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Evaluation of the Obstetrical Brachial Plexus Injuries with Forensic Perspective
No full textAim: Obstetrical brachial plexopathy (OBP) is the loss of function of the brachial plexus due to a traumatic, idiopathic, or iatrogenic reason since birth. OBP mostly occurs with a traumatic background that is secondary to a difficult birth. In this study, we aimed to investigate the medical characteristics of the OBP cases, which were evaluated for malpractice reasons by the Forensic Medicine and define the features that should be considered in the forensic evaluation of OBP. Methods: The medical files of all cases with OBP evaluated in the 2nd Specialization Board of the Council of Forensic Medicine between 2013 and 2017 due to malpractice were included in the study. The dates of birth, maternal ages, comorbid diseases of the mother, the number of pregnancies, birthplaces and birth weeks, birth weights, and additional comorbid pathologies were investigated retrospectively. Results: A total of 287 cases were evaluated in this study. The mean age of forensic evaluation was found to be 2.9 +/- 2.3 years. All patients were born with vaginal delivery except one caesarean case. In 55% of cases had shoulder dystocia, 16% clavicle fracture, 4% humerus fracture and humeral head dislocation were detected. 23.3% of the cases had a history of a difficult birth and 11.5 % had assisted delivery. In 45% of cases had developmental pathologies accompanied by hypotonia. None of the cases were evaluated as medical malpractice. Conclusion: Standard medical records of cases with OBPs contained sufficient information for neurological and forensic evaluation. Our study shows the OBP's does not only originate from the traumatic etiology; about half of the cases have different comorbid pathologies, especially neurodevelopment problems. In order to achieve standardization and understand the comorbidities of plexopathy better, it would be appropriate to expand the medical data in detail
Protective effect of oxytocin through its anti-inflammatory and antioxidant role in a model of sepsis-induced acute lung injury: Demonstrated by CT and histological findings
No full textPurpose: Although several studies demonstrate the anti-inflammatory effect of oxytocin in different pathophysiological processes, there are limited data describing the impact of oxytocin on acute respiratory distress syndrome (ARDS). We aimed to elucidate the protective effect of oxytocin in ARDS with histopathological evaluation and radiological imaging in addition to biochemical markers. Materials and Methods: Fecal intraperitoneal injection procedure (FIP) was performed on 24 of 32 rats included in the study for creating a sepsis model. Rats were randomly assigned into four groups: control group (no procedure was applied, n = 8), untreated septic group [was operated (FIP) and received no treatment, n = 8], placebo group (FIP, treated with 10 ml/kg of saline at once, n = 8), and treated group (FIP, treated with 0.1 mg/kg of oxytocin at once, n = 8). Chest CT was performed for all rats 20 hours after the procedure and density of the lungs were measured manually by using HU. All animals were sacrificed for histopathological examination of lung damage and blood samples were collected for biochemical analysis. Results: Plasma malondialdehyde (MDA), lactic acid (LA), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), interleukin 1-beta (IL 1-beta) levels were significantly increased in the placebo (FIP + saline) and the untreated (FIP) groups, and plasma levels of all biomarkers were reversed by oxytocin. Further, the density of the lung parenchyma (Hounsfield unit) on CT images and the histopathological lung damage score values were closer to the control group in the oxytocin-treated group compared to the placebo group. Conclusion: Our findings suggested that oxytocin could exert anti-inflammatory, antioxidant and protective effects in FIP-induced ARDS
Obstructive sleep apnea in surgical patients and its relationship with difficult intubation: two years of experience from a single center
No full textBackground and objectives: In this study, we aimed to determine the risk of obstructive sleep apnea (OSA) in patients undergoing elective surgery and its relationship with difficult intubation (DI). Methods: This prospective, descriptive, cross-sectional study was conducted between December 2018 and February 2020 in the anesthesiology and reanimation service of a training and research hospital. The study included patients who were ASA I–II, 18 years of age, and older who underwent elective surgery under general anesthesia. A form regarding the baseline characteristics of the participants as well as STOP-Bang score, Mallampati, and Cormack-Lehane classification was used to collect the data. Results: The study included 307 patients. It was determined that 64.2% of patients had a high risk of OSA. The presence of DI (determined by repeated attempts at intubation) was 28.6% in the high-risk OSA group, while there was no DI in the low-risk OSA group. A statistically significant difference was found between the groups in terms of OSA risk according to the presence of DI according to repeated attempts, Cormack-Lehane classification, and Mallampati classification (p < 0.001). Conclusion: Due to the high rate of DI in patients with a high risk of OSA, the security of the airway in these patients is endangered. Early clinical recognition of OSA can help in designing a safer care plan. © 2021 Sociedade Brasileira de Anestesiologi
