Validity and reliability of the Turkish version of the orthognathic quality of life questionnaire in patients with dentofacial deformity

Background

Due to the lack of a specific quality of life (QoL) survey on dentofacial deformities (DFD) for Turkish speakers, the present research aimed to perform a translation of the English version of the Orthognathic Quality of Life Questionnaire (OQLQ) into Turkish (the OQLQ-TR) and provide cultural adaptation to the Turkish population.

Material and Methods

The process of this cross-cultural adaptation followed the six stages given in the guidelines that were proposed by Beaton et al. (2000), which comprised the following: 1) performing the initial translation, 2) synthesizing the translation, 3) performing the back translation, 4) presenting it to the expert committee, and 5) testing the prefinal version. Throughout the process of validating the Turkish version, the results of the OQLQ were compared with the Oral Health Impact Scale-14 (OHIP-14) and Short Form-36 (SF-36) questionnaires and the Visual Analogue Scale (VAS), which were previously validated in Turkish. All of these Turkish questionnaires (OHIP-14, SF-36, OQLQ) were applied to 69 patients at the Çukurova University Faculty of Dentistry.

Results

Analysis of the internal consistency of the OQLQ-TR exhibited good correlations for the domains. Moreover, the test-retest reliability also exhibited intra-class correlation coefficients that were excellent. The correlation between the OQLQ-TR and SF-36 was weak and negative. The OQLQ-TR exhibited good correlations with the OHIP-14 and VAS.

Conclusions

The OQLQ-TR was found to be valid, reliable, and reproducible. Thus, it has become a useful instrument for assessing the quality of life of Turkish-speaking patients with dentofacial deformity.

Key words:Dentofacial deformity, orthognathic quality of life, quality of life (QoL), orthognathic surgery.

Temporomandibular disorders in patients with rheumatoid arthritis: A clinical study

OBJECTIVES

The aim of this study is to evaluate the prevalence and type of temporomandibular disorders (TMD) in patients with rheumatoid arthritis (RA).

MATERIALS AND METHODS

Fifty-four patients having RA treatment at Cukurova University in Rheumatology Clinic were enrolled to the study. Demographic and rheumatologic data were recorded. The patients were examined in Dental Faculty by using Research Diagnostic Criteria/TMD (RDC/TMD) axis I and answered RDC/TMD axis II Biobehavioral Questionnaire. Data were evaluated according instructions for scoring and assessment of RDC/TMD. Mann-Whitney test was performed to compare continuous variables between two groups and Kruskal-Wallis test was performed to compare continuous variables for more than two groups.

RESULTS

Although their activity situations were 55.6% active and 44.4% inactive, the distribution of treatment modality was 31.5% for anti-tumor necrosis factor-α (TNF-α) and 68.5% for disease-modifying antirheumatic drugs (DMARD). The distribution of temporomandibular joint (TMJ) involvement was; 9.3% with no involvement, 7.4% with joint involvement, 64.8% with muscular involvement, 18.5% with both muscular and joint involvement. Rheumatologic functional scores were (0) 3.7%, (1) 50%, (2) 38.9%, (3) 7.4%. Patients' chronic pain was graded from 0 to 4 and the distribution was 3.7%, 24.1%, 20.4%, 31.5% and 20.4%, respectively. The mean duration of RA for anti-TNF-α (11.47 ± 7.67) was significantly higher compared with DMARD (7.09 ± 5.21) P = 0.040.

CONCLUSION

There was a high prevalence of TMD in RA patients, and muscular involvement was the highest among the TMJ involvements. Thus, this study supports TMJ examination should be encouraged in the rheumatology settings.

Avascular osteonecrosis and accompanying anemia, leucocytosis, and decreased bone mineral density in renal transplant recipients

BACKGROUND

Avascular osteonecrosis (AVN) is a complication of renal transplantation. In this study, we present 12 cases of AVN associated with renal transplantation.

