Northern clinics of Istanbul最新文献

Objective: This study was designed to evaluate the relationship between Atherogenic Plasma Index (API), a cardiovascular event risk marker, and hepatic fibrosis level in non-alcoholic fatty liver disease (NAFLD) patients.

Methods: 129 people over the age of 18 with NAFLD were included in the study. Fasting blood glucose (FBG), HOMA-IR, HbA1C, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), albumin, triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), nonHDL-cholesterol (nonHDL-C), direct bilirubin, TC/HDL-C, LDL-C/HDL-C and TG/HDL-C ratios were calculated. NAFLD fibrosis score (NFS), FIB-4, APRI scores were determinated. It was classified as low, high and intermediate. The API was calculated and its relationship with the level of hepatic fibrosis was evaluated.

Results: The API level in the high group of NFS is higher than that in the low group. Similarly, the API level in the high group of FIB-4 is higher than that in the low group. The API in the low group of APRI are lower than the ID group. There is a positive correlation between API and NFS, FIB-4, APRI scores in all NAFLD subjects. There is a positive correlation between API and NFS, FIB-4, APRI scores in all NAFLD subjects in the study.

Conclusion: In this study, we found that there was a relationship between FIB-4, NFS, APRI scores, API and dyslipidemia in people with NAFLD, and that as the level of fibrosis increased, the risk of cardiovascular event also increased. Liver fibrosis scores can also be used as cardiovascular risk markers.

Objective: This study aimed to ensure that newborns receive early diagnosis through P-wave dispersion (PWD) in terms of possible atrial arrhythmias on the provocative basis of sepsis.

Methods: In this prospective study twenty term sepsis and twenty preterm sepsis patients were compared with control groups with their own characteristics in terms of PWD by electrocardiography.

Results: The P-wave dispersion value in patients with term sepsis was determined to be statistically significant (p=0.03). There was no difference in PWD between the patient and control groups in preterms (p<0.05). Heart rate in preterm patients with sepsis was found to be statistically significantly higher than in the control group (p=0.001).

Conclusion: Our study revealed a tendency for atrial arrhythmias in term newborn infants with sepsis. These babies should be followed by pediatric cardiology with cardiac monitoring throughout their treatment.

Objective: We aimed to examine the clinical characteristics, surgical findings, histopathological results, laboratory parameters of histopathologically confirmed ovarian torsion cases.

Methods: This was a retrospective study that analyzed 96 surgically proven cases of ovarian torsion treated at a tertiary care referral hospital between 2018 and 2024. The study reviewed demographic characteristics, clinical features, surgical details, laboratory findings, and histopathological results of patients through the hospital's electronic medical records. In addition, a comparative analysis was conducted to evaluate differences between patients undergoing laparoscopic and laparotomy surgical approaches.

Results: Ninety-six surgically confirmed ovarian torsions with a median age 27 years were included. The main presenting symptoms were pelvic pain (93.8%) and abdominal pain (40.6%). Laparoscopy was performed in 61 (63.5%) patients, while laparotomy was performed in 35 (36.5%) patients. Surgical approaches included salpingo-oophorectomy with cystectomy (12.1%), salpingo-oophorectomy alone (40.6%), adnexectomy (41.7%), and hysterectomy with bilateral salpingo-oophorectomy (5.2%). Ovarian size ranged from 2-30 cm (mean 7.0 cm) with right-sided involvement in 60.4%. Hemorrhagic infarction was the most common histopathologic finding, followed by simple cysts, with only one case of borderline serous cystadenoma.

Conclusion: Adnexal torsion is a rare emergency requiring a high index of clinical suspicion due to nonspecific symptoms. Surgical intervention is the definitive approach, with laparoscopy preferred for faster recovery and superior outcomes.

Objective: Blood and blood products are a scarce resource and thus, they should be used efficiently. Inappropriate use of blood leads not only to waste of valuable medical resource, but also increases the risks of blood transfusion and economic burden.

Methods: This study is a prospective, observational one-day single-center point prevalence study in which transfusion activities performed in our hospital. It was aimed to determine the prevalence of patients receiving blood products in hospitals, types of blood products, characteristics of recipients, distributions of blood group, appropriateness of blood transfusion and the cost of these products, using the one-day standardized prevalence method for the first time in our country.

Results: One hundred seventy blood transfusions were performed in 102 patients. It was found that 64 (37.6%) of 170 blood products used according to the guidelines were non-evidence-based and inappropriate blood transfusions. It was established that the frequency of inappropriate use of blood products was significantly higher in surgical divisions (n=31 48.4%) compared to internal medicine divisions (n=20, 31.3%) (p<0.0001). The amount corresponding to 64 (37.6%) units transfused inappropriately according to the guidelines was found for one day. When we estimated the results of this study at the level of yearly use of blood products, we found that transfusion of approximately 28 000 units of blood products was being performed yearly in our hospital and a total of 8.435.006 TL/281.166 USD was being spent yearly considering 10 523 units were being transfused inappropriately.

