Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament

SUMMARY OBJECTIVE: Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger. METHODS: The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication. RESULTS: Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions. CONCLUSION: This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.

Enhancing Nutrient Content and Uptake in Chickpea through Phosphorus and PSB Inoculation in Custard Apple Based Agri-horti System

The field experiment was conducted during the Rabi season of 2018-19 at the Agricultural Research Farm of Rajiv Gandhi South Campus, Banaras Hindu University, Barkachha, Mirzapur, Uttar Pradesh, India. This study aimed to investigate the effects of varying levels of phosphorus and inoculation with Phosphate Solubilizing Bacteria (PSB) on nutrient content and uptake in chickpea (Cicer arietinum L.) in a custard apple-based agri-horticultural system. The experimental design employed a Factorial Randomized Block Design with three replications and twelve treatments, resulting in a total of 36 plots. The treatments ranged from different levels of phosphorus and PSB inoculation, denoted as T1 to T12. The study assessed the impact of these treatments on nitrogen (N), phosphorus (P) and potassium (K) content in grain and straw, as well as their uptake by chickpea. Findings reveal that higher PSB levels and phosphorus applications led to increased nitrogen and phosphorus content and uptake in both grain and straw, demonstrating a significant synergistic effect. Conversely, potassium content and uptake exhibited limited response to PSB inoculation. Moreover, protein content and yield in grain and straw significantly improved with these treatments.

Transformative Role of Remote Sensing in Advancing Horticulture: Optimizing Sustainability, Efficiency and Resilience

The field of horticulture, vital for addressing global challenges like food security and sustainable agriculture, has been revolutionized by remote sensing technology. This comprehensive review explores the transformative impact of remote sensing on horticulture, emphasizing its role in optimizing resource utilization, promoting environmental sustainability, and mitigating the effects of climate change. Remote sensing, encompassing a range of sensors, satellites, and data analysis techniques, enables the collection of critical information from a distance, providing insights into crop health, soil conditions, water availability, and more. Precision agriculture, including the use of GPS and GIS, is integrated with remote sensing to enhance agricultural efficiency while minimizing environmental impacts. Site-Specific Crop Management (SSCM) is highlighted as a key component of precision agriculture, enabled by geospatial technologies, including remote sensing. It discusses how remote sensing systems, with their multispectral and multi-temporal capabilities, support various horticultural applications such as crop yield estimation, abiotic and biotic stress management, crop classification, canopy measurement, crop area estimation, and even crop insurance validation. The use of Geographic Information Systems (GIS) and the Global Positioning System (GPS) in tandem with remote sensing is explored in the context of spatial analysis, mapping, and precise navigation.

Performance of Wheat Varieties at Different Sowing Dates under Open and Pongamia pinnata Based Agroforestry Systems

The experiment was carried out in a Pongamia pinnata-based agroforestry system to assess the impact of land use systems, sowing dates, and wheat varieties on wheat cultivation at the Forestry Research Farm, JNKVV, Jabalpur during the Rabi season of 2021-22 The experiment followed a three-factor double split plot design with two systems (open system and agroforestry system) as the main plot, three sowing dates (12th November, 27th November, and 12th December) as subplots, and two wheat varieties (MP-3336 and GW-322) as sub-sub plots. The results showed that the open system outperformed the agroforestry system in terms of plant population, plant height at harvest, grain yield, straw yield, biological yield, and harvest index. Early-sown wheat consistently showed better performance in most parameters compared to timely-sown and late-sown varieties. Among the wheat varieties, the MP-3336 variety exhibited higher plant population, while the GW-322 variety showed taller plants at harvest, longer spikes, higher grain yield, and better harvest index. These findings provide valuable insights into optimizing wheat cultivation in agroforestry systems and emphasize the importance of considering land use systems, sowing dates, and wheat varieties to maximize crop productivity.