METHODS

Renal transplant recipients (RTRs) with AVN (group I [GI]) were evaluated by using magnetic resonance imaging and blood urea nitrogen, creatinine, glucose, calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone, and urine analysis. We evaluated bone mineral density (BMD) of the femoral neck and lumbar vertebrae. All patients were treated with steroids, cyclosporine, or tacrolimus plus mycophenolate mofetil. Twenty-six RTRs (GII) without AVN were randomly selected as control subjects.

RESULTS

The mean ages of GI and GII, were 33.81 ± 6.72 and 34.00 ± 7.65 years respectively (P > .05). The mean interval between transplantation and development of AVN was 12.08 ± 6.48 months. Although levels of blood urea nitrogen, creatinine, calcium, magnesium, and parathyroidhormone, as well as glucocorticoid doses in the first 12 months were similar in GI and GII, there were significant differences in serum alkaline phosphatase, hemoglobin levels, and white blood cell count between GI and GII (P < .05 for each). BMD T score <-1.5 was observed in 8/9 GI and 15/26 patients in GII. All of the patients with AVN except 1, were followed with conservative measures including calcium, magnesium, and vitamin D replacement therapies, bisphosphonate, and reduced or ceased glucocorticoid treatment. Although T scores of the femoral head were similar in GI and GII, the lumbar vertebral T score was significantly lower in GI than in GII (P < .052).

CONCLUSION

AVN developed within the first year after transplantation. Decreased lumbar vertebral BMD, which can be an indicator of glucocorticoid effect, accompanied AVN in nearly all patients. Despite the absence of renal dysfunction, increased bone destruction, anemia, and leucocytosis were coincidental or accompanying findings in our patients with AVN.

Clinical trial: oral ondansetron for reducing vomiting secondary to acute gastroenteritis in children--a double-blind randomized study

BACKGROUND

Vomiting as a consequence of gastroenteritis frequently occurs in children. It is still debatable whether vomiting should be treated with antiemetic drugs.

AIM

To investigate potential beneficial effects of ondansetron in treating vomiting during acute gastroenteritis.

METHODS

A randomized, double blind, placebo-controlled trial was performed in our emergency departments. Children, aged 5 months to 8 years, were randomized to receive either ondansetron 0.2 mg/kg or placebo at 8h intervals. The primary outcome measure was the frequency of emesis during an 8-h-period after enrollment.

RESULTS

A hundred and nine patients were enrolled; 54 received placebo and 55 received ondansetron. As compared with the children who received placebo, children who received ondansetron were less likely to vomit both during the first 8-h follow-up in the emergency department [relative risk (RR): 0.33, 95% CI: 0.19-0.56, NNT: 2, 95% CI: 1.6-3.5], and during the next 24-h follow-up (RR: 0.15, 95% CI: 0.07-0.33, NNT: 2, 95% CI: 1.3-2.1).

CONCLUSION

Ondansetron may be an effective and efficient treatment that reduces the incidence of vomiting from gastroenteritis during both the first 8 h and the next 24 h, and is probably a useful adjunct to oral rehydration.

Gastric lavage with normal saline: effects on serum electrolytes

OBJECTIVE

The aim of this study is to determine the intensity of changes in serum calcium, ionized calcium, and magnesium levels after gastric lavage with normal saline in patients with amitriptyline intoxication.

MATERIAL AND METHODS

In this study, thirty patients older than 16 years with the history of intoxication with amitriptyline were included. After the baseline serum calcium, ionized calcium, and magnesium levels had been measured, gastric lavage with normal saline was performed. Serum levels of calcium, ionized calcium, and magnesium were monitored at 15 minutes, 6 hours, and 12 hours.

