravenously), for post-operative analgesia, was started at fascia closure. Incidences of post-operative nausea and vomiting, pain intensity, tramadol use, and the need for a rescue antiemetic (metoclopramide 10 mg) were recorded 0 h, 2 h, 6 h, 12 h, 24 h and 48 h post-operatively. Vomiting and nausea incidences were reported fewer in group 1 than in group 2, but statistical significance was only reached for vomiting incidence 6 h post-operation. Tropisetron seems to have better antiemetic properties than droperidol in patients receiving tramadol, because of the length of its duration of action. Further studies, investigating alternative ways of managing postoperative nausea and vomiting, and the use of tramadol for post-operative analgesia, are needed.
Angiotensin-Converting Enzyme Gene Polymorphism as a Potent Risk Factor for Developing Microalbuminuria in Japanese Patients with Type 2 Diabetes Mellitus: A 9-Year Follow-up Study
Authors: Okuno S , Utsugi T , Ohno T , Ohyama Y , Uchiyama T , Tomono S , Kurabayashi M
Published: February 2013

To clarify the risk factors for developing microalbuminuria in patients with type 2 diabetes mellitus, a longitudinal observational study was performed. Fifty patients with normoalbuminuria were recruited and treated conventionally for 9 years. Polymorphisms of the angiotensin-converting enzyme ( ACE) gene and the angiotensinogen M235T polymorphism were examined. During the study period, 12 of the 50 patients developed microalbuminuria; no patients progressed to macroalbuminuria. Multiple logistic regression analysis was performed using age, duration of diabetes, body mass index, haemoglobin A1c, blood pressure, serum lipid profile and genetic polymorphisms as independent variables and development of microalbuminuria as the dependent variable. The D allele of the ACE gene was an independent and significant variable. We conclude that the ACE gene D allele polymorphism is a potent risk factor for developing microalbuminuria in type 2 diabetic patients.
Pulse Pressure Responses in Patients Treated with Valsartan and Hydrochlorothiazide Combination Therapy
Authors: Carretta R , Trenkwalder P , Martinez F , Tykarski A , Teitelbaum I , Fagan T , Oddou P , Mallion J-M
Published: February 2013

In a randomized, double-blind, parallel-group study of middle-aged and elderly patients, we examined the effects of treatment with the angiotensin receptor blocker valsartan (Val) in combination with hydrochlorothiazide (HCTZ) on pulse pressure (PP). After a 2-week washout period, patients entered a 4-week single-blind Val 160 mg once daily run-in period before randomization to one of three treatment groups: Val 160 mg ( n = 666), Val 160 mg/HCTZ 12.5 mg ( n = 670) or Val 160 mg/HCTZ 25 mg ( n = 666), once daily for eight weeks. Sitting PP at baseline was similar in all groups. From baseline to randomization, Val monotherapy reduced PP by 4.7 ± 10.2 mmHg (mean ± SD). At the end of the study, overall reductions in PP were 6.7 mmHg for Val 160/HCTZ 12.5 and 7.5 mmHg for Val 160/HCTZ 25. Val monotherapy reduced PP in mild-to-moderate hypertensive patients. Val combined with HCTZ provides an additional dose-related reduction in PP.
The Effects of Haemodialysis and Peritoneal Dialysis on Serum Lipoprotein(a) and C-Reactive Protein Levels
Authors: Borazan A , Üstün H , Yilmaz A
Published: February 2013

Elevated serum lipoprotein(a) is an independent risk factor for coronary artery disease, and C-reactive protein (CRP) is a general and cardiovascular marker in haemodialysis patients. We studied lipoprotein(a) and CRP levels in 48 haemodialysis and 24 continuous ambulatory peritoneal dialysis (CAPD) patients and 20 healthy individuals, after a 12 h fast. Serum lipoprotein(a) levels were elevated in 31.3%, 66.7% and 5% of haemodialysis and CAPD patients and control subjects, respectively. The difference between all groups was significant. Serum CRP levels were high in 43.8%, 58.4% and 5% of haemodialysis and CAPD patients, and healthy subjects, respectively. The mean serum CRP level was significantly different between all groups. Both protein levels were higher in CAPD patients than haemodialysis patients, suggesting that CAPD patients should be more closely monitored for coronary artery disease.
Elevated Serum Soluble Fas Levels in the Various Stages of Hepatitis C Virus-Induced Liver Disease
Authors: Özaslan E , Kiliçarslan A , Şimşek H , Tatar G , Lkirazli Ş
Published: February 2013

