Neuroprotective effects of high-dose human albumin against traumatic spinal cord injury in rats.

BACKGROUND AND OBJECTIVES: Human serum albumin (HA) is a unique multifunctional protein with neuroprotective properties. We aimed to delineate the mechanisms of HA-induced neuroprotection, supresses inflammatory response and lipid peroxidation after spinal cord injury (SCI). METHODS AND STUDY DESIGN: Adult female Wistar rats weighing 210-250 g were used for the study. The rats were randomly and blindly allocated into five groups. The one-way analysis of variance (ANOVA) for parametric data and Shapiro-Wilk test was used for evaluating the normal distribution of the variables. Kruskal-Wallis for nonparametric data was used to compare groups. Electron and light microscopies were used to demonstrate ultrastructural changes in spinal cord. RESULTS: The HA group was significantly different from all the other groups (p < 0.05). Both MPSS and HA treatments decreased the MPO significantly. HA treatment decreased the lipid peroxidation. HA treatment prevented the worsening of clinical results. In the HA treatment group, the ultrastructure was protected significantly. The neuronal bodies and axonal structures were normal except for some limited edematous spaces. CONCLUSIONS: HA improves early clinical results, protects spinal cord ultrastructure, and decreases MPO and LPO levels after spinal cord contusion injury (Tab. 3, Fig. 3, Ref. 39).

Systematic review with network meta-analysis: comparative efficacy and tolerability of different intravenous iron formulations for the treatment of iron deficiency anaemia in patients with inflammatory bowel disease.

BACKGROUND: Iron deficiency anaemia (IDA) is a common complication of inflammatory bowel disease (IBD) associated with reduced quality of life and increased hospitalisation rates. While the best way of treating IDA in IBD patients is not clearly established, current European guidelines recommend intravenous iron therapy in IBD patients with severe anaemia or intolerance to oral iron compounds. AIM: To compare the efficacy and tolerability of different intravenous iron formulations used to treat IDA in IBD patients in a systematic review and Bayesian network meta-analysis (NMA), PROSPERO registration number: 42016046565. METHODS: In June 2016, we systematically searched for studies analysing efficacy and safety of intravenous iron for IDA therapy in IBD. Primary outcome was therapy response, defined as Hb normalisation or increase ≥2 g/dL. RESULTS: Five randomised, controlled trials (n = 1143 patients) were included in a network meta-analysis. Only ferric carboxymaltose was significantly more effective than oral iron [OR=1.9, 95% CrI: (1.1;3.2)]. Rank probabilities showed ferric carboxymaltose to be most effective, followed by iron sucrose, iron isomaltose and oral iron. Pooled data from the systematic review (n = 1746 patients) revealed adverse event rates of 12.0%, 15.3%, 12.0%, 17.0% for ferric carboxymaltose, iron sucrose, iron dextran and iron isomaltose respectively. One drug-related serious adverse event (SAE) each was reported for ferric carboxymaltose and iron isomaltoside, and one possibly drug-related SAE for iron sucrose. CONCLUSIONS: Ferric carboxymaltose was the most effective intravenous iron formulation, followed by iron sucrose. In addition, ferric carboxymaltose tended to be better tolerated. Thus, nanocolloidal IV iron products exhibit differing therapeutic and safety characteristics and are not interchangeable.

Omega-3 prevents myelin degeneration in rat foetuses exposed to radiation.

The aim of this study is to investigate the protective effect of antioxidant omega-3 fatty acid (FA) on demyelinisation and degeneration of nerves in central and peripheral nervous systems (CNS and PNS) of rat foetuses. 38 pregnant rats weighing 140-155 g were used. Rats were divided into five groups. Group 1: 7 rats exposed to radiation treatment (RT) for 1 hour/day only; Group 2: 7 rats exposed to RT + Omega-3 FA (p.o.) for 1 hour/day; Group 3: 7 rats exposed to RT for 4 hours/day; Group 4: 7 rats exposed to RT + Omega-3 FA (p.o.) for 4 hours/day; and Group 5: 10 rats with no treatment. Nerve injury was induced by whole-body exposure to 20-µT magnetic field. Omega-3 FA was given orally at a dose of 50 mg/kg. After 18 days, foetuses were delivered by the milking method; CNS and PNS were taken out for pathological examination. The degeneration scores of Group 2 were significantly lower than those of Group 1, whereas the degeneration scores of Group 4 were significantly higher than those of Groups 1 and 3. In conclusion, radiation increases demyelinisation and degeneration of nerves in the rat foetuses' CNS and PNS. Omega-3 FA prevents myelin and nerve degeneration in rat foetuses in low-dose radiation exposure.