RESULTS

Serum calcium levels decreased significantly from 9.32 +/- 0.47 mg/dL to 8.40 +/- 0.61 mg/dL (15 minutes, p < 0.001), 8.92 +/- 0.54 mg/dL (6 hours, p < 0.001), and 8.93 +/- 0.54 mg/dL (12 hours, p < 0.001). Serum ionized calcium levels decreased significantly from 1.26 +/- 0.10 mmol/L to 1.20 +/- 0.07 mmol/L (15 minutes, p = 0.004), 1.21 +/- 0.08 mmol/L (6 hours, p = 0.024), and 1.21 +/- 0.08 mmol/L (12 hours, p = 0.034). Serum magnesium levels decreased from 2.41 +/- 0.43 mg/dL to 2.04 +/- 0.25 mg/dL (15 minutes, p < 0.001), 2.14 +/- 0.26 mg/dL (6 hours, p < 0.001), and 2.16 +/- 0.25 mg/dL (12 hours, p < 0.001).

CONCLUSION

Our study demonstrated that gastric lavage with normal saline can cause a statistically significant decrease in serum calcium, ionized calcium, and magnesium (Fig. 4, Ref. 8).

Uncommon Side Effect of MMF in Renal Transplant Recipients

Mycophenolate mofetil (MMF) is a potent immunosuppressive agent used in renal transplantation. Gastrointestinal and hematological side effects are commonly observed, but hepatotoxicity has not been reported. In this study, we assessed MMF-related hepatotoxicity in renal transplant recipients. A total of 124 renal transplantation recipients (RTRs) were evaluated for elevated liver enzymes associated with MMF, and 79 patients were enrolled to the study. Patients used MMF 2 g/day. The patients who had progressive increase in liver enzymes after renal transplantation and their AST, ALT, GGT, ALP, bilirubin levels, hepatitis, cytomegalovirus (CMV), abdominal ultrasonography, duration of hepatotoxicity, and decreased dosage or withdrawal of MMF were recorded. Also, we evaluated their liver enzymes while the patients were on the waiting list. Of the 79 patients, 11 patients (13.9%) had a progressive increase in liver enzymes. The median (min-max) age of the patients with MMF-hepatotoxicity was 29 (19-54) and 72.7% of them were male. None of the patients had hepatitis B or C, CMV infection, or other possible causes for elevated liver enzymes and their abdominal ultrasonography were normal. High liver enzyme levels regressed after the withdrawal (n=6) or reduce dosage (n=5) of MMF. The median time of the increase in liver enzymes was 28 (4-70) days and after 50% reduction or withdrawal of MMF, returned to normal values in 16 (4-210) days. The median levels of ALT in waiting list (I), before (II), and after (III) reduction dosage or withdrawal of MMF were 22.0 (3-22), 222.0 (51-508), and 33.0 (21-64) U/L, respectively (p I-II=0.004,p I-II=0.013, andp II-III=0.005). There were no differences for ALP, GGT, total bilirubin, and direct bilirubin levels. Also, the correlation between recovery time of ALT and persistence time of ALT elevation before adjustment of MMF was significant (r=0.739, p=0.009). Consequently, after renal transplantation, hepatotoxicity can occur due to a lot of reason including MMF usage. If hepatotoxicity related to MMF is not considered, especially in the early period of renal transplantation, resolution of hepatotoxicity can be required long term.

Does the decision in a validation process of a surrogate endpoint change with level of significance of treatment effect? A proposal on validation of surrogate endpoints

BACKGROUND

In recent years the use of surrogate end points (S) has become an interesting issue. In clinical trials, it is important to get treatment outcomes as early as possible. For this reason there is a need for surrogate endpoints (S) which are measured earlier than the true endpoint (T). However, before a surrogate endpoint can be used it must be validated. For a candidate surrogate endpoint, for example time to recurrence, the validation result may change dramatically between clinical trials. The aim of this study is to show how the validation criterion (R(2)(trial)) proposed by Buyse et al. are influenced by the magnitude of treatment effect with an application using real data.

METHODS

The criterion R(2)(trial) proposed by Buyse et al. (2000) is applied to the four data sets from colon cancer clinical trials (C-01, C-02, C-03 and C-04). Each clinical trial is analyzed separately for treatment effect on survival (true endpoint) and recurrence free survival (surrogate endpoint) and this analysis is done also for each center in each trial. Results are used for standard validation analysis. The centers were grouped by the Wald statistic in 3 equal groups.

