Differences and agreement between two portable hand-held spirometers across diverse community-based populations in the Prospective Urban Rural Epidemiology (PURE) study.

INTRODUCTION: Portable spirometers are commonly used in longitudinal epidemiological studies to measure and track the forced expiratory volume in first second (FEV1) and forced vital capacity (FVC). During the course of the study, it may be necessary to replace spirometers with a different model. This raise questions regarding the comparability of measurements from different devices. We examined the correlation, mean differences and agreement between two different spirometers, across diverse populations and different participant characteristics. METHODS: From June 2015 to Jan 2018, a total of 4,603 adults were enrolled from 628 communities in 18 countries and 7 regions of the world. Each participant performed concurrent measurements from the MicroGP and EasyOne spirometer. Measurements were compared by the intra-class correlation coefficient (ICC) and Bland-Altman method. RESULTS: Approximately 65% of the participants achieved clinically acceptable quality measurements. Overall correlations between paired FEV1 (ICC 0.88 [95% CI 0.87, 0.88]) and FVC (ICC 0.84 [0.83, 0.85]) were high. Mean differences between paired FEV1 (-0.038 L [-0.053, -0.023]) and FVC (0.033 L [0.012, 0.054]) were small. The 95% limits of agreement were wide but unbiased (FEV1 984, -1060; FVC 1460, -1394). Similar findings were observed across regions. The source of variation between spirometers was mainly at the participant level. Older age, higher body mass index, tobacco smoking and known COPD/asthma did not adversely impact on the inter-device variability. Furthermore, there were small and acceptable mean differences between paired FEV1 and FVC z-scores using the Global Lung Initiative normative values, suggesting minimal impact on lung function interpretation. CONCLUSIONS: In this multicenter, diverse community-based cohort study, measurements from two portable spirometers provided good correlation, small and unbiased differences between measurements. These data support their interchangeable use across diverse populations to provide accurate trends in serial lung function measurements in epidemiological studies.

Does hyperbaric oxygen administration before or after irradiation decrease side effects of irradiation on implant sites?

BACKGROUND: One of the main limitations of implant-based breast reconstruction is the high rate of complications such as capsular contracture and poor aesthetic outcome, due to adjuvant radiotherapy. Hyperbaric oxygen treatment (HBOT) has been used to assist wound healing in the prevention and treatment of the side effects of irradiation. We aimed to investigate this effect of HBOT on the capsule reaction and skin, applied before and after irradiation, following the placement of an implant under the dorsal skin of the rat. METHODS: Fifteen Wistar rats were randomly divided into 3 groups. A 18-mL smooth testicular implant was introduced into a subcutaneous pocket located on the dorsum of each rat. A single dose of 17-Gy irradiation was given to the implanted area of each rat at the third week. HBOT which lasted 3 weeks was administered to group I before irradiation, group II after irradiation. The control group did not receive HBOT. All of the rats were killed at the ninth week (6 weeks after irradiation). The dorsal skin with the capsule overlying the implant were excised for histopathological processing. The thickness of the capsule reaction of each group was evaluated statistically. RESULTS: Our histopathological examination revealed changes due to radiation in the control group. Many of these findings were found to be more subtle in group I and nearly absent in the group II. There was not any statistical difference between the thickness of the capsule reactions of the control group and group I, or group I and group II, but the capsular thickness of the control group was statistically higher than group II. CONCLUSION: It can be predicted that the use of HBOT following irradiation is an effective tool to reduce the capsule reaction of the implanted area and the tissue damage seen in radiodermatitis.

The effect of vitamin C on ischemia reperfusion injury because of prolonged tourniquet application with reperfusion intervals.

We examined the effect of vitamin C on muscle injury distal to the tourniquet which was applied for 4 hours with 10- and 20-minute reperfusion intervals after 2 hours of tourniquet. Sixty-four Sprague-Dawley rats were allocated to 4 randomized groups. After 2 hours tourniquet, 10- and 20-minutes of reperfusion were allowed to half of each group respectively. Afterward an additional 2 hours compression was applied. Except the control group the animals received vitamin C intravenously, before the first tourniquet in Group I, at the reperfusion interval in Group II, and at both times in Group III. Malondialdehyde levels were measured in blood and the tibialis anterior muscle. The muscle was histopathologically examined. The data was evaluated statistically. The effects of timing and the dose of vitamin C on ischemia reperfusion injury remain controversial and there was no statistical difference between 10- and 20-minute reperfusion intervals. But the blood malondialdehyde levels showed that vitamin C has a positive effect on the muscle injury caused by ischemia-reperfusion.

The Prospective Urban Rural Epidemiology (PURE) study: PURE Turkey.

