First electrochemical investigation and determination of non-steroidal anti-inflammatory drug etofenamate using disposable pencil graphite electrode with voltammetric techniques.

In this study, the electrochemical properties of etofenamate, an active ingredient belonging to the non-steroidal anti-inflammatory drug group, were investigated using cyclic voltammetry (CV) and square wave voltammetry (SW) techniques on a disposable pencil graphite electrode (PGE). With the CV technique, reversible voltammetric waves of around +0.470 V and irreversible voltammetric waves of around +1.02 V were produced on the PGE. An environmentally friendly, selective and highly sensitive SW voltammetric method was developed using disposable PGE. This voltammetric method gave very good analytical working range on PGE in PBS (pH = 3.0) medium at concentrations ranging from 0.017 µM to 0.306 µM. The LOD value of this analytical method in PBS (pH = 3.0) medium was calculated as 0.0011 µM (0.406 µg L-1). The developed voltammetric method was successfully applied to urine and drug samples. The results of the voltammetric method were compared with the results of the spectrophotometric method. The results were found to be compatible with each other.

Evaluation of the auditory findings of patients with obstructive sleep apnea syndrome.

OBJECTIVES: To investigate the effects of hypoxia occurring in patients with Obstructive Sleep Apnea Syndrome (OSAS) on Auditory evoked late latency, Auditory brainstem response, and the contralateral suppression of otoacoustic emissions. MATERIALS AND METHODS: 46 patients diagnosed with OSAS were divided into groups as moderate and severe based on their Apnea Hipopnea Index (AHI) values. The control group consisted of 22 healthy individuals. All participants underwent an Auditory Brainstem Response (ABR) test, Auditory Evoked Late Latency Response (LLR), and Contralateral Suppression Otoacoustic Emission (CS-OAE). FINDINGS: There was no statistical difference between the OSAS group and the control group regarding P1 latency, N1 latency, and P1 and N1 wave amplitude (p > 0.05). In ABR, statistically significant differences were found between the control, moderate OSAS, and severe OSAS groups in wave I in the right and left ear (p < 0.05). In the analyses performed for the otoacoustic emission frequencies with and without contralateral suppression of the right and left ear, suppression was not observed at some frequencies, and this was regarded as statistically significant (p < 0.05). CONCLUSION: It is considered that OSAS does not have cortical effects but impacts the brainstem region and the cochlea. Bilateral impact, especially observed in wave I of ABR, is prominent on the auditory nerve. Considering that the medial olivo-cochlear (MOC) system is affected in patients with OSAS, it is thought that these patients are inadequate in suppressing noise, and this may cause various problems, particularly the inability to distinguish speech in noisy environments.

Investigation of the electrochemical properties of edoxaban using glassy carbon and boron-doped diamond electrodes and development of an eco-friendly and cost effective voltammetric method for its determination.

In this study, the highly risky drug Edoxaban (EDX), which can threaten life and cause bleeding, was electro analytically evaluated. The electrochemical behavior of EDX was investigated using glassy carbon electrode (GCE) and boron-doped diamond electrode (BDDE). In this study, for the first time, a simple, rapid, sensitive, and selective voltammetric technique was developed by using different electrodes for the electrochemical characterization and detection of EDX. The optimized voltammetric technique showed anodic signals of EDX at +1.09 V and +1.08 V on GCE and BDDE, respectively, in BR (pH 5.0) solution. The developed voltammetric method provided a very good analytical working range for EDX in BR (pH 5.0) solution on GCE and BDDE, covering concentration ranges from 1.84 µM to 12.88 µM and from 3.68 µM to 14.72 µM, respectively. The limits of detection for EDX on GCE and BDDE under these experimental conditions were calculated as 0.24 µM and 0.57 µM, respectively. The developed voltammetric methods on both electrodes were successfully applied to urine and tablet samples. Additionally, the obtained voltammetric results were compared with UV-Vis spectroscopy results.

96th-hour impact of scalding burns on end organ damage, systemic oxidative stress, and wound healing in rats treated with three different types of dressings.

