Growth of Microorganisms in Propofol and Mixture of Propofol, Lidocaine and Fentanyl.

OBJECTIVE: To determine the growth of microorganisms in propofol when combined with fentanyl and lidocaine in different temperatures and times in order to find out whether there is any improvement in antimicrobial effect to lengthen the safe duration of time for application of propofol. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Istanbul Aydin University Laboratory, Istanbul, Turkey, from June to September 2018. METHODOLOGY: The studied drugs and thier combination was used to determine their effect on bacterial growth of Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans and Acinetobacter baumanni. Bacterial solutions were prepared at 0.5 MacFarland in sterile 0.9% physiological saline and diluted at 1:100 concentration. Colony numbers were measured as colony forming units mL-1 at 0, 8, and 24 hours and at 4oC, 22oC and 37oC. RESULTS: In general, propofol supported the growth of microorganisms. Fentanyl with propofol also promoted the growth, especially in room and body temperature at 8th and 24th hours but when combined with lidocaine, the number of CFUs was reduced significantly compared with propofol + fentanyl group. Lidocaine inhibited the growth of microorganisms in all the solutions except for candida albicans. CONCLUSION: Lidocaine was shown to have antibacterial effect which carries advantage for inhibiting infections due to propofol; but aseptic technique is essential during preparation of propofol infusions. Fentanyl like propofol also promoted the growth at room and body temperatures.

Systemic Prolidase Activity and Oxidative Stress in Keratoconus.

AIM: Our aim was to evaluate the serum prolidase activity, total antioxidant capacity (TAC) and total oxidant status (TOS) in patients with keratoconus. MATERIAL AND METHOD: A total 69 keratoconus patients and 72 control subjects with similar age and gender were evaluated within the scope of this study. The keratoconus group was divided into four stages with the modified Krumeich classification. Serum prolidase activity, TAC and TOS were measured and compared between the patient and control groups. RESULTS: The median serum prolidase enzyme activity value was 528.3 (684.1-416.7) U/L in the keratoconus group and 606.2 (812.9-482.3) U/L in the control group. The difference between the groups was statistically significant (p = 0.027). The median TAC value was 1.24 (1.37-1.05) mmol/L in the keratoconus group and 1.29 (1.38-1.18) mmol/L in the control group. The median TOS value was 2 (4-1) µmol/L in the keratoconus group and 3 (4-2) µmol/L in the control group. There was no statistically significant difference between the two groups in terms of TAC or TOS (p = 0.113 and p = 0.366, respectively). There was a positive correlation between TAC and TOS in keratoconus group but not in the control group (r = 0.670, p = 0.001 and r = 0.141, p = 0.241, respectively). No significant relationship was seen between the keratoconus group stages and serum prolidase activity, TAS or TOS (p = 0.894, p = 0.155 and p = 0.381, respectively). CONCLUSION: In conclusion, a significant relationship was found between decreased serum prolidase activity and keratoconus but there was no significant relationship between keratoconus and serum TAC or TOS.

The prevalence of exfoliation syndrome in Turkey.

PURPOSE: To investigate the prevalence of the exfoliation syndrome and its relationship with ocular and cardiovascular diseases in the Central Anatolia region of Turkey. METHODS: This cross-sectional and population-based study was conducted at the Sivas Province among the population aged 40 years and over. The diagnosis of XFS was made when exfoliative material was found on the anterior lens capsule or iris on slit-lamp examination. The subjects were divided into an XFS group and a non-XFS group according to the presence of exfoliative material, and the groups were compared for the presence of glaucoma, cataract, age-related macular degeneration, phacodonesis, hypertension, diabetes mellitus, coronary artery disease, smoking and alcohol-use frequency. RESULTS: XFS was present in 63 subjects consisting of 42 males (8.0%) and 21 females (3.6%) for an overall rate of 5.7% (95% CI: 0.054-0.060). Once we adjusted the values for age, we found a statistically significant relationship of increased age and male gender with the presence of XFS (p = 0.001, p = 0.027, respectively). The relationship between XFS and glaucoma, cataract and phacodonesis was found to be statistically significant (p = 0.001). No relationship was found between exfoliation syndrome and hypertension, diabetes mellitus and coronary artery disease. CONCLUSION: The prevalence of exfoliation syndrome was 5.7% in this population-based study. There was a statistically significant relationship between XFS and advancing age and male gender.

The frequency of exfoliation syndrome in the central anatolia region of Turkey.

