Impact of radiologic variables on item responses of ODI, SRS22 and SF-36. in adult spinal deformity patients: differential item functioning (DIF) analysis results from a multi-center database.

PURPOSE: To determine if responses given to each question of the Scoliosis Research Society-22 (SRS22), Oswestry disability index (ODI) and Short Form-36 (SF-36) questionnaires are influenced by the radiological parameters. METHODS: Patients enrolled in a multi-centre prospectively collected adult spinal deformity database who had complete SRS22, ODI and SF-36 data at baseline and at one-year follow-up were analysed. The presence of a differential item function of each question within each score in relation to radiological parameters was analysed using a mixed Rasch model with the radiological threshold value(s) determined. RESULTS: Of those patients analysed (n = 1745; 1406 female, average age 51.0 ± 19.8 years), 944 were surgically and 801 were non-surgically treated. For the SRS22, questions (Q) 3, 5 and 18 were sensitive to almost all radiological parameters and the overall score was found sensitive to the Cobb angle. For the ODI, Q3, 6, 9 and 10 were not sensitive to any radiologic parameters whereas Q4 and 5 were sensitive to most. In contrast, only 3 of the SF-36 items were sensitive to radiological parameters. CONCLUSIONS: 78% of the SRS-22, 60% of the ODI and 8% of the questions in the SF-36 are sensitive to radiological parameters. Sagittal imbalance is independently associated with a poor overall outcome, but affects mental status and function more than pain and self-image. The assembly of questions responsive to radiological parameters may be useful in establishing a connection between changes in radiologic parameters and HRQL.

Tunnel widening after single- versus double-bundle anterior cruciate ligament reconstruction: a randomized 8-year follow-up study.

OBJECTIVE: The purpose of this study was to compare the single-bundle (SB) and double-bundle (DB) surgical techniques for anterior cruciate ligament (ACL) reconstruction with regard to tunnel widening, isokinetic muscle strength, and clinical outcomes over an 8-year follow-up period. METHODS: This study included 31 patients with ACL injury who underwent ACL reconstruction via the SB (n = 16) or the DB (n = 15) technique. Isokinetic and concentric strength measurements of the quadriceps and hamstring muscles were conducted at postoperative 6 months and postoperative 8 years, and 3D-CT scans of the knee joints were performed on the 2nd, 3rd and 6th month, and the 8th year postoperatively. Clinical evaluations were performed at 8 years postoperatively with the International Knee Documentation Committee (IKDC), Tegner, and Lysholm knee scoring systems. RESULTS: There was marked widening of the parts of the femoral tunnel close to the knee joint in both the SD and the DB groups. There was no difference between the two groups in terms of clinical results and isometric muscle strength at postoperative 8 years; however, there was a significant difference between the preoperative and 6 months postoperative clinical and strength results in both group (P < 0.05). There was no difference between the groups in IKDC score, Lysholm score, Tegner activity scale, and anterior drawer test at postoperative 8 years. On evaluation of the anteromedial bundles alone, the DB group had greater widening than the SB group. CONCLUSION: In this study, we have found that the tunnels continue to enlarge after 6 months. However, that has no impact in patients comfort and that did not made any change in our daily routine. On the other hand, we found that the reconstruction of the double-band ligament technique is useless for non-professional athletes.

Using PVA and TPGS as combined emulsifier in nanoprecipitation method improves characteristics and anticancer activity of ibuprofen loaded PLGA nanoparticles.

In the preparation of nanoparticles (NPs) by the nanoprecipitation method, emulsifiers play a key role for NPs' characteristics. The present study aimed to investigate the combined emulsifier effect on ibuprofen loaded poly(lactic-co-glycolic acid) (PLGA) NPs' characteristics and anticancer activity. Ibuprofen loaded PLGA NPs were prepared by nanoprecipitation using different concentrations of PVA (poly(vinyl alcohol)) or PVA-TPGS (d-α-tocopherol polyethylene glycol 1000 succinate) combination as emulsifier. It was found that encapsulation efficiencies of NPs varied between 17.9 and 41.9 % and the highest encapsulation efficiency was obtained with 0.5% PVA + 0.1% TPGS (coded as PLGA PVA/TPGS NPs). PLGA PVA/TPGS NPs were characterized and compared with PLGA PVA NPs, which was obtained by 0.5% PVA alone. Polydispersity index of PLGA PVA/TPGS and PLGA PVA NPs were found to be 0.08 and 0.15, respectively. Incorporation of TPGS with PVA slightly decreased the initial ibuprofen release. Transmission electron microscopy analyses demonstrated a nearly uniform particle size distribution and spherical particle shape of the PLGA PVA/TPGS NPs. Additionally, PLGA PVA/TPGS NPs were significantly more cytotoxic than PLGA PVA NPs on the MCF-7 (human breast adenocarcinoma cells) and Caco-2 (human epithelial colorectal adenocarcinoma) cells (p<0.05). Also PLGA PVA/TPGS NPs were not cytotoxic on normal cells (L929, mouse healthy fibroblast cells) (p>0.05). In conclusion, these results indicated that using a combination of TPGS and PVA as an emulsifier in nanoprecipitation could be a promising approach for preparing ibuprofen loaded PLGA NPs because of their improved characteristics and anticancer activity.

