Targeting apoptosis through FOXP1, and N-cadherin with glatiramer acetate in chick embryos during neural tube development

AIM: To demonstrate the effect of glatiramer acetate (GA) in chick embryos on neural tube (NT) development, and to explore its effects of FOXP1, apoptosis, and N-cadherin. MATERIAL and METHODS: One hundred fertile, specific pathogen free eggs were divided into 5 groups for this study. The eggshell was windowed specifically at 24 hours of incubation. The embryos in Group 1 (n=20) were treated with 10 mu l physiological saline; in Group 2 the embryos (n=20) were given 10 mu l GA (equal to daily human therapeutic dose); 20 mu l GA (equal to twice daily human therapeutic dose) was injected to embryos in Group 3 (n=20); in Group 4 and 5, 30 mu l and 40 mu l GA were administered to the embryos (n=20) (equal to x3 and x4 daily human therapeutic dose, respectively). Each egg was re-incubated for 24 hours more. Then, histological and immunohistochemical evaluation of the subjects were done. RESULTS: The embryos with NT defect showed FOXP1 expression without N-cadherin or staining with N-cadherin in another location in our study. We interpreted this result as GA leading to an NT closure defect by increasing FOXP expression. Moreover, we also showed the reverse relation between FOXP1 and N-cadherin at the immunohistochemical level for the first time. CONCLUSION: GA affects the spinal cord development through FOXP in the chick embryo model at high doses

Histologic features of spindle cell lipoma and problems in the differential diagnosis

AMAÇ: İğsi hücreli lipomun histolojik ve tipik immunhistokimyasal özelliklerini araştırmak ve diğer subkutan yerleşimli benzer histolojik ve immunhistokimyasal özellikleri olan neoplazmlarla ayırıcı tanısını yapmaktır. YÖNTEMLER: İstanbul Eğitim ve Araştırma Hastanesi patoloji laboratuarında lipom tanısı almış 3100 olguda son Dünya Sağlık Örgütü Yumuşak Doku Tümörleri Sınıflamasına göre alt tipler belirlendi ve bunların içinden 22 İHL çalışmaya alındı. 22 iğsi hücreli lipom olgusunda klinik (yaş, lokalizasyon, cinsiyet, nüks), morfolojik özellikler (tümör boyutu, alt tip, histoloji, mast hücre varlığı ve immunhistokimya), tümörlerin natürü ve ayrıcı tanı problemleri değerlendirildi. BULGULAR: 3100 lipomun alt tiplere göre dağılımı şu şekildeydi: 2864 klasik lipom (%90), 293 anjiyolipom (%9), 1 kondroid lipom (%0.03), 1 miyolipom (%0.03 ve 22 iğsi hücreli lipom (% 0.7). 22 iğsi hücreli lipomların 9’u fibröz, 3’ü miksoid, 1’i anjiyomatoid ve 9’u nonfibröz alt tipti. Erkek kadın oranı 18/4 olarak belirlendi. Olguların 2’si sırt, 3’ü omuz, 1’i ön kol, 1’i oral olup 15’ü baş-boyun bölgesinde lokalize idi. Ortalama tümör çapı 3.2 cm olup en büyük ve küçük çaplar 1 cm ve 6.1 cm olarak ölçüldü. Fibromatöz alt tipte belirgin olmak üzere Toluidin blue boyasıyla her olguda mast hücresi mevcuttu. Mast hücre sayısı on büyük büyütme alanında ortalama 23 olarak bulundu. S–100 tüm iğsi hücrelerde negatif ve yağ hücrelerinde pozitif olarak tespit edildi. CD34 olguların 21’inde pozitif, 1’inde negatif bulundu. Hiçbir olguda nüks izlenmedi. SONUÇ: İğsi hücreli lipom, subkutan lokalizasyonlu, iyi sınırlı, iğsi hücreli komponenti CD34 pozitif, mast hücrelerinden zengin bir tümör olup birçok subkutan tümörle ayırıcı tanı yapılmasını gerektiren nadir bir antitedir.OBJECTIVE: To investigate the histologic and immunohistochemical properties of spindle cell lipoma and to make its differential diagnosis from other subcutaneous neoplasms having similar histologic or immunohistochemical charecteristics. METHODS: 3100 cases of lipoma diagnosed in the Pathology Laboratory of İstanbul Educational and Research Hospital were reclassified according to the recent classification of Soft Tissue Tumors by World Health Organization and 22 spindl cell lipomas were included in the study. Clinical (age, gender, location, and recurrences) and morphologic features (tumor size, subtype, histology, presence of mast cells, and immunohistochemistry) as well as tumor nature and problems in differential diagnosis were evaluated. RESULTS: The histologic subtypes of 3100 lipomas were as follows: 2864 classical lipoma (90 %), 293 angiolipoma (9 %), 1 chondroid lipoma (0.03 %), 1 myolipoma (0.03 %) and 22 spindl cell lipoma (% 0.7). Of the 22 spindl cell lipoma 9 were fibrous, 3 myxoid, 1 angiomatoid and 9 non-fibrous subtypes. Male to female ratio was 18: 4. 2 cases were localized in dorsal region, 3 in shoulders, 1 in forearm, 1 in oral cavity and 15 in head and neck. Average tumor diameter was 3.2 cm ranging from 1 to 6.1 cm. Mast cells highligtened by Toluidin blue were seen in all cases, most prominently in the fibrous subtype. Mast cell count in 10 high power field was 23. S–100 was negative in all spindle cells while lipomcytes were positive. CD34 was positive in 21 cases and negative in 1 case. No case recurred. CONCLUSION: Spindl cell lipoma is a subcutaneous, well-circumscribed tumor rich in mast cells with a CD34+ spindle cell component and is an uncommon entity requiring differential diagnosis with several subcutaneous tumors

