Are the GLIM Criteria Guiding in the Course of Hematological Malignancies?

BACKGROUND: Different degrees of malnutrition are seen in patients with hematological malignancies. None of the approaches used to determine malnutrition risk have general acceptance. The use of the GLIM criteria developed by the Global Leadership Initiative on Malnutrition has promising results. MATERIALS AND METHODS: A total of 67 patients with leukemia, lymphoma, and multiple myeloma were included in the study. NRS-2002 (Nutritional Risk Screening-2002) was used to screen the nutritional status of the patients, and malnutrition was diagnosed and graded using the GLIM criteria in patients who were found to be at risk of malnutrition in this test. The parameters followed in the groups with and without malnutrition were compared. The Kolmogorov-Smirnov, Mann-Whitney U, and Chi-square test were used for statistical analysis. RESULTS: Patients were analyzed by dividing them into two groups as those with and without malnutrition. The presence of infection, duration of fever, antibiotic, and antifungal use were significantly higher in malnourished than in nonmalnourished patients. Platelet counts and sodium levels were significantly lower in the malnourished arm. CONCLUSION: Early nutritional support can increase the immunological status of patients with malignant disorders as well as their tolerability to treatment. Minimizing the risk of malnutrition and providing timely calorie and vitamin support are factors that may directly affect febrile neutropenia, duration of fever, and antifungal use, which will consequently lead to a decrease in the length of hospitalization.

Orthorexia and eating attitudes in health sciences students.

Background: The prevalence of eating disorders and orthorexia nervosa has steadily increased and this situation may lead to severe physical, psychological, and social disorders. Aim: The aim of this study was to investigate the prevalence of disordered eating attitudes and orthorexia tendencies among university students studying in various Health Sciences departments in Turkey. Subjects and Methods: The study subjects were selected from Health Sciences Faculty students. Among the students who accepted the study, 639 people were reached by simple random sampling method. The EAT-40 and ORTO-15 which are validated instruments for the screening of abnormal eating behaviors and orthorexia nervosa respectively, were used as measurement tools. Results: The majority of the students who participated in the study were found to exhibit orthorexic tendencies, and male students had a higher orthorexic tendency in comparison to female students (p = 0.022). More specifically, the students studying in the Department of Nutrition and Dietetics had lower orthorexic tendencies compared with the students from other departments. There was no significant relationship between BMI values and the mean ORTO-15 scores, whereas the mean EAT-40 score was found to increase statistically significantly with increased BMI (p = 0.038). There was a statistically significant difference between the departments and classes in terms of mean EAT-40 scores, whereas no difference was found regarding gender. Conclusion: Orthorexia nervosa is a common problem for university students studying in health-related departments. Interestingly, the orthorexic tendencies of girls and students studying in the Nutrition and Dietetics department were found to be lower in this study. It was determined that all students except the Nutrition and Dietetics department had orthorexia tendencies. More comprehensive studies are needed to better understand orthorexia nervosa and healthy lifestyle interaction.

Effects of different storage media on dentin moisture, microhardness, and bond strength of resin composite.

Background: In in vitro studies, it is desirable that the storage solutions in which dental samples kept between extraction and experiment should prevent dehydration and have antimicrobial properties. However, it should be taken into consideration that these solutions may have some effects that directly change test results on physical and mechanical properties of laboratory samples. Aims: The aim of this in vitro study was to evaluate the effects of different storage media on dentin moisture, microhardness, and microshear bond strength of resin composite to dentin. Thirty non-carious human premolars were randomly divided into three groups: 1. 0.1% Thymol (T), 2. Distilled water (DW), 3. Dry storage (DS) (control) (n = 10). Dentin moisture was measured with a digital grain moisture meter. Dentin microhardness was measured with the Vickers test. The bond strength was measured with a microshear test. Materials and Methods: Analysis of variance (ANOVA) followed by the Bonferroni test was used for statistical evaluation (p = 0.05). Results: Dentin moisture of the experimental groups was statistically higher than that of the control group (p < 0.05). In addition, the dentin moisture of group DW was significantly higher than that of group T (p < 0.05). The mean microshear bond strength of resin composite to dentin was higher in group DW than in group T and group DS (p < 0.05), while there was no statistical difference between group T and group DS. The microhardness values of all groups were statistically similar. Conclusions: Storage solutions used for disinfection and to prevent dehydration may have negative effects on dentin moisture and bond strength.

