BHK cell attachment and growth on EDA-plasma-modified poly(L-lactide/epsilon-caprolactone) biodegradable films

In this study, attachment and growth of Baby Hamster Kidney (BHK) cells on ethylene diamine (EDA)-plasma-treated poly(L-lactide/epsilon-caprolactone) biodegradable copolymer films were investigated. The co-polymer (Mw: 58000; Mn: 35000 and PI 1.60) was synthesised by ring-opening polymerization of the respective dimers with using stannous octoate as the catalyst. The final ratio of L-lactide to epsilon-caprolactone obtained by 1H-NMR was 87:13. The co-polymer films were treated with the EDA-plasma in a glow-discharge apparatus. The BHK-30 cell line was cultured on plain and EDA-plasma-treated films and their pre-wetted forms (with ethanol and/or cell culture medium before use). Cell attachment and growth were followed. Alkaline phosphatase (ALP) activity and glucose uptake in cell culture medium were also investigated. There was no attachment in the first 12 h. Glow-discharge treatment increased significantly the attachment and growth. Pre-wetting with ethanol and cell culture medium was also increase significantly both the attachment and growth.     

<Emphasis Type="Italic">Demodex folliculorum</Emphasis> in patients with rheumatoid arthritis

The objective of this study was to investigate the incidence and density of Demodex folliculorum in the patients with rheumatoid arthritis (RA). Forty-one patients with RA and twenty-seven age and sex matched healthy controls were enrolled in this study. Disease Activity Score (DAS 28) was used for the assessment of disease activity. Out of 41 patients, 33 were females and 8 males. The mean disease duration was 10.9 ± 8.2 years. The mean DAS 28 was 3.8 ± 1.2. No statistically significant differences in the incidence and density of Demodex mites were found between patients with RA and controls. Although immunosuppression is thought to be a risk factor for the D. folliculorum infestation no such correlations could be found in the 41 immunosuppressed patients with RA, therefore, further studies with larger groups are needed.     

Cross-cultural adaptation,validity and reliability of Turkish version of Oxford Ankle Foot Questionnaire for children with congenital talipes equinovarus

BackgroundThe purpose of the study was to evaluate the reliability and validity of the Turkish version of the Oxford Ankle Foot Questionnaire (OxAFQ) to provide cultural adaptation.MethodsThis study involved translation, back translation, and cross-cultural adaptation. Forty-nine patients with congenital talipes equinovarus were evaluated using the Turkish version of OxAFQ. Turkish version of the Childhood Health Assessment Questionnaire (CHAQ) was used as a gold standard to validate the Turkish version of the OxAFQ. The validation was assessed with Spearman correlation analysis by using CHAQ. The reliability of the questionnaire was assessed with Cronbach alpha (internal consistency) and exploratory factor analysis.ResultsHigh validity was found between OxAFQ and CHAQ (r = -0.422?0.292) (p < 0.01). Reliability analysis showed that OxAFQ had a high level of Cronbach alpha (α = 0.88?0.96) and internal consistency (ICC = 0.90?0.96).ConclusionThe Turkish version of OxAFQ is a valid, reliable and useful quality of life questionnaire in patients with congenital talipes equinovarus and it is proper for use by health professionals and researchers.     

The effect of combined spinal‐epidural (CSE) anaesthesia and size of spinal needle on postoperative hearing loss after elective caesarean section

The effect of combined spinal epidural (CSE) anaesthesia and size of spinal needle on postoperative hearing loss after elective caesarean section The exact aetiology of vestibulocochlear dysfunction after spinal anaesthesia is unknown. Low‐frequency hearing loss occurs after spinal anaesthesia. The aim of this study was to investigate the effects of combined spinal–epidural (CSE) anaesthesia and size of spinal needle on vestibulocochlear dysfunction, using pure tone audiometry performed pre‐ and on the first and the second day postoperatively. Forty‐five patients who were to undergo elective caesarean section were evaluated. In group I, CSE anaesthesia (18 G Tuohy, 25 G Whitacre pencil‐point‐design spinal needles) was performed in 15 patients. In group II, spinal anaesthesia was performed in 15 patients with 25 G Whitacre pencil‐point‐design spinal needles and, in group III, spinal anaesthesia was performed in 15 patients with 22 G Whitacre pencil‐point‐design spinal needles. In the pre‐ and on the first and the second day postoperatively, the pure tone audiogram was performed in the audiology laboratory of our hospital, using a calibrated Kamplex Diagnostic Audiometer AC 40 in a noise‐free room. When the CSE anaesthesia group and 22 G spinal group were compared for change in hearing between the pre‐ and postoperative periods, a statistically significant difference was observed at R‐right ear 125 Hz (P < 0.025) and at L‐left ear 125 Hz (P < 0.023), and at L‐left ear 1000 Hz (P < 0.036) and at R‐right ear 1500 Hz (P < 0.006), and at L‐left ear 1500 Hz (P < 0.022). At other frequencies, the difference was insignificant. When the CSE anaesthesia group and 25 G spinal group were compared for change in hearing between the pre‐ and postoperative periods, no statistically significant difference was detected at any frequency tested. When 22 G spinal group and 25 G spinal group were compared for change in hearing between the pre‐ and postoperative periods, there was some hearing loss at low frequency, although this difference did not reach statistical significance. The positive correlation of low‐frequency hearing loss and increased pressure in the epidural space (which decrease the risk of cerebrospinal fluid leakage through the dura) suggests that cerebrospinal fluid leakage via the spinal puncture hole is not the only factor involved. Perioperative fluid replacement alone may not prevent hearing loss but CSF loss through the dural puncture site should also be prevented.     

