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Role of plasma asymmetric dimethylarginine levels in diagnosis and follow-up of acute pulmonary thromboembolism
No full textPurpose: Nitric oxide is an important mediator that plays a major role in platelet adhesion/aggregation. Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of endothelial nitric oxide synthase. In this study, we aimed to examine the ADMA levels in diagnosis and follow-up of acute pulmonary thromboembolism.
Materials and Methods: The study was designed as a prospective study. Thirty consecutive patients with acute PTE and 20 healthy volunteers were enrolled into the study. Patients were followed 1 month. Plasma ADMA levels were measured on admission and following the first month.
Results: Ona dmision there was statistically significant difference between two groups. When we compared serum ADMA levels difference between patients group with resolution and without resolution, there was not any statistically significant difference. There was a significant difference between serum ADMA levels of massive group and the other 2 groups.
Conclusion: Plasma ADMA levels elevated in patients with pulmonary thromboembolism. This finding supports the idea ADMA levels correlated with thrombus burden
On reflexivity of the Bochner space L-P (mu, E) for arbitrary mu
No full textLet (Omega, A, mu) be a finite positive measure space, E a Banach space, and 1 < p < infinity. It is known that the Bochner space L-P (mu, E) is reflexive if and only if E is reflexive. It is also known that L(L-1(mu), E) = L-infinity (mu, E) if and only if E has the Radon-Nikodym property. In this study, as an application of hyperstonean spaces, these results are extended to arbitrary measures by replacing the given measure space by an equivalent perfect one
Bilateral Asymmetric Rhegmatogenous Retinal Detachment in a Patient with Stickler Syndrome
No full textHere we present the long-term anatomical and visual outcomes of bilateral asymmetric rhegmatogenous retinal detachment repair in a patient with Stickler syndrome. A 17-year-old girl presented with decreased visual acuity in both eyes for more than one year. Her best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.05 in the left eye. Slit-lamp anterior segment examination revealed subcapsular cataract in both eyes. Fundus examination showed bilateral rhegmatogenous retinal detachment, chronic retinal detachment accompanied by multiple retinal holes, tears and membranous fibrillary vitreous in the peripheral retina. Grade C2 proliferative vitreoretinopathy was observed in the left eye. Scleral buckling surgery was performed initially for both eyes. After the primary surgical procedure, retinal reattachment was achieved in the right eye and the left eye underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy (PPV), and silicone oil injection. After these surgical procedures retinal reattachment was achieved in the left eye. Silicone oil removal was performed six months after PPV surgery. After surgical treatment, BCVA was 0.6 in the right eye at the end of the 3.5-year follow-up period. After silicone oil removal, BCVA reached 0.2 in the left eye after 36 months of follow-up and retinal reattachment was achieved in both eyes. Scleral buckling surgery and PPV are effective and confidential methods for the treatment of chronic retinal detachment cases in Stickler syndrome
Solitary Fibrous Tumor of the Vagina with Potentially Malignant Features: A Case Report and Review of the Literature
No full textExtrapleural solitary fibrous tumors are being increasingly reported. The retroperitoneum, deep soft tissues of the proximal extremities, abdominal cavity, trunk, head and neck are among the most common extraserosal locations reported. A recurrent solitary fibrous tumor involving the vagina of a 25-year-old woman is reported. Microscopically, the tumor was hypercellular and composed of mitotically active spindle cells. Immunohistochemically, the tumor cells were positive for vimentin, CD34, and bcl-2. Four cases of solitary fibrous tumors involving the vagina have been reported previously. To the best of our knowledge, this is the first case with clinical and histological features suggestive of a malignant behavior
Obese patients require higher, but not high pneumatic tourniquet inflation pressures using a novel technique during total knee arthroplasty
No full textObjectives: This study aims to investigate the effect of obesity on pneumatic tourniquet inflation pressures determined with a novel formula during total knee arthroplasty (TKA).
Patients and methods: Data of 208 patients (19 males, 199 females; mean age 69.8 years; range, 53 to 84 years) who were performed TKA between January 2013 and December 2016 were evaluated prospectively. Patients were divided into two groups as non-obese (body mass index [BMI] 30.0 kg/m(2)) according to BMI. Tourniquet inflation pressures were set using arterial occlusion pressure (AOP) estimation method and adding 20 mmHg of safety margin to AOP value. All patients were assessed intra-and postoperatively with outcome measures such as systolic blood pressure, AOP, tourniquet pressure and its effectiveness. The quality of the surgical field and complications were assessed by the surgical team in a blinded fashion.
Results: The study included 118 and 90 lower extremity operations in obese and non-obese groups, respectively. Compared to non-obese group; extremity circumference, initial and maximal systolic blood pressures, AOP values, initial and maximal tourniquet pressures were higher in obese group. The performance of the tourniquet was assessed as "excellent" and "good" at almost all stages of the surgical procedure in all patients in both groups. No complication occurred intra-or postoperatively.
Conclusion: Compared to non-obese patients, higher tourniquet inflation pressure is required in obese patients during TKA due to their wider extremity circumference and higher systolic blood pressure profile
Tourniquet pressure settings based on limb occlusion pressure determination or arterial occlusion pressure estimation in total knee arthroplasty? A prospective, randomized, double blind trial
No full textObjective: The aim of this study was to compare the limb occlusion pressure (LOP) determination and arterial occlusion pressure (AOP) estimation methods for tourniquet pressure setting in adult patients undergoing knee arthroplasty under combined spinal-epidural anesthesia.
