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1.
Folia Morphol (Warsz) ; 81(3): 567-573, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34699056

RESUMEN

BACKGROUND: Pseudotumor cerebri (PTC) occurs when the pressure inside the skull increases for no obvious reason. The aim of this study was to investigate three different methods: the optic nerve sheath diameter (ONSD) method, ONSD/eyeball transverse diameter (ETD) index, and ONSD/orbital transverse diameter (OTD) index for the initial detection of elevated intracranial pressure in patients with PTC. MATERIALS AND METHODS: A retrospective study of magnetic resonance data from adult PTC patients (n = 42) and control group (n = 40) was performed. ONSD and OTD measurements were made 3 mm and 10 mm posterior to the globe, after intracranial pressure was measured with lumbar puncture. The sensitivity, specificity, and overall accuracy of the findings on magnetic resonance imaging were calculated. RESULTS: The optic nerve sheath was enlarged in the PTC group compared with the control group. It showed 97% sensitivity and 100% specificity and 79% sensitivity and 87.5% specificity for 3 mm and 10 mm, respectively. The ONSD/ETD and ONSD/OTD indices were increased in the PTC group compared with the control group. For 3 mm posterior to the globe, the ONSD/ETD index had 90.5% sensitivity and 92% specificity, and the ONSD/OTD index had 86% sensitivity and 95% specificity. For 10 mm posterior to the globe, the sensitivity and specificity of the ONSD/ETD and ONSD/OTD indices were 86% and 80% and 74% and 82.5%, respectively. CONCLUSIONS: According to our study, the ONSD method and the ONSD/ETD and ONSD/OTD indices are reliable diagnostic markers for PTC. These noninvasive techniques may be useful in monitoring the invasive intracranial catheter and have wide potential clinical applications in district hospitals, emergency departments and intensive care units.


Asunto(s)
Hipertensión Intracraneal , Seudotumor Cerebral , Adulto , Humanos , Hipertensión Intracraneal/diagnóstico por imagen , Presión Intracraneal/fisiología , Nervio Óptico/diagnóstico por imagen , Seudotumor Cerebral/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía
2.
Eur Rev Med Pharmacol Sci ; 25(12): 4345-4350, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34227069

RESUMEN

OBJECTIVE: We aimed at investigating the effects of clinical data, urgent thoracotomy (UT) indications and results on prognosis and mortality in traumatic and non-traumatic patients who were and underwent UT in the operating room. PATIENTS AND METHODS: Patients (17-90 years old) who were admitted to the Emergency Department of Afyonkarahisar State Hospital between 01.01.2012 and 31.06.2020 with traumatic and non-traumatic reasons requiring UT were retrospectively conducted from the archive. The patients' age, gender, complaints during admission, trauma classification, reports of thorax images, injury sites accompanying trauma, hospitalization and mortality rates were examined. IBM SPSS 22.0 program was used to compare all the data obtained. RESULTS: During the 90-month study period, a total of 40 patients who were admitted for traumatic and non-traumatic reasons were applied UT. The mean age of all patients (77.5% male, 22.5% female) was 33.35±14.1 years. There were 55% penetrating injuries, 32.5% blunt injuries and 12.5% non-traumatic causes. Indications for UT in the study were; massive hemothorax (25%), diaphragmatic rupture (22.5 %), hypovolemic shock (25%), heart or great vessel injuries (15%), massive air leak despite thoracostomy (10%), rupture of the pulmonary hydatid cyst into the bronchus and accompanying hemoptysis (2.5%). The time to surgical procedure in patients who underwent thoracotomy was shorter in patients with death. Mean time to thoracotomy was 4.5±6.5 hours. Mortality of UT was 20% with survival of 80%. CONCLUSIONS: In the context of indications, urgent thoracotomy reduces mortality. The cooperation between the emergency physician and the thoracic surgeon is important during the decision phase.


