Attitudes of psychiatrists toward patients with schizophrenia

A questionnaire was distributed to psychiatrists to investigate their attitudes toward patients with schizophrenia. A total of 42.7% of 60 respondents never informed patients of the diagnosis of schizophrenia and 40.7% informed on a case-by-case basis. The reason that psychiatrists gave for avoiding informing the patients/family members of the diagnosis was the idea that they would not understand the meaning (32.6%) and that they would drop-out from treatment (28.3%). A total of 88.4% of respondents thought the term 'schizophrenia' was used in a pejorative manner in public. The findings revealed that stigmatizing attitudes of society are also shared by some psychiatrists.     

Hepatitis B virus vaccination of recipients and donors of allogeneic peripheral blood stem cell transplantation

Abstract: Background: The aim of this study was to determine the role of hepatitis B virus (HBV) vaccination as defined by the seroconversion to hepatitis B surface antibody (anti‐HBs) positivity in peripheral blood stem cell transplants. Methods: A total of 65 recipients and their donors were enrolled in this study. Recipients were divided into four distinct groups. Group 1 consisted of individuals who were vaccinated, group 2 consisted of individuals who were naturally immunized, group 3 consisted of individuals who were HBs‐Ag positive, and group 4 consisted of individuals who were HBV naïve and not vaccinated. Results: Eighty‐eight percent of the HBV‐vaccinated recipients (14 of 16), who had vaccinated‐donors, seroconverted to anti‐HBs positivity. Eighty‐three percent of HBV‐naïve recipients (five of six), who received stem cells from HBV‐immune donors, seroconverted to anti‐HBs positivity. Two of the four HBs‐Ag positive recipients with HBV‐immune donors seroconverted to anti‐HBs positivity after transplantation. Fifty‐seven percent of previously vaccinated‐recipients (eight of 14) lost detectable anti‐HBs antibody following transplantation. Finally, 31% of HBV‐naïve recipients with HBV‐naïve donors acquired a de novo HBV infection. Conclusions: (i) Hepatitis B virus immunization of recipients of allogeneic hematopoietic cell transplantation results in an effective antibody response. (ii) The HBV‐immune status of the donor plays an important role in post‐transplantation HBs‐Ab on seroconversion. (iii) Systematic re‐immunization of recipients will be necessary to maintain HBV immunity in long‐term serving recipients.     

Amikacin induced renal damage and the role of the antioxidants on neonatal rats

Amikacin (AK) is frequently used on the treatment of Gram-negative infections on neonates, but its usage is restricted because of nephrotoxicity. In this study, on neonatal rats, we aimed to investigate the effects of erythropoietin and vitamin E on AK induced nephrotoxicity. A total of 35 newborn Wistar Albino rats were divided into four groups: (1) injected with saline (serum physiological was administered to placebo controls), (2) injected with AK (1200?mg/kg), (3) injected with AK?+?vitamin E (150?mg/kg), (4) injected with AK?+?erythropoietin (EPO) (300?IU/kg/day). In renal tissue, AK levels were significantly high in all groups except the control. Tissue malondialdehyde (MDA) and nitric oxide (NO) levels were statistically higher in AK -treated group than the control. MDA and NO levels were significantly decreased with the administration of vitamin E and EPO. Glutathione peroxidase (GPX) levels were statistically low in AK group compared with the controls. The levels of GPX, in vitamin E group, were increased significantly. However, superoxide dismutase and catalase levels were not significantly different in none of the groups. Insulin-like growth factor-1 values in AK, EPO and vitamin E groups were significantly higher than the control group. Histomorphological changes such as tubular epithelial necrosis were seen in AK treated group. Histopathological improvements observed with EPO and vitamin E administration. AK nephrotoxicity is related to oxidative stress and is supported with biochemical and histopathological findings. Vitamin E and EPO, as antioxidants, can be useful renoprotective agents for ameliorating AK induced nephrotoxicity in neonates.     

Determinants of BMI in patients with COPD

OBJECTIVE: COPD is characterized by significant chronic inflammation that is evident not only in the pulmonary compartment but also in the circulation. Peripheral blood features of COPD include markers of oxidative stress and altered circulating levels of inflammatory mediators and acute-phase proteins. The presence of a systemic inflammatory response may influence quality of life by giving rise to weight loss, muscle wasting and tissue depletion. The aim of the present study was to evaluate the determinants of body mass and the value of serum tumour necrosis factor alpha (TNF-alpha) as a marker of weight loss in COPD patients, and to correlate this with the burden of oxidative stress as measured by serum malonyldialdehyde (MDA) levels. METHODOLOGY: Fifty-two male COPD patients (mean age 62.55 +/- 6.81 years) were studied. After anthropometric measurements and standard spirometry, serum TNF-alpha concentration was measured by enzyme-linked immunosorbent assay using an hTNF-alpha kit, and MDA was studied spectrophotometrically using the Yoshioka-Kawada method. RESULTS: The mean BMI was 24.82 +/- 3.46. BMI was lower than normal (< 19) in six patients. Mean serum TNF-alpha concentration was 14.99 +/- 8.98 pg/mL and MDA was 0.93 +/- 0.13 nmol/L. There was no significant correlation between serum MDA and TNF concentrations (P = 0.140). Serum TNF-alpha and MDA concentrations were not correlated with severity of airflow obstruction or degree of hypoxaemia (P > 0.05 for all). BMI was negatively correlated with burden of smoking (pack-years) (r = -0.392, P= 0.004); but not with pulmonary function, degree of hypoxaemia, serum TNF-alpha or MDA levels. BMI was significantly lower in current smokers than ex-smokers (P = 0.041); however, serum MDA and TNF levels were similar in both groups. CONCLUSION: The results of this study indicate that body mass is related to smoking status (both pack-years and continuance of smoking) in COPD; however, serum TNF-alpha concentration does not seem to be a good marker of weight loss in these patients.     

