The protective effect of letrozole in a rat ovarian ischemia-reperfusion injury model

INTRODUCTION: Torsion of the ovary is a surgical emergency. Future fertility is an important question for choosing the most appropriate treatment strategy as radical or conservative. Conservative treatment includes detorsion of the twisted ovary and after detorsion, the ischemic injury in ovary increases with reperfusion. During the detorsion process, abundant amounts of reactive oxygen species (ROS) are produced. ROS causes cellular injury by attacking cellular membranes through the peroxidation of polyunsaturated fatty acids and causing cellular death. Letrozole is a nonsteroid aromatase inhibitor that blocks estrogen production in all tissues, increases gonadotropin secretion and induces follicular development. METHODS: In this study, rats are divided into 5 groups including 8 rats in each group; control group, ischemia group, ischemia and letrozole group, ischemia-reperfusion group, ischemia-reperfusion and letrozole group. For each group Malondialdehyde (MDA) levels were measured, degree of ischemia and number of follicles were recorded by histopathological examination. Endometrial thicknesses were also measured. RESULTS: In the ischemia and ischemia-reperfusion groups, MDA levels and grade of ischemia were significantly decreased with letrozole. Ovarian follicle numbers were higher and endometrial thickness was lower in the letrozole used groups. DISCUSSION AND CONCLUSION: Letrozole can be protective on ovarian ischemia-reperfusion injury and this effect will be related to hypoestrogenic environment by inhibition of aromatase activity, antiinflammatory effects and increased blood flow to the ovary by letrozole

Effects of esmolol on hemodynamic responses to endotracheal intubation

Amaç: Çalısmamızın amacı laringoskopi ve endotrakeal entübasyona yanıt olarak olusan tasikardi ve hipertansiyonu baskılamada, bir beta bloker olan esmolol'ün etkilerini arastırmaktır. Gereç ve yöntem: Çalısma prospektif, randomize, tek kör olarak düzenlendi,ASAI-II, 20-50 yas arası 60 olgu 2 gruba ayrılarak yapıldı. Grup Esmolol'e (Grup E) esmolol (Brevibloc®) 1.5 mg/kg, Grup Kontrol'e (Grup K)%5 dekstroz 5 cc, laringoskopi ve entübasyondan 2 dakika önce I.V bolus verildi. Preoperatif, indüksiyondan sonra, entübasyonun ardından ve 1., 3., 5., 7., 10. dakikalarda kalp atımhızı (KAH), ortalama arter basıncı (OAB) ve hız basınç ürünü (RPP) degerleri kaydedildi. Bulgular: Grup K'da KAH bazal degeri ile karsılastırıldıgında; indüksiyondan sonra ,5., 7., 10. dk'da anlamlı düsme, entübasyondan sonra ise anlamlı yükselme, Grup E'de ise; indüksiyondan sonra, 3., 5., 7., 10. dk'da anlamlı düsme saptandı (P<0.05). Grup K'da OAB bazal degeri ile karsılastırıldıgında; indüksiyondan sonra, 5., 7., 10. dk'da anlamlı düsme, entübasyondan sonra ve 1. dk'da anlamlı yükselme, Grup E'de indüksiyondan sonra ve 3., 5., 7., 10. dk'da anlamlı düsme, entübasyondan sonra ise anlamlı yükselme saptandı (P<0.05). Grup K'da RPP bazal degeri ile karsılastırıldıgında; indüksiyondan sonra, 5., 7., 10. dk'da anlamlı düsme, entübasyondan sonra ve 1. dakikada ise anlamlı yükselme, Grup E'de ise; indüksiyondan sonra ve 3., 5., 7., 10., dk'da anlamlı düsme saptandı (P<0.05). Gruplar arasında Grup E'de indüksiyondan ve entübasyondan hemen sonra ve 1. dakikadaKAHve RPPbakımından anlamlı düsmegözlendi (P<0.05). Sonuç: Çalısmamızda esmololün bu dozda laringoskopi ve endotrakeal entübasyon sırasında olusan tasikardi ve RPP'yi baskılamada etkili, hipertansiyonu baskılamada yetersiz oldugunu gözlemledik.Objective: To evaluate the efficacy of esmolol in modifying hemodynamic response to laryngoscopy and endotracheal intubation. Materials and methods: ASA I-II 60 subjects, aged between 20-50 years, were included in this prospective, randomized and single-blind study. Patients were divided into two groups. Group Esmolol(Group E) and Group Control (Group C) received IV bolus of esmolol 1.5 mg/kg and %5 dextrose 5 cc respectively, 2 minutes before laryngoscopy and intubation. We recorded heart rates (HR), mean arterial pressures (MAP), and rate pressure products (RPP) preoperatively, after induction and intubation and in 1st, 3rd, 5th, 7th, and 10th minutes after intubation. Results: In Group C, HR decreased after induction in 5th, 7th, and 10th minutes, whereas it increased after intubation. In Group E, HR decreased after induction, in 3rd, 5th, 7th, and 10th minutes (P<0.05). In Group C, MAP decreased after induction, in 5th, 7th, and 10th minutes, while it increased after intubation and in the first minute. In Group E, MAPdecreased after induction, in 3rd, 5th, 7th, and 10th minutes, but increased after intubation (P<0.05). In Group C, RPP decreased after induction, at 5th, 7th, and 10th minutes, however it increased in the first minute. In Group E, RPP decreased after induction, in 3rd, 5th, 7th, and 10th minutes (P<0.05). When we compared the two groups, HR and RPPdecreased in Group E immediately after induction and intubation and in the first minute. Conclusion: This dose of esmolol was effective in controlling the tachycardia and RPP, but it was ineffective in controlling the hypertensive response to laryngoscopy and endotracheal intubation

