Biomedical ethical evaluation of Turkish newspaper articles on face transplants

The use of face transplants has become possible in Turkey and the world in recent years. Face transplants are not just an exchange of tissue between the donor and the recipient and are social and ethical issues concerning the health care institutions, health care team and the public. The interest and criticism of the health care professionals, institutions, public and media regarding the transplants have led to various ethical problems.This study aimed to perform an biomedical ethical evaluation of the newspaper articles on face transplant cases. The study used retrospective, descriptive, qualitative and quantitative data. The study scope included news from the three highest-selling newspapers published in Turkey with Internet archives that were accessible online. An evaluation form developed by the investigators after a literature review was used for evaluation of the articles.According to the study data, we found that the articles focused mostly on benefits such as the positive changes in the individual patient and the relatives, the decreased or eliminated psychological pain of the patient, the importance of organ transplants, and increased trust in the health care team. The most common violations in the articles were regarding protection of privacy and confidentiality by announcing the names of the donor and recipient, and sharing the treatment process.In conclusion, the necessary training must be provided to ensure health care staff, health care institutions and journalists possess the necessary ethical sensitivity and act according to professional ethical principles

Expression of vascular endothelial growth factor and transforming growth factor alpha in rat testis during chronic renal failure

Introduction. Vascular endothelial growth factor (VEGF) is known to influence testis function. Transforming growth factor alpha (TGF-α) is expressed in the postnatal testis, and has been demonstrated to stimulate testis development. Systemic diseases such as chronic renal failure (CRF) interfere with hypothalamic-pituitary-go­nadal axis, which may cause defective steroidogenesis and gonadal functions. The aim of this study was to inve­stigate the expression and localization of VEGF and TGF-α in testicular tissues of experimental CRF model. Material and methods. Experimental CRF was induced in rats by the resection of more than 85% of renal mass. The expression of VEGF and TGF-α in testicular tissues were assessed by immunohistochemistry on paraffin sections of control, CRF-nondialysed and CRF-dialysed rats. Results. The microscopic evaluation of the testicular structure showed that CRF did not affect testicular histology. Immunohistochemical evaluation showed that VEGF was expressed in the cytoplasm of primary and secondary spermatocyte series as well as the early spermatids. Staining intensity was lower in sperma­tocytes going through the first meiotic division. TGF-α was expressed in the nuclei of spermatogonia and primary spermatocytes with stronger staining intensity in spermatogonia. The intensity of VEGF staining was similar in control and experimental animals, however, TGF-α expression was lower in the CRF group.Conclusions. The continuous expression of VEGF in spermatocytes and spermatids suggests that the applied model of CRF does not directly disrupt morphology of seminiferous epithelium, thus also spermiogenesis. However, difference between control rats and CRF group in TGF-α immunopositivity, which was localised in spermatogonial mitosis step, may suggest the interference of CRF with early stages of spermatogenesis.

Atomoxetine treatment may decrease striatal dopaminergic transporter availability after 8 weeks: pilot SPECT report of three cases

Attention deficit/hyperactivity disorder is one of the most common neurodevelopmental disorders. The pathophysiology is thought to involve noradrenaline and dopamine. The role of dopamine transporter (DAT) was evaluated in imaging studies using mostly dopamine reuptake inhibitors. Atomoxetine is a selective noradrenaline reuptake inhibitor. Here we report the results of a pilot study conducted to evaluate changes in striatal DAT after 8 weeks of atomoxetine treatment. Our results suggest that 8 weeks of atomoxetine treatment may change striatal DAT bioavailability as measured via SPECT but that change was not correlated with genotype or clinical improvement

Hiperemezis gravidarumu olan hastalarda tiroid fonksiyonları ve batın ultrasonografi bulgularının araştırılması.

