The effects of melatonin and alpha lipoic acid in cisplatin induced ototoxicity

Çalışmamızda ratlarda deneysel olarak CP ile oluşturulan ototoksisiteyi BİUP ile belirlemek ve izlemek, ayrıca ALA ve melatonin gibi antioksidan ajanların kullanımı ile ototoksisitenin azaltılabilir ya da önlenebilir olup olmadığını araştırmayı amaçladık.Çalışma 60 adet Sprague-Dawley cinsi rat üzerinde yapıldı. Her biri 10 rattan oluşan 6 grup oluşturuldu. Kontrol grubuna 8 gün boyunca i.p. 1 mg/kg serum fizyolojik uygulandı. CP grubuna bir kez i.p. 10 mg/kg CP uygulandı. ALA grubuna 8 gün boyunca i.p. 100 mg/kg ALA uygulandı. Melatonin grubuna 8 gün boyunca i.p. 4 mg/kg melatonin uygulandı. CP+ALA grubuna bir kez i.p. 10 mg/kg CP uygulandı ve 8 gün boyunca i.p. 4 mg/kg melatonin uygulandı. CP+Melatonin grubuna bir kez i.p. 10 mg/kg CP uygulandı ve 8 gün boyunca i.p. 4 mg/kg melatonin uygulandı. Tüm gruplarda ilk enjeksiyonlara başlamadan 30 dk. önce ve enjeksiyondan sonra 3., 7. ve 15. günlerde BİUP ölçümü yapıldı.CP uygulanan ratlarda V. dalga latansının CP+Melatonin ve CP+ALA verilen ratlara göre istatistiksel olarak anlamlı derecede farklı olduğu tespit edildi. CP verilen ratlarda CP+Melatonin verilen ratlara göre I-V IpL intervallerinin istatistiksel olarak anlamlı derecede farklı olduğu tespit edilirken, CP+ALA verilen grupla istatistiksel olarak anlamlı fark tespit edilemedi. İşitme eşikleri değerlendirildiğinde sadece CP verilen ratlarda CP+Melatonin verilen ratlara göre eşik değerinin anlamlı derecede yüksek olduğu tespit edildi. Ancak CP verilen ratlarla CP+ALA alanlar arasında istatistiksel olarak anlamlı fark tespit edilmedi.Çalışmamızda CP ototoksisitesini engellemede melatonin ve ALA'nın etkili olduğu bulunmuştur. Ancak hücresel düzeyde olan etkileşimi değerlendirmek amacıyla elektron mikroskobu ile yapılacak ileri çalışmalara ihtiyaç vardır.The aim of study to evaluate whether melatonin and alpha lipoic acid (ALA) can reduce and prevent otoxicity of cisplatin (CP) by using auditory brainstem response (ABR) in the rat.The study group consist of 50 rats and the control group consist of 10 rats. Saline was administered intraperitoneally (i.p.) to control group through 8 days. CP (10 mg/kg, i.p.) was administered to CP group one time. ALA (100 mg/kg, i.p.) was administered to ALA-group and melatonin (4 mg/kg, i.p.) was adminestered to Mel-group through 8 days. CP (10 mg/kg/day, i.p., one day) and melatonin (4 mg/kg/day, i.p., 8 days) were adminestered to CP-Mel group. CP (10 mg/kg/day, i.p., one day) and ALA (100 mg/kg/day, i.p., 8 days) were adminestered to CP-ALA group. ABR were recorded in the each groups 30 minutes before injection and 3., 7. and 15. days after injection.There was significant statistical difference in the latency wave V. between CP group and CP-Mel and CP-ALA groups. Although I-V interpeak latency interval and pure-tone thresholds were significant statistical difference relationship between CP group and CP-Mel group, they were no significant statistical difference relationship between CP group and CP-ALA group.The results supported that melatonin and ALA can prevent from ototoxicity of CP. However, further studies are needed with larger groups by using electron microscope to evaluate cellular interactions

Isolated Congenital Nasal Bifid Septum Separated by a Wide Layer of Soft Tissue

This is an Open Access article distributed under the terms of the Creative Common