Aim. The aim of this study was to investigate the frequency of exfoliation syndrome in the Central Anatolia region of Turkey and to evaluate its relationship with cardiovascular and ocular diseases. Methods. Patients over the age of 45 years who presented to the clinic were included in the study. All cases underwent a comprehensive ophthalmology examination. Exfoliation syndrome was diagnosed with the presence of exfoliative material on the lens anterior capsule or iris on slit lamp examination. The patients were divided into two groups as the exfoliation syndrome group and nonexfoliation syndrome group according to the presence of exfoliative material. Results. Exfoliative material was found in one or both eyes of 212 of the 2103 patients (10.1%) evaluated within the scope of the study. A significant relationship was found between exfoliation syndrome and increasing age and male gender. A significant relationship was found between exfoliation syndrome and glaucoma, cataracts, age-related macular degeneration, and phacodonesis. While no relationship was found between exfoliation syndrome and hypertension or diabetes mellitus, a significant relationship was found with coronary artery disease. Conclusion. The unilateral or bilateral exfoliation syndrome frequency was 10.1% in this hospital-based study. A statistically significant relationship was found between exfoliation syndrome and advancing age, gender, and coronary artery disease.

Investigation of wound healing in rat lung tissues in the postpartum period.

To assess the wound healing capabilities of damaged lung tissue in the postpartum period, we investigated the parameters related to wound healing in a rat model of lung damage. Rats were divided into six groups: IA, IB, II, IIIA, IIIB and IV (n=7 in each group). Group IA included rats not in the postpartum period that were sacrificed on the third day after lung injury, group IB included rats not in the postpartum period that were sacrificed on the tenth day after lung injury, group II included rats not in the postpartum period that did not receive lung injury, group IIIA included rats in the postpartum period that were sacrificed on the third day after lung injury, group IIIB included rats in the postpartum period that were sacrificed on the tenth day after lung injury and group IV included rats in the postpartum period without lung injury. Wound healing was evaluated histopathologically and measurements of hydroxyproline levels, serum alanine and glutamine were taken. A significant difference in serum alanine levels was evident between groups IA and IIIA. Significant differences were also observed between serum alanine and glutamine levels in groups IB and IIIB. In conclusion, we demonstrated that serum alanine levels were reduced in the postpartum period following lung injury, which may be expected to negatively impact wound healing in this period. The administration of exogenous alanine for traumatic events occurring during the postpartum period may thus contribute positively to wound healing capabilities during this period.

Predictors of preoperative anxiety in surgical inpatients.

AIMS AND OBJECTIVES: The aims of the present study were to identify the levels of preoperative anxiety in patients undergoing elective surgery and the relationship between preoperative anxiety and social support. In addition, predictors of preoperative anxiety were studied in surgical inpatients. BACKGROUND: Major life changes are significant factors that cause anxiety; hospitalisation and surgery are among such changes. Social support may decrease the anxiety associated with surgery. DESIGN: This is a descriptive study that included 500 patients in a surgery clinic. METHODS: The data collected included: A Patient Information Form, Multidimensional Scale of Perceived Social Support and the Surgical Anxiety Scale. The results were analysed using the Chi-square test and logistic regression analysis. RESULTS; Five hundred patients participated in this research: 59·6% were female, 54·6% were 65 years of age or older, 80·6% were married, 70·4% were literate and 62% of the patients had moderate level surgery. There was a significant relationship between the sociodemographic patient features, the level of preoperative anxiety (p < 0·05), the presence of social support and the severity of anxiety (p = 0·001). The age and level of anxiety were not significant factors. The mean anxiety score for all patients was 31·91 (SD 6·30) and the mean social support score was 66·38 (SD 13·69). CONCLUSION: The results of this study showed that the preoperative anxiety of patients awaiting surgery was associated with demographic characteristics as well as social support resources. RELEVANCE TO CLINICAL PRACTICE: Anxiety testing is feasible during the preoperative period. Such testing allows for the detection of patients with high anxiety, and for clinicians to take the appropriate steps to ameliorate this problem. Identification of patient anxiety allows for providing a focus on social support in an attempt to reduce the level of anxiety.

Breast cancer risk factors in Turkey: a hospital-based case-control study.

BACKGROUND: Regional disparities in breast cancer (BC) outcomes have been reported in Turkey. METHODS: In a hospital-based case-control study in Sivas, Turkey, 172 patients with histologically confirmed BC were compared with 383 controls, recruited from visitors in various departments of the same hospital, who had not been previously diagnosed with BC. Information was collected from both groups using a questionnaire and logistic regression analysis was applied to assess associations between each risk factor and BC risk with adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: In multivariable models, family history of BC (OR=4.67, 95% CI: 2.23-9.76), history of smoking (OR=1.75, 95% CI: 1.08-2.84), and higher education level (OR=2.88, 95% CI: 1.64-5.07) were the strongest predictors of BC in the study population. A separate analysis studying only postmenopausal women using hormone replacement therapy (HRT) (comparing duration of use, >36 months versus ≤36 months, P<0.05) found that use of HRT was also a risk factor for BC. Duration of HRT use (P<0.05) was significantly associated with the elevated risk. On the other hand, certain factors such as first full-term pregnancy before age 30 (χ2=5.755 P<0.05) and higher parity (χ2=20.731, P<0.05) were found to be protective factors for BC. CONCLUSION: The findings of the present study indicate that family history of BC, history of smoking, education, and HRT are factors significantly associated with increased BC risk among Turkish women within the area of Central Anatolia, Turkey.

