A Novel Technique for Conjunctivoplasty in a Rabbit Model: Platelet-Rich Fibrin Membrane Grafting

Purpose. To investigate the effect of platelet-rich fibrin (PRF) membrane on wound healing. Methods. Twenty-four right eyes of 24 New Zealand rabbits equally divided into 2 groups for the study design. After the creation of 5 × 5 mm conjunctival damage, it was secured with PRF membrane, which was generated from the rabbit’s whole blood samples in PRF membrane group, whereas damage was left unsutured in the control group. Three animals were sacrificed in each group on the 1st, 3rd, 7th, and 28th postoperative days. Immunohistochemical (IHC) stainings and biomicroscopic evaluation were performed and compared between groups. Results. PRF membrane generated significant expressions of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and platelet-derived growth factor (PDGF) in the early postoperative period. However, the IHC evaluation allowed showing the excessive staining at day 28, in control group. Biomicroscopic evaluation revealed complete epithelialization in PRF membrane group, but none of the cases showed complete healing in the control group. Conclusions. This experimental study showed us the beneficial effects of the PRF membrane on conjunctival healing. Besides its chemical effects, it provides mechanical support as a scaffold for the migrating cells that are important for ocular surface regeneration. These overall results encourage us to apply autologous PRF membrane as a growth factor-enriched endogenous scaffold for ocular surface reconstruction

Matrix metalloproteinase-9, neuron-specific enolase, S100 B and tau protein levels in the patients with carbon monoxide poisoning

Background: S100B, NSE, MMP-9, and Tau protein levels increase in cases causing hypoxic cell damage. The diagnosis of the severity of carbon monoxide (CO) poisoning in the early period of these parameters was studied. Material and Methods: COHb level measurement was made using a signal capture CO-pulse oximeter (Masimo's SET Rainbow, Masimo's Co, USA) at the first admission of the patients. Then, COHb levels were confirmed by arterial blood gas(ABG) analysis. The patients were divided into two groups as mild and moderate-severe, according to their Glasgow coma scores (GCS) [Mild (14–15); Moderate (9–13) or Severe (3–8)]. The control group was composed of 16 healthy and non-smoking volunteers. Results: The serum S100B protein and MMP-9 values at 0 hr of admission in the hospital and 3hr of treatment were not significantly different in the patient group as compared to the control group. Tau protein levels were significantly higher in the patient group at 0 and 3 hours (p> 0.05) as compared to healthy person. Conclusion: There was no relationship between CO poisoning and MMP-9 and S100B protein levels. NSE and Tau protein were significantly higher in the patient group than the control group. Tau protein may be more useful marker as compared to neuron-specific enolase.Firat University Scientific Research Projects Management Uni

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

1999–2012 yılları arasında Ekşi Sözlük : alt kültürden popüler kültüre

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2014.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Sert, Özlem

Comparison of the efficiency of subconjunctival aflibercept ranibizumab and bevacizumab in corneal neovascularization in a rat model

Background: Corneal neovascularization (CN) might be a sight-threatening condition via reducing the corneal transparency. One of the most significant proangiogenic factors is vascular endothelial growth factor (VEGF) that is shown to be upregulated in CN. Accordingly, we aimed to evaluate and compare the effectiveness of aflibercept, ranibizumab, and bevacizumab in CN in a rat model. Material and methods: Twenty-eight male Wistar-Albino rats were administered general anesthesia. 2-mm-diameter central burns were formed on the corneas. Rats were divided into four groups randomly, and one group was administered subconjunctival saline solution as the control group. Subconjunctival aflibercept, bevacizumab, and ranibizumab were applied to the other three groups, respectively. Three rats from each group were randomly selected, and digital photographs of the corneas were taken under general anesthesia. Then, rats were euthanized, and eyes were enucleated one week and one month after the corneal injury. Three enucleated eyes from each group were prepared for histological evaluation with hematoxylin and eosin. Results: According to the first week results, there was no central CN in all groups except the control group. There was no statistically significant difference in total CN among the groups according to the Kruskal-Wallis test (p = 0.09). The control group had a higher inflammation score than the other groups in the central cornea. On the other hand, the control group had less intense fibrosis than the other groups in the central cornea. In the first month, there was a spontaneous regression in central CN in the control group. There was again no statistical difference among the groups regarding the CN (p = 0.46). There was no inflammation in the central cornea in any groups. Conclusion: single-dose subconjunctival injection of aflibercept, ranibizumab, and bevacizumab prevents thecentral CN and reduces the inflammation

