Relation of ambulatory blood pressure measurement and cognitive functions in hypertensive elderly patients.

INTRODUCTION: Hypertension is an important risk factor for dementia as much as the morbidity and mortality of cardiovascular disease. Sustained hypertension is also more related to that risk. The aim of the study was to determine the relationship between 24-h ambulatory blood pressure monitoring (ABPM) and cognitive functions in elderly hypertensive patients without comorbid diseases which may deteriorate cognitive functions. MATERIALS AND METHODS: Ninety-one patients (21 male, 72.5 ± 8.1;70 female, 71.7 ± 7.7) above 60 years old previously diagnosed as hypertensive (HT) have been included to this study. The ABPM was performed after standardized mini mental test (sMMT) and geriatric depression scale (GDS) has been examined. The patients were divided into the groups as dipper/nondipper and regulated/nonregulated. The sMMT scores of the groups were compared. RESULTS: There was no statistical difference in average sMMT scores and distribution of mini mental groups between the dipper and nondipper groups. Hypertension regulation and mini mental measurements of the studied groups were moderately suggestive in the same direction (r = 0.333, p = 0.001). DISCUSSION AND CONCLUSION: There is an association between tension regulation and cognitive functions in elderly patients who have primary HT, but no relationship have been found between being nondipper and low cognitive function. Our results suggested that this study is critically important by means of revealing that the studies which are perceived distinctly about HT and cognitive functions need further evaluation with subgroup analyses in selected patient groups.

Graphical modeling for item difficulty in medical faculty exams.

BACKGROUND: There are different indexes used in the evaluation of exam results. One important index is the difficulty level of the item that is also used in this study to obtain control charts. This article offers some suggestions for the improvement of multiple-choice tests using item analysis statistics. MATERIALS AND METHODS: The graphical modeling is important for the rapid and comparative evaluation of test results. The control chart is a tool that can be used to sharpen our teaching and testing skills by inspecting the weaknesses of measurements and producing reliable items. The research data for the application of control charts were obtained using the results of the fourth and fifth-grade student's exams at Ondokuz Mayis University, Faculty of Medicine. I-chart or moving range chart (MR) is preferred for whole variable data. RESULTS: It is seen that all observations are within control limits for I-chart, but three points on MR-chart are settled on the LCL. Using X--chart with subgroups, it was determined that control measurements were within the upper and lower limits in both charts. The difficulty levels of items were examined by obtaining different variable control charts. The difficulty level of the two items exceeded the upper control limit in R- and S-charts. CONCLUSION: The control charts have the advantage for classifying items as acceptable or unacceptable based on item difficulty criteria.

Color Stability and Surface Roughness of a Laboratory-Processed Composite Resin as a Function of Mouthrinse.

STATEMENT OF THE PROBLEM: Mouthrinses can cause discoloration on indirect resin composites. PURPOSE OF THE STUDY: The purpose of the study was to investigate the effect of different mouthrinses on the color changes and surface roughness of a laboratory-processed composite. METHODS AND MATERIALS: Fifty discs were made using GC Gradia/GC indirect composites and divided into five groups which immersed in artificial saliva and four different types of mouthrinses. The samples were immersed daily for 14 days in 20 mL of the solutions for 2 minutes twice a day (with a 12-hour interval between exposures). Measurements were carried out at four different times: 1 hour after sample preparation (t0 ), 1 day (t1 ), 7 days (t2 ), and 14 days (t3 ) after the first immersion in the solutions. The color before and after immersion was measured according to Comission Internationale de L'Eclairage (CIE L*, a*, b*) System and ΔL*, Δa*, Δb*, and ΔE* values were calculated. The surface roughness Ra (µm) of the specimens was evaluated using a profilometer. RESULTS: There were significant differences between the groups at all time representing ΔE values (p < 0.001). At (t1 ) time representing ΔRa value, there were significant differences between the groups (p < 0.05). At (t2, t3 ) time representing ΔRa values, there were significant differences between the groups (p < 0.001). Pharmol Zn immersed specimens showed ΔE values between 1.04 and 3.67. CONCLUSIONS: The result of this study indicated that the mouthrinses affected the color stability of indirect composites. CLINICAL SIGNIFICANCE: Based on the results of this study, patients with resin composite restorations should be warned by the dentists about the discoloration of the restorations and the time period of the mouthrinse that will be used.

