Current ınspect to pain and pain mechanism

Kimyasal, mekanik veya termal uyarılar doku yaralanmasına yol açarak veya damarsal bütünlüğü bozarak ağrının subjektif etkilerine ilaveten otonomik (kalp hızı veya kan basıncında değişiklik) veya hormonal (adrenal ve hipofizer sekresyonlar) yanıtlara neden olur.Ağrı fizyopatolojisini ve ağrı yolaklarını bilmek, ağrı tedavisinde bize yardımcı olur. Son yıllarda ağrıda rol oynayan fizyolojik ve kimyasal mekanizmaların daha iyi anlaşılmasıyla ağrı tedavisinde çok önemli gelişmeler sağlanmıştır. Bu yazıda ağrı ile ilgili tanımlamalar, sınıflamalar ve ağrıda rol oynayan fizyolojik ve kimyasal mekanizmalar konusundaki güncel bilgiler gözden geçirilmiştir.Chemical, mechanical, orthermalstimuli leadto autonomic (changes inheartrate orbloodpressure) or hormonal (adrenal and pituitary secretion) responses well as causing subjective sensation of pain by tissue destruction and disruption of vasculature integrity. A better understanding of pain physiopathology and pain pathways helps us in treatment of pain. Recent advances in our understanding of the chemical and physiologic pain mechanisms have provided us with important developments in pain therapy. In this article, current information about the definition and classification of pain and its chemical and physiologic mechanisms are reviewed

AN INVESTIGATION OF THE RELATIONSHIP BETWEEN THE REACTION TIMES AND THE STATE AND TRAIT ANXIETY LEVELS OF THE ATHLETES

Besides supposing that the anxiety levels of the athletes have an impact on their performance it is also important to know the level of this impact. In this study it was aimed to investigate the relationship between the anxiety level and the sporting performance especially the reaction time which is the determinant of the speed requiring sudden movements. The study included 60 university students who participated voluntarily, were actively engaged in sports and were living in Esenyurt district of Istanbul. The average age of the participants was 20,68±2,33, their average height was 179,05±6,43cm, their average body weight was 75,55±9,32 kg and their average sport age was 6,31±3,23years. The State and Trait Anxiety Inventory (STAI) was used in the study in order to determinate and measure the state and trait anxiety levels of participants. The State and Trait Anxiety Inventory (STAI) was developed by Spielberger and his colleagues in 1970 and its reliability and validity study was carried out by Öner and La Compte by translating it into Turkish in 1983. The analyses of the obtained data were carried out with the SPSS Statistic 17.0 package program. The measurement results were given as mean (x) and as standard deviation (SD). Correlation and regression analysis were applied for the statistical evaluation of the data.  In the conducted study the state anxiety level of the athletes was detected to be  29,62±4,46 points, their trait anxiety level was 32,12±6,39 while their double hand reaction time was found to be 0,23±0,02 sec. A positive low level relationship was detected between the trait anxiety levels and the double hand reaction times of the athletes (r=,279,p<,05) while a positive and moderate level relationship was observed between the state anxiety level and the state anxiety level (r=,311, p<,016). Due to the fact that this research is a preliminary study done in the field of sport science, this study is considered to contribute to other studies planned to be done in the future. As a result, it was detected that with the increase in the anxiety level the response time given to an effect from any external factors lengthened. The fact that there was a low level positive relationship with the trait anxiety level revealed the conclusion that with the increase in the trait anxiety level, the reaction time also increases.  Article visualizations

Humerus başının yukarı kayması: rotator kılıf cerrahisinde prognostik bir araç olarak kullanılabilir mi?

