Efficacy and safety of particle embolization in bronchial arteries of hemoptysis patients with shunts.

AIM: This study assesses the safety and efficacy of particle embolization during bronchial artery embolization (BAE) in patients with shunts between bronchial and non-bronchial systemic arteries and the pulmonary artery. METHODS: In this retrospective, single-center study, we analyzed 312 BAE procedures performed from June 2020 to April 2023. The patient cohort had shunts between bronchial and non-bronchial systemic arteries and the pulmonary artery. We meticulously collected and examined comprehensive data, including clinical characteristics, computed tomography (CT) imaging, and embolization procedural details. RESULTS: Vascular shunts were identified in 49 patients. The etiologies of hemoptysis included post-TB sequelae (42.8%), bronchiectasis (26.5%), active TB (12.2%), aspergilloma (8.1%), bacterial pneumonia (4.1%), lung cancer (4.1%), and non-tuberculous mycobacterial infection (2%). The technical success rate of the procedures was 98%, with 149 out of 152 identified vessels successfully embolized. All patients experienced cessation or significant reduction of hemoptysis within 24 hours following the procedure. The clinical success rates were 97.9% at one month, 93.9% at six months, and 89.8% at one year. No shunt-related complications were detected. CONCLUSION: BAE with particle embolization is a safe and effective treatment for hemoptysis, particularly in cases with complex shunts between bronchial and non-bronchial systemic arteries and the pulmonary artery.

Comprehensive anatomy of the superior hypogastric plexus and its relationship with pelvic surgery landmarks: defining the safe zone around the promontory.

BACKGROUND: Pelvic surgery carries an inherent risk of autonomic nerve injury leading to genitourinary and bowel dysfunction due to the close proximity of the superior hypogastric plexus (SHP). The aim of this study was to define the detailed anatomy of SHP and identify its relationship with the vascular landmarks and ureters for pelvic autonomic nerve-preserving surgery. METHODS: A cadaveric study on the detailed anatomy of the SHP was conducted in our surgical anatomy research unit. Between 02/2019 and 10/2019, macroscopic anatomical dissections were performed on 45 fresh adult cadavers (39 male, 6 female). Distances between the SHP, major vascular structures, and other anatomical landmarks were measured. RESULTS: Three types of SHP morphology were observed: mesh (64.8%), single nerve (24.4%), and fiber (10.8%). SHP bifurcation was located inferior to the aortic bifurcation in all cases; however, it was observed cranial to the promontory in 80% of the cases, whereas 18% were caudally and 2% were over the promontory. The closest vessels to the left and right of the SHP bifurcation were the left common iliac vein (LCIV) (86.2%, the mean distance was 8.49 ± 7.97 mm) and the right internal iliac artery (RIIA) (48.2%, mean distance was 13.4 ± 9.79 mm), respectively. At SHP bifurcation level, the lateral edge of the SHP was detected on the LCIV in 22 cases and on the RIIA in 10 cases for the left and right side of the plexus, respectively. The distance between the SHP bifurcation and the ureter was 27.9 mm on the right and 24.2 mm on the left. The width of the left (LHN) and right hypogastric nerves (RHN) were 4.35 mm and 4.62 mm at 2 cm below the SHP bifurcation, respectively. LHN was on the vascular structures in 13 cases, whereas RHN in only 1 case, 2 cm below the SHP bifurcation. CONCLUSIONS: Understanding the location of the SHP, including its relationship with important anatomical landmarks, might prevent iatrogenic injury and reduce postoperative morbidity in the pelvic surgery setting.

Apelin-13: A Promising Biomarker for Age-Related Macular Degeneration?

