Performance of anaerobic sequencing batch reactor in the treatment of pharmaceutical wastewater containing erythromycin and sulfamethoxazole mixture

This study evaluates the joint effects of erythromycin-sulfamethoxazole (ES) combinations on anaerobic treatment efficiency and the potential for antibiotic degradation during anaerobic sequencing batch reactor operation. The experiments involved two identical anaerobic sequencing batch reactors. One reactor, as control unit, was fed with synthetic wastewater while the other reactor (ES) was fed with a synthetic substrate mixture including ES antibiotic combinations. The influence of ES antibiotic mixtures on chemical oxygen demand (COD) removal, volatile fatty acid production, antibiotic degradation, biogas production, and composition were investigated. The influent antibiotic concentration was gradually increased over 10 stages, until the metabolic collapse of the reactors, which occurred at 360 days for the ES reactor. The results suggest that substrate/COD utilization and biogas/methane generation affect performance of the anaerobic reactors at higher concentration. In addition, an average of 40% erythromycin and 37% sulfamethoxazole reduction was achieved in the ES reactor. These results indicated that these antibiotics were partly biodegradable in the anaerobic reactor system.

Efficacy of preincisional levobupivacaine for adult tonsillectomy patients

PROBLEM/OBJECTIVE

We compared the effects of preincisional peritonsillar infiltration of 5 ml levobupivacaine hydrochloride (50 mg/10 ml) on bleeding during surgery and pain after tonsillectomy in patients aged 16 years or older.

METHODOLOGY

The study was conducted in 44 adult patients who underwent tonsillectomy. These patients were randomized to either the study group (SG) who received levobupivacaine infiltration to the peritonsillary fossae prior to surgery, or a control group (CG) treated with 0.9% sodium chloride infiltration to the peritonsillary fossae prior to incision. The volume of intraoperative bleeding was recorded. Pain was evaluated using a visual analogue scale (VAS). The first pain score was assessed immediately after arriving in the postoperative care unit. VAS scores were subsequently re-assessed 2, 4, 8, 12, and 24 hours postoperatively. The first analgesic requirement was assessed 24 hours postoperatively.

RESULTS

The pain relieving effect in the levobupivacaine group was statistically significant 2, 4, 12, and 24 hours postoperatively (p ≤ 0.05), but there was no difference in VAS scores between groups at the first and 8-hour postoperative assessments. There were no differences between the two groups regarding analgesic requirements. The difference between the mean intraoperative blood loss in the SG and CG was statistically significant (p ≤ 0.05). No serious complications were observed in either group.

CONCLUSION

Preincisional levobupivacaine infiltration seems to be a safe and easily applied medication for postoperative pain control, and decreased the volume of intraoperative blood loss in adult patients after tonsillectomy.

Adropin: a key component and potential gatekeeper of metabolic disturbances in policystic ovarian syndrome

PURPOSE

The aim of the current study was to evaluate potential relationships between serum adropin levels and metabolic parameters in polycystic ovary syndrome (PCOS).

MATERIALS AND METHODS

Twenty women with PCOS and 20 healthy, age and body mass index (BMI) matched controls were included in the study. All subjects underwent venous blood drawing on the early follicular phase after an overnight fasting. Serum adropin levels were measured with enzyme immunosorbent assay (EIA). The relationships between serum adropin levels and metabolic parameters were also assessed.

RESULTS

Serum adropin levels were found to be significantly lower in women with PCOS when compared to control group (p < 0.001). Serum adropin level was correlated negatively with fasting serum insulin levels, homeostasis model of assessment - insulin resistance (HOMA-IR) and serum lipid markers including cholesterol, very low-density lipoprotein, and triglycerides (TG) in PCOS patients (p < 0.05).

CONCLUSION

The findings of current study suggest that women with PCOS have low serum adropin levels that may contribute to the underlying pathogenesis of metabolic disturbances in PCOS.

