Evaluation of prediabetes patients in terms of metabolic syndrome.

OBJECTIVE: Prediabetes accompanied by metabolic syndrome accelerates the process leading to diabetes and causes an increase in complications. The current study aimed to investigate the clinical conditions accompanying prediabetes and the effect of the association of metabolic syndrome on clinical outcomes in prediabetics. SUBJECTS AND METHODS: This cross-sectional study was conducted with 88 prediabetic individuals between November 2022 and January 2023. Prediabetes was diagnosed using the American Diabetes Association (ADA) criteria, and metabolic syndrome was diagnosed using the International Diabetes Federation criteria. Clinical history, physical examination and laboratory tests of the participants were recorded. RESULTS: Metabolic syndrome (MetS) was present in 69 of 88 prediabetic patients included in the study (78.4%). Hypertension (p=0.019), abdominal obesity (p<0.001), low-density lipoprotein (LDL) elevation (p=0.006), and dyslipidemia (p=0.020) were detected more frequently in prediabetic individuals accompanied by MetS. Median values of waist circumference (p=0.020), systolic blood pressure (p=0.021), triglyceride (p<0.001), LDL (p=0.003) and postprandial blood sugar (p=0.049) in prediabetics accompanied by MetS were statistically significant. It was higher than those without MetS. The median Vit-D level of prediabetics without MetS was higher than those with MetS (p=0.049). The median creatinine value of prediabetics without MetS was higher than that of prediabetics with MetS (p=0.049). CONCLUSIONS: Hypertension, dyslipidemia, abdominal obesity, and metabolic obesity increased in the coexistence of prediabetes and MetS. At the same time, the coexistence of prediabetes and MetS was associated with higher systolic blood pressure, postprandial blood sugar, and LDL levels. Prediabetic individuals accompanied by MetS are at greater metabolic risk.

HyperColorization: propagating spatially sparse noisy spectral clues for reconstructing hyperspectral images.

Hyperspectral cameras face challenging spatial-spectral resolution trade-offs and are more affected by shot noise than RGB photos taken over the same total exposure time. Here, we present a colorization algorithm to reconstruct hyperspectral images from a grayscale guide image and spatially sparse spectral clues. We demonstrate that our algorithm generalizes to varying spectral dimensions for hyperspectral images, and show that colorizing in a low-rank space reduces compute time and the impact of shot noise. To enhance robustness, we incorporate guided sampling, edge-aware filtering, and dimensionality estimation techniques. Our method surpasses previous algorithms in various performance metrics, including SSIM, PSNR, GFC, and EMD, which we analyze as metrics for characterizing hyperspectral image quality. Collectively, these findings provide a promising avenue for overcoming the time-space-wavelength resolution trade-off by reconstructing a dense hyperspectral image from samples obtained by whisk or push broom scanners, as well as hybrid spatial-spectral computational imaging systems.

A first-in-human pilot study of a novel electrically-passive metamaterial-inspired resonator-based ocular sensor embedded contact lens monitoring intraocular pressure fluctuations.

Glaucoma is a leading cause of blindness with no cure, but early treatment and effective monitoring can often slow the progression of the disease. Monitoring of glaucoma is based on the measurement of intra-ocular pressure (IOP) that is a physiological parameter related to the mechanical state and parameters of the eye. Conventionally, diagnosing and assessing the progression of glaucoma is based on the method of measuring IOP discretely at clinics. Recent studies have demonstrated the importance of continuously monitoring IOP for 24 h to elucidate the effect of circadian rhythm. In this work, a metamaterial-inspired electrically-passive sensor-embedded contact lens is presented to monitor the IOP fluctuations based on a first-in-human pilot study. The sensor inside the contact lens is an electrically passive, metamaterial-based resonator that can be measured using a wearable antenna patch. The system has been tested with six healthy volunteers during an experiment to induce deliberate IOP changes via water-loading and placing the individuals in supine position using a recliner seat. The initial data compared with tonometer measurements suggest that the system can be used to assess the variation of IOP continuously.