Does adenosine deaminase activity play a role in the early diagnosis of ectopic pregnancy?

Early diagnosis of ectopic pregnancy (EP) is important due to life-threatening consequences in the first trimester of pregnancy. In this study we aimed to investigate the role of adenosine deaminase (ADA) activity in the prediction of EP. Forty-one patients with unruptured ectopic pregnancy comprised the case group and forty-two first trimester pregnant women with shown foetal heart beating in ultrasound comprised the control group. The mean ADA level in EP (10.9 ± 3.0 IU/L) was higher than that in control group (9.2 ± 3.6 IU/L) (p = 0.018). Receiver operating characteristics or ROC curve identified ADA value of 10.95 IU/L as optimal threshold for the prediction of EP with 56% sensitivity and 67% specificity. High ADA levels are valuable in the early diagnosis of EP. However more comprehensive studies are required.

Local sympathetic stimulation not only have local effects in patients with Raynaud's phenomenon.

OBJECTIVE: Many other organs and system can be affected in the course of Primary Raynaud's Phenomenon (RP). Simultaneously increased vasospasm in the pulmonary vascular bed may likely affect the pulmonary function. Therefore, we investigated the effect of Raynaud's phenomenon on the respiratory functions in this study. PATIENTS AND METHODS: Between March 2014 and December 2014, 30 patients with the diagnosis of PRP more than two years and 32 age-sex matched healthy controls were enrolled into this study. Cold stimulation test (CST) was performed. Pulmonary function test were performed following 30 minutes after CST and spirometric measurements were calculated. RESULTS: There were no statistically significant differences between two groups regarding their demographic and clinical data. Mean duration of symptoms from onset to present was 3.01 ± 1.05 years. Patients with Primary RP had significantly lower FVC and higher FEV1/FVC values compared to the control groups (p = 0.015 and p=0.045, respectively). CONCLUSIONS: We found that statistically significant decrease of FVC values in patients with Primary RP compared to the healthy controls could be a impaired innervation of pulmonary system and a predictor of pulmonary vasospasm and/or pulmonary Raynaud's phenomenon, which may develop in future periods.

Can plateletcrit, an underestimated platelet parameter, be related with preterm labour?

OBJECTIVE: Noninvasive and simple markers are needed for the prediction of preterm delivery in women at risk for preterm labour. The aim of this study was to determine the value of platelet indices in the prediction of preterm delivery. DESIGN: A retrospective study. SETTING: Routine antenatal care in Zonguldak Bülent Ecevit University between 2008 and 2011. SAMPLE: Ninety patients who delivered between 28 and 37 weeks of gestational age and 128 patients who delivered at term. METHODS: Plateletcrit and other haematological markers, cervical dilatation and effacement, and the neutrophil-to-lymphocyte ratio as an inflammation marker. MAIN OUTCOME MEASURE: The role of platelet indices in predicting the preterm delivery. RESULTS: The platelet count, plateletcrit, white blood cell count, red cell distribution width, and neutrophil count were significantly higher in the preterm delivery group. Receiver operating characteristic curve analysis showed that the plateletcrit cut-off value for predicting spontaneous preterm labour was 0.201%, with a sensitivity of 95.6% and specificity of 87.5%; the cut-off value for the platelet count was 234 ? 103/mm3 with a sensitivity of 81.0% and specificity of 71.0%. CONCLUSION: Plateletcrit is a low-cost, widely available, and noninvasive marker that might be used for the prediction of preterm delivery in patients with a history of preterm labour.

Resveratrol inhibits postoperative adhesion formation in a rat uterine horn adhesion model.

