A study of the respiratory function in insulin-dependent diabetic patients with and without limited joint mobility (LJM)

Summary The respiratory function of 51 insulin-dependent diabetic patients (31 with and 20 without LJM) was studied. The variables age, diabetes duration, height, and metabolic control were similar for both groups. Vital capacity (VC), forced expiratory volume (FEV), mean maximum expiratory flow (MMEF), and FEV/VC ratio were determined before and after the administration of a bronchodilator. VC, FEV, and MMEF showed significantly lower values (p<0.02) in patients without LJM as compared to those with LJM. It is suggested that these alterations may be due to abnormalities of collagen fibers and elasticity in the lung and are not related to reversible bronchial obstruction. We believe that LJM is an extrinsic manifestation of a systemic process, aggravating the prognosis of diabetes mellitus.     

The changes in the T-lymphocyte subsets in a population of Turkish children with puberty gingivitis

Objective.   The aim of the study was to investigate the number of CD4 and CD8 T lymphocytes, analyse subjects with gingivitis and those without, and determine the role of T lymphocytes in the pathobiology of puberty gingivitis.
Material and methods.   Fifty individuals with and without puberty gingivitis were recruited for this study. The CD4⁺ and CD8⁺ T-lymphocyte counts were determined using flow cytometry on the biopsy samples, and the CD4⁺/CD8⁺ ratio was calculated. At the same time, periodontal index scores were recorded to assess the periodontal status. Acquired data were analysed statistically using a paired t -test to compare laboratory values obtained before and after the treatment in individuals with puberty gingivitis and disease-free individuals. In addition, Pearson's correlation analysis was performed to investigate the relation between laboratory values and clinical measurements.
Results.   The CD4⁺/CD8 ratio in gingival tissues obtained from test group was significantly higher ( P <  0.05) than that found in the gingival tissue obtained from control group. We found that the CD4⁺ and CD8⁺ lymphocyte counts continued to increase significantly ( P <  0.001) and the CD4⁺/CD8⁺ ratio continued to drop significantly ( P <  0.05) after treatment in test group.
Conclusions.   T lymphocytes could play a significant role in the pathobiology of puberty gingivitis     

Local complications of hydatid disease involving thoracic cavity: imaging findings

Hydatid disease, a worldwide zoonosis, is caused by the larval stage of the Echinococcus tapeworm. Although it can involve almost every organ of the body, lung involvement follows in frequency the hepatic infestation in adults and is the predominating site in children. Radiologically, hydatidosis usually demonstrates typical findings, but many patients are at risk of developing various complications of hydatid disease with atypical imaging findings and these are rarely described in the literature. In this pictorial review, the imaging features of local complications of hydatid disease involving the thorax including intrapulmonary or pleural rupture, infection of the ruptured cysts, reactions of the adjacent tissues, thoracic wall invasion and iatrogenic involvement of pleura are described. Additionally, imaging characteristics of transdiaphragmatic thoracic involvement of hepatic hydatid disease are presented. To prevent the development of subsequent catastrophic results, all radiologists need to be aware of the atypical imaging appearances of complications of pulmonary hydatid disease.     

The role of diffusion- and perfusion-weighted magnetic resonance imaging in drug development for ischemic stroke: from laboratory to clinics

Ischemic stroke is a major cause of mortality and morbidity in industrialized countries and is almost always caused by occlusion of a cerebral artery by a clot. As the reversibly injured brain tissue evolves into irreversible infarction within a short period of time after onset of ischemia, it is extremely important and urgent to reverse the serious consequences of brain ischemia in the hyperacute phase when the ischemic brain tissue is still salvageable. Numerous thrombolytic and potentially neuroprotective agents have been studied in stroke patients with little success as the only approved therapy is thrombolysis with recombinant tissue plasminogen activator (r-tPA) within 3 h of stroke onset in highly selected patients (approximately 5 to 10 % of all acute stroke patients). One major obstacle in the development of effective therapies for ischemic stroke has been the lack of versatile imaging techniques. New magnetic resonance imaging (MRI) modalities, specially diffusion- and perfusion-weighted MRI (DWI and PWI, respectively) have been used in experimental studies with great success for over a decade and now are gradually entering clinical use. DWI and PWI can detect brain ischemia in the early phase in its full extent thus ensuring a definite diagnosis, allowing for follow-up of the ischemic lesion size over time with good spatial and temporal resolution, demonstrating perfusion deficit and reperfusion and the existence and the extent of penumbra while only requiring a few minutes of imaging time. DWI and PWI do not just give us the correct diagnosis of ischemic stroke, but allow us to acquire in vivo lesion size before therapeutic regimen is started and monitor the therapeutic efficacy thereafter, thus overcoming the potential pretreatment bias. We used DWI and PWI to evaluate novel therapeutic approaches for ischemic stroke in numerous experimental studies and lately in humans. With DWI and PWI, we are able to determine the in vivo efficacy (or lack of efficacy) of new therapeutic regiments (both neuroprotective and thrombolytic agents, or combination therapies) in a rapid, safe, and reliable way and in a relatively small number of well-selected, well-defined, and homogeneous patients. This approach may, therefore, significantly accelerate the development of new remedies for stroke patients.     