Far-infrared treatment of experimental sinusitis in rabbits: a pilot study.

OBJECTIVE: Thermal therapy has existed for thousands of years and dates back to ancient civilizations such as the Finns, Romans, ancient Chinese, American Indians, and Egyptians. Sun therapy is a form of natural Far Infrared Rays (FIR) thermal therapy. Far infrared rays are invisible rays with the longest wavelength of natural sunlight. However, sunbathing should only be done in moderation, as sunlight contains ultraviolet rays that can burn and damage the skin. More than 30 million people in Asia, Europe, and Australia receive Far Infrared Therapy with FIR lamps. They emit 2-25-micron wavebands. We aimed to investigate whether FIR therapy that uses a similar waveband improves sinusitis symptoms. MATERIALS AND METHODS: This study was conducted on 10 New Zealand rabbits of both sexes, 7-8 months old, with an average weight of 1.8-2.4 kg. They were divided into four study groups. Sinusitis was induced in rabbits by blocking the sinus ostium, whereas some were left as control. Far infrared treatment with an infra-sin device was given with or without antibiotics. Mucosal samples were evaluated microscopically regarding epithelial eruption, epithelial vacuolization, interstitial edema, vascular congestion, leukocyte infiltration, and mucosal thickening. RESULTS: We found clinical and histopathological improvements in rabbits with sinusitis on the right side of the nose, to which we applied FIR treatment with the device Infra-Sin. CONCLUSIONS: Our findings in this animal study led us to conclude that it would be beneficial to study the effects of FIR treatment on people with allergic rhinitis and sinusitis and to identify the optimal dosing, treatment duration, and intensity. To add to our findings, looking into whether FIR therapy can be used as an alternative to antibiotic treatment for human sinusitis is essential.

The relationship of promoter methylation of calcium voltage-gated channel alpha 1 and interleukin-16 to primary osteoarthritis.

OBJECTIVE: Osteoarthritis is the most prevalent joint disease worldwide and the primary cause of musculoskeletal dysfunction. Epigenetic changes in various genes, particularly methylation, have been implicated as possible underlying causes of primary osteoarthritis. The aim of our study was to investigate the promoter methylation status of the calcium voltage-gated channel alpha 1 subunit G (CACNA1G) and interleukin-16 (IL-16) genes, which are strongly associated with calcium channel activity and antigen presentation, respectively, in primary osteoarthritis patients. PATIENTS AND METHODS: Twenty-one patients with primary osteoarthritis and 25 healthy controls were included in our study. The methylation status of CACNA1G and IL-16 genes was analyzed with methylation-specific Polymerase Chain Reaction (PCR), and the serum levels of IL-16 were determined with Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: The age of the patients was 63.95±8.41 years, and they were 15 females and 6 males. The promoter of the CACNA1G gene was found to be hypermethylated in primary osteoarthritis patients (p<0.001). In contrast, the promoter of the IL-16 gene was found to be hypomethylated compared to the control (p<0.001). The serum levels of IL-16 increased in parallel with the hypomethylated promoter status of IL-16 gene in primary osteoarthritis patients compared to the control (p<0.001). CONCLUSIONS: Our study indicates that the methylation status of CACNA1G and IL-16 gene promoters are epigenetically altered in patients with primary osteoarthritis. Moreover, increased serum IL-16 levels in osteoarthritis patients may be associated with hypomethylation of the IL-16 gene promoter.

Subfatin, asprosin, alamandine and maresin-1 in cerebral ischemia, intracranial and subarachnoid hemorrhages.

OBJECTIVE: Cerebrovascular diseases (CVDs) remain an important public health issue due to the increasing number of deaths worldwide. Changes in the synthesis and release of peptides in CVDs may play an important role in elucidating the physiopathology of the disease. Therefore, this study was to investigate the fate of maresin-1 (MaR-1), subfatin (SUB), asprosin (ASP), and alamandine (ALA) levels in patients with cerebral infarction (CI), intracranial hemorrhage (ICH), subarachnoid hemorrhage (SAH) evaluated within the scope of CVDs, and voluntary healthy controls. PATIENTS AND METHODS: The study participants were divided into 4 groups: CI patients, ICH patients, SAH patients, and healthy volunteers. The diagnosis of CVDs was made based on the National Institutes of Health Stroke Scale (NIHSS), Intracerebral Hemorrhage Score (ICHS), Botterel-Hunt-Hess Scale (BHHS), and cranial computed tomography (CT). The levels of MaR-1 (ng/mL), SUB (ng/mL), ASP (ng/mL), and ALA (pg/mL) in the blood samples collected from the participants were studied using the ELISA method. Other parameters included in the study were obtained from the patient records of our hospital. RESULTS: The comparison of MaR-1 [(control 1.38 ± 0.14), SAH (0.98 ± 0.087), CI (0.67 ± 0.04), ICH (0.51 ± 0.03)], SUB [(control (13.2 ± 1.4), SAH (10.1 ± 1.2), CI (7.9 ± 0.8), ICH (5.8 ± 0.5)], and ALA [(control (67.2 ± 7.9), SAH (58.2 ± 4.3), CI (42.1 ± 3.7), and ICH (34.2 ±3.9)] values revealed a significant decrease compared to the control values. The comparison of the ASP values of SAH, CI, and ICH patients and control values (11.6 ± 1.2) showed significantly higher asprosin values in SAH (13.8 ± 1.1), CI (15.4 ± 1.2) and ICH (28.9 ± 2.8) patients. Similarly, systolic blood pressure (SBP), diastolic blood pressure (DBP), and glucose levels of CKD patients were also high. CONCLUSIONS: Decreased MaR-1, SUB, ALA and increased ASP compared to the control values may play a role in the physiopathology of these diseases. MaR-1, SUB, ALA, and ASP differences between SAH, CI and ICH patients may also guide clinicians along with SBP, DBP and glucose values.

Nutrition and oral health in children with recently and previously diagnosed celiac disease.

OBJECTIVES: To evaluate the nutritional and oral health status of children with previously diagnosed celiac disease (CD) who follow a gluten-free diet and recently diagnosed CD patients. MATERIALS AND METHODS: Previously and recently diagnosed groups were formed from children with CD, aged 4 to 15 years. A questionnaire was completed about the children's dental history and nutritional and oral hygiene habits. All the children underwent an oral examination, and dmft-DMFT indices were determined. Dental plaque status, periodontal health, and dental enamel defects were recorded. Oral soft tissues were examined for the presence of lesions. Unstimulated salivary flow rate and pH value were evaluated. RESULTS: A statistically significant difference was determined between the previously and recently diagnosed patients in terms of toothpaste preference (p=0.003), frequency of going to the dentist (p=0.039), and the types of dental treatment they had received (p=0.001). A statistically significant difference was determined between the previously and recently diagnosed patient groups in terms of dmft values (p=0.005). CONCLUSIONS: Children with CD should be directed to a pediatric dentist to improve oral and dental health, relieve the symptoms of oral mucosal lesions, be informed about enamel defects, and be encouraged to use gluten-free oral care products. CLINICAL RELEVANCE: The collaboration of pediatric gastroenterologists and pediatric dentists can prevent the progression of oral symptoms in children with CD and eliminate long-term complications in terms of both oral health and multisystemic problems.

Do Gene Polymorphisms Play a Role in Newborn Hyperbilirubinemia?

