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2.
Scand J Clin Lab Invest ; : 1-12, 2024 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-39321099

RESUMEN

Preeclampsia (PE) pathogenesis is strongly related to diminished nitric oxide (NO) bioavailability and enhanced oxidative stress. Emerging evidence suggests that red blood cells (RBCs) eNOS enzyme contributes to systemic NO bioavailability by its ability of both NO and ROS generation. We aimed to investigate RBC eNOS enzyme activity, NO and ROS generation capacity, eryptosis index and aggregation levels in preeclamptic and uncomplicated pregnant women. Fifty-eight PE patients and 36 healthy pregnant women were included to the investigation. RBC eNOS enzyme activity, intracellular NO, calcium and ROS concentrations and eryptosis levels were determined via flow cytometric methods. RBC deformability and aggregation were measured via LORRCA. Intracellular NO and phosphorylated RBC eNOS levels decreased in PE group compared to healthy pregnant group (p < 0.05, p < 0.001 respectively). Intracellular ROS and calcium levels, eryptosis values and aggregation indexes in the PE group were significantly higher than healthy pregnant group (p < 0.05, p < 0.01, p < 0.05, p < 0.05 respectively). Our results demonstrate for the first time that RBC produce lower NO and higher ROS under PE conditions. Further, RBC of PE patients were more prone to eryptosis and aggregation compared to control group. Our results suggest that, in addition to endothelial cells, RBC also contribute to decreased plasma NO bioavailability via producing less NO and high ROS in PE. Considering increased tendency to eryptosis and aggregation, RBC seem to play role in haemodynamic changes of PE pathogenesis.

3.
BMC Musculoskelet Disord ; 25(1): 790, 2024 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-39369251

RESUMEN

BACKGROUND: Fixation of trochanteric fractures with an intramedullary nail in a non-physiological position can cause poor functional outcomes. The aim of this study is to evaluate the effect of intraoperative patient position on rotational alignment in intramedullary nail fixation of trochanteric fractures. METHODS: The femoral rotational alignment of 84 trochanteric fracture patients who underwent intramedullary nailing was measured by computed tomography (CT) images. Patients were divided into two groups: the supine position on the fracture table (FT) (Group 1, n = 42) and the lateral decubitus (LD) position (Group 2, n = 42). Femoral malrotation angles were measured and divided into three subgroups: insignificant, significant, and excessive. The number of intraoperative fluoroscopy images, preparation time, surgery time, and anesthesia time in both groups were compared. RESULTS: The malrotation degrees of patients in Group 1 ranged from 17° external rotation (ER) to 57° internal rotation (IR), with a mean of 10° IR. Of the patients in Group 1, 27 were insignificant, 5 were significant, and 10 were in the excessive subgroup. The malrotation degrees of patients in Group 2 ranged from 33° ER to 47° IR, with a mean of 11° IR. Of the patients in Group 2, 21 were insignificant, 12 were significant, and 9 were in the excessive subgroup. There was no statistically significant relationship between patient position and malrotation angle. The number of intraoperative fluoroscopy images, preparation time, and anesthesia time were statistically lower in Group 2. There was no statistically significant difference between Group 1 and Group 2 in terms of surgery time. CONCLUSION: Intramedullary nailing in the LD position is a reliable and practical surgical method in the treatment of femoral trochanteric fractures since there is no need for the use of a FT, the surgeon is exposed to less radiation, there is no risk of complications related to the traction of the FT, and there is a shorter operation time.


Asunto(s)
Fijación Intramedular de Fracturas , Fracturas de Cadera , Posicionamiento del Paciente , Humanos , Fijación Intramedular de Fracturas/métodos , Fijación Intramedular de Fracturas/efectos adversos , Fijación Intramedular de Fracturas/instrumentación , Femenino , Fracturas de Cadera/cirugía , Fracturas de Cadera/diagnóstico por imagen , Masculino , Anciano , Posición Supina , Posicionamiento del Paciente/métodos , Anciano de 80 o más Años , Rotación , Persona de Mediana Edad , Tempo Operativo , Clavos Ortopédicos , Fluoroscopía , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
4.
J Appl Biomed ; 22(2): 67-73, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38912861

