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1.
Diagnostics (Basel) ; 14(9)2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38732302

RESUMEN

In age determination, different methods aiming to obtain the closest result to chronological age have been investigated so far. The most commonly used one among these is the radiological method, which is usually used to evaluate the developmental stages of wrist bones or teeth. In our study, we assessed bone age estimations using the Gilsanz-Ratib atlas (GRA), which has recently become commonly used for children aged 9 to 15 years; evaluated the dental age, determined with Cameriere's European method; conducted morphometric measurements of the mandibular bone; and then examined their relationships with chronological age. The results of our study reveal that, in children during the puberty growth spurt, Cameriere's EU formula might have higher accuracy in estimating chronological age in younger age groups, while the GRA might be more accurate for older ages. Additionally, we conclude that of the mandibular morphometric measurements, condylar height and tangential ramus height show strong positive correlations with age. As a result, we conclude that the morphometric measurements evaluated in the present study can be used as auxiliary methods in forensic anthropology and forensic dentistry.

2.
J Clin Med ; 12(11)2023 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-37297868

RESUMEN

Objective: Congenital heart disease (CHD) plays a key role in oral and dental health regarding its own impacts on teeth (i.e., enamel hypoplasia), infective endocarditis and choice of dental treatment. The purpose of this study's comparing the oral and dental health status in children with or without CHD is to contribute to the literature by determining the effects of CHD on oral and dental health. Material and Methods: The present study was conducted using a descriptive and correlational design and consisted of 581 children aged between 6 months and 18 years who were healthy (n = 364) or experienced CHD (n = 217). CHD-impacted children were classified according to their shunt and stenosis and then their saturation values were noted. In the intraoral examination, caries data (dmft/DMFT, PUFA/pufa), oral hygiene (OHI-S) and enamel defect (DDE) indices were recorded. Statistical analyses were performed using SPSS 26.0 at a significance level of 0.05. Results: In our study, caries index scores of children with or without CHD in primary or permanent dentition were found to be similar. The mean OHI-S index (p < 0.001) and gingivitis findings (p = 0.047) of children with CHD had a higher prevalence than the healthy ones. The incidence of enamel defects was determined as 16.5% in CHD-affected children whereas an incidence rate of 4.7% was observed in healthy children. The mean saturation value of the participants with enamel defects (89 ± 8.9) was observed to be significantly lower (p = 0.03) than the patients with no enamel defects (95 ± 4.2). Conclusions: Whereas the caries index scores of CHD-affected children with a history of hypoxia in primary and permanent dentition were found to be similar to the healthy ones, children with CHD were observed to be more prone to enamel defects and periodontal diseases. Furthermore, considering the risk of infective endocarditis resulting from existing carious lesions and periodontal problems, it is highly important for pediatric cardiologists, pediatricians and pediatric dentists to collaborate in a multidisciplinary manner.

3.
J Clin Pediatr Dent ; 47(3): 103-108, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37143428

RESUMEN

Nablus mask-like facial syndrome (NMLFS) (OMIM: 608156) is an extremely rare genetic syndrome first reported by Ahmad Teebi in 2000. Although it is a rare condition, it is characterized by distinctive facial features such as, expressionless facial appearance, tight, glistening facial skin, low anterior hairline, sparse eyebrows, small palpebral fissures (blepharophimosis), hypertolerism, bulbous nose with prominent columella, abnormally short nose and flat nasal bridge, abnormal ear configuration, bilateral longitudinal cheek dimples, everted lower lip, long philtrum, and maxillary hypoplasia. In addition, a happy and friendly disposition is considered to be the common symptom of this syndrome. Previous studies revealing the intraoral findings of this rare symptom are inadequate and the present report is the first one that presents a dental case involving Nablus syndrome in detail. The aim of this report is to contribute to the current literature through our oral findings in an NMFLS patient, presented at our clinic with toothache and through our treatment approach.