Multi-organ injuries caused by lipopolysaccharide-induced periodontal inflammation in rats: role of melatonin.

BACKGROUND AND OBJECTIVE: Periodontitis, a chronic inflammatory disease caused by oral bacterial infection, is considered to be a risk factor for systemic diseases including diabetes mellitus, bacterial pneumonia, hyperlipidemia and atherosclerosis. The aim of this study was to evaluate the effectiveness of melatonin against periodontal inflammation-induced multiple organ injury in rats. MATERIAL AND METHODS: Eighteen female Wistar albino rats were randomly divided into three groups of six rats each: control; lipopolysaccharide (LPS); and LPS + melatonin. During the experimental period (10 d) all rats in the LPS and LPS + melatonin groups were given 10 µL of LPS (from a 10 mg/mL standard solution of LPS dissolved in saline) on days 1, 3 and 5. The rats in the LPS + melatonin group were given 50 mg/kg of melatonin, daily for 10 d, starting on day 1 after the administration of LPS. All rats were killed at the end of the experimental period. Liver, kidney and lung tissues were removed for investigation by light microscopy. RESULTS: The levels of serum aspartate aminotransferase (AST), alanine transaminase (ALT) and blood urea nitrogen (BUN) were significantly increased in the LPS group compared with the LPS + melatonin group (p < 0.05). There was no significant change in the serum creatinine levels in the groups. However, the changes in serum AST, ALT and BUN levels in the experimental groups did not correlate with changes in histological data. Both LPS and LPS + melatonin groups displayed structural features similar to those of the control group. CONCLUSION: The results revealed that increased serum AST, ALT and BUN levels following periodontitis are ameliorated with melatonin treatment.

Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC).

PURPOSE: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. METHODS: A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. RESULTS: In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) CONCLUSIONS: The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey.

mESAdb: microRNA expression and sequence analysis database.

microRNA expression and sequence analysis database (http://konulab.fen.bilkent.edu.tr/mirna/) (mESAdb) is a regularly updated database for the multivariate analysis of sequences and expression of microRNAs from multiple taxa. mESAdb is modular and has a user interface implemented in PHP and JavaScript and coupled with statistical analysis and visualization packages written for the R language. The database primarily comprises mature microRNA sequences and their target data, along with selected human, mouse and zebrafish expression data sets. mESAdb analysis modules allow (i) mining of microRNA expression data sets for subsets of microRNAs selected manually or by motif; (ii) pair-wise multivariate analysis of expression data sets within and between taxa; and (iii) association of microRNA subsets with annotation databases, HUGE Navigator, KEGG and GO. The use of existing and customized R packages facilitates future addition of data sets and analysis tools. Furthermore, the ability to upload and analyze user-specified data sets makes mESAdb an interactive and expandable analysis tool for microRNA sequence and expression data.

Biodegradable stents for caustic esophageal strictures: a new therapeutic approach.

The treatment of caustic esophageal strictures is a challenging topic. Although traditional therapies have limited efficacy, most of these patients eventually require surgery. Biodegradable (BD) stents are newly designed stents for benign conditions. This is a retrospective case series of seven patients with caustic esophageal stricture. BD esophageal stents were inserted for palliation of dysphagia. The position of the stent was checked at 1, 4, 8, 12 16, 20, and 24 weeks and at the end of follow-up period. The follow-up period was 60 ± 23 (36-102) weeks. Complete dissolution of the stent occurred at 16 ± 4 (12-20) weeks. Three patients had partial/complete relief of dysphagia. The remaining four patients experienced tissue hyperplasia at the edges of the stent and required serial dilations. At the end of follow-up, all patients had partial or complete relief of dysphagia. Although BD stents have some efficiency, tissue hyperplasia is the main limiting factor. Further randomized trials are needed to determine efficiency of BD stents for caustic damage.

