Tetramethylpyrazine Attenuates Radiation-Induced Ototoxicity in a Rat Model.

INTRODUCTION: Tetramethylpyrazine (TMP) is a chemical compound, which has been shown to possess numerous biological features such as anticoagulation, inhibition of platelet aggregation, anti-inflammation, capillary dilatation, improvement in microcirculation, and protection against reactive oxygen radicals. The aim of the present study was to investigate the protective effect of TMP against radiation-induced ototoxicity. MATERIALS AND METHODS: 40 rats were divided into four groups. The first group was irradiated for 5 days. The second group received a single dose of 140 mg/kg/day intraperitoneal TMP given to the rats 30 min before radiotherapy (RT) for 5 days. The third group received a single dose of 140 mg/kg/day i.p. TMP for 5 days, whereas the fourth group was administered saline. All rats underwent distortion product otoacoustic emission (DPOAE) and auditory brainstem response measurements before and after the application. The temporal bulla of animals was removed for immunohistopathological examination. RESULTS: Signal-noise ratio values were significantly decreased in the RT group for the frequencies of 2-32 kHz after RT (p < 0.05), whereas the difference was not significant in terms of pre- and posttreatment values for the other groups. Also in the RT group, the ABR thresholds were significantly increased after treatment. In H&E staining, the mean scores for outer hair cells (OHCs), stria vascularis (SV), and spiral ganglion (SG) injuries were significantly higher in RT and RT + TMP groups than in the other groups. The mean OHCs and SV injury scores were also significantly higher in the RT group than in the RT + TMP group (p < 0.05). The number of cochleas that showed cytoplasmic caspase-3 immunoreactivity in the OHC, SV, and SG was significantly higher in RT and RT + TMP groups than in the other groups. CONCLUSION: The findings of the present study suggest that TMP may have a therapeutic potential for preventing sensorineural hearing loss (SNHL) related to RT.

Incidental papillary thyroid microcarcinomas in thyroidectomy specimens: A single-center experience from Turkey.

BACKGROUND: Papillary thyroid microcarcinoma (PTM) is a relatively common entity in the general population. PTM is often asymptomatic and is detected incidentally during the histopathological examination of thyroidectomy specimens from operations because of benign thyroid disease. AIMS: The aims of the study are to determine the incidence of incidental papillary thyroid microcarcinomas (IPTMs) in our center, to examine the clinicopathologic characteristics of these tumors, and to present our experiences. MATERIALS AND METHODS: This study includes 827 patients who underwent thyroidectomy operation in our center between January 2013 and June 2017 and were examined histopathologically in the Pathology Clinic. Patients' demographic characteristics, preoperative diagnoses, operative procedure, histopathological findings, and postoperative prognostic indexes are presented. RESULTS AND CONCLUSION: Of the 827 patients, 138 (16.6%) were diagnosed with a malignancy. Of these, 124 were papillary carcinoma, 5 were follicular carcinoma, 4 were lymphoma, 2 were medullary carcinoma, 2 were anaplastic carcinoma, and 1 was poorly differentiated carcinoma. The IPTM incidence rate was 8.01%; the multifocality and bilaterality rates were 23.3% and 13.3%, respectively. In 98.3% of IPTM cases, total thyroidectomies were performed, and in 1.7% of cases, subtotal thyroidectomy was performed followed by complementary thyroidectomy. No relapse or metastasis was detected in any of these cases. A careful histopathological examination of the thyroidectomy specimen is essential because IPTM is frequently skipped in fine needle aspiration cytology. We consider it best to perform total thyroidectomies because bilaterality and multifocality rates are high in IPTM. Long-term life expectancy in these tumors is quite good.

Prognostic Value of Cancer Stem Cell Markers CD44 and ALDH1/2 in Gastric Cancer Cases

Purpose: To determine expression levels of CD44 and ALDH1/2, known cancer stem cell (CSC) markers, in stomach adenocarcinomas and assess relationships with clinicopathologic parameters and prognosis. Methods: Eighty patients diagnosed with gastric cancer between the years 2011-2015 were included in this study of clinicopathologic characteristics, postoperative prognostic indexes and stem cell marker CD44 and ALDH1/2 expression in paraffin-embedded tumour sections analyzed immunohistochemically. Clinicopathologic parameters were evaluated using the chi-square test and t-test. Survival analyses were conducted using Kaplan-Meier statistics. Results: We observed positive CD44 and ALDH1/2 staining in 45.0 % and 67.5% of tumour tissues, respectively, but not in normal gastric mucosa. Recurrence-free survival (RFS) was found to be shorter in cases with high levels of CD44 expression (p=0.004). Similarly, short RFS was observed in patients with high levels of CD44 and ALDH1/2 co-expression (p=0.004). Furthermore, tumour invasion depth was found to correlate with high CD44 and ALDH1/2 co-expression (p=0.028). Conclusion: The cancer stem cell markers CD44 and ALDH1/2 may indicate poor patient prognosis and play a role in tumour development and invasion.

Effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants: a randomised controlled trial.