Asunto(s)
Blefarofimosis , Anomalías Craneofaciales , Humanos , Blefarofimosis/diagnóstico , Blefarofimosis/genética , Anomalías Craneofaciales/diagnóstico , Anomalías Craneofaciales/genética , Cara/anomalías , Atención Odontológica
4.
Curr Vasc Pharmacol ; 21(4): 268-273, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37138441

RESUMEN

OBJECTIVES: This study aims to determine the protective effect of cilostazol on myocardium in obese Wistar rats with induced ischemia-reperfusion injury (IRI). METHODS: Four groups with 10 Wistar rats were included: 1] Sham Group: IRI was not established in normal weight-Wistar rats. 2] Control Group: IRI but no cilostazol in normal weight-Wistar rats. 3] Cilostazol in normal weight-Wistar rats: IRI and cilostazol was administered. 4] Cilostazol in obese- Wistar rats: IRI and cilostazol was administered. RESULTS: Tissue adenosine triphosphate (ATP) levels were significantly higher and superoxide dismutase (SOD) levels significantly lower in the control group than in the sham group and normal weight cilostazol group (p=0.024 and p=0.003). Fibrinogen levels were 198 mg/dL in the sham group, 204 mg/dL in the control group, and 187 mg/dL in the normal-weight cilostazol group (p=0.046). Additionally, plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in the control group (p=0.047). The level of ATP was significantly lower in the normal-weight cilostazol group than in the obese group (104 vs 131.2 nmol/g protein, p=0.043). PAI-1 level was 2.4 ng/mL in the normal weight cilostazol group and 3.7 ng/mL in the obese cilostazol group (p=0.029). Normal-weight Wistar rats with cilostazol had significantly better histologic outcomes than the control group and obese Wistar rats (p=0.001 and p=0.001). CONCLUSION: Cilostazol has a protective effect on myocardial cells in IRI models by decreasing inflammation. The protective role of cilostazol was reduced in obese Wistar rats compared with normal-weight Wistar rats.


Asunto(s)
Inhibidor 1 de Activador Plasminogénico , Daño por Reperfusión , Ratas , Animales , Ratas Wistar , Cilostazol/farmacología , Cilostazol/metabolismo , Inhibidor 1 de Activador Plasminogénico/metabolismo , Daño por Reperfusión/tratamiento farmacológico , Daño por Reperfusión/prevención & control , Daño por Reperfusión/metabolismo , Miocardio/metabolismo
5.
Children (Basel) ; 10(2)2023 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-36832356

RESUMEN

Congenital heart disease (CHD) has effects on growth and development. However, information on how the structure of the mandibular bone is affected is limited. In the present study, we aim to compare mandibular bone structures of children affected with CHD and healthy ones through the fractal analysis method and radiomorphometric indices based on panoramic radiographs. The study consisted of 80 children (20 with cyanotic CHD, 20 with acyanotic CHD, 40 control) who were diagnosed with CHD and were treated through interventional therapy or followed up through medical therapy. Fractal dimension (FD) was performed in three different areas (angulus, corpus, and interdental bone) on 80 panoramic radiographs. Additionally, we assessed various radiomorphometric indices: mandibular cortical width (MCW), panoramic mandibular index (PMI), mandibular cortical index (MCI), and simple visual estimation (SVE). p < 0.05 was accepted as statistically significant in the analysis. Values of mean MCW, PMI, MCI, SVE, and FD measurements in children affected with CHD were found to be similar to the control group, regardless of whether they were cyanotic or acyanotic (p > 0.05). In this study, fractal analysis and radiomorphometric indices revealed no trabecular structure and mineral density changes in mandibular bone of children and adolescents with CHD compared to healthy subjects.

6.
Children (Basel) ; 10(1)2022 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-36670612

RESUMEN

Background: Dental caries is a chronic, infectious and preventable disease that is very common around the world. It has been observed that dental caries affect not only the majority of adults but also 60% to 90% of children. Permanent first molars (PFM) are the most commonly decayed teeth observed in children. Aim: The aim of this study is to evaluate the decayed, missing filled teeth (DMFT) scores of PFMs in the early post-eruptive stage, within the scope of the United Nations Agenda for 2030 Sustainable Development Goals, thereby raising awareness for the prevention and treatment of permanent tooth decay. Methods: This descriptive cross-sectional epidemiological study was conducted in Erzurum between the years 2015−2016 by collecting data from children aged 7−10 years (17,208). In addition to the decayed, filled and missing data of the students' 6-year-molars, their ages, genders, frequencies of both tooth brushing and dental office visits were evaluated. The relationship between the variables was analyzed with chi-square. Result: The present study analyzed the data of a total of 11,457 children, 5704 girls and 5753 boys with a mean age of 8.74 ± 1.18. There was a statistically significant difference between the PFMs 16, 26, 36 and 46 regarding the number of healthy, decayed, missing and restored teeth (p < 0.001). Conclusion: In this study, the prevalence of caries in the PFMs of children aged 7−10 years was 15.9% and the mean DMFT was 0.79 ± 1.39. This result showed that PFMs might develop carious lesions and even be lost within three years in the early post-eruptive stage.