RESULTS

Validation criteria R(2)(trial) were 0.641 95% CI (0.432-0.782), 0.223 95% CI (0.008-0.503), 0.761 95% CI (0.550-0.872) and 0.560 95% CI (0.404-0.687) for C-01, C-02, C-03 and C-04 respectively. The R(2)(trial) criteria changed by the Wald statistics observed for the centers used in the validation process. Higher the Wald statistic groups are higher the R(2)(trial) values observed.

CONCLUSION

The recurrence free survival is not a good surrogate for overall survival in clinical trials with non significant treatment effects and moderate for significant treatment effects. This shows that the level of significance of treatment effect should be taken into account in validation process of surrogate endpoints.

Effects of pentoxifylline on the cytokines that may play a role in rejection and resistive index in renal transplant recipients

Pentoxifylline (PTX) is a nonselective phosphodiesterase inhibitor that inhibits the production of TNFalpha and IL6 and IL-10 cytokines. In renal rejection TNFalpha, IL-6, and IL-10 may have important roles. In this study, 22 renal transplant recipients treated with tacrolimus, prednisolone, and mycophenolate mofetil were prescribed PTX (2 x 600 mg/d) for 3 months (GI), and 20 similar patients not receiving PTX were used as controls (GII). Stable subjects whose serum creatinine was lower than 1.8 mg/dL and were more than 6 months posttransplant, were enrolled into this study if the blood pressure was well controlled and there was no diabetes mellitus, infection, or inflammation. At the end of 3 months TNF-alpha decreased from 4.2 +/- 2.1 to 2.4 +/- 0.7 (P = .001) and 4.0 +/- 2.2 to 3.9 +/- 1.7 (P = .718), IL-10 also decreased from 3.90 +/- 1.9 to 2.38 +/- 0.6 (P = .001) and 4.02 +/- 1.6 to 3.82 +/- 1.5 (P = .225) in GI and GII, respectively. For IL-10 and TNF-alpha the alterations between baseline and the last visit of GI and GII were significant (P < .002 for all). Resistive index (RI) decreased in GI but the difference in alterations between baseline and the last visit of GI and GII was marginal. In summary IL-10 and TNF-alpha levels decreased in stable recipients treated with PTx. RI also decreased marginally secondary to PTx treatment. PTx was well tolerated and free side effects. PTx did not affect tacrolimus levels or other biochemical and hematological parameters.

Prevention of new sensitizations by specific immunotherapy in children with rhinitis and/or asthma monosensitized to house dust mite

BACKGROUND

Previous studies have suggested that single-allergen-specific immunotherapy (SIT) may prevent sensitization to other airborne allergens in monosensitized children. We aimed to assess the prevention of new sensitizations in monosensitized children treated with single-allergen SIT injections in comparison with monosensitized patients given appropriate pharmacologic treatment for their disease.

METHODS

A total of 147 children with rhinitis and/or asthma monosensitized to house dust mite were studied; 45 patients underwent SIT with adsorbed extracts and 40 patients underwent SIT with aqueous extracts for 5 years. The control group was comprised of 62 patients given only pharmacologic treatment for at least 5 years. Skin prick tests, medication scores for rhinitis and asthma, and atopy scores according to skin prick tests were evaluated at the beginning and after 5 years of treatment.

RESULTS

All groups were comparable in terms of age, sex, and disease characteristics. At the end of 5 years, 64 out of 85 (75.3%) in the SIT group showed no new sensitization, compared to 29 out of 62 children (46.7%) in the control group (P = .002). There were no differences between the SIT subgroups with regard to onset of new sensitization (P = .605). The patients developing new sensitizations had higher atopy scores (P = .002) and medication scores for both rhinitis (P = .008) and asthma (P = .013) in comparison to patients not developing new sensitizations after 5 years of SIT.

