Preparation and monitoring of small animals in renal MRI

Renal diseases remain devastating illnesses with unacceptably high rates of mortality and morbidity worldwide. Animal models are essential tools to better understand the pathomechanism of kidney-related illnesses and to develop new, successful therapeutic strategies. Magnetic resonance imaging (MRI) has been actively explored in the last decades for assessing renal function, perfusion, tissue oxygenation as well as the degree of fibrosis and inflammation. This chapter aims to provide an overview of the preparation and monitoring of small animals before, during, and after surgical interventions or MR imaging. Standardization of experimental settings such as body temperature or hydration of animals and minimizing pain and distress are essential for diminishing nonexperimental variables as well as for conducting ethical research.This publication is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers

Fear avoidance beliefs and quality of life quality after lumbar disc surgery

Fear avoidance beliefs (FAB) in low back pain (LBP) are associated with disability and pain. There is no data on how changes in FAB affect disability and other factors after lumbar disc surgery. The aim of this study was to evaluate the effects of lumbar disc surgery on FAB and to investigate whether FAB changes predict changes in emotions, disability, and quality of life after lumbar disc surgery. 106 patients with chronic LBP were evaluated 1 day preoperatively and 3 months postoperatively. Sociodemographic questionnaire, Visual Analog Scale (VAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Fear and Avoidance Beliefs Qquestionnaire (FABQ), Oswestry Disability Index (ODI), and Short form-36 (SF-36) Health Survey Questionnaire were used. The end point ODI, VAS, BDI, BAI, FABQ fear avoidance (work) scores, most of SF-36 the subscale scores were significantly lower than the baseline scores. According to correlation analyses between mean changes in the outcome measures, there was no significant relationship between changes in fear avoidance (physical), fear avoidance (work) and other outcome measures. In conclusion, future research is needed to evaluate the effect of lumbar disc surgery on FAB. [JCBPR 2017; 6(1.000): 1-8

A study on the standard setting, validity, and reliability of a standardized patient performance rating scale – student version

The quality of the performances of standardized patients plays a significant role in the effectiveness of clinical skills education. Therefore, providing standardized patients with constant feedback is essential. It is especially important to get students’ perspectives immediately following their encounters with standardized patients. In the literature, there is no scale for use by students to evaluate the performance of standardized patients. Thus, the three main goals of this study were to: (1) develop a scale for use by students to evaluate the performance of standardized patients, (2) examine the psychometric properties of the scale, and (3) determine a cut-off score for the scale in a standard-setting Seven hundred and two medical students participated in the scale- development process, the pilot test, and the validation process, and seven educators took part in the standard-setting process. After the evaluation of content validity, construct validity was assessed via exploratory and confirmatory factor analyses. For the standard-setting study, the extended Angoff method was used. The exploratory factor analysis revealed that the scale had a single-factor structure, which was confirmed by confirmatory factor analysis. The Cronbach’s alpha internal consistency coefficient was 0.91. The scale consists of nine items. The cut-off score was determined to be 24.11/45, which represents the minimum acceptable standard for standardized patient performance. Our study outlined the critical steps in developing a measurement tool and produced a valid and reliable scale that allows medical students to assess the performance of standardized patients immediately following their interaction with the standardized patient. This scale constitutes an important contribution to the literature as it provides a tool for standardized patient trainers to assess standardized patients’ weaknesses and help them improve their performance.KEY MESSAGESEvaluation of SP performance is essential to ensure the educational quality of clinical skills training programs.Students are the most relevant stakeholders to give feedback about SP performance immediately after encounters.The ‘Standardized Patient Performance Rating Scale – Student Version’ is a valid, reliable scale that can be used by students for the evaluation of standardized patients’ strengths and weaknesses at individual-performance levels quickly. Evaluation of SP performance is essential to ensure the educational quality of clinical skills training programs. Students are the most relevant stakeholders to give feedback about SP performance immediately after encounters. The ‘Standardized Patient Performance Rating Scale – Student Version’ is a valid, reliable scale that can be used by students for the evaluation of standardized patients’ strengths and weaknesses at individual-performance levels quickly.</p

Effects of suture tecnique on mesh shrinkage

Summary: Objective: Polypropylene meshes are one of the most frequently used patches in inguinal hernia repairs. This material was proved to be not completely inert, and may cause inflammatory responses like foreign body reactions. One of the physical results of these inflammatory reactions against the mesh is mesh shrinkage which is responsible for recurrence and pain. In this study, we aimed to investigate the effects of the suture technique on mesh shrinkage. Methods: 36 animals were used for the study. Subjects were divided into 3 groups. In the first group the mesh (onlay) was not fixated by any means. In the second group, mesh was placed on the abdomen wall, after which the mesh was fixated with interrupted suturing. In the third group, continuous suturing was applied after the placement of the mesh. Mesh shrinkage was measured macroscopically, and the mesh site reaction was evaluated microscopically. At the end of the second month, 18 subjects were sacrificed again to conduct the same procedure. Results and Conclusion: When meshes are used for hernia repairs, shrinkage may be observed in meshes placed on fascia. In the first group without mesh fixation, mesh shrinkage was more significant in the second month compared to the first month. The amount of shrinkage of without fixation group was found to significantly differ during the second month from interrupted and continuous suture groups. Even though statistically not significant, fixation of the mesh with interrupted sutures seems to be more advantageous compared to fixation with continuous sutures. Keywords: mesh shrinkage, suture technique, hernia repai