7.
Exp Clin Transplant ; 2021 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-34387147

RESUMEN

OBJECTIVES: Liver function is affected by ischemiareperfusion. Ischemia-reperfusion injury to the liver often follows hepatobiliary surgery. Here, we investigated biomarkers of liver ischemia-reperfusion injury using an animal model. MATERIALS AND METHODS: For this study, 24 male Sprague Dawley rats (146-188 g) were divided into 4 groups: group A was the control group, group B was the partial hepatic ischemia-reperfusion group, group C was the total hepatic ischemia-reperfusion group, and group D was the intermittent total hepatic ischemiareperfusion group. Laboratory liver function levels were measured before ischemia, after ischemia, and after reperfusion. We used liver and renal biopsies for histopathological examination at the end of the study. RESULTS: After clamping and reperfusion, alanine aminotransferase and cystatin C levels in groups B, C, and D were significantly higher than levels in group A. In group B, after clamping, neutrophil gelatinaseassociated lipocalin levels were higher than in groups A and D, with significantly higher level than in group D after reperfusion. Neutrophil gelatinase-associated lipocalin levels decreased significantly in groups B, C, and D after reperfusion. There was significantly greater hepatic damage in groups B, C, and D compared with group A but no significant differences in renal injury scores among the groups. There was a significant positive correlation between hepatic damage and renal injury. With regard to histopathological examination versus laboratory results, a statistically significant positive correlation was shown between grade of hepatic damage and serum alanine aminotransferase and cystatin C levels. Similarly, there was a positive correlation between renal damage score and alanine aminotransferase level. CONCLUSIONS: In our animal model, alanine amino - transferase and cystatin C levels tended to increase with ischemia-reperfusion injury levels but neutrophil gelatinase-associated lipocalin decreased during reperfusion. In liver ischemia, we suggest that neutrophil gelatinase-associated lipocalin may be an important biomarker for distinguishing the reperfusion phase.

8.
Arch Esp Urol ; 74(3): 328-334, 2021 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33818429

RESUMEN

OBJECTIVE: To investigate the diagnostic value of testicular fatty acid-binding protein (T-FABP) in acute testicular ischemia and prolonged ischemia. METHODS: The study included a total of 28 prepubertal male Wistar-Hannover rats. The animals were randomly divided into 4 groups as torsion groups (group I; min 30; 7 rats, group II; min 120; 7 rats, group III; min 240; 7 rats) and control group (group IV; 7 rats). In each group, the left testis was separated from the gubernaculum by blunt dissection together with the tunica vaginalis and spermatic cord, and then exposed. In the control group, the blood samples and left testicular tissues were collected at min 240 after extraction. In torsion groups, the left testis was rotated together with its cord elements,720° in a clockwise direction for the induction of an extravaginal TT model. The blood samples were obtained at min 30, 120, and 240 in the torsion groups. Bilateral testicular tissues were collected via orchiectomy for histopathological examination in all groups. RESULTS: The mean plasma T-FABP level in group III (torsion, min 240) was significantly higher than those of other groups. The T-FABP level at min 240 had a sensitivity and specificity of 100% and 85%, respectively, at a cut-off value of 1.059. A significant difference was found between the torsion groups and the control group with regard to histopathological scores. CONCLUSIONS: The increased T-FABP levels in testicular ischemia seem to be correlated with testicular necrosis rather than acute ischemia.


OBJETIVO: Investigar el valor diagnostico de la proteína testicular acido graso (PTAG) en la isquemia testicular aguda y prolongada. MÉTODOS: El estudio involucró 28 ratas Wastar-Hannover varones prepuberales. Los animales fueron randomizados y divididos en 4 grupos: grupo torsión (grupo I; min 30; 7 ratas, grupo II; min 120; 7 ratas, grupo III; min 240; 7 ratas), grupo control (grupo IV; 7 ratas). En cada grupo, el testículo izquierdo fue separado del gubernáculo con disección, junto con la túnica vaginalis y el cordón espermático, y después fueron expuestos. En el grupo control, la extracción de sangre y tejido testicular izquierdo fueron recolectados a los 240 minutosde la extracción. En el grupo de torsión, el testículo izquierdo se rotó junto con los elementos del cordón espermático, 720 grados en la dirección de las agujas del reloj para la inducción de un modelo TT extravaginal. Las muestras de sangre fueron obtenidas a los 30 minutos, 120 y 240 minutos en los grupos torsión. Tejido testicular bilateral fue recogido vía orquiectomia para examen anatomopatológico en todos los grupos. RESULTADOS: El nivel medio de PTAG en el grupo III (torsión 240 min) fue significativamente superior a los demás grupos. El nivel de PTAG a los 240 minutos tuvo una sensibilidad y especificidad del 100% y 85%, respectivamente a un valor de corte de 1.059. Se encontró una diferencia significativa entre los grupos de torsión y control en relación a los "scores" anatomopatológicos. CONCLUSIONES: Los niveles elevados de PTAG en la isquemia testicular parecen correlacionados con la necrosis testicular más que con la isquemia aguda.


