Pleiotropic effects of pitavastatin: a pilot study using the saphenous vein endothelial cell model of endothelial injury and prevention of atherosclerosis

OBJECTIVE

Cardiovascular diseases are responsible for the majority of deaths on a global scale. Atherosclerosis is the main risk factor for cardiovascular disorders and represents a complex phenomenon associated with endothelial dysfunction and inflammation. Statins, especially atorvastatin (ATV) and pitavastatin (PTV), are common agents used to control ongoing atherosclerotic events in the body to minimize cardiovascular disease-based deaths.

MATERIALS AND METHODS

The present study aimed at comparing the efficacy of ATV and PTV in a cell line model of inflammation. Human saphenous vein cells were treated with TNF-alpha to mimic atherosclerotic conditions, and the cells were divided into 7 groups, including control, DMSO, TNF-alpha (10 ng/mL-6 hours), ATV (50 μM/24 hours), PTV (2 μM/24 hours), ATV (50 μM/24 hours)+TNF-alpha (10 ng/mL-6 hours) and PTV (2 μM/24 hours)+TNF-alpha (10 ng/mL-6 hours). The expression levels of 20 proinflammatory cytokines and chemokines were investigated in these groups using a human atherosclerosis antibody array.

RESULTS

Possible pathway interactions were determined by STRING and PANTHER analyses. Comparison with the effect of ATV indicated that PTV reduced the levels of 4 proinflammatory cytokines: CCL11, CSF2, CCL20, and TGFB1 (p<0.05).

CONCLUSIONS

Pleiotropic effects of pitavastatin against cardiovascular diseases appeared to be better; however, additional studies are required to compare statins and to identify new drugs that maintain broader protection from the risks of cardiovascular diseases.

Changes in the ocular and nasal cultures in patients who had undergone septoplasty

OBJECTIVE

The aim of the study was to evaluate the microbiologic changes that occurred in the nasal and ocular mucosa before and after surgery in patients who had undergone septoplasty.

DESIGN SETTING

Fifty-five patients who applied to our clinic with septal deviation were included in the study.

METHODS

Before and after the operation, samples were taken from the ocular and inner nasal mucosa for cultures and direct microscopic evaluation and the microbiologic changes were compared.

MAIN OUTCOME MEASURES

The results of ocular preoperative cultures were different from the results of postoperative cultures.

RESULTS

The most frequent microorganisms in all pre- and postoperative ocular and nasal cultures were similar; coagulase-negative Staphylococcus, Staphylococcus aureus, and Diphtheroid spp were dominant. Following septoplasty, the rate of determining microorganisms in the eye in both microscopic evaluation and cultures had increased. In the postoperative period, the rate of growing S. aureus increased in ocular cultures (p < .01) while remaining the same in nasal cultures.

CONCLUSIONS

These results suggest that ocular flora can indeed change following septoplasty; however, the risk of ocular infection is not increased. This is the first study to investigate the risk of ocular infection in addition to local nasal infection after septoplasty.

Factors influencing the prescription of add-on long-acting muscarinic antagonists in real-world asthma management: Insights from a national registry

Current guidelines recommend adding long-acting muscarinic antagonists (LAMAs) in patients with uncontrolled asthma, despite the use of moderate to high doses of inhaled steroid-long-acting beta agonists (ICS/LABA). This study aims to analyze the factors related to the prescription of add-on LAMA in clinical practice for asthma patients, shedding light on physicians' preferences. This study included adult asthma patients on add-on LAMA and ICS/LABA monitored for at least one year in a national registry comprising 2053 asthmatics. Patients' characteristics and disease profiles were analyzed to identify factors associated with the prescription of add-on LAMA across the entire cohort. A comparative analysis was performed among three groups: MART (ICS/formoterol as a maintenance and reliever therapy) plus LAMA, Conventional (ICS/LABA as a maintenance and short-acting beta agonist as reliever) plus LAMA and Triple (ICS/LABA/LAMA single inhaler). LAMAs were added to ICS/LABA in 11.7 % of patients in the national registry. Logistic regression analysis revealed that older age, low FEV1 (%), Asthma Control Test (ACT) scores less than 20, and severe exacerbation were the main factors influencing the initiation of LAMA in our registry. However, demographic characteristics of asthma, control status, pulmonary function test results were similar among the three groups of LAMA users (p > 0.05). Physicians used LAMAs without phenotyping based on allergic status or eosinophil levels (p > 0.05). Mepolizumab was added after LAMA in all patients, while omalizumab was initiated before LAMA in 16.9 % of the patients receiving LAMA along with biologics. Add-on LAMAs were predominantly prescribed for older, uncontrolled, and exacerbated asthma patients with low FEV1.