Objectives: Polymorphisms of the uridine-diphospho-glucuronosyltransferase 1A1 (UGT1A1) gene, hepatic solute carrier organic anion transporter 1B1/B3 (SLCO1B1/3) gene, and glutathione S-transferase (GST) gene have been associated with significant hyperbilirubinemia in some populations. This study aims to determine whether the variation of UGT1A1, SLCO1B1/3 and GST genes play an important role in neonatal hyperbilirubinemia in Turkish newborn infants. Methods: The study included 61 idiopathic hyperbilirubinemia cases, 28 prolonged jaundice cases, and 41 controls. Ten common polymorphisms in four genes involved in bilirubin metabolism were examined. Polymerase chain reaction-restriction fragment length polymorphism method was used to detect variants of those genes. Results: No association was found between the variants of UGT1A1 at nt 211, the SLCO1B1 gene at nt 388, 463, 521, 1463, the SLCO1B3 gene at nt 334, 727+118, 1865+19721, and the GST gene at nt 313, 341, and neonatal hyperbilirubinemia. There was no difference between the case and control groups in terms of allele frequencies of these genes (except SLCO1B3 at nt 334) (p>0.05 in all comparisons). The presence of the G allele of the SLCO1B3 at nt 334 variant gene seemed to protect from jaundice in infants with idiopathic hyperbilirubinemia. Conclusion: These gene polymorphisms currently studied do not seem to modulate the risk of hyperbilirubinemia in Turkish newborn infants.

Acetabular dysplasia: a comparison of periacetabular osteotomy results of patients older and younger than 35 years.

OBJECTIVE: Patient age has been reported to be an important determinant of treatment success in developmental dysplasia of the hip (DDH). This study aimed to determine the efficacy of periacetabular osteotomy (PAO) in DDH patients aged ≥ 35 years and to compare patient-reported and radiological outcomes with a control cohort of younger patients. PATIENTS AND METHODS: This retrospective analysis included 43 patients (23 aged < 35 years; 20 aged ≥ 35 years) who underwent unilateral Bernese PAO for symptomatic DDH, between May 2001 and August 2015. Patients with a history of ipsilateral pelvic osteotomy or other pelvic pathologies were excluded. To evaluate the morphology of the dysplastic hip joints, 11 conventional radiographic measures were taken. Preoperative and postoperative Harris Hip Scores, postoperative visual analogue scale scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and hip range of motion measurements were used for clinical evaluation. RESULTS: Of the 43 patients, 31 (72.1%) were women and 14 (27.9%) were men. The average age was 32 (range: 19-45) years. Regarding sex, surgery site, mean body mass index and mean follow-up time, there were no significant differences between the groups. Both groups showed significant differences in radiographic parameters before and after the PAO. There were no significant differences in preoperative or postoperative clinical outcomes between the groups, except for the WOMAC score. CONCLUSIONS: PAO can be performed safely to treat acetabular dysplasia in patients aged ≥ 35 years, before the onset of femoroacetabular osteoarthritis, with satisfactory clinical and functional outcomes.

Peritoneal dialysis in children: Infectious and mechanical complications: Experience of a tertiary hospital in Elazig, Turkey.

Background: Peritoneal dialysis (PD) is frequently used in pediatric patients with renal failure. Aim: In the present study, we evaluated the indications and complications of PD and patients' outcomes in pediatric patients. Patients and Methods: Medical records of patients who underwent PD between 2012 and 2019 were analyzed retrospectively. The patients were divided into two groups as acute PD (APD) (Group 1) and chronic PD (CPD) (Group 2). If the patient was diagnosed with acute kidney injury (AKI), an APD catheter was inserted, while a CPD catheter was inserted for patients with stage 5 chronic renal failure or those in which AKI persisted for more than 6 weeks. Results: Group 1 and Group 2 consisted of 62 and 64 patients, respectively. The most common indications for PD were AKI (64.5%) in Group 1, and obstructive uropathy and reflux nephropathy (45.3%) in Group 2. The overall complication rate was 30%. These were leakage at the catheter insertion site (11.2%), catheter occlusion (4.8%), and peritonitis (4.8%) in Group 1; and peritonitis (14.1%), catheter occlusion (6.2%), and inguinal hernia (4.6%) in Group 2. The mortality rate was 72.5% and 23.4% in Group 1 and Group 2, respectively. The most common causes of mortality were multisystem organ failure (40%) and sepsis (33.5%) in both groups. A total of 83 patients (32 in Group 1 and 51 in Group 2) had omentectomy. Catheter revision and/or removal were performed in 11.9% of all patients. Omentectomy had no effect on the prevention of catheter occlusion (p > 0.05). Conclusion: The mortality rate is lower in CPD patients than in APD patients. Although PD in pediatric patients is associated with potential complications, its actual rate is relatively low. The primary catheter dysfunction rate is low, and omentectomy has no significant effect on preventing catheter occlusion.

