Comparison of cerebral magnetic resonance and electroencephalogram findings in pre-eclamptic and eclamptic women

OBJECTIVE: To compare the cerebral magnetic resonance (MR) and electroencephalogram (EEG) findings in pre-eclamptic and eclamptic pregnant women. METHODS: A total of 38 pregnant women with mild pre-eclampsia (n = 15), severe pre-eclampsia (n = 11) and eclampsia (n = 12) were included in this study. Cranial MR without contrast and EEG were performed in these women on admission or within 3 days of onset. Follow-up control MR or EEG evaluations were performed 4-6 weeks postpartum in women with MR or EEG abnormalities in the initial examination. To compare differences, X(2) test, Fisher exact or Mann-Whitney U-tests were used. RESULTS: Abnormal cranial MR findings were found in one (6%) pre-eclamptic woman, in four (36%) severe pre-eclamptic women, and in 11 (92%) eclamptic women. Cranial MR findings were consistent with ischaemia in 15 (39%) patients and haemorrhage in one (3%) case. Two (5%) severe pre-eclamptic women showed cerebral infarction during the follow-up period. MR and EEG abnormalities were totally resolved in 88% of cases. The MR findings of 12 (71%) patients were located in the occipital lobes followed by the parietal lobes in six (40%) cases. Three (20%) mild pre-eclamptic women, four (36%) severe pre-eclamptic women and 10 (83%) eclamptic women had abnormal EEGs. The EEG changes were totally resolved in 13 of 14 (93%) patients after the first month. In one patient with cerebral haemorrhage, the EEG changes lasted for a duration of 6 months. CONCLUSIONS: A correlation between EEG abnormalities and MR findings was found in this study. The combined use of MR and EEG may help to determine the prognosis for these patients, but the interictal EEG findings recorded in eclampsia were non-specific.     

The relation of increased uterine artery blood flow resistance and impaired trophoblast invasion in pre-eclamptic pregnancies

Objective: To assess the association between histopathologically confirmed vascular abnormalities developed during pre-eclampsia and abnormal arterial blood flows recorded during Doppler sonographies. Materials and methods: From pregnant women who attended our clinic between 01/03/2002 and 01/07/2002, a detailed medical history was obtained and routine biochemical blood tests, fetal ultrasonography and UA Doppler scans were performed. In addition, from pre-eclamptic and normal pregnant women who underwent cesarean sections, placental bed biopsies were taken. Thirty two pre-eclamptic [12 mild, 20 severe cases according to American College of Obstetricians and Gynecologogists (ACOG) criteria] cases and as a control group 20 normal pregnancies were included in the study. In our study trophoblast invasion into decidual spiral arteries was observed in 75% of mild (9/12), and 55% of severe (11/20) pre-eclampsias. In the control group all the cases demonstrated trophoblast invasion in decidual spiral arteries. Trophoblast invasion in myometrial spiral arteries was noted in 50% (6/12) of mild and 25% (5/20) of severe pre-eclamptic pregnancies. It was seen in 16 cases out of 20 (80%) pregnancies. In the control group, decidual spiral artery invasion manifests significant differences (P<0.01) among groups studied. Invasion in decidual spiral arteries was seen in all normal pregnancies of the control group. There is not any significant difference between mild and severely pre-eclamptic groups (P>0.05). Conclusion: Doppler ultrasonography is not only a non-invasive method for evaluating fetal status in pre-eclamptic pregnancies, but it also correlates with partial trophoblastic invasion in spiral arteries, which contributes to the pathophysiologic mechanisms involved in pre-eclampsia.     

What is behind smoking among pharmacy students: a quantitative and qualitative study from Turkey

This study, performed in two phases, compared the smoking status of first- and last-year pharmacy students and identified underlying factors of smoking using both "quantitative" and "qualitative" research techniques. The quantitative phase was a cross-sectional study with 207 students (of these, 102 were first-year and 105 were last-year students). The mean age at which first-year students tried tobacco/tobacco products was 14.1 +/- 3.2 and for last-year students, 16.0 +/- 2.4. The students completed an 18-item questionnaire at the end of the spring semester in May 2004. Chi-square and t-test analyses were used for statistical comparisons. Furthermore, focus group discussion techniques were used to find out the underlying factors of smoking in the second phase.     