Investigation of the Effects of Edaravone on Valproic Acid Induced Tissue Damage in Pancreas

Valproic acid (VPA), an effective antiepileptic and anticonvulsant drug, has some toxic side effects due to causing elevated oxidant production. The aim of this study is to investigate the effects of edaravone, a potent free radical scavenger on VPA induced toxicity and tissue damage by biochemical and histological examinations on pancreas. Female Sprague Dawley rats were divided into four groups as follows; control, edaravone, VPA, VPA+edaravon. VPA and edaravone were injected intraperitonally for seven days. Total protein, lipid peroxidation (LPO), sialic acid (SA) and glutathione (GSH) levels and alkaline phosphatase (ALP), tissue factor (TF), superoxide dismutase (SOD), glutathione-S-transferase GST), catalase (CAT), glutathione peroxidase (GPx) and myeloperoxidase (MPO) activities were determined in pancreas homogenates. In VPA given group, LPO and SA levels, and ALP, TF, MPO activities significantly increased and GST, CAT, GPx activities significantly decreased compared to control group. A marked morphological damage was detected in the VPA group. Ameliorative effects of edaravone were observed in SA, TF, CAT, GPx parameters and histological examination in the VPA group. Therefore, edaravone may be effective in moderation and/or reduction of toxic effects of VPA on pancreas

Investigation of the Effects of Edaravone on Valproic Acid Induced Tissue Damage in Pancreas

Valproic acid (VPA), an effective antiepileptic and anticonvulsant drug, has some toxic side effects due to causing elevated oxidant production. The aim of this study is to investigate the effects of edaravone, a potent free radical scavenger on VPA induced toxicity and tissue damage by biochemical and histological examinations on pancreas. Female Sprague Dawley rats were divided into four groups as follows; control, edaravone, VPA, VPA+edaravon. VPA and edaravone were injected intraperitonally for seven days. Total protein, lipid peroxidation (LPO), sialic acid (SA) and glutathione (GSH) levels and alkaline phosphatase (ALP), tissue factor (TF), superoxide dismutase (SOD), glutathione-S-transferase GST), catalase (CAT), glutathione peroxidase (GPx) and myeloperoxidase (MPO) activities were determined in pancreas homogenates. In VPA given group, LPO and SA levels, and ALP, TF, MPO activities significantly increased and GST, CAT, GPx activities significantly decreased compared to control group. A marked morphological damage was detected in the VPA group. Ameliorative effects of edaravone were observed in SA, TF, CAT, GPx parameters and histological examination in the VPA group. Therefore, edaravone may be effective in moderation and/or reduction of toxic effects of VPA on pancreas

Antibody response to two doses of inactivated SARS-CoV-2 vaccine (CoronaVac) in kidney transplant recipients

Background Coronavirus Disease-19 (COVID-19) has high mortality in kidney transplant recipients (KTR), and vaccination against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is vital for this population. Although the humoral response to messenger RNA vaccines was shown to be impaired in KTR, there is a lack of data regarding the antibody response to inactivated vaccines. We investigated the antibody response to two consequent doses of the inactivated SARS-CoV-2 vaccine (CoronaVac; Sinovac Biotech, China). Methods A total of 118 patients from two centers were included. The levels of anti-SARS-CoV-2 immunoglobulin-G antibodies against the nucleocapsid and spike antigens were determined with enzyme immunoassay (DIA.PRO; Milano, Italy) before the vaccine and one month after the second dose of the vaccine. Thirty-three patients were excluded due to antibody positivity in the serum samples obtained before vaccination. Results Eighty-five patients, 47 of whom were female, with a mean age of 46 +/- 12, were included in the statistical analysis. The maintenance immunosuppressive therapy comprised tacrolimus (88.2%), mycophenolate (63.6%), and low-dose steroids (95.3%) in the majority of the patients. After a median of 31 days following the second dose of the vaccine, only 16 (18.8%) patients developed an antibody response. The median (IQR) antibody level was 52.5 IU/ml (21.5-96). Age (48 vs. 38, p = .005) and serum creatinine levels (1.14 vs. 0.91, p = .04) were higher in non-responders and were also found to be independently associated with the antibody response (odds ratio (OR): 0.93, p = 0.012 and 0.15, p = 0.045, respectively) in multivariate analysis. Conclusion In this study, we found the antibody response to the inactivated vaccine to be considerably low (18.8%) in KTR. Increased age and impaired renal function were associated with worse antibody response. Based on the knowledge that mRNA vaccines yield better humoral responses, this special population might be considered for additional doses of mRNA vaccination

Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient

Original Article The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study

Background: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis

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

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: 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<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<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. Funding: National Institute for Health and Care Research