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Kronik Hepatit B Hastalarında Delta Hepatit Seroprevalansı: Tek Merkez Çalısması
No full textObjective: Hepatitis B virus (HBV) infection is an important health problem in Turkey. Mortality and morbidity rates arise by accompanion of Hepatitis D infection (HDV). Prevalence of Hepatitis Delta virus (HDV) in HBV-positive individuals varies according to the regions in Turkey with 20% occurence in the western and up to 46% in the eastern parts. The aim of this study is to assess the presence of HDV in HBV patients applying to the center of our study. Materials and Methods: A total of 1025 patient records were reviewed retrospectively. Eighty-four were excluded due to insufficient case data; the remaining 941 patients were included in the review process. Patients were divided into those with chronic hepatitis B (group A) and those with liver cirrhosis (group B). HDV presence in both groups was assessed and compared between each group. Results: Of all 941 patients included in the study, 857 (91%) had chronic hepatitis B (Group A) and 84 (9%) had liver cirrhosis (Group B). Among group A patients, 62% were male and 38% were women; average age was 42±13 years. Group B patients were 77% male and 23% female; mean age was 54±14 years. Among all patients, HDV seropositivity was 3.4%, with 1.8% among group A patients and 20% in Group B (P= 0.001). Results were assessed by Chi-Square test and t–test. Group B patients were found to have significantly higher age (P= 0.007) and HDV seropositivity (P= 0.004) compared to group A patients. Conclusion: Cirrhotic patients were found to have 11-fold higher presence of HDV compared to non-cirrhotic patients.Amaç: Hepatit B virüs (HBV) infeksiyonu Türkiye’de önemli bir sağlık problemidir ve Hepatitis D infeksiyonu (HDV) ile birlikte olması ile mortalite ve morbidite artmaktadır. HDV prevelansı Türkiye’nin batı bölgesinde %20 iken Doğu Anadolu Bölgesinde %46 olarak farklılıklar göstermektedir. Bu çalışmanın amacı hastanemize gelen HBV hastalarındaki HDV seroprevalansı saptamaktır. Gereç ve Yöntem: Toplam 1025 hastanın kayıtları retrospektif olarak incelendi. 84 kişinin verileri yetersiz olduğundan dışlandı. Kalan 941 hastaya ait kayıtlar değerlendirildi. Hastalar Kronik Hepatit B (Group A) ve Siroz (Group B) olarak ayrıldı. Her iki grup arasında HDV infeksiyonunun bulunması açısından karşılaştırma yapıldı. Bulgular: 941 hastanın 857’si (%91) kronik Hepatit B (Grup A), 84’ü (%9) sirotik (Grup B) idi. Grup A daki hastların %62’si erkek, %38’i kadın olup yaş ortalaması 42±13 yıldı. Grup B deki hastaların %77’si erkek ve %23’ü bayan olup yaş ortalaması 54±14 yıldı. Grup B de yaş ortalaması daha yüksekdi (P= 0.015) Total hastalarda HDV seropozitifliği %3.4 olup, Grup A da %1.8, Grup B de %20 idi, Grup B de HDV pozitifliği yüksekti (P= 0.001). Sonuçlar ki kare ve t test ile değerlendirildi. Her iki grupta da erkek cinsiyet olması kadın cinsiyet olmasına göre daha yüksek oranda görüldü (Grup A da P= 0.007, Group B de P= 0.004) Sonuçlar istatistiksel olarak alamlı bulundu. Sonuç: Çalışmaya katılan tüm hastlarda %3.4 oranında HDV seropozitifliğ saptanmıştır. Sirotik hastlarda ise (%20), kronik hepatit B (%1.8) hastalarından 11 kattır
The Effect of Mini-Latissimus Dorsi Flap (MLDF) Reconstruction on Shoulder Function in Breast Cancer Patients
No full textWOS: 000473357300005PubMed ID: 31312791Objective: The aim of this study is to investigate the effect of mini latissimus dorsi flap (MLDF) reconstruction on ipsilateral shoulder functions. Materials and Methods: Those included in the study are the patients aged between 23 and 73, who were operated with the diagnosis of early breast cancer (cT1-3)N0). The first group includes the patients who had sentinel lymph node biopsy (SLNB) with partial mastectomy. The second group consists of the patients who had axillary lymph nodule dissection (ALND) with partial mastectomy. The third group includes the patients who had SLNB and MLDF with partial mastectomy. The fourth group includes the patients who had ALND and MLDF with partial mastectomy. Patients' Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score