Shoulder tip pain after cesarean section: General versus spinal anesthesia.

Background and Aim: Shoulder tip pain is a common but overlooked complication during the postoperative cesarean section. In this study, we aimed to investigate the relationship between the anesthesia method and the incidence of shoulder tip pain. Patients and Methods: In this randomized clinical study, 117 patients who underwent cesarean section were divided into two groups as spinal anesthesia and general anesthesia. The demographic characteristics, the presence, the severity of shoulder tip pain, and also analgesic consumption in the first 24 hours were compared. Results: The incidence of shoulder tip pain was significantly higher in the spinal anesthesia group than in the general anesthesia group (p = 0.032). While there was no statistically significant difference in terms of the number of patients who needed opioid treatment within the first 24 hours between patients with and without STP, a statistically significant difference was observed in terms of the use of nonsteroidal anti-inflammatory drugs (P < 0.001). Conclusions: This study shows that the frequency and severity of shoulder pain are higher in women who have had cesarean section under spinal anesthesia, compared to those who had received general anesthesia.

Macular capillary system and ganglion cell-layer complex of the amblyopic eye with optical cohorence tomography angiography and optical cohorence tomography.

PURPOSE: To investigate the macular capillary system and ganglion cell-layer complex of the amblyopic eye with OCTA and OCT in comparison with fellow non-amblyopic eyes and a healthy control group and to examine their relationship with the severity of amblyopia. METHODS: This prospective, cross-sectional comparative study enrolled 25 amblyopic patients and 25 healthy controls. All patients and controls underwent OCTA and OCT imagining. Macular vessel densities of the Superficial Capillary Plexus (SCP) and Deep Capillary Plexus (DCP) and retinal thickness were measured by OCTA and ganglion cell layer (GCL) by OCT. RESULTS: SCP density at the fovea and parafovea was significantly lower in amblyopic eyes than in fellow eyes and control group. DCP density at the fovea was significantly lower in amblyopic eyes than fellow eyes and control group. Mean GCL thickness on OCT was 0.73 ± 0.07 µm in amblyopic eyes, 0.75 ± 0.06 µm in fellow eyes and 0.77 ± 0.06 µm in the control group. GCL volume was significantly lower in amblyopic eyes than the fellow eyes. The SCP and DCP and GCL thickness were not affected by the severity of amblyopia. CONCLUSION: Macular vessel densities of the SCP and DCP of eyes with amblyopia is lower compared to the fellow non-amblyopic eyes and the control group. The thickness of GCL was lower in amblyopic eyes than fellow eyes while the severity of amblyopia did not have any impact on these structures. Microvascular retinal structures may have been affected in the course of amblyopia development.

Perspective on rhabdomyolysis-induced acute kidney injury and new treatment options.

AIM: The purpose of this study was to assess the role of caspase-dependent apoptosis, caspase 1, calpain 1, inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) and the protective effect of grape seed proanthocyanidin extract (GSPE) in the development of rhabdomyolysis-induced acute kidney injury (AKI). MATERIALS AND METHODS: Twenty-one rats were divided into 3 groups - control, rhabdomyolysis and rhabdomyolysis + GSPE. Rhabdomyolysis was induced in the rhabdomyolysis and rhabdomyolysis + GSPE groups with the injection into both hind limbs of 10 ml/kg hypertonic (50%) glycerol following 24-hour dehydration on the 6th day. The rhabdomyolysis + GSPE group was given GSPE at 100 mg/kg by gavage for 7 days. The experiment was concluded 48 h after glycerol injection. Blood specimens were collected, and kidney tissues were extracted for histopathological examination. RESULTS: We identified an increase in blood urea nitrogen, creatinine, histopathological score, iNOS, caspase 3, caspase 1 and calpain 1 expression in the rhabdomyolysis group compared to the controls and a decrease in eNOS expression. In the rhabdomyolysis + GSPE group, however, there was a decrease in these mediators, together with an increase in eNOS expression. CONCLUSION: This study shows for the first time in the literature that calpain 1 is involved in the pathogenesis of rhabdomyolysis-induced AKI, and that GSPE may have a renoprotective effect.

Risk factors for peritonitis related to peritoneal dialysis.