How high is the inter-observer reproducibility in the LIRADS reporting system?

Purpose: To investigate the reproducibility of LIRADS v2014 and contribute to its widespread use in clinical practice. Material and methods: This retrospective, single-centre study was conducted between January 2010 and October 2015. A total of 132 patients who had dynamic magnetic resonance imaging (MRI)/computed tomography (CT) images in the Picture Archiving and Communication Systems (PACS) with liver nodule were included in the study, 37 of whom had histopathology results. Five radiologists who participated in the study, interpreted liver nodules independently on different PACS stations according to the LIRADS reporting system and its main parameters. Results: We determined that level of inter-observer agreement in the LR-1, LR-5, and LR-5V categories was higher than in the LR-2, LR-3, and LR-4 categories (κ = 0.522, 0.442, and 0.600 in the LR-1, LR-5, and LR-5V categories, respectively; κ = 0.082, 0.298, and 0.143 in the LR-2, LR-3, and LR-4 categories, respectively). The parameter that we observed to have the highest level of inter-observer agreement was venous thrombus (κ = 0.600). Conclusions: Our study showed that LIRADS achieves an acceptable inter-observer reproducibility in terms of clinical practice although it is insufficient at intermediate risk levels. We think that the prevalence of its use will be further increased with training related to the subject and the assignment of numerical values that express the probability of malignancy for each category and including the ancillary features in the algorithm according to clearer rules