The utility of CONUT score in indolent lymphoma patients.

Background and Aim: Similar to the uncertainties in the treatment criteria for indolent non-Hodgkin lymphoma (iNHL), the prognostic criteria have not been fully clarified. The Controlled Nutritional Status (CONUT) score is not only used as a predictor of malnutrition but also indicates prognosis in many chronic or malignant diseases. The aim of this study is to investigate the predictive and prognostic significance of the CONUT score in patients with iNHL. Patients and Methods: A retrospective evaluation was made of 109 patients with iNHL. The CONUT scores of the patients were compared between those with an indication for treatment and those followed without treatment. The same analysis was performed between patients who developed relapse after treatment. Survival analysis was performed on all patients, and associations between survival and the CONUT score were examined. Results: The median CONUT score was found to be higher in those who had treatment indications compared to those who did not (2 vs 1; P = 0.014). In the regression model, a CONUT absolute value above 5 was found as an independent risk factor predicting relapse. In the whole study population, a CONUT absolute value >2 predicted the risk of mortality with 53.9% sensitivity and 68.7% specificity (AUC ± SE = 0.639 ± 0.07; +PV = 35%; -PV = 82.6%; P = 0.034). Conclusion: CONUT score is a predictive and prognostic factor for patients with iNHL. The development of simple, low-budget prognostic and predictive biomarkers is critical not only for determining the course of the disease but also for follow-up and treatment management.

The prognostic impact of comorbidity, nutritional and performance status on patients with diffuse large B cell lymphoma.

Background: The aim of the study was to investigate the impact of nutritional status, comorbidity, and performance status on patients with diffuse large B-cell lymphoma (DLBCL). Methods: A retrospective study was conducted on 112 DLBCL patients who were diagnosed at our center between 2009 and 2018. Demographic and disease characteristics and laboratory test results were recorded. Assessments were made using the age-adjusted Charlson comorbidity index (CCI-A) for comorbidity, albumin level for nutritional status, and Eastern Cooperative Oncology Group (ECOG) score for performance status. Results: The mean age of the patients was found to be 62.63 ± 15.16 years. The ECOG score of 65 patients (69.1%) was in the range of 0-1. The mean follow-up time of the patients was determined to be 25.24 ± 25.11 months, and at the end of the follow-up period, 64 patients (57.1%) were survivors. The progression-free survival (PFS), overall survival (OS), and 5-year OS rates of those with CCI-A > 4 were found to be significantly lower than those with CCI-A score ≤4 (P < 0.05). As a result of the Cox-Regression (Backward: LR method) analysis, ECOG and albumin levels were found to be independent risk factors for both OS and PFS (P < 0.05). Conclusion: This study demonstrated that CCI-A, ECOG, and nutritional status are independent prognostic markers for DLBCL patients. Initial evaluation of these patients should include all these parameters, which are easily available at the time of diagnosis.

The effect of different preservation media and temperatures on sperm quality and DNA integrity in mouse cauda spermatozoa.

BACKGROUND: Mouse sperm can be stored for long or short-time periods. Nevertheless long-term storage leds to significantly reduced sperm quality and fertility because of cryodamage. Thus, in the storage of semen in mice, it is necessary to focus on media and temperatures that gives good results in short-term storage. OBJECTIVE: To determine favorable media for short-term storage of mice spermatozoa by evaluating progressive motility, viability, membrane function integrity, acrosome integrity and fragmented DNA rates at various storage temperatures. MATERIALS AND METHODS: Mouse spermatozoa were collected from epididymides of mature CD1 males and samples were stored at 24 degree C and 4 degree C for 60 h. RESULTS: Motility, viability and membrane function of mice spermatozoa were greatest when stored in KSOM media. Motility and viability were not different when stored at refrigerator or room temperature in KSOM compared to HTF or PBS mediums for 48 h, but were after 60 h. There was not any significant variation in terms of acrosome integrity in different preservation conditions. Fragmented DNA rates were similar in fresh sperm with KSOM and HTF media, while there was higher damage in PBS medium at 60 h. Overall, sperm parameters were affected significantly by the time of storage and type of preservation medium, and PBS extender was not suitable for mice spermatozoa at room and refrigerated temperatures as it caused the lowest progressive motility, viability, membrane function integrity and the highest DNA damage. CONCLUSION: Mice spermatozoa stored in KSOM retained the best sperm quality parameters both 24 degree C and 4 degree C for the first 48 h. doi.org/10.54680/fr22610110612.