work model point were recorded. Results: 174 patients were included in this study. According to Q-DASH score, no functional change was detected in 69.5% of the patients, whereas slight functional loss was identified in 23.6%, moderate functional loss in 5.7%, severe functional loss 1.1%. In the comparison of Q-DASH scores in surgery groups, while these four groups were being analyzed, a significant difference was determined (p=0.007). When dual analyses were made, it was also established that the difference resulted from the group to which ALND and MLDF were applied together. Conclusion: We conclude that MLDF application for reconstruction purposes after breast surgery has a negative impact on shoulder functions of the patients who had both of partial mastectomy and ALND
The Role of Elastography in Diagnosis and Staging of Breast Cancer-Related Lymphedema
No full textWOS: 000444392800001PubMed ID: 30212266Background: Early detection of lymphedema gives an opportunity for effective and successful treatment of lymphedema. However, the current diagnosis methods, except the bioimpedance analysis, perometry, and indocyanine green lymphography, have limitations in detecting early stage lymphedema. Sonoelastography is a diagnostic ultrasound technique that provides an opportunity to estimate soft tissue stiffness. Shear wave elastography (SWE) is a brand new elastography technique. Unlike strain elastography, this method is conducted automatically, that is, independently of user's manual tissue compression. The aim of this study is to establish the role of sonoelastography in diagnosis and staging of lymphedema by using the SWE technique in lymphedema patients. Methods and Results: A total of 36 female lymphedema patients were included in the study. There was no significant difference between patients with stages 1 (n = 17) and 2 (n = 19) lymphedema in terms of age, duration after surgery, and body mass index (p > 0.05). But, differences in terms of circumference measurements for forearm and arm, L-DEX values, and duration of lymphedema were found to be statistically significant (p = 0.002-0.000-0.000-0.001). Elastography measurements between normal forearm and forearm with lymphedema showed a statistically significant difference (p = 0.012). Correlation was found between circumference measurements and elastography values of forearms (p = 0.004, r = 0.471) and L-DEX scores and elastography measurements (p = 0.041, r = 0.352). When circumferential measurements of the forearms with lymphedema were compared with those with normal forearms, stage 1 patients showed no significant difference (p = 0.850), whereas a significant difference was detected in stage 2 patients (p = 0.003). Conclusion: SWE should be a useful tool in diagnosis and distinguishing early and late stages of lymphedema
Platelet-rich plasma as an additional therapeutic option for infected wounds with multi-drug resistant bacteria: in vitro antibacterial activity study
No full textWOS: 000471927600024PubMed ID: 29700554PurposeInfected wounds, such as diabetic foot infections, are mostly polymicrobial and microorganisms have high resistance rates to antimicrobials. Infected wounds in diabetic patients have high cost, morbidity, and mortality rates. Based on these facts, there is a need for supportive localized treatment options such as platelet-rich plasma (PRP) implementations. Demonstrating the in vitro antimicrobial effect, our aim was to lead up to clinical trials of localized PRP implementations in infected wounds such as diabetic foot infections. In this study, we aimed to demonstrate the in vitro antibacterial activity of PRP against methicilin-resistant Staphylococcus aureus (MRSA) and three more multi-drug resistant bacteria species that are important and hard-to-treat in wound infections.Materials and methodsIn vitro antimicrobial activity of autologous PRP, platelet-poor plasma (PPP), and phosphate-buffered saline (PBS) on methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., extended spectrum beta lactamase producing Klebsiella pneumoniae, and carbapenem-resistant Pseudomonas aeruginosa was compared by assessment of bacterial growth on agar