The effect of gender on acute kidney injury developing in the intensive care unit.

BACKGROUND: There are distinct differences specific to gender in the susceptibility, prevalence, and progression of kidney injuries. We aimed to investigate whether there is a correlation between acute kidney injury (AKI) developing in patients monitored in the intensive care unit (ICU) with regards to gender. METHODS: The current study retrospectively screened the electronic records of patients monitored in the adult ICU between 2015 and 2018. The patients' age, gender, duration of their stay in the ICU, mortality rate, and need for hemodialysis were recorded and analyzed. The diagnosis of AKI was defined according to the Acute Kidney Injury Network (AKIN) criteria. Patients with AKIN stage 2 and stage 3 were accepted as having an AKI. Patients were separated into two groups: those who developed an AKI and those who did not. The patients were classified into age groups: those aged 18-65 years and those older than 65 years. The demographic data and gender distribution of the groups were then compared. RESULTS: Of the patients who developed AKI, the mean age (p =0.0001), the number of days they stayed at the ICU (p =0.006), the mortality rate (p =0.0001), and the need for hemodialysis were significantly higher than the non-AKI group. There was no statistically significant difference between the groups with regards to gender distribution (p =0.612). Acute kidney injury was found to be statistically significantly higher in both the male and female groups over 65 years when compared to the group aged 18-65-years (male p =0.004, female p =0.002, respectively). CONCLUSIONS: When surveying the complete patient sample, AKI in the ICU was more prevalent in adult males under 65 than their female counterparts. However, there were more incidences of AKI in women over 65 than in men over 65 years. This may be due to structural changes and comorbidities in the kidney due to advanced age, as well as a decrease in estrogen levels. HIPPOKRATIA 2019, 23(3): 126-130.

Trophoblast calcyclin is elevated in placental tissue from patients with early pre-eclampsia.

The aetiology of pre-eclampsia is thought to originate from aberrant spiral artery remodelling and invasion evoking cellular oxidative stress. Previously, we discovered differentially expressed proteins in trophoblast cells of pre-eclamptic pregnancies. One of these proteins is calcyclin (S100A6); a Ca(2+)-binding protein associated with cellular stress response. By immunohistochemistry on formalin-fixed paraffin-embedded placental tissue, calcyclin expression was compared between women with early pre-eclampsia (n=72) and non-hypertensive control patients (n=66) (χ(2), p=0.006) blindly by two observers. Significantly more intense staining was seen in trophoblast cells of pre-eclamptic pregnancies compared to control placentas suggesting that trophoblast calcyclin is elevated in early pregnancy.

In vitro pharmacodynamic properties of colistin methanesulfonate and amikacin against Pseudomonas aeruginosa.

PURPOSE: In vitro pharmacodynamic properties of colistin methanesulfonate and amikacin were investigated by studying time-kill kinetics and post-antibiotic effect (PAE) against strains of Pseudomonas aeruginosa isolated from patients with cystic fibrosis. METHOD: Synergy was investigated at 0.5 ×, 1 × and 5 × MIC of antibiotics using time-kill curve method. PAEs were determined by the standard viable counting method where bacteria in the logarithmic phase of growth were exposed for 1 h to the antibiotics at 1 × or 20 × MIC, alone and in combinations. Synergy and additive effects were detected at 1 × MIC, at 24 h. RESULTS: Some of the strains produced an earlier synergistic effect at 12 h. No antagonism was observed. Colistin methanesulfonate and amikacin produced PAEs 1.16 ± 0.10 to 2.25 ± 0.16 h and 0.96 ± 0.15 to 2.69 ± 0.32 h, respectively. When the antibiotics were used in combination the PAEs were prolonged to a value of 3.88 ± 0.25 h. Consequently, the CONCLUSIONS: Findings of this study may play useful role in selecting the appropriate combinations when a single agent is inadequate, and may have important information for optimizing the dose intervals.

Comparison of total thyroidectomy, bilateral subtotal thyroidectomy and Dunhill operations in the treatment of benign thyroid disorders.

AIM: The surgical treatment of benign thyroid disease is still controversial. Many treatment modalities have been described for the surgical management of various thyroid diseases, including excision, bilateral subtotal thyroidectomy (BST), near-total thyroidectomy, and total thyroidectomy (TT). METHODS: Hospital records were reviewed for 2863 patients who underwent thyroid surgery for presumed multinodular goiter (MNG) between 1990 and 2009. However, due to the inefficiency of the hospital archive system, we were able to access detailed personal and surgical information for only 803 patients. RESULTS: Of the 803 patients, 227 (28.3%) underwent DP, 228 (28.4%) BST and 348 (43.3%) TT operations. While there were no complications in 683 (85.1%) of the 803 operations, complications developed with 120 (14.9%). A definite difference between TT and the other (BST and DP) types of operation in relation to complications. The duration of hospital stay was 2.2±0.4 days for the BST group, 2.2 ± 0.4 days for the DP group and 2.3 ± 0.7 days for the TT group. There was a significant difference among all three groups. Recurrence rates of the operations performed were 35 (15.3%), 20 (8.8%) and 4 (1.15%), respectively, for BST, DP and TT. There was significant difference between the recurrence rates of TT and BST, and between TT and DP. CONCLUSION: When the frequency of complications in recurrent operations and the malignity possibility of the thyroid tissue left behind are taken into consideration, we believe that TT will be more beneficial in the surgical treatment of benign thyroid disorders.

