Talking technology: exploring chatbots as a tool for cataract patient education.

CLINICAL RELEVANCE: Worldwide, millions suffer from cataracts, which impair vision and quality of life. Cataract education improves outcomes, satisfaction, and treatment adherence. Lack of health literacy, language and cultural barriers, personal preferences, and limited resources may all impede effective communication. BACKGROUND: AI can improve patient education by providing personalised, interactive, and accessible information tailored to patient understanding, interest, and motivation. AI chatbots can have human-like conversations and give advice on numerous topics. METHODS: This study investigated the efficacy of chatbots in cataract patient education relative to traditional resources like the AAO website, focusing on information accuracy,understandability, actionability, and readability. A descriptive comparative design was used to analyse quantitative data from frequently asked questions about cataracts answered by ChatGPT, Bard, Bing AI, and the AAO website. SOLO taxonomy, PEMAT, and the Flesch-Kincaid ease score were used to collect and analyse the data. RESULTS: Chatbots scored higher than AAO website on cataract-related questions in terms of accuracy (mean SOLO score ChatGPT: 3.1 ± 0.31, Bard: 2.9 ± 0.72, Bing AI: 2.65 ± 0.49, AAO website: 2.4 ± 0.6, (p < 0.001)). For understandability (mean PEMAT-U score AAO website: 0,89 ± 0,04, ChatGPT 0,84 ± 0,02, Bard: 0,84 ± 0,02, Bing AI: 0,81 ± 0,02, (p < 0.001)), and actionability (mean PEMAT-A score ChatGPT: 0.86 ± 0.03, Bard: 0.85 ± 0.06, Bing AI: 0.81 ± 0.05, AAO website: 0.81 ± 0.06, (p < 0.001)) AAO website scored better than chatbots. Flesch-Kincaid readability ease analysis showed that Bard (55,5 ± 8,48) had the highest mean score, followed by AAO website (51,96 ± 12,46), Bing AI (41,77 ± 9,53), and ChatGPT (34,38 ± 9,75, (p < 0.001)). CONCLUSION: Chatbots have the potential to provide more detailed and accurate data than the AAO website. On the other hand, the AAO website has the advantage of providing information that is more understandable and practical. When patient preferences are not taken into account, generalised or biased information can decrease reliability.

Uncovering ecological regime shifts in the Sea of Marmara and reconsidering management strategies.

Ecosystem regime shifts can alter ecosystem services, affect human well-being, and trigger policy conflicts due to economic losses and reductions in societal and environmental benefits. Intensive anthropogenic activities make the Sea of Marmara ecosystem suffer from nearly all existing available types of ecosystem pressures such as biological degradation, exposure to hydrological processes, nutrient and organic matter enrichment, plastic pollution, ocean warming, resulting in deterioration of habitats. In this study, using an integrated ecosystem assessment, we investigated for the first time the historical development and ecosystem state of the Sea of Marmara. Multivariate analyses were applied to the most comprehensive and unique long-term data sets of 9 biotic and 15 abiotic variables for ecosystem state and drivers respectively, from 1986 to 2020. Observed changes were confirmed by detecting shifts in the datasets. The Sea of Marmara ecosystem was classified into three regimes: i) an early initial state regime under the top-down control of predatory medium pelagic fish and fisheries exploitation until mid-1990s, ii) a transitional regime between mid-1990s and mid-2010s as from ecosystem restructuring, and iii) an alternate state late regime with prevailing impacts of climate change from mid-2010s until 2020. During the 20 years transitional regime, three different phases were also characterized; i) the 1st phase between mid-1990s and early 2000s with its gradual change in ecosystem state from a decrease in predators and significant shift in physical drivers of the ecosystem, ii) the 2nd phase between 2000 and mid-2000s with a strong shift in ecosystem state, an ongoing increase in climate indices and fishing mortality, and a gradual decrease in water quality; and iii) the 3rd phase between mid-2000s and mid-2010s with the reorganization of the ecosystem dominated by small pelagic fish and ameliorated water quality. During late regime, we observed that most of the biotic variables, mainly fish biomass, and climate variables did not return to their initial state despite the improvement in some abiotic variables such as water quality. We identify these observed changes in the SoM ecosystem as a non-linear regime shift. Finally, we also developed concrete suggestions for improved regional management.

Determination of the cryoprotective effect of n-methylacetamide in rabbit semen.