Smoking among nurses in Turkey: comparison with other countries.

The purpose of this study was to obtain baseline information on smoking among nurses. An attempt was made to contact, in person, all 301 nurses working for the university hospital in Sivas, Turkey, and when contacted they were asked to complete an anonymous questionnaire. Each unit of the hospital was visited three times, and 239 (79%) nurses were reached who all completed the questionnaire. Of the 239 respondents, 107 (45%) were current smokers, reflecting a substantially higher prevalence compared to that among the adult female population. The quit ratio was 22.5%. Of 127 ever-smoker nurses who responded to the related item, 90% started smoking during or after nursing education. This pattern of smoking initiation was different from the pattern in developed countries where nurses had already started smoking before beginning that training. Nurses with a high school education had a significantly higher prevalence of ever-smoking. Most respondents frequently or sometimes saw doctors smoking in rooms for nurses and in rooms for doctors in inpatient services. In-depth qualitative studies are needed to determine the reasons for the different smoking-initiation pattern.

The effect of personality type on denture satisfaction.

PURPOSE: The aim of this study was to determine the correlation between personality type and denture satisfaction of totally and partially edentulous patients. MATERIALS AND METHODS: Two hundred thirty-nine patients (107 women and 132 men) aged 31 to 78 years (mean, 51.87) using removable dentures (165 maxillary and mandibular partial, 51 maxillary and mandibular complete, and 23 maxillary complete and mandibular partial) were asked to fill out a questionnaire on their satisfaction with their dentures with regard to esthetics, speaking ability, and masticatory function. Personality types were evaluated using both the responses to this questionnaire and the Type A Behavior Pattern Test. Chi-square test and logistic regression analysis were used to compare the denture satisfaction scores of the groups (Type A, Type B, and Type AB). The level of statistical significance was set at P = .05. RESULTS: Denture satisfaction of the patients with regard to esthetics, speaking ability, and masticatory function was affected by personality type. Statistically significant differences were found between Type A and types B and AB, as well as between types B and AB. CONCLUSION: The personality type of the patients had an effect on their satisfaction with dentures. The lowest denture satisfaction values were observed in the Type A patients.

A case-control study on the effect of exposure to different substances on the development of COPD.

PURPOSE: The purpose of this study was to examine the effect of exposure to different substances on the development of chronic obstructive pulmonary disease (COPD). METHODS: The case group consisted of 74 housewives. These were female patients who never smoked who had a diagnosis of COPD and were seen at the Cumhuriyet University Hospital in Sivas, Turkey, between January 1, 2001, and March 31, 2002. The control group consisted of 74 housewives; this group consisted of healthy women who never smoked who came to the hospital as visitors and who did not have the diagnosis of COPD. The control group was chosen by group matching of the age distribution of the women in the case group and the regions and the neighborhoods where they lived. All of the women in the case and control groups were evaluated with a questionnaire for exposure to wood ashes, biomass, and cigarette smoke in closed areas. RESULTS: No difference was found in the groups for exposure to wood ashes (p > 0.05). Logistic regression analysis resulted in the following odds ratio of COPD estimate for women with > or = 30 years biomass exposure, 6.61 (95% Confidence interval [CI]: 2.17-20.18); for women with > or = 30 years cigarette smoke exposure, 4.96 (95% CI: 1.65-14.86). CONCLUSION: A statistically significant correlation was found between the effect of > or = 30 years of exposure to biomass and cigarette smoke exposure and the development of COPD.

The relationship between anticardiolipin antibodies and vascular access occlusion in patients on hemodialysis.

