Güçlü Kaan Beriat

Is pimecrolimus cream (1%) an appropriate therapeutic agent for the treatment of external ear atopic dermatitis?

Summary Background In recent years, pimecrolimus 1% cream has been demonstrated to reduce symptoms of atopic dermatitis in patients when applied topically. Material/Methods In our study we compared the therapeutic effects of local 1% pimecrolimus to 1% hydrocortisone, and to a control group in a mouse model with atopic dermatitis in the external ear canals. Atopic dermatitis was created by application of Dinitrochlorobenzene in the external ear canals of mice. The development of atopic dermatitis was detected by clinical observation score and determination of total serum IgE levels. Pimecrolimus and hydrocortisone cream were topically applied to the external ear canal skin once a day for 14 days. Results There was no significant difference between the hydrocortisone and the pimecrolimus therapy groups, while there was a statistically significant difference between these 2 groups and the control group (p<0.05) Assessment of the clinical observation scoring carried out on the 14th day of therapy revealed that there was no difference between the hydrocortisone and pimecrolimus groups. Biopsies were taken on the 14th day following treatment. Tissue samples were histologically evaluated; contact dermatitis was observed microscopically in the control group, but in the therapy groups only minimal evidence of contact dermatitis was found. Conclusions The results of our study reveal that the therapeutic efficacy of 1% pimecrolimus was equivalent to 1% hydrocortisone treatment in the artificially developed atopic dermatitis model in external ear canals of mice. These results clearly demonstrate that 1% pimecrolimus cream can be an effective alternative therapeutic agent in cases where steroid treatment proves to be insufficient or in cases where treatment must be discontinued due to its adverse effects.

Oropharyngeal angioneurotic edema due to recombinant tissue plasminogen activator following massive pulmonary thromboembolism

Although hypersensitivity reactions secondary to recombinant tissue plasminogen activator (rtPA) are rarely encountered, they may have important consequences. In this case presentation, oropharyngeal angioneurotic edema due to rtPA following pulmonary thromboembolism is presented. On the 4th hour of initiation of treatment, throat pain, laryngeal stridor and expansive edema in the neck ensued, upon which the patient was intubated and mechanically ventilated. The patient was extubated after her findings showed a remission on the 48th hour of his inotropic, antihistaminic and intravenous corticosteroid therapy.

Microdebrider Tonsillotomy in Children with Obstructive Tonsillar Hypertrophy

Aim: To compare intracapsular microdebrider tonsillotomy with conventional cold dissection tonsillectomy in the management of tonsillar hypertrophy causing obstructive airway problems in children. Material and Method: 37 children who underwent microdebrider tonsillotomy were compared with other 45 children who had conventional cold dissection tonsillectomy to examine intraoperative blood loss, operation time, duration of oral intake, intake of analgesics, recovery time and post-operative pain. Results: Children who underwent intra-capsular micro-debrider tonsillotomy had significantly less pain throughout their recovery period than those who had conventional tonsillectomy. In the microdebrider tonsillotomy group intraoperative blood loss, operation time, duration of oral intake, intake of analgesics, and postoperative pain score were found to be less than the conventional tonsillectomy group scores(p <0,05). Tonsillar hypertrophy recurred in two patients of micro-debrider tonsillotomy group. Discussion: Intracapsular tonsillotomy is as effective and safe as conventional tonsillectomy to relieve obstructive sleep apnea in pediatric patients. Intracapsular microdebrider tonsillotomy reduces postoperative pain, improves quality of life and shorthens the recovery time. Therefore; this procedure is more tolerable in children with obstructive tonsillar hypertropy in respect to conventional tonsillectomy.

The Evaluation of Relationship Between the Adiponectin and Laryngopharyngeal Reflux Desease ( A Preliminary Report)

Aim The aim of our study is to identify etiopathology of Laryngopharyngeal Reflux (LPR) disease by determining level of serum adiponectin whose relation is shown between inflamation and oxidation in the present studies. Materials and Methods 32 patients with LPR ( mean age is 29.72 ± 7.06)) and 25 healthy volunteers (mean age 28 ± which is 7.86) were included in our study. The blood serum adiponectin levels, biochemical values and obesity parameters, systolic and diastolic blood pressures were measured and compared within two groups. Results and Analysis The BMI, WHR, systolic and diastolic blood pressure values and blood serum glucose, HbA1c, blood urea nitrogen, creatinin and triglyserides values were higher in LPR patients ( p< 0,05). The serum adiponectin and high-density cholestrole values noted lower in LPR patient group than healty volunterees ( p< 0,05). Discussion LPR disease can be one of the diseases that is related to lower plasma adiponectin levels. Many diseases that create cardiovascular and metabolic problems, which adiponectin levels are shown to be low , should be researched in LPR patients whom values of reflux symptom index and reflux finding score are high.