Prognosis of proliferative lupus nephritis subsets in the Louvain Lupus Nephritis inception Cohort

Objective

The objective of this paper is to evaluate whether the different International Society of Nephrology/Renal Pathology Society (ISN/RPS) classes of proliferative lupus nephritis (LN) have a distinct baseline presentation, short-term response to immunosuppression (IS) and long-term prognosis.

Methods

Ninety-eight patients with new onset (first renal biopsy) ISN/RPS proliferative LN (Class III: n = 24; IV-S: n = 23; IV-G: n = 51) were diagnosed at our institution between 1995 and 2012 (Louvain Lupus Nephritis inception Cohort). Their baseline renal parameters, primary response to IS at one year, survival and long-term renal outcome (mean follow-up: 77 months) were compared.

Results

At baseline, serum creatinine and 24-hour proteinuria were higher in Class IV-G, as was activity index on renal biopsy in Class IV-S and IV-G compared to III. Upon treatment, renal parameters improved with the same kinetics and to the same extent in the three pathological classes. On repeat renal biopsies ( n = 43), activity indices dropped similarly. Poor outcomes (death, end-stage renal disease, renal impairment defined by an eGFR <60 ml/min/1.73 m2) did not statistically differ between groups, although there was a trend toward more renal impairment at follow-up in Class IV-G compared to IV-S and III. Finally, the presence of even mild chronic lesions on baseline biopsy was clearly predictive of late renal outcome.

Conclusion

Subsetting proliferative LN into Class III, IV-S and IV-G provides less clinically discriminant prognostic information than baseline chronicity index.

The first year of the Venlo percutaneous coronary intervention program: procedural and 6-month clinical outcomes

Objectives

Analysis of the first results of off-site percutaneous coronary interventions (PCI) and fractional flow reserve (FFR) measurements at VieCuri Medical Centre for Northern Limburg in Venlo.

Background

Off-site PCI is accepted in the European and American Cardiac Guidelines as the need for PCI increases and it has been proven to be a safe treatment option for acute coronary syndrome.

Methods

Retrospective cohort study reporting characteristics, PCI and FFR specifications, complications and 6-month follow-up for all consecutive patients from the beginning of off-site PCI in Venlo until July 2012. If possible, the data were compared with those of Medical Centre Alkmaar, the first off-site PCI centre in the Netherlands.

Results

Of the 333 patients, 19 (5.7 %) had a procedural complication. At 6 months, a major adverse cardiovascular event (MACE) occurred in 43 (13.1 %) patients. There were no deaths or emergency surgery related to the PCI or FFR procedures. There was no significant difference in occurrence of a MACE or adverse cerebral event between the Alkmaar and Venlo population in the 30-day follow-up.

Conclusion

This study demonstrates off-site PCI at VieCuri Venlo to have a high success rate. Furthermore, there was a low complication rate, low MACE and no procedure-related mortality.

Prevention of bone loss by Panax ginseng in a rat model of inflammation-induced bone loss

This study evaluated the protective effect of Panax Ginseng (PG) on bone metabolism in an experimental ovariectomy (OVX) model of osteoporosis in which inflammation was induced by subcutaneous magnesium silicate. The groups were: sham control (Group1, SH), sham+inflammation (Group2, SHinf), OVX (Group3), OVX+inflammation (Group4, OVXinf), OVX+inflammation+PG 100 mg/kg (Group5, OVXinf+PG1), OVX+inflammation+PG 200 mg/kg (Group6, OVXinf+PG2), OVX+PG 100 mg/kg (Group7, OVX+PG1), OVX+PG 200 mg/kg (Group8, OVX+PG1). After the OVX surgery, all the groups were allowed to recover for two months. On the 59th day after the OVX, inflammation was induced in Groups 2, 4, 5, and 6 by subcutaneous injections of magnesium silicate in the back of the animals. Groups 5 and 7 were administered oral PG 100 mg/kg, and Groups 6 and 8 were administered oral PG 200 mg/kg from the 60th to the 80th day. PG 200 mg/kg was able to restore BMD, up to values measured in both the OVX and the SH animals. The levels of OC and OP decreased in OVXinf+PG1 and OVXinf+PG2 groups. The serum levels of TNF—α, IL—1β, and IL—6 were increased significantly in the OVXinf rats compared with the SH group. The present data showed that PG protected against in the OVX model and in inflammation-induced bone loss rat model.