RESUMEN

BACKGROUND AND OBJECTIVES: We aimed to determine the effects of vanillic acid (VA) on fracture healing radiologically, histologically, immunohistochemically, and biomechanically using a rat femur open fracture injury model. METHODS: 32 male Wistar-Albino rats were used and divided into two groups: the study group (VA) and the control group. From the time they were operated on until they were sacrificed, the rats in the study group were given 100 mg/kg/day VA by oral gavage. After sacrification, the femurs were analyzed. RESULTS: It was observed that the Huo histological scoring was significantly higher in the VA group (p = 0.001), and the ratio of the amount of callus tissue compared to intact bone tissue was significantly higher. While no significant difference was observed in immunohistochemical H-scores in ColI antibody staining (p = 1.000), a borderline significant difference in favor of VA was observed in ColIII antibody staining (p = 0.078). In biomechanical analysis, failure load (N), total energy (J), maximum stress (MPa), and stiffness (N/mm) measurements were significantly higher in the VA group (p = 0.040, p = 0.021, p = 0.015, and p = 0.035, respectively). CONCLUSION: It has been observed that VA, with its antioxidative properties, increases fracture healing in rats, in which an open fracture model was created. We are hopeful that such an antioxidant, which is common in nature, will increase fracture healing. Since this study is the first to examine the effect of VA on fracture healing, further studies are needed.


Asunto(s)
Fracturas del Fémur , Curación de Fractura , Ratas Wistar , Ácido Vanílico , Animales , Ácido Vanílico/farmacología , Ácido Vanílico/uso terapéutico , Curación de Fractura/efectos de los fármacos , Masculino , Fracturas del Fémur/tratamiento farmacológico , Fracturas del Fémur/patología , Ratas , Modelos Animales de Enfermedad , Fenómenos Biomecánicos/efectos de los fármacos , Fémur/efectos de los fármacos , Fémur/patología , Callo Óseo/efectos de los fármacos , Callo Óseo/patología
5.
J Chem Inf Model ; 63(1): 9-19, 2023 01 09.
Artículo en Inglés | MEDLINE | ID: mdl-36513349

RESUMEN

Proteases are major drug targets for many viral diseases. However, mutations can render several antiprotease drugs inefficient rapidly even though these mutations may not alter protein structures significantly. Understanding relations between quickly mutating residues, protease structures, and the dynamics of the proteases is crucial for designing potent drugs. Due to this reason, we studied relations between the evolutionary information on residues in the amino acid sequences and protein dynamics for SARS-CoV-2 main protease. More precisely, we analyzed three dynamical quantities (Schlitter entropy, root-mean-square fluctuations, and dynamical flexibility index) and their relation to the amino acid conservation extracted from multiple sequence alignments of the main protease. We showed that a quantifiable similarity can be built between a sequence-based quantity called Jensen-Shannon conservation and those three dynamical quantities. We validated this similarity for a diverse set of 32 different proteins, other than the SARS-CoV-2 main protease. We believe that establishing these kinds of quantitative bridges will have larger implications for all viral proteases as well as all proteins.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , SARS-CoV-2/metabolismo , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Inhibidores de Proteasas/química , Proteasas 3C de Coronavirus/metabolismo , Antivirales/química
6.
Surgeon ; 21(2): 108-118, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35430110

RESUMEN

INTRODUCTION: We aimed to investigate the relationship between central sarcopenia and survival in patients with pathological fracture. METHODS: We reviewed records of patients who were treated for pathological fracture of axial and appendicular skeleton in our clinic between 2011 and 2020. We used the psoas: lumbar vertebral index (PLVI) on axial computer tomographic evaluation to assess for central sarcopenia. A multivariate Cox algorithm was applied to recognize these factors independently associated with one month, six months, one year, and overall survival. RESULTS: A total of 147 patients [61 (41.4%) male and 86 (58.6%) female] were included, with an average age of 62.4 years. During the study, 108 (73.4%) patients died, and 39 (26.6%) were alive. The survival rates at 1 month, 6 months, and 1 year after surgery were 94.6%, 68.7%, and 53.1%, respectively. PLVI values ranged from 0.21 to 1.20 with a mean of 0.536 and a median of 0.520. According to the median value of PLVI, 68 patients with sarcopenia had low PLVI and 79 patients without sarcopenia had high PLVI. For the first month, only the preoperative albumin level was identified as a prognostic factor. Eastern Cooperative Oncology Group Performance Status (ECOG), American Society of Anesthesia (ASA) scores and primary malignancy (rapid grade) were strong predictor of poor survival. The PLVI was independent significant predictor of first month (HR, 0.083 [95% CI, 0.011-0.649], p = 0.018) and overall survival (HR, 0.129 [95% CI, 0.034-0.492], p = 0.003). CONCLUSION: The PLVI was a strong predictor of first year, and overall survival in patients with pathological fracture.


