Surgery-Induced Changes in Erythrocyte and Plasma Lipid Peroxidation, Enzymatic and Non-Enzymatic Antioxidants of Female Rats: Protective Role of Heparin and Pentoxifylline

Background: Intra abdominal adhesions are a complication that occurs after many abdominal surgical procedures, especially gynecological operations. These complications occur by irritating the peritoneum due to such circumstances as infection or surgical trauma, and are considered a pathological part of the healing process of peritoneal injury. It manifests itself with symptoms such as pain, intestinal or urethral obstruction and abdominal abscesses. Oxidative stress due to adhesions plays an important role on adhesion formation. In addition to many researches done at the point of prevention of adhesion and decreasing stress parameters, in this study, it was planned to determine the effect of Heparin (H) and Pentoxifylline (PTX) on malondialdehyde (MDA) and some antioxidant values.Materials, Methods & Results: This study was performed on rats and thirty-seven female Sprague-Dawley rats were randomized into four groups. The first group was sham (Sh) group (n = 7) and laparotomy was performed and 2 mL of 0.9 % NaCl was applied. For all other rats (n = 30) the small intestine was withdrawn and the uterus was uncovered and the anti mesenteric surfaces of the left uterine horn and left abdominal wall were superficially tilted until slight bleeding was seen. Lesion areas have been covered. Two mL 0.9 % NaCl to control (C) group (n = 10), 500 IU heparin to group H, and 25 mg / kg Pentoxifylline to group PTX (n = 10) have been given and then the abdominal incision was closed. The adhesion score of group Sh was found to be more important than C and PTX groups (P < 0.05). The adhesion score of group C was determined to be more significant than group H (P < 0.05). In group Sh, erythrocyte reduced glutathione (GSH) levels were found to be more significant (P < 0.01) than C, H and PTX groups whereas it was found that group C was more significant than group H (P < 0.01). In group Sh, glutathione peroxidase (GSH-Px) activity was found to be more significant (P < 0.05) than H and PTX groups, while MDA level was found to be lower and more significant (P < 0.01) than group C. In addition, group C was found to be higher and more significant (P < 0.01) than group H. Plasma vitamin E levels in Sh, H and PTX groups were found to be higher and more significant (P < 0.01) than group C. It is also observed that MDA levels in group C are higher and more significant (P < 0.01) than all groups. Nitric oxide (NO) level in Sh group was found to be lower and more significant (P < 0.05) than the other groups whereas it is determined that NO level in H group is higher and more significant (P < 0.05) than group C. Activites of erythrocyte catalase (CAT) and superoxide dismutase (SOD), the levels of plasma vitamin A and β-carotene were not important in all groups.Discussion: Intra abdominal adhesions that occur due to operations performed in the abdominal region still remain as a major problem. This adhesion brings certain problems with itself. Various applications have been made to reduce these problems. In this study, it was observed that inhibition of heparin and pentoxifylline adhesions contributed to the reduction of MDA levels and the reduction of oxidative damage due to the increase in levels of Vitamin E, GSH, GSH-Px and NO levels. In conclusion, it is suggested that heparin and pentoxifylline should be used to prevent adhesions due to abdominal operations and to reduce oxidative damage

Efficacy of vitamin E and selenium for the prevention of intra-abdominal adhesions in rats: uterine horn models

OBJECTIVE: This study compares the efficacies of vitamin E and selenium, both individually and in combination, for the prevention of postoperative intra-abdominal adhesions in rats. METHODS: Forty-seven female rats were divided into five groups. The sham animals (S group, n = 7) were given only laparotomies and intraperitoneally received 0.9% NaCl (2 ml). In the 40 other rats, abrasions of the left uterine horn were performed, followed by intraperitoneal administration of either 2 ml 0.9% NaCl (C group), 10 mg vitamin E (vitamin E group), 0.2 mg/kg selenium (Se group) or 10 mg vitamin E with 0.2 mg/kg selenium (vitamin E + Se group), with 10 animals in each treatment group. RESULTS: Adhesion formation was significantly reduced in animals in the Se and vitamin E + Se groups (p<0.05). Tissue catalase and glutathione peroxidase activities did not significantly differ between the groups. However, catalase and glutathione peroxidase activities and reduced glutathione levels were slightly increased in the vitamin E, Se and vitamin E + Se groups. In the vitamin E group, malondialdehyde concentrations were significantly lower than in the C group (p<0.05), but no significant differences were present among the S, C, Se and vitamin E + Se groups. Levels of nitric oxide were significantly higher in the C group than in the other groups (p<0.01). CONCLUSION: Intraperitoneal administration of selenium or combined vitamin E and selenium appears to be effective in preventing intra-abdominal adhesion formation in rat models through the reduction of lipid peroxidation products

