Comparison of the effects on spinal reflexes of acetylsalicylate and metamizol in spinalized and normal rats.

The effects of nonsteroidal antiinflammatory drugs, acetylsalicylate and metamizol, on spinal monosynaptic reflexes were investigated in spinalized and normal rats. Adult rats (n=36) weighing 150-200 g were anesthetized with ketamine and artificially ventilated. Half of rats were spinalized at C1 level. A laminectomy was performed in the lumbosacral region. Following electrical stimulation of the sciatic nerve by single pulses, reflex potentials were recorded from the ipsilateral L5 ventral root. Acetylsalicylate was administered orally (100 mg/kg for both spinalized and normal rats). Metamizol was administered intramuscularly (15 mg/kg for both spinalized and normal rats). These drug administrations significantly decreased the amplitude of reflex response in all groups (p < 0.05). These data verify that observed inhibition by acetylsalicylicate and metamizol may be at the level of spinal cord. Also we suggested that the cyclooxygenase products of arachidonic acid may play an important role in regulating the reflex potential

Investigation of the relationship between mean platelet volume and obstructive sleep apnea syndrome

Objective: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent upper airway obstruction and intermittent hypoxia during sleep. Intermittent hypoxia and increased inflammatory activity plays a role in increased risk of cardiovascular disease in the OSAS. OSAS is an important cause of morbidity and mortality and cardiovascular disorders are the most important complications of OSAS. Mean platelet volume (MPV) is a marker of platelet activation and function, and increased platelet volume is associated with increased platelet activity. Different diseases related with inflammation, hypoxia, vascular injury, thrombosis and atherosclerosis were found to be associated with MPV. In this study, we aimed to investigate the relationship between OSAS and MPV. Methods: In this retrospective study, data of sex and age matched 33 patients with moderate OSAS, 34 patients with severe OSAS and 30 healthy subjects were evaluated. Results: The mean MPV was found in control, moderate OSAS and severe OSAS groups as 7.83±1.00, 8.26±1.40 and 8.94±1.20 (fL) respectively. The mean MPV value was significantly higher in severe OSAS group than control subjects (p=0.001). In correlation analysis, there were positive correlation between MPV with apnea-hypopnea index and total sleep time, and negative correlation between MPV with platelet count and minimum oxygen saturation (Respectively, p=0.003 / R=0.295, p=0.030 / R=0.221, p=0.011 / R= -0.257, p=0.019 / R= -0.238). Conclusion: In this study, the increased MPV was associated with severe OSAS and the results of this study suggest that the platelet activation is increased in OSAS. Hypoxia caused by OSAS, due to the activated platelets, may play a role in the development of cardiovascular diseases which is an important cause of morbidity and mortality in OSAS. J Clin Exp Invest 2013; 4 (4): 492-49

Possible activation of the immune system by chronic peripheral nesfatin-1 application at the acute phase of ischemia/reperfusion injury

Objective: Organ transplantation is one of the clinical scenarios involving ischemia and reperfusion process. Ischemia/reperfusion is the pivotal mechanism of organ injury during transplantation. Thus, ischemia/reperfusion (I/R) injury is a biphasic phenomenon that can damage the graft by inflammatory responses. The hypothalamic-pituitary-adrenal (HPA) axis is the main hormonal system that is activated under the influence of stress. Normal HPA axis activity leading to the release of glucocorticoids is essential for homeostasis and survival during stress. Cortisol, a key controller of stress response, is released by the HPA axis. The disrupted release of cortisol in response to inflammation has been shown in animal models. Nesfatin-1 is a peptide involved in the regulation of homeostasis and has anti-inflammatory as well as anti-ischemic properties. Therefore, we aimed to identify the effect of chronic peripheral nesfatin-1 application on the plasma level of cortisol in a rat model of intestinal I/R-based stress. Materials and Methods: Two-month-old 28 Wistar Albino male rats that weighed an average of 200–250 g were used and were randomly divided into the following four experimental groups (n=7): laparotomy, I/R, nesfatin-1+laparotomy, nesfatin-1+I/R. Blood samples were collected in tubes with EDTA. Plasma cortisol levels were analyzed by rat enzyme-linked immunosorbent assay (ELISA) kits. Results: Statistically significant decrease was found in the plasma level of cortisol in nesfatin-1+I/R group compared with I/R group (p=0.026) Conclusion: Nesfatin-1 application can inhibit anti-inflammatory responses under the early phase of intestinal I/R and support immune reactions by reducing plasma cortisol level. This effect of nesfatin-1 may also increase the rejection of grafts during transplantation period. © 2015 by Erciyes University School of Medicine