We aimed to determine serum soluble Fas antigen (sFas) levels at various stages of hepatitis C virus (HCV)-induced liver disease, and investigate correlations between serum sFas levels and clinical, biochemical and pathologic features. Sixty-five patients were categorized into five groups: 1, chronic active hepatitis C, elevated alanine aminotransferase (ALT), HCV-polymerase chain reaction (PCR) positive;2, responders to interferon + ribavirin therapy; 3, cirrhosis; 4, chronic hepatitis C, normal ALT, HVC-PCR positive;and 5, sustained responders. Group 6 comprised 15 control individuals. Serum sFas levels were measured by enzyme-linked immunosorbent assay. Significant differences in serum sFas levels were found between the following groups: 1 and 2; 1 and 3; 1 and 4; 1 and 6; and 3 and 6. Serum sFas levels did not correlate with ALT, histological activity or HCV-PCR positivity within group 1. Serum sFas levels appear to increase in advanced stages of HCV-induced liver disease, as a result of host-related immunological factors.
Microscopic Pathology of the Liver in Rats Fed a Fusarium Graminearum-Inoculated Diet
Authors: Ozbek E , Ozbek A
Published: February 2013

Fusarium graminearum is a fungus frequently isolated from cereal grains. This study investigates the histopathological effects of dietary F. graminearum on rat liver. Treatment and control group rats were fed F. graminearum-inoculated and non-inoculated rice, respectively. After 14 days, all rats were sacrificed, and their livers analysed by electron and light microscopy. Electron microscopy of treatment group livers identified hepatocytes with well-developed smooth endoplasmic reticulum, swollen mitochondria, lipid accumulation, numerous vesicles containing electron-lucent materials and increased lysosomes. Many Kupffer's cells containing apoptotic bodies were also seen. Light microscopy identified hepatocytes from the treatment group with: cytoplasmic and nuclear pleomorphism; foci of necrosis; mononuclear cell infiltration; and presence of apoptotic bodies. These changes were absent in control rat livers indicating that dietary F. graminearum causes inflammation and parenchymal damage in the rat liver. This is the first histopathological study showing the association between F. graminearum and liver damage.
Actin Gene-Targeted RT-PCR Could be a Useful Method for Evaluating In Vitro Fungicidal Activity against Dermatophytes
Authors: Nimura K , Niwano Y , Ishiduka S , Kato M
Published: February 2013

This study examined the effects of the antifungal agents amorolfine hydrochloride (AMF) and bifonazole (BFZ) on actin mRNA expression determined by reverse transcription-polymerase chain reaction (RT-PCR) amplification, and the morphology of Trichophyton mentagrophytes. In AMF-treated cultures, the hyphal cells of T. mentagrophytes exhibited concentration- and/or time-dependent progressively degenerative morphological damage. Those cultures exhibiting severe and necrotic morphological changes (such as crushed, bent and flattened hyphal cells) did not express actin mRNA. In BFZ-treated cultures, similar morphological changes were seen in the hyphae of T. mentagrophytes, but these changes were milder than observed in the AMF-treated samples, and actin gene fragments were amplified in all of these samples. These results indicate that actin gene-targeted RT-PCR could be a useful tool for testing the susceptibility of dermatophytes to antifungal agents in vitro.
Congestive Heart Failure Induced by the Combination of Atrial Fibrillation and Tricuspid Regurgitation
Authors: Kusaka K , Takahashi T , Kotajima N , Sekiguchi K , Fukumura Y , Murakami M , Kanda T
Published: February 2013

Atrial fibrillation (AF) and tricuspid regurgitation (TR) may induce congestive heart failure (CHD). Using electrocardiography and echocardiography, we examined the clinical characteristics and haemodynamic findings in 100 patients with AF + TR + CHF, AF + TR, AF or TR. The fractional shortening in all groups with AF was significantly decreased compared with the TR group. The ejection fraction in patients with AF + TR + CHF was significantly lower than in the TR group. Twenty-four of the 72 patients with AF and TR (with or without CHF) were treated, and 13 were monitored for heart rate and severity of TR. Eight months after start of treatment the heart rate and typical symptoms and signs of heart failure had improved significantly in nine patients, but the severity of TR did not change. TR worsened in the remaining four patients but they did not develop CHF. Our results suggest that increased heart rate due to the combination of AF and TR could be responsible for CHF.
Comparative Efficacy of Oral and Intravenous Calcitriol Treatment in Haemodialysis Patients: Effects on Serum Biochemistry and Cytokine Levels
Authors: Borazan A , Üstün H , Cefle A , Sekitmez N , Yilmaz A
Published: February 2013

