The Effects of Remote Ischemic Preconditioning On Pulmonary Ischemia-Reperfusion Injury on a Rat Model

Ischemia and reperfusion of a tissue or a viscera can induce a protectiveeffect such as development of preconditioning on the other tissues which haveanother source of arterial blood flow. This mechanism of action is known asremote ischemic preconditioning. The objective of this study was to investigatethe effects of preconditioning formed by coronary artery occlusion over thepulmonary ischemia and ischemia-reperfusion injury in a rat model. We usedadult, 30 Sprague-Dawley rats (n=6). There were five experimental groups;Group 1: Control (Sham operated), Group 2: Pulmonary ischemia (30 min),Group 3: Pulmonary ischemia (30 min)-reperfusion (60 min), Group 4:Cardiac ischemic preconditioning followed by pulmonary ischemia (30 min),Group 5: Cardiac ischemic preconditioning followed by pulmonary ischemia(30 min)-reperfusion (60 min). In the end of experimental procedures,histopathological assessments were performed on lung tissue specimens andmalonyldialdehyde and purine nucleotide levels of lung tissue were measuredby High Performance Liquid Chromatography. As a conclusion, cardiacischemic preconditioning can induce a protective effect over the pulmonaryischemia and ischemia-reperfusion injury. It can be suggested that theprotective effect of remote ischemic preconditioning is related with adenosine

Predictive value of maternal serum podocalyxin in the diagnosis of preeclampsia: a prospective case-control study

Objectives: There is a need for markers to facilitate the diagnosis of preeclampsia, one of the most chief causes of maternal and infant mortality. Preeclampsia causes damage to the glomeruli and vascular endothelium in pregnant women. Podocalyxin is a sialoglycoprotein found in both glomeruli and vascular endothelium. In this study, we investigated the levels of podocalyxin in preeclampsia, and studied its potential to predict preeclampsia. Material and methods: Women admitted to the Health Sciences University Derince Training and Research Hospital, Department of Obstetrics and Gynecology between February–November 2018 due to high direct blood and diagnosed with preeclampsia according to the 2013 American College of Obstetricians and Gynecologists criteria were included in the study. The control group consisted of healthy volunteers having similar demographic features ‎(gestational week, gravida, parity, and age) with the preeclampsia group. The main outcome variable was serum podocalyxin levels. Results: ‎The mean (± SD) podocalyxin levels of the study and control groups were 124.15 ± ‎39.63 ng/mL and ‎71.47 ± ‎16.86 ng/mL, respectively (‎t = 7.845‎, ‎p < 0.001‎). Using a cut-off of 91.7123, podocalyxin could predict preeclampsia with 90% sensitivity and 98% specificity. Furthermore, podocalyxin levels were significantly higher than the normotensive participants in both early (‎14‎‎3.81‎ ± ‎5‎‎1.96 ng/mL‎ vs. ‎75.‎‎35 ± ‎1‎‎9.36 ng/mL‎) and late-onset (‎11‎‎0.22 ± ‎1‎‎9.11 ng/mL‎ vs ‎68.‎‎26 ± ‎1‎‎4.13 ng/mL‎) preeclampsia (p < 0.001). Conclusions: Serum podocalyxin levels increase in preeclampsia. We conclude that podocalyxin is a candidate for predicting preeclampsia

Different features of lung involvement in Niemann-Pick disease and Gaucher disease