Serum concentration and kidney expression of salusin-α and salusin-β in rats with metabolic syndrome induced by fructose

Salusins expressed in a variety of tissues exert a hypotensive effect owing to their vasodilator action. They are found in serum and tissues in two different forms: salusin-α and salusin-β. Metabolic syndrome (MetS) is an important public health problem characterized by diabetes, obesity, abnormal blood lipid levels and high blood pressure. We investigated how salusins in the circulation and in kidney tissues change in relation to MetS. Experiments were conducted on 5-week-old Sprague-Dawley male rats assigned to either a control group or a MetS group. Controls were fed standard rat food and water ad libitum, while the MetS group was fed standard food with 10% fructose solution added to their drinking water for three months. After three months, all animals were sacrificed after a one night fast. Blood and tissues were collected and stored appropriately. Biochemical parameters were analyzed using the Konelab 60 auto-analyzer. Salusin-α and salusin-β levels in the blood and kidneys were studied using the ELISA method. The salusin expression in the renal tissue was shown by immunohistochemical staining. Compared to the control group, the MetS group showed elevated uric acid and other lipid parameters for high-density lipoprotein cholesterol. Serum salusin-α and salusin-β levels were decreased; however, salusin levels/mg kidney tissue were elevated. Immunohistochemical analysis of salusins in kidney tissue revealed their presence in the epithelium cells of the glomeruli, and proximal and distal tubule cells. The expression of both peptides in renal tissues was greater in the MetS group than in the control group. We believe that salusins are critical mediators in the etiopathology of MetS. Altered salusin levels are thought to regulate hypertension, which is a component of MetS.

Protective effects of resveratrol on sepsis-induced DNA damage in the lymphocytes of rats

Sepsis, often initiated by an infection, is a state of disrupted inflammatory homeostasis. There is increasing evidence that oxidative stress has an important role in the development of sepsis-induced multiorgan failure. Resveratrol (RV) is a polyphenolic compound found in the skin of red fruits, such as mulberries and red grapes, and in peanuts. RV has been reported to have an antioxidant, antiproliferative, and anti-inflammatory properties in various models. It has also been found to inhibit the proliferation of a variety of human cancer cell lines, including breast, prostate, colon, pancreatic, and thyroid. This study has been undertaken to assess the role of RV on the sepsis-induced oxidative DNA damage in the lymphocytes of Wistar albino rats by the standard and formamidopyrimidine DNA glycosylase (Fpg)-modified comet assays. The parameters of tail length, tail intensity, and tail moment were evaluated for the determination of DNA damage. According to the study, the DNA damage was found to be significantly higher in the sepsis-induced rats when compared with the control rats (p < 0.05). The parameters were significantly decreased in the RV-treated sepsis-induced group when compared with the sepsis-induced group. The parameters in the sepsis-induced rats were found to be significantly higher in the Fpg-modified comet assay when compared with the standard comet assay (p < 0.05), and RV treatment decreases the DNA damage in the sepsis-induced rats, suggesting that the oxidative stress is likely to be responsible for DNA damage and RV might have a role in the prevention of sepsis-induced oxidative DNA damage.

