Effects of Topical Ozone Application on Outcomes after Accelerated Corneal Collagen Cross-linking: An Experimental Study

Purpose: Ozone is a trioxygen molecule that spontaneously degrades into oxygen and oxygen free radicals. This study was designed to assess the effects of topical ozone application on outcomes after corneal collagen cross-linking (CXL). Methods: Enucleated fresh cadaver yearling sheep eyes (n = 28) were divided into five groups: control (C, n = 6), sham (S, n = 6), ozone only (Z, n = 6), CXL only (X, n = 5), and Ozone + CXL (ZX, n = 5). In all groups, except C, the epithelial layer was removed. In group Z, 20 μg/mL liquid ozone was topically applied. In group X, CXL was performed in the accelerated pulse mode. In group ZX, both CXL and ozone were applied. Post-interventional oxygen levels were determined and corneal confocal microscopy and optical coherence tomography were performed. Corneas were evaluated using light and electron microscopy. Results: Pre-interventional central corneal thickness (CCT) was highest in the control group and considerably similar in the remaining groups (P = 0.006). Pre- and post-interventional CCT were significantly different in the ozonated groups (Z and ZX) (P = 0.028; P = 0.043). Demarcation line depths were similar in groups Z, X, and ZX (P = 0.343). Increased stromal tissue reflectivity was observed in groups Z, X, and ZX. Oxygen levels were higher in the ozonated groups (Z and ZX) (P = 0.006), and caspase activity was higher in the CXL groups (X and ZX) (P = 0.028) as compared to the other groups. Group ZX showed tighter, more regular, and parallel fibrils. Conclusion: Ozone increases corneal stromal oxygenation which can probably augment the effect of CXL. Future studies should investigate the safety and feasibility of ozone application during CXL

Perinatal and neonatal outcomes of adolescent pregnancies over a 10-year period

Objectives: Poor overall neonatal outcomes, small neonatal head circumference, neonatal hypoglycemia, need for Neonatal Intensive Care Unit and late-onset neonatal sepsis are more common in adolescents. The aim of this study is to draw attention to the outcomes of adolescent pregnancies. Material and methods: This retrospective study was conducted in adolescent singleton pregnancies with maternal age < 15 years (n = 20, group 1), 16–19 years (n = 1929, group 2), and 20 years (n = 866, group 3). Age, gravidity, parity, and body mass index (BMI) measurements of mothers; mode of delivery, maternal and neonatal outcomes were evaluated and compared. Results: The rate of preterm birth, postpartum hemorrhage, asymmetrical intra-uterine growth restriction (IUGR, as 3% percentile), macrosomia, and height of newborn of Group 3 was significantly higher. The rate of asymmetrical IUGR (as 10% percentile) was significantly lower in Group 3. The rate of severe preeclampsia and cesarean section was significantly higher in Group 3. The rate of Small for Gestational Age newborn, neonatal hypoglycemia, and late-onset neonatal sepsis was significantly higher in Group 1. Conclusions: Neonatal problems with poor obstetric outcomes are common in adolescent pregnant women, so that a family planning and baby care social trainings are important in achieving good long-term maternal and neonatal outcomes

Morbidly adherent placenta and cesarean section methods. A retrospective comparative multicentric study on two different skin and uterine incision