Asunto(s)
Torsión del Cordón Espermático , Testículo , Animales , Masculino , Ratas , Proteínas de Unión a Ácidos Grasos , Isquemia/diagnóstico , Ratas Wistar , Torsión del Cordón Espermático/diagnóstico
9.
Emerg Med Int ; 2020: 7925975, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32509350

RESUMEN

AIM: The aim of this study was to evaluate the diagnostic value of serum ischemia-modified albumin (IMA) levels in patients presenting to the emergency department with acute abdominal pain and its use in differentiating acute surgical abdomen. METHODS: This single-center prospective cross-sectional study included 334 adult patients who presented to the emergency department. These consisted of 194 patients (Group 1) with nontraumatic abdominal pain commencing in the preceding week, who were definitely diagnosed and either hospitalized in a specific department or planned for discharge, and a control group of 140 patients (Group 2). RESULTS: The mean IMA value of the patients diagnosed with acute appendicitis was statistically significantly higher than that of the control group. The mean IMA value of the patients diagnosed with acute appendicitis, ovarian pathologies, and gastritis-peptic ulcer was statistically significantly higher than that of the nonspecific abdominal pain group. CONCLUSION: Serum IMA levels can be used as a diagnostic marker in patients with acute appendicitis. Furthermore, serum IMA levels in patients presenting to the emergency department with abdominal pain may be indicative of patients requiring surgery or of complicated cases, particularly in terms of acute appendicitis and ovarian pathologies.

10.
Urol J ; 16(6): 567-571, 2019 12 24.
Artículo en Inglés | MEDLINE | ID: mdl-31119719

RESUMEN

PURPOSE: We aimed to investigate the potential early diagnostic value of ischemia modified albumin (IMA) and D-dimer in testicular torsion. MATERIAL AND METHODS: A total of 42 prepubertal Wistar-Hannover rats (26-30 days old, weighing 75-125 grams) were used in the study. They were randomly divided into 2 groups as torsion (21 rats) and control (21 rats). Both torsion and control groups were subdivided into three subgroups as 30th, 120th and 240th minutes. Intraperitoneal injection of 70 mg/kg ketamine (Ketalar, Pfizer, Istanbul, Turkey) plus 10 mg/kg of xylazine (Rompun, Bayer, Istanbul, Turkey) were used for general anesthesia. In the control group, scrotal incision was made and the left testis gently extracted. Then, intracardiac blood and testicular tissue were obtained at 30th, 120th and 240th minutes. In torsion group, testicular ischemia was achieved by rotating left testis 720° clockwise and maintained by fixing the testis. Blood and testicular samples were obtained at 30th, 120th and 240th minutes. All animals were sacrificed after completion of the study. RESULTS: There was a statistically significant difference between the IMA and D-dimer levels at 30th, 120th and 240th minutes of torsion group when compared with the control group (p = .001). When compared in terms of pathological changes at 30th, 120th and 240th minutes, significant difference was found for all 3 periods (p = 0.039, p = 0.014, p = 0.03, respectively). The D-dimer and IMA estimated torsion with reasonable accuracy [Area under the curve (AUC)= 0.771 (p = 0.003, 95% confidental interval: 0.620-0.922) and AUC = 0.706 (95% confidental interval: 0.549-0.863, p = 0.022), respectively. CONCLUSION: The elevated D-dimer and IMA serum levels observed in the experimental testicular torsion modelseem to have a potential role as a serum marker in the early diagnosis of testicular torsion.


