Investigations of Phlebotomus perniciosus sand flies in rural Spain reveal strongly aggregated and gender-specific spatial distributions and advocate use of light-attraction traps

The spatial and temporal distribution of Phlebotomus perniciosus (Diptera: Psychodidae) (Newstead, 1911), the sand fly vector of pathogens of public and animal health importance, was investigated in a high sand fly density rural area in Spain using light-attraction and sticky-interception traps. Traps were placed inside animal buildings and outside at increasing distance from animals. A total of 8506 sand flies were collected, 87% with light traps. Species frequency differed between trap types. The abundance of P. perniciosus decreased exponentially with increasing distance to animals and, while females were most common in the animal enclosure, males predominated in adjoining storage places. Increasing CO₂ concentration had an additional positive effect on female abundance only. Both male and female density increased with rising temperature, and there was some indication that females were more active than males at higher relative humidity. The study confirms that P. perniciosus aggregates around animal premises, although male and female distributions differ and should be analysed separately to account for biological and behavioural differences. This provides further evidence that light traps offer an accurate estimation of the relative spatial and temporal abundance of P. perniciosus, conferring an added value for the study of this species and the risk of pathogen transmission.

Is Tear Calcium An Indicator of Ocular Calcification in Patients with Chronic Renal Failure?

BACKGROUND

In patients with chronic renal failure (CRF) on regular dialysis treatment, limboconjunctival degeneration and calcifications are common. The mechanisms of ectopic conjunctival and corneal calcification remain largely speculative. The aim of the present work was to study tear calcium levels in patients with chronic renal failure, which could alter calcium excretion patterns, and to examine whether the calcium level in tear fluid is of more diagnostic importance than static calcium levels in blood.

METHODS

Tear calcium levels were measured in 25 patients with chronic renal failure, compared with 14 normal subjects. Conjunctival and corneal calcium deposits were graded by the Porter and Crombie classification.

RESULTS

While 11 of the 25 patients had no clinically apparent calcium deposits, six had Grade 1 or 2, and eight had Grade 3 and over limboconjunctival calcification. Mean tear calcium levels were 1.436 +/- 0.165 mg/dl in the patients and 1.307 +/- 0.155 mg/dl in the normal group. The difference was not significant (P = 0.572). No correlation was found between the grade of the calcium deposits and tear calcium levels.

CONCLUSIONS

Tear calcium level has no diagnostic importance for the development of ocular calcification in chronic renal failure.

Investigation of the excitation functions for the (n, 2n) reactions on the structural fusion material 58,60 – 62,64Ni

The theoretical prediction of the cross-sections in the determination of the structure materials used in the fission and fusion technology is very important in terms of reactor safety. Also, theoretical cross-sections are necessary to evaluate the performance of structure materials, especially, in the lack or absence of experimental data. Nickel base alloys are one of the wide ranges of structural materials used in fission and fusion reactors. Therefore, the excitation functions of the (n, 2n) reactions on the structure material nickel with neutrons producing via fusion reactions are investigated in this study. Thus, the excitation functions for 58,60 – 62,64Ni(n, 2n) reactions are calculated using some pre-equilibrium models which are the hybrid, the geometry depended hybrid and the two-component excitation models. The calculations are performed in the ALICE/ASH and the Talys 1.8 codes. Also, the equilibrium and pre-equilibrium effects on these reactions are investigated in this study. The obtained cross-sections are discussed and compared with the experimental data and the theoretical predicted data.

Neuroprotective effects of high-dose human albumin against traumatic spinal cord injury in rats

BACKGROUND AND OBJECTIVES

Human serum albumin (HA) is a unique multifunctional protein with neuroprotective properties. We aimed to delineate the mechanisms of HA-induced neuroprotection, supresses inflammatory response and lipid peroxidation after spinal cord injury (SCI).

METHODS AND STUDY DESIGN

Adult female Wistar rats weighing 210-250 g were used for the study. The rats were randomly and blindly allocated into five groups. The one-way analysis of variance (ANOVA) for parametric data and Shapiro-Wilk test was used for evaluating the normal distribution of the variables. Kruskal-Wallis for nonparametric data was used to compare groups. Electron and light microscopies were used to demonstrate ultrastructural changes in spinal cord.