Evaluation of postprandial symptoms in two different laparoscopic sleeve gastrectomy techniques using gastric emptying scintigraphy.

Background: Laparoscopic sleeve gastrectomy (LSG) is a frequently used procedure in the surgical treatment of obesity in recent years. However, surgeons have different opinions regarding the distance from the antrum to the pylorus. In addition, postprandial symptoms significantly affect the overall quality of life. Aim: Therefore, this study aimed to understand the relationship between postprandial symptoms with gastric emptying time and surgical procedures. Patients and Methods: Sixty patients who underwent LSG surgery were analyzed retrospectively and divided into two groups: antrum preserved (AP) and antrum resected (AR). The antral resection margin was 2 cm from the pylorus in 35 patients (AR group) and 6 cm in 25 patients (AP group). Semisolid gastric emptying scintigraphy (GES) was performed prospectively in both groups. Postprandial symptoms were standardized with a questionnaire. The relationship of symptoms with a half time of gastric emptying (GE T½), retention percentage at 30 and 60 minutes, lag phase, body mass index (BMI), and a decline in excess weight (% EWL), and antrum resection were investigated. The obtained results were compared between the two groups and with the control group. Results: The study group comprised 60 patients (49 F/11 M, mean age: 40.3 ± 20.1 years, BMI 31.6 ± 8.1 kg/m2). The half-time of gastric emptying in the AR and AP groups (28.00 min ± 9.58, 28.24 min ± 11.90, respectively), percentage gastric retention at 30 and 60 minutes in the AR and AP groups (30 minutes: %44.37 ± 17.88, %40.52 ± 14.56 and 60 minutes: 17 ± 8.9, 19 ± 3.1) was significantly different compared with the control group, but no significant difference was observed between the study groups. In addition, there was no statistically significant difference between the AR and AP groups in postprandial symptom scores >9 (68.6%, 60%, P = 0.681), GER (77.1%, 64%, P = 0.253), and postoperative BMI (p = .397), % EWL (p = .975), and T lag phase (p = .332). Conclusions: In our study, the postprandial symptoms were not affected between two different surgical procedures in LSG.

The prognostic significance of blood counts in patients with hodgkin lymphoma.

Background and Aim: The aim of the study was to examine the demographic, clinical features, treatment responses, and outcomes of Hodgkin lymphoma (HL) patients and to investigate the factors affecting their survival. Patients and Methods: A retrospective analysis was made of patients diagnosed with HL in our department between 2009 and 2019. Treatment regimen, treatment response, and follow-up times were recorded for all patients. Using these data, complete response (CR) rates, overall survival (OS), and progression-free survival (PFS) were calculated. The effects of parameters on survival were investigated with Cox regression analysis. Results: Evaluation was made of 60 patients with a median age of 33.5 years [18.0-80.0] and mean follow-up duration of 29.34 ± 23.64 months. Median OS and PFS could not be reached with a mean OS of 85.6 months, and PFS of 71.7 months at the final visit. Only initial leukocyte and neurophil count were determined to have a statistically significant impact on survival (OR = 1.004; P = 0.031 vs OR = 0.996; P = 0.036). Conclusion: In HL patients, in addition to the many prognostic scoring systems, leukocyte and neutrophil count can be used as an independent prognostic parameter. Patients with higher leukocyte and lower neutrophil counts at the time of diagnosis should be managed more carefully.

Red blood cell distribution width is a predictor of chronic kidney disease progression and all-cause mortality.

