Factors Affecting Optimal Titration Pressure of Continuous Positive Airway Pressure Device in Patients with Obstructive Sleep Apnea Syndrome

Objective: To assess the effects of anatomical, clinical parameters, and pulmonary respiratory function on the therapeutic titration pressure of continuous positive airway pressure (CPAP) device in obstructive sleep apnea syndrome (OSAS).Methods: The study comprised 41 OSAS patients whose optimum CPAP titration pressures were measured. Each patient underwent an otorhinolaryngologic and thoracic examination, and data was recorded for height, weight, body mass index, neck-waist circumferences, Mallampati classification, tonsillar hypertrophy, hypopharyngeal collapse, soft palate-tongue base obstruction scores, peak nasal inspiratory flow and acoustic rhinometry measures, and CPAP device therapeutic pressures. Forced vital capacity, forced expiratory volume, FEV1/FVC ratio and peak expiratory flow values were noted.Results: Median CPAP optimal pressure cut-off value was determined as 9 mmH2O. Statistical analysis was made in two groups as CPAP titration optimal pressure ≤9 and >9 mmH2O. In the optimal pressure >9 group, neck and waist circumferences, hypopharyngeal collapse score, retropalatal and retrolingual lateral wall collapse scores were significantly higher (p<0.05). In multivariate and univariate model analysis, neck and waist circumferences, hypopharyngeal collapse score, retropalatal and retrolingual lateral wall collapse scores were observed to be significant in predicting high and low pressures in univariate model.Conclusion: For the prediction of optimal CPAP titration pressure in OSAS treatment, wide neck and waist circumferences, high hypopharyngeal collapse score and retropalatal and retrolingual lateral wall collapse grades may be determinative

Giant Arteriovenous Malformation of the Floor of the Mouth Presenting With Dysarthria and Difficulty in Swallowing

Arteriovenous malformation (AVM) is a vascular abnormality resulting in the development of abnormal connection between an artery and vein without capillary connections. An AVM develops mainly intracranially. Extracranial AVMs are rarely seen. Cheek, ear, nose, auricle, and forehead are the more common sites in the extracranial involvement. They cause cosmetic problems when located in the head and neck region. We report a case of a giant AVM in the floor of the mouth, which has not been specified and has not been reported until now. The lesion, in an elderly man, was supplied by multiple vessels and caused difficulty in speaking and swallowing. The lesion was totally excised after embolization of feeding vessels

The Changes in Histopathology and Mass in Hyperbaric Oxygen-Treated Auricular Cartilage Grafts in a Rabbit Model

The aim of the study is to investigate the histopathologic and cartilage mass changes in hyperbaric oxygen (HBO)-treated auricular cartilage grafts either crushed or fascia wrapped in a rabbit model. This is a prospective, controlled experimental study. Sixteen rabbits were randomly allocated into control (n=8) and treatment groups (n=8). Each group was further grouped as crushed cartilage (n=4) and fascia wrapped crushed cartilage (n=4). The eight rabbits in the treatment group had HBO once daily for 10 days as total of 10 sessions. The mass of cartilage, cartilage edge layout, structural layout, staining disorders of the chondroid matrix, necrosis, calcification besides bone metaplasia, chronic inflammation in the surrounding tissues, fibrosis, and increased vascularity were evaluated in the hematoxylin and eosin (H&E)-stained sections. Fibrosis in the surrounding tissue and cartilage matrix was evaluated with Masson's trichrome stain. The toluidine blue staining was used to evaluate loss of metachromasia in matrix. The prevalence of glial fibrillary acidic protein (GFAP) staining in chondrocytes was also evaluated. Although the remaining amount of cartilage mass after implantation does not show a significant difference between the control and the study group (p=0.322, p <0.05).The difference between control and study group in terms of positive staining with GFAP was statistically significant (p=0.01, p <0.05). Necrosis and loss of matrix metachromasia were significantly low in the study group compared with control group (p=0.001, p=0.006, p <0.05). HBO therapy did not have significant effect on the mass of rabbit auricular cartilage graft. HBO therapy significantly reduced loss of metachromasia, necrosis, and GFAP staining in the auricular cartilage grafts of the animal model

The effects of radioactive iodine therapy on olfactory function

Conclusion: The olfactory function deteriorated in almost half of the patients in the early stage after RAI. Mild and moderate hyposmia in particular occurred in the first year after RAI

Does procalcitonin have a role in the pathogenesis of nasal polyp?