Asunto(s)
Fracturas Espontáneas , Sarcopenia , Humanos , Masculino , Femenino , Persona de Mediana Edad , Fracturas Espontáneas/complicaciones , Sarcopenia/complicaciones , Sarcopenia/diagnóstico , Estudios Retrospectivos , Pronóstico
7.
ORL J Otorhinolaryngol Relat Spec ; 85(3): 150-155, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36907176

RESUMEN

INTRODUCTION: Multiple sclerosis (MS) is an autoimmune disease that can affect balance, gait, and improve fall risk. The aim of this study was to investigate peripheral vestibular system involvement in MS and associations with the disease severity. METHODS: Thirty-five adult patients with MS and 14 age- and gender-matched healthy controls were evaluated using video head impulse test (v-HIT), cervical vestibular evoked myogenic potential (c-VEMP), ocular vestibular evoked myogenic potentials (o-VEMPs), and sensory organization test (SOT) of computerized dynamic posturography (CDP). The results of both groups were compared, and association with EDSS scores was evaluated. RESULTS: There was no significant difference between the groups regarding v-HIT and c-VEMP results (p > 0.05). There was no association of the v-HIT, c-VEMP, and o-VEMP results with EDSS scores (p > 0.05). There was no significant difference between the o-VEMP results of the groups (p > 0.05) except for N1-P1 amplitudes (p = 0.01). The amplitudes of N1-P1 were significantly lower in the patients compared to controls (p = 0.01). There was no significant difference between the SOT results of the groups (p > 0.05). However, significant differences were found within and between groups when the patients were categorized according to their EDSS scores with a cutoff point of 3 (p < 0.05). There were negative correlations between the EDSS scores and composite (r = -396, p = 0.02) and somatosensory (SOM) scores (r = -487, p = 0.04) of CDP in the MS group. CONCLUSION: Although central and peripheral balance-related systems are affected in MS, the impact of disease on the peripheral vestibular end organ is subtle. In particular, the v-HIT, which was mentioned previously as a detector of brainstem dysfunction could not be a reliable tool in the detection of brainstem pathologies in MS patients. The o-VEMP amplitudes may be affected in the early stages of the disease, possibly due to the crossed ventral tegmental tract, oculomotor nuclei, or interstitial nucleus of Cajal involvements. An EDSS score >3 seems a cutoff level indicating abnormalities in balance integration.


Asunto(s)
Esclerosis Múltiple , Potenciales Vestibulares Miogénicos Evocados , Vestíbulo del Laberinto , Adulto , Humanos , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/patología , Potenciales Vestibulares Miogénicos Evocados/fisiología , Gravedad del Paciente , Prueba de Impulso Cefálico
8.
J Foot Ankle Surg ; 62(1): 107-114, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35732561

RESUMEN

The optimal treatment strategy after syndesmotic injuries is still controversial. In our study, we aimed to evaluate ideal fixation method in syndesmotic injury by using finite element analysis method. A 3D SolidWorks model file was created by taking computed tomography (CT) images of the area from the right foot base to the knee joint level of a healthy adult male. The intact model, injury model, and 8 different fixation models were created that 3.5 mm screw and suture-button were used in. The models were compared in terms of lateral fibular translation, posterior fibular translation and external rotation of fibula compared to tibia and stress values occurred on screws and suture-buttons. In the hybrid-1 model, lateral fibular translation and external fibular rotation values were obtained as close to the intact model. Von Mises stresses occurred in the screw (435.7 MPa) and suture-button (424.7 MPa) that used in hybrid-1 model was more than single screw at 4 cm model (316.8 MPa) and single suture-button at 2 cm model (160.7 MPa). In the Hybrid-1 model, the screw compensates for posterior fibular translation and external fibular rotation, while the suture-button compensates for lateral fibular translation. Also, the effect of the distal suture-button preventing diastasis in case of proximal screw failure, it was concluded that the hybrid-1 model can be used as a good treatment alternative in the surgical treatment of distal tibiofibular syndesmotic injuries.