PURPOSE: To investigate the value of serum apelin-13 levels in patients with age-related macular degeneration (AMD). METHODS: Patients with dry-type AMD, patients with treatment-naïve neovascular-type AMD, and healthy controls were included in this study. Diagnoses were confirmed on detailed fundus examination, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA). Central foveal thickness and subfoveal choroidal thickness were evaluated. Both serum apelin-13 and vascular endothelial growth factor (VEGF) levels were measured by a competitive enzyme-linked immunosorbent assay (ELISA) principle. RESULTS: A total of 84 subjects, i.e., 24 in the dry-type AMD group (group 1), 27 in the neovascular-type AMD group (group 2), and 33 in the control group (group 3) were included in the study. Mean best-corrected visual acuity (BCVA) was 76 ± 4.5, 48.4 ± 16.3, and 83.4 ± 3.09 ETDRS letters in group 1, 2, and 3, respectively. The level of serum VEGF was 44.11 ± 26.14, 56.53 ± 53.77, and 61.47 ± 41.62 pg/mL in groups 1, 2, and 3, respectively (p = 0.553, p = 0.286, and p = 0.896, respectively). The level of serum apelin-13 was 586.47 ± 167.56, 622.18 ± 324.52, and 379.31 ± 171.96 pg/mL in groups 1, 2, and 3, respectively (p = 0.847, p = 0.04, and p ≤ 0.001, respectively). There was a negative correlation between the level of serum apelin and visual acuity (VA) and choroidal thickness. CONCLUSION: Serum apelin-13 levels were higher in both dry-type and neovascular-type AMD patients than in controls. Further studies demonstrating the relationship of the level of serum apelin-13 and AMD are needed.

Coronary CT angiography for suspected acute coronary syndrome: sex-associated differences.

AIM: The optimal diagnostic test in the work-up of suspected acute coronary syndrome (ACS) may differ between men and women. The aim of this study was to compare sex-associated differences between using a diagnostic strategy including early coronary computed tomography angiography (CCTA) and standard of care (SOC). METHODS: In total, 500 patients who presented with symptoms suggestive of ACS at the emergency department were randomised between a diagnostic strategy supplemented with early CCTA and SOC. RESULTS: Women were generally older than men (mean ± standard deviation 56 ± 10 vs 53 ± 10 years, p < 0.01) and were less often admitted to hospital (33% vs 44%, p = 0.02). Obstructive coronary artery disease on CCTA (> 50% luminal narrowing) was less frequently seen in women (14% vs 26%, p = 0.02), and ACS was diagnosed less often in women (5% vs 10%, p = 0.03). Women underwent less outpatient testing when early CCTA was used in the emergency department evaluation of suspected ACS (p = 0.008). CONCLUSION: Women had a lower incidence of obstructive CAD on CCTA and were less often admitted to hospital than men. They were subjected to less outpatient testing when early CCTA was used in the emergency department evaluation of suspected ACS.

Effect of favorite music on postoperative anxiety and pain.

BACKGROUND: Music is one of the most commonly used non-pharmacological interventions to reduce anxiety. It helps patients overcome emotional and physical alienation, provides comfort and familiarity in an improved environment and offers a pleasant distraction from pain and anxiety. This study aimed to evaluate the effects of listening to preoperative favorite music on postoperative anxiety and pain. MATERIAL AND METHODS: This prospective, randomized, single-blinded, controlled trial included the American Society of Anesthesiologists (ASA) I-III patients, aged 18-70 years, undergoing elective inguinal hernia surgery. Demographic data and anxiety status were recorded. Anxiety status was measured using the Spielberger state-trait anxiety inventory form 1 (STAI-1) and state-trait anxiety inventory form 2 (STAI-2). After recording baseline heart rate, blood pressure and STAI levels, patients were randomly allocated to the music group (Group M) or control group (Group C). Patients in Group M listened to their favorite music using headphones and patients in the control group received standard care. The STAI­1 was repeated after surgery and the numeric rating scale (NRS) and patient satisfaction were measured. RESULTS: A total of 117 patients were included. Demographic data, educational status, and previous surgical history were similar between the groups. Mean preoperative STAI­1 and STAI­2 scores were similar between the groups (p > 0.05). Mean postoperative STAI­1 score was significantly lower in Group M than in Group C (39 [range 35-43] vs. 41 [range 37-43], p < 0.05). Moreover, the change in the STAI score was significantly higher in Group M compared with Group C (p < 0.05). The difference of hemodynamic measurements pre-music to post-music was significant between Group M and Group C (p = 0.001). The NRS scores remained similar between the groups. Patient satisfaction score was significantly higher in Group M (p = 0.017). CONCLUSION: Listening to patient-preferred favorite music preoperatively reduced anxiety, regulated hemodynamic parameters, and improved postoperative patient satisfaction. Reduced anxiety was not associated with reduced pain.