Vasküler Malformasyonlarda Yalnızca Skleroterapi Yapılan Olgular İle Skleroterapi Sonrası Eksizyon Yapılan Olguların Karşılaştırılması

Vasküler Malformasyonlarda YalnızcaSkleroterapi Yapılan Olgular İleSkleroterapi Sonrası Eksizyon YapılanOlguların KarşılaştırılmasıMerve Terzi, Cenk Demirdöver, Can Karaca,Selin Güler, Merve Özger, Hasan Basri ÇağlıDokuz Eylül Üniversitesi Tıp Fakültesi, PlastikRekonstrüktif ve Estetik Cerrahi Ana Bilim Dalı, İzmirGiriş: Vasküler malformasyonlar hemanjiyomlardanfarklı olarak doğumda mevcut olan damarların kalıtımsalbozukluğundan kaynaklanan büyüme ile orantılı olarakbüyüyen kadın ve erkeklerde eşit sıklıkta görülenlezyonlardır. Tanıda kontrastlı MR altın standarttır vetedavide klinik takip, laser, skleroterapi, cerrahi rezeksiyongibi çeşitli yöntemler mevcuttur. Bu çalışmada vaskülermalformasyonlarda skleroterapinin lezyonlar üzerineetkinliği, takiplerde regresyon oranları ve cerrahi tedaviile kombine edildiğinde klinik izlemdeki değişikliklertartışılmaktır.Gereç Ve Yöntem: Dokuz Eylül Üniversitesi Tıp FakültesiPlastik, Rekonstrüktif ve Estetik Cerrahi Kliniği’ne 2013 ile2020 yılları arasında vasküler malformasyon tanılı başvuran47 hasta değerlendirildi. Hastaların yaş aralığı dört ile73 yaş arasında olduğu saptandı. Hastalara minimumbir kez maksimum sekiz kez skleroterapi uygulandı.Hastaların ortalama yaşı 21,9 olarak hesaplanırkenortalama skleroterapi seans sayısı 2,2 olarak hesaplandı.Toplam 20 hastaya (%42,5) skleroterapi ve sonrasındacerrahi eksizyon kombine edildi. Hastaların bir tanesindefenilketonüri tanısı, bir hastada talasemi taşıyıcılığımevcutken diğer hastalarda eşlik eden majör ek hastalıksaptanmadı. Hastaların 25 tanesinde (%53,1) vaskülermalformasyon dudakta, altı hastada (%12,7) yanakta, ikihastada (%4) kolda, iki hastada (%4) elde, beş hastada(%10) ayakta, altı hastada (%12,7)bacakta ve bir hastada(%2) dizde saptandı.Bulgular: Postoperatif dönemde bir hastanın takiplerindesütür hatlarında seperasyon gelişti ve sekonder iyileşmeyebırakılarak pansumanla takip edildi. Postoperatif uzundönem kontrollerine gelmediği saptanan sekiz hasta içinlezyonun uzun dönem progresyonu/regresyonu takipedilemedi. Cerrahi eksizyon yapılan dört hastada polikliniktakiplerinde lezyonda tekrar progresyon saptandı. Kalandokuz hastanın postoperatif dönemde estetik açıdandaha tatmin edici sonuç elde edildiği ve kitlede daha fazlaregresyon olduğu görüldü. Eksizyon yapılan hastalardasadece skleroterapi uygulananlara göre postoperatifpoliklinik takiplerinde nüks ve kitlede küçülme oranınve hasta memnuniyetinin daha fazla olduğu saptandı.Hastaların ek hastalıklarının veya sigara kullanımının yaraiyileşmesi üzerine belirgin etkisi saptanmadı.Sonuç: Skleroterapi, cerrahi eksizyon ile kombineedildiğinde kitlenin küçüldüğü, postoperatif dönemdenüks oranlarının azaldığı ve hasta memnuniyetinin dahafazla olduğu görüldü. Hastaya ait faktörlerde ise çalışılanhasta grubunda belirgin farklılık saptanmadı. Çalışmalardarezeksiyon yapılmadan uygulanan skleroterapinin dahagüvenli ve efektif olduğu saptansa da bu çalışma grubundarezeksiyonun eklendiği hastalarda etkinliğin daha fazlaolduğu bulunmuştur. Yine de her vasküler malformasyonkitle ve yerleşimden ötürü rezeksiyona uygun olmayıp buhastalarda skleroterapi bazen tek alternatif tedavi yöntemiolmaktadır. Bu yüzden bu hasta gruplarında daha dahaefektif sonuç elde edebilmek için lezyonun yerleşimi,postoperatif düzenli uzun dönemli poliklinik takipleri dahadüzenli ve daha detaylı analizler yapılmalıdır.Anahtar Kelimeler: Eksizyon, Malformasyon,Skleroterapi, Vasküler</p

İzmir'de von Willebrand hastalığı sıklığını belirlemeye yönelik epidemiyolojik çalışma

Von Willebrand Disease is an autosomally inherited disease resulting from a quantitative or qualitative defect of von Willebrand factor (vWf). It is considered as the most common cause of hereditary bleeding disorders. The aim of this study was to evaluate the prevalence of vWD in Izmir. A total of 3485 children aged 6-13 years attending at six different primary and secondary school in Izmir were given a questionnaire form to determine the presence of bleeding symptoms and their severity in children and their families. Questionnaire forms were completed by parents and turned back from 3179 children. Children who had bleeding symptoms and at least one other family member with a bleeding history were asked to give blood samples for vWf antigen (vWf: Ag) and its activity (RiCof). A total of 179 children out of 194 who had personal and family history of bleeding accepted to participate in the study and gave the blood samples. Blood analysis revealed decreased vWf: Ag and/or RiCof in 14 children. The prevalence of vWD among the school children in Izmir was found to be.0.44%. In this study the most common bleeding symptoms in children with vWD were easy bruising and epistaxis.Von Willebrand Hastalığı (vWH) von Willebrand faktörün nitelik veya niceliksel bozukluğundan kaynaklanan otozomal geçişli kalıtsal bir hastalıktır. En sık görülen kalıtsal kanama bozukluğu olarak kabul edilir. Bu çalışmada amaç İzmir'de vVVH'nın görülme sıklığını belirlemektir. Yaşları 6- 13 yıl arasında değişen toplam 3485 çocuğa kendilerinde ve ailelerinde kanama semptomlarının varlığını, varsa ağırlığını belirlemeye yönelik bir anket formu verildi. Anne ve babaları tarafından bu anket formları dolduruldu ve 3179 çocuğun anket formu geri alındı. Kanama bulguları olan ve ailesinde kendisinden başka en az 1 bireyde daha kanama öyküsü tanımlanan çocuklardan vWf antijen (vWf: Ag) ve aktivitesi (RiCof) çalışılmak üzere kan örneği alınması önerildi. Kişisel kanama semptomları bulunan ve ailesinde kanama öyküsü tanımlanan 194 çocuğun 179'undan kan örneği alındı. Tetkikler sonucunda 14 çocukta azalmış vWf:Ag ve/ veya RiCof değerleri saptandı. İzmir ilinde okul çocuklarında vWH görülme sıklığı % 0.44 olarak belirlendi

Feasibility of Using Thrombin Generation Assay (TGA) for Monitoring Bypassing Agent Therapy in Patients With Hemophilia Having Inhibitors

WOS: 000321308000006PubMed ID: 22395575Background: Monitoring bypassing agent therapy and observing concordance with clinical hemostasis is crucial in vital hemorrhages and major surgeries in patients with hemophilia having inhibitor. Objective: We aimed to investigate the value of the thrombin generation assay (TGA) and thromboelastography (TEG) for monitoring hemostasis in patients with hemophilia having inhibitor, during supplementation therapy with bypassing agents. Patients and Methods: The study group consisted of 7 patients with hemophilia having factor VIII inhibitor. All patients were male. The median age of the participants was 10 years. Age range was 6 to 32 years. The median inhibitor level was 10 Bethesda units (BU), with a range of 5 to 32 BU. A total of 17 bleeding episodes were evaluated. Both TEG and TGA tests were assessed in addition to clinical responses. Assessments were made prior to bypass agent therapy such as recombinant factor VIIa (rFVIIa) or activated prothrombin complex concentrate (aPCC) for bleeding episodes, during the first hour and 24 hours after either intervention in patients. Results: No relation between clinical response and TGA or TEG parameters was found in patients. There was no difference between clinical responses after rFVIIa and aPCC treatments. However, after aPCC treatment, endogenous thrombin potential and peak thrombin levels and also TEG R, K, and alpha angle degrees were significantly higher. Conclusions: In conclusion, we found that the clinical effectiveness of bypass therapy in hemophilia cannot be assessed by TGA and TEG