Cord blood cardiac troponin I as an early predictor of short-term outcome in perinatal hypoxia

BACKGROUND: In most perinatal-hypoxia survivors, myocardial dysfunction can be reversed with appropriate inotropic support and oxygenation. The main problem related to outcome is cerebral damage. OBJECTIVE: We tested the hypothesis that cardiac troponin I (cTnI), a known marker of myocardial injury, is also an early predictor of severity of cerebral damage and mortality in intrauterine hypoxia. METHODS: Venous and arterial cord blood samples were collected at delivery from 54 consecutive newborns with hypoxic-ischemic encephalopathy and from 50 consecutive healthy controls. Arterial blood gas analysis was performed and levels of cTnI, creatine kinase and creatine kinase-MB in venous cord blood were measured. The same serum parameters were also measured on the 3rd and 7th day of life. RESULTS: Infants with hypoxia had a significantly higher cord blood cTnI levels than controls (p < 0.0001). Cord blood and 3rd and 7th day serum cTnI values showed a significant increase with severity of HIE (p < 0.0001). In non-survivors cord blood cTnI levels were significantly higher than the survivors (5.9 ng/ml, range 2.1-12.8, and 1.6 ng/ml, range 0.4-5.8, respectively; p < 0.0001). Receiver-operator curve analysis revealed cord cTnI as the most sensitive factor for predicting early death (area under curve = 0.956; SE: 0.028; 95% CI: 0.9-1.01). Cord blood cTnI of 4.6 ng/ml was identified as the optimal cut-off level for predicting serious risk of early mortality. CONCLUSION: The results suggest that significant elevation of cord cTnI is an excellent early predictor of severity of hypoxic-ischemic encephalopathy and mortality in term infants.     

Effect of brimonidine tartrate 0.15% on scotopic pupil size and upper eyelid position: controlled trial

BackgroundTo evaluate the effect of brimonidine tartrate 0.15% ophthalmic solution on pupil size under scotopic condition and upper eyelid position.MethodsThis study comprised 72 eyes of 36 healthy subjects. A single drop of brimonidine tartrate 0.15% ophthalmic solution was instilled in the right eye and artificial tear was instilled in the left eye. Pupil size was measured using an infra-red pupillometer under scotopic condition before and at 30 min, 2, 4, 6, 8 and 10 h after instillation. Measurement of margin reflex distance 1 (MRD1) was performed using a millimetre ruler before and after at 10 min after instillation.ResultsThe mean age of the subjects was 32.19 ± 11.43 years (range 10–52 years), 17 were female and 19 were male. Before brimonidine instillation, the mean pupil size was 6.09 ± 1.03 mm in the brimonidine eyes and 6.06 ± 1.04 mm in the control eyes. There was a significant decrease in mean pupil size at 30 min (4.45 ± 1.04), 2 h (4.49 ± 1.06), 4 h (4.59 ± 1.06), 6 h (4.89 ± 1.06) and 8 h (5.38 ± 1.02) after instillation compared to before in brimonidine eyes (p < 0.001 for all). There was a significant miosis continued for at least 6 h (5.95 ± 1.03) in control eyes (p < 0.001). There was no significant change in MRD1, before and after instillation both in brimonidine and control eyes.ConclusionsBrimonidine tartrate 0.15% had a significant miosis under scotopic condition for at least 8 h after instillation and had a significant miosis on the untreated eye for at least 6 h.Subject terms: Outcomes research, Eye manifestations     

Changes in Sexual Function of Patients with Cancer in Turkey

Sexuality and Disability - This study was carried out to determine the changes in sexual functioning of patients with cancer. We identified the frequency and causes of changes in sexual functioning...     

Attitude and Behavior Related to Organ Donation and Affecting Factors: A Study of Last-Term Students at a University

Aim

The aim of this study was to detect the behavior and attitude of our last-term students.

Methods

The study group for this cross-sectional research consisted of 1690 last-term students. We applied a questionnare about sociodemographic features, behaviors, and attitudes about organ donation. Data were evaluated with SPSS 11.0.

Results

We accessed 1287 students among whom 1.3% stated that they would donate their organs. Among students who did not agree, 58.7% were considering donation. The main reasons for not agreeing to donation were fear of commercial use (45.7%) and the belief of inappropriateness related to religion (25.7%). In contrast, 62.3% stated that they would donate their organ when needed for their relatives. Also, 50.6% indicated that if one of their relatives died, they would donate their relative's organs; there was no significant difference based on gender. In addition, favorable thoughts about donation were significantly more prevalent for female subjects (P = .001). Organ donation behavior and thoughts were significantly higher among the group with better economic position (P = .001, .018); and for students whose mother had an education higher than high school (P = .003, .004). Higher donation ratios were observed for students who had a relative working in the medical field (P = .04) and the group who stated they were well informed about organ donation (P < .001).