Fatty acid, cholesterol and fat-soluble vitamin composition of wild and captive freshwater crayfish (Astacus leptodactylus)

The proximate analysis (dry matter, protein, fat and ash), cholesterol, fatty acid and fat-soluble vitamin compositions of the tail muscle of wild caught and captive crayfish (Astacus leptodactylus) were investigated. Captive crayfish contained higher moisture and fat content than wild crayfish. In contrast, wild crayfish contained a higher level of crude protein, ash and n-3 polyunsaturated fatty acids (PUFA), particularly eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) than captive crayfish. Arachidonic acid (C20:4 n-6) was the major n-6 PUFA in wild A. leptodactylus, and linoleic acid (C18:2 n-6) was the major n-6 PUFA in captive A. leptodactylus. The percentages of total saturated fatty acids (SFA), PUFA, and n-3/n-6 ratio were higher in wild crayfish and total monounsaturated fatty acids (MUFA) were lower. Although differences existed between wild and captive crayfish in vitamins A (p < 0.001), δ-Tocopherol (p < 0.001), α-Tocopherol acetate (p < 0.05), no differences were found in vitamins D(2), D(3), α- Tocopherol and K (p > 0.05). The differences may be originated from the diet provided to captive crayfish. Since wild A. leptodactylus contained higher n-3/n-6 ratio than captive A. leptodactylus, crayfish farms can potentially produce a better quality of crayfish meat by increasing the PUFA n-3 (especially DHA and EPA) in the diets of A. leptodactylus.

Coexistence of blaOXA48 and aac(6′)-Ib-cr Genes in Klebsiella Pneumoniae Isolates from Istanbul, Turkey

This study evaluated the presence of carbapenem hydrolysing β-lactamase genes and plasmid-mediated quinolone resistance (PMQR) determinants in 22 Klebsiella pneumoniae isolates collected from the Istanbul Medical Faculty, Turkey, which reduced the susceptibility or resistance to carbapenem. The VITEK® 2 system and E-tests were used to determine the minimum inhibitory concentrations needed to inhibit bacterial growth. Genes were screened by polymerase chain reaction, and gene transferability was evaluated by transconjugation. Strain clonality was investigated by pulsed-field gel electrophoresis (PFGE). All strains were OXA-48 β-lactamase producers and three (13.6%) were also positive for the aac(6′)-Ib-cr gene. Most of the strains harboured other b-lactamase (bla) genes such as blaTEM, blaSHV, blaCTX-M and blaVEB-1. The transconjugants mostly harboured blaOXA-48 and other β-lactamases separately. PFGE revealed eight pulsotypes among the isolates. The coexistence of blaOXA-48 and PMQR in K. pneumoniae isolates may present a significant threat to health, especially in the nosocomial setting.

Use of Cervical Spinal Cord Stimulation in Treatment and Prevention of Arterial Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Based on past laboratory and anecdotal clinical experience, we hypothesized that prolonged cervical spinal cord stimulation (SCS) in the acute settings of aneurysmal subarachnoid hemorrhage (aSAH) would be both safe and feasible, and that 2-week stimulation will reduce incidence of cerebral arterial vasospasm. The goal of our clinical study was to establish feasibility and safety of cervical SCS in a small group of selected aSAH patients. Single-arm non-randomized prospective study of cSCS in aSAH patients involved percutaneous implantation of 8-contact electrode in 12 consecutive aSAH patients that satisfied strict inclusion criteria. The electrode insertion was performed immediately upon surgical or endovascular securing of the ruptured aneurysm while the patient was still under general anesthesia. Patients were stimulated for 14 consecutive days or until discharge. There were no complications related to the electrode insertion or to SCS during the study and no long-term side effects of SCS during 1-year follow-up. There was 1 unrelated death and two electrode pullouts. This article summarizes technical details of SCS electrode insertion and the stimulation parameters used in the research study. Our study of SCS for prevention of vasospasm after aSAH conclusively shows both safety and feasibility of this promising treatment approach. Despite high level of acuity in aSAH patients, impaired level of consciousness, frequent patient repositioning, need in multiple tests and variety of monitors, SCS electrodes may be safely implanted and maintained for the two-week period. Long-term follow up shows no adverse effects of cervical SCS in this patient category.

