Use of the fertilized hen's egg in the evaluation of embryotoxicity of dental alloys

In this study, embryotoxic effects of five commercially available dental alloys were investigated by using fertilized hens' eggs. One sample of each alloy was conditioned in one of the conditioning media, physiological saline (PS), 0.1 M phosphate-buffered saline (PBS, pH 7.4), and 0.1 M protein (3% bovine serum albumin, BSA) containing PBS (pH 6.8), respectively. The test solutions were injected into the fertilized hen's eggs via air sac at the beginning of the incubation. Various concentrations of a highly embryotoxic substance, AFB1, was also used as positive control test material. Mortality of the AFB1 treatment groups increased with increasing concentrations of AFB1 and the mortality values were significantly (p < 0.05) higher than those of the controls and eluent injected groups. The eluents of five commercially available dental alloys tested in the study did not have significant embryotoxic effects. Cu- and Pd-containing alloys displayed relatively high but statistically insignificant embryotoxic effects. Chick embryo might be used in determination of the embryotoxic effects of the dental alloys with its several advantages. Nevertheless, the test should be further standardized and new methods such as micronucleus test showing possible genotoxic effects of the materials should be used.     

Ultrasound evaluation of the normal fetal pharynx

OBJECTIVE: To obtain normative data for fetal pharyngeal diameter and to investigate the ability to visualize pharynx at different gestational ages during routine prenatal sonography. METHODS: Sonographic studies were performed in 292 consecutive pregnant women. The diameters of the pharynx were measured and our ability to visualize pharynx was evaluated at different gestational ages. RESULTS: Sonographic measurements of the pharyngeal diameter were obtained in 153 of the 292 fetuses. The diameter of the pharynx increased from a mean of 4.5+/-0.53 mm at 16 weeks to 9.1+/-1.72 mm at 36 weeks. Pharyngeal diameters showed a significant positive relationship with advancing gestational age (p<0.0001, R2=0.571). The differences in visualization among different gestational age groups were found to be significant (p<0.05 by Chi-Square). CONCLUSION: This study reports normative data for fetal pharyngeal diameter. Pharyngeal measurements were similar to previous reports in the literature. Our success in visualizing the pharynx was best between 21 and 30 weeks of gestation. This period might be the optimum time for evaluating fetal pharynx.     

Effects of the acute exposure to the electromagnetic field of mobile phones on human auditory brainstem responses

The purpose of this study was to evaluate the short-term effects of the electromagnetic fields (EMF) of mobile phones on human auditory brainstem responses. This prospective study of healthy adults evaluated the influence of EMF. Eighteen healthy adult volunteers participated in this study. Mobile telephones emitting signals in the region of 900 MHz and with the highest SAR value of 0.82 W/kg were positioned in direct contact to the right ear, which was exposed to the phone signal for 15 min before and after ABR testing with click stimuli of 60 and 80 dB nHL intensities. The latencies of the waves and interwave latencies were measured on screen by an experienced audiologist. The differences of the mean latencies of waves I, III and IV were not significant in initial and post-exposure ABR measurements at both 60 and 80 dB nHL stimulus levels ( P >0.05). Similarly, differences of the mean interwave intervals I-III, I-V and III-V remained insignificant at the initial and postexposure ABR measurements at stimulus levels of both 60 and 80 dB nHL ( P >0.05). Acute exposure to the EMF of mobile phones does not cause perturbations in ABR latencies. However, these negative results should not encourage excessive mobile communication, because minor biological and neurophysiological influences may not be detectable by the current technology.     

Sexual life following total abdominal hysterectomy

Aim The goal of this study was to evaluate the effect of total abdominal hysterectomy (TAH) on sexual lives of patients in the postoperative period.Materials and methods Eighty-six patients who accepted to participate a phone-questionnaire were recruited in the study after TAH or TAH + BSO. They were asked about sexual desire, pain during sexual intercourse, frequency and satisfaction of sexual intercourse at pre- and postoperative periods, and loss of feeling a woman in the postoperative period. Sexual desire, pain during sexual intercourse, loss of feeling a woman questions were answered as yes or no, number of weekly sexual intercourse was recorded, and satisfaction was graded as no = 0, mild = 1 and complete = 2 points.Results While sexual desire and frequency were found to be significantly lower (p=0.026 and p=0.01 respectively), no difference was noted in dyspareunia and satisfaction. When the patients were divided into two groups according to the presence of endogenous or exogenous estrogen, no difference was seen between the two groups in the postoperative period.Conclusion We concluded that the effect of TAH or TAH+BSO operations were mainly on sexual desire and the number of weekly intercourse, and estrogen in the postoperative period did not make any difference between the two groups.     