AIMS AND OBJECTIVES: To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants. BACKGROUND: Feeding problems in preterm infants cause delays in hospital discharge, extend mother-infant reunification and increase medical cost. Nutritive sucking skills of preterm infants may develop by improving non-nutritive sucking skills and increasing sucking experiences. DESIGN: A prospective, randomised controlled trial conducted in the Eastern Turkey. METHODS: Seventy infants were randomised into two groups: a pacifier group (n = 34) and a control group (n = 36). Pacifier use was applied in the preterm infants in the pacifier group, up to switching to full breastfeeding. The infants in the control group did not use pacifiers. Data were collected by a researcher using the Preterm Infant Introductory Information Form, the Preterm Infant Monitoring Form and the LATCH Breastfeeding Assessment Tool. For the study, ethics committee approval, official permission and written informed consents of the families were obtained. RESULTS: The time to transition to full breastfeeding (123·06 ± 66·56 hours) and the time to discharge (434·50 ± 133·29 hours) in the pacifier group were significantly shorter compared to the control group (167·78 ± 91·77 and 593·63 ± 385·32 hours, respectively) (p < 0·05). The weight at transition to full breastfeeding (1944·12 ± 275·67 g) and the weight of discharge (1956·45 ± 268·04 g) in the pacifier group were significantly lower compared to the control group (2155·58 ± 345·57 and 2159·75 ± 341·22 g, respectively) (p < 0·05). Sucking skills of the infants in the pacifier group at 48 hours after transition to oral feeding and before the discharge was better than in the control group (p < 0·05). CONCLUSION: Pacifier use improved the sucking skills and shortened the time to transition to full breastfeeding and to discharge in preterm infants receiving complementary feeding. RELEVANCE TO CLINICAL PRACTICE: Pacifier use may be recommended to accelerate transition to full breastfeeding and to improve the sucking skills in preterm infants who were fed by both oral route and complementary feeding in the neonatal intensive care units.

Effect of White Noise in Relieving Vaccination Pain in Premature Infants.

The purpose of this study was to evaluate the effect of white noise as a distraction method in relieving procedural pain caused by vaccination for premature infants. This experimental study was performed at a neonatal intensive care unit (NICU) of a university hospital in Turkey between July and September 2013. The study population was composed of 75 premature infants (35 in the study group and 40 in the control group) who met the inclusion criteria. Premature infants in the study group were exposed to white noise using MP3 players placed at the head of the infants' open crib for 1 minute before vaccination. The white noise continued until 1 minute after vaccination. Premature infants in the control group were not exposed to white noise. The Premature Infant Information Form, Intervention Follow-up Form, and Premature Infant Pain Profile (PIPP) were used to collect study data. Descriptive statistics, chi-square test, and independent sample t-tests were used to evaluate the data. The pain level of the control group (PIPP = 14.35 ± 2.59) was significantly higher than the pain level of the study group (PIPP = 8.14 ± 3.14) (p < .05). The authors found that 67.6% of the infants in the study group had moderate pain during vaccination and only 2.9% had severe pain. Most of the infants in the control group (82.5%) had severe pain, whereas 17.5% had moderate pain (p < .05). White noise was found to be effective for this sample; however, there is a dire need for extensive research on white noise and its use with this vulnerable population.

The Effects of Distraction on Preoperative Anxiety Level in Children.

PURPOSE: The purpose of this study was to investigate the effects of distraction on the preoperative anxiety levels of pediatric patients. DESIGN: A prospective, two-group experimental design was used. METHODS: This study was conducted in the clinic of pediatric surgery of a university hospital in Turkey between November 20, 2013 and January 25, 2014. The population of the study was composed of a total of 83 children (40 in the study group and 43 in the control group) who met the inclusion. The data were collected using the "Personal Information Form," "Separation Scoring," and "State-Trait Anxiety Inventory for Children-State Form." Distraction was performed on the children in the study group during the preoperative period. No intervention was applied to the children in the control group. FINDING: The results of this study demonstrated that the separation scores and State-Trait Anxiety Inventory for Children-State scores of the children in the study group, on whom distraction was applied, were lower than those of the control group. CONCLUSIONS: Distraction applied to children in the preoperative period significantly reduced anxiety and separation anxiety.

The effect of the facilitated tucking position in reducing vaccination-induced pain in newborns.

BACKGROUND: This study was conducted to evaluate the pain perceptions of newborns during the hepatitis B (HBV) vaccinations performed in the facilitated tucking position and the classical holding position, respectively. METHODS: The randomized controlled experimental study was conducted between 1 September 2014 and 30 December 2014 at the neonatal intensive care unit of a Turkish university hospital. One group of infants was held in the facilitated tucking position (the treatment group; n = 30) during HBV vaccination; infants in the other group were held in the classical holding position (the control group; n = 30) during HBV vaccination. The Neonatal Infant Pain Scale (NIPS) scores of the infants in the treatment and control groups were compared during procedure. Also, the infants' physiological parameters were compared before, during, and after the procedure. Descriptive statistics, a chi-square test, and an independent samples t-test were used to assess the data. RESULTS: The mean pain scores of infants vaccinated in the facilitated tucking position (2.83 ± 1.18) were significantly statistically lower than the scores of infants vaccinated in the classical holding position (6.47 ± 1.07) (p < 0.05). CONCLUSIONS: The pain perceptions of newborns held in the facilitated tucking position during HBV vaccination were lower. The facilitated tucking position, a non-pharmacological method, is recommended as an effective and useful method for reducing pain during the procedure.

