Evaluation of Helicobacter pylori with a stool antigen assay in frail, elderly patients

OBJECTIVE: Helicobacter pylori infection has not been studied thoroughly in elderly patients. The aim of this study was to evaluate the reliability of stool antigen assay (HpSA) in the assessment of H. pylori infection in hospitalized, frail, elderly patients. MATERIALS AND METHODS: The study population consisted of 85 consecutively recruited elderly patients (> or =65 years old) hospitalized between May 1999 and December 2001 with diagnostic indications for upper gastrointestinal endoscopy. Twenty-nine subjects had been receiving treatment with proton-pump inhibitors (PPIs), such as omeprazole (10-20 mg/day) for 2-15 days, and 56 were not receiving treatment. HpSA was evaluated versus UBT (urea breath test), serology and histology: patients with at least two positive results out of the latter three tests were considered positive for H. pylori infection, while patients with at least two negative tests out of three were considered negative. RESULTS: The sensitivity and specificity of HpSA in the 56 untreated patients were, respectively, 76% (true positives TP = 22; false negatives FN = 7) and 93% (true negatives TN = 25; false positives FP = 2). The sensitivity and specificity of HpSA in the 29 patients on PPI treatment were, respectively, 82% (TP = 9; FN = 2) and 83% (TN = 15; FP = 3). CONCLUSIONS: HpSA is an accurate, non-invasive and easy method for diagnosing H. pylori infection in elderly patients.     

Progressive hemifacial atrophy with linear scleroderma

We describe a 4-year-old girl with hemifacial atrophy. She had a linear white-colored sclerotic plaque on the right submandibular area of skin. Histologic findings of the lesion were consistent with a diagnosis of scleroderma. The relationship between progressive facial hemiatrophy and linear scleroderma are discussed. We think that linear scleroderma of childhood and hemifacial atrophy have considerable clinical overlap and these two syndromes appear to be manifestations of the same or related pathogenic processes. Recently, the beneficial effects of 1.25-dihydroxyvitamin D3 (calcitriol) were reported in adults and in children with linear scleroderma. We assessed the efficacy of oral calcitriol treatment in our patient. Our result indicates that calcitriol may be an effective agent for treating localized scleroderma in children.     

Time-frequency component analyser and its application to brain oscillatory activity

Currently, event-related potential (ERP) signals are analysed in the time domain (ERP technique) or in the frequency domain (Fourier analysis and variants). In techniques of time-domain and frequency-domain analysis (short-time Fourier transform, wavelet transform) assumptions concerning linearity, stationarity, and templates are made about the brain signals. In the time-frequency component analyser (TFCA), the assumption is that the signal has one or more components with non-overlapping supports in the time-frequency plane. In this study, the TFCA technique was applied to ERPs. TFCA determined and extracted the oscillatory components from the signal and, simultaneously, localized them in the time-frequency plane with high resolution and negligible cross-term contamination. The results obtained by means of TFCA were compared with those obtained by means of other commonly used techniques of ERP analysis, such as bilinear time-frequency distributions and wavelet analysis. It is suggested that TFCA may serve as an appropriate tool for capturing the localized ERP components in the time-frequency domain and for studying the intricate, frequency-based dynamics of the human brain.     

Radial artery graft for bypass of the maxillary to proximal posterior cerebral artery: an anatomical and technical study

