Protective effects of p-coumaric acid against gentamicin-induced nephrotoxicity in rats.

The most important side effect of gentamicin (GM) is nephrotoxicity. p-Coumaric acid (PCA) is a phenolic compound that scavenges free radicals, reduces fibrosis, and tissue damage. This study investigates the protective effect of PCA on tissue damage and kidney function in gentamicin-induced nephrotoxicity (GIN). Thirty-five rats were separated into five groups and each group contained seven animals: control group, ethanol group, GM group, PCA group, and GM + PCA group. At the end of the seven-day treatment, the rats were sacrificed after blood and kidney tissue samples were taken. While serum urea, creatinine, and neutrophil gelatinase-associated lipocalin (NGAL) levels increased significantly in the GM group compared to the control, they showed a significant decrease in the GM + PCA group compared to the GM. Serum tumor necrosis factor-α (TNF-α) and tissue malondialdehyde (MDA) levels were significantly increased in the GM group compared to the control. While the tissue total oxidant status (TOS) and oxidative stress index (OSI) values of the GM group were significantly higher than the control, they showed a significant decrease in the GM + PCA group compared to the GM. In the histopathological examination, significant tubular necrosis and tubulointerstitial inflammation were detected in the proximal tubules in the GM group compared to the control, while a significant decrease was observed in the severity of these findings in the GM + PCA group compared to the GM. This study shows that PCA has biochemical and histopathological ameliorating effects on GIN in the rat model.

Anxiety and Salivary Cortisol Levels in Children Undergoing Esophago-Gastro-Duodenoscopy Under Sedation.

OBJECTIVES: Esophagogastroduodenoscopy (EGD) can cause fear and anxiety in children. Cortisol, which is the most important glucocorticoid hormone in humans, can increase under physiological stress. The purpose of this study was to measure the salivary cortisol level (SCL) and anxiety level in patients undergoing EGD and evaluate their effects on the procedure. METHODS: Children undergoing EGD under sedoanalgesia with propofol for various reasons were included. Their basal SCLs were compared with those of healthy age- and sex-matched controls. Moreover, SCL of the patient group at 30 minutes before EGD and 2 hours after the procedure were measured. Their anxiety scores were calculated using the modified Yale Preoperative Anxiety Scale before EGD. Duration of endoscopy, sedation, and recovery and total propofol doses were recorded. RESULTS: Demographic properties of the patient group (n = 119; 10.9 ±â€Š3.2 years; 43.7% boys) and control group (n = 85; 11.8 ±â€Š2.8 years; 45.1% boys) were not significantly different. Basal SCLs of both groups were similar (16.9 ±â€Š0.7 vs 19.7 ±â€Š1.8 ng/mL, P = 0.16). SCL before EGD in the patient group was significantly higher than basal and post-EGD values (P < 0.001 for each). Pre-EGD SCL was positively correlated with anxiety level, propofol dose, and duration of sedation, procedure, and recovery. Anxiety levels of patients were positively correlated with propofol dose and duration of sedation and recovery, and negatively correlated with age. CONCLUSIONS: Childhood EGD is a significant stress factor, which was reflected by the pre-procedural SCL in this study. Increased anxiety resulted in increased propofol doses and sedoanalgesia-related procedural durations, which may cause potential complications.

Is surgery a risk factor for separation anxiety in children?

OBJECTIVE: Postoperative anxiety symptoms are distressing for both family and child. The aim of this study was to examine the prevalence of postoperative anxiety symptoms in children. METHODS: 60 children aged 6-12 undergoing surgery were included in the study group. The study group was assessed three times in terms of separation anxiety disorder (SAD), at the time of presentation, 1 and 3 months postoperatively. A personal information form and the SAD section of the K-SADS-PL on the basis of DSM-IV diagnostic criteria for screening SAD symptoms were used. RESULTS: Study group consisted of 19 girls (31.7%) and 41 boys (68.3%) (mean age 8.9 ± 2.3). Four (6.6%) of the cases at the time of presentation and 13 (21.6%) in the study group met SAD diagnostic criteria in 1 month and 21 (35.0%) in 3 months. Anxiety disorder symptoms were significantly higher in the study group at 3 months postoperatively (p < 0.05). There is significant correlation between both SAD symptoms and duration of hospitalization. There was also a positive correlation between duration of hospitalization and parental education and SAD symptoms. CONCLUSION: Greater SAD was observed in children undergoing surgical procedures. It will be useful to physicians to consider SAD after surgery in pediatric patients especially when the level of parental education and duration of hospitalization increase. Since SAD may persist long after surgery, it may cause constant fear in personality disorders and lead to psychological problems by significantly lowering quality of life.