BACKGROUND: The aim of this study was to evaluate risk factors for peritonitis associated with peritoneal dialysis in our centre. METHODS: Forty patients on chronic peritoneal dialysis between 2006-2010 were enrolled in this study. Nutritional, sociodemographical, psychological, dialysis related (peritoneal modality, characteristics and adequacy) possible risk factors associated with the development of peritonitis were recorded. Data of patients with and without peritonitis were compared using the Student's t-test and chi-square test. RESULTS: There were 31 episodes of peritonitis among 21 patients, while other 19 patients had not experienced peritonitis resulting in a rate of 1 episode / 44 patient months. Staphylococcus aureus was the most frequent microorganism isolated (31 %). Hypoalbuminemia, technical problems, poor personal and environmental hygiene, low educational status, current or former smoking history and less urine output were observed significantly more in patients who had peritonitis. CONCLUSIONS: Our results confirm that educational, psychological, nutritional, smoking and hygiene status and amount of urine output are closely associated with peritonitis among peritoneal dialysis patients. Measures to improve these factors may help prevent and control peritoneal dialysis related peritonitis (Tab. 4, Ref. 14).

COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission.

OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.

Carbonic anhydrase I and II autoantibody levels in primary hypertension: our preliminary results.

OBJECTIVE: The pathogenesis of primary hypertension (HT) is still not completely clear, although autoimmunity has been implicated in recent years. Carbonic anhydrase (CA) is an enzyme involved in a number of important metabolic processes. CA I and II autoantibodies have been linked to various autoimmune diseases. However, CA I and II autoantibody levels in primary HT have not been previously investigated. The purpose of this study was, therefore, to investigate levels of CA I and II autoantibodies in primary HT. PATIENTS AND METHODS: Fifty-six patients newly diagnosed with primary HT and 33 healthy individuals were included in the study. Twenty-four-hour ambulatory blood pressure monitoring was performed following office controls. Blood specimens were collected under appropriate conditions for CA I and II autoantibody level investigation and biochemical tests. Urine sodium and protein excretion were measured after 24 h. Demographic and biochemical parameters and CA I and II autoantibody levels were then compared between the patient and healthy groups. RESULTS: CA II autoantibody and uric acid levels were significantly higher in the hypertensive group than in the control group (p=0.005, and p<0.001, respectively). CA II autoantibody (exp ß: 79.06 CI: 4.44-1407.02) (p=0.003) and uric acid elevation (exp ß: 2.10 CI: 1.31- 3.34) (p=0.002) were identified as independent predictors of HT development at logistic regression analysis. CONCLUSIONS: CA II autoantibody levels were higher in hypertensive patients, and this elevation is an independent predictor of HT development.

A new COVID-19 prediction scoring model for in-hospital mortality: experiences from Turkey, single center retrospective cohort analysis.

OBJECTIVE: Although many studies reported prognostic factors proceeding to severity of COVID-19 patients, in none of the article a prediction scoring model has been proposed. In this article a new prediction tool is presented in combination of Turkish experience during pandemic. MATERIALS AND METHODS: Laboratory and clinical data of 397 over 798 confirmed COVID-19 patients from Gülhane Training and Research Hospital electronic medical record system were included into this retrospective cohort study between the dates of 23 March to 18 May 2020. Patient demographics, peripheral venous blood parameters, symptoms at admission, in hospital mortality data were collected. Non-survivor and survivor patients were compared to find out a prediction scoring model for mortality. RESULTS: There was 34 [8.56% (95% CI:0.06-0.11)] mortality during study period. Mean age of patients was 57.1±16.7 years. Older age, comorbid diseases, symptoms, such as fever, dyspnea, fatigue and gastrointestinal and WBC, neutrophil, lymphocyte count, C-reactive protein, neutrophil-to-lymphocyte ratio of patients in non-survivors were significantly higher. Univariate analysis demonstrated that OR for prognostic nutritional index (PNI) tertile 1 was 18.57 (95% CI: 4.39-78.65, p<0.05) compared to tertile 2. Performance statistics of prediction scoring method showed 98% positive predictive value for criteria 1. CONCLUSIONS: It is crucial to constitute prognostic clinical and laboratory parameters for faster delineation of patients who are prone to worse prognosis. Suggested prediction scoring method may guide healthcare professional to discriminate severe COVID-19 patients and provide prompt intensive therapies which is highly important due to rapid progression leading to mortality.

Evaluation of the factors associated with sublingual varices: a descriptive clinical study.