OBJECTIVES: The aim of this study was to investigate the association of RDW with all-cause mortality and disease progression in patients with CKD in stage 3-4. METHODS: This longitudinal observational cohort study of patients with CKD was conducted at a single center. We categorized baseline RDW into two groups by its median (14.9 %). The associations between baseline RDW values and all-cause mortality over 56 months were examined in unadjusted and adjusted models. The effect of RDW value on renal outcomes and mortality was evaluated by using Cox regression analysis. RESULTS: A total of 261 patients were enrolled in the study. During an average follow-up of 56 months, 19.8 % of patients died. The area under the ROC curve for RDW for all-cause mortality was 0.746, with sensitivity of 0.74 and specificity of 0.69 for a cut-off point of 14.3 %. The incidence of all-cause mortality in the group with increased RDW was significantly higher than in the normal RDW group (p < 0.001). The Cox proportional hazard model showed that the elevated RDW level was an independent risk factor for all-cause mortality in patients with CKD in stage 3-4. CONCLUSION: RDW is a powerful and independent prognostic marker for predicting all-cause mortality and disease progression in stage 3-4 of CKD (Tab. 4, Fig. 4, Ref. 29).

Determination of ecologically sensitive areas in Denizli province using geographic information systems (GIS) and analytical hierarchy process (AHP).

Ecological sensitivity is defined as the ecosystem's reaction to environmental change caused by internal and external factors. The degree of ecological sensitivity varies in spatial dimension depending on the natural and cultural features. Ecological sensitivity analysis is based on basis of mapping these differences. As a result of the analysis, an important data that can be a base for spatial plans at different scales is provided. In accordance with this aim, Denizli province was selected for the study area in this research. The factors affecting sensitivity were determined by the literature survey, which was conducted by considering the characteristics of the study area. In this context, elevation, slope, aspect, the proximity to water surface, land cover, and vegetation coverage were evaluated as natural factors, and the proximity to primary traffic roads and residential areas as cultural factors. Each factor was spatially grouped by means of geographic information systems (GIS) according to the degree of impact on ecological sensitivity. Scale 1 (lowest ecological sensitivity) to 5 (highest ecological sensitivity) was used for the spatial grouping. A analytical hierarchy process (AHP) was applied to weight the factors. The overlay method was used in line with the weighted scores in order to determine the composite ecological sensitivity. As a result of the study, the area of 286.26 sq km (2.37%) as highly and more sensitive, 5267.47 sq km (43.50%) as moderately sensitive, and 6554.56 sq km (54.13%) as mildly and less sensitive was determined. In line with the results, suggestions for protection-utilization balance were developed.

The dosage-dependent prenatal caffeine exposure adversely affects levels of integrin αVß3 and MMP-9 in a rat model of embryo implantation.

OBJECTIVE: In the pregnancy period, it is recommended to limit the consumption of caffeine.​ However, the mechanisms of caffeine effect during pregnancy are not fully known.​ In our study, we aimed to investigate the effect of prenatal caffeine consumption on the embryonic implantation in rats as well as shed light on the relationship between the molecules and implantation stages.​MATERIALS AND METHODS: ​Forty-five Wistar albino pregnant rats were randomly divided into 3 main groups, namely into control, low­dose and high­dose groups, representing the dose-dependent effects of caffeine. Each main group was divided into 3 subgroups, namely those to be sacrified on days 4 (pre-implantation), 5 (peri-implantation) and 6 (post-implantation) ​. Different doses of caffeine were given on consecutive days, starting from day 1 of pregnancy up to the day of euthanasia. The implantation sites were investigated with the use of hematoxylin et eosin, Masson trichrome and immunostaining of VEGF, MMP-9, integrin αVß3, mucin-1 and HB-EGF. RESULT: ​ Prenatal caffeine consumption in rats resulted in a dose-dependent decrease in the number of implantation sites.​ It has been shown that the immunoreactivity of integrin αVß3 and MMP-9 underwent a change. CONCLUSION: ​ It has been shown that the levels of integrin αVß3 and MMP-9 were decreased by prenatal caffeine consumption in rats, which resulted in a decrease in embryo implantation in a dose-dependent manner, especially in the high-dose group (Fig. 5, Ref. 36). Text in PDF www.elis.sk Keywords: caffeine, embryo implantation, integrin, MMP-9.

Ability to detect endodontic complications using three different cone beam computed tomography units with and without artefact reduction modes: an ex vivo study.

