Effect of trospium chloride therapy on intraocular pressure and tear secretion in overactive bladder patients.

PURPOSE: To investigate the effect of trospium chloride, which has an anticholinergic effect, used in overactive bladder (OAB) treatment on the intraocular pressure (IOP) and tear secretion after 12 weeks of treatment. MATERIALS AND METHODS: This prospective study was performed at a single center between October 2014 and January 2016. A detailed history was obtained from the female OAB patients at the eye outpatient department. After checking the exclusion criteria, oral trospium chloride 30 mg bd was started. The patients were followed-up in terms of drug effectiveness and ophthalmic and other side effects at the 4th and 12th weeks. All procedures were repeated at both of these time-points. RESULTS: The mean age of the patients was 48.98 ± 11.98 years (range 19-75). The data of 80 OAB patients were evaluated in the study. Trospium chloride did not cause any significant change in the OAB patients regarding their 4th week and 12th week IOP measurements (p = 0.251, p = 0.340, respectively). It was found to decrease tear secretion significantly at both time-points (p = 0.020, p = 0.001, respectively). Trospium chloride treatment of one patient (1.25%) was discontinued due to dry eye. CONCLUSIONS: Trospium chloride decreases the symptoms in female OAB patients. Trospium chloride can be safely used in female OAB patients with normal IOP and no comorbidity as regards IOP changes as it did not cause a significant change in IOP in these patients. Pre-treatment and post-treatment dry eye symptoms of OAB patients about to start using trospium chloride should be queried beforehand as it can cause a statistically significant decrease in tear secretion. We concluded that it would be appropriate to refer the patients to an ophthalmologist before starting the drug if relevant symptoms are present.

Association of Aortic Diameters with Coronary Artery Disease Severity and Albumin Excretion.

INTRODUCTION: Aortic diameters, aortic distensibility, microalbuminuria, coronary artery disease which are all together related to vascular aging are investigated in this paper. METHODS: Eighty consecutive nondiabetic patients undergoing elective coronary angiography were enrolled into the study. Systolic and diastolic aortic diameters, aortic distensibility, CAD severity by angiogram with the use of Gensini scoring, and albumin excretion rates were determined. RESULTS: Cases with CAD had significantly larger systolic (30,72 ± 3,21 mm versus 34,19 ± 4,03 mm for cases without and with CAD, resp.) and diastolic aortic diameters measured 3 cm above aortic valve compared to patients without CAD (33,56 ± 4,07 mm versus 29,75 ± 3,12 mm). The systolic and diastolic diameters were significantly higher in albuminuria positive patients compared to albuminuria negative patients (p = 0.017 and 0.008, resp., for systolic and diastolic diameters). CONCLUSION: In conclusion aortic diameters are increased in patients with coronary artery disease and in patients with microalbuminuria. In CAD patients, systolic blood pressure, pulse pressure, aortic systolic and diastolic pressure, and albumin excretion rate were higher and aortic distensibility was lower.

The Effects of Metabolic Syndrome on TpTe Interval and TpTe/QT Ratio in Patients with Normal Coronary Arteries.

OBJECTIVE: T wave peak to T wave end (TpTe) interval and TpTe/QT have been accepted as predictors of ventricular arrythmia. In this study our aim is to investigate the effect of metabolic syndome on these parameters in patients with angiographically normal coronary arteries. MATERIALS AND METHODS: Thirty patients with metabolic syndrome (4 male, mean age 52±7.8 years) and twenty patients without metabolic syndrome as control group (8 male, mean age 54±9.3 years) were included. TpTe interval and TpTe/QT ratio were measured from the 12-lead electrocardiogram. These parameters were compared between the groups. RESULTS: When compared with to the control group the systolic and diastolic blood pressure, pulse pressure, waist circumference, triglyceride and fasting plasma glucose levels were higher and HDL cholesterol level was lower in the metabolic syndrome group. In the analysis of electrocardiography, QT dispersion (QTd) and corrected QTd were significantly increased in metabolic syndrome group as compared to the controls group (44±14 versus 30±12 ms and 433±10 versus 405±4 ms, all p value p=0.01). TpTe interval and TpTe/QT ratio were also significantly higher in patient with metabolic syndrome (112±10 versus 91±10 ms and 0.25±0.02 versus 0.22±0.01, all p value p=0.01). CONCLUSION: According to these results, we supposed that TpTe/QT ratio and TpTe interval is prolonged and those patients with metabolic syndrome may be at greater risk of ventricular arrhythmias.

Aortic distensibility and coronary artery bypass graft patency.

BACKGROUND: Aortic distensibility is an elasticity index of the aorta, and reflects aortic stiffness. Coronary artery disease has been found to be substantially associated with increased aortic stiffness. In this study we aimed to retrospectively analyze the association of angiographically determined aortic distensibility with the patency rates of coronary bypass grafts METHODS: The study was conducted in the Cardiology department of the Applied Research Centre for Health of Uludag University. The coronary angiograms of 53 consecutive coronary bypass patients were analysed retrospectively. Aortic distensibility was calculated using the formula: 2 x (change in aortic diameter)/(diastolic aortic diameter) x (change in aortic pressure). The number of stenosed and patent bypass grafts and the patient characteristics like age, risk factors were noted. RESULTS: There were 44 male (83%) and 9 female (17%) cases. Eighteen cases had only one saphenous vein grafting. The number of cases with two, three and four saphenous grafting were 18, 11 and 1; respectively. In the control angiograms the number of cases with one, two, three and four saphenous vein graft obstruction were 15 (31.3%), 7 (14.6%), 1 (2.1%) and 1 (2.1%) respectively. The aortic distensibility did not differ in cases with and without saphenous graft occlusion (p > 0.05). Also left internal mammary artery (LIMA) graft patency was not related to the distensibility of the aorta (p > 0.05). We also evaluated the data for cut-off values of 50 and 70 mmHg of pulse pressure and did not see any significant difference between the groups in terms of saphenous or LIMA grafts. CONCLUSION: In this study we failed to show association of angiographically determined aortic distensibility with coronary bypass graft patency in consecutive 53 patients with coronary artery bypass graft surgery (CABG).