This study compared the effects of oral and intravenous calcitriol on serum biochemistry parameters and levels of bone-resorptive cytokines in haemodialysis patients. Patients were randomized to receive oral ( n = 18) or intravenous ( n = 16) calcitriol treatment for 6 months. Serum levels of total calcium, ionized calcium, intact parathyroid hormone (iPTH), magnesium, alkaline phosphatase, tumour necrosis factor-α (TNF-α), interleukin (IL)-1 and IL-6 were measured at baseline and after 3 and 6 months of treatment. After treatment, serum levels of iPTH, total calcium, ionized calcium, TNF-α, IL-1 and IL-6 were not significantly different from baseline. The intravenous calcitriol treatment group showed significant decreases in levels of iPTH, TNF-α, IL-1 and IL-6 and a significant increase in total calcium level after 3 and 6 months. There was no significant change in serum ionized calcium levels. Significantly decreased serum alkaline phosphatase and magnesium levels were found in both treatment groups after 3 and 6 months. In conclusion, intravenous calcitriol treatment has a significant depressive effect on iPTH and bone-resorptive cytokines in patients undergoing haemodialysis.
A New Approach to Drug Therapy in Non-Alcoholic Steatohepatitis (NASH)
Authors: Fehér J , Lengyel G
Published: February 2013

Liver steatosis is a common human disease, most often caused by long-term alcohol consumption. Non-alcoholic steatohepatitis (NASH) is characterized by similar histopathological features to those observed in alcoholic liver disease, but occurs in the absence of significant alcohol consumption. Several aetiological factors contribute to NASH: obesity, type 2 diabetes mellitus, hyperlipidaemia, pregnancy, different chemical intoxications, parenteral nutrition, jejeuno-ileal bypass, chronic inflammatory bowel disease, nutritional protein deficiency and congenital metabolic disorders. Biochemically, oxidative stress and lipid peroxidation and their ensuing damage are implicated in the pathogenesis of NASH and alcoholic steatohepatitis (probably resulting from free fatty acids in the mitochondria, and induction of the cytochrome P450 isoform CYP2E1 in hepatocytes and Kupffer's cells). This paper deals with the pathomechanisms, clinical findings and currently available therapies for NASH. The potential use of metadoxine in the treatment of NASH is also discussed.
Assessment of Interventricular Septal Motion Using Colour Tissue Doppler Imaging in Adult Patients with Atrial Septal Defect
Authors: Kardesoglu E , Cebeci BS , Celik T , Cingozbay BY , Dincturk M , Demiralp E
Published: February 2013

We aimed to characterize changes in interventricular septum (IVS) motion and any relationship between them and the pulmonary-to-systemic flow ratio (Qp/Qs) in adult patients with atrial septal defect (ASD). Patients and controls were studied using colour tissue Doppler imaging (TDI). The septum length (SL) and distance from the colour change point (CCP) on the IVS to the aortic valve (the CCP distance) were measured on parasternal long axis views. Values normalized for body surface area, and the CCP distance to SL ratio, were calculated.

Q p/ Q s values were correlated with CCP distance, normalized CCP distance and CCP distance: SL ratio. Statistically significant differences in CCP distance, normalized CCP distance and CCP distance: SL ratio were found between the two groups. In the ASD group, there was no correlation between Q p/ Q s and the echocardiographic measurements. The point between the motions in two different directions from the IVS shifted toward the apex in ASD patients compared with controls, and may be a mechanism involved in paradoxical septal motion.
Nicardipine versus Nitroprusside Infusion as Antihypertensive Therapy in Hypertensive Emergencies
Authors: Yang HJ , Kim JG , Lim YS , Ryoo E , Hyun SY , Lee G
Published: February 2013