Asunto(s)
Traumatismos del Tobillo , Articulación del Tobillo , Adulto , Humanos , Masculino , Articulación del Tobillo/diagnóstico por imagen , Articulación del Tobillo/cirugía , Análisis de Elementos Finitos , Cadáver , Peroné/cirugía , Traumatismos del Tobillo/diagnóstico por imagen , Traumatismos del Tobillo/cirugía , Fijación Interna de Fracturas
9.
Mikrobiyol Bul ; 57(1): 71-82, 2023 Jan.
Artículo en Turco | MEDLINE | ID: mdl-36636847

RESUMEN

Three obligate intracellular protozoan parasite species, namely Trypanosoma cruzi, Leishmania tropica and Toxoplasma gondii, causative agents of Chagas disease, Leishmaniasis and toxoplasmosis, respectively, which are responsible for significant morbidity and mortality and reside in macrophage cells, affect more than half of the world's population in connection with socio-economic and geographical factors and also causes neglected parasitic diseases of increasing importance. This study aimed to evaluate the ex vivo cultivation potential of T.cruzi, L.tropica and T.gondii parasites in J774, Vero and HeLa cells and to reproduce in a short time and in large amounts without losing their virulence properties. Ex vivo experimental models were created by infecting J774, Vero and HeLa cell lines confluently produced in cell culture flasks with T.cruzi, L.tropica and T.gondii parasites. In ex vivo cultivation, one passage was applied for seven days and three times in a row. Cells removed from the surface after each passage were plated on eight-well chamber slides. Giemsa stained slides were prepared and infection rates were evaluated by light microscopic examination. At the end of the study, it was observed that all three cell lines could be infected with T.cruzi, L.tropica and T.gondii parasites, and infection rates increased in all cell lines after consecutive passages. As a result of ex vivo cultivation, the best cell lines from which T.cruzi and L.tropica strains grew, were J774, Vero and HeLa, and HeLa, J774 and Vero cell lines for T.gondii strain, respectively (p<0.05). Trypanosoma cruzi, L.tropica and T.gondii parasites were successfully grown in J774, Vero and HeLa cell lines by ex vivo culture method in a short time and in large amounts without losing their virulence properties. Cell lines with the best ex vivo cultivation potential for T.cruzi and L.tropica parasites were J774, Vero and HeLa, respectively, while HeLa, J774 and Vero for T.gondii. It is thought that the data obtained in this regard will contribute to many studies on the development of vaccines, drugs and new diagnostic kits.


Asunto(s)
Enfermedad de Chagas , Leishmania tropica , Parásitos , Toxoplasma , Trypanosoma cruzi , Animales , Humanos , Células HeLa
10.
Mikrobiyol Bul ; 57(3): 463-472, 2023 Jul.
Artículo en Turco | MEDLINE | ID: mdl-37462309

RESUMEN

Leishmania RNA virus (LRV) is a double-stranded RNA (dsRNA) virus that is thought to contribute to the severe inflammatory response of the causative Leishmania parasite in the mammalian host by being present in many isolates of Leishmania spp. In our study, it was aimed to obtain data on the presence of Leishmania RNA Virus 2 (LRV2), which is thought to cause a change in the clinical course of leishmaniasis, in Leishmania major and Leishmania tropica isolates isolated from cutaneous leishmaniasis (CL) patients in Türkiye. Leishmania strains stored in liquid nitrogen tank by cryopreservation in Manisa Celal Bayar University Faculty of Medicine Parasite Bank were resuscitated under suitable conditions and cultivated in NNN and RPMI-1640 media. Then, the isolates were allowed to enter the logarithmic phase in a 26ºC incubator and DNA isolations were made using the "High Pure PCR Template Preparation Kit". Real-time polymerase chain reaction (Rt-PCR) melting analyzes were applied to the DNAs obtained by using primers and probes specific to the internal transcribed spacer-1 (ITS-1) gene region of Leishmania. After RNA isolation from promastigote suspension, cDNA synthesis was performed by reverse transcription. After gel electrophoresis with PCR amplification products, dsRNA band formation was evaluated in terms of LRV2 positivity under ultraviolet light. Among the 20 examined Leishmania spp. isolates (10 L.tropica and 10 L.major), four (three L.tropica, one L.major) were found to be positive for the presence of LRV2. Although the mechanism of LRV in recent studies has not been fully understood, it is known that it exacerbates the clinic of the disease and even has an effect on the formation of drug resistance by the parasite. It is important to obtain data on the presence of LRV in our country and to contribute to various clinical, drug development, prevalence studies, diagnosis and treatment of the disease in the future.