A Review on Remote Sensing as a Tool for Irrigation Monitoring and Management

Remote sensing has played a vital role in advancement of agriculture and is effective technical method for agriculture crop management. It is a technology which acquisite information regarding objects on earth surface as well as atmosphere from a distance without being in contact with the object. Researchers have proved its high potential with accuracy in the field of agriculture. After various experiments, the qualitative and quantitative assessment of soil, crop and atmosphere demonstrated the better understanding between the crop and its management practices. The collected spatial and temporal data via various passive and active sensors has been utilized not only for morphological study but also for monitoring the vegetation moisture content. The paper reviews about the potential studies carried out to investigate the water content in plant to make use in irrigation management. Diverse spectral reflectance indices have been mentioned from which special emphasis on NDWI has been given. It is an index which is used in remote sensing to assess the crop water status and can be utilized in efficient operation of irrigation to improve water use efficiency (WUE) in agriculture. In order to make irrigation practices more efficient by making the lab restricted irrigation scheduling methods like IW:CPE method applicable in regular practice by using remote sensing. This paper firstly identifies areas where researches and techniques have real-world application. Next, it identifies actual issues that remote sensing could address and solve with further research and its related development. All opportunities for managing agricultural water resources effectively to be explored and made successful through precision agriculture. Using the fast, impartial and reliable information offered by remote sensing is a significant difficulty in the field of water resource management.

Impact of COVID-19 pandemic on the course of refractory chronic spontaneous urticaria under omalizumab treatment

Abstract Background: The course of chronic spontaneous urticaria (CSU) can be influenced by infections, depression, and stress. Objectives: Our aim was to investigate the impact of the COVID-19 pandemic on the course of refractory CSU together with patient adherence to omalizumab and treatment adjustments. Methods: Urticaria Activity Score (UAS7) was used to assess disease activity. Fear of COVID-19 Scale (FC-19s), and Depression Anxiety Stress Scale (DASS-21s) were performed to assess mental health status. All scales were performed during the Quarantine Period (QP) and Return to the Normal Period (RTNP). UAS7 Before Pandemic (BP) was recorded from the patients medical records. Results: The authors evaluated 104 omalizumab-receiving CSU patients. UAS7 scores during QP were significantly higher than those in RTNP and BP (p < 0.01). DASS-21 and FC-19 scores were significantly higher during QP compared to RTNP (p < 0.01). Nineteen (18.2%) patients ceased omalizumab, 9 patients prolonged the intervals between subsequent doses during the pandemic. UAS7 scores in QP were significantly higher in patients who ceased omalizumab than in those who continued (p < 0.001). Among patients who continued omalizumab, 22.4% had an increase in urticaria activity and higher FC-19 scores in comparison with those with stable disease activity (p = 0.008). Study limitations: The small sample size of patients with prolonged intervals of omalizumab and the lack of mental health evaluation with the same tools prior to the study. Conclusions: Fear induced by COVID-19 can determine an increase in disease activity. Therefore, patients on omalizumab should continue their treatment and prolonged interval without omalizumab can be considered in patients with good urticaria control.

Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment

Abstract Acne vulgaris is one of the most common chronic inflammatory diseases and is characterized by papules, pustules, comedones, and nodules. Although adolescence is the preferential age group, acne may affect various age groups. Acne shares different properties in adults and adolescents. These differences extend from epidemiology to treatments. Increased awareness of these two subtypes will allow for better management of the disease. In this review, the authors examined all aspects of acne in adults and adolescents under the light of current literature.

Is cutaneous microbiota a player in disease pathogenesis? Comparison of cutaneous microbiota in psoriasis and seborrheic dermatitis with scalp involvement

Background: Knowledge about cutaneous microbiota in psoriasis vulgaris and seborrheic dermatitis is limited, and a comparison of microbiota in the two diseases was not yet previously undertaken. Aims/Objectives: This study aimed to compare the scalp lesional and non-lesional microbiota in psoriasis vulgaris and seborrheic dermatitis with that in a healthy control group. Methods: Fifty samples were taken with sterile swabs from patients’ and controls’ scalps, and 16S rRNA gene sequencing analyses were performed. Results: Alpha and beta diversity analyses showed that bacterial load and diversity were significantly increased in psoriasis vulgaris and seborrheic dermatitis lesions compared to the controls. As phyla, Actinobacteria decreased and Firmicutes increased, while as genera, Propionibacterium decreased; Staphylococcus, Streptococcus, Aquabacterium, Neisseria and Azospirillum increased in lesions of both diseases. Specifically, Mycobacterium, Finegoldia, Haemophilus and Ezakiella increased in psoriasis vulgaris and Enhydrobacter, Micromonospora and Leptotrichia increased in seborrheic dermatitis lesions. Mycobacterium, Ezakiella and Peptoniphilus density were higher in psoriasis vulgaris compared to seborrheic dermatitis lesions. The bacterial diversity and load values of non-lesional scalp in psoriasis vulgaris and seborrheic dermatitis lay between those of lesional areas and controls. Limitations: The small sample size is the main limitation of this study. Conclusion: Higher bacterial diversity was detected in lesions of both psoriasis and seborrheic dermatitis compared to the controls, but similar alterations were observed when the two diseases were compared. Although these differences could be a result rather than a cause of the two diseases, there is a need to analyze all members of the microbiota and microbiota-host interactions

Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: real-world data from a retrospective multicenter study

Abstract Background: Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. Objective: The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. Method: The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. Results: In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. Study limitations: Retrospective design. Conclusions: These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population.

Sacroiliitis in children and adolescents with familial Mediterranean fever

Abstract Background: Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent episodes of fever and serositis. Sacroiliitis can be observed in some FMF patients. This study aimed to compare the demographic, clinical, and laboratory findings, and treatment in children with FMF and sacroiliitis, and children with juvenile spondyloarthropathy (JSpA). Methods: In total, 1687 pediatric FMF patients that were followed-up between May 2010 and June 2020 were evaluated retrospectively. Among them, those with sacroiliitis ( n = 63) were included in the study and compared to patients with JSpA ( n = 102). Results: The study included 63 FMF patients with sacroiliitis (38 males [60.3%] and 25 females [39.7%]) with a mean age of 15.2 ± 4.1 years. Mean age at symptom onset was 7.2 ± 5.05 years and mean age at diagnosis was 9.74 ± 4.67 years. The most common mutation in the FMF patients was M694V/M694V ( n = 22). Patients were diagnosed with sacroiliitis with a mean of 12 months (range: 6-36 months) after the diagnosis of FMF. Among the FMF patients, 28 (44.4%) had enthesitis, 23 (36.5%) had heel pain, and 11 (17.4%) had low back pain. The study also included 102 JSpA patients (90 males [88.2%] and 12 females [11.8%]). Mean age of patients with JSpA was 16.1 ± 2.8 years. As compared to 102 JSpA patients, patients with FMF and sacroiliitis had higher acute phase reactants, whereas HLA- B27 positivity rate was lower. In addition, axial involvement rate was higher in the JSpA patients. Conclusion: Sacroiliitis is a common co-morbidity in FMF patients. The phenotypic features of these patients are different from patients with JSpA.

Nursing diagnoses and NIC interventions in adult males undergoing radical prostatectomy / Diagnósticos de Enfermagem e intervenções NIC em adultos do sexo masculino que passaram por prostatectomia radical / Diagnósticos de Enfermería e intervenciones NIC en adultos del sexo masculino que pasaron por prostatectomía radical

ABSTRACT Objective: To determine NANDA-I nursing diagnoses and NIC nursing interventions in patients who underwent radical prostatectomy. Method: A cross-sectional and descriptive study was conducted in a research and teaching hospital in western Turkey between June 2016 and June 2017. The sample included adult patients diagnosed with prostate cancer in the immediate postoperative period of radical prostatectomy. Data collection was performed using Gordon's Functional Health Patterns, NANDA-International and Nursing Interventions Classification Taxonomy Systems. Results: Participants were 54 adult patients. The main nursing diagnoses were in the classes of "physical injury", "self-care", "hydration" and "physical comfort". Some nursing diagnoses were identified in all patients, namely: "risk for deficient fluid volume", "risk for imbalanced fluid volume", "impaired urinary elimination". The most selected NIC interventions were in the classes of "risk management", "elimination management", "coping assistance", "tissue perfusion management" and "self-care facilitation". Conclusion: future studies with larger populations are needed to explore the nursing diagnoses and effects of nursing interventions on patients who underwent radical prostatectomy.