In this study, we investigated the effects of three different burn dressing treatments, including experimental, silver, and modern dressing materials, on systemic oxidative stress in rats with severe scald burns within the first 96 h. The rats were divided into five groups: a burn group (n = 10), a polylactic membrane (PLM) group (n = 10), a silver sulfadiazine (SSD) group (n = 10), a curcumin group (n = 10), and a control group (n = 10), consisting of equal numbers of female and male rats. In the first four groups, 30% of the rats' total body surface area was scalded at 95°C. The burn group was not treated. Each group was treated with group-name dressing material. The control group was neither treated nor burned. The rats were sacrificed, and blood and tissue samples were obtained at the 96th hour when severe effects of oxidative stress developed postburns. Systemic inflammatory biomarkers and oxidative stress parameters were examined. In addition, apoptosis and organ damage in liver, kidney, lung, and skin tissues were evaluated biochemically and histopathologically. When the parameters were statistically analyzed, we found that systemic levels of oxidative stress and inflammatory damage to liver, kidney, and lung tissues were lower in the three treated groups than in the burn group. We believe that the dressing material's efficacy in the treatment of severe burns may be dependent on its ability to combat oxidative stress and inflammation.

Electrochemical evaluation of nivolumab used in cancer treatment with differential pulse voltammetry: A novel approach with single-use pencil graphite electrode.

OBJECTIVES: Nivolumab is used in a treatment called immunotherapy, which helps the immune system cells to attack cancer cells. The electrochemical properties and quantification of this drug were performed using single-use pencil tips. EVIDENCE ACQUISITION: Here, a selective voltammetric method for the determination and electrochemical characterization of Nivolumab used in cancer therapy was developed for the first time using a disposable pencil electrode by cyclic voltammetry and differential pulse voltammetry techniques. Nivolumab exhibited an anodic signal at +0.879 V (vs. Ag/AgCl) in PBS (pH 3.0, 0.02 M NaCl) medium. RESULTS: This procedure showed a linear response in phosphate buffer solutions (pH 3.0, 0.02 M NaCl) media within the concentration range of 0.01 mg mL-1 to 0.07 mg mL-1 and limit of detection and the limit of quantification values were determined to be 2.49 µg mL-1 and 8.30 µg mL-1, respectively. CONCLUSIONS: The developed method offers an important analytical approach for the detection and characterization of NIVO. Precisely measuring and monitoring the levels of such drugs in real sample analyses or biological samples is critical for evaluating response to treatment, optimizing treatment strategies. Therefore, the method was applied to real sample analyses. Voltammetric results developed using PG electrode were compared with UV-Vis results. It has been determined that the results obtained are compatible with each other.

Firstly electrochemical investigetions and determination of anticoagulant drug edoxaban at single-use pencil graphite electrode: an eco-friendly and cost effective voltammetric method.

OBJECTIVES: The anticoagulant drug edoxaban has a blood thinning mechanism of action. In this study, a pencil graphite electrode was electrochemically activated at + 1.4 V for 60 s. in a Britton-Robinson (pH 9.0) supporting electrolyte solution. EVIDENCE ACQUISITION: A simple, fast, and sensitive electrochemical procedure was developed using cyclic voltammetry and square wave voltammetry techniques. It was observed that edoxaban gave a good oxidation signal with cyclic voltammetry technique at a potential of + 0.98 V (vs. Ag/AgCl). RESULTS: This procedure showed a linear response in a Britton-Robinson (pH 9.0) media within the concentration range of 0.2-1.8 µM and limit of detection (LOD) and the limit of quantification (LOQ) values were determined to be 0.073 µM (0.133 µg mL-1) and 0.243 µM (0.443 µg mL-1), respectively. CONCLUSION: The method developed in this study was successfully applied to drug and urine samples. The developed voltammetric method was highly selective and gave satisfactory recovery results in urine and pharmaceutical samples. The results of the voltammetric method were compared with the spectroscopic method and it was determined that the results were compatible.

Protective Effect of Vaccinium myrtillus Extract on X-ray Irradiation-Induced Retinal Toxicity via eNOS and 8-OHdGexpression.

