Ischemia-modified albumin levels in cerebrovascular accidents

Background

Previous studies have demonstrated that ischemia-modified albumin (IMA) is a useful marker for the diagnosis of ischemic events. It was also recently demonstrated that IMA levels increase in the acute phase of cerebrovascular diseases. Yet the data regarding IMA levels in various types of cerebrovascular events are insufficient. The aim of this study was to evaluate IMA levels in various types of cerebrovascular events such as ischemic stroke, subarachnoid hemorrhage (SAH), and intracranial hemorrhage.

Methods

This case-controlled study consisted of 106 consecutive patients, 43 with brain infarction (BI), 11 with brain hemorrhage (ICH), 52 with SAH, and a 43-member control group. We investigated whether there was a statistical correlation between these 3 groups and the control group. The relations among the 3 groups were also examined. Comparisons among groups were done with analysis of variance.

Results

Mean serum IMA levels were 0.280 ± 0.045 absorbance units (ABSU) for BI patients, 0.259 ± 0.053 ABSU for ICH patients, 0.243 ± 0.061 ABSU for SAH patients, and 0.172 ± 0.045 ABSU for the control group.There was a statistically significant difference between the mean IMA levels of BI, ICH, and SAH patients and the mean control patient IMA levels (P < .0001).

Conclusions

Ischemia-modified albumin levels are high in cerebrovascular diseases. Ischemia-modified albumin measurement can also be used to distinguish SAH from BI during the acute phase of cerebrovascular event in the emergency department.     

Evaluation of the outcome of out-of-hospital cardiac arrest resuscitation efforts in Denizli, Turkey

The objective of this study was to evaluate the outcomes and associated factors for short-term success and long-term survival rates of resuscitated non-traumatic out-of-hospital cardiac arrest (OHCAs) in Denizli, Turkey. All non-traumatic OHCA patients from the Emergency Departments of the Pamukkale University and City Hospitals between the dates of January 1, 2004 and March 1, 2005 were included in this study. A successful outcome was defined as the return of spontaneous circulation or breathing, or evidence of a palpable pulse or a measurable blood pressure. Information on post-resuscitation long-term survival up to 9 months also was obtained by telephone. A total of 222 adults experiencing OHCAs were resuscitated. The number of successful outcomes was 85 (38.3%); 25 (11.2%) were discharged alive; and 21 (9.4%) were alive at the 9-month follow-up. The predicted mean arrest time was 11.7 min (95% confidence interval 10.27-13.2). Type of transportation to the Emergency Department (ambulance, 32.1% vs. private vehicle, 44.5%; p = 0.057), place of arrest (home, 32.6% vs. other, 44.0%; p = 0.08), first rhythm at the scene (asystole, 22.9% vs. ventricular fibrillation-pulseless ventricular tachycardia, 48.0%, vs. pulseless electrical activity, 12.5%; p = 0.056), and advanced cardiac life support starting time (the first 8 min, 46.8% vs. later than 8 min, 32.0%; p = 0.025) had an effect on outcome. Intensive public education for diagnosis and appropriate reporting of OHCA, the importance of bystander cardiopulmonary resuscitation, and the use of automated external defibrillators have an impact on the potential to increase the number of survivors.     

The phenomenology of autistic regression: subtypes and associated factors

This study aimed to investigate the association of autistic regression (AR) and subtypes of AR with medical, developmental and psychiatric factors. Fifty-seven children with autistic spectrum disorders (ASD) were included in the study. Two types of AR are defined as regression after a normal social/language development (type 1) and regression as the worsening of previously reported autistic features (type 2). The frequency of history of AR was 56.1%. Male gender and sleep problems were found to be associated with a positive history of AR. The frequency of gastrointestinal complaints/diseases was higher in children with regression type 2 when compared to the children with regression type 1. Future studies with larger sample size and prospective design will contribute to clarifying the phenomenology and the associated factors of AR.     

The color differences of direct esthetic restorative materials after setting and compared with a shade guide

BackgroundThe authors conducted a study to evaluate esthetic restorative materials’ color differences after setting and color matching between set materials and a shade guide.Materials and MethodsThe authors evaluated 13 resin-based composites, one silorane-based composite, two polyacid-modified resin composites and one conventional glass ionomer cement. They measured the color parameters of the samples, which were 8 millimeters in diameter and 1.5 mm in thickness, before and after they were set according to the Commission International de l’Eclairage (CIE) L*a*b* color scale relative to standard illumination against a white background by means of a dental colorimeter. They also compared the final colors of the restorative materials with a shade guide.ResultsColor difference values for each restorative material ranged from 3.25 to 14.04. With the exception of Fuji IX (GC, Tokyo), Filtek P60 (3M ESPE) and Te-Econom (Ivoclar Vivadent), the restorative materials exhibited a perceptible color change after setting. Color difference values between the set materials and the shade guide tabs ranged from 1.86 to 11.83. With the exception of Filtek Supreme XT (3M ESPE) and Fuji IX, the materials exhibited a perceptible difference.ConclusionMost of the materials tested exhibited a significant color change after polymerization and did not match the shade guide tab after undergoing light curing.     

