Ocena zależności między ciśnieniem centralnym w aorcie a zesztywniającym zapaleniem stawów kręgosłupa

Introduction. Ankylosing spondylitis (AS) is a chronic inflammatory disease with an unknown etiology that belongs to the group of spondyloarthropathies. Patients with AS have an increased cardiovascular mortality but the reason is controversial. Central aortic pressure (CAP) is defined as the blood pressure in the aortic root and can be measured non-invasively via arteriography. Inflammation in the aortic root, which also causes aortic regurgitation in late sta ges of AS, possibly causes increased levels of central aortic pressure and this may explain the increased mortality rates from cardiovascular events in patients with AS. We investigated the CAP levels in patients with AS compared to healthy age- and sex-matched control group in this novel study. Material and methods. This is an observational case-control study composed of 30 patients with ankylosing spondylitis without conventional cardiovascular risk factors (such as known diabetes, hypertension, and smoking) or heart failure, peripheral or coronary artery disease. The peripheral blood pressures and CAP measurements were obtained with ‘arteriograph’ (TensioMed, Budapest, Hungary).Pulse wave velocity (PWV), peripheral and central augmentation index (pAIx and cAIx) and systolic central aortic pressure (sCAP) of both the AS and control group were compared. Results. There was no statistically significant difference between the groups for pAIx, cAIx, PWV or PP. Patient with AS had higher sCAP values but there wasn’t any statistically significant difference for sCAP. Conclusion. Our objective was to investigate the relationship between the AS and sCAP. There was an increase in sCAP in AS group compared to controls. But this was not statistically significant. This result can be due to the small population size and should be verified in larger population.Wstęp. Zesztywniające zapalenie stawów kręgosłupa (AS) to przewlekła choroba zapalna o nieznanej etiologii należąca do spondyloartropatii. U chorych z AS obserwuje się zwiększoną śmiertelność sercowo-naczyniową, jednak przyczyny tego zjawiska nie są znane. Ciśnienie centralne w aorcie (CAP) jest definiowane jako ciśnienie krwi w korzeniu aorty. Możliwy jest nieinwazyjny pomiar CAP metodą arteriografii. Zapalenie w obrębie korzenia aorty, będące również przyczyną niedomykalności w późnym stadium AS, może powodować wzrost ciśnienia centralnego w aorcie, co może tłumaczyć zwiększoną śmiertelność z powodu zdarzeń sercowo-naczyniowych w grupie chorych z AS. Autorzy zbadali wartości CAP u chorych z AS w porównaniu z wartościami uzyskanymi w grupie kontrolnej złożonej ze zdrowych osób dobranych pod względem wieku i płci. Materiał i metody. Tym obserwacyjnym badaniem kliniczno-kontrolnym objęto 30 chorych z AS, u których nie występowały tradycyjne czynniki ryzyka sercowo-naczyniowego (rozpoznana cukrzyca, nadciśnienie tętnicze, palenie tytoniu), niewydolność serca, choroba tętnic obwodowych ani choroba wieńcowa. Wartości obwodowego ciśnienia tętniczego i pomiary CAP uzyskano metodą arteriografii (TensioMed, Budapeszt, Węgry). Porównano wartości następujących parametrów w grupie AS i grupie kontrolnej: szybkość fali tętna (PWV), wskaźnik wzmocnienia ciśnienia obwodowego i centralnego (pAIx, cAIx) i skurczowe ciśnienie centralne w aorcie (sCAP). Wyniki. Nie stwierdzono statystycznie istotnych różnic między grupami pod względem wartości pAIx, cAIx, PWV ani PP. U chorych z AS zaobserwowano wyższe wartości sCAP, jednak różnice nie osiągnęły poziomu istotności statystycznej. Wnioski. Badanie przeprowadzono w celu zbadania zależności między AS a sCAP. W grupie chorych na AS wartości sCAP były wyższe niż w grupie kontrolnej. Jednak różnice nie były istotne statystycznie. Wyniki te mogą być spowodowane niewielką liczebnością badanej populacji i powinny zostać zweryfikowane w badaniu z większą liczbą uczestników