Investigation into the protective effects of Naringenin in phthalates-induced reproductive damage.

OBJECTIVE: Di-n-butyl phthalate (DBP) is a ubiquitous environmental pollutant, extensively used as a plasticizer in many products, including plastics, cosmetics, and medical devices. Naringenin (NAR) is a flavonoid belonging to the flavanones subclass. It is widely distributed in several citrus fruits, bergamot, tomatoes, and other fruits. It is also found in its glycoside form (mainly naringin). Several biological activities have been ascribed to this phytochemical: antioxidant, antitumor, antiviral, antibacterial, anti-inflammatory, antiadipogenic, and cardioprotective effects. This study hypothesized that phthalates' possible reproductive damage mechanism is oxidative attack, and naringenin could have a protective effect against radical forms in the body through its antioxidant properties. MATERIALS AND METHODS: Thirty-two male rats were used in our study (n=8 each). Rats were randomly divided into four groups: Control, DBP, DBP +NAR and NAR. Phthalate (DBP) and NAR were administered through gastric oral gavage (phthalate group 500 mg/kg/day DBP; NAR group 50 mg/kg/day NAR). At the end of four weeks, testis tissue samples were taken under anesthesia. Testis tissue and blood samples were collected from the four groups in this study. Histological, biochemical and spermatological analyses were conducted. RESULTS: Tissue samples from the control and NAR groups showed normal histological appearance on light microscopy. The DBP group exhibited deterioration in seminiferous tubules, vascular congestion in capsule, vascular congestion between the seminiferous tubules, edema in the intestinal area and vacuolization, arrested spermatocytes in different stages of division; sloughing of cells into the seminiferous tubular lumen was observed. It was also observed that NAR treatment significantly inhibited and prevented the histopathological damage caused by DBP. Tissue TBARS, antioxidant parameters, sperm motility, sperm density and abnormal spermatozoon ratios were determined. As a result, it was shown that DBP caused oxidative damage by increasing TBARS levels and decreasing antioxidant parameters, increased abnormal sperm rate and decreased sperm motility, and concentration and histopathological damage, so the antioxidant activity of naringenin inhibited this damage. CONCLUSIONS: DBP had toxic effects in rat testis tissue; NAR treatment ameliorated these effects. Further studies are warranted to confirm our findings.

Peer-Assisted skills learning in structured undergraduate medical curriculum: An experiential perspective of tutors and tutees.

Background and Aims: : This study aims to evaluate the implication of peer-assisted learning model adopted in students' clinical skills training from the perspective of tutees and tutors at the end of a peer-tutored clinical skills program and peer tutors themselves. Subjects and Methods: This cross-sectional study was conducted in the Faculty of Medicine, Bursa Uludag in between January and March 2018. Following the clinical skills training, a questionnaire designed to assess the views of tutees and peer tutors was filled out on a voluntary basis by 159 tutees and 43 tutors. The statistical analysis of the collected and processed data was analyzed by using IBM SPSS 23.0 statistical program. The statistical significance level was maintained as α = 0.05. Results: According to the Likert scale, satisfaction with the tutors and the educational environment was high in general. The 2nd term tutees provided more negative feedback compared to other terms. Among all the terms, the most positive answers were provided by the 3rd term students. Although the tutors found themselves fully skilled in communication with colleagues, there were striking differences between the tutors in the 5th and 6th terms of providing a good role model for pre-clinical terms students. Conclusion: Considering peer assisted learning (PAL)'s positive responses from this study, the adoption of PAL has been started to be used as a supplementary teaching method for the clinical skills training at the Faculty of Medicine, Bursa Uludag University. PAL is considered a successful education model since it is cost-efficient for undergraduate medical training and improves the professional skills of both teacher and learner students. It can be availed of as an alternative method in medical faculties where especially the number of academic members is insufficient.

