The effects of streptozotocin-induced diabetes on ghrelin expression in rat testis: biochemical and immunohistochemical study

Introduction. Ghrelin is a hormone which has effects on the secretion of growth hormone, gastrointestinal system, cardiovascular system, cell proliferation and reproductive system. The present study we focused on the relation between ghrelin and GHS-R1a gene expression and the regulation of their expression in the testes of diabetic rats. Material and methods. 40 male Wistar albino rats were divided into four groups: control, and sampled 4, 8 and 12 weeks after induction of diabetes by streptozotocin (STZ) intraperitoneal injection (40 mg/kg). The rats were decapitated under ketamine anesthesia and their testes were removed. Blood was obtained from heart and serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were measured by ELISA. Tissue ghrelin and GHS-R mRNA levels were determined by qRT-PCR, while ghrelin protein expression was studied by immunohistochemistry. Histopathological damage scores were also assessed. Results. Eight weeks after diabetes induction serum FSH level was increased, whereas LH and testosterone concentrations decreased. The ghrelin and GHS-R1a gene expression and ghrelin immunohistochemistry score first tended to increase after first four weeks of diabetes, and then tended to decrease. Ghrelin-immunopositive cells were detected in Leydig cells in all groups of rats, however, not in the germinal epithelium. Congestion of vessels and hemorrhage, formation of the vacuoles in spermatogonia and spermatocytes, desquamation of spermatids in the lumen and disorganization of seminiferous tubule germinal epithelium were observed in testis of all the diabetic rats. In addition, mean testicular biopsy score and mean seminiferous tubule diameter were getting lower in diabetic animals. Conclusion. Our results suggest that diabetes affects ghrelin expression in rat testis.

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Examining Relationships Between Father Involvement of Fathers Who Have Children in Adolescence and Their Levels of Spousal Support

The main purpose of this study was to examine the relationship between father involvement and spousal support. The participants of this study were 129 father-child pairs. The mean age of fathers was 45.43 years (SD = 5.92), and the mean age of children was 14.91 years (SD = 0.63). The fathers completed the personal information form and Spouse Support Scale, while children completed the Father Involvement Scale. Analyses revealed positive, significant relationships between father involvement and spousal support. Results of the present study were consistent with related research in the literature

Turkish Adaptation Of the Maternal Gatekeeping Scale

Bu çalışmanın amacı, çocuklarının babalarına erişimini kısıtlayan anneleri değerlendirebilmek için Fagan ve Barnett (2003) tarafından geliştirilen Annelik Bekçiliği Ölçeği'nin (ABÖ) Türkçe'ye uyarlanmasıdır. Orijinal çalışmanın katılımcıları, 3-16 yaş aralığında en az bir çocuğu olan, çocuğu annesiyle ya da hem annesi hem de babasıyla birlikte yaşayan ailelerdeki annelerden oluşmaktadır. Bu çalışmanın katılımcıları ise, lise birinci ya da ikinci sınıfa devam eden 136 çocuğun babasıdır. Katılımcıların yaş ortalaması 45.5'tir (SS=5.9). Çalışmanın geçerlik ve güvenirlik analizleri, uyarlanan Annelik Bekçiliği Ölçeği'nin (ABÖ) yeterli düzeyde psikometrik özelliklere sahip olduğunu göstermektedir. Katılımcıların ABÖ puan ortalamaları, bazı demografik değişkenlere göre de (anne-baba eğitim düzeyi, ekonomik durum, anne-baba çalışma biçimi, çocuk cinsiyeti, anne yaşı) incelenmiştirThe purpose of the present study was to make the adaptation of the Maternal Gatekeeping Scale for use in Turkey, which was developed by Fagan and Barnett (2003) to assess that mothers restricting access of their children to the fathers. The participants of the original study had at least one child who was between the ages of 3 and 16 years living with the mother or with the mother and father. But the participants of this study are 136 fathers who have first or second grade high school children. Participant’s mean of age was 45.5 (SD=5.9). The validity and reliability analyses in this study showed that adaptation of Maternal Gatekeeping Scale has sufficient level of psychometric properties. Participants’ mean of Maternal Gatekeeping Scale scores were also investigated according to some demographic characteristics (parents’ educational level, economic condition, parents’ way of work, sex of children, age of mother