BACKGROUND: Age is considered as an important factor for the development of sublingual varices (SV). It has been suggested that some other conditions such as gender, systemic diseases, smoking, denture wearing may play a role in aetiology. However, there are a limited number of studies investigating these associations. This study was perform to evaluate association between SV and the conditions which are described as possible risk factors previously. MATERIALS AND METHODS: A total of 691 patients (470 females, 221 males) who attended for comprehensive clinical examination were included in the study. Age, gender, systemic health, venous varix of the lower extremities, smoking status, denture wearing were recorded during the history taking. SV were classified into two categories: stage 0 (few or none visible) and stage 1 (moderate or severe). Tongue photographs were taken from a group of these patients. For the evalu- ation of intra-observer reliability, 60 photographs of tongue were re-evaluated by the same observer. Intra-observer reliability was evaluated using Kappa statistics. Pearson c2 test and Fisher's exact test were used to assess SV in relation to each variable, and variables showing associations with p < 0.05 were selected for the multivariable analysis, then logistic regression analysis was applied. RESULTS: Kappa value of intra-observer reliability was 0.91. SV were significantly associated with age (odds ratio [OR] = 1.08, p = 0.000), hypertension (OR = 2.3, p = 0.007) and denture wearing (OR = 2.17, p = 0.02). CONCLUSIONS: The presence of SV is associated with hypertension and denture wearing as well as aging. More detailed studies are needed to prove causative relations between SV and systemic diseases.

Sedoanalgesia for cardioversion: comparison of alfentanil, remifentanil and fentanyl combined with propofol and midazolam: a prospective, randomized, double-blind study.

OBJECTIVE: Electrical cardioversion (EC) is a short but painful procedure to restore sinus rhythm. The aim of this study is to compare the effect of fentanyl, remifentanil and alfentanil in association with propofol and midazolam for elective EC. PATIENTS AND METHODS: Ninety-nine patients older than 18-years, American Society of Anesthesiologists I/II/III grades undergoing elective EC were randomized into 3 groups. All patients received 2 mg midazolam and propofol (0.5 mg/kg). Group A received alfentanil (5 µg/kg i.v. bolus), Group F received fentanyl (0.5 µg/kg i.v. bolus) and Group R received remifentanil (0.25 µg/kg i.v. bolus). Hemodynamics and respiratory variables [Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), SpO2, respiratory rate (RR)], and Modified Aldrete recovery score (MARS) were assessed at six different time points (baseline, right after EC, and 3rd min, 5th min, 10th min, 30th min following EC). Also, induction times (time to reach RSS to 5) and recovery times (time to reach MARS to 8) were recorded. The incidence of respiratory depression, bradycardia, hypotension and adverse effects were also recorded. RESULTS: Hemodynamic variables were similar in all groups. SpO2 values in Group R were significantly lower at 3rd min (p = 0.005). Induction and recovery times were longest in Group F. There were significant differences at 3rd, 5th and 10th minute MARS values between groups. The incidence of hypotension and bradycardia were similar in all groups (p > 0.05) but respiratory depression was higher in Group R (p = 0.047). CONCLUSIONS: Propofol alfentanil combination has more beneficial advantages in their rapid onset, early recovery time and less respiratory depression than remifentanil and fentanyl.

Polidocanol (Lauromacrogol 400) has anti-angiogenic effects in vitro and in vivo.

OBJECTIVE: Polidocanol is the most frequently used sclerosant for sclerotherapy all around the world. Our experimental research aims to find out the angiogenic effects of Polidocanol. MATERIALS AND METHODS: Angiogenic activity of polidocanol was examined in vivo in the chick chorioallantoic membrane (CAM) model, cell viability assay (human umbilical vein endothelial cells - HUVECs) and in vitro tube formation assay of HUVECs. RESULTS: In CAM assay, a significant decrease on CAM vessel growth was observed after the application of polidocanol solutions. Vessel growth inhibition was strongly dose-dependent. There was a cytotoxic effect on HUVECs in the presence of polidocanol observed with MTT assay (p < 0.05). In the tube formation assay, statistically significant decrease in tube formation was observed in polidocanol group. It was found that polidocanol had an anti-angiogenic effect (p < 0.05). The results provide evidence that polidocanol decreases angiogenesis and has a cytotoxic effect on ECs. CONCLUSIONS: These results provide evidence that Polidocanol (lauromacrogol 400) have strong anti-angiogenic effects in vitro and in vivo. Further researches needed to reveal early and long-term effects of polidocanol in the human vascular system and new treatment approach as an anti-angiogenic therapy.

New probing and warm-wash-out technique improves early patency rates in arteriovenous fistula surgery.