Every year, hundreds of thousands of cancer patients receive radiotherapy treatment. Oxidative stress is observed in healthy tissues due to irradiation exposure. The present study is the first to address the effects of Vaccinium myrtillus (whortleberry, WB) against the effects of x-ray irradiation on retinal tissue. Twenty-four Sprague-Dawley rats were randomly allocated into 4 groups: (1) control group: rats without any treatment, (2) x-ray irradiation group: 8 Gray (Gy) RT for 2 days, (3) 100 mg WB extract + x-ray irradiation group: 8 Gy irradiation for 2 days and followed by intraperitoneal (IP) WB extract (100 mg/kg) supplementation for 10 days, (4) 200 mg WB extract + x-ray irradiation group: 8 Gy irradiation for 2 days and followed by intraperitoneal (IP) WB extract (200 mg/kg) supplementation for 10 days. Eyes were enucleated on the 10th day after RT for histopathological, immunohistochemical (8-hydroxy deoxyguanosine (8-OHdG), endothelial nitric oxide synthase (eNOS), and biochemical analyses (glutathione peroxidase (GSH), and malondialdehyde (MDA). The GSH levels significantly decreased and MDA levels and 8-OHdG staining increased after x-ray irradiation compared to the control group. Combined x-ray irradiation +WB treatment significantly increased GSH levels and significantly decreased MDA production and 8-OHdG staining. However, eNOS staining was not affected in any of the groups. Besides, x-ray irradiation significantly increased cell losses and edematous areas. The WB significantly reversed the cellular damage in ganglion cells, inner nuclear, and outer nuclear layers in quantitative analyses. The x-ray irradiation caused significant retinal impairment, and additional WB therapy provided protective effects against radiation-induced retinopathy. These results may suggest WB extract as an adjuvant therapy to reverse retinal impairments after x-ray irradiation.

Voltammetric studies and spectroscopic investigations of the interaction of an anticancer drug bevacizumab-DNA and analytical applications of disposable pencil graphite sensor.

A sensitive, simple, fast electrochemical biosensor for the DNA interaction of bevacizumab (BEVA), which is used as a targeted drug in cancer treatment, was developed using the differential pulse voltammetry (DPV) technique with pencil graphite electrode (PGE). In the work, PGE was electrochemically activated in a supporting electrolyte medium of +1.4 V/60 s (PBS pH 3.0). Surface characterization of PGE was carried out by SEM, EDX, EIS, and CV techniques. Determination and electrochemical properties of BEVA were examined with CV and DPV techniques. BEVA gave a distinct analytical signal on the PGE surface at a potential of +0.90 V (vs. Ag/AgCl). In the procedure proposed in this study, BEVA gave a linear response on PGE in PBS (pH 3.0 containing 0.02 M NaCl) (0.1 mg mL-1 - 0.7 mg mL-1) with LOD and LOQ values of 0.026 mg mL-1 and 0.086 µg mL-1, respectively. BEVA was reacted with 20 µg mL-1 DNA in PBS for 150 s and analytical peak signals for adenine and guanine bases were evaluated. The interaction between BEVA-DNA was supported by UV-Vis. Absorption spectrometry and the binding constant was determined as 7.3 × 104.

Reasons for parental hesitancy or refusal of childhood vaccination in Türkiye.

Background: Although vaccines play a critical role in the control of infectious diseases and disease outbreaks, vaccination rates have been declining in recent years because of vaccine hesitancy or refusal. Aims: We aimed to determine the rates and reasons for parental hesitancy or refusal of vaccination for their children in Türkiye. Method: A total of 1100 participants selected from 26 regions of Türkiye were involved in this cross-sectional study conducted between July 2020 and April 2021. Using a questionnaire, we collected data on the sociodemographic characteristics of parents, the status of vaccine hesitancy or refusal for their children, and reasons for the hesitancy or refusal. Using Excel and SPSS version 22.0, we analysed the data with chi-square test, Fisher's exact test and binomial logistic regression. Results: Only 9.4% of the participants were male and 29.5% were aged 33-37 years. Just over 11% said they were worried about childhood vaccination, mainly because of the chemicals used in manufacturing the vaccines. The level of concern was greater among those who got information about vaccines from the internet, family members, friends, TV, radio, and newspapers. Those who used complementary health services were considerably more hesitant about vaccination than those who used mainstream services. Conclusions: Parents in Türkiye have several reasons for hesitating or refusing to vaccinate their children, key among which are concerns about the chemical composition of the vaccines and their ability to trigger negative health conditions such as autism. This study used a large sample size across Türkiye, although there were differences by region, the findings would be useful in designing interventions to counter vaccine hesitancy or refusal in the country.

