Social and Medical Characteristics of Neonates Who Were Abandoned in a Tertiary Maternity Hospital in Turkey.

OBJECTIVE: This study aimed to investigate the characteristics of neonates who were aban- doned in a tertiary maternity hospital and to determine the accompanying morbidities. MATERIALS AND METHODS: This hospital-based, retrospective descriptive study was conducted by evaluating the medical records between 2012 and 2019 in a tertiary hospital in Izmir. RESULTS: During the study period, there were 76 women who left their babies in the hospital following delivery. Median age of the mothers was 23 (range 12-44) years. Among them, 31.5% (n = 24) were below 18 years of age. Seventy-three of the pregnancies (96%) were unwanted, 67 of the mothers were unmarried (88.16%), of which 17 revealed a history of rape (22.36%), and 2 of them were victims of incest (2.63%). Thirty-six (47.36%) neonates were female and 36 of them (47.36%) were delivered by cesarean section. The mean gestational age was 37.3 ± 2.2 weeks and the mean birth weight was 2927 ± 572 g. Twenty-one (27.63%) babies were born prematurely and 15 (19.73%) had low birth weight. Four babies (5.26%) had hypoglycemia, 3 (3.94%) had hyponatremia, 5 (6.57%) had hypocalcemia, and 3 (3.94%) had hypomagnesemia. CONCLUSION: Unwanted pregnancies were found to be one of the key reasons for newborn aban- donment and linked to a higher risk of complications for both mother and child. To prevent unintended pregnancy and its negative effects, it is important to ensure that all adolescents have access to high-quality education in a safe and supportive learning environment, school- based health services, and increase access to contraceptive services, including emergency contraception and safe and legal abortion services.

Bilirubin Measurement Through a Smartphone Application in Preterm Infants.

BACKROUND: Aim of the present study is to evaluate the feasibility and reliability of an smartphone application for monitore of bilirubin levels in preterm infants. METHODS: Preterm infants hospitalized in the neonatal intensive care unit with gestational age of<35 weeks were included. Exclusion criteria were parental reluctance and requirement of phototherapy in the last 12 hours. Measurements were obtained through a smartphone application (BiliScan) along with simultaneous transcutaneous device (Dräger JM 105) and venous blood biochemistry. RESULTS: Mean gestational age was 30.8±2.4 weeks and birth weight was 1622±566 g. Measurements were obtained at a median of 4 (1-21) days of life. Twenty-five infants (19.4%) had ABO and/or Rh incompatibility and 39 infants (30.2%) required phototherapy. None of the cases required exchange transfusion. Mean total serum bilirubin (TSB) level was 8.16±2.60 mg/dL, mean transcutaneous bilirubin (TcB) level was 8.60±2.70 mg/dL, and the mean bilirubin level measured by BiliScan was 7.26±2.68 mg/dL. For TSB and TcB measurements, the intraclass correlation coefficient (ICC) was found to be 0.915 (95% confidence interval 0.835-0.951; p<0.001) and a strong positive correlation was found between these two measurements. When TSB and BiliScan measurements were compared, ICC was found to be significant as 0.512 (95% confidence interval 0.353-0.638; p<0.001), with a moderate correlation. CONCLUSIONS: In this study, we evaluated the feasibility and reliability of a smartphone application for monitoring bilirubin levels in preterm infants. Although BiliScan measurements reported to display high correlation in term infants, a moderate correlation was found in the preterm infants. It is an emerging low-cost, non-invasive alternative for neonatal jaundice monitoring, however, results should be interpreted with caution in preterm infants.

Dedifferentiated Liposarcoma of the Left Thigh: a Rare Case.

INTRODUCTION: Liposarcoma is generally classified into four subtypes: a) well-differentiated liposarcoma/atypical lipomatous tumor, b) dedifferentiated liposarcoma, c) myxoid/round cell liposarcoma, and d) pleomorphic liposarcoma. Dedifferentiated liposarcoma is mostly seen in the region of retroperitoneum. AIM: To present a case of dedifferentiated liposarcoma in a rare site of location: the lower extremity. CASE REPORT: A 24-year-old woman presented with a firm painful mass, 3x2 cm in diameter on the medial side of left thigh. MRI demonstrated a lesion on that location showing low signal intensity on T1-wieghted and high signal intensity on T2A-wieghted sequences. After an excisional biopsy the histopathological examination via Haematoxylin and Eosin firstly revealed the diagnosis of malign undifferentiated tumor. The results of immunohistochemical evaluations were as follows: SMA (-), HMB45 (-), S100 (+, focally), Desmin (-), Vimentin (+, focally), CD68 (+, focally), CD34 (-), LCA (-), and Inhibin (-). The final histopathological diagnosis was dedifferentiated liposarcoma. CONCLUSIONS: In English-language literature data for dedifferentiated liposarcoma of the lower extremities are very restricted. Although imaging with CT and MRI, the final and distinct diagnosis is made immunohistochemically. A clinician should be aware of the presence of a dedifferentiated liposarcoma within a mass on the lower extremities.