Asunto(s)
Traumatismos Torácicos/cirugía , Toracotomía/efectos adversos , Heridas no Penetrantes/cirugía , Heridas Penetrantes/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Servicio de Urgencia en Hospital , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Traumatismos Torácicos/diagnóstico , Heridas no Penetrantes/diagnóstico , Heridas Penetrantes/diagnóstico , Adulto Joven
3.
Biotech Histochem ; 96(6): 431-438, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32957855

RESUMEN

We investigated the antioxidant effects of vitamin E on a glucocorticoid (GC) induced model of cataracts in chick embryos. We used 70 fertilized eggs divided into seven groups as follows: phosphate-buffered saline (PBS) group, olive oil treatment (OO) group, hydrocortisone treatment (HC) group, olive oil and hydrocortisone treatment (OO + HC) group, 50 mg/kg vitamin E and hydrocortisone treatment (HC + VE (50)) group, 25 mg/kg vitamin E and hydrocortisone treatment (HC + VE (25)) group and 15 mg/kg vitamin E and hydrocortisone treatment (HC + VE (15)) group. On day 17, chick embryos were removed from the eggs and lens and liver tissues were excised. Cataract formation was evaluated and total antioxidant status (TAS), total oxidant status (TOS), malondialdehyde (MDA) and glutathione peroxidase (GPx) were measured in lens and liver tissues; MDA was measured only in liver. The lenses in the HC + VE (50) group exhibited significantly higher levels of GPx and TAS, and lower levels of TOS than for HC and OO + HC groups. The livers of the HC + VE (50) group exhibited significantly higher levels of GPx and lower levels of MDA than for the HC and OO + HC groups. The HC + VE (50) group lenses were evaluated as grade 1, because the nuclei were completely free of cataracts, likely due to the antioxidative effect of high dose VE. VE is an effective antioxidant agent that exhibits a dose-response effect, for ameliorating the negative effects of GCs.


Asunto(s)
Catarata , Glucocorticoides , Animales , Catarata/inducido químicamente , Embrión de Pollo , Pollos , Glucocorticoides/toxicidad , Glutatión , Vitamina E
4.
Int J Hypertens ; 2020: 2693534, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32411439

RESUMEN

AIM: To compare the plasma N-terminal pro-C-type natriuretic peptide concentrations of normotensive pregnant women, patients with mild preeclampsia, and patients with severe preeclampsia. METHODS: We collected venous blood samples from 25 normotensive pregnant women, 15 patients with mild preeclampsia, and 15 patients with severe preeclampsia. The women were at 30th to 40th weeks of gestation and in an age range of 20 to 35. The N-terminal pro-C-type natriuretic peptide levels were measured by ELISA. Statistical comparisons were made by one-way analysis of variance, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS: The median (interquartile range-IQR) values of the N-terminal pro-C-type natriuretic peptide were 6.48 (3.33) pmol/L in the normotensive women group, 7.37 (3.43) pmol/L in patients with mild preeclampsia, and 11.52 (6.13) pmol/L in patients with severe preeclampsia. The N-terminal pro-C-type natriuretic peptide was significantly elevated in the severe preeclampsia study group (P < 0.001), whereas there was no significant difference between those with mild preeclampsia and the normotensive groups (P > 0.05). CONCLUSION: Our data indicate that the plasma concentration of the N-terminal pro-C-type natriuretic peptide is significantly increased in patients with severe preeclampsia, but not in patients with mild preeclampsia. The severity of preeclampsia may be related to the circulating levels of the N-terminal pro-C-type natriuretic peptide concentrations.

5.
Folia Morphol (Warsz) ; 78(2): 307-313, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30178461

RESUMEN

BACKGROUND: Neural tube defects are congenital malformations of the central nervous system. Genetic predisposition and some environmental factors play an important role in the development of neural tube defects. This study aimed to investigate the effects of diclofenac sodium on the neural tube development in a chick embryo model that corresponds to the first month of vertebral deve- lopment in mammals. MATERIALS AND METHODS: Seventy-five fertile, specific pathogen-free eggs were incubated for 28 h and were divided into five groups of 15 eggs each. Diclofenac sodium was administered via the sub-blastodermic route at this stage. Incubation was continued till the end of the 48th h. All eggs were then opened and embryos were dissected from embryonic membranes and evaluated morphologically and histopathologically. RESULTS: It was determined that the use of increasing doses of diclofenac sodium led to defects of midline closure in early chicken embryos. There were statistically significant differences in neural tube positions (open or close) among the groups. In addition; crown-rump length, somite number were significantly decreased in high dose experimental groups compared with control group. CONCLUSIONS: This study showed that development of neurons is affected in chi- cken embryos after administration of diclofenac sodium. The exact teratogenic mechanism of diclofenac sodium is not clear; therefore it should be investigated.