Molsidomine decreases hyperoxia-induced lung injury in neonatal rats.

BACKGROUND: The study's objective is to evaluate if Molsidomine (MOL), an anti-oxidant, anti-inflammatory, and anti-apoptotic drug, is effective in treating hyperoxic lung injury (HLI). METHODS: The study consisted of four groups of neonatal rats characterized as the Control, Control+MOL, HLI, HLI + MOL groups. Near the end of the study, the lung tissue of the rats were evaluated with respect to apoptosis, histopathological damage, anti-oxidant and oxidant capacity as well as degree of inflammation. RESULTS: Compared to the HLI group, malondialdehyde and total oxidant status levels in lung tissue were notably reduced in the HLI + MOL group. Furthermore, mean superoxide dismutase, glutathione peroxidase, and glutathione activities/levels in lung tissue were significantly higher in the HLI + MOL group as compared to the HLI group. Tumor necrosis factor-α and interleukin-1ß elevations associated with hyperoxia were significantly reduced following MOL treatment. Median histopathological damage and mean alveolar macrophage numbers were found to be higher in the HLI and HLI + MOL groups when compared to the Control and Control+MOL groups. Both values were increased in the HLI group when compared to the HLI + MOL group. CONCLUSIONS: Our research is the first to demonstrate that bronchopulmonary dysplasia may be prevented through the protective characteristics of MOL, an anti-inflammatory, anti-oxidant, and anti-apoptotic drug. IMPACT: Molsidomine prophylaxis significantly decreased the level of oxidative stress markers. Molsidomine administration restored the activities of antioxidant enzymes. Molsidomine prophylaxis significantly reduced the levels of inflammatory cytokines. Molsidomine may provide a new and promising therapy for BPD in the future. Molsidomine prophylaxis decreased lung damage and macrophage infiltration in the tissue.

Investigation of Serum Interleukin 6, High-Sensitivity C-Reactive Protein and White Blood Cell Levels during the Diagnosis and Treatment of Paediatric Appendicitis Patients Before and during the COVID-19 Pandemic.

Introduction: In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. Materials and Methods: A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared. Results: WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group. Conclusions: Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively.

Can combined use of tumor markers in pancreatic cancer be a solution to short- and long-term consequences?: A retrospective study.

As in other types of cancer, tumor markers are used in pancreatic ductal adenocarcinoma (PDAC) for disease follow-up, especially after surgery. There has been shown to be a significant correlation between the tumor marker levels and poor prognosis in locally or systemic advanced stage PDAC patients. However, there is no significant correlation between prognosis and marker levels in patients with early stage PDAC patients. This study aimed to examine the effect of the carbohydrate antigen 19-9 (Ca19-9)/carcinoembryogenic antigen (CEA) ratio in ductal adenocarcinoma of the pancreatic head on disease prognosis and mean survival. This retrospective study was conducted with 129 pancreatic head adenocarcinoma patients who were treated with whipple procedure at the Ankara University Surgical Oncology Clinic between 2010 and 2020. All patients' demographics, stage of the disease, CEA, CA 19-9 levels, and CEA/Ca 19-9 ratio were enrolled and compared statistically. A new cutoff value was calculated for the Ca19-9/CEA ratio. A Ca19-9/CEA ratio >29.77 showed 69.9% sensitivity and 70.9% specificity for the probability of the T3 and T4 stages. The cutoff value for the Ca19-9/CEA ratio was 27.18. This cutoff value had a sensitivity of 79.4% and a specificity of 80.3% for lymph node metastasis. Patients with a Ca19-9/CEA ratio below the cutoff value of 28.475 had a mean survival of 93.161 months and those with a value higher than the cutoff value had a mean survival of 28.541 months (P < .001). A simple combination of tumor markers was determined to have higher accuracy rates in predicting tumor prognosis and in determining mean survival, which are particularly needed in early stage cancers.

A novel, easier and safer alternative method for oesophagojejunal reconstruction after totally laparoscopic total gastrectomy.