RESULTS

The HA group was significantly different from all the other groups (p < 0.05). Both MPSS and HA treatments decreased the MPO significantly. HA treatment decreased the lipid peroxidation. HA treatment prevented the worsening of clinical results. In the HA treatment group, the ultrastructure was protected significantly. The neuronal bodies and axonal structures were normal except for some limited edematous spaces.

CONCLUSIONS

HA improves early clinical results, protects spinal cord ultrastructure, and decreases MPO and LPO levels after spinal cord contusion injury (Tab. 3, Fig. 3, Ref. 39).

Posterior Chamber Lens Implantation Techniques in Posterior Capsular Rupture

Purpose

To evaluate posterior chamber lens implantation techniques and their results in patients in whom posterior capsular rupture and zonular dialysis arose during cataract operation.

METHODS

Forty-three cataractous eyes of 43 consecutive patients with complicated cataract operations such as posterior capsular rupture or zonular dialysis were accepted into this prospective study between November 1999 and January 2001. Intraocular lens implantation to ciliary sulcus was achieved without sutures in 19 cases (Group 1), with one suture from 12 o'clock quadrant in 14 cases (Group 2), and with two sutures from 3 to 9 o'clock quadrants in 10 cases (Group 3). Patients were followed up for 3 months after operation and evaluated for best-corrected visual acuity, refractive astigmatism, corneal edema, anterior chamber depth and inflammation, synechia at angle, intraocular pressure, lens tilt and decentration, intraocular hemorrhage, cystoid macular edema, and retinal detachment.

Results

There was no difference among groups in best-corrected visual acuity, refractive astigmatism, corneal edema, anterior chamber depth and inflammation, intraocular pressure, lens tilt and decentration, cystoid macular edema, or retinal detachment. Anterior chamber and vitreous hemorrhage and peripheral anterior synechia were significantly higher in Group 3 when compared with Group 1 (p=0.009, p=0.009, and p=0.004).

CONCLUSIONS

In all cases with posterior capsular rupture and zonular dialysis, different posterior chamber lens implantation techniques could be performed, beginning with the least invasive procedure suitable for the conditions with the least complications.

Computerized Tomography-Guided Stereotactic Biopsy of Intracranial Lesions: Report of 500 Consecutive Cases

AIM

Computed tomography (CT)-guided stereotactic brain biopsy has been performed in our clinic since March 1998. In this prospective study, we examined the patient data undergoing stereotactic biopsy and the results of biopsies in 500 consecutive patients.

MATERIAL AND METHODS

Between the dates of March 1998 and January 2015, CT-guided stereotactic biopsies were performed by using the Leksell stereotactic frame system (Elekta Instruments EU, Sweden) in 500 patients. A total of 512 procedures were performed in patients consisting of 184 females (36.8%) and 316 males (63.2%), ages ranging from 3 to 81 years (mean 50.40±16.67).

RESULTS

Conclusive histopathological diagnosis was not achieved in 17(3.3%) of 512 procedures. Of the others, 173 (33.8%) were high-grade gliomas, 103 (20.1%) were low-grade gliomas, 36 (7%) were malignant lymphomas, 34 (6.6%) were other types of brain tumors, 82 (16%) were metastasis and 67 (13.1%) were non-tumoral lesions. Complications were occurred in ten cases: 3 tumoral bleedings, 2 hypertensive cerebral hematomas, 2 peroperative convulsions, 1 epidural hematoma, 1 myocardial infarction and 1 brain edema. The patients who developed myocardial infarction and hypertensive thalamic hematoma died. The mortality was 0.4% and morbidity was 1.6% in 512 procedures.

CONCLUSION

CT-guided stereotactic biopsy is a reliable and a safe procedure in cases with intracranial lesions when histopathological diagnosis is required for the appropriate treatment.

The role of pegaptanib sodium in the suppression of epidural fibrosis in a postlaminectomy rat model

OBJECTIVE

Spinal epidural fibrosis is a clinical condition that develops after laminectomy and can compress the spine. Many agents have been tried for the treatment, but none has entered clinical use at present. Pegaptanib sodium is an antiangiogenetic drug that prevents the development of new vessels and thus adhesion by inhibiting the effect of VEGF.

MATERIAL AND METHOD

20 Wistar rats were used in this study. The rats were divided into 2 different groups as the control and pegaptanib sodium group. Three levels of laminectomy were performed. Only laminectomy was performed in the control group. A cotton ball soaked with 3 mg/kg Pegaptanib sodium diluted 1: 10 with 0.9 % NaCl was topically applied to the dura in the surgical field for 5 minutes in the pegaptanib sodium group. The rats were sacrificed 3 weeks later and histopathologically examined. The epidural fibrosis was graded.

