Northern clinics of Istanbul最新文献

Objective: In this study, the possible role of dardarin and spexin in the protective effect of hydroxytyrosol (HT) against corn syrup-induced renal injury in rats was investigated.

Methods: Rats were categorized into four groups (n=6) as control, HT, corn syrup, and corn syrup+HT. Over 6 weeks, rats were administered water infused with 30% corn syrup, 4 ml/kg/day solution containing HT was administered, both independently and in conjunction with corn syrup, throughout the 6 weeks. The molecular parameters of dardarin and spexin in the renal tissue were assessed through histopathological examination. Biochemical parameters were also examined with the ELISA Method.

Results: In this study, it was observed that the dardarin and spexin levels increased in the control group as a result of the administration of corn syrup. After HT treatment, it was observed that the dardarin and spexin levels decreased. The increase in glucose, amylase, and lipase levels because of corn syrup consumption decreased with hydroxytyrosol consumption. The increase in erythrocyte extravasation, exudate accumulation, and fibrosis in kidney tissue observed as a result of corn syrup decreased as a result of HT administration.

Conclusion: It is thought that the protective effect of HT against damage to the renal due to corn syrup consumption may be mediated by dardarin and spexin.

Heavy metals exposure might be linked to rheumatic diseases and has been studied in a few articles. The aim of this article is to review the studies that evaluated metal toxicity in rheumatological diseases. A systematic search of PubMed, Embase, and Scielo databases was performed, looking for articles on toxic metals and rheumatic diseases published between 1966 and March 2023. A total of 31 studies (1,559 RA and 4,308 patients with other rheumatic diseases) were included. Most patients were females, ranging from 4 to 62 years old. Although most studies showed higher concentrations of toxic metals in rheumatic diseases, a few showed a positive association with disease activity or severity of the conditions. This systematic review reveals the presence of toxic metals in patients with rheumatic disease. Screening for toxic metals may be elucidative in selected cases.

Objective: Laparoscopic techniques have emerged as the preferred approach over traditional open surgery for the treatment of adrenal gland disorders. Right laparoscopic adrenalectomy (RLA) typically requires liver retraction for exposure, and various retractors can be used for this purpose. While studies have been conducted on liver injury during liver retraction in upper abdominal surgeries, no research has specifically addressed liver damage during laparoscopic adrenalectomy (LA). This study aims to evaluate the impact of two retractors used for liver retraction during RLA on liver function test results (LFTs) and their clinical significance.

Methods: This retrospective study included 87 LA patients who underwent surgery for adrenal gland pathology at our institution between 01/01/2010 and 04/30/2024. The patients were divided into two groups: RLA (n=42) and left LA (LLA) (n=45). The RLA patients were further categorized into two subgroups based on the retractor used: 5-blade retractor (FB) (n=22) and full ring retractor (GF) (n=20). Clinicopathological findings, operative outcomes, and laboratory test results were compared across groups.

Results: Postoperative levels of aspartate aminotransferase (AST), alanine aminotransferase, and alkaline phosphatase were significantly higher in the RLA groups (FB and GF) compared to the LLA group (p<0.001, p<0.001, p=0.001, respectively). Although no statistically significant difference was observed between groups, the median length of stay (LOS) was slightly shorter in the FB group (2 (2-3), p=0.058). There were no significant differences between FB and GF groups in terms of operation time, LFTs, complications, or mortality. Correlation analysis showed a statistically significant positive correlation between postoperative AST levels and lesion size (rho=0.31, p=0.045). Additionally, patients with functional adrenal pathologies had a significantly longer hospital stay compared to those with nonfunctional pathologies (2 (2-2.25) vs. 3 (2-3.5), p<0.001).

Conclusion: In RLA procedures, the LFT values were higher compared to LLA procedures. The effects of FB and GF retractors on surgical outcomes and LFT values were similar, indicating both retractors can be safely used during RLA surgeries. While no clinical impact was detected, caution is advised regarding potential liver injury during RLA procedures.

Objective: Inflammatory bowel diseases (IBD) are lifelong conditions that exhibit periods of remission and exacerbation. In addition to gastrointestinal manifestations, they can also cause growth retardation and disorders of puberty in children. The objective of this study was to evaluate the effects of the disease and the treatment regimens on growth and puberty in children and adolescents with IBD.

Methods: A retrospective screening of patients aged 2 to 18 years with a minimum of six months of follow-up due to inflammatory bowel disease (IBD) between January 2016 and April 2022 was conducted. The growth parameters were compared between disease groups, gender groups, disease activity and level of inflammation groups, and treatment regimen groups. The effects of treatment protocols on growth were evaluated by comparing the data before and after treatment, and the pubertal status of patients was evaluated by comparing them with healthy children.

Results: A total of 58 patients were evaluated, comprising 29 individuals with Crohn's Disease (CD) and 29 with ulcerative colitis (UC). The growth and pubertal development of patients at the time of diagnosis did not differ based on gender or the specific disease type. A negative deviation from the target height was observed to be more prevalent in patients with Crohn's disease. Following treatment, patients exhibited a significant improvement in weight and BMI SDS, although no significant change in height SDS was observed. In comparison to healthy Turkish children, the patients exhibited a delayed pubertal progression, despite the normal onset of puberty.