Effects of azelastine nasal spray on nasal and nasopharyngeal microflora

Objective: Azelastine nasal spray is a topical antihistaminic drug for the symptomatic treatment of allergic rhinitis. This study aimed to investigate the effects of azelastine on nasal and nasopharyngeal microflora

Science and economy: The place of Turkey in the world

Aims: We aimed to provide information on world's economic and academic citation and to find the characteristics of overall, medical and particularly general surgical scientific paper production

Comparison of Pilonidal Sinus Repair Techniques: Phenol Application After Minimal Surgical Excision and Flap Repair

Objective: To compare the results of pilonidal sinus repair techniques using crystallized phenol after a minimal excision and flap repair

Impact of ligating gonadal or adrenal collateral veins with the left renal vein on renal function and histology in right-nephrectomized rats

Background: In cases of trauma to the left renal vein (LRV), its ligation near the inferior vena cava (IVC) is considered, but the consequences are not always good. We investigated the role of collateral venous drainage after ligation of the LRV by studying the renal function and histology after ligation of the LRV near the IVC alone or with ligation of the gonadal or adrenal collaterals, in right-nephrectomized (RN) rats

Palonosetron versus ondansetron for prevention of chemotherapy-induced nausea and vomiting in paediatric patients with cancer receiving moderately or highly emetogenic chemotherapy: a randomised, phase 3, double-blind, double-dummy, non-inferiority study.

BACKGROUND: Palonosetron has shown efficacy in the prevention of chemotherapy-induced nausea and vomiting in adults undergoing moderately or highly emetogenic chemotherapy. We assessed the efficacy and safety of palonosetron versus ondansetron in the prevention of chemotherapy-induced nausea and vomiting in paediatric patients. METHODS: In this multicentre, multinational, double-blind, double-dummy, phase 3 study, paediatric patients aged between 0 and younger than 17 years, who were naive or non-naive to chemotherapy, and scheduled to undergo moderately or highly emetogenic chemotherapy for the treatment of malignant disease were randomised centrally (1:1:1) to receive up to four cycles of 10 mug/kg or 20 mug/kg palonosetron on day 1, or three 150 mug/kg doses of ondansetron on day 1, scheduled 4 h apart, according to a static central permuted block randomisation scheme by an interactive web response system. Randomisation was stratified according to age and emetogenicity. Treatment allocation was masked to project team members involved in data collection and analysis, and members of the investigator's team. The primary endpoint was complete response (no vomiting, retching, or use of rescue drugs) during the acute phase (0-24 h post-chemotherapy) of the first on-study chemotherapy cycle, as assessed in the population of randomly assigned patients who received moderately or highly emetogenic chemotherapy and an active study drug. The primary efficacy objective was to show the non-inferiority of palonosetron versus ondansetron during the acute phase (0-24 h post-chemotherapy) of the first on-study chemotherapy cycle through comparison of the difference in the proportions of patients who achieved a complete response with palonosetron (piT) minus ondansetron (piR) versus a preset non-inferiority margin (delta -15%). To be considered as non-inferior to ondansetron, for at least one of the doses of palonosetron, the lower limit of the 97.5% CI for the weighted sum of the differences in complete response rates had to be superior to -15%. Safety was assessed, according to treatment received. This study is registered with ClinicalTrials.gov, number NCT01442376, and has been completed. FINDINGS: Between Sept 12, 2011, and Oct 26, 2012, we randomly assigned 502 patients; 169 were assigned to receive 10 mug/kg palonosetron, 169 to receive 20 mug/kg palonosetron, and 164 to receive 3 x 150 mug/kg ondansetron, of whom 166, 165, and 162, respectively, were included in the efficacy analysis. In the acute phase, complete responses were recorded in 90 (54%) patients in the 10 mug/kg palonosetron group, 98 (59%) in the 20 mug/kg palonosetron group, and 95 (59%) in the ondansetron group. Non-inferiority versus ondansetron was shown for 20 mug/kg palonosetron in the acute phase (weighted sum of the differences in complete response rates 0.36% [97.5% CI -11.7 to 12.4]; p=0.0022). Non-inferiority versus ondansetron was not shown for 10 mug/kg palonosetron in the acute phase (weighted sum of the differences in complete response rates -4.41% [97.5% CI -16.4 to 7.6]). In the first on-study treatment cycle, treatment-emergent adverse events were reported in 134 (80%) of 167 patients who received 10 mug/kg palonosetron, 113 (69%) of 163 who received 20 mug/kg palonosetron, and 134 (82%) of 164 who received ondansetron. The most common drug-related treatment-emergent adverse events were nervous system disorders, mainly headache, which occurred in three (2%) patients who received 10 mug/kg palonosetron, one (<1%) patient who received 20 mug/kg palonosetron, and two (1%) patients who received ondansetron. The incidence of serious adverse events in the first on-study treatment cycle was lower in the 20 mug/kg palonosetron group (43 [26%]) than in the 10 mug/kg palonosetron group (52 [31%]) and the ondansetron group (55 [34%]). INTERPRETATION: Non-inferiority was shown for 20 mug/kg palonosetron during the acute phase of the first on-study chemotherapy cycle. 20 mug/kg palonosetron is now indicated by the European Medicines Agency and the US Food and Drug Administration for the prevention of chemotherapy-induced nausea and vomiting in paediatric patients aged 1 month to younger than 17 years. FUNDING: Helsinn Healthcare