RESULTS

The epidural fibrosis grade in the pegaptanib sodium was significantly lower than in the control group c2 = 11,65; (p = 0.004)CONCLUSION: Pegaptanib sodium blocked the VEGF through its anti-VEGF effect and decreased spinal epidural fibrosis in rats that had undergone laminectomy (Tab. 2, Fig. 3, Ref. 53).

Factors that Affect Postoperative Hydrocephalus Development in Aneurysmal Subarachnoid Hemorrhage: A Clinical Study

AIM

Factors affecting the development of postoperative hydrocephalus patients who underwent surgery after aneurysmal subarachnoid hemorrhage were retrospectively assessed.

MATERIAL AND METHODS

201 cases, who underwent aneurysm surgery in our clinic after subarachnoid hemorrhage between 2008 and 2013, were retrospectively assessed. Twenty-one cases with hydrocephalus development were retrospectively examined according to their age, gender, history (hypertension, alcohol, and smoking), blood type, the number and size of aneurysms, aneurysm localization, the presence of ventricular hemorrhage, baseline-final neurological diagnosis, Fisher grading system, history of vasospasm and meningitis. The initial neurological course and Hunt-Hess, and also final neurological course of the patients were evaluated according to World Federation of Neurosurgical Societies (WFNS) Grading Scale.

RESULTS

Age, history of hypertension, aneurysm localization, Hunt-Hess grading, vasospasm, meningitis and Glasgow Outcome Scale (GOS) are determinative factors in hydrocephalus development due to subarachnoid hemorrhage. It was detected that gender, alcohol and tobacco use, blood group, the size and the number of aneurysm, the presence of intraventricular hemorrhage and Fisher grading were not the determinative factors in the patients.

CONCLUSION

In patients who underwent surgery for subarachnoid hemorrhage, risk factors for postoperative hydrocephalus should be determined and the patients with these risk factors should be closely monitored.

Chronic subdural hematoma associated with arachnoid cyst of the middle fossa : Surgical treatment and mid-term results in fifteen patients

AIM

We report the neurological and radiological features, surgical management and Mid-term outcome in a series of patients with chronic subdural hematoma (CSDH) and associated ipsilateral arachnoid cyst (AC) of the middle fossa.

MATERIAL AND METHODS

Between August 2004 and August 2012, 453 patients were treated with diagnosis of CSDH in our clinic. Of those, 15 patients had ipsilateral arachnoid cyst in the middle fossa. A single burr hole craniostomy was performed to drain the hematoma and the AC left intact at first in 14 patients, one patient had no surgical intervention. Follow-up period ranged from 13 months to 88 months (mean 43.07 ± 23.23 months).

RESULTS

The patients having CSDH with AC were found to be younger than the patients with CSDH alone, the mean age was 13.93 ±12.37 years Eleven patients had head trauma 21 to 50 days before admission. Hematoma evacuation through a single burr hole and closed system subdural drainage 2 to 4 days after surgery improved the symptoms in all patients. Two patients developed subdural fluid collection which is treated by subduroperitoneal shunt placement.

CONCLUSION

Greater prevalence of ACs in patients with CSDHs has been reported in the literature. We recommend the drainage of the hematoma via a single craniostomy and to leave the AC intact as the first choice of treatment if the associated AC is a Galassi type I or II. Additional subduroperitoneal shunting may be performed in patients with Galassi type III cyst.

Assessing cervical intraepithelial neoplasia as an indicator disease for HIV in a low endemic setting: a population-based register study

OBJECTIVES

To analyse whether the prevalence of undiagnosed HIV among (1) all women in Sweden and (2) migrant women, diagnosed with cervical intraepithelial neoplasia grade 2 or worse CIN2⁺ reaches the threshold of 0.1%, which has been suggested to be cost-effective for HIV testing.

DESIGN

Population-based register study.

SETTING

Counties of Stockholm and Gothenburg, Sweden, 1990-2014.

POPULATION

All women, born between 1940 and 1990, with at least one cervical cytology or histology registered in the Swedish National Cervical Screening Register (NKCx).

METHODS

Data were collected from the NKCx and the Swedish National HIV register. The proportion of women with undiagnosed HIV among women with CIN2⁺ compared with women with a normal/mildly abnormal cytology/histology was assessed.