This prospective study compared the efficacy of nicardipine and nitroprusside for treating hypertensive emergencies by measuring haemodynamic indices and serum catecholamine levels. Patients admitted to the emergency department with a hypertensive crisis and acute pulmonary oedema received intravenous infusions of nitroprusside (starting dose 1 μg/kg per min, n = 20) or nicardipine (starting dose 3 μg/kg per min, n = 20). Both groups experienced significant declines in systolic and diastolic blood pressure after treatment, but there were no significant time-dependent differences between the groups. Heart rate decreased in the nicardipine group and increased in the nitroprusside group, but neither change was significant. Respiration rate decreased and capillary oxygen saturation rate increased after treatment in both groups. Adrenaline and noradrenaline levels decreased significantly after treatment in both groups; noradrenaline levels were significantly decreased in the nicardipine-treated group compared with the nitroprusside-treated group. Injectable nicardipine is easy to use and as effective as nitroprusside for treating hypertensive crisis with acute pulmonary oedema.
The Role of General Practitioners in the Diagnosis and Treatment of Alzheimer's Disease: A Multinational Survey
Authors: Wilkinson D , Stave C , Keohane D , Vincenzino O
Published: February 2013

Alzheimer's disease (AD) is a growing healthcare problem. Early diagnosis and effective treatment would benefit patients and caregivers, as well as having economic implications. We conducted a survey of 741 caregivers of patients with AD in Australia, France, Italy, Spain and the UK to assess the current situation regarding the diagnosis and treatment of AD in routine clinical practice. The average time from when symptoms were first noticed by the caregiver to making the first doctor's appointment was 4 months, but 22% of caregivers waited more than 1 year before consulting a doctor. Although the majority of patients (74%) consulted their general practitioner first, the diagnosis was more likely to be made by a specialist; on average, there was a 1-year delay from when symptoms were first noticed by the caregiver to diagnosis. Access to AD care is restricted by many national healthcare systems. The delay in diagnosis imposed by such restrictions impacts on access to early and effective treatment.
Efficacy of Prophylactic Ondansetron in a Patient-Controlled Analgesia Environment
Authors: Han SH , Lim YJ , Ro YJ , Lee SC , Park YS , Kim YC
Published: February 2013

We conducted a prospective, randomized, double-blind, placebo-controlled trial to examine the efficacy of prophylactic ondansetron on post-operative nausea and vomiting (PONV) during opioid patient-controlled analgesia (PCA). In total, 374 patients using opioid PCA, but otherwise considered to be low risk for PONV, were randomly allocated to ondansetron (4 mg given intravenously and 16 mg added into the PCA pump) or saline (control group). PONV was evaluated in terms of nausea graded on a visual analogue scale, and the number of patients who experienced emetic episodes or needed rescue anti-emetics in the 48-h post-operative period. Patient satisfaction for PCA was scored at the end of the evaluation period. The only difference between the two groups was the higher number of headaches in the ondansetron group. In patients using opioid PCA, but with no other high risk factors for PONV, prophylactic ondansetron does not have any clinical benefit.
Adherence to Calcium Channel Blocker Therapy in Older Adults: A Comparison of Amlodipine and Felodipine
Authors: Menzin J , Lang K , Elliott WJ , Boulanger L , Arocho R , Tran M-H , Friedman M
Published: February 2013

The efficacy of dihydropyridine calcium channel blockers for treating hypertension appears to be similar, but a variety of factors, including patient characteristics, tolerability and pharmacokinetic properties, may influence treatment adherence and outcome. We aimed to evaluate treatment adherence in clinical practice among older hypertensive adults (50+ years) prescribed amlodipine or felodipine for the first time as part of the California Medicaid (Medi-Cal) program. We used a retrospective, matched, cohort-analysis design. Over 1 year, patients prescribed amlodipine were 21% less likely to discontinue study treatment than those prescribed felodipine. Discontinuation tended to occur early, with 20% and 30% of amlodipine and felodipine patients, respectively, discontinuing treatment after one prescription. A non-significant difference in favour of amlodipine was demonstrated for anti-anginal medication use among patients taking these drugs at baseline. This study suggests that use of amlodipine may be associated with improved adherence, compared with felodipine, among older out-patients in the Medi-Cal program.
Intra-articular Injection of Tenoxicam in Rats: Assessment of the Local Effects on the Articular Cartilage and Synovium
Authors: Ozyuvaci H , Bilgic B , Ozyuvaci E , Altan A , Altug T , Karaca C
Published: February 2013

