Scheduling surgery after transarterial embolization: does timing make any difference to intraoperative blood loss for renal cell carcinoma bone metastases?

PURPOSEOur purpose is to clarify the optimal timing of surgery after transarterial embolization (TAE) for renal cell carcinoma (RCC) bone metastases.METHODSThis retrospective study included 41 patients with RCC bone metastases embolized between 2013 and 2019. Different-sized particulate and/or liquid embolic agents were used for TAE. Embolizations were categorized into groups 1–3 according to the interval between TAE and surgery (group 1: 3 days). Degree of embolization after TAE was graded visually based on angiographic images (90%). The relationship between the TAE–surgery interval and intraoperative blood loss (IBL) and the correlation between IBL and embolization grade were examined. Lesion sizes and the relationships among lesion localizations and contrast media usage, intervention time, and IBL were also analyzed.RESULTSForty-six pre-operative TAEs (single lesion at each session) were performed in this study (26 in group 1, 13 in group 2, 7 in group 3). Lesion sizes and distributions were similar between groups (p = 0.897); >75% devascularization was achieved in 40 (TAEs 86.96%), but the IBL showed no correlation with the embolization rate (r=0.032, p = 0.831). The TAE–surgery interval was 1–7 days. The median IBL in group 1 (750 mL; range, 150–3000 mL) was significantly lower than those in the other groups (p = 0.002). Contrast media usage (p = 0.482) and intervention times (p = 0.261) were similar for metastases at different localizations. IBL values after TAE were lower for extremity metastases (p = 0.003).CONCLUSIONBone metastases of RCC are well-vascularized, and to achieve lowest IBL values, surgery should preferably be performed <1 day after TAE

Does Ozone Administration Have a Protective Effect Against Cisplatininduced Histological Changes in Rat Testis?

Objective:We investigated the protective and therapeutic effects of ozone therapy (OT) on cisplatin (CP)-induced testicular damage.Materials and Methods:Thirty healthy adult male Wistar rats were divided into five groups consisting of 6 animals each: 1) control, 2) CP, 3) OT, 4) OT + CP and 5) CP + OT groups. Histopathological findings, Johnsen scores, thiobarbituric acid-reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), catalase, and GSH peroxidase (GPx) levels were evaluated.Results:CP caused a significant decrease in testicular weight and Johnsen score compared to the control group. In addition, TBARS level was significantly higher, whereas GSH, SOD, catalase and GPx levels were significantly lower in the CP group when compared to the control group. Pre- and post-CP OT significantly increased GSH, SOD, catalase and GPx levels and decreased TBARS level. Also, testicular weight and Johnsen score were increased with OT.Conclusion:The present study showed that OT is protective against CP-induced testicular damage. OT may be beneficial to patients who underwent CP chemotherapy

Türkiye’de nonvalvüler atriyum fibrilasyonlu hastalarda vitamin K antagonisti ve yeni oral antikoagülan kullanımı uygulamalarını değerlendirmek için epidemiyolojik çalışma - AFTER*-2 çalışması dizaynı

Amaç: Atriyum fibrilasyonu (AF) önlenebilir iskemik inmenin en sık nedenlerinden biri olup artmış kardiyovasküler morbidite ve mortaliteyle ilişkilidir. Ülkemizde yeni oral antikoagülan kullanım sıklığı, vitamin K antagonisti kullanan hastalarda Uluslararası Düzeltme Oranı’nın (INR) etkin düzeyde kalma oranı ve AF tedavi yönetimi ile ilgili büyük bir çalışma mevcut değildir. Bu çok merkezli çalışmada amacımız nonvalvüler AF hastalarında epidemiyolojik verilerin analizi, takibi ve değerlendirilmesidir. Çalışma planı: Kırk iki merkezden elektrokardiyografisinde en az bir defa AF atağı tespit edilmiş ardışık 4100 erişkin hasta çalışmaya alınacaktır. Romatizmal mitral darlığı ve protez kapak hastalığı olan AF hastaları çalışmaya alınmayacaktır. Hastalar birinci yılın sonunda majör kardiyak sonlanım noktaları (ölüm, geçici iskemik atak, inme, sistemik tromboembolizm, majör kanama ve hastane yatışı) açısından değerlendirilecektir. Bulgular: İlk sonuçlar Haziran 2015 yılında bekleniyor. Majör kardiyak sonlanım noktaları açısından veriler Ocak 2016’da elde edilecektir. Sonuç: AFTER-2 çalışması ile ülkemizdeki non-valvüler AF hastalarının oral antikoagülan tedavi kullanım sıklığı ve çeşidi, varfarin alan hastalarda etkin INR düzeylerinde kalma oranı ve benimsenen tedavi yönetimi belirlenecektir. Ayrıca, ülkemizde AF’li hastalarda majör istenmeyen olay sıklığı ve bu olayların bağımsız belirteçleri de ortaya çıkarılacaktır (AFTER-2 Study ClinicalTrials.gov number, NCT02354456). Anahtar Kelimeler: Antikoagülan ilaç; atriyum fibrilasyonu/epidemiyoloji; ilaç kullanımı; elektrokardiyografi; uluslararası düzeltme oranı; varfarin.Objectives: Atrial fibrillation (AF) is one of the most common causes opreventable ischemic stroke and is related to increased cardiovasculamorbidity and mortality. There is a lack of data in Turkey on the use onew oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modalityIn this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adulpatients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, strokesystemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about majocardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 studyIn addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.)