MAIN OUTCOME MEASURES

Proportion of women with undiagnosed HIV.

RESULTS

The proportion of undiagnosed HIV was higher among all women with CIN2⁺ than among those without CIN2⁺ : 0.06% (95% CI 0.04-0.08) versus 0.04% (95% CI 0.04-0.04); P = 0.017). Among migrant women, the proportion of undiagnosed HIV was higher among those with CIN2⁺ than among those without [0.30% (95% CI 0.20-0.43) versus 0.08% (95% CI 0.07-0.10); P < 0.001] and exceeded 0.1%, suggesting the cost-effectiveness of HIV testing. Women with undiagnosed HIV at the time of CIN2⁺ had a significantly lower nadir CD4⁺ T-cell count, as a measure of immunosuppression, compared with women without CIN2⁺ before HIV diagnosis (median nadir CD4, 95 cells/mm³ versus 210 cells/mm³ ; P < 0.01).

CONCLUSIONS

HIV testing should be performed in migrant women with unknown HIV status diagnosed with CIN2⁺ .

TWEETABLE ABSTRACT

HIV testing should be performed in migrant women with unknown HIV status diagnosed with CIN2⁺ .

Simultaneous thoraco-laparoscopic repair of giant hiatal hernias: an alternative approach

Laparoscopic repair of giant hiatal hernias with intrathoracic displacement of organs is recommended to relieve troublesome symptoms in patients. During this procedure, incomplete excision of the hernia sac from the mediastinum and omission of creating a 'non-tension-free position' of the cardio-esophageal junction into the abdominal cavity are associated with hiatal hernia recurrence. Giant hiatal hernias therefore often require a thoracotomy or thoracoscopy, to free dense adhesions higher up the chest. These procedures may increase the risk of perioperative morbidity due to lengthy operating times. We developed an operation procedure for giant hiatal hernia repair containing all the benefits of minimal invasive surgery, with overview of both thoracic and abdominal herniated structures. Three patients with a giant hiatal hernia were treated by a simultaneous thoraco-laparoscopic approach, which proved to be technically feasible and safe. Simultaneous thoraco-laparoscopic hernia repair can be considered a reasonable treatment option in selected cases such as type IV hernias, hernia recurrence or traumatic diaphragmatic herniation.

Erythropoietin stimulates the coronary collateral development in patients with coronary chronic total occlusion

Objective

Erythropoietin (EPO) improves cardiac function and induces neovascularisation in post-myocardial infarction heart failure. The aim of this study was to analyse the association between the serum erythropoietin level and coronary collateral development in patients with coronary artery disease and chronic total occlusion.

Methods

A total of 168 patients consisting of 117 with coronary artery disease (CAD, (62 with chronic total occlusion (CTO), 55 without CTO)) and 51 with healthy coronary arteries were included in the study. The patients were assigned as coronary artery disease without CTO (group 0), CAD with CTO (group 1: poor collateral development, group 2: good collateral development) and normal coronary arteries (group 3).

Results

There was a significant positive correlation between serum EPO levels and the Rentrop scores in angiography (r = 0.243, p = 0.001). Similarly, a positive correlation was found between serum EPO levels and the Syntax scores (r = 0.253, p = 0.001). Echocardiography revealed a negative correlation between serum EPO levels and the cardiac ejection fraction (r = −0.210, p = 0.006).

Conclusions

Serum EPO is a useful biomarker for coronary collateral development in patients with CTO.

Morphometric Analysis of Lumbar Disc Space in the Turkish Population and Safe Discectomy Distance in Lumbar Disc Surgery

AIM

Lumbar discectomy is a common surgical intervention in neurosurgical practice. Iatrogenic vascular injury during this surgery is a rare, but serious complication. In this study, our aim was to review the average safe depth of discectomy for both sexes.

MATERIAL AND METHODS

This study involved a total of 56 patients between 21 and 79 years old (28 male and 28 female) who had no surgical pathology as documented by lumbar magnetic resonance imaging study. Measurements at L3-4, L4-5, and L5-S1 were performed for both sexes as follows: 1 < sup > st < /sup > measurement, from the furthest lateral part of the dura to the end of the disc (right-left); 2 < sup > nd < /sup > measurement, the anteroposterior length of the cross-section passing through the midline of the disc; 3rd measurement; from the furthest lateral part of the dura to the furthest lateral part of the disc (right-left); 4th measurement, the length from right to left of the cross-section passing through the midline of the disc.

