Impaired global and segmental myocardial deformation assessed by two-dimensional speckle tracking echocardiography in patients with vitamin B12 deficiency

Background: Contrary effects of vitamin B12 deficiency have been shown on the cardiovascular system. Aim of our study was to analyze left ventricular (LV) myocardial deformation, by using the two dimensional (2D) speckle tracking echocardiography (STE) in patients with vitamin B12 deficiency and normal LV ejection fraction.Methods: Twenty-five patients with vitamin B12 deficiency (B12 levels < 200 pg/mL; meanage: 29.6 ± 8.2 years, 15 female), and 27 healthy controls (B12 levels > 200 pg/mL; meanage: 30.1 ± 6.9 years, 13 female) were included in the study. 2D echocardiography images were transferred to a workstation for further offline analysis. Longitudinal peak systolic (LPSS) and global strain (LGS) was obtained from 4 chamber and apical long axis (APLAX) views.Results: Standard echocardiographic parameters and tissue Doppler imaging (TDI) velocities were compared between the groups. All LPSS values in the patient group except for apical 4C septal wall longitudinal strain were significantly decreased than those in the control group. There was a positive correlation between B12 levels and strain values except apical 4C septal wall strain values.Conclusions: We found that in patients with vitamin B12 deficiency, global and segmental myocardial deformation was impaired and this impairment was correlated with the levels of vitamin B12

Comparison of estimated continuous cardiac output with echocardiography in patients with systolic heart failure

Background: Cardiac output (CO) is an important hemodynamic parameter in the management of heart failure. The aim of this study was to compare CO measurements obtained from the bedside monitor specialized for CO measurement, which is known as estimated continuous CO (esCCO), and  transthorasic echocardiography (echoCO) in patients with ejection fraction (EF) <40%.Methods: A total of 49 patients (36 male) with EF <40% were studied in this study. CO was measured using esCCO and transthorasic echocardiography (TTE). Measurements of CO were compared using Bland-Altman statistical method.Results: Mean ejection fraction was 27.11 ± 7.31%. Measurements of CO using esCCO and echoCO were found to be different (5.44±1.10 L/min vs. 5.08±1.08 L/min, respectively, p=0.004). CO was higher in esCCO compared to TTE. Bland-Altman analysis showed that the bias between esCCO and echoCO was -0.36 L/min [95% CI: -0.60 – (-0.13)], 95% limits of agreement were ranged from -1.77 to 1.05 L/min, and percentage errors of measurements of CO was 13%. A significant positive correlation was found between esCCO and echoCO (r = 0.785, p< 0.001).Conclusions: esCCO was well correlated with echoCO in patients with low EF. The esCCO may be useful for non-cardiologist such as specialist for anaesthesiology and thorasic disease. Also, it may be used in the patients with HF having poor echocardiographic image quality due to co-morbidities including chronic obstructive pulmonary disease

Paratracheal air cysts: prevalence and relevance to pulmonary emphysema and bronchiectasis using thoracic multidetector CT

PURPOSEWe aimed to determine the prevalence of paratracheal air cysts (PTACs) and the relationship of PTACs with emphysema and bronchiectasis through retrospective analysis of multidetector computed tomography (MDCT) findings.METHODSMDCT findings of 1027 consecutive patients who underwent routine thorax examination between January 2012 and January 2013 were evaluated retrospectively for the presence of PTACs. Localization of the PTACs, as well as their size, shape, and relationship with the trachea were examined. Presence of emphysema and bronchiectasis was recorded, and bronchiectasis severity index was calculated when present. We randomly selected 80 patients who had no visible PTACs as the control group. The findings of patients with and without PTACs were compared.RESULTSPTACs were determined in 82 of 1027 patients (8%), in 8.8% of females and 7.3% of males. The presence of PTACs was determined to be independent of gender (P = 0.361). Eighty-one PTACs (98.8%) were located in the right side of the trachea and 56.1% had a tracheal connection. The presence of PTACs significantly correlated with the presence and severity of bronchiectasis (P = 0.001 and P = 0.005 respectively). There was no significant relationship between the presence of PTACs and the presence of emphysema on CT images (P = 0.125).CONCLUSIONThe prevalence of PTACs was determined as 8% in this study. There was significant association between PTACs and bronchiectasis

Contraception counselling during gynecology visit — does a questionnaire help?