Conclusion: This study shows that the condition in our country is only the tip of the iceberg. Examination of the indications for use of blood products by transfusion committees in hospitals and generalizing use of national guidelines could be the primary applications to prevent inappropriate use of blood products.

Objective: Stem cell studies have been increasing in recent years owing to the healing effect of stem cells on colitis. This study aimed to compare the effects of locally and intra-arterially administered adipose tissue-derived stem cells (ATDSCs) in a colitis model induced by acetic acid (AA).

Methods: Five groups were established, each consisting of six Wistar-Albino male rats. Group 1, colitis control group; Group 2, local phosphate-buffered saline (PBS) group; Group 3, local stem cell group; Group 4, intra-arterial PBS group; Group 5, intra-arterial stem cell group. Colitis was induced by the rectal administration of acetic acid. All rats were weighed on the day colitis was induced, on the day of stem cell administration (day 7), and on the day of sacrifice (day 14). All groups were evaluated for weight loss, histopathology, blood tumor necrosis factor-α-stimulated gene/protein-6 (TSG-6) levels, macroscopic laparotomy findings, and fluorescence microscopy.

Results: Significant weight loss was observed in all the animals with colitis (p<0.05). Histopathological examination revealed less mucosal damage and greater healing in the intra-arterial group (p<0.05). Blood TSG-6 levels were also significantly higher in the intra-arterial group than in the other groups (p<0.05). Immunofluorescence microscopy showed that intra-arterially administered stem cells exhibited a more uniform and widespread distribution throughout the colon.

Conclusion: We believe that intra-arterially administered ATDSCs spread to the colon more effectively than locally administered ATDSCs, and that intra-arterial ATDSCs application may be a safe option for treating colitis with interventional angiographic techniques. Further experimental and clinical studies are needed to assess the efficacy of this treatment.

Objective: The current study aims to describe the infection and infestation adverse events that may be associated with the use of ocrelizumab using real-world data.

Methods: Infection and infestation adverse event reports with the generic name ocrelizumab as the primary suspect in the FAERS database from Q4 2003 to Q3 2024 were included in the study. The disproportionality analysis software package OpenVigil 2.1-MedDRA-v24, including the Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) algorithms, was used to determine signal strength of infection and infestation adverse events associated with ocrelizumab. The signal intensity for ROR and PRR was classified as low, medium and strong according to signal strength.

Results: The analysis of infection and infestation reports of the drug pharmacovigilance database on the use of ocrelizumab revealed 161 positive signals. The most common adverse event reported was COVID-19 (n=2287, ROR 24.303; PRR 22.681). According to the disproportionality analysis, the top six adverse events with the highest ROR and PRR were encephalitis enteroviral (ROR 101.831; PRR 101.809), meningitis enteroviral (ROR 76.019; PRR 76.005), fallopian tube abscess (ROR 51.225; PRR 51.221), nasal herpes (ROR 45.676; PRR 45.662), neuroborreliosis (ROR 28.563; PRR 28.559) and babesiosis (ROR 25.507; PRR 25.5).

Conclusion: Ocrelizumab may increase the risk of many infections and infestations, including enterovirus-related central nervous system infections, tick-borne infections, COVID-19-related disorders, genital tract infections and herpes infections, and therefore requires careful monitoring in clinical practice.

Objective: In this study, the protective effect of Caffeic acid phenethyl ester (CAPE) against doxorubicin (DOX)-induced cardiotoxicity was investigated by evaluating oxidative stress parameters, ECG changes, matrix metalloproteinase 2 (MMP-2) gene expression, troponin I level and histopathology in Wistar Albino rats.

Methods: Forty rats were divided into 4 groups (n=10) including control (saline (vehicle for DOX) and 2.5% ethanol (vehicle for caffeic acid phenethyl ester), CAPE only (10 µmol/kg bw), DOX only (10 mg/kg bw) and CAPE+DOX groups. Molecular, biochemical and histopathological analyses were performed on blood and heart tissues.

Results: No alterations were observed in oxidative stress parameters and MMP-2 gene expression of DOX and CAPE+DOX groups compared to control. Troponin I levels were higher in DOX and CAPE+DOX groups than in the control. Variable ECG changes were observed in the experimental groups such as increased systolic blood pressure, decreased QRS and QT interval in DOX group compared to the control without any ameliorative effect of CAPE. The presence of dense degenerative cardiomyocytes in the myocardium of the DOX group was noted. DOX caused damage to cardiomyocytes. It was observed that CAPE showed a significant decrease in histopathological changes and histopathological scoring in the CAPE+DOX group compared to DOX group.

Conclusion: CAPE treatment ameliorated histopathological changes induced by DOX while other parameters including oxidative stress, MMP-2 gene expression, Troponin I and ECG studied in our study were not altered remarkably.