RESULTS

Measurement 1 at L3-4, L4-5, and L5-S1, this value was estimated to be 35.9 and 36.7 mm, 35.9 and 36.9, and 34 and 34.9 mm in the right and left sides respectively, for female subjects. The corresponding values for males were 41.4 and 42.1, 40.6 and 40.9, and 37.4 and 37.7 mm at L3-4, L4-5, and L5-S1, respectively. Measurement 3 in L3-4, L4-5, and L5-S1 disc spaces on the right and left sides in female subjects were 14.8 and 16.3 mm, 15.7 and 17.2 mm, and 14.9 and 17.1 mm, respectively, with corresponding figures of 18.6 and 19.5, 19.7 and 20.6, and 18.2 and 18.6 mm among male participants. Measurement 2 and 4 in females for L3-4, L4-5, and L5-S1 were 38.4 and 52.3 mm, 38.9 and 53.4 mm, and 37 and 51.8 mm, respectively. The corresponding figures for males were 43.2 and 57.6 mm, 43.2 and 58.9 mm, and 40.1 and 56.7 mm, respectively.

CONCLUSION

Determination of the safe discectomy depth in both males and females, as well as the use of marking disc punches to indicate the safe margins may help clinicians to avoid this unwanted complication.

Inflammation, vitamin D and dendritic cell precursors in chronic kidney disease

Decreased blood dendritic cell precursors (DCP) count is linked with atherosclerotic disease, while reduction of circulating DCP is also seen in patients with chronic kidney disease (CKD). As poor vitamin D status could be linked to a compromised innate immune response, we hypothesized that vitamin D status might be involved in the decrease in circulating DCP in CKD. Moreover, the potential role of inflammation was considered. Circulating myeloid (mDCP), plasmacytoid (pDCP) and total DCP (tDCP) were analysed using flow cytometry in 287 patients with CKD stage 3. Serum 25(OH)D and 1,25(OH)2D levels were measured using enzyme-linked immunosorbent assays (ELISA), interleukin (IL)-6, IL-10 and tumour necrosis factor (TNF)-α using cytometric bead array, C-reactive protein (CRP) using a high-sensitivity (hs) ELISA. Contrary to our hypothesis, there was no association between vitamin D levels and DCP, although their number was decreased significantly in CKD (P < 0·001). Instead, mDCP (r = -0·211) and tDCP (r = -0·188,) were associated slightly negatively with hsCRP but positively with the estimated glomerular filtration rate (eGFR, r = 0·314 for tDCP). According to multivariate linear regression, only higher hsCRP concentration and the presence of diabetes mellitus had a significant negative influence on DCP count (P < 0·03, respectively) but not vitamin D, age and eGFR. A significant impact of vitamin D on the reduction of circulating DCP in CKD 3 patients can be neglected. Instead, inflammation as a common phenomenon in CKD and diabetes mellitus had the main influence on the decrease in DCP. Thus, a potential role for DCP as a sensitive marker of inflammation and cardiovascular risk should be elucidated in future studies.

Acute amitraz intoxication: retrospective analysis of 45 cases

Objective: To present special clinical and laboratory features of 45 cases (44 adult cases) who were intoxicated through oral route. Design: Retrospective study. Setting: Intensive care unit (ICU) of a university hospital. Patients: Forty-five patients admitted to the ICU of Cumhuriyet University Hospital. Results: Forty-five patients between 4 and 97 years of age were evaluated. Intoxication was the result of a suicide attempt in 67% of cases and accidental in 33% of cases. Unconsciousness, nausea and vomiting were the common initial symptoms. The major clinical findings in the ICU were bradycardia, myosis, hypothermia, hyperglycemia, hypotension, coma and respiratory depression. Blood glucose level was increased in 64% of cases. No problem was noted in the patient or the fetus in a pregnant, 27-year-old patient, who was intoxicated with 10 mL of 12.5% amitraz. The length of stay in the ICU was between 2 and 15 days. None of the patients died. All patients were discharged without neurological sequela. Conclusion: The prognosis of amitraz intoxications through oral route is benign and results in complete healing; however, we suggest that these cases should be well monitored and followed-up in ICUs.