Evaluation of efficacy of caudal analgesia on pediatric surgery

Amaç: Retrospektif olarak, hastanemizde 2006 yılının Ocak-Haziran ayları arasında, pediatrik cerrahide inguinal, ürogenital ve rektal bölgede elektif cerrahi operasyon geçirmis 125 olguda genel anestezi indüksiyonu sonrasında yapılan kaudal blogun, intraoperatif, postoperatif dönemde analjezik etkinligini ve komplikasyonlarını degerlendirmeyi amaçladık. Gereç ve yöntem: Retrospektif olarak pediatrik cerrahide elektif cerrahi operesyon geçirmis kaudal blok uygulanmıs hasta dosyalarında yer alan anestezi izlem, anestezi derlenme odası hasta takip ve hemsire gözlem formları incelenerek, demografik veriler, operasyon türü, indüksiyon ve idamede uygulanan anestezik ajanlar, anestezi sekli, kaudal blokta uygulanan lokal anestezigin türü, miktarı, konsantrasyonu; intraoperatif, postoperatif dönemde uygulanan analjezik ihtiyaçları ile verilme zamanları ve komplikasyonlar kaydedilmistir. Bulgular: Yas ortalamaları 41.57±38.55, yas aralıgı 1-132 ay olup, cinsiyet 118 erkek (%94.4) ve 7 kız (%5.6), vücut agırlıkları ortalama 14.60±7.81 kg olarak bulundu. Kaudal blokla %0.25 bupivakainden 1ml/kg uygulanan hastaların anestezi süreleri ortalama 61.50±42.07 dak. olarak bulunmustur. Intraoperatif dönemde herhangi bir analjezik yapılmamıs olup postoperatif analjezi süreleri ortalama 412.88±163.13 dak. olarak saptanmıstır. Postoperatif dönemde herhangi bir komplikasyon bildirilmemistir. Sonuç: Kaudal blok pediatrik cerrahide inguinal, ürogenital, rektal bölgede yapılan operasyonlarda intraoperatif ve postoperatif dönemde analjezi saglamada etkili bir yöntem oldugunu gözlemledik.Objective: We aimed to retrospectively evaluate analgesic effect and complications in intraoperative and post operative periods of caudal block performed after induction of general anesthesia in 125 pediatric patients who underwent elective surgical operations on the inguinal, urogenital and rectal regions in 2006. Material and Methods: Data were collected from anesthesia monitoring forms, recovery room monitoring forms and nursing monitoring forms about demographics, types of operations, anesthetic agents used for induction and maintenance of anesthesia, types of anesthesia, types, doses and concentrations of local anesthetics used for caudal block, analgesics given in intraoperative and postoperative periods, time of analgesic administration and complications. Results: The patients were aged 1-132 months, with a mean of 41.57±38.55 months. Out of 125 patients, 118 (94.4%) were male and 7 (5.6%) female with a mean weight of 14.60±7.81 kg. Duration of anesthesia was 61.50±42.07 min in patients administered 0.25% bubivacain for caudal block. No analgesics were administered during operation and mean duration of analgesia in the postoperative period was 412.88±163.13 min. No complications were noted in the postoperative period. Conclusion: It can be concluded that caudal block decreases the need for general anesthesia in the intraoperative period and provides effective analgesia in the postoperative period in operations on the inguinal, urogenital and rectal regions

Evaluation of the effects of remifentanyl and alfentanyl on spirometric parameters in endotracheal intubations