This study investigated the possible local adverse effects of intra-articular administration of tenoxicam in the rat knee joint. A total of 50 rats were given 0.25 ml of a standard preparation of tenoxicam by injection into the right knee joint and 0.25 ml of 0.9% saline solution by injection into the left knee joint as a control. Groups of 10 rats were killed 24 h, 48 h, 7 days, 14 days and 21 days after tenoxicam administration. Two rats were sham operated; one was killed on the first day and the other on the second day after this procedure. All the joints were prepared and sectioned for histological examination. Tissue loss and oedema were observed in the specimens obtained 24 h and 48 h after treatment with tenoxicam. No pathological changes were observed in the 7-day, 14-day and 21-day specimens, or in the control joints. Caution should be exercised when using intra-articular tenoxicam for postoperative analgesia.
Comparison of the Effects of Nicardipine and Sodium Nitroprusside for Control of Increased Blood Pressure after Coronary Artery Bypass Graft Surgery
Authors: Kwak YL , Oh YJ , Bang SO , Lee JH , Jeong SM , Hong YW
Published: February 2013

We compared the haemodynamic effects of nicardipine and sodium nitroprusside after coronary artery bypass graft surgery. When post-surgery systolic blood pressure reached > 150 mmHg, patients were randomly given nicardipine (N group, n = 26) or sodium nitroprusside (S group, n = 21). The drugs were infused at a rate of 2 μg/kg per min for 10 min. If the target blood pressure (120-140 mmHg) was not achieved, the infusion rate was increased by 1 üg/kg per min every 10 min. Cardiac and stroke volume indices had increased significantly in the N group after 10 min and in both groups after 60 min. The infusion duration and total dose of drug were significantly lower in the N group compared with the S group. Nicardipine infusion controlled post-operative hypertension more rapidly and was superior to sodium nitroprusside in maintaining left ventricular performance immediately after drug infusion.
Dehydroepiandrosterone Prevents Oxidative Injury in Obstructive Jaundice in Rats
Authors: Çelebi F , Yilmaz I , Aksoy H , Gümüş M , Taysi S , Oren D
Published: February 2013

We investigated the effect of dehydroepiandrosterone (DHEA) on oxidative injury in obstructive jaundice using three groups of rats: sham-operated group; common bile duct (CBD) group — the CBD was ligated; and DHEA group — DHEA administration followed CBD ligation. Liver function tests were performed using blood samples, and malondialdehyde concentration (MDA), superoxide dismutase activities (SOD), glutathione peroxidase (GPx), and total glutathione (tGSH) concentrations were measured in liver tissue. Serum alkaline phosphatase, γ-glutamyltransferase and alanine aminotransferase activity were significantly elevated in the CBD group compared with the other groups. Serum aspartate aminotransferase and total bilirubin were highest in the CBD group; the MDA concentration was higher in the CBD group than the sham group. There were no significant differences in GPx activity among the groups. SOD activity and tGSH concentration were significantly lower in the CBD group than the other groups. DHEA may protect hepatic tissue against oxidative injury in obstructive jaundice by decreasing MDA concentration and increasing SOD activity and tGSH concentration.
Effects of n-3 Fatty Acids on Serum Interleukin-6, Tumour Necrosis Factor-α and Soluble Tumour Necrosis Factor Receptor p55 in Active Rheumatoid Arthritis
Authors: Sundrarjun T , Komindr S , Archararit N , Dahlan W , Puchaiwatananon O , Angthararak S , Udomsuppayakul U , Chuncharunee S
Published: February 2013

We investigated the effects of a low n-6 fatty acid (FA) diet supplemented with fish oil on serum pro-inflammatory cytokine concentrations and clinical variables in patients with active rheumatoid arthritis (RA). Sixty patients were randomly assigned to receive a diet low in n-6 FAs and n-3 FAs supplement (fish oil group), a diet low in n-6 FAs and placebo (placebo group), or no special diet or intervention (control group). Serum cytokines and clinical and biochemical variables were evaluated at baseline and various timepoints. At week 18 the fish oil group had significant reductions in linoleic acid, C-reactive protein (CRP) and soluble tumour necrosis factor receptor p55 (sTNF-R p55), and significant elevations in eicosapentaenoic acid and docosahexaenoic acid compared with baseline. There were no significant differences in the clinical variables between the three groups. At week 24 there were significant reductions in interleukin-6 and TNF-α in the fish oil and placebo groups. Supplementation with n-3 FA and a low n-6 FA intake decreased serum sTNF-R p55 and CRP levels in patients with RA.
Selective Binding of Sucralfate to Endoscopic Mucosal Resection-Induced Gastric Ulcer: Evaluation of Aluminium Adherence
Authors: Itoh T , Kusaka K , Kawaura K , Kashimura K , Yamakawa J , Takahashi T , Kanda T
Published: February 2013