Effects of the Autologous Platelet-Rich Plasma in Nasal Pack on Postoperative Quality of Life.

Aim: The authors aimed to research the effects of autologous platelet-rich plasma, which is known for the positive effects on wound healing, on postoperatif living quality of the patients after using on nasal surgery. Methods: Patients who undergo nasal operation according to randomized patients choice have been injected with saline merocel pack and platelet-rich plasma (PRP) in their nasal path. Postoperative is followed by 1 month; Nose Obstruction Symptom Evaluation (NOSE) scala score, bleeding, pain, and crust rate have been compared between 2 groups. Results: As a result of the 1 month follow-up, it was seen that the treatment group experienced better results in terms of NOSE scale than the control group patients and this was significant difference in terms of NOSE. Less bleeding and crust was seen on the treatment group patients than the control group patients and statically significant difference was found. In terms of visual analogue scale score no statically significant difference was found between 2 groups. Conclusion: According to the authors’ study on PRP, the authors found out that by using PRP wound can be healed faster in early period of postoperative. It was seen with the authors’ research that on postoperative early period crusts, bleeding and postoperative complaints are lesser.

Non-invasive detection and monitoring of experimental hydrocephalus with distortion product otoacoustic emissions

OBJECTIVE We aimed to find out the effects of short term and long term hydrocephalus and intracranial ventricular volume changes on cochlear functions by using distortion product otoacoustic emission (DPOAE) in experimental hydrocephalus rat models for the first time in literature. METHODS This study was performed with 48 healthy, adult (8 weeks old), Sprague-Dawley rats which weighed between 200 and 240g. Six groups were formed in this study: short term control, short term sham, short term hydrocephalus, long term control, long term sham and long term hydrocephalus groups. Each group contained eight rats. Short term period was 4 weeks and long term period was 8 weeks after the study started. At the end of these periods, DPOAE measurements were performed and then rats were sacrificed to determine ventricular volumes. RESULTS DPOAE values at all frequencies were significantly decreased in the short term hydrocephalus group when compared to the short term control and short term sham groups. DPOAE values at all frequencies were significantly decreased in the long term hydrocephalus group when compared to the long term control and long term sham groups. Besides, long term sham group which had higher ventricular volumes than long term control group also had lower DPOAE measurements. Significant associations were present between DPOAE measurements and ventricular volumes in hydrocephalus models. CONCLUSION The functional disturbances in cochlear functions due to hydrocephalus have been demonstrated with DPOAE measurements in this study. DPOAE measurements may be thought as an easily applicable non-invasive method in detection and follow-up of patients with hydrocephalus. Our findings should be supported with clinical studies in humans.

Temporal Bone Posterior Wall Defect, a New Clinic Entity?

OBJECTIVE To define clinical and audiological findings in patients with temporal bone posterior wall defects (TBPWD) and to investigate possible relationships between these findings and the characteristics of the defect. MATERIALS AND METHODS The computed tomography (CT) views of 1198 patients with vestibulocochlear symptoms between 2007 and 2012 were retrospectively evaluated, and TBPWD and associated anomalies were investigated. Patients who had TBPWD were called back, and clinical and audiological examinations (tympanometry, pure tone audiometry, acoustic reflexes, and otoacoustic emission) were performed. RESULTS Twenty-eight (2.34%) patients had TBPWD. Twenty-three of them were eligible for the study. Size of the defect was significantly correlated with the presence of tinnitus and/or vertigo (p<0.005). The cut-off values for the largest size of TBPWD were 1.65 mm [sensitivity: 0.67 and specificity: 0.77 (95% CI: 0.58-0.97); p=0.04] in case of the presence of tinnitus and 1.85 for vertigo (sensitivity: 0.78 and specificity: 0.86 (95% CI: 0.67-0.99); p=0.006). In pure tone audiometry tests, mixed-type hearing loss was present in four (17%) patients, sensorineural hearing loss was present in three (13%) patients, and conductive-type hearing loss was present only in one (4%) patient. Otoacoustic emission tests revealed significant differences in signal/noise ratios at frequencies of 500, 750, 1000, and 6000 Hz. CONCLUSION For the first time in the literature, we defined clinical and audiological findings in patients with TBPWDs. These defects seem to cause more prevalent symptoms of vertigo and tinnitus and disturb the audiological characteristics of patients.