SS-120 Hiperemezis Gravidarum’u Olan Hastalarda Tiroid Fonksiyonları Ve Batın UltrasonografiBulgularının AraştırılmasıTuğçe Baykara Demir1, Gökhan Açmaz2, Banu Açmaz3, Erol Karakaş2, Fatma Özdemir21Çorum Alaca Devlet Hastanesi2Erciyes Üniversitesi, Kadın Hastalıkları ve Doğum Ana Bilim Dalı, Kayseri3Kayseri Şehir Hastanesi, İç Hastalıkları Ana Bilim Dalı, KayseriAMAÇ: Gebelikte bulantı ve kusma fizyolojik olarak kendiliğinden geçen hafif ve orta dereceli bulantıve kusmadan, kilo kaybı, elektrolit bozuklukları ve metabolik değişikliklerin de eşlik ettiği hiperemezisgravidaruma uzanan bir spektrum içerir. Çalışmanın amacı, hipermezis gravidarum tanısı olanolgularda tiroid fonksiyon testleri ve batın ultrasonografi bulgularının araştırılmasıdır.YÖNTEM: Çalışmaya Erciyes Üniversitesi Kadın Hastalıkları Ve Doğum Kliniği’ndeki hipermezisgravidarum tanılarıyla hospitalize edilen 100 olgu alındı. Hastalar tiroid fonksiyon testleri ( TSH,serbest T4, serbest T3), hepatit serolojisi (Anti-Hbs, Hbs-ag, Anti-HCV, Anti-HIV) ve batınultrasonografi bulguları açısından retrospektif olarak incelendi.BULGULAR: Toplam 100 olgunun ortalama sT3 değeri 3.53 (1.30-8.48), sT4 değeri 1.66 (0.97-3.94),TSH değeri 1.24 (0.01-10.40) olarak bulundu. Bu 100 olgunun 26’sında (26%) TSH düşük, 4’ünde(4%) TSH yüksek olarak belirlendi. TSH yüksekliği olan hastaların sT3 ve sT4 değerleri normalsınırlardaydı. TSH düşüklüğü olan hastaların 6’sında (23%) sT3 ve sT4 yüksek, 3’ünde (11,5%) sT3yüksek ve sT4 normal, 3’ünde (11,5%) sT3 normal ve sT4 yüksek olarak belirlendi. Bu hastalarınyapılan batın ultrasonografileri normal olarak değerlendirildi. İzole sT4 yüksekliği 16 hasta (16%)’damevcuttu. Bu 16 hastanın 14’ünde ( 87,5%) TSH düşüklüğü mevcuttu. Serbest T3 yüksekliği 10 hasta(10%)’da mevcuttu. Bu 10 hastanın 14’ünde( 87,5%) TSH düşüklüğü mevcuttu. Bu 10 hastanın7’sinde (70%) sT4 yüksekliği de eşlik ediyordu. Serbest T3 düşüklüğü olan 1 hasta (0,1%)’da T4 veTSH normal seviyelerde bulundu. 100 olgunun 2 (2%)’sinde yapılan batın ultrasonografisinde safraçamuru eşlik ediyordu ve bu hastaların sT3-sT4 değerleri normal, TSH değeri ise düşük olarakbulundu.TARTIŞMA: βhCG, tirotropin benzeri aktiviteye sahiptir. Hipertiroksemiden hCG’nin sorumluolabileceği düşünülmektedir. Ancak tiroid stimulan aktivasyonuyla serum immunolojik βhCGkorelasyon göstermez. Hiperemezis gravidarumlu hastalarda hCG immun reaksiyonu ile tiroidstimulasyon derecesi ilişkilidir. Hiperemezis gravidarum ve gestasyonel tirotoksikoz bilmecesininaçıklanmasında yüksek tirotropik potansiyele sahip hCG izoformlarının molekül yapısını belirlenmesietkili olacaktır. Biz de yaptığımız çalışmada 100 hiperemezis gravidarumlu hastanın 26 (26%)’sındahipertiroidizm saptadık. Ancak hiperemezis gravidarum şiddetiyle tiroid hormon seviyeleri arasında birilişki bulamadık. Hastların hipertiroidi dışında olabilecek hepatobilier bulgularını saptamak için yapılanbatın ultrasonografilerinde ise anlamlı ilişki bulunamamıştır.SONUÇ: Hiperemezis gravidarumda tiroid fonksiyon testleri ile batın ultrasonografi yapılan hastalarındeğerlendirilmesi önemlidir. Hastaların önemli bir kısmında (n=30) Tiroid fonksiyon testleri anormalolarak raporlanmıştır. Hiperemezis gravidarumda hastaların yaklaşık 1/3-1/4’ünde anormal olaraksaptanan testlerin takiplerinin gerekli olduğunu düşünüyoruz.Anahtar Kelimeler: Hiperemezis gravidarum, Hipertiroidizm, Safra Çamuru</p

A multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal complications

PubMedID: 24807019Even though preoperative marking of the stoma area is considered important for the prevention of postoperative complications, not all healthcare institutions have universally adopted this practice. A multicenter, retrospective, descriptive study was conducted to determine the effect of stoma site marking on stomal and peristomal complications. The 1-year study included 748 patients (408 [54.5%] male, mean age 56.60 ± 16.73 years) from eight stomatherapy units in Turkey. Patient data, including age, gender, diagnosis, type of surgery, history of preoperative stoma site marking, person performing the marking, and postoperative complications, were obtained from patient records, abstracted, and analyzed. Cancer was the reason for the operation in 545 (72.9%) of the cases. In 287 patients (38.4%), the stoma and wound care nurse and/or surgeon marked the stoma area; this occurred 1 day before or on the day of surgery according to Wound Ostomy Continence Nurses Society and American Society of Colon and Rectal Surgeons recommendations. Stomal/ peristomal complications developed in 248 (33.2%) persons; the most frequently observed complications in patients were parastomal skin problems (136, 48.7%), mucocutaneous separation (52, 18.6%), and retraction (31, 11.1%). The rate of complications was higher among patients whose stoma site was not marked than among those whose stoma site was marked (22.9% and 46%, respectively; P < 0.001). The results of this study confirm the stoma area should be marked preoperatively in all planned surgical interventions in order to reduce the risk of postoperative complications. Additional prospective and experimental studies on effectiveness of preoperative stoma site marking should be conducted with larger sample groups

factor alpha in rat testis during chronic renal failure

Introduction. Vascular endothelial growth factor (VEGF) is known to influence testis function. Transforming growth factor alpha (TGF-alpha) is expressed in the postnatal testis, and has been demonstrated to stimulate testis development. Systemic diseases such as chronic renal failure (CRF) interfere with hypothalamic-pituitary-gonadal axis, which may cause defective steroidogenesis and gonadal functions. The aim of this study was to investigate the expression and localization of VEGF and TGF-alpha in testicular tissues of experimental CRF model.Material and methods. Experimental CRF was induced in rats by the resection of more than 85% of renal mass. The expression of VEGF and TGF-alpha in testicular tissues were assessed by immunohistochemistry on paraffin sections of control, CRF-nondialysed and CRF-dialysed rats.Results. The microscopic evaluation of the testicular structure showed that CRF did not affect testicular histology. Immunohistochemical evaluation showed that VEGF was expressed in the cytoplasm of primary and secondary spermatocyte series as well as the early spermatids. Staining intensity was lower in spermatocytes going through the first meiotic division. TGF-alpha was expressed in the nuclei of spermatogonia and primary spermatocytes with stronger staining intensity in spermatogonia. The intensity of VEGF staining was similar in control and experimental animals, however, TGF-alpha expression was lower in the CRF group.Conclusions. The continuous expression of VEGF in spermatocytes and spermatids suggests that the applied model of CRF does not directly disrupt morphology of seminiferous epithelium, thus also spermiogenesis. However, difference between control rats and CRF group in TGF-alpha immunopositivity, which was localised in spermatogonial mitosis step, may suggest the interference of CRF with early stages of spermatogenesis