Plasma levels of interleukin-10 and nitric oxide in response to two different desflurane anesthesia flow rates

OBJECTIVE: This study investigated interleukin-10 and nitric oxide plasma levels following surgery to determine whether there is a correlation between these two variables and if different desflurane anesthesia flow rates influence nitric oxide and interleukin-10 concentrations in circulation. MATERIALS AND METHODS: Forty patients between 18 and 70 years and ASA I-II physical status who were scheduled to undergo thyroidectomy were enrolled in the study. INTERVENTIONS: Patients were allocated into two groups to receive two different desflurane anesthesia flow rates: high flow (Group HF) and low flow (Group LF). MEASUREMENTS: Blood samples were drawn at the beginning (t 0) and end (t 1) of the operation and after 24 h (t 2). Plasma interleukin-10 and nitric oxide levels were measured using an enzyme-linked-immunosorbent assay and a Griess reagents kit, respectively. Hemodynamic and respiratory parameters were assessed. RESULTS: There was no statistically significant difference between the two groups with regard to interleukin-10 levels at the times of measurement. Interleukin-10 levels were increased equally in both groups at times t 1 and t 2 compared with preoperative concentrations. For both groups, nitric oxide circulating concentrations were significantly reduced at times t 1 and t 2 compared with preoperative concentrations. However, the nitric oxide value was lower for Group HF compared to Group LF at t 2. No correlation was found between the IL-10 and nitric oxide levels. CONCLUSION: Clinical usage of two different flow anesthesia forms with desflurane may increase interleukin-10 levels both in Group HF and Group LF; nitric oxide levels circulating concentrations were significantly reduced at times t 1 and t 2 compared with preoperative concentrations; however, at 24 h postoperatively they were higher in Group LF compared to Group HF. No correlation was detected between interleukin-10 and nitric oxide levels

Evaluation of Consultations Requested from Patients Admitted to the Emergency Department

Aim: This study was aimed to conduct an investigation towards evaluation of the efficiency of the consultation system that is in place in the emergency service of our hospital and identification and correction of deficiencies in this system. Materials and Methods: Patients who were admitted to the emergency department and for whom requesting a consultation were required for any reason were included in the study. Forms were filled out by the emergency research assistants. Patients whose data was incomplete and consents could not be obtained were excluded from the study.Results: A total of 213 patients were included in the study, and a total of 315 consultations were requested. The total number of consultations requested by the internal medicine departments was 126, and the total number of consultations requested by the trauma (surgery) departments was 189. Of the 213 patients, 104 (48.8%) were hospitalized and 109 (51.2%) were discharged. The average number of consultations of 213 patients was 1.5±0.7, the average length of stay of the patients in the emergency service was 366.7±312.9 min. and the mean age of the patients was 41±24 years. The average seniority of the consultant physicians in a total of 315 consultations performed was 26.8±10.6 months, and the average consultation response time of the consultant physicians was 62.2±67.8 min. Conclusion: Because of the changing healthcare system in our country, the consultation services, particularly in university hospitals, should be re-structuredAim: This study was aimed to conduct an investigation towards evaluation of the efficiency of the consultation system that is in place in the emergency service of our hospital and identification and correction of deficiencies in this system. Materials and Methods: Patients who were admitted to the emergency department and for whom requesting a consultation were required for any reason were included in the study. Forms were filled out by the emergency research assistants. Patients whose data was incomplete and consents could not be obtained were excluded from the study.Results: A total of 213 patients were included in the study, and a total of 315 consultations were requested. The total number of consultations requested by the internal medicine departments was 126, and the total number of consultations requested by the trauma (surgery) departments was 189. Of the 213 patients, 104 (48.8%) were hospitalized and 109 (51.2%) were discharged. The average number of consultations of 213 patients was 1.5±0.7, the average length of stay of the patients in the emergency service was 366.7±312.9 min. and the mean age of the patients was 41±24 years. The average seniority of the consultant physicians in a total of 315 consultations performed was 26.8±10.6 months, and the average consultation response time of the consultant physicians was 62.2±67.8 min. Conclusion: Because of the changing healthcare system in our country, the consultation services, particularly in university hospitals, should be re-structure

Sığır ve koyunlardan izole edilen escherichia coli suşlarında verotoxin üretimi ve antibiyotiklerde direnç durumu