Evaluation of retinal nerve fiber layer and ganglion cell layer thicknesses with optical coherence tomography in patients with vitamin B12 deficiency

Aim: We aimed to compare the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness of B12 vitamin deficiency patients with healthy controls using optical coherence tomography (OCT). Methods: Forty-six patients (27 females / 19 males) diagnosed with B12 vitamin deficiency and 46 healthy controls (26 females / 20 males) with similar age and sex were included in the study. RNFL thickness of global, superotemporal, temporal, inferotemporal, superonasal, nasal and inferonasal sectors and GCL thickness and volume measurements of central, superior, inferior, temporal, and nasal sectors were performed using Spectralis-OCT device in all cases. Results: The mean age of the patient group was 42.17±15.34 years, while that of the control group was 44.21±12.34 years (p=0.528). Mean serum vitamin B12 levels were measured as 163,47±19,80 pg/ml in the patient group and 311,80±76,30 pg/ml in the control group (p <0,01). There was no statistically significant difference between the global RNFL thicknesses of the two groups (p> 0,05). However, statistically non-significant thinning was observed in the superotemporal and global RNFL thickness of the group with B12 vitamin deficiency (p values are 0,140 and 0,171, respectively). There was also no statistically significant difference between GCL thicknesses and volumes of the two groups (p> 0.05). Conclusions: No significant reduction was observed in RNFL and GCL thicknesses of adult subjects with B12 vitamin deficiency compared with healthy controls

Complications of cardiopulmonary resuscitation in non-traumatic cases and factors affecting complications

AbstractIn this study, bodily injuries related to chest compression were examined in non-traumatic death cases that underwent autopsy. This study aimed to evaluate factors that can affect these injuries.Data were collected retrospectively, and injuries related to chest compression during cardiopulmonary resuscitation were determined over a 10-year period. Age, gender and cause of death were determined, and when cardiopulmonary resuscitation was performed, cardiopulmonary resuscitation duration, intubation and the injury that occurred due to chest compression were also determined.The study included data from 203 cases. The most frequent injuries were a single fracture in the left ribs (19.7%). Only the duration of cardiopulmonary resuscitation was determined to be associated with injuries. Ventricle rupture in 1 case and liver laceration in 2 cases were the most significant injuries.It has been shown that during cardiopulmonary resuscitation, severe injuries can occur due to thoracic compression. Only a positive correlation with the duration of cardiopulmonary resuscitation was found in our study

Suturing of the Arachnoid Membrane for Reconstruction of the Cisterna Magna: Technical Considerations

Background Postoperative cerebrospinal fluid (CSF) fistula following cranial or spinal surgery is associated with increased morbidity and mortality. To prevent CSF fistulas, various techniques have been described. Here, we describe the arachnoid membrane continuous-running suture technique in cisterna magna reconstruction for preventing postoperative CSF leakage. Methods After craniotomy and dural opening, the incision of the arachnoid of the cisterna magna was performed using a diamond blade. To prevent the arachnoid from drying out and shrinking during surgery, it was periodically irrigated with warm saline solution. Posterior fossa surgery was performed. When closing the membranes, the arachnoid membrane was closed with the running-suture technique. After the first surgical knot was made in the cranial end of the arachnoid opening, continuous suturing with a 2-mm distance between the stitches was performed without stretching them. After every 3 stitches, the free end of the thread was pulled gently along the suturing axis, and the edges of the arachnoid were closed. After the arachnoid edges were approximated, the surgical knot was tied. Watertight closure was checked by performing the Valsalva maneuver at the end of the surgery. Results No CSF leakages were observed after surgery. Conclusions Arachnoid membrane suturing seems to be safe and effective in preventing postoperative CSF leakage and CSF-related complications. Using continuous running suturing alone, without any sealant, might be effective in cases with untraumatized arachnoid membrane

Is Placing Prophylactic Dural Tenting Sutures a Dogma?