Oxidase Activity of Ceruloplasmin and Some Acute Phase Reactant and Trace Element Concentrations in Serum of Patients with Chronic Lymphocytic Leukemia

In the present study, we aimed to investigate the parameters in serum of patients with chronic lymphocytic leukaemia (CLL) and correlate with the cancer stage. The serum concentrations of ceruloplasmin, a-1-acid glycoprotein, albuminumin, transferrin, copper, zinc, manganese, and ceruloplasmin oxidase activity were measured, and compared with those from a healthy control group. The serum from 34 patients with CLL were extracted before chemotherapy. Serum transferrin, albuminumin and Zinc concentrations were lower in patients with CLL while serum a-1-acid glycoprotein, ceruloplasmin, copper concentrations, and ceruloplasmin oxidase activity were higher in CLL patients when compared with the control group. Although serum manganese concentration was lower in CLL groups than in the control group, the difference was not statistically significant. Serum transferrin concentration was lower in the early stage group compared with the advanced stage. Serum ceruloplasmin level positively correlated with serum ceruloplasmin oxidase activity in patients from the early stage group. Serum ceruloplasmin level positively correlated with serum ceruloplasmin oxidase activity in patients with advanced stage. In conclusion, increased serum ceruloplasmin oxidase activity, ceruloplasmin, a-1-acid glycoprotein, copper levels and decreased transferrin and albuminumin, unchanged manganese levels are associated with CLL and appear to be a consequence of the disease itself.

Increased pregnancy-associated plasma protein A in retinal vein occlusion

OBJECTIVE

The aim of this study was to evaluate pregnancy-associated plasma protein A (PAPP-A) levels in patients with retinal vein occlusion (RVO), and to investigate its possible role as a predictive biomarker.

PATIENTS AND METHODS

The study included 26 patients with RVO and 30 age- and gender-matched healthy subjects as controls. PAPP-A levels were measured using an enzyme-linked immunosorbent assay (ELISA) kit. The PAPP-A levels in patients with RVO were compared with those in the control group using the Mann-Whitney U test.

RESULTS

The mean serum PAPP-A levels were 1.27 ± 0.46 mIU/L (mean ± standard deviation) in the RVO group and 1.14 ± 0.11 mIU/L in the control group. There was a significant difference in PAPP-A levels between RVO patients and healthy subjects (p = 0.03). Moreover, in ROC analysis comparing the RVO patients and controls, a cutoff value of 1.126 (AUC: 0.669), specificity of 63.3% and sensitivity of 76.9% were calculated for the RVO patients (p = 0.03).

CONCLUSIONS

Our data seems to support the roles of both thrombosis and atherosclerosis in the development of RVO. It is possible that PAPP-A may be involved in the pathogenesis of venous thrombosis in the retina.

Altered platelet morphological parameters in patients with retinal vein occlusion

OBJECTIVE

The purpose of this work was to investigate whether platelet morphology or functions are altered in retinal vein occlusion (RVO) patients.

PATIENTS AND METHODS

Eighty-three patients with a RVO and eighty-five healthy subjects were included in this prospective study. RVO was diagnosed by ophthalmic fundus examination, and complete ophthalmic evaluations of both eyes were performed. The platelet large cell ratio (PLCR), platelet distribution width (PDW), mean platelet volume (MPV), platelet crit (PCT), and platelet count were determined for each participant.

RESULTS

The MPV, PDW and PLCR were significantly higher in the RVO group than in the control group (MPV: 8.26 ± 1.22 fL vs. 7.41 ± 0.69 fL, respectively, p = 0.006; PDW: 13.43 ± 1.75% vs. 12.19 ± 1.51%, respectively, p = 0.0022; and PLCR: 30.62 ± 4.65% vs. 28.59 ± 4.18%, respectively, p = 0.003). There were no significant differences in the PCT or platelet count between the two groups (253.76 ± 70.87 x 103/µl vs. 248.96 ± 62.44 x 103/µl, respectively p > 0.05; and PCT: 0.24 ± 0.07 % vs. 0.27 ± 0.06%, respectively, p > 0.05).

CONCLUSIONS

We observed that the platelets RVO patients exhibit morphological evidence of hyperreactivity (e.g., a higher MPV, PDW and PLCR). Also, larger platelets are hemostatically more active than small ones and an increased proportion of large platelets is a risk factor for developing RVO.