Asunto(s)
Diclofenaco/efectos adversos , Tubo Neural/embriología , Animales , Embrión de Pollo , Desarrollo Embrionario/efectos de los fármacos , Tubo Neural/efectos de los fármacos , Tubo Neural/patología , Defectos del Tubo Neural/embriología , Defectos del Tubo Neural/patología , Estadística como Asunto
6.
Int J Clin Pract ; 69(5): 588-96, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25472768

RESUMEN

PURPOSE: This study evaluated levels of metabolic control, resource use and quality of life in Turkish patients with type 2 diabetes initiated on insulin in routine care. PATIENTS AND METHODS: The prospective, observational TREAT study evaluated patients from five different countries who were initiated on insulin and followed for 24 months. In this paper, we present the results of a cohort analysis specific to Turkish patients from the study. RESULTS: A total of 211 patients in the Turkish multicenter cohort [male patients 50.2%, age 56.5 year±8.9 SD, body mass index (BMI) 30.6 kg/m2±5.4 SD, diabetes duration 9.7 year±5.9 SD] initiated insulin at baseline. Oral antidiabetic drugs had been used by 93.4% of patients prior to insulin initiation, and 65.9% had used more than one regimen. Pre-existing metformin therapy was continued by 68.7% of patients after insulin initiation. In the three most common insulin regimens, glycosylated haemoglobin (HbA1C) declined over 24 months from 10.27% to 7.82% (long/intermediate acting), from 10.82% to 7.52% (premixed) and from 10.42% to 7.67% (basal-bolus). Less than 25% achieved a glycaemic goal of HbA1C≤7.0% and changes in insulin dose or regimen rarely occurred. Premixed insulin regimens were associated with greatest weight gain. Hypoglycaemic episodes were reported by more patients at 3, 6 and 12 months than at baseline or at 18 or 24 months. Healthcare use increased over baseline levels in the first 6 months, but was closer to baseline levels at subsequent assessments. Patient recorded health profiles improved after initiating insulin, particularly quality of life scores related to psychological distress and pain/discomfort. Morisky scores predictive of medication adherence and treatment persistence also improved. CONCLUSIONS: In Turkish patients with type 2 diabetes, metabolic control remained suboptimal after initiating insulin as part of routine care even after 24 months of insulin treatment. Apparent shortcomings in routine care in most patients included a high baseline HbA1C because of delayed insulin initiation and an unwillingness to individualise insulin regimens.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Aceptación de la Atención de Salud , Estudios de Cohortes , Diabetes Mellitus Tipo 2/sangre , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Calidad de Vida , Resultado del Tratamiento , Turquía
7.
Pak J Med Sci ; 30(6): 1232-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25674114

RESUMEN

OBJECTIVE: The aim of the study was to investigate whether the use of low molecular weight heparin (LMWH) improve live birth rates when compared with control group in patients with unexplained recurrent miscarriages (URM). METHODS: In this prospective observational study 150 women with a history of two or more previous unexplained first trimester pregnancy loss who received LMWH; either enoxaparin (n=50), tinzaparin (n=50) or nothing (n=50) were followed for the pregnancy outcome measures. Only the patients who have used standardized dosage of LMWH (4000 IU/day enoxaparin or 3500 IU/day tinzaparin ) were included to the study. The primary end point was the live birth rate and secondary end points were the side effects, late pregnancy complications and neonatal outcome in the study cohorts. RESULTS: Live birth was achieved 85% of the LMWH group and 66% of the control group (p=0.007). According to the subgroup analysis; live birth rates did not differ significantly between the enoxaparin and tinzaparin group (84% and 86%, respectively). Maternal and neonatal side effects were not statistically significant among the study participants. CONCLUSION: Thromboprophylaxis with LMWH resulted in a improved live-birth rate in patient with 2 or more consecutive unexplained recurrent pregnancy loss. Nevertheless these findings need to be confirmed in larger randomized trials.