Intragastric injection botulinum toxin A for obesity management with or without liraglutide.

OBJECTIVE: Obesity is a global public health problem with rapidly increasing prevalence in many countries, including Turkey, and different treatment modalities have been used. This study aimed to compare the effect of intragastric botulinum toxin A (BTA) injection and BTA injection combined with low-dose liraglutide in patients with obesity. PATIENTS AND METHODS: Records of 701 patients (female/male, 660:41; mean age, 45.6 ± 6.2 years) who received an intragastric injection of BTA for weight loss between November 2019 and May 2020 were reviewed retrospectively. The patients were divided into the BTA group, which included patients who received BTA injection alone, and BTA + liraglutide, which included those who used liraglutide after BTA injection. The demographic characteristics and comorbid diseases of the patients and follow-up results 6 months after the procedure were evaluated. RESULTS: In the comparison of the 3-month and 6-month weights of the patients, weight measurements were significantly lower in the BTA + liraglutide group than in the BTA group (p < 0.001 and p  < 0.001, respectively). Adverse effects were observed in 212 (30.2%) of the study participants, of which 25% were observed in the BTA group and 31.8% in the BTA + liraglutide group, with no significant difference. CONCLUSIONS: The intragastric injection of BTA combined with liraglutide is a safe method that provides more effective weight loss than BTA alone, which is minimally invasive without any serious adverse effects.

Tumor heparanase expression in predicting response to induction chemotherapy in patients with locally advanced laryngeal cancer.

PURPOSE: Induction chemotherapy is a feasible alternative to surgery for the treatment of locally advanced laryngeal cancer. Determining predictive factors associated with a better response to chemotherapy would help choose the patients most likely to benefit from larynx preservation. METHODS: Eighty-four patients diagnosed with locally advanced laryngeal cancer (stage III-IV) between April 1999 and May 2006 were retrospectively reviewed. Eightytwo of them received 2 cycles and 2 received only 1 cycle of cisplatin and 5-fluorouracil (5-FU) chemotherapy. Patients were then grouped, based on response to treatment, as either having complete response (CR), partial response (PR), stable (SD) or progressive disease (PD). Factors predicting response to treatment were evaluated. Paraffin blocks were immunohistochemically examined for heparanase activity to see for any link between heparanase expression and response to treatment. RESULTS: There were 73 males and 11 females with a mean age of 59 years. After induction chemotherapy (cisplatin and 5-FU), 33 patients achieved PR and 20 CR. SD and PD occurred in 9 and 21 patients, respectively. Patients with stage III disease had better overall (CR and PR) response rates when compared with those with stage IV disease. Moreover, development of bone marrow suppression and heparanase positivity were both associated with better overall response rates. CONCLUSION: This study supports the hypothesis that heparanase positivity is associated with better responses to induction chemotherapy, regardless of TNM stage. Furthermore, a higher overall response rate was observed in patients who developed myelosuppression secondary to chemotherapy.

Sensitivity and specificity of infrared thermography in detection of subclinical mastitis in dairy cows.