Amaç:Rotator kılıf yırtığı bulunan hastalarda sağlam ve yırtık kılıf bulunan omuzda humerus başının glenoide göre superior’a kaymasının tamir sonrası prognostik kriter olarak kullanılabilirliği araştırıldı. Hastalar ve Yöntem:Tek taraflı tam kat rotator kılıf yırtığı tanısı konulan 27 hasta (14K, 13E) çalışmaya dahil edildi. Ortalama yaş 56 (Aralık: 32-71) idi. Ameliyat öncesi her iki omuz glenohumeral eklemin AP grafileri çekildi.Humerus başının yukarı kayma miktarı (∆e) ölçüldü. Kayma miktarı 0-3 mm olan hastalar Grup A, 4-5 mm olan hastalar Grup B olarak sınıflandı. Açık rotator kılıf tamiri yapıldı.Değerlendirmede Constant omuz skorlaması kullanıldı. Bulgular: Supraspinatus, infraspinatus ve subskapularis tendon yırtıkları sırasıyla 27 hastada (%100), 11 hastada (%40.7) ve 6 hastada (%22.2) saptandı.19 hasta A grubunda, 8 hasta B grubundaydı. İzole supraspinatus yırtığı bulunan hastaların hepsi (n=10) ve supraspinatus, infraspinatus yırtığı bulunan 11 hastanın 9'u A grubundaydı. Supraspinatus, infraspinatus ve subskapularis yırtığı bulunan hastaların hepsi (n=6) B grubundaydı. Ortalama preoperatif Constant skoru Grup A'da 48.6, Grup B'de 21.5 olarak tespit edildi. Aradaki fark istatistiksel olarak anlamlı bulundu (p<0.001). Ortalama postoperatif Constant skoru Grup A'da 75.3 grup B'de 69 idi. Her iki grup karşılaştırıldığında aradaki fark istatistiksel olarak anlamlı bulundu.(p<0.05) Ameliyat öncesi ve sonrası Constant skorlarıyla ∆e değeri arasında ters bir ilişki olduğu tespit edildi. Sonuç:Rotator kılıf yırtığından şüphelenilen hastalarda direk radyografide humerus başının yukarı kayması tamir sonrası prognozu göstermesi açısından önemlidir

Chronic Tubal Torsion Mimicking a Tubo-Ovarian Abscess; Case Report

Isolated tubal torsion is an uncommon cause of acute abdominal pain with the incidence of about 1/1,500,000 women. Here, we present a 36-year-old patient who was referred to us with the diagnosis of tuboovarian abscess resistant to medical treatment. Although she was hospitalized and was medicated, her complaints did not reduce. Diagnostic laparoscopy was performed, and salpingectomy was performed on account of tubal torsion

Cholelithiasis and gastrointestinal cancer: Is there a relationship that increases the risk of developing cancer?

Aim: To investigate the co-existence of cholelithiasis in patients with gastrointestinal (GI) cancer both in preoperative and postoperative periods. Methods: We retrospectively analyzed the data of patients who underwent GI tract cancer surgery in the general surgery clinic of a university hospital between January 2013 and December 2019 for the presence of 'cholelithiasis' in the preoperative and postoperative periods. Age, gender, tumor type and localization and presence of the cholelithiasis in the patients were determined. In addition, the cases were divided into two as upper GI tract and lower GI tract according to tumor location and the relationship with cholelithiasis was evaluated. Results: A total of 680 GI cancer patients were included in the study. Localization of GI cancers were; colon in 211 cases (31%), rectum in 195 cases (28.7%), gastric in 187 cases (27.5%), periampullary region in 55 cases (8.1%), and small intestine in 32 cases (4.7%). In the preoperative period, 69 (10.1%) patients were associated with cholelithiasis. Thirty-one (5.1%) patients had accompanying cholelithiasis in the postoperative period. Coexistence of cholelithiasis according to cancer location was not statistically significant in the preoperative and postoperative periods. Conclusions: Our available data make it difficult to distinguish the roles of cholelithiasis on gastrointestinal cancers, because no statistically causal relationship was found between cholelithiasis and gastrointestinal cancers. However, the role of asymptomatic and symptomatic stones, which may or may not require cholecystectomy, in the development of GI tract cancers should not be ignored

Nuclear and organelle genes based phylogeny of dryomys (glirıidae, rodentıa, mammalıa) from Turkey

