Does supplementation of boron with yeast or humate substances have a better chance at modulating rumen fermentation in yearling rams?

This study aimed to determine the effects of boron fed alone or with yeast culture or liquid humate on ruminal pH, ammonia-N, short-chain fatty acid (SCFA) concentration, protozoa counts and some nutrients’ apparent digestibility in yearling rams. Therefore, four Merino rams were allocated to 4×4 Latin square design and were randomly assigned to one of four treatments to basal diet: negative control with no supplements (NC), positive control (PC) with 30 ppm (Dry matter basis) boric acid alone, combinations of 30 ppm boric acid and 3 g/kg yeast culture (YC) and 30 ppm boric acid and 5 ml/kg liquid humate (LH). There were no negative effects of additives’ supplementation on animals daily feed consumption. No significant differences were observed among treatments for rumen parameters investigated, however, numerically lowest values for pH & ammonia-N in LH while highest SCFA concentrations in YC and LH groups were observed. Apparent nutrient digestibility was altered with boron addition to diets. Boron analysis of blood serum and fecal samples showed non-significant changes, except higher serum concentration of boron in YC compared to PC. It can be concluded that tested dosage of boron was not enough to considerably modify rumen fermentation characteristics in yearling rams. Better modulation of rumen fermentative characteristics might be possible when boron is supplemented with yeast or liquid humate, however, this possibility should be verified in the large-scale experiment.

Type-H, and Type-L COVID-19: are they different subtypes or the same?

OBJECTIVE

SARS-CoV-2 infection, which causes severe pneumonia, caused an epidemic that started in Wuhan, China in December 2019 and spread to the whole world. COVID-19 mainly affects the respiratory system and causes the development of severe pneumonia and related acute respiratory distress syndrome (ARDS) in some patients. We aimed to investigate whether COVID-19 pneumonia cases can be evaluated in different categories in clinical and radiological terms.

PATIENTS AND METHODS

COVID-19 associated ARDS cases being treated with the diagnosis of severe pneumonia between March 21, 2020 and June 15, 2020 in Anesthesia Intensive Care Unit were examined and divided into 2 groups (type-L and type-H, total 29 cases) according to their clinical findings (according to whether they benefited from high PEEP and their lung compliance) and lung computed tomography findings (according to the severity of the ground glass appearance). The groups were compared with each other in terms of inflammatory markers [CRP (C reactive protein), ferritin, D Dimer, PCT (procalcitonin), white blood cell, lymphocyte count, arterial blood gas analysis] and imaging findings.

RESULTS

It was observed that the prone position was beneficial in improving oxygenation in both H-type and L-type patients. 7 of 22 L-type patients were intubated and 5 of these patients died. There was no statistical difference between the two groups in terms of intubation times, hospital stays, cytokine levels, prone position application responses and mortality rates.

CONCLUSIONS

Are there two separate forms of COVID-19 pneumonia, such as h-type and l-type, or are they intertwined and describe the early and late stages of the disease? This question needs to be discussed. In addition, we believe that subtyping COVID-19 pneumonia patients does not make a difference in the treatments to be applied.

Description and Outcomes of Three Different End-to-Side Microsurgical Techniques for the Anastomosis of Accessory Renal Artery With the Dominant Renal Artery in Kidney Transplantation

BACKGROUND

In this study, we compared the outcomes of three different surgical microscope-assisted end-to-side anastomosis techniques between the dominant and accessory renal arteries during living donor kidney transplant.

METHODS

The demographics, serum creatinine levels, warm and cold ischemia times, rate of complications, and incidence of delayed graft function of 135 kidney recipients were analyzed according to the type of arterial anastomosis. Group A (n = 98) had one dominant renal artery (DRA) with one end-to-side anastomosis to the external iliac artery (EIA) using a surgical microscope. Group B (n = 17) had one DRA plus one accessory renal artery (ARA) with two separate end-to-side anastomoses to the EIA using a surgical microscope. Group C (n = 20) had one DRA with end-to-side anastomosis to the EIA and one ARA with an ex vivo on-bench end-to-side anastomosis to the DRA using a surgical microscope.

RESULTS

Compared with groups A and B, the cold ischemia time and the rate of delayed graft function were significantly higher in group C (P ≤ .001). At 6 months after transplant, group B demonstrated a higher creatinine value (2.40 ± 3.41 mg/dL) than group A and group B (P = .032). Also, the decrease in creatinine at postoperative month 6 was limited in group B as compared with groups A and C.

