A dynamic study of the thermal components in electrical injury mechanism for better understanding and management of electric trauma: an animal model

The thermal effects of acute electric trauma to living cells show some variation patterns and kinetics for different body components (muscle, bone, blood-vein and skin). Thermal energy transfer is random with no preferred directions, but electrical energy transfer is vectorial in the direction of the current. In the present study, a total 50 white male Wistar Albino rats, body weight 250-300 g, have been used to study electrical injury mechanism with subsequent change in muscle perfusion at different post-traumatic stages. The muscle temperature was found to increase with a sudden jump from 35.3+/-1.2 to 75.2+/-7.6 degrees C. The bone temperature increased from 35.2+/-1.4 to 45.8+/-1.2 degrees C and decayed slowly within 600+/-90 s. The venous blood curves show a similar pattern to that of muscle with a sudden jump of temperature from 36.4+/-.9 to 40.5+/-3.1 degrees C. The core temperature showed a flat pattern with a slight increase from 36.1+/-0.8 to 37.3+/-0.6 degrees C and the peak temperature was found after 70+/-10 s. From the scintigraphic study, muscle perfusion was found to be a minimum 72 h after electric shock. The right hind limbs of all the rats (ground) exhibited more intense histopathological damages (electric burns) than the left fore limb (source).     

Antibody response following Hepatitis B vaccination in peritoneal dialysis patients: does normalized urea clearance matter?

OBJECTIVES:

Data on the factors that contribute to the antibody response to hepatitis B virus vaccination in peritoneal dialysis patients are scarce. The current study was conducted on a group of peritoneal dialysis patients to learn how the response to hepatitis B virus vaccination varies according to the patient''s clearance of urea normalized to total body water (Kt/V).

METHODS:

A convenience sample of 33 peritoneal dialysis patients (13 women and 20 men, with a mean age of 49±12 years) was administered double doses (20 µg IM in each deltoid muscle) of recombinant hepatitis B vaccine at 0, 1, 2, and 6 months. Response to immunization was measured at one to three months after the final dose of vaccine. The subjects were divided into groups according to the level of antibodies to hepatitis B surface antigen (anti-HBs), including non-responders (<10 IU/L), weak responders (10-100 IU/L), and good responders (>100 IU/L).

RESULTS:

Among non-responders, weak responders, and good responders, significant differences were found in age (54±12 vs. 56±9 vs. 45±12 years, respectively; p = 0.049) and recombinant human erythropoietin use (20 vs. 29 vs. 76%, respectively; p = 0.016). No significant differences in weekly total Kt/V (p = 0.704), weekly peritoneal Kt/V (p = 0.064) and residual glomerular filtration rate (p = 0.355) were found across the three groups.

CONCLUSIONS:

Delivered clearance measured by weekly peritoneal Kt/V and total clearance measured by weekly total Kt/V did not predict the response to hepatitis B virus vaccination in patients on peritoneal dialysis.     

Levels of Organochlorine Pesticide Residues in Butter Samples Collected from the Black Sea Region of Turkey

The aim of the present study was to evaluate the levels of 9 organochlorine compounds (aldrin, hexachlorobenzene, 2,4-DDE, 4,4-DDE, 2,4-DDT, 4,4-DDT, and α-, β-, and γ-HCH) in butter samples collected in the Eastern, Middle and Western Black Sea Regions of Turkey between October 2009 and June 2010. The liquid–liquid extraction method was used to extract the organochlorine compounds from the samples and the measurements were performed by using a gas chromatograph-electron capture detector system. DDT metabolites, aldrin, hexachlorobenzene (HCB), and α-, and γ-HCH were not detected in the samples but β-HCH was detected in 3 of a total of 88 samples. In the first period, only one sample from the West Black Sea Region was β-HCH positive (0.014 mg kg^?1). The other β-HCH positive samples collected in Middle and West Black Sea Regions in the second period had a concentration of 0.066 and 0.019 mg kg^?1, respectively. All concentrations of the detected compounds exceeded the legal limits of 0.003 mg kg^?1 for β-HCH, as prescribed by the Turkish Food Codex, and therefore pose a potential health risk for consumers. The contamination detected is most likely due to the past usage of β-HCH in agriculture and its long term persistence in the environment. These results strongly suggest that further research should be focused on the detection of pesticide residues in agricultural areas across the nation.     