Fusarium enfeksiyonu ve nadir mutasyon ilişkili ailesel hemofagositik lenfohistiyozisi olan ölümcül vaka

Background: Hemophagocytic lymphohistiocytosis (HLH) is classified as primary or secondary. While primary (familial)HLH is caused by genetic mutations, secondary (acquired, reactive) HLH is the type that has an underlying cause and is notassociated with genetic mutations.Case Report: We report a two-year-old female patient with a fatal course of Fusarium sepsis who was diagnosed withprimary HLH. A homozygous variant of PRF1 (c.445G &gt; A, p.Gly149Ser) was detected. Hyphal growth was detected onSabouraud dextrose agar and Fusarium multiplied in blood cultures. The patient’s clinical course was fulminant, and she diedof septic shock 4 days after admission to the hospital. Fusarium, a rare infection in HLH, was found in this case.Conclusion: We discovered the rare PRF1 (c.445G&gt;A, p.Gly149Ser) mutation in HLH and the high morbidity and mortality associated with Fusarium infection</p

Acil Servislerdeki Geriatrik Hastaların Epidemiyolojik Özellikleri: Çok Merkezli Çalışma Koşulları

Girifl: Beklenen yaflam süresinin uzamasının sonucu olarak yafllı popülasyondaki artıfl, bu yaflgrubu için daha sık sağlık bakımı verilmesini zorunlu kılmaktadır. Bu çalıflmada acil servise baflvuran 65 yafl ve üzeri hastaların genel özelliklerini, baflvuru nedenlerini, acil servis ve hastane ziyaretlerinin sonuçlarının saptanması amaçlandı. Gereç ve Yöntem: Çok merkezli, prospektif, gözlemsel çalıflma Türkiye'de 13 hastaneninacil servislerinde bir hafta süre ile gerçekleflti. Çalıflma süresi içinde akut tıbbi veya cerrahi sorunlar ile acil servise baflvuran 65 yafl ve üstü hastalar çalıflmaya dahil edildi. Altmıfl befl yafl altı ve/veya travma nedenli baflvurular ise çalıflma kapsamına alınmadı.Bulgular: Ortalama yaflı 74.8±7.3 yıl olan toplam 1299 hasta çalıflmaya dahil edildi. Bu hastalardan %51.9'u (n=674) 65-74 yafl grubundaydı, %67.5'u (n=877) hastaneden taburcu edildive %5.8'i (n=75) yatıfl süreci içinde öldü. Acil serviste en sık konulan tanılar kardiyovasküler, gastrointestinal ve solunum hastalıklarıydı. Hastaneden taburcu olan ve hastane yatıflı sırasında ölenhasta grupları kıyaslandığında yafl açısından istatistiksel olarak anlamlı fark varken (p=0.001), cinsiyet dağılımı (p=0.259), hastane yatıfl süresi (p=0.259) ve yoğun bakım ünitesi yatıfl süresi(p=0.055) açısından fark tespit edilmedi. Sonuç: Yafllı nüfusunun ve genel nüfusa oranının artıflı ile birlikte yafllı hastaların acil servisbaflvuru sayısı artıyor ve gelecekte daha da artacaktır. Bu çalıflma, çalıflma merkezlerine baflvuranyafllı hastaların demografik özelliklerini ve klinik seyirlerinin sonuçlarını ortaya koymaktadır.Introduction: The increasing proportion of elderly individuals in the population due to increased life expectancy has necessitated greater provision of health care. Here we aimed to determine patient characteristics, reasons for referral, and outcomes of emergency department visits and hospitalization in patients aged ?65 years with referrals to emergency departments.Materials and Method: This prospective, multicenter observational study was conductedover one week at the emergency departments of 13 Turkey hospitals. All patients aged ?65 years who were referred to emergency departments with acute medical or surgical issues duringthe study period were included. Patients aged <65 years or those referred for trauma were excluded. Results: In total, 1299 patients with a mean age of 74.8±7.3 years were included. Of these, 51.9% (n=674) were aged 65-74 years, 67.5% (n=877) were discharged from the hospital,and 5.8% (n=75) died during admission. The most frequently diagnosed disorders in the emergency departments were cardiovascular, gastrointestinal, and pulmonary diseases. A significantdifference in age was observed between the survival and non-survival groups (p=0.001), with nosignificant differences in gender distribution (p=0.259), length of stay in intensive care units(p=0.605), or length of stay in hospital (p=0.055).Conclusion: With an increased proportion of elderly individuals in the general population,the number of elderly patients referred to emergency departments continues to increase. Thisstudy presents the demographic features and clinical course of elderly patients referred to study centers

Can Platelet and Leukocyte Indicators Give Us an Idea about Distant Metastasis in Nasopharyngeal Cancer?