CT and MRI examinations left behind in the radiology department

PURPOSE: To retrospectively document the reported computerized tomography (CT) and magnetic resonance imaging (MRI) examinations that were left behind in our radiology department, to calculate their cost, and to determine possible sources of waste in order to draw attention to this subject. MATERIALS AND METHODS: The reported and billed CT and MRI examinations for 2003 that were not taken from the radiology department were documented, and the percentage they represented of all CT and MRI performed that year were determined. The total cost of the examinations, including contrast media, was calculated. RESULTS: In all, 200 CTs out of 4390 and 95 MRIs out of 7003 were left behind in the radiology department during 2003. Total cost of the examinations, including the contrast media, was 31,320 YTL. CONCLUSION: The percentages of CT and MRI examinations left behind in the radiology department were evaluated in this preliminary report. Since we did not find any similar study in the literature, we could not comment on the limits of acceptability of the results; however, we think other radiology departments should determine the percentages CTs and MRIs that are left behind and take the necessary precautions to minimize waste and reduce expenses.     

Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire

OBJECTIVES: The aim of this study was to develop a Turkish version of the Boston Questionnaire and assess its reliability and validity. METHODS: Sixty-seven patients with idiopathic carpal tunnel syndrome were included in the study. The Turkish version of Boston Questionnaire was obtained after translation process, and was then administered to subjects twice within seven days. Reliability was assessed by internal consistency (Cronbach's alpha and item-total correlation), and reproducibility. Validity was examined by correlating the Boston Questionnaire scores to general health status (Short Form-36), pain severity (Visual Analogue Scale) and pinch and grip strength measures. RESULTS: Reliability of the Turkish version was very good, with high internal consistency (Cronbach's alpha 0.82 for symptom severity scale, and 0.88 for functional status scale), and reproducibility (Pearson correlation coefficient 0.60 for symptom severity scale, and 0.77 for functional status scale). The Boston Questionnaire scores were correlated with Visual Analogue Scale, physical functioning, physical role, bodily pain and emotional role subscales of Short Form-36, pinch and grip strength scores to obtain coefficients for external construct validity. CONCLUSION: Adaptation of the Boston Questionnaire for use in Turkey was successful. Our results seem to support previous finding of the English version, indicating that it is valid and reliable.     

Extramedullary myeloid leukemia mimicking lepromatous leprosy

Granulocytic sarcoma is an extramedullary localized tumoral lesion of myeloid precursors. It is composed of immature cells of the granulocytic series known to occur in patients with myelodysplastic syndrome, chronic myelogenous leukemia or acute myelogenous leukemia. We present a 29-year-old female who was admitted to hospital for lesions that appeared on the face, lips and nose, mimicking lepromatous leprosy. It should be kept in mind that granulocytic sarcoma may mimick lepromatous leprosy.     

Assessment of indoor air fungi in Western-Anatolia, Turkey

This study was conducted to determine fungal spores in the indoor air of the houses in the city of Afyon, Western-Anatolia, Turkey. We investigated the seasonal properties of mould spores in 10 houses of Afyon over a period of one year. Viable moulds were recovered from all 10 houses. Twenty seven different moulds were isolated and identified from the indoor air of the houses. The most common genus was Cladosporium spp. (31.9%), followed by Aspergillus spp. (18.6%), Penicillium spp. (15.5%), Altemaria spp. (13.0%) and other species (21.0%). The mould concentration was higher in the kitchens than in other parts of the houses such as the living rooms and bedrooms (p < 0.05). The fungal flora of the air in the Afyon city region has a seasonal variation. All fungal species had their highest prevalence in summer and their lowest in winter, but only Aspergillus spp. had a significant seasonal variation (p = 0.012). Viable moulds are common in the houses of Afyon. Reducing these indoor fungi is necessary to improve the health of individuals with fungal-induced diseases like asthma.     

Fibroblast growth factor-19 levels in type 2 diabetic patients with metabolic syndrome

This study aimed to examine fibroblast growth factor-19 (FGF-19) in type 2 diabetic (T2DM) patients with metabolic syndrome (MetS) and to evaluate the relationship between FGF-19 and other cardiovascular risk factors, such as atherogenic index of plasma (AIP) and hsCRP. 26 T2DM patients with MetS and 12 healthy controls were enrolled in the study. Serum FGF-19 levels were measured by sandwich ELISA, and compared with other cardiovascular risk factors; lipid profile, AIP, glucose, HbA1c, and hsCRP. AIP was calculated as log (TG/HDL-c). The median (1-3.quartile) FGF-19 levels in T2DM patients with MetS and healthy controls were 122.90 (108.63-237.60) pg/ml and 293.45 (153.64-370.31) pg/ml, respectively (P=0.003). Patients were also grouped by body mass index (BMI) <30 kg/m(2) (n=13) and ≥30 kg/m(2) (n=13) with median (1-3.quartile) FGF-19 values 168.70 (113.54-275.77) pg/mL and 115.89 (97.94-200.40) pg/mL, respectively (P=0.007). Significant negative correlations were found between FGF-19 and BMI, triglyceride, log (TG/HDL-c), hsCRP, and HbA1c (r=-0.526, P=0.001; r=-0.327, P=0.05; r=-0.312, P=0.05; r=-0.435, P=0.006; r=-0.357, P=0.028, respectively). We showed that FGF-19 levels are low in T2DM patients with MetS. The negative relationship between FGF-19 and several known cardiovascular risk factors such as TG, log (TG/HDL-c), hsCRP and HbA1c in diabetic patients with MetS suggests that FGF-19 can be used as a contributing marker.