CONCLUSIONS

An end-to-side anastomosis between ARA (group B) and DRA (group A) of the kidney graft using a surgical microscope on the bench ex vivo results in superior outcomes. Single arterial anastomosis techniques are associated with a better function in a 6-month follow-up than two separate arterial anastomoses.

A simple and rapid spectrofluorometric determination of pomalidomide in spiked plasma and urine. Application to degradation studies

A rapid and accurate spectrofluorimetric method for the determination of pomalidomide was developed and validated based on the measurement of its native fluorescence without the need for any derivatization and separation for the first time. The fluorescence intensity of the drug in acetonitrile solution allowed precise detection at 460 nm after excitation at 296 nm. The calibration curve was linear in the concentration range 31.0-500.0 ng/ml. Limit of detection and limit of quantification were found to be 8.04 and 24.36 ng/ml, respectively. Sensitive results allowed the drug to be detected with good recovery (75.46-109.72%) in human plasma and urine using the developed method. The proposed method was validated in terms of linearity, sensitivity, precision, accuracy, recovery, and stability parameters. Pomalidomide was subjected to degradation under various stress conditions (hydrolytic, oxidative and thermal) to demonstrate that the method was stable, indicating and identifying possible degradation products. In addition, the drug was exposed to electrochemical degradation using the chronoamperometry technique for the first time. Characterization of pomalidomide degradation products obtained because of oxidative degradation and electrochemical degradation was carried out using attenuated total reflection Fourier transform infrared spectroscopy, mass spectrometry and high performance liquid chromatography - mass spectrometry methods and possible structures were proposed.

Donkey milk kefir induces apoptosis and suppresses proliferation of Ehrlich ascites carcinoma by decreasing iNOS in mice

Donkey milk and donkey milk kefir exhibit antiproliferative, antimutagenic and antibacterial effects. We investigated the effects of donkey milk and donkey milk kefir on oxidative stress, apoptosis and proliferation in Ehrlich ascites carcinoma (EAC) in mice. Thirty-four adult male Swiss albino mice were divided into four groups as follows: group 1, administered 0.5 ml water; group 2, administered 0.5 ml water + EAC cells; group 3, administered 0.5 ml donkey milk + EAC cells; group 4, administered 0.5 ml donkey milk kefir + EAC cells. We introduced 2.5 x 10⁶ EAC cells into each animal by subcutaneous injection. Tap water, donkey milk and donkey milk kefir were administered by gavage for 10 days. Animals were sacrificed on day 11. After measuring the short and long diameters of the tumors, tissues were processed for histology. To determine oxidative stress, cell death and proliferation iNOS and eNOS, active caspase-3 and proliferating cell nuclear antigen were assessed using immunohistochemistry. A TUNEL assay also was used to detect apoptosis. Tumor volume decreased in the donkey milk kefir group compared to the control and donkey milk groups. Tumor volume increased in the donkey milk group compared to the control group. Proliferating cell nuclear antigen levels were higher in the donkey milk kefir group compared to the control and donkey milk groups. The number of apoptotic cells was less in the donkey milk group, compared to the control, whereas it was highest in the donkey milk kefir group. Donkey milk administration increased eNOS levels and decreased iNOS levels, compared to the control group. In the donkey milk kefir group, iNOS levels were significantly lower than those of the control and donkey milk groups, while eNOS levels were similar to the control group. Donkey milk kefir induced apoptosis, suppressed proliferation and decreased co-expression of iNOS and eNOS. Donkey milk promoted development of the tumors. Therefore, donkey milk kefir appears to be more beneficial for treating breast cancer than donkey milk.

Clinical performance of a combined approach for the esthetic management of fluorosed teeth: Three-year results

OBJECTIVE

The long-term clinical performance of combined therapy including enamel microabrasion and vital bleaching is debatable due to the abrasion of outer enamel surface. The aim of this longitudinal cohort study was to evaluate the 3-year clinical performance of enamel microabrasion in combination with vital tooth bleaching for the esthetic management of fluorosed teeth.

MATERIALS AND METHODS

Fifteen patients with 176 fluorosed incisors and canines were included in this study. All the teeth were treated with enamel microabrasion (Opalustre, Ultradent), and at-home bleaching technique (10% Opalescence PF, Ultradent). Fluorosed teeth were evaluated at baseline, after microabrasion, after combined therapy, and at 3-year follow-up in terms of esthetic criteria (esthetic appearance, brown stains, and opaque white areas), side effects, and patient satisfaction using visual analog scales. The data were statistically analyzed (α = 0.05).