The objectives of this experiment were to determine interrelationships among mastitis indicators and evaluate the subclinical mastitis detection ability of infrared thermography (IRT) in comparison with the California Mastitis Test (CMT). Somatic cell count (SCC), CMT, and udder skin surface temperature (USST) data were compiled from 62 Brown Swiss dairy cows (days in milk=117+/-51, milk yield=14.7+/-5.2 kg; mean +/- SD). The CORR, REG, and NLIN procedures of Statistical Analysis System (SAS Institute Inc., Cary, NC) were employed to attain interrelationships among mastitis indicators. The diagnostic merit of IRT as an indirect measure of subclinical mastitis was compared with CMT using the receiver operating characteristics curves. The udder skin surface temperature was positively correlated with the CMT score (r=0.86) and SCC (r=0.73). There was an exponential increase in SCC (SCC, x10(3) cells/mL=22.35 x e(1.31 x CMT score); R(2)=0.98) and a linear increase in USST (USST, degrees C=33.45+1.08 x CMT score; R(2)=0.75) as the CMT score increased. As SCC increased, USST increased logarithmically [USST, degrees C=28.72+0.49 x ln(SCC, x10(3) cells/mL); R(2)=0.72]. The USST for healthy quarters (SCC 400,000 cells/mL; n=135) (mean +/- SE; 33.45+/-0.09 vs. 35.80+/-0.08 degrees C). The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value were 95.6, 93.6, 14.97, 0.05, 95.0, and 93.6, respectively, for IRT and 88.9, 98.9, 83.56, 0.11, 99.2, and 86.1, respectively, for CMT. The area under the receiver operating characteristics curve for IRT and CMT was not different. In conclusion, as a noninvasive and quick tool, IRT can be employed for screening subclinical mastitis via measuring USST, with a high predictive diagnostic ability similar to CMT when microbiological culturing is unavailable. However, the reliability of IRT among cows with different characteristics and those living under various environmental conditions remains to be determined.

Protective effect of adenosine triphosphate against sunitinib-related skin damage in rats.

Cutaneous side effects associated with sunitinib use are a major problem in patients receiving cancer treatment. The aim of this study was to investigate the protective effect of adenosine triphosphate (ATP) against possible skin damage resulting from sunitinib use in rats. Thirty Albino Winstar rats were divided into the following three groups: healthy controls (HCs, n = 10), sunitinib (SUN, n = 10), and sunitinib + ATP (SAT, n = 10). ATP was injected intraperitoneally at a dose of 2 mg/kg. One hour subsequent to the administration of ATP and 0.9% NaCl, the SAT and SUN groups were orally administered a dose of 25 mg/kg sunitinib to the stomach. Macroscopic evaluation of the skin indicated lower levels of skin damage in the SAT group than in the SUN group. As an indicator of oxidative stress, malondialdehyde (MDA), total oxidant status (TOS), and oxidative stress index (OSI) levels were significantly higher in the SUN group than in the HC group, while total glutathione (tGSH) and total antioxidant status (TAS) levels were significantly lower. However, MDA, TOS, and OSI levels were significantly lower in the SAT group than in the SUN group, while tGSH and TAS levels were significantly higher. Histopathological examination revealed keratin plugs with edema, vasopathology, and inflammatory cell infiltration in the SUN group. The SAT group showed less necrotic epithelium, keratin plugs, edema, and vasopathology than the SUN group. ATP can be effective in preventing skin damage caused by sunitinib use by reducing oxidative stress.

Periodontal disease in patients with familial Mediterranean fever: from inflammation to amyloidosis.

BACKGROUND AND OBJECTIVE: Familial Mediterranean fever stimulates a very intense acute-phase reactants response and if left untreated eventually leads to amyloidosis. The aim of this study was to determine the prevalence of periodontal disease among patients with familial Mediterranean fever in the Black Sea region in Turkey and to evaluate whether periodontitis is related to amyloidosis in patients with familial Mediterranean fever. MATERIAL AND METHODS: One-hundred and thirty three patients with familial Mediterranean fever and 50 healthy subjects were included in this study. Periodontal health and disease were evaluated using the gingival index, papillary bleeding index, plaque index and periodontal disease index. The concentrations of serum acute-phase reactants were measured at baseline and at 4-6 wk after completion of the nonsurgical periodontal therapy. Genetic testing for familial Mediterranean fever was performed using the familial Mediterranean fever StripAssay. Kidney biopsy was carried out on all proteinuric patients. RESULTS: The prevalence of moderate to severe periodontitis in familial Mediterranean fever patients with amyloidosis (80.6%) was significantly greater (p < 0.01) than in familial Mediterranean fever patients without amyloidosis (38%) and in controls (20%). Serum levels of acute-phase reactants in familial Mediterranean fever patients were reduced significantly following nonsurgical periodontal therapy (p < 0.01). CONCLUSION: Periodontal therapy seems to reduce the serum levels of acute-phase reactants in patients with familial Mediterranean fever. Therefore, treating periodontitis might help to alleviate the disease burden in patients with familial Mediterranean fever.