Conclusion: Children and adolescents with IBD exhibited no significant adverse effects on linear growth at diagnosis or during the follow-up period, regardless of the primary disease and the treatment protocols. This was likely due to their timely diagnosis and successful treatment. It is important to monitor puberty, as it may progress more slowly or even cease in these patients compared to healthy children.

Objective: TFE3 rearranged carcinomas constitute 5% of malignant tumours of the kidney in adults. TFE3 immunohistochemistry plays a crucial role in the diagnosis. TFE3 positivity in the appropriate histological context supports the diagnosis of Xp11 translocation renal cell carcinomas. However, there isn't any standardized approach to performing and interpreting immunohistochemical staining.

Methods: A total of 51 renal cell carcinomas are included in the study. In this study, we compared the expression profiles of two different anti-TFE3 antibody clones (MRQ37, Cell Marque, and IHC627, GeneAbTM) on renal cell carcinoma samples that have conflicting morphologies and assessed the overall performance of these clones to identify TFE3 rearranged carcinomas.

Results: There was a statistically significant difference in terms of immunohistochemical staining with TFE3-MRQ37 clone between TFE3 rearranged renal cell carcinomas and other subtypes, while no significant difference was found in staining with TFE3-IHC672. 47% of cases were stained with the TFE3-IHC672 clone and 9.8 % of cases were stained with the TFE3-MRQ37 clone at different staining intensities and proportions.

Conclusion: The TFE3-MRQ37 clone is easier to interpret because of the absence of background staining and is more reliable in identifying TFE3 rearranged renal cell carcinomas. However, because of various sensitivity and specificity rates, and immunoreactivity in many subtypes of renal cell carcinomas, there is a need for a standardised approach for TFE3 immunohistochemistry for diagnostic use in TFE3-tRCCs.

Objective: Metformin, which is commonly recommended drug for managing type II diabetes, has been reported to have anti-cancer properties and may improve the prognosis of some malignancies. Epidemiology studies have shown improved survival in cancer patients using metformin. However, the mechanism behind this phenomenon remains incompletely understood. In our study, Our objective was to investigate how metformin influences the proliferation and apoptosis of hepatocellular carcinoma cells induced with steatosis via palmitic acid and oleic acid.

Methods: We established an in vitro cellular model of non-alcoholic fatty liver disease by inducing lipid accumulation in HepG2 cells through the use of oleic acid and palmitic acid. Oil Red O staining was conducted to observe the distribution of intracellular lipid droplets. Cell proliferation were detected using the BrdU cell proliferation detection kit. Protein expressions were detected by western blot method techniques.

Results: We found that metformin reduced cell proliferation in palmitic acid and oleic acid-induced HepG2 cells compared to the control group. Moreover, our western blot data show that metformin treatment changes apoptosis.

Conclusion: Our results show that metformin inhibits cell viability of steatosis HepG2 cells. These findings may be preliminary for new studies in steatosis HepG2 cells and may provide new therapeutic targets or treatment strategies against hepatocellular carcinoma.

Objective: Febrile neutropenia is a critical condition in patients with malignancy, requiring oral and/or parenteral antibiotic treatment; and a significant cause of mortality and morbidity. It is well known that nutritional status is excessively impaired in these patients due to underlying disease itself along with the chemotherapeutics used. In this study we investigated nutritional status and general characteristics of patients admitted to our internal medicine clinic with febrile neutropenia.

Methods: Thirty patients who were followed up in the internal medicine service were included in the study. For the analysis of the data of the patients, height, weight, body mass index (BMI), weight loss in the last three months, albümin and total iron binding capacity values were recorded. Hand grip strength, mid-upper arm and mid-calf circumference measurements were obtained for the assessment of muscle strength; Mini Nutritional Assessment (MNA) and Nutrition Risk Screening 2002 (NRS 2002) scores were calculated at admission and discharge to evaluate nutritional status. Multinational Association of Supportive Care in Cancer (MASCC) score was used to identify risk and manage treatment.

Results: We included thirty patients (mean age 58.27±16.52 years, 53% females). Of 30, six patients had lung cancer, four patients had myelodysplastic syndrome, three patients had stomach cancer, two patients had gastrointestinal system lymphoma, two patients had colon cancer, two patients had breast cancer, two patients had Non-Hodgkin's lymphoma.

Conclusion: Majority of the patients, admitted to our internal medicine clinic, with febrile neutropenia were found to be malnourished; regardless of their risk classifications. Nutritional assessment scores of the majority were in the low-risk group. In conclusion, patients hospitalized with febrile neutropenia had poor nutritional status.

Objective: The aim of this study is to radiologically compare area and volume changes in the costoclavicular region with the unaffected side in patients treated nonoperatively after unilateral midshaft clavicle fracture and to evaluate functional outcomes.