plates and antimicrobial susceptibility test results.ResultsWhen compared to control group, PRP and PPP significantly suppressed bacterial growth of MRSA, K. pneumoniae, and P. aeruginosa at 1st, 2nd, 5th, and 10th hours of incubation (p<0.05). VRE was the only bacteria that PRP and PPP showed limited activity against. When compared to PPP, PRP showed higher activity against MRSA, K. pneumoniae, and P. aeruginosa. However, the differences between PRP and PPP were statistically significant only against MRSA and P. aeruginosa at the first hour of incubation.ConclusionsEmerging PRP and other platelet-derived products seem to be promising alternative tools besides antibiotic treatment, debridement, negative pressure wound therapy, hyperbaric oxygen therapy, and other treatment options for treating diabetic foot infections
Urinary CXCL9 and CXCL10 Levels and Acute Renal Graft Rejection
No full textWOS: 000468209600001Background: Monitoring of chemokines, CXCL9 and CXCL10, in serum may present a non-invasive detection method for rejection. Objective: To investigate the relationship between urinary levels of CXCL9 and CXCL10 and graft function following renal transplantation. Methods: 75 living-related donor renal transplant recipients were studied. Urinary levels of chemokines were collected pre-operatively, on post-operative 1st day, 7th day, 1st month, 3rd month, and at the time of rejection. Chemokines levels were assayed using and enzyme-linked immunosorbent assay. Results: Clinical variables were monitored. 10 (15%) patients had biopsy-proven rejection during the follow-up period. The urinary CXCL9 level in those with rejection was significantly higher than that in those with non-rejection group at the 1st day (p<0.001), 7th day (p<0.001), and at the time of rejection (p=0.002). The urinary CXCL10 level was also significantly higher in those with rejection compared with non-rejection group at 1st day (p<0.001), 7th day (p<0.001), and at the time of rejection (p=0.001). Serum creatinine level was strongly correlated with the urinary CXCL9 and CXCL10 levels at the time of rejection (r=0.615, p=0.002; and r=0.519, p=0.022, respectively). Among those with T cell-mediated rejections the mean urinary CXCL10 level increased to as high as 258.12 ng/mL. Conclusion: Urinary CXCL9 and CXCL10 levels might have a predictive value for T cell-mediated rejection in early post-transplantation period. Measurement of urinary CXCL9 and CXCL10 levels could provide an additional tool for the diagnosis of rejection.Scientific Research Projects Coordination Unit (BAP) of Istanbul University [47549]The study was supported by the Scientific Research Projects Coordination Unit (BAP) of Istanbul University (project number 47549)
The Preventive Effect of Oxytocin on Retinopathy in Streptozotocin-Induced Diabetic Rats
No full textWOS: 000466509800005PubMed ID: 31055890Objectives: The aim of this study was to investigate the impact of intravitreal and intraperitoneal use of oxytocin (OT) on retinopathy in streptozotocin-induced diabetic rats. Materials and Methods: Twenty-four 6-8-week-old adult male and female Sprague Dawley rats were used in the study. Diabetes was induced in the rats with a single injection of intraperitoneal streptozotocin. Diabetes was verified after 48 hours by measuring blood glucose levels of 260 mg/dl (14.4 mmol/L) or higher in diabetic rats. The rats were divided into 4 groups and treated as follows: intravitreal physiological saline group (0.01 mL saline weekly), intravitreal OT group (10 mu U/mu L OT weekly), intraperitoneal physiological saline group (1 mL daily), and intraperitoneal OT group (100 IU/kg OT daily). Hamilton syringes fitted with 27-gauge needles were used for intraperitoneal injections while 31-gauge needles were used for intravitreal injection. After 4 weeks of treatment the rats were euthanized to evaluate outer nuclear layer (ONL) thickness, vascular endothelial growth factor (VEGF) immunoexpression, and plasma VEGF levels from blood samples obtained by cardiac puncture. Results: Morphometric analysis of retinal cross-sections showed that intravitreal and intraperitoneal OT significantly increased ONL thickness compared to physiological saline-treated groups. Also, OT treatment significantly decreased VEGF protein expression compared with the physiological saline groups. Plasma VEGF level was significantly higher in the physiological saline treatment group compared to the OT treatment group. Conclusion: OT reduces diabetic retinopathy progression, particularly when administered intravitreally. To our knowledge, this is the first attempt to investigate the impact of OT on diabetic retinopathy and may provide a new area for further research