Effects o follicular fluid oxidative status on human mural granulosa cells, oocyte competency and ICSI parameters

Purpose: The aim of the present study was to understand the molecular and genetic alterations involved in follicular fluid oxidative process by investigating human mural granulosa cells and to find possible biomarkers for oocyte competency and ICSI outcome measures.Methods: A total of 166 patients were included in the study. Total antioxidant and oxidant levels of follicular fluids were measured on the day of oocyte pick-up and oxidative status were calculated. Expression profiles of three potential target proteins in cases of oxidative stress (Hsp70, Tgf-beta, Notch1), DNA status and chromatin integrity of mural granulosa cells were analyzed.Results: TAS levels were positively correlated with the Hsp70 and Tgf-beta expression patterns of mural granulosa cells. Mature oocyte rate and fertilization rates were affected negatively by the presence of oxidative stress and a significant positive correlation was found with the oxidative status and the fertilization rate, whereas no correlation with the remaining ICSI parameters in the overall group.Conclusions: Oxidative stress detected in follicular fluid adversely affects fertilization rates post-ICSI however no effect on the remaining parameters including embryo quality, pregnancy, and implantation rates. DNA damage, chromatin integrity were increased, whereas Hsp70 and Tgf-ss were decreased in mural granulosa cells in cases of oxidative stress which may indirectly reflect the oocyte competency and may be used as biomarkers for ICSI outcome measures

ORTAOKUL ÖĞRENCİLERİNE YÖNELİK 21 YÜZYIL BECERİLERİ YETERLİK ALGISI ÖLÇEĞİ: GEÇERLİK VE GÜVENİLİRLİK ÇALIŞMASI

Bu çalışmanın amacı ortaokul öğrencilerine yönelik 21. yüzyıl becerileri yeterliliklerini belirleyen ölçek geliştirmektir. İlgili araştırmada geliştirilen ölçeğin geçerlik ve güvenirlik kanıtlarını elde etmek amacıyla nicel araştırma yöntemlerinden tarama modeli kullanılmıştır. Ulaşılabilir durum örneklemesi kullanılarak seçilen örneklem grubu 400 ortaokul öğrencisinden oluşmaktadır. Ölçeğin geliştirilmesi sürecinde ilk olarak alan yazın taranarak 47 madden oluşan madde havuzu oluşturulmuştur. Ölçeğin kapsam geçerliliğini sağlamak amacıyla uzman görüşleri alınmıştır. Uzman görüşü sonucunda taslak ölçek 40 maddeden oluşmaktadır. Geliştirilen ölçek beşli Likert tipindedir. Ölçeğin yapı geçerliliğine kanıt sağlamak amacıyla açımlayıcı ve doğrulayıcı faktör analizleri yapılmıştır. Farklı örneklemler üzerinden yapılan açımlayıcı ve doğrulayıcı faktör analizi sonucunda 34 madde 6 faktörlü bir ölçek elde edilmiştir. Ölçekte bulunan faktörler; “iletişim”, “bilgi okuryazarlığı”, “Eleştirel düşünme ve yaratıcılık”, “yaratıcı düşünme ve yenilik”, “bilgi teknoloji okuryazarlığı” ve “liderlik ve sorumluluk becerileri” şeklindedir. 34 madden oluşan ölçeğin genel güvenirliğini hesaplamak için Cronbach's Alpha katsayısı 0.92 olarak hesaplanmıştır. Araştırmacılara önerimiz farklı örneklemler üzerinde bu ölçeğin geçerlik-güvenirlik kanıtlarının elde edilmesi şeklindedir.</jats:p