An early diagnostic tool for diabetic neuropathy: conduction velocity distribution

Diabetes is a metabolic disorder that affects much of the human population. As a secondary complication, diabetic neuropathy causes time-dependent damage to peripheral nerves. In this study, experimental diabetes was induced by streptozotocin (STZ; 50 mg/kg intraperitoneally) in rats. Diabetic animals were grouped into those with 2 or 4 weeks of diabetes, whereas a control group received only the STZ vehicle (0.1 M citrate). Sciatic nerves were dissected, and compound action potentials (CAPs) were recorded. Results deduced by conventional calculation carried less information when compared with conduction velocity distribution (CVD) obtained by a computer-based mathematical model. Using the conventional approach, statistically significant changes were first seen in the fourth week of diabetes, whereas results deduced by CVD measurement could be seen in the second week. Consequently, the CVD calculation provides more information for the early diagnosis of neuropathies compared with classical conduction velocity measurements.     

Psychological and physical correlates of disordered eating in male and female Turkish college students

The aim of this study was to examine the relationship between disordered eating and three psychological variables (obsessive and depressive symptoms, self-esteem) and body mass index (BMI) in a sample of male and female college students in Turkey. Maudsley Obsessive-Compulsive Inventory (MOCI), Beck Depression Inventory (BDI), Rosenberg Self Esteem Scale (RSES), Eating Attitude Test (EAT), and Bulimic Investigatory Test, Edinburgh (BITE) scales were administered to 408 college students (279 women; 129 men). By multiple regression analysis, the scales of MOCI, BDI, RSES and BMI were used as potential predictors of EAT and BITE scores for each gender. Obsessionality and BMI were the strongest predictors of bulimic and anorexic symptoms in women. In men, while the strongest predictors of bulimic symptoms were the depressive and obsessive symptoms, the best predictor of anorexic symptoms was obsession scores. There were significant differences and some similarities between male and female Turkish college students.     

Acetabular dysplasia may be related to global joint hyperlaxity

Purpose

Some patients with shoulder laxity complain of coxalgia without a history of trauma. We hypothesised that patients who have recurrent shoulder instability accompanied with generalised joint hyperlaxity tend to have acetabular dysplasia.

Methods

Pelvic radiographs of 26 young patients with hyperlaxity who had shoulder instability complaints without any history of hip joint trauma were evaluated by measuring their centre-edge angle (CEA) and acetabular angle (AA). In addition, Beighton generalised joint laxity tests were performed. All of the patients had shoulder pain and instability accompanied with hyperlaxity. We performed magnetic resonance imaging examination to show SLAP-Bankart lesions and pelvis anteroposterior X-rays to detect acetabular dysplasia.

Results

The average age of the study group was 26?±?8.03 years (13-39). Six patients were female and 20 were male. When CEA (<22.6 degrees) was used as a criterion for acetabular dysplasia, the dysplasia rate of our patient group was 3.84 % for the right hip, 3.84 % for the left hip and 3.84 % overall. When AA (>42.2 degrees) was used as the dysplasia criterion, the dysplasia rate of patient group was 30.76 % for the right hip, 57.69 % for the left hip and 57.69 % overall.

Conclusions

CEA values were significantly lower (p?=?0.009) and AA values were significantly higher (p?<?0.001) in our study group than the previously-reported average values of the Turkish population. We think that acetabular dysplasia is more frequent in patients with hyperlaxity; further studies are needed to test this idea.

     

Factors affecting outcomes of corneal collagen crosslinking treatment

Purpose

To assess the effects of preoperative patient characteristics on clinical outcomes of corneal crosslinking (CXL) treatment in patients with progressive keratoconus.

Methods

This retrospective study comprised 96 eyes of 96 patients who had unilateral CXL treatment for progressive keratoconus. All patients underwent a complete ophthalmological examination and corneal topography at baseline and 1 year. Subgroup analyses were performed according to the age (<30 and≥30 years), gender, preoperative corrected distance visual acuity (CDVA, <0.3 and ≥0.3 logMAR (log of the minimum angle of resolution)), preoperative maximum keratometry (K, <54 and ≥54 D), baseline topographic cone location (central, paracentral, and peripheral), and preoperative thinnest pachymetry (<450 and ≥450 μm) to determine the associations between preoperative patient characteristics and outcomes (changes in visual acuity and maximum keratometry) of CXL treatment.