Purpose The aim of this study is to investigate serum and tissue procalcitonin (PCT) levels in patients with nasal polyps

Diagnosis of opioid use disorder with high sensitivity and specificity by advanced computational analysis of Fourier transform infrared spectroscopy

Opioid use disorder (OUD), which is a chronic disease and widespread public health problem results in death of the patient in the early period. The consumption of opioid depending on the use disorder time, affects blood biochemical parameters. OUD diagnosis can be clinically determined from biochemical values and with the screening tools in substance abuse. However, long-term OUD causes multiple pathological and physiological changes in many organs. Opioid initiated diseases, such as changes in tissue level and molecular level can be detected with advanced diagnostic methods after a long period of usage. It is important to diagnose these changes without causing organ dysfunction. The tests for the diagnose of chronic effects of OUD are expensive and time-consuming. In this study, we used Fourier transform infrared (FTIR) spectroscopy to discriminate the whole blood samples of opioid-addicted patients (n = 20) from healthy persons (n = 14) with an average addiction period of for 8 +/- 5.8 years. We purposed to compare whole blood vibrational results of OUD and HC. In order to identify absorption bands on structures of proteins, lipids and nucleic acids, their corresponding absorbance of band spectra were measured. We had chosen following bands 2959, 2931, 1646, 1550, 1453, 1400, 1314, 1243, 1080, 1079, 1542, 1045, 1467 to identify peak heights and to compare peak height ratios such as H1646 to H1550, H1079 to H1542, H2959 to H2931, H1453 to H1400, H1314 to H1243, H1045 to H1467, H1080 to H1550. Statistically, the p value of group heights were significantly different (p < 0.001). As a chemometric method, features extracted by principal component analysis (PCA) and then classified by linear discriminate analysis (LDA) and support vector machine (SVM) to determine the spectral data of disorder zones. The confidence of specificity and sensitivity and accuracy were obtained as 93.33%, 85%, 80.57% in raw data, and 100%, 100% and 100% in the second derivative respectively. Our research illustrates that whole blood analyses by FTIR, on the selected peak heights may discriminate pathological and healthy structural changes induced long term opioid use disorder.Thus, we have demonstrated that infrared spectroscopy can provide a simple and available diagnostic test for OUD patients

Investigation of the discrimination and characterization of blood serum structure in patients with opioid use disorder using IR spectroscopy and PCA-LDA analysis

