Graft of 3D bioprinted autologous minimally manipulated homologous adipose tissue for the treatment of diabetic foot ulcer.

INTRODUCTION: Adipose-derived stem cells are multipotent precursor cells with the ability to differentiate into cell lineages associated with the regeneration of tissues. OBJECTIVE: The authors investigated the efficacy of AMHAT with 3D bioprinting technology in DFU. MATERIALS AND METHODS: Twenty patients were enrolled in a clinical prospective interventional pilot study. The primary endpoint was a reduction in the size of DFU, and the secondary endpoints were the epithelialization rate and amount of granulation of wound bed at weekly assessments. A bioprinter was used to produce AMHAT in the customized shape of DFU. The data were obtained using photography and computerized digital surface calculation. RESULTS: The mean wound size at the time of hospitalization was 7.529 cm2. All but one of the wounds were completely epithelialized at the ninth week. The mean wound areas decreased at weekly assessments for the first 7 weeks of treatment compared to the pre-application. When the mean decrease in the wound size was compared between consecutive weeks, there were decreases at each of the first 7 weeks. The mean time to the complete closure was 32.20±23.862 days. CONCLUSION: These data indicate that AMHAT is beneficial in terms of ease of application, significant decrease in the wound surface area, no scarring compared to grafting, and full healing times.

Predictive Efficacy of Delta Neutrophil Index in Diagnosis of Acute and Complicated Appendicitis.

Background The delta neutrophil index has been accepted as an inflammatory marker, especially in sepsis. This study aimed to evaluate the effectiveness of the delta neutrophil index in predicting acute and complicated appendicitis. Methods Patients aged 18 years and over who underwent appendectomy were reviewed. The demographic features, pathology results, and the delta neutrophil index, leukocyte, and C-reactive protein levels were evaluated. According to the pathology results, the patients were grouped as those having a normal appendix or acute appendicitis. Results In this study, 74 (8.1%) of the patients had a normal appendix, and 718 (86.1%) were diagnosed with simple appendicitis, and 116 (13.9%) with complicated appendicitis. In the acute appendicitis group, the leukocyte value and delta neutrophil index were found to be statistically significantly higher than in the normal appendix group. Age, C-reactive protein, and the delta neutrophil index ​​were statistically significantly higher in the complicated appendicitis group. In the receiver operating characteristic curve analysis for the prediction of acute appendicitis, the area under the curve values for leukocyte and the delta neutrophil index were calculated as 0.780 and 0.741, respectively. In predicting complicated appendicitis, the area under the curve of the delta neutrophil index and C-reactive protein were 0.671 and 0.709, respectively. Conclusion The delta neutrophil index was more significant than leukocyte values in diagnosing acute and complicated appendicitis. We consider that the delta neutrophil index ​​is an effective and reliable parameter in diagnosing acute appendicitis and differentiating simple/complicated appendicitis, especially when combined with the analysis of leukocyte and C-reactive protein.

Updated experience of a tertiary pandemic center on 533 pregnant women with COVID-19 infection: A prospective cohort study from Turkey.

OBJECTIVE: To investigate the clinical course and impact of coronavirus disease 2019 (COVID-19) infection on pregnant women. METHODS: A prospective cohort study was conducted on pregnant women with confirmed COVID-19 infection. Demographic features, clinical characteristics, and perinatal outcomes were prospectively evaluated. RESULTS: Of the 533 cases, 161 (30.2%) had co-morbidities and 165 (30.9%) were asymptomatic. Cough (n = 178, 33.4%) and myalgia (n = 168, 31.5%) were the leading symptoms. In total, 261 patients (48.9%) received COVID-19 therapy, 509 (95.5%) had mild disease, 7 (1.3%) were admitted to the intensive care unit (ICU), and invasive mechanical ventilation was necessary in 2 (0.4%) patients. Maternal mortality was observed in 2 (0.4%) cases. Of the patients, 297 (55.7%) were hospitalized, 39 (7.3%) had suspicious radiologic imaging findings, 66 (12.4) had pregnancy complications (preterm delivery [n =22, 4.1%] and miscarriage [n =12, 2.2%] were the most common pregnancy complications), 131 births occurred, and the cesarean section rate was 66.4%. All neonates were negative for COVID-19. The rate of admission to the neonatal ICU was 9.9%. One specimen of breast milk was positive for the infection. CONCLUSION: The course of COVID-19 was mild in the majority of cases. However, increased rates of pregnancy complications and cesarean delivery were observed.

A pandemic center's experience of managing pregnant women with COVID-19 infection in Turkey: A prospective cohort study.

OBJECTIVE: To evaluate the course and effect of coronavirus disease 2019 (COVID-19) on pregnant women followed up in a Turkish institution. METHODS: A prospective, single tertiary pandemic center cohort study was conducted on pregnant women with confirmed or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Positive diagnosis was made on a real-time polymerase chain reaction (RT-PCR) assay of a nasopharyngeal and oropharyngeal specimen. Demographic features, clinical characteristics, and maternal and perinatal outcomes were evaluated. RESULTS: SARS-CoV-2 was suspected in 100 pregnant women. Of them, 29 had the diagnosis confirmed by RT-PCR. Eight of the remaining 71 cases had clinical findings highly suspicious for COVID-19. Ten (34.5%) of the confirmed cases had co-morbidities. Cough (58.6%) and myalgia (51.7%) were the leading symptoms. COVID-19 therapy was given to 10 (34.5%) patients. There were no admissions to the intensive care unit. Pregnancy complications were present in 7 (24.1%) patients. Half of the births (5/10) were cesarean deliveries. None of the neonates were positive for SARS-CoV-2. Samples of breastmilk were also negative for the virus. Three neonates were admitted to the neonatal intensive care unit. CONCLUSION: The clinical course of COVID 19 during pregnancy appears to be mild in the present study.