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Protective effects of rectal ozone administration on colon anastomoses following radiotherapy
No full textBackground. Anastomotic leakage (AL) following rectal surgery is associated with increased mortality and morbidity. Neoadjuvant radiotherapy disrupts the wound healing process in rectal surgery. Objectives. To evaluate the effects of intra-rectal ozone application on rectal anastomoses after radiotherapy. Materials and methods.This study was performed on animals. Thirty-two male Wistar rats were randomly divided into 4 groups: control group, ozone group, radiotherapy group, and radiotherapy/ozone group. Ozone was administered intrarectally in the ozone group and water was administered intrarectally in rthe control group for 5 days. The radiotherapy group received 20 Gy of pelvic radiotherapy. The radiotherapy/ozone group received 20 Gy of pelvic radiotherapy after the administration of ozone. Afterward, colon resection followed by an anastomosis were performed under general anesthesia in all groups. Anastomotic segments were resected to evaluate tissue hydroxyproline (HYP) and myeloperoxidase (MPO) levels, perform a histological evaluation, and measure bursting pressure.Results. There were no statistically significant differences between groups regarding tissue MPO levels (p = 0.55). Tissue HYP levels were significantly decreased in the radiotherapy group (p = 0.04). Bursting pressure was found to be significantly lower in the radiotherapy group (p < 0.05). No significant differences were found between adhesion scores in the control and ozone groups. Exudate formation was significantly lower in the radiotherapy group (p < 0.05). The lowest macrophage scores were found in the radiotherapy group (p < 0.05). Fibroblast scores were the highest in the control group and the lowest in the radiotherapy group (p < 0.05). Conclusions. Intra-rectal ozone application significantly improved the anastomotic healing process after radiation exposure
Association between sagittal alignment and loads at the adjacent segment in the fused spine: a combined clinical and musculoskeletal modeling study of 205 patients with adult spinal deformity
No full textPurposeSagittal malalignment is a risk factor for mechanical complications after surgery for adult spinal deformity (ASD). Spinal loads, modulated by sagittal alignment, may explain this relationship. The aims of this study were to investigate the relationships between: (1) postoperative changes in loads at the proximal segment and realignment, and (2) absolute postoperative loads and postoperative alignment measures. MethodsA previously validated musculoskeletal model of the whole spine was applied to study a clinical sample of 205 patients with ASD. Based on clinical and radiographic data, pre-and postoperative patient-specific alignments were simulated to predict loads at the proximal segment adjacent to the spinal fusion. ResultsWeak-to-moderate associations were found between pre-to-postop changes in lumbar lordosis, LL (r = - 0.23, r = - 0.43p < 0.001), global tilt, GT (r = 0.26, r = 0.38p < 0.001) and the Global Alignment and Proportion score, GAP (r = 0.26, r = 0.37p < 0.001), and changes in compressive and shear forces at the proximal segment. GAP score parameters, thoracic kyphosis measurements and the slope of upper instrumented vertebra were associated with changes in shear. In patients with T10-pelvis fusion, moderate-to-strong associations were found between postoperative sagittal alignment measures and compressive and shear loads, with GT showing the strongest correlations (r = 0.75, r = 0.73, p < 0.001). ConclusionsSpinal loads were estimated for patient-specific full spinal alignment profiles in a large cohort of patients with ASD pre-and postoperatively. Loads on the proximal segments were greater in association with sagittal malalignment and malorientation of proximal vertebra. Future work should explore whether they provide a causative mechanism explaining the associated risk of proximal junction complications
Secondary metabolites from Gentiana cruciata L. and their anti-inflammatory and analgesic activities
No full textA previously unreported secoiridoid glycoside, cruciatoside (1) was isolated from the aerial parts of Gentiana cruciata L. along with ten known compounds eustomoside (2), eustomorusside (3), gentiopicroside (4), 6'-O-beta-D-glucopyranosyl gentiopicroside (5), loganic acid (6), isoorientin (7), isovitexin (8), isovitexin 2''-(E)-ferulate (9), mangiferin (10), and 2-methyl-inositol (11). The chemical structures of the isolates were elucidated based on extensive 1 D and 2 D NMR experiments as well as HRMS analysis. All isolates were evaluated for their in vitro anti-inflammatory and analgesic activities. Compounds 9, 4, and 7 (200 mu M) showed moderate anti-inflammatory activity by inhibiting nitrite production from LPS-induced RAW 264.7 macrophage cells, with the inhibition rates of 39.5\%, 25.8\% and 22.9\% respectively without exhibiting substantial cytotoxicity. Besides, 1, 2, 4, and 7 exerted the highest decrease in IL-6 levels. Moreover, compound 4 showed in vitro analgesic activity by decreasing the PGE(2) level comparable to the reference drugs