AIM: Adhesion formation is one of the most important problems occuring after pelvic surgery in the majority of women. The aim of this experimental study was to investigate the effects of the antioxidant resveratrol (3,5,4'-o-trihydroxystilbene) on adhesion formation in a rat uterine horn adhesion model. MATERIALS AND METHODS: Thirty Wistar-Albino female rats were randomly divided into three groups with equal numbers. In Group A, 5.9 mg/kg/day resveratrol was applied by the orogastric route for 10 days before and 20 days after surgery. In Group B, resveratrol was given only for 20 days after surgery. In the control group, no drug was applied before or after surgery. A uterine serosal injury was created using a standard technique after laparotomy in all rats. All animals were sacrificed 3 weeks after surgery and intrapelvic adhesions determined macroscopically and microscopically. RESULTS: Adhesion formation, total adhesion score and the severity of adhesions were all significantly lower in both resveratrol treatment groups than in the control group (p < 0.05). Notably, the severity of adhesions was much less in Group A in which the rats received resveratrol before and after surgical operation. CONCLUSIONS: This study suggests that 5 ± 1 mg/kg/day perioperative resveratrol administration is an effective strategy for the prevention of postoperative peritoneal adhesion formation after pelvic surgery in a rat model.

Surgical management of bronchiectasis: a collective review of 339 patients with long-term follow-up.

OBJECTIVE: The incidence of bronchiectasis has decreased significantly in developed countries due to successful control of childhood infections. However, the surgical treatment of this disease still plays an important role in thoracic surgical practice in underdeveloped and developing countries. The aim of this retrospective study was to present our surgical experience in patients with bronchiectasis, including our surgical treatment strategies and the results of long-term follow-up. METHODS: A retrospective chart review was conducted of 339 patients who underwent surgical resection for bronchiectasis between January 1992 and December 2009. The patients' demographic features, the symptoms, etiologies and resection types, morbidity, mortality and outcomes after surgical management were analyzed. RESULTS: There were 301 (88.8 %) male and 38 (11.2 %) female patients; the average patient age was 22.4 years (range 15-50 years). The most common presenting symptoms were productive cough in 197 (58.1 %) patients. There were 21 (6.2 %) asymptomatic patients. Two hundred and thirty of the 339 patients (67.8 %) had had previous medical therapy before admission to our department. The most common etiology of bronchiectasis was childhood infections in 101 (29.8 %) patients. In most patients, bronchiectasis was found on the left side (n = 225, 66.4 %). Thirty-five patients underwent a second operation for bilateral disease. There were two (0.6 %) early postoperative mortalities including one myocardial infarction and one respiratory insufficiency. Complications occurred in 43 patients (12.7 %). The median follow-up was 13.6 months. Symptoms disappeared in 201 patients (71 %), and 66 patients (23.3 %) experienced an improvement, while 16 patients (5.7 %) continued to be symptomatic. CONCLUSION: Although improvements in medical treatment have resulted in a significant decrease in the number of patients with bronchiectasis, surgical management is still very important in developing countries. Surgical resection can be performed with acceptable morbidity and mortality rates. The aim should be the resection of all involved bronchiectatic sites, even in patients with bilateral disease, if the pulmonary reserve is adequate.

Cervical screw missing secondary to delayed esophageal fistula: case report.

Although anterior surgical approaches to the cervical spine have become popular and safe in recent years, they also have some complications. We present a case of loss of an anterior cervical plate screw by the natural tracts. The patient was a 47- year-old woman who was operated on for cervical spondylotic myelopathy at another institution. Surgical interference included two levels of anterior discectomy, iliac graft placement and fixation using plate and screws. Two years later, plate dislocation and partial migration of the upper screws were observed. After 7 years the patient complained of dysphagia and she accepted removal of the osteosynthesis. Radiographical examination showed that one of the upper screws was missing and two lower screws were broken. Esophageal perforation was found during the surgery and repaired. Further progress was favourable. Complications associated with esophageal perforation may range from massive infection and death to spontaneous recovery. Erosion of the esophageal wall due to extruded bulky constructs may lead to a persistent fistula, abscess or septic diffusion. Spontaneous perforation of the esophagus and screw loss via the gastrointestinal tract make this case interesting..