RESULTS

Fluorosed teeth revealed significantly better esthetic appearance after microabrasion and combined therapy and at 3-year follow-up compared to those at baseline (P P Conclusions: The combined therapy was effective in the esthetic management of fluorosed teeth. However, a significant relapse was observed in the esthetic appearance and brown stains of these patients after 3 years, which also reduced patient satisfaction.

Neutrophil-to-lymphocyte ratio as a possible indicator of epicardial adipose tissue in patients undergoing hemodialysis

INTRODUCTION

Chronic inflammation is a major risk factor in the pathogenesis of cardiovascular disease in end-stage renal disease (ESRD) patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease and EAT was shown in healthy subjects and ESRD patients. In the present study we aimed to investigate the relationship between EAT and inflammation parameters including neutrophil-to-lymphocyte ratio (NLR) in hemodialysis (HD) patients.

MATERIAL AND METHODS

Forty-three HD patients (25 females, 18 males; mean age: 64.1 ±11.9 years) receiving HD and 30 healthy subjects (15 females, 15 males; mean age: 59.1 ±10.8 years) were enrolled in the study. Epicardial adipose tissue measurements were performed by echocardiography.

RESULTS

Neutrophil-to-lymphocyte ratio levels were significantly higher in HD patients than in the healthy control group. Hemodialysis patients were separated into two groups according to their median value of NLR (group 1, NLR < 3.07 (n = 21) and group 2, NLR ≥ 3.07 (n = 22)). Group 2 patients had significantly higher EAT, C-reactive protein and ferritin levels, while albumin levels were significantly lower in this group. In the bivariate correlation analysis, EAT was positively correlated with NLR (r = 0.600, p < 0.001) and ferritin (r = 0.485, p = 0.001) levels.

CONCLUSIONS

Neutrophil-to-lymphocyte ratio was found to be an independent predictor of EAT in HD patients (odds ratio = 3.178; p = 0.008). We concluded that this relationship might be attributed to increased inflammation in uremic patients.

Update in urethral stents

Urethral stents were first introduced in 1988, and since then, they have undergone significant improvements. However, they did not gain a wide popularity and their use is limited to a small number of centers around the world. Urethral stents can be used in the entire urethra and for various and diverse indications. In the anterior urethra, it can be used to treat urethral strictures. In the prostatic urethra, they can be used for the treatment of prostatic obstruction, including benign, malignant and iatrogenic prostatic obstruction. Moreover, although not widely used, it can be also applied for the treatment of posterior urethral stricture and bladder neck contracture, usually resulting in urinary incontinence and the need for subsequent procedures. Our main experience are with Allium urethral stents, and as such, we provide the latest updates in urethral stents with special emphasis on the various types of Allium urethral stents: bulbar, prostatic and bladder neck stents.

Gene-environment Interactions in the Etiology of Dental Caries

Dental caries is a multifactorial disease that can be conceptualized as an interaction between genetic and environmental risk factors. The aim of this study is to examine the effects of AMELX, CA6, DEFB1, and TAS2R38 gene polymorphism and gene-environment interactions on caries etiology and susceptibility in adults. Genomic DNA was extracted from the buccal mucosa, and adults aged 20 to 60 y were placed into 1 of 2 groups: low caries risk (DMFT ≤ 5; n = 77) and high caries risk (DMFT ≥ 14; n = 77). The frequency of AMELX (+522), CA6 (T55M), DEFB1 (G-20A), and TAS2R38 (A49P) single-nucleotide polymorphisms was genotyped with the polymerase chain reaction-restriction fragment length polymorphism method. Environmental risk factors examined in the study included plaque amount, toothbrushing frequency, dietary intake between meals, saliva secretion rate, saliva buffer capacity, mutans streptococci counts, and lactobacilli counts. There was no difference between the caries risk groups in relation to AMELX (+522) polymorphism (χ(2) test, P > 0.05). The distribution of CA6 genotype and allele frequencies in the low caries risk group did not differ from the high caries risk group (χ(2) test, P > 0.05). Polymorphism of DEFB1 (G-20A) was positively associated, and TAS2R38 (A49P) negatively associated, with caries risk (χ(2) test, P = 0.000). There were significant differences between caries susceptibility and each environmental risk factor, except for the saliva secretion rate (Mann-Whitney U test, P = 0.000). Based on stepwise multiple linear regression analyses, dental plaque amount, lactobacilli count, age, and saliva buffer capacity, as well as DEFB1 (G-20A), TAS2R38 (A49P), and CA6 (T55M) gene polymorphism, explained a total of 87.8% of the variations in DMFT scores. It can be concluded that variation in CA6 (T55M), DEFB1 (G-20A), and TAS2R38 (A49P) may be associated with caries experience in Turkish adults with a high level of dental plaque, lactobacilli count, and age and when saliva buffer capacity is low.