Acute formation of lumbar discal cyst: what is the mechanism?

Lumbar discal cysts are extremely rare pathologies, with only few reports describing these lesions in the literature. Moreover, their definite pathogenesis is still unknown, with proposed theories based on radialogic and histologic findings. In this report, the authors present an acute formation of a discal cyst, which is reported for the first time. Also, we center our case on the discussion of the possible pathogenesis. Also, this is the first case of discal cyst reported in Turkey. A 67-year-old woman, whose complaints, and clinical and radiological findings demonstrated lumbar disc herniation with acute Modic 1 degererative changes of the adjacent end plates of L3-4 level. After medical and physical therapies, follow-up lumbar MRI has been taken to demonstrate a discal cyst formation on the adjacent intervertebral disc, showed cranially migrated cyst superior posterior on herniated disc, in 2 weeks period. The patient was treated by microsurgical resection of the cyst, and her complaints resolved completely.

Effectiveness of erdosteine, a second generation mucolytic agent, in children with acute rhinosinusitis: a randomized, placebo controlled, double-blinded clinical study

AIM

To evaluate whether mucolytic agents have an adjuvant role with antibiotics in the treatment of children with rhinosinusitis.

METHODS

Ninety-two children with rhinosinusitis were recruited for this randomized, placebo controlled, double-blinded clinical trial. Mean age was 8.5 +/- 3.2 years. Erdosteine (5-8 mg/kg/day) was administered to 49 children, and 43 children received placebo. Changes in symptoms were recorded with the standard S5 scoring for 14 days. Complete resolution of symptoms on day 14 was considered to be clinical improvement.

RESULTS

Eighty-one participants completed the study. Forty-one were in the treatment group and 40 in the placebo group. The average S5 scoring value at the onset of study was 11.0 in treatment group and 12.1 in placebo group. On day 14, mean scores were 3.1 in the treatment group and 2.8 in the placebo group. Complete improvement was 78% in the treatment group and 74.4% in the placebo group. There was no significant difference between the groups. There were no clinically detected serious side effects or complications in both groups.

CONCLUSION

Use of erdosteine as a mucolytic agent in children with acute rhinosinusitis does not directly affect the success of treatment.

Effect of orlistat on the total ghrelin and leptin levels in obese patients

Obesity, characterized by hyperleptinemia and hypoghrelinemia, has become a major health problem all over the world and is associated with an increased risk of complications including insulin resistance, hypertension, dyslipidemia, diabetes mellitus and atherosclerosis. The use of the pancreatic lipase inhibitor Orlistat can help seriously overweight people to achieve and maintain weight loss. The aim of our study was to compare the serum leptin and ghrelin levels in obese subjects who take orlistat with those receiving only dietary treatment. Twenty-one obese patients and 10 control subjects participated. The obese patients were divided into two groups; one group (n=11) took orlistat (120 mg, 3 times daily) and received dietary treatment and the other (n=10) only received the dietary treatment. The study lasted twelve weeks. The concentrations of serum ghrelin, leptin, insulin and C-peptide, and routine biochemical parameters, were measured in both groups. The serum ghrelin level was higher in control (183+/-62 fmol/ml) than obese (59+/-30 fmol/ml) subjects while the plasma leptin level was lower in control (8.7+/-12 microg/L) than obese (36.7+/-19 microg/L) subjects (all p<0.001). BMI and the total blood cholesterol, LDL and triglyceride levels fell significantly after both orlistat and dietary treatment in the obese subjects (all p<0.01), and the plasma ghrelin level rose (p<0.01). The leptin level demonstrated the opposite trend in both groups but only the patients taking orlistat showed a significant change (p<0.05).Taken together, these results show that orlistat has no effect on body weight in obese subjects additional to that conferred by a non-pharmacological life-style intervention. We therefore conclude that weight lost rather than type of treatment might be more valuable in obesity.