CONCLUSION

According to our data, SIT has the potential to prevent the onset of new sensitizations in children with rhinitis and/or asthma monosensitized to house dust mite.

Chromosomal fragile sites in schizophrenic patients

Schizophrenia is a common and complex mental disorder. Cytogenetic and molecular studies have shown that genetic factors play an important role in the etiology of schizophrenia. As a preliminary step in the search for chromosomal location of a susceptible gene predisposing to schizophrenia, cytogenetic screening patients might be useful. Therefore, this report is aimed at studying the relationship between chromosomal fragile sites (FS: gaps, breaks, triradial figures, and several rearrangements) and the etiology of schizophrenia. Because of this, we were compared the frequencies of folate-sensitive FS from schizophrenic patients and normal individuals in short-term whole blood cultures. The rate of FS expression in the patients was considerably higher than in the controls. We determined 15 common FS (cFS) (1q21, 1q32, 2q21, 2q31, 3p14, 4q31, 5q31, 6q21, 6q26, 7q22, 7q32, 10q22, 13q32, Xp22 and Xq22), 6 rare FS (rFS) (6p21, 8q22, 11q23, 12q24, 16q22, and Xq26) and 2 previously unknown FS (3p25 and 5q22). Among these expressed FS, there was a significantly higher frequency of 12 FS at 2q31, 3p25, 3p14, 5q31, 6q21, 7q22, 7q32, 10q22, 11q23, 12q24, Xq22 and Xq26 in patient group than in controls by chi2 test (P = between 0.0001 to 0.036). Sites 3p14, 5q31 and 7q22 were also the most frequently observed cFS. Males exhibited twice as many FS as females, but no age effects were observed. The potential relationship between increased FS frequency and the occurrence of schizophrenia in these patients is discussed.

Efficacy and Safety of Vardenafil in Renal Transplant Recipients With Erectile Dysfunction

Erectile dysfunction (ED) profoundly affects the quality of life. The prevalence of ED in renal transplant recipients is reported by high as 50% to 60%. We evaluated the efficacy and safety of vardenafil in these patients with ED as well as its effects on graft function and on cylosporine or tacrolimus concentrations. Thirty-nine recipients with ED and serum creatinine values<2 mg/dL were treated with vardenafil. ED was assessed using the self-administered International Index of Erectile Function (IIEF). ED was diagnosed by using penile color-Doppler ultrasonography and intracavernosal injection. Vardenafil efficacy was assessed by readministering the IIEF questionnaire after 4 weeks of therapy. Serum creatinine levels, creatinine clearances, and cyclosporine/tacrolimus concentrations were measured before and after vardenafil therapy. Twenty-one recipients with ED served as placebo controls and 15 without ED as another control group. The IIEF scores improved from 12.80+/-3.5 to 26.46+/-2.4 in vardenafil-treated patients with ED (P<.001). Renal function and cyclosporine/tacrolimus concentrations did not change with vardenafil therapy. Side effects were observed in 7 (18%) patients: headache in three, palpitations in one, flushing in two, and dyspepsia in one. This study demonstrated that ED improved with vardenafil in renal transplant recipients with ED. For 4 weeks vardenafil therapy was free of side effects. Renal function tests did not change. Also, no dose change in immunosuppressive drugs was required during 4 weeks of verdanafil therapy.

Determining the level of the dural sac tip: magnetic resonance imaging in an adult population

PURPOSE

To determine the variation in the location of the dural sac (DS) in a living adult population and to correlate this position with age and sex.

MATERIAL AND METHODS

T2-weighted, midline, sagittal, spin-echo magnetic resonance imaging (MRI) studies of 743 patients were assessed to identify the tip of the DS. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disk.

RESULTS

Frequency distribution for levels of termination of the DS on MRI demonstrated that the end of the DS was usually located at the upper one-third of S2 (25.2%). The mean level in females was also the upper one-third of S2 (26.5%) and in males the lower one-third of S2 (24.1%). The overall mean DS position was mostly at the upper one-third of S2. No significant differences in DS position were seen between male and female patients or with increasing age.

