An Investigation on Freshwater Fish Oreochromis niloticus (Linnaeus, 1758): Assessing Hemotoxic Effects of Different Copper Compounds Used as Nanomaterial or Pesticide.

Considering the constant exposure of fish to copper oxide nanoparticles (CuO-NPs) and copper sulphate (CuSO4) in natural aquatic environments as a result of increased usage of these chemicals in industry, medicine and aquaculture/agriculture over the past few decenniums, the current investigation aimed to reveal their comparative hemotoxic effects on freshwater fish Oreochromis niloticus by measuring hematological and blood oxidative stress biomarkers and Cu levels. Fish were exposed to 0.05 mg/L CuO-NPs and CuSO4 for 4 and 21 days. Both copper forms decreased erythrocyte, hematocrit, and hemoglobin values, and superoxide dismutase and catalase activities while they elevated glucose-6-phosphate dehydrogenase activity, and glutathione, malondialdehyde and Cu levels. Leukocyte levels and glutathione peroxidase activity did not show any significant change. In a conclusion, the current research demonstrates that CuO-NPs and CuSO4 for O. niloticus have similar hemotoxic effects, however, CuO-NPs are slightly more toxic than CuSO4 regarding hematological changes and oxidative stress observed.

Comparative Acute Toxicity Assessment of Organophosphate and Avermectin Insecticides on a Freshwater Fish Oreochromis niloticus.

Oreochromis niloticus was exposed to 10.0 ppb of organophosphate insecticide chlorpyrifos (CPF) and avermectin insecticides abamectin (ABM) and emamectin benzoate (EB) for 48 and 96 h. RBC and Hb decreased in CPF- and ABM-exposed fish after 96-h. Plasma ALT, AST, cortisol, and glucose increased in 96-h CPF-, ABM- and EB-exposed fish, while plasma ions declined in 96-h CPF-exposed ones. Insecticides caused alterations in liver oxidative stress parameters. In fish exposed to CPF, CAT increased after 48-h whereas it decreased after 96-h. Also, CAT declined in 48- and 96-h ABM-exposed fish, whereas it elevated in 48-h EB-exposed ones. Insecticides caused decreases in SOD at 48- and 96-h and in GR after 96-h. GSH elevated in CPF-exposed fish after 48-h, while it decreased in all the tested insecticide exposures after 96-h. Malondialdehyde of fish exposed to insecticides for 96-h increased. Consequently, toxic effects of insecticides on O. niloticus were generally as CPF > ABM > EB.

Long-term outcome of kidney transplantation from elderly living and expanded criteria deceased donors.

The imbalance between organ demand and supply causes the increasing use of suboptimal donors. The aim of this study is to investigate the survival and allograft function of kidney transplantation from standard (SLD) and elderly living (ELD), standard criteria (SCDD) and expanded criteria deceased (ECDD) donors. All patients transplanted from 1997 to 2005 were investigated according to the donor characteristics. Data were collected retrospectively during the 83.4±43.1 months of follow-up period. ELD was defined as donor age≥60 years. ECDD was defined as UNOS criteria. A total of 458 patients were divided into four groups: SLD (n:191), ELD (n:67), SCDD (n:154), and ECDD (n:46). Seven-year death-censored graft survival in SLD, ELD, SCDD, and ECDD were 81.6%, 64.8%, 84.7%, and 68.3%, respectively (p=0.003). The death-censored graft survival in ELD group was lower than in SLD (p=0.007) and SCDD (p=0.007) groups, while in ECDD group it was lower than in SCDD group (p=0.026). Patient survival was similar. In ECDD group, 83% of total deaths occurred within the first 3 years, mainly due to infections (66.6%) (p<0.05). Estimated glomerular filtration rate (eGFR) was lower in ELD (compared with SLD and SCDD); and ECDD (compared with SCDD) at last visit. In multivariate analysis, ELD, experience of an acute rejection episode and presence of delayed graft function were the independent predictors for death censored graft loss. Transplantation of a suboptimal kidney provides inferior graft survival and function. A higher number of deaths due to infection in the early post-transplant period in the ECDD group are noteworthy.