Asunto(s)
Diagnóstico Precoz , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Albúmina Sérica Humana/metabolismo , Torsión del Cordón Espermático/diagnóstico , Cordón Espermático/patología , Animales , Biomarcadores/metabolismo , Modelos Animales de Enfermedad , Masculino , Ratas , Ratas Wistar , Torsión del Cordón Espermático/metabolismo
11.
J Paediatr Child Health ; 55(10): 1247-1250, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30723978

RESUMEN

AIM: The differential diagnosis of paediatric patients admitted to the emergency department presenting with acute abdominal pain may be difficult. This study aims to investigate the diagnostic value of ischaemia-modified albumin (IMA) in the differential diagnosis of acute abdominal pain in children and in distinguishing surgical from non-surgical cases. METHODS: The study was conducted with a total of 152 subjects who provided informed consent, including 112 patients admitted to the paediatric emergency department and paediatric surgical clinic and 40 healthy control subjects. Blood samples were collected after initial examination to determine IMA, white blood cell (WBC) and C-reactive protein (CRP) values. RESULTS: Mean IMA values of patients with acute appendicitis (AA), perforated appendicitis (PA) and non-specific abdominal pain were significantly higher compared to the control group. Mean IMA values of the AA and PA cases were also significantly higher compared to the group with non-specific abdominal pain. No significant difference was determined in mean IMA between the AA and PA groups. WBC and CRP levels of the AA and PA groups were significantly higher compared to the group with non-specific abdominal pain. CONCLUSION: Our study shows that IMA, together with WBC and CRP, may be a biomarker capable of assisting the differential diagnosis of acute abdominal pain in children and distinguishing surgical from non-surgical cases.


Asunto(s)
Dolor Abdominal/diagnóstico , Dolor Abdominal/fisiopatología , Enfermedad Aguda , Adolescente , Distribución por Edad , Biomarcadores/sangre , Proteína C-Reactiva , Niño , Preescolar , Estudios Transversales , Diagnóstico Diferencial , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Valor Predictivo de las Pruebas , Estudios Prospectivos , Albúmina Sérica Humana , Distribución por Sexo
12.
J Invest Surg ; 32(6): 507-514, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29469635

RESUMEN

Purpose/Aim: Acute mesenteric ischemia is a syndrome characterized by sudden onset abdominal pain followed by intestinal necrosis. Morbidity and mortality increase with delayed diagnosis. Even with the latest radiological diagnostic methods, early diagnosis and initiation of treatment can be delayed. Using an experimental model, here we aim to determine the relationship between the laboratory parameters used to detect acute mesenteric ischemia and the duration of irreversible ischemia. Materials and Methods: A total of 30 male Wistar albino rats were divided into five groups, all of which underwent general anesthesia: (i) Superior mesenteric artery (SMA) dissection with laparotomy was performed, and blood samples and intestinal segment samples were taken after 2 hr (Sham group); (ii) volvulus of one-third of the small intestines was performed manually by laparotomy, and blood samples and intestinal segment samples were taken after 2 hr (Volvulus group); (iii) SMA was ligated with laparotomy, and blood samples and intestinal segment samples were taken after 2 hr (SMA+ligated 2-hr group); (iv) SMA was ligated with laparotomy, and blood samples and intestinal segment samples were taken after 4 hr (SMA+ligated 4-hr group); and (v) SMA was ligated with laparotomy, and blood samples and intestinal segment samples were taken after 6 hr (SMA+ligated 6-hr group). Results: The mean lactate dehydrogenase (LDH) activities of the SMA+ligated 2-hr and SMA+ligated 6-hr groups were statistically higher than the control group (p = .004). Compared to the Sham and Volvulus groups, the mean lactate level of the SMA+ligated 6-hr group was significantly higher (p = .004). Compared to the Sham and Volvulus groups, the mean D-dimer levels of the SMA+ligated 4-hr and SMA+ligated 6-hr groups were significantly higher (p = .004 and .003, respectively). By histopathological evaluation, we found that pathological damage increased as the ischemia lengthened. Conclusions: Mesenteric ischemia leads to an irreversible loss of intestinal perfusion and an increase in parameters of ischemia. Irreversible tissue damage occurs after 4 hr of ischemia and peaks after 6 hr, whereas parameters of ischemia (D-dimer, LDH, and L-Lactate levels) are highest at 2 hr after the onset of ischemia.