Wpływ rodności na kształt fali przepływu Dopplera w pierwszym trymestrze pojedynczej ciąży niskiego ryzyka

Objectives: The aim of the study was to evaluate the effect of parity on uteroplacental blood flow during the first trimester in low-risk singleton pregnancies. Materials and methods: Uterine artery Doppler examinations were performed in 190 singleton pregnancies between 11-14 gestational weeks. Twenty-five pregnancies were excluded from the study due to history of preeclampsia, diabetes mellitus or inherited thrombophilia. A total of 165 low-risk singleton pregnancies were included in the study. Mean uterine artery pulsatility index (PI) was recorded and compared between nulliparous and multiparous women. The relation between maternal age, gestational week, maternal weight, parity, biochemical markers and abnormal uterine artery Doppler flows was evaluated. T-test and logistic regression analyses were used for the statistical analysis. Results: A total of 165 singleton pregnancies without any risk factors for uteroplacental insufficiency were included in the study. Of them, 58 (36.7%) were nulliparous and 107 (63.3%) were parous. Correlation analysis revealed that the uterine artery pulsatility indices during the first trimester were not affected by maternal age and parity. Conclusions: Mean uterine artery pulsatility indices are not different in nulliparous and multiparous low risk pregnancies at 11-14 weeks of gestation.Cel: Celem badania była ocena wpływu rodności na przepływ maciczno-łożyskowy w pierwszym trymestrze pojedynczej ciąży niskiego ryzyka. Materiał i metoda: Przepływ w tętnicy macicznej zbadano w 190 pojedynczych ciążach w 11-14 tygodniu. Z analizy wyłączono 25 ciąż z powodu dodatniego wywiadu w kierunku stanu przedrzucawkowego, cukrzycy lub wrodzonej trombofilii. Ostatecznie do badania włączono 165 pojedynczych ciąż niskiego ryzyka. Zmierzono średni indeks pulsacji w tętnicy macicznej (PI), który porównano pomiędzy nieródkami i wieloródkami. Oceniono również związek pomiędzy wiekiem matki, wiekiem ciążowym, masą matki, liczbą porodów, markerami biochemicznymi a nieprawidłowym przepływem w tętnicach macicznych. T-test i regresji logistycznej zostały wykorzystane do analizy statystycznej. Wyniki: Do badania włączono 165 pojedynczych ciąż bez czynników ryzyka niewydolności maciczno-łożyskowej. Z tej grupy, 58 (36,7%) kobiet było nieródkami a 107 (63,3%) wieloródkami. Analiza statystyczna wykazała brak związku pomiędzy indeksem pulsacji w pierwszym trymestrze ciąży a wiekiem matki i rodnością. Wnioski: Średni indeks pulsacji w tętnicy macicznej nie różni się pomiędzy nieródkami a wieloródkami w ciąży niskiego ryzyka w 11-14 tygodniu

A Very Rare Cause of Shoulder Weakness: Concurrent Traumatic Neuropathies of Accessory, Long Thoracicus, and Suprascapular Nerves

Accessory nerve is one of the most sensitive cranial nerves to injury, and its injuries are usually caused by iatrogenic interventions. As many other causes can mimic its clinical presentation, careful physical examination should be performed while evaluating a patient suspected of accessory neuropathy. In this report, we aimed to illustrate a very rare case with concurrent traumatic cranial neuropathies of accessory nerve, suprascapular nerve, and long thoracicus. A 16-year-old boy was admitted with complaints of shoulder weakness and pain following a trauma of strain injury. He had first taken the misdiagnosis of brachial plexopathy; however, after a detailed physical examination and electrophysiological study, the diagnosis of concurrent traumatic neuropathies of accessory, suprascapular, and long thoracicus nerves was made. In our opinion, during evaluation of these rare traumatic neuropathies, detailed clinical evaluations combined with detailed electromyography investigations may give crucial data for the proper diagnosis

