Effects of Calcium Dobesilate on Adrenomedullin, Nitric Oxide and Superoxide Dismutase Levels in Experimental Stress Ulcer Formation

Objective: In the present study, we investigated the adrenomedullin (AM) and total nitric oxide (NOx) [nitrite plus nitrate] levels in experimentally induced stress ulcer model in rats. To examine the relation with oxidative stress, we measured the levels of thiobarbituric acid-reactive substances (TBARS) as an index of lipid peroxidation, and superoxide dismutase (SOD) activity together with the effect of calcium dobesilate (Ca-D) as well. Material and Methods: In this study, 33 female Wistar-Albino rats weighing about 230 g (200-250) aged 7-8 months were used. The rats were divided into 3 groups each containing 11 rats. The Ca-D-treated stress group received daily single oral dose of calcium dobesilate for 10 days (group 1). The saline-treated stress group received daily single oral dose of saline (same volume with calcium dobesilate) for 10 days (group 2). The non-stressed control group received daily single oral dose of saline (same volume with calcium dobesilate) for 10 days (group 3). In all groups of rats, plasma AM, NOx and TBARS levels as well as gastric mucosa NOx, TBARS levels. and SOD activity were determined. Results: In group 2 plasma AM (p< 0.001), plasma NOx (p< 0.001), gastric mucosa NOx (p< 0,001), and gastric mucosa TBARS levels (p< 0.01) were significantly higher than the levels in the control group. In group 1, elevated plasma NOx, gastric mucosa NOx, and plasma TBARS levels were found compared to the control group. On the other hand, the average plasma adrenomedullin and gastric mucosa TBARS levels in group 2 were significantly higher (p< 0.001) and plasma NOx levels were lower (p< 0.01) compared to group 1. In addition, in group 1 and 2, decreased SOD activity (p< 0.001) was found in gastric mucosa compared to the control group. Conclusion Elevated levels of AM and NOx may be generated to protect the organism as a response to increased oxidative stress. Calcium dobesilate may partially protect the organism against oxidative stress in stress ulcer pathogenesis, probably in relation to NO. However, further studies will be required to evaluate the role of calcium dobesilate in stress ulcer pathogenesis because of low levels of plasma AM and high levels of plasma TBARS in Ca-D-treated stress group

Role of the antiangiogenetic drug paclitaxel on healing of intestinal anastomosis: An experimental study

Background: The aim of intraperitoneal administration of antineoplastic agents is the prevention of the implantation of tumoral cells after surgical intervention or the treatment of peritoneal carcinomatosis. The efficiency of intraperitoneal administration of paclitaxel, which is also an antiangiogenetic agent, has been investigated recently. The aim of this experimental study was to evaluate, taking into consideration its antiangiogenetic properties, the effects of intraperitoneal paclitaxel on healing of end to end colonic anastomosis. Methods: 42 rats were allocated to 2 main groups (n=21 for each group) to be evaluated on postperative day 3 (group A) and postoperative day 7 (group B). Each of the two main groups was divided into 3 subgroups (7 rats each). These subgroups were determined as control and two treatment groups administered paclitaxel in a dose of 2.5 mg/kg and 3.5 mg/kg intraperitoneally. Anastomosed segments of colon were harvested on postoperative day 3 or 7 and evaluated to determine bursting pressure of anastomoses, hydroxyproline levels and neovascularization with CD-31. Results: In both groups, there were no significant differences between control and paclitaxel-treated groups with respect to bursting pressure. The level of hydroxyproline showed a significant decrease in all paclitaxel-treated groups compared with control groups (p=0.001). Neovascularization was found to be decreased significantly on day 3 in the doses of paclitaxel 2.5 mg/kg (6.4±1.63) and 3.5 mg/kg (5.89±1.01) compared with control (8.02±0.88) (p=0.029 and p=0.005, respectively). There were no significant differences in neovascularization in either groups on postoperative day 7. Conclusions: We suggest that intraperitoneal administration of paclitaxel during surgical procedure decreases the hydroxyproline content and neovessel formation that are necessary for healing of intestinal anastomosis

Propeller and Pre-expanded Propeller Use of a Transversely Oriented Upper Trapezius Perforator Flap in Head and Neck Reconstruction: Clinical Experience and Review of Vascular Anatomy of the Supraspinal Trapezius Muscle