CONCLUSION

It is important to know the possible range for the termination level of the DS when performing caudal anesthesia and craniospinal irradiation in some clinical situations. The distribution of DS location in a large adult population was shown to range from the L5-S1 intervertebral disk to the upper third of S3 vertebrae.

Dyslipidemia and weight gain secondary to lifestyle changes in living renal transplant donors

We evaluated renal function, lipid profile, body weight, and physical activity of living donors in long-term follow-up after nephrectomy. A total of 121 living donors were compared with 81 healthy subjects with normal renal function and no history of any surgery or disease. Before and after donor nephrectomies, we recorded age, body weight, systolic and diastolic blood pressures, serum creatinine, creatinine clearance, lipids, and serum glucose levels of the donors. Preoperative (baseline) and postoperative (last visit) physical activities of donors and controls were evaluated through the Modified Baecke Questionnaire (occupational activities, sports activities, leisure-time activities). There were no differences between donors and controls for age (P = .772), gender (P = .927), and follow-up period (P = .564). According to baseline levels, blood pressure and serum creatinine were increased and creatinine clearance was decreased (P < .001 for all). The mean increases in body weight (P = .012), LDL (P = .004), and triglyceride (P < .001) were higher in donors than in controls. But the mean decrease in HDL was not different between controls and donors (P = .057). Indices of sports and total activities were lower in donors than in controls on the last visit (P < .001). Indices of occupational and leisure-time activities were similar on the last visit in donors and in controls (P = .126, P = .083). The alterations in total cholesterol and total activity showed significant negative correlations in donors (r = -.581, P < .001). Also, the alterations in total cholesterol and body weight showed a significant correlation (r = .25, P = .02). We followed donors together with serum lipid levels, body weight, and total physical activities as well as blood pressure and renal function tests.

Dipyridamole for renal phosphate leak in successfully renal transplanted hypophosphatemic patients

AIM AND BACKGROUND

Hyphosphatemia can be seen in renal transplant recipients. Hyperparathyroidism, glucocorticoid treatment, renal denervation and impairment of renal tubular phosphate reabsorption are the most common causes of hyphosphatemia in these patients. It is well-known that dipyridamole enhances renal tubular phosphate reabsorption in some clinical conditions. We did not find any information about the effect of dipyridamole in renal transplant recipients (RTRs) with hypophosphatemia. For this reason, we decided to give dipyridamole 11 RTRs with hypophosphatemia.

PATIENTS AND METHODS

Eleven RTRs whose serum phosphate and creatinine levels were below 2.5 mg/dl and 2 mg/dl, respectively, were included in this study. None of the patients received drugs altering phosphate metabolism and they did not change their routine diets. Urinary phosphate excretion and tubular phosphate reabsorption (TPR) were calculated before and 3 weeks after dipyridamole treatment.

RESULTS

The mean levels of serum-urine (daily) phosphate and TPR before dipyridamole treatment were 1.94 +/- 0.46 mg/dl, 7,187.5 +/- 1,833.49 mg/day and -2.78 +/- 0.62, respectively. After treatment, the mean levels of serum-urine phosphate and TPR were 2.73 +/- 0.46 mg/dl, 4,845.27 +/- 1,138.99 mg/day and -1.48 +/- 0.80, respectively. Serum and urine phosphate levels and TPR were found to be significantly different before and after dipyridamole therapy (p < 0.05).

CONCLUSION

Short-term dipyridamole therapy increased TPR and serum phosphate levels and decreased urinary phosphate excretion. We did not observe negative effect on renal functions in these cases. Although the number of the cases included in this study is small, dipyridamole is an effective choice in management of hypophosphatemic RTRs.