We evaluated the effect of sucralfate in patients with early gastric cancer in endoscopic mucosal resection (EMR)-induced gastric ulcers, and in rats with acetic acid-induced ulcers, by measuring concentrations of aluminium adhering to mucosal lesions. Twenty-two patients who underwent EMR received sucralfate with or without ranitidine and were examined endoscopically after 1 week, 2 weeks and 3 weeks. Gastric juice pH and concentration of aluminium in samples of ulcerated and normal mucosa were measured at various time-points. Good ulcer healing was observed in all patients. Significantly higher concentrations of aluminium were found in ulcerated tissue compared with normal mucosa. This selective binding of sucralfate was even found 12 h after drug administration and was confirmed in acetic acid-induced ulcers in 40 rats. Neutral rather than acid gastric juice was observed up to 12 h after the administration of sucralfate alone. These results suggest that sucralfate with or without ranitidine may contribute to the healing of EMR-induced ulcers by selectively binding to lesions.
Acute Painful Neuropathy Restricted to the Abdomen following Rapid Glycaemic Control in Type 2 Diabetes
Authors: Takayama S , Takahashi Y , Osawa M , Iwamoto Y
Published: February 2013

A 46-year-old Japanese man with type 2 diabetes mellitus, whose only diabetic complication was simple retinopathy, developed acute painful neuropathy. This presented as paresthesia and hyperesthesia restricted to the abdomen. The patient's haemoglobin A1c had dropped from 12% to 7.5% within 5 months, following a rapid improvement in glycaemic control. On investigation, there were no indications of disease in the intraabdominal area. Nerve conduction studies were consistent with mild sensorimotor peripheral and autonomic neuropathy. The patient required medication (mexiletine, sulpiride and imipramine hydrochloride) to control the pain. Four months after presentation, the symptoms showed a dramatic improvement and the treatment for pain relief was discontinued without any recurrence of paresthesia or hyperesthesia in the patient's abdomen. This was a very unusual case of diabetic post-treatment painful neuropathy in which the prominent features were severe pain, paresthesia and hyperesthesia restricted to the abdomen.
White Blood Cell Count and C-reactive Protein Predict Short-term Prognosis in Acute Myocardial Infarction
Authors: Keskin O , Ulusoy RE , Kalemoglu M , Us MH , Yildirim I , Tarcin O , Pocan S , Ardiç N
Published: February 2013

An elevated white blood cell (WBC) count and C-reactive protein (CRP) concentration are associated with acute myocardial infarction (AMI) and long-term mortality in patients with coronary artery disease. Their relationship with short-term prognosis following AMI is less clear, however. We investigated the relationship between WBC count and CRP concentration, obtained at the time of admission, and the development of subsequent ischaemic coronary events (SICE) within 30 days of AMI in 177 patients. After adjustment for confounding factors, CRP concentration was found to be a strong independent predictor for SICE within 30 days in patients with AMI. WBC count was not found to be an independent predictor, but there was a strong correlation between high WBC counts and the onset of SICE within 30 days in patients with AMI. We conclude that CRP concentration and WBC count could be used to predict the short-term prognosis of patients with AMI.
Antioxidant and Cardioprotective Properties of the Sulphydryl Angiotensinconverting Enzyme Inhibitor Zofenopril
Authors: Evangelista S , Manzini S
Published: February 2013