Objectives: Morbidly adherent placenta (MAP) is one of leading causes of maternal mortality, with an increasing rate because of repeated cesarean sections (CS). The primary objective of this study is to compare two techniques of skin and uterine incisions in patients with MAP, evaluating the maternal fetal impact of the two methods. Retrospective multicentric cohort study.Material and methods: A total of 116 women with MAP diagnosis were enrolled and divided in two groups. Group one, comprised of 81 patients, abdominal entry was performed by Pfannenstiel skin incision plus an upper transverse lower uterine segment (LUS) incision (transverse-transverse), which was 2–3 cm above the MAP border, with the uterus in the abdomen. In group two, comprised of 35 patients, abdominal entry was performed by an infra-umbilical midline abdominal incision, by vertical-vertical technique, and the pregnant uterus was incised by a midline incision (vertical) from the fundus till the border of the MAP. Total surgery time, blood loss, blood product consumption, total hospital stay, cosmetic outcomes, and postoperative complications were investigated.Results: Total time of surgery was significantly shorter in group 1 (p < 0.05). Intraoperative blood loss was higher in group 2. Difference between preoperative and postoperative Hb and Htc levels were 3.30 ± 1.04 and 12.99 ± 5.07 respectively (p = 0.012; p = 0.033). The use of erythrocyte suspension (ES), fresh frozen plasma (FFP), and cryoprecipitate and thrombocyte suspension (TS) were found to be significantly lower in patients of group 1than vertical-vertical group (p = 0.008, p = 0.009, p = 0.001, p = 0.001, respectively). There was no difference in terms of total length of hospital stay between groups.Conclusions: In a subgroup of patients diagnosed for MAP, the transverse-transverse incision resulted in less bleeding, less blood and blood product use, and had better cosmetic results than vertical-vertical incision. Moreover, the total time of surgery, crucial for MAP patients, seems to be shorter also in transverse-transverse incision than in vertical-vertical incision

Quantification of market liquidity risk

Da Banken eine wesentliche Rolle bei der Bereitstellung von Liquidität im Finanzsystem darstellen, sind Regulatoren und Gesetzgeber sehr besorgt über die Liquiditätsposition dieser Institute, um ein robustes Rahmenwerk im gesamten Finanzsystem sicherzustellen. Diese Arbeit zielt darauf ab, selektierte Modelle zur Quantifizierung des Marktliquiditätsrisikos zu beschreiben und zu vergleichen, und dasjenige Modell zu identifizieren, das die adäquatesten Ergebnisse liefert und daher von den Anwendern für die Umsetzung bevorzugt werden könnte. Obwohl alle in dieser Arbeit beschriebenen Modelle von jedem Marktteilnehmer verwendet werden kann, wird der Modellvergleich hauptsächlich aus der Perspektive des Risikomanagements ausgeführt mit klarem Fokus auf regulatorische und interne Anforderungen für Finanzinstitute. Das Papier beginnt mit einer Beschreibung der internationalen regulatorischen Anforderungen zum Management des Liquiditätsrisikos. Nachfolgend wird das Konzept der Marktliquidität und die Hauptquellen in Bezug auf die Market-Mikrostruktur und Handelsmechanismus erklärt. Basierend auf die entwickelten Konzepte wird das Marktliquiditätsrisiko als quantifizierbarer Faktor definiert und selektierte Modelle zu dessen Messung beschrieben. Nach der Präsentation jedes selektierten-einzelnen Modellgruppe, werden die wesentlichen Schwächen jeden Modelles diskutiert und es wird evaluiert, in welchem Ausmaß das präsentierte Modell die Komponenten des Marktliquiditätsrisikos adressiert, so wie in diesem Papier beschrieben. Die Analyse inkludiert ebenfalls die Ausarbeitung der erforderlichen Datensets zur Modellierung und zum Vergleich der praktischen Anwendbarkeit des Modells. Das nachfolgende Kapitel diskutiert die Herausforderungen, die bei Messung und Management des Marktliquiditätsrisikos beachtet werden müssen. Abschließend werden eine kurze Zusammenfassung der Erkenntnisse dieser Studie sowie Modellvorschläge präsentiert, die zur Messung und Management des Marktliquiditätsrisikos herangezogen werden können.As banks being one of the main liquidity providers in the system; regulators and policy makers are very much concerned with the liquidity position of these institutions in order to ensure a robust liquidity framework in the overall financial system. This paper aims to describe and compare selected models quantifying market liquidity risk and to identify which model delivers more adequate results and thus could be preferred for implementation by practitioners. Even though all the models described in this work can be used by any market participant; the model comparison is performed mainly from a risk management perspective with a clear focus on the regulatory and internal requirements for financial institutions. The paper starts with a description of international regulatory requirements for management of liquidity risk. In what follows, the concept of market liquidity is explained and its main sources related to market microstructure and trading mechanism are explained. Based on the developed concepts, market liquidity risk is defined as a quantifiable factor and selected models for its measurement are described. After presentation of every selected model group, main weaknesses of each model are discussed and it is evaluated to what extend the presented model addresses the components of market illiquidity the way it is described in this paper. The analysis includes also elaboration of the requested data set for model set-up and comparison of the practical applicability of the models. The consequent chapter discusses challenges to be considered for measurement and management of market liquidity risk. And in conclusion a brief summary of the findings of this research are provided as well as model/s suggestions that could fit for the purpose of measurement and monitoring of market liquidity risk