Objective: To characterise the clinical spectrum, prognostic indicators and seasonal relapse patterns of cytomegalovirus anterior uveitis (CMV-AU), with particular emphasis on glaucoma risk and treatment outcomes.

Methods: This retrospective study analysed 53 eyes of 52 immunocompetent patients diagnosed with CMV-AU between 2019 and 2023 at a tertiary referral centre. Diagnosis relied on characteristic clinical findings and, in selected cases, aqueous-humour polymerase chain reaction (PCR) testing. Demographic data, best-corrected visual acuity (BCVA), intraocular pressure (IOP), keratic precipitate (KP) patterns, anterior segment changes, treatment regimens and relapse rates were reviewed.

Results: The cohort (67.3% male) had a mean diagnosis age of 34.3±11.1 years. Most eyes were Posner-Schlossmann-like (63.5%), followed by chronic non-specific AU (34.6 %) and Fuchs-like AU (1.9 %). KPs were chiefly solitary (58.5%), centrally located (50.9%) and sparse (< 5) in 66.0 %. Corneal endothelitis occurred in 39.6% of eyes and was an independent predictor of secondary glaucoma (OR=6.20, 95 % CI 1.04-36.86). Glaucoma developed in 56.6% of eyes; 13.2% required glaucoma surgery. Glaucoma was more frequent and more likely to require surgery in patients treated with oral valganciclovir compared to those treated with topical ganciclovir alone (p=0.049 and p=0.034, respectively). Having ≥ 1 winter relapse (OR=4.99, 95 % CI 1.14-21.86) and, in women, ≥1 spring relapse (OR=5.38, 95 % CI 1.11-25.96) independently predicted > 3 relapses. Overall relapse frequency peaked in winter and summer (p<0.05).

Conclusion: Corneal endothelitis appears to be an independent risk factor for secondary glaucoma in CMV-AU, warranting vigilant IOP monitoring and timely antiviral therapy. The observed seasonal pattern, with more frequent relapses in winter overall and an increased rate in spring among female patients, may assist clinicians in identifying high-risk groups and planning closer follow-up.

Objective: Prenatal exposure to medications or environmental agents may contribute to adverse pregnancy outcomes and birth defects. This study provides a comprehensive bibliometric overview of the global research landscape on prenatal exposures and associated outcomes.

Methods: A systematic literature search was conducted in the Web of Science database on November 11, 2024. Articles and reviews addressing prenatal exposures and pregnancy outcomes, indexed in the Science Citation Index, Science Citation Index-Expanded, or Emerging Sources Citation Index, were screened. Data were analyzed and visualized using VOSviewer, the R-package Bibliometrix, and Microsoft Excel 2021.

Results: A total of 3,361 articles were analyzed. Publications on this topic have steadily increased over the past two decades, peaking in 2022. The United States emerged as the most productive country, followed by China and Canada. Gideon Koren was identified as the most prolific author, while Reproductive Toxicology published the highest number of articles. Among the keywords, "pregnancy" remained the most frequent overall; however, "placenta," "adverse pregnancy outcomes," and "systematic review" peaked in 2022, while "meta-analysis," "outcomes," and "stillbirth" peaked in 2021.

Conclusion: This bibliometric study highlights the global evolution of scientific research on prenatal exposures and pregnancy outcomes. The findings offer valuable insights for clinicians, researchers, and policymakers, enabling a better understanding of the dynamic trends and emerging areas in this field.

Objective: Autophagy plays a crucial role in neuroprotection by helping to clear toxic substances, like misfolded proteins. In neurodegeneration, autophagy is impaired leading to the accumulation of harmful proteins that disrupt neuronal function, promote inflammation, and contribute to the degeneration of brain cells. Therefore, because of its anti-inflammatory and anti-oxidative actions, the effects of Urtica dioica (UD) on the proteins of autophagy signaling pathways was studied in the hippocampus of rats with streptozotocin-(STZ) induced neurodegeneration.

Methods: Neurodegeneration model of rats was induced by intracerebroventricular injection of STZ (3 mg/kg) to observe both cognitive deficits and autophagic dysfunction. Then, the rats in the treatment group were consumed UD at the dose of 50 mg/kg/day for 4 weeks. At the end of 4 weeks, passive avoidance test was applied for cognitive functions and hippocampal tissue of rats were investigated to determine the changes in the proteins related to autophagy by western blotting and immunofluoresecence.

Results: UD treatment slightly attenuated the STZ-induced memory deficiencies in the rats. In addition, an increase in the autophagy was noted by increasing the expression of Beclin, ATG5, and LC3β proteins in the STZ-UD group compared to the STZ group.

Conclusion: In summary, UD may be a candidate molecule as a therapeutic strategy to protect neurons in neurodegeneration through increasing autophagy to reduce toxic protein accumulation.