Axonal excitability and conduction alterations caused by levobupivacaine in rat

In this study, effects of the long-acting amide-type local anesthetic levobupivacaine on axonal conduction and excitability parameters of the rat sciatic nerve were thoroughly examined both in vitro and in vivo. In order to deduce its effects on isolated nerve conduction, compound nerve action potential (CNAP) recordings were performed using the suction method over sciatic nerves of Wistar rats before and after administration of 0.05 % (1.7 mmol L–1) levobupivacaine. Levobupivacaine caused complete CNAP area and amplitude depression by blocking conduction in a time-dependent manner. To assess the influence of levobupivacaine on in vivo excitability properties, threshold-tracking (TT) protocols were performed at sciatic nerves of rats injected with perineural 0.05 % (1.7 mmol L–1) levobupivacaine or vehicle alone. Charge-duration TT results revealed that levobupivacaine increases the rheobase and decreases the strength-duration time constant, suggesting interference of the anesthetic with the opening of Na+ channels. Twenty and 40 % threshold electrotonus curves were found for both groups to follow the same paths, suggesting no significant effect of levobupivacaine on K+ channels for either the fastest or relatively slow conducting fibers. Current-threshold relationship results revealed no significant effect on axonal rectifying channels. However, according to the results of the recovery cycle protocol yielding the pattern of excitability changes following the impulse, potential deviation was found in the recovery characteristics of Na+ channels from the absolute refractory period. Consequently, conduction blockage caused by levobupivacaine may not be due to the passive (capacitive) properties of axon or the conductance of potassium channels but to the decrease in sodium channel conductance

The Status of Ethical Education at Undergraduate Level Nursing Schools

Giriş: Hemşirelik uygulamalarında etik bilincin ve duyarlılığın gelişmesinde etik eğitimi son derece önemlidir. Amaç: Bu araştırma, hemşirelik eğitiminde verilen etik derslerinin özellikleri ve dersi veren öğretim elemanlarının derse ilişkin görüşlerinin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı olarak yapılan araştırmanın çalışma grubunu Türkiye'deki doktora düzeyinde hemşirelik eğitimi veren on fakülte ve yüksekokulda etik/deontoloji dersini yürüten ve daha önce yürütmüş olan, çalışmaya gönüllü 30 öğretim elemanı oluşturmuştur. Veriler ilgili literatür doğrultusunda hazırlanmış anket formu ile toplanmıştır. Anket formu, kişisel bilgilere ilişkin yedi ve etik eğitimine ilişkin on sorudan oluşmuş ve posta yoluyla toplanmıştır. Verilerin değerlendirilmesinde sayı, yüzdelik ve tanımlayıcı istatistikler kullanılmıştır. Bulgular: Tümü kadın olan katılımcıların, yaş ortalamasının 42.73±9.35, eğitimcilik deneyimi ortalamasının ise 17.73±8.94 yıl olduğu, %96.70'inin hemşireliğin değişik alanlarında doktora eğitimi aldığı, %93.30'unun eğitimlerinde etik/deontoloji dersi aldığı, %66.70'inin etik/deontolojiye ilişkin bilimsel toplantılara katıldığı, %50.00'ının etik/deontoloji dersinin farklı sınıflarda parçalar halinde verildiğini, ideal olarak ise %43.30'unun ayrı bir ders olarak ve farklı sınıflarda parçalar halinde verilmesi gerektiğini ifade ettikleri görülmüştür. Sonuç: Araştırmanın yapıldığı okullarda etik eğitiminin bu alanda uzman olmayan öğretim elemanları tarafından verildiği, etik/deontoloji dersinin süresinin, içeriğinin ve adının okuldan okula değiştiği görülmüştür. Background: Ethical education is extremely important for the development of ethical awareness and sensitivity in nursing practices. Objectives: This study aims at evaluating the features of ethics courses in nursing education and indentifying the views of instructors in relation to these courses. Methods: The participants are 30 instructors who have taught ethics/deontology courses in ten nursing schools at doctorate level in Turkey. The data were collected through a questionnaire prepared in light of the related literature. The questionnaire included seven questions regarding personal identification and ten questions regarding ethics education. The data collected from the study were analyzed using numbers, percentages, and descriptive statistics in SPSS 11.5. Findings: Average age of the participants, all of whom were females, was found 42.73 ± 9.35 with the average 17.73 ± 8.94 years of experience; 96.70% had doctorate education in various areas of nursing, 93.30% received ethics/deontology courses in their education, 66.70% participated in meetings in relation to ethics/deontology, 50.00% taught ethics/deontology in parts in different classes, 43.30% believed ethics should be instructed as a separate course and in different classes. Conclusion: Ethics education is usually instructed as a part of the integrated system by those who are not expert in this field and the duration, content, and name of the course differ from school to school