Initial Clinical Experiences With Novel Diagonal ECLS System in Pediatric Cardiac Patients

Extracorporeal life support (ECLS) provides mechanical support following cardiac surgery when respiratory or cardiac failure occurs. The aim of this study was to analyze the safety and feasibility of the Medos Deltastream diagonal pump (DP3) ECLS system in pediatric cardiac patients. We described the technical considerations and risk factors related to the survival outcomes in 102 pediatric cardiac patients who received ECLS support between March 2011 and April 2016. We switched from the DP2 system, which was used for the initial 25 patients, to the DP3 system after November 2012. The DP3 was then used in a consecutive series of 77 patients (4.5% of all pediatric patients who underwent congenital heart surgery during the same time period). The patients’ median age was 90 days (range: 2 days–12 years), while their median weight was 4 kg (range: 2.1–40 kg). Fifty four patients (70%) were weaned off ECLS, while 28 patients (36.3%) were successfully discharged from the hospital by means of the DP3 system. The median ECLS duration for survivors was 8.2 days (range: 4–14.5 days). The ECLS indications, durations, and initiation times had no statistical significance in terms of survival. Renal, hemorrhagic, and neurologic complications were all associated with decreased hospital discharge rates (P = 0.003, P = 0.045, and P < 0.001 respectively). Higher lactate levels (P = 0.009) and longer duration for normalization (P < 0.001) were both associated to failure to wean off ECLS support and, hence, to hospital deaths. The weaning rate was 36% prior to November 2012. It increased to 70.3% after that time (P = 0.009). The mechanical complication rate was 9% with the DP3 system and 32% with the DP2, which was statistically significant (P = 0.009). Additionally, the lactate levels were higher and decreased more slowly in the patients supported by the DP2. As a result of the shift to the DP3 system, a revised ECLS protocol, and increased ECLS experience, a significant improvement was observed in our clinical outcomes. The results of this study suggested that the combination of a DP3 pump and a Hilite oxygenator in pediatric ECLS circuits may improve durability and reduce circuit‐induced complications.     

Optical coherence tomography angiography findings of multiple sclerosis with or without optic neuritis

ABSTRACT

Objective: Nowadays, retinal microvascular structures can be investigated using optical coherence tomography angiography (OCTA). We aimed to evaluate the probable vascular changes in the foveal and peripapillary regions of patients with multiple sclerosis (MS).

Methods: A total of 20 patients with relapsing remitting multiple sclerosis (RRMS) and 24 healthy controls were recruited in this study. All participants’ superficial and deeper retinal and peripapillary layers were evaluated using OCTA after a total ophthalmologic examination.

Results: In the superficial plexus, the whole image (49.53 ± 3.9% and 51.83 ± 2.1%, p = 0.009), superior hemisphere (49.44 ± 4.11% and 51.63 ± 2.3%, p = 0.018), inferior hemisphere (49.75 ± 3.9% and 52.03 ± 2.2%, p = 0.012), parafoveal (51.87 ± 3.9% and 53.08 ± 3.46%, p = 0.048) and perifoveal (50.41 ± 3.86% and 52.76 ± 2.1%, p = 0.007) vascular densities were statistically significant lesser in patients with RRMS than in controls. In the optic disc OCTA parameters, the vessel density of the inferior (50.15 ± 6.99% and 53.04 ± 3.63% p = 0.043) and temporal sector (48.09 ± 5.47% and 50.85 ± 5.24%, p = 0.045) were statistically significantly lesser in patients with RRMS than in controls.

Conclusion: The reductions in vessel density of the retinal or peripapillary area of patients with RRMS shown in this study should be investigated further to determine whether it is a secondary lesion to optic neuritis (ON) or a primary vasculopathic condition of MS.     

Synthesis and evaluation of antioxidant properties of novel 2-[2-(4-chlorophenyl) benzimidazole-1-yl]-N-(2-arylmethylene amino) acetamides and 2-[2-(4-chlorophenyl) benzimidazole-1-yl]-N-(4-oxo-2-aryl-thiazolidine-3-yl) acetamides-I

Our approach was to synthesize and examine the antioxidant properties of some new 2-[2-(4-chlorophenyl)benzimidazole-1-yl]-N-(2-arylmethyleneamino) acetamide (1-18) and 2-[2-(4-chlorophenyl)benzimidazole-1-yl]-N-(4-oxo-2-aryl-thiazolidine-3-yl)acetamide (1t-18t) derivatives. Their in vitro effects on rat liver microsomal NADPH-dependent lipid peroxidation levels (LP assay) and microsomal ethoxyresorufin O-deethylase activities (EROD assay) were determined. The free radical scavenging properties of the compounds were also examined in vitro determining the interaction of 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical. The compounds showed significant effects in the above tests.