Medical ozone treatment on prevention of epidural fibrosis in the rat model.

Background/Aim: Epidural fibrosis is one of the problems that can be seen after spinal surgery. The aim of this study was to investigate the possible preventive role of medical ozone (O) treatment on epidural fibrosis. Materials and Methods: Twenty-four Sprague Dawley rats were randomly split into four groups: control (C), O, laminectomy (L), and L+O groups. Animals in the C group were sacrificed at the beginning of the experiment. The L and L+O groups had L procedure, while O treatment was supplied for the O and O+L groups. After 42 days of follow-up, for histological evaluation and biochemical measurements, the ratio of epidural fibrosis and catalase (CAT) with malondialdehyde (MDA) levels in serum, respectively, were analyzed in terms of statistical differences. Results: Histologically, a distinct difference was o bserved in the epidural space after O treatment. A significant difference in epidural fibrosis areas is found to be between the O, L, and O+L groups (P < 0,0001). There was no statistically significant difference between CAT and MDA levels that were obtained by spectrophotometric analysis. Conclusion: Histological results suggest that medical O treatment after L can be used as an alternative method to prevent epidural fibrosis. Further studies with wide cohorts and interval measures are required to detail the effects of doses.

The effects of melatonin and thymoquinone on doxorubicin-induced cardiotoxicity in rats.

OBJECTIVES: This study aims to investigate the protective effects of thymoquinone and melatonin on the heart against doxorubicin-induced cardiotoxicity in rats. BACKGROUND: Melatonin and thymoquinone may play an important role in cardiotoxicity. METHODS: The subjects were divided into four groups: Control (physiological serum on 5th day), Doxorubicin (DXR), Doxorubicin+Melatonin (DXR+MEL, 10 mg/kg melatonin, intraperitoneally), and Doxorubicin+Thymoquinone (DXR+TQ, 50 mg/kg thymoquinone, orally). On the 5th day of the experiment, all groups were injected with 45 mg/kg DXR into the tail vein. On the 8th day of the experiment, ECG recordings were performed under anaesthesia. RESULTS: Thymoquinone reduced the PR, QRS and QTc intervals, which were increased by DXR, while melatonin only reduced the QTc interval. Melatonin had a protective effect against the histopathological changes induced by DXR, while TQ did not demonstrate such an effect. DXR increased CK-MB, IL-6, MDA, IL-1, IL-18 levels and decreased SOD in the cardiac tissue. MEL reduced the levels of CK-MB, MDA, NO, SOD, IL-1, IL-6, IL-18. Meanwhile, TQ only reduced CK-MB, IL-1 and IL-18. CONCLUSION: Our study showed that DXR induces cardiac injury and that melatonin improves biochemical parameters and offers histological protection; while thymoquinone improves ECG parameters and causes partial recovery of biochemical parameters (Tab. 4, Fig. 2, Ref. 41).

Assessment of the temporal crest canal using cone-beam computed tomography.

The temporal crest canal (TCC) is a rare variant of the mandibular canal, and it is important to locate the presence and site of mandibular canals and their variants before operation. We have examined the anatomical features and prevalence of TCC with cone-beam computed tomography (CT) in south-east Anatolia. The cone-beam CT images of 1023 patients (2026 sides) referred to the Department of Dentomaxillofacial Radiology between 2015 and 2017 years were evaluated retrospectively. Sagittal, cross-sectional, and reformatted panoramic images were analysed to see if a TCC was present. The canals were grouped as Type 1 and Type 2 according to their configuration. Seven (0.7%) were found in 1023 patients. Two of them (0.2%) were in female, and five (0.5%) in male, patients. Four (0.4%) were increasingly narrow and noticeably curved (Type 1), and three (0.3%) were uniformly wide and slightly curved (Type 2). All TCC were unilateral: two on the right and five on the left. We conclude that knowledge of the presence of a TCC and its anatomical variants in the mandibular ramus is important to ensure a proper local anaesthetic nerve block for surgical operations. Cone-beam CT is an important diagnostic tool in dentistry, and clearly recognises a TCC.

Epicardial fat thickness is associated with severity of disease in patients with chronic obstructive pulmonary disease.

OBJECTIVE: Cardiovascular diseases (CVD) are common in patients with chronic obstructive pulmonary disease (COPD) and the BODE index is an important tool for the prognostic assessment of COPD patients. It is well known that epicardial fat thickness (EFT) is related to CVD. However, there are very few data about the relationship between EFT and BODE index. The aim of this study is to investigate the relationship between EFT and BODE index in patients with COPD. PATIENTS AND METHODS: We prospectively included 157 patients with COPD and 45 controls in the present study. All patients underwent pulmonary function tests and six-minute walking test. EFT and other echocardiographic parameters were measured using transthoracic echocardiography on admission. Patients were divided into four quartiles according to the BODE index scores (Quartile-1 (Q1): 0-2 points; Quartile-2 (Q2): 3-4 points; Quartile-3 (Q3): 5-6 points; Quartile-4 (Q4): 7-10 points). High sensitive C-reactive protein (Hs-CRP) and other biochemical parameters were measured in all participants. RESULTS: COPD patients had higher EFT values compared with control group (p<0.05). When COPD patients were classified according to BODE index quartiles, the highest EFT values were observed in Q1 compared with other quartiles (p<0.05, for all). EFT values showed a decreasing trend from Q1 to Q4. Furthermore, EFT was independently associated with BODE index (ß=0.405, p<0.001), Hs-CRP (ß=0.300, p<0.001) and diabetes (ß=0.338, p<0.001) in multivariate linear regression analysis. CONCLUSIONS: Our findings suggested that EFT is independently and negatively associated with the severity of disease as indicated by BODE index in patients with COPD.

