Melatonin protects the heart and endothelium against high fructose corn syrup consumption-induced cardiovascular toxicity via SIRT-1 signaling.

High fructose corn syrup (HFCS) has been shown to cause cardiovascular toxicity via oxidative stress and inflammation. The aim of this study is to demonstrate the protective effects of melatonin (MLT) against HFCS-induced endothelial and cardiac dysfunction via oxidative stress and inflammation. Thirty-two Sprague Dawley male rats were distributed into three groups as control, HFCS, and HFCS + MLT. HFCS form F55 was prepared as 20% fructose syrup solution and given to the rats through drinking water for 10 weeks, and MLT administrated 10 mg/kg/day orally for last 6 weeks in addition to F55. After decapitation, blood and half of the heart samples were collected for biochemical analysis and other half of the tissues for histopathological and immunohistochemical analysis. Aspartate transaminase, creatine kinase MB, lactate dehydrogenase, total oxidant status and oxidative stress index, and caspase-3 levels increased and total antioxidant status levels decreased significantly in HFCS group. MLT treatment reversed all these parameters. Histopathologically, hyperemia, endothelial cell damage and increased levels of angiogenin, C-reactive protein, inducible nitric oxide synthase, myeloperoxidase and decreased sirtuin-1 (SIRT-1) expressions were observed in HFCS group. MLT ameