Helicobacter pylori Eradication Lowers Serum Asymmetric Dimethylarginine Levels

Introduction. Microbial pathogens, one of them is Helicobacter pylori (H. pylori), have frequently been implicated in the atherogenesis. Endothelium-derived nitric oxide (NO) is synthesized from L-arginine by nitric oxide synthase (NOS) and plays a pivotal role in the regulation of vascular tone. Asymmetric dimethylarginine (ADMA) is the most potent endogenous NOS inhibitor. Elevated levels of ADMA have been reported in many circumstances associated with a high cardiovascular risk. The aim of the present study was to investigate whether the eradication of H. pylori infection affects serum ADMA levels. Materials and Methods. Forty-two H. pylori-positive patients were enrolled in the study. Triple therapy for 14 days were given to all patients. Serum ADMA levels were measured at baseline and 2 months after therapy. Results. Eradication was achieved in 34 (81%) patients. The mean serum ADMA levels before and after therapy were 1, 77 ± 0, 30 and 1, 67 ± 0, 29 ng/mL in the group with H. pylori eradicated and 1, 63 ± 0, 28 and 1, 56 ± 0, 32 ng/mL in the noneradicated, respectively. We detected statistically significant decreased serum ADMA levels after therapy in H. pylori eradicated group. Conclusion. These findings have indicated that eradication of H. pylori infection may decrease the risk of atherosclerosis and cardiovascular events

Extraction socket healing in rats treated with bisphosphonate : animal model for bisphosphonate related osteonecrosis of jaws in multiple myeloma patients

Aim: The aim of this study is to replicate both clinical and histological presentation of bisphosphonate induced osteonecrosis of the jaws (BONJ) in an animal model of the disease state. Successful recapitulation of a BONJlike indication in an animal model will be useful for studying pathogenesis, as well as prevention and treatment strategies for BONJ. Materials and Methods: Eighty (80) rats were prospectively and randomly divided into two groups; control group(40) and study group(40). All animals in study group, injected with a dose of 1 mg/kg dexamethasone (DX) subcutaneously on day 7, 14, or 21; and 1, 2, or 3 doses of 7.5 ?g/kg zoledronic acid (ZA) subcutaneously administered to coincide with the last day of DX. Half of the animals from each group underwent extraction of the left mandibular molars and the remaining animals underwent extraction of the left maxillary molars under pentobarbital-induced general anesthesia. All animals were euthanized twenty-eight (28) days following tooth extractions. Results: The amount of new bone trabecules as significantly decreased in bisphosphonate-dexamethasone (BPDX) treated sockets. Difference between both groups was found statistically significant (p=0,0001). There's no foreign body reaction in sockets of both groups and no significance difference observed for fibrosis (p=0,306). The necrosis scores were significantly higher in BP-DX treated sockets (p=0,015). The inflamation scores were significantly higher for study group (p=0,0001). Conclusion: This study provides preliminary observations for the development of an animal model of BONJ. But we think that there is need for other studies have only BP treated group and larger study population. © Medicina Oral S. L

Use of Cone-Beam Computerized Tomography for Evaluation of Bisphosphonate-Associated Osteonecrosis of the Jaws in an Experimental Rat Model

Background: Bisphosphonate-induced osteonecrosis of the jaw (BONJ) is a frequently reported complication. The aim of this study was to investigate the clinical and histopathological presentation of BONJ with the Hounsfield score and to evaluate the reliability of the score for determining necrosis in an animal model

The 3'-untranslated region of ADAMTS1 regulates its mRNA stability

ADAMTS1 (a disintegrin and metalloproteinase with thrombospondin motifs 1) is an inflammatory-induced gene. We have previously reported that ADAMTS1 was strongly but transiently expressed in the infarcted heart. In this study, we investigated whether a 3'-untranslated region (UTR) affects the mRNA stability of this gene. When stimulated with tissue necrosis factor (TNF)-alpha, the expression level of ADAMTS1 mRNA rapidly increased, but the induction of ADAMTS1 mRNA peaked at 6h after stimulation, after which the expression levels of ADAMTS1 mRNA decreased. The 3'-UTR ADAMTS1 mRNA contains multiple adenine and uridine-rich elements, suggesting that the 3'-UTR may regulate gene stability. The addition of actinomycin D, an RNA synthesis inhibitor, demonstrated the decay of induced ADAMTS1 mRNA by TNF-alpha. Furthermore, a region containing multiple AUUUA motifs within the ADAMTS1 3'-UTR destabilized transfected Enhanced Green Fluorescence Protein (EGFP) mRNA expression. These results demonstrated that the ADAMTS1 3'-UTR may regulate the expression of ADAMTS1 mRNA.</p

The role of ADAMTS1 and versican in human myocardial infarction: A postmortem study