BACKGROUND: Amides are low molecular weight cryoprotectants. N-methylacetamide (MA) is one of the cryoprotectant agents in this group. OBJECTIVE: To investigate the cryoprotective effect of MA in rabbit semen. MATERIALS AND METHODS: For this purpose, six ejaculates from six New Zealand rabbits were collected and pooled using an artificial vagina. Pooled semen was divided into four equal parts and diluted with TCG+ egg yolk. CPA was added to form the following groups: Control with 6% DMSO; Group 1 with 1% MA; Group 2 with 2% MA; and Group 3 with 3% MA. After the addition of CPA, the semen eqilibration procedure was started. Sperm were then drawn into 0.25 mL straws, frozen by automatic semen freezing and stored in a liquid nitrogen container. Pipettes were thawed after 24 h and analyses were performed. RESULTS: Total, progressive and rapid motility values of the Control group were higher than those of the MA groups (p<0.05). However, there was no statistical difference between the Control and Group 2 in terms of these parameters. While there was no statistical difference between the groups in terms of acrosome damage and mitochondrial membrane potential, the best results were observed in Control, Group 2, Group 1 and Group 3, respectively. When we compared all groups, no difference was found in terms of MDA, CAT and GSH-Px. There was a statistical difference between Group 3 and the Control in terms of GSH level (p<0.05). CONCLUSION: DMSO appeared to be more useful for the cryopreservation of rabbit semen compared to MA. Doi.org/10.54680/fr23610110812.

Can transcription factors in the intervertebral disc of lopinavir/ritonavir prevent degeneration in the nucleus pulposus by mediating the regulation of inflammation through signaling pathways?

OBJECTIVE: This study was conducted to examine whether lopinavir/ritonavir (Lop/r), an HIV protease inhibitor, can improve disc physiology and slow down intervertebral disc (IVD) degeneration through in vitro experimental methods, as well as whether it can suppress inflammation with interleukin-1 beta (IL-1ß) and sex-determining region Y (SRY) protein-related high-mobility group box genes-9 (SOX9) through hypoxia-inducible factor 1-alpha (HIF-1α) and the nuclear factor kappa B (NF-κB) signaling pathway. The aim was to investigate whether Lop/r application is toxic to IVD cells and the microenvironment simultaneously. PATIENTS AND METHODS: Human primary cell cultures were prepared using herniated IVD tissues obtained from patients with lumbar disc hernia who were unresponsive to conservative and medical treatment, and thereby, were operated on. The untreated culture samples served as control group, and the samples treated with Lop/r served as study group. Microscopic evaluations were performed simultaneously using fluorescent and supravital dyes in all groups. In addition to cell viability, toxicity, and proliferation analysis through a commercial kit, IL-1ß, SOX9, HIF-1α, and NF-κB protein expressions were evaluated using Western blotting. In the statistical comparison of the obtained data, an alpha value less than 0.05 was considered significant. RESULTS: Cell proliferation decreased in the Lop/r group, but no cell death was observed (p < 0.05). Moreover, at the end of 72 hours after Lop/r application, IL-1ß and NF-kB protein expressions decreased by 40% and 52%, respectively, while HIF-1α and SOX9 protein expressions increased by 4% and 59%, respectively (p< 0.05). CONCLUSIONS: Although these data were obtained from an in vitro experimental study, it is believed that these findings could make significant contributions to the pharmaco-regenerative treatment modalities of IVD degeneration. Lop/r suppresses the IL-1ß and NF-κB and induces SOX9 and HIF-1α, since these signaling pathways may be related to human IVD degeneration.

The shortest distance between the skin and the peritoneal cavity is obtained with fascial elevation: a preliminary prospective laparoscopic entry study.

The purpose of this study was to prospectively compare the measurement of skin-to-fascia distances in the neutral state, during manual elevation and by fascial elevation in patients who underwent laparoscopic surgery. In 53 patients, the distance between the skin and anterior wall of the rectus sheath was measured prospectively in following three different ways: (1) in neutral position, (2) during manual elevation and (3) during elevation of the fascia using forceps following an infraumbilical vertical skin incision. In all patients, subcutaneous tissue up to the fascia was dissected after a vertical skin incision. The skin-to-fascia distance of 30.9 mm (14.0-52.0 mm) in the neutral position decreased to 11.1 mm (0.0-26.0 mm) during the fascial elevation, while the mean distance increased to 40.1 mm (19-70 mm) during manual elevation (p < 0.001). In the closed laparoscopic entry technique in which a Veress needle is inserted into the peritoneum through a small incision, the needle should be introduced from the shortest distance between the skin and the peritoneum. Lifting the fascia with a proper surgical instrument in suitable patients could enable us to achieve this goal.