Molecular phylogeny, phylogeography and genetic structure of the genus Dryomys Thomas, 1906 from Turkey were identified by using partial sequences of beta-fibrinogen intron 7 and mitochondrially encoded 12S ribosomal RNA genes and also combined data of two genes. Within Dryomys nitedula species, both, nuclear and mitochondrial genes coherently separated the Thrace lineage from the other lineages in Anatolia. Contrary to this, complex and incomprehensible phylogenies were recovered for Anatolian populations of this species. The analysis of the combined data of these two genes resolved mentioned complexity and incongruity and made phylogeny compatible with the results of past studies for the relative position of the Anatolian lineages. Thus, the presence of four different lineages (one in Thrace and three in Anatolia) within D. nitedula in the localities exemplified across Turkey was confirmed. Genetic differentiation (K2P distances) between the lineages were moderate at the level of intraspecific diversity. In addition to this, genetic distance (K2P = 5.5%) determined between D. nitedula and D. laniger conformed the distance suggested for the separate species of mammals. Evolutionary divergence time estimations demonstrated that the probable divergence between D. laniger and D. nitedula and among its detected lineages started in the border of Late Miocene and Pliocene (5.3 Mya) and lasted to the beginning of the Calabrian Stage of Pleistocene (1.8 Mya) in line with the previous results obtained from fossil and molecular data

In Vitro Regulation of the Expression of the Sars-Cov-2 Receptor Angiotensin-Converting Enzyme (Ace2) in Lung Cancer Cells by Natural Products

DergiPark: 896013trkjnatThe COVID-19 pandemic continues infecting people causing deaths globally. Although various medicines have been tried to combat with COVID-19, there is no medicine or treatment that has been validated yet. People have been using natural products for centuries against bacterial and viral illnesses. This study aimed to test the effects of the biomolecule oleuropein, whey collected from industrial waste and soaproot extracts obtained from Gypsophila arrostii Guss. var. nebulosa Boiss. amp; Heldr. and Saponaria officinalis L. on the expression of the human ACE2 gene as SARS-CoV-2 receptor on the A549 adenocarcinoma cell-line by Real-Time Quantitative Polymerase Chain Reaction (qPCR). According to the cytotoxicity tests, G. arrostii var. nebulosa and S. officinalis extract treatments showed a dose dependent cytotoxic effect on the cells. The EC50 values of G. arrostii var. nebulosa and S. officinalis were found to be 54.3 ?g/ml and 17.3 ?g/ml, respectively. Oleuropein showed moderate cytotoxic effects with the EC50 value over 250 ?g/ml. Whey (fermented and non-fermented) did not show any cytotoxic effect at the applied doses. The qPCR results showed that the ACE2 mRNA level decreased by 89.8% and 35.2% due to the fermented and non-fermented whey extracts, respectively. Similarly, G. arrostii var. nebulosa and S. officinalis downregulated ACE2 by 79.8% and 90.1%, respectively. In contrast, oleropein upregulated ACE2 (102.8%). Our results showed that the natural supporting products produced from soaproot extracts and fermented whey can be used against COVID-19 by both cancer patients and people in potential risk groups. COVID-19 pandemisi tüm dünyada küresel çapta insanları enfekte etmeye ve ölümlere neden olmaya devam etmektedir. COVID-19 ile mücadelede birçok ilaç denenmiş olmasına karşın henüz herhangi bir ilaç veya tedavi yöntemi onaylanmamıştır. İnsanlar yüzyıllardan bu yana hastalıklara karşı doğal ürünleri kullanmışlardır. Bu çalışmadaki amacımız bir biyomolekül olan oleuropein, endüstriyel atık olarak bertaraf edilen peynir altı suyu ve Gypsophila arrostii Guss. var. nebulosa Boiss. amp; Heldr. ve Saponaria officinalis L. bitkilerinden elde edilen ekstraktların A549 kanserli hücre hatlarında ACE2 reseptörünü kodlayan ACE2 geninin anlatım seviyesi üzerine etkilerini Gerçek Zamanlı Kantitatif Polimeraz Zincir Reaksiyonu (qPCR) ile belirlemektedir. Yaptığımız sitotoksisite testlerine göre G. arrostii var. nebulosa ve S. officinalis ekstraktları sırası ile 54,3 ?g/ml ve 17,3 ?g/ml EC50 değerleri ile doza bağımlı sitotoksik etki gösterirken, oleuropein 250 ?g/ml’nin üzerinde bir değerle orta dereceli sitotoksik etki göstermiştir. Öte yandan peynir altı suyu (ferment eve fermente edilmeyen), çalışmada kullanılan dozlarda sitotoksik etki göstermemiştir. qPCR sonuçlarına göre fermente edilmiş ve edilmemiş peynir altı suyunun ACE2 genine ait mRNA seviyesini sırası ile %89,8 ve %35,2 oranlarında düşürdüğü belirlenmiştir. Benzer şekilde G. arrostii var. nebulosa ve S. officinalis ekstraktlarının ACE2 geni mRNA seviyesini sırası ile %79,8 ve %90,1 oranında düşürdüğü belirlenmiştir. Bu sonuçların aksine oleuropein biyomolekülünün ACE2 mRNA seviyesini %102,8 oranında arttırdığı belirlenmiştir. Çalışma sonuçlarına göre kullanılan bitki ekstraktlarının ve fermente edilmiş peynir altı suyunun COVID-19 ile mücadelede kanser hastalarında ve risk gruplarında kullanılabilecek doğal destek ürünlerinin üretilmesinde kullanılabileceğini göstermektedir