Migration of ingested sewing needle from within sigmoid colon to outside of the lumen.

Foreign body ingestion is a frequently observed condition in children. However, migration of an ingested foreign body from the gastrointestinal tract toward any abdominal organ is extremely rare. We report herein a case of a 2-year-old female patient in whom an ingested sewing needle was palpable by rectal examination and was determined to have migrated from within the sigmoid colon to outside of the lumen. The needle was surgically removed. In cases of foreign body ingestion, both physical examination and radiological follow-up should be performed.

[Intestinal perforation due to multiple magnet ingestion: a case report]. / Coklu miknatis yutulmasina bagli bagirsak perforasyonu: olgu sunumu.

Multiple magnet ingestion during childhood may result in emergency situations. A single magnet may be discharged with intestinal peristalsis, but multiple magnets may stick together and cause significant intestinal complications. Here we present a case with intestinal perforation due to ingestion of multiple magnets and metal pieces. An eight-year-old girl presented with abdominal pain and vomiting. She had abdominal tenderness and defense on the physical examination. Abdominal X-ray showed air and fluid levels. Metallic images were not considered at first as important in the diagnosis. Abdominal ultrasonography was reported as acute appendicitis. During the abdominal exploration, the appendix was normal, but there were dense adherences around the ileum and cecum. After adhesiolysis, intestinal perforations were seen in the cecum and 15 and 45 cm proximal to the cecum. Magnet and metal pieces were present in the perforated segments. Wedge resection and primary repair was performed. There were no postoperative complications, and she was discharged on the postoperative fifth day. Pediatric surgeons should be aware of the complications of multiple magnet ingestion. If the patient has a history of multiple magnet ingestion, follow-up with daily abdominal X-rays should be done, and in cases where magnets seem to cluster together or if acute abdominal signs develop, surgical exploration should be considered.

Effect of tunica albuginea incision on testicular tissue in testicular torsion.

BACKGROUND: Testicular torsion is the underlying cause in 15-20% of children presenting to the emergency department with scrotal pain. Testicular torsion, which is defined as the rotation of the testis around itself at the level of the spermatic cord, may cause organ loss due to impaired circulation. It is recommended to detortion the testis within the first 6 h to prevent organ loss. The aim of the study is to examine the effect of Tunica Albuginea incision (TAI) made in addition to detorsion (DT) on the viability of the torted testis. METHODS: The research has an experimental design. The study was carried out on three groups of rats (Sham, testicular torsion-(T-DT), TAI, and testicular torsion-detortion. After 10 days of follow-up, testes in the groups were taken for pathological examination. In the pathological examination, necrosis, ischemic changes, Johnsen score, edema, inflammation, and basement membrane thickening were evaluated and scored in all pathological samples. RESULTS: Necrosis, ischemic changes, edema, inflammation, and basal membrane thickening were found to be significantly less in the TAI group. Furthermore, the mean Johnsen Scores were significantly different between the T-DT (7.44±0.52) and TAI (8.60±0.51) groups. CONCLUSION: The results showed that the testicles in the TAI group were better preserved than the testicles, in which only DT was applied. It can be argued that in testicular torsion, the DT procedure is not sufficient to protect the testis, and it would be bene-ficial to add TAI to the procedure.

A case of atypically located leiomyoma mimicking axillary lymphadenomegaly.

Cevizci MN, Fettah A, Kabalar ME. A case of atypically located leiomyoma mimicking axillary lymphadenomegaly. Turk J Pediatr 2018; 60: 319-321. Leiomyomas are benign smooth muscle tumors rarely seen in children and may occur anywhere in the body containing smooth muscle. Here, we report a case of a 4-year-old girl presenting with swelling in the left axillary region and with pain during arm movements. The solid mass in the axillary region was totally excised. The patient was discharged without complications on the same day.