Effects of an acetylcholinesterase inhibitor and an N-methyl-D-aspartate receptor antagonist on inflammation and degeneration of the nucleus pulposus.

OBJECTIVE: The study aimed to examine the effects of two drugs, an acetylcholinesterase inhibitor (AChEI) and an N-methyl-D-aspartate receptor (NMDAR) antagonist, on degenerated annulus fibrosus (AF) and nucleus pulposus (NP) cells and the extracellular matrix (ECM) structure in vitro. PATIENTS AND METHODS: Tissue samples were obtained from patients with intervertebral disc herniation (four males and four females; classified as Pfirmann stage IV) and used to prepare cell cultures. Untreated cell culture samples served as the control group. Study group samples were treated with donepezil, memantine or a combination of the two drugs. Cell viability, toxicity and proliferation were evaluated in all groups. Western blotting was used to examine changes in protein expression of signal transducer and activator of transcription 3 (STAT3), phospho-STAT3 (ser727), hypoxia-inducible factor (HIF)-1 alpha (HIF-1α) and nucleotide-binding oligomerisation domain (NOD) leucine-rich repeat (LRR)-containing proteins (NLR) family pyrin domain containing 3 (NLRP3) inflammasome. The alpha significance value was < 0.05. RESULTS: Analysis of the microscopy and commercial kit results revealed that cell proliferation was suppressed, and no cell death was observed. The protein expression levels of NLRP3, STAT3, ser727 and HIF-1α were lower in the samples treated with donepezil and memantine at 72 h (p < 0.05). The protein expression levels of NLRP3, STAT3, ser727 and HIF-1α were higher in the samples treated with the combination of donepezil and memantine (p < 0.05). CONCLUSIONS: The combined administration of memantine a NMDAR antagonist which can prevent neurodegeneration and donepezil an AChEI used for pain relief increased the protein expression levels in the anabolic pathway. However, it did not reduce the protein expression levels in the catabolic pathway. Therefore, further studies are needed to provide extensive insight into whether it may be among the potential targets for the therapy of intervertebral disc (IVD) diseases.

Admission monocyte to high density lipoprotein cholesterol ratio predicts amputation in patients undergoing embolectomy for acute lower extremity ischemia.

OBJECTIVE: Acute limb ischemia is a common clinical manifestation of embolism or thrombosis, which can lead to amputation. Increasing evidence suggests that various biomarkers can predict amputation at the time of admission. Identifying an easily obtainable and inexpensive indicator has always been a major objective. The aim of this study was to determine the predictive value of the admission monocyte count to the HDL-C ratio for a lower extremity amputation in patients undergoing embolectomy for acute limb ischemia. PATIENTS AND METHODS: This retrospective, single-center study included 269 patients who underwent an emergent embolectomy. The study population was divided into two groups according to early amputation: the non-amputation group (n = 220) and the amputation group (n = 49). Two groups were compared based on various data. RESULTS: According to the multivariate regression analysis, patients with a higher CRP and MHR have a significantly higher amputation rate (HR: 1.148; CI: 1.075-1.225; p < 0.001 and HR: 1.547; CI: 1.003-2.387; p = 0.04, respectively). Patients with arterial back bleeding have a significantly lower amputation rate (HR: 0.106; CI: 0.02-0.558; p = 0.008). CONCLUSIONS: Our study demonstrated that preoperative CRP, MHR, and no arterial back bleeding after surgery were found to be independent predictors of amputation as a poor prognostic factor within 30 days after an embolectomy.

Does oseltamivir protect human chondrocyte and nucleus pulposus cells from degeneration by inhibiting senescence and proinflammation mediated by the NLRP3 inflammasome and NF-κB?