Objective: To determine the role of a disintegrin and metalloproteinase with thrombospondin type 1 motif (ADAMTS1) and fragmented versican in the myocardial infarction (MI) process in humans and to evaluate the diagnostic efficacy of ADAMTS1 for postmortem diagnosis of MI. Methods: Thirty autopsied individuals were allocated into 2 groups, namely, a study group of individuals who died of myocardial infarction (n = 20), and a control group who died of trauma (n = 10). We performed standard immunohistochemical staining on myocardial tissue specimens, studying anti-ADAMTS1, anti-versican, and anti-versican C terminal peptide sequence (DPEAAE) fragments. Results: Strong, diffuse staining was observed throughout myocardial tissue for ADAMTS1 in the 2 groups. However, in the study group, we observed no expression for ADAMTS1 around fibrotic areas but detected slight staining in coagulative and necrotic zones. Conclusion: Similar localizations of ADAMTS and fragmented versican in human heart tissue indicate that versican presumably is cleaved by ADAMTS1. Hence, ADAMTS1 can be regarded as a new marker for postmortem differential diagnosis of MI

Long-Term Outcomes Of Vitrectomy And Internal Limitıng Membrane Peeling For Myopic Foveschisis

INTRODUCTION: To evaluate the long-term results of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) peeling in patients with myopic foveoschisis (MF) METHODS: In this retrospective study, the medical records of the patients who underwent PPV combined with ILM peeling due to myopic foveoschisis were examined. The best corrected visual acuity (BCVA) and the change in BCVA were evaluated. Preoperatively fovea detachment (FD), presence of postoperative ellipsoid zone defect (EZD), and preoperative and postoperative central macular thickness (SMC) were evaluated using optical coherence tomography (OCT). RESULTS: Twenty-five eyes of 20 patients were included in the study. The mean preoperative BCVA was 1.41 +- 0.32 logMAR (1.0-1.8 logMAR) and postoperative BCVA was 0.87 +- 0.41 logMAR (0.3-1.8 logMAR). Postoperative visual acuity improved in 20 eyes (80%). Postoperatively, 4 eyes (16%) had no change in visual acuity and 1 eye (4%) had a decrease in visual acuity. The mean CMT was 683.8 µm +- 155.4 and 262.6 µm +- 46.5 preoperatively and postoperatively, respectively. There was a significant decrease in CMT in the first year after surgery when it was compared with the preoperative CMT (p &lt;0.001). In 20 (80%) eyes, foveoschisis was completely resolved anatomically in the first year after surgery. In 5 eyes (20%), there was a decrease in CMT in the OCT, and a partial improvement in the foveoschisis. DISCUSSION AND CONCLUSION: It is concluded that vitrectomy combined with ILM peeling in the treatment of myopic foveoschisis is an effective and reliable surgical method for increasing visual acuity and providing anatomical improvement

Advantages of early intervention with arterial embolization for intra-abdominal solid organ injuries in children

PURPOSEActive bleeding due to abdominal trauma is an important cause of mortality in childhood. The aim of this study is to demonstrate the advantages of early percutaneous transcatheter arterial embolization (PTAE) procedures in children with intra-abdominal hemorrhage due to blunt trauma.METHODSChildren with blunt abdominal trauma were retrospectively included. Two groups were identified for inclusion: patients with early embolization (EE group, n=10) and patients with late embolization (LE group, n=11). Both groups were investigated retrospectively and statistically analyzed with regard to lengths of stay in the intensive care unit and in the hospital, first enteral feeding after trauma, blood transfusion requirements, and cost.RESULTSThe duration of stay in the intensive care unit was greater in the LE group than in the EE group (4 days vs. 2 days, respectively). The duration of hospital stay was greater in the LE group than in the EE group (14 days vs. 6 days, respectively). Blood transfusion requirements (15 cc/kg of RBC packs) were greater in the LE group than in the EE group (3 vs. 1, respectively). The total hospital cost was higher in the LE group than in the EE group (4502 USD vs. 1371.5 USD, respectively). The time before starting enteral feeding after first admission was higher in the LE group than in the EE group (4 days vs. 1 day, respectively).CONCLUSIONEarly embolization with PTAE results in shorter intensive care and hospitalization stays, earlier enteral feeding, and lower hospital costs for pediatric patients with intra-abdominal hemorrhage due to blunt trauma

Electrocardiography interpretation training in emergency medicine: methods, resources, competency assessment, and national standardization

Objective(s). The aim of this study was to evaluate the status of electrocardiography (ECG) training in emergency medicine residency programs in Turkey, and the attitude of the program representatives towards standardization of such training. Methods. This investigation was planned as a cross-sectional study. An 18-item questionnaire was distributed to directors of residency programs. Responses were evaluated using SPSS (v.16.0), and analyzed using the chi-square test. Results. Thirty-nine program directors (out of 42) responded to the questionnaire. Twenty-eight of them stated they did not have a formal ECG training curriculum. The most preferred ECG education method was clinical education in the Emergency Department; the most common education resource was ECG textbooks; and the most common evaluation method was case scenarios. Only thirteen of the programs had an obligation to prove competency. The most common competency-assessment method was obtaining a passing grade based on an instructor’s observation. The majority of program directors are of the opinion that there should be a formal ECG teaching curriculum, and that a national ECG training program and national ECG database should be formed. Conclusions. The majority of programs do not have a formal ECG interpretation curriculum, which is an obligation to prove competency. As a result, their training methods, resources, and assessment tools were determined to be subjective