Are differences in shoulder morphology and hand dominance risk factors for rotator cuff tears?

OBJECTIVE: The purpose of this study was to evaluate whether there was a difference in shoulder morphology and hand dominance between a healthy shoulder and a shoulder with rotator cuff tear (RCT) in the same patient. PATIENTS AND METHODS: Between 2015 and 2020, 120 shoulders from 60 patients with complete RCT and contralateral intact rotator cuffs were enrolled in this retrospective analysis. Physical examinations, shoulder radiographs, and magnetic resonance imaging (MRI) pictures of the patients were reviewed. On radiographs, the AT, CSA, LAA, and AI values were compared between shoulders with complete RCT and contralateral healthy shoulders from the same individuals. Additionally, the association between hand dominance and RCT was evaluated. RESULTS: This study enrolled 60 patients. 59.17% of the participants are female, and 40.83% are male. The mean age of the patients was 54.5±7.1 years. There were statistically significant differences in AI, CSA, and LAA measurements between the study group (RCT group) and the control group. There was no significant difference in AT between the two groups. CONCLUSIONS: There are morphological differences between a healthy shoulder and a shoulder with an RCT in the same patient, and these differences (LAA/CSA/AI/AT) may have an effect on the prevalence of RCT.

A comparison of patients who have appendectomy during the COVID-19 pandemic period with the period before the pandemic.

BACKGROUND: This study aims to compare the waiting and operating times of the patients who applied to our hospital with the diagnosis of acute appendicitis (AA) during the pandemic, how the process was managed in terms of AA and other data of the patient compared to the pre-pandemic period. METHODS: A retrospective cohort analysis was performed among patients who were hospitalized in the Fatih Sultan Mehmet Training and Research Hospital General Surgery Clinic with a pre-diagnosis of AA. For this purpose, two groups were formed. Group 1: It comprised patients who were operated between March 11 and June 1, 2020; Group 2: It comprised patients who were operated between March 11 and June 1, 2019, with a pre-diagnosis of AA. RESULTS: Forty-six patients in Group 1 and 79 patients in Group 2 were operated with the pre-diagnosis of AA. There was no difference between groups in terms of pre-operative symptom durations or surgery waiting times. CONCLUSION: During the COVID-19 pandemic, significant decrease observed in the number of patients operated because of AA can be interpreted as the avoidance of patients from applying to the hospital with the concern of infection. Moreover, it may suggest that uncomplicated cases undergo spontaneous resolution; however, there is a requirement for further research to support this assumption and define the criteria for this condition by including a level of scientific evidence.

Influence of ultrasound application on the microbiota of raw goat milk and some food pathogens including Brucella melitensis.

The aim of the present study was to investigate the detrimental effect of ultrasound application, as an alternative to pasteurization, on raw goat milk microorganisms and some food pathogens including Brucella melitensis. For this purpose, six different ultrasound applications with a power of 20 kHz at 100%, 50% and 10% amplitudes with or without pulsation were practiced. Colour changes as an increase in brightness (L-value) and decrease in yellow colour value (b-value) were determined in either pasteurized or ultrasonified groups. The most efficient detrimental effect on bacteria was obtained at 100% amplitudes (III and IV group). In these groups, decrease of TAMB, coliforms, streptococci, lactobacilli, yeast and mould counts were 6.52, 6.27, 5.31, 5.61, 5.27 and 4.02 log cfu/ml respectively in raw milk. Inactivation of food pathogens Brucella melitensis type 3, Salmonella Typhimirium, Escherichia coli, Listeria monocytogenes and methicilin resistant Staphylococcus aureus inoculated in goat milk was approximately 99%, which was as efficient as HTST and LTLT pasteurization process. Consequently, ultrasound applications can be an alternative to heat processes in dairy since effective bacterial inactivation could be attained in a relatively economic and environmentally friendly way.

Curcumin protects against testis-specific side effects of irinotecan.