Prognostic Significance of Two Dimensional AgNOR Evaluation in Local Advanced Rectal Cancer Treated with Chemoradiotherapy.

The prognostic significance of AgNOR proteins in stage II-III rectal cancers treated with chemoradiotherapy was evaluated. Silver staining was applied to the 3µm sections of parafin blocked tissues from 30 rectal cancer patients who received 5-FU based chemoradiotherapy from May 2003 to June 2006. The microscopic displays of the cells were transferred into the computer via a video camera. AgNOR area (nucleolus organizer region area) and nucleus area values were determined as a nucleolus organizer regions area/total nucleus area (NORa/ TNa). The mean NORa/TNa value was found to be 9.02±3.68. The overall survival and disease free survival in the high NORa/TNa (>9.02) patients were 52.2 months and 39.4 months respectively, as compared to 100.7 months and 98.4 months in the low NORa/TNa (<9.02) cases. (p<0.001 and p<0.001 respectively). In addition, the prognosis in the high NORa/TNa patients was worse than low NORa/TNa patients (p<0.05). In terms of overall survival and disease-free survival, a statistically significant negative correlation was found with the value of NORa/TNa in the correlations tests. Cox regression analyses demostrated that overall survival and disease-free survival were associated with lymph node status (negative or positive) and the NORa/TNa value. We suggest that two-dimensional AgNOR evaluation may be a safe and usable parameter for prognosis and an indicator of cell proliferation instead of AgNOR dots.

Effect of soothing noise on sucking success of newborns.

BACKGROUND: Starting and continuing breastfeeding are influenced by many factors affecting the mother and the infant. No study is found in the literature investigating how to achieve success in the first nutrient-sucking experiences by decreasing the stress experienced by newborns during the adaptation phase of the early postpartum period. The objective of this study was to determine the effect of soothing noise on sucking success in full-term infants. MATERIALS AND METHODS: This semi-experimental study was conducted with a total of 127 newborns: 64 in the control group and 63 in the experimental group. The data were collected by the researchers using the Mother and Infant Descriptive Information Form and the LATCH Breastfeeding Assessment Tool, in accordance with the literature. Infants in the experimental group (n=63) were exposed to soothing noise (a song) during the first breastfeeding after birth and again 24 hours later, and their sucking success was assessed. No intervention was applied to the infants in the control group. RESULTS: The results demonstrated that the sucking success of newborns who were exposed to soothing noise in the early postpartum period was higher than that of the control group (p<0.05). CONCLUSIONS: It was revealed that exposure to soothing noise is effective for the development of newborns' sucking behaviors as they adapt to extrauterine life in the early postpartum period.

The effect of feeding with spoon and bottle on the time of switching to full breastfeeding and sucking success in preterm babies.

AIM: This research was conducted to determine the effect of the feeding methods of spoonfeed and feeding by bottle on the time of switching to full breastfeeding and sucking success. MATERIAL AND METHODS: The study was conducted between September 2013 and January 2014 at the primary level of the neonatal intensive care clinics in two hospitals found in the eastern region of Turkey in a comperative and descriptive fashion. The population was composed of preterm babies who received treatment and care in these clinics during the period when the study was conducted and who met the criteria of the investigators. Without selecting the sample group the whole of the population was studied. The study was conducted with 37 preterm babies who were spoonfed and 35 preterm babies who were fed by bottle. The data were collected with "information form introducing preterm baby", "follow-up form for preterm baby" and "LATCH Breastfeeding Assessment Tool". The data were evaluated using percentage distribution, mean, chi-square test, t-test in independent groups, Cronbach alpha coefficient and McNemar analysis. Ethics committee approval was obtained from Atatürk University Faculty of Health Sciences (dated 08.05.2013) and official approvals were obtained from the related hospitals to conduct the study. RESULTS: A significant difference was found between the mean times of switching to full breastfeeding from the first breast-feeding in preterm babies in the spoonfed group and bottle fed group in favour of the spoodfed group (p<0.05). No significant difference was found between the two groups in terms of starting breastfeeding, switching to full breastfeeding, the mean weights at discharge and the mean times of discharge (p>0.05). While no significant difference was found between the groups in terms of mean LATCH scores measured initially (p>0.05), the mean scores in the spoonfed group at the second and final measurement were found to be statistically significantly higher (p<0.05). CONCLUSIONS: It was found that the preterm babies in whom spoonfeeding was used as a supportive method in addition to breast-feeding switched to full breastfeeding in a shorter time compared to the babies who were fed by bottle and their sucking success was at a better level.