The Effects of Colchicine-Impregnated Oxidized Regenerated Cellulose on Capsular Contracture.

Capsular contracture is the most common complication of breast augmentation. Oxidized regenerated cellulose can be used as a matrix for drug transport. Colchicine is an antimitotic drug that interferes with various steps of wound healing. The aim of this study was to evaluate the effects of oxidized regenerated cellulose alone or in combination with colchicine on capsular contracture. Twenty-one adult female Wistar-Albino rats were divided into 3 groups. In group 1 silicone blocks only, in group 2 oxidized regenerated cellulose-wrapped silicone blocks, and in group 3 colchicine-impregnated oxidized regenerated cellulose-wrapped silicone blocks were inserted in the dorsal region. Four weeks later, implants were removed and histopathological examination was performed. Capsular thickness, inflammatory infiltrate degree, collagen fiber organization, and myofibroblast density were evaluated. Macroscopic examination revealed a distinct capsule formation only in group 1 animals, with average measurement being 134.65 µm on histopathological examination. In groups 2 and 3 animals, no distinct capsule formation was seen. Inflammatory infiltrate degree was found to be less in groups 2 and 3 animals than in group 1 animals. Collagen fiber organization around the implants was found to be parallel and organized in group 1 animals, whereas it was random and disorganized in animals in both groups 2 and 3. High myofibroblast density was observed in animals in groups 1 and 2, while no myofibroblast was found in animals in group 3. The results of our study suggest that coating silicone implants with oxidized regenerated cellulose or with colchicine-impregnated oxidized regenerated cellulose may be effective in preventing capsular contracture.

Topiramate as a neuroprotective agent in a rat model of spinal cord injury.

Topiramate (TPM) is a widely used antiepileptic and antimigraine agent which has been shown to exert neuroprotective effects in various experimental traumatic brain injury and stroke models. However, its utility in spinal cord injury has not been studied extensively. Thus, we evaluated effects of TPM on secondary cellular injury mechanisms in an experimental rat model of traumatic spinal cord injury (SCI). After rat models of thoracic contusive SCI were established by free weight-drop method, TPM (40 mg/kg) was given at 12-hour intervals for four times orally. Post TPM treatment, malondialdehyde and protein carbonyl levels were significantly reduced and reduced glutathione levels were increased, while immunoreactivity for endothelial nitric oxide synthase, inducible nitric oxide synthase, and apoptotic peptidase activating factor 1 was diminished in SCI rats. In addition, TPM treatment improved the functional recovery of SCI rats. This study suggests that administration of TPM exerts neuroprotective effects on SCI.

Ultrastructural analyses of the novel chimeric hemostatic agent generated via nanotechnology, ABS nanohemostat, at the renal tissue level.

Ankaferd Blood Stopper (ABS), a hemostatic agent of plant origin, has been registered for the prevention of clinical hemorrhages. Currently there is no data regarding the ultrastructural analysis of ABS at the tissue level. The aim of this study is to assess renal tissue effects via scanning electron microscopy (SEM) analyses for the ABS and ABS nanohemostat (formed by the combination of self-assembling peptide amphiphile molecules and ABS). SEM experiments were performed with FEI Nova NanoSEM 230, using the ETD detector at low vacuum mode with 30 keV beam energy. SEM analyses revealed that significant erythroid aggregation are present inside the capillary bed of the renal tissue. However, neither the signs of necrosis nor any other sign of tissue damage are evident in the surrounding renal tissue supplied by the microcapillary vasculature. Our study is important for several reasons. Firstly, in our study we used ABS nanohemostat which was recently developed. This study adds valuable information to the literature regarding ABS nanohemostat. Secondly, this study is the first ultrastructural analysis of ABS that was performed at the tissue level. Thirdly, we disclosed that ABS nanohemostat could induce vital erythroid aggregation at the renal tissue level as detected by SEM. Lastly, we detected that ABS nanohemostat causes no harm to the tissues including necrosis and any other detrimental effects.