Protective effect of thymoquinone against cyclophosphamide-induced genotoxic damage in human lymphocytes.

OBJECTIVE: Protective effect of thymoquinone (TQ) against the cytotoxic and genotoxic effects of cyclophosphamide (CP) was assessed in human peripheral blood lymphocyte culture. METHODS: Mitotic indices were determined as endpoints of cytotoxicity, while sister chromatid exchanges (SCE) served as endpoints of genotoxicity. Firstly, the genotoxic effect of 0.16 µg/ml of CP was tested and CP was detected as genotoxic. In the second set, CP group was treated with 20 µM and 40 µM TQ. RESULTS: TQ reduced the SCE frequencies, suggesting its protective action on human lymphocytes in vitro against the CP induced genotoxic damage. CONCLUSIONS: Our results suggest that TQ produces a protective mechanism against CP-induced genetic damage, and suggest a role of DNA strand breaks in the genotoxicity (Tab. 1, Fig. 1, Ref. 19).

The role of reactive oxygen species in the antibacterial photodynamic treatment: photoinactivation vs proliferation.

UNLABELLED: Low-level light/low concentration of reactive oxygen species (ROS) may trigger some biochemical pathways that lead to cell proliferation. Thus, there is a risk of stimulation of bacterial cell proliferation during photodynamic therapy (PDT). In this study, PDT with different doses of 809-nm laser and indocyanine green (ICG) was investigated in vitro for safe bactericidal application. The combined effect of laser doses with ICG concentrations were examined on Pseudomonas aeruginosa in vitro. Data showed that low energy dose and ICG concentration caused bacterial cell proliferation. When these parameters were increased high enough, photoinactivation of the bacteria was achieved. Energy dose and photosensitizer concentration ranges at which proliferation, cell death or neither observed were determined. Furthermore, l-histidine was used as a scavenger of ROS to block the mechanism of biostimulation and cell killing. It inhibited proliferation when laser dose and ICG concentrations were low. It also inhibited cell killing when dose and concentration were high. Data showed that mechanisms of proliferation and cell killing depend on the amount of ROS and antibacterial photodynamic treatment have serious biostimulative risk. Effective range might need to be determined before any therapeutic usage. The risk seems to exist specifically at lower energy doses and photosensitizer concentrations. SIGNIFICANCE AND IMPACT OF THE STUDY: The main purpose in antibacterial photodynamic therapy (PDT) is to kill the micro-organisms that cannot be destroyed by conventional methods. Low-level light and/or low concentration of reactive oxygen species may trigger some biochemical pathways that lead to cell proliferation. Thus, there is a risk of bacterial cell proliferation during PDT. In this study we report that PDT with ICG application can induce biostimulation when laser dose and photosensitizer concentration are not optimized properly. Therefore, optimum dosimetry in PDT possesses great importance in the treatment of wounds infected by antibiotic-resistant bacteria.

A CASE OF CONFINED PLACENTAL MOSAICISM WITH TRISOMY 15 ASSOCIATED WITH TURNER SYNDROME.

We here present a rare case of a Turner syndrome with mosaic trisomy 15 identified on chorionic villous sampling (CVS). Although there are several reports in the literature indicating confined placental mosaicism (CPM), counseling parents of a fetus with trisomy 15 mosaicism at CVS remains difficult because of the phenotypic variability. To illuminate that condition an amniocentesis or cord blood study should be offered in conjunction with genetic counseling.

Primary mucinous carcinoma of the vulva with signet ring cells deriving from the cloaca.

Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are primary or metastatic. Presence of signet ring cells in a tumour at female genito-urinary tract is highly suggestive of a metastatic lesion particularly from a gastrointestinal tumour. Here the authors present a case of vulvar carcinoma with signet ring cells with an undetermined primary site possibly originating from embryonic cloaca.

Determinants of nocebo effect during oral drug provocation tests.

BACKGROUND: A "nocebo" effect is defined as troublesome symptoms after the administration of placebo. The aim of this study was to determine characteristics of nocebo responses and related factors. METHODS: Patients with a reliable history of drug-induced hypersensitivity reactions subjected to placebo-controlled oral drug provocation tests and reacted to placebo, were consecutively included in this case-control study. Controls consisted of the randomly selected subjects who had a history of drug hypersensitivity reaction but did not react to placebo. A structured questionnaire was performed by an allergy specialist. RESULTS: There were 137 subjects (mean age: 43.10 ± 12.65 years), with nocebo and 91 subjects (42.38 ± 12.18 years) without any reaction to placebo. Most nocebo reactions (71.5%, n=98) were classified as subjective, with local pruritus as the most common finding. A minority of nocebo reactions (11.7%, n=16) were objective as cutaneous reactions including flushing and urticaria. Factors related with nocebo risks were university graduation (OR: 2.96, 95% CI: 1.27-6.93, p=0.012) and non-atopy (OR: 2.12, 95% CI: 1.02-4.40, p=0.043). In terms of the time of first and last historical reaction to drugs, each 1-unit (a month) increase in first reaction time (OR: 1.008, 95% CI: 1.00-1.02, p=0.001) and last reaction time (OR: 1.019, 95% CI: 1.01-1.03, p<0.001) were associated with increased nocebo risk. CONCLUSION: In conclusion, subjects with high education, non-atopy, and older drug hypersensitivity reactions history seem to be more likely to experience nocebo effect during oral drug provocation tests. These risk factors should be considered and managed accordingly to complete the drug provocation procedure successfully.

Management of a Benign Phyllodes Tumor in a 13-Year-Old Girl with Trans-position of the Nipple Areola Complex and Breast Reconstruction.

Phyllodes tumor is a rare primary tumor of the breast. In children and adolescents, it is even rarer with only 20 cases, treatment of which vary in the literature. Herein we report the case of a 13-year-old female patient with a giant benign phyllodes tumor eroding the bottom of the breast skin and causing nipple retraction. We performed breast conservative surgery by mobilizing the areola, using skin flaps and inserting an implant. Breast malignancy, including phyllodes tumor (PT), is very rare in adolescents. PT, previously called cystosarcoma phylloides, consists of leaf-like fronds, from which the tumor gets its name (1, 2). Although PT is most often seen in the fourth decade of life, almost 20 cases have been reported in the adolescent period, most of which are benign. The histologic types are benign, borderline, and malignant, depending on the mitotic rate of the tumor (3, 4).

Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity.

BACKGROUND: The aims of this study were to investigate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in inflammatory bowel disease (IBD). METHODS: Sixty-six patients (22 CD, 44 UC) and 41 healthy controls were enrolled in the study. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and complete blood count (CBC) were measured. The neutrophil and lymphocyte counts were recorded and NLR was calculated. The patients with active or inactive UC and CD were classified according to the severity of the disease. RESULT: The serum NLR values of active CD patients were significantly higher than those of inactive ones and controls (p = 0.000, p = 0.000, respectively). NLR values of active UC patients were significantly higher than those of inactive ones and controls (p = 0.000, p = 0.000, respectively. The optimum NLR cut-off point for active CD and UC was 3.2 and 3.1. CONCLUSION: This study demonstrates that NLR in subjects with IBD is strongly associated with active disease and correlated with clinical and laboratory indices (Tab. 5, Fig. 2, Ref. 31).

Genotoxic and genoprotective effects of some antipsychotic drugs, methylphenidate and atomoxetine on human lymphocytes and HepG2 cells.

