4053 research outputs found
Sort by
Intersphincteric Resection for Low Rectal Cancer: Parameters Affecting Functional Outcomes and Survival Rates
No full textINTRODUCTION: The development of new surgical techniques and devices, as well as the improvements in neoadjuvant chemoradiotherapy enabled intersphincteric resection (ISR), has reduced permanent colostomy usage. The aim of this study was to assess the long-term oncological and functional outcomes of patients who underwent partial ISR for rectal cancer located less than 5cm from the anal verge. MATERIALS AND METHODS: A series of 106 consecutive patients with very low rectal cancer underwent curative partial ISR from January 2006 to September 2019 were retrospectively evaluated. One-hundred-three (97%) of 106 patients received neoadjuvant chemo-radiotherapy. Overall survival (OS), disease-free survival (DFS), and local recurrence (LR) rates were calculated using Kaplan-Meier methods. The Wexner incontinence score and Kirwan classification were used to evaluate patients' functional results. RESULTS: The median follow up was 60 months (range, 18-174). The estimated five-year overall and disease-free survival rates were 89% and 81.6%, respectively. Five-year local recurrence and distant metastasis rates were 6.6% and 10.4%, respectively. There was no in-hospital and 30-day mortality. The median Wexner score was 9 (range, 0-20) for 72 patients. Age (<65 years, p=0.027) and gender (male, p=0.019) had a positive effect on functional outcomes after surgery. One and five years colostomy-free survival rates were 96% and 89%, respectively. CONCLUSION: Intersphincteric resection techniques are feasible for patients with very low rectal cancer, providing good oncological and functional outcomes
Thiol/disulfide homeostasis and oxidant status in children with congenital heart disease
No full textObjectives This article aims to explain the altered oxidative status and thiol/disulfide homeostasis before and after surgery in children with congenital heart disease (CHD). Methods Blood samples were taken from the patients (n=50) before the operation (baseline), at the 1st hour, and at the 24th hour after the operation. Thiol-disulfide levels, total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), myeloperoxidase (MPO), ceruloplasmin, albumin, ischemia-modified albumin (IMA), and prolidase activities of all samples were measured. Pre-operative oxygen saturation (SaO(2)) values and neutrophil/lymphocyte ratios (NLR) were also measured. Results Before the operation, TOS, OSI, MPO, ceruloplasmin, IMA, NRL, and disulfide levels were higher in the cyanotic group than in the acyanotic group. When the indicated three different time points were compared, the TOS, OSI levels, and MPO activities of the 24th hour were significantly lower than the baseline and 1st hour. In comparison, ceruloplasmin levels of 1st hour were significantly higher than of the baseline and 24th hour. Native thiol and total thiol levels in the baseline group were significantly lower than in the 1st and 24th hours. Disulfide levels of the 24th hour were significantly lower than of the baseline. Conclusions The operation leads to changes in the thiol-disulfide balance and oxidant status in CHD.Istanbul Bilim University Technology Transfer Office [MARTEK 01]This study was supported by Istanbul Bilim University Technology Transfer Office (MARTEK 01)
Idiopathic intracranial hypertension: Do we diagnose and manage it appropriately in the light of current data?
