The Influence of Class III Obesity on Subarachnoid Depth of Turkish Parturient: A Prospective Observational Study

Introduction: This observational study aimed to investigate the effects of morbid obesity on the subarachnoid depth and spinal anaesthesia technique

The Influence of Class III Obesity on Subarachnoid Depth of Turkish Parturient: A Prospective Observational Study

Seyhan, Tulay Ozkan/0000-0002-7070-8827WOS: 000535666500001Introduction: This observational study aimed to investigate the effects of morbid obesity on the subarachnoid depth and spinal anaesthesia technique. Methods: Sixty American Society of Anesthesiologists Classification II women with term pregnancy who were candidates for elective caesarean section under spinal anaesthesia were enrolled in this prospective, observational study. Only patients with a Body Mass index (BMI) of = 40 kg/m(2) (obesity group) were included in the study. Spinal anaesthesia was performed in the sitting position via a midline approach at either L3-4 or L4-5 level by using a 25G 90-mm Quincke spinal needle with an introducer. Demographic data of the parturient, visual characteristics of the lumbosacral region, palpation of landmarks, depth of the spine, technical characteristics of the block, time of block performance and satisfaction of patients were recorded. Results: the spinal depth of the control and obesity groups were 51.7 +/- 4.4 and 69 +/- 10.4 mm, respectively (p<0.001). Although needle change was not necessary for any of the patients in the control group, a 120-mm long needle change was required in six patients in the obesity group (p<0.024). We found that the incidence of patients with landmarks that were difficult to palpate was higher in the obesity group, and significantly increased attempt number, skin puncture and needle pass were also required in this group. Conclusion: Anaesthesiologists should be prepared for a longer attempt in patients with obesity but should not be discouraged as the increase in the number of attempts or prolonged initiation time of spinal anaesthesia was not associated with patient dissatisfaction or discomfort

Effect of ozone and methylprednisolone treatment following crush type sciatic nerve injury

PURPOSE: To assess and compare the histopathological effects of ozone therapy and/or methylprednisolone (MPS) treatment on regeneration after crush type sciatic nerve injury

DECREASED FUNCTIONING AND CONTENTS OF WORRIES ASSOCIATED WITH ANXIETY OR DEPRESSION SYMPTOM LEVELS WITHIN PATIENTS HOSPITALIZED WITH COVID-19 INFECTION

Background: High levels of anxiety and depression symptoms have been reported in patients with COVID-19 compared to the general population. These symptoms were related to variables such as gender, age, and education level with anxiety/depression levels. We aimed to determine the relationship between anxiety and depression symptoms and epidemic-related decreased functioning, worry, and quality of life (QoL). Subjects and methods: The study included 238 hospitalized participants due to COVID-19 and 168 participants who were hospitalized for reasons other than COVID-19. The Hospital Anxiety and Depression Scale (HADS), Short Form 36 (SF-36) QoL Scale, and questionnaires prepared by the researchers were applied. The effects of current worries, impairment in QoL, and decreased functioning during quarantine on levels of anxiety and depressive symptoms were investigated by implementing multiple linear regression analyzes. Results: Our study results suggested the anxiety and depression levels of patients with COVID-19 were not higher than those in the internal medicine inpatient unit at the same time. Worries about transmission to others, uncertainty, social media news, and health anxiety increased the psychiatric symptoms of participants with COVID-19. Disruptions in social relationships and health also have an effect on anxiety/depression symptom levels. Conversely, results indicated losses and worries in occupation and finance did not significantly affect mental symptoms. Conclusion: Worries about transmission to others, uncertainty and health anxiety are closely related to anxiety and depression among patients with COVID-19. There is a need for research in the mental health field for the later stages of the pandemic in different cultures

Ribavirin shows antiviral activity against SARS-CoV-2 and downregulates the activity of TMPRSS2 and the expression of ACE2 In Vitro

Ribavirin is a guanosine analog and has a broad-spectrum antiviral activity against RNA viruses. Based on this, we aimed to show the anti-SARS-CoV-2 activity of this drug molecule via in vitro, in silico and molecular techniques. Ribavirin showed antiviral activity in Vero E6 cells following SARS-CoV-2 infection whereas the drug itself did not show any toxic effect over the concentration range tested. In silico analysis suggested that Ribarivin has a broad-spectrum impact on SARS-CoV-2, acting at different viral proteins. According to the detailed molecular techniques, Ribavirin was shown to decrease the expression of TMPRSS2 both at mRNA and protein levels 48 hours after treatment. The suppressive effect of Ribavirin in ACE2 protein expression was shown to be dependent on cell types. Finally, proteolytic activity assays showed that Ribavirin also showed an inhibitory effect on TMPRSS2 enzyme. Based on these results, we hypothesized that Ribavirin may inhibit the expression of TMPRSS2 by modulating the formation of inhibitory G-quadruplex structures at the TMPRSS2 promoter. As a conclusion, Ribavirin is a potential antiviral drug for the treatment against SARS-CoV-2, and it interferes with the effect of TMPRSS2 and ACE2 expression.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Clinical outcomes of cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors in patients with male breast cancer: A multicenter study

Background: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4-6 (CDK 4-6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4-6 inhibitors in a multicenter real-life cohort. Methods: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4-6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. Results: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04-25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4-6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. Conclusion: In our study, we found that CDK 4-6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4-6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer

Intraoperative transfusion practices in Europe

BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. METHODS: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. RESULTS: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl(-1) and increased to 9.8 (1.8) g dl(-1) after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). CONCLUSION: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl(-1)), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold. CLINICAL TRIAL REGISTRATION: NCT 01604083