Long-term comparative results of C0 and C2 monitoring of CyA in renal transplanted patients

The purpose of this study was to evaluate the effects of CyA monitoring using C0 monitoring (fasting level after 12 h from last dose), and C2 monitoring (2 h after morning dose) on renal functions, lipid levels, CyA levels, and daily dosages of CyA in renal transplanted patients in the posttransplant period from the first month to the 36th month. In our center between 1992-2003, 37 of the 54 renal transplanted patients were treated with CyA, prednisolone, and mycophenolate mofetil or azathioprine. The mean age was 32.36 +/-10.32 and 35.00 +/- 10.23 (p = 0.39) in C0 (M/F: 18/7) and in C2 (9/3), respectively. Cadaveric donor (d), living related d, and living unrelated d were in four patients (p), 17 p and four p in C0, and two p, seven p, and three p in C2, respectively (p = 0.79). Chronic allograft nephropathy (CAN) developed in 13 p (52%) and one p (8.3%) in C0 and in C2, respectively (p =0.013). Creatinine clearance values were 72.31 +/- 23.10 mL/min and 78.73 +/- 22.42 mL/min (p:0.621) at first month, 64.97 +/- 22.58 mL/min and 78.00 +/- 19.90 mL/min (p:0.065) at sixth month, 56.50 +/- 19.62 mL/min and 76.62 +/- 21.06 mL/min (p:0.006) at 12th month, 50.28 +/- 24.79 mL/min and 80.87 +/- 18.24 mL/min (p < 0.001) at 24th month, and 55.15 +/- 19.21 mL/min and 86.65 +/- 14.97 mL/min (p:0.004) at 36th month in C0 and C2, respectively. The mean daily dosages of CyA were 354.35 +/- 122.63 and 266.67 +/- 64.95 mg/d (p:0.031) at first month, 277.17 +/- 77.94 and 250.00 +/- 73.31 mg/d (p:0.228) at sixth month, 247.92 +/- 58.48 and 211.36 +/- 62.61 mg/ d (p:0.09) at 12th month, 232.95 +/- 56.90 and 170.45 +/- 41.56 mg/ d (p:0.003) at 24th month, and 240.63 +/- 52.34 and 153.57 +/- 46.61 mg/d (p:0.002) at 36th month in C0 and C2, respectively. In C2, systolic and diastolic blood pressure, uric acid, total cholesterol (C), LDL-C, and triglyceride levels were lower than those monitored with C0. In C2, HDL-C levels were also higher than those monitored with C0. None of these patients returned to dialysis or died in this period. In conclusion, during the first 36 months with monitoring C2, preservation of renal function, control of blood pressure serum lipids and uric acid were better than those with monitoring C0. In addition, daily dose of CyA was lower in C2 method and, at the same time, this effect of C2 can be accepted as cost effective.

Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit

AIMS

To investigate the correlation of pH, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), base excess (BE), and bicarbonate (HCO3) between arterial (ABG), venous (VBG), and capillary (CBG) blood gases.

METHODS

Patients admitted to the paediatric intensive care unit (PICU) in Cukurova University between August 2000 and February 2002 were enrolled.

RESULTS

A total of 116 simultaneous venous, arterial, and capillary blood samples were obtained from 116 patients (mean age 56.91 months, range 15 days to 160 months). Eight (7%) were neonates. Sixty six (57%) were males. pH, PCO2, BE, and HCO3 were all significantly correlated in ABG, VBG, and CBG. Correlation in PO2 was also significant, but less so. Correlation between pH, PCO2, PO2, BE, and HCO3 was similar in the presence of hypothermia, hyperthermia, and prolonged capillary refilling time. In hypotension, correlation in PO2 between VBG and CBG was similar but disappeared in ABG-VBG and ABG-CBG.

CONCLUSIONS

There is a significant correlation in pH, PCO2, PO2, BE, and HCO3 among ABG, VBG, and CBG values, except for a poor correlation in PO2 in the presence of hypotension. Capillary and venous blood gas measurements may be useful alternatives to arterial samples for patients who do not require regular continuous blood pressure recordings and close monitoring of PaO2. We do not recommend CBG and VBG for determining PO2 of ABG.