Interleukin-8 and tumor necrosis factor-α levels in vitreous samples from patients with diabetic retinopathy

AIM: To measure the interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)levels in vitreous samples obtained the patients undergoing pars plana vitrectomy(PPV)due to diabetic retinopathy(DR), then to compare these results with those of the control group and to state their impact on DR pathogenesis.<p>METHODS: From Istanbul Bilim University Ophthalmology Department, 57 eyes of 57 diabetes mellitus(DM)patients who had been diagnosed with proliferative diabetic retinopathy and 22 cases of macular hole, with no proliferative vitreoretinopathy were included in the study as the study and the control groups respectively. All of the 79 patients underwent a 3-port, 20 gauge PPV. Vitreous samples of 0.5mL were aspirated with vitrector at the beginning of the PPV operation before the intraocular infusion and being diluted. Samples were transferred to the freezer to be stored at -70℃. Results of IL-8 and TNF-α were calculated as pg/mL with ELISA method.<p>RESULTS: IL-8 levels 〖82.7891±74.08700(0.08- 307.09)pg/mL〗 in which vitreous samples obtained DR patients during vitrectomy were significantly elevated when compared to IL-8 levels 〖2.9805±3.77546(0.08-18.53)pg/mL〗 of control patients(<i>P</i><0.001). Similarly, TNF-α level 〖18.0007±13.90015(2.32-51.11)pg/mL〗 was also significantly elevated in DR patients when compared to control patients' TNF-α level 〖1.7005±1.26949(0.1- 5.17)pg/mL〗(<i>P</i><0.001). <p>CONCLUSION: The levels of TNF- α, which plays a role in retinal neovascularization, and, IL-8, which acts as an inflammatory and angiogenic mediator were found to be high in DR patients

Acute effect of phosphodiesterase type 5 inhibitor on serum oxidative status and prolidase activities in men with erectile dysfunction

OBJECTIVES: To investigate the acute effect of phosphodiesterase type 5 (PDE5) inhibitor on erectile dysfunction by evaluating serum oxidative status and prolidase activity. METHODS: Serum samples of 36 patients with erectile dysfunction and 30 control cases were analyzed for total antioxidant status, total oxidant status, and prolidase activity, before and after the administration of tadalafil citrate. RESULTS: Before and after tadalafil citrate administration, serum total antioxidant status, total oxidant status, and prolidase were 1.1+0.0 vs. 1.6 + 0.0 umol H2O2 Eq/L, 10.3+1.1 vs. 6.9 + 1.2 umol H2O2 Eq/L, and 236.4+19.5 vs. 228.2 + 19.2 U/L, respectively (

THE EFFICIENCY OF SUCTION DRAIN USAGE IN ARTHROSCOPIC KNEE SURGERY

Aim:The study was designed to investigate the efficiency of suction drain after arthroscopic knee surgery. It is hypothesized that suction drain decreases postoperative hemarthrosis after arthroscopic knee surgery. Methods: Patients were randomized into two groups. Suction drain was used in Group I and no drain was used in Group II. The groups were compared in terms of rest and activity pain, range of motion, Lysholm and International Knee Documentation Committee (IKDC) scores, patellar shock, need for postoperative knee puncture, amount of drainage, time of hospitalization, and loss of labor. Arthroscopic interventions like meniscectomy, synovectomy, meniscus repair and microfracture were also compared for the amount of patellar shock, need for postoperative knee puncture and amount of drainage. Results: The difference for activity pain and range of motion between the two groups was statistically nonsignificant. Rest pain improved faster in control group. Lysholm and IKDC scores were improved in both groups but the amount of increase was statistically nonsignificant. The amount of patellar shock was also statistically nonsignificant between the two groups. The amount of patellar shock, need for postoperative knee puncture and amount of drainage were also statistically nonsignifiant for arthroscopic interventions like meniscectomy and synovectomy. Conclusions: Suction drain application was unnecessary in many situations after arthroscopic knee surgery in this study. Although suction drain usage delayed the recovery from postoperative pain in this study, other parameters of pain were not affected from suction drain usage. Routine usage of a suction drain after arthroscopic knee surgery was not recommended

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Rib Tuberculosis Treatment By Steel Greft which has Fractured after a Thoracic Trauma: 10-year Follow up Case

Rib tuberculosis is an uncommon form of osteoarticular tuberculosis. The physical and radiological examination can often mimic other conditions ,including primary and metastatic chest wall tumors . A 60 year-old male patient had a mass in the chest wall. Surgery aiming diagnosis and treatment based on physical and radiological findings were performed. Histopathological examination of the mass specimen revealed tuberculosis. The chest wall defect was supported with a stell greft after the six month . The patient had fallen from stairs and hit his chest six year after . The case had a significant fracture in the steel graft . This is unusual manifestation of chest wall grefts . This, chest wall, showing a softer steel materials should be used in grafts that would break a long-term follow-up is presented [Cukurova Med J 2013; 38(2.000): 295-298

The Significance of Video-Mediastinoscopy in Diagnostic Accuracy

Purpose: Video-mediastinoscopy, which has been recently employed, is a method for the diagnosis of mediastinal diseases and staging lung cancer. Material and Method: In our study, we retrospectively evaluated patients admitted to our clinic between 2008-2011 to determine the diagnostic success of video-mediastinoscopy. Results: A total of 58 (88%) cases out of 66 were diagnosed. Lymphadenopathy was not observed in 2 cases. Sarcoidosis was the most common type of mediastinal pathology seen in 28 (67%) cases. Tuberculous lymphadenitis was the second most common seen in 11 (27%) cases. Eight (5.3%) cases had anthrocosis, and 12 cases had reactive lymphadenitis. N3 counterpart staging was performed. Two of them were found to be positive. N2 found to be positive in 4 cases. These findings were correlated with PET scan. Mortality was not observed in any of the patients. Repeated mediastinoscopy for investigating N3 in one patient leads to disappearance of temporary hoarseness after about 2 months, which occurred due to paralysis recurrens. One patient had cervical subcutaneous emphysema, and one had major bleeding. Conclusion: Video-mediastinoscopy is a highly effective tool and important in finalizing the diagnosis. Moreover, it is reliable for the complete secure exploration of the mass, which we believe that it could be used in all patients required especially those with thoracic and mediastinal pathologies. [Cukurova Med J 2013; 38(4.000): 719-722

Emergency Management of Thoracic Injuries

Thoracic trauma is responsible for 20 to 25% of trauma related deaths. Motor vehicle accident is the most common cause of thoracic injuries. Chest or thoracic injuries are the second most common injuries (just after head injuries) causing death after traffic accidents,. Thoracic injuries may present itself from simple rib fractures through to intrathoracic organ injuries. As with any trauma in thoracic trauma, effective transport of patient as soon as possible and performing very simple intervention in the accident location are quite important for saving lives of the patients. In 70% of cases thoracic trauma affects chest wall, followed in order by the lungs, heart, diaphragm and the aorta. Since hypoxia causes serious damages to the lungs, early precautions will ensure delivery of adequate amount of oxygen to the tissues. Early diagnosis and and management of thoracic trauma would help us to apply appropriate treatment strategies and prevent complications [Archives Medical Review Journal 2013; 22(1.000): 110-129