Effects of fullerenol nanoparticles on kidney tissue in sevoflurane­treated rats.

AIM: The aim of this study is to demonstrate whether fullerenol C60 protects renal injury in sevoflurane­administered rats. METHOD: Rats (n: 24) were randomly divided into four groups: Control (Group C), Fullerenol C60 (Group F), Sevoflurane (Group S), Fullerenol C60-Sevoflurane (Group FS). Thirty minutes before the procedure, Fullerenol C60, 100 mg/kg, was administered intraperitoneally. Sevoflurane (2.3 %) was applied for 3 hours to rats in S and FS groups. Biochemical and histopathological parameters were analyzed in renal tissue samples. Kruskal-Wallis and Mann-Whitney U tests were used in statistical analyzes. RESULTS: Malondialdehyde (MDA) level and catalase (CAT) enzyme activity in Group S were significantly higher than that in all other groups. Paraoxanase (PON) enzyme activity in Group S was significantly lower than in Groups C and FS. The histopathological examination showed that vascular vacuolization and hypertrophy (VVH) and lymphocyte infiltration (LI) were significantly higher in the Group S compared to the Group C. CONCLUSION: Renal histopathology revealed that the administration of Fullerenol C60 prior to sevoflurane inhalation reduced oxidative stress and partially corrected the damage caused by anesthesia. We concluded that Fullerenol C60 has a renal protective effect in rats when administered before sevoflurane anesthesia (Tab. 2, Fig. 4, Ref. 40).

Effects of recurrent sevoflurane anesthesia on cognitive functions with streptozotocin induced Alzheimer disease.

OBJECTIVE: We aimed to investigate the effects of recurrent sevoflurane anesthesia on cognitive functions in Alzheimer Disease. MATERIALS AND METHODS: Rats were divided into 4 groups as followed: control (Group C), sevoflurane (Group S), Alzheimer's (Group A) and Alzheimer's + sevoflurane (Group AS)]. Cognitive functions were evaluated with Radial Arm Maze Test (RAMT). Alzheimer model was created by administering 3 mg/kg (10 µl) STZ. Sevoflurane was administered to S and AS groups. Serum samples and hippocampus tissues were analyzed. RESULTS: In RAM test, the entry-exit data were significantly decreased in A and AS groups. After the 2nd and 3rd administration of anesthesia, the numbers were significantly decreased in Group S. Glial-fibrillary-acidic protein levels were significantly higher in AS compared to the C and S groups. The brain tissue caspase 3 activity was less than 1% in all rats in the Group C, 3 % in 2 rats and 1 % in 1 rat in the Group AS. In A and AS group, serum catalase, myeloperoxidase and ferroxidase activities were found to be higher than in the other groups and myeloperoxidase activity was higher in the AS than in the A Group. Serum native thiol, total thiol and disulfide levels were found to be significantly different in the A and AS groups. CONCLUSION: Sevoflurane anesthesia negatively affected the cognitive functions (Tab. 5, Fig. 10, Ref. 51).

Ultrasound-accelerated catheter-assisted thrombolytic therapy applications in deep vein thrombosis.

