The relationship between extracellular fluid and obstructive sleep apnea in non-obese patients

OBJECTIVE

To evaluate the relationship between obstructive sleep apnea syndrome (OSAS) and the fluid change in composition throughout the night.

METHODS

The study included 92 non-obese patients who underwent polysomnography because of suspected OSAS. Weight and body composition analyses were applied using a Tanita DC-360 multi-frequency body composition analysis device.

RESULTS

In the correlation analyses between apnea/hypopnea index (AHI) values and independent variables, a positive relationship was determined with extracellular fluid shift (r: 0.381, p = 0.009) and change in neck circumference (r: 0.226, p = 0.031), and there was a negative relationship between disease severity and an increase in the number of daily steps taken (r: 0.208, p = 0.047).

CONCLUSION

The results of the study clearly showed that movement to the neck area of fluid accumulated in the lower extremities and an increase in extracellular fluid were related to AHI values independent of body mass index (BMI).

An Evaluation of the Relationship between Retinal Nerve Fiber Thickness, Cochlear Nerve Thickness, the Level of Tinnitus, and Hearing Loss in Unilateral Tinnitus Patients

BACKGROUND

In this study, optic coherence tomography (OCT) examination was performed to check whether there was any interaction between ophthalmic axonal structures in unilateral tinnitus patients, and the relationship between optic nerve thickness and cochlear nerve thickness was evaluated.

OBJECTIVE

The aim of the study was to evaluate the relatioship between hearing loss, tinnitus, and nerve thicknesses.

STUDY DESIGN

Prospective study.

SETTING

Tertiary referral university hospital.

PATIENTS

The study included 88 patients with unilateral tinnitus, for which no organic cause could be found in physical examination, psychiatric evaluation, or with imaging methods. Study groups were formed of the tinnitus side and control groups were formed of the healthy side as follows: Group 1 (Non-tinnitus side normal hearing values - n = 30), Group 2 (non-tinnitus side minimal hearing loss - n = 27), Group 3 (non-tinnitus side moderate hearing loss - n = 31), Group 4 (tinnitus side normal hearing values - n = 25), Group 5 (tinnitus side minimal hearing loss - n = 25), and Group 6 (tinnitus side moderate hearing loss - n = 38).

INTERVENTION

Retinal nerve fiber layer (RNFL) thickness was evaluated with OCT, and the cochlear nerve cross-sectional area was evaluated with MRI.

MAIN OUTCOME MEASURES

RNFL measurements were taken with OCT from the subfoveal area (RNFL-SF) and 1.5 mm temporal to the fovea (RNFL-T µm) and nasal (RNFL-N µm) sectors. On MRI, 3 measurements were taken along the nerve from the cerebellopontine angle as far as the internal auditory canal, and the mean value of these 3 measurements was calculated.

RESULTS

When the groups were evaluated in respect of cochlear nerve thickness, a significant difference was seen between Group 1 and both the groups with hearing loss and the tinnitus groups. In the subgroup analysis, a statistically significant difference was determined between Group 1 and Groups 3, 4, 5, and 6 (p = 0.013, p = 0.003, p < 0.001, and p < 0.001, respectively). When the groups were evaluated in respect of the RNFL-SF (µm), RNFL-T (µm), and RNFL-N (µm) values, the differences were determined to be statistically significant (p < 0.001 for all). In the correlation analysis, a negative correlation was determined between hearing loss and cochlear nerve diameter (r: -0.184, p = 0.014), and RNFL-N (r: -0.272, p < 0.001) and between tinnitus and cochlear nerve diameter (r: -0.536, p < 0.001), and RNFL-T (r: -0.222, p < 0.009).

CONCLUSION

The study results clearly showed a relationship between cochlear nerve fiber thickness and hearing loss and the severity of tinnitus in cases with unilateral tinnitus and that there could be neurodegenerative factors in the disease etiology. A similar relationship seen with the RNFL supports the study hypothesis.

Evaluation of the relationship between patient expectation, patient expectation coverage rates and patient satisfaction in open primary septorhinoplasty surgery: a prospective randomized study

PURPOSE

The aim of this study was to evaluate the relationship between preoperative patient expectation and postoperative patient expectation coverage rates and patient satisfaction.

METHODS

183 patients who underwent SRP for various reasons were divided into 6 groups according to surgical indication and the postoperative Rhinoplasty Outcome Evaluation Scale (ROE). The groups were evaluated in terms of preoperative expectation levels and postoperative expectation coverage rate.

RESULTS

When the patients were evaluated in terms of preoperative expectation levels, a significant difference was determined between the patients who underwent surgery for cosmetic reasons (86.15 ± 8.61) and those with functional reasons (79.24 ± 6.62) (p < 0.001). Similarly, the lowest patient expectation coverage rates were in the patient group with cosmetic reasons for the operation. When patients were grouped according to the ROE scores in the postoperative period and surgical indication, expectation was higher in the groups that were not satisfied with the results (Groups 2, 4 and 6). The highest expectation levels among the groups were seen in the dissatisfied patients who had undergone surgery for cosmetic reasons (92.17 ± 4.96). A strong positive correlation was found between expectation coverage rates and patient satisfaction (r 0.907, p < 0.001).

CONCLUSION

Determination and rationalization of the expectations of patients in the preoperative period is one of the factors that will increase the satisfaction of the patients about the surgical procedure.

Intraperitoneal curcumin and vitamin E combination for the treatment of cisplatin-induced ototoxicity in rats

INTRODUCTION

Cisplatin ototoxicity is characterized by irreversible, progressive, bilateral sensorineural hearing loss at high frequencies, accompanied by tinnitus. The aim of this study is to demonstrate the protective action of curcumin alone or in combination with vitamin E against cisplatin-induced ototoxicity in animal models.

MATERIAL AND METHODS

The study included 42 rats. Experimental animals were randomized into 6 groups. In the first group, intra-peritoneal cisplatin was administered alone. In the second group, intra-peritoneal cisplatin and curcumin were administered together. In the third group, intra-peritoneal cisplatin and vitamin E were administered together. In the fourth group, intra-peritoneal cisplatin was administered together with curcumin in combination with vitamin E. In the fifth group, intra-peritoneal curcumin was administered alone. The sixth group was sacrificed directly without administration of any drugs. A distortion product otoacoustic emission (DPOAE) test was applied to both ears of all experimental animals. Curcumin was administered 1 h before cisplatin treatment continued for three successive days. Vitamin E was administered only as a single dose 30 min prior to cisplatin. All animals were sacrificed following DPOAE testing on the 5th day of cisplatin administration. Histopathological findings included a TUNEL (TdT-mediated deoxyuridine triphosphate nick end-labeling) assay, and the percentage of apoptotic cells was calculated. DPOAE values and the percentage of apoptotic cells were compared before and after treatment and between experimental groups.

RESULTS

In Group 1, DPOAE values were significantly decreased at all frequencies (3000 Hz, 4000 Hz and 6000 Hz; P < 0.05). In Groups 2, 3, 4 and 5 there was no significant difference between the pre- and post-treatment DPOAE results (p > 0.05). Apoptotic index values were lower in all treatment groups compared to the cisplatin group, however the difference was only statistically significant in group 3 (p = 0.009).

CONCLUSION

In rats, cisplatin ototoxicity can be prevented with curcumin or curcumin-vitamin E combination.