Survival and prognostic factors in patients with recurrent low-grade epithelial ovarian cancer: An analysis of five prospective phase II/III trials of NOGGO metadata base
No full textObjective: Low-grade epithelial ovarian cancers (EOC), constitute the minority among all epithelial cancers. Our study objective was to focus on low-grade recurrent EOC and compare the survival with high-grade disease, as well as in regard to “platinum-sensitive” and “-resistant” recurrences according to platinum-free interval. Methods: This is an exploratory analysis within the North-Eastern German Society of Gynecological Oncology (NOGGO) database including five randomized phase II/III trials comparing different chemotherapy regimens in recurrent EOC. We conducted survival analyses and cox-proportional regression models. Results: Out of 1050 patients having the first recurrence, 42 (4%) patients had low-grade and 1008 (96%) patients had high-grade disease. In the subgroup of platinum-sensitive recurrences, progression-free survival (PFS) (8.7 m vs 9.7 m, p = 0.7) and overall survival (OS) (23.9 m vs 24.8 m, p = 0.9) did not differ between low-grade and high-grade diseases. In platinum-resistant recurrences, patients with low-grade ovarian cancer had significantly better PFS (7.6 m vs 3.6 m, p = 0.03) and OS (41.9 m vs 9.5 m p = 0.002) in comparison to those with high-grade cancer. At low-grade EOC, there were no significant PFS (p = 0.91) and OS (p = 0.25) differences between platinum-sensitive and –resistant recurrences. Patients with low-grade non-serous histology had lower PFS with compared to those with low-grade serous histology (p = 0.004). At cox regression analysis presence of ascites and residual disease after secondary cytoreductive surgery were independently associated with poor PFS within low-grade recurrent EOC. Conclusion: Our study indicates, platinum-free interval does not have any prognostic significance at recurrent low-grade EOC and non-serous histology is associated with poorer outcome in recurrence. Secondary surgical cytoreduction to no-gross residual disease and ascites are independently associated with disease progression. © 201
The ANK nail treatment of lateral malleolar fractures with syndesmosis injury: Clinical outcomes at 10 years of follow-up
No full textWOS: 000461477900014PubMed ID: 30742291BACKGROUND: Lateral malleolar fractures associated with syndesmotic injuries are common. Various surgical implants may be used for the management of syndesmosis injury. One of these is ANK nail. The aim of the present study was to assess the clinical and radiological outcomes of patients treated with ANK nail. METHODS: Forty-eight patients who were followed up for a minimum of 10 years were reviewed retrospectively using American Orthopedic Foot and Ankle Society (AOFAS) score, radiological evaluation, and development of posttraumatic arthritis. Final data were collected at the last follow-up. RESULTS: The mean age of the patients was 37.3 (17-69) years. The mean follow-up was 129.9 (123-150) months. Twenty-two patients had Weber type B fracture, and their mean AOFAS score was 93.36 points. The remaining 26 patients had Weber type C fracture, and their mean AOFAS score was 97.66 points. There was no relationship between the type of fracture and the clinical outcome. There was a significant correlation between shortening of the fibula and posttraumatic arthritis. CONCLUSION: The ANK nail used for the management of ankle fractures may provide both fracture and syndesmosis stabilities in selected cases and is also a cost effective method as cheap as a cortical screw and a Kirschner wire
