Use of dual energy CT urography in evaluation of urinary stone and complex cyst.

BACKGROUND: Dual-energy computed tomography scans can provide significant benefits to the urinary system. The aim of this study is to determine the limitations and benefits of using dual energy CT urography in patients with urinary system stones and cysts. METHODS: In the analysis of the images, the virtual noncontrasted images obtained from the combined nephrogenicexcretory phase and the true noncontrasted images were evaluated. The true noncontrast images were accepted as the gold standard for stone detection. RESULTS: Eighty-three different stones were detected in 26 of the 115 patients included in the study. Sensibilities of virtual noncontrast images in detecting urinary system stones were 66.7% and 65.4% according to the first and second radiologists, respectively. In this study, 32 hyperdense cysts were detected. According to iodine map images, there was no enhancement in 26 of 32 cysts; only 5 cysts showed minimal contrast enhancement. One patient could not decide on contrast enhancement. DISCUSSION: As a result, if CT urography is performed with dual energy, it can provide additional information in patients with urinary system disorder.

How do vegetable oils (hazelnut and canola) affect the reproductive system in male rats?

OBJECTIVE: Vegetable oils have an important place in our daily diet. This study starts from this point to investigate the effects of canola oil and hazelnut oil in the male reproductive system in rats. MATERIAL AND METHODS: 30 male rats were used in this 16-week study. The animals were divided into three groups: the animals in group I served as the control group, while the animals in group II and group III were fed with hazelnut and canola oil, respectively. The testes of all rats were excised for histopathologic evaluation and immunohistochemical (IHC) evaluation with a standard method. Blood samples were obtained for determination of serum hormone levels. RESULTS: No significant differences were noted with respect to behavior or weight among the three groups. Rats in the canola oil group (group III) had higher luteinizing hormone (LH) and higher testosterone levels than rats in the control group. Rats who received hazelnut oil (group II) exhibited similar findings, with these levels being higher than they were in the control group. No statistical differences were shown for histopathology or IHC testosterone antibody levels across all treatment groups. Conclussion: Canola oil was shown to have a greater effect on serum LH and testosterone compared to the control group and the group fed with hazelnut oil. Further investigation is required into how these oils affect serum hormone and sperm activity.

Protective effects of molsidomine against doxorubicin-induced renal damage in rats.

PURPOSE: The purpose of this study was to investigate the therapeutic and protective effects of molsidomine (MLS) against doxorubicin (DOX)-induced renal damage in rats. METHODS: Forty rats were randomly divided into five groups (control, MLS, DOX, DOX+MLS and MLS+DOX groups). Thiobarbituric acid reactive substance (TBARS), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), nitric oxide (NO) and glutathione peroxidase (GPx) levels were determined from kidney tissues and blood urea nitrogen (BUN), creatinine (Cr) and albumin (Alb) levels also determined. RESULTS: DOX treatment caused a significant increase in TBARS levels and a significant decrease in the GSH and CAT levels compared with the control group. In comparison, MLS administration before DOX injection caused a significant decrease in TBARS levels and also increases in GSH and CAT levels, whereas treatment of MLS after DOX injection did not show any beneficial effect on these parameters. All groups showed a significant increase in NO levels compared to the control group. There were no significant differences among the all groups for BUN and Cr levels. Serum level of Alb decreased in the DOX-treated groups when compared with control and MLS groups. The histopathological findings were in accordance with the biochemical results. MLS treatment reversed the DOX-induced kidney damage in group 4. MLS treatment before DOX injection exerted a protective effect against DOX-induced kidney damage. CONCLUSIONS: MLS shows promise as a possible therapeutic intervention for the prevention of kidney injury associated with DOX treatment. Additional studies are warranted.

Inflammation is associated to volume status in peritoneal dialysis patients.