CXCL13 Levels Indicate Treatment Responsiveness to Fingolimod in MS Patients
No full text[No Abstract Availale]Novartis PharmaceuticalsNovartisThis study was sponsored by Novartis Pharmaceuticals
Comparison of Dosage Loss Between Medications Crushed with Two Different Methods by Two Nurses: An In Vitro Study
No full textUnal, Nursemin/0000-0003-3141-7194WOS:000613760800018Objective: Administration of crushed medications can lead to various problems associated with use of inappropriate crushing method, such as administration of an incorrect dosage, alterations in drug bioavailability, and reduction in the effectiveness of the treatment. This experimental study aimed to compare the dosage loss of crushed metoclopramide hydrochloride (MT-HCI) 10-mg tablet using two crushing methods. Methods: MT-HCI 10 mg tablets (n=80) were crushed by two nurses, and each nurse used a pill crusher and a pestle and plastic bag to crush the tablet. Dosage loss was calculated by a specialist pharmacist in a laboratory environment. Results: The dosage loss was 0.515 +/- 0.299 mg (5.16%) with the pestle and self-sealing plastic bag and 0.415 +/- 0.359 mg (4.16%) with the pill crusher. No statistically significant difference was found between the two methods (p>0.05). The mean dosage loss was 0.482 +/- 0.367 mg for the first nurse and 0.449 +/- 0.298 mg for the second nurse. No statistically significant difference was noted in the mean dose between the two nurses (p>0.05). Conclusion: This study found no significant difference between the nurses and die crushing methods, but the mean dosage loss with both methods was not within the limits recommended by the United States Food and Drug Administration
Impact of eating habits and nutritional status on children with autism spectrum disorder
No full text2-s2.0-85098619400Objectives: Obesity is common among children with Autism Spectrum Disorder (ASD). They suffer more feeding problems than children with normal developmental milestones. Several kinds of diet are recommended for children with ASD. This study determines the frequency of eating disorders and obesity among such children. We investigate the predisposing factors of eating disorders and examine the effects of consumed food on autism scores. Methods: In this single-centre, cross-sectional study, 46 children with ASD aged between 2 and 10 years were included. Anthropometric measurements were recorded and Brief Autism Mealtime Behavior Inventory (BAMBI), Autism Behavior Checklist (ABC), and Food Frequency Questionnaire (FFQ) forms were filled in by their parents. Results: The rates of being overweight and obese were 10.9% and 28.3%, respectively. Food selectivity was observed in 84.8% of the children, and BAMBI food refusal scores were significantly higher for those aged between 2 and 5 years (p = 0.03). Autism scores and consumption of milk, yoghurt, oily seeds, rice/pasta, and fruits (p < 0.05) were significantly correlated. There were also significant differences between these scores and the frequency of consuming eggs, legumes, and other cereals (p < 0.05). Conclusion: Obesity was more common in children with ASD than typically developed children. Despite the high rate of food selectivity, our findings confirmed that food selectivity could be considered independent of obesity. Further, the diet of patients with ASD must include more fruits, yogurt, eggs, legumes, other cereals, less milk, and less rice/pasta. © 2020 The Author
Effect of fluid resuscitation on acute lung injury in a rat model of sepsis
No full textPubMed: 337298222-s2.0-85103145858Aim: Sepsis is a systemic infection reaction and intravascular volume therapy plays a crucial role in it’s treatment. Acute respiratory distress syndrome (ARDS) occurs in the lungs, the most affected organ. This study aimed to investigate the different effects of fluid therapy on ARDS caused by sepsis. Method: To form a sepsis model, cecal ligation and puncture (CLP) procedure were performed on 44 adult rats. Divided into six groups; normal, CLP group, those treated with 40 ml/kg 0.9 % NaCl, 3 % NaCl (hypertonic saline), Ringer Lactate and Hydroxyethyl starch. After 24 hours treatments, histopathological examination of the lungs were done, and the plasma levels of CRP, TNF-? and IL-6 and paO2were measured. Results: The scores of all histological parameters of the group treated with hypertonic saline were significantly lower than of the other groups (p < 0.001). Likewise, according to the arterial blood gas results, paO2was significantly higher (p < 0.01) in the hypertonic saline group compared to the other groups, and paCO2was significantly lower (p < 0.01). CRP, TNF-? and IL-6 levels of inflammatory markers were also significantly lower in hypertonic saline groups compared to other groups (p < 0.001). Conclusions: Our study shows that treatment with hypertonic saline reduces the progression of ARDS in sepsis (Tab. 3, Fig. 4, Ref. 49). Text in PDF www.elis.sk © 2021. All Rights Reserved
