Association of epicardial fat thickness with clinical and polysomnographic parameters in non-obese obstructive sleep apnoea patients.

OBJECTIVES: This study aimed to investigate the relationship of epicardial fat thickness with severity of obstructive sleep apnoea, and clinical and polysomnographic parameters, and to determine independent predictors for epicardial fat thickness. METHODS: A total of 84 patients with a body mass index of less than 30 kg/m2 and suspected sleep-disordered breathing were included in the study. The correlations of epicardial fat thickness with polysomnographic and clinical data, and severity of obstructive sleep apnoea, were investigated. RESULTS: Mean epicardial fat thickness was 3.75 ± 1.07 mm in the study group (n = 62) and 2.97 ± 0.62 mm in the control group (n = 22) (p < 0.001). There were significant positive correlations between epicardial fat thickness and: apnoea/hypopnoea index, oxygen desaturation index 3 and minimum oxygen saturation, as well as with age, body mass index, and neck and waist circumferences. CONCLUSION: Non-obese obstructive sleep apnoea patients have thicker epicardial fat compared to controls. Oxygen desaturation index 3 has a strong correlation with epicardial fat thickness and is an independent predictor of it.

The effect of non-diabetic chronic renal failure on olfactory function.

OBJECTIVES: In chronic renal failure (CRF), deterioration of glomerular filtration results in accumulation of metabolites in the body which affect all organs. This study was performed to investigate the olfactory functions, and determine if hemodialysis or peritoneal dialysis improves olfactory function in non-diabetic CRF patients. MATERIALS AND METHODS: The olfactory functions were analyzed in CRF patients not on a dialysis program and had a creatinine level≥2mg/dL, in CRF patients on hemodialysis or peritoneal dialysis, and in healthy controls. Diabetic patients were excluded since diabetes alone is a cause of olfactory dysfunction. The study group consisted of a total of 107 individuals including 38CRF patients on a hemodialysis program, 15 CRF patients on peritoneal dialysis, 30 patients with a creatinine level ≥ 2mg/dL without any need for dialysis, and 24 healthy controls with normal renal functions. Olfactory functions were analyzed with "Sniffin' sticks" test, and the groups were compared for the test results. RESULTS: All test parameters were impaired in patients with CRF. The median TDI scores of the patients with CRF and the healthy subjects were 24.75 (13-36) and 32.5 (27.75-37.75), respectively, with a statistically significant difference in between (P<0.001). The olfactory functions for the dialysis patients were better than those for the CRF patients not on a dialysis program (P=0.020). CONCLUSION: Non-diabetic CRF affects olfactory functions negatively. Dialysis improves olfactory functions in those patients.

Initial assessment of hearing loss using a mobile application for audiological evaluation.

OBJECTIVE: This study aimed to compare an Apple iOS mobile operating system application for audiological evaluation with conventional audiometry, and to determine its accuracy and reliability in the initial evaluation of hearing loss. METHODS: The study comprised 32 patients (16 females) diagnosed with hearing loss. The patients were first evaluated with conventional audiometry and the degree of hearing loss was recorded. Then they underwent a smartphone-based hearing test and the data were compared using Cohen's kappa analysis. RESULTS: Patients' mean age was 53.59 ± 18.01 years (range, 19-85 years). The mobile phone audiometry results for 39 of the 64 ears were fully compatible with the conventional audiometry results. There was a statistically significant concordant relationship between the two sets of audiometry results (p < 0.05). CONCLUSION: Ear Trumpet version 1.0.2 is a compact and simple mobile application on the Apple iPhone 5 that can measure hearing loss with reliable results.

Evaluation of hematological markers in minor head trauma in the emergency room.