AIM: To assess observer performance in detecting endodontic complications using three different cone beam computed tomography (CBCT) units with and without the application of artefact reduction modes. METHODOLOGY: The study involved 40 freshly extracted human mandibular teeth (n = 10 per group) and divided randomly into four endodontic complication groups. Group 1) Instrument fracture; Group 2) Strip perforation; Group 3) Canal underfilling; and Group 4) Canal overfilling. Images of each tooth were obtained using three different CBCT units offering artefact reduction algorithms: the ProMax 3D Max, the Pax Flex 3D and the Dentri S. Four observers evaluated the images for the presence/absence of the four simulated endodontic complications. Weighted kappa coefficients and intra-class correlation coefficients (ICCs) were calculated to reveal the intra- and inter-observer agreement for each imaging mode, respectively. Receiver operating characteristic (ROC) analysis was used to evaluate the observers' performance. DeLong tests were used to compare the results for each image mode and observer using a significance level of α = 0.05. RESULTS: In each of the four simulated endodontic complication groups, no significant differences were observed with and without application of artefact reduction for any of the three CBCT units tested. Only two significant differences were detected, and both were between the ProMax 3D Max at low mode AR and ProMax 3D Max without AR: observer 2 in group 1 (P = 0.0001) and observer 4 in group 4 (P = 0.0256). CONCLUSION: For each of the three CBCT units tested, application of artefact reduction for detecting endodontic complications is not recommended as a routine tool.

The effect of ferulic acid on experimental traumatic brain damage in rats.

AIM: Traumatic brain injury is an important social health problem due to the fact that young adults are more likely to be affected, and advanced functional limitations are observed in survivors. In this study, we aimed to investigate the protective effect of ferulic acid in an experimental trauma model. MATERIAL AND METHODS: This study was performed in March 2016 at Dokuz Eylül University Experimental Animal Laboratory. Subjects were randomly divided into 4 groups Control, Ethyl Alcohol, Trauma, Trauma/Ferulic Acid groups. For histological findings, Cresyl violet; for immunohistochemical analysis, TUNEL and Active Caspase-3 staining were used. For biochemical analysis, Superoxide dismutase, Malondialdehyde, and Glutathione values ​​were examined. RESULTS: The application of ferulic acid has been shown to primarily reduce neuronal apoptosis, the levels of free radicals, and to effect oxidant/antioxidant balance positively by increasing the levels of antioxidants, such as Superoxide dismutase and Glutathione that are developed due to brain damage. Our study group has shown that ferulic acid decreased nerve tissue pathologies after generated brain trauma compared to injury groups. CONCLUSION: Addition of ferulic acid to the traditional head trauma treatment has the strength, and ability to increase the rate, and percentage of healing (Tab. 2, Fig. 4, Ref. 28).

Accuracy of CBCT images in the volumetric assessment of residual root canal filling material: Effect of voxel size.

AIMS: Our aim was to compare three different voxel sizes of CBCT images for the determination of residual filling material volume in root canals when compared with micro CT. MATERIAL AND METHODS: Forty-two root canals of 14 extracted human maxillary molar teeth were retreated by using ProFile® instruments. Images were obtained after retreatment by using ProMax 3D Max CBCT at 3 different voxel sizes (1) High resolution (0.1 mm); (2) High definition (0.15 mm); and (3) Normal resolution (0.2 mm). Two observers measured volumes of residual filling materials in exported CBCT images by means of 3D Doctor Software. Micro CT measurements were served as gold standard. Mann-Whitney U test and Wilcoxon Test were used for the comparison of CBCT and micro CT measurements. Statistical significance was set at P < 0.05. RESULTS: No statistically differences were found between the two observers for all measurements (P > 0.05). There were no significant differences among different CBCT voxel sizes used (0.1 mm, 0.15 mm, and 0.2 mm) (P > 0.05). The Spearman correlation coefficients between CBCT at different voxel sizes significantly highly correlated with micro CT measurements for each observer (P < 0.05). Furthermore, no significant differences were found between the measurements obtained by the two observers in consideration to root canal location (P > 0.05). CONCLUSION: CBCT images may provide useful information in the volumetric assessment of the amount of residual filling material in root canals for retreatment procedures.

Cytopathology of pericardial effusions : Experience from a tertiary center of cardiology.

