Delirium Following Acute Myocardial Infarction: Incidence,Clinical Profiles,and Predictors

PURPOSE. To examine the incidence, clinical profile, and predictors of delirium following acute myocardial infarction (MI). DESIGN AND METHODS. The study sample included 212 consecutive patients with acute MI who were admitted to the coronary intensive care unit of a university hospital. FINDINGS. Delirium was found to occur in 5.7% of the patients. The predictors of delirium were advanced age, higher level of serum potassium at admission, and experience of cardiac arrest during MI. PRACTICE IMPLICATIONS. Delirium is reasonably prevalent in patients with acute MI. We propose that patients with the risk factors that have been delineated in this study should be evaluated carefully.     

Behçet's disease and hearing loss

OBJECTIVES: The aim of this study was to determine the incidence and severity of hearing loss in different frequencies in Beh?et's patients in a Turkish population. MATERIAL AND METHOD: Sixty-three consecutive cases with Beh?et's syndrome and 63 sex- and age-matched healty subjects as control group were included in this study. A detailed history was taken, all patients underwent neuro-otolological, ophthalmologic and dermatologic examination. Audiometric pure-tone thresholds at 125-8000Hz were obtained in all subjects in both groups. The results of the two groups were statistically evaluated by Chi-square, Student's-t and McNemar tests. RESULTS: In 35 patients (55%), a hearing loss equal or more than 30dB hearing level was detected. 24 of 35 patients (68%) showed hearing loss in the higher frequencies (6 and 8kHz). 12 of 35 patients (34%) showed hearing loss in speech frequencies (500-2000Hz). No relationship could be found between hearing loss and other system involvements in Beh?et's group. Also there was no correlation between hearing loss and duration of the disease, but the mean age of Beh?et's patients with hearing loss was found to be significantly higher than the mean age of the patients without hearing loss. CONCLUSION: We suggest that presence of hearing loss in Beh?et's disease is prevalent and represents a fourth clinical symptom after oral, genital ulcers and skin lesions and especially there is a statistically significant hearing loss at high frequencies when compared with the speech frequencies.     

Relationship between bone mineral density, bone turnover markers and homocysteine, folate and vitamin B12 levels in postmenopausal women

Purpose  

We aimed to investigate whether levels of homocysteine (Hcy), folate, and vitamin B12 are related to bone turnover markers and bone mineral density (BMD) in postmenopausal women.     

Optic Atrophy Secondary to Preseptal Cutaneous Anthrax: Case Report

Bacillus anthracis, the agent of anthrax, is a nonmotile, aerobic gram-positive rod that can form very resistant spores in economically poor environments. Anthrax can manifest as cutaneous, gastrointestinal, or inhalational form. Cutaneous anthrax, caused by direct skin contact, presents with eschar, lymphadenopathy, and a febrile illness. The face and eyelids are most commonly involved in cutaneous anthrax. A 45-year-old man was admitted to our clinic with high fever and swelling of the right eyelid. One day later on re-examination, formation of ulcerous lesions in the right medial canthal region was observed, with general oedema in the upper and lower eyelids. The patient was evaluated as having cutaneous anthrax and medical treatment was continued until the 28th day; he was discharged from the hospital with no loss of vision. He returned for a follow-up examination after 2 months, with decreased visual acuity (<logMAR 1.0). In the fundus examination, optic atrophy was observed. The patient was evaluated as having toxic optic neuropathy.     

Axis I and Axis II psychiatric disorders in patients with fibromyalgia

ObjectiveTo determine the current prevalence of Axis I and Axis II psychiatric disorders in patients with fibromyalgia.MethodThe study sample includes 103 patients with fibromyalgia and 83 control subjects. Axis I and Axis II disorders were determined by structured clinical interviews.ResultsThe rate of any Axis I psychiatric disorder (47.6% vs. 15.7%), major depression (14.6% vs. 4.8%), specific phobia (13.6% vs. 4.8%), any Axis II disorder (31.1% vs. 13.3%), obsessive–compulsive (23.3% vs. 3.6%) and avoidant (10.7% vs. 2.4%) personality disorders were significantly more common in the patient group compared to the control group.ConclusionOur results suggest that a considerable proportion of patients with fibromyalgia also present with Axis I and Axis II psychopathologies.     

Vitamin D deficiency might pose a greater risk for ApoEɛ4 non-carrier Alzheimer’s disease patients

Vitamin D is a secosteroid hormone that shares a synthetic pathway with cholesterol. ApoE, which is involved in the transport of cholesterol, is the most significant genetic risk factor for sporadic Alzheimer’s disease (AD). Surprisingly, recent studies have indicated the presence of an evolutionary juncture between these two molecules. To demonstrate this possible relationship, we investigated serum levels of 25-hydroxyvitamin-D₃ (25OHD) in patients with early onset-AD (EOAD; n:22), late onset-AD (LOAD; n:72), mild cognitive impairment (MCI; n:32) and in healthy subjects (n:70). We then analyzed the correlation between 25OHD and cytokines, BDNF and Hsp90 with respect to ApoE alleles, as these molecules were investigated in our previous studies. The LOAD patients had low levels of 25OHD, but these low levels originated only from ApoE?4 non-carrier patients. Negative correlations were observed between serum 25OHD and TNFα, IL-1β or IL-6 levels in healthy subjects or MCI patients, but these same correlations were positive in LOAD patients. ApoE alleles indicated that these positive correlations exist only in ?4 carrier LOAD patients. Consequently, our results indicate that vitamin D deficiency presents a greater risk for ApoE?4 non-carrier AD patients than for ?4 carriers. Therefore, it might be beneficial to monitor the vitamin D status of ApoE?4 allele non-carrier AD patients.     

Shear bond strengths of self-etching adhesives to caries-affected dentin on the gingival wall

The purpose of this study was to evaluate the bonding ability of five current self-etching adhesives to caries-affected dentin on the gingival wall. Seventy extracted human molars with approximal dentin caries were employed in this study. In order to obtain caries-affected dentin on the gingival wall, grinding was performed under running water. Following which, specimens mounted in acrylic blocks and composite resins of the bonding systems were bonded to dentin with plastic rings and then debonded by shear bond strength. With Clearfil SE Bond, bonding to caries-affected dentin showed the highest bond strength. With Optibond Solo Plus Self-Etch, bonding to caries-affected dentin showed higher shear bond strength than AQ Bond, Tyrian SPE & One-Step Plus, and Prompt-L-Pop (p<0.05). Further, the bond strengths of Clearfil SE Bond and Optibond Solo Plus Self-Etch to sound dentin were higher than those of Prompt-L-Pop, AQ Bond, and Tyrian SPE & One-Step Plus (p<0.05). In conclusion, besides micromechanical interlocking through hybrid layer formation, bond strength of self-etch adhesives to dentin may be increased from additional chemical interaction between the functional monomer and residual hydroxyapatite. The results of this study confirmed that differences in bond strength among self-etching adhesives to both caries-affected and sound dentin were due to chemical composition rather than acidity.