Harmful illicit drug use, such as opioid use disorder (OUD), causes multiple diseases that result in physiological, pathological, and structural changes in serum biochemical parameters based on the period of use. Fourier-transform infrared (FTIR) spectrometry is a noninvasive optical technique that can provide accurate evidence about the biochemical compounds of analytical samples. This technique is based on the detection of functional groups and the spectral analysis of the region of the selected bands, which provides a reliable and accurate tool for evaluating changes in the biochemical parameters of OUD patients. In the present study, the Attenuated Total Reflection (ATR)-FTIR technique and clinical laboratory biochemical results were used to investigate the phospholipid-protein balance in the blood serum of participants with OUD by comparing their data to that of healthy controls. To compare the biochemical laboratory results with serum vibrational spectroscopy, we used infrared (IR) spectroscopy to distinguish the serum of the OUD patients, who had an average duration of use of 7.31 +/- 3.8 years (ranging from 6 to 15 years). We aimed to compare the clinical reports with findings from IR spectroscopy coupled with chemometrics analysis, principal component analysis (PCA), and linear discriminant analysis (LDA). The serum samples of the OUD male patients (n = 20) and healthy male individuals (n = 14) were evaluated using FTIR spectroscopy (range of 4000 cm(-1) - 400 cm(-1)). We focused on the areas where the results showed significant band differences and significant chemometric differences at the fingerprint region (1800 cm(-1) 900 cm(-1)), Amide I (1700 cm(-1) -1600 cm(-1)), C-H stretching band (3000 cm(-1) -2800 cm(-1)), triglyceride (Tg) levels and cholesterol esters (1800 cm(-1) -1700 cm(-1)), and total protein region (1700 cm(-1) -1350 cm(-1)). The intensity of these band areas was significantly different (p < 0.01) between OUD patients and healthy controls. Moreover, different bands on the serum spectrum of the OUD patients were explored. The results successfully specified the distinctions between OUD and the healthy controls (HCs). We compared the results with biochemical markers, such as albumin (Alb), Tg, and total cholesterol (Tc) levels of the patients, as well as the data of the healthy subjects obtained from the hospital. Additionally, we found that the Tg, Tc, and Alb levels decreased as the duration of heroin use increased based on the biochemical markers of the OUD patients. The laboratory biochemical reports and the vibrational spectroscopic analysis were correlated. The confidence of specificity, sensitivity, and accuracy was 100%, 92.85%, and 97.06% in the second derivative, respectively. Thus, we demonstrated that IR spectroscopy, multivariate data analysis, and clinical reports are consistent and correlated. Furthermore, FTIR is a simple and readily available diagnostic test that can successfully differentiate the serum samples of OUD patients from those of healthy subjects. (C) 2020 Elsevier B.V. All rights reserved

Biochemical assay and spectroscopic analysis of oxidative/antioxidative parameters in the blood and serum of substance use disorders patients. A methodological comparison study

Substance abuse such as opioids, cannabis, and alcohol causes activation on the immune system and the release of reactive oxygen species (ROS) into the blood and serum. These substances cause an effect on oxidant and an-tioxidant status in patients with substance abuse. Mainly, wide-open to the ROS are lipids and proteins included blood, which suffers peroxidation. In this study, for the first-time differentiation of the effects of cannabis, alcohol and other synthetic substances on blood and serum samples, were performed. For this purpose, the level of the malondialdehyde (MDA) and glutathione (GSH) in serum and red blood cells, was measured using biochemical assay methods and Fourier Transform InfraRed spectroscopy (FTIR). The results showed, that peroxidation which is dignified as the production of MDA was increased for substance use disorder (SUD) patients (18.01 +/- 2.97) compared to the control group (10.75 +/- 2.28) (p < 0.001) and for antioxidant capacity, GSH level were signifi-cantly increased for SUD patients (p < 0.001). For the discrimination of protein and lipid region obtained from FTIR spectroscopy, we extracted features by principal component analyze (PCA) of protein (1800 cm(-1) to 900 cm(-1)) and lipid (3200 cm(-1) to 2800 cm(-1)) regions for blood and serum samples collected from patients with different types of SUD and healthy control (HC) participants. For the consideration of lipid oxidation, lipid satu-ration, lipid desaturation and protein aggregation the peak heights at 1740 cm(-1) to 2960 cm(-1), 2920 cm(-1) to 2960 cm(-1), 3012 cm(-1) to 2960 cm(-1), and 1630 cm(-1) to 1650 cm(-1) regions were studied for SUD and HC. More-over, more visible changes were noticed for proteins region, than for lipids. The most notice structural changes were observed in amide II in serum spectra. Then we classified protein and lipid region's PCA results of blood and serum by Linear discriminant analysis (LDA) and Support vector machine (SVM). Confidence of the specific-ity, sensitivity and accuracy of blood and serum were obtained as 100%, 100% and 100% individually. This is the first comparative study on the spectrochemical tool and biochemical assay on SUD. Our results presented 100% discrimination of disorder region compared to healthy subjects. (c) 2020 Elsevier B.V. All rights reserved