Özet: Bu çalışmada, sığır ve koyun dışkısından izole edilen toplam 306 Escherichia coli susunun 10 antibiyotiğe direnç durumu ve bu suşlardan 130'unun verotoxin üretimi ve hemoliz özelliği araştırılmıştır. E. coli suşlarında tespit edilen antibiyotik direnç oranları sırasıyla; tetrasiklin % 51,6, streptomisin % 24,2, ampisilin % 13,1, amoksisilin-klavulanik asit % 5,2, gentamisin % 4,6, siprofloksasin % 4,6 ve trimetoprim-sulfametaksazol % 4,3, sefotaxim % 0,7 olup sefepim ve seftazidim'e dirençli suş saptanmamıştır. Test edilen antibiyotikler arasında sadece streptomisin direncinin sığır suşlarında koyun suşlarından yüksek olduğu tespit edilmiştir (P 0,043). Sığır suşları cinsiyete ve yaşa göre değerlendirildiğinde dişi sığırlarda tetrasiklin ve streptomisin direncinin erkek sığırlara göre yüksek olduğu, ayrıca 2 yaş ve altındaki sığırlarda 3 yaşın üzerindeki sığırlara göre tetrasiklin direncinin anlamlı oranda yüksek olduğu görülmüştür. Sığırlardan izole edilen suşlardan dört tanesinin (% 2,2) VTEC O"157 serotipine ait olduğu, bu suşların test edilen antibiyotiklere duyarlı olduğu ve VTEC non-0157 serotipinin izolasyon oranının % 14,5 olduğu görüldü.E. colisuşlarında yerotoxin üretimi % 36,9 olup, koyun suşlannda bu oran % 61,1 ve sığır suşlarında % 19,7'dir. Koyunlardan izole edilen suşlarda verotoxin üretiminin sığırlardan izole edilen suşlardan anlamlı düzeyde yüksek olduğu görülmüştür (P 0,001). Sığır suşlarında verotoxin üretimiyle antibiyotik direnci arasında bir ilişki tespit edilememiş olmasına rağmen koyun suşlannda ampisilin ve streptomisin direnci verotoxin salgılamayan suşlarda verotoxin salgılayan suşlara göre yüksek bulunmuştur (sırasıyla P 0,048 ve P 0,009). . E. co//suşlannda en sık rastlanan .hemoliz tipinin gamma hemoliz (% 46,2) olduğu, ampisilin ve amoksisilin-klavulanik asit direncinin hemoliz oluşturan suşlarda hemoliz oluşturmayan suşlardan anlamlı oranda yüksek olduğu tespit edilmiştir. Sonuç olarak, verotoxin salgılayan E. coli suşları açısından koyunların sığırlara göre daha fazla risk teşkil ettiği ayrıca insan enfeksiyonlarının tedavisinde de kullanılan tetrasiklin ve streptomisin gibi antibiyotiklere direnç oranlarının yüksek düzeyde bulunduğu ve bu direncin özellikle verotoksijenik türlerde de yüksek düzeyde bulunması antibiyotik seçiminde daha titiz davranılması gereğini ortaya koymuştur.Abstract: In this study, 130 Escherichia coli strains isolated from 306 cattle and sheep fecal samples were studied for their resistance to 10 antibiotics, verotoxin production, and hemolyzation. The antibiotic resistance rates of the E. coli strains were as follows: tetracycline, 51.6%; streptomycin, 24.2%; ampicillin, 13.1%; amoxicillin/clavulanic acid, 5.2%; gentamycin, 4.6%; ciprofloxacin, 4.6%; trimethoprim-sulfamethoxazole, 4.3%; cefotaxime, 0.7%. None of the strains were resistant to cefepime or ceftazidime. Of all the antibiotics tested, only resistance to streptomycin was higher in the strains isolated from cattle than in the sheep strains (P 0.043). The evaluation of the cattle strains, based on gender and age, indicated that the resistance to tetracycline and streptomycin was higher in the female cattle than in male cattle, whereas in cattle under 2 years of age resistance to tetracycline was significantly higher than in 3-year-old cattle. Among the cattle strains there were 4 (2.2%) of the VTEC 0157 serotype. All were sensitive to the antibiotics tested, and the isolation rate of VTEC non-0157 serotypes was 14.5%. The overall verotoxin production rate of the E. constrains was 36.9%, while it was 61.1% in sheep strains and 19.7% in cattle strains. Verotoxin production in sheep strains was significantly higher than in cattle strains (P < 0.001). No correlation was detected between verotoxin production in the cattle strains and antibiotic resistance; however, resistance to ampicillin and streptomycin in the sheep strains that did not produce verotoxin was higher than that observed in the sheep strains that did (P 0.048 and P 0.009, respectively). The most common hemolysis type in the isolated E. coli strains was gamma hemolysis (46.2%). Ampicillin and amoxicillin/clavulanic acid resistance was significantly higher in the strains that hemolyzed than in the strains that did not. . In conclusion, sheep carry higher risks of verotoxin produced by E. coli strains than cattle do. Furthermore, due to higher resistance rates to such antibiotics as tetracycline and streptomycin, careful antibiotic selection for infections, particularly those caused by verotoxigenic E. coli, is of extreme importance