THE USE OF 18F-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY TO ASSESS CLINICAL OUTCOMES OF PATIENTS WITH BORDERLINE RESECTABLE PANCREATIC CANCER

The aim of this study is to evaluate the effect of 18FDG PET on preoperative staging and clinical management of pancreatic cancer. Between December 2011 and February 2015, 28 consecutive patients with borderline resectable pancreatic cancer were evaluated with both 18FDG PET scans and conventional preoperative imaging studies. Medical records of all patients were noted prospectively. 18FDG PET findings were compared with conventional imaging studies and over-staging or down-staging rates with changes in clinical management were evaluated. The correlation of 18FDG PET with conventional imaging studies was evaluated with a kappa agreement coefficient. A number of 22 (78.5%) patients had pancreatic head cancer and 6 (21.4%) patients had pancreatic body and tail cancers. Based on 18FDG PET, additional lesions were found in 4 (14.28%) of the patients which were lung and peritoneal lesions as metastasis. No hepatic metastasis or supraclavicular lymph node involvement was confirmed in patients. Routine use of 18FDG PET for preoperative staging has not an effect on cancer management in 96.8% of our patients. In conclusion, 18FDG PET has additional value over conventional radiologic techniques for monitoring the treatment response in locally advanced pancreatic cancer patients. It is feasible to predict early metastasis and patient outcome early (after one course of IC) during therapy.

Magnetic resonance imaging study; does the olfactory bulb volume change in major depression?

Goal: The olfactory region function disorders and olfactory bulb volume changes in neurodegenerative and neuropsychiatric disorders are defined. In this study, the olfactory bulb values of patients diagnosed with major depression in accordance with DMS-IV criteria, are measured with MRI, and these values are compared with the values of healthy volunteers to see if there are any statistically significant changes.

Method: The study was carried out with 20 healthy volunteers and 20 patients who had been diagnosed with acute major depression in accordance with ‘diagnostic and statistical manual of mental disorders’ (DMS) IV criteria and have been getting treatment for more than 2 years in Istanbul Education and Research Hospital. 1,5 Tesla MRI were used in 40 cases, and the olfactory bulb volume on two hemispheres were measured separately.

Results: Contrary to the former studies, we found no statistically significant difference between the olfactory bulb volume measurements of the control group and the group diagnosed with major depression.

Application of neural based estimation algorithm for gait phases of above knee prosthesis

In this study, two gait phase estimation methods which utilize a rule based quantization and an artificial neural network model respectively are developed and applied for the microcontroller based semi-active knee prosthesis in order to respond user demands and adapt environmental conditions. In this context, an experimental environment in which gait data collected synchronously from both inertial and image based measurement systems has been set up. The inertial measurement system that incorporates MEM accelerometers and gyroscopes is used to perform direct motion measurement through the microcontroller, while the image based measurement system is employed for producing the verification data and assessing the success of the prosthesis. Embedded algorithms dynamically normalize the input data prior to gait phase estimation. The real time analyses of two methods revealed that embedded ANN based approach performs slightly better in comparison with the rule based algorithm and has advantage of being easily-scalable, thus able to accommodate additional input parameters considering the microcontroller constraints.

FT-IR spectroscopy and multivariate analysis as an auxiliary tool for diagnosis of mental disorders: Bipolar and schizophrenia cases

In this study, a methodology based on Fourier-transform infrared spectroscopy and principal component analysis and partial least square methods is proposed for the analysis of blood plasma samples in order to identify spectral changes correlated with some biomarkers associated with schizophrenia and bipolarity. Our main goal was to use the spectral information for the calibration of statistical models to discriminate and classify blood plasma samples belonging to bipolar and schizophrenic patients. IR spectra of 30 samples of blood plasma obtained from each, bipolar and schizophrenic patients and healthy control group were collected. The results obtained from principal component analysis (PCA) show a clear discrimination between the bipolar (BP), schizophrenic (SZ) and control group' (CG) blood samples that also give possibility to identify three main regions that show the major differences correlated with both mental disorders (biomarkers). Furthermore, a model for the classification of the blood samples was calibrated using partial least square discriminant analysis (PLS-DA), allowing the correct classification of BP, SZ and CG samples. The results obtained applying this methodology suggest that it can be used as a complimentary diagnostic tool for the detection and discrimination of these mental diseases.

Deficiencies in the health care system contribute to a high rate of late HIV diagnosis in Sweden

OBJECTIVES

The aim of the study was to identify factors in HIV-infected patients and the health care system which contribute to late diagnosis.