Amaç: Çalısmamızın amacı remifentanil ve alfentanil kullanılan hastalarda endotrakeal entübasyona yanıt olarak olusan solunumsal degisikliklerin etkilerini spirometrik olarak arastırmaktır. Gereç ve yöntem: Çalısma retrospektif olarak hasta dosyalarındaki anestezi takip fisleri taranarak, genel anestezi altında opere olan 18-60 yas arası 40 olgu seçilerek 2 esit grup olusturularak gerçeklestirildi. Remifentanil (Ultiva®,) grubunda (Grup R) remifentanil; entübasyondan önce 1 µg/kg IVbolus, entübasyondan sonra 0.25 g/kg/dak. infüzyonla, alfentanil (Rapifen®) grubunda (Grup A) alfentanil; entübasyondan önce 20 g/kg IV bolus ve entübasyondan sonra 1 µg/kg/dak infüzyonla uygulanmıs. Ilaç verildikten sonra, entübasyondan hemen önce ve sonra, intraoperatif 5., 10. dakikalarda spirometreyle pik inspiratuvar basınç (PIP), plato basıncı (Pplato), havayolu direnci (Raw), akciger kompliyans (C) degerleri kaydedilmistir. Bulgular: Gruplar arasında pik inspiratuar basınç, plato basıncı, kompliyans degerleri arasında anlamlı fark saptanmazken; havayolu direnci bazal degerleri arasında alfentanil grubunda daha düsük olmak üzere istatiksel olarak anlamlı fark saptandı (P<0.05). Çalısmamızda remifentanil ve alfentanilin endotrakeal entübasyonda spirometrik parametreler; pik inspiratuar basınç, plato basıncı, havayolu direnci, kompliyans degerleri üzerinde anlamlı fark olusturmadıgı saptanmıstır. Sonuç: Remifentanil ve alfentanilin elektif cerrahi uygulanan vakalarda solunumsal yan etkilere yol açmaksızın genel anestezi uygulamalarında güvenle kullanılabilecegini gözlemledik.Objective: The aim of this study was to evaluate respiratory changes on spirometry which occur in response to endotracheal intubations in patients receiving remifentanyl and alfentanyl. Materials and methods: This is a retrospective study. Spirometric data were derived from anaesthesia monitoring forms in patient files. The study included 40 patients aged between 18 and 60 years. They were assigned into two groups i.e. Group remifentanyl (R) (n=20) and Group alfentanyl (A) (n=20). Group R received intravenous bolus 1 µg/kg remifentanyl before intubations and 0.25 µg/kg/min remifentanyl after intubations and Group A received IV bolus 20 µg/kg alfentanyl before intubations and 1 µg/kg/min alfentanyl after intubations. Peak inspiratory pressure (PIP), plateau pressure (Pplateau), airway resistance (Raw) and pulmonary compliance (C) measured just before and soon after Remifentanyl and Alfentanyl were given and in the intraoperative fifth and tenth minutes were obtained. Results: There was no significant difference in peak inspiratory pressure, plateau pressure and pulmonary compliance between the groups, but the difference in baseline airway resistance between the groups was significant (P<0.05). In fact, Group A had a lower airway resistance at baseline. Also, there was no significant difference between remifentanyl and alfentanyl in the spirometric parameters of peak inspiratory pressure, plateau pressure, airway resistance and pulmonary compliance upon endotracheal intubations. Conclusion: It can be concluded that remifentanyl and alfentanyl do not cause respiratory side-effects in patients who undergo elective operations and can be administered safely for general anesthesia

The evaluation of Pat-Pat related injuries in the western black sea region of Turkey

BACKGROUND: Accidents caused by motorized vehicle in the agricultural sector are frequently observed. In Turkey; accidents arising from motorized vehicles, named Pat-Pat, which are used by farmers in the Western Black Sea region is not unusual. METHODS: One hundred five patients who were brought into the Emergency Department of Duzce University, Medical Faculty Hospital between September 2009 and August 2010 due to Pat-Pat related accidents were evaluated. RESULTS: The cases consisted of 73 (69.5%) males and 32 (30.5%) females, ranging from 2 to 73 years of age. In the 10-39 age group, a total of 63 (60.0%) cases were determined. The months when the greatest rate of cases applied to the hospital consisted of July, August, September and the season is summer. The cases were exposed to trauma in roads in 54 (51.4%), and 51 (48.6%) occurred in agricultural area without roads. Eighty seven (82.9%) cases were injured due to the overturning of vehicle. The patients were brought to the hospital using a private vehicle in 54 (51.4%) of the cases and in 51 (48.6%) cases, 112 ambulance system was used. The cases were determined to apply to the hospital most frequently between 6 pm-12 am. The injuries frequently consisted of head-neck and spine traumas, thorax traumas and upper extremity traumas. In 55 (52.4%) cases, open wound-laceration was determined. Seventy five (71.4%) cases were treated in the Emergency Department, and 28 (26.7%) were hospitalized. Three (2.9%) cases were deceased. CONCLUSIONS: Serious injuries can occur in Pat-Pat related accidents, and careful systematic physical examination should be conducted. In order to prevent these accidents, education of farm operators and engineering studies on the mechanics and safety of these vehicles should be taken and legal regulations should be created

Bıologıcal resıstance of acetylated spruce partıcleboards agaınst to brown rot fungı (coniophora puteana)