OBJECTIVE: To examine the use of a radial artery graft for bypass of the maxillary artery (MA) to proximal posterior cerebral artery (PCA) as an alternative to the external carotid artery (ECA) to PCA anastomosis used in posterior circulation bypass surgery. MATERIALS AND METHODS: The method was applied to five adult cadaver sides bilaterally. The MA was easily found 1-2 cm beneath the infratemporal crest after a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally, 2-3 cm posterolateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4-mm tipped drill. After sylvian fissure, the interpedincular and ambient cisternae were opened and the P2 segment of the PCA appeared. The graft was passed through the hole and dura to reach the P2 segment. Proximal to the infraorbital artery branch, the MA was freed from the surrounding tissue and transected. The proximal side of the radial artery graft was anastomosed end-to-end with the MA and the distal side was anastomosed end-to-side with the P2 segment of the PCA. RESULTS: The average diameter of the MA proximal to the infraorbital artery branch was 2.6+/-0.3 mm. The average diameter of the P2 was 2.2+/-0.2 mm. The average length of the graft was 47+/-5.2 mm. CONCLUSION: As MA to proximal PCA bypass uses a short radial graft and as the calibers of the MA and PCA are >2 mm such a bypass may provide sufficient blood flow and represents a reasonable alternative to "ECA to PCA" bypass.     

Exposure to low outdoor temperature in the midtrimester is associated with low birth weight

BACKGROUND: Although seasonal variation of birth weight has been reported previously, contributing factors such as the meteorological factor and its specific period of exposure remain unclear. AIM: To investigate the effect of season on birth weight and to determine the meteorological factor and its specific period of exposure which can contribute to any seasonal variation in birth weight. METHODS: Retrospective analysis of 3333 singleton live births after 36 completed weeks of pregnancy. Maternal age, parity, route of delivery, sex and individual meteorological variables for the first, second, and third trimesters of each pregnancy were analysed using multiple regression analysis with the birth weight as the dependent variable. RESULTS: A seasonal pattern was observed with lowest birth weights in women who had their last menstrual periods in summer and autumn. Upon multiple regression analysis, sex, parity, mode of delivery, and the temperature which the mother was exposed to in the second trimester were the independent determinants of birth weight. CONCLUSION: Exposure to low outdoor ambient temperature in the midtrimester can be associated with low birth weight.     

The analgesic efficacy of dipyrone during removal of nasal packings after septal surgery

Abstract Septoplasty is one of the most common nasal operations performed in otorhinolaryngological practice. At the end of the operation, most surgeons place nasal packings and remove them after 48–72 hours. The removal of the packings may be very painful. The objective of this study was to evaluate the analgesic effectiveness of dipyrone, when given before the procedure in a placebo-controlled, randomised design. Thirty-eight patients undergoing septal surgery at the Department of Otorhinolaryngology, Ankara University were included in this study. Twelve patients did not get any analgesic treatment during removal (control group). Ten patients received 2 ml of intramuscular (i. m.) physiological saline solution (placebo group) and sixteen patients were pretreated with 1 g of i. m. dipyrone 45 min prior to the removal of the nasal packings (treatment group). Pain intensity was measured prior to the procedure, just after the packings were removed (0 min) and then at 5, 10, 15, 20, 30, 60 and 120 min after the removal by using visual analogue scales, verbal scales and the percentage score. The groups were compared by using Kruskal–Wallis and Mann–Whitney tests. No significant difference in baseline pain scores was found before the procedure started. At 0, 5 and 10 min the dipyrone group showed significant lower pain intensity when compared to the control and placebo groups. Dipyrone was found to be effective in lowering initial pain intensity and in reducing it during the first 10 min after removal. We conclude that dipyrone is an effective agent when given before the procedure of removal of nasal packing-induced postprocedural pain.This study has been presented at the 6th Congress of the European Association for Clinical Pharmacology and Therapeutics, 24–28 June 2003, Istanbul     

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.     

Effects of melatonin on plasma S-nitrosoglutathione and glutathione in streptozotocin-treated rats

The aim of this study was to determine the effects of streptozotocin-induced diabetes on plasma reduced glutathione (GSH) and S-nitrosoglutathione (GSNO) levels. Further, the study investigated whether an antioxidant, pineal hormone melatonin, could protect against STZ-induced effects. STZ significantly decreased plasma GSH but increased the levels of plasma GSNO. Daily supplementation with melatonin restored plasma thiol to control values. Data suggest that STZ-induced hyperglycemia and compounds that act as scavengers of free radicals and peroxynitrite like melatonin may exert protection against STZ-induced toxicity.