The effect of the duration of the dialysis in hemodialysis patients on dental and periodontal findings.

OBJECTIVE: The purpose of this study was to investigate the dental and periodontal health status of patients on regular hemodialysis (HD) maintenance therapy, and the effect of duration of HD on oral status. STUDY DESIGN: Sixty-eight HD patients and 41 controls were examined. Decayed, Missing or Filled Teeth (DMFT index), plague index (PI), gingival index (GI), Probing pocket depth (PPD) and loss of periodontal attachment (LPA) were examined. RESULTS: Except DMFT index, significant differences were found in the other index values between patients and controls (P < 0.01). Dialysis duration significantly correlated not with DMFT but with the others. Also, DMFT values showed no significant differences between the five HD subgroups. For the PI, GI and PPD values, the first 5-year period revealed no significant variation, whereas the second 5-year period included significant increases. After 10 years, a much more significant increase was observed. The LPA values did not show any significant differences between the HD subgroups, but after 10 years a significant progressive increase can be observed. CONCLUSIONS: The dental and periodontal health is poor in HD patients and becomes worse with time on dialysis. Thus, oral health maintenance is of utmost importance in this patient group.

Hypofractionated radiotherapy for non-metastatic bone and soft tissue sarcomas.

PURPOSE: To evaluate the efficacy and toxicity of hypofractionated radiotherapy in non-metastatic soft tissue and bone sarcomas. PATIENTS AND METHODS: Thirty patients underwent hypofractionated radiotherapy between 2007 and 2015. Overall, 17 patients underwent primary hypofractionated radiotherapy, nine underwent hypofractionated radiotherapy for reirradiation, and four received a boost dose via hypofractionated radiotherapy after external beam radiotherapy. Most common disease sites were head and neck and retroperitoneum. Hypofractionated radiotherapy was administered with a definitive, adjuvant, or neoadjuvant intent. RESULTS: Median age was 37 years (range: 11-82 years). Median hypofractionated radiotherapy dose was 35Gy (range: 20-50Gy) in three to five fractions. Median follow-up was 21 months (range: 1-108 months). One- and 2-year overall survival rate was 75% and 52%, respectively. One- and 2-year local recurrence-free survival rate was 59% and 48%, with local recurrence rates of 16% and 33% in 1 and 2 years, respectively. Univariate analysis revealed tumour size (P=0.04), hypofractionated radiotherapy intent (P=0.016) and reirradiation (P=0.001) as prognostic factors for local recurrence-free survival. Severe late toxicity was observed in one patient as grade 3 trismus. CONCLUSION: Hypofractionated radiotherapy as the primary treatment or for reirradiation has been shown to be safe in the treatment of bone and soft tissue sarcomas. It can provide relatively good local control and survival rates.

Radiotherapy in congenital vulvar lymphangioma circumscriptum.

Congenital lymphangioma circumscriptum (LC) of the vulva is a rare disorder with unknown etiology. Treatment options include ablative approaches such as laser therapy, sclerotherapy, and surgery. Radiotherapy has been shown to be effective in the management of congenital lymphangioma especially in the thoracic and abdominal lesions. In this report, we describe a patient with persistent vulvar LC despite sclerosing therapy and several surgical excisions. She was treated with a course of external radiotherapy and showed a dramatic objective response with relief of all symptoms.