OBJECTIVE: Recent drug design studies suggest that inflammation is among the most important factors in the development of both intervertebral disc (IVD) degeneration (IVDD) and osteoarthritis (OA) due to cartilage damage. This study aimed to investigate whether the anti-inflammatory drug oseltamivir has a toxic effect on IVD and cartilage tissue cells. It assessed what effect oseltamivir has on hypoxia-inducible factor (HIF)-1 alpha (HIF1α), which plays an important role in anabolic pathways in IVD and cartilage tissue. In addition, the study analyzed whether oseltamivir could inhibit the release of inflammatory interleukin-1 beta (IL-1ß) via the nuclear factor kappa-B (NF-κB) signaling pathway by activating the nucleotide-binding oligomerization domain and leucine-rich repeat protein-3 (NLRP3) inflammasome. MATERIALS AND METHODS: Human lumbar IVD (n = 8) tissues were isolated for annulus fibrosus (AF) and nucleus pulposus (NP) primary cell cultures, and human tibial and femoral cartilage tissues (n = 8) were isolated for primary chondrocyte cultures. Untreated groups served as the control and oseltamivir-treated groups as the study sample. Cell viability and cytotoxicity were evaluated at 0, 24, 48, and 72 h in all groups for changes in HIF-1α, IL-1ß, NF-κB, and the NLRP3-inflammasome protein expressions using Western blotting. The α significance value was < 0.05. RESULTS: In the oseltamivir-treated groups, cell proliferation decreased in both AF/NP cell and chondrocyte cultures obtained from IVD cartilage tissues. After Western blotting analysis, changes were observed in the protein expressions of HIF-1α, IL-1ß, NF-κB, and the NLRP3 inflammasome in both AF/NP cells and chondrocytes. The results were statistically significant (p < 0.05). CONCLUSIONS: Oseltamivir treatment may be a promising regenerative strategy to manage IVDD and osteoarthritic cartilage tissues.

Fencing farm dams to exclude livestock halves methane emissions and improves water quality.

Agricultural practices have created tens of millions of small artificial water bodies ("farm dams" or "agricultural ponds") to provide water for domestic livestock worldwide. Among freshwater ecosystems, farm dams have some of the highest greenhouse gas (GHG) emissions per m2 due to fertilizer and manure run-off boosting methane production-an extremely potent GHG. However, management strategies to mitigate the substantial emissions from millions of farm dams remain unexplored. We tested the hypothesis that installing fences to exclude livestock could reduce nutrients, improve water quality, and lower aquatic GHG emissions. We established a large-scale experiment spanning 400 km across south-eastern Australia where we compared unfenced (N = 33) and fenced farm dams (N = 31) within 17 livestock farms. Fenced farm dams recorded 32% less dissolved nitrogen, 39% less dissolved phosphorus, 22% more dissolved oxygen, and produced 56% less diffusive methane emissions than unfenced dams. We found no effect of farm dam management on diffusive carbon dioxide emissions and on the organic carbon in the soil. Dissolved oxygen was the most important variable explaining changes in carbon fluxes across dams, whereby doubling dissolved oxygen from 5 to 10 mg L-1 led to a 74% decrease in methane fluxes, a 124% decrease in carbon dioxide fluxes, and a 96% decrease in CO2 -eq (CH4 + CO2 ) fluxes. Dams with very high dissolved oxygen (>10 mg L-1 ) showed a switch from positive to negative CO2 -eq. (CO2 + CH4 ) fluxes (i.e., negative radiative balance), indicating a positive contribution to reduce atmospheric warming. Our results demonstrate that simple management actions can dramatically improve water quality and decrease methane emissions while contributing to more productive and sustainable farming.

Examining the effects of HMG-CoA reductase inhibitors on anabolic and catabolic signaling pathway proteins associated with degenerative disc disease.

OBJECTIVE: Recent evidence suggests that statins, among lipid-lowering drugs, can be used to lower serum cholesterol levels for reducing the risk of cardiovascular disease in individuals with high cholesterol, as well as reducing DNA damage and having anti-ageing and pleiotropic effects. Additionally, nuclear factor kappa B (NF-κB) is reported to be suppressed in statin-administered nucleus pulposus (NP) cells for the prevention of interleukin (IL) -1 beta (IL-1ß)-induced apoptosis and extracellular matrix (ECM) degradation. The purpose of this study is the examine whether it is possible for pharmacological synthetic statin agents added into primary cell cultures obtained from human intervertebral disc tissue (IVD) to stop and eliminate tissue degeneration through the anabolic/catabolic signaling pathways associated with inflammation. MATERIALS AND METHODS: Pitavastatin and rosuvastatin were added to monolayer grown human primary annulus fibrosus (AF)/NP cells. Cytotoxicity and proliferation analyses were carried out. AF/NP cells and ECM structure were also examined microscopically. In addition, changes in transcription factors and protein expressions of proinflammatory cytokines, which play important roles in anabolic and catabolic pathways associated with inflammation, were analyzed. RESULTS: Decreased proliferation and cell necrosis were observed at the end of 72 hours in the samples, in which statins were added, compared to the samples in the control group to which no pharmacological agent was administered. In addition to this, changes were observed in the expressions of proteins. All results were statistically significant (p<0.05). CONCLUSIONS: To better understand the regenerative effects of these two pharmacological agents on degenerated AF/NP cells, there is an urgent need for prospective studies in which different signaling pathways and receptors on these pathways are investigated, apart from IL-1ß; NF-κB signaling pathway and SOX9.