BACKGROUND: This study presents a novel laparoscopic modified overlapping oesophagojejunostomy anastomosis method which consists of self-pulling and latter transection to perform a safer anastomosis, describes the anastomosis technique in detail and reveals its short-term outcomes. METHODS: Forty-five patients underwent totally laparoscopic total gastrectomy using the self-pulling and oesophagus latter-cut overlap method anastomosis for gastric cancer from January 2019-2022. During the self-pulling phase, the oesophagus was ligated at the level of the gastroesophageal junction or above and dragged down by a ligature rope to mobilise up to 5-6 cm. An entry hole was created on the right side of the oesophagus, and a nasogastric tube was taken out through the hole and tip of the tube was used as a guide for the endoscopic linear stapler to decrease the risk of entering the false lumen and creating a side-to-side anastomosis. The oesophagus was then latter-transected by a second endoscopic linear stapler. The common entry hole was closed using a hand-sewing method. Clinicopathological characteristics and surgical outcomes were collected and retrospectively evaluated. RESULTS: The mean anastomosis duration was 27 min. The morbidity rate was 4.4%. Only two patients experienced postoperative complications but subsequently recovered conservatively. None of the patients suffered anastomotic leak or stricture. CONCLUSIONS: Self-pulling and latter transection-based overlapping anastomosis is a simple and reliable approach that overcomes most of the limitations of standard overlap method and provides satisfactory surgical outcomes.

Successful localization of abnormal parathyroid tissue with ultrasound-guided methylene blue dye injection before surgery for metastatic or recurrent thyroid cancers and parathyroid adenomas.

OBJECTIVES: A surgery to be performed on a previously operated neck includes difficulties such as increased risk of complications and prolonged operation time. The aim of the present study is to analyze the benefit of pre-anesthetic ultrasound-guided injection of methylene blue into parathyroid adenomas and abnormal lymph nodes to simplify their safe and satisfactory extraction. METHODS: We analyzed the case series records of 14 patients who were operated for reoperative neck surgery due to recurrent thyroid cancer (8 patients) and parathyroid adenoma (6 patients) and in the technique; 0.2 ml of a 1:5 dilution of 1 % methylene blue solution was injected directly onto the target during real-time ultrasound guidance before the operating room. RESULTS: In adenomas, ultrasound-guided methylene blue injection was successfully applied in all cases, an average of 33.1 min before entering the operating room (range = 28-38 min). There were no complications related to dye injection. For patients with recurrent thyroid tumors, preoperative ultrasound-guided methylene blue injection was successfully applied in all patients, on average 27.5 min before entering the operating room (range = 20-35 min). No complications occurred due to dye injection. The blue stained lesion was easily identified during surgery. CONCLUSIONS: We analyzed the feasibility of the injection process, the certainty of defining pathological lymph nodes, and the complications of the procedure. Preoperative administration of methylene blue preserved its intraoperative efficacy and maintained the easy the detection of reoperative or primary pathologies. The present study suggest that methylene blue dye injection is a safe, sufficient, and quietly effective method for identifying recurrent tumors and parathyroid adenomas in scarred reoperative neck surgeries. Our cases had comparatively short operative times and lower complication rates.

The relationship between thiol-disulfide balance and idiopathic sudden sensorineural hearing loss / Relação entre equilíbrio tiol-dissulfeto e perda auditiva neurossensorial súbita idiopática

Abstract Introduction: Impaired cochlear perfusion is a major etiological factor in idiopathic sudden sensorineural hearing loss. Oxidative stress has been shown to be a risk factor for oxidative damage. Objectives: We investigated the role of oxidative stress in idiopathic sudden sensorineural hearing loss by comparing serum levels of oxidant and antioxidant molecules including thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin and myeloperoxidase in patients who did and did not recover after treatment. Methods: The amount of dynamic disulfide was calculated by determining half of the difference between the total thiols and native thiols. After the determination of native, total thiol, and disulfide amounts, the disulfide/total thiol percent ratio, native thiol/total thiol ratio and disulfide/native thiol percent ratio were calculated and then compared between the two groups. Additionally, clinical relationship between audiological recovery and native thiol, disulfide, disulfide/native thiol percent ratio, and disulfide/total thiol percent ratio levels was investigated. Blood samples were also analyzed for the assessment of thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels. Results: A significant difference was found between the two groups with regard to total oxidant status disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio, and native thiol/total thiol ratio levels (p = 0.001, p = 0.001, p = 0.001, p = 0.003, p = 0.001, p = 0.002, respectively). However, no significant difference was found between the two groups with regard to thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, ceruloplasmin, and myeloperoxidase levels (p > 0.05 for all). Conclusion: The results supported the common hypothesis that vascular pathologies are the primary cause of idiopathic sudden sensorineural hearing loss and that other etiological factors ultimately result in vascular pathologies. The oxidant-antioxidant and thiol-disulfide balances were impaired in the idiopathic sudden sensorineural hearing loss group.