Effect of Different Oximes on Rat and Human Cholinesterases Inhibited by Methamidophos: A Comparative In Vitro and In Silico Study

Methamidophos is one of the most toxic organophosphorus (OP) compounds. It acts via phosphorylation of a serine residue in the active site of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), leading to enzyme inactivation. Different oximes have been developed to reverse this inhibition. Thus, our work aimed to test the protective or reactivation capability of pralidoxime and obidoxime, as well as two new oximes synthesised in our laboratory, on human and rat cholinesterases inhibited by methamidophos. In addition, we performed molecular docking studies in non‐aged methamidophos‐inhibited AChE to understand the mechanisms involved. Our results suggested that pralidoxime protected and reactivated methamidophos‐inhibited rat brain AChE. Regarding human erythrocyte AChE, all oximes tested protected and reactivated the enzyme, with the best reactivation index observed at the concentration of 50 μM. Concerning BChE, butane‐2,3‐dionethiosemicarbazone oxime (oxime 1) was able to protect and reactivate the methamidophos‐inhibited BChE by 45% at 50 μM, whereas 2(3‐(phenylhydrazono)butan‐2‐one oxime (oxime 2) reactivated 28% of BChE activity at 100 μM. The two classical oximes failed to reactivate BChE. The molecular docking study demonstrated that pralidoxime appears to be better positioned in the active site to attack the O‐P moiety of the inhibited enzyme, being near the oxyanion hole, whereas our new oximes were stably positioned in the active site in a manner similar to that of obidoxime. In conclusion, our work demonstrated that the newly synthesised oximes were able to reactivate not only human erythrocyte AChE but also human plasma BChE, which could represent an advantage in the treatment of OP compounds poisoning.     

Reactogenicity and immunogenicity of inactivated poliovirus vaccine produced from Sabin strains: A phase I Trial in healthy adults in Cuba

Background

To ensure that developing countries have the option to produce inactivated poliovirus vaccine (IPV), the Global Polio Eradication Initiative has promoted the development of an IPV using Sabin poliovirus strains (Sabin IPV). This trial assessed the reactogenicity and immunogenicity of Sabin IPV and adjuvanted Sabin IPV in healthy adults in Cuba.

Methods

This is a randomized, controlled phase I trial, enrolling 60 healthy (previously vaccinated) male human volunteers, aged 19–23 years to receive one dose of either Sabin IPV (20:32:64 DU/dose), adjuvanted Sabin IPV (10:16:32 DU/dose), or conventional Salk IPV (40:8:32 DU/dose). The primary endpoint for reactogenicity relied on monitoring of adverse events. The secondary endpoint measured boosting immune responses (i.e. seroconversion or 4-fold rise) of poliovirus antibody, assessed by neutralization assays.

Results

Sixty subjects fulfilled the study requirements. No serious adverse events reported were attributed to trial interventions during the 6-month follow-up period. Twenty-eight days after vaccination, boosting immune responses against poliovirus types 1–3 were between 90% and 100% in all vaccination groups. There was a more than 6-fold increase in median antibody titers between pre- and post-vaccination titers in all vaccination groups.

Discussion

Both Sabin IPV and adjuvanted Sabin IPV were well tolerated and immunogenic against all poliovirus serotypes. This result suggests that the aluminum adjuvant may allow a 50% (or higher) dose reduction.     

Ethanol extract of Cotinus coggygria leaves accelerates wound healing process in diabetic rats

Context: Cotinus coggygria Scop. (Anacardiaceae) leaves that were used as wound healing in traditional Balkan and Anatolian folk medicine, could be potentially effective in treating diabetic wounds.

Objective: This study investigates biochemical and histological effects of ethanol extract of C. coggygria (CCE) on excision wound model in diabetic rats.

Materials and methods: This study was conducted on diabetic Wistar albino rats, which were injected by a single dose (50?mg/kg i.p.) streptozotocin. Afterward an excision wound model was created in all animals; diabetic control rats were applied topically simple ointment and diabetic treatment rats were applied topically 5% (w/w) ointment with CC, once a day during the experimental period. Malondialdehyde, glutathione and hydroxyproline levels in wound tissues were investigated at the end of 3rd, 7th, and 14th days. Histopathological examination was also performed.