AIM: The aim of this study is to investigate whether there is a relationship between inflammation and volume status in patients underwent peritoneal dialysis (PD). PATIENTS AND METHOD: This cross-sectional study included 159 PD patients. The median duration of PD was 17 (range, 1-151) months. All patients were examined using bioelectrical impedance analysis to estimate the ratio of extracellular water to total body water (ECW/TBW), which was used to assess their volume status. The patients were categorized as having one of the following three volume statuses: hypervolemic (above +2 SD from the mean, which was obtained from healthy controls), normovolemic (between +2 SD and -2 SD), or hypovolemic (below -2 SD from the mean). Five patients with hypovolemia were excluded from the study. Fifty-six patients were hypervolemic whereas 98 patients were euvolemic. High-sensitive C-reactive protein (hs-CRP) levels were measured to evaluate inflammation in all patients. RESULTS: hs-CRP value levels were significantly higher in hypervolemic patients compared with euvolemic patients [7.1 (3.1-44.0) mg/L vs. 4.3 (3.1-39.6), p: 0.015, respectively]. Left ventricular hypertrophy was more frequent in hypervolemic patients compared with euvolemic patients (53.6% vs. 30.6%, p: 0.004, respectively). ECW/TBW ratio positively correlated with hs-CRP (r: 0.166, p: 0.039). Gender, hs-CRP, and residual Kt/V urea were found to be independent risk factors for hypervolemia in multivariate analysis. CONCLUSION: Inflammation is associated with hypervolemia in PD patients. Residual renal functions play an important role to maintain euvolemia in PD patients.

Is there a relationship between chronic periodontitis and erectile dysfunction?

INTRODUCTION: Chronic periodontitis (CP) is characterized with inflammation of the gingival tissues, which causes endothelial dysfunction in different organs. AIM: In this study, we investigated the association of CP with the erectile dysfunction (ED). METHODS: The study group included 80 male patients with ED and 82 male patients without ED (control), aged between 30 and 40 years. The International Index of Erectile Function (IIEF) questionnaire was used to assess male sexual function, particularly the presence or absence of ED. MAIN OUTCOME MEASURES: The patients in the study and control groups were statistically compared according to their plaque index (PI), bleeding on probing (BoP), probing depth (PD), and clinical attachment level (CAL). RESULTS: In the non-ED and the ED groups, the mean age was 35.7 ± 4.8 and 34.9 ± 4.9 years, respectively. Patients' characteristics including body mass index, household income, and education status were similar in both groups (P > 0.05). Nineteen patients (23%) had severe CP in the non-ED group; 42 patients (53%) had severe CP in the ED group. Logistic regression analysis showed a significantly high association between ED and the severity of CP (odds ratio: 3.29, 95% confidence interval: 1.36-9.55, P < 0.01). The mean values of PI, BoP, and the percentages of sites with PD >4 mm and sites with CAL >4 mm were significantly higher in the ED group than in the control group (P < 0.05). The mean values of PD and CAL were not significantly different in the two groups (P > 0.05). The decayed, missing, filled teeth scores were also significantly higher in the ED group than in the non-ED group (P < 0.05). CONCLUSION: Our results have suggested that CP had a high association with ED in young adults at 30-40 years. We think that it will be of benefit to consider periodontal disease as a causative clinical condition of ED in such patients.

The effect of periodontal treatment in improving erectile dysfunction: a randomized controlled trial.

OBJECTIVE: The aim of the study was to evaluate changes in the International Index of Erectile Dysfunction (IIEF) score following periodontal treatment in patients who had severe or moderate erectile dysfunction (ED) and chronic periodontitis (CP). MATERIALS AND METHODS: The authors declare that they have no conflict of interest. The study population consisted of 120 patients with severe or moderate ED and CP. The treatment group (n = 60) comprised patients who received periodontal treatment, whereas the control group (n = 60) comprised patients who did not receive periodontal treatment. The clinical assessments were recorded at baseline, and at 1 month (R1) and 3 months (R2) after intervention for both groups. The periodontal examination involved assessment of the plaque index, bleeding on probing, probing depth and clinical attachment level. The IIEF questionnaire was used to assess the severity of ED. RESULTS: In the treatment group, the improvement in all clinical periodontal parameters was greater than that in the control group, at both R1 and R2 (p < 0.05). The increase in the IIEF scores of the treatment group at R2 was higher than that of the control group (p < 0.05), whereas the IIEF scores were similar for both groups at R1 (p > 0.05). CONCLUSION: The findings of the study suggest that periodontal treatment can provide additional benefits in the improvement of ED. However, further studies are needed to understand the mechanisms of interaction between these diseases.

Assessment of urinary incontinence in the women in eastern Turkey.

