Investigation of hearing loss in patients with acute brucellosis by standard and high-frequency audiometry

This study aimed to determine the effect of acute brucellosis on the auditory system. Forty-two patients with acute brucellosis were evaluated clinically, and with serological and audiological tests, before and after treatment. Hearing threshold averages were calculated at 11 different frequencies (250-8000 Hz) of the auditory airway, and statistical analysis was performed. The average hearing thresholds were > 20 dB, with standard audiometry at 6000-8000 Hz, and < 20 dB at all other frequencies. After treatment, the average auditory threshold decreased to < 20 dB at 6000-8000 Hz (p < 0.0001). Pure-tone hearing thresholds were improved at all frequencies after treatment, with statistically significant differences at all frequencies except 12,000, 14,000 and 16 000 Hz (p < 0.05). There was no permanent hearing loss caused by acute brucellosis, and hearing thresholds were restored after treatment. It was concluded that acute brucellosis affects the auditory system, especially at high frequencies, and that patients with all forms of brucellosis should be evaluated for hearing loss.     

Stereological evaluation of liver volume in living donor liver transplantation using MDCT via the Cavalieri method.

In living donor liver transplantation (LDLT), obtaining the precise volume of the graft is very important to decrease volume-related postoperative complications, especially in cases with suspected small-for size grafts. We used stereology based on the Cavalieri method (CM), a new method to measure liver graft volume, and compared the results with those obtained through intraoperative measurement (IOM) and through multidetector computed tomography (MDCT) measurement. Liver volumes estimated using the 3 methods were well-correlated with each other (r(2) = 0.94 and P < 0.001 for IOM and CM; r(2) = 0.91 and P < 0.001 for IOM and MDCT, and r(2) = 0.95 and P < 0.001 for CM and MDCT); however, they were different from each other (in descending order, 908 +/- 124 cm(2), 861 +/- 121 cm(2), and 777 +/- 168 cm(2) for MDCT, CM, and IOM, respectively). Although MDCT and CM overestimated the volumes, the results of CM were almost similar to those obtained via IOM. In conclusion, our results suggest that CM measured the liver graft volume more reliably. Thus, its use, particularly in cases with suspected small-for-size graft, may prove useful.     

Adiponectin is an independent determinant of insulin resistance in women with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is frequently associated with insulin resistance and a consequent increased risk of metabolic diseases. The aim of the present study was to investigate the role of adiponectin in insulin resistance in PCOS women. MATERIALS AND METHODS: Forty-seven patients with PCOS and 23 control subjects, matched for age and body mass index (BMI), were enrolled in the study. Clinical, metabolic and hormonal parameters and adiponectin levels were measured, and HOMA-IR score (homeostasis model assessment-insulin resistance index) was calculated for each subject. RESULTS: There was no difference in adiponectin levels between PCOS patients and the control group. However, adiponectin levels were negatively correlated with obesity-associated parameters and HOMA-IR score in PCOS patients and controls. As adiponectin is modulated by BMI we adjusted for BMI among the PCOS patients, and found a negative correlation between adiponectin levels and HOMA-IR score (r = -0.51, p < 0.001). Adiponectin and BMI were independent determinants of insulin resistance in PCOS patients (adjusted R2 = 0.66, p < 0.001). CONCLUSION: Adiponectin did not seem to be actively involved in the pathogenesis of PCOS. However, adiponectin levels were independently associated with insulin resistance in PCOS patients, suggesting that adiponectin might play a role in the complicated metabolic abnormalities of PCOS.     

Airway hyper-responsiveness to adenosine 5''-monophosphate in preschool-age children with asthma

Airway hyper-responsiveness (AHR) to adenosine 5'-monophosphate (AMP) is closely associated with airway inflammation; however, not all asthmatic patients are responsive to it. This study was planned to investigate the predictive factors of AHR to AMP in asthmatic children aged between 3 and 6 yr. We performed a retrospective analysis of data from 63 asthmatic preschool-age children who were challenged by AMP in our department. All children were characterized by skin-prick tests, serum immunoglobulin E (IgE) levels, peripheral blood eosinophil percentage and bronchial challenge with methacholine (MCH) and AMP. Potential determinants for AHR to AMP were assessed within the group. AHR to AMP was found in 46% of preschool-age children with asthma, while that of MCH was 93.7%. All children responsive to AMP were also responsive to MCH. The geometric mean provocative concentration of MCH and AMP causing a 15% fall in transcutaneous oxygen tension (PC(15)PtcO(2)MCH and AMP) were 0.55 mg/ml (0.004-9.19) and 10.53 mg/ml (0.59-342.89), respectively. AMP-responsive children did not differ from non-responsive ones with respect to demographic factors, geometric mean PC(15)PtcO(2)MCH and atopic status. The median serum IgE level was significantly higher in AMP-responsive group than the non-responsive ones (p = 0.011). The peripheral blood eosinophilia was more frequent among responsive children (p = 0.019), and it was found as the only predictive factor for AMP responsiveness in preschool-age children with asthma in logistic regression model (odds ratio: 5.14; 95% CI: 1.23-21.47; p = 0.025). AMP responsiveness may be predicted by peripheral blood eosinophilia but not with atopy markers in young children with asthma.     

Comparison of amoxicillin with second and third generation cephalosporins in the treatment of acute otitis media

The aim of the present study was to compare the efficacy and the tolerability of three different antibiotic regimens for the treatment of acute otitis media in paediatric patients. 75 children, age range 6 months-6 years, divided into three groups, were involved in the study, each group consisting of 25 randomly assigned children (Group 1, amoxicillin 40 mg/kg tid per os for 10 days; Group 2, cefuroxime axetil 30 mg/kg bid per os for 10 days; ceftriaxone 50 mg/kg single-dose i.m.). No statistically significant difference was noted in the clinical efficacy among the different groups. Although amoxicillin is the drug of choice in paediatric otitis media, single dose ceftriaxone might be considered as an interesting alternative regimen when ease of administration and cost of therapy are considered.     

Aglossia-adactylia syndrome (special emphasis on the inheritance pattern)

Three cases, one with aglossia-adactylia and two with aglossia, are presented, all of whom were born to consanguineous families. Although none of the cases had similarly affected sibs, the possibility of the autosomal recessive mode of inheritance might be taken into account in this syndrome. The dermatoglyphic findings in one previously reported patient showed great similarity to those of one of our cases.     

Establishment of titration system for human herpesvirus 6 and evaluation of neutralizing antibody response to the virus.

The susceptibilities of seven T-cell lines to human herpesvirus 6 (HHV-6) infection were examined. MT-4 cells were the most susceptible of these lines to infection with this virus. Therefore, chemically adhered MT-4 cell monolayers were used for infectious HHV-6 assay by indirect immunofluorescent-antibody (IFA) staining. When cell monolayers were fixed 30 to 45 h postinfection, the foci stained with IFA were easy to count and a linear relationship was observed between the number of foci and the virus concentration. MT-4 cell monolayers were also used for a focus reduction neutralizing-antibody test. In this test, sera from patients in the convalescent stage of exanthem subitum all showed significant neutralizing activity (1:80 to 1:320), whereas sera from patients in the acute stage of disease showed no detectable neutralizing activity. The titers of neutralizing antibody correlated well with the levels of anti-HHV-6 antibodies detected by IFA.     

Kidney biopsy in the elderly: diagnostic adequacy and yield

International Urology and Nephrology - The number of kidney biopsies (KB) performed in elderly patients has been increasing. Safety and usefulness of elderly KB have been well established, whereas...