OBJECTIVE: Arteriovenous fistulas (AVFs) are commonly used during hemodialysis. Early failure of AVFs is quite common with incidence of 43% to 63%. In this study we aimed to describe a novel approach to AVF surgery for improving early patency rates. PATIENTS AND METHODS: Patients were divided into two groups according to use of probing and warm-wash-out technique. Group I consisted of 31 patients with additional probing technique. Group II consisted of 32 patients without additional maneuver. End-to-side anastomosis were used to all patients. Technical success was defined as having palpation of a thrill on fistula. Flow rates of draining vein was measured at 1st hour, 24th hour, 1st week and 3rd week of surgery. SURGICAL TECHNIQUE: Classical maneuvers were performed until end of the anastomosis. At this time, vein lumen was washed by low-dosed heparinized warm fluid, with assistance of a simple catheter. RESULTS: Technical success was similar in both groups at 1st hour and 24th hour, while there were significantly differences between groups at 1st week (p = 0.042) and 3rd week (p = 0.05) assessments. Flow rates were also measured significantly higher in Group I at 1st hour (p = 0.011) and 24th hour (p = 0.016). Flow rates were almost similar in two groups at 1st and 3rd weeks but overall success rate was higher in Group I comparing with Group II (96.8% vs. 81.3%, respectively, p = 0.05). CONCLUSIONS: Probing and warm-wash out technique will simply increase the surgical success and flow rate of draining vein.

Comparison of angiogenic and proliferative effects of three commonly used agents for pulmonary artery hypertension (sildenafil, iloprost, bosentan): is angiogenesis always beneficial?

OBJECTIVE: Pulmonary artery hypertension (PAH) is devastating disease that has very serious outcomes. Dysregulated angiogenesis is one of the main responsible courses in pathophysiology of disease. Our experimental research intends to find out and compare the angiogenic effects of medications used sildenafil, iloprost, and bosentan in the treatment of PAH. MATERIALS AND METHODS: This study was performed in Department of Biochemistry and Cancer and Stem Cell Research Laboratory of our institutes between August and October 2014. Angiogenic activity of sildenafil, iloprost, and bosentan were examined in vivo in chick chorioallantoic membrane (CAM) model and in vitro tube formation assay of human umbilical vein endothelial cells (HUVECs). Proliferative activity of these three agents was also determined through 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on HUVECs. RESULTS: In CAM assay, when compared to the control and drug groups, treatment with sildenafil solutions resulted in a significant dose-dependent increase (budding, sprouting, extravasation) on CAM vessel growth. While there was no significant proliferative effect with iloprost and bosentan, presence of sildenafil caused a statistically significant proliferation on HUVECs following 24 and 48 h incubation (p < 0.05) compared to the control group. Comparing the tube length/area ratio values, there was statistically significant increase in sildenafil group with respect to the other 2 groups (p < 0.05). Iloprost and bosentan did not show a significant effect. CONCLUSIONS: The results provide evidence that sildenafil but not iloprost and bosentan induces angiogenesis in vitro and in vivo. Dysregulated angiogenesis, as an important pathophysiological part in the progression of PAH, may be triggered by the chronic ingestion of sildenafil in the long treatment period and may cause negative effects.

NMR spectroscopic studies of intermediary metabolites of cyclophosphamide. A comprehensive kinetic analysis of the interconversion of cis- and trans-4-hydroxycyclophosphamide with aldophosphamide and the concomitant partitioning of aldophosphamide between irreversible fragmentation and reversible conjugation pathways.

