The effect of thiocolchicoside on cerebral vasospasm following experimental subarachnoid hemorrhage in the rabbit

Background

This study investigated the effects of thiocolchicoside to prevent cerebral vasospasm in a rabbit model of subarachnoid hemorrhage.

Methods

Twenty-four adult male New Zealand white rabbits were randomly divided into three groups of eight rabbits each: group 1 (control), group 2 (subarachnoid hemorrhage), group 3 (treatment). Thiocolchicoside (4 mg/kg, intraperitoneally) was administered just before intracisternal blood injection and continued for 72 h once a day in the same dose for group 3. Animals were killed 72 h after subarachnoid hemorrhage. Basilar artery cross-sectional areas and arterial wall thicknesses were measured in all groups.

Results

Intraperitoneal administration of thiocolchicoside was found to attenuate cerebral vasospasm after subarachnoid hemorrhage in rabbits. Thiocolchicoside treatment was determined to be effective in increasing the luminal area and reducing the wall thickness of the basilar artery.

Conclusions

Our findings, for the first time, showed that TCC can prevent vasospasm induced by SAH. Our results also showed that GABAergic activity may play an important role in cerebral vasospasm etiopathogenesis. In conclusion, the thiocolchicoside treatment might be beneficial in preventing vasospasm after subarachnoid hemorrhage, thus showing potential for clinical application.

     

Nosocomial infections due to Acinetobacter baumannii in a pediatric intensive care unit in Turkey

The aim of this study is to document the clinical characteristics and outcomes of Acinetobacter baumannii infections in pediatric patients in a pediatric intensive care unit (PICU) in Turkey. The ages ranged from 1 month to 16 years with a mean age of 55.5 months, and the male-to-female ratio was 1:1.5. Ventilator-associated pneumonia (10 patients) was the leading diagnosis, followed by catheter-related blood stream infection (4 patients), and bacteremia and ventilator-associated pneumonia associated with meningitis (1 patient) due to A. baumannii. Mechanical ventilation (93.3%), central venous catheter (73.3%), urinary catheter (93.3%), and broad spectrum antibiotic usage (80%) were the frequently seen risk factors. Neuromuscular (40%) and malignant (26.7%) disorders were the most common underlying diseases. Nosocomial A. baumannii is commonly multidrug-resistant, prolongs the length of stay in the PICU and increases the mortality rates in pediatric critical care.     

Breastmilk ghrelin,leptin, and fat levels changing foremilk to hindmilk: is that important for self-control of feeding?

The aim of this study was to evaluate the changes in the ghrelin, leptin, and fat levels in the foremilk and hindmilk and the possible relationship between these levels with the age and growth of term healthy infants. Sixty-two babies were subdivided (according to their nutrition) into breastfed (BF), formula-fed (FF), and BF plus FF (BF + FF) groups. The total and active ghrelin and tryglyceride levels and the total cholesterol levels in the foremilk and hindmilk were studied at the first and second visits (mean of the second and fifth months, respectively). At both visits, the total and active ghrelin and the total cholesterol levels were lower in the hindmilk than in the foremilk. However, the triglyceride levels were higher in the hindmilk than in the foremilk (p < 0.001). The leptin levels were also higher in the hindmilk, but this difference was not statistically significant. At the second visit, the mean total foremilk ghrelin (p < 0.01), leptin (p < 0.05), tryglyceride (p < 0.001), and cholesterol (p < 0.01) levels in the BF group were decreased compared with the levels at the first visit, whereas the active ghrelin levels increased (p < 0.001). At the second visit, we observed a 3.5% increase in the body mass index in BF infants, a 14.6% increase in FF infants, and an 11.8% increase in BF + FF infants (p < 0.01). The foremilk leptin levels were lower in the BF + FF group than in the BF group at both visits. In conclusion, at the first and second visits, the decreased ghrelin and increased tryglyceride and leptin levels in the hindmilk might be associated with the important role of self-control when feeding BF infants. The stable content of formulas might be associated with a lack of self-control during feeding and increased nutrition. Changing the breast milk ghrelin, leptin, and fat levels between the foremilk and hindmilk and between the first and second visits might explain the differences in the weight gain patterns of BF and FF infants.     

Traditions, anthrax, and children

Anthrax is sporadically seen in Turkey, especially among people who live in rural areas and who come in contact with animals. Two siblings with cutaneous anthrax are described in this report. A week before their admission to the hospital, contaminated cow's blood was smeared on their foreheads as part of a traditional ritual. Both children were successfully treated with crystalline penicillin. In developing countries, traditions such as blood smearing may be an important factor in the transmission of anthrax to children.     

Treatment of arsenical keratosis and Bowen's disease with acitretin

BACKGROUND: Long-term exposure to arsenic is associated with the development of arsenical keratosis, Bowen's disease, squamous cell carcinoma, and basal cell carcinoma. The efficacy of acitretin therapy was examined in two patients with cutaneous arsenical neoplasms. METHODS: Lipid profile, hematological and liver function tests were performed regularly during the therapy at monthly intervals. RESULTS: After the third month of treatment, improvement of lesions of arsenical keratosis and Bowen's disease were observed in both patients. For the first patient who received 1 mg/kg daily acitretin for 10 months nearly total clearing was obtained at the end of therapy. The second patient discontinued the treatment after a period of 5 months because of symptomatic side-effects. During therapy no new lesions and no laboratory side-effects were observed in either patient. CONCLUSIONS: Although these results need to be confirmed by larger, long-term trials, it appears that acitretin is effective in the treatment of Bowen's disease related with arsenic, as well as arsenical keratosis.     

Can preoperative gonadotropin and testosterone levels predict the success of varicocelectomy?

We examined the effects of preoperative hormonal values on varicocelectomy success. A total of 136 patients who underwent varicocelectomy for infertility in our clinic were analysed retrospectively. Improvement in semen quality was defined as >50% increase in post-operative total motile sperm count (TMSC) in those with preoperative TMSC >5 million and at least 100% increase in those with <5 million. The patients were divided into two groups as benefiting from the treatment (Group A) and no benefits (Group B). The best cut-off value for follicle-stimulating hormone (FSH) and the luteinising hormone/testosterone ratio (LTR) that can predict varicocelectomy success were 7.01 and 0.016 with an area under the curve of 0.844 and 0.856 respectively. The highest sensitivities and specificities of FSH and LTR were 0.845 and 0.788 and 0.821 and 0.846 respectively. Binary logistic regression analysis showed FSH (odds ratio [OR]: 3.7; p < .001) and LTR (OR: 5.2; p < .001) as independent predictive factors in predicting varicocelectomy success. Our study demonstrated that low FSH (7.01 IU/L) and LTR (<.016) can be a useful preoperative predictive tool to help identify men who benefit most from varicocelectomy in infertile patients with varicocele.     

Sodium fusidate-poly(D,L-lactide-co-glycolide) microspheres: preparation, characterisation and in vivo evaluation of their effectiveness in the treatment of chronic osteomyelitis

PURPOSE: The aim of this study was to prepare poly(D,L-lactide-co-glycolide) (PLGA) microspheres containing sodium fusidate (SF) using a double emulsion solvent evaporation method with varying polymer:drug ratios (1:1, 2.5:1, 5:1) and to evaluate its efficiency for the local treatment of chronic osteomyelitis. METHODS: The particle size and distribution, morphological characteristics, thermal behaviour, drug content, encapsulation efficiency and in vitro release assessments of the formulations had been carried out. Sterilized SF-PLGA microspheres were implanted in the proximal tibia of rats with methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis. After 3 weeks of treatment, bone samples were analysed with a microbiological assay. RESULTS: PLGA microspheres between the size ranges of 2.16-4.12 microm were obtained. Production yield of all formulations was found to be higher than 79% and encapsulation efficiencies of 19.8-34.3% were obtained. DSC thermogram showed that the SF was in an amorphous state in the microspheres and the glass transition temperature (T(g)) of PLGA was not influenced by the preparation procedure. In vitro drug release studies had indicated that these microspheres had significant burst release and their drug release rates were decreased upon increasing the polymer:drug ratio (p < 0.05). Based on the in vivo data, rats implanted with SF-PLGA microspheres and empty microspheres showed 1987 +/- 1196 and 55526 +/- 49086 colony forming unit of MRSA in 1 g bone samples (CFU/g), respectively (p < 0.01). CONCLUSION: The in vitro and in vivo studies had shown that the implanted SF loaded microspheres were found to be effective for the treatment of chronic osteomyelitis in an animal experimental model. Hence, these microspheres may be potentially useful in the clinical setting.     

Protective effect of sildenafil citrate on contralateral testis injury after unilateral testicular torsion/detorsion

OBJECTIVES:

This study was designed to investigate prevention of contralateral testicular injury with sildenafil citrate after unilateral testicular torsion/detorsion.

METHODS:

Thirty‐seven adult male rats were divided into four groups: sham operated (group 1, n  =  7), torsion/detorsion + saline (group 2, n  =  10), torsion/detorsion + 0.7 mg of sildenafil citrate (group 3, n  =  10) and torsion/detorsion + 1.4 mg of sildenafil citrate (group 4, n  =  10). Unilateral testicular torsion was created by rotating the right testis 720° in a clockwise direction for 2 h in other groups, except for group 1, which was served as sham group. After torsion (2 h) and detorsion (2 h) periods, rats were killed.

RESULTS:

The level of reduced glutathion (GSH) (p<0.05) and the activities of catalase (p<0.01) and glutathione peroxidase (p<0.05) in the contralateral testis from group 2 were significantly lower and nitric oxide (NO) (p<0.05) level in the contralateral testis were significantly higher than those of group 1. Administration of low‐dose sildenafil citrate (group 3) prevented the increases in malondialdehyde and NO levels and decreases in glutathione peroxidase activities and GSH values induced by testicular torsion. However, administration of high‐dose sildenafil citrate (group 4) had no effect on these testicular parameters (p>0.05). Histopathological changes were detected in groups 2, 3 and 4.

CONCLUSION:

These results suggest that biochemically and histologically torsion/detorsion injury occurs in the contralateral testis following 2‐h torsion and 2‐h detorsion and that administration of low‐dose sildenafil citrate before detorsion prevents ischemia/reperfusion cellular damage in testicular tissue.     

A Novel‐Modified Provisional Bifurcation Stenting Technique: Jailed Semi‐Inflated Balloon Technique

Objective

We proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi‐inflated balloon technique (JSBT).

Background

Currently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri‐procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach.

Methods

Between September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.6 ± 11.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month.

Results

The majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in‐hospital stay and 1 month follow‐up.

Conclusions

The JSBT technique can be successfully performed in both LM and non‐LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome. (J Interven Cardiol 2015;28:420–429)