The Role of Melatonin, IL-8 and IL-10 in Intrahepatic Cholestasis of Pregnancy

Introduction Intrahepatic cholestasis of pregnancy is a pregnancy-specific liver disease that usually emerges during the third trimester of pregnancy. It is characterized by itching and elevated serum total bile acid levels, and it may lead to severe fetal complications. This study aimed to investigate the role of interleukin-8, a pro-inflammatory cytokine; interleukin-10, an anti-inflammatory cytokine; and melatonin in intrahepatic cholestasis of pregnancy. Materials and Methods This prospective, case-controlled study was conducted with 51 women with intrahepatic cholestasis of pregnancy (40 mild and 11 severe cases) and 43 healthy pregnant women. Serum interleukin- 8, interleukin-10, and melatonin levels were evaluated. Results Melatonin and interleukin -10 were significantly lower in subjects with intrahepatic cholestasis of pregnancy (p = 0.001; p = 0.001, respectively p < 0.05). Interleukin-8 levels were found to be significantly higher in the cholestasis group than control group (p = 0.001, p < 0.05). Conclusions Because interleukin-8, interleukin-10, and melatonin were found to be significantly correlated with intrahepatic cholestasis of pregnancy, we believe this finding could shed light on the etiology of the disease.WOS:0005701539000012-s2.0-85091930530PubMed: 3294232

Linear fractures of the cranium: follow-up and management results of 442 cases

WOS: 000435652100014Aim: We aimed to evaluate the clinical and radiological follow-up of cases with isolated linear fractures detected in the cranium in the post-traumatic period, to determine on which cases and when to perform control radiological examinations and to suggest follow-up protocol. Material and Method: 442 cases with isolated linear cranium fracture were evaluated in the study. Imaging examinations and clinical findings of the cases at the time of admission were compared with radiological examinations and clinical findings at follow-up. Fracture localizations and trauma types were compared. Accompanying maxillofacial fractures depending on the localization of fractures detected in the cranium were determined. Results: In the follow-up CT examinations of 18 out of 442 cases, cerebral contusion in 12 cases and epidural hematoma in 1 case, not detected during initial admission were found. Post-traumatic epilepsy was observed in 4 cases without radiologic findings. In cases receiving follow-up radiological examinations, no significant difference was found between radiological examinations performed during 4-6 hours versus 12-24 hours after trauma. Discussion: Isolated linear fracture cases do not require neurosurgical intervention. The treatment protocol may change depending on findings during the follow-up period. Performing routine follow-up radiological examinations is not cost-effective in cases in which no additional finding is present, and symptoms do not persist

Predictive and Diagnostic Value of Serum Adipokines in Pregnant Women with Intrahepatic Cholestasis

The objective of this study was to assess the value of serum leptin, adiponectin, apelin, and ghrelin as biomarkers for the prediction and diagnosis of intra-hepatic cholestasis (ICP). This prospective study included pregnant women in the third trimester of pregnancy: 63 with ICP, 48 and 15 of whom had mild and severe disease, respectively, and 32 as controls. ICP women had increased median levels of serum leptin, adiponectin, apelin, and ghrelin compared to the controls (p &lt; 0.05). These biomarkers meaningfully changed regarding the severity of ICP: While leptin was reduced, apelin and ghrelin were increased, and adiponectin was increased somewhat. To predict and diagnose ICP, the predictive values of serum leptin, adiponectin, and apelin need to be accepted as comparable, with moderate to high sensitivity and specificity; however, the predictive value of serum ghrelin was somewhat lower. More research is needed to clarify the potential properties of adipokines to gain acceptance as a predictive or diagnostic biomarker for ICP

Derangements of vaginal and cervical canal microbiota determined with real-time PCR in women with recurrent miscarriages