Asunto(s)
Productos de Degradación de Fibrina-Fibrinógeno/análisis , Vólvulo Intestinal/complicaciones , L-Lactato Deshidrogenasa/sangre , Isquemia Mesentérica/diagnóstico , Tiempo de Tratamiento , Enfermedad Aguda/terapia , Animales , Biomarcadores/sangre , Modelos Animales de Enfermedad , Humanos , Vólvulo Intestinal/sangre , Vólvulo Intestinal/cirugía , Intestinos/irrigación sanguínea , Intestinos/cirugía , Masculino , Arteria Mesentérica Superior/cirugía , Isquemia Mesentérica/sangre , Isquemia Mesentérica/etiología , Isquemia Mesentérica/cirugía , Ratas , Factores de Tiempo
13.
Ulus Travma Acil Cerrahi Derg ; 24(6): 539-544, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30516253

RESUMEN

BACKGROUND: The aim of this study was to investigate the prognostic value of irisin by examining the serum level of this smooth muscle protein in patients presenting at the emergency department (ED) with acute abdominal pain. METHODS: This research was performed as a single-center, prospective, cross-sectional study. In all, 213 adult patients presenting at the ED with acute abdominal pain and 140 healthy controls were enrolled. The serum irisin level was correlated with the leukocyte, C-reactive protein, amylase, and creatine kinase values. The irisin level was compared between groups of those who were admitted or discharged, and those who received surgical or medical treatment. RESULTS: The mean irisin level of the 213 patients and the 140 controls was 6.81±3.17 mcg/mL vs. 5.69±2.08 mcg/mL. The mean irisin value of the hospitalized patients (7.98±3.11 mcg/mL) was significantly higher than that of the discharged patient group (6.38±3.09 mcg/mL) and the controls (control vs. discharged: p=0.202; control vs. hospitalized: p<0.001; discharged vs. hospitalized: p=0.001). When compared with that of the control group, the irisin level was significantly higher in patients with gall bladder diseases, urolithiasis, and acute appendicitis (p=0.001, p=0.007, p=0.007). CONCLUSION: The serum irisin level in patients with abdominal pain may serve as a guide in diagnostic decision-making and determining the prognosis for cases of acute abdominal pain involving luminal obstruction in tubular intra abdominal organs.


Asunto(s)
Abdomen Agudo/diagnóstico , Fibronectinas/sangre , Abdomen Agudo/sangre , Abdomen Agudo/epidemiología , Apendicitis , Estudios Transversales , Humanos , Pronóstico , Estudios Prospectivos
14.
Emerg Med Int ; 2018: 3296535, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30345115

RESUMEN

OBJECTIVES: Diagnosis of pediatric patients presenting to the Emergency Department with acute abdominal pain is not always easy. The purpose of this study was to investigate the effectiveness of irisin, a peptide hormone with reactivity shown in the appendix and neutrophils, in the differential diagnosis of pediatric patients with acute abdominal pain. METHODS: 162 subjects consenting to participate, including 112 patients presenting to the Pediatric Emergency and Pediatric Surgery clinics with acute abdominal pain and 50 controls, were enrolled in the study. Blood was collected from all patients following initial examination for irisin, WBC, and CRP investigation. RESULTS: Mean irisin levels in cases of acute appendicitis (AA) and perforated appendicitis (PA) were statistically significantly higher compared to nonspecific abdominal pains and the control group. No statistically significant difference was observed in irisin levels between AA and PA cases. WBC and CRP levels were also significantly higher in cases of AA and PA compared to nonspecific abdominal pains. CONCLUSIONS: Differential diagnosis of acute abdominal pains in children and deciding on surgery are a difficult and complex process. Our study shows that irisin can be a useful biomarker in differentiating AA and PA from other acute abdominal pains in children.

15.
Biomed Res Int ; 2016: 6508619, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27274988

RESUMEN

Background. Acute appendicitis (AA) associated with acute phase reaction is the most prevalent disease which requires emergency surgery. Its delayed diagnosis and unnecessarily performed appendectomies lead to numerous complications. In our study, we aimed to detect the role of WBC and CRP in the exclusion of acute and complicated appendicitis and diagnostic accuracy in pediatric age group. Methods. Appendectomized patient groups were constructed based on the results of histological evaluation. The area under a receiver operating characteristic (ROC) curve (AUC) was performed to examine diagnostic accuracy. Results. When WBC and CRP were used in combination, based on cut-off values of ≥13.1 × 10(3)/µL for WBC counts and ≥1.17 mg/dL for CRP level, diagnostic parameters were as follows: sensitivity, 98.7%; specificity, 71.3%; PPV, 50.6%; NPV, 99.5%; diagnostic accuracy, 77.6%; LR(+), 3.44; LR(-), 0.017. AUC values were 0.845 (95% CI 0.800-0.891) for WBC and 0.887 (95% CI 0.841-0.932) for CRP. Conclusions. For complicated appendicitis, CRP has the highest degree of diagnostic accuracy. The diagnosis of appendicitis should be made primarily based on clinical examination, and obviously more specific and systemic inflammatory markers are needed. Combined use of cut-off values of WBC (≥13100/µL) and CRP (≥1.17 mg/L) yields a higher sensitivity and NPV for the diagnosis of complicated appendicitis.