Quantitative analysis of preclinical ocular microvascular changes in Multisystemic Inflammatory Syndrome in Children (MIS-C) detected by optical coherence tomography angiography
No full textObjectives To evaluate the macular and optic nerve head (ONH) vascular density, foveal avascular zone area, and outer retina and choriocapillaris flow in Multisystemic Inflammatory Syndrome in Children (MIS-C) using optical coherence tomography angiography (OCTA). Methods Thirty-four eyes of 34 patients with MIS-C and 36 age and sex-matched healthy controls were investigated in this prospective, cross-sectional study. The superficial capillary plexus (SCP) and deep capillary plexus (DCP), ONH, FAZ parameters, the flow area of the outer retina, and choriocapillaris were evaluated using OCTA. Results All VD parameters in SCP were significantly lower in MIS-C patients. There was no significant difference between the groups in VD parameters of both DCP and ONH, as well as FAZ area and FAZ perimeter. However, foveal density (FD-300) was significantly decreased in the MIS-C group. (p = 0.024). The outer retina flow area at 1 mm, 2 mm, and 3 mm radius and CC flow area at 1 mm and 2 mm radius were significantly lower in the MIS-C group than in the control group. Although CC flow area at 3 mm radius was decreased in the MIS-C group compared to healthy controls, the difference was not statistically significant. Conclusions We demonstrated a decreased vessel density in SCP, choriocapillaris flow area, and outer retinal flow area in MIS-C patients. Hence, we proposed that OCTA could reveal retinal and choroidal microvascular changes in MIS-C patients who were completely healthy before the diagnosis of MIS-C
Sequential percutaneous tricuspid and pulmonary valve implantation in a young child operated previously for Ebstein Anomaly
No full textWe report a successful percutaneous tricuspid valve implantation followed by a percutaneous pulmonary valve implantation in a young child with Ebstein's anomaly of tricuspid valve and pulmonary stenosis who was previously treated surgically at 1 year of age with tricuspid ring annuloplasty and a transannular outflow patch. This article shows the feasibility of sequential implantation of two valves in young patients with severe tricuspid and pulmonary valve insufficiency
Association Between History of Polymerase Chain Reaction-verified COVID-19 Infection and Outcomes of Subsequent ST-Elevation Myocardial Infarction
No full textWhile the acute phase of coronavirus disease 2019 (COVID-19) is associated with worsening cardiac outcomes, it is unclear whether it affects the outcome of patients with ST-segment elevation myocardial infarction (STEMI) after the acute phase. In addition, while many studies compared the course of STEMI during the COVID-19 pandemic with the years before the outbreak, we evaluated the course of STEMI during the pandemic according to whether or not patients had history of COVID-19. Patients diagnosed with STEMI during the ongoing COVID-19 pandemic were included in the study. The Ministry of Health database was analyzed retrospectively, and patients with (n = 191) and without (n = 127) a history of polymerase chain reaction (PCR) confirmed COVID-19 infection were divided into groups. Clinical and angiographic characteristics were assessed. The rates of in-hospital major adverse cardiac events (MACE) were higher in those who had a history of PCR-verified COVID-19 infection. Angiographic and procedural findings indicating successful reperfusion were better in patients without a history of COVID-19. A history of COVID-19 infection (odds ratio 1.40, 95\% confidence interval 1.25-1.60, P < .01) independently predicted MACE. A history of COVID-19 infection is a predictor of worse outcomes following coronary intervention and in-hospital MACE among patients with STEMI
A complete case of Cantrell's Pentalogy with isolated left ventricular diverticulum
No full textThe congenital left ventricular diverticulum is a rare cardiac malformation, and it may associate with Cantrell's Pentalogy with other cardiac defects. However, isolated ventricular diverticulum without any other cardiac defect in complete Cantrell's syndrome is very rare. We describe a 6-year-old male patient with a complete Cantrell's syndrome with isolated left ventricular diverticulum
Genome of Pythium myriotylum Uncovers an Extensive Arsenal of Virulence-Related Genes among the Broad-Host-Range Necrotrophic Pythium Plant Pathogens
No full textThe Pythium (Peronosporales, Oomycota) genus includes devastating plant pathogens that cause widespread diseases and severe crop losses. Here, we have uncovered a far greater arsenal of virulence factor-related genes in the necrotrophic Pythium myriotylum than in other Pythium plant pathogens. The genome of a plant-virulent P. myriotylum strain (similar to 70 Mb and 19,878 genes) isolated from a diseased rhizome of ginger (Zingiber officinale) encodes the largest repertoire of putative effectors, proteases, and plant cell wall-degrading enzymes (PCWDEs) among the studied species. P. myriotylum has twice as many predicted secreted proteins than any other Pythium plant pathogen. Arrays of tandem duplications appear to be a key factor of the enrichment of the virulence factor-related genes in P. myriotylum. The