Endoscopic butterfly cartilage myringoplasty: our long term results

BACKGROUND

Myringoplasty is one of the treatments used for perforated tympanic membrane.

AIM/OBJECTIVE

We aimed to evaluate the long-term anatomical and functional outcomes of patients who underwent endoscopic inlay butterfly cartilage myringoplasty.

MATERIAL AND METHODS

We retrospectively analyzed 74 patients who had undergone endoscopic butterfly cartilage myringoplasty were followed for at least five years. The evaluation included age, sex, duration of follow-up, perforation location, size, preoperative and postoperative pure tone audiometry thresholds (years 2 and 5), air-bone gap, follow-up complications, and postoperative graft and tympanic membrane status.

RESULTS

The study included 74 patients with a mean follow-up duration of 76.7 months (range: 60-125 months). The graft success rates were 89.1% at two years and 82.4% at five years postoperatively. There was a significant improvement in air conduction thresholds when comparing preoperative levels to those at two and five years postoperatively (p = 0.003). The air-bone gap showed a significant reduction from preoperative levels to those observed at two and five years postoperatively (p < 0.0001).

CONCLUSION AND SIGNIFICANCE

Our study demonstrates that endoscopic butterfly cartilage myringoplasty is safe and effective for achieving long-term anatomical and functional success. We recommend extending the follow-up period to five years with additional annual assessments thereafter.

Test-Retest Reliability and Discriminatory Power of Multi-Dimensional Voice Analysis Program (MDVP)

OBJECTIVES

The objectives of this study were to evaluate and compare the test-retest reliability of acoustic parameters (jitter [%], shimmer [%], noise-to-harmonic ratio (NHR), and voice turbulence index (VTI)) by using multidimensional voice program (MDVP), and to detect the discriminatory power of the acoustic measures with respect to dysphonic voices and normal voices.

DESIGN, SETTING, PARTICIPANTS, AND METHODS

Fifty-four (25 male and 29 female) participants with voice disorders and fifty-one (27 male and 24 female) participants with normal voices were enrolled in this study. They were assessed by anamnesis, visual examination, auditory perceptual assessment (GRBAS), and acoustic measurements. The intraclass correlation coefficient was used to determine the test-retest reliability. The effect size (d value) and p value obtained from the t-test were used to determine the discriminatory power.

RESULTS

In the normal group, good reliability was observed for jitter, shimmer, and NHR, and moderate reliability was observed for VTI. With regard to the dysphonic group, jitter, shimmer, and VTI were moderately reliable, and the NHR had good reliability. Meanwhile, the discriminatory powers of jitter and shimmer were evaluated as 'medium', and those of NHR and VTI as 'small'.

CONCLUSIONS

The reliability and discriminatory powers of our acoustic measures were high compared with most other studies. Their level of reliability and discriminatory power can be maximised by using stringent rules. However, attaining an excellent level of reliability and discriminatory seems infeasible power owing to the variable characteristic of voice. Therefore, acoustic measures should be adopted as a complementary tool.

Status of Neutrophils, Lymphocytes and Platelets in Patients with Recurrent Aphthous Stomatitis: A Retrospective Study

INTRODUCTION

The aim of this study was to evaluate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) in patients with recurrent aphthous stomatitis (RAS).