Resumo Introdução: A perfusão coclear prejudicada é um fator etiológico importante na perda auditiva neurossensorial súbita idiopática (PANSSI). O estresse oxidativo mostrou ser um fator de risco para danos oxidativos. Objetivos: Investigamos o papel do estresse oxidativo na PANSSI mediante a comparação dos níveis séricos de moléculas oxidantes e antioxidantes, inclusive homeostase de tiol/dissulfeto, paraoxonase, paraoxonase estimulada, arilesterase, ceruloplasmina e mieloperoxidase em pacientes com e sem recuperação após o tratamento. Método: A quantidade de dissulfeto dinâmico foi calculada mediante a determinação de metade da diferença entre os tiois totais e os tiois nativos. Após a determinação das quantidades de tiol nativo, tiol total e dissulfeto, as razões percentuais de dissulfeto/tiol total, tiol nativo/tioltotal e dissulfeto/tiol nativo foram calculadas e depois comparadas entre os dois grupos. Além disso, a relação clínica entre a recuperação audiológica e os níveis de tiol nativo, tiol nativo/tiol total, dissulfeto, dissulfeto/tiol nativo e dissulfeto/tiol total foi investigada. Amostras de sangue também foram analisadas para avaliar os níveis de paraoxonase, paraoxonase estimulada, arilesterase, ceruloplasmina e mieloperoxidase. Resultados: Uma diferença significante foi encontrada entre os dois grupos em relação ao estado oxidante total e aos níveis de dissulfeto, dissulfeto/tiol nativo, dissulfeto/tiol total, tiol nativo/tiol total (p = 0,001, p = 0,001, p = 0,001, p = 0,003, p = 0,001, p = 0,002, respectivamente). Porém, não foi encontrada diferença significante entre os dois grupos em relação aos níveis de paraoxonase, paraoxonase estimulada, ceruloplasmina e mieloperoxidade (p> 0,05 para todos). Conclusão: Os resultados apoiaram a hipótese comum de que as doenças vasculares são a principal causa de PANSSI e que, em última análise, outros fatores etiológicos resultam em doenças vasculares. Os equilíbrios de oxidante-antioxidante e tiol-dissulfeto estavam prejudicados no grupo PANSSI.

Therapeutic plasma exchange in gastric signet ring cell carcinoma presenting as microangiopathic hemolytic anemia: A rare case report.

Microangiopathic hemolytic anemia (MAHA) defines a group of disorders characterized by the formation of microthrombi in capillaries and arterioles and the fragmentation of erythrocytes that pass through. Cancer-related MAHA is a rare but serious condition that is encountered in patients diagnosed with a malignancy. This clinical picture is thought to be linked to certain tumor characteristics; particularly, adenocarcinoma histology, vascular invasion, and bone marrow infiltration. MAHA is most commonly associated with tumors of gastric, prostate, and breast origin. The optimal treatment is not clear; however, there is evidence for the importance of promptly starting an effective antineoplastic regimen and it was also reported that administering therapeutic plasma exchange (TPE) therapy for immunocomplex removal could be beneficial for patients with symptoms of bleeding and thrombosis. Here, we present a case that presented a picture of MAHA secondary to gastric signet-ring cell adenocarcinoma (SRCC). The clinical picture was initially evaluated as thrombotic thrombocytopenic purpura and the patient benefited significantly from the TPE treatment administered before the adenocarcinoma diagnosis was confirmed. In this period, epistaxis stopped, platelet count increased from 25 × 109 /L to 162 × 109 /L, fragmented erythrocyte rate in the peripheral smear decreased by more than 75% and other laboratory findings of hemolysis (LDH, bilirubin, etc.) significantly improved.