Methods: Ninety-three patients were randomized into two groups. Pneumatic tourniquet inflation pressures were adjusted based either on LOP determination or AOP estimation in Group 1 (46 patients, 38 female and 8 male; mean age: 67.71 +/- 9.17) and Group 2 (47 patients, 40 female and 7 male; mean age: 70.31 +/- 8.27), respectively. Initial and maximal systolic blood pressures, LOP/AOP levels, required time to estimate AOP/determinate LOP and set the cuff pressure, initial and maximal tourniquet pressures and tourniquet time were recorded. The effectiveness of the tourniquet was assessed by the orthopedic surgeons using a Likert scale.
Results: Initial and maximal systolic blood pressures, determined LOP, estimated AOP, duration of tourniquet and the performance of the tourniquet were not different between groups. However, the initial (182.44 +/- 14.59 mm Hg vs. 200.69 +/- 15.55 mm Hg) and maximal tourniquet pressures (186.91 +/- 12.91 mm Hg vs. 200.69 +/- 15.55 mm Hg) were significantly lower, the time required to estimate AOP and set the tourniquet cuff pressure was significantly less (23.91 +/- 4.77 s vs. 178.81 +/- 25.46 s) in Group II (p = 0.000). No complications that could be related to the tourniquet were observed during or after surgery.
Conclusion: Tourniquet inflation pressure setting based on AOP estimation method provides a bloodless surgical field that is comparable to that of LOP determination method with lower pneumatic inflation pressure and less required time for cuff pressure adjustment in adult patients undergoing total knee arthroplasty under combined spinal epidural anesthesia. (C) 2018 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V
Importance of laboratory parameters in patients with obstructive sleep apnea and their relationship with cardiovascular diseases
No full textBackgroundOstructive sleep apnea (OSA) is an independent risk factor for the development of cardiovascular events. Platelet activation and inflammation are the mechanisms involved in the association between OSA and cardiovascular disease (CVD). The markers of platelet activation and inflammation are the mean platelet volume (MPV), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), neutrophil- lymphocyte ratio (NLR). We aimed to define the association of NLR, PLR, RDW, and MPV with the severity of disease and the presence of CVD.
MethodsThis study consisted of 300 patients who were admitted to the sleep laboratory. The patients were classified according to their apnea- hypopnea index (AHI) scores as OSA negative (Group A: AHI30).
ResultsThere were no significant differences in the NLR, PLR, and MPV among the groups (P>.05); only RDW differed significantly (P=.04). RDW was significantly higher in patients with than without risk factors for CVD [15.6% (15.4-15.7) vs 15.3% (15.1-15.3), respectively; P=.02].
ConclusionsNLR, PLR, MPV, and RDW are widely available and easily obtained from a routinely performed hemogram. Among these laboratory parameters, only RDW can demonstrate the reverse consequences of OSA-associated comorbidities, because vascular damage due to systemic inflammation is an important underlying mechanism in these diseases. RDW might be used as a marker of the response and patient compliance with continuous positive airway pressure treatment
Assessment of the Platelet Parameters in Children With Type 1 Diabetes Mellitus
No full textBackground: The purpose of this study was to assess platelet morphological parameters in children and adolescents with type 1 diabetes mellitus (T1DM) and to determine the factors affecting those parameters.
Methods: A total of 80 children with type 1 diabetes mellitus and 80 healthy control subjects were included in this study. All subjects' platelet parameters including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) levels were measured. Age at diagnosis, duration of diabetes, and hemoglobin A1c (HbA1c) levels of patients with T1DM were also recorded.
Results: There was no significant difference in PLT, MPV, PDW and PCT values between patients and controls (P > 0.05). PCT and PLT values were higher in patients with poor metabolic control compared to the other cases (P = 0.002, P = 0.005). Positive correlation was found between HbA1c and PCT (r = 0.28, P = 0.01). There was no correlation between HbA1c and MPV, PDW and PLT.
Conclusions: Indices of platelet morphology such as PCT, PLT, PDW and MPV were similar in children with T1DM and in healthy controls. However, an increase in PCT values in poor glycemic control group and a significant positive correlation between PCT and HbA1c were observed, suggesting that PCT levels may be an early marker of vascular complication
Angiopoietin-1, Angiopoietin-2, and Periostin Levels in Children with Recurrent Wheeze
No full textBackground: Recurrent wheeze (RW) is frequent in preschool children. Wheezing phenotypes, asthma predictive index (API), and modified API (mAPI) have been described for clinical purposes. Our aim was to examine whether inflammatory markers including serum angiopoietin (Ang)-1, Ang-2, and periostin levels differ according to wheezing phenotypes and mAPI. Materials and Methods: Ninety-eight children who were <4 years of age with history of at least 4 episodes of wheezing during the past 12 months and 51 age-matched healthy controls were included in the study. Children with RW were classified according to wheezing phenotypes as episodic viral wheeze or multitrigger wheeze, and positive or negative mAPI. Blood for Ang-1, Ang-2, and periostin levels was drawn during wheezing episode-free periods. Results: Atopic children with RW (31.4 +/- 34.4 ng/mL) demonstrated higher serum Ang-1 levels than nonatopic children (16.5 +/- 13.8 ng/mL) with RW (P = 0.03). When we compared children according to wheezing phenotypes, we could not find any difference in serum Ang-1, Ang-2, and periostin levels between groups. Children with positive mAPI showed similar Ang-1, Ang-2, and periostin levels with children having negative API and healthy children. Conclusions: We have found higher serum Ang-1 levels in atopic children with RW, and this result might be explained by increased inflammation. The evidence was not strong enough to associate serum Ang-1, Ang-2, or periostin and asthma in preschool children with RW. However, Ang-1 can be a candidate for investigating its role in predicting atopic children and diagnosing atopic childhood asthma