A Case of Secondary Narcolepsy Presenting with Obstructive Sleep Apnea Symptoms

Obstructive sleep apnea syndrome (OSAS) and narcolepsy are two diseases causing excessive daytime sleepiness (EDS). As they are often confused, these two disorders can also coexist. Therefore there is need to distinguish these disorders in patients with EDS. We would like to present a case on a patient who sent to our sleep laboratory with a preliminary diagnosis of OSAS and suspicion of narcolepsy in detailed history. The case is a 24 year-old male. He was diagnosed with OSAS and narcolepsy while being investigated for OSAS. Neurological examination revealed an additional diagnosis of multiple sclerosis. In this case report, we emphasize that in patients with EDS, particularly if EDS cannot be explained with OSAS, investigation for narcolepsy should also be done. In addition, when narcolepsy is detected; neurological examination is actually necessary considering the possibility of secondary narcolepsy

Attitudes of Pulmonologists about Obstructive Sleep Apnea Syndrome and its Treatment in Izmir

Objective We aimed to evaluate pulmonary medicine physicians’ attitudes about obstructive sleep apnea syndrome (OSAS) and its treatment in Izmir. Materials and Methods About 78 of 120 pulmonary medicine physicians in Izmir answered the questionnaire containing 24 items (demographics: 6, education: 4, attitudes: 9, knowledge: 5). Results 67.9% of the participants were female. Mean age was 41.06±5.63, mean working year was 11.16±6.09. 52.6% worked in training and research hospitals, 32.1% in state hospitals, and the rest in private and university hospitals. Monthly patient number was 714.10±3.24, patients number with OSA symptoms was 14.85±2.15. 64.1% had completed speciality education in hospitals with sleep disorders centers and this ratio was higher in physicians whose working year was less than 10. 24.4% had practiced sleep study during this education. Participation in sleep study courses after speciality education was 48.7%. 26.9% worked as sleep specialist. 67.9% usually asked patients OSA symptoms and 38.5% asked preoperative OSA symptoms. 97.4% usually referred patients to sleep centers. 65.4% had been working in hospitals with sleep disorders centers. The ratio of correct answers in knowledge part of the questionnaire was 95%. Conclusion OSAS is a major pulmonary disease and it is important in order to find out the patients with OSA risk. 2.07% of patients in clinics have OSA symptoms. Physicians’ confidence in diagnosis is more than managing patients with OSA. Practical part of sleep study is not enough in speciality education. Asking OSA symptoms is not common in pre-operative examination

Evaluation of whether the ACE gene I/D polymorphism constitutes a risk factor for chronic obstructive pulmonary disease in the Turkish population

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that occurs as a result of the normal inflammatory process to protect against harmful irritants and chemicals. Another physiological regulatory process, the renin angiotensin system (RAS), plays an important role in the pathology of many diseases. Angiotensin converting enzyme (ACE) is a key enzyme of RAS. We investigated the frequency of the ACE gene I/D polymorphism in patients with COPD in Turkey. This study was performed on 47 unrelated patients with COPD and 64 healthy subjects. DNA samples were isolated from peripheral blood, and ACE DNA was amplified by polymerase chain reaction. The frequencies of ACE genotypes were 27.7, 55.3, and 17% for DD, ID, and II in the COPD group, respectively, and 43.8, 43.8, and 12.4% in the control group. There was no statistically significant difference between groups (χ2 = 3.078; df = 2; P = 0.220). The distributions of ACE gene D alleles were 38.2% (N = 52) in the COPD group and 61.8% (N = 84) in the control group; and those of I alleles were 48.8% (N = 42) in the COPD group and 51.2% (N = 44) in the control group. There was no statistically significant difference between groups for allele frequency (χ2 = 2.419; df = 2; P = 0.120). We believe these results can be useful for large-scale population genetic research considering the frequency of the ACE gene variation in COPD patients in the Turkish population. © FUNPEC-RP