Rational use of drugs in healthcare services: a sample of tertiary hospital.

OBJECTIVE: This study aimed at evaluating physicians' attitudes towards the rational use of drugs (RUD) at a training and research hospital. SUBJECTS AND METHODS: This cross-sectional study was conducted in a training and research hospital affiliated with the Ministry of Health between December 2014 and April 2015. All 424 active-duty physicians were asked to participate in the survey study. Of these physicians, 193 (45.5%) volunteered to respond to a 64-item survey. A total of 193 (45.5%) physicians volunteered to participate in the study. The chi-squared test, ANOVA, and multiple logistic regression analysis were used for the evaluation of the study data. RESULTS: Of the physicians who participated in the study, 58.0% were male. Prescriptions were dispensed for 52.73% (± 27.44) of the patients, with a mean of 2.67±0.98 items per prescription. The rational use of drugs was defined as prescribing an effective drug for the patient (85.4%), prescribing an appropriate drug for the patient (84.9%), and prescribing a safe drug for the patient (77.2%). Compared to residents, the prescription preferences of specialists were affected 2-fold by follow-up visit (p=0.010, ß 0.694, CI 1.180 3.396), 1-fold by patient examination percentage (p=0.002, ß 0.022, CI 1.008 1.037), and 3.5-fold by prescribing iron supplements (p=0.001, ß 1.274, CI 1.644 7.774) (R2 0.259, p=0.001). CONCLUSIONS: The results of the study showed that tertiary hospital specialists and residents have similar attitudes towards patients, their prescribing preferences and RUD knowledge level. This study provides comprehensive information on physicians' attitudes towards RUD.

Haematological inflammatory markers for indicating ischemic bowel in patients with incarcerated abdominal wall hernias.

PURPOSE: To reveal the clinical significance of preoperative haematological inflammatory markers in the diagnosis of abdominal wall hernias with strangulation. METHODS: The data of 200 patients who underwent surgery for incarcerated hernia were retrospectively analysed. The patients were grouped into three groups; Group 1; only surgical reduction and hernia repair, Group 2; small bowel resection and Group 3; omentum resection. Age, gender, hernia type, the presence of radiological bowel obstruction and preoperative complete blood count data were obtained. Neutrophil-leukocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), haematological inflammatory index (HII) and systemic immune-inflammation index (SII) values were calculated. RESULTS: The study was consisted of; Group 1: 119 patients (59.5%), Group 2: 46 patients (23%) and Group 3: 35 patients (17.5%). Advanced age (p = 0.001), female gender (p = 0.036), incisional hernias (p = < 0.001) and the presence of bowel obstruction (p = < 0.001) were found to be statistically significant in terms of strangulation. NLR, PLR and SII values were significantly higher in Group 2 compared to Group 1, and PLR values were significantly higher in Group 2 compared with Group 3 (p < 0.05). CONCLUSION: The preoperative elevated NLR, PLR and SII values may indicate strangulation and possible intestinal resection, in incarcerated abdominal wall hernias.

Planted mangroves cap toxic petroleum-contaminated sediments.

Mangroves are known to provide many ecosystem services, however there is little information on their potential role to cap and immobilise toxic levels of total petroleum hydrocarbons (TPH). Using an Australian case study, we investigated the capacity of planted mangroves (Avicennia marina) to immobilise TPH within a small embayment (Stony Creek, Victoria, Australia) subjected to minor oil spills throughout the 1980s. Mangroves were planted on the oil rich strata in 1984 to rehabilitate the site. Currently the area is covered with a dense mangrove forest. One-meter-long sediment cores revealed that mangroves have formed a thick (up to 30 cm) organic layer above the TPH-contaminated sediments, accumulating on average 6.6 mm of sediment per year. Mean TPH levels below this organic layer (30-50 cm) are extremely toxic (30,441.6 mg kg-1), exceeding safety thresholds up to 220-fold which is eight times higher when compared to top layer (0-10 cm).