This study aimes to evaluate platelet and leucocyte indicators, such as the mean platelet volume, platelet distribution width, plateletcrit, white blood cell count, neutrophil to lymphocyte ratio in nasopharyngeal cancer patients and also to evaluate the relationship between these indicators and nasopharyngeal cancer with distant metastasis. The medical records of 118 patients diagnosed with nasopharyngeal cancer in our hospital between January 2006 and August 2015 were reviewed. The nasopharyngeal cancer group was further sub grouped according to the presence or absence of distant metastasis and TNM (tumour – T, node – N, metastasis – M) classification. A control group consisted of 120 healthy patients. The platelet and leucocyte values at the time of the initial diagnosis were recorded. Neutrophil to lymphocyte ratio and platelet distribution width values were significantly higher in the nasopharyngeal cancer group. But only platelet distribution width values were significantly higher in the nasopharyngeal cancer group with distant metastasis compared to the nasopharyngeal cancer group without distant metastasis. Neutrophil to lymphocyte ratio and platelet distribution width values may increase in nasopharyngeal cancer. But only the platelet distribution width values may give us an idea about the distant metastasis in nasopharyngeal cancer

Effect of methylprednisolone loaded poly lactic-co-glycolic acid (PLGA) bioabsorbable nanofibers on tendon healing and adhesion formation

Background: Nanomaterials have been widely used in many fields such as vaccination and drug delivery. Beside its behavior as a degradable physical barrier, it can provide a controlled drug release. Tendon healing is a process full of complications, one of which is adhesion caused by excessive fibrosis. Aim: In this study, we aimed to prevent adhesion formation by using methylprednisolone (MP) loaded Poly lactic-co-glycolic acid (PLGA) mats. We used PLGA mats as both, biodegradable physical barrier to reduce the contact between surrounding tissues and healing tendon and as a drug delivery vehicle to release the antifibrotic MP with a controlled pattern. Methods: MP-loaded PLGA nanofiber mats were produced using electrospinning technique under optimized parameters. To find the optimal MP dose, the drug was loaded in 15%, 25% and 35% concentrations. In vitro analysis included FT-IR, antibacterial, water absorption, biodegradability and drug release behavior tests. 70 rats' tendons were used for this study. After scarification of the rats, tendons were analyzed in terms of macroscopic, histopathological and biomechanical evaluation. Results: The neat PLGA and 15%, 25%, and 35% MP-loaded nanofibers lost 47%, 83%, 88%, and 97% of their initial weights at the end of the 8 weeks' degradation process. Within the first 24 h, mats including higher drug concentrations showed more initial release burst effect than samples loaded with lower concentrations. Cumulative drug release at 24 h was 29.5%, 27.6%, and 24.7% for PLGA nanofiber samples containing 15%, 25%, 35% MP, respectively. Macroscopically, When the groups were compared, no statistically significant difference was found between group 1 (no surgical intervention) and group 5 (25% MP/PLGA) in terms of length, characteristics and degree of the adhesion. Comparing to other groups statistically significant atrophic effect was found in group 6 (35% MP/PLGA). Conclusion: 25% MP-loaded PLGA reduces the formation of adhesions macroscopically comparable to tendons that didn't receive any surgical intervention. Microscopically, it provides better tendon healing compared to tendons that received only surgical repair or surgery + neat PLGA. Methylprednisolone did not only add an antibacterial effect to PLGA but also increased the hydrophilic property and degradation rate of PLGA. Increased steroid concentration also leads to atrophy at the healing tendons which can be prevented by modifying the PLGA design