Asunto(s)
Leishmania major , Leishmania tropica , Leishmaniasis Cutánea , Leishmaniavirus , Virus ARN , Animales , Humanos , Leishmania major/genética , Leishmania tropica/genética , Leishmaniasis Cutánea/parasitología , Leishmaniavirus/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Virus ARN/genética , Mamíferos/genética
11.
Turk J Med Sci ; 53(1): 1-9, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36945953

RESUMEN

BACKGROUND: This experimental study aimed to define a biochemical marker that will enable early diagnosis of acute compartment syndrome (ACS) of extremities, a mortal condition that occurs due to trauma. METHODS: A total of 15 Wistar rats were included in the study in which saline infusion technique, a clinically compatible ACS model, was applied. After the rats were anesthetized with ketamine-xylazine, the in-compartment pressure of the hind limb was slowly increased with saline delivered through the angiocatheter, and after reaching the target compartment pressure, the pressure level was kept with a rubber tourniquet. The in-compartment pressure level was continuously monitored with a pressure transducer. The rats were divided into three groups. No intervention was applied to the control group (CG) (n = 3). In study group 1 (SG1) (n = 6), ACS was created using the saline infusion technique, keeping the in-compartment pressure between 30 and 40 mmHg for 45 min. In study group 2 (SG2) (n = 6), ACS was created using the saline infusion technique, keeping the in-compartment pressure between 30 and 40 mmHg for 90 min. Fasciotomy was performed on all rats. Tissue samples were obtained for histopathological examination and blood samples for biochemical analysis. RESULTS: Total oxidant status (TOS) (p = 0.004), ischemia-modified albumin (IMA) (p = 0.030), aspartate transferase (AST) (p = 0.003) and neopterin (p = 0.012) levels differed significantly between groups in the early period of muscle ischemia. In fact, TOS levels differed significantly between the groups even in the cellular phase where signs of ischemia were not observed (p = 0.048, p = 0.024). According to histopathological evaluation, there was no significant difference between the groups. DISCUSSION: TOS can be detected in the early reversible stage of ischemia, when the histopathological findings of ACS do not occur.


Asunto(s)
Síndromes Compartimentales , Albúmina Sérica , Ratas , Animales , Biomarcadores , Ratas Wistar , Síndromes Compartimentales/diagnóstico , Síndromes Compartimentales/patología , Isquemia , Extremidad Inferior
12.
ORL J Otorhinolaryngol Relat Spec ; 84(2): 147-152, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35114674

RESUMEN

INTRODUCTION: The aim of the study was to present the results of our experience in three-corridors procedures applied for the tumors and inflammatory lesions of the infralabyrinthine cervico-jugulo-carotico-tympanic area. METHODS: The lesions located in the infralabyrinthine cervico-jugulo-carotico-tympanic area were operated in 13 patients using the 3-corridors technique. The anatomical and functional integrity of the external and middle ears and the facial nerve (FN) could be preserved. RESULTS: The diagnoses were glomus jugulare, infralabyrinthine petrous bone cholesteatoma, jugular foramen schwannoma, and giant-cell tumor. The follow-up duration ranged from 2 to 24 months. No tumor recurrence or growth was encountered in the follow-up. The operations were uneventful. Total surgical excision could be achieved in 10 patients. A second-stage retrosigmoid approach was performed for the total removal of the intracranial tumor remnant in two patients. A wait-and-scan policy has been considered in one patient who had partial resection for a glomus jugulare tumor. CONCLUSION: Three-corridors procedure seems to be a useful technique to operate in the infralabyrinthine, cervico-jugulo-carotico-tympanic area as it takes the advantage of hearing preservation, preservation of the anatomic and functional integrity of the external and middle ear structures as well as the FN.


Asunto(s)
Tumor del Glomo Yugular , Recurrencia Local de Neoplasia , Oído Medio/patología , Nervio Facial , Tumor del Glomo Yugular/patología , Tumor del Glomo Yugular/cirugía , Humanos , Hueso Petroso/cirugía , Estudios Retrospectivos
13.
ORL J Otorhinolaryngol Relat Spec ; 84(3): 211-218, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34500448

RESUMEN

INTRODUCTION: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. METHODS: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. RESULTS: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). CONCLUSION: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3.


