Mechanical lithotripsy and/or stenting in management of difficult common bile duct stones

BACKGROUND:Mechanical lithotripsy and/or stent insertion is the alternative therapeutic approach in difficult endoscopic retrograde cholangiopancreatography (ERCP)case.This study was designed to investigate the appropriate treatment for extraction of bile duct stones in difficult cases of ERCP. METHODS:Between 2000 and 2008,744 ERCP procedures were performed in 592 patients with choledocholithiasis in our endoscopy unit.The demographic features,and clinical and laboratory findings were collected from a pros...     

Protective role of caffeic acid phenethyl ester in the liver of rats exposed to cold stress

Cold exposure can induce a form of environmental stress. Cold stress (CS) alters homeostasis, results in the creation of reactive oxygen species and leads to alterations in the antioxidant defense system. The caffeic acid phenethyl ester (CAPE), an active component of propolis, has an antioxidant capacity. We investigated the effect of CS on oxidative stress and antioxidant defense system and the possible protective effect of CAPE in rat liver tissue. Twenty-four female Wistar Albino rats were divided into four groups: Control, CAPE-treated, CS, and CAPE-treated CS (CS + CAPE) group. Catalase (CAT), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) activities and total glutathione (GSH) and malondialdehyde (MDA) levels were measured. In addition, histological changes in liver tissue were examined by light microscopy. SOD, CAT and GSH-Px activities and total GSH level were significantly declined in the CS group. In the CS + CAPE group, the activities of these three enzymes and GSH level significantly raised with regard to the CS group. MDA levels increased in the CS group and decreased in the CS + CAPE group. The tissues of the CS group showed some histopathological changes such as necrosis, hepatocyte degeneration, sinusoidal dilatation, hemorrhage and vascular congestion and dilatation. In the CS + CAPE group, the histopathological evidence of hepatic damage was markedly reduced. Histological parameters were consistent with biochemical parameters. In this study, CS increased oxidative stress in liver tissue. CAPE regulated antioxidant enzymes, inhibited lipid peroxidation and reduced hepatic damage.     

The relation between impaired glucose tolerance and slow coronary flow

BACKGROUND: Impaired glucose tolerance is a preliminary stage in the development of type 2 diabetes mellitus and has been shown to increase the risk of cardiovascular morbidity and mortality in addition to causing endothelial dysfunction. In this study, we sought to determine if impaired glucose tolerance is related to slow coronary flow, an angiographic phenomenon caused by coronary micro and macrovascular endothelial dysfunction. METHODS: The population of this prospective study consisted of 28 patients with documented slow coronary flow, defined according to TIMI frame count method, [20 (71.4%) males; 51+/-9 years] and 30 patients with normal coronary flow [17 (56.6%) males; 47+/-6 years]. All study patients underwent an oral glucose tolerance test after 12 h of fasting. Lipid profile, hemoglobin A1c and systemic blood pressure were measured in all patients. RESULTS: There was no difference between two groups with respect to age, fasting plasma glucose, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein, hemoglobin A1c, systolic-diastolic blood pressure levels, history of smoking and alcohol consumption. Plasma glucose at 2 h of oral glucose tolerance test was significantly higher in slow coronary flow patients compared to control group (145+/-44 vs. 112+/-38 mg/dl, P = 0.001, respectively). In addition, the number of patients who met the criteria of impaired glucose tolerance was significantly higher in slow coronary flow patient group [16 (57%) vs. 7 (23%), P = 0.002, respectively). CONCLUSIONS: Our results suggest that impaired glucose tolerance may be an independent etiological factor for slow coronary flow phenomenon.     