Hypermethylation of tumor suppressor genes in gastric cancer: associations with demographic and clinicopathological characteristics

Background: Gastric cancer (GC) is one of the most common cancers worldwide. Despite the declining prevalence in Western countries, it is still a major health problem in Turkey and Asian countries. In the current study, we investigated the hypermethylation status of 25 TSGs in GC. Furthermore, the association between hypermethylation status of these TSGs and some demographic and clinicopathological characteristics were investigated.Methods: Formalin-fixed paraffin-embedded tissue samples obtained from 27 patients with GC and genomic DNA isolated from these tissues. To compare the methylation status of 25 TSGs, methylation-specific multiplex ligation-dependent probe amplification (MS–MLPA) technique was used. Results were evaluated in terms of age, gender, positive lymph node status, lymphovascular invasion, perineural invasion, mortality and five-years of survival, retrospectively.Results: Tumor suppressor gene hypermethylation was detected 16 (59.3%) of 27 GC tissues. Patients with hypermethylation-detected and patients with no hypermethylation-detected in their TSGs were classified as group 1 and group 2, respectively. The mean age of group 1 was 66.38±7.43 and the mean age of group 2 was found as 58.18±11.12 (p= 0.03). Hypermethylation was detected in 12 of 25 TSGs in patients with GC. Hypermethylation was detected as 51.8% for WT1, 40.7% for ESR1, 18.5% for CDH13, 14.8% for MSH6 and CD44, 7.4% for TP73 and PAX5 genes in the tumor tissues of patients with GC. Mean positive lymph node number was 8.81±5.38 in group 1 and 4.81±3.21 in group 2 (p= 0.037). Lymphovascular invasion, perineural invasion, mortality and five-years of mean survival were not statistically different between group 1 and group 2 (p>0.05 for all comparisons).Conclusions: Hypermethylation frequency of certain tumor suppressor genes may increase with advancing age and with positive lymph nodes in gastric cancer patients.

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Lisans Düzeyindeki Hemşirelik Okullarında Etik Eğitiminin Durumu

Giriş: Hemşirelik uygulamalarında etik bilincin ve duyarlılığın gelişmesinde etik eğitimi son derece önemlidir. Amaç: Bu araştırma, hemşirelik eğitiminde verilen etik derslerinin özellikleri ve dersi veren öğretim elemanlarının derse ilişkin görüşlerinin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı olarak yapılan araştırmanın çalışma grubunu Türkiye'deki doktora düzeyinde hemşirelik eğitimi veren on fakülte ve yüksekokulda etik/deontoloji dersini yürüten ve daha önce yürütmüş olan, çalışmaya gönüllü 30 öğretim elemanı oluşturmuştur. Veriler ilgili literatür doğrultusunda hazırlanmış anket formu ile toplanmıştır. Anket formu, kişisel bilgilere ilişkin yedi ve etik eğitimine ilişkin on sorudan oluşmuş ve posta yoluyla toplanmıştır. Verilerin değerlendirilmesinde sayı, yüzdelik ve tanımlayıcı istatistikler kullanılmıştır. Bulgular: Tümü kadın olan katılımcıların, yaş ortalamasının 42.73±9.35, eğitimcilik deneyimi ortalamasının ise 17.73±8.94 yıl olduğu, %96.70'inin hemşireliğin değişik alanlarında doktora eğitimi aldığı, %93.30'unun eğitimlerinde etik/deontoloji dersi aldığı, %66.70'inin etik/deontolojiye ilişkin bilimsel toplantılara katıldığı, %50.00'ının etik/deontoloji dersinin farklı sınıflarda parçalar halinde verildiğini, ideal olarak ise %43.30'unun ayrı bir ders olarak ve farklı sınıflarda parçalar halinde verilmesi gerektiğini ifade ettikleri görülmüştür. Sonuç: Araştırmanın yapıldığı okullarda etik eğitiminin bu alanda uzman olmayan öğretim elemanları tarafından verildiği, etik/deontoloji dersinin süresinin, içeriğinin ve adının okuldan okula değiştiği görülmüştür.Background: Ethical education is extremely important for the development of ethical awareness and sensitivity in nursing practices. Objectives: This study aims at evaluating the features of ethics courses in nursing education and indentifying the views of instructors in relation to these courses. Methods: The participants are 30 instructors who have taught ethics/deontology courses in ten nursing schools at doctorate level in Turkey. The data were collected through a questionnaire prepared in light of the related literature. The questionnaire included seven questions regarding personal identification and ten questions regarding ethics education. The data collected from the study were analyzed using numbers, percentages, and descriptive statistics in SPSS 11.5. Findings: Average age of the participants, all of whom were females, was found 42.73 ± 9.35 with the average 17.73 ± 8.94 years of experience; 96.70% had doctorate education in various areas of nursing, 93.30% received ethics/deontology courses in their education, 66.70% participated in meetings in relation to ethics/deontology, 50.00% taught ethics/deontology in parts in different classes, 43.30% believed ethics should be instructed as a separate course and in different classes. Conclusion: Ethics education is usually instructed as a part of the integrated system by those who are not expert in this field and the duration, content, and name of the course differ from school to school