CD38 increases CXCL12-mediated signals and homing of chronic lymphocytic leukemia cells

Homing of chronic lymphocytic leukemia (CLL) cells to sites favoring growth, a critical step in disease progression, is principally coordinated by the CXCL12/CXCR4 axis. A cohort of 62 CLL patients was divided into migrating and nonmigrating subsets according to chemotaxis toward CXCL12. Migrating patients phosphorylated extracellular signal-regulated kinase 1/2 (ERK1/2) proteins more than nonmigrating patients (P<0.0002). CD38 expression was the parameter most strongly associated with heightened CXCL12 signaling (P<0.0001), confirmed by independent statistical approaches. Consistent with this observation, CD38(-) CLL cells in samples with bimodal CD38 expression responded less to CXCL12 than the intact clone (P=0.003). Furthermore, lentivirus-induced de novo expression of CD38 was paralleled by increased responses to CXCL12, as compared with cells infected with a control virus. CD38 ligation with agonistic monoclonal antibodies (mAbs) enhanced CXCL12 signaling, whereas blocking anti-CD38 mAbs inhibited chemokine effects in vitro. This is attributed to physical proximity on the membrane between CD38 and CXCR4 (the CXCL12 receptor), as shown by (i) coimmunoprecipitation and (ii) confocal microscopy experiments. Blocking anti-CD38 mAbs significantly compromised homing of CLL cells from blood to lymphoid organs in a mouse model. These results indicate that CD38 synergizes with the CXCR4 pathway and support the working hypothesis that migration is a central step in disease progression.

Methotrexate: can it be a choice for nasal polyposis in aspirin exacerbated respiratory disease?

Nasal polyposis (NP) is considered a subgroup of chronic rhinosinusitis and is commonly associated with asthma, bronchiectasis, and cystic fibrosis. A certain subgroup of nasal polyposis is known as Aspirin Exacerbated Respiratory Disease (AERD), previously called Samter's Triad or aspirin triad, comprising polyposis, asthma, and aspirin hypersensitivity and makes up almost 10% of cases of NP. Therapy of NP involves a combination of medical and surgical treatments. However, recurrences are common, particularly in patients with asthma and aspirin hypersensitivity. Both topical and systemic corticosteroids form the mainstay of conservative therapy for NP as well as a primary treatment and prevention for recurrences. They have been shown to improve nasal breathing, rhinitis symptoms, and reduce the size of NP, along with the rate of recurrence. There is great concern about the adverse effects of systemic steroids, especially when long-term usage is necessary to maintain improvement. So far, no knowledge exists about the effects of methotrexate (MTX) on NP of the patients with asthma. We report two patients whose NP dramatically reduced in size after a course of MTX therapy administered as an additional treatment for their steroid- dependent asthma.

Ghrelin and obestatin levels in end-stage renal disease

Malnutrition is fairly common in end-stage renal disease (ESRD) patients, persistent lack of appetite being a major symptom. Ghrelin and obestatin are two hormones that are involved in appetite and energy homeostasis. The present study examined ghrelin and obestatin levels in 24 ESRD patients undergoing haemodialysis and 24 age-matched healthy controls. Serum and saliva ghrelin and obestatin levels in the ESRD patients were significantly higher compared with controls, while saliva ghrelin and obestatin levels in all study participants were significantly higher than serum levels. Saliva ghrelin correlated with serum ghrelin and saliva obestatin correlated with serum obestatin in all study participants, although there was no correlation between ghrelin and obestatin levels. In conclusion, the results suggest that the kidneys may have a role in the metabolism and/or clearance of obestatin, as they do for ghrelin. Further studies are needed to determine if elevated levels of these hormones in ESRD patients contribute to the malnutrition that is common in these patients.