Balanced vaginal microbiota and, as a continuum, cervical canal microbiota help prevent reproductive disorders, including recurrent miscarriage (RM). In a significant proportion of couples with RM, routine diagnostic workup cannot find any manageable cause, leading to a requirement for new diagnostic tools. In the present study, we determined the quantitative composition of the microbiota of the vagina and cervical canal, assessed by real-time polymerase chain reaction, in women with RM. It also evaluated their derangements related to the pathogenesis of RM, and thus the suitability of this test as a diagnostic tool for managing RM. Vaginal and cervical canal specimens of 25 women with RM and 25 healthy volunteers were collected. The test results revealed information about the total vaginal bacterial biomass by measuring the abundance of Lactobacillus spp.; other bacteria; and pathogens, including Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma (urealyticum + parvum), and Candida spp. Overall, the findings of this study implied the abundance of Lactobacillus spp. decreased in women with RM with an increase in the abundance of other microorganisms in accordance with the reduction in the abundance of Lactobacillus spp. due to aerobic vaginitis and bacterial vaginosis. Vaginal and cervical canal microbiota need to be considered during the diagnostic workup of women with RM.IMPACT STATEMENT What is already known on this subject? Recurrent miscarriage (RM) is a well-known reproductive disorder. Its diagnostic workup is not successful in determining the underlying problem in many cases. Hence, novel diagnostic tools based on real-time polymerase chain reaction (PCR) are needed for evaluating reproductive microbiota, which are considerably reliable, to satisfy the expectations of women with RM. What do the results of this study add? Overall, the decrease in the abundance of Lactobacillus spp. was found to be related to RM, and the patterns of the presence of other microorganisms were in accordance with the reduction in the abundance of Lactobacillus spp. These findings suggested an important role of vaginal and cervical canal microbiota in the pathogenesis of RM. What are the implications of these findings for clinical practice and/or further research? Additional research is warranted to elucidate the functional impact of altered components of the microbiota of vaginal and cervical canals on the physiology of the local cervical canal and its participation in the microbiota of the endometrial cavity, especially regarding unsuccessful pregnancies as a result of the disturbed physiology of the local endometrial microenvironment. However, possible applications of real-time PCR-based tests for the screening of subclinical infections in clinical practice require the performance of further investigations in patients with RM

Morbidly adherent placenta and cesarean section methods. A retrospective comparative multicentric study on two different skin and uterine incision

Objectives: Morbidly adherent placenta (MAP) is one of leading causes of maternal mortality, with an increasing rate because of repeated cesarean sections (CS). The primary objective of this study is to compare two techniques of skin and uterine incisions in patients with MAP, evaluating the maternal fetal impact of the two methods. Retrospective multicentric cohort study. Material and methods: A total of 116 women with MAP diagnosis were enrolled and divided in two groups. Group one, comprised of 81 patients, abdominal entry was performed by Pfannenstiel skin incision plus an upper transverse lower uterine segment (LUS) incision (transverse-transverse), which was 2-3 cm above the MAP border, with the uterus in the abdomen. In group two, comprised of 35 patients, abdominal entry was performed by an infra-umbilical midline abdominal incision, by vertical-vertical technique, and the pregnant uterus was incised by a midline incision (vertical) from the fundus till the border of the MAP. Total surgery time, blood loss, blood product consumption, total hospital stay, cosmetic outcomes, and postoperative complications were investigated. Results: Total time of surgery was significantly shorter in group 1 (p < 0.05). Intraoperative blood loss was higher in group 2. Difference between preoperative and postoperative Hb and Htc levels were 3.30 +/- 1.04 and 12.99 +/- 5.07 respectively (p = 0.012; p = 0.033). The use of erythrocyte suspension (ES), fresh frozen plasma (FFP), and cryoprecipitate and thrombocyte suspension (TS) were found to be significantly lower in patients of group 1than vertical-vertical group (p = 0.008, p = 0.009, p = 0.001, p = 0.001, respectively). There was no difference in terms of total length of hospital stay between groups. Conclusions: In a subgroup of patients diagnosed for MAP, the transverse-transverse incision resulted in less bleeding, less blood and blood product use, and had better cosmetic results than vertical-vertical incision. Moreover, the total time of surgery, crucial for MAP patients, seems to be shorter also in transverse-transverse incision than in vertical-vertical incision.WOS:0006614424000052-s2.0-85105788658PubMed: 3384425