MATERIALS AND METHODS

Eighty patients who were diagnosed with RAS between January 2014 and January 2016 were included in this study. Eighty age- and gender-matched healthy subjects were also enrolled as a control group. Neutrophil, lymphocyte, and platelet counts were compared between groups, in addition to NLR, PLR, and MPV values.

RESULTS

There was no significant difference in terms of lymphocyte count, platelet count, PLR, or MPV values between the two groups (P>0.05). However, white blood count, neutrophil count, and NLR were significantly higher in patients with RAS compared with the control group (P<0.05).

CONCLUSION

The present study revealed an increased NLR among RAS patients compared with healthy controls. This suggests that development of RAS involves an inflammatory process. We believe that NLR could be used as a cheap and simple marker of inflammation.

The relations of circulating agouti-related peptide and leptin with altered sleep architecture in patients with active Cushing's disease: a pilot study

AIM

To evaluate sleep architecture of patients with Cushing's disease (CD) and to explore whether agouti-related peptide (AgRP) and/or leptin play a permissive role in sleep alterations in patients with active CD.

METHODS

We performed polysomnography on 26 patients with active CD and age 26 age- and sex-matched control subjects. Blood samples were obtained from all participants for the analyzes of AgRP and leptin. The laboratory and sleep-related parameters were compared.

RESULTS

The groups were similar in age, gender, and body mass index. The CD group had reduced sleep efficiency (71.6 ± 12.1% vs. 78.8 ± 12.6%, p = 0.042) and increased wake after sleep onset (WASO%) (24.7 ± 13.1% vs. 17.4 ± 11.6%, p = 0.040) as compared to control group. Seventeen patients with CD (65.4%) and 18 control subjects (69.2%) had obstructive sleep apnea. Serum AgRP (13.2 ± 7.4 pg/ml vs. 9 ± 3.1, p = 0.029), leptin (59.5 mcg/l, [IQR] 32.6-94.6 vs. 25.3 mcg/l, [IQR] 12.9-57.5, p = 0.007) were higher in CD group. AgRP and leptin correlated negatively with total sleep time, sleep efficiency, stage N2 sleep (%), and positively with WASO%. In multiple regression analyses, serum cortisol (ß =  - 0.359, p = 0.042) and AgRP (ß =  - 0.481, p = 0.01) were significant predictor of sleep efficiency. AgRP was also significant predictor of WASO% (ß = 0.452 and p < 0.05).

CONCLUSIONS

Active CD carries an increased risk of impaired sleep efficiency and continuity which may worsen health-related quality of life. Elevated circulating AgRP and, to a lesser extent, leptin may be associated with decreased sleep efficiency and continuity in patients with CD. Patients with CD who have subjective sleep symptoms should be screened with polysomnography.

Flexural Properties, Wear Resistance, and Microstructural Analysis of Highly Filled Flowable Resin Composites

OBJECTIVE

This study aimed to evaluate the flexural properties and two-body wear resistance of nine highly filled flowable resin composites relative to those of viscous and conventional low-filled flowable composites. In addition, scanning electron microscopy (SEM) analysis of the microstructures was performed.

METHODS AND MATERIALS

For each resin composite group (n=12), 12 specimen bars (25 mm × 2 mm × 2 mm) were fabricated using a silicon mold for performing flexural strength (FS), flexural modulus (E), flexural toughness (FT), Weibull modulus (m) tests, and SEM microstructural analysis. For each group, ten bars were tested using a three-point flexural test on a universal testing machine, while the other two were embedded in acrylic resin before being observed by SEM for structural analysis. During the two-body wear test with a chewing simulator, 8 specimens (12 groups, n=8) of each resin composite group were manufactured in a specific mold and subjected to 120,000 cycles of wear against a steatite ball, and the depth loss was measured. Three one-way ANOVA tests followed by Tukey's post hoc tests were conducted to compare the flexural and wear properties among the different groups.