No full textBackground and objective: Idiopathic intracranial hypertension (IIH) is an increase of intracranial pressure without a known cause, which usually presented with headache. This study aimed to evaluate the changing diagnosis and management approaches of neurologists for IIH in light of recent data. Methods: An online questionnaire about IIH was developed covering 28 questions, and five sections: demographic data, diagnosis, examination, treatment, and follow-up. We compared the approach of neurologists with 1-9 years of experience (group-A) with that of neurologists with more than 10 years' experience (group-B). Results: A total of 517 neurologists (group A: n = 252, group B: n = 265) participated in the study. Responder rate of questionarre is 18.3%. The approach to IIH in diagnosis, examination, treatment, and follow-up processes was similar in both groups. The younger group (group A) recognized all neuro-radiologic findings, especially flattening of the posterior aspect of the globe (p = 0.001) and tortuosity of the optic nerve (p < 0.001) at higher rates compared with group B. The most commonly used medical treatment was acetazolamide (99%); corticosteroids were used more frequently by group B (p < 0.001). Optic nerve sheath fenestration (88.3%) was the first-line and ventriculo-peritoneal shunt (70.5%) was the second preferred surgical approach. It was observed that serial lumbar puncture applications (57.0%) were preferred more frequently than venous sinus stenting (19.0%) and bariatric surgery (10.0%). Conclusions: The changing information in the last decade about IIH was more closely followed by younger neurologists despite their lesser experience, but classic methods were preferred in surgical approaches in both groups. Our findings indicated that post-graduate education and guidelines should be disseminated for IIH
Preventive effect of trimetazidine against ischemia-reperfusion injury in rat epigastric island flaps: an experimental study
No full textBackground: For plastic surgery, ischemia-reperfusion (I-R) injury is a critical problem that results in partial or total flap necrosis. Trimetazidine (TMZ) is a drug used in the treatment of angina pectoris. This study investigated the effect of TMZ on I-R injury in epigastric island flaps using a rat model. Methods: Sixteen Sprague–Dawley rats were assigned to two groups, each with eight rats. The sham group comprised of saline-treated rats, while the TMZ group had TMZ-treated rats. An epigastric flap measuring 6 × 4 cm in size was created 30 min after the intraperitoneal administration of either physiological saline or TMZ in both groups. Ischemia was induced on the flaps for 10 h, followed by reperfusion. The flaps were then inset to the original position. Samples were obtained 24 h after reperfusion for biochemical analysis and on day 7 for histopathological analysis. Also, flap survival was evaluated on day 7 using Image-Pro Express. Results: The TMZ group had a significantly greater flap survival area compared to the sham group. On histopathological examination, the two groups showed significant differences. The TMZ group had a higher epidermal thickness. On biochemical examination, there were significantly higher levels of malondialdehyde and myeloperoxidase activity in the sham group, while the TMZ group showed significantly greater glutathione and nitric oxide levels. Conclusions: In the present study, TMZ administration was found to reduce I-R injury macroscopically, histopathologically, and biochemically in a rat epigastric island flap model. Level of evidence: Not ratable. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature
The value of potassium, pH and D-dimer levels in early diagnosis of acute mesenteric ischemia: an experimental study on rats
No full textegin, seracettin/0000-0002-4090-5205PubMed: 33488876WOS:000615581000028Introduction: The aim of this randomized controlled experimental study was to evaluate the efficacy of potassium, pH and D-dimer levels in blood, as well as potassium and pH levels in peritoneal lavage fluid, in the early diagnosis of acute mesenteric ischemia. Material and methods: This study was conducted at the Istanbul University Center of Experimental Medicine after having received approval from the Istanbul University animal testing ethics committee. Male albino Wistar rats (n = 24; 250 to 350 g) were divided into two control groups and two ischemic groups. Levels of potassium, pH, and D-dimer in blood and levels of potassium and pH in peritoneal lavage fluid were analyzed for 1 h and 2 h after the induced acute mesenteric ischemia procedure. The degree of ischemic injury was determined using the histopathological damage score in tissue samples taken from the terminal ileum. Results: Ischemic groups had statistically significant differences in potassium and pH in blood and peritoneal lavage fluid compared to non-ischemic groups (p < 0.05). There was no significant difference between control and ischemic groups in terms of D-dimer and histologic grading results after 1 h (p = 0.132, p = 0.475 respectively), while there was a significant difference between control and ischemic groups after 2 h (p < 0.05). Conclusions: The levels of potassium, pH, and D-dimer could be useful in daily practice for the early diagnosis of acute mesenteric ischemia