Ghrelin immunohistochemistry of gastric adenocarcinoma and mucoepidermoid carcinoma of salivary gland

Ghrelin (G-HH) synthesized in several tissues including salivary and stomach glands stimulates appetite in humans by modulating neuropeptide Y neurons in the hypothalamic arcuate nucleus. Loss of appetite is one of the most important symptoms of stomach cancer. We conducted a study using immunohistochemistry to determine whether salivary glands and stomach cancer tissues produce ghrelin. We determined that negative ghrelin immunohistochemistry discriminates tumors from normal tissues and may therefore further our understanding of the clinically important problem of reduced food intake and anorexia in cancer patients. Radioimmunoassay analyses confirmed that cancer cells do not produce a G-HH peptide, whereas normal cells yield this peptide.

Effects of estrogens on oxidative protein damage in plasma and tissues in ovariectomised rats

Purpose: To assess estrogen-related changes in the redox status of the brain and liver proteins as well as the systemic oxidative stress in ovarectomised (OVX) rats Methods: Twelve-week-old, sexually mature female Sprague–Dawley rats (200-250g) were randomly divided into four groups: The following treatment combinations were administrated daily to all in 0.05 ml 96% ethanol solution by gastric gavage. (1) Sham operation (2) OVX rats (3) OVX rats [0.02 mg/kg/day of 17?-estradiol (E2) and 0.01 mg/kg/day of norethisterone acetate] (4) OVX rats [E2 (0.01 mg/kg/day) and drospirenon (0.02 mg/kg/day)]. Estrogen levels were determined using routine clinical-chemistry methods. We also measured protein oxidation parameters such as protein carbonyl (PCO), total thiol (T-SH) and the other oxidative stress markers malondialdehyde (MDA) and glutathione (GSH). Results: Ovariectomy resulted in abnormal elevation of plasma and tissue oxidative stress markers and changes in redox status of the proteins in tissue dependent manner. Supplementation of various estrogens combinations partially alleviated these abnormalities and restored redox homeostasis of proteins after the ovariectomy. Among the studied protein oxidation parameters, plasma and tissue PCO levels of the OVX rats were higher than those of the control groups (P < 0.01). Hormone replacement therapies (HRT) caused a decrease in PCO and MDA in both plasma and tissue of the OVX rats (P < 0.01). HRT in OVX rats decreased plasma MDA and increased liver and brain GSH (P < 0.01). Liver MDA levels of the Drospirenon-treated rats were lower than in the norethisterone acetate group (P < 0.01). On the other hand, Drospirenon increases brain GSH s more effectively than norethisterone acetate (P < 0.01). After bilateral oopherectomy, plasma and tissue T-SH levels decreased in the OVX group compared with control (P < 0.01). Norethisterone acetate increased plasma T-SH more effectively than Drospirenon (P < 0.05) Conclusions: The study showed the extent of oxidative protein damage (OPD) in this model of estrogen deficiency. The protective effect of estrogens against tissue specific OPD suggests that estrogens play an important role within the antioxidant defense systems in plasma, liver and brain. The exact molecular mechanisms leading to these findings are not yet completely known. Meanwhile, hormone replacement therapy for the prevention of OPD in a tissue specific manner may be required.

An objective method to determinme corneal changes during menopause

OBJECTIVE

We hypothesized that menopause has a measurable effect on corneal thickness. The aim of this study was to evaluate central corneal thickness (CCT) differences between women in the premenopausal and postmenopausal period.

METHODS

A prospective, case-control, single-blind study was designed. Two groups were included: Group I (premenopausal period) and Group II (postmenopausal period). Forty women were recruited in each group. The correlation between CCT with age, estradiol (E2) and follicle stimulating hormone (FSH) levels were evaluated.

RESULTS

CCT was significantly decreased in postmenopausal women compared to premenopausal women (521.18 +/- 37.97 microm 561 +/- 42.84 microm, respectively, p < 0.005). Similarly, there was a linear correlation between CCT and serum E2 levels of patients overall (p < 0.01).