New approach for the identification of folate-related pathways in human embryogenesis.

The role of natural folate intake and synthetic folic acid supplementation in the prevention of some congenital malformations is known, but on a molecular biological level poorly understood. In a first approach to identify folate-regulated pathways in human embryogenesis, tryptic digests of Epstein Barr Virus-immortalized B-lymphoblasts proteins from 6 cleft lip and/or palate patients and 2 controls were compared using matrix assisted laser desorption ionisation--time of flight (MALDI-TOF) mass spectrometry. After immortalisation, the lymphoblasts were cultured for 22 days in folate-rich, i.e. 5-methyltetrahydrofolate (5-mTHF), or folate-free medium. On day 22, 5-mTHF was added to the folate-free cultures and the profiles on day 22 and 23 were compared. After background correction for the peptide profiles of the folate-rich cultures, we found in the folate-free mediaseveral differentially expressed peptide peaks upon addition of 5-mTHF. These peptide peaks were mass annotated and matched withthe MSDB human database. The results suggest some folate-regulated protein candidates as Frizzled and the Rho GTP-ases WRCH and Chp that are known in human embryogenesis. Differential folate expressed proteins in patients and controls, however, have to be further investigated.

Effect of fish oil on indometacin-induced gastric lesions in rats.

The effect of fish oil in promoting the healing of indomethacin-induced gastric lesions was investigated in Wistar albino rats. After indomethacin treatment (30 mg/kg, s.c.), animals were given fish oil, olive oil, or normal diet for 48 h. The ulcer index was found to be decreased to 2.1 +/- 1.8 mm with fish oil, 13.7 +/1 5.4 mm with olive oil, and 14.6 +/- 2.4 mm with normal diet. Fish oil showed a potent healing-promoting effect on acute gastric erosions and ulcers induced by indomethacin and significantly enhanced the mucus content of the mucosa (p < 0.05).

Protective effect of fish oil against stress-induced gastric injury in rats.

The effect of fish oil and olive oil on the gastric mucosal damage induced by cold-restraint stress was investigated in rats. The oils were dietary supplemented for 3 weeks. The results demonstrate that a diet containing fish oil, when ingested for 3 weeks before exposure to stress, protected from gastric ulceration significantly (p < 0.01) and led to a statistically significant increase both in mucus and phospholipid content of the gastric mucosal barrier (p < 0.02 and p <0.001, resp.) in cold-restraint stress-induced gastric injury in rats. However, further studies are required to determine the role of dietary fish oils in the prophylaxis and treatment of peptic ulcer.

Effect of oral pyridoxine hydrochloride supplementation on in vitro platelet sensitivity to different agonists.

Effect of vitamin B6 (pyridoxine-HCl, CAS 58-56-0) on platelet aggregation, plasma lipids and serum zinc level was investigated. The trial comprised 24 healthy male volunteers, aged between 19-24 years. The subjects were randomized in two groups of 12 and treated for 4 weeks by a single daily oral dose of 5 mg/kg vitamin B6 or placebo. Pyridoxine inhibited ADP- or epinephrine-induced aggregation by 48% and 41% (p < 0.001), respectively, whereas there was no change in control group. No significant effect on either, bleeding time, coagulation time or on platelet count was demonstrated in subjects given placebo. Pyridoxine prolonged both bleeding and coagulation time but not over the physiological limits. It had no effect on platelet count. These observations strongly suggest that vitamin B6, with no effect on platelet count, not only inhibits platelet aggregation but also prolongs clotting time. Pyridoxine significantly reduced total plasma lipid and cholesterol levels, whereas it enhanced HDL-cholesterol level. Serum zinc level was also significantly increased by pyridoxine (p < 0.001). These findings suggest that oral vitamin B6 inhibits platelet aggregation in normal subjects.

Alveolar hydatid disease of the liver: a report on thirty-nine surgical cases in eastern Anatolia, Turkey.

The charts of 39 consecutive patients who underwent surgery between 1979 and 1989 with a diagnosis of alveolar hydatid disease (AHD) of the liver were reviewed. The analysis of these cases from eastern Anatolia, which is the endemic region in Turkey, was undertaken to determine the current experience for AHD lesions. Of these patients, 33 (84.6%) had unresectable disease and the remaining six patients (15.4%) were treated by hepatic resection of the primary lesion. In the unresectable cases, laparotomy with biopsy was the most commonly used surgical procedure (56.4%), followed by tube drainage of the necrotic cavity (18.0%), marsupialization (5.1%), and cystojejunostomy (5.1%). Diagnostic studies and operative findings were useful in detecting the AHD lesions. Differential diagnosis was established mainly by histopathologic examination of a biopsy specimen or resected tissue. Pulmonary metastases were seen in two cases, and mortality occurred due to brain metastases in two other cases. Mebendazole was administered postoperatively to 19 patients with indications for 1) advanced AHD, 2) adjuvant therapy to radical and palliative surgical procedures, and 3) recurrences of disease after hepatic resection. The patients were treated with daily doses of approximately 50 mg/kg for periods of one and six years (median 3.2 years). Encouraging results were obtained in 11 of nineteen patients. Five-year survival was seen in 8 of the patients with AHD in this series. There were 18 deaths (46.2%) in our 39 patients. Long-term follow-up was not possible in four cases, and 17 patients (43.6%) were still living. The causes of mortality were advanced AHD in 14 cases, brain metastases in two, and acute myocardial infarction in another two.(ABSTRACT TRUNCATED AT 250 WORDS)