Comparison of analytical performances between clot waveform analysis and FibWave in edoxaban-treated patients and healthy controls

The activated partial thromboplastin time (aPTT) and the prothrombin time (PT) are widely available coagulation parameters which are however poor predictors of the anticoagulant effect of direct oral anticoagulants (DOACs). Some coagulometers use the clot waveform analysis (CWA) to assess the clotting time but mainly based on a unique parameter. The improvement of these methodologies and the evaluation of the other waveform parameters may increase the sensitivity to DOACs. To assess the performance of an improved clot waveform an method (i.e. FibWave) to detect the impact of edoxaban on the coagulation and the fibrinolytic systems. Seventy-one samples from patients treated with edoxaban collected at minimum concentration (C) and/or maximum concentration (C), and 45 control samples were included. The aPTT- and PT-based CWA as well as the FibIn, FibEx, and FibLysis methodologies of the FibWave were implemented and performed on an ACL-TOP 700. PT and FibEx clotting time were strongly correlated to edoxaban concentration (Pearson  = 0.80 and 0.89, respectively). The FibEx clotting time allowed a better discrimination for samples with 30 and 50 ng/ml of edoxaban compared to PT (cutoffs of 96.5 and 114.2 s for the FibEx versus a unique cutoff of 13.1 s for the PT). The fibrinolytic process was impaired in the presence of edoxaban in a dose-dependent manner. FibEx is more sensitive than aPTT- and PT-based CWA for the detection of the clinically relevant anticoagulant level of edoxaban

Burnout in Turkish Adult Neurology Specialists

Aim:Burnout in medical doctors may worse affect patient care or physical performance of clinician. We aimed to investigate the burnout ratio and the factors associated with burnout in Turkish neurology specialists.Materials and Methods:The neurology specialists in Turkey were included in the study. The participants were asked to fill a questionnaire comprised of 33 questions regarding various thoughts and experiences. The participants gave a response to the questions as follows: strongly disagree, slightly agree, moderately agree, strongly agree, completely agree. According to the meaning value of the question (negative or positive meaning), the answer was given a point in a range of 1-5. Sum of points divided by the maximum point (165) gave a burnout ratio.Results:The mean age was 38.78 (±8.42) years, and the female/male ratio was 461/255. The mean burnout ratio was found to be 46.73% (±8.95). Male sex, academic membership, higher academic degree, working in medical faculty hospital, lower salary, being single or nonparent, nightshift, absence of on call work, or working in the intensive care unit were detected to be associated with a higher burnout ratio. Burnout ratio was in positive correlation with age, number of patients examined, and duration of working hours, but in negative correlation with number of auxiliary staff or neurologists in hospital.Conclusion:Our study is the first study to demonstrate a high burnout ratio in a large sample of Turkish adult neurology specialists. Being male, older, academician, professor, single or nonparent, working in medical faculty hospital or in intensive care, low salary, nightshift, and high patient number or working hours seem to be associated with burnout

Prevalence of Subclinical Hypothyroidism among Patients with Acute Myocardial Infarction

Introduction. Subclinical hypothyroidism (SCH) is defined as a serum thyroid-stimulating hormone (TSH) level above the upper limit of normal despite normal levels of serum free thyroxine. There is growing evidence that SCH is associated with increased cardiovascular risk. We tried to investigate prevalence of SCH in acute myocardial infarction patients. Methods and Results. We evaluate free T3, free T4, and TSH levels of 604 patients (age 58.4) retrospectively, who have been admitted to the coronary intensive care unit between years 2004–2009 with the diagnosis of ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI). Mild subclinical hypothyroidism (TSH 4.5 to 9.9 mU/l) was present in 54 (8.94%) participants and severe subclinical hypothyroidism (TSH 10.0 to 19.9 mU/l) in 11 (1.82%). So 65 patients (10.76%) had TSH levels between 4.5 and 20. Conclusions. In conclusion, 65 patients (10.76%) had TSH levels between 4.5 and 20 in our study, and it is a considerable amount. Large-scale studies are needed to clarify the effects of SCH on myocardial infarction both on etiologic and prognostic grounds