Performance measures for endoscopy services: A European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative
No full textWOS: 000457497200003PubMed ID: 30788114The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a list of key performance measures for endoscopy services. We recommend that these performance measures be adopted by all endoscopy services across Europe. The measures include those related to the leadership, organization, and delivery of the service, as well as those associated with the patient journey. Each measure includes a recommendation for a minimum and target standard for endoscopy services to achieve. We recommend that all stakeholders in endoscopy take note of these ESGE endoscopy services performance measures to accelerate their adoption and implementation. Stakeholders include patients and their advocacy groups; service leaders; staff, including endoscopists; professional societies; payers; and regulators.Research Foundation-Flanders (FWO); United European Gastroenterology (UEG)The authors gratefully acknowledge the contributions from: Dr. Stuart Gittens, ECD Solutions in the development and running of the web platform; Iwona Escreet and all at Hamilton Services for project administrative support; Debbie Johnston, Craic Consultancy Ltd, for support creating the minimum and target standards; the Scottish Intercollegiate Guidelines Network for hosting the critical appraisal module; and the Research Foundation-Flanders (FWO) for providing funding for Professor Raf Bisschops; also thank you to all members of the wider working group who attended meetings, participated in discussions, and voted on the measures including Bamakhrama K. (UAE), Fretwell I. (UK), Hamoudi W. (Jordan), Kariis T. (Estonia), Lauri A. (Italy), WMadacsy L. (Hungary), Narra Figueiredo P. (Portugal), Nashat A. (Egypt), Ormeci N. (Turkey), Paraskeva K. (Greece), Patchett S. (Ireland), Stefanovic M. (Slovenia), Wurm Johansson G.G. (Sweden), Seebach L. (Switzerland), Stirna D. (Latvia); Nurses: Bakic B. (Croatia), Beilenhoff U. (Germany), Christensen J.S. (Denmark), Jorgensen A. (Norway), Martisen K. (Norway), Petraki S. (Greece); Patient representative: Gore-Booth J. (France EuropaColon). United European Gastroenterology (UEG) supplied co-funding and additional project governance to this endeavour
Ellagic Acid Enhances the Antitumor Efficacy of Bevacizumab in an in Vitro Glioblastoma Model
No full textCetin, Abdurrahman/0000-0002-5246-7652WOS: 000496966300010PubMed: 31518741BACKGROUND: the anticarcinogenic effect of ellagic acid (EA), a natural phenol of fruits and vegetables, has been investigated in several types of tumors. the combined effect of EA with bevacizumab (BEV), a common drug used in treatment of recurrent glioma, on glioblastoma has not been reported. This study observed the combined effect of EA with BEV on the expression profile of the C6 glioma cell line. METHODS: Rat C6 glioma cells were treated with EA at 100 mu mol/L concentration in combination with BEV at 100 ng/mL concentration for 24, 48, and 72 hours. Cell proliferation was detected by 5-bromo-2'-deoxyuridine immunohistochemistry, and p53 and caspase-3 protein levels were determined by immunohistochemistry and assessed by the H-Score. Expression profiles for P-glycoprotein (MDR1), O-6-methylguanine DNA methyltransferase (MGMT), caspase-3, and p53 related proteins were detected by reverse transcriptase polymerase chain reaction after EA treatment with or without BEV. RESULTS: EA combined with BEV conspicuously reduced the cell viability of C6 glioma cells for all incubation times. EA significantly downregulated expression of MGMT regardless of combination with BEV even in the early hours after treatment. Combined EA and BEV reduced MDR1 expression only at 72 hours. EA affected the apoptotic proteins of p53 and caspase-3 at protein level in a time-dependent manner, but not at gene level. CONCLUSIONS: This study suggests successful antiproliferative efficacy of EA combined with BEV, probably through inhibition of MGMT expression and time-dependent inhibition of MDR1. EA combined with BEV may be an alternative treatment for drug-resistant gliomas