Use of oxidative stress biomarkers in Cyprinus carpio L. for the evaluation of water pollution in Ataturk Dam Lake (Adiyaman, Turkey).

Adiyaman city, which is located in the north of the Ataturk Dam Lake, has no wastewater purification facilities which results in municipal, agricultural, and industrial wastewater discharges directly entering the reservoir. To assess the pollution in the dam lake, we used several oxidative stress biomarkers in blood tissue of Cyprinus carpio. Fish samples were taken from Sitilce, polluted area by untreated wastewaters, and Samsat, relatively clean area, in the reservoir in August 2012. The activity of catalase and level of malondialdehyde increased while activity of superoxide dismutase and glutathione level decreased in fish from Sitilce site when compared to Samsat site. The findings of the present investigation suggest that the presence of certain prooxidative compounds that can lead to oxidative stress in the fish at the Sitilce site and oxidative stress biomarkers may be important in order to evaluate the effects of untreated wastewaters on living organisms in the dam lake.

Long-Term Efficacy of Single-Incision Laparoscopic Intragastric Resection in Treating Gastrointestinal Stromal Tumors.

Gastrointestinal stromal tumors (GISTs), the most common mesenchymal tumors in the gastrointestinal tract, are increasingly treated with minimally invasive surgeries. Developed techniques include laparoscopic, endoscopic, and hybrid methods for gastric GIST resection. Our study, focusing on single-incision laparoscopic intragastric resection for gastric GISTs, aims to evaluate its safety, efficacy, and long-term outcomes. In a retrospective study of GIST surgery involving 14 patients who underwent single-incision laparoscopic intragastric resections, we analyzed and compared their preoperative demographics, American Society of Anesthesiologists (ASA) scores, tumor size, neoadjuvant treatment, operation duration, hospital stay, mitotic and Ki-67 indexes, and histological features with those of patients who underwent open and laparoscopic wedge resections, to assess the impact on both survival and disease-free survival. Average operation time was 93.07 minutes (range 81-120 minutes). Average blood loss: 67 ± 20 mL (range 40-110 mL). Postoperative hospital stay averaged 6.79 days (range 4-16 days). Strong correlations were observed between preoperative and pathological tumor sizes (P = .001, P < .001). Survival analysis indicated a significant association with ASA scores (P = .031), but not with mitotic index, Ki-67, or tumor size. Average survival was 80.57 months, with no recurrence or metastasis during follow-up. Based on our experience, the single-incision laparoscopic intragastric resection method emerges as a highly efficient, timesaving, and gentle oncological procedure, providing a safe and minimally invasive alternative resulting in shorter hospital stays and excellent long-term outcomes with minimal recurrence. For more definitive conclusions, larger, multicenter, and prospective studies are recommended.

The impact of the preoperative red blood cell distribution width on weight loss prediction after sleeve gastrectomy.

AIM: We aimed to evaluate whether RDW has a predictive impact on weight loss after obesity surgery. MATERIAL AND METHODS: This was a single-institution retrospective study. Multiple linear regression analysis was used to determine the variables affecting the %EBMIL and %EWL values. Surgery of patients with %EMBIL > 50% and %EWL > 25% was considered successful. RESULTS: Hundred and ten patients were included in the study. The %EBMIL and %EWL values of patients with RDW>14.5% were lower. In the evaluation of successful surgeries, the probability of failure for those with RDW>14.5% is 10.93 times higher for %EBMIL and 21.55 times for %EWL. DISCUSSION: After the linear regression analysis, it was observed that the %EBMIL and %EWL were higher in the patients whose RDW values were 14.5 and below in the preoperative period. In these patients, it is an indication that more weight loss has occurred. Similar to our study, Wise et al. showed that weight loss was greater with a decrease in the RDW value 10. CONCLUSION: Preoperative RDW value can be used as a predictor of weight loss and surgical success. It can provide an idea about whether the patient will lose enough weight and the success of the surgery. KEY WORDS: Prediction, RDW, Sleeve Gastrectomy.