INTRODUCTION: A rule exists regarding the use of computed tomography (CT) for patients presenting to the emergency department with head trauma and a Glasgow coma score (GCS) of 15; however, it can be difficult to make this decision due to overcrowded emergency rooms or exaggerated patients complaints. We evaluated patients who presented to the emergency room with minor head trauma, and we aimed to investigate the relationship between brain pathology on CT and hematological markers in order to find markers that help us identify brain pathology in patients with a GCS of 15. METHODS: This retrospective study included 100 patients with pathologies present on their CT scans and a control group consisting of 100 patients with a normal CT. All data obtained from this study were recorded and evaluated using "Statistical Package for Social Sciences for Windows 20" program. Parametric tests (independent samples test) were used with normally distributed data, while non-parametric tests (Mann-Whitney U test) were used with non-normally distributed data. A p ≤ 0.05 was considered significant. FINDING: When we divided the cases into two groups based on the presence of pathologies on CT scan, we determined that there were significant differences between the groups in terms of white blood cell (WBC), hemoglobin (Hb), mean platelet volume (MPV), neutrophil (neu), troponin T, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). When differentiating the patients that had brain pathologies on CT scan from patients that had normal CT scans, the troponin T cut-off value of 6.16 lead to 90 % specificity, and setting the NLR cut-off value at 4.29 resulted in a specificity of 90 %. CONCLUSION: MPV, NLR, and troponin T can be used as parameters that indicate brain pathologies on CT scans of patients presenting to the emergency department with isolated minor head trauma and GCS of 15 when the necessity of a CT scan is otherwise unclear.

Evaluation of the effect of nasal dorsal skin cooling on nasal mucosa by acoustic rhinometry.

BACKGROUND: The use of cold nasal packs on the nose and nape of the neck is currently recommended for patients with epistaxis as this is thought to induce reflex nasal vasoconstriction, which decreases the bleeding. There have been a few investigations on the effect of cold compress application to the nose, but none of these focused specifically on nasal cooling of the skin of the nose. METHODS: Acoustic rhinometry was performed to obtain baseline measurements. Nasal dorsal skin was then cooled with two ice packs that were held on the left and right side of the nose for a total of 10 minutes by the subjects. The rhinometry measurements were taken at the time of initial application (baseline), and after 5 and 10 minutes of ice pack application. RESULTS: Comparisons of the first and second minimal cross-sectional area values, and total nasal cavity volume measurements revealed no statistical differences. CONCLUSION: The results of this study indicate that one should be sceptical about the efficiency of cold compress application, which is frequently used in clinical practice in cases with epistaxis.

Is nasal packing required in epistaxis?

OBJECTIVE: To demonstrate the efficacy of identification of bleeding source with nasal endoscopy and cauterization (bipolar or radiofrequency) without nasal packing in adults with posterior epistaxis unable to be treated with nasal packing. MATERIALS AND METHODS: The average age of patients was 56.16 ± 12.6 (38-72) years, and female-male ratio was 1/5. The average systolic blood pressure was found to be 150 ± 30, while diastolic blood pressure was 90 ± 20 mmHg. Average hemoglobin concentration was 11.2 ± 3.1 (7-15). The bleeding was on the left side in 8 patients and on the right in 4 patients. Probable etiology was considered hypertension crisis (33.3%), use of nasal steroids (8.3%), nasal surgery (8.3%), however in half (50%) of the cases the cause was unidentified. Of the cases, 6 had hypertension, 4 COPD, 10 tobacco use and 5 alcohol use. The source of epistaxis was anterior ethmoidal artery in 2 cases and spheopalatine artery in 10 cases. Two of the cases were treated with radiofrequency coagulation, and ten with bipolar cauterization. Only one of the cases was administered 2 units of packed red blood cells, and one of the cases had postoperative recurrent bleeding. The patients were hospitalized in average 3.2 (2-5) days and no reccurence of hemorrhage was seen in 3 month follow up. CONCLUSIONS: Dundee epistaxis menagement protocol described by Barnes and Spielman may be applied in adults. Endoscopical detection of the bleeding site and cauterizing the arterial feed source is highly successful in the treatment. Nasal packing may more commonly lead to complication especially in the elderly and in patients with heart and respiratory problems.

Myoblast alignment on 2D wavy patterns: dependence on feature characteristics and cell-cell interaction.

In this study, we investigate the effects of micron-scale surface patterns on the alignment of individual cells and groups of cells. Using a simple replication molding process we produce a number of micron-scale periodic wavy patterns with different pitch and depth. We observe C2C12 cells as they grow to confluence on these patterns and find that, for some geometries, cell-cell interaction leads to global alignment in a confluent culture when individual cells would not align on the same pattern. Three types of alignment behavior are thus defined: no alignment, immediate alignment, and alignment upon confluence. To further characterize this response, we introduce a non-dimensional parameter that describes the aligning power of a periodic pattern based on its geometry. The three types of alignment behavior can be distinguished by the value of the alignment parameter, and we identify values at which the transitions in alignment behavior occur. Applying this parameter to data from the current and several earlier studies reveals that the parameter successfully describes substrate aligning power over a wide range of length scales for both wavy and grooved features.