Evaluation of tear parameters and meibomian gland morphology in keratoconus patients after epithelial-on corneal cross-linking.

PURPOSE: To evaluate the variations in tear parameters and meibomian gland morphology after epithelial-on (epi-on) corneal collagen cross-linking (CXL) in keratoconus (KC) patients. METHODS: This prospective observational study included 38 KC eyes that underwent epithelium-on CXL. Thirty-three eyes of 33 stable KC patients with no prior CXL treatment formed the KC group and 35 eyes of 35 healthy volunteers were recruited as the control group. All participants were evaluated by Schirmer I test, first and average noninvasive tear break-up time (NITBUT), ocular surface disease index (OSDI) questionnaire, and meibography scores. The CXL patients were evaluated preoperatively and at the 1st, 3rd, and 6th months, and participants without any intervention (KC and control groups) were evaluated initially, at 1st, 3rd, and 6th months. RESULTS: The KC patients had significantly lower average NITBUT, higher OSDI scores, and impaired meibomian gland morphology than healthy individuals (NITBUT(seconds): KC, 12.8(2.4-17.6), healthy group (HG), 17.1(6.8-17.6); p = 0.012, OSDI: KC, 27.5(0.0-87.5), HG, 7.5(0.0-55.0); p < 0.001, p < 0.001, respectively). A significant difference was found in Schirmer values of the CXL group at 0-1st months, first NITBUT values at 1-6 months, and average NITBUT values at 1-3 and 1-6 months (p = 0.003, p = 0.001, p = 0.003, p = 0.001, respectively). All meibography parameters remained unchanged after CXL over a 6-month follow-up compared to initial measurements. CONCLUSIONS: Even though the KC patients had lower NITBUT, higher OSDI scores, and increased meibomian gland disfunction, the CXL treatment did not significantly affect tear quantity, dry eye symptoms, and meibomian gland morphology.

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria / Parâmetros hematológicos para prever a gravidade da hiperêmese gravídica e da cetonúria

Abstract Objective Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG. Method A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared. Results Themean age of the HG group (n=532) was 26.3 ± 4.1 years, and that of the control group (n=534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n=249) had ketone(+), 33% (n=174), ketone(++), and 21% (n=109), ketone(+++). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p<0.001; and 135.2 ± 30.4/108.9 ± 62.2; p<0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone(+++) than in the groups with ketone(+) or ketone(++): 7.6 ± 1.9/5.5 ± 2.4; p<0.001; 3.8(2.8-4.6)/2.9(2.3- 3.6); p<0.001; and 149.9 ± 48.0/135.9 ± 65.7; p<0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients. Conclusion The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

Resumo Objetivo A hiperêmese gravídica (HG) é uma complicação da gravidez que pode evoluir com náuseas e vômitos persistentes. O objetivo deste estudo é avaliar a relação entre os parâmetros hematológicos e a HG. Método Foram incluídas neste estudo 532 gestantes com HG internadas no Departamento de Obstetrícia e Ginecologia entre março de 2019 e fevereiro de 2021, e 534 gestantes saudáveis com características semelhantes às do grupo de caso. Os parâmetros hematológicos foram comparados entre gestantes com e sem HG. Além disso, os parâmetros hematológicos foram comparados entre as pacientes com HG de acordo com a gravidade da cetonúria. Resultados A média de idade do grupo GH (n=532) foi de 26,3 ± 4,1 anos, e a do grupo de controle (n=534) foi de 25,9 ± 4,8 anos. Entre as pacientes com HG, 46% (n=249) tinham cetona(+), 33% (n=174), cetona(++), e 21% (n=109), cetona (+++). A razão de neutrófilos para linfócitos (RNL) e a razão de plaquetas para linfócitos (RPL) forammaiores no grupo HG do que no grupo de controle: 3,8 (2,8-5,8)/3,2 (2,6-4,0); p<0,001; e 135,2 ± 30,4/108,9 ± 62,2; p<0,001, respectivamente). A contagem de neutrófilos, a RNL e a RPL foram maiores no grupo com cetona(+++) do que nos grupos comcetona(+) e cetona(++): 7,6 ± 1,9/5,5 ± 2,4; p<0,001; 3,8 (2,8- 4,6)/2,9 (2,3-3,6); p<0,001; e 149,9 ± 48,0/135,9 ± 65,7; p<0,001, respectivamente. O nível médio de hemoglobina corpuscular (MHC), a RNL e a RPL foram identificados como preditores independentes da presença de HG e do nível de positividade de cetona em pacientes com HG. Conclusão A RNL e RPL estavam elevadas em pacientes com HG, o que sugere a sua atividade inflamatória. Elas podem ser marcadores importantes associados à presença e à gravidade da HG.