BACKGROUND: Ultrasound-accelerated catheter-directed thrombolysis (UCT) increases the invasion of thrombolytic agent into the thrombus using ultrasonic energy, provides less infusion of thrombolytic agent, reduces complication, and post-thrombotic syndrome (PTS) development rates. For these reasons, this procedure is a promising method for the treatment of deep vein thrombosis (DVT). MATERIALS AND METHODS: Patients diagnosed with DVT by ultrasonography (USG) who underwent UCT between May 2013 and August 2014 at Gazi University Hospital Cardiovascular Surgery Clinic were included in the study. The demographic characteristics and postoperative acute and long-term patency rates and deep venous insufficiency rates were evaluated retrospectively to determine the efficacy of the UCT procedure. Patients were classified as acute, subacute, and chronical DVT according to the onset of complaints. The efficacy of the UCT procedure was assessed by Doppler USG performed 6 months and 2 years after the procedure, and patients were re-evaluated for deep venous insufficiency and thrombus findings to determine the relationship between UCT procedure and deep venous insufficiency. RESULTS: In acute phase, 57.1% (n = 8) complete and 35.7% (n = 5) partial openings were obtained. No complete patency was obtained in any of the subacute patients. However, partial openness rate was 60%. In patients admitted during the chronic period, complete patency was obtained in 20% (n = 8) and partial openings in 60% (n = 3). Although thrombolysis success was not considered as statistically significant, the success rate was numerically higher in the acute phase. CONCLUSION: As a result, UCT applications provide thrombolysis especially in acute deep vein thrombosis, preventing deep venous insufficiency and especially post-thrombotic syndrome formation. UCT prevents bleeding complications by keeping thrombolytic amount low and can be used as an endovascular method of high safety in patient population with high bleeding complications such as patients with malignancies.

Spontaneous regression of lumbar disc herniations: A retrospective analysis of 5 patients.

The aim of this study is to describe patients who represent spontaneous regression of lumbar disc herniations (LDHs) subsequent to conservative treatments. In this retrospective study, medical records of 862 patients who had presented to our neurosurgery department with LDHs between May 2014 and May 2016 were studied. All of these patients had a history of low back pain and radiculopathy. Lumbar magnetic resonance imaging (MRI) scans were performed to diagnose them.LDHs were categorized into four subtypes including disc bulging, protrusion, extrusion, and sequestration. Five patients developed spontaneous regression of LDHs according to spinal MRI scans. All patients relieved radiculopathy symptoms in 2 to 4 weeks and low back pain symptoms in 3 to 8 weeks except one patient. In one patient hypoesthesia symptom, in one patient motor deficit, and in one patient low back painremained after the regression. The clinical and diagnostic imaging characteristics and outcomes of these five patients are described and the pertinent literature regarding spontaneous regression of LDHs is reviewed. Sequestrated disc herniations represent the main candidates for spontaneous regression according to our clinical research and the pertinent literature. Dehydration and inflammation-related resorption are the main mechanisms for this event. Conservative treatment modalities should not be underestimated for the treatment of such patients in the absence of definitive surgical indications.

Neutrophil elastase and myeloperoxidase mRNA expression in overweight and obese subjects.

Neutrophil elastase and myeloperoxidase enzymes have been implicated in high-fat diet-induced obesity, insulin resistance (IR) and atherosclerosis in animal models. The aim of the present study was to explore neutrophil elastase and myeloperoxidase mRNA expressions in the peripheral blood leukocytes (PBL) in overweight and obese subjects, and to correlate those mRNA expressions with BMI, IR and cardiovascular biomarkers. In this cross-sectional study, 74 apparently healthy subjects including 22 lean, 27 overweight and 25 obese subjects were recruited. Cardiovascular and metabolic biomarkers were evaluated from fasting blood samples. The mRNA levels of neutrophil elastase and myeloperoxidase genes in the PBL were quantified by real-time PCR. Compared to lean group, the overweight and obese groups showed significant upregulation of both neutrophil elastase (p < 0.001) and myeloperoxidase (p < 0.03) mRNA expressions in the PBL. But no difference was found between overweight and obese groups. The neutrophil elastase and myeloperoxidase mRNA levels showed significant positive correlation with BMI, serum triglyceride, atherogenic index of plasma and 10-year risk of developing cardiovascular disease. But no correlation was found with glucose, insulin or IR. It was concluded that the neutrophil elastase and myeloperoxidase genes are up-regulated in both overweight and obese subjects and are associated with BMI and markers of cardiovascular disease.