Partial neuromuscular blockage levels with mivacurium during mastoidectomy allows intraoperative facial nerve monitoring.

BACKGROUND: Facial nerve monitoring during otologic surgery is helpful for facial nerve preservation, but its usage is closely related to anesthetic procedures. OBJECTIVES: The aim of this study was to investigate the effectiveness of mivacurium-based partial neuromuscular blockade on facial nerve monitoring during otologic surgery. METHODS: Forty-three patients scheduled for elective otologic surgery (mastoidectomy with and without tympanoplasty) participated in the study. After induction with propofol 2-3 mg x kg(-1), remifentanil 1 microg x kg(-1) and mivacurium 0.2 mg x kg(-1), anesthesia was maintained with isoflurane 0.6-1.6 minimum alveolar concentration and remifentanil 0.25 microg x kg(-1) x min(-1). Following complete recovery of neuromuscular blockade during induction, mivacurium infusion was initiated at 6 microg x kg(-1) x min(-1) in an adjusted dose to reflect adductor pollicis activity of 50, 75 or 100% of normal. The minimum stimulation thresholds obtained from each case were recorded. RESULTS: Pre- and postoperatively, all 43 patients demonstrated clinically normal facial nerve function. In all cases, intraoperative facial nerve monitoring was performed successfully. There were no differences in threshold levels of the facial nerve stimulation between group I (1.84 +/- 0.4 mA ) and group II (1.97 +/- 0.2 mA). However, the stimulation thresholds of group III (1.53 +/- 0.4 mA ) were found to be lower than those of groups I and II (p < 0.05). CONCLUSION: We conclude that partial neuromuscular blockade with mivacurium permits intraoperative facial nerve monitoring.

Does periodontal disease reflect atherosclerosis in continuous ambulatory peritoneal dialysis patients?

BACKGROUND: Chronic infection and inflammation, including periodontitis, are linked to an increased risk for atherosclerosis. To investigate the possible adverse effects of periodontitis in continuous ambulatory peritoneal dialysis (CAPD) patients, we compared periodontal severity with inflammation and malnutrition, which are associated with poor atherosclerotic outcome in CAPD patients. METHODS: A total of 110 CAPD patients were included in this study to evaluate their clinical periodontal status by using the plaque index, gingival index, and periodontal disease index. Values for nutritional and inflammatory markers and atherosclerotic risk factors were included for analysis with the periodontal index. Analysis of variance, post hoc Tukey's honestly significant difference, univariate and multivariate linear regression analysis, Pearson correlation analysis, and chi2 analysis were used in the evaluation of the data. RESULTS: Poor oral health status was exhibited by 85.5% of our CAPD patients with periodontal disease. We found that age and longer dialysis duration were associated with the severity of periodontitis. Parameters of malnutrition and inflammation and atherosclerotic risk factors also were associated with poor periodontal status. We carried out multiple regression analysis and found that age, albumin level, and duration of dialysis were associated independently with the severity of periodontitis in CAPD patients. A higher percentage of patients in the severe periodontitis group had malnutrition (chi2 = 59.4; P < 0.001), inflammation (chi2 = 60; P < 0.001), and atherosclerosis (chi2 = 65.6; P < 0.001). CONCLUSIONS: Periodontal health is poor in CAPD patients and correlates with markers of malnutrition, inflammation, and atherosclerosis. The diagnosis and treatment of periodontal diseases require better awareness.

Sutureless vascular anastomoses by N-butyl-2 cyanoacrylate adhesive: an experimental animal study.