Resumo Objetivo: Determinar os diagnósticos de enfermagem da NANDA-I e as intervenções de enfermagem (NIC) em pacientes que passaram por prostatectomia radical. Método: um estudo transversal e descritivo foi realizado em um hospital universitário e de pesquisa na Turquia ocidental entre junho de 2016 e junho de 2017. A amostra incluiu pacientes adultos diagnosticados com câncer de próstata no período pós-operatório imediato da prostatectomia radical. A coleta de dados foi realizada usando os padrões funcionais de saúde de Marjory Gordon, NANDA-Internacional e os sistemas de taxonomia para a classificação das intervenções de enfermagem. Resultados: Participaram 54 pacientes adultos. Os principais diagnósticos de enfermagem foram nas classes de "lesão física", "autocuidado", "hidratação" e "conforto físico". Alguns diagnósticos de enfermagem foram identificados em todos os pacientes, especificamente: "risco para volume de líquidos deficiente", "risco para volume de líquidos desequilibrado", "eliminação urinária prejudicada". As intervenções (NIC) mais selecionadas foram nas classes de "manejo de riscos", "manejo da eliminação", "assistência de cobertura", "manejo da perfusão tecidual" e "facilitação do autocuidado". Conclusão: Estudos futuros com populações maiores são necessários para explorar os diagnósticos de enfermagem e os efeitos das intervenções de enfermagem em pacientes que passaram por prostatectomia radical.

Resumen Objetivo: Determinar los diagnósticos de enfermería de la NANDA-I y las intervenciones de enfermería (NIC) en pacientes que pasaron por prostatectomía radical. Método: Un estudio transversal y descriptivo fue realizado en un hospital universitario y de investigación en Turquía occidental entre junio de 2016 y junio de 2017. La muestra incluyó a pacientes adultos diagnosticados con cáncer de próstata en el período posoperatorio inmediato de la prostatectomía radical. La recolección de los datos se llevó a cabo utilizándose los patrones funcionales del paciente de Marjory Gordon, NANDA Internacional y los sistemas de taxonomía para la clasificación de las intervenciones enfermeras. Resultados: Participaron 54 pacientes adultos. Los principales diagnósticos de enfermería fueron en las clases de "daño físico", "autocuidado", "hidratación" y "comodidad física". Algunos diagnósticos enfermeros fueron identificados en todos los pacientes, específicamente: "riesgo para volumen de líquidos deficiente", "riesgo para volumen de líquidos desequilibrado", "eliminación urinaria perjudicada". Las intervenciones (NIC) más seleccionados fueron en las clases de "manejo de riesgos", "manejo de la eliminación", "asistencia de cobertura", "manejo de la perfusión tisular" y "facilitación del autocuidado". Conclusión: Estudios futuros con poblaciones más grandes son necesarios para explorar los diagnósticos de enfermería y los efectos de las intervenciones enfermeras en pacientes que pasaron por prostatectomía radical.

Effect of Ramadan fasting on glycaemic parameters & body mass index in type II diabetic patients: A meta-analysis

Background & objectives: There has been an ongoing debate about the impact of Ramadan fasting (RF) on the health of these individuals who fast during Ramadan. The aim of this meta-analysis was to evaluate the relationship between RF and glycaemic parameters in type 2 diabetes mellitus (T2DM) patients. Methods: Search terms were decided and databases such as MEDLINE EBSCO, Google Scholar and EMBASE were searched for eligible studies. Standardized mean differences and 95 per cent confidence intervals (CIs) of post-prandial plasma glucose (PPG), fasting plasma glucose (FPG), glycated haemoglobin (HbA1c) (%) and fructosamine levels were calculated for different treatment regimens. Results: Of the 40 studies, 19 were found eligible for inclusion in the meta-analysis. Based on pooled results, significant reductions in FPG were found in single oral antidiabetics (OAD) [standardized weighted mean difference (SMD)=0.47, 95% CI=(0.20-0.74)], multi-OAD [SMD=0.36, 95% CI=(0.11-0.61)] and multitreatment subgroups [SMD=0.65, 95% CI=(0.03-1.27)] and overall [SMD=0.48, 95% CI=(0.27-0.70)]. Furthermore, HbA1c(%) [SMD=0.26, 95% CI=(0.03-0.49)] and body mass index (BMI) [SMD=0.18, 95% CI=(0.04-0.31)] were significantly decreased in the multi-OAD group. Interpretation & conclusions: The meta-analysis showed that RF was not associated with any significant negative effects on PPG and fructosamine levels. However, BMI and FPG and HbA1c(%) were positively affected by RF.

