The effects of epidermal growth factor on early burn-wound progression in rats.

After burns, protecting tissues by medicines in the zone of stasis reduces the width and depth of injury. This study's goal was to reduce burned tissue damage in the zone of stasis using epidermal growth factor (EGF). Forty-eight Wistar rats were separated into three groups. In all groups, the burn procedure was applied following the comb burn model. In Group 1, no postburn treatment was administered. In Group 2, physiological saline solution (0.3 cc) was injected intradermally and in Group 3, EGF (0.3 cc) was injected intradermally into stasis zone tissues after the burn procedure. Surviving tissue rates were 24.0% in Group 1, 25.3% in Group 2, and 70.2% in Group 3. The average numbers of cells stained with Nrf2, HO-1, and the number of apoptotic cells were 230, 150, and 17.5 in Group 1, 230, 145, and 15.0 in Group 2, and 370, 230, and 0 in Group 3, respectively. Values in Group 3 were found to be statistically significantly different than those of Groups 1 and 2; there was no difference between Groups 1 and 2. This study shows that EGF protects zone of stasis tissue from burn damage.

Comparison of Dexamethasone-Dimenhydrinate and Dexamethasone-Ondansetron in Prevention of Nausea and Vomiting in Postoperative Patients.

INTRODUCTION: Postoperative Nausea and Vomiting is one of the most common problems after implementation of general anesthesia. The incidence can reach 80% in high-risk patients, depending on the type of surgery. In our study, we aimed to compare dexamethasone-dimenhydrinate and dexamethasone-ondansetron combinations in prevention of nausea and vomiting in postoperative patients. METHOD: Sixty 18-65-year-olds ASAI-II females who underwent rhinoplasty were included in the study. Patients were randomly included in two groups: Dexamethasone-dimenhydrinate group (group DD) and dexamethasone-ondansetron group (group DO). All patients received dexamethasone 8 mg iv after endotracheal intubation. Anesthesia continuation was established with sevoflurane, air-oxygen mixture and remifentanil infusion. At the 30th minute of the operation, group DO received ondansetron 4 mg iv and group DD received dimenhydrinate 1 mg/kg iv. For postoperative analgesia tramadol (1.5 mg/kg) iv, tenoksikam (20 mg) and afterward for postoperative patient-controlled tramadol was used. In the postoperative recovery room, nausea and vomiting were evaluated at the 30th, 60th, 120th minutes and at the end of 24 h. Total amount of tramadol was recorded. All results were statistically evaluated. OBSERVATIONS: Demographics and Apfel risk scores of both groups were similar. Surgical operation duration (p = 0.038) and total preoperative remifentanil consumption were higher in group DD (p = 0.006). In group DO, nausea at 30 and 60 min (p = 0.001, p = 0.007), retching at 30 and 60 min (p = 0.002, p = 0.006) were higher than group DD. The additional antiemetic need in group DO was significantly higher at 30 min (p = 0.001). Postoperative analgesic consumption was similar in both groups. RESULT: Our study revealed that dexamethasone-dimenhydrinate combination was more effective than dexamethasone-ondansetron in prevention of nausea and vomiting after rhinoplasty operations. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Is high level of hemoglobin A1C an indicator for extended period of antibiotherapy in diabetic foot ulcers?

OBJECTIVE: Diabetic foot ulcers are the most common cause of hospitalization among the diabetic complications. Hemoglobin A1C (HbA1C) has a critical role in medical follow-up of diabetic patients. In fact, the role of HbA1C and related clinical parameters has been investigated in literature there are only a few studies investigating the relationship between HbA1C and the prolonged antibiotherapy. We aim to reveal the reciprocal relationship between this two parameters. METHODS: The clinical data of 139 patients who admitted with diabetic foot ulcers are analyzed retrospectively. Besides the demographic information, the levels of HbA1C wound localizations, the degree of the wounds regarding the Wagner classification, culture antibiogram, and the duration of the antibiotic agents. The data have been analyzed with IBM SPSS Statistics (IBM Statistical Package for the Social Sciences) for Windows 22.0. RESULTS: The clinical data of the 139 diabetic foot patients are retrospectively assessed. The mean age was 56.50 (±4.12). There were 81 male (58.27%) and 58 (41.73%) female patients. The distal type diabetic foot ulcers were found to be the most frequent type (n=83, 59.71% [±3.12]). The mean HbA1C level was 9.60 (±1.10). The "7-15%" subgroups of HbA1C level patients showed statistically significant prolongation of the antibiotherapy time (p<0.01). CONCLUSION: The results showed that the higher levels of HbA1C have a significant effect on treatment duration and formation of deeper and larger wounds with advanced stages of Wagner classification. This result may reveal the importance of the exact starting time of the treatment besides the proper glycemic control. Lager scaled studies may clarify the credited parameters related to diabetic foot ulcers for a reinterpretation of the issue.