Investigation of the effects of thymoquinone on erythrocyte deformability in sepsis treatment which created by cecal perforation in rat.

AIM: We aimed to study the effects of thymoquinone on erythrocyte deformability in an experimental model of sepsis given before or after the initiation of the sepsis model. METHOD: The animals were grouped as (n = 6) control, nigella sativa, sepsis, sepsis group with administration of nigella sativa before sepsis development and sepsis group with nigella sativa administration after sepsis development. Cecal ligation and puncture model (CLP) was used to induce sepsis in the animals. The thymoquinone was given 1 hour before or after the CLP in the study groups with a dose of 500 mg·kg(-1). Erythrocyte deformability and relative resistance was calculated. RESULT: Relative resistance was increased in the sepsis groups when compared to the control group (p < 0.0001). Deformability index was increased in the sepsis group when compared to the other groups (p < 0.0001 in all groups). Sepsis group with after nigella sativa groups deformability index was significantly different from the deformability index in control group (p = 0.002). The use of nigella sativa before the initiation of sepsis corrected the deformability index significantly and the results were comparable to the control group (p = 0.078). CONCLUSION: Thymoquinone administration before induction of CLP was observed to have protective effects on these alterations in CLP sepsis (Tab. 1, Fig. 1, Ref. 26).

Effect of cerium oxide on erythrocyte deformability in rat lower extremity ischemia reperfusion injury.

BACKGROUND: Cerium oxide is the oxide form of cerium, which has protective effects in ischemia reperfusion (I/R) injury. The purpose of our study was to look into the effects of this rare-earth metal on erythrocyte deformability in rat lower extremity I/R injury model. MATERIALS AND METHODS: We used 24 Wistar albino rats as subjects in our study. They were divided into 4 groups; randomized control group (group C; n = 6), cerium oxide group 0.5 mg.kg-1, intraperitoneal (group CO; n = 6), I/R group (group I/R; n = 6) and I/R group with cerium oxide 0.5 mg.kg-1 intraperitoneally (group I/R-CO; n = 6). Erythrocyte packs were prepared from heparinized blood samples and deformability measurements were performed. RESULTS: We obtained similar results from the control and I/R-CO groups (p = 0.158). The results in I/R group were evidently higher than those of the control, CO, and IR-CO groups (p < 0.0001, p < 0.0001, p = 0.001, respectively). CONCLUSION: We detected unfavorable effects of I/R on erythrocyte deformability, which may impair blood flow and hence tissue perfusion in infrarenal rat aorta. We also found that cerium oxide had beneficial effects by reversing undesirable effects of I/R. Further studies with larger volume are required to support our promising results (Fig. 1, Ref. 24).

Effects of apelin-13 on myocardial ischemia reperfusion injury in streptozotocine induced diabetic rats.