The Effect of Mupirocin- and Fusidic Acid-nasal Packings, Placed after Septoplasty, on the Nasal Bacterial Profile

Aim To examine the effects, after septoplasty, of local antibiotic pomades as an alternative to prophylactic antibiotic use, which is a controversial matter among the otolaryngologists, on nasal flora and bacterial growth. Material and Method Nasal packings placed after septoplasty surgery to provide septal stabilization and bleeding control pose a risk in terms of infection. In this study, 106 patients, who were examined by comparing mupirocin- and fusidic acid-soaked packings and antibiotic-free packings, were divided into three groups. Nasal cultures were obtained from each patient twice, before the surgery and on the second day immediately after the packings were removed, and the culture results were statistically compared. Results In the mupirocin group (group 2), postoperative normal flora growth rate was significantly higher than in the fusidic acid group (group 3) and the antibiotic-free group (group 1) (p < 0.024). In the mupirocin group (group 2), the gram-positive growth rate in the postoperative period showed a significant decrease when compared when the preoperative period (p < 0.05) (5.7%). In the fusidic acid group (group 3), the postoperative gram-positive rate showed a significant decrease compared with the preoperative period (p < 0.05). In group 2, the postoperative methicillin-resistant Staphylococcus aureus rate showed a significant decrease than in the preoperative period (2.9%) (p < 0.05). Similarly, in group 3, the postoperative methicillin-resistant S. aureus rate showed a significant decrease compared with that of the preoperative period (11.1%) (p < 0.05). Conclusion Use of mupirocin- and fusidic acid-soaked nasal packings after septoplasty significantly decreased, especially, postoperative gram-positive bacterial growth in nasal cultures. Although systemic antibiotherapy was not administered, the lack of local and systemic infection findings was an important result that we obtained in terms of clinical use. Usage advantages of mupirocin and fusidic acid soaked packings are an easily applicable, cost-effective, and safe method

Elevation in serum uric acid levels predicts favourable response to erlotinib treatment in patients with metastatic non-small-cell lung cancer

What is known and objective Erlotinib is a small molecule tyrosine kinase inhibitor which blocks the activation of epidermal growth factor receptor (EGFR), a transmembrane receptor that is upregulated in many cancer types. Inhibition of angiogenesis with consequent impairments in intratumoral microcirculation is one of the mechanisms through which EGFR inhibition halts the progression of cancer. A consequence of impaired microcirculation is intratumoral hypoxia, which results in increases in serum uric acid levels. The goal of this study was to investigate the relationship between serum uric acid levels and response to erlotinib in metastatic non-small-cell lung cancer (NSCLC). Methods A total of 56 patients with metastatic non-small-cell lung cancer who received erlotinib for a duration of at least 3 months were included in this retrospective cohort study. Demographic characteristics, progression status, baseline serum uric levels and 3-month serum uric acid levels were recorded and analysed. Results and discussion Of the study population, 21 (37.5%) were female and 35 (62.5%) were male patients. No significant difference in above demographic characteristics was observed among exitus, survivor with progression and survivor without progression groups. Patients who responded favourably to erlotinib with no progression of their disease had significantly increased uric acid levels at 3-month follow-up (P = .01). Such a correlation was not observed if the patient was exitus (P = .47) or had progressed on erlotinib therapy (P = .19). What is new and conclusion In conclusion, this study is the first to demonstrate significant increases in serum uric acid levels in patients with metastatic NSCLC who responded favourably to erlotinib and had no progression under erlotinib therapy. Further studies are required to confirm and characterize serum uric acid as a novel biomarker in predicting the outcome in those with metastatic NSCLC.Türkiye Cumhuriyeti Kalkınma Bakanlığ