Melkersson-Rosenthal Syndrome: A Rare Cause of Recurrent Facial Nerve Palsy and Acute Respiratory Distress Syndrome

Melkersson-Rosenthal Syndrome (MRS) is a rare disease characterized by persistent or recurrent orofacial oedema, relapsing peripheral facial paralysis, and furrowed tongue. Pathologically, granulomatosis is responsible for oedema of face, labia, oral cavity, and facial nerve. We present a patient with MRS admitted to our hospital with acute respiratory distress syndrome (ARDS). 45-year-old woman was admitted to an emergency department with dyspnea and swelling on her hands and face. She was intubated because of ARDS and accepted to intensive care unit (ICU). After weaning from ventilatory support, peripheral facial paralysis was diagnosed and steroid treatment was added to her therapy. On dermatologic examination, oedema on her face, pustular lesions on her skin, and fissure on her tongue were detected. The patient informed us about her recurrent and spontaneous facial paralysis in previous years. According to her history and clinical findings, MRS was diagnosed

Mean Platelet Volume Decreases in Adult Patients With Obstructive Sleep Apnea After Uvulopalatal Flap Surgery

SIMSEK, GOKCE/0000-0001-5281-0986WOS: 000367905900025PubMed: 26468800Aim:The main purpose of the study was to investigate changes in mean platelet volume (MPV) values in patients with obstructive sleep apnea syndrome (OSAS) who had undergone uvulopalatal flap (UPF) surgery.Method:The study included a review of the medical records of 37 adult patients who had undergone UPF surgery after being diagnosed with OSAS. The baseline blood parameters of patients, including the MPV and platelet distribution width (PDW) values, were measured and repeated 3 months after treatment. Polysomnographic evaluations of the patients were also performed during admission and the 3rd month control. Comparisons of MPV values and their correlation with polysomnographic parameters were the main outcomes measured.Results:The blood parameters of all patients were similar except for MPV values, which were significantly lower after treatment (P0.05).Conclusion:The UPF surgery, which is a relatively simple surgical intervention to treat OSAS, alleviates nocturnal hypoxic episodes and lowers platelet volume. These may both be important predictors of adverse cardiovascular outcomes related to OSAS

A Comparison of the Effects of Platelet-Rich Plasma and Demineralized Bone Matrix on Critical Bone Defects: An Experimental Study on Rats

BACKGROUND: Delayed union of fractured bone is one of the main problems of orthopedics and traumatology practice. It was hypothesized that the beneficial effects of allogeneic platelet-rich plasma (PRP) would be valuable in the treatment of segmental bone defects. This study is a comparison of the effects of demineralized bone matrix (DBM) and PRP in a segmental bone defect model. METHODS: Total of 48 Wistar albino rats were separated into 4 groups. Segmental bone defect was created at right radius diaphysis in all specimens using dorsal approach. Four additional rats were used as PRP source. Intracardiac blood was withdrawn before the operation for preparation of allogeneic PRP. Group I (n= 12) served as control group and defects were left untreated. Group 2 (n= 12), was PRP group, and received grafting with PRP. Group 3 (n= 12) was PRP+ DBM combination group, and was treated with grafting and mixture of DBM and PRP. In Group 4 (n= 12), defect area was grafted with DBM only. At the end of 10(th) week, rats were sacrificed, forearms were dissected, and defect areas were examined with radiological and histopathological parameters. RESULTS: Radiological evaluation revealed that ossification was best in PRP group, followed by DBM group. According to results of histopathological studies, union quality was better than control group in all treatment groups (Groups 2, 3, and 4), and was best in PRP group (p < 0.05). Results were also better in PRP group when examined in terms of cortex development and remodeling (p < 0.05). When examined in terms of new osteogenesis, results were comparable in Groups 2, 3, and 4, but all were better than control group. CONCLUSION: It was concluded that PRP and DBM have comparable effect on recovery of defective bones, but there is no synergistic effect when used together. We believe that PRP can be a cost-effective, readily available alternative to DBM with minimal morbidity.WoSScopu

Effect of Continuous Positive Airway Pressure Treatment on Mean Platelet Volume and Platelet Distribution Width in Patients with Sleep Apnea Syndrome