9.
J Reprod Med ; 43(3): 185-90, 1998 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-9564642

RESUMEN

OBJECTIVE: To determine the efficiency and comparison of two different protocols, human menopausal gonadotropin (hMG) plus gonadotropin-releasing hormone analog (GnRH-a) and low-dose hMG to reduce multifollicular development in clomiphene-resistant polycystic ovary syndrome (PCOS) patients. STUDY DESIGN: Prospective comparative and pilot study in 20 patients for 31 cycles. The first group (n = 10) was treated with buserelin acetate, 600 micrograms/d, for six weeks before ovulation induction with hMG in conventional doses for 14 cycles. The other group (n = 10) was treated only with low-dose hMG for 17 cycles. All cycles were compared in terms of the number of follicles per cycle, cycles human chorionic gonadotropin withheld, estradiol level on ovulation day, treatment duration and number of ampules used per cycle. In addition, the outcome of cycles and complications of multifollicular development, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy were determined. RESULTS: As compared with the GnRH-a + hMG protocol, the low-dose hMG protocol yielded less multifollicular (57.1% vs. 17.6%) and more monofollicular (35.7% vs. 70.6%) development. Consequently, less OHSS (21.4% vs. 0%) and multiple pregnancy (10% vs. 0%) occurred in the low-dose group. CONCLUSION: Low-dose hMG therapy has distinct advantages in eliminating multifollicular development and related complications in clomiphene citrate-resistant PCOS patients. The addition of GnRH-a to gonadotropins does not change the incidence of multifollicular development.


Asunto(s)
Clomifeno/farmacología , Fármacos para la Fertilidad Femenina/farmacología , Hormona Liberadora de Gonadotropina/uso terapéutico , Menotropinas/uso terapéutico , Folículo Ovárico/efectos de los fármacos , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adulto , Anovulación/etiología , Anovulación/terapia , Relación Dosis-Respuesta a Droga , Resistencia a Medicamentos , Femenino , Hormona Liberadora de Gonadotropina/administración & dosificación , Hormona Liberadora de Gonadotropina/análogos & derivados , Humanos , Infertilidad/etiología , Infertilidad/terapia , Menotropinas/administración & dosificación , Folículo Ovárico/patología , Inducción de la Ovulación , Proyectos Piloto , Estudios Prospectivos
10.
Zentralbl Gynakol ; 120(2): 75-8, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-9531711

RESUMEN

The prenatal diagnosis of the thrombocytopenia absent radius (TAR) syndrome using ultrasound and cordocentesis at the 34th week of gestation is established. Two basic components of the syndrome, bilateral absence of radius and thrombocytopenia at a level 12.000/mm3 were detected. No complication during the cordocentesis and delivery occurred due to thrombocytopenia. This case report, to our knowledge, is one of a limited number of cases emphasized on prenatal diagnosis of TAR syndrome in the world.


Asunto(s)
Radio (Anatomía)/anomalías , Trombocitopenia/genética , Ultrasonografía Prenatal , Aberraciones Cromosómicas , Trastornos de los Cromosomas , Femenino , Humanos , Recién Nacido , Recuento de Plaquetas , Embarazo , Radio (Anatomía)/diagnóstico por imagen , Síndrome , Trombocitopenia/diagnóstico por imagen
11.
Ultrasound Obstet Gynecol ; 10(3): 215-9, 1997 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9339531

RESUMEN

We describe the color Doppler sonographic features of uterine arteriovenous malformations in two cases. In both cases color Doppler imaging demonstrated hypervascularity throughout the arteriovenous malformation. The dominance of pale shades during both systole and diastole represented low-impedance, high-velocity flow within the lesion and a colored mosaic pattern representing turbulent flow was noted. Spectral analysis of the vessels within the lesion confirmed high-velocity flow during both systole and diastole, and a low resistance index. The spectral waveform trace also showed spectral broadening consistent with turbulence and the spectral envelope was irregular. These findings indicated the presence of numerous arteriovenous shunts and marked turbulence within the arteriovenous malformation. Spectral analysis of the venous flow revealed high flow velocities and systolic velocity peaks similar to an arterial pattern. The uterine artery velocity waveforms were characterized by high flow velocity and a low resistance index. The diagnosis of uterine arteriovenous malformation was confirmed by histological examination in both cases. The findings of these two cases suggest that color Doppler sonography may play an important role in the diagnosis of uterine arteriovenous malformations.


Asunto(s)
Malformaciones Arteriovenosas/diagnóstico por imagen , Ultrasonografía Doppler en Color , Útero/irrigación sanguínea , Adulto , Malformaciones Arteriovenosas/diagnóstico , Malformaciones Arteriovenosas/cirugía , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Arteria Ilíaca/anomalías , Arteria Ilíaca/diagnóstico por imagen , Flujo Sanguíneo Regional , Sensibilidad y Especificidad , Hemorragia Uterina/diagnóstico por imagen , Hemorragia Uterina/etiología , Útero/anomalías , Útero/diagnóstico por imagen
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