Evaluation of choroidal perfusion changes in obese patients: ocular effects of insulin resistance / Avaliação das alterações da perfusão coroidiana em pacientes obesos: efeitos oculares da resistência à insulina

ABSTRACT Purpose: We aimed to evaluate choroidal per­fusion changes in obese patients using optical coherence tomography and dynamic contour tonometry, to determine whether these changes are associated with body mass index, and to assess the ocular effects of insulin resistance. Methods: We retrospectively evaluated the data of 32 obese patients with body mass index >30 kg/m2 and 45 healthy control individuals. Intraocular pressure and ocular pulse amplitude values of the patients were measured using dynamic contour tonometry, and the mean choroidal thickness was measured using enhanced depth imaging optical coherence tomography. Insulin resistance was assessed using the homeostasis model assessment-estimated insulin resistance index. Results: The mean choroidal thickness (294.30 ± 60.87 μm) and ocular pulse amplitude (2.10 ± 0.74) were lower, whereas the mean intraocular pressure (16.61 ± 2.35 mmHg) was higher in obese patients than in controls. There was a significant negative correlation between body mass index and ocular pulse amplitude (r=-0.274; p=0.029) and an insignificant negative correlation between mean choroidal thickness, intraocular pressure, and body mass index. There was an insignificant negative correlation between homeostasis model assessment-estimated insulin resistance index, mean choroidal thickness, and intraocular pressure and significant ne­gative correlation between homeostasis model assessment-estimated insulin resistance index and ocular pulse amplitude (r=-0.317; p=0.022). Conclusion: We found reduced mean choroidal thickness and ocular pulse amplitude and increased mean intraocular pressure in obese patients. These changes indicated a decrease in choroidal perfusion and ocular blood flow. It may be possible to detect ocular blood flow changes in obese patients through noninvasive assessment using the choroid. The negative correlation between insulin resistance and ocular pulse amplitude may be associated with intracellular fat accumulation in obese patients.

RESUMO Objetivo: Avaliar as alterações da perfusão coroidiana em pacientes obesos utilizando tomografia de coerência óptica e a tonometria de contorno dinâmico, para determinar se essas alterações estão associadas ao índice de massa corporal e avaliar os efeitos oculares da resistência à insulina. Métodos: Foram avaliados, retrospectivamente, os dados de 32 pacientes obesos, com índice de massa corporal >30 kg/m2, e 45 controles saudáveis. Os valores de pressão intraocular e da amplitude de pulso ocular dos pacientes foram medidos por meio de tonometria de contorno dinâmico e a espessura média da coroide foi medida por tomografia de coerência óptica com profundidade de imagem aprimorada. A resistência à insulina foi avaliada usando o índice de estimativa da resistência à insulina pelo modelo de homeostase. Resultados: A espessura média da coroideia (294,30 ± 60,87 μm) e a amplitude de pulso ocular (2,10 ± 0,74) foram menores, enquanto a pressão intraocular média (16,61 ± 2,35 mmHg) foi maior nos obesos do que nos controles. Houve uma correlação negativa significativa entre o índice de massa corporal e a amplitude de pulso ocular (r=-0,274; p=0,029) e uma correlação negativa insignificante entre a espessura média da coroide, a pressão intraocular e o índice de massa corporal. Houve uma correlação negativa insignificante entre a avaliação do modelo de homeostase - estimativa do índice de resistência à insulina, espessura média da coróide e pressão intraocular e correlação negativa significativa entre o modelo de avaliação de homeostase - o índice de resistência à insulina estimado e a amplitude de pulso ocular (r=-0,317; p=0,022). Conclusão: Encontramos redução da espessura média da coroide e da amplitude de pulso ocular e aumento da pressão intraocular em pacientes obesos. Essas alterações indicaram uma diminuição na perfusão coroidal e no fluxo sanguíneo ocular. Pode ser possível detectar alterações no fluxo sanguíneo ocular em pacientes obesos por meio de avaliação não invasiva usando a coróide. A correlação negativa entre a resistência à insulina e a amplitude de pulso ocular pode estar associada ao acúmulo de gordura intracelular em pacientes obesos.