Objective In this study, we investigated if and when dural tenting sutures are necessary during craniotomy. Methods Results from 437 patients aged 18 to 91 years (average, 43.5 years) who underwent supratentorial craniotomy between 2014 and 2019 were evaluated. The patients were categorized into 1 of 3 groups, patients who had at least 3 prophylactic dural tenting sutures placed before opening of the dura (group 1), at least 3 dural tenting sutures placed after surgery was completed, during closure (group 2), or no dural tenting sutures (group 3 [control]). All such sutures in groups 1 and 2 were placed in the circumference of the craniotomy and dural junction. No central dural tenting sutures were placed in any of the patients. Results Among the 437 patients, 344 underwent surgery for the first time and 93 were undergoing a second surgery. Cranial computed tomography imaging was performed for each patient 1 hour, 3 days, and 1 month after surgery. In group 1, 3 patients had a cerebral cortex contusion and 2 patients had acute subdural hematoma after the sutures were placed. In groups 2 and 3, none of the patients had a cerebral cortex contusion or acute subdural hematoma. Fewer complications were observed when dural tenting sutures were placed during postsurgical closure. Conclusion Placing dural tenting sutures is an important technique for ensuring hemostasis. However, when not needed, they seem to cause inadvertent complications. As our results suggest, knowing when and where to use them is equally important

HIGH LEVELS OF GENETIC VARIATION AS DETECTED BY AFLP IN Sideritis tmolea FROM WESTERN TURKEY

ABSTRAC

HIGH LEVELS OF GENETIC VARIATION AS DETECTED BY AFLP IN Sideritis tmolea FROM WESTERN TURKEY

ABSTRAC

HIGH LEVELS OF GENETIC VARIATION AS DETECTED BY AFLP IN Sideritis tmolea FROM WESTERN TURKEY

ABSTRAC

Osteogenesis Imperfecta and Extra-/Intradural Hematomas: A Case Report and Review of the Literature.

Osteogenesis imperfecta, also named as brittle bone disease, is characterized by fragile bones and short stature caused by mutations in the collagen gene. Subdural and intraparenchymal hematomas are defined and associated with trauma, vascular causes, and systemic bleeding diathesis. Skull fragility may lead to epidural hematoma, which is a life-threatening situation. Vascular fragility and intrinsic platelet defects are the causes of bleeding in patients with osteogenesis imperfecta, which is a major management challenge for neurosurgeons. Here, we reported on a 5-year-old boy with osteogenesis imperfecta with epidural hematoma and skull fracture following a trivial trauma, and made a literature review of 28 cases with extra-/intradural hematoma

Cytogenetic effects of Helichrysum arenarium in human lymphocytes cultures

Helichrysum Mill., belonging to the family Asteraceae, is commonly known as "everlasting'. Helichrysum species have been used as herbal tea for centuries in Turkey against gallbladder disorders because of their bile regulatory and diuretic properties. However, there are few reports in the literature regarding the genotoxic effects of these plants. In the present study, the genotoxic effects induced by aqueous (decoction) and methanol extracts of Helichrysum arenarium (L.) Moench subsp. rubicundum (K.Koch) P.H.Davis & Kupicha, H. arenarium (L.) Moench subsp. aucheri (Boiss.) P.H.Davis & Kupicha, and H. arenarium (L.) Moench subsp. erzincanicum P.H.Davis & Kupicha on human lymphocyte cultures at 0.01, 0.05, 0.1, 0.5, and 1 mg/mL concentrations were evaluated. Three different parameters (micronucleus, mitotic, and replication indexes) were used. H. arenarium subsp. erzincanicum induced the formation of micronuclei and decreased the mitotic and replication indexes as well. H. arenarium subsp. rubicundum and H. arenarium subsp. aucheri did not affect these parameters. Our results clearly indicate that H. arenarium subsp. erzincanicum has genotoxic effects. Therefore, this plant should not be used freely in alternative medicine although its antiproliferative activity may suggest antimitotic and anticarcinogenic properties. H. arenarium subsp. rubicundum and H. arenarium subsp. aucheri, on the other hand, do not have genotoxic effects. Thus, they can be used freely in alternative medicine. Further studies are needed to determine the effects of the main bioactive components isolated from H. arenarium on the micronucleus, mitotic index, and replication index