Intensive care nurses' evidence-based knowledge and experiences regarding closed suctioning system.

BACKGROUND: Endotracheal suctioning is a vital procedure performed by intensive care nurses to maintain airway patency and optimal gas exchange in critically ill patients under mechanical ventilation. As the procedure can cause several complications, intensive care nurses should have adequate evidence-based knowledge on how to perform the procedure. AIMS: This study aimed at examining intensive care nurses' knowledge and experience of the closed suctioning system. This study was a prospective, cross-sectional, descriptive, and multi-centered study conducted with 195 nurses working in the tertiary intensive care units in five Turkish hospitals. SUBJECTS AND METHODS: The data were collected with a questionnaire developed by the researchers in light of the literature. The data were evaluated with Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The mean age of the nurses was 30.58 ± 6.28 years. The mean knowledge score of the nurses for the closed system was 27.35 ± 12.05 (range = 0-80) and 80.5% of them obtained scores ranging between 0 and 40. Also, 71.8% stated that they did not have any difficulty performing suctioning with the closed system catheter, and 85% said that they saved time with the closed system. However, 50.8% of the nurses said they were not able to suction viscous and sticky secretions efficiently, 44.6% stated they did not need to irrigate the inside of the catheter, and 45.1% of them were undecided whether the coude tip catheter led to hemorrhagic secretion more than straight tip catheter. CONCLUSIONS: Almost one-fifth of the nurses had good scores on evidence-based knowledge of suctioning. Most of the nurses' experiences regarding the use and manipulation of the closed system were positive. However, almost half of the nurses pointed out that the closed system was not effective enough to suction viscous and sticky secretions. Regular in-service training sessions may help to improve nurses' current knowledge and experiences.

Can intraoperative endoscopy prevent esophagojejunal anastomotic leakage after total gastrectomy?

BACKGROUND: Esophagojejunostomy (EJ) is frequently performed after total gastrectomy for proximal gastric tumors. Despite evolving surgical techniques and improving perioperative care, the EJ leak is one of the most severe life-threatening complications. This study investigated the preventability of postoperative anastomotic complications by performing intraoperative endoscopy. METHODS: We included 86 patients who underwent total gastrectomy and Roux-en-Y esophagojejunostomy anastomosis in the study. Patients were divided into two groups and analyzed retrospectively. Group 1 consisted of 43 patients who did not undergo intraoperative endoscopy between 2017 and 2019, and Group 2 included 43 patients who underwent intraoperative endoscopy between 2019 and 2020. RESULTS: Esophagojejunostomy anastomotic leak (EAL) was observed in 2.3 % of patients in Group 1 but not in Group 2. Anastomosis-related abnormal findings (anastomotic defect, bleeding, air leak, mucosal separation) were recorded in seven patients of Group 2 during endoscopy. When such findings were observed, additional full-thickness sutures were placed on the anastomosis line and strengthened. Complication related to anastomosis was not observed in the postoperative period in Group 2. DISCUSSION: After a total gastrectomy, the most severe complication affecting mortality, morbidity, and consequently the cost of the disease is esophagojejunal anastomotic leakage. Most of these complications are induced by technical errors not noticed during surgery. The crucial advantage of performing intraoperative endoscopy is the technically detailed evaluation of anastomosis. CONCLUSION: Intraoperative endoscopy is a safe method to evaluate the strength of anastomosis. This procedure provides detailed information regarding anastomotic integrity. HIPPOKRATIA 2021, 25 (3):108-112.

Pharmaco-molecular assessment of the effects of anandamide and its antagonists on hippocampal tissue in Wistar albino rats.