INTRODUCTION AND HYPOTHESIS: The aims of the present study were to determine the types of UI among women visiting the urology department, to identify the potential risk factors associated with each type of UI, and to identify healthcare-seeking behaviors of affected women in our region. METHODS: The data of 617 community-dwelling women, who were at least 18 years of age or older and who presented with a complaint of UI ongoing over a year, and those without UI, who were admitted for any other reason, from June 2010 to April 2012, were evaluated. RESULTS: Mean age was 51.29 years (range 18-110 years); median parity was 3.54 (range 0-11) and 88.2% of the women were married. Mean BMI was 28.01 kg/m(2). Very few women (18.5%) accepted UI as a disease and searched for medical help by themselves; however, the remaining women (81.5%) were brought or directed for evaluation by someone else. Stress UI was reported by 43 women (10.5%), urge UI and mixed UI were noted by 153 (37.5%) and 212 (52%) women respectively. CONCLUSIONS: The most frequent type of UI was mixed UI in our region. Age, BMI, multiparity, and hypertension were identified to have a different importance for each type of UI, but diabetes mellitus, birth trauma, gynecological surgery, lumbar disc hernia (LDH), and multiple sclerosis (MS) were the other important related factors. However, a small number of patients accepted UI as a disease and searched for therapy. This reveals that the public should be informed in detail about female UI in developing countries.

Efficacy and safety of Hyadex for treatment of vesicoureteral reflux: a multicenter experience.

OBJECTIVE: This study was performed to evaluate the efficacy and safety of dextranomer/cross-linked hyaluronic acid (Hyadex) in patients with a clinical diagnosis of vesicoureteral reflux (VUR). METHODS: In this cross-sectional multicenter observational study, Hyadex was used in four different centers for the endoscopic treatment of VUR from 2020 to 2022. The study involved 74 patients (93 renal units) who were diagnosed with VUR according to voiding cystourethrography (VCUG) findings and were considered suitable for subureteric endoscopic treatment. The follow-up time (control VCUG time) was 3 months. RESULTS: In the VCUG evaluation, grade I VUR was found in 13 renal units, grade II in 23 renal units, grade III in 42 renal units, and grade IV in 12 renal units. The success rates of Hyadex treatment according to the degree of VUR were as follows: 84.6% for grade I, 82.6% for grade II, 71.4% for grade III, and 66.0% for grade IV. No major complications were observed. CONCLUSION: Endoscopic subureteric Hyadex injection had high success rates in appropriately selected patients with VUR and may be used as the first-line treatment for children with VUR.

Ameliorating effects of quercetin and chrysin on 2,3,7,8-tetrachlorodibenzo- p-dioxin-induced nephrotoxicity in rats.

The aim of this study is to investigate the beneficial effects of the quercetin (Q) and chrysin (CH) against nephrotoxicity induced by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a persistent environmental contaminant, in rats. Rats were divided randomly into six equal groups. TCDD, Q and CH were administered by gavages dissolved in corn oil at the doses of 2 µg/kg/week, 20 mg/kg/day and 50 mg/kg/day, respectively. The kidney samples were taken from all rats on day 60 for the determination of thiobarbituric acid reactive substances (TBARS), glutathione (GSH), catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD) levels by spectrophotometric method. The results indicated that TCDD significantly induced lipid peroxidation and reduced antioxidant activities in rats. In contrast, Q and CH significantly prevented toxic effects of TCDD via increased GSH, CAT, GPx and SOD levels but decreased formation of TBARS. Also, it was determined that exposure to TCDD leads to significant histological damage in kidney tissue, and these effects can be eliminated with Q and CH treatment. In conclusion, the current study showed that exposure to TCDD can exert nephrotoxicity in rats. When Q and CH were given together with TCDD, they prevented nephrotoxic effects of TCDD. Their preventive effect lends more support to the role of oxidative and histological damage in the overall toxicity of TCDD.

Mortality after kidney transplantation: 10-year outcomes.