Eccrine Syringofibroadenomatosis of the Soles.

Eccrine syringofibroadenoma is a rare adnexal tumor with acrosyringeal differentiation. It was first described by Mascaro in 1963. Its clinical presentation varies from a solitary nodule, keratotic papule, verrucous plaque, or palmoplantar keratoderma to multiple lesions with linear or diffuse distributions. Age at onset ranges from 16 to 80 years. Lesion distribution is wide and includes the face, back, abdomen, buttocks, extremities, and, rarely, nails. There are five subtypes of eccrine syringofibroadenoma. Histologically, eccrine syringofibroadenoma, independent of the subtype, is characterized by anastomosing cords of acrosyringeal cells forming ductal structures in a fibrovascular stroma and attached to the undersurface of the epidermis in multiple foci. In this article, we describe a 51-year-old woman diagnosed as having eccrine syringofibroadenomatosis.

Evaluation of Invasive and Noninvasive Methods for the Diagnosis of Helicobacter Pylori Infection

Objective: The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection of Helicobacter pylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the study. The presence of H. pylori was determined by invasive tests including culture, rapid urease test, polymerase chain reaction (PCR) and histopathology. Among noninvasive tests, urea breath test, serological tests and enzyme-linked immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures, whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110 (87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA. In the present study, the culture findings and histopathological examination findings were accepted as gold standard. According to the gold standard, urea breath test had the highest sensitivity (96.5%) and the lowest specificity (30%), whereas culture and histopathology had the highest specificities (100%). Conclusion: The use of PCR invasively with gastric biopsy samples yielded parallel results with the gold standard. PCR can be recommended for routine use in the diagnosis of H. pylori.

A case of mesotherapy-induced panniculitis.

Mesotherapy was first introduced in Europe for the treatment of localized pain. It is currently used mainly for aesthetical purposes and gradually getting widely used for body contouring, cellulite reduction, and skin rejuvenation. The reports concerning about mesotherapy is increasing in number in the literature. There are reported systemic and local side effects of mesotherapy. Panniculitis is a rare side effect of mesotherapy. In this article, we report a case of mesotherapy-induced panniculitis who responded to dapsone therapy.

Ocular surface changes in patients treated with oral antidiabetic drugs or insulin.

PURPOSE: To describe and compare ocular surface changes in patients with type 2 diabetes treated with either oral antidiabetic drugs (OAD) or insulin. METHODS: Forty eyes of 20 patients treated with OAD, 40 eyes of 20 patients treated with insulin, and 10 nondiabetic controls seen at Ministry of Health Ankara Educational and Research Hospital, 1st Eye Clinic, were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis, and conjunctival impression cytologic analysis. Patients treated with OAD or insulin and a control group were compared for tear function parameters, goblet cell density, and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorder and serum HbA1c levels of diabetic patients were also noted. RESULTS: The tear film break-up time values were significantly lower in patients treated with OAD (p<0.05). There was no statistically significant difference in Schirmer test results of the 3 groups. Goblet cell density and squamous metaplasia grade were similar in all groups. The median grade was grade 1, in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm, and goblet cells are decreased in number. Status of retinopathy did not seem to relate to ocular surface disorder. The serum HbA1c level of diabetic patients treated with insulin or OAD was similar (p>0.05). CONCLUSIONS: Precorneal tear film stability was worse in patients treated with OAD; however, impression cytology analysis and Schirmer test results were similar in all groups.

Comparison of Conjunctival Cytological Alterations following Conventional and Sutureless Sclerotomies.

PURPOSE: To assess the alterations in conjunctival impression cytology following 23-gauge transconjunctival sutureless versus conventional pars plana vitrectomy. PATIENTS AND METHODS: Sixty consecutive patients were enrolled in the study. Conjunctival impression cytology was performed on 30 eyes (of 30 subjects) with 23-gauge transconjunctival sutureless vitrectomy and on 30 eyes (of 30 subjects) with conventional vitrectomy. Conjunctival impression cytology was performed preoperatively on the 1st day and in the 3rd month after the surgery. Impression cytology specimens of each group were graded and scored using a range of 0-3 according to Nelson's method. RESULTS: In the conventional pars plana vitrectomy group, statistically significant alterations in the conjunctival impression cytology were detected on the 1st postoperative day (p = 0.001) and in the 3rd postoperative month (p = 0.001), whereas in the 23-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were observed on the 1st postoperative day. However, no significant changes were observed in the following 3 postoperative months (p = 0.08). CONCLUSION: The properties of impression cytology were altered in the early postoperative period after sutureless and conventional vitrectomy. These changes were improved in the sutureless vitrectomy group only. Sutureless vitrectomy also had an advantageous effect on the conjunctival cytological changes and conjunctival structure.