Angiogenesis and endothelial markers in primary CNS tumors

The neovascularization and endothelial antigenic changes of 47 different types of central nervous system tumors were analyzed • histochemically and immunohistochemically. The relation between the endothelial antigenic characteristics and the histological grading was also examined. Vascular endothelial proliferation was detected in the reticulum stain. Immunohistochemically, factor VIM related antigen (FVIIIR:Ag) and blood-group isoantigens (BGAg) were used as endothelial markers. In all the examined sections a diffuse, linear or slightly granular immunostaining pattern was observed in the endothelium for both antigens. The distribution and intensity of the antigens were nonspecific among the grades. [Turk J Cancer 1995;25(3):i11-9]The neovascularization and endothelial antigenic changes of 47 different types of central nervous system tumors were analyzed • histochemically and immunohistochemically. The relation between the endothelial antigenic characteristics and the histological grading was also examined. Vascular endothelial proliferation was detected in the reticulum stain. Immunohistochemically, factor VIM related antigen (FVIIIR:Ag) and blood-group isoantigens (BGAg) were used as endothelial markers. In all the examined sections a diffuse, linear or slightly granular immunostaining pattern was observed in the endothelium for both antigens. The distribution and intensity of the antigens were nonspecific among the grades. [Turk J Cancer 1995;25(3):i11-9

Arhytmogenic right ventricular displasia and sudden young adult deaths

Ani-beklenmedik ölümler ve mekanizmalarının açıklığa kavuşması adli tıp uygulamaları içinde önemli bir yer tutmaktadır. Son yıllarda tanımlanarak, klâsik kitaplarda yerini bulan Aritmojenik Sağ Verttriküler Displazi (ARVD), özellikle ani genç ve sporcu ölümlerinden sorumlu tutulmaktadır. Klinik tanı yöntemlerinin yanısıra, morfolojik olarak ta tanımlanabileceği ileri sürülmektedir. Anabilim dalımızda daha önce gerçekleştirilen iki ayrı çalışmada, patognomonik olduğu ileri sürülen morfolojik kriterlerin, rastgele seçilen populasyonda değişen oranlarda izlenmesi, bu konuda daha geniş serilerde çalışılarak morfometrik kriterlerin belirlenmesi gerekliliğini ortaya koymaktadır. Bu yazıda; ARVD'yi ani beklenmedik ölüm nedenleri açısından gündeme getirmek, ileri sürülen görüşleri destekleyen ve bu görüşlere ters düşen bulguları tartışmak amacı güdülmüştür.Forensic Medicine specialists often has to deal with sudden-unexpected deaths. Arhytmogenic Right Ventricular Displasia (ARVD) had been defined in 1961, yet previously took place in the textbooks. It is claimed that, this antity is responsible from the sudden deaths of the young adults and athletes. Some of the authors assert that it can be defined not only clinically but also morphologically. Our two different serials revealed that, the criterias' which are defined as patognomonic morphology, should be crossed over again in large serials, since these findings are common in randomly selected violent deaths also.In this paper, the findings of the two previous studies are summarized and the proposed morphological criterias of ARVD are criticized