SummaryBackgroundNiemann-Pick disease (NPD) and Gaucher disease (GD) are well-known lysosomal storage diseases. Respiratory system involvement is an important cause of morbidity and mortality in patients with NPD and GD.ObjectivesWe tried to assess the clinical, radiological, and histological features of GD and NPD patients with lung involvement.MethodsWe reviewed medical history, physical examination, radiological, and histological data of 10 NPD and 7 GD patients.ResultsThe most common respiratory symptoms were recurrent lung infection and dyspnea. Although lung examination results in 6 NPD patients were normal, they had lung involvement; 3 patients were diagnosed as NPD directly via lung biopsy during investigation of recurrent lung infection or interstitial lung disease. All GD patients but 1 had respiratory system symptoms at the time of diagnosis. Hepatopulmonary syndrome was present in 4 GD patients. A ground-glass pattern and atelectasis were 2 important high-resolution computed tomography features in the NPD and GD patients. Flexible bronchoscopy and bronchoalveolar lavage were used for emergency extraction of bronchial casts in 1 NPD patient.ConclusionsLung involvement in NPD and GD patients should be included in the differential diagnosis of interstitial lung disease. Besides interstitial appearance on HRCT, atelectasis related to bronchial cast and bronchiectasis are other radiological findings in these group of patients. Analysis of bronchoalveolar fluid and lung biopsy provide very important clues for diagnosis. Hepatopulmonary syndrome is an important vascular complication observed in GD patients

Cardiac Troponin I, Creatine Phosphokinase and Myoglobine Levels in Preeclampsia

To evaluate minor myocardial injury in preeclamptic pregnancies by serum markers of cardiac troponin-I, creatine phosphokinase and myoglobine. Group I consisted of 45 preeclamptic pregnancies, Group 2 consisted of uncomplicated pregnancies. The groups were compared for maternal age, parity, mean troponin–I, creatine phosphokinase and myoglobine values. Student-t test were used in statistical analyses. Significance was accepted as p<0.05. Cardiac troponin-I levels were statistically significantly higher in preeclamptic pregnancies (0,97 ± 0,11ng/ml) than control groups (0,12 ± 0.09 ng/ml) (p<0.001). No statistically significant difference was found with mean levels of creatine phosphokinase and myoglobin levels between two groups. Higher values of troponin-I’in preeclamptic patients is thought to be a result of myocardial injury and associated with pregnancy-induced hypertension

Effect of multiparity on bone mineral density, evaluated with bone turnover markers

Abstract Objective: Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (five deliveries or more) and nulliparous women in the post-menopausal period. Methods: A total of 91 multiparous (five deliveries or more) and 31 nulliparous postmenopausal women were included in this study. All patients were interviewed on sociodemographic characteristics, gynecologic history, personal habits, levels of physical activity, and life-long intake of calcium. Bone mineral density was measured at lumbar (L1-4) and femoral neck regions with Dexa. Results: The mean age of multiparous women was 58.79 ± 7.85 years, and the mean age of nulliparous women was 55.84 ± 7.51. The femoral BMD was 0.94 ± 0.16 and lumbar BMD 1.01 ± 0.16 in multiparous women, femoral BMD was 0.99 ± 0.16 and lumbar BMD 1.07 ± 0.14 in nulliparous women. There were no statistical differences between the femoral and lumbar T scores and BMD values of the two groups. Lumbar T scores and lumbar BMD showed a decrease with increasing total duration of breast-feeding in multiparous women. The independent risk factors for osteoporosis in the regression analysis of multiparous women were found to be the duration of menopause and body weight of 65 kg and less. Conclusion: There is no difference between the bone mineral densities of multiparous and nulliparous women. Females with lower body-weight and longer duration of menopause should be followed-up more carefully for development of osteoporosis

Evaluation of Oxidative Stress and Using a Novel Automated Method For Measurement of Total Antioxidant Status in Preeclampsia