Multinuclear (31P, 13C, 2H, and 1H) Fourier-transform NMR spectroscopy, with and without isotopically enriched materials, was used to identify and quantify, as a function of time, the following intermediary (short-lived) metabolites of the anticancer prodrug cyclophosphamide (1, Scheme I): cis-4-hydroxycyclophosphamide (cis-2), its trans isomer (trans-2), aldophosphamide (3), and its aldehyde-hydrate (5). Under a standard set of reaction conditions (1 M 2,6-dimethylpyridine buffer, pH 7.4, 37 degrees C), the stereospecific deoxygenation of synthetic cis-4-hydroperoxycyclophosphamide (cis-12, 20 mM) with 4 equiv of sodium thiosulfate (Na2S2O3) afforded, after approximately 20 min, a "pseudoequilibrium" distribution of cis-2, 3, 5, and trans-2, i.e., the relative proportions of these reactants (57:4:9:30, respectively) remained constant during their continual disappearance. NMR absorption signals indicative of "iminophosphamide" (8) and enol 6 were not detected (less than 0.5-1% of the synthetic metabolite mixture). A computerized least-squares fitting procedure was applied to the individual 31P NMR derived time courses for conversion of cis-2, 3 plus 5 (i.e., "3"), and trans-2 into acrolein and phosphoramide mustard (4), the latter of which gave an expected array of thiosulfate S-alkylation products (e.g., 16) and other phosphorus-containing materials derived from secondary decomposition reactions. This kinetic analysis gave the individual forward and reverse rate constants for the apparent tautomerization processes, viz., cis-2 in equilibrium "3" in equilibrium trans-2, as well as the rate constant (k3) for the irreversible fragmentation of 3. The values of k3 at pH 6.3, 7.4, and 7.8 were equal to 0.030 +/- 0.004, 0.090 +/- 0.008, and 0.169 +/- 0.006 min-1, respectively. Replacement of the HC(O)CH2 moiety n 3 with HC(O)CD2 led to a primary kinetic isotope effect (kH/kD = 5.6 +/- 0.4) for k3. The apparent half-lives (tau 1/2) for cis-2, "3", and trans-2 under the standard reaction conditions, at "pseudoequilibrium" (constant ratio of cis-2/"3"/trans-2), were each equal to approximately 38 min, which is considerably shorter than the widely cited colorimetrically derived half-lives reported by earlier investigators. The values of tau 1/2 for cis-2, "3", and trans-2 were affected by pH in the same manner as that found for k3 but were relatively insensitive to the presence of either K+, Na+, Ca2+, or Mg2+. The presence of certain primary amines led to marked decreases in tau 1/2 and, in some cases, the formation of acyclic adducts of aldehyde 3.(ABSTRACT TRUNCATED AT 400 WORDS)

Prediction of chromatographic retention, pKa values and optimization of the separation of polyphenolic acids in strawberries.

Polyphenolic acids are a complex group of compounds that have attracted enormous attention in the last few years because of their biological properties. In this work, the proportion of organic modifier and the pH of acetonitrile-water mixtures used as mobile phases were optimized in order to separate a series of polyphenolic compounds. The linear solvation energy relationship formalism based on the single solvent polarity parameter, E(T)N was used to predict their chromatographic behavior as a function of the percentage of acetonitrile in the eluent. Moreover, the correlation established between retention and the pH of the aqueous-organic mobile phase was used to optimize the pH of the mobile phase. The optimized mobile phase is composed of acetonitrile and formic acid buffer adjusted to pH 4.25, with 12% (v/v) acetonitrile. Also, the pKa values of polyphenolic acids in acetonitrile-water mixtures were determined using chromatographic data, and in order to validate the optimized conditions, a series of polyphenolic compounds was studied in strawberries.

Synthesis, hydrolytic reactivity, and anticancer evaluation of N- and O-triorganosilylated compounds as new types of potential prodrugs.

N- and O-Triorganosilylated compounds related to various anticancer agents were synthesized for evaluation as potential anticancer prodrugs. 1H-NMR and UV kinetic measurements of hydrolytic desilylation were used to correlate relative rates of structural unmasking with steric bulk about the silicon reaction center. The tert-butyldimethylsilyl ester of chlorambucil and a number of O- triorganosilylated carbamate derivatives of nor-nitrogen mustard showed significant activity against P-388 lymphocytic leukemia in mice.

Synthesis and evaluation of 3-halocyclophosphamides and analogous compounds as novel anticancer "pro-prodrugs".

3-Fluoro-, 3-chloro-, and 3-bromocyclophosphamide were prepared from the reaction of trifluoromethylhypofluorite, sodium hypochlorite, and bromine with the anticancer drug cyclophosphamide. Treatment of cis- and trans-4-phenylcyclophosphamide and 5,6-benzocyclophosphamide with sodium hypochlorite afforded cis- and trans-3-chloro-4-phenylcyclophosphamide and 3-chloro-5,6-benzocyclophosphamide, respectively. 31P-NMR spectroscopy was used to study the reactivity of these compounds: the fluoro derivative was reduced to cyclophosphamide on incubation with mouse liver slices, and the reactivity order for sulfhydryl-induced reduction of the 3-halocyclophosphamides was Br approximately equal to Cl much greater than F. Compared with the therapeutic efficacy of cyclophosphamide against L-1210 and P-388 cancers in mice, 3-fluoro- and 3-chlorocyclophosphamide were less active, although the fluoro derivative was more efficacious than the 3-chloro compound. The individual R and S enantiomers of 3-chlorocyclophosphamide, prepared from (S)- and (R)-cyclophosphamide, respectively, showed no significant difference in therapeutic activity in the P-388 test system.