Results: Hydroxyproline content was significantly increased in the CCE treated group versus control after the 3rd and 7th days (15.33 versus 11.83; 19.67 versus 15.67?mg/g, p?<?0.05; respectively). A statistically significant elevation in glutathione at the end of 3rd, 7th, and 14th days (5.13 versus 1.58, p?<?0.05; 4.72 versus 1.88, p?<?0.05; 3.83 versus 1.88?μmol/g, p?<?0.05, respectively) and a statistically significant decrease in malondialdehyde level at the end of 7th day (4.49 versus 1.48?nmol/g, p?<?0.05) were determined in the treated group versus control group. These results were also supported by histological analyses.

Discussion and conclusion: These findings indicate that CCE accelerated the cutaneous wound healing process in diabetic wounds, in confirmation of its traditional use.     

Long-term effect of systemic isotretinoin on female fertility

Background/objective: Acne vulgaris is one of the most common diseases of the youth. Systemic isotretinoin is the only drug which acts on all of the etiopathogenic mechanisms of acne. Isotretinoin has some well-known side effects. Besides these, there is a suspicion whether it affects fertility or not. Previously, we conducted a study about isotretinoin’s effect on ovarian reserve which showed deteriorative reserve. In this study, we aimed to evaluate the long-term effects of systemic isotretinoin on female fertility.

Materials and methods: Of the 82 female patients who were enrolled in the first study, 79 patients were included in this study. Twelve months after the end of systemic isotretinoin treatment, patients were reevaluated by using the same parameters which include anti-Mullerian hormone (AMH), ovarian volume (OV), antral follicle count (AFC), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, free testosterone and total testosterone.

Results: The changes in the mean AMH, OV and AFC were statistically significant between the sixth and eighteenth months (the end of systemic isotretinoin treatment and 12 months treatment free). The mean AMH, OV and AFC values at the beginning and at the 18th month were statistically similar.

Conclusion: The deteriorative effects of systemic isotretinoin treatment on ovarian reserve, which can be accepted as an indicator of female fertility, diminish in time.     

Plasma and vitreous homocysteine concentrations in patients with proliferative diabetic retinopathy

PURPOS: An increase in plasma concentrations of homocysteine (Hcy) in proliferative diabetic retinopathy (PDR) has been described. The aim of this study was to investigate vitreous Hcy levels in patients with PDR. METHODS: Plasma and vitreous samples were obtained simultaneously at the time of vitreoretinal surgery from 20 patients with PDR and 12 nondiabetic patients with nonproliferative ocular diseases. Hcy levels were determined by high-performance liquid chromatography. RESULTS: The mean vitreous and plasma Hcy concentrations for the diabetic group were 3.64 +/- 0.65 micromol/L and 16.04 +/- 2.75 micromol/L, respectively. The mean intravitreal and plasma Hcy concentrations for the control group were 1.08 +/- 0.45 micromol/L and 9.18 +/- 3.91 micromol/L, respectively. Both plasma and vitreous Hcy concentrations for the diabetic group were significantly higher than those for the control group (P < 0.001). A statistically significant correlation between vitreous and plasma Hcy concentrations was present only for the diabetic group (r = 0.525; P = 0.017). CONCLUSION: Vitreous Hcy concentrations were elevated in patients with PDR probably due to breakdown of the blood-retina barrier.     

Injuries related to the Feast of Holy Sacrifice

Objective

The aim of this study is to evaluate and draw attention to sacrification injuries that occurred during the Feast of Holy Sacrifice.

Methods

Two hundred and sixty-two patients who were admitted to the emergency services in the city of Kirikkale with sacrification injuries during four consecutive Feast of Holy Sacrifice holidays between 2008 and 2011 were evaluated according to age, sex, admission day and time, experience level, type and mechanism of injury and treatment type.

Results

Average age was 43?±?14 and 83 % of were male. Only 7 patients (2.7 %) were professional butchers, while 155 patients had sacrificed previously. Eighty-three patients had not sacrificed previously and 24 patients had only witnessed sacrification. Penetrating injuries were 81 % (206 cases from knives and 6 cases from animals’ horns) and 19 % were blunt. The admittance to the EDs was highest on the first day. Upper extremity trauma constituted for 80 % of cases (n?=?209) and 197 (94 %) were hand injuries, whereas 39 patients (15 %) had lower extremity injury. While 174 patients (67 %) injuries were self-inflicted with a knife, 32 (12 %) were injured by the knife of another and 50 (21 %) were injured by animal aggression. Primary suture (155 patients), splint and tendon repairing were undertaken. No deaths occurred.

Conclusions

Sacrification injuries can sometimes be serious with the injuries consisting mainly of tendon cuts and bone fractures. Preliminary arrangements with medical staff and equipment support should be provided during the Feast of Holy Sacrifice, especially on the first day. The butchering jobs during this period should be given to professionals.