Bioimpedance spectroscopy for the differential diagnosis of hyponatremia

BACKGROUND

Hyponatremia is classified according to volume status with the help of physical examination, biochemical measures, urine and serum osmolalities, and echocardiography. Bioimpedance spectroscopy (BIS) has been getting popularity for revealing tissue compositions of various patient groups. The aim of this observational study was to investigate the role of BIS for the differential diagnosis of hyponatremia (ClinicalTrials.gov Identifier: NCT01838759).

PATIENTS AND METHODS

Personal characteristics of age, sex, weight, height, and blood pressure were recorded. Body composition monitor (BCM) was used for hydration status for each individual. Primary outcome was investigated by the accuracy of volume status measured by BIS.

STATISTICS

Kappa statistic (K) is a measure of agreement between two sources, which is measured on a binary scale (i.e., condition present/absent). K statistic can take values between 0 and 1: poor agreement: K < 0.20, fair agreement: 0.2.0-0.3.9, moderate agreement: 0.40-0.59, substantial: 0.60-0.79, very good agreement: 0.80-1.00.

RESULTS

Fifty-eight hyponatremia-diagnosed patients, 32 (55.2%) of male with the mean age of 65.2 ± 11 (40-89) years were included. Kappa statistic (K) were very good (K = 0.925) for male (p < 0.00), substantial agreement (K = 0.601) for female (p <  0.002) with the use of BIS for the differential diagnosis of either hypo or hypervolemia in hyponatremic patients compared with gold standard tests which were the combination of echocardiography, serum, and urine osmolality biochemical tests, and physical examination.

CONCLUSION

Bioimpedance spectroscopy is a practical and an inexpensive method. This is the first study in the literature showing the role of BIS for the determination of the volume status and differential diagnosis of hyponatremia when compared with echocardiography.

Influence of single hemodialysis session on serum paraoxonase-1, arylesterase activity, total oxıdant status and total antioxidant status

AIM

Chronic kidney disease(CKD) and hemodialysis (HD) are associated with increased oxidative stress. Cardiovascular diseases (CVD) are the most important cause of mortality in these patients. Increased cardiovascular risk is associated with oxidative stress. The aim of this study was to evaluate whether the duration of single session hemodialysis may affect oxidative stress parameters on the patients with end-stage renal disease (ESRD).

METHODS

Total oxidant status (TOS) and oxidative stress index (OSI) as oxidative markers and total antioxidant status (TAOS), paraoxonase1 (PON1) and arylesterase (ARES) as antioxidant markers were compared hemodialysis therapy before and after the treatment.

RESULTS

TOS levels before hemodialysis were found as 4.4±2.4 μmol H2O2 Equiv/L, TAOS 2.1±0.3 µmol trolox Equiv./L, OSI 0.2±0.1%, PON1 levels 58.5±35.6 U/L and ARES levels 22±0.2 U/L while after the HD the respective values were 1.4±1.2 μmol H2O2 Equiv/L, 1.4±0.5 µmol trolox Equiv./L, 0.1±0.1%, 54.3±31.3 U/L, 21.8±0.1 U/L. A significant decreasing was observed in TOS TAOS OSI and ARES values before the HD compared to after the HD (P=0.0001, P=0.0001, P=0.0001, P=0.031, respectively).

CONCLUSION

This study shows oxidant (TOS, OSI) and antioxidant (TAOS, ARES) markers were found to be significantly decrease after the HD compared to pre-hemodialysis. Although reverse is expected it is found that oxidants (indirectly ROS) did not increase and antioxidant reserve decreased in HD.

Carotid artery Doppler ultrasonography in patients with chronic kidney disease

BACKGROUND

We investigated the changes in the values of carotid intima-media thickness (IMT) and Doppler index measurements in the autosomal dominant polycystic kidney disease (ADPKD), peritoneal dialysis (PD), and hemodialysis (HD) patients.

MATERIAL AND METHODS

Twenty outpatients on HD (mean age 46.1 ± 16.4), 27 outpatients on PD (mean age 45 ± 12.4), and 26 normotensive outpatients with ADPKD (mean age 52.4 ± 16.7) as the case groups and 21 healthy subjects (mean age 48.4 ± 7.2), as the control group, were included. The participants underwent ultrasonography of the common, right, and left carotid arteries for the IMT and Doppler flow measurements.