BACKGROUND: The purpose of this animal study was to find out whether sutureless anastomoses using N-butyl-2-cyanoacrylate were effective in the suppression of neointimal hyperplasia or not. MATERIAL AND METHODS: Ten male adult mongrel dogs were used in this animal study. The animals were randomly divided into a control group (n = 5) and a study group (n = 5). The study group underwent sutureless anastomoses using N-buthyl-2-cyanoacrylate adhesive. Infrarenal aortoaortic graft was interposed using polytetrafluoroethylene. RESULTS: In the study group, the mean intimal thickness at the proximal anastomosis was 27.4 +/- 1.94 microm and 27.4 +/- 1.51 microm at the distal anastomosis. In the control group, the mean intimal thickness was 138.4 +/- 5.02 mum at the proximal anastomosis and 67.6 +/- 6.42 microm at the distal anastomosis. Intimal thickness at the proximal and distal anastomoses in the control group was significantly (p < 0.001) greater than in the study group. Also, perianastomotic inflammation was more obvious in the control group compared to the study group (p < 0.01). CONCLUSION: Sutureless anastomoses using with N-butyl-2-cyanoacrylate adhesive might be a good alternative to conventional suture technique.

Analysis of thrombosis and bleeding complications in patients with polycythemia vera: a Turkish retrospective study.

The aims of this study are to determine the incidence and risk factors of thrombosis and bleeding in polycythemia vera (PV) patients and to research the effects of these risk factors on survival. The medical records of 155 PV patients were analyzed retrospectively. Patients were divided into groups according to whether or not thrombosis had developed in follow-up, and according to whether or not bleeding had occurred during follow-up. The mean age at diagnosis was 53 years, and the mean follow-up period was 66 months. The percentage of cases in which thrombosis events had occurred before diagnosis and during follow-up were 26 and 28 %, respectively. Comparisons of disease duration and average thrombosis risk score between groups with or without thrombosis drew statistically significant results. A patient's history of thrombosis and thrombocytosis at first visit was found to have a significant effect on thrombosis recurrence. The major bleeding rate was 8 %. Post-PV myelofibrosis was an independent risk factor for bleeding. The major cause of death among the patients in this study was primary thrombosis. The most important causes of mortality among PV patients are thrombosis, and the most prominent risk factors for thrombosis development are disease duration and high thrombosis risk scores. Thrombocytosis in patients with a history of thrombosis may cause thrombosis recurrence during the follow-up period.

Effect of ticlopidine in the prevention of radiation enteropathy.

Impairment of vascular function is considered to play an important role in chronic radiation enteropathy. In this experimental study, the role of ticlopidine, an inhibitor of ADP-induced platelet aggregation, was investigated in radiation enteropathy. 80 male Wistar albino rats, each weighing 170-200 g, were divided into four groups: (a) radiation alone (n = 20); (b) radiotherapy plus ticlopidine (n = 20); (c) ticlopidine control (n = 20) and (d) control (n = 20). Both radiation groups received 19 Gy radiation to the exteriorized intestinal segments in a single fraction. Ticlopidine or vehicle was administered 12 h after radiotherapy and continued for 1 month. Rats from every group were euthanized randomly at intervals of 6 weeks from 2 weeks to 26 weeks. Histopathological radiation injury was assessed using radiation injury scoring (RIS). Radiation with ticlopidine or radiation alone groups showed significant RIS deterioration compared with controls in all time points studied. Comparison of median RIS of radiotherapy and radiotherapy+ticlopidine groups at the 2nd, 14th and 26th weeks yielded statistically significant RIS in favour of radiotherapy+ticlopidine group (p = 0.05). However, these differences were less pronounced at the 8th and 20th week (p = 0.07). Both radiation groups had poor weight gain when compared with control and ticlopidine groups. The weight gain in radiotherapy+ticlopidine group was significantly superior to only radiation group between 10th and 20th weeks (p = 0.05). This study showed that inhibition of platelet aggregation with ticlopidine might be useful in radiation enteropathy. However, the precise role of antiaggregant therapies on radiation enteropathy should be comprehensively studied before clinical consideration.