OBJECTIVE: Irinotecan (IR/CPT-11) is a semisynthetic, water-soluble derivative of the alkaloid camptothecin. It is a topoisomerase I group antineoplastic drug commonly used for the treatment of many cancer types, although it has side effects in tissues such as the testis. Curcumin (CRC) is a polyphenol compound produced from the Indian saffron root; it is used as food colouring and food flavouring. This study examined the testis-specific side effects of IR and the ability of CRC to protect against these side effects. MATERIALS AND METHODS: Forty male Sprague-Dawley rats were used in our study (n = 10). The rats were randomly divided into the following four groups: control, IR, IR + CRC, and CRC. IR 10 mg/kg/day was administered intraperitoneally and CRC 100 mg/kg was administered orally. Blood and testicular samples were collected from rats in all four groups on day 30 after drug administration. Histological, biochemical, and spermatological analyses were conducted. RESULTS: Testis tissue and blood samples were collected from the four groups. Tissue samples from the control and CRC groups demonstrated normal histological appearance on light microscopy. The IR group exhibited the following findings: vascular congestion in the tunica albuginea layer; tubular degeneration and vascular congestion in the interstitial area; oedema, vacuolisation, and luminised cells in the seminiferous tubule; and cells that temporarily stopped dividing at any stage of division in the seminiferous tubule epithelium. In the IR+CRC group, histopathological damage was significantly reduced by CRC treatment. Biochemical analysis showed that the level of thiobarbituric acid reactive substance (TBARS) was significantly increased in the IR group, compared with the other groups. CRC treatment significantly decreased this IR-mediated increase in TBARS level, and the TBARS level in the IR + CRC group approached the level observed in the control group. IR treatment caused significant decreases in glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) levels. However, CRC administration tended to ameliorate the decreases in GSH, SOD, CAT, and GPx levels. CONCLUSIONS: In this study, IR had some toxic effects in rat testis tissue; these effects were ameliorated by CRC treatment. Further studies are warranted to confirm our results.

Comparison of conservative and surgical treatment in Gartland Type IIB fractures in pediatric patients.

OBJECTIVE: In this study, our aim was to compare conservative treatment and surgical treatment radiologically and clinically in the treatment of pediatric Gartland type IIB SCHF, which is a controversial issue in the literature. PATIENTS AND METHODS: This retrospective study included 86 patients with a Gartland type IIB humerus fracture. Forty-three patients were treated conservatively, and 43 patients were surgically treated. Radiological results were evaluated according to the Baumann angle and anterior humerus line. The Mayo Elbow Performance Score (MEPS) and Flynn's criteria were used to assess the functional evolution. RESULTS: The mean MEPS was 94 for the conservative treatment group and 93 for the surgical treatment group. According to Flynn's criteria, 31 (72.09%) excellent results were obtained in patients who were treated conservatively, and 26 (60.46%) excellent results were obtained in the surgical treatment group. CONCLUSIONS: The conservative and surgical treatment of Gartland type IIB SCHF is not superior to each other if anatomic reduction is achieved. Complications of each treatment can be prevented by following strict treatment principles.

Destructive Effects of Acidic Blood on the Intestines: Experimental Study.

OBJECTIVE: This study aimed to investigate the destructive effects of acidic blood on the intestinal structures, which has been reported as the most hazardous biochemical result of vagosympathetic autonomic imbalances in intensive care unit patients with subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: In total, 27 hybrid rabbits were used; 5 rabbits were used as a control group, 7 as the SHAM group into whom 1 cc saline was injected into the cisterna magna, and the remaining 15 were used as the study group. These animals received 1 cc of autologous arterial blood injection into the cisterna magna to create the SAH group. Blood pH values were recorded before, during, and after the experimental procedures. Computed tomography was performed to examine the intestinal morphology. Normal and degenerated epithelial cell densities of the intestine were estimated by stereological methods. The relationship between pH values and intestinal tissue changes was analyzed statistically using the Mann-Whitney U test. RESULTS: The mean blood pH values were 7.364±0.042 in the control group, 7.326±0.059 in the SHAM group, and 7.23±0.021 in the study group. Intestinal epithelial cell injury, desquamation of villus, and cell loss were observed. It is observed that the number of degenerated epithelial cells, fragmented villi numbers, and vacuoles significantly increased in the study group (p<0.05). CONCLUSION: Acidotic intestinal injury secondary to blood pH changes following SAH may be considered as a generalized and dangerous complication with their multiorgan insuficiency effect.