Role of Systemic Inflammatory Markers in Pediatric Kidney Transplantation.

BACKGROUND: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII = N × P/L), and neutrophil percentage-albumin ratio (NPAR) have become accepted markers of inflammation in recent years. These indices are used as indicators of disease activity, mortality, and morbidity in many diseases. This study evaluated the relationship between inflammatory indices and graft function in pediatric kidney transplant recipients. METHODS: Medical records of pediatric patients who underwent kidney transplantation at Ege University between 1995 and 2020 were reviewed retrospectively. Demographic, clinical, and laboratory data were recorded during the third month, first year, and fifth year of transplantation and at the last visit. RESULTS: The median age of the 119 patients (60 boys/59 girls) at the time of transplantation was 154 months, and the median follow-up period was 101 months. According to Spearman correlation analysis, patients' final creatinine levels were positively correlated with NLR (r = 0.319), PLR (r = 0.219), SII (r = 0.214), and NPAR (r = 0.347) of the last visit; final estimate glomerular filtration rate levels were negatively correlated with NLR (P = .010, r = -0.250) and NPAR (P = .004, r = -0.277). The median NPAR of the patients with chronic allograft dysfunction at the last visit was found to be statistically significantly higher than without (P = .032). CONCLUSION: NLR, PLR, SII, and NPAR values are correlated with creatinine levels after 5 years of kidney transplantation. The NPAR and final creatinine levels had the highest correlation coefficient among these inflammatory markers. These results suggest that inflammatory markers, especially NPAR, may be a candidate to be an indicator of ongoing inflammation in the graft.

Protective effect of selenium against mercury-induced toxicity on hematological and biochemical parameters of Oreochromis niloticus.

In this study, to identify mercury (Hg) toxicity and whether selenium (Se) has any role in alleviation of this toxicity, it was investigated the changes in hematological and serum biochemical parameters of Oreochromis niloticus. Fish were exposed to 0.01 and 0.1 mg/L Hg and 0.01 mg/L Hg + 0.1 mg/L Se and 0.1 mg/L Hg + 1.0 mg/L Se for 7 and 14 days. The exposure of O. niloticus to Hg alone resulted in decreases in red blood cell, white blood cell, hemoglobin, hematocrit values, and cholinesterase activity while it increased in alanine aminotransferase and aspartate aminotransferase activities and cortisol and glucose levels. Se, in combination with Hg, partially or totally caused an alleviation for the toxic effect of Hg on the above mentioned hematological and biochemical parameters. The results of our study showed that Se has a protective effect against toxicity induced by Hg.

Assessment of pollution in Ataturk Dam Lake (Adiyaman, Turkey) using several biochemical parameters in common carp, Cyprinus carpio L.

Ataturk Dam Lake, the largest impounded lake in Turkey, has been contaminated by domestic, industrial and agricultural effluents coming from Adiyaman city. In this study, we investigated the possible effects of pollutants on several biochemical parameters in the cyprinid fish, Cyprinus carpio, by comparing the parameters in fish collected from a polluted area (Sitilce) to a relatively clean area (Samsat) in August 2011. The activities of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase and levels of cortisol, glucose, and K increased while total protein, cholesterol, Ca, Na and Cl levels decreased in fish from the Sitilce site when compared to the Samsat site. The observed alterations in these biochemical parameters indicate that the Ataturk Dam Lake is affected by untreated wastewater discharges.

Effects of Individual and Co-exposure of Copper Oxide Nanoparticles and Copper Sulphate on Nile Tilapia Oreochromis niloticus: Nanoparticles Enhance Pesticide Biochemical Toxicity.