Çürütücü mantarlara karşı oduna oldukça iyi koruma ve biyolojik dayanım sağlayan asetillendirme teknolojisinin etkinliğini yongalevhada gözlemleyebilmek amacıyla yürütülen çalışmada, yaklaşık %15 ve %20 ağırlık kazanç değerleri verecek şekilde 1 ve 3 saat boyunca asetillendirilen ladin yongalevhaları EN 113 standardına uygun olarak esmer çürüklük mantarının saldırısına (Coniophora puteana) maruz bırakılmıştır. Çalışmada, asetillendirilmiş levhalar ile asetillendirilmemiş kontrol levhalarının biyolojik dayanım performansları karşılaştırılmıştır. Asetillendirme işleminin yongalevhaları esmer çürüklük mantarlarına karşı büyük ölçüde koruduğu gözlenmiştir. Özellikle 3 saat uygulanan asetillendirme işlemi yoğun mantar tahribatına karşı oldukça düşük ağırlık kaybı değerleri vererek iyi bir performans sergilemiştir.In this study, it was aimed to see the superior properties of acetylation technology which protects the wood against to wood destroying organisms perfectly, on particleboards. Therefore, particleboards made from 1 and 3 hour acetylated particles and gave approximately 15% and 20% weight percent gain, exposed to brown rot fungi Coniophora puteana according to procedures defined in EN 113 standard. Biological resistance of acetylated and untreated (control) boards were compared. The acetylated boards demonstrated increased durability against brown rot fungi. Especially 3 hour acetic anhydride treatment reduced the weight losses more significantly than others and showed greater biological resistance

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

İklim Değişikliğinin Önlenmesine Yönelik Umut Ölçeği%253A Türkçeye Uyarlama Çalışması

Bu çalışmada, Li ve Monroe (2018) tarafından geliştirilen İklim Değişikliğinin Önlenmesine Yönelik Umut Ölçeğinin (İDÖUÖ) Türkçeye uyarlanması amaçlanmıştır. Araştırma, 453 üniversite öğrencisinden oluşan üç ayrı çalışma grubu üzerinde yürütülmüştür. Dilsel eşdeğerlik çalışmasında ölçeğin Türkçe ve İngilizce formundan alınan puanlar arasında pozitif yönlü yüksek korelasyonlar saptanmıştır. İDÖUÖnün Türkçe formunun yapı geçerliği açımlayıcı faktör analizi (AFA) ile birinci ve ikinci düzey doğrulayıcı faktör analizi (DFA) uygulanarak test edilmiştir. AFAda ölçeğin üç boyutlu orijinal formuyla örtüşen ve toplam varyansın %2551.37sini açıklayan bir yapı elde edilmiştir. Birinci düzey DFAda ölçeğin orijinal formundaki üç boyutlu yapının Türk kültürü için de geçerli olduğu belirlenmiştir. İkinci düzey DFA sonucunda ise iklim değişikliğinin önlenmesine yönelik umudun%253B bireysel alandaki isteklilik ve çözüm yolları bulma inancı, toplumsal alandaki isteklilik ve çözüm yolları bulma inancı ile isteksizlik ve çözüm yolu bulmada inançsızlık boyutlarıyla ölçülebileceği tespit edilmiştir. İDÖUÖ ile toplanan ölçümlerin güvenirliğini incelemek için Cronbach alfa ve bileşik güvenirlik katsayıları hesaplanmıştır. Alt ölçeklerdeki madde sayıları dikkate alındığında, hesaplanan güvenirlik değerlerinin ölçümlerin güvenirliğine kanıt oluşturabileceği sonucuna varılmıştır. Madde analizi sonuçları, madde korelasyonlarının İDÖUÖdeki tüm maddeler için .30 eşik değerini aştığını göstermiştir. Araştırmaya ilişkin bu sonuçlar, ölçeğin Türkçe formunun geçerli ve güvenilir ölçümler ürettiğini yansıtmaktadır