Evaluation of P Wave Dispersion, QT Dispersion and P Wave Amplitude in Patients with Obstructive Sleep Apnea Syndrome

Objective The purpose of the study is to evaluate the risks of atrial and ventricular tachyarrhythmia and the risk of right atrial dilatation by using P wave amplitude (Pda) measurement, in patients with Obstructive Sleep Apnea syndrome (OSAS) by using the parameters of the P wave dispersion (Pd) and QT interval dispersion (QTc) the accepted non-invasive risk indicators for atrial and ventricular tachyarrhythmia. Materials and Methods Patients who had applied to our clinic’s sleep laboratory with pre-diognosis of OSAS were evaluated. Two hundred twenty five cases were included in the study who met the criteria for acceptance to work. Polysomnographic tests and routine blood tests applied to all patients. In addition, electrocardiography was performed. Pd, QTc and corrected QT dispersion (QTcd) calculated on a 12 lead surface electrocardiographic examination. The difference between patient and control groups were evaluated. Results After polysomnographic workup, 56 cases with apnea-hypopnea index (AHI) 0.05). Although QTcd was higher than normal range in patient group, the differences was not significant compared to control group (p>0.05). In the studies made for P wave, although the values in terms of Pmax, Pmin and Pd were found higher in the patient group than in the control group, a significant difference was not determined between the groups. However, P wave amplitude was significantly higher as statistically in the patient group than in the control group (p=0.02). Conclusion Pd and QTc/QTcd parameters do not seem to be appropriate for the assessment of ventricular and atrial arrhythmia risk in patients with OSAS. However, the increase in Pda may be indicative of an increased risk of right atrial dilatation. There is a need for forward studies involving large case series in order to provide clarity on the subject

The effect of fibrin glue in preventing staple-line leak after sleeve gastrectomy. An experimental study in rats

Purpose: To evaluate the effect of fibrin glue on staple-line leak after sleeve gastrectomy. Methods: Fourteen adult wistar rats 300 gr were randomized into two groups: Control group (n=7) and study group (n=7). All the rats underwent sleeve gastrectomy using lineer stapler. In the study group, fibrin glue was used to reinforce the staple-line. The rats were sacrificed 7 days after surgery. The stomach was resected, submerged in saline and exposed to excess pressure to obtain a burst pressure value. The gastric staple line was evaluated histopathologically according to the Ehrlich Hunt scale. The results of the two groups were compared. Results: The mean Ehrlich-Hunt scores for inflammation, fibroblastic activity and neo-angiogenesis were similar between the groups (p>0.05). Collagen deposition was significantly higher in study group (3.42±0.53) when compared with control group (2.57±0.78) (p=0.035). The mean burst pressure was 137.8±8.5 mmHg for control group and 135.0±8.1 mmHg for study group (p=0.536). Conclusion: Reinforcement of the staple-line with fibrin glue has no effect on the burst pressure after sleeve gastrectomy. More studies are needed to evaluate the precautions against leak after sleeve gastrectomy

Functionalized imidazolium and benzimidazolium salts as paraoxonase 1 inhibitors: Synthesis, characterization and molecular docking studies

Ozdemir, Namik/0000-0003-3371-9874; Gencer, Nahit/0000-0001-7092-8857; ALICI, Bulent/0000-0001-5009-3223; USLU, HARUN/0000-0001-8827-8557; ARSLAN, N. Burcu/0000-0002-1880-1047WOS: 000370822700026PubMed: 26879855Paraoxonase (PON) is a key enzyme in metabolism of living organisms and decreased activity of PON1 was acknowledged as a risk for atherosclerosis and organophosphate toxicity. The present study describes the synthesis, characterization, PON1 inhibitory properties and molecular docking studies of functionalized imidazolium and benzimidazolium salts (1a-5g). The structures of all compounds were elucidated by IR, NMR, elemental analysis and structures of compounds 2b and 2c were characterized by single-crystal X-ray diffraction. Compound 1c, a coumarin substituted imidazolium salt showed the best inhibitory effect on the activity of PON1 with good IC50 value (6.37 mu M). Kinetic investigation was evaluated for this compound and results showed that this compound is competitive inhibitor of PON1 with K-1, value of 2.39 mu M. Molecular docking studies were also performed for most active compound 1c and one of least active compound 2c in order to determine the probable binding model into active site of PON1 and validation of the experimental results. (C) 2016 Elsevier Ltd. All rights reserved

The effect of positive pressure ventilation on serum ischemia-modified albumin levels in obese patients with obstructive sleep apnea syndrome

Introduction: Respiratory abnormalities in obstructive sleep apnea syndrome (OSAS) are corrected with positive pressure ventilation treatments. We inves-tigated the effect of positive airway pressure (PAP) treatment on the serum level of ischemia-modified albumin (IMA), an oxidative stress product, in OSAS patients with higher body mass index (BMI) and indication for PAP treatment.Materials and Methods: Seven consecutive female and 23 male patients with a BMI of >= 30 kg/m2 who were diagnosed as having OSAS according to ICSD-3 criteria and were planned for PAP, were included. The Epworth Sleepiness Scale and STOP-Bang Questionnaire were performed. Morning arterial blood gas, hemogram, biochemistry, insulin, and IMA were measured after polysom-nography and after three months of PAP.Results: There were no significant changes in lactate, CRP, and serum elect-rolyte levels measured before and after PAP, except for potassium. When 30 patients were compared in terms of serum IMA levels at baseline and after treatment, the mean baseline value was 0.56 absorbance units (ABSU), and the 3rd-month follow-up IMA value was 0.53 ABSU (p= 0.537). The mean serum fasting insulin level was 15.85 mu IU/mL and 11.6 (p= 0.002) and the mean HOMA index was 4.4 and 3.0 (p= 0.001), respectively.Conclusion: Serum IMA levels seem not to be an appropriate marker for the evaluation of PAP treatment in OSAS patients with higher BMI. PAP is associ-ated with a decrease in the fasting insulin level, HOMA index, and hematocrit, but not with serum electrolytes except potassium