The impact of bronchiectasis in clinical presentation of asthma

BACKGROUND: Though asthma and bronchiectasis are two different diseases, their coexistence has been shown in many patients. The aim of this study was to evaluate the clinical features of asthmatics with bronchiectasis compared with pure asthmatics. METHODS: We evaluated 1680 asthmatics followed-up in our clinic. Fifty-one asthmatics had the diagnosis of bronchiectasis. These patients were compared with fifty-one age and gender matched asthmatics without bronchiectasis. RESULTS: The prevalence of bronchiectasis among the asthmatics was 3%. Asthma diagnosis was made at the age of 33.2 +/- 16.8 years for asthmatics with bronchiectasis and 39.5 +/- 16.2 years for pure asthmatics (P = 0.05). Asthmatics with bronchiectasis mostly had severe persistent asthma (49.0%), while pure asthmatics mostly had mild persistent and intermittent asthma (69.4%). History of hospitalization due to severe asthma exacerbation and presence of chronic respiratory failure was significantly higher in bronchiectatic group. CONCLUSIONS: These data show that bronchiectasis can contribute to severe and difficult to control asthma with pulmonary complications like chronic respiratory failure.     

Inhibition of corneal angiogenesis by ascorbic acid in the rat model

Purpose To evaluate the effect of topically administered ascorbic acid on experimentally induced corneal neovascularization in the rat model. Materials and methods Corneal chemical cauterization of 72 eyes in Long-Evans male rats was performed using silver nitrate/potassium nitrate sticks. Nine groups of eight eyes were used to evaluate eight concentrations of ascorbic acid with one group of eight eyes serving as a control. Topical instillation of 100 mg/ml non-pH-neutralized ascorbic acid was performed in one group while the remaining seven groups were evaluated using pH-neutralized ascorbic acid in concentrations of 100 mg/ml, 50 mg/ml, 10 mg/ml, 5 mg/ml, 1 mg/ml, 500 μg/ml, and 250 μg/ml. Results The percentage of corneal neovascularization and burn stimulus score was determined for all the eyes. The means of percent of corneal neovascularization in ascorbic acid 100 mg/ml (non-neutralized), 100 mg/ml, 50 mg/ml, 10 mg/ml, 5 mg/ml, 1 mg/ml, 500 μg/ml, 250 μg/ml, and control group were 17.50 ± 12.80 (p = 0.001), 17.00 ± 19.30 (p = 0.001), 15.25 ± 13.26 (p = 0.001), 17.62 ± 11.89 (p = 0.001), 28.87 ± 23.08 (p = 0.001), 29.62 ± 16.91 (p = 0.001), 60.12 ± 8.50 (p = 0.04), 65.62 ± 2.26 (p = 0.185), and 68.25 ± 4.06, respectively (Tables 1 and 2). All animals had a burn score of 2+ or higher (Table 1). Conclusion Ascorbic acid applied in a topical solution appears to inhibit corneal neovascularization in the rat model of inflammatory neovascularization in concentrations in a dose-dependent manner. The optimal dose-effect relation was in our model found in concentrations between 1 mg and 500 μg/ml. At concentrations below 500 μg/ml there was no statistically significant inhibition in the degree of corneal neovascularization compared to control. None of the authors has any proprietary interest in any technique or product described herein.     

Neuron-specific enolase levels and neuroimaging in asphyxiated term newborns

The study was designed to investigate the cerebrospinal fluid and serum levels of neuron-specific enolase, along with cranial ultrasonography, magnetic resonance imaging (MRI), and electroencephalography (EEG), for predicting the clinical state and neurologic outcome of 26 asphyxiated term newborns. The babies were graded according to the Sarnat and Sarnat classification. Cerebrospinal fluid neuron-specific enolase levels of the 18 babies in the whole hypoxic-ischemic encephalopathy group were higher than the 8 babies in the "no encephalopathy" group. Cerebrospinal fluid neuron-specific enolase levels of 13 cases in the hypoxic-ischemic encephalopathy grade 2 and 3 groups (high-risk group) were higher than both the no encephalopathy and hypoxic-ischemic encephalopathy grade 1 groups when pooled. Cerebrospinal fluid neuron-specific enolase levels of the 7 newborns in the hypoxic-ischemic encephalopathy grade 3 group were also significantly higher than the 5 in the hypoxic-ischemic encephalopathy grade 1 group. The findings of cranial MRI, EEG, and cerebrospinal fluid neuron-specific enolase levels were correlated with each other and the clinical grade of the patients and also were predictive of the neurologic outcome at 1 year of age. Cerebrospinal fluid neuron-specific enolase levels, cranial MRI, and EEG are predictive of outcome of hypoxic-ischemic brain damage in asphyxiated newborns, and this predictivity would increase with the combination of these diagnostic parameters.     