Beta2-microglobulin amyloidosis in hemodialysis and peritoneal dialysis patients

Beta(2)-microglobulin (beta(2)-M) amyloidosis is an important cause of morbidity in patients on dialysis. In this cross-sectional study, we evaluated supraspinatus tendon thickness (as a measure of shoulder involvement from beta(2)-M amyloidosis) in patients who are on hemodialysis (HD) compared with those on continuous ambulatory peritoneal dialysis (CAPD). In 27 patients on HD who were treated with high-flux dialyzers, 31 patients on CAPD, and 31 healthy volunteers, we performed bilateral shoulder magnetic resonance imaging and measured the supraspinatus tendon thickness using electronic calipers. There were no statistically significant differences in age or dialysis duration between the HD and CAPD patients. Each patient was asked about the presence or absence of shoulder pain. The supraspinatus tendon thickness in HD patients (mean thickness 6.6 +/- 1.3 mm, range 3.20-8.80 mm, N = 53) and CAPD patients (6.8 +/- 0.9 mm, range 4.9-8.8 mm, N = 61) was not significantly different (P = 0.289); however, the mean thickness in either group was higher than in the healthy controls (5.5 +/- 0.6 mm, range 4.3-6.8 mm, N = 61) (HD patients vs. controls: P = 0.000; CAPD patients vs. controls: P = 0.000). Patients with shoulder pain had higher mean supraspinatus tendon thickness measurements than patients without shoulder pain (P = 0.042). The thickness of supraspinatus tendons is not significantly different between patients on CAPD and HD. An association exists between shoulder pain and mean supraspinatus tendon thickness. This hidden complication of ESRD should be further studied in larger populations of dialysis patients.     

Changes in the threshold voltage and alterations of smooth-muscle physiology after bladder outlet obstruction.

The purpose of this study was to determine the resultant changes in the bladder function after partial bladder outlet obstruction (BOO), with particular emphasis on the threshold voltage and on the role of NO. A total of 12 adult rabbits were used in the study. New Zealand-type rabbits were subjected to no intervention and 3 weeks duration of a partial outlet obstruction. They underwent an in vivo cystometric evaluation before and after the BOO, histological studies, bladder-strip stimulation studies using acetylcholine, electrical field stimulation, and relaxation studies using NO donor nitroprusside. Statistical significance was determined by two-way ANOVA for multiple variations and Student's t-test. Histology sections demonstrated smooth-muscle hypertrophy, hyperemia of the vessels in the wall and widely set mononuclear cell infiltration in the rabbits with partial BOO. Cystometry showed markedly decreased bladder capacities, and decrease of compliance from 4.3 +/- 1.8 to 1.6 +/- 0.3 in the obstructed group. Tissue bath studies demonstrated no meaningful change with cholinergic stimulation, increased contractility in response to electrical field stimulation, and increased threshold voltage values from 57.5 to 93.3 compared to controls. Nitroprusside did not induce relaxation of the neostigmine and acetylcholine-precontracted bladder in all animals. Hypertrophy was observed due to adaptation of the detrusor against the obstruction. During this adaptation period, bladder capacity decreases and the elasticity disappears, thus causing higher pressures with lesser volumes. In other words, compliance decreases. The neurogenic damage can be shown with increasing values of threshold voltage, and higher voltages are needed to start a contraction. Nitroprusside has no inhibitory effect on smooth-muscle tone in the rabbit bladder.     

Dual treatment of albendazole in hepatic hydatidosis: New therapeutic modality in 52 cases

BACKGROUND: Hepatic hydatidosis still remains as a serious problem in general surgery. Recurrence and/or secondary hydatidosis rates are up to 25% in the cases treated with surgery alone. Albendazole is the most commonly used drug in the medical treatment of echinococcosis. The aim of the present study was to evaluate the effect of albendazole using the intraoperative and perioperative periods as dual therapy. METHODS: Fifty-two cases of hepatic hydatidosis were evaluated and treated by dual treatment of albendazole together with surgery. Perioperative albendazole treatment was given in a dose of 12-15 mg/kg per day in four divided doses. The treatment started 2-28 days before the surgery when the diagnosis was established and continued for 2-24 months (4.76 +/- 3.25) postoperatively in a cyclic monthly form. A total of 1.7 microg/mL albendazole solution was used as a protoscolicidal agent in the cystic cavity intraoperatively. In the postoperative period serology, ultrasonography and computed tomography evaluations were done. The follow-up period was 5-92 months (mean: 62.48 months). RESULTS: There was no recurrence in the present study. One patient died in the 6th postoperative week due to cerebral hydatidosis and multiple organ failure. Early and late morbidity rates were 7.69 and 9.61%, respectively. CONCLUSIONS: Dual albendazole treatment is effective in the prevention of recurrences and/or secondary hydatidosis.