Alpha-lipoic acid inhibits peridural fibrosis following laminectomy through the inactivation of TGF-ß1, PDGF, PAI-1 and IL-6 expressions.

AIM: The objective of this study was to investigate the antifibrotic effect of parenteral administration of alpha-lipoic acid (ALA), which has been reported to reduce fibrosis in the liver, oral mucosa, and peritoneum, in laminectomized rabbits as a potential candidate for the prevention of peridural fibrosis. MATERIAL AND METHODS: Twelve adult New Zealand white male rabbits were divided into control (n=6) and ALA treatment groups (n=6). Laminectomy of the lumbar spine was performed in all animals, and ALA was administered intramuscularly in six rabbits composing the treatment group. Total RNA obtained from the paraffin-embedded tissues was analyzed for transforming growth factor-ß1 (TGF-ß1), plateletderived growth factor (PDGF), plasminogen activator inhibitor-1 (PAI-1) and interleukin-6 (IL-6). RESULTS: mRNA investigations showed that TGF-ß1, PDGF, PAI-1 and IL-6 gene expressions, which constitute strong evidence for the development of fibrosis, were significantly lower in the treatment group compared with the results obtained from the control group. According to the histological peridural grading, the ALA-treated group showed significantly less peridural fibrosis than the control group. CONCLUSION: Intramuscular administration of ALA is a promising treatment for the prevention of peridural fibrosis in the postoperative period.

Effects of the Oral Nutritional Supplement Containing Arginine, Glutamine, and Hydroxymethylbutyrate (Abound®) on Healing of Colonic Anastomoses in Rats.

We evaluated the effects of the oral nutritional supplement containing arginine, glutamine, and hydroxymethylbutyrate (Abound®) on healing of colonic anastomoses in experimental rat model. Seventy Wistar-Albino male rats were divided into seven groups. Colon transection and anastomosis were performed in all groups except for the sham group. In groups 2 and 5, rats were fed with standard rat chow after the operation. Oral nutritional supplement was added to standard nutrition for 3 days postoperatively in group 3 and 7 days in group 6 and preoperative 7 days plus postoperative 3 days in group 4 and preoperative 7 days plus postoperative 7 days in group 7. Bursting pressures were measured, adhesions were evaluated, and tissue samples were taken for measurement of tissue hydroxyproline levels and for histopathological examination. The usage of oral nutritional supplement had positive effects on bursting pressures, tissue hydroxyproline levels, and histopathological findings of anastomoses, but feeding with oral nutritional supplement both preoperatively and postoperatively had no additive effect on these parameters when compared with the groups that were fed only postoperatively. The mixture of arginine, glutamine, and hydroxymethylbutyrate may be safely used for achieving better healing results after colonic anastomoses.

The Effectiveness of Porcine Dermal Collagen (Permacol(®)) on Wound Healing in the Rat Model.

Porcine acellular dermal collagen (PDC), which is a biological material derived from processing porcine dermis, has already been used for urologic, gynecologic, plastic, and general surgery procedures up to now. The aim of this study is to investigate the effectiveness of PDC on wound healing as a dermal substitute in the rat model. Twenty Wistar albino rats were divided into two groups. Standard full-thickness skin defects were created on the back of the rats. In the control group (Group 1), the dressings moisturized with saline were changed daily. In the study group (Group 2), porcine dermal collagen was implanted onto each wound and fixed with 4-0 polypropylene sutures. Contraction percentages of wound areas were calculated on the third, seventh, tenth, and fourteenth days by using the planimetric program. On fourteenth day, the wound areas were excised for histopathological examination, inflammatory scoring, and evaluation of collagen deposition. The study group was superior to the control group in terms of inflammatory scoring, type I/type III collagen ratio, and wound contraction rates. Porcine dermal collagen may be used effectively and safely on full-thickness wounds as a current dermal substitute.

Significance of androgen receptor and CD10 expression in cutaneous basal cell carcinoma and trichoepithelioma.