Asunto(s)
Implantación Coclear , Implantes Cocleares , Oído Interno , Implantación Coclear/efectos adversos , Comunicación , Oído Interno/cirugía , Pérdida Auditiva Sensorineural , Humanos , Estudios Retrospectivos , Acueducto Vestibular/anomalías
14.
Ann Surg Oncol ; 28(9): 5048-5057, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33532878

RESUMEN

BACKGROUND: More evidence shows that primary surgery for de novo metastatic breast cancer (BC) prolongs overall survival (OS) in selected cases. The aim of this study was to evaluate the role of locoregional treatment (LRT) in BC patients with de novo stage IV bone only metastasis (BOM). METHODS: The prospective, multicenter registry study BOMET MF14-01 was initiated in May 2014. Patients with de novo stage IV BOM BC were divided into two groups: those receiving systemic treatment (ST group) and those receiving LRT (LRT group). Patients who received LRT were further divided into two groups: ST after LRT (LRT + ST group) and ST before LRT (ST + LRT group). RESULTS: We included 505 patients in this study; 240 (47.5%) patients in the ST group and 265 (52.5%) in the LRT group. One hundred and thirteen patients (26.3%) died in the 34-month median follow-up, 85 (35.4%) in the ST group and 28 (10.5%) in LRT group. Local progression was observed in 39 (16.2%) of the patients in the ST group and 18 (6.7%) in the LRT group (p = 0.001). Hazard of death was 60% lower in the LRT group compared with the ST group (HR 0.40, 95% CI 0.30-0.54, p < 0.0001). CONCLUSION: In this prospectively maintained registry study, we found that LRT prolonged survival and decreased locoregional recurrence in the median 3-year follow-up. Timing of primary breast surgery either at diagnosis or after ST provided a survival benefit similar to ST alone in de novo stage IV BOM BC patients.


Asunto(s)
Neoplasias de la Mama , Neoplasias de la Mama/cirugía , Femenino , Humanos , Mastectomía , Estudios Multicéntricos como Asunto , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia/cirugía , Sistema de Registros , Estudios Retrospectivos , Tasa de Supervivencia
15.
Pediatr Int ; 63(8): 889-894, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33249714

RESUMEN

BACKGROUND: The present study aimed to investigate diagnostic values of C-reactive protein (CRP), white blood cell (WBC), erythrocyte sedimentation rate (ESR), neutrophil to lymphocyte ratio (NLR), and the platelet to lymphocyte ratio as possible indirect inflammatory markers in children with septic arthritis (SA) for diagnosis process. METHODS: The medical records of pediatric patients with SA who underwent debridement surgery between February 2005 and November 2018 were obtained from the hospital records. A total of 59 children with SA and 60 age- and gender-matched healthy controls were enrolled in the study. Hemograms parameters including WBC count, neutrophil count, lymphocyte count, hemoglobin, platelet count, CRP, ESR, NLR, and platelet to lymphocyte ratio. Biochemical parameters including alanine transaminase, aspartate aminotransferase, blood urea nitrogen, creatinine, glucose, and albumin were investigated and compared between both groups. RESULTS: Fifty-nine patients, 30% female (n: 18) and 70% male (n: 41), who had received operations for SA were included in the study. The mean age of the patients was 7.1 (range 6 days to 15 years) years and mean follow up 56.6 (12-140) months. No significant differences were observed in any biochemical parameters between the groups. However, a significant difference was found between the septic arthritis and the control group in all hemogram parameters. CONCLUSIONS: Although the sensitivity and specificity of the NLR are lower than CRP, ESR, and WBC which are most commonly used inflammatory parameters in diagnosis process of septic arthritis, NLR may be useful in confirming the diagnosis in the clinical practise, with an optimum diagnostic cut-off value of 4.05.


Asunto(s)
Artritis Infecciosa , Linfocitos , Artritis Infecciosa/diagnóstico , Biomarcadores , Sedimentación Sanguínea , Proteína C-Reactiva/análisis , Niño , Femenino , Humanos , Lactante , Recuento de Linfocitos , Masculino , Neutrófilos , Estudios Retrospectivos
16.
Artículo en Inglés | MEDLINE | ID: mdl-32966989