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria.

OBJECTIVE: Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG. METHOD: A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared. RESULTS: The mean age of the HG group (n = 532) was 26.3 ± 4.1 years, and that of the control group (n = 534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n = 249) had ketone (+), 33% (n = 174), ketone (++), and 21% (n = 109), ketone (++ + ). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p < 0.001; and 135.2 ± 30.4/108.9 ± 62.2; p < 0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone (++ + ) than in the groups with ketone (+) or ketone (++): 7.6 ± 1.9/5.5 ± 2.4; p < 0.001; 3.8(2.8-4.6)/2.9(2.3-3.6); p < 0.001; and 149.9 ± 48.0/135.9 ± 65.7; p < 0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients. CONCLUSION: The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

OBJETIVO: A hiperêmese gravídica (HG) é uma complicação da gravidez que pode evoluir com náuseas e vômitos persistentes. O objetivo deste estudo é avaliar a relação entre os parâmetros hematológicos e a HG. MéTODO: Foram incluídas neste estudo 532 gestantes com HG internadas no Departamento de Obstetrícia e Ginecologia entre março de 2019 e fevereiro de 2021, e 534 gestantes saudáveis com características semelhantes às do grupo de caso. Os parâmetros hematológicos foram comparados entre gestantes com e sem HG. Além disso, os parâmetros hematológicos foram comparados entre as pacientes com HG de acordo com a gravidade da cetonúria. RESULTADOS: A média de idade do grupo GH (n = 532) foi de 26,3 ± 4,1 anos, e a do grupo de controle (n = 534) foi de 25,9 ± 4,8 anos. Entre as pacientes com HG, 46% (n = 249) tinham cetona(+), 33% (n = 174), cetona(++), e 21% (n = 109), cetona(+ + +). A razão de neutrófilos para linfócitos (RNL) e a razão de plaquetas para linfócitos (RPL) foram maiores no grupo HG do que no grupo de controle: 3,8 (2,8­5,8)/3,2 (2,6­4,0); p < 0,001; e 135,2 ± 30,4/108,9 ± 62,2; p < 0,001, respectivamente). A contagem de neutrófilos, a RNL e a RPL foram maiores no grupo com cetona(++ + ) do que nos grupos com cetona(+) e cetona(++): 7,6 ± 1,9/5,5 ± 2,4; p < 0,001; 3,8 (2,8­4,6)/2,9 (2,3­3,6); p < 0,001; e 149,9 ± 48,0/135,9 ± 65,7; p < 0,001, respectivamente. O nível médio de hemoglobina corpuscular (MHC), a RNL e a RPL foram identificados como preditores independentes da presença de HG e do nível de positividade de cetona em pacientes com HG. CONCLUSãO: A RNL e RPL estavam elevadas em pacientes com HG, o que sugere a sua atividade inflamatória. Elas podem ser marcadores importantes associados à presença e à gravidade da HG.

A Rare Cause of Dysphagia: A Giant Ganglioneuroma in Parapharyngeal Space.

Parafarengeal ganglioneuroma is a very rare benign tumor originating from the sympathetic nervous system that produces mass and functional effects. Ganglioneuroma is most commonly caused by the posterior mediastinal, retroperitoneal area and adrenal glands. Generally, they do not present any additional signs or symptoms other than mass. Horner's syndrome may sometimes occur due to the compression of the sympathetic chain. A 41-year-old male patient with a long-standing mass in the lateral compartment of the left neck was admitted to our clinic. The patient was operated, and the pathological result of the mass was reported as ganglioneuroma. We present a rare case of ganglioneuroma in paraphryngeal space by reviewing the current literature.