OBJECTIVE: The Prospective Urban Rural Epidemiology (PURE) study is a prospective cohort study that collects data on social, environmental, and individual risk factors and chronic diseases among residents of 25 countries in the range of 35 to 70 years of age, living in rural and urban areas. The PURE study is directed by the Population Health Research Institute of McMaster University in Canada. In Turkey, the study is conducted by the Metabolic Syndrome Society. METHODS: In Turkey, the study is being conducted in 8 cities. The initial fieldwork began in 2008. Questionnaires were completed, and anthropometric measurements, blood and urine samples, handgrip strength evaluations, electrocardiogram readings, and spirometer and body composition measurements were obtained. Each year, participants were followed up via telephone. Every third year, questionnaires, field measurements, and biological data sampling were repeated. RESULTS: PURE Turkey has 4056 participants (female: 60.7%, male: 39.3%; mean age: 50±9.1 years). Among them, 43.9% had metabolic syndrome and 52.8% were obese. The prevalence of hypertension was 41.1% and proportion of controlled hypertension was 34%. A total of 2098 (51.7%) of the participants had a total cholesterol of ≥200 mg/dL or were using a lipid lowering agent. In patients with diabetes, 79.8% had low-density lipoprotein cholesterol levels ≥100 mg/dL. Although a dramatic change was not observed in those parameters in the follow-up years, the prevalence of diabetes mellitus increased from 13.7% in 2008 to 21% in 2015. The baseline and follow-up data of the PURE study were analyzed with the other countries participating in the study and reported for international publication. CONCLUSION: The PURE study is a large, ongoing, prospective epidemiological study that is investigating the "causes of the causes" of noncommunicable diseases in the world. In addition to revealing the health status of nations, the study also has the potential to affect health politics.

Evaluation of anterior segment parameters using pentacam in silicone oil-injected patients after pars plana vitrectomy.

BACKGROUND: The aim of this study is to evaluate anterior segment changes with Pentacam Scheimpflug camera after pars plana vitrectomy (PPV) and silicone oil injection. MATERIALS AND METHODS: In all, 44 eyes of 44 patients who underwent PPV by one surgeon were evaluated with Pentacam preoperatively, first week, and first month after surgery. The patients were divided into two groups, eyes with silicone injection after PPV and eyes with PPV and no endotamponade. Main outcome measures were preoperative and postoperative anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle (ACA), and central corneal thickness (CCT) obtained with pentacam. RESULTS: Each group consisted of 22 patients. In both groups no significant difference was detected among preop and postop changes in ACV and ACA values (p > 0.05). The increase in ACD in silicone oil-injected group and the decrease in ACD in PPV group at postop 1 week were statistically significant (p < 0.05). The increase in CCT in silicone oil-injected group at postop 1 week and then decrease in postop 1 month were also significant (p < 0.05). Surgically induced astigmatism (SIA) was 3.7 Dioptry (D) in silicone oil-injected group and 2.4 D in PPV group at postop 1 week. SIA decreased to 1.7 D and 1.5 D, respectively, at postop 1 month. Changes in SIA were significant (p < 0.05). CONCLUSION: PPV effects cornea and anterior segment. Changes in cornea and anterior segment after PPV seem to return to preoperative values among 1 month after surgery.

Evaluation of anterior segment parameters using pentacam in silicone oil–injected patients after pars plana vitrectomy.

Background: The aim of this study is to evaluate anterior segment changes with Pentacam Scheimpflug camera after pars plana vitrectomy (PPV) and silicone oil injection. Materials and Methods: In all, 44 eyes of 44 patients who underwent PPV by one surgeon were evaluated with Pentacam preoperatively, first week, and first month after surgery. The patients were divided into two groups, eyes with silicone injection after PPV and eyes with PPV and no endotamponade. Main outcome measures were preoperative and postoperative anterior chamber volume (ACV), anterior chamber depth (ACD), anterior chamber angle (ACA), and central corneal thickness (CCT) obtained with pentacam. Results: Each group consisted of 22 patients. In both groups no significant difference was detected among preop and postop changes in ACV and ACA values (P > 0.05). The increase in ACD in silicone oil–injected group and the decrease in ACD in PPV group at postop 1 week were statistically significant (P < 0.05). The increase in CCT in silicone oil–injected group at postop 1 week and then decrease in postop 1 month were also significant (P < 0.05). Surgically induced astigmatism (SIA) was 3.7 Dioptry (D) in silicone oil–injected group and 2.4 D in PPV group at postop 1 week. SIA decreased to 1.7 D and 1.5 D, respectively, at postop 1 month. Changes in SIA were significant (P < 0.05). Conclusion: PPV effects cornea and anterior segment. Changes in cornea and anterior segment after PPV seem to return to preoperative values among 1 month after surgery.