Zofenopril, a new potent sulphydryl angiotensin-converting enzyme (ACE) inhibitor, is characterized by high lipophilicity, selective cardiac ACE inhibition, and antioxidant and tissue protective activities. In vitro and in vivo experiments suggest that zofenopril exerts antioxidant properties at clinically achievable tissue concentrations. In endothelial cells, zofenopril enhances nitric oxide production, attenuates atherosclerotic lesion development and inhibits adhesion molecule expression by reducing reactive oxygen species. These peculiar characteristics are reflected in the drug's cardioprotective activity, which has been shown to be greater than that of non-sulphydryl ACE inhibitors. Cardiac hypertrophy was also reduced by chronic zofenopril administration, independently of its blood pressure-reducing effect. ACE inhibitors with a sulphydryl group could have an advantage in improving vascular function and reducing cardiac impairment compared with non-sulphydryl-containing ACE inhibitors. This could explain zofenopril's remarkable clinical efficacy post-infarction, and potentially beneficial use in prevention and therapy of cardiovascular diseases, such as atherosclerosis, thrombosis and heart failure.
Preparation and Evaluation of a Hyaluronate-Collagen Film for Preventing Post-Surgical Adhesion
Authors: Tsai S-W , Fang J-F , Yang C-L , Chen J-H , Su L-T , Jan S-H
Published: February 2013

Post-surgical adhesion occurs when fibrous strands of scar tissue form, leading to the abnormal joining of anatomical structures. Patients undergoing abdominal surgery are at risk of the complications associated with intraperitoneal adhesions. Hyaluronic acid (HA) is a biocompatible, biodegradable and non-toxic natural polymer, which is gaining popularity as a barrier agent for preventing post-surgical adhesions. As HA is water-soluble and rapidly degraded in vivo, chemical modification is required to produce a non-soluble sheet that might be used to prevent tissue adhesion. We developed a range of biocompatible cross-linked HA-collagen composites and then evaluated them in a rat model of post-surgical adhesion. The results showed that cross-linked HA-collagen was almost totally resistant to hyaluronidase digestion. HA-collagen membranes induced minimal tissue reactions and were bioresorbed within 14 days post-surgery. These results suggest that cross-linked HA-collagen membrane may be a valuable anti-adhesion material to prevent post-surgical intraperitoneal adhesion.
Incidence of the Type and Calcification Patterns in Patients with Elongated Styloid Process
Authors: Ilgüy M , Ilgüy D , Güler N , Bayirli G
Published: February 2013

We investigated the incidence of elongated styloid process (Eagle's syndrome) using panoramic radiographs taken of 860 patients referred to our clinic. Any styloid process identified was classified according to its length, type and the pattern of calcification. Fifty-nine elongated styloid processes were identified in 32 patients (3.7%), most being bilateral; 24 patients were female and eight were male (female/male ratio: 3:1). The mean age of these patients was 43 ± 14 years (range: 18 − 78 years). Type I (elongated) was the most frequent type on both sides (42/59); and the most frequent patterns of calcification were partially calcified on the left side (18/59) and completely calcified on the right side (16/59). Only two patients were symptomatic. A corrected differential diagnosis is important to distinguish elongated styloid process from other pathologies with partially overlapping symptoms. We would recommend that clinicians consider the possibility of Eagle's syndrome when both the clinical and radiographic evidence support this diagnosis.
Effect of Angiotensin-converting Enzyme Inhibitors on Phenylephrine Responsiveness in Patients with Valvular Heart Disease
Authors: Kwak HJ , Kwak YL , Oh YJ , Shim YH , Kim SH , Hong YW
Published: February 2013

We studied patients with valvular heart disease to investigate whether chronic pre-operative treatment with angiotensin-converting enzyme (ACE) inhibitors modulates the effect of phenylephrine (PE) on anaesthesia-induced hypotension. Sixty-five patients were enrolled in the study and hypotension developed after anaesthesia in 36 (18 in the control group and 18 in the ACE inhibitor group). These patients received PE infusions, which were increased in a stepwise fashion at 10-min intervals. Increased mean arterial pressure due to PE infusion was significant only in the control group. There was no significant difference in pressor response or change in haemodynamic variables with PE infusion between the two groups. Treatment with ACE inhibitors did not increase the incidence of hypotensive episodes or significantly modify pressor response after anaesthesia in patients with valvular heart disease.
Pre-treatment Haemoglobin Concentration is a Prognostic Factor in Patients with Early-stage Breast Cancer
Authors: Kandemir EG , Mayadagli A , Turken O , Yaylaci M , Ozturk A
Published: February 2013