RESULTS

The majority of highly filled composites tested in this study exhibited similar flexural strengths (between 105.68 MPa and 135.49 MPa) and superior wear resistance to those of viscous composites. The flexural moduli (between 5.12 GPa and 9.62 GPa) of these composites were in between those of the viscous and low-filled composites tested in this study.

CONCLUSIONS

The highly filled flowable composites tested in this study exhibited different in vitro properties but were often superior to those of viscous resin composite suggesting their possible use for posterior restorations.

The effectiveness of concentrated growth factor in facial nerve crush injury

AIM

To evaluate the effect of concentrated growth factor (CGF) on regeneration of facial nerve after crush injury.

MATERIALS AND METHODS

Fourteen rats were randomized into two groups. The control group (CG) (n = 7) received a crush injury to the right facial nerve. The CGF group (CGFG) (n = 7) received a crush injury to the right facial nerve and concentrated growth factor prepared from their own blood thereafter. Left facial nerves were used for functional comparison. Nerve function was evaluated using whisker movements and electromyography. Histologic properties were evaluated using hematoxylin and eosin and Masson-trichrome staining, and immunohistochemical properties were evaluated using Neurofilament-H and Anti-Tau degeneration markers.

RESULTS

In the CGFG, whisker functions began to recover earlier and recovered more quickly compared with the CG. The CG showed significantly prolonged latency and reduced amplitudes in the first week compared with the CGFG (p < 0.05). Recordings of 4th-week latency and amplitudes were similar to the preoperative period in the CGFG (p > 0.05), whereas recordings of the same week were significantly worse in the CG (p < 0.05). Edema and fibrosis were also more pronounced in the CG compared with the CGFG. Neurofilament-H and Anti-Tau were at significantly high levels in the CG (p < 0.05).

CONCLUSION

Concentrated growth factor promotes recovery in facial crush injury and may prove a cost-effective, practical, and effective treatment choice in peripheral nerve injury.

Calcitonin treatment in reflex sympathetic dystrophy: a preliminary study

Reflex sympathetic dystrophy is one of the important complications effecting the rehabilitation programmes of hemiplegic patients in a negative manner by causing pain and function loss. In this study, the aim was to investigate the effects of salmon calcitonin treatment in reflex sympathetic dystrophy that develops in hemiplegia. Forty-one patients with hemiplegia resulting from cerebrovascular events and stage 1-2 reflex sympathetic dystrophy were included in the study. Salmon calcitonin, 1 x 100 IU/day intramuscularly for 4 weeks, was administered to 25 of these patients (calcitonin group) to the other 16 patients physiological saline, 1 ml/day intramuscularly for 4 weeks, was administered (control group). At the end of the fourth week of treatment the pain score of the calcitonin group was significantly lower than that of the control group. Shoulder abduction and external rotation, wrist flexion and metacarpophalangeal extension of the calcitonin group were found to be significantly better than those of the control group. In the calcitonin group the significant decrease in pain and tenderness resulted in improvement of range of motion and motor functions.

Is septoplasty alone adequate for the treatment of chronic rhinosinusitis with septal deviation?

BACKGROUND

The purpose of this study was to reveal the role of septoplasty in curing chronic rhinosinusitis (CRS) in patients with significant septal deviation.

METHODS

This prospective study involved 26 patients with CRS and septal deviation. The patients were randomly divided into two groups according to the applied surgical procedures. In the first and second groups, septoplasty and septoplasty plus endoscopic sinus surgery were applied, respectively. Subjective (questionnaire) and objective (endoscopy and computerized tomography) success rates were used to analyze the results.

RESULTS

Septoplasty alone and septoplasty plus endoscopic sinus surgery were applied in 57.7% (15/26) and 42.3% (11/ 26) of the patients, respectively. Success rates were 93.3% (14/15) and 81.8% (9/11), subjectively (p > 0.05), and 66.7% (10/15) and 54.5% (6/11), objectively (p > 0.05), respectively in each group.

CONCLUSION

We suggest that septoplasty alone can be adequate for the treatment of CRS with septal deviation.

