Antioxidant effects of insulin-like growth factor-I (IGF-I) in rats with advanced liver cirrhosis

BACKGROUND: The exogenous administration of Insulin-like Growth Factor-I (IGF-I) induces hepatoprotective and antifibrogenic actions in experimental liver cirrhosis. To better understand the possible pathways behind the beneficial effect of IGF-I, the aim of this work was to investigate severe parameters involved in oxidative damage in hepatic tissue from cirrhotic animals treated with IGF-I (2 μg. 100 g(-1). day(-1)). Iron and copper play an important role in oxidative mechanisms, producing the deleterious hydroxyl radical (*OH) that peroxides lipid membranes and damages DNA. Myeloperoxidase (MPO) and nitric oxide (NO) are known sources of free radicals and induce reduction of ferritin-Fe(3+ )into free Fe(2+), contributing to oxidative damage. METHODS: Liver cirrhosis was induced by CCl(4 )inhalation in Wistar male rats for 30 weeks. Healthy controls were studied in parallel (n = 10). Fe and Cu were assessed by atomic absoption spectrometry and iron content was also evaluated by Perls' staining. MPO was measured by ELISA and transferrin and ferritin by immunoturbidimetry. iNOS expression was studied by immuno-histochemistry. RESULTS: Liver cirrhosis was histologically proven and ascites was observed in all cirrhotic rats. Compared to controls untreated cirrhotic rats showed increased hepatic levels of iron, ferritin, transferrin (p < 0.01), copper, MPO and iNOS expression (p < 0.01). However, IGF-treatment induced a significant reduction of all these parameters (p < 0.05). CONCLUSION: the hepatoprotective and antifibrogenic effects of IGF-I in cirrhosis are associated with a diminution of the hepatic contents of several factors all of them involved in oxidative damage

Management of Brucella endocarditis: Results of the Gulhane study

PubMedID: 22727531Brucella endocarditis (BE) is a rare but life-threatening complication of human brucellosis. The aim of this study was to investigate the course of BE along with the therapeutic interrelations. A total of 53 patients with BE hospitalised in 19 health institutions between 2006 and 2011 were included in the Gulhane study. Diagnosis of brucellosis was established by either isolation of Brucella sp. or the presence of antibodies, and the definition of endocarditis was made according to Duke's criteria. There were four treatment groups: ceftriaxone combined with oral antibiotics (Group 1); aminoglycosides combined with oral antibiotics (Group 2); oral antibiotic combinations (Group 3); and aminoglycoside plus ceftriaxone combined with an oral antibiotic (Group 4). Involvement rates of the aortic, mitral and tricuspid valves were 49.1%, 43.4% and 5.7%, respectively. Thirty-two patients (60.4%) had an underlying cardiac valvular problem, including previous prosthetic valve replacement (n = 18). Medical treatment was provided to 32 patients (60.4%), whilst concordant medical and surgical approaches were provided to 21 patients (39.6%). Mortality in Group 1 was 15% (3/20), whilst in Group 2 it was 5.3% (1/19). In Group 3, 25.0% (3/12) of the cases died, whereas none of the cases in Group 4 died. In conclusion, mortality increased 47-fold with pericardial effusion and 25-fold due to congestive heart failure that developed after BE. Although mortality was lower in the aminoglycoside-containing arm (Groups 2 and 4), statistical analysis could not be performed owing to the small number of patients. © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved

Hemostatic efficacy of folkloric medicinal plant extract in a rat skin bleeding model

PubMed: 22268820Objective To assess the in vivo hemostatic effect of a folkloric medicinal plant extract. Subjects and Methods Wistar rats were randomized into four groups of seven. Group 1, a control group, received no pretreatment and was irrigated with saline. Group 2 received no pretreatment and was irrigated with the plant extract. Group 3, a control group, received pretreatment with heparin and was irrigated with saline. Group 4 received pretreatment with heparin and was irrigated with the plant extract. A standardized skin-bleeding model was created using full-thickness skin defects on the Wistar rats' dorsal skin. To control bleeding, compressive dressings were placed after inserting 1 mL of the plant extract or saline into the bleeding area. Hemostasis time and amount of nasal bleeding were measured in all groups to compare the treatments without and with the plant extract. Results Without heparin pretreatment, the folkloric medicinal plant extract shortened the hemostasis time by 1.29 minute and reduced the amount of bleeding by 0.63 g. With heparin pretreatment, the plant extract shortened the hemostasis time by 2.29 minutes and reduced the amount of bleeding by 0.70 g. Conclusion The medicinal plant extract irrigation was more effective than saline irrigation for treating hemorrhagic skin defects in animals using a compressive dressing with or without heparin pretreatment. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