NT-proBNP is associated with SYNTAX score and aortic distensibility in patients with stable CAD.

OBJECTIVE: A high N-terminal pro-brain natriuretic peptide (NT-proBNP) level provides significant prognostic information on patients with coronary artery disease (CAD). It is unclear whether aortic distensibility (AD), which reflects the aortic stiffness, and the extent and complexity of CAD, assessed with the SYNTAX score (SS), affect the secretion of NT-proBNP in stable CAD. We aimed to investigate the relationship between NT-proBNP levels and AD as well as with the extent and complexity of CAD in stable CAD patients. METHODS: The study included 411 patients with stable CAD (mean age = 61.7 ± 9.9 years, male/female = 247/164). The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group < 114 pg/ml and NT-proBNPhigh group ≥ 114 pg/ml). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. Coronary angiography was performed and SS was determined in all patients. NT-proBNP and other biochemical markers were measured in all subjects. RESULTS: The AD and ejection fraction values of the NT-proBNPhigh group were lower and their SS levels were higher compared with those from the NT-proBNPlow group (p < 0.05, for all). The NT-proBNP level was independently associated with AD (ß = -0.378, p < 0.001), SS (ß = 0.262, p < 0.001), and ejection fraction (ß = - 0.295, p < 0.001) on multiple linear regression analysis. CONCLUSION: NT-proBNP was independently associated with an impaired elastic property of the aorta and with the extent and complexity of CAD as well as with left ventricular systolic dysfunction.

Serum uric acid and slow coronary flow in cardiac syndrome X.

OBJECTIVE: It has been recently shown that cardiac syndrome X (CSX) patients with slow coronary flow (SCF) have a worse long-term prognosis than those with normal coronary flow. Increased uric acid levels were shown to be associated with atherosclerosis, oxidative stress, and endothelial dysfunction. The purpose of the study was to investigate the relationship between coronary flow assessed with TIMI frame count (TFC) and serum uric acid (SUA) levels in patients with CSX. METHODS: The study population consisted of 113 consecutive patients with typical cardiac CSX and 41 controls without cardiac CSX. Frequencies of risk factors as well as biochemical and hematological data were recorded for all participants. Coronary blood flow was evaluated by TFC. All patients with a TFC greater than two standard deviations from the published normal range for any one of the three vessels were accepted as having slow coronary flow (SCF group), while those whose TFC values fell within the standard deviation of the published normal range for all of the three vessels were considered to have normal coronary flow. RESULTS: Of the 113 CSX patients enrolled, 40 (35.4%) had SCF. The mean TFC value was strongly positively correlated with SUA level, but weakly correlated with male sex, hypertension, diabetes, smoking, serum creatinine level, and hemoglobin. Multivariate regression analysis showed that only the SUA level was independently associated with SCF. The cut-off value for uric acid obtained by the ROC curve analysis was 4.55 mg/dl for the prediction of SCF (sensitivity, 77.5%; specificity, 73.6%). CONCLUSION: The SUA level is independently associated with SCF in patients with CSX.

The anticancer mechanism of caffeic acid phenethyl ester (CAPE): review of melanomas, lung and prostate cancers.

BACKGROUND: Caffeic acid phenethyl ester (CAPE), an active component of propolis extract, specifically inhibits NF-κB. It exhibits antioxidant, antiinflammatory, antiproliferative, cytostatic, and most importantly, antineoplastic properties. AIM: The aim of the present mini-review is to summarize and evaluate the anticancer mechanism of CAPE with examples of several cancer types. RESULTS: In view of the mechanisms and findings in our laboratory and those of others in literature, we suggest that CAPE possess anticancer and apoptosis inducing activities. CONCLUSIONS: Further researches are needed regarding the anticancer basis of CAPE in all disciplines of medicine. Also, clinical potential toxicities of CAPE should be revealed if it is going to be used as an anticancer agent.

Spontaneous bilateral femoral neck fractures in a young adult with chronic renal failure.

Pathologic femoral neck fracture due to renal osteodystrophy is rare. We report the case of a young adult patient with chronic renal failure who presented with bilateral spontaneous femoral neck fractures due to renal osteodystrophy. The pathophysiology of renal osteodystrophy and the treatment of hip fractures in patients with renal failure is discussed.

Delirium associated with the combination of a neuroleptic, an SSRI, and benztropine.

BACKGROUND: On the basis of recent findings, the increased use of serotonin selective reuptake inhibitors (SSRIs) in combination with antipsychotics and concomitant benztropine is likely. METHOD: Five patients who developed delirium while receiving a neuroleptic, an SSRI, and benztropine are described. RESULTS: The timing of the delirium in relation to drug administration suggests the delirium was the result of an interaction of the SSRI and benztropine. CONCLUSION: Possible mechanisms are explored. Clinicians should be aware that patients receiving this combination may be at increased risk for delirium.