The Timing of Granulocyte Colony-Stimulating Factor in Hematopoietic Stem Cell Transplant in the Pandemic

Granulocyte-colony stimulating factors (G-CSF) are used to shorten the duration of neutropenia after hematopoietic cell transplantation (HCT). However, there is no consensus on which days treatment should be started post-transplantation during the COVID-19 pandemic. In this study, we looked at the influence of G-CSF on clinical outcomes on the fifth (G-CSFd5) and tenth (G-CSFd10) days following allo-HCT. Our study includes the data of 60 patients (G-CSFd5, n=28 vs G-CSFd10, n=32) who underwent HCT with the diagnosis of acute lymphoblastic leukemia (ALL) between 2015 and 2022. Primary outcome is the effect of G-CSF on hospital stay. Secondary outcomes are the development and duration of febrile neutropenia (FEN), neutrophil engraftment (NE), platelet engraftment (PE), engra ftment syndrome (ES), acute graft versus host disease (aGVHD), cytomegalovirus (CMV) viremia, and effects on antimicrobial use . Length of hospital stay, 34.5 days vs. 30 days (p=0.19); median NE, 13.85 vs 15.03 days (p=0.007); median PE, 15.5 vs 12 days (p =0.12); ES, 28.5% vs 12.5% (p=0.12); FEN, 85.7% vs 84.3% (p=0.88); aGVHD, 39.2% vs 40.6% (p=0.92); were observed for G-CSFd5 and G-CSFd10, respectively. Although starting G-CSF in the early period after allo-HCT shortened the duration of NE, positive effects on clinical outcomes were not observed. On the contrary, the frequency of ES increased in the group that received GCSF early

The effect of pre-conditioning immunoglobulin and absolute lymphocyte count on the outcomes of allogeneic hematopoietic cell transplantation

Introduction: The prevention of mortality and morbidity related to the increasingly used allogeneic hematopoietic cell transplantation (allo-HCT), along with the effects of pre- and post-transplant immune status on transplant outcomes, have become the focus of the studies conducted on this subject in recent years. In parallel, this study was designed to investigate the effects of pre-conditioning immunoglobulin (pre-conditioning-Ig) and pre-conditioning absolute lymphocyte count (pre-conditioning-ALC) levels on transplant outcomes. Methods: This study was designed as a retrospective, observational and cross-sectional study. The objective of the study is to investigate the effects of pre-conditioning-Ig and ALC levels primarily on the rate of patients with febrile neutropenia (FEN) and the duration of FEN and length of hospital stay (LoS), and secondarily on acute graft-versus-host disease (aGVHD), cytomegalovirus (CMV) viremia, and mortality in the acute leukemia patients who underwent allo-HCT. Results: A total of 104 acute leukemia patients, of whom 55 had acute lymphoblastic leukemia (ALL) and 49 had acute myeloid leukemia (AML), were included in the study. Compared to the AML group, the median pre-conditioning-IgG, IgA, and IgM levels were found to be significantly lower in the ALL group (11.3 vs. 6.6, p < 0.001; 1.8 vs. 0.9, p < 0.001; and 0.7 vs. 0.4, p < 0.001; respectively). But, there was no significant difference between the groups in pre-conditioning-Ig and ALC levels and transplant outcomes. However, subgroup analysis revealed that high pre-conditioning-ALC levels were significantly correlated with aGVHD levels (Odds Ratio: 1.02; p = 0.034) and low pre-conditioning-IgM levels were significantly correlated with increased mortality rate (Hazard Ratio: 0.08; p = 0.042) in AML patients. Conclusion: The significant difference determined between the ALL and AML groups in pre-conditioning-Ig levels was not reflected on the effects of pre-conditioning-Ig and ALC levels on transplant outcomes. However, we observed that pre-conditioning-IgM and ALC levels have an impact on transplant outcomes in AML patients