OBJECTIVE: The purpose of this study was to ev aluate total antioxidant status of preeclampsia with using a more recently developed automated measurement method and measurement of malondialdehy de (MDA) lev els as an oxidativ e stress marker in women with preeclampsia STUDY DESIGN: We perf ormed a case-control study consisting of randomly selected 50 healthy pregnant women and 50 patients diagnosed as preeclampsia. We measured the total plasma antioxidant capacity for all patients and oxidativ e stress was ev aluated with measurement of red blood cell malondialdehyde (MDA) lev els. RESULTS: The serum total antioxidant response (TAR) lev els were lower (1.29±0.33 TAR mmol Trolox eq/L) and the red blood cell malondialdehy de lev els of (MDA) were higher (7.1±0.4 nmol MDA/l) bef ore delivery (P<0.001) and these levels were not diff erent af ter delivery (six weeks later) in preeclampsia than control group (P>0.05). The serum total antioxidant response (TAR) levels significantly increased (1.55±0.49 mmol Trolox eq/L) and the malondialdehyde lev els signif icantly decreased (2.9±0,6 nmol MDA/l) in preeclamptic women af ter deliv ery when compared with the pre deliv ery levels CONCLUSIONS: Our findings suggest that preeclampsia is related with enhanced lipid peroxidation and decreased total antioxidant response before delivery and these parameters may be related at least partly to the pathogenesis of preeclampsia. Decreased lipid peroxidation and increased total antioxidant response after delivery may suggest recov ery of preeclampsia and using a simple, rapid and reliable automated method f acilitates to ev aluate and follow up of the lev els of oxidativ e stress in preeclampsia and this novel method may be used as a routine test in clinical practice while managing preeclampsi

Polypropylene Suture Versus Absorbable Tack Mesh Fixation in Laparoscopic Pectopexy: A Retrospective Study

Backgound: The aim of this study to investigate whether tacker and suture materials used for mesh fixation in the laparoscopic pectopexy would yield significant differences with respect to feasibility, safety, and postoperative outcomes Methods: A total of 26 women who underwent laparoscopic pectopexy between January 2015 and June 2017 at the Kocaeli Derince Education and Research Hospital were retrospectively analyzed. Fourteen patients had the mesh fixation onto the iliopectineal ligaments and vaginal stump with polypropylene suture using intra-corporeal suturing technique and twelve patients had the mesh fixation tacks via the absorbable mesh fixation devices of commercial tack device - Absorbatack™. (Suture group: 14 subjects, tacker group: 12 subjects). Results: Twenty-six patients underwent laparoscopic pectopexy. Tacker group had a significantly shorter duration of operation and time required for placement of mesh than the suture group (P<0.001). The Visual Pain Scale (VAS) score rates at the 6th, 12th, 24th hours did not demonstrate significant differences between the two groups. (P=0.159, P= 0.222, P= 0.215, respectively). The follow- up period in the suture group averaged 16.4±7.3 months and 13.8±4.7 months in the tacker group (P=0.312). Conclusion: Fixation of mesh onto the iliopectineal ligament and vaginal vault via absorbable mesh fixation devices may be a safe, feasible, and time-saving procedure that might be an alternative to polypropylene suture fixation. However, this study displays the initial experiences of "absorbable mesh fixation device" usage in laparoscopic pectopexy. Further prospective comparative studies are necessary to show long term results

Laparoscopic pectopexy: initial experience of single center with a new technique for apical prolapse surgery

ABSTRACT Objective: To share our first experience with laparoscopic pectopexy, a new technique for apical prolapse surgery, and to evaluate the feasibility of this technique. Materials and Methods: Seven patients with apical prolapse underwent surgery with laparoscopic pectopexy. The lateral parts of the iliopectineal ligament were used for a bilateral mesh fixation of the descended structures. The medical records of the patients were reviewed, and the short-term clinical outcomes were analyzed. Results: The laparoscopic pectopexy procedures were successfully performed, without intraoperative and postoperative complications. De novo apical prolapse, de novo urgency, de novo constipation, stress urinary incontinence, anterior and lateral defect cystoceles, and rectoceles did not occur in any of the patients during a 6-month follow-up period. Conclusion: Although laparoscopic sacrocolpopexy has shown excellent anatomical and functional long-term results, laparoscopic pectopexy offers a feasible, safe, and comfortable alternative for apical prolapse surgery. Pectopexy may increase a surgeon's technical perspective for apical prolapse surgery