Comparison of 300 mg versus 600 mg daily maintenance doses of aspirin treatment after desensitization in N-ERD: A three-year multicentre experience

Background: Aspirin treatment after desensitization (ATAD) is effective in preventing nasal polyps recurrence as well as respiratory symptoms in patients with nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory diseases (N-ERD). However, there is no consensus on effective daily maintenance doses in ATAD. Therefore, we aimed to compare the effects of two different maintenance doses of aspirin on clinical outcomes for 1-3 years of ATAD. Methods: This was a retrospective, multicenter study that involved four tertiary centers. The maintenance doses of daily aspirin were 300 mg in one center and 600 mg in the remaining three. The data of patients who were on ATAD for 1-3 years were included. Study outcomes (nasal surgeries, sinusitis, asthma attacks, hospitalization, oral corticosteroid use, and medication uses) were assessed in a standardized way and recorded from case files. Results: The study initially included 125 subjects, 38 and 87 were receiving 300 and 600 mg daily aspirin for ATAD, respectively. Number of nasal polyp surgeries decreased after 1 -3 years compared with before ATAD in both groups (group 1, baseline: 0.44 ± 0.07 versus first year: 0.08 ± 0.05; p < 0.001 and baseline: 0.44 ± 0.07 versus 3rd year: 0.01 ± 0.01; p < 0.001; and group 2, baseline 0.42 ± 0.03 versus first year: 0.02 ± 0.02; p < 0.001 and baseline: 0.42 ± 0.03 versus 3rd year: 0.07 ± 0.03; p < 0.001). Conclusion: Given the comparable effects of 300 mg and 600 mg aspirin daily as maintenance treatment of ATAD on both asthma and sinonasal outcomes in N-ERD, our results suggest using 300 mg of aspirin daily in ATAD owing to its better safety profile.

Does Radiofrequency Radiation From Mobile Phones Affect the Formation of Parotid Gland Malignancy? An Experimental Study

Objectives: The use of mobile phone is increasing around the world. Although it is beneficial in terms of communication, the electromagnetic radiations emitted by mobile phones may cause undesirable biological effects on the human body. In practical use, the tissue with which mobile phones come into most and are closest is the parotid gland. This study investigated the effects of the 1800 MHz electromagnetic field created by a generator on the parotid gland in rats. Methods: A total of 21 Sprague-Dawley Albino rats were included in the study. The rats were randomly divided into three equal groups. To simulate a mobile phone in conversation mode, the first study group was exposed to an 1800-MHz electromagnetic field for 6 hours a day for 30 days, and the second study group was exposed to an 1800-MHz electromagnetic field for 12 hours a day for 30 days. After 30 days, rats were sacrificed, and histopathological and immunohistochemical methods were used to evaluate the effects on the parotid gland. The total antioxidant level and the total oxidant level were measured biochemically in homogenized parotid tissue. Results: Histopathological results showed an increase in degeneration in rats exposed to electromagnetic fields for 6 and 12 hours a day, and immunohistochemical analysis showed an increase in the apoptotic index in both study groups (P = .001, P < .001). Intranuclear inclusions was observed during histopathological examination performed by electron microscopy. Conclusions: This study observed that the 1800 MHz electromagnetic field caused undesirable adverse histopathological and biochemical effects on the parotid gland of rats. Histopathological and biochemical findings were detected with increasing contact and exposure time. This study will lead to other studies on this topic and contribute to the literature by completing other studies.

Rhinoscintigraphic analysis of nasal mucociliary function in patients with Bell's palsy

OBJECTIVE

Mucociliary transport (MCT) is an important defense mechanism of the respiratory tract. One of the major factors determining MCT is the ciliary activity of the respiratory epithelium. Rhinoscintigraphy is the most commonly used method for the analysis of mucociliary activity. The aim of this study was to investigate the effect of facial paralysis on the nasal mucociliary clearance.