SIMSEK, GOKCE/0000-0001-5281-0986WOS: 000382875700005Objective: Obstructive sleep apnea (OSA) syndrome is a common disorder that can cause hypercoagulation. Mean platelet volume (MPV) and platelet distribution width (PDW) are associated with hypercoagulability. This study aimed to investigate whether MPV and PDW values change in patients with OSA who were treated with continuous positive airway pressure (CPAP) device. Methods: A total of 43 adult patients with OSA who were treated with CPAP were included in this retrospective study. Patients who underwent CPAP treatment for <5 days/week and <4 h/day were excluded. Blood parameters, including MPV and PDW, were recorded before CPAP treatment and at the third month of CPAP treatment. All patients underwent polysomnographic evaluation with full night polysomnography and in the second night CPAP titration was performed together with full night polysomnography and MPV and PDW values were statistically compared before and after CPAP treatment. Results: Apnea hypopnea index was significantly reduced, whereas oxygen saturation was significantly increased at CPAP titration night (p<0.001). The third month of CPAP treatment resulted in significantly low PDW (p=0.004) values, but MPV values did not change. Conclusion: PDW value at the third month of CPAP treatment revealed a significant improvement compared with the values before treatment; moreover, no change was observed in MPV values. It was concluded that in patients with OSA who were treated with CPAP, activation of platelets may result in recovery

Effect of CPAP Treatment on Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) in Patients With Sleep Apnea Syndrome

Objective: Obstructive sleep apnea (OSA) syndrome is a common disorder that can cause hypercoagulation. Mean platelet volume (MPV) and platelet distribution width (PDW) are associated with hypercoagulability. This study aimed to investigate whether MPV and PDW values change in patients with OSA who were treated with continuous positive airway pressure (CPAP) device. Methods: A total of 43 adult patients with OSA who were treated with CPAP were included in this retrospective study. Patients who underwent CPAP treatment for <5 days/week and <4 h/day were excluded. Blood parameters, including MPV and PDW, were recorded before CPAP treatment and at the third month of CPAP treatment. All patients underwent polysomnographic evaluation with full night polysomnography and in the second night CPAP titration was performed together with full night polysomnography and MPV and PDW values were statistically compared before and after CPAP treatment. Results: Apnea hypopnea index was significantly reduced, whereas oxygen saturation was significantly increased at CPAP titration night (p<0.001). The third month of CPAP treatment resulted in significantly low PDW (p=0.004) values, but MPV values did not change. Conclusion: PDW value at the third month of CPAP treatment revealed a significant improvement compared with the values before treatment; moreover, no change was observed in MPV values. It was concluded that in patients with OSA who were treated with CPAP, activation of platelets may result in recovery

Perioperative High-Dose Amiodarone Elevates Nitric Oxide Levels in Patients Undergoing Coronary Artery Bypass Surgery.

Burma, Oktay/0000-0002-0880-4578; Ustundag, Bilal/0000-0001-6621-2450; uysal, ayhan/0000-0001-7526-5554; ozguler, ibrahim murat/0000-0002-9928-9056WOS: 000325694600013The aim of the current study was to assess the effects of the Class III antiarrhythmic drug amiodarone on arterial blood Nitric oxide (NO) levels together with malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-px), and catalase (CAT) levels in patients undergoing coronary artery bypass surgery (CABG). Twenty patients undergoing CABG were included in the study. The patients were divided into control and amiodarone groups (n=10 in each group). The patients in group 1 did not receive any drugs. The patients in group II received 4X400 mg/day amiodarone on the day before surgery, 2X600 mg/day amiodarone on the day of surgery, and 2X400 mg/day amiodarone for the first consecutive four days after the surgery. NO, MDA, SOD, GSH-px, and CAT values were measured for biochemical evaluation of oxidative stress before the induction of anesthesia (T-A), before CPB (T-CPB), five minutes after the clamp was removed (T-c), after protamine (T-P), and on postoperative days 1 (T-1), 3 (T-3), and 5 (T-5). Hemodynamic changes of all patients were recorded at before the induction of anesthesia (TA), before CPB (TCPB), after protamine (T-P), and on postoperative day 1 (T1). Amiodarone elevated NO levels at all times during the study period but did not cause changes in MDA, SOD, GSH-px, or CAT. In addition, amiodarone decreased mean pulmonary artery pressure, pulmonary capillary wedge pressure, and heart rate in these patients. No side effect due to drug was observed. Heart rate was found more decreased in amiodarone group at T-1 and T-2 stages when compared with controls (p<0.05). Perioperative high- dose amiodarone might be beneficial for patients who are pulmonary hypertensive and are undergoing CABG