Methods: A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.Background: Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.Results: A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.Conclusions: The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole

Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control

Introduction: Although the methods used in thoracic surgery have been developing rapidly over the last five decades, postoperative pulmonary complications are seen in this field more than in other surgical branches. We aimed at comparing the acute effects of incentive spirometry (IS) and breathing retraining exercises by a respiratory physiotherapist or experienced physiotherapist.Methods: Patients were randomized into two groups as spirometry and physiotherapist. Combined respiratory exercises were implemented through IS inspirometry group and by a physiotherapist in physiotherapist group. Blood gas, respiratory function tests, survey results of the Burford pain thermometer, discharge days, and cost analyses of both groups were examined just before the beginning of physiotherapy and on the 3rd day of therapy.Results: There were no statistical difference in first and last values of pH and PCO2 and also there were no difference between groups (P &gt; 0.05). Forced expiratory volume one second (FEV1) values are statistically increased compared to basal levels in both groups and mean difference in FEV1 values was statistically increased in physiotherapist group compared to spirometry group (P &lt; 0.001). Forced vital capacity (FVC), PO2 and SaO2 values are statistically increased compared to basal levels in both groups but mean difference in FVC values was not statistically different between groups (P &gt; 0.05). Cost analysis was not statistically different, mean hospitalization day and mean pain score were statistically decreased in physiotherapist group.Conclusions: Based on the outcome of this study, respiratory physiotherapy methods carried out by a respiratory physiotherapist are more effective in acute cardiothoracic conditions after thoracotomy compared to IS by patients.Keywords: Incentive spirometry, postoperative complications, respiratory physiotherap

The characteristics of patients with chronic hepatitis B in Turkey

Aim To evaluate the characteristics of patients with hepatitis B virus (HBV) infection and summarize the treatment modalities. Methods By September 30, 2011 the data of 7871 HBsAg (+) patients were complied and analysed according to demographic and medical records (age, sex, laboratory tests, treatment with antiviral agents) in thirty centres of Turkey. Results Of the 7871 patients 3078 (39.1%) were females; mean (standard deviation) age was 35 (14) years, 3180 (40.4%) were HBsAg positive (+) after admission to a hospital, 1488 (18.9%) after blood donation and 967 (11.9%) were found during routine screening. The HBV prevalence among relatives of HBsAg (+) patients was 1764 (22.4%), and most frequently infected family members were siblings and mothers, 4961 (63.0%) and 2149 (27.3%), respectively). Anti-HDV was negative in 7407 94.1% of patients. Three-fourths of the patients 6383 (81.1%) were HBeAg negative (-). Mean (SD) ALT was 85.8 (266.4) U/L. Majority of patients, 5588 (71.0%) were chronic hepatitis-B patients under treatment, while 2283 (29.0%) were asymptomatic carriers without treatment and only 165 (2.1%) of patients were cirrhotic and 6612 (84.0%) of those were compensated. One-third of the patients 2983 (37.9%) were under a combined treatment, while others were under monotherapy. Lamivudine, entecavir and adefovir were the most frequently used oral therapies, used for 2583 (32.8%), 11.6% and 787 (10.0%) of patients, respectively), while 2975 (37.8%) of patients were under interferon treatment. Conclusion Hepatitis B is still a problem in our country. First task of the physicians and our state should be to prevent the development and spread of the disease with education and vaccination programs, safe blood transfusions, and control of barbers

West nile virus infection in the Mesopotamia region, Syria border of Turkey.

We described the serological prevalence of West Nile Virus (WNV) antibodies among the human population in a historical and strategic region of Turkey. A serologic survey was conducted based on suspected cases in April, 2009, in the Mesopotamia region of Turkey, in the villages that were located alongside the Zergan River. All the sera were tested by enzyme-linked immunosorbent assay ELISA (Euroimmune™), and the positive samples were tested by immunofluorescent assay (IFA; Euroimmune™). As confirmation, neutralizing antibodies against WNV were tested by microneutralization assay (MNTA). In total, 307 individuals were included. The MNTA test was found to be positive among 52 individuals out of 307 (17\%). In multivariate analysis, age >50 [odds ratio (OR)=5.2, confidence interval (CI) 2.76-9.97, p<0.001) and being in an occupational risk group (OR=2.02, CI 1.02-4.04, p=0.044) were found to be the risk factors for WNV seropositivity with the MNTA test. The physicians in the region should be aware of the risk of WNV infection and should be alerted to detect the clinical cases