Intraventricular hemorrhage in preterm newborns: Risk factors and results from a University Hospital in Istanbul, 8 years after

BACKGROUND: In this prospective study, the authors aimed to show intraventricular hemorrhage (IVH) incidence of premature newborns in the Neonatal Intensive Care Unit of Cerrahpasa Faculty of Medicine, Istanbul, Turkey, and its risk factors, and they tried to compare these results with those they reported 8 years ago. METHODS: A total of 103 premature newborns, hospitalized between August 2003 and January 2005 with a gestational age equal or less than 33 weeks, were included in this study. IVH rates and changes in the incidences of risk factors were compared with those that had been reported between January 1995 and January 1997. RESULTS: Mean birthweight of this population was 1400 +/- 380 g (min, 550 g; max, 2000 g) and gestational age 30.3 +/- 2.1 weeks (min, 25 weeks; max, 33 weeks). IVH was diagnosed in 13 (13%) of them. IVH rates were 37, 10 and 5% for birthweight groups 501-1000, 1001-1500 and 1501-200 g, respectively. Statistically significant risk factors were found to be birthweight, gestational age, clinical risk index for babies score >5, mechanical ventilation, sepsis and hypotension. Maternal corticosteroid administration was found to be significantly protective. IVH rates and incidences of risk factors in this study were decreased compared to those reported 8 years ago. CONCLUSIONS: In developing countries, where well equipped Neonatal Intensive Care Units are limited, prevention of prematurity, better prenatal care and maternal corticosteroid administration become essential points for the prevention of IVH and its neurological consequences.     

Effect of renin–angiotensin–aldosterone system (RAAS) blockade on visfatin levels in diabetic nephropathy

Aim: Plasma visfatin levels are elevated in diabetic nephropathy in parallel to the severity of proteinuria and glomerular filtration rate. The aim of this study was to find out whether the renin–angiotensin–aldosterone system (RAAS) blockage has any effect on the plasma visfatin levels. Methods: Thirty‐two patients with diabetic proteinuria (>500 mg/day) with a normal glomerular filtration rate (GFR) and 33 healthy subjects were enrolled. Patients were treated with ramipril 5 mg daily for 2 months. Proteinuria, GFR, high‐sensitivity C‐reactive protein (hsCRP), visfatin, flow‐mediated dilatation (FMD) and homeostasis model assessment of insulin resistance (HOMA‐IR) index measurements were performed both before and after the treatment. Results: The plasma visfatin, and hsCRP levels of the patients were significantly higher and the FMD was significantly lower (P < 0.001 for all). The visfatin levels were significantly correlated to FMD, systolic and diastolic blood pressures, proteinuria, eGFR, HOMA‐IR and hsCRP. Ramipril treatment resulted in a significant decrease in plasma visfatin, proteinuria, hsCRP, HOMA‐IR and increase in FMD (P < 0.001) in patients (P < 0.001 for all). Conclusion: The present study suggests that plasma visfatin levels are related to the endothelial functions, inflammation and the severity of proteinuria in diabetic nephropathy. Treatment with ramipril causes a significant decrease in visfatin levels along with the improvement of proteinuria, endothelial dysfunction and inflammatory state in diabetic nephropathy.     

Effects of platelet-activating factor on nitrergic transmission in rabbit corpus cavernosum

AIM: The information currently available suggests that nonadrenergic noncholinergic (NANC) transmitters, particularly nitric oxide, are involved in the relaxation of penile erectile tissues. Platelet-activating factor (PAF) is a chemical mediator and is involved in many physiological and pathophysiological events. It is well known that several of the vascular actions of PAF are mediated by the generation of nitric oxide. We designed this study to test the hypothesis that PAF has an effect on NANC responses in rabbit corpus cavernosum strips. METHODS: Rabbit corpus cavernosum strips were precontracted with phenylephrine (10(-5) mol/L). Isometric tension changes produced by carbachol (10(-9)-10(-5) mol/L), sodium nitroprusside (10(-8)-10(-5) mol/L) and electrical field stimulation (for 10 s at sequential frequencies of 2, 4, 8, 16, and 32 Hz as square-wave pulses of 50 mV) were recorded with a pressure transducer. These relaxations were compared to those obtained in the presence of PAF. RESULTS: PAF had no effect on endothelium-dependent, endothelium-independent or electrical field stimulation-induced NANC relaxation responses in isolated rabbit corpus cavernosum strips. There was no statistically significant difference between the pD(2) and E(max) values for carbachol or sodium nitroprusside in the presence of PAF. CONCLUSIONS: Our results suggest that PAF does not modify the endothelium-dependent, endothelium-independent or electrical field stimulation-induced NANC relaxation responses in isolated rabbit corpus cavernosum strips.     

Transition zone biopsy and prediction of extraprostatic extension at radical prostatectomy

BACKGROUND: There is limited data in the literature that suggests that transition zone (TZ) biopsy might be useful for the prediction of extraprostatic extension (EPE) in clinically localized prostate cancer. We studied the role of TZ biopsy in the prediction of EPE. METHODS: Transition zone biopsies were performed in addition to systematic peripheral zone (PZ) biopsies between November 1995 and December 1999. During this period, 59 patients underwent radical prostatectomy for clinically localized disease. Final pathological results were compared with preoperative clinical and biopsy findings. RESULTS: Of the 59 patients who underwent radical prostatectomy, 46 had cancer only in the PZ cores and 13 had cancer both in the PZ and the TZ cores at the biopsy. Final histopathological results revealed EPE in 19 (32%) patients and positive surgical margins in 22 (37%). In univariate analysis of age, prostate-specific antigen (PSA), mean percentage of positive PZ cores, mean biopsy Gleason score and positive TZ biopsy, there was a significant difference for serum PSA levels (P = 0.021), presence of positive TZ cores (P = 0.018) and percentage of positive PZ cores in patients with and without EPE (P < 0.001). In multivariate analysis, the single independent predictor of EPE was the percentage of positive PZ biopsy cores (P = 0.0227). There was agreement between the side of positive TZ biopsy and EPE in seven of eight patients. CONCLUSION: Taking two TZ cores in addition to peripheral sextant biopsy did not result in better prediction of EPE. The relationship between TZ involvement and the presence of EPE can be investigated further in radical prostatectomy specimens.     

The effect of long-term use of progesterone therapy on proliferation and apoptosis in simple endometrial hyperplasia without atypia

The aim of this study was to evaluate the effect of long-term use of progesterone treatment on proliferation and apoptosis in simple endometrial hyperplasia without atypia. In this prospective control study, endometrial tissue samples of 19 patients with simple endometrial hyperplasia without atypia (group 1), posttreatment biopsy materials of the patients after 3 months of cyclic progesterone treatment with noretisterone for 10 days (group 2), and 18 endometrial biopsy materials of the control group (group 3) were examined for proliferative and apoptotic activities. There was a statistically significant difference between the median values of the proliferative index of the three groups (P = 0.000). The proliferative index was significantly higher in the endometrial hyperplasia group than in posttreatment group (P = 0.000). But there was no significant difference between posttreatment group and control group. The median value of apoptotic activity was significantly different between three groups (P = 0.000). Apoptotic index was highest in hyperplasia group. A significant decrease in apoptosis was observed after the progesterone treatment (P = 0.002). The lowest apoptotic activity was detected in the control group. In conclusion, 3 months of cyclic progesterone treatment reduces both proliferative and apoptotic activities in endometrial tissue with simple hyperplasia.