Cost analysis of inguinal hernia repair: the influence of clinical and hernia-specific factors.

INTRODUCTION: As in the rest of the world, in Germany, inguinal hernia operations are among the most common operations. From an economic standpoint, very little is known about the influence of demographic, clinical or hernia-related parameters on the cost of inguinal hernia repair. We, therefore, evaluated individual patient parameters associated with higher costs with a special focus on multimorbidity. METHODS: A total of 916 patients underwent hernia repair for primary or recurrent inguinal hernia between 2014 and 2017 at a single university center and were included in the analysis. The clinical and financial data of these patients were analyzed to identify cost-increasing parameters. RESULTS: A majority of patients were male (90.7%), with a mean age of 55 years. The surgical methods utilized were mainly the TAPP (57.2%) and Lichtenstein (41.7%) procedures, with an average duration of surgery of 85 min and an average duration of anesthesia of 155 min. The mean cost of all procedures was 3338.3 € (± 1608.1 €). Older age, multimorbidity, emergency operations with signs of incarceration, longer hospital stays and postoperative complications were significant cost-driving factors. On the other hand, sex, the side of the hernia (left vs. right) and the presence of recurrent hernias had no influence on the overall direct costs. CONCLUSION: From a purely economic point of view, older age and multimorbidity are demographic cost-driving factors that cannot be influenced. The national hospital reimbursement system needs to consider and compensate for these factors. Emergency operations need to be prevented by early elective treatment. Long postoperative stays and postoperative complications need to be prevented by proper preoperative check-ups and accurate treatment.

Clinical approach to patients admitted to the emergency room due to acute cholecystitis during the COVID-19 pandemic and percutaneous cholecystostomy experience.

BACKGROUND: Acute cholecystitis (AC), a common complication of gallstones, is responsible for a significant part of emergency applications, and cholecystectomy is the only definitive treatment method for AC. Early cholecystectomy has many reported advantages. Operation-related morbidity and mortality have increased during the COVID-19 pandemic. In this study, our aim is to present our general clinical approach to patients who were diagnosed with AC during the pandemic and our percutaneous cholecystostomy experience during this period. METHODS: This study included 72 patients who were presented to our hospital's emergency room between March 11 and May 31, 2020, with AC. Patients were divided into three groups based on their treatment: outpatients (Group 1), inpatients (Group 2) and patients undergoing percutaneous cholecystostomy (Group 3). These three groups were compared by their demographic and clinical characteristics. RESULTS: There were 36 (50%) patients in Group 1, 25 (34.7%) patients in Group 2, and 11 (15.3%) patients in Group 3. The demographic characteristics of the patients were similar. The CRP and WBC levels of the patients in Group 3 were significantly higher compared to the other groups. Moreover, the wall of the gallbladder was thicker and the size of the gallbladder was larger in Group 3. Patients had percutaneous cholecystostomy at the median of 3.5 days and the length of hospital stay was longer compared to Group 2 (3.9 days versus 9.2 days, p=0.00). The rate of re-hospitalization after discharge was similar in Group 2 and Group 3, but none of the patients in Group 1 required hospitalization. None of 72 patients developed an emergency condition requiring surgery, and there was no death. CONCLUSION: Although many publications emphasize that laparoscopic cholecystectomy (LC) can be performed with low morbidity at the first admission in acute cholecystitis, it is a clinical condition that can be delayed in the COVID-19 pandemic and other similar emergencies. Thus, percutaneous cholecystostomy should be effectively employed, and its indications should be extended if necessary (e.g., younger patients, patients with lower CCI or ASA). This approach may enable us to protect both patients and healthcare professionals that perform the operation from the risk of COVID-19.