Results

In the entire study population, mean CDVA and maximum K significantly improved after CXL treatment (P<0.001). Patients with a preoperative CDVA of 20/40 Snellen equivalent or worse (≥0.3 logMAR) experienced more visual improvement after CXL treatment (P<0.001). However, an age ≥30 years and a baseline thinnest pachymetry less than 450 μm were found significantly associated with more flattening in maximum keratometry (P=0.024, P=0.005 respectively). Gender, preoperative maximum K, and baseline topographic cone location did not show significant effect on postoperative visual acuity and maximum keratometry (P>0.05).

Conclusions

In patients with progressive keratoconus, age, baseline visual acuity, and baseline thinnest pachymetry seem to affect the success of the CXL treatment.     

Transcatheter Closure of a Large Left Atrial Aneurysm With a Right Pulmonary Artery-to-Left Atrium Connection Using the Amplatzer Ventricular Septal Occluder

A right pulmonary artery-to-left atrium connection is a very rare cyanotic congenital heart defect. Although it is generally treated with surgery, we describe the case of a 5-year-old girl whose connection was successfully closed the Amplatzer muscular ventricular septal defect occluder. The patient was asymptomatic at last follow-up.     

Digital eye strain and its associated factors in children during the COVID-19 pandemic

Purpose:This study was undertaken to identify the prevalence of symptoms related to the use of display devices and contributing factors in children engaged in distance learning during the COVID-19 pandemic.Methods:An online electronic survey form was prepared using Google Forms (Alphabet Co., Mountain View, CA) and sent to parents of children under the age of 18 years engaged in distance learning during the COVID-19 pandemic. The types of display devices children use, how often such devices are used, the symptoms of digital eye strain, and the severity and frequency of the symptoms were recorded, and the associations between the factors were analyzed.Results:A total of 692 participants were included. The mean age of the children was 9.72 ± 3.02 years. The most common display devices used were personal computers (n = 435, 61.7%) for online classes and smartphones (n = 400, 57.8%) for nonacademic purposes. The mean duration of display device use was 71.1 ± 36.02 min without a break and 7.02 ± 4.55 h per day. The most common reported symptom was headache (n = 361, 52.2%). Of the participants, 48.2% (n = 332) reported experiencing 3 or more symptoms. The multivariate analysis detected that being male (P = 0.005) and older age (P = 0.001) were independent risk factors for experiencing 3 or more symptoms.Conclusion:The increasing use of digital devices by children is exacerbating the problem of digital eye strain in children as a side effect of online learning. Public awareness should be improved.     

A retrospective study of central nervous system shunt infections diagnosed in a university hospital during a 4-year period

Background  

Ventriculoperitoneal (VP) shunts are used for intracranial pressure management and temporary cerebrospinal fluid (CSF) drainage. Infection of the central nervous system (CNS) is a major cause of morbidity and mortality in patients with CSF shunts. The aim of the present study was to evaluate the clinical features, pathogens, and outcomes of 22 patients with CSF shunt infections collected over 4 years.     

Investigating the volume status before contrast nephropathy studies.

Sir, We read with great interest the original article by Drager etal. [1] about the mechanism of a protective effect of N-acetylcysteine(NAC) against contrast-induced nephropathy (CIN) in patientsundergoing elective coronary angiography. This study assessedpre- and post-radiocontrast NAC effects on specific oxidativestress and renal tubular injury markers. CIN is one of the well-recognizedrisks of coronary     

A review of late complications of allogeneic hematopoietic stem cell transplantations

Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is an effective and curative treatment of different malignant and non‐malignant diseases. Early transplant‐related mortality after allo‐HSCT has decreased with reduced‐intensity conditioning regimens and effective anti‐infectious treatments, but late transplant‐related mortality is still a problem. Physicians are now paying more attention to late complications that may worsen the quality of life of many transplant recipients. Chronic graft versus host disease (cGVHD) is one of the major causes of late transplant‐related mortality after allo‐HSCT. This review discusses recent advances that have been made in clinical evaluation and treatment of late transplant‐related complications including cGVHD. The different sites of involvement are organs, especially the skin and eye, and the gastrointestinal, endocrinologic, metabolic, renal, cardiologic, pulmonary, connective tissue, and neurological systems. In addition, this review includes infections and secondary malignancies in post‐transplant settings that worsen quality of life in long‐term follow‐ups.