OBJECTIVES: In the past decade, advances in immunological therapy have increased the survival of kidney recipients and their grafts. However, it has not achieved the desired level of improvement. This study aims to reveal the mortality among kidney recipients. METHODS: Medical data of the patients, who had undergone kidney transplantation (KT) between November 2010 and December 2020, were retrospectively reviewed. Inclusion criteria were adult kidney recipients, who had died. Exclusion criteria were pediatric recipients, recipients of en bloc and dual KT, recipients with missing data, and recipients with a primary non-functioning graft. The recipients were grouped according to their donor type; Group 1 (from a living donor) and Group 2 (from a deceased donor). Subgroup analyses were done for mortality by time-period post-transplant and for infectious causes of mortality. RESULTS: Of 314 recipients, 35 (11.14%) died. Twenty-nine recipients were included in the study (Group 1: 17 and Group 2: 12). The most common cause of mortality was infection (58.6%), and the second was cardiovascular disease (CVD) (24.1%). Sepsis developed in 29.4% of infection-related deaths, while COVID-19 constituted 23.5% of infection-related deaths. CONCLUSION: Early diagnosis and treatment of infectious and CVD are important to improve survival in kidney recipients.

OBJETIVOS: En la última década, los avances en la terapia inmunológica han aumentado la supervivencia de los receptores de riñón y sus injertos. Sin embargo, no se pudo lograr el nivel de mejora deseado. Este estudio tiene como objetivo revelar la mortalidad entre los receptores de riñón. MATERIALES Y MÉTODOS: Se revisaron retrospectivamente los datos médicos de los pacientes, que se habían sometido a un trasplante de riñón entre Noviembre de 2010 y Diciembre de 2020. Los criterios de inclusión fueron los receptores de riñón adultos, que habían fallecido. Los criterios de exclusión fueron los receptores pediátricos, los receptores de trasplantes de riñón dual y en bloque, los receptores con datos faltantes y los receptores con un injerto primario no funcionante. Los receptores se agruparon según su tipo de donante; Grupo 1 (de un donante vivo) y Grupo 2 (de un donante fallecido). Se realizaron análisis de subgrupos para la mortalidad por período de tiempo posterior al trasplante y para las causas infecciosas de mortalidad. RESULTADOS: De 314 beneficiarios, 35 (11,14%) fallecieron. Se incluyeron 29 receptores en el estudio (Grupo 1:17; Grupo 2:12). La causa más común de mortalidad fue la infección (58,6%) y la segunda fue la enfermedad cardiovascular (24,1%). La sepsis se desarrolló en el 29,4% de las muertes relacionadas con la infección, mientras que el COVID-19 constituyó el 23,5% de las muertes relacionadas con la infección. CONCLUSIÓN: El diagnóstico y tratamiento tempranos de enfermedades infecciosas y cardiovasculares es importante para mejorar la supervivencia de los receptores de riñón.

Pulmonary hypertension in peritoneal dialysis patients: prevalence and risk factors.

AIM: To investigate the prevalence of pulmonary arterial hypertension (PAH) and the possible contributing factors for PAH in patients receiving regular continuous ambulatory peritoneal dialysis (CAPD). PATIENTS AND METHODS: The study included 135 CAPD patients and 15 disease-free controls. Patients that had chronic obstructive pulmonary disease, severe mitral or aortic valve disease, connective tissue disease, history of pulmonary embolism, left ventricular ejection fraction <50%, or chest wall or parenchymal lung disease were excluded. All patients and controls were examined using echocardiography and bioelectrical impedance analysis. PAH was defined as systolic pulmonary artery pressure (PAP) >35 mmHg at rest. RESULTS: Mean systolic PAP was higher in the CAPD patients than in the controls (19.66 +/- 11.66 vs 14.27 +/- 4.55 mmHg, p = 0.001). PAH was detected in 17 (12.6%) of the 135 CAPD patients. Mean systolic PAP was significantly higher in patients with PAH than in those without PAH (42.00 +/- 9.13 vs 16.44 +/- 7.83 mmHg, p = 0.001). Serum albumin level and ejection fraction were lower in patients with PAH than in those without PAH (p = 0.001 and 0.003 respectively). The ratio of extracellular water/total body water (ECW/TBW), which can reflect hydration status, was significantly higher in patients with PAH than in those without PAH (p = 0.008). In the PD group, no patients were hypovolemic; 51 (37.8%) of the 135 PD patients were hypervolemic and 84 (62.2%) were normovolemic. Only 3 of the 17 patients with PAH were normovolemic; the rest were hypervolemic. Mean systolic PAP was significantly higher in hypervolemic PD patients (24.57 +/- 14.19 mmHg) than in normovolemic PD patients (16.68 +/- 7.61 mmHg) (p = 0.001). PAP correlated with ECW/TBW (r = 0.317, p = 0.001) and left ventricular mass index (LVMI; r = 0.286, p = 0.001). On the other hand, it inversely correlated with serum albumin level (r = -0.281, p = 0.001), hemoglobin level (r = -0.165, p = 0.044), and ejection fraction (r = -0.263, p = 0.001). Serum albumin level, ECW/TBW, and LVMI were found in multivariate analysis to be independent risk factors for PAP. CONCLUSION: PAH is a frequent cardiovascular complication in CAPD patients. Serum albumin level, hypervolemia, and LVMI are major risk factors for PAH. Therefore, strategies for treatment of hypervolemia, left ventricular hypertrophy, and hypoalbuminemia should be enhanced to prevent the development of PAH in CAPD patients.