RESULTS

Overall, compared to the normal group, in the study groups, the IMT and peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) were significantly higher in common carotid arteries; however, their differences were not meaningful in internal carotid arteries (p<0.05).

CONCLUSIONS

Overall, ADPKD, PD, and HD increase the IMT, PSV, EDV, RI, and PI values of CCA; however, their effect considerable less on the study parameters of ICA. There is no considerable difference among the effects of ADPKD, HD, and PD on the study parameters. Of CKD patients during the first diagnostic and follow-up workups, the measurements of carotid IMT and Doppler indices may provide valuable data for improving success of the clinical management.

Role of matrix metalloproteinases and tissue inhibitor of matrix metalloproteinases-1 in Crimean-Congo hemorrhagic fever disease

AIM

Crimean-Congo hemorrhagic fever is a potentially fatal viral disease in humans caused by CCHF virus. We aimed to demonstrate change in serum levels of matrix metallopeinase/tissue matrix metalloproteinase inhibitor (MMP/TIMP) associated with CCHF.

PATIENTS AND METHODS

Blood specimens were collected in acute and convalescence periods from the patients presented to Cumhuriyet University Hospital, Department of Emergency and Infection Diseases with presumed as CCHF between May 2010 and September 2010. Forty-one age and gender matched healthy individuals had not any viral, bacterial, acute or chronic disease were enrolled as the controls. Blood specimens were centrifuged at 4000 rpm for 5 min with in "Hettich universal 32" centrifuge. Serum samples obtained were kept at -80°C. All the specimens were brought to room temperature during the study and MMP-1, 2, 7, 9, 10 and TIMP-1 tests were studied at one time using "RayBiotech" brand kit in "Grifols" brand "Triturus" model ELISA device. Acute, convalescence and control groups were compared in terms of the serum levels of MMP-1, 2, 7, 9, 10 and TIMP-1.

RESULTS

There was a statistically significant increase in serum levels of MMP-1, 7, 9, 10 and TIMP-1 in the convalescence period (p < 0.05) compared to the controls, while the increase in levels of MMP-2 was not statistically significant (p > 0.05). In acute period of CCHF, mean TIMP-1 levels of severe patients was significantly lower than that of the non-severe patients (207913 ± 31051 versus 231300 ± 13267, respectively, p = 0.023).

CONCLUSIONS

High serum levels of MMP and TIMP in CCHF disease were found to decrease as progressed to convalescence from the acute period. It is thought MMP and TIMP plays a significant role in pathogenesis of CCHF.

Glomerular filtration rate: which method should we measure in daily clinical practice?

AIM

In this study, we compared estimated glomerular filtration rate (eGFR) calculated with the formulas of Cockcroft-Gault (C&G), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Mayo Clinic Quadratic (Mayo Q) and, GFR (mGFR) that was scintigraphically measured with creatinine clearance (CrCl) and technetium-99m diethylene triamine penta-acetic acid (99mTc-DTPA). Objective of this study was to define the correlations between the formulas, provide a reliable method for measurement and estimation of GFR in daily clinical practice and demonstrate the potential errors.

METHODS

C&G, CKD-EPI, Mayo Q and MDRD eGFR of 84(37 males, 47 females) patients diagnosed with chronic kidney disease were calculated. Values of 99mTc-DTPA based on mGFR were compared with eGFR values of the formulas.

RESULTS

Significant correlations were found with the values of 99mTc-DTPA mGFR, CrCl, MDRD, CKD-EPI, Mayo Q and C&G eGFR. The highest correlation was found between LBM(lean body mass) corrected C&G, MDRD-6, Mayo Q and CKD-EPI eGFR. The best estimate was made with MDRD-6 in the cases with 99mTc-DTPA mGFR<30 mL/min/1.73 m(2) and with MDRD-4 in the cases with 99mTc-DTPA mGFR≥30 mL/min/1.73 m(2), while the worst estimate was made with uncorrected C&G formula in both groups.

CONCLUSION

All eGFR formulas can be used in daily clinical practice. However, using MDRD-6 in the cases with GFR<30 mL/min/1.73 m(2) and MDRD-4 in the cases with GFR≥30 mL/min/1.73m(2) as well as using LBM for C&G eGFR or correction according to LBM when AW (actual weight) is used, might provide a more accurate estimation.

