EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Graham Little-Piccardi-Lassueur Syndrome: Case report

Graham-Little syndrome, also known as Graham Little-Piccardi-Lassueur Syndrome is characterized by the presence of cicatricial alopecia on the scalp, keratosis pilaris located to trunk and extremities, and non-cicatricial hair loss of pubis and axillae. Graham Little-Piccardi-Lassueur Syndrome is a relatively rare disease. It is four times more common in females in the age group of 30-70 years. Topical or systemic corticosteroids, retinoids or PUVA therapy are the treatments usually proposed and these have partial and temporary benefits. A 31-year-old woman presented with a 18-year history of scarring alopecia of the scalp and pruritic lichenoid papules on the trunk and extremities. On the basis of the clinical features and the histopathological findings, Graham Little-Piccardi-Lassueur syndrome (GLPLS) was diagnosed. Copyright © 2012 by Türkiye Klinikleri

Trastuzumab induced maculopapular skin reactions localized on the left forearm and arm: A case report

Trastuzumab, a monoclonal antibody targeting the extracellular domain of the HER-2 protein, either alone or in combination with chemotherapy, improves the outcome of women with early and metastatic breast cancer. Adverse events including cardiac dysfunction and infusion reactions may develop during trastuzumab therapy. However, skin toxicities are infrequent. We described a 57-year-old woman who was treated with trastuzumab for metastatic breast cancer. Due to the peripheral vein problems experienced by the patient, an implanted central venous access port was placed for the trastuzumab treatment by accessing the left subclavian vein with the distal tip in the mid-superior vena cava. The unusual finding appearing after trastuzumab treatment was the maculopapular rash, which was limited to the left arm and forearm. The patient underwent skin biopsy and pathological examination of specimen showed fixed drug eruptions. We reported this case because drug eruptions due to the trastuzumab treatment are rare and the lesion was only localized to the left arm and forearm of the mastectomy side and port catheter. Copyright © 2009 by Türkiye Klinikleri

Rectal squamous cell carcinoma: A case report and review of the literature [Rektal skuamöz hücreli karsinom: Bir olgu sunumu ve literatürün Gözden Geçirilmesi]

Colorectal squamous cell carcinoma is an extremely rare tumor, comprising 0.01-0.025% of all colorectal cancers. A 55 years-old woman complaining of rectal bleeding was admitted to the hospital. An ulcerovegetan mass was seen in rectosigmoidoscopy and biopsies were taken. Histopathological examination revealed diagnosis as epidermoid cell carcinoma of rectum. Hypodense nodules were seen in different segments of liver in computerized tomography. After she was admitted to our hospital, rectosigmoidoscopy was repeated and biopsies were taken from ulcerovegetan mass in the rectum. The diagnosis was confirmed as squamous cell carcinoma. Paliative pelvic radiotherapy was delivered because of pain complain. The combination regimen including uracil-tegafur and carboplatin was administered because of the lack of standart chemotherapy regimens in this type cancer. After 3 cycles of chemotherapy, stable disease was defined in the radiological evaluation and her ECOG performance status improved. Therefore, we planned to continue with the same chemotherapy regimen. We detected radiologically progressive disease after six cycles of chemotherapy. We decided to report this case because of the rarity of squamous cell carcinoma of the rectum and the absence of standart chemotherapy regimen

Diet, lifestyle and cardiovascular diseases: Linking pathophysiology to cardioprotective effects of natural bioactive compounds

Heart and blood vessels disorders comprise one of the main causes of death worldwide. Pharmacologically active natural compounds have been used as a complementary therapy in cardiovascular disease around the world in a traditional way. Dietary, natural bioactive compounds, as well as healthy lifestyles, are considered to prevent coronary artery diseases. Pre-clinical and clinical studies reported that consumption of plant-food bioactive derivatives including polyphenolic compounds, peptides, oligosaccharides, vitamins, unsaturated fatty acids possess protective effects on cardiovascular diseases. This review aims to summarize the cardiovascular risk factors, pre-clinical studies and clinical trials related to cardioprotective properties of the plant-food-derived bioactive compounds. Molecular mechanisms by the natural bioactive compounds exert their cardiovascular protective properties have also been highlighted. © 2020 by the authors. Licensee MDPI, Basel, Switzerland