Vascular access occlusion is frequently seen in some patients on hemodialysis. There are different opinions about pathogenesis of recurrent access thrombosis. Anticardiolipin (aCL) antibodies have been suggested to be involved in thrombosis and can be found in a high proportion of patients with chronic renal failure. We investigated the relationship between vascular access occlusion and the level of aCL antibodies in hemodialysis patients. We measured serum IgG and IgM aCL antibodies and protein C levels in 50 patients on hemodialysis having no fistule thrombosis (group 1), in 33 patients on hemodialysis with fistule thrombosis (group 2), and 20 nondialyzed patients with chronic renal failure (group 3). There were no differences in age and duration on hemodialysis (p > 0.05). No significant correlation was found between protein C and platelet counts in all groups (p > 0.05). In group 1, aCL IgG and IgM were 2%. In group 2, aCL IgG and IgM were 6.06% and 0%, respectively. In group 3, aCL IgG and IgM were negative. We did not find any significant difference between aCL IgG and IgM in all groups (p > 0.05). No association was found between aCL antibodies and vascular access thrombosis in our patients on hemodialysis.

Evaluation of nasal airway resistance during rapid maxillary expansion using acoustic rhinometry.

The purpose of this study was to evaluate nasal airway resistance (NAR) during rapid maxillary expansion (RME) using acoustic rhinometry (AR). The sample comprised 22 children (13 girls and nine boys) with maxillary constriction. The mean age was 12.9 +/- 1.54 years and all patients were found to have normal nasal cavities following anterior rhinoscopic examination. A modified bonded splint type RME appliance was used for expansion. AR was used to measure NAR before (T1), during (T2) and after (T3) expansion, and at the end of retention (T4). Each AR recording was performed, for each patient, with and without the use of a decongestant. Subjective evaluation of reported changes in nasal breathing were also undertaken at T3. The results showed that NAR was significantly reduced with the use of RME, with the main decrease observed during expansion (P < 0.05). The use of a decongestant was not found to have any effect on the results. Subjective evaluation showed that 59 per cent of patients considered that their nasal breathing had improved following RME.

The seven flap Z-plasty revisited.

Although multiple Z-plasties are widely used for burn contractures, the seven flap Z-plasty procedure has not gained wide acceptance in plastic surgery practice. However, the technique has the advantage of achieving more elongation than other Z-plasty techniques. The technique safely performed with satisfactory results in 31 cases.

Periodontal status of chronic renal failure patients receiving hemodialysis.

Host factors such as systemic diseases, genetic polymorphism or drug usage play a major role in the pathogenesis of periodontal disease by modifying the host response to periodontal infection or altering the susceptibility to infection by periodontal organisms. This study was designed to evaluate the clinical response of patients receiving hemodialysis to existing microbial dental plaque. Gingival Index (GI) and Plaque Index (PI) scores and probing depths (PD) were recorded for the entire dentition on 36 chronic renal failure patients receiving hemodialysis (H) and 36 systemically healthy individuals (C), matched with the patient group, based on age and extent of plaque accumulation. No statistically significant difference was observed in the clinical parameters between the two groups (PI: t=1.69 p= 0.096; GI: t=1.057 p=0.294; PD: t=0.01 p=0.99). In the present study, H patients revealed a similar response to existing bacterial plaque and their periodontal status was comparable to that of the control group. Although patients receiving hemodialysis have been suggested to present a certain degree of immunosuppression, based on the findings of the present study chronic renal failure does not seem to be an additional risk factor for more severe periodontal destruction.

Anticardiolipin antibody positivity in diabetic patients with and without diabetic foot.

Anticardiolipin (aCL) antibodies may play a role in the enhancement of platelet aggregation and/or progression of the macrovascular diabetic complications. Also, aCL antibodies may cause or promote ischemia and thrombosis. Therefore, we aimed to investigate IgG aCL and IgM aCL antibodies positivity in type 2 diabetic patients with and without ischemic diabetic foot. In this case-control study, we examined 40 diabetic patients without diabetic foot problem and 35 diabetic patients with ischemic diabetic foot. Forty diabetic patients (19 females, 21 males) without diabetic foot served as Group 1 and 35 diabetic patients (17 females, 18 males) who had ischemic diabetic foot served as Group 2. In the control group, 35 nondiabetic healthy subjects (18 females, 17 males) were included in Group 3. The groups were similar in age and sex, which is not statistically significant (P>.05). There was no difference in the IgG aCL antibodies positivity between Groups 1 and 3 (P>.05). However, IgG aCL antibodies positivity in Group 2 was significantly higher than those of the other groups (P<.05). IgG aCL antibodies were found positive in 10% (4/40) of Group 1, 34.3% (12/35) of Group 2 and 8.6% (3/35) of Group 3. When Groups 1 and 2 were compared, the odds ratio adjusted for age, gender, hypertension, coronary artery disease history, cigarette smoking, duration of diabetes mellitus, cholesterol, and haemoglobin A(1C) (HbA1c) was 6.8 [95% confidence interval (CI), 1.41-32.66; P=.016] for aCL positivity. In conclusion, although available evidence does not prove a causal association between positivity of aCL and diabetic foot, we believe that a causal association is supported by the data obtained from this study.