Is Tissue-Plasminogen Activator Gene Polymorphism a Risk Factor for Venous Thromboembolism in Every Population?

Background: Tissue-plasminogen activator is a key protein of fibrinolytic system. In recent years the relation between t-PA, its genetic polymorphisms and arterial or venous thrombosis were investigated in different populations. The aim of this study is to investigate the role of t-PA gene polymorphism in Turkish venous thromboembolism (VTE) patients.Methods: A case-control study was performed. We investigated the t-PA insertion/deletion (I/D) polymorphism in 93 VTE patients and 146 controls without VTE. Recurrent cases and documented risk factors for PTE were recorded.Results: Cases and controls did not differ with respect to the different t-PA genotypes. The prevalence of I allele was 44.1%, 44.5% in cases and controls respectively (OR = 0.95, 95% CI: 0.78–1.24, p > 0.05). Different t-PA genotypes had no effect on recurrent disease. No gender difference was observed with respect to the different t-PA genotypes. There was no significant difference for genotype frequency between PTE patients with documented risk factors and unprovoked cases.Conclusions: In conclusion there was no association between t-PA genotype and VTE in this group of Turkish population. It was also found that genotype frequencies for t-PA in both VTE and control subjects seems different from those reported from western part of the world.Abbreviated Abstract. The aim of this study is to investigate the role of t-PA gene polymorphism in Turkish VTE patients. We investigated 93 VTE patients and 146 controls without VTE. Cases and controls did not differ with respect to the different t-PA genotypes. The prevalence of I allele was 44.1%, 44.5% in cases and controls respectively (OR = 0.95, 95% CI: 0.78–1.24, p > 0.05). Different t-PA genotypes had no effect on recurrent disease. No gender difference was observed with respect to the different t-PA genotypes. There was no significant difference for genotype frequency between PTE patients with documented risk factors and unprovoked cases. In conclusion there was no association between t-PA genotype and VTE in this group of Turkish population. It was also found that genotype frequencies for t-PA in both VTE and control subjects seems different from those reported from western part of the world.     

Intracranial venous thrombosis after hypoxic-ischemic brain insult in two newborns: could low serum carnitine levels have contributed?

Sinovenous thrombosis is a definite cause of mortality or morbidity in newborns. Perinatal hypoxia is one of the well known risk factors. Two term newborns were diagnosed to have cerebral venous thrombosis after a hypoxic-ischemic insult. They were later found to have carnitine deficiency. Both of the patients died. Carnitine was previously shown to have inhibitory effects on thrombogenesis in experimental studies. The possible contribution of carnitine in thrombogenesis was discussed.     

Neonatal cerebral venous thrombosis coexisting with bilateral adrenal hemorrhage

We report a case of severe perinatal asphyxia with both cerebral venous thrombosis and adrenal hemorrhage who survived with severe sequela including multicystic encephalomalasia, acquired microcephaly and blindness. Hematological investigations showed normal levels of anticardiolipin antibodies, protein C and S levels and activity, antithrombin III levels. Factor V Leiden mutation was negative. The adrenal hemorrhage resolved within three months with glucocorticoid therapy, the cerebral venous thrombosis resolved within two months without treatment. The literature on neonatal cerebral venous thrombosis is also reviewed.     

Assessment of mothers’ knowledge and perceptions of electroencephalography and determination of the short-term effect of an informational leaflet

ObjectiveThe goal of the study described here was to determine mothers’ knowledge and perceptions of electroencephalogram (EEG), to assess mothers’ understanding of the main aspects of electroencephalography (EEG), and to determine the effect of an informational leaflet on increasing knowledge and perception.MethodsA 20-item questionnaire was developed to assess mothers’ knowledge and perceptions of EEG. The questionnaire comprised 20 simple statements on aspects of the procedure, to which the mothers answered “yes” or “no.” Mothers were interviewed in person by an EEG technician at the beginning of the study. On completion of the questionnaire, the same technician provided the mothers with an informational leaflet. One month later, the mothers were telephoned and administered the same questionnaire over the phone.ResultsThe response rate was 86%. Before reading the informational leaflet, 89.5% of the mothers stated that they knew why their child was undergoing electroencephalography, and 67.6% knew what electroencephalography was. Furthermore, 78.1% of them believed that their child’s brain was mapped by electroencephalography. In addition, nearly 1 in 10 believed that EEG is a hazardous procedure and 6% believed it was addictive. Knowledge and perceptions changed after distribution of the informational leaflet. Comparison of mothers with different income levels, educational status, and numbers of electroencephalograms their child underwent revealed statistically significant differences with respect to knowledge and perceptions of electroencephalography.ConclusionWritten information is a simple, inexpensive, easy-to-implement, yet effective method of improving parental understanding of EEG. The present study has significant implications for informing individuals regarding medical procedures.