Ayse Orman

The Comparative Cardiovascular, Pulmonary, Ocular Blood Flow, and Ocular Hypotensive Effects of Topical Travoprost, Bimatoprost, Brimonidine, and Betaxolol

OBJECTIVE This study evaluated systemic and ocular acute safety and intraocular pressure (IOP)-lowering efficacy of travoprost 0.004% and bimatoprost 0.03%, compared to brimonidine 0.2% and betaxolol 0.25% in healthy subjects. PATIENTS AND METHOD Nineteen (19) young men, ages between 24 and 42, were enrolled in a single-center, institutional randomized, double-masked, crossover clinical trial. Baseline IOP, heart rate, blood pressure, and respiratory rate were recorded at hour 0. At minute 30, heart rate, blood pressure, respiratory rate, and spirometry were measured. At hour 1, color Doppler imaging of retrobulbar vessels was performed. At hour 2, heart rate, blood pressure, and respiratory rate were measured; spirometry and a 15-minute treadmill test were performed. The same protocol was applied after one drop of a study medication was instilled into each eye on four subsequent visits at 5-day intervals. RESULTS Travoprost and bimatoprost did not cause significant reductions in systolic blood pressure during exercise and recovery. The mean respiratory rate and forced expiratory volume in 1 second were not significantly altered by any study medication. Travoprost reduced the resistive index and increased blood velocities in the ophthalmic artery and its branches. Bimatoprost caused a significant increase in end diastolic velocity of the ophthalmic artery. At hour 6, all medications reduced IOP significantly (p < 0.05). The most frequent ocular side effect of travoprost and bimatoprost was conjunctival hyperemia. CONCLUSION Travoprost and bimatoprost were found to be systemically safe and caused an increase in blood-flow velocities of the retrobulbar vessels after a single-dose application. Their ocular hypotensive effect was comparable to that of brimonidine and greater than that of betaxolol in healthy subjects.

Kronik Obstrüktif Akciğer Hastalarında Mekanik Ventilasyon Sonrası Görülen Hipofosfatemi

Kronik solunum yetmezligi tablosuna, akut solunum yetmezliginin eklenmesi ve mekanik ventilasyona duyulan gereksinim, beslenme bozuklugunu ve elektrolit bozukluklarini da beraberinde getirmektedir. Kronik Obstruktif Akciger Hastaligi (KOAH) nedeniyle takip edilen ve daha sonra akut solunum yetmezligi gelisen yaslari 58-75 arasinda degisen 25 erkek hastanin dosyasi retrospektif olarak incelendi. Mekanik olarak solutulan ve enteral beslenme uygulanan KOAH’li hastalarda mekanik ventilasyon oncesi, ventilasyonun birinci gunu ve 5 gunluk enteral beslenme sonrasi fosfor (P) duzeyleri karsilastirildi. Olgularin tumunun KOAH’i ve uzun yillar sigara icme anamnezi mevcuttu. P1: Mekanik ventilasyon oncesi, P2: Mekanik ventilasyonun birinci gunu ve P3: 5 gunluk enteral beslenme sonrasi fosfor (P) duzeyleri karsilastirildi. P1=3,55±0,90 iken, mekanik ventilasyondan yirmi dort saat sonra P2=2,05±0,96 degerine dustu ve bes gunluk tibbi tedavi ve yaklasik 2000 Kcal’lik beslenmeye sekonder olarak P3=4,46±0,84 degerine yukseldi. Mekanik ventilasyon oncesi normal olan P duzeylerinde mekanik ventilasyondan sonra dusme gozlemlenirken, enteral beslenme sonrasi artis saptanmistir. Buna paralel olarak hastalarin protein ve albumin degerlerinde de mekanik ventilasyon sonrasi dusme gozlemlenirken, enteral beslenme sonrasi bu miktarlarda da artis oldugu gorulmustur