transcriptomic analysis performed on two P. myriotylum isolates infecting ginger leaves showed that proteases were a major part of the upregulated genes along with PCWDEs, Nep1-like proteins (NLPs), and elicitin-like proteins. A subset of P. myriotylum NLPs were analyzed and found to have necrosis-inducing ability from agroinfiltration of tobacco (Nicotiana benthamiana) leaves. One of the heterologously produced infection-upregulated putative cutinases found in a tandem array showed esterase activity with preferences for longer-chain-length substrates and neutral to alkaline pH levels. Our results allow the development of science-based targets for the management of P. myriotylum-caused disease, as insights from the genome and transcriptome show that gene expansion of virulence factor-related genes play a bigger role in the plant parasitism of Pythium spp. than previously thought. IMPORTANCE Pythium species are oomycetes, an evolutionarily distinct group of filamentous fungus-like stramenopiles. The Pythium genus includes several pathogens of important crop species, e.g., the spice ginger. Analysis of our genome from the plant pathogen Pythium myriotylum uncovered a far larger arsenal of virulence factor-related genes than found in other Pythium plant pathogens, and these genes contribute to the infection of the plant host. The increase in the number of virulence factor-related genes appears to have occurred through the mechanism of tandem gene duplication events. Genes from particular virulence factor-related categories that were increased in number and switched on during infection of ginger leaves had their activities tested. These genes have toxic activities toward plant cells or activities to hydrolyze polymeric components of the plant. The research suggests targets to better manage diseases caused by P. myriotylum and prompts renewed attention to the genomics of Pythium plant pathogens
Clinical Outcome and Characteristics of Turkish Breast Cancer Patients who had SARS-Cov-2 Infection
No full textOBJECTIVE COVID-19 pandemic has placed an unprecedented burden on health-care system. Patients with cancer are reported to have a higher risk of infection and a more complicated COVID-19 course. Breast cancer (BC) is the most common cancer in women in Turkey. We report clinical outcomes and characteristics of patients with COVID-19 who were on treatment for BC at our center. METHODS We reviewed medical records of BC patients who had COVID-19 between July 2020 and 2021 at our center. We recorded pathological, clinical, treatment characteristics, and the clinical outcome of COVID-19 infection. RESULTS A total 82 BC patients had COVID-19 between July 2020 and 2021. All patients were female, with a median age of 49 (43-64 years). 85\% of all patients had early and 14.6\% of them had advanced stage BC. COVID-19 had a mild clinical course in 73\%, hospitalization was required in 27\% of patients. Twenty-five patients who required hospitalization were discharged and three patients died due to COVID-19. All of the patients who died from COVID-19 had metastatic BC (p=0.002). Metastatic disease (p=0.002) and chemotherapy within 7 days of COVID-19 diagnosis (p=0.024) have been associated with increased mortality. CONCLUSION Majority of BC patients with COVID-19 have a mild course, patients with risk factors that increase mortality should be followed more carefully
UNNOTICED ETIOLOGY IN ORTHOPEDIC COMPLAINTS: CHRONIC MOUNTAIN SICKNESS
No full textObjective: Chronic mountain sickness (CMS) is a clinical syndrome with symptoms of polycythemia that may interfere with other nonspecific diseases. The current study aimed to investigate the symptoms of patients living at high altitudes, who initially presented complaints that seemed to be common orthopedic problems, and to examine their relationship with chronic mountain sickness. Material and Methods: The prospectively collected data of 104 patients were retrospectively evaluated for serum hemoglobin (Hb) and hematocrit (Hct) levels, oxygen saturation (sO(2)), Qinghai CMS questionnaire score, alcohol and tobacco use, ``any history of acute mountain sickness, body mass index (BMI), blood pressure, heart rate, and duration of high-altitude living. Patients grouped according to the Qinghai score as healthy, mild, moderate or severe CMS. The groups were investigated in terms of parameters and demographic characteristics. Results: Of the 104 patients, 33 (31.7\%) had a mild CMS score >= 6 (28 patients, 6-10, 5 patients, 11-14 points)remaining patients had no CMS. The frequency of excessive erythrocytosis was 4.5\% in men and 3.3\% in women. There was a significant difference in Hb, Hct and sO(2) levels between the healthy and mild CMS groups (p<0.001). CMS score had a positive correlation with Hct (rho 0,381 p<0.001) and negative correlation between sO(2) levels (rho -0.432 p<0.001). Conclusions: CMS can be observed at lower altitudes than described in literature. In individuals living in high altitudes, some of the CMS symptoms may be confused with real orthopedic symptoms and orthopedists working in these areas should increase their awareness on this issue. In order to make an appropriate approach, other symptoms related to CMS should be questioned in patients living at high altitudes