Effectiveness of caudal septal extension graft application in endonasal septoplasty / Eficácia da aplicação de enxerto de extensão septal caudal em septoplastia endonasal

Abstract Introduction Septal deviation is a common disease seen in daily otorhinolaryngology practice and septoplasty is a commonly performed surgical procedure. Caudal septum deviation is also a challenging pathology for ear, nose, and throat specialists. Many techniques are defined for caudal septal deviation. Objective To evaluate the effectiveness of caudal septal extension graft (CSEG) application in patients who underwent endonasal septoplasty for a short and deviated nasal septum. Methods Forty patients with nasal septal deviation, short nasal septum, and weak nasal tip support who underwent endonasal septoplasty with or without CSEG placement between August 2012 and June 2013 were enrolled in this study. Twenty patients underwent endonasal septoplasty with CSEG placement. The rest of the group, who rejected auricular or costal cartilage harvest for CSEG placement, underwent only endonasal septoplasty without any additional intervention. Using the Nasal Obstruction Symptom Evaluation (NOSE) and Rhinoplasty Outcome Evaluation (ROE) questionnaires, pre- and post-operative acoustic rhinometer measurements were evaluated to assess the effect of CESG placement on nasal obstruction. Results In the control group, preoperative and postoperative minimal cross-sectional areas (MCA1) were 0.44 ± 0.10 cm2 and 0.60 ± 0.11 cm2, respectively (p < 0.001). In the study group, pre- and postoperative MCA1 values were 0.45 ± 0.16 cm2 and 0.67 ± 0.16 cm2, respectively (p < 0.01). In the control group, the nasal cavity volume (VOL1) value was 1.71 ± 0.21 mL preoperatively and 1.94 ± 0.17 mL postoperatively (p < 0.001). In the study group, pre- and postoperative VOL1s were 1.72 ± 0.15 mL and 1.97 ± 0.12 mL, respectively (p < 0.001). Statistical analysis of postoperative MCA1 and VOL1 values in the study and the control groups could not detect any significant intergroup difference (p = 0.093 and 0.432, respectively). In the study group, mean nasolabial angles were 78.15 ± 4.26º and 90.70 ± 2.38º, respectively (p < 0.001). Conclusion Endonasal septoplasty with CESG placement is an effective surgical procedure with minimal complication rate for subjects who have a deviated, short nasal septum and weak nasal tip support.

Resumo Introdução Desvio septal é doença comum no cotidiano da prática otorrinolaringológica e a septoplastia é procedimento cirúrgico comum. Desvio caudal do septo nasal é também uma condição desafiadora para os otorrinolaringologistas. São muitas as técnicas definidas para desvio caudal do septo nasal. Objetivo Avaliar a eficácia da aplicação de enxerto de extensão septal caudal (EESC) em pacientes que passaram por septoplastia endonasal devido a septo nasal curto e com desvio. Método Foram recrutados para o estudo 40 pacientes com desvio de septo nasal, septo nasal curto e fraca sustentação da ponta do nariz, tratados com septoplastia endonasal com ou sem a aplicação de EESC, entre agosto de 2012 e junho de 2013. Ao todo, 20 pacientes foram tratados com septoplastia endonasal com aplicação de EESC. O restante do grupo, que rejeitou coleta de cartilagem auricular ou costal para a aplicação de EESC, foi tratado apenas com septoplastia endonasal. Com a aplicação dos questionários Nose (Nasal Obstruction Symptom Evaluation, Avaliação dos Sintomas de Obstrução Nasal) e ROE (Rhinoplasty Outcome Evaluation, Avaliação dos Desfechos da Rinoplastia), as mensurações pré e pós-operatórias com o rinômetro acústico foram obtidas com o objetivo de avaliar o efeito da aplicação de EESC na obstrução nasal. Resultados No grupo controle, as áreas de secção transversal mínima (ASTM1) antes e depois da operação foram 0,44 ± 0,10 cm2 e 0,60 ± 0,11 cm2, respectivamente (p < 0,001). No grupo de estudo, os valores antes e depois da operação para ASTM1 foram 0,45 ± 0,16 cm2 e 0,67 ± 0,16 cm2, respectivamente (p < 0,01). No grupo controle, o valor para os volumes da cavidade nasal (VOL1) foi 1,71 ± 0,21 mL no pré-operatório e 1,94 ± 0,17 mL no pós-operatório (p < 0,001). No grupo de estudo, os VOL1 antes e depois da operação foram 1,72 ± 0,15 mL e 1,97 ± 0,12 mL, respectivamente (p < 0,001). A análise estatística dos valores pós-operatórios para ASTM1 e VOL1 nos grupos de estudo e controle não permitiu a detecção de qualquer diferença intergrupos (p = 0,093 e 0,432, respectivamente). No grupo de estudo e no grupo controle, os ângulos nasolabiais médios foram 78,15 ± 4,26º e 90,70 ± 2,38º, respectivamente (p < 0,001). Conclusão A septoplastia endonasal com aplicação de EESC é um procedimento cirúrgico efetivo, com mínimo percentual de complicações para pacientes que se apresentam com septo nasal curto e com desvio e com fraca sustentação da ponta do nariz.