Recovery process in patients followed-up due to acute kidney injury

INTRODUCTION

Acute kidney injury (AKI) may result in complete recovery in some of the patients and partial recovery in others. AKI episodes may accelerate the progression to chronic kidney disease and end-stage renal failure, while risk for morbidity and mortality is high following AKI. Discharge of patients from the hospital, independently from dialysis is a crucial outcome. Many patients without a need for dialysis, require follow-up for various durations and different treatments. The objective of this study was to compare mean recovery time of the patients followed-up due to prerenal, renal and postrenal AKIs.

METHOD

In this prospective observational study, a total of 159 patients hospitalized in Bulent Ecevit Hospital, clinic of nephrology or monitored in the other wards and intensive care unit due to AKI, between June 2011 and January 2012, were enrolled. The cases were divided into three groups as prerenal, renal and postrenal, and monitored with the daily visits and renal function testing.

RESULTS

Prerenal AKI was seen by 54%, while renal AKI was observed by 34% and post-renal AKI by 12%. Incidence of chronic kidney disease was 17.6%. Totally 43 patients required hemodialysis (27%). Of these patients, 23 were in the prerenal AKI (53.4%), 15 in the renal AKI (34.8%) and 5 (11.6%) in the postrenal AKI group. Blood urea nitrogen (BUN) and creatinine levels were dropped to the basal values only in the prerenal AKI group, on the seventh day of treatment. These levels remained higher in the postrenal and renal groups on the 7th day of treatment compared to the basal values. BUN levels decreased to the normal values on average 7th day in the postrenal, while remained higher in the renal group.

CONCLUSION

Prerenal AKI patients recovered in seven days with a proper treatment, although AKI patients due to other reasons should be followed-up for a longer time.

[Diabetes and fasting during Ramadan. A observational study among Turkish immigrants in Belgium]

AIMS

To investigate (i) Ramadan participation, (ii) provision of Ramadan related advice by healthcare providers (iii) medication use during Ramadan fasting among Turkish migrants with diabetes in Belgium.

METHODS

This pilot observational study was conducted among a convenience sample of 52 Turkish migrants with diabetes in Belgium. Two questionnaires collected information on socio-demographic characteristics, diabetes related characteristics, current hypoglycaemic medication with dosing regimen, participation in the past Ramadan, reasons for (non)participation, use of hypoglycaemic medication during the past Ramadan, advice from their healthcare providers about fasting during Ramadan and follow up of this advice.

RESULTS

Sixteen patients (31%) had fasted during the past Ramadan. Main reason for Ramadan participation was reinforcement of faith (12/15), while the main reason for non participation was having diabetes (34/36). About 56% of the study population had received recommendations from their healthcare provider(s) about fasting and diabetes during Ramadan. The most commonly provided advice was not to participate in Ramadan, followed by modification of drug therapy. Only 3 patients ignored the advice of their healthcare professionals. In addition, only 60% of those who actually fasted received recommendations about intake of diabetes medication during the ramadan. Most fasters continued their medication dose unchanged (87% of OHA users and 80% of the insulin users).

CONCLUSIONS

This pilot study found a low prevalence of Ramadan fasting among Turkish migrants with diabetes in Belgium. We also found that provision of advice by healthcare providers could be improved. Larger scale studies are warranted to confirm these findings.

The importance of myeloperoxidase enzyme activity in the pathogenesis of Crimean-Congo haemorrhagic fever

Crimean-Congo haemorrhagic fever (CCHF) is a disease with a severe course including acute viral haemorrhagic fever, ecchymosis, thrombocytopenia, hepatic function disorder and high mortality. Myeloperoxidase (MPO) is an enzyme located in neutrophil granulocytes and plays an important role in the destruction of phagocytosed micro-organisms. The aim of this study was to analyse MPO enzyme activity in CCHF cases compared with a control group. A total of 47 randomly selected CCHF patients admitted to the Department of Infectious Diseases of Cumhuriyet University Hospital in Sivas, Turkey, were studied, and as a control group, 41 age- and sex-matched individuals without any systemic disease were included in this study. MPO enzyme activity was measured in plasma and leukocytes for both groups by the ELISA method. MPO plasma and MPO leukocyte values were calculated as 57.62 ± 8.85 and 44.84 ± 9.71 in CCHF patients, and 0.79 ± 0.29 and 0.49 ± 0.11 in the controls, respectively. MPO enzyme activity was statistically significantly higher in patients with CCHF when compared to the control group. In conclusion, MPO enzyme activity is directly related to the activation of phagocytic leukocytes, and increases in both the plasma and leukocytes in CCHF patients. The increase of the MPO enzyme activity in leukocytes due to viral load leads to the destruction of the leukocyte. It is thought that MPO enzyme activity in plasma was higher in CCHF patients due to the destruction of leukocytes. MPO enzyme activity may be important in terms of the prognosis in patients with CCHF; however, more extensive studies are required on this subject.

