RECONSTRUCTION OF MICROFORM CLEFT LIP

Partial cleft of the orbicularis oris muscle without skin and mucosa can also be called "discontinuity of the orbicularis oris muscle" or "subepithelial cleft". Microform cleft lip or mini-cleft lip are better definitions. We present two women aged 25 and 29 years old who complained of vermilion notching, vertical depression on the upper lip, and asymmetry of lower lateral cartilage of the nose. The "discontinuity of the muscle" was found at operation in both cases and reconstructed successfully.     

High frequency of aspirin resistance in patients with acute coronary syndrome

Aspirin is widely used for secondary prevention of cardiovascular disease, but is not effective for all patients. This phenomenon is called as aspirin resistance. Although the prognosis is worse in patients who develop acute coronary syndrome (ACS) while using aspirin, the frequency of aspirin resistance in these patients has not been evaluated. We aimed to evaluate the frequency of aspirin resistance in patients with ACS and to determine its relationship with the angiographic severity and extent of the associated coronary artery disease. The present study included 104 patients with ACS (75 men, 60.4 +/- 10.8 years) who were hospitalized while using aspirin for at least last 7 days and 100 patients with stable coronary artery disease (73 men, 57.6 +/- 10.6 years), documented by coronary angiography, history of revascularization or myocardial infarction (MI), and the use of aspirin for last 7 days. The latter group had no MI or ACS for last 3 months. Platelet function was assessed with PFA-100, which simulates primary homeostasis at injured blood vessels. Coronary angiography was performed in 83 cases of the patients with ACS during hospital stay. Aspirin resistance is more prevalent in patients with ACS (40.3%) when compared with stable coronary artery disease patients (27%). The difference was statistically significant (p = 0.04). The ACS patients with aspirin resistance were older and had severe myocardial damage. However, there were no significant differences in angiographic severity and extent of coronary artery disease between aspirin-resistant and aspirin-sensitive patients. Frequency of aspirin resistance is higher in patients who develop ACS while using aspirin than that in patients with stable coronary artery disease.     

Intra-erythrocyte magnesium levels and their clinical implications in geriatric outpatients

Objectives

Magnesium deficiency has been implicated as a factor in numerous chronic diseases and previous studies suggest a greater prevalence of occult magnesium deficiency among older adults. Serum is the choice for the assessment of most analyses used in clinical medicine, although serum magnesium concentrations have been shown to be poor predictors of intracellular magnesium concentration. The aim of this study was to compare intracellular and extracellular magnesium concentrations in geriatric outpatients. Moreover, we examined whether a significant correlation between magnesium parameters and clinical outcome existed.

Design

Cross-sectional study.

Setting

Geriatric medicine outpatient clinic of a university hospital.

Participants

A total of 246 patients with a mean age of 71.9±5.7 years were involved.

Measurements

Intra-erythrocyte magnesium levels were analyzed with atomic absorption spectrophotometry.

Results

Serum magnesium levels were within normal range in all patients, whereas intra-erythrocyte magnesium measurements were low in 57% of the patients. Increase in serum levels were together with just only a slightly increase in intra-erythrocyte measurements and the relationship was very weak. Intra-erythrocyte Mg levels were not significantly correlated with many laboratory or clinical parameters.

Conclusion

Our results confirm that intra-erythrocyte Mg does not correlate with serum levels and clinical parameters in geriatric outpatients, but further studies are needed to define the correlation.     

The effect of hysterectomy and bilaterally salpingo-oophorectomy on sexual function in post-menopausal women

Objective

To examine the effects of hysterectomy and bilaterally salpingo-oophorectomy (BSO) on Female Sexual Function Index (FSFI) in the post-menopausal women.

Method

This study included 92 women who underwent vaginal hysterectomy (VH) and BSO (n:37) and who underwent abdominal hysterectomy (AH) and BSO (n:55). Estrogen replacement therapy (ERT) was given 21 women who underwent VH and BSO and 28 women who underwent AH and BSO in pre- and postoperative periods. All patients were evaluated preoperatively and postoperative 6th month in terms of FSFI scores.

Results

It was found that hysterectomies by abdominal or vaginal routes reduced FSFI scores significantly (P < 0.05). The use of ERT were no effect on total score of FSFI in AH and BSO (P > 0.05). ERT prevented deterioration of FSFI in women who underwent VH relative to preoperative values but AH.

Conclusion

Hysterectomy causes unfavourable effects on sexual functions at least in the first 6 postoperative months and this negative effect can not be repaired by estrogen replacement therapy in AH and BSO.