We investigated the prevalence of anaemia (haemoglobin concentration < 12 g/dl) in 336 women with early-stage breast cancer and its association with other known prognostic factors. The median follow-up period was 60.5 months (range 9-123 months). Seventy-nine women (23.5%) had a low pre-treatment haemoglobin concentration, but anaemia was not correlated with age, tumour size, nodal status, histological grade or hormone receptor status. Univariate analysis revealed that disease-free survival and overall survival were shorter in patients with anaemia at the time of diagnosis than in patients with normal haemoglobin concentrations. Anaemia remained a significant prognostic factor for disease-free survival and overall survival in the multivariate analysis (relative risk, 1.884 and 1.785, respectively). These results suggest that pre-treatment haemoglobin concentration is an independent prognostic factor in patients with early-stage breast cancer.
Hydroxyethyl Starch Inhibits Intestinal Production of Cytokines and Activation of Transcription Factors in Endotoxaemic Rats
Authors: Lv R , Zhou W , Yang J-J , Jin Y , Xu J-G
Published: February 2013

We studied the effect of hydroxyethyl starch (HES) on intestinal production of cytokines and activation of transcription factors in sepsis. Septic rats, induced by intraperitoneal lipopolysaccharide (LPS) (5 mg/kg), were treated with intravenous HES (16 ml/kg) or saline (64 ml/kg). Rat ileal tissues were collected at 2 h, 3 h or 6 h after LPS challenge. Levels of tumour necrosis factor alpha (TNF-α), interleukin (IL) 1β, IL-6, IL-8 and IL-10, cytokine mRNAs, activities of nuclear factor kappa-B (NF-κB) and activator protein-1 (AP-1), and the number of ileal myeloperoxidase (MPO)-positive cells were determined for each group. HES significantly reduced the LPS-induced increase in intestinal levels of TNF-α, IL-1β, IL-6, IL-8 and their corresponding mRNAs. HES also decreased the number of MPO-positive cells induced by LPS and inhibited activation of NF-κB and AP-1. The results suggest that in sepsis, HES may down-regulate intestinal pro-inflammatory cytokine production via suppression of NF-κB and AP-1 activation.
Comparing Risk-adjusted Hospital Mortality for CABG and AMI Patients
Authors: Park HK , Ahn HS , Yoon SJ , Lee HY , Hong JM , Lee SW , Hann HJ
Published: February 2013

The objectives of this study were to compare the risk-adjusted mortality of coronary artery bypass graft (CABG) and acute myocardial infarction (AMI) patients simultaneously in six hospitals in Seoul, Korea, and to investigate the relationship between these performance measures by developing a predictive model of mortality. The medical records of 749 AMI and 564 CABG patients were reviewed. A predictive model was developed using logistic regression, including 170 variables selected as risk factors for risk adjustment. The validity of our predictive model was demonstrated to be within an acceptable range. The results showed that one hospital with a significantly low AMI mortality rate also had a low CABG mortality rate, while another hospital with a significantly high AMI mortality rate also had a high CABG mortality rate. Our results implied that hospitals providing good-quality medical management of coronary artery disease also provided a good-quality surgical service.
Protective Antioxidant Effects of Carvedilol in a Rat Model of Ischaemia-reperfusion Injury
Authors: Akbas H , Ozden M , Kanko M , Maral H , Bulbul S , Yavuz S , Ozker E , Berki T
Published: February 2013

This study investigated the protective effects of carvedilol, a potent antioxidant, in a rat model of tourniquet-induced ischaemia-reperfusion injury of the hind limb. Thirty rats were divided equally into three groups: the control group (group 1) was only anaesthetized, without creating an ischaemia-reperfusion injury; group 2 was submitted to ischaemia (4 h), followed by a 2-h reperfusion period; and group 3 was pre-treated with carvedilol (2 mg/kg per day) for 10 days prior to ischaemia-reperfusion. Ischaemia-reperfusion produced a significant decrease in superoxide dismutase and glutathione peroxidase activities in the liver, lungs, muscle and serum compared with control treatment, and pre-treatment with carvedilol prevented these changes. Ischaemia-reperfusion caused a significant increase in malondialdehyde and nitric oxide (NO) levels in liver, lungs, muscle (except NO) and serum compared with control treatment, and carvedilol prevented these changes. In conclusion, it might be inferred that carvedilol could be used safely to prevent oxidative injury during reperfusion following ischaemia in humans.