MATERIALS AND METHODS

This study included 38 Bell's palsy patients as the study group and 10 subjects without any history of paranasal sinus disease or facial paralysis as the control group. A drop of technetium 99m-labeled macroaggregated albumin (Tc-99m MAA) was placed posterior to the head of the inferior turbinate and followed with a gamma camera. MCT rate was measured as the velocity of Tc-99m MAA drop.

RESULTS

The mean MCT rate was 4.27 ± 0.76 millimeters per minute (mm/min) on 20 sides of 10 healthy controls, 4.11 ± 2.91 mm/min on the affected sides of the patients with Bell's palsy, and 6.03 ± 3.13 mm/min on the nonparalyzed sides of the patients. MCT rate was statistically significantly faster in the nonparalyzed side when compared to the paralyzed side in Bell's palsy patients (P = 0.001). MCT rates were not significantly different in the control group and paralyzed sides of the Bell's palsy patients (P = 0.810). The MCT rate was statistically significantly faster in the nonparalyzed sides of Bell's palsy patients when compared to the controls (P = 0.017).

CONCLUSION

This study showed a faster MCT rate on the nonparalyzed side in Bell's palsy patients when compared to the paralyzed side and the control subjects. A compensatory mechanism could be the underlying reason for faster MCT on the nonparalyzed side. Further studies on larger patient groups are needed to investigate the effect of facial paralysis on the MCT and changes of facial nerve function on the opposite, nonparalyzed side of the face.

The role of botulinum toxin a in the management of lower limb spasticity in patients with cerebral palsy

This study aimed to determine the effects of botulinum toxin-A (btA) on spasticity in children with cerebral palsy (CP). Thirty-five children with spastic CP were evaluated. The injection group consisted of 25 patients who were injected with btA and received conventional physical therapy. The control group consisted of 10 patients who were treated with conventional physical therapy only. In the injection group, btA was applied to the lower extremity spastic muscles at a total dose of 8-10 lU/kg. Spasticity was measured by the Ashworth scale. Gait function was evaluated by clinical gait assessment in all patients and temporal distance factors in 16 patients. All the parameters were recorded before treatment, after three days and after one month of therapy. Following injection of btA, significant improvement in all parameters was observed. No statistically significant progression was noted in the control group except clinical gait analysis scores. Comparing the three-day and one-month measurements of spasticity of the two groups, statistically significant results were obtained in favour of the injection group in all parameters except for clinical gait analysis scores. The findings of this study showed btA injection to be an effective treatment for reducing spasticity and improving gait function in patients with spastic CP

Asthma patients with obesity have a unique phenotype: a subanalysis of the Turkish adult asthma registry

OBJECTIVE

The obese-asthma phenotype has gradually increased in the last few years. We aimed to assess the differences between obese and non-obese patients with asthma.

METHODS

This research is a subanalysis of the Turkish Adult Asthma Registry (TAAR). Clinical presentation, disease control, severity, and demographics of obese and non-obese (normal-weight, overweight) patients were compared.

RESULTS

The obesity rate in TAAR was 32.2% (n = 619/1919; 18-83 years; 527 F/92 M). Patients with asthma and obesity had higher rates of childhood obesity, longer symptom duration, later onset of asthma, and more severe asthma. These patients were more likely to be female, older, less educated, and live in rural areas. Patients with obesity had more scheduled visits and emergency visits compared with non-obese patients, but similar asthma control, oral corticosteroid use, hospitalizations, intensive care unit admissions, and unscheduled visits. They also had a higher frequency of T2-high but lower frequency of possible T2-low phenotypes compared with normal-weight asthmatics. The risk of severe asthma in patients with obesity was 6.04 times higher for allergic than non-allergic patients and 3.58 times higher for the T2-high phenotype than for possible T2-low phenotypes. A one-unit increase in the asthma control test reduced the risk of severe asthma by 22%.

CONCLUSIONS

A good definition of this phenotype is important to ensure that appropriate treatment strategies are implemented to achieve the control goal. We also believe that prevention of childhood obesity is an effective and pivotal strategy to achieve the goal of asthma control.