Diagnosis and treatment of hydatid cysts: Results of 120 patients

Amaç: Kist hidatik hem sosyal hem de coğrafik koşullar nedeniyle ülkemizde sık görülmektedir. Bu çalışmada kist hidatik nedeniyle tedavi edilen hastaların sonuçları değerlendirildi. Hastalar ve Yöntemler: Çalışmaya, kist hidatik nedeniyle tedavi edilen 120 hasta (35 erkek, 85 kadın; ort. yaş 40.7; dağılım 7-75) alındı. Hastaların tanısal araştırma, tıbbi ve cerrahi tedavi ve izlem bulguları geriye dönük olarak değerlendirildi. Bulgular: En sık rastlanan yakınmalar karın ağrısı, bulantı ve kusmaydı. Fizik muayenede 54 hasta normal bulundu. En sık rastlanan bulgular hepatomegali ve karında kitleydi. Yirmi bir hastada karaciğer dışı abdominal organ kistleri vardı. Hastaların 16’sına medikal tedavi, altısına PAIR (perkutan aspirasyon, injeksiyon, reaspirasyon) uygulandı. Cerrahi tedavide tercih edilen yöntem parsiyel kistektomiydi. Elli beş hastada cerrahiye ek medikal tedavi uygulanmıştı. En sık cerrahi komplikasyon (%12.8) yara enfeksiyonuydu. Olguların 16.3’ünde nüks görüldü. Sonuç: Kist hidatikte temel tedavi seçeneği olan cerrahide tercih edilen konservatif yaklaşım yeterli ve güvenli bir tedavi sağlamaktadır. Medikal ajanların tedaviye eklenmesiyle tedavi başarısının yükselmesi beklenmektedir.Objectives: Hydatidosis is frequently seen in Turkey due to social and geographical conditions. The aim of this study was to evaluate the results of treatment in patients with hydatidosis. Patients and Methods: The study included 120 patients (35 males, 85 females; mean age 40.7 years; range 7 to 75 years) who underwent treatment for hydatidosis. Data on diagnostic evaluation, medical and surgical treatments, and follow-up results were reviewed. Results: The most frequent complaints were abdominal pain, nausea, and vomiting. Fifty-four patients were found normal on physical examination. The most frequent findings were hepatomegaly and abdominal mass. The cysts developed in other abdominal organs other than the liver in 21 patients. Treatment was medical in 16 patients, and six patients underwent PAIR (Percutaneous aspiration, injection, and reaspiration). The preferred surgical procedure was partial cystectomy. Medical treatment was added to surgery in 55 patients. The most frequent surgical complication was wound infection (12.8%). Recurrences were encountered in 16.3%. Conclusion: Conservative surgery which is the preferred option for main line of treatment is adequate and reliable for hydatidosis. Addition of medical agents may increase treatment success rate