OBJECTIVE: The members of the matrix metalloproteinase (MMP) family and cannabinoids (CBs) are reportedly associated with hippocampus-dependent memory functions. However, the effects of endogenously formed CBs on hippocampal long-term potentiation remain unknown. The present study aimed to investigate the changes in the gene and protein expression levels of matrix metallopeptidase 9 (MMP-9), phosphatase and tensin homolog (PTEN), and NOTCH receptor 1 (NOTCH1) in rat hippocampal tissues treated with anandamide (AEA), AM251, 6-iodopravadolin (AM630), and N-[4-{[(3,4-Dimethyl-5-isoxazolyl)amino]sulfonyl}phenyl] (ML193). MATERIALS AND METHODS: The subjects were divided into 10 groups (n = five per group). The pharmaceuticals were administered via intraperitoneal injection once a day for seven days, except for the control group. The resected hippocampal tissues were then evaluated using a quantitative real-time polymerase chain reaction (RT-qPCR) and Western blot analysis. The data obtained were statistically analyzed, and p < 0.01 was considered statistically significant. RESULTS: Contrary to the literature, the changes in MMP-9 expression were not statistically significant, but the changes in PTEN and NOTCH1 were. The findings of this in vivo experimental study revealed that the agonists and antagonists acting on the CB system have significant molecular effects on hippocampal tissue. CONCLUSIONS: The changes in gene and protein expressions may be one of the reasons for the neurodegenerative processes observed in patients using these agonists and antagonists, whose effects on the CB system have not been fully explained yet. Our study can contribute to the literature as it is the first study investigating the MMP-9, PTEN and NOTCH1 gene and protein expression.

A comparative evaluation of segmental analysis of macular layers in patients with early glaucoma, ocular hypertension, and healthy eyes.

PURPOSE: To compare macular layer thicknesses between early glaucoma, ocular hypertension, and healthy eyes and to evaluate the accuracy of spectralis optical coherence tomography (OCT) segmentation software in discriminating early glaucoma from ocular hypertension and healthy eyes. METHODS: OCT scans were performed using the standard macular and peripapillary retinal nerve fiber layer (pRNFL) protocols on the Spectralis-OCT. The following macular thickness parameters were compared in the inner and outer circles of the Early Treatment Diabetic Retinopathy Study: total macular thickness (MT), retinal nerve fiber layer (mRNFL), ganglion cell layer (mGCL), inner plexiform layer (mIPL), inner nuclear layer (mINL), outer plexiform layer (mOPL), outer nuclear layer (mONL) and ganglion cell complex (mGCC: sum of mRNFL, mGCL, and mIPL). Sectors and layers with the best area under the receiver operating characteristic curve (AUC) were determined and compared between groups. RESULTS: Of a total of 200 eyes included in this study, 64 eyes had primary open angle glaucoma, 69 had ocular hypertension, and 67 were healthy. Peripapillary RNFL was significantly thinner in the early glaucoma group (P<0.05). For the macular variables, there was a significant reduction in the MT, mGCC, mRNFL, mGCL, and mIPL thicknesses in the early glaucoma group; while there were no statistically significant differences between the ocular hypertension and control groups (P>0.05). For distinguishing early glaucoma from normal eyes, AUCs for mGCC, mGCL, and mRNFL were similar to the pRNFL; and for early glaucoma and ocular hypertension, AUCs for mGCC, mGCL mRNF and mIPL were comparable to the pRNFL. CONCLUSION: Macular segmentation can assist in the early diagnosis of glaucoma as a complementary study to pRNFL analysis.

DICER1 Hotspot Mutations in Pleuropulmonary Blastoma: A Case Series From a Tertiary Center.

Pleuropulmonary blastoma (PPB) is a potentially aggressive, rare childhood neoplasia. We investigated histopathological features, survival, and DICER1 hotspot mutations among PPB patients. Archive records at our institution were reviewed, covering a 20-year period. Thirteen children (6 males and 7 females) with a mean age of 30.5 (range 6-83) months were included. The tumor subtypes were type I in 6 (46%), type II in 4 (31%), and type III in 3 (23%). Only tumors with type II and type III histology showed anaplasia (4/7, 57%). Median follow-up was 28 (range 9-216) months. Three-year overall survival rate was 83.3% and 3-year progression-free survival rate was 25%. Progression was seen in 60% (3/5) of type I and 66.7% (4/6) of type II and type III cases. Two patients died of disseminated disease at 9 and 44 months. Hotspot missense mutations on DICER1 gene were detected in all 11 patients with available tumor tissue. We found an additional novel germline loss-of-function mutation (c.5436dupT; p.E1813*) in 1 case. To the best of our knowledge, this is the first study to investigate hotspot missense mutations on DICER1 gene among the largest series of Turkish children with PPB.