METHODS

All patients who were newly diagnosed with HIV infection at 12 clinics in Sweden over a period of 2.5 years (n = 575) were included in the study, corresponding to three-quarters of newly diagnosed HIV infections in the country. The patients were classified as non-late presenters or late presenters (LPs), defined as those with a CD4 count < 350 cells/μL or AIDS. LPs were subdivided into those without and those with advanced HIV disease, which was defined as a CD4 count < 200 cells/μL or AIDS. Demographics, missed AIDS and HIV-associated symptoms in the preceding 3 years, immigration date, and health examination at immigration were recorded.

RESULTS

Fifty-eight per cent of the patients were LPs, of whom 66% had advanced disease. Age > 30 years, origin in sub-Saharan Africa or Eastern Europe/Asia/the Pacific region, and country of transmission being in sub-Saharan Africa or unknown were associated with late presentation. Half of the patients of non-Swedish origin had lived for more than 1 year in Sweden at diagnosis and 66% had a missed HIV testing opportunity at immigration. Twenty-seven per cent of all patients had presented for health care with AIDS- and/or HIV-associated conditions without having an HIV test. Sixteen per cent had a history of symptoms without seeking care.

CONCLUSIONS

Deficiencies in the health care system with missed HIV testing opportunities contribute to the high proportion of late presenters in Sweden, especially among migrants. With increased testing at immigration and further incorporation of "indicator-guided" testing in general practice, most patients could be diagnosed earlier.

Bifidobacterium lactis B94 plus inulin for Treatment of Helicobacter pylori infection in children: does it increase eradication rate and patient compliance?

The aim of this study is to investigate the effects of Bifidobacterium lactis B94 and inulin (synbiotic) treatment on eradication rate and patient compliance in subjects treated for symptomatic H. pylori infection. Patients with symptomatic H. pylori infection were divided into two groups. One group was treated with standard triple therapy (lansoprazole, amoxicillin, and clarithromycin) and B. lactis B94 (5 × 109 CFU/dose) plus inulin (900 mg) twice daily for seven days. The control group was treated with standard triple therapy and placebo. The side effects and eradication rates were evaluated at the end of the study. Ninety-three patients with H. pylori infection were treated with either synbiotic plus triple therapy (n = 47) or placebo plus triple therapy (n = 46). The infection eradication rates were not significantly different between the synbiotic and placebo groups [intent-to-treat (ITT), 80.8% and 67.3%, p = 0.13, respectively; per-protocol (PP), 86.3% and 81.5%, p = 0.55, respectively]. The drug side effects were significantly higher in the placebo group than in the synbiotic group (63% and 17%, respectively, p < 0.01). Although no intolerable adverse side effects were observed in the synbiotic group, intolerable adverse side effects were observed in 13% of the placebo group (p = 0.01). Our results suggest that twice daily 5 × 109 CFU/dose B. lactis B94 plus 900 mg inulin treatment did not have a direct positive effect on the H. pylori eradication rate. However, this treatment had significantly reduced side effects and indirectly increased eradication rates by increasing patient compliance.

Spinal nerve root compositions of musculocutaneous nerve: an anatomical study

AIM

This study was aimed to investigate the variations in the spinal nerve root compositions of musculocutaneous nerve and to confirm which spinal nerve root is the main ingredient in participating amount.

MATERIAL AND METHODS

A total of 20 fresh cadavers were dissected. Brachial plexus and its branches were extracted. Musculocutaneous nerve stump was traced back to the roots to identify its fascicular origin. The number of fascicles originating from a particular nerve root and their axial location with in the nerve were noted.

RESULTS

The most frequent type of spinal nerve compositions of musculocutaneous nerve was C5, C6, and C7 with incidence of 60%. Musculocutaneous nerve had bundles from C5 root in all specimens, 90% of the specimens had contribution from C6 and only 70% of them had bundles from C7 root. There were a total of 46 (37.7%) bundles in C5 fascicles, 48 (39.3%) bundles in C6 fascicles, and 28 (22.9%) bundles in C7 fascicles.

CONCLUSIONS

In electrophysiological studies it should be remembered that C7 or C6 lesions may not impair musculocutaneous nerve functions. The success of musculocutaneous nerve neurotization may be improved if care is taken to ensure whether or not C7 root is contributing to the musculocutaneous nerve.