Bioimpedance and echocardiography used interchangeably in volume comparison of dialysis patients

BACKGROUND

Euvolemia is a major issue in chronic kidney disease. The present study compares cardiac condition and volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients and points out importance of volume control.

METHODS

From a single-center center, 81 PD and 89 HD patients were enrolled. Echocardiography and body composition analysis using bioimpedance spectroscopy (BIS) technique were performed. Overhydration (OH) and extracellular water (ECW) in liters and OH/ECW % were used as volume indices.

RESULTS

Patients were younger (47.6±14. 5 and 53.1±11.8 years, p< 0.05), daily urine volume higher (1068±926 vs 290±444 ml, p <0.001) and dialysis vintage was shorter (30.1±18.6 vs 53.6±35.4 months, p<0.001), systolic blood pressure was lower (127.5±15.4 vs 140.3±18.9 mmHg, p<0.001) in PD than HD group respectively. Volume indices were (OH, OH/ECW %, ECW/height, ECW to Intracellular Water ratios (E/I) (p<0.05)) significantly higher in HD patients compared to PD patients. Over all 66 of 170 patients (39%) had OH/ECW % <5 and OH/ECW % ratio was positively correlated with Left atrium index (R(2):0.105, p<0.05). Interventricular septum diameter and Left ventricular mass index (1.41±0.24 and 159.6±48.2 vs. 1.27±0.17 cm and 115.8±37 g/m(2), p<0.001) were increased in HD than in PD group. After multivariate adjustment OH/ECW increased with: HD and diabetic patients. LVH increased with: HD group, OH/ECW (%) and SBP significantly.

CONCLUSION

Overhydration was more common among HD. Excess fluid may lead adverse effect in organ functions especially cardiac condition. This indicates that the current clinical and technical tools to achieve euvolemia are insufficient and that an additional tool, such as BIS, could be useful in the diagnosis of overhydration.

Effect of uterine artery blood flow on recurrent pregnancy loss

We investigated the effect of uterine artery blood flow on recurrent pregnancy loss. One hundred and twelve patients admitted to our clinic were included in the prospective study. The study group consisted of 28 cases with a history of three miscarriages before the 20th gestational week, and the control group consisted of cases with at least one prior live birth without any history of miscarriage or poor obstetric outcome. The mean pulsatility index (PI) , resistance index (RI) and systolic/diastolic ratio (S/D ratio) values of the uterine artery were measured between the 18th and 23rd days of the menstrual cycle via transvaginal Doppler ultrasonography. No statistically significant difference could be detected regarding uterine artery PI (p=0.703), RI (p=0.333), and S/D (p=0.403) values between the study group and the control group (p>0.05). In order to clearly determine etiologic causes of recurrent pregnancy loss, new randomized and controlled clinical trials with large patient populations are needed.

Respirometric assessment of biodegradation for acrylic fibre-based carpet finishing wastewaters

The paper evaluates biodegradation characteristics of wastewaters generated from acrylic fibre-based carpet processing and manufacturing. It involves detailed characterisation, respirometric modelling and kinetic description of dyeing and softening wastewater streams and the composite effluent. The wastewaters exhibit different COD content and fractionation. The resulting composite effluent has a total COD of 775 mgL(-1), predominantly soluble and with a biodegradable fraction of 86%. In respirometric studies, the OUR profiles can only be calibrated with a dual hydrolysis model with rates significantly slower compared to domestic sewage and other textile plant effluents. Kinetic information derived from the experiments is applied for the conceptual evaluation of the treatability of the composite wastewater using two different continuous-flow activated sludge configurations.