Essential oil composition, insecticidal and antibacterial activities of Salvia tomentosa Miller

The effectiveness of the essential oil of Salvia tomentosa Miller was assessed on two important pest insects and seven pathogenic bacteria. The essential oil of aerial parts of this plant was hydro-distillated using a clevenger-type apparatus (yield 0.31 % v/w) and constituents were determined using GC–MS analysis. β-pinene (37.28 %) and α-pinene (5.73 %) were the predominant chemical constituents, followed by trans-pinocarveol (3.05 %), myrtenol (2.81 %), caryphyllene oxide (2.68 %), d-camphor (2.08 %). The complete mortality was determined at above doses of 50 μl L^?1 air on Acanthoscelides obtectus (Say) adults. However, the essential oil in concern caused 83.34 and 100 % mortality at higher doses (150 and 200 μl L^?1 air) against Tribolium castaneum (Herbst) adults. The essential oil also revealed significant bacteriostatic and bactericidal activities against Staphylococcus aureus, Bacillus subtilis, Bacillus cereus, Micrococcus luteus, Escherichia coli, Enterobacter aerogenes and Yersinia enterocolitica. The essential oil of S. tomentosa in concern can be used as a potential insecticide and bactericidal agents in food applications and agricultural commodities and/or other fields.     

Nursing diagnoses in elderly residents of a nursing home: a case in Turkey

There are limited studies on nursing diagnoses of the elderly living in nursing homes worldwide. This study aimed to define the most frequent nursing diagnoses in the elderly residents of a nursing home elder care and rehabilitation center. Seventy-four elderly individuals were included in the study. Data were collected using the “Elderly Individual’s Introduction Form” between April 2007 to August 2007. The content of the form was based on a guide to gerontologic assessment, and Gordon’s Functional Health Patterns. The nursing diagnoses (NANDA-I Taxonomy II) were identified by the 2 researchers separately according to the defining characteristics and the risk factors. The consistency between the nursing diagnoses defined by the 2 researchers was evaluated using Cohen’s kappa (κ). There was an 84.7% agreement about nursing diagnoses defined by the 2 researchers separately. The weighted kappa consistency analyses showed there was an adequate level of consistency (κ = 0.710), and the findings were significant (p < 0.0001). The most frequent diagnoses were ineffective role performance (86.5%), ineffective health maintenance (81.2%), risk for falls (77%), and impaired physical mobility (73%). The diagnosis of ineffective role performance was more frequent in patients with dementia (x² =10.993, df = 1, p = 0.001). There was a very significant relationship between dementia and the diagnosis of impaired verbal communication (x² = 32.718, df = 1, p = 0.0001). The relationship between mobility disorder and self-care deficit was also significant (x² = 19.411, df = 1, p = 0.0001). To improve quality in patient care, nurses should use nursing diagnoses with a systematic assessment and should help the elderly in health promotion or use of the maximum current potential.     

Volatile compounds and bioactivity of Eremurus spectabilis (Ciris), a Turkish wild edible vegetable

Eremurus spectabilis grows in the spring as a wild vegetable and for many years has been used both as a food or food additive and for therapeutic purposes. This study investigated the total phenolic content and the antimicrobial, antioxidant, and antiradical activities of methanol, ethanol, and aqueous extracts of E. spectabilis (obtained from the Antalya region of Turkey). In addition, volatile compounds of E. spectabilis were characterized by using gas chromatography/mass spectrometry. Major components of E. spectabilis volatile compounds were carvone (44.64%), carvacrol (14.45%), pentane, 2-methyl- (7.34%), (E)-caryophyllene (5.57%), valencene (5.11%), cis-calamenene (2.01%), cadalene (1.10%), and acetic acid (1.12%). The highest total phenolic content was seen with methanol extract (mean±standard deviation, 31.92 ± 0.48 mg gallic acid equivalents/g dry extract). The ethanol extract showed the highest antiradical activity, with a 50% inhibitory concentration of 35.14 μg/L in the 1,1-diphenyl-2- picrylhydrazyl assay. The strongest antioxidant activity was detected in methanol extract (81.72 ± 0.62 mg ascorbic acid equivalents/g). Twelve bacteria species were used to analyze the antimicrobial activity of extracts. The 1% concentrations of all extracts showed no inhibitive effect on any bacterium. The most resistant bacterium was Yersinia enterocolitica, and the most sensitive bacterium was Pseudomonas aeruginosa. A positive correlation was seen between concentrations and inhibition zones, and some differences occurred between antimicrobial activity of other concentrations.