AIM: We want to investigate the protective effects of apelin-13 on myocardial ischemia reperfusion (I/R) injury. MATERIAL AND METHODS: 30 Wistar Albino rat were divided into 5 groups (n:6), namely control group (C), diabetes group (D), diabetes+apelin-13 group (DA), diabetes+I/R group (DIR) and diabetes I/R+apelin-13 group (DIR-A). Rats were subjected to 30­min ischemia and 90­min reperfusion. Biochemical and histopathological parameters were measured. RESULTS: Caspase-3 enzyme activity was significantly higher in the DIR group than in the C, DA, and DIR-A groups. The intensity of caspase 3 enzyme activity was significantly higher in the I/R group than in all other groups. Inflammation and vascular dilatation were found significantly higher in the DIR group than in all other groups. Congestion was significantly higher in the DIR group than in the C and D groups. TOS enzyme activity was significantly higher in the DIR group than in the C, DA and DIR-A groups. TAS enzyme activity was significantly lower in the DIR group than in the C and DIR-A groups. CONCLUSION: We believe that the protective effects of apelin-13 in ischemia-reperfusion injury and its use indications can be demonstrated in detail as long as the findings we have reached in our study are supported by other studies (Tab. 2, Fig. 10, Ref. 43).

Effects of dexmedetomidine and thymoquinone on erythrocyte deformability in lower limb ischemia reperfusion injury in streptozotocin-induced diabetic rats.

OBJECTIVE: In this study we aimed to evaluate the effect of dexmedetomidine and thymoquinone on erythrocyte deformability in lower limb ischaemia-reperfusion (IR) injury in streptozotocin-induced diabetic rats. MATERIAL AND METHODS: Thirty Wistar albino rats were equally divided into 5 groups (n = 6); randomized control group (Group C), diabetes control group (Group DC), DIR group (Group DIR), DIR group with thymoquinone 25 mg.kg‒1 intraperitoneally (Group DIRT) and Group DIR with dexmedetomidine 100 µg.kg‒1 intraperitoneally (Group DIRD). Erythrocyte packs were prepared from heparinized blood samples and deformability measurements were performed. RESULTS: IR significantly increased the relative resistance, a marker of erythrocyte deformability when compared to control group (p < 0.05). There were significant differences among the groups in comparisons with ANOVA test (p < 0.0001). Comparisons of the groups DIRD and DIRT revealed similar results (p = 0.824). The values of Group DIR were significantly higher than those of the control, DC, DIRD and DIRT groups (p < 0.0001, p = 0.001, p = 0.004, p = 0.002, respectively). The values of the DC, DIR, DIRD and DIRT groups were significantly higher than those of the control group (p < 0.0001, all). CONCLUSION: Erythrocyte deformability may cause more problems in microcirculation. Dexmedetomidine and thymoquinone may be useful in reducing the adverse effects of this type of injury (Fig. 1, Ref. 41).

Effects of thoracic epidural or intravenous analgesia on the neutrophil-to-lymphocyte ratio in thoracotomy cases.

BACKGROUND AND PURPOSE: Postoperative pain is a significant problem in thoracotomy patients. Our aim in this study was to investigate the relationship between postoperative pain and neutrophil-to-lymphocyte ratio (NLR) which is a marker of acute inflammatory response. MATERIALS AND METHODS: Thoracic epidural or intravenous analgesia was administered to thoracotomy patients who elected to undergo a planned surgery. Patients were divided into two groups according to the analgesia method applied postoperatively. Thoracic epidural analgesia was recorded as Group 1 and intravenous analgesia as Group 2. Whole blood counts were recorded from preoperative and postoperative 24th- and 48th-hour routine blood samples, and NLRs were recorded as retrospective file scanning. Postoperative 24th- and 48th-hour NLRs and preoperative NLR values were recorded. RESULTS: Demographic data of the patients included in the study were similar except for age. Preoperative NLR was significantly higher in Group 1 at 3.50 (P = 0.004) than in Group 2 at 2.51. Postoperative NLRs were similar among both groups. Postoperative NLR values at both the 24th- and 48th-hour increased by4.9 times in Group 1 and 9.23 times in Group 2 from the 24th-hour preoperative period, when the preoperative NLRs were evaluated. The rate of increase in Group 1 was significantly lower than in Group 2 (P = 0.006). CONCLUSION: Postoperative NLR alterations when compared with preoperative values were related to the analgesic regimen used.