Copper, like iron and zinc, is one of the most essential trace elements for organisms. Different forms of copper have distinctive and specific uses. For example, copper oxide nanoparticles (CuO-NP) are widely used in the world as a nanomaterial. Copper sulphate (CuSO4) is worldwide used as a fungicide in agriculture and as an algaecide in aquaculture. Nowadays, the increasing use of these chemicals raises concerns regarding their potential effects on the health of aquatic organisms and ecological risks. Therefore, in the present research, toxic effects of CuSO4 and CuO-NP, alone and in combination, were evaluated using biochemical markers (plasma biochemical and gill and liver oxidative stress) in freshwater fish, Oreochromis niloticus. The fish were exposed to 0.05 mg/L CuSO4, CuO-NP, and CuSO4+CuO-NP for 4 and 21 days.  Especially at 21 days, CuSO4 and CuO-NP, alone and combined, generally increased plasma alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, cortisol, glucose, creatinine, blood urea nitrogen, and tissue malondialdehyde while they decreased plasma total protein, and tissue superoxide dismutase, catalase, glutathione-S-transferase, glutathione reductase, and glutathione. Consequently, our results illustrate that CuSO4 and CuO-NP have similar toxic effects in fish, however, co-exposure of CuO-NP and CuSO4 is more toxic than effects of these chemicals alone.

Tension-free inguinal hernia repair with transversus abdominis plane (TAP) block in elderly high-risk patients.

BACKGROUND: Inguinal hernia repair is still being studied today because it is one of the most commonly performed surgical procedures in the world and is used in people of all ages. Although many centers use spinal anesthetic to treat inguinal hernias, complications such as hypotension from peripheral vasodilation, delayed mobilization from paralysis, urine retention and post-spinal headache might occur. Regional blocks are a significant component of multimodal anaesthesia that promotes postoperative recovery. Transversus abdominis plane (TAP) block is a regional anesthetic block technique that is effective on the parietal peritoneum, skin, and anterior abdominal wall. METHODS: This study aimed to show that TAP block administration may be done safely without the use of an extra anesthetic treatment, especially in older patients who may experience complications from general or spinal anesthesia. Without either general, spinal or epidural anesthetic, we conducted a tension-free - Lichtenstein - inguinal hernia repair operation with only TAP block application. This retrospective case-control study received ethics committee approval (decision number 21-5T/108). Between September and December 2019, patients who underwent elective Lichtenstein hernia repair in our clinic were evaluated retrospectively. RESULTS: We think that inguinal hernia repair can be safely performed with only TAP block and that TAP block application has fewer anaesthesia-related complications such as postspinal headache and urinary retention compared with spinal anaesthesia, and that it can be used as an alternative to spinal anaesthesia in patients who cannot tolerate general anaesthesia. CONCLUSION: Even hernia surgery can be very challenging in patients with advanced age and comorbidities. We wanted to show the feasibility of the TAP block method as an alternative to anaesthesia in such patients.

Nonoperative Management of Leaks After Laparoscopic Sleeve Gastrectomy With Endoscopic Stents in a Tertiary Referral Center.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a frequently performed operation. Leaks are formidable complications; however, the optimal management of these leaks is controversial. METHODS: We retrospectively reviewed the medical records of 15 patients referred to our tertiary center between 2012 and 2016 with leaks after LSG. RESULTS: In 12 patients with whom ongoing leaks were identified, stents were inserted with the intent of definitive therapy. In addition to attempts at source control, percutaneous drainage was carried out for intraabdominal collection in 9 patients and pleural effusion in 4 patients. The length of stay in the intensive care unit was significantly shorter in patients referred earlier or in those without any intervention. CONCLUSION: LSG leaks can be treated nonoperatively in well-organized centers under meticulously designed protocols, depending on the clinical condition of the patient.

Foreign bodies in the rectum: an analysis of 30 patients.

