Osman Saka

Endoscopic Transnasal Dacryocystorhinostomy and Bicanalicular Silicone Tube Intubation

Purpose: To evaluate the results of endoscopic transnasal dacryocystorhinostomy (ETDCR) combined with bicanalicular silicone tube intubation (BSTI) performed in 49 patients with nasolacrimal canal obstructions secondary to chronic dacryocystitis. Material and Methods: ETDCR combined with BSTI was applied as a primary procedure in 47 cases, and as a secondary procedure in 2 cases. All patients underwent dacryocystography, and 41 patients underwent radionuclide dacryoscintigraphy before the surgery. Silicone tubes were left in place for about 6.2 months. The patency of the lacrimal passages was controlled with a clinical examination, nasolacrimal canal lavage, and dacryoscintigraphy. Results: Patients were followed up for a mean period of 25.1 months after the removal of the tubes. The epiphora symptom disappeared and a successful drainage could be maintained in 43 out of 49 cases (87.7%). The obstruction rate found in the dacryoscintigraphy performed 15 days after extubation was 22.9%, while it was found to be 14.2% in the nasolacrimal canal lavage. Conclusion: ETDCR combined with BSTI proved to be an effective surgical method in chronic dacryocystitis. The sensitivity and specificity of the postoperative dacryoscintigraphy in determining the surgical success were lower than those of the nasolacrimal canal lavage.

Serum Prolactin Levels in Behçet's Disease

PURPOSE Evaluation of serum prolactin levels in Behçets disease patients in Turkey. METHODS Serum prolactin levels were measured by radioimmunoassay (RIA) in 17 patients with ocular findings, and 20 patients without ocular findings of Behçets disease, and in 17 healthy volunteers. RESULTS The average prolactin levels were measured as 9.53 ng/mL in patients with ocular findings, 8.84 ng/mL in patients without ocular findings, and 9.59 ng/mL in healthy controls. There was no statistical significance among these three groups. Also, the average levels were 9.84 ng/mL in remission periods and 7.54 ng/mL in attacks. CONCLUSIONS In some studies, it has been suggested there is a correlation between high serum prolactin levels and activation of some autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis. However, we found no such correlation in Behçets disease. On the contrary, prolactin levels were lower in attacks than in remissions.

Risk prediction using a neonatal therapeutic intervention scoring system in VLBW and ELBW preterm infants

Background:  The Neonatal Therapeutic Intervention Scoring System (NTISS) is a therapy‐based severity‐of‐illness index, The aim of the present study was to evaluate whether: (i) NTISS can predict the severity of illness with the same accuracy both in very low‐birthweight (VLBW) and extremely low‐birthweight (ELBW) infants, using all parameters; and (ii) the performance of NTISS can be increased by using only the significant variables.

Ischemia modified albumin levels cannot predict stress induced ischemia shown by myocardial perfusion scintigraphy

PURPOSE Ischemia modified albumin (IMA) is a new marker of ischemia which is used in especially emergency room. Aim of this study is showing the association of IMA with stress induced ischemia on Tc-99m 2-methoxyisobutyl-nitrate (MIBI) myocardial perfusion scintigraphy (MPS). METHODS 56 patients (23 F, 33 M; 56.04 ± 8.45 years old) were included in our study. Stress-rest two days protocol Tc-99m MIBI MPS single photon emission tomography (SPECT) was performed to all patients. IMA levels from the blood samples which were taken before and after the treadmill test were measured. Thirty patients additionally underwent coronary angiography. RESULTS The difference of IMA levels of ischemia between positive and negative groups was not statistically significant. Also, there was not statistically significant difference between IMA levels of patients who have narrowing in the coronary arteries and not. CONCLUSION Although IMA is an important marker of ischemia, probably because of other ischemic process during stress; it cannot reflect stress induced ischemic changes on MPS.

Comparison of predictor approaches for longitudinal binary outcomes: application to anesthesiology data

Longitudinal data with binary repeated responses are now widespread among clinical studies and standard statistical analysis methods have become inadequate in the answering of clinical hypotheses. Instead of such conventional approaches, statisticians have started proposing better techniques, such as the Generalized Estimating Equations (GEE) approach and Generalized Linear Mixed Models (GLMM) technique. In this research, we undertook a comparative study of modeling binary repeated responses using an anesthesiology dataset which has 375 patient data with clinical variables. We modeled the relationship between hypotension and age, gender, surgical department, positions of patients during surgery, diastolic blood pressure, pulse, electrocardiography and doses of Marcain-heavy, chirocaine, fentanyl, and midazolam. Moreover, parameter estimates between the GEE and the GLMM were compared. The parameter estimates, except time-after, Marcain-Heavy, and Fentanyl from the GLMM, are larger than those from GEE. The standard errors from the GLMM are larger than those from GEE. GLMM appears to be more suitable approach than the GEE approach for the analysis hypotension during spinal anesthesia.