Asunto(s)
Apendicitis/sangre , Apendicitis/diagnóstico , Proteína C-Reactiva/metabolismo , Recuento de Leucocitos , Dolor Abdominal/diagnóstico , Enfermedad Aguda , Adolescente , Área Bajo la Curva , Niño , Femenino , Humanos , Leucocitos , Masculino , Valor Predictivo de las Pruebas , Curva ROC , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad
16.
Ulus Cerrahi Derg ; 31(1): 44-6, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25931945

RESUMEN

Neonatal colonic perforation is a rarely seen condition. Plain abdominal radiography of a 28-hour newborn consulted for vomiting and bloody stool revealed the presence of subdiaphragmatic free air, which necessitated surgical exploration. Transverse colonic perforation was detected during the exploration, and subsequently, a colostomy and appendectomy were performed. The postoperative follow-up period was uneventful. Necrotizing enterocolitis, Hirschsprung disease, and mechanical obstruction are some of the causes of colonic perforation during the neonatal period. Herein, we have shared a case of colonic perforation in an asphyctic newborn delivered after prolonged labor.

17.
J Pediatr Surg ; 50(6): 1067-71, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25783339

RESUMEN

BACKGROUND AND PURPOSE: In our study, we investigated the effects of methylene blue (MB) on histopathological changes in renal ischemia/reperfusion (I/R) injury rat model. MATERIAL AND METHODS: Twenty-one Sprague-Dawley male rats were divided equally into three groups. Group 1 (control) was administered intraperitoneal saline solution. In Groups 2 (untreated group) and 3 (MB treatment), the renal arteries were clamped, and ischemia (for 1 hour) and then reperfusion (for 4 hours) were applied. Thirty minutes before ischemia, the untreated group received physiological saline, whereas the treatment group was administered 30 mg/kg MB through an intraperitoneal route. Blood samples were drawn, and renal specimens were harvested 5.5 hours after physiologic saline injection in the control and immediately after the reperfusion period in the other groups. The levels of tissue superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), total oxidant status (TOS), total antioxidant status (TAS), plasma urea, creatinine and ischemia modified albumin (IMA) were measured. Moreover, the histopathological damage score of the renal tissue was determined. RESULTS: MB significantly alleviated the severity of histopathological damage by increasing the levels of tissue SOD and TAS and decreasing TOS concentrations in the renal I/R model (p<0.05). CONCLUSION: Administration of MB in renal I/R damage may play a protective role.


Asunto(s)
Enfermedades Renales/tratamiento farmacológico , Azul de Metileno/farmacología , Daño por Reperfusión/tratamiento farmacológico , Animales , Biomarcadores , Modelos Animales de Enfermedad , Inhibidores Enzimáticos/farmacología , Riñón/patología , Enfermedades Renales/etiología , Enfermedades Renales/patología , Masculino , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/complicaciones , Daño por Reperfusión/patología , Albúmina Sérica , Albúmina Sérica Humana
18.
Pediatr Surg Int ; 31(2): 155-61, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25503581

RESUMEN

OBJECTIVE: To investigate the effects of probiotics on bacterial translocation in the obstructive common bile duct with comparison to an enteral product containing arginine and glutamine. MATERIAL AND METHOD: In our study, 40 Sprague-Dawley rats each weighing 250-300 g were used. Animals in Group 1 (sham) were laparatomized and fed standard chow supplemented with physiologic saline at daily doses of 2 ml through orogastric tube for 7 days. Common bile ducts of the animals in the other groups were ligated with 3/0 silk sutures. Group 2 (control group) was fed standard chow supplemented with daily doses of 2 ml physiologic saline. Group 3 (probiotic group) was fed standard chow supplemented with a probiotic solution (Acidophilus plus) containing strains of Lactobacillus acidophilus, Bifidobacterium bifidum and Lactobacillus bulgaricus at a daily doses of 2 × 10(9) colony forming units (CFU). Group 4 (formula group) was fed only an enteral solution (Stresson Multi Fiber) containing glutamine, arginine and a medium-chain fatty acid at daily doses of 2 g/kg. At the end of the 7th day, all animals were relaparatomized, and to determine bacterial translocation, aerobic, and anaerobic cultures were obtained from the specimens of mesenteric lymph nodes, intestinal mucosa, and blood samples. Smear cultures prepared from caecum were examined to determine the number of CFU. Finally, for histological examination specimens were excised from terminal ileum, and oxidative damage was assessed in liver tissues. Afterwards all animals were killed. RESULTS: Moderately lesser degrees of bacterial translocation, and mucosal damage were seen in Groups 3, and 4 relative to Group 2 (p < 0.05). In Group 4, any difference was not seen in the number of cecal bacteria relative to baseline values, while in Group 3, significant decrease in cecal colonization was seen. Among all groups, a significant difference between levels of malondialdehyde, and glutathione was not observed. CONCLUSION: At the end of our study, we have concluded that both probiotics, and enteral diets which contain immunomodulators such as glutamine, and arginine alleviate bacterial translocation, and impairment of intestinal mucosa.