PURPOSE: A foreign body in the rectum is a rare clinical entity. These foreign bodies can be classified under two major groups: the ones that are inserted from the anus and the ones that are swallowed and thereafter become stuck in the rectum. METHODS: Data of patients admitted with a foreign body in the rectum between 1988 and 2008 were retrospectively analyzed. A total of 30 patients were reviewed. RESULTS: The most common reason for a foreign body in the rectum was insertion for erotic purposes, which was seen in 19 of the 30 patients. All these patients were male. The remaining 11 patients reported nonerotic causes. The most efficient and implemented therapeutic method was simple extraction during the first examination. CONCLUSIONS: The most common reason for a foreign body in the rectum is insertion for erotic purposes. The first target of therapy should be extraction of the foreign body using the simplest method possible. Meanwhile, protecting the integrity of the intestine is of the utmost importance. The care for maintaining the integrity of the rectum should include an evaluation of the patient's psychological status.

Differential diagnosis of an unusual pelvic mass in a renal transplant recipient: multidrug-resistant abdominopelvic tuberculosis.

Renal transplant patients are more prone to tuberculosis infection due to the underlying intense immunosuppression, with an incidence 20-74 times higher than that in the general population. It is associated with graft dysfunction and increased mortality rates. It can be frequently pulmonary but extra-pulmonary involvement is not rare, and in the latter case, it may be misinterpreted as genital malignancies. In this case report, we discuss a renal transplant patient with pelvic pain and fever, who was later diagnosed as having abdominopelvic tuberculosis.

A comparative study on the effects of a pesticide (cypermethrin) and two metals (copper, lead) to serum biochemistry of Nile tilapia, Oreochromis niloticus.

The present study was designed to compare the responses in freshwater fish Oreochromis niloticus exposed to a synthetic pyrethroid, cypermethrin (CYP); an essential metal, copper (Cu); and a nonessential metal, lead (Pb). Fish were exposed to 0.05 µg/l CYP, 0.05 mg/l Cu, and 0.05 mg/l Pb for 4 and 21 days, and the alterations in serum enzyme activities, metabolite, and ion levels were determined. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities increased in response to CYP, Cu, and Pb exposures at both exposure periods. While elevations in alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) activities and in cholesterol level were observed in pesticide-exposed fish at 4 and 21 days, they increased in Cu- and Pb-exposed fish at 21 days. Although metal-exposed fish showed increases in cortisol and glucose levels at 4 days followed by a return to control levels at the end of the exposure period, their levels elevated in pesticide-exposed fish at both exposure periods. Total protein levels decreased in Pb- and pesticide-exposed fish at 21 days. Na⁺ and Cl⁻ levels decreased in pesticide-exposed fish at both exposure periods and in Cu- and Pb-exposed fish at 21 days. The exposures of pesticide and metals caused an elevation in K⁺ level at the end of the exposure period. The present study showed that observed alterations in all serum biochemical parameters of fish-treated pesticide were higher than those in fish exposed to metals.

Abdominal cocoon syndrome as a rare cause of mechanical bowel obstruction: report of two cases.

An abdominal cocoon is an extremely rare condition, and has been reported mainly in young adolescent women as a cause of small bowel obstruction. In these patients, the small bowel is encased in a fibrous sac called an abdominal cocoon. We hereby present two cases who were diagnosed only by laparotomy and their correlation with the literature. They both received early intervention, thus preventing the need for bowel resection. The pathology of both membranes showed inflammation.

Incidence and risk factors for incisional hernia after abdominal aortic aneurysm and aortic occlusive disease surgery.

BACKGROUND: This study aims to investigate incisional hernia incidence and risk factors after abdominal aortic aneurysm and aortic occlusive disease surgery via a midline laparotomy. METHODS: A total of 110 patients (66 males, 44 females; mean age: 69.3±8.8 years; range, 36 to 88 years) who underwent open elective surgery for aortoiliac occlusive diseases or abdominal aortic aneurysm between January 2005 and December 2016 were retrospectively analyzed. Both patient groups were compared in terms of surgical procedures, sex, age, American Society o f A nesthesiologists s core ( 1-3), b ody m ass i ndex (<25 vs. ≥25 kg/m2), smoking (non-smoker <1 pack/day, smoking ≥1 pack/day), and time to incisional hernia development. RESULTS: Incisional hernia occurred in 14.3% of the patients operated for aortoiliac occlusive disease and in 17.6% of the patients operated for abdominal aortic aneurysm (p=0.643). Incisional hernia was seen in three (5.7%) of 53 patients with a body mass index of <25 kg/m2 and was in 15 (26.3%) of 57 patients with a body mass index of ≥25 kg/m2 (p=0.03). CONCLUSION: High body mass index is a risk factor for incisional hernia in patients undergoing aortic reconstructive surgery.