RESUMEN

INTRODUCTION: Tinnitus is a widely seen otological symptom that interferes with daily activities and causes discomfort. Tinnitus treatments can be classified into 4 main groups: pharmacological treatments, cognitive and behavioral therapy, psychological treatments, and combined treatment approaches made up of at least 2 of these 3 treatment methods. OBJECTIVE: The aim of this study was to assess whether it would be possible to develop an individualized treatment method of tinnitus by application of a combined tinnitus signal and music during sleep. METHODS: Forty-three ears of 30 patients who had subjective tinnitus were included. The patients were evaluated using Tinnitus Handicap Inventory, Visual Analogue Scale, and Beck Depression Inventory. The psychoacoustic parameters of tinnitus, such as tinnitus frequency and loudness, and minimal masking levels, were determined. The patients were asked to select musical melodies that they liked. The tinnitus frequency of each patient was taken as the central frequency according to ANSI 2004. All sound files were prepared as stereo channels, with 16-bit resolution and 44,100 Hz sampling rate. The root mean square power value of the music and the band noise's average root mean square power value were equalized with the "Amplification" command, and 70% of the music and 30% of wide/narrow-band noise were mixed as a stereo channel by the "Mix Paste" command. The patients were instructed to listen to that individualized music/narrow-band noise (tinnitus signal) for 2 h during sleep for a duration of 6 months. RESULTS: Tinnitus frequencies of the patients measured prior to treatment and at the second, fourth, and sixth months of follow-up were not significantly different. A statistically significant decrease was seen in tinnitus loudness, minimal masking levels, and residual inhibition during the follow-up. Tinnitus Handicap Inventory scores decreased significantly during follow-up, and the number of patients who complained of tinnitus decreased (p < 0.05). The Visual Analogue Scale scores significantly decreased during follow-up (p < 0.05). Beck Depression Inventory scores decreased significantly during follow-up (p < 0.05). CONCLUSION: Stimulation of the auditory and limbic systems during sleep by the tinnitus signal combined with individualized musical melodies seems an alternative, effective, and cheap method in the treatment of tinnitus.


Asunto(s)
Música , Acúfeno , Humanos , Sueño , Acúfeno/complicaciones , Acúfeno/terapia , Escala Visual Analógica
17.
ORL J Otorhinolaryngol Relat Spec ; 83(4): 280-285, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33784673

RESUMEN

INTRODUCTION: Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs. METHODS: The study group consisted of 39 patients with COM who received CIs. Age- and gender-matched 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared. RESULTS: The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (p > 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (p > 0.05). CONCLUSION: Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery performed. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable.


Asunto(s)
Colesteatoma del Oído Medio , Colesteatoma , Implantación Coclear , Otitis Media , Audiometría de Tonos Puros , Colesteatoma del Oído Medio/complicaciones , Colesteatoma del Oído Medio/cirugía , Enfermedad Crónica , Humanos , Apófisis Mastoides/cirugía , Otitis Media/complicaciones , Otitis Media/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
18.
ORL J Otorhinolaryngol Relat Spec ; 83(4): 272-279, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33784680

RESUMEN

OBJECTIVE: The aim of the study was to evaluate the association of conductive hearing loss (CHL) with the structural changes in the organ of Corti. METHODS: Twenty ears of 10 healthy adult Wistar albino rats were included in the study. The right ears (n = 10) of the animals served as controls (group 1), and no surgical intervention was performed in these ears. A tympanic membrane perforation without annulus removal was performed under operative microscope on the left ears (n = 5) in 5 of 10 animals (group 2). A tympanic membrane perforation with annulus removal was performed under operative microscope on the left ears (n = 5) of the remaining 5 animals (group 3). Auditory brainstem response testing was performed in the animals before the interventions. After 3 months, the animals were sacrificed, their temporal bones were removed, and inner ears were investigated using scanning electron microscopy (SEM). The organ of Corti was evaluated from the cochlear base to apex in the modiolar axis, and the parameters were scored semiquantitatively. RESULTS: In group 1, the pre- and post-intervention hearing thresholds were similar (p > 0.05). In group 2, a hearing decrease of at least 5 dB was encountered in all test frequencies (p > 0.05). In group 3, at the frequency range of 2-32 kHz, there was a significant hearing loss after 3 months (p < 0.01). After 3 months, the hearing thresholds in group 2 and 3 were higher than group 1 (p < 0.01). The hearing threshold in group 3 was higher than group 2 (p < 0.01). On SEM evaluation, the general cell morphology and stereocilia of the outer hair cells were preserved in all segments of the cochlea in group 1 with a mean SEM score of 0.2. There was segmental degeneration in the general cell morphology and outer hair cells in group 2 with a mean SEM score of 2.2. There was widespread degeneration in the general cell morphology and outer hair cells in group 3 with a mean SEM score of 3.2. The SEM scores of group 2 and 3 were significantly higher than group 1 (p < 0.05). The SEM scores of group 3 were significantly higher than group 2 (p < 0.05). CONCLUSION: CHL may be associated with an inner ear damage. The severity of damage appears to be associated with severity and duration of CHL. Early correction of CHL is advocated in order to reverse or prevent progression of the inner ear damage, which will enhance the success rates of hearing restoration surgeries. Subjective differences and compliance of the hearing aid users may be due to the impact of CHL on inner ear structures.