Reduced heart rate volatility: an early predictor of death in trauma patients

OBJECTIVE: To determine if using dense data capture to measure heart rate volatility (standard deviation) measured in 5-minute intervals predicts death. BACKGROUND: Fundamental approaches to assessing vital signs in the critically ill have changed little since the early 1900s. Our prior work in this area has demonstrated the utility of densely sampled data and, in particular, heart rate volatility over the entire patient stay, for predicting death and prolonged ventilation. METHODS: Approximately 120 million heart rate data points were prospectively collected and archived from 1316 trauma ICU patients over 30 months. Data were sampled every 1 to 4 seconds, stored in a relational database, linked to outcome data, and de-identified. HR standard deviation was continuously computed over 5-minute intervals (CVRD, cardiac volatility-related dysfunction). Logistic regression models incorporating age and injury severity score were developed on a test set of patients (N = 923), and prospectively analyzed in a distinct validation set (N = 393) for the first 24 hours of ICU data. RESULTS: Distribution of CVRD varied by survival in the test set. Prospective evaluation of the model in the validation set gave an area in the receiver operating curve of 0.81 with a sensitivity and specificity of 70.1 and 80.0, respectively. CVRD predict death as early as 24 hours in the validation set. CONCLUSIONS: CVRD identifies a subgroup of patients with a high probability of dying. Death is predicted within first 24 hours of stay. We hypothesize CVRD is a surrogate for autonomic nervous system dysfunction.     

Nigella sativa (black seed) oil does not affect the T-helper 1 and T-helper 2 type cytokine production from splenic mononuclear cells in allergen sensitized mice

Nigella sativa Linn. (Ranunculaceae) is known to have beneficial effects on a wide range of diseases including asthma. However, the mechanism of action in asthma and other allergic diseases is not entirely clear. The present study was planned to evaluate the effects of Nigella sativa on cytokine production of splenic mononuclear cells in ova-sensitized mice. Nineteen two-month-old BALB/c mice were given 0.3 mL of Nigella sativa oil by oro-eosophageal cannula once a day for a month. The control group consisting of 10 mice took 0.3 mL of 0.9% saline solution by the same route for the same period. In the third week of the study, all mice were sensitized by means of intraperitoneal injections of 20 μg of ovalbumin (OVA-Grade VI, Sigma). Ova injections were repeated three times with 7-day intervals. After another week, all mice were sacrificed by means of cervical dislocation. Then the splenic mononuclear cells (MNCs) of mice were cultured with OVA or Concavalin A (Con-A). From the culture supernatants, IL-4, IL-10 and IFN-γ were assessed by means of ELISA. The cytokine production of splenic MNCs of mice that were given Nigella sativa for 30 days was not significantly different than those who took saline solution instead. In conclusion, Nigella sativa oil seems not to have an immunomodulatory effect on Th1 and Th2 cell responsiveness to allergen stimulation.     

Heterotopic gastric mucosa in the cervical esophagus: could this play a role in the pathogenesis of laryngopharyngeal reflux in a subgroup of patients with posterior laryngitis?

OBJECTIVE: Acid secretion produced by a heterotopic gastric mucosal patch (HGMP) in the proximal esophagus, instead of gastric acid, may be responsible for laryngopharyngeal reflux (LPR), passing the upper esophageal sphincter. The aim of this study was to investigate the prevalence of HGMP in the proximal esophagus in patients with posterior laryngitis indicating the presence of LPR in comparison with a control group and to elucidate the possible role of this lesion in the pathogenesis of LPR. MATERIAL AND METHODS: A total of 36 consecutive patients with posterior laryngitis diagnosed on laryngoscopic examination were enrolled in the study. Esophagoscopy and ambulatory 24-h intra-esophageal dual-probe pH monitoring were performed in all patients. During endoscopy, special attention was paid to the proximal part of the esophagus, and the proximal electrode for pH monitoring was placed in this region under endoscopic view. The control group comprised 660 consecutive patients who had undergone upper gastrointestinal endoscopy for the usual indications. When HGMP was found, biopsies were taken for histological confirmation. RESULTS: HGMP was detected in 5 out of 36 patients. One out of five patients with patches was excluded from the study because the histopathology of this patient's patch revealed antral-type mucosa, which is not capable of acid secretion. Thus a total of 35 patients were included in the study, yielding a HGMP prevalence of 11.4% (4/35). Compared with the prevalence of the control group (1.6%), a significant difference was observed (p<0.005). pH monitoring showed that 45.4% of the patients had abnormal proximal acid reflux. All of four HGMP (+) patients with posterior laryngitis revealed significantly higher abnormal proximal reflux compared to the patients without patches (p<0.05). CONCLUSIONS: This first preliminary study may suggest that HGMP in the cervical esophagus could play a role in the pathogenesis of LPR, at least in a minor group of patients with posterior laryngitis, depending on its capability to produce acid in situ, although isolated proximal reflux could not be demonstrated. This finding may need to be supported by further studies with larger patient populations and using acid stimulation tests.     