[Rumen fermentation and digestibility of nutrients studied by the addition of Ca soaps of palm oil fatty acids and their analogous fatty acids in the sheep model]

The ruminally fistulated sheep was used as a model to study the effects of fat supplementation (Ca-soaps and free long chain fatty acids from palm oil) on rumen physiology and digestibility of the nutrients. The animals were fed with a typical ration of hay and concentrate supplying nutrients according to maintenance levels. The following results should be pointed out: The addition of free fatty acids and their Ca-soaps induced a retarded recovery of postprandially decreased pH-values in ruminal fluid. This retardation was more pronounced after addition of free long chain fatty acids than with their Ca-soap-analogous acids. Compared to the control, the concentration of short chain fatty acids was depressed by fat addition in the period 2 hours after feed intake. The release of ammonia in the first period after feed intake was reduced by fat addition. A lack of synchronity could be observed in this post-prandial period in ruminal fluid between concentration of short chain fatty acids and ammonia. This effect was most obvious with supplementation of unprotected fatty acids. This might be one reason for the better tolerance of Ca soaps from palm oil fatty acids. Formation of hydrides, branched chains and transforms proceeds more effectively with free fatty acids than with their analogous forms of Ca-soaps. The well-known effect of depression of digestibility of nutrients due to fat supplementation was--under present conditions--quite low. This might be different in lactating dairy cows with higher levels of feed intake. With high feed intake, passage time is reduced. This will affect digestibility and interactions with fat supplementation.

Comparison of antioxidant activities of aminoguanidine, methylguanidine and guanidine by luminol-enhanced chemiluminescence

1. The objective of this study was to investigate the ability of aminoguanidine, methylguanidine and guanidine to inhibit free radicals or metabolites generated by either stimulated human leucocytes or cell-free systems using luminol-enhanced chemiluminescence (CL). 2. Aminoguanidine (0.1 microM-10 mM), methylguanidine (10 microM-10 mM) and guanidine (10 microM-10 mM) produced concentration-dependent inhibition (96+/-0.1%, n=7, 59+/-1.3%, n=6, and 62+/-3%, n=6, P<0.05 at 10 mM, respectively) in FMLP-stimulated leucocytes CL. 3. In cell-free experiments, hydrogen peroxide (H2O2), hypochlorous acid (HOCl), hydroxyl radical and peroxynitrite-induced CL responses were initiated by hydrogen peroxide (3.5 mM), NaOCl (50 microM), FeSO4 (40 nM) and peroxynitrite (20 nM), respectively. Aminoguanidine, methylguanidine and guanidine produced concentration-dependent inhibition in H2O2-(69+/-0.7%, n=7, 26+/-1%, n=6, and 15+/-0.5%, n=6, at 1 mM, respectively) and HOCl-(84+/-0.3%, n=6, 50+/-1%, n=6, and 29+/-1%, n=7, at 1 mM, respectively) induced luminol CL. Peroxynitrite-induced CL was markedly attenuated in a concentration-dependent manner by aminoguanidine (99+/-0.1%, n=6, at 10 mM), methylguanidine (5+/-0.2%, n=6, at 10 mM) and guanidine (27+/-0.4%, n=7, at 10 mM). However, inhibition with aminoguanidine was found to be more marked than with methylguanidine and guanidine. Aminoguanidine (95+/-0.5%, n=6, at 1 mM) and methylguanidine (25+/-1%, n=6, at 1 mM), but not guanidine (2+/-1%, n=6, at 1 mM), significantly decreased ferrous iron-induced CL. 4. Collectively, these data suggest that aminoguanidine and a high concentration (> or = 0.1 mM) of methylguanidine have direct scavenging activities against H2O2, HOCl, hydroxyl radical and peroxynitrite. Guanidine, at a high concentration (> or = 0.1 mM), scavenges H2O2, HOCl and peroxynitrite, but not the hydroxyl radical. These direct scavenging properties may contribute to inhibitory effects of these compounds on human leucocyte CL.

Ferrous iron-induced luminol chemiluminescence: a method for hydroxyl radical study

We have investigated the chemiluminescence signal of the ferrous iron in the presence of the luminol and lucigenin. Ferrous, but not ferric, iron produced a transient signal in the presence of luminol, but not lucigenin. Ferrous iron-induced luminol chemiluminescence was significantly inhibited in a concentration-dependent manner by superoxide dismutase (SOD) and catalase. Specific hydroxyl radical scavengers, mannitol and dimethyl sulfoxide (DMSO), also markedly attenuated the ferrous iron-induced chemiluminescence. Additionally, antioxidants, urate, ascorbate, and methionine produced concentration-dependent significant inhibitions in this chemiluminescence. These results show that the hydroxyl radical generation is dependent on simultaneous formation of superoxide and hydrogen peroxide (H2O2). Ferrous iron does not generate a chemiluminescence signal in the presence of lucigenin suggesting that the formation of a hydroxyl radical is responsible for the luminol chemiluminescence. Thus, the present study has established a simple and inexpensive cell-free screening method for monitoring the scavenging effects of drugs on the hydroxyl radical.