The new Classification of Sleep Disorders (ICSD-3): The Changes in The Classification Of Sleep Related Breathing Disorder with ICSD-3

First classification regarding sleep disorders has been done in 1979, revised by American Academy of Sleep Medicine (AASM) in 1991 and 2005 and published as Classification of Sleep Disorders-1 (ICSD-1) and ICSD-2. Finally it took its final form as ICSD-3 by AASM in 2014 and sleep disorders has been gathered under 7 main topics. Major changes have been done in the classifications of insomnia, narcolepsy, parasomnia and diagnosis of sleep breathing disorders by the final classification. In this article, we reviewed the significant changes in the diagnosis of sleep-related breathing disorders due to the new sleep related disorders classification

Influence of acute exercise on urinary protein, creatinine, insulin-like growth factor-I (IGF-1) and IGF binding protein-3 concentrations in children

Insulin-like growth factor-I (IGF-I) is a polypeptide hormone and present in human urine. Insulin-like growth factor binding protein-3 (IGFBP-3) is the major form of binding protein in human circulation and functions as a carrier for IGF-I. Our goal was to determine the effects of volleyball exercise on the concentrations of urine protein, creatinine, IGF-I, and IGFBP-3 in children and to find out whether these effects differ between boys and girls. Volunteer children (13 females and 14 males), aged 10-13 years old were included in this work. Weight and height of the subjects were measured, and urine samples of their were collected before and after 2 hours of exercise. Urinary protein, creatinine, IGF-I and IGFBP-3 levels were analysed. Urinary protein, creatinine and IGF-I concentrations were increased after two hours of exercise wheres urinary IGFBP-3 concentrations did not change. In addition, no statistically significant difference in all parameters analysed was observed between boys and girls of similar age and body mass index. © 2003 Tohoku University Medical Press

Atipik klinikle seyreden bir allerjik bronkopulmoner aspergilloz olgusu

Allerjik bronkopulmoner aspergilloz (ABPA) astım ya da kistik fibrozisli hastalarda görülen ve Aspergillus fumigatus ’a karşı gelişen yaygın bir hipersensitivite reaksiyonudur. Astımı olmayan hastalarda da nadiren bildirilmiştir. Burada atipik klinik bulgularla gelen ve “High attenuation mucoid impaction” saptanan bir ABPA olgusu sunulmaktadır. Amaç, ABPA’nın atipik klinik bulgularla ortaya çıkabileceğini vurgulamaktır.Allergic bronchopulmonary aspergillosis (ABPA) is a common hypersensitivity reaction to Aspergillus fumigatus in patients with asthma or cystic fibrosis. It is rarely reported in patients without asthma. We hereby presented an ABPA case with an atypical clinical presentation and high attenuation mucoid impaction. Our aim is to emphasize that ABPA can occur with atypical clinical findings

Inhibition of spinal reflexes by acetylsalicylate and metamizol (dipyrone) in rats

The effects of acetylsalicylate and metamizol on spinal monosynaptic reflexes were tested in spinal rats. Adult rats were anesthetized with ketamine, artificially ventilated, and spinalized at the C1 level. A laminectomy was performed in the lumbosacral region. Following electrical stimulation of the sciatic nerve by single pulses, the reflex potentials were recorded from the ipsilateral L5 ventral root. Acetylsalicylate was administered orally via nasogastric tube and metamizol intramuscularly. Acetylsalicylate (50 and 100 mg/kg) and metamizol (15 mg/kg) significantly decreased the amplitude of the reflex response (p < 0.05). But the 10-mg/kg metamizol dose did not significantly decrease the amplitude of the reflex response. The cyclooxygenase products of arachidonic acid may play an important role in regulating the reflex potential. Copyright © 2003 S. Karger AG, Basel