Blood transfusion in obstetricks and gynecology

Amaç: Ilimizde bulunan üniversite ve dogum hastanelerinin verilerini kullanarak kadın hastalıkları ve dogum servislerinde yapılan kan transfüzyonları hakkında bilgi saglamak. Gereç ve Yöntem: Ilimiz hastanelerinin Kadın Hastalıkları ve Dogum servislerinde Ocak 2005 ileAgustos 2006 tarihleri arasındaki 20 aylık transfüzyon kayıtları geriye dönük tarandı. Bu sürede dogum servisleri ile erken gebelik ve jinekoloji servisleri degerlendirildi. Bu servislerde kaç hastaya kan ürünü verildigi ve miktarı belirlendi, dogum sayıları dogum sekline bakılmaksızın kaydedildi. Erken gebelik müdahaleleri ve jinekolojik hasta olarak bu servislere yatırılıp ameliyat edilen veya invaziv girisimde bulunulan hasta sayıları da saptandı. Sadece tıbbi tedavi gören hastalar bu çalısmanın dısında tutuldu. Her iki hastanenin transfüzyon hızları, kan ürünü çesidi kullanımı özellikleri, toplam transfüzyon miktarları, yıllık ihtiyaçları, transfüzyon yapılan olgularda hasta basına transfüzyon miktarları belirlendi. Yine her gruptan 100 hasta için ihtiyaç duyulan miktarlar hesaplandı.Bu incelemeler yine tüm olguları kapsayacak sekilde irdelendi. Iki hastane degerlerini karsılastırmak için iki örnek oranının karsılastırılması yapıldı. Bulgular: Bu çalısmada dogum hastaları, erken gebelik veya jinekolojik hastalıklar nedeniyle invaziv girisim yapılmıs 10.149 hasta saptandı. Bunların 954'üne (%9,4) kan ürünü verildi. Hasta basına ortalama 2 ünite transfüzyon yapıldıgı, her 100 hasta için 18,3 ünite kan ürünü gerektigi belirlendi. Hem dogum hastaları hem diger hastalar için üniversite hastanesinde daha az oranda hastaya ancak hasta basına daha çok miktarda kan verilmesi gerektigi saptandı (p<0.05). Sonuç: Kadın hastalıkları ve dogum servislerinde girisim ve müdahale yapılan hastalarda kan ve kan ürünleri transfüzyonu önemli bir oranda gerçeklestirilmektedir. Kan ürünlerinin ayrıstırılması tam kan kullanım oranını azaltacaktır.Purpose: Using data from a university and a maternity hospital in our province, we aimed to report on the practice of blood use. Material and Methods: Data between January 2005 and August 2006 were retrospectively obtained from the archives of the obstetrics and gynecology clinics from two hospitals. The data of obstetrics clinics and early pregnancy and gynecology clinics were evaluated seperately. Patients treated medically were excluded. Transfusion rates, type of blood product rates, total and annual uses, requirements for every 100 patients and amounts of transfusion per patient were calculated. Two-sample ratio-test was used for comparison of the data from two hospitals. Results: There are 10149 patients who had delivered or experienced any invasive procedures, and 954 (9.4%) of them had been transfused. The amount of blood products transfused was at an average of 2 units per patient. The requirement for every 100 patients was 18.3 units of blood products in these two hospitals. More blood was used per patient in the university hospital, although the transfusion rate was lower than the maternity hospital's (p<0.05). Conclusion: Transfusions of blood and use of blood products are quite common in the practice of obstetrics and gynecology clinics. Providing blood products would reduce the use of whole blood

Did radiation exposure increase with chest computed tomography use among different ages during the COVID-19 pandemic? A multi-center study with 42028 chest computed tomography scans

PURPOSETo determine whether radiation exposure increased among different ages with chest computed tomography (CT) use during the coronavirus disease-2019 (COVID-19) pandemic.METHODSPatients with chest CT scans in an 8-month period of the pandemic between March 15, 2020, and November 15, 2020, and the same period of the preceding year were included in the study. Indications of chest CT scans were obtained from the clinical notes and categorized as infectious diseases, neoplastic disorders, trauma, and other diseases. Chest CT scans for infectious diseases during the pandemic were compared with those with the same indications in 2019. The dose-length product values were obtained from the protocol screen individually.RESULTSThe total number of chest CT scans with an indication of infectious disease was 21746 in 2020 and 4318 in 2019. Total radiation exposure increased by 573% with the use of chest CT for infectious indications but decreased by 19% for neoplasia, 12% for trauma, and 43% for other reasons. The mean age of the patients scanned in 2019 was significantly higher than those scanned during the pandemic (64.6 vs. 50.3 years). A striking increase was seen in the 10–59 age group during the pandemic (P < 0.001). The highest increase was seen in the 20–29 age group, being 18.6 fold. One death was recorded per 58 chest CT scans during the pandemic. Chest CT use was substantially higher at the beginning of the pandemic.CONCLUSIONChest CT was excessively used during the COVID-19 pandemic. Young and middle-aged people were exposed more than others. The impact of COVID-19-pandemic-related radiation exposure on public health should be followed carefully in future years