Can procalcitonin be a diagnostic marker for catheter-related blood stream infection in children? / A procalcitonina pode ser um marcador de diagnóstico de infecções de corrente sanguínea relacionadas a cateter em crianças?

Abstract Objective The potential role of procalcitonin (PCT) in the diagnosis of catheter-related bloodstream infection (CRBSIs) is still unclear and requires further research. The diagnostic value of serum PCT for the diagnosis of CRBSI in children is evaluated here. Method This study was conducted between October 2013 and November 2014, and included patients with suspected CRBSI from 1 month to 18 years of age who were febrile, with no focus of infection, and had a central venous catheter. Levels of PCT and other serum markers were measured, and their utility as CRBSI markers was assessed. Additionally, the clinical performance of a new, automated, rapid, and quantitative assay for the detection of PCT was tested. Results Among the 49 patients, 24 were diagnosed with CRBSI. The PCT-Kryptor and PCT-RTA values were significantly higher in proven CRBSI compared to those in unproven CRBSI (p = 0.03 and p = 0.03, respectively). There were no differences in white blood cell count and C-reactive protein (CRP) levels between proven CRBSI and unproven CRBSI. Among the 24 patients with CRBSI, CRP was significantly higher among those with Gram-negative bacterial infection than in those with Gram-positive bacterial infections. PCT-Kryptor was also significantly higher among patients with Gram-negative bacterial infection than in those with Gram-positive bacterial infections (p = 0.01 and p = 0.02, respectively). Conclusions The authors suggest that PCT could be a helpful rapid diagnostic marker in children with suspected CRBSIs.

Resumo Objetivo O possível papel da procalcitonina (PCT) no diagnóstico de infecções de corrente sanguínea relacionadas a cateter (ICSRCs) ainda não está claro e precisa ser mais pesquisado. O valor diagnóstico da PCT sérica para o diagnóstico de ICSRC em crianças é avaliado neste estudo. Método Este estudo foi feito entre outubro de 2013 e novembro de 2014 e incluiu pacientes com suspeita de ICSRC de um mês a 18 anos que estavam febris, não tinham foco de infecção e tinham cateter venoso central. Foram medidos os níveis de PCT e de outros marcadores séricos, cuja utilidade como marcadores de ICSRC foi avaliada. Adicionalmente, foi testado o desempenho clínico de um novo ensaio quantitativo automatizado e rápido para a detecção de PCT. Resultados Dentre 49 pacientes, 24 foram diagnosticados com ICSRC. Os valores de PCT-Kryptor e PCT-RTA foram significativamente maiores em ICSRCs comprovadas do que em ICSRCs não comprovadas (p = 0,03 e p = 0,03, respectivamente). Não houve diferença na contagem de glóbulos brancos e nos níveis de proteína C reativa (PCR) entre ICSRCs comprovadas e ICSRCs não comprovadas. Dentre os 24 pacientes com ICSRC, a PCR era significativamente maior entre aqueles com infecção bacteriana gram-negativa do que naqueles com infecção bacteriana gram-positiva. O PCT-Kryptor também foi significativamente maior entre pacientes com infecção por bactérias gram-negativas do que naqueles com infecção por bactérias gram-positivas (p = 0,01 e p = 0,02, respectivamente). Conclusões Sugerimos que a PCT pode ser um marcador de diagnóstico rápido útil em crianças com suspeita de ICSRCs.