Protein intensity changes in the hemoglobin and plasma electrophoretic patterns of Oreochromis niloticus in response to single and combined Zn and Cd exposure.

The purpose of this study was to evaluate the effects of metals on the electrophoretic patterns of hemoglobin and blood plasma proteins of Oreochromis niloticus. Fish were exposed to 0.5 and 5.0 mg/L Zn, 0.1 and 1.0 mg/L Cd, and 0.5 mg/L Zn + 0.1 mg/L Cd, and 5.0 mg/L Zn + 1.0 mg/L Cd mixtures for 7 and 28 days. In all concentrations tested, electrophoretic pattern of hemoglobin and plasma proteins by cellulose acetate electrophoresis consist of three and eight bands, respectively. The three bands for hemoglobin are one cathodic (Hb1) and two anodic (Hb2 and Hb3) bands. The protein intensity in hemoglobins of fish following Zn, Cd, and Zn + Cd exposures decreased in Hb1, whereas it increased in Hb3. The eight bands for plasma proteins are 60, 78, 87, and 94 kDA high molecular weight proteins (HMP) for four bands and 120, 132, 176, and 273 kDA very high molecular weight proteins (VHMP) for four bands. The level of 60, 78, and 94 kDA HMP and 120, 132, and 176 kDA VHMP increased in response to single and combined Zn and Cd exposure. Also, there was increasing level of the metals in the whole blood with increasing concentrations of metals in the exposure medium and with increasing duration of exposure.

Effects of zinc and cadmium on erythrocyte antioxidant systems of a freshwater fish Oreochromis niloticus.

In this work to determine the effects of metals exposure of Oreochromis niloticus on erythrocyte antioxidant systems, fish were exposed to 5.0 mg/L Zn, 1.0 mg/L Cd, and 5.0 mg/L Zn + 1.0 mg/L Cd mixtures for 7 and 14 days and reduced glutathione (GSH) level, catalase (CAT), and glucose-6-phosphate dehydrogenase (G6PD) activities were investigated. In addition, Zn or Cd levels in whole blood were studied. Erythrocyte GSH level and CAT and G6PD enzyme activities increased in response to single and combined Zn and Cd exposure. The elevation observed in the CAT activity was higher in the Cd alone, and in combination with Zn, than in Zn alone. Time-dependent alteration was not observed in all antioxidant parameters. Exposure to metals (alone and in mixture) resulted in elevatation of Zn and Cd levels in the blood. Concentration of metals in the blood of fish exposed to the Zn + Cd combination was lower than in fish exposed to the single metal. This study demonstrates that metals caused oxidative stress in fish erythrocytes, and an adaptation with an increase in CAT and G6PD activities and GSH level, which were important in the protection against metal damage, was observed.

Single-incision laparoscopic cholecystectomy: is it more than a challenge?

BACKGROUND: Single-incision laparoscopic surgery (SILS) is a promising technique with regard to reducing postoperative pain, decreasing complications, and improving cosmesis. METHODS: Between September 2008 and April 2009, 20 patients underwent cholecystectomy via SILS. The umblicus was the access point of entry to the abdomen for all the patients. RESULTS: Of the 20 cholecystectomies, 19 were performed with SILS. Failure of trocar insertion was the reason for conversion with the first patient. No complications or mortalities were associated with the technique. The mean operating time was 94 min. CONCLUSION: The use of SILS for cholecystectomy is safe and feasible with reasonable operation times.