Investigating the effects of two different pump heads (Centrifugal vs. Roller Pump) on hematological and immunological mechanisms.

BACKGROUND AND AIM: Technological developments and enhancement of knowledge level enable heart surgery with low mortality rates in most centers. On the other hand, increased systemic inflammatory response against cardiopulmonary bypass (CPB) plays a critical role in the development of postoperative complications. We aimed to compare the effects of centrifugal pump where it is claimed that blood is exposed to minimal trauma and roller pump techniques on inflammatory response and oxidant status during CPB. MATERIALS AND METHODS: : A total of 40 patients, who had coronary artery disease and underwent coronary artery bypass graft (CABG) surgery using either roller or centrifugal pump between June 2012 and June 2013 were enrolled in this study. Patients over 40 years old and without any known immunologic, infectious, or inflammatory incidents and hematological problems for the past 6 months were included in the study. Two study groups (Group R: roller pump group and Group C: centrifugal pump group) were created. During CABG surgery tumor necrosis factor (TNF) alpha, interleukin (IL)-6, IL-8, superoxide dismutase (SOD), catalase (CAT), and nitric oxide levels were measured before and after CPB. RESULTS: TNF alpha, IL-6, and IL-8 levels measured before and after CPB were found to be similar between groups. SOD, CAT and Nitric oxide levels were also similar between groups. After the CPB period, glutathione peroxidase enzyme activities in Group R measured after CPB were significantly lower than those measured in Group C. The platelet-activating factor (PAF) levels before CPB usage period were same in both groups, where PAF levels after CPB were found to be significantly higher in roller pump group than centrifugal pump group. At inter-group comparisons, the levels of PAF were same at each group before and after CPB. CONCLUSION: The study findings indicate that usage of the centrifugal pump does not have a clear superiority in terms of the effects on inflammatory response and oxidant status during CPB when compared to roller pump. Nevertheless, we believe that our results should be supported by further clinical and experimental studies.

Effect of apelin-13 on erythrocyte deformability during ischaemia-reperfusion injury of heart in diabetic rats.

OBJECTIVES: Erythrocyte deformability and plasma viscosity are of crucial importance for the perfusion of tissues and organs. The aim of this study was to evaluate the effect of apelin-13 on erythrocyte deformability during IR heart injury in diabetic rats. METHODS: Eighteen Wistar Albino rats were included in the study after streptozotocin (55 mg/kg) treatment for four weeks of observation for diabetes existence. The animals were randomly assigned to one of five experimental groups. In the Group C, DC (sham-control group) and DCA (sham-control group-apelin-13), the coronary artery was not occluded or re-perfused. In the Group DIR, a branch of the left coronary artery was occluded for 30 minutes followed by 90 minutes of re-perfusion to produce IR. In the Group DIRA, a branch of the left coronary artery was occluded for 30 minutes followed by 90 minutes of re-perfusion to produce IR, and apelin-13 was administrated via 10 µg.kg-1 IP route 30 minutes before ligating the left coronary artery.Deformability measurements were performed in erythrocyte suspensions containing Htc 5% in a PBS buffer. RESULTS: The deformability index was significantly increased in diabetic rats; however, it was similar in Group DC, DCA and DIRA. It was significantly increased in the Group DIR when compared to the Group C, DIRA, DCA and DC. The relative resistance was increased in IR models. CONCLUSION: Erythrocyte deformability was decreased in rats having diabetes and IR injury. This injury might lead to further problems in microcirculation. It was shown that apeline-13 may be useful in enhancing the adverse effects of this type of injury (Fig. 1, Ref. 35).

Effect of different doses of pregabalin on skeletal muscle ischaemia-reperfusion injury in rats.