Projecting future drug expenditures--2003.

Drug expenditure projections for 2003 and factors likely to influence drug costs are discussed. The United States continues to face the challenge of increased growth in health expenditures, and drug expenditures are continuing to increase faster than the growth in total health care expenditures. These increases can be largely attributed to an increase in the average age of the U.S. population and technological advancement. On the basis of price inflation and non-price inflationary factors, including increases in volume, shifts in patient and therapeutic intensity, and expected approval of new drugs, a 10-12% increase in drug expenditures in 2003 for the inpatient setting and a 13.5-15.5% increase for ambulatory care settings are forecasted. While few new drugs are expected to greatly influence expenditures in 2003, the continued diffusion of recently approved drugs such as drotrecogin alfa and nesiritide will have a dramatic impact on total drug expenditures and must be carefully considered in the budgeting process. An agent likely to have a significant impact on HIV treatment is enfuvirtide, the first in a new class of antiretrovirals (fusion inhibitors), but its high cost ($10,000-$15,000 per year) may limit patients' access to this medication. An expanded user's guide is provided to assist the reader in appropriate application of this information in the drug budgeting process. Technological, demographic, and market-based changes and changes in public policy will continue to influence pharmaceutical expenditures in the coming year. An understanding of the overall drivers of medication expenditures and vigilance in monitoring pharmaceutical innovation are critical in the effective management of these resources.     

Can possible toxic effect of ultraviolet-A after corneal cross-linking be prevented? In vitro transmittance study of contact lenses at 370 nm wavelength

Context: Corneal collagen cross linking (CCL) with ultraviolet A (UVA) has been proposed as a treatment for the progression of corneal ectasia associated with keratoconus and post-laser-assisted in situ keratomileusis (LASIK) ectasia. Despite the reports about safety of procedure, we consider that UVA of sunlight can effect riboflavin saturated and de-epitelizated cornea early after CCL.

Objectives: To evaluate the UVA blockage capability of 11 different silicone hydrogel contact lenses which are widely used after CCL treatment.

Methods: Eleven different silicone hydrogel and daily disposable contact lenses were evaluated. The UVA light at 365?nm wavelength for UVA source and UV light meter to measure UVA radiation were used. 3, 9 and 18?mW/cm² power of UV radiance was applied centrally to the each type of contact lenses. The power of UVA transmittance for each radiance and percentage of blockage were evaluated for each brand. Also, protection factor (PF) was calculated.

Results: The senofilcon A and narafilcon A had the highest blockage and lowest transmittance (p?=?0.02). PF was significantly higher in the senofilcon A and narafilcon A at 3, 9 and 18?mW/cm² (p?=?0.0001). And also, the hilafilcon B, filcon IV, nelfilcon A, enfilcon A, lotrafilcon A and lotrafilcon B had the highest UVA transmittance.

Conclusion: The narafilcon A and the senofilcon A may be a good options for epithelial healing after CCL procedure to protect the cornea from UVA of sunlight. And also, the hilafilcon B, filcon IV, nelfilcon A, enfilcon A, lotrafilcon A and lotrafilcon B contact lenses that have high-UVA transmittance feature can be a treatment choice for contact lens-assisted CCL technique in thin corneas.     

Exchange transfusion for neonatal hyperbilirubinemia: an 8-year single center experience at a tertiary neonatal intensive care unit in Turkey

Objective: The aim of present study was to evaluate the indications and the complications associated with neonatal exchange transfusion (ET) performed for hyperbilirubinemia.

Methods: This study included overall 306 neonates who underwent ET between 2005 and 2012. The demographic characteristics of patients, causes of jaundice and adverse events occurred during or within 1 week after ET were recorded from their medical files. Those newborns that underwent ET were classified as either “otherwise healthy” or “sick” group.

Results: Of the 306 patients who underwent ET, 244 were otherwise healthy and had no medical problems other than jaundice. The remaining 62 patients were classified as sick that had medical problems other than jaundice ranging from mild to severe. The mean gestational age was 37.6?±?2.5 weeks and the mean peak total bilirubin levels was 25.8?±?6.6?mg/dl. The mean age at presentation was 5.4?±?3.8?d for all infants. The most common cause of hyperbilirubinemia was ABO isoimmunization (27.8%). None of newborns died secondary to ET. Three infants had had necrotizing enterocolitis, and also three infants had had acute renal failure. The most common encountered complications of ET procedure were hyperglycemia (56.5%), hypocalcaemia (22.5%) and thrombocytopenia (16%).

Conclusions: Our data showed that ABO isoimmunization was the most common cause of hyperbilirubinemia. Even mortality was not seen, very rare but major gastrointestinal and renal complications were associated with ET. The majority of adverse events associated with ET were laboratory abnormalities mainly hyperglycemia, hypocalcaemia and thrombocytopenia which were asymptomatic and treatable.