Evaluation of reproductive and renal toxicity of varenicline in male rats.

OBJECTIVES: Varenicline is a selective partial agonist for the nicotinic acetylcholine receptor a4b2 subtype, which is widely used to treat smoking addiction. However, there is still no data about its potential toxic effects on tissues. In this study, we aimed to determine the varenicline-induced toxicity on reproductive and renal tissues in rats. MATERIALS AND METHODS: Rats were randomly divided into two groups: control (n=10) and varenicline (n=24). Then, rats in each group were sub-divided equally as acute and chronic groups. The control rats were orally given distilled water only. Varenicline was administrated orally as follows: 1st-3rd days 9 µg/kg/day, 4th-7th days 9 µg/kg twice daily, and 8th-90th days 18 µg/kg twice daily. The rats of acute and chronic groups were sacrificed on the 45th and 90th days, respectively. Some tissue markers related to oxidative stress were measured, and sperm characteristics were observed. RESULTS: In the acute group, varenicline led to a significant decrease in SOD activities in both kidney and testis tissues. In the chronic group, varenicline significantly increased MDA and MPO production, and reduced CAT and GPx levels in the kidneys and testes. Also, SOD and GSH levels significantly decreased in the testes. Moreover, sperm characteristics were negatively affected; histopathological deformation was observed in the testes and kidneys in all groups. CONCLUSION: This study showed that varenicline could detrimentally affect the kidneys and testes in both acute and chronic term usage. Further studies will provide more insights into the molecular dynamics of this damage.

Therapeutic and protective effects of montelukast against doxorubicin-induced acute kidney damage in rats.

OBJECTIVES: The current study was designed to investigate the therapeutic and protective effects of montelukast (ML) against doxorubicin (DOX)-induced acute kidney damage in rats. MATERIALS AND METHODS: Thirty-five Wistar albino female rats were randomly divided into 5 groups as follows: Group I: Control; Group II: Control+ML; Group III: DOX; Group IV: DOX+ML; Group V: ML+DOX. At the end of the experiment, the kidney tissues of rats were collected. Thiobarbituric acid reactive substance (TBARS), reduced glutathione, superoxide dismutase (SOD), and catalase levels were determined from the kidney tissues. In addition, the kidney tissues were examined histologically. RESULTS: DOX induced a significant increase in the kidney TBARS levels, whereas SOD contents significantly decreased when compared with the control group. On the other hand, ML administration before and after DOX injection caused significant decreases in TBARS production and also increases in SOD levels. Histologically, the most remarkable damage was glomerulosclerosis and tubular changes in the DOX group. Moreover, marked tubular necrosis and swelling in tubular epithelial cells were observed in this group. Contrarily, although glomerulosclerosis was recognized as alleviated also in both DOX+ML and ML+DOX groups, the lesions did not completely ameliorate. However, treatment with ML after DOX injection was more effective than treatment with ML before DOX injection with respect to the protection of tubular structures. CONCLUSION: It was determined that ML treatment after DOX injection caused therapeutic effects against DOX-induced kidney damage. Thence, ML treatment is of some clinical properties for oxidative stress damage in kidney tissues.

Prospective evaluation of the alterations in the morphology and vascular resistance of the renal parenchyma with color Doppler ultrasonography after percutaneous nephrolithotomy.