CONCLUSION

The data presented in this study suggest that menopause causes corneal changes, which may be documented by central corneal thickness measurement.

The WHO global alliance against chronic respiratory diseases in Turkey (GARD Turkey)

In order to prevent and control non-communicable diseases (NCDs), the 61st World Health Assembly has endorsed an NCD action plan (WHA resolution 61.14). A package for essential NCDs including chronic respiratory diseases (CRDs) has also been developed. The Global Alliance against Chronic Respiratory Diseases (GARD) is a new but rapidly developing voluntary alliance that is assisting World Health Organization (WHO) in the task of addressing NCDs at country level. The GARD approach was initiated in 2006. GARD Turkey is the first comprehensive programme developed by a government with all stakeholders of the country. This paper provides a summary of indicators of the prevalence and severity of chronic respiratory diseases in Turkey and the formation of GARD Turkey.

Dynamic MR dacryocystography in patients with epiphora

OBJECTIVE

The purpose of this study was to investigate the diagnostic value of dynamic MRI dacryocystography (dMR-DCG) for the assessment of nasolacrimal drainage system (NLDS).

METHODS

The study population consisted of 35 patients with a history of epiphora. Each patient underwent bilateral dMR-DCG and conventional dacryocystography (DCG) to assess the NLDS. Two radiologists, who were unaware of the clinical data, evaluated the images separately for the level of obstruction at the nasolacrimal passage and the presence or absence of lacrimal sac dilatation. The findings from the dMRI-DCG and DCG images were compared. DCG was considered to be the gold standard imaging technique.

RESULTS

dMRI-DCG had a sensitivity of 90.5% and a specificity of 89.3% to detect nasolacrimal passage. In 24 out of 70 NLDS that were assessed, there was 100% agreement between the dMRI-DCG and DCG images in the detection of the obstructed level in the nasolacrimal pathway. The lacrimal sac dilatation finding detected by DCG was not observed by dMRI-DCG in only two patients, in whom there was a prior history of dacryocystorhinostomy (DCR) operation. These findings suggest that dMRI-DCG has 94.3% sensitivity and 100% specificity for the diagnosis of lacrimal sac dilatation.

CONCLUSION

dMRI-DCG is an easily performed, minimally invasive imaging technique to identify the presence or absence of obstruction and its level, and lacrimal sac dilatation in the evaluation of NLDS. dMRI-DCG does not require the use of contrast material and ionizing radiation and provides functional information by depicting dynamic behaviour. Thus, dMRI-DCG could be useful as a reliable diagnostic imaging technique in many patients prior to surgery.

The relationship of inflammatory cytokines with asthma and obesity

OBJECTIVES

Obesity is considered a risk factor for asthma. However, the mechanism that connects the two is not well understood. In this study we investigated the relationship between inflammatory cytokines and acute phase reactants in obesity, and asthma.

METHOD

Asthmatic and control subjects were divided into 2 sub-groups: obese and non-obese. Anthropomorphic parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leptin, tumour necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) were compared between obese, asthmatics and control subjects of normal weight. Respiratory function tests and allergy skin tests were also performed in the patients with asthma.

RESULTS

ESR, CRP, TNF-alpha, IL-6, and leptin levels in obese asthma patients were higher than in the healthy controls (P < 0.01). TNF-alpha, IL-6, and leptin levels were higher in obese asthma patients than in non-obese asthma patients (P < 0.01). Inflammatory markers were related to parameters of obesity. No association was found between allergy test results and obesity (P > 0.05).

CONCLUSION

We identified a relationship between acute phase reactants and inflammatory cytokines, and the criteria for obesity in obese asthma patients. Inflammation markers were at their highest levels in obese asthma patients. Leptin levels were considerably higher in obese patients than in normal weight controls. Like obesity, leptin is suggested to play a role in the pathogenesis of asthma.