Sensorineural Hearing Loss in Patients with Inflammatory Bowel Disease: A Subclinical Extraintestinal Manifestation

Isolated case reports in which symptomatic hearing loss develops suddenly during the course of inflammatory bowel disease (IBD) have been reported, but the presence of subclinical sensorineural hearing loss (SNHL) associated with IBD has been investigated in only two preliminary studies.In order to research this further, we aimed to investigate the presence of subclinical SNHL in IBD by comparison with a control group and to examine possible relations between the bowel disease parameters and hearing loss.Otoscopy, tympanometry, and pure tone audiometry were carried out in 39 patients with IBD (21 Crohn's disease [CD], 18 ulcerative colitis [UC]) and 25 healthy age- and sex-matched controls. All patients and control subjects had normal otoscopy findings and tympanometry was unremarkable, excluding middle ear disease and conductive hearing loss. Analysis of each frequency examined showed that the average hearing thresholds were increased significantly in the study group compared to those of the control group at higher frequencies (2, 4, and 8 kHz). When these parameters were compared with the control group according to subgroups of IBD, a significant difference was determined for the UC group at frequencies of 2, 4, and 8 kHz and for the CD group only at the frequency of 4 kHz. Although there was a trend of increment in SNHL as the age of the patient and duration and extent of UC increased, no significant correlation was observed between SNHL and these parameters or sex, activity, involvement site, medication history of IBD, and coexistence of other extraintestinal manifestations. In conclusion, it was demonstrated that a subclinical SNHL may be associated with UC and somewhat with CD, affecting mainly the high frequencies. In light of this finding, it may be advisable to investigate labyrinth functions as well as other extraintestinal manifestations in patients with IBD. This article was presented at the 12th United European Gastroenterology Week, 2004, in Prague, Czech Republic.     

The impact of a normoglycemic management protocol on clinical outcomes in the trauma intensive care unit

BACKGROUND: The purpose of this study was to determine if protocol-driven normoglycemic management in trauma patients affected glucose control, ventilator-associated pneumonia, surgical-site infection, and inpatient mortality. METHODS: A prospective, consecutive-series, historically controlled study design evaluated protocol-driven normoglycemic management among trauma patients at Vanderbilt University Medical Center. Those mechanically ventilated > or =24 hours and > or =15 years of age were included. A glycemic-control protocol required insulin infusion therapy for glucose >110 mg/dL. Control patients included those who met criteria, were admitted the year preceding protocol implementation, and had hyperglycemia treated at the physician's discretion. RESULTS: Eight hundred eighteen patients met study criteria; 383 were managed without protocol; 435 underwent protocol. The protocol group had lower glucose levels 7 of 14 days measured. After admission, both groups had mean daily glucose levels <150 mg/dL. No difference in pneumonia (31.6% vs 34.5%; p = .413), surgical infection (5.0% vs 5.7%; p = .645) or mortality (12.3% vs 13.1%; p = .722) occurred between groups. If one episode of blood glucose level was > or =150 mg/dL (n = 638; 78.0%), outcomes were worse: higher daily glucose levels for 14 days after admission (p < .001), pneumonia rates (35.9% vs 23.3%; p = .002), and mortality (14.6% vs 6.1%; p = .002). One or more days of glucose > or =150 mg/dL had a 2- to 3-fold increase in the odds of death. Protocol use in these patients was not associated with outcome improvement. CONCLUSIONS: Protocol-driven management decreased glucose levels 7 of 14 days after admission without outcome change. One or more glucose levels > or =150 mg/dL were associated with worse outcome.