Asunto(s)
Cóclea , Pérdida Auditiva Conductiva , Animales , Umbral Auditivo , Potenciales Evocados Auditivos del Tronco Encefálico , Células Ciliadas Auditivas Externas , Audición , Pérdida Auditiva Conductiva/etiología , Ratas
19.
Turk J Med Sci ; 51(4): 2142-2149, 2021 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-33714238

RESUMEN

Background/aim: The purpose of this study was to investigate the antiarthritic potentials of the inhibition of Src kinase in vivo and in vitro settings. Materials and methods: Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant (collagen induced arthritis [CIA] model) in Wistar albino rats. One day after the onset of arthritis, dasatinib, a potent Src kinase inhibitor, (5 mg/kg/day) was given via oral gavage. Tissue Src, Fyn, MAPK and STAT mRNA expressions were determined by real-time polymerase chain reaction. On the other hand, fibroblast like synoviocytes (FLSs) were harvested patients with rheumatoid arthritis (RA) undergoing surgical knee joint replacement. FLSs were stimulated with cytokines and dasatinib was added in different concentrations. MMP ­1, ­3, and ­13 levels in FLSs culture were determined by ELISA. Results: The tissue mRNA expressions of Src, Fyn, MAPK and STATs were increased in the arthritis CIA group compared to the control group. Their mRNA expressions in the CIA + dasatinib group were decreased and similar in the control group. In in vitro setting, MMP ­1, ­3, and ­13 expressions from FLSs induced by IL-1ß and TNF-α were increased, while dasatinib suppressed their productions from FLSs. Conclusion: The present study shows that the inhibition of Src kinase has antiarthritic potentials in both in vivo and in vitro settings. Src kinase inhibition may be candidate to further research in human RA.


Asunto(s)
Artritis Experimental/tratamiento farmacológico , Artritis Reumatoide/tratamiento farmacológico , Dasatinib/farmacología , Metaloproteinasas de la Matriz/metabolismo , Familia-src Quinasas/genética , Animales , Artritis Experimental/genética , Células Cultivadas , Fibroblastos , Regulación de la Expresión Génica , Proteína Quinasa 3 Activada por Mitógenos/genética , Proteína Quinasa 3 Activada por Mitógenos/inmunología , ARN Mensajero , Ratas , Ratas Endogámicas WF , Membrana Sinovial , Familia-src Quinasas/antagonistas & inhibidores , Familia-src Quinasas/inmunología
20.
Knee Surg Sports Traumatol Arthrosc ; 28(9): 3055-3060, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31728604

RESUMEN

PURPOSE: Vancomycin powder (VP) has been used to prevent periprosthetic joint infection (PJI). However, studies investigating the efficacy of VP to prevent infection in primary total knee arthroplasty (TKA) are very rare. The purpose of this study was to investigate the efficacy of VP application to prevent PJI in TKA. METHODS: Between 2012 and 2016, 976 consecutive patients who underwent primary TKA were included in the present study. Patients were divided into two groups. There were 474 patients (48.6%) in the VP group and 502 patients in the control group (51.4%). Except for VP, all procedures were the same in both groups. In the VP group, 2 g of VP was poured into the joint just before the fascia was closed. Average follow-up was 53.2 months (24-84 months). RESULTS: Infection was found in 4 (0.84%) of 474 patients in the VP group and 5 (0.99%) of 502 patients in the control group. There was no statistically significant difference between groups in terms of infection rates (p = 0.535). Staphylococcus aureus was found in 2 patients in the VP group. Two patients had S. aureus and 1 patient had Pseudomonas aeruginosa in the control group. There was no statistically significant difference between groups in terms of demographic parameters (p > 0.05). CONCLUSION: Intrawound VP administration doesn't change the infection rates in primary TKA. The VP administration for preventing PJI is not recommended in primary TKA. LEVEL OF EVIDENCE: III.


Asunto(s)
Antibacterianos/administración & dosificación , Profilaxis Antibiótica , Artroplastia de Reemplazo de Rodilla , Infecciones Relacionadas con Prótesis/prevención & control , Vancomicina/administración & dosificación , Anciano , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Prótesis de la Rodilla , Masculino , Persona de Mediana Edad , Polvos , Infecciones Relacionadas con Prótesis/etiología , Estudios Retrospectivos
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