Asunto(s)
Aminoácidos Básicos/administración & dosificación , Traslocación Bacteriana/fisiología , Colestasis Extrahepática/fisiopatología , Conducto Colédoco , Nutrición Enteral , Probióticos/administración & dosificación , Animales , Arginina/administración & dosificación , Suplementos Dietéticos , Glutamina/administración & dosificación , Mucosa Intestinal/microbiología , Ganglios Linfáticos/microbiología , Mesenterio , Ratas , Ratas Sprague-Dawley
19.
Am J Case Rep ; 15: 4-6, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24427377

RESUMEN

PATIENT: Female, 16 FINAL DIAGNOSIS: Ovarian cyst Symptoms: - MEDICATION: - Clinical Procedure: Laparoscopic surgery Specialty: Surgery. OBJECTIVE: Rare disease. BACKGROUND: The use of the laparoscopic approach versus open approach for the management of giant ovarian cysts is controversial. Exclusion of malignant conditions has critical importance in the laparoscopic management of these cases. However, in some cases, the possibility of malignancy and the ovarian origin of a cyst cannot be excluded during the preoperative period. CASE REPORT: Herein we present the case of a 16-year-old girl with a giant ovarian cyst. The abdominal cavity was laparoscopically explored, and no signs suggestive of malignancy were encountered; the ovarian origin of the cyst was confirmed. A Veress needle was inserted percutaneously, and the cyst was drained and laparoscopically excised. No complications were encountered at follow-up visits 3 and 6 months after surgery. CONCLUSIONS: In addition to the well-known advantages of laparoscopic surgery (e.g., decreased postoperative pain, length of hospital stay, and wound infection), perfect cosmetic results are particularly important for young women. The pure laparoscopic management of giant ovarian cysts is safe and feasible.

20.
Eur J Pediatr Surg ; 24(5): 403-9, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23918668

RESUMEN

INTRODUCTION: The aim of this study was to investigate the effects of dimethyl sulfoxide (DMSO) on stricture formation in corrosive esophageal burns. MATERIALS AND METHODS: A total of 21 male rats were divided equally into three groups. In Group 1 (burn) and Group 2 (burn + DMSO) burns were induced in the distal esophagi with a 30% NaOH solution. In Group 3 (control), a saline solution was applied to the esophageal lumen. In Group 2, DMSO was administered intraperitoneally (3 mg/kg) 15 minutes after the burn was induced and then every 24 hours for 7 days. All rats were humanely killed at the end of Day 22. Distal esophagi were harvested for analysis. The stenosis index (SI) and histopathologic damage score were evaluated in addition to malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), tumor necrosis factor alpha (TNF-α), and interleukin-6 (IL-6) levels. RESULTS: DMSO significantly decreased the levels of MDA, NO, TNF-α, and IL-6 in the rats with burned esophagi. Furthermore, the SI and histopathologic scores decreased significantly in the burn + DMSO group relative to the burn group (p < 0.05). CONCLUSIONS: Our results suggest that DMSO can decrease the occurrence of stricture formation and could represent a beneficial alternative therapy for the treatment of corrosive esophagitis.


Asunto(s)
Antioxidantes/uso terapéutico , Quemaduras Químicas/complicaciones , Dimetilsulfóxido/uso terapéutico , Estenosis Esofágica/prevención & control , Esófago/lesiones , Animales , Quemaduras Químicas/patología , Estenosis Esofágica/etiología , Estenosis Esofágica/patología , Esófago/metabolismo , Esófago/patología , Interleucina-6/metabolismo , Masculino , Malondialdehído/metabolismo , Óxido Nítrico/metabolismo , Peroxidasa/metabolismo , Ratas Sprague-Dawley , Factor de Necrosis Tumoral alfa/metabolismo
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