Objectives: Women are at risk of unplanned pregnancy and inappropriate choice of contraception if not given effectivecontraception counselling. We aimed to understand the contraceptive needs of women, improve effective contraceptioncounselling promoting modern contraception methods during gynecology outpatient visit using a contraception counsellingquestionnaire.Material and methods: All reproductive-age women over 18 were given Contraception Counselling Project Form to fill inwhile in the waiting room. The form consisted of 15 questions evaluating patients’ characteristics and contraceptive methodused. Physicians evaluated these forms during the examination and an appropriate method was chosen. Forms of pregnant,postmenopausal and sexually inactive patients as well as forms with more than one answer missing were excluded.Results: 778 questionnaires were accepted for evaluation. 340 women (43.8%) used modern contraception, 112 (14.4%)used interrupted coitus, 3 (0.4%) used calendar method. 738 women could be given adequate contraception counsellingby the physicians. 215 women among 323 women (66.5%) who did not use modern contraception and did not desirepregnancy, were convinced to use modern contraception and 103 (91.9%) among 112 women who used interruptedcoitus for contraception were convinced to use modern contraception. There was a significant relationship between age,education, working state, parity, number and type of delivery, previous OCP usage, resources of contraception and thepreferred contraception method.Conclusions: More than half the women preferred to use modern contraception methods by means of contraceptioncounselling questionnaire. Women’s backgrounds significantly affected their choice of contraception method

Recurrent suprapubic abscess and vaginal fistula after anterior intravaginal slingplasty

Anterior intravaginal slingplasty is a widely used procedure for the treatment of stress urinary incontinence. After the operation, defective wound healing, infection, and fistula formation may follow. We present an unusual complication of anterior IVS that is recurrent suprapubic abscess and vaginal fistula formation in a 72-year-old woman. Fistulography was obtained and revealed a fistula tract extending from the suprapubic incision through the entire length of the mesh. Removal of the mesh and obliteration of the fistula tract was performed. Although the symptoms were relieved, the patient started to have episodes of stress urinary incontinence three weeks after the procedure

Clinical and biochemical efficacy of minocycline in nonsurgical periodontal therapy: a randomized controlled pilot study.

The present study evaluated the effects of systemic minocycline on clinical and biochemical parameters of chronic periodontitis, which is a common inflammatory disorder of the periodontium initiated by the presence of bacteria in the gingival sulcus. Besides nonsurgical periodontal therapy, 20 individuals received minocycline systemically while another 20 subjects received placebo capsules for 2 weeks. Plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), and relative attachment level (RAL) were measured and gingival crevicular fluid (GCF) samples were obtained at baseline and first, third, and sixth months. Matrix metalloproteinase-8 (MMP-8) and prostaglandin E-2 (PGE(2)) levels were analyzed by enzyme immunoassay method. Significant improvements in all parameters in both groups were recorded. In the minocycline group, changes in PI and SBI were significantly greater only at first month, whereas reductions in PD, RAL, MMP-8, and PGE(2) levels were greater at all times. MMP-8 and PGE(2) exhibited positive correlations with SBI, PD, and each other. Minocycline demonstrated clinical benefit for periodontal therapy and provided further improvements on inflammatory mediators promising a host-modulating capacity

The effects of posterior tibial nerve stimulation on refractory overactive bladder syndrome and bladder circulation

Aim We aimed to evaluate if posterior tibial nerve stimulation (PTNS) exerts its effects on overactive bladder symptoms through changes in bladder circulation

Evaluation of Periimplant Crevicular Fluid Prostaglandin E2 and Matrix Metalloproteinase-8 Levels From Health to Periimplant Disease Status: A Prospective Study

Objective: To compare the levels of prostaglandin E-2 (PGE(2)) and matrix metalloproteinases-8 (MMP-8) in periimplant crevicular fluid (PICF) after osseointegration and loading