Feasibility and diagnostic reliability of quantitative flow ratio in the assessment of non-culprit lesions in acute coronary syndrome

Several studies have demonstrated the feasibility and safety of hemodynamic assessment of non-culprit coronary arteries in setting of acute coronary syndromes (ACS) using fractional flow reserve (FFR) measurements. Quantitative flow ratio (QFR), recently introduced as angiography-based fast FFR computation, has been validated with good agreement and diagnostic performance with FFR in chronic coronary syndromes. The aim of this study was to assess the feasibility and diagnostic reliability of QFR assessment during primary PCI. A total of 321 patients with ACS and multivessel disease, who underwent primary PCI and were planned for staged PCI of at least one non-culprit lesion were enrolled in the analysis. Within this patient cohort, serial post-hoc QFR analyses of 513 non-culprit vessels were performed. The median time interval between primary and staged PCI was 49 [42–58] days. QFR in non-culprit coronary arteries did not change between acute and staged measurements (0.86 vs 0.87, p?=?0.114), with strong correlation (r?=?0.94, p?≤?0.001) and good agreement (mean difference -0.008, 95%CI -0.013–0.003) between measurements. Importantly, QFR as assessed at index procedure had sensitivity of 95.02%, specificity of 93.59% and diagnostic accuracy of 94.15% in prediction of QFR?≤?0.80 at the time of staged PCI. The present study for the first time confirmed the feasibility and diagnostic accuracy of non-culprit coronary artery QFR during index procedure for ACS. These results support QFR as valuable tool in patients with ACS to detect further hemodynamic relevant lesions with excellent diagnostic performance and therefore to guide further revascularisation therapy.

     

Comparison of Orthodontic Root Resorption of Root-filled and Vital Teeth Using Micro–computed Tomography

ObjectiveTo evaluate the difference in orthodontic root resorption between root-filled and vital teeth.Material and MethodsSixteen individuals who required bilateral premolar tooth extraction due to orthodontic treatment and had a previously root-filled premolar tooth on one side were included in the study. The experimental group consisted of root-filled premolar teeth, and the control group consisted of contralateral vital premolar teeth. A 150-g buccally directed force was applied to these teeth using 0.017 × 0.025-inch TMA cantilever springs. The premolars were extracted 8 weeks after the application of force. Images were obtained using micro–computed tomography. Resorption measurements were obtained using the Image J program.ResultsThe mean values for resorption were 0.08869 mm³ for the root-filled teeth and 0.14077 mm³ for the contralateral teeth, indicating significantly less resorption for the root-filled teeth compared with the contralateral teeth after the application of orthodontic force (P = .003). In both groups, the most resorption was seen on the cervical-buccal and apical-lingual surfaces. The mean resorption value of the cervical region was 0.06305 mm³ in the control group and 0.0291 mm³ in the experimental group, and the difference was statistically significant (P = .002).ConclusionsRoot-filled teeth showed significantly less orthodontic root resorption than vital teeth.     

The crosstalk of gut microbiota and chronic kidney disease: role of inflammation,proteinuria, hypertension,and diabetes mellitus

Chronic kidney disease (CKD) has been shown to result in profound changes in the composition and functions of the gut microbial flora which by disrupting intestinal epithelial barrier and generating toxic by-products contributes to systemic inflammation and the associated complications. On the other hand, emerging evidence points to the role of the gut microbiota in the development and progression of CKD by provoking inflammation, proteinuria, hypertension, and diabetes. These observations demonstrate the causal interconnection between the gut microbial dysbiosis and CKD. The gut microbiota closely interacts with the inflammatory, renal, cardiovascular, and endocrine systems via metabolic, humoral, and neural signaling pathways, events which can lead to chronic systemic inflammation, proteinuria, hypertension, diabetes, and kidney disease. Given the established role of the gut microbiota in the development and progression of CKD and its complications, favorable modification of the composition and function of the gut microbiome represents an appealing therapeutic target for prevention and treatment of CKD. This review provides an overview of the role of the gut microbial dysbiosis in the pathogenesis of the common causes of CKD including hypertension, diabetes, and proteinuria as well as progression of CKD.