PURPOSE: To evaluate the kidneys with color Doppler ultrasonography (CDUS) to determine whether percutaneous nephrolithotomy (PNL) causes renal parenchymal damage. PATIENTS AND METHODS: In 24 patients who underwent unilateral PNL with single renal pole access, cortical thickness, echogenicity, and resistive index (RI) were measured in each pole of the operated and contralateral kidney separately before and at postoperative day (POD) 1, and at 3, 6, and 12 months after PNL. RESULTS: The mean age of the patients was 36.67 +/- 14.68 years. The serum creatinine level increased significantly immediately after PNL but diminished to the preoperative level at POD 1. Changes in serum blood urea nitrogen and electrolyte levels were insignificant. Mean cortical thickness increased significantly in the access pole and contralateral kidney and insignificantly in the nonaffected pole. No statistically significant change was recorded in parenchymal echogenicitiy. Statistically significant differences in cortical thickness between the access pole and the contralateral kidney and between the nonaffected pole and the contralateral kidney disappeared 3 months later. Differences in mean cortical thickness between the access pole and the nonaffected pole were insignificant at all examination periods. Echogenicity was greater in the access pole and the nonaffected pole than in the contralateral kidney only at POD 1. No significant difference was noted in the echogenicity between the access pole and the nonaffected pole. Mean RIs were lower than the universally accepted pathologic RI level (0.70) at all periods. There was no statistically significant difference between the mean RI values of the access pole, nonaffected pole, and contralateral kidney. CONCLUSION: PNL does not cause obvious renal dysfunction and significant parenchymal scarring, which is indicated by the decrease in cortical thickness and increases in cortical echogenicity and intrarenal RI.

Renal cell carcinoma diagnosed during pregnancy: a case report and literature review.

Diagnosing cancer during pregnancy is uncommon. Although pregnancies with concomitant malignancies have been reported, urological tumours are possibly the most rarely identified tumours during pregnancy. Renal cell carcinoma appears to be the most common urological malignancy during pregnancy. In this case report, we discuss successful management of a patient who was diagnosed with renal cell carcinoma during the antenatal period.

The effect of eggshell thickness on hatchability of quail eggs.

BACKGROUND AND AIM: The aim of the successful incubation period is to achieve maximum health chicks in each batch. Therefore, all factors affecting incubation have to be investigated in detail. This study investigated the effect of eggshell thickness on hatchability of quail eggs. MATERIALS AND METHODS: A total of 1415 eggs were collected from the same flock at the ages of 23 and 41 weeks. Two different incubations were performed at these eggs. Eggshell thicknesses of all eggs were determined with an ultrasonic gauge before incubation. Incubation period was applied as for 18 days. After 15 days of incubation, eggs were transferred to hatching machine. Eggs were classified as thin-, medium-, and thick-shelled according to eggshell thickness values. RESULTS: Eggshell thicknesses were ranged between 0.24 and 0.36 mm, and the differences between the hatching rates of thickness values were not found significant. Hatchability of thin-, medium-, and thick-shelled eggs was found as 69.2%, 69.4%, and 82.4% for Experiment 1. These values were as 87.8%, 89.2%, and 91.9% for Experiment 2, respectively. Similar to eggshell thickness frequencies, the differences between hatching rates of eggshell thickness groups were found insignificant. CONCLUSION: Results of this study showed that eggshell thickness does not affect hatchability.

An Angiotensin-converting enzyme inhibitor, zofenopril, prevents renal ischemia/reperfusion injury in rats.

Zofenopril ameliorates experimental cardiac ischemia/reperfusion (IR) injury in animal models and exhibits beneficial cardiovascular effects in patients with myocardial infarction. The objective of the present research was to investigate whether zofenopril can protect against renal IR injury. Rats were divided into 4 experimental groups: (a) control, (b) IR (60 min of ischemia followed by 24 hr of reperfusion), (c) zofenopril (15 mg/kg/day for 2 days), and (d) zofenopril+IR. All of the rats underwent right nephrectomy, and the rats in the IR and zofenopril+IR groups also underwent IR.then the left kidneys were removed for biochemical analyses and microscopic examination. There were no abnormalities in the biochemical and microscopic findings in the preoperative right kidneys. The lipid peroxidation, protein oxidation, and nitric oxide levels as well as xanthine oxidase and myeloperoxidase activities were increased and the catalase and superoxide dismutase activities were decreased in the IR group; zofenopril treatment prevented these changes (p <0.05). In the IR group, the kidney sections showed severe acute tubular damage including brush border loss, nuclear condensation, cytoplasmic swelling, and loss of nuclei; in the zofenopril+IR group, the normal glomerular morphology was preserved and there was slight edema of the tubular cells. The renal damage score was significantly reduced in the zofenopril+IR group vs the IR group (p <0.05). In conclusion, IR injury caused oxidative damage in renal tissue and zofenopril prevented this IR injury.

