Evaluation of the effectiveness of Ampicillin and Lactobacillus casei rhamnosus treatment in cases of preterm premature rupture of membranes remote from term

Objectives: Preterm premature rupture of membranes (PPROM) remote from term is an important obstetric cause of maternal and fetal adverse outcomes. The aim of our study is to examine the efficacy of ampicillin and Lactobacillus casei rhamnosus treatment in cases of PPROM remote from term. Material and methods: The study was carried out by examining the results of cases who were given Ampicillin and Lactobacillus casei rhamnosus treatment. The patients were divided into two groups. Group 1 who didn’t develop clinical chorioamnionitis and Group 2 who developed clinical chorioamnionitis. Obstetric characteristics, neonatal outcomes, adverse events were recorded. Results: A total of 46 pregnant women, 40 in Group 1 and six in Group 2, were included in the study. The frequency of clinical chorioamnionitis developing during the treatment was found to be 13.0%. Mean gestational age at diagnosis was 28.43 ± 2.38 and 28.17 ± 1.33 for Groups 1 and Group 2, respectively. Mean gestational age at the time of delivery was 32.38 ± 2.07 31.33 ± 1.63 for Group 1 and Group 2, respectively. The mean latency period for Group 1 and Group 2 was 27.45 ± 1.71 days, 23.66 ± 4.53, respectively. Sepsis developed in six newborns (15%) in Group 1, while it developed in three newborns (50%) in Group 2. While 90% of the babies in Group 1 were discharged from the hospital, this rate was 66.7% in Group 2. Conclusions: Ampicillin + Lactobacillus casei rhamnosus is an effective treatment method in PPROM cases and positively affects perinatal outcomes

Differential Pulse Voltammetric Determination of Anticancer Drug Regorafenib at a Carbon Paste Electrode: Electrochemical Study and Density Functional Theory Computations

Electrochemical properties of regorafenib (REG) were studied in 0.1 M Britton-Robinson buffer-methanol solutions (3 : 2, v/v) with pH between 3 and 8 at carbon paste electrode by cyclic and differential pulse voltammetry. The results exhibited irreversible anodic peak at about 0.90 V vs. Ag/AgCl, NaCl (3 M). The anodic peak was found to be diffusion-adsorption controlled. Mechanism of REG electrochemical reaction was studied by performing density functional theory computations and mass spectrometric analysis. A validated differential pulse voltammetry (DPV) technique for REG determination was performed. The calibration curve of REG on carbon paste electrode was linear in the concentration range of 0.5-13 mu g/mL and limit of detection was 0.10 mu g/mL. The recommended DPV method was used to detect REG in spiked plasma and urine specimens and average recoveries were 94%

Acute Phosphate Nephropathy

Oral sodium phosphate (OSP) is frequently used in colonoscopy preparation for both cost and ease of use. Acute renal failure may occur due to these OSP-and sodium phosphate-containing enemas used in colonoscopy preparation. A 55-year-old female patient with type 2 diabetes mellitus and essential hypertension, known for 5 years, and normal renal function tests, underwent colonoscopy. For colonoscopy preparation, she used two OSP containing purgatives and sodium phosphate containing enema. The patient presented to the emergency service with a complaint of being unable to urinate 1 day after colonoscopy. Renal biopsy was performed and acute phosphate nephropathy was reported. Chronic renal failure is a contraindication to the use of OSP. Old age, female sex, electrolyte imbalance and inappropriate use of OSP increase the acute phosphate nephropathy risk. Acute phosphate nephropathy should be kept in mind in patients who undergo colonoscopy, use OSP for the preparation, and present with impaired renal function

Acute Phosphate Nephropathy

Oral sodium phosphate (OSP) is frequently used in colonoscopy preparation for both cost and ease of use. Acute renal failure may occur due to these OSP-and sodium phosphate-containing enemas used in colonoscopy preparation. A 55-year-old female patient with type 2 diabetes mellitus and essential hypertension, known for 5 years, and normal renal function tests, underwent colonoscopy. For colonoscopy preparation, she used two OSP containing purgatives and sodium phosphate containing enema. The patient presented to the emergency service with a complaint of being unable to urinate 1 day after colonoscopy. Renal biopsy was performed and acute phosphate nephropathy was reported. Chronic renal failure is a contraindication to the use of OSP. Old age, female sex, electrolyte imbalance and inappropriate use of OSP increase the acute phosphate nephropathy risk. Acute phosphate nephropathy should be kept in mind in patients who undergo colonoscopy, use OSP for the preparation, and present with impaired renal function

PULMONARY EMBOLISM: CARDIOVASCULAR AND PARENCHYMAL CHANGES

WOS: 000435654000009Aim: To investigate the effects and the severity of pulmonary embolism on the cardiovascular system and lung parenchyma. Material and Method: Pulmonary artery (PA) obstruction index ratios were calculated, and cardiovascular and pleuroparenchymal changes were retrospectively assessed in 180 patients with a prediagnosis of PE using computerized tomography pulmonary angiography (CTPA). Results: Main PA, right PA, and mean superior vena cava (VCS) diameters, right (RV) and left ventricle (LV) short diameters, and RV/LV ratios in patients with PE were increased (p<0.001, p=0.004, p=0.007, p=0.01, p=0.001, respectively) and correlated with the obstruction index ratio (OIR). Also, the convexity of the interventricular septum, VCI, and vena azygos reflux frequency were increased with PE (p<0.001, p=0.001, p=0.001) and with massive PE (p<0.001, p=0.003, p<0.001). It was determined that the frequency of the presence of wedge-shaped opacities and vein mark findings was increased in patients with PE (p<0.001, p<0.001); however, it was found less frequently in patients with massive PE when compared to the submassive patients (p=0.002, p=0.014). The presence of atelectasis was not different between patients with and without PE; consolidation, ground glass appearance, oligemia frequency, and the average scores were increased in the patients with PE (p=0.02, p<0.001, p=0.001), and there was a positive correlation between the oligemia score and OIR (r=0.202, p=0.027). Pleural effusion was infrequent with PE. Discussion: CTPA is a rapid and reliable method for the determination of the severity of PE, affected vascular structures and lung regions, and for the assessment of right heart function

Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: a Turkish oncology group study

Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results