Conclusion

When we take into account that our study group consisted of university students, organ donation rates were low. To overcome the difficulties, we have to inform the community and collaborate with religious organizations. To prevent fear that organs will be used commercially we must prove confidence in the system.     

Evaluation of mineral content of enamel prepared by erbium, chromium:yttrium–scandium–gallium–garnet laser

The aim of this study was to evaluate the mineral content of enamel etched at two different power settings with an erbium, chromium:yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser. Buccal, lingual and mesial or distal surfaces of five premolar teeth were cut, and three enamel slabs were obtained from each tooth. Fifteen enamel specimens were divided into three groups (1 W, 2 W and control) of five specimens each and subjected to Er,Cr:YSGG laser. The mean percentage weights of the five elements [calcium (Ca), potassium (K), magnesium (Mg), sodium (Na) and phosphorus (P)] in each slab were measured by inductively coupled plasma-atomic emission spectrometry (ICP-AES). One way analysis of variance (ANOVA) was used to analyze differences among the groups (1 W, 2 W and control). There were no significant differences among the groups (1 W, 2 W and control) for Ca, K, Mg, Na, or P, or for the Ca/P ratio (P > 0.05). Scanning electron microscopy (SEM) photographs indicated that the surface irregularities increased with increased power setting. Laser treatment did not affect the mean percentage weights of Ca, K, Mg, Na, and P, or the Ca/P ratio, in any group.     

Do schizophrenia and bipolar disorders share a common disease susceptibility variant at the MMP3 gene?

There is growing evidence of partial etiological overlap between schizophrenia (SZ) and bipolar I disorder (BD-I) from linkage analysis, genetic epidemiology and molecular genetics studies. SZ and BD-I are neurodevelopmental disorders with genetic and environmental etiologies. Recent studies have demonstrated that matrix metalloproteinase 3 (MMP3) is a key event in associative memory formation, learning and synaptic plasticity, which are important in psychiatric disorders. In the light of these findings, we analyzed the genetic variations in the MMP3-1171 5A/6A in patients with SZ, patients with BD-I and healthy controls. To the best of our knowledge, this is the first study to report an association of variation in gene encoding MMP3 with SZ. Our study group consisted of 111 unrelated patients with SZ, 141 unrelated patients with BD-I, and 121 unrelated healthy controls. The frequencies of 6A6A genotype and 6A allele distributions of MMP3 in patients with SZ were significantly decreased when compared with controls. In contrast, in patients with SZ, the distributions of 5A5A genotype and 5A allele of MMP3 gene were significantly increased as compared with healthy controls. When the frequencies of genotypes or alleles in schizophrenic patients and bipolar patients were compared, 6A6A genotype and 6A allele in patients with BD-I were significantly higher than patients with SZ. In contrast, 5A5A genotype and 5A allele distributions of MMP3 gene were significantly frequent in patients with SZ. On the other hand, no significant differences were found in the allele or genotype distribution in patients with BD-I compared with controls. In conclusion, our data have supported the hypothesis that there is a possible relationship between − 1171 5A/6A polymorphism of MMP3 gene and SZ. A larger sample group is needed to confirm the potential role of this gene in the pathophysiology of psychiatric disorders.     

Concomitant Laparoscopic Adjustable Gastric Banding and Laparoscopic Cholecystectomy in a Super-Obese Patient with Situs Inversus Totalis Who Previously Underwent Intragastric Balloon Placement

Laparoscopic adjustable gastric banding has been increasingly performed since its introduction in 1990. Situs inversus totalis is a rare anomaly in which transposition of organs to the opposite side of the body occurs. Laparoscopic gastric banding in such few patients has been reported in the literature. We discuss a super-obese patient with situs inversus totalis and asymptomatic cholelithiasis who previously underwent endoscopic intragastric balloon placement in preparation for bariatric surgery. Afterwards, laparoscopic cholecystectomy and laparoscopic adjustable gastric banding were performed in the same session. Special attention is paid to the literature review and the mirror-image modification of the laparoscopic cholecystectomy and laparoscopic gastric banding procedures. With preoperative assessment, modifications in the surgical team, and equipment, the operation can be performed safely.     

Ischemic necrosis of the right colon in a patient with a ventricular assist device system

Despite improvements in medical therapy, the annual high mortality rate from end-stage heart failure continues. Although cardiac transplantation is a succesful treatment for these patients, the shortage of donor hearts has led surgeons to seek other options. Ventricular assist device (VAD) technology is applied to a broader population of heart failure patients, and clinicians are confronted with the specialized perioperative and chronic care of patients who receive these devices. VAD implantation is now an acceptable means of bridging to heart transplantation. We report a case of isolated right colon necrosis in a patient with VAD, who was successfully treated with right hemicolectomy and ileocolostomy.