Problematic Internet Use in Turkish High School Students: Prevalence and Related Factors
No full textSayili, Ugurcan/0000-0002-5925-2128PubMed: 33402236WOS:000606483100003Objectives: In this study, we sought to determine the prevalence of problematic Internet use (PIU) among high school students and identify demographic and socioeconomic factors related to PIU. Methods: Using a cross-sectional design, we conducted this study between November 2017 and January 2018 of 1412 students attending high schools in the Silivri District of Istanbul in Turkey. We administered a questionnaire inquiring about sociodemographic information, Internet use, and Young's Internet Addiction Test to participating students. Results: Among participants, 18.5% (male = 17.2%; females = 19.8%) were found to show PIU. PIU rates were higher among those with a high household income and lower among those who studied in science high schools, performed physical activities at least 2 days a week, and read at least one book a month. PIU rates were also higher among those who had their own bedrooms, phones, smartphones, Internet connections at home, and social networking accounts. Conclusion: The prevalence of PIU among the participants was 18.5%. Female sex, high household income, low physical activity, grade level, school type, reading fewer than one book per month, and Internet use experience were risk factors for PIU. PIU is considered a significant public health concern across the world, including in Turkey
Noninvasive ventilation with nursing perspective: Impacts on patient tolerance, short-term adverse effects, and nursing workload
No full textPubMed: 33605906WOS:000623686500006Background: The success of noninvasive ventilation (NIV) treatment is closely related to high levels of clinical support. Aims: In this study, we sought to analyze patient mask compliance and minor side effects and to evaluate additional nursing workload needed for the NIV care. Materials and Methods: The study was designed as a prospective and observational. The data were collected from an intensive care unit. Clinical and physiological data, patient tolerance and adverse effects, subjects' complaints about their experience, and additional nursing workload associated with NIV treatment were assessed. Results: Statistically significant improvements were obtained in arterial blood gas analysis, respiratory rate, and heart rate during treatment. In the first 2 h, 65% of subjects had poor mask compliance, patients' comfort scores were poor, and incompliance was associated with discomfort. The ratio of skin problems was 15% in the first 24 h and reached 60% at 48 h. The pain rate due to mask ties was 80% and then increased to 90% at 48 h. There was a significant relationship between the problems detected by the nurses and problems described by the subjects. Additional nursing workload was found as 110 min for 0-6 h. Conclusions: We observed that the mask compliance and comfort levels of the subjects were poor. Skin breakdowns increased depending on the duration of treatment. Treatment would require continuous nursing support in seven areas. NIV treatment generated a significant amount of workload for nurses. Additional nursing workforce planning is required for NIV units for successful NIV treatment
The therapeutic effect of ALT-711 on erectile function in rats treated with high-level AGEs (advanced glycation end products) containing diet
No full text2-s2.0-85102525616To investigate, if advanced glycation end products (AGEs) are involved in erectile dysfunction (ED) and also ALT-711, a cross-link breaker of AGEs, has the therapeutic potential against the development of ED in rats treated with high concentrated AGEs including food. For this purpose, 30 male Harlan Spraque-Dawley rats randomly were divided into three groups; (1) control rats treated with regular diet, (2) rats treated with high-level of AGE specific diet for 6 months, and (3) rats having AGE-diet treated with ALT-711 for the final 3 months of 6 months of AGE-diet period. Erectile response to cavernosal nerve stimulation (CNS), protein expression of neuronal nitric oxide synthase (nNOS) and levels of AGEs, Malondialdehyde (MDA), cyclic guanosine monophosphate (cGMP) were determined in penile tissues. Erectile responses to CNS and penile nNOS and cGMP content were significantly reduced, while AGEs and MDA were elevated in penises of Group-2. Treatment with ALT-711 reversed ED and depletion of both nNOS and cGMP. Additionally, ALT-711 treatment reduced penile tissue AGEs and MDA expression. In present study: rats without any co-morbidity such as diabetes mellitus (DM) and chronic renal failure (CRF) were treated with high-level AGEs containing food. Our results suggest that ALT-711 may be an interesting and promising approach in the treatment of AGEs-related ED. © 2021, The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature.Akdeniz ÜniversitesiAcknowledgements This work was supported by the Akdeniz University Research Foundation