Conventionally, trapezius musculocutaneous flap is raised to harbour perforators located inferior to the scapular spine (i.e. 'lower trapezius flap'). In this clinical study, we aimed to use trapezius perforators located superior to the scapular spine to raise a transversely oriented propeller fasciocutaneous flap based on the superficial cervical artery to reconstruct head and neck defects. Patients with head and neck defects who underwent reconstruction with a propeller trapezius perforator flap between August 2014 and October 2019 were evaluated. Demographic data of the patients, topographic data on defects and the flaps were analysed. A total of 14 patients underwent reconstruction with upper trapezius perforator flap with equal gender distribution. Defects were due to tumour resections, burn contractures and exposed foreign materials; located in occipital, temporal, parietal, midfacial and cervical areas; with sizes ranging between 8 x 7 cm and 22 x 19 cm. Overall patient satisfaction was assessed subjectively using a pre-determined set of questions. The sizes of the flaps ranged between 15 x 8 cm - 20 x 9 cm in non-expanded and 26 x 15 cm - 30 x 16 cm in expanded cases. One flap suffered distal superficial flap loss, which was treated with wound care. Follow up period of the patients ranged between 3 and 40 months with an average of 29 months. Using trapezius perforators located above the scapular spine provides thin transversely oriented propeller flaps to be used in head and neck reconstruction. In our series, this flap is further enhanced by pre-expansion for wider uses, e.g. facial resurfacing and releasing neck contractures. (C) 2021 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved

Internalized Stigma in Hidradenitis Suppurativa: A Multicenter Cross-Sectional Study

Background: Hidradenitis suppurativa (HS) causes significant physical, social, and psychological burdens. Internalized stigma, acceptance of negative attitudes and stereotypes of society regarding a person's illness, has not been studied previously in HS. Objectives: The objective of this study was to investigate the internalized stigma state of HS patients and identify the factors affecting it. Methods: This multicenter, prospective, cross-sectional study included 731 patients. Internalized Stigma Scale (ISS), Hurley staging, Physician Global Assessment, Dermatology Life Quality Index (DLQI), Skindex-16, Beck Depression Inventory-II (BDI-II), and Visual Analog Scale (VAS)-pain score were used in the study. Results: The mean ISS value (57.50 ± 16.90) was comparable to the mean ISS values of studies in visible dermatological and various psychiatric diseases. A significant correlation was found between the mean values of ISS and all disease activity scores, quality of life measures, BDI-II, and VAS-pain scores. Obesity, family history, low education and income level, vulva/scrotum involvement and being actively treated are significant and independent predictive factors for high internalized stigma in multivariate analysis. Conclusions: HS patients internalize society's negative judgements, which may create a profound negative effect on access to health care. Therefore, in addition to suppressing disease activity, addressing internalized stigma is fundamental for improving health care quality

Internalized stigma in Hidradenitis Suppurativa; A multicenter cross-sectional study

Background: Hidradenitis suppurativa (HS) causes significant physical, social, and psychological burdens. Internalized stigma, acceptance of negative attitudes and stereotypes of society regarding a person's illness, has not been studied previously in HS. Objectives: The objective of this study was to investigate the internalized stigma state of HS patients and identify the factors affecting it. Methods: This multicenter, prospective, cross-sectional study included 731 patients. Internalized Stigma Scale (ISS), Hurley staging, Physician Global Assessment, Dermatology Life Quality Index (DLQI), Skindex-16, Beck Depression Inventory-II (BDI-II), and Visual Analog Scale (VAS)-pain score were used in the study. Results: The mean ISS value (57.50 ± 16.90) was comparable to the mean ISS values of studies in visible dermatological and various psychiatric diseases. A significant correlation was found between the mean values of ISS and all disease activity scores, quality of life measures, BDI-II, and VAS-pain scores. Obesity, family history, low education and income level, vulva/scrotum involvement and being actively treated are significant and independent predictive factors for high internalized stigma in multivariate analysis. Conclusions: HS patients internalize society's negative judgements, which may create a profound negative effect on access to health care. Therefore, in addition to suppressing disease activity, addressing internalized stigma is fundamental for improving health care quality