Rose petal topography mimicked poly(dimethylsiloxane) substrates for enhanced corneal endothelial cell behavior
No full text2-s2.0-85105450948Low proliferation capacity of corneal endothelial cells (CECs) and worldwide limitations in transplantable donor tissues reveal the critical need of a robust approach for in vitro CEC growth. However, preservation of CEC-specific phenotype with increased proliferation has been a great challenge. Here we offer a biomimetic cell substrate design, by optimizing mechanical, topographical and biochemical characteristics of materials with CEC microenvironment. We showed the surprising similarity between topographical features of white rose petals and corneal endothelium due to hexagonal cell shapes and physiologically relevant cell density (? 2000 cells/mm2). Polydimethylsiloxane (PDMS) substrates with replica of white rose petal topography and cornea-friendly Young's modulus (211.85 ± 74.9 kPa) were functionalized with two of the important corneal extracellular matrix (ECM) components, collagen IV (COL 4) and hyaluronic acid (HA). White rose petal patterned and COL 4 modified PDMS with optimized stiffness provided enhanced bovine CEC response with higher density monolayers and increased phenotypic marker expression. This biomimetic approach demonstrates a successful platform to improve in vitro cell substrate properties of PDMS for corneal applications, suggesting an alternative environment for CEC-based therapies, drug toxicity investigations, microfluidics and organ-on-chip applications. © 2021 Elsevier B.V.11501, 6701This study was supported by Bogazici University Research Fund by Grant Numbers 11501 and 6701
Effects of the Prenatal Administration of Tetanus Toxoid on the Sociability and Explorative Behaviors of Rat Offspring: A Preliminary Study
No full textErdogan, Mumin/0000-0003-0048-444X; Atasoy, Ozum/0000-0001-5115-7815PubMed: 33508791WOS:000614138000008Objective: Autism spectrum disorder (ASD) is a severely disabling psychiatric disease characterized by impairments in communication and social skills. Although efforts have been made to explore the etiology of ASD, its pathophysiology remains unclear. This issue is rendered more challenging by confounding data about the effects of vaccination on disease etiology. In this study, therefore, we investigated the neurodevelopmental effects of maternal tetanus toxoid administration on rat offspring. We hypothesized that the vaccine affects the sociability and preference for social novelty of rat offspring as well as the production of immunological and neurotrophic factors, including tumor necrosis factor-alfa (TNF-alpha), neuregulin-1 (NRG-1), neuron growth factor (NGF), and oxytocin. Methods: The study involved 12 female and 4 male adult Sprague -Dawley rats (238 +/- 10 g), which were assigned to two groups. Group 1 (control group) was given 0.5 ml of normal saline (0.9% NaCl) on the 10th day of pregnancy, whereas Group 2 (experimental group) was administered 0.5 ml of tetanus vaccine (tetanus toxoid, 40 IU). Results: Maternal tetanus toxoid administration exerted beneficial effects on the sociability and explorative behaviors of the rats. The brain tissue levels of TNF-alpha, NGF, NRG-1, and oxytocin were higher in the experimental group than those among the controls. All these significant differences were found in both the male and female rats. Conclusion: This study is the first to demonstrate the advantages of tetanus toxoid administration in relation to the sociability and explorative behaviors of rat offspring. The results showed that the vaccine also influences NRG-1, neuregulin, and oxytocin production
COVID-19 Among Patients With Inflammatory Rheumatic Diseases
No full textPubMed: 339360732-s2.0-85105241251Background: The course of novel coronavirus disease 2019 (COVID-19) has been of special concern in patients with inflammatory rheumatic diseases (IRDs) due to the immune dysregulation that may be associated with these diseases and the medications used for IRDs, that may affect innate immune responses. Objective: In this cohort study, we aimed to report the disease characteristics and variables associated with COVID-19 outcome among Turkish patients with IRDs. Methods: Between April and June, 2020, 167 adult IRD patients with COVID-19 were registered from 31 centers in 14 cities in Turkey. Disease outcome was classified in 4 categories; (i) outpatient management, (ii) hospitalization without oxygen requirement, (iii) hospitalization with oxygen requirement, and (iv) intensive care unit (ICU) admission or death. Multivariable ordinal logistic regression analysis was conducted to determine variables associated with a