Differential diagnosis of trichoepithelioma (TE) and basal cell carcinoma (BCC) on the basis of clinical symptoms and laboratory investigations may be difficult in certain patients. The aim of the present study was to compare cluster of differentiation 10 (CD10) and androgen receptor (AR) expression patterns in BCC and TE, to investigate the predictive power of these proteins as markers of the two conditions. A total of 39 cases of BCC and 15 cases of TE were retrieved from the pathology department archives. AR and CD10 immunohistochemistry was performed on all of the specimens; 23 BCC cases displayed focal nuclear AR staining, however, none of the cases demonstrated diffuse nuclear staining and 16 BCC cases were negative for AR staining. Stromal CD10 staining was more common in TE cases than in BCC cases, and peripheral CD10 staining was more common in BCC cases than in TE cases. AR immunostaining of the BCC samples typically appeared as scattered clusters and individual cells. In addition, AR and CD10 staining exhibited varying staining intensities within each samples. Incisional punch biopsy specimens have the potential to present false-negative results. Therefore, AR and CD10 staining of total excision biopsies provides a more accurate differential diagnosis of BCC and TE for cases with difficulties in the histopathological analysis.

Comparison of conjunctival impression cytology in primary open angle glaucoma, ocular hypertension and normal subjects / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM:To compare the tear functions and the impression cytology scores of the patients with primary open angle glaucoma ( POAG ) , ocular hypertension ( OHT ) and normal subjects with healthy ocular surface both functionally and clinically. ?METHODS: Eleven eyes of 11 patients with POAG (mean age: 62. 7±6. 1y), 12 eyes of 12 patients ( mean age:62. 8±6. 4y ) with OHT and 12 eyes of 12 normal subjects ( mean age: 62. 9±6. 03y) were included to this prospective study. The patients with POAG and OHT had been recently diagnosed with these diseases and none of them had taken anti - glaucoma treatment before. ln addition to conjunctival impression cytology, tear break-up time ( TBUT ) and basal Schirmer’s tests ( BST ) were performed. lmpression cytology specimens of each group were graded and scored in the range of 0-3 according to Nelson’s method. Kruskal- Wallis analysis and Dunn’s multiple comparison tests were used for statistical analysis. ?RESULTS:The mean BST values were 10. 4±1. 3, 10. 9±1. 2 and 11. 1±1. 1 mm/5min of POAG, OHT and control groups respectively. The differences among the BST values of the POAG, OHT and control group were not statistically significant (P=0. 33). The mean TBUT values were 11. 2±1. 1, 11. 3±1. 1 and 11. 8±1. 2s in POAG, OHT and normal subjects respectively. The differences among the BUT values of the POAG, OHT and control group were not statistically significant (P=0. 35). Six eyes (54. 5%) revealed grade 0 and 5 eyes ( 45. 5%) revealed grade 1 impression cytology scores in POAG group. Six eyes (50%) revealed grade 0 and 6 eyes (50%) revealed grade 1 impression cytology scores in OHT group and 6 eyes (50%) revealed grade 0 and 6 eyes (50%) revealed grade 1 impression cytology scores in normal subjects ( P =0. 97). ?CONCLUSlON: Oxidative stress may cause glaucoma, ocular surface diseases, lacrimal gland malfunction and a decrease in mucus secretion ofgoblet cells in all of the body. There were no significant differences between the impression cytology scores of patients with POAG, OHT and normal subjects.

Conjunctival impression cytology in non-proliferative and proliferative diabetic retinopathy.

AIM: To examine the integrity of the ocular surfaces of subjects with and without diabetes with no conjunctival and dry eye signs and symptoms and compare conjunctival impression cytology findings in diabetics with non-proliferative and proliferative diabetic retinopathy. METHODS: Conjunctival impression cytology was performed on 43 eyes of 43 subjects with non-proliferative diabetic retinopathy (NPDR), 42 eyes of 42 subjects with proliferative diabetic retinopathy (PDR), and 30 eyes of 30 control subjects. Impression cytology specimens of each group were graded and scored in the range 0-3 according to Nelson's method. RESULTS: There were 45 (52.9%) women and 40 (47.1%) men. The mean age of the patients was 59.6±9.3y (range, 43-76y) in NPDR group and 58.0±8.8y (range, 41-85y) in PDR group. Cases with NPDR and PDR showed statistically significant higher impression cytology scores than control group (P<0.05). There was no difference between the NPDR and PDR patients for impression cytology grading scores. CONCLUSION: It is determined that impression cytology grades are altered in patients with NPDR and PDR. Consequently, we suggest that there might be an association between the impression cytology grading scores and the severity of diabetic retinopathy.