BACKGROUND: Pericardial effusion (PE) is a common clinical condition that can develop as a result of systemic or cardiac diseases. Here, we report the results of cytology for patients who underwent pericardiocentesis for PE. METHODS: The study comprised 283 patients who underwent primary percutaneous pericardiocentesis between 2007 and 2016. The mean age of the patients was 60.0 ± 16.6 years; 162 (57.2%) were male and 121 (42.8%) were female. The presence of reactive mesothelial cells, acute and chronic inflammatory cells, and/or blood without evidence of malignant cells was considered as benign. The presence of malignant cells with/without reactive mesothelial cells, inflammatory cells, and/or blood was considered as malignant. RESULTS: The vast majority of PE specimens (219 cases; 77.4%) were classified as benign. Only 20 cases (7.1%) were classified as atypical, and malignant cells were present in the PE specimens of 44 cases (15.5%). The most common diagnosis was benign PE. The most commonly encountered malignancy was lung cancer. The rate of malignancy was 1.9% in the serous group and 24% in the hemorrhagic group, which was statistically significant. CONCLUSION: Benign PE was the most frequent cytological diagnosis in our study. Chronic nonspecific pericarditis was the most frequent type of pericarditis in the benign PE group, while lung adenocarcinoma was the most frequent malignancy in the malignant PE group. The rate of malignancy was significantly higher in the hemorrhagic group than in the serous group.

Is elevated triglyceride high density lipoprotein cholesterol ratio a risk factor that causes acute coronary syndrome to appear earlier?

BACKGROUND: The purpose of this study was to assess the relationship between the triglyceride/high density lipoprotein cholesterol ratio and the risk of acute myocardial infarction in young adults. PATIENTS AND METHODS: A total of 621 patients, who underwent coronary angiography (CAG) due to Myocardial Infarction (MI) at our hospital were included in this study. Demographic characteristics, risk factor profile, laboratory test results, electrocardiographic and CAG findings were assessed in the selected groups. RESULTS: Total cholesterol, triglyceride/high density lipoprotein cholesterol (Tg/HDL) ratio, Tg levels, were higher in younger patients with MI, while glucose and high-density lipoprotein levels were lower. Using propensity score matching in the matched population comparing young patients to the older ones, serum triglyceride levels [179 (145-231) vs 148 (101-197)] and triglyceride to high density lipoprotein cholesterol ratio [5.8 (4.1-9.1) vs 3.0 (1.8-4.6)] were significantly higher, whereas high density lipoprotein levels were observed dramatically lower (32.6 ± 8.2 vs 41.7 ± 8.8). CONCLUSION: This study demonstrated that Tg/HDL ratio may be an important predictor for an acute coronary syndrome in the young adult population. Tg/HDL ratio can be used to prevent MI in young adults (Tab. 3, Fig. 1, Ref. 32.).

The validity and reliability of Systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL) in a Turkish population.

Background Systemic lupus erythematosus (SLE) may have a profound impact on quality of life. There is increasing interest in measuring quality of life in lupus patients. The purpose of this study was to investigate the validity and reliability of SLE Quality of Life Questionnaire (L-QoL) in Turkish SLE patients. Methods SLE according to 2012 Systemic Lupus International Collaborating Clinics Classification Criteria were recruited into the study. Demographic data, clinical parameters and disease activity measured with the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K); were noted. Nottingham Health Profile and Health Assessment Questionnaire were filled out in addition to the Turkish L-QoL (LQoL-TR). Internal consistency, test-retest reliability, and convergent and discriminant validity were evaluated. Results The mean age of participants was 43.55 ± 14.33 years and the mean disease duration was 89.8 ± 92.1 months. The patients filled out LQoL-TR in 2.5 min. Strong correlation of LQoL-TR with all subgroups of the Nottingham Health Profile and the Health Assessment Questionnaire were established showing the convergent validity. The highest correlation was demonstrated with emotional reactions (rho = 0.72) and sleep component (rho = 0.65) of the Nottingham Health Profile scale ( p < 0.0001). Its poor and not significant correlation with nonfunctional parameters (age, disease duration, perceived general health, SLEDAI-2K) showed its discriminative properties. LQoL-TR demonstrated good internal reliability with a Cronbach's α of 0.93 and test-retest reliability with intraclass correlation coefficient of 0.87. Conclusion The LQoL-TR is a practical and useful tool which demonstrates good validity and reliability.