worse outcome. Results: 165 patients (mean age: 50 ± 15.6 years, 58.2% female) were included. Twenty-four patients (14.5%) recovered under outpatient management, 141 (85.5%) were hospitalized, 49 (30%) required inpatient oxygen support, 22 (13%) were treated in the ICU (17 received invasive mechanic ventilation) and 16 (10%) died. Glucocorticoid use (OR: 4.53, 95%CI 1.65-12.76), chronic kidney disease (OR: 12.8, 95%CI 2.25-103.5), pulmonary disease (OR: 2.66, 95%CI 1.08-6.61) and obesity (OR: 3.7, 95%CI 1.01-13.87) were associated with a worse outcome. Biologic disease-modifying antirheumatic drugs (DMARDs) do not seem to affect COVID-19 outcome while conventional synthetic DMARDs may have a protective effect (OR: 0.36, 95%CI 0.17-0.75). Estimates for the associations between IRD diagnoses and outcome were inconclusive. Conclusions: Among IRD patients with COVID-19, comorbidities and glucocorticoid use were associated with a worse outcome, while biologic DMARDs do not seem to be associated with a worse outcome. © Copyright © 2021 Esatoglu, Tascilar, Babaoğlu, Bes, Yurttas, Akar, Pehlivan, Akleylek, Tecer, Seyahi, Yuce-Inel, Alpay-Kanitez, Bodakci, Tekgoz, Colak, Bolek, Koca, Kalyoncu, Icacan, Ugurlu, Oz, Hamuryudan, Hatemi and the Turkish Society for Rheumatology COVID-19 Registry Investigators
Knowledge Level of Nursing Students on Nosocomial Infection
No full textWOS:000626292700006Objective: This study was carried out to evaluate the knowledge level of student nurses on nosocomial infection. Materials and Methods: The sample of this descriptive study consisted of a total of 208 nursing students in the 2nd, 3rd, and 4th year of a foundation university between February and March 2019. Study data were collected through "Student Information Form" and "Nosocomial Infection Information Form of Nursing Students" prepared in accordance with the literature. Results: The mean age of the student nurses was 21.78 +/- 2.21 years. Moreover, 27.4% of the students graduated from a vocational school of health services and 20.7% of them were already employed while continuing their education. Further, 72.1% of the student nurses stated that they received training on nosocomial infections, 90.4% needed training on nosocomial infections, and 76.9% required training, most importantly, on the measures related to the route of transmission. The item in which most of the student nurses provided an incorrect answer (92.3%) was "The intravenous catheters attached to the patient should be changed every 48-72 h at the latest." Conclusion: The total mean score of student nurses' knowledge level of nosocomial infection was above the moderate level. To meet the educational needs of the student nurses about nosocomial infections, provisions of more comprehensive trainings on this issue and of updated information in line with the recently published guidelines through continuing education programs after graduation are necessary
Bioinspired hydrogel surfaces to augment corneal endothelial cell monolayer formation
No full textBulut, Osman/0000-0001-8200-1119; Ozturk-Oncel, M.Ozgen/0000-0001-8576-2845PubMed: 33448665WOS:000613666500001Corneal endothelial cells (CECs) have limited proliferation ability leading to corneal endothelium (CE) dysfunction and eventually vision loss when cell number decreases below a critical level. Although transplantation is the main treatment method, donor shortage problem is a major bottleneck. The transplantation of in vitro developed endothelial cells with desirable density is a promising idea. Designing cell substrates that mimic the native CE microenvironment is a substantial step to achieve this goal. In the presented study, we prepared polyacrylamide (PA) cell substrates that have a microfabricated topography inspired by the dimensions of CECs. Hydrogel surfaces were prepared via two different designs with small and large patterns. Small patterned hydrogels have physiologically relevant hexagon densities (similar to 2000 hexagons/mm(2)), whereas large patterned hydrogels have sparsely populated hexagons (similar to 400 hexagons/mm(2)). These substrates have similar elastic modulus of native Descemet's membrane (DM; similar to 50 kPa) and were modified with Collagen IV (Col IV) to have biochemical content similar to native DM. The behavior of bovine corneal endothelial cells on these substrates was investigated and results show that cell proliferation on small patterned substrates was significantly (p = 0.0004) higher than the large patterned substrates. Small patterned substrates enabled a more densely populated cell monolayer compared to other groups (p = 0.001 vs. flat and p < 0.0001 vs. large patterned substrates). These results suggest that generating bioinspired surface topographies augments the formation of CE monolayers with the desired cell density, addressing the in vitro development of CE layers.Bogazici University Research FundBogazici University [11501, 6701]Bogazici University Research Fund, Grant/Award Numbers: 11501, 670