AIM/INTRODUCTION: Analgesic, anti-inflammatory and anti-apoptotic effects of pregabalin have been shown previously. In this study, we investigated the protective effect of different doses of pregabalin on skeletal muscle IR injury in rats. MATERIALS AND METHODS: 24 rats were randomly divided into 4 groups (Control, Ischaemia-Reperfusion (IR), IR-Pregabalin 50 mg, IR-Pregabalin 200 mg). Following IR, serum Ischemia Modified Albumin (IMA) and tissue Paraoxonase (PON) were studied and gastrocnemius muscle tissue was removed for histopathologic examination. RESULTS: Interstitial inflammation was higher in the IR group than in the control and Pregabalin 200 mg groups (p = 0.037, p = 0.037, respectively). Congestion was higher in the IR group than in the control, Pregabalin 50 and 200 mg groups (p = 0.001, p = 0.004, p = 0.004, respectively). PON was lower in the IR group than in the Control, Pregabalin 50 and 200 mg groups (p = 0.001, p = 0.007, p = 0.015, respectively). IMA was higher in the IR group than in the Control, Pregabalin 50 and 200 mg groups (p < 0.0001, all). CONCLUSION: We think that administration of pregabalin, more prominent at 200 mg, can reverse the injury that occurs in the skeletal muscle of IR-induced rats. Pregabalin can be safely used for analgesia in cases of IR (Tab. 2, Fig. 9, Ref. 41).

Neutrophil lymphocyte ratio predicts postoperative pain after orthognathic surgery.

BACKGROUND AND AIM: Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate possible relationship between preoperatively measured neutrophil-lymphocyte ratio (NLR) - as an inflammation marker - and postoperative analgesic demand in patients underwent orthognathic surgery. MATERIALS AND METHODS: We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery. Demographical data, preoperative NLR, type of surgery, modified Mallampati score, difficulty degree of intubation, duration of surgery, and postoperative analgesic (tenoxicam - as the first drug of choice, paracetamol, tramadol, or pethidine) usage were recorded. A cutoff value of NLR ≥2 was determined for inflammation threshold. Two groups (Group 1 NLR ≥2, Group 2 NLR <2) were compared for analgesic doses, numbers of patients needed analgesic treatment, and other parameters. RESULTS: Mean administered tenoxicam dose was significantly higher in Group 1 than in Group 2 (P < 0.0001). Further, ratio of patients treated with tenoxicam in Group 1 was significantly higher than that in Group 2 (χ2 = 4.779, P = 0.029). CONCLUSIONS: Preoperatively measured NLR may help to predict postoperative analgesic demand in patients undergoing orthognathic surgery, and thus sufficient postoperative pain control can be achieved with various preventive treatments taken at the perioperative period such as preemptive analgesia, local anesthetic administration at the end of surgery, or early administration of analgesics.

SERUM OMENTIN-1 LEVELS AND ENDOTHELIAL DYSFUNCTION IN OBESITY.

INTRODUCTION: Our aim was to investigate the relationship between serum omentin-1 levels and endothelial dysfunction in obese patients. MATERIAL AND METHODS: We evaluated 50 obese patients, and age/gender matched 45 healthy non-obese subjects as controls. Oral glucose tolerance test, lipid parameters, uric acid levels, homeostatic model assessment-insulin resistance (HOMA-IR) index, serum omentin-1 levels and flow mediated dilatation (FMD) % were measured in all subjects. Body compositions were analyzed with bioelectrical impedance method using a Tanita Body Composition Analyzer and ViScan. RESULTS: Serum omentin-1 levels were found significantly lower in obese population compared to the control subjects. FMD response was significantly decreased in obese population. There was a significant positive correlation between serum omentin-1 levels and FMD response (r=0.359, p<0.001). Serum omentin-1 levels were negatively correlated with body mass index (BMI), waist circumference, total fat percentage, visceral fat, fasting insulin and HOMA-IR index. CONCLUSION: Lower serum omentin-1 levels and decreased FMD response may be an early marker of endothelial dysfunction in obese patients.