Protective effects of hesperidin in experimental testicular ischemia/reperfusion injury in rats.

INTRODUCTION: In this study, we aimed to determine the protective effects of hesperidin, a citrus flavonoid, in a model of testicular ischemia/reperfusion injury in rats. MATERIAL AND METHODS: Forty-two pubertal male Wistar-Albino rats were divided into six groups: group 1 - control; group 2 - 50 mg/kg hesperidin (low dose hesperidin) used without torsion (LH group); group 3 - 100 mg/kg hesperidin without torsion (HH group); group 4 - torsion/detorsion group (T/D); group 5 - T/D + 50 mg/kg hesperidin treatment group (T/D + LH); and group 6 - T/D + 100 mg/kg hesperidin treatment group (T/D + HH). Hesperidin was given to the treatment groups 30 min before detorsion. After the fourth hour of reperfusion, orchiectomy was performed on the rats under anesthesia. The tissue samples were examined histologically and biochemically. RESULTS: In the T/D group testicular malondialdehyde (MDA) levels were increased significantly (p < 0.001) whereas superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH) levels were decreased compared to the control and other groups. However, hesperidin caused the effect of T/D to become closer to normal biochemical values. In addition, the histological examinations showed that T/D caused damage in the testis but hesperidin reduced this effect. The effects of hesperidin were found to be dose dependent. Thus, applying high doses would generate greater therapeutic effects. CONCLUSIONS: In a rat testicular T/D model we observed biochemical and histological damage due to ischemia. However, high and low dose applications of hesperidin were shown to have protective effects against this damage. Therefore, the aforementioned citrus flavonoid may provide positive results in cases of testicular torsion.

Oral amoxicillin-clavulanic Acid treatment in urinary tract infections caused by extended-spectrum Beta-lactamase-producing organisms.

BACKGROUND: Extended-spectrum ß-lactamases (ESBLs) are increasing problems. The involvement of ESBL-producing organisms is associated with higher rates of carbapenem usage in urinary tract infections (UTIs). Though some strains are susceptible to amoxicillin-clavulanic acid (AMC) in vitro, there is very less data about the consequences of AMC usage for such infections. OBJECTIVES: The purpose of this study was to evaluate the clinical and microbiological outcomes of AMC treatment in UTIs caused by AMC-susceptible ESBL-producing organisms. PATIENTS AND METHODS: A retrospective cohort study was conducted in a tertiary care hospital. Forty-six out of 652 patients (F/M ratio: 32/14; mean age: 43.9 years) with ESBL-positive UTIs were eligible for this study. These patients had cystitis (n = 23), vesicoureteral reflux (n = 7), hyperactive bladder (n = 6), and prostatitis (n = 10). Data was collected via chart review and was statistically analyzed. RESULTS: AMC-susceptible ESBL-producing Escherichia coli, Klebsiella pneumoniae and K. oxytoca were identified as the causative agents in 31, 14, and 1 patients, respectively. Thirty-nine (84.7%) out of 46 patients were successfully treated with oral AMC. Additionally, 2 (4.3%) patients' urine cultures turned to be negative, though their clinical complaints and leukocyturia had continued. In the remaining 5 (10.8%) patients, no positive clinical and microbiological response was obtained. Increased minimum inhibitory concentration levels of AMC (from 4 to > 256 µg/mL) were detected in these patients and the treatment failures were attributed to this developing resistance. We found that therapeutic failure was significantly more frequent in Klebsiella spp. than in E. coli (33.3% vs 6.5%, P = 0.029). Furthermore, no treatment failure was observed in pathogens with minimum inhibitory concentrations (MICs) ≤ 2 mg/mL, and the high AMC MIC (8 mg/mL) was associated with resistance development and therapeutic failure (71.4% vs. 5.1%, P = 0.0001). CONCLUSIONS: Our results suggested that amoxicillin-clavulanic acid may be a good oral antimicrobial which can be used for treatment of ESBL-positive UTIs, if the causative agent is susceptible to this antibiotic. However, some strains may develop resistance during therapy, especially in those exhibiting high AMC MICs.