Choice of marker for assessment of RV dysfunction in acute pulmonary embolism : NT-proBNP, pulmonary artery systolic pressure, mean arterial pressure, or blood pressure index.

BACKGROUND: We aimed to examine the value of NT-proBNP, pulmonary artery systolic pressure (PASP), blood pressure index (BPI), and mean arterial pressure (MAP) in the determination of right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (APE). PATIENTS AND METHODS: A total of 547 patients diagnosed with APE were included in the study. Demographic characteristics and comorbid conditions of patients were recorded in patient files. For blood pressure measurement, a calibrated digital blood pressure monitor was used at regular intervals. Blood samples were taken from patients at the time of admission for hemogram, biochemical, and hemostasis blood tests. Echocardiography was performed on all patients to detect RVD and evaluate pulmonary artery pressure. RESULTS: PASP (p < 0.001), MAP (p < 0.001), diastolic blood pressure (p < 0.001), D­dimer (p = 0.001), NT-proBNP (p = 0.001), white blood cell (p < 0.001), and platelet (p = 0.001) counts were higher in APE patients with RVD compared with those without RVD, whereas the mean BPI level (p < 0.001) was lower. BPI had a negative correlation with PASP, NT-proBNP, platelet count, and triglyceride levels in patients with RVD. In regression analysis, BPI and PASP were found to be independent predictors of RVD. In receiver operating characteristic curve analysis, BPI (AUC ± SE = 0.975 ± 0.006; p < 0.001) was found to be the best predictor of RVD with a higher sensitivity (92.8%) and specificity (100%). CONCLUSION: We found that BPI had a better diagnostic discrimination for RVD compared with PASP and NT-proBNP.

Protective effect of oxymatrine against renal ischemia/reperfusion injury in rats.

BACKGROUND: Renal ischemia/reperfusion (I/R) injury is a common cause of acute kidney injury. The pathologic mechanisms underlying renal I/R injury are complicated, involving reactive oxygen species, necrosis, cell apoptosis, and inflammation, but the exact mechanisms remain unclear. OBJECTIVES: This study aimed to investigate the effect of oxymatrine (OMT) on renal I/R injury and its underlying mechanism. METHODS: Thirty male Sprague-Dawley rats were randomly allocated to three groups (n = 10): the sham-control group, the renal I/R-untreated (I/R-untreated) group, and the I/R-OMT group. Renal I/R injury were induced by clamping the left renal artery for 45 min followed by 24 h of reperfusion. At 10 min before reperfusion, the rats in the I/R-OMT-treated group rats received an intravenous injection of 40 mg/kg OMT. Renal function and histological changes were compared and the relevant parameters of oxidative stress and inflammation were detected. RESULTS: Oxymatrine pretreatment significantly decreased the level of renal dysfunction, attenuated the renal histological changes, the levels of reactive oxygen species production in renal tissue upon I/R. Additionally, OMT pretreatment could further activate the serum antioxidant enzyme activities. CONCLUSION: The beneficial effects of OMT were likely mediated by the inhibition of lipid peroxidation and the increase in endogenous antioxidant activity. The results of this study indicate that oxymatrine may represent a potent anti-oxidant drug to protect the kidney against I/R injury (Fig. 5, Ref. 29).

2016 Comprehensive Update of the Banff Working Group on Liver Allograft Pathology: Introduction of Antibody-Mediated Rejection.

The Banff Working Group on Liver Allograft Pathology reviewed and discussed literature evidence regarding antibody-mediated liver allograft rejection at the 11th (Paris, France, June 5-10, 2011), 12th (Comandatuba, Brazil, August 19-23, 2013), and 13th (Vancouver, British Columbia, Canada, October 5-10, 2015) meetings of the Banff Conference on Allograft Pathology. Discussion continued online. The primary goal was to introduce guidelines and consensus criteria for the diagnosis of liver allograft antibody-mediated rejection and provide a comprehensive update of all Banff Schema recommendations. Included are new recommendations for complement component 4d tissue staining and interpretation, staging liver allograft fibrosis, and findings related to immunosuppression minimization. In an effort to create a single reference document, previous unchanged criteria are also included.