Methods: This study included 16 patients (14 males, 2 females) with midshaft clavicle fractures who were admitted between 2017-2018 and union was achieved with conservative methods. Magnetic resonance imaging (MRI) of the shoulder including the costoclavicular region was performed after union. Area and volume calculations of the fractured and unaffected costoclavicular region of the patients were performed on the standard MR sections under the guidance of a specialist radiologist. The Short Version of Disabilities of the Arm, Shoulder and Hand (QDASH) score was used for functional assessment. Range of motion was measured on the affected and unaffected sides at the last follow-up visit.

Results: The mean age of the patients was 30.4±20.8 years (5-69) and the mean follow-up was 8.3±1.3 (6-10) months. The mean shortening was 14.3 mm±8.2 (3-29). The area measurements of the costoclavicular region were divided into 3 levels in axillary section: acromioclavicular joint, mid 1/3 of the clavicle, and sternoclavicular joint level. The median area measurements were 1115 (364-3675) mm², 1495 (365-4199) mm², and 1201 (197-3812) mm² on the unaffected side and 895.5 (351-3670) mm², 1098.5 (340-3191) mm², and 1037.5 (166-3237) mm² on the fractured side, respectively (p=0.905, p=0.491, p=0.888). In volume measurements, the median volumes of the unaffected side and the fractured side were 34.3 (10.7-69.7) mm³ and 28.9 (8.1-60.9) mm³, respectively (p=0.268). No significant difference was found in the statistical analysis of area and volume measurements. At the end of the follow-up period, the QDASH score and functional outcome of the patients were good.

Conclusion: Conservative treatment of midshaft clavicle fractures did not result in significant area and volume changes in the costoclavicular region. The inability to clinically demonstrate the theoretical expectation of decreased area and volume on the fractured site suggests that other biomechanical factors are involved in the healing process of the human body.

Objective: A combination of local anesthetic treatments provides better pain alleviation than periprostatic nerve block (PPNB) alone during a prostate biopsy procedure. The primary objective of this study was to compare Visual Analog Scale (VAS) pain levels during transrectal ultrasound (TRUS)- guided prostate biopsy whilst the use of prilocaine-lidocaine cream, diclofenac suppository, or PPNB only in a prospective, randomized study.

Methods: This study included 162 patients who had TRUS-guided prostate biopsies performed at the Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Center within a 6 month period, from April to October 2017. Three groups of patients were randomly assigned: group 1 underwent PPNB plus prilocaine-lidocaine cream, group 2 received diclofenac suppository along with PPNB, and group 3 underwent PPNB alone. The VAS was used to measure the degree of pain: VAS 1 was used to record the pain at the time the ultrasound probe was inserted, VAS 2 was used to document the pain during PPNB, and VAS 3 was used to record the pain during needle biopsy. Following the biopsy, any complications or negative consequences were recorded.

Results: Mean age or serum prostate specific antigen (PSA) levels were similar between the three groups. The VAS 1, VAS 2, and VAS 3 pain scores showed statistically significant difference among the three groups (p=0.001). Between groups 1 and 2, there was a statistically significant difference in VAS 1 pain scores (p=0.01). There was no statistically difference in VAS 2 and VAS 3 pain scores between the groups 1 and 2 (p=0.08 and p=0.23, respectively). Patients between the groups 3 and other groups had significantly difference in VAS pain scores (p<0.05).

Conclusion: In this study, we highlight that when applied as an adjuvant to PPNB, either 5% prilocaine-lidocaine cream or a 100 mg diclofenac suppository reduced pain levels relative to PPNB alone. When compared to a 100 mg diclofenac suppository, prilocaine-lidocaine cream significantly reduces pain during the insertion and manipulation of the ultrasound probe.

Objective: Congenital myasthenic syndromes (CMS) represent a group of genetically heterogenous disorders characterized by defective signal transmission at the neuromuscular junction. Although global prevalence of CMS remains uncertain, regional studies have reported varying prevalence rates. This study aimed to define the incidence and prevalence of CMS in Turkiye utilizing data from the national electronic health registry. Additionally, the rate of pyridostigmine prescriptions among patients with CMS was assessed.

Methods: The study was a retrospective national cohort study, and patients with at least three G70.2 ICD-10 code entries between 1 January 2015 and 22 May 2024 were included. While calculating incidence and prevalence rates official census data from the Turkish Statistical Institute were used.

Results: A total of 406 patients were included in the study, with females comprising 48.8% of the cohort. The mean age at diagnosis was 20.59±21.65 years (median: 12.00, min-max: 0-86). Among the cohort, 58.6% were diagnosed before the age of 18, and 12.3% before the age of one. Pyridostigmine was prescribed at least once to 68.2% of the patients. The annual incidence of CMS ranged from 0.28 to 0.59 per million between 2016 and 2023. In 2023, the incidence and prevalence rates of CMS were calculated as 0.63 and 4.49 per million, respectively.

Conclusion: This study represents the first comprehensive nationwide epidemiological analysis of CMS in Turkiye utilizing the national electronic health registry. The study enhances the understanding of the epidemiological landscape of CMS in the country by reporting the current incidence, prevalence, and pyridostigmine prescription rates and underscores the significance of this rare but impactful neuromuscular disorder.