The effects of a starter culture on the formation of biogenic amines in Turkish soudjoucks.

The effects of starter culture containing Lactobacillus sake, Pediococcus pentosaceus, Staphylococcus carnosus plus Staphylococcus xylosus on the formation of biogenic amines during ripening of Turkish soudjoucks were investigated. Determination of eight different biogenic amines was carried out by reverse-phase high performance liquid chromatography (HPLC) using diode array detection. It was found that aerobic plate counts (APC) decreased in the samples with added starter culture. Lactic acid bacteria counts increased in both the controls and samples with added starter during ripening. Total Enterobacteriaceae (ENT) counts decreased on the 30th day for vacuum packed and starter added samples. Yeast counts decreased only in vacuum packed and starter added samples on the 30th day. No biogenic amines were found in ground meat samples. Putrescine (PU) and tyramine (TYR) were determined in all control samples during the storage at 4°C. Starter addition inhibited formation of PU but not TYR.

Investigation of NF-κB1 and NF-κBIA gene polymorphism in non-small cell lung cancer.

Lung cancer is a complex, multifactorial disease which is the leading cause of cancer death in both men and women. NF-κB is a transcription factor which is known to affect the expression of more than 150 genes related to inflammation, lymphocyte activation, cell proliferation, differentiation, and apoptosis, as well as contributing to cell apoptosis and survival. However, NF-κBIA (IκBα) is the inhibitor of the transcription factor. The--94ins/delATTG polymorphism of the NF-κB1 gene promoter region which causes a functional effect and NF-κBIA 3'UTR A → G polymorphism has been shown to be related to various inflammatory diseases and cancer. Ninety-five NSCLC patients and 99 healthy controls were included in study. The NF-κB1-94ins/delATTG and NF-κBIA 3'UTR A → G polymorphism have been studied by using PCR-RFLP method. It was found that the NF-κB1 -94ins/delATTG DD genotype and D allele frequencies were higher in patients than healthy controls and the presence of the DD genotype has a 3.5-fold increased risk of the disease (P: 0.014). This study is the first to investigate the NF-κB1-94ins/delATTG and NF-κBIA 3'UTR A → G polymorphism together in the Turkish population. According to the results, the NF-κB1-94ins/del ATTG promoter polymorphism may have a role in lung carcinogenesis and prognosis.

Acute high dose-fentanyl exposure produces hyperalgesia and tactile allodynia after coronary artery bypass surgery.

OBJECTIVE: Opioid-induced hyperalgesia is well known complication of acute high dose and chronic opioid therapy. In this study, we evaluated development of opioid-induced hyperalgesia following intraoperative short-term use of µ-opioid agonist fentanyl after coronary artery bypass surgery. PATIENTS AND METHODS: 100 patients undergoing elective coronary artery bypass graft surgery is divided into two groups. In group I (low dose), anesthesia was induced with propofol 1-2.5 mg/kg and fentanyl 2 mcg/kg, in group II (high dose) fentanyl 40-70 mcg/kg was used. In group I, propofol 5-10 mg/kg/h, fentanyl 1-3 mcg/kg/h, in group II fentanyl 5-10 mcg/kg/h was used for maintenance of anesthesia. The tactile and thermal thresholds were measured before surgery and in 1st, 3rd and 7th postoperative days by using Von Frey filaments and a thermal source, respectively. RESULTS: Tactile thresholds were significantly decreased at the first (6,08±0.21 and 3.76±0.13 g; p<0.001) and third (6.76±0.24 and 4.96±0.16 g; p<0.001) postoperative days compared to baseline preoperative values (7.72±0.26, and 7.60±0.21 g; p=816) in two groups. Postoperative 1st (13.45±0.33 and 10.05±0.24 sec; p<0.001) and 3rd day (14.77±0.28 and 13.17±0.26 sec; p<0.001) assessments showed a statistically significant thermal hyperalgesia compared to the preoperative baseline values (16.67±0.51 and 16.45±0.42 sec; p=0.997) in two groups. This decrease in both tactile and thermal thresholds returned to baseline control values at the 7th day of measurement. CONCLUSIONS: Our results showed that patients undergoing coronary artery bypass surgery receiving fentanyl anesthesia developed postoperative tactile allodynia and thermal hyperalgesia and this was more prominent in high dose group.