OBJECTIVE: Aripiprazole, risperidone, atomoxetine, and methylphenidate are drugs commonly prescribed for many psychiatric conditions and can be used alone or in combination in children and adolescents. This study aimed to investigate comparatively the possible genotoxic effects or genoprotective potentials of these drugs on human lymphocytes and HepG2 cells. MATERIALS AND METHODS: Cytotoxicity analysis was performed with the cell viability test on human lymphocytes and HepG2 cells, and half-maximal inhibitory concentration (IC50) values of the drugs were determined, and three different doses (» IC50, ½ IC50, and IC50) were applied for genetic analysis. For the determined doses, cells with and without DNA damage were examined by comet analysis. RESULTS: In lymphocytes, aripiprazole and risperidone increased DNA damage at moderate and maximum doses, whereas atomoxetine increased DNA damage only at the maximum dose. In HepG2 cells, risperidone reduced DNA damage at all doses, while atomoxetine increased DNA damage at all doses. On the other hand, in the DNA-damaged cells induced by hydrogen peroxide (H2O2), DNA damage decreased at all concentrations of all drugs in both lymphocytes and HepG2 cells. CONCLUSIONS: As a result, the genotoxicity of the drugs was found to be dose-dependent, and all drugs showed a genoprotective effect on DNA-damaged cells.

Robotic gastrectomy is safe in geriatric patients with gastric cancer: a retrospective cohort study.

OBJECTIVE: The efficacy of robotic surgery in oncological operations has been demonstrated, but its applicability in the elderly population (≥70 years) is limited in studies. This study aims to investigate the feasibility, safety, and short-term outcomes of robotic surgery in gastric cancer surgery in geriatric patients. PATIENTS AND METHODS: Patients who underwent robotic surgery for gastric cancer between July 2021 and September 2023 were included in the study. Patients were divided into two groups: the elderly group (≥70 years) and the younger group (<70 years). Demographic data, clinical findings, perioperative outcomes, and pathology results were analyzed and compared between the two groups. RESULTS: 63 patients were included in our study. Group 1, the younger patients (<70 years), consisted of 44 patients, while Group 2, the older patients (>70 years), consisted of 19 patients. The male gender was dominant in both groups (70.5% vs. 78.9%, p=0.486). ASA 2 was the most common score in both groups (70.5% vs. 52.6%, p=0.261). Group 2 had lower hemoglobin (11.3 vs. 10.1, p=0.017) and albumin levels (39.9 vs. 37.6, p=0.049). The average operation times were similar in both groups (255 min vs. 242 min, p=0.457). The median postoperative hospital stay was 5 days in both groups. The distributions of postoperative complications according to the Clavien-Dindo classification were similar. Postoperative 30-day mortality was observed in one patient in Group 2. The 90-day hospital readmission rates were similar (11.3% vs. 10.6%, p=0.459). The average tumor diameters were similar (38 mm vs. 48 mm, p=0.165), as were the numbers of dissected lymph nodes (35 vs. 34, p=0.796). According to pathology results, T4a tumors were most common in Group 1 and T0 tumors in Group 2 (34.1% vs. 31.6%, p=0.149). The most common lymph node involvements were N0 in Group 1 and N1 in Group 2 (36.4% vs. 36.8%, p=0.515). CONCLUSIONS: Robotic surgery in gastric cancer is considered a safe and feasible method in the elderly population due to its successful early outcomes, suggesting its reliability and effectiveness.

Visibility of artificial buccal recurrent caries under restorations using different radiographic techniques.

The aim of the present study was to assess intraoral images and two cone beam computed tomography (CBCT) systems for detection of artificial buccal recurrent caries under restorations. Class V cavities were made for composite (30 teeth) and amalgam (30 teeth). Full restorations with thermoplastic polymer (30 teeth) and nickel-chromium metal crown (30 teeth) were constructed. In 60 teeth, artificial buccal recurrent caries were simulated; 60 other teeth served as controls. Intraoral film, intraoral digital, Veraviewepocs 3D, and Kodak 9000 images were scored twice. κ Coefficients were calculated and Az values were compared using Z-tests, with a significance level of α=0.05. Higher interobserver agreement was obtained from the CBCT images compared with the intraoral images. The Az values of both readings of all three observers were highest for the Veraviewepocs 3D followed by Kodak 9000 except for the second reading of the third observer. CBCT outperformed intraoral radiography in detection of artificial buccal recurrent caries under restorations.

The relationship between microsatellite instability in colorectal adenocarcinoma and tumor budding and histopathological parameters.

OBJECTIVE: This study aims to investigate the correlation between the presence of microsatellite instability (MSI) and tumor budding, as well as their relationship with histopathological parameters in patients diagnosed with colorectal adenocarcinoma. PATIENTS AND METHODS: The study encompassed patients who underwent curative surgery to treat colorectal cancer. These patients were classified into groups based on their MSI status. The International Tumor Budding Consensus Conference (ITBCC) 2016 guidelines were utilized to identify tumor budding. Demographics, clinical data, tumor budding, and histopathological attributes were assessed across study groups. RESULTS: The study analyzed 268 patients, out of which 32 (11.9%) were identified as having MSI. Microsatellite Stable (MSS) patients were placed in Group 1, and those with MSI were classified into Group 2. The average age was lower in Group 2 compared to Group 1 (55.9 years vs. 61.4 years, p=0.034). Tumor localizations in the caecum (5.9% vs. 18%) and the ascending colon (11.9% vs. 25%) were more prevalent in Group 2 (p=0.019). The occurrence of tumor budding (75% vs. 62.5%, p=0.133) and the budding degree in those with tumor budding were comparable between the groups. Poorly differentiated tumors were more prevalent in Group 2 (5.5% vs. 25%, p=0.001). Additionally, the tumor diameter was larger in Group 2 (3.58 cm vs. 4.35 cm, p=0.007). CONCLUSIONS: MSI is a significant biomarker, possessing diagnostic, prognostic, and predictive value in colorectal cancer (CRC). Understanding the connection between MSI and tumor budding in CRC may provide clinicians with insights to enhance patient management.

Prevalence of aspirin-exacerbated respiratory disease in patients with asthma in Turkey: a cross-sectional survey.

BACKGROUND: There are no country-based data focused on aspirin (ASA)-exacerbated respiratory disease (AERD) in Turkey. OBJECTIVE: To assess the prevalence of AERD in adult patients with asthma. METHODS: A structured questionnaire was administered via face-to-face interview by a specialist in pulmonology/allergy at seven centres across Turkey. RESULTS: A total of 1344 asthma patients (F/M: 1081/263: 80.5%/19.5%, mean age: 45.7 ± 14.2 years) were enrolled. Atopy rate was 47%. Prevalence of allergic rhinitis, chronic rhinosinusitis/rhinitis, and nasal polyposis (NP) were 49%, 69% and 20%, respectively. Of 270 patients with NP, 171 (63.3%) reported previous nasal polypectomy and 40 (25%) had a history of more than three nasal polypectomies. Aspirin hypersensitivity was diagnosed in 180 (13.6%) asthmatic patients, with a reliable history in 145 (80.5%), and oral ASA provocation test in 35 (19.5%) patients. Clinical presentations of ASA hypersensitivity were respiratory in 76% (n=137), respiratory/cutaneous in 15% (n=27), and systemic in 9% (n=16) of the patients. Multivariate analysis indicated that a family history of ASA hypersensitivity (p: 0.001, OR: 3.746, 95% CI: 1.769-7.929), history of chronic rhinosinusitis/rhinitis (p: 0.025, OR: 1.713, 95% CI: 1.069-2.746) and presence of NP (p<0.001, OR: 7.036, 95% CI: 4.831-10.247) were independent predictors for AERD. CONCLUSION: This cross-sectional survey showed that AERD is highly prevalent among adult asthmatics and its prevalence seems to be affected by family history of ASA hypersensitivity, history of rhinosinusitis and presence of NP.

To study the correlation between carrier status of nasal Staphylococcus aureus in patients on haemodialysis with hepatitis C, hepatitis B and their sociodemographic features.

AIM: To study the correlation of nasal Staphylococcus aureus carrier status in patients on haemodialysis, infected by hepatitis C virus (HCV), hepatitis B virus (HBV), and their sociodemographic features. SUBJECTS AND METHODS: A survey, including patients' sociodemographic features, was applied to patients by physicians in face to face interviews. Medical records regarding their serologic data were recorded from haemodialysis centres. Nasal swab samples of 2 cm depth from both nostrils of patients were obtained for nasal culture. Samples were inoculated in 5% sheep blood agar and incubated in an incubator at a temperature of 37 degrees C for 24 hours. The results were studied by the same microbiologist. RESULTS: A total of 185 patients were enrolled in the study. According to culture results, 14.1% of patients (n = 26) had methicillin sensitive Staphylococcus aureus (MSSA) and 1.1% (n = 2) had methicillin resistant Staphylococcus aureus (MRSA). Status of viral hepatitis was 3.8% (n = 8), 10.8% (n = 20) for HBV and HCV respectively. Forty per cent (n = 8) of patients with HBV (+) had MSSA carrier status. Statistically significant positive correlation between MSSA and HCV carrier was detected (r = 0.325, p = 0.001) but not between HBV carrier and MSSA (p = 0.255). CONCLUSION: In the present study, significant positivity was detected between MSSA carrier status and HCV in patients on haemodialysis and who have lived together with < or = 2 family members at home. Particularly, statistically significant correlation between HCV(+) and MSSA carrier was observed.

Genotoxic effects of tacrolimus on human lymphocyte cells.

We designed in vitro study to determine possible genotoxic effects oftacrolimus (FK-506), which is used as a potent immunosuppressive drug, by using sister chromatid exchange (SCEs), chromosome aberration (CAs), micronuclei tests (MN) and cell growth kinetics such as mitotic index (MI) and replication index (RI) in human lymphocytes. The cells were treated with 5, 25, 50, and 100 ng/mL concentrations of tacrolimus, for 24 h and 48 h treatment periods. Tacrolimus induced CA and MN frequency at all concentrations for 24 and 48 h In additon, it induced the SCE at the highest concantration for 24 h and at 25 and 100 ng/mL for 48 h. Tacrolimus decreased MI at all concentrations (except 5 ng/mL) for all treatment periods. It also inhibited the RI at 50 and 100 ng/mL concentrations for 24 h and at all concentrations for 48 h. Treatments given with tacrolimus result in the enhance of the different endpoints ofgenotoxicity, suggesting its mutagenic action on lymphocytes in vitro.

Porous silicon-based direct hydrogen sulphide fuel cells.

In this paper, the use of Au/porous silicon/Silicon Schottky type structure, as a direct hydrogen sulphide fuel cell is demonstrated. The porous silicon filled with hydrochlorid acid was developed as a proton conduction membrane. The Au/Porous Silicon/Silicon cells were fabricated by first creating the porous silicon layer in single-crystalline Si using the anodic etching under illumination and then deposition Au catalyst layer onto the porous silicon. Using 80 mM H2S solution as fuel the open circuit voltage of 0.4 V was obtained and maximum power density of 30 W/m2 at room temperature was achieved. These results demonstrate that the Au/Porous Silicon/Silicon direct hydrogen sulphide fuel cell which uses H2S:dH2O solution as fuel and operates at room temperature can be considered as the most promising type of low cost fuel cell for small power-supply units.

Lack of association between catalase gene polymorphism (T/C exon 9) and susceptibility to vitiligo in a Turkish population.

Accumulation of hydrogen peroxide (H(2)O(2)) and low catalase (CAT) activity have been demonstrated in the epidermis of vitiligo patients. We investigated a possible association between the CAT exon 9 (Asp-389) gene and vitiligo susceptibility in the Turkish population. Thirty-four patients with vitiligo and 49 gender, age and ethnic matched controls were enrolled in the study. Genotyping was done by PCR-RFLP. The CAT exon 9 (Asp-389) genotype and allele frequencies of vitiligo patients did not differ significantly from those of healthy controls. We found no association between CAT (Asp-389) gene polymorphism and vitiligo susceptibility in Turkish vitiligo patients.

The therapeutic effect of Cilastatin on drug-induced nephrotoxicity: a new perspective.

OBJECTIVE: By creating nephrotoxicity models with cisplatin, vancomycin, and gentamicin in HK-2 (human renal proximal tubule cell) and HEK293T (human embryonic kidney epithelial cells) cell lines, we aimed to evaluate the effect of cilastatin on recovery of cell damage after toxicity had occurred. MATERIALS AND METHODS: In the first phase of the study, the doses of cisplatin, vancomycin, and gentamicin (50% inhibitive concentration; IC50) were determined. In the second phase, the effective dose of cilastatin against these drugs was determined, and IC50 doses of nephrotoxic agents were administered simultaneously. In the third phase of our study, to evaluate the possible therapeutic effect of cilastatin after toxicity had occurred, the analyses of cell viability, apoptosis, oxidative stress, expression of kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) were performed. RESULTS: In the second phase of the study, it was observed that cilastatin increased cell viability when treated simultaneously with a nephrotoxic agent. In the third phase, cilastatin provided a significant increase in cell viability. After treatment with each agent for 24 hours, we determined that adding cilastatin to the medium had an effect on the recovery of cell damage by increasing cell viability and reducing apoptosis and oxidative stress. The expression of KIM-1 and NGAL increased when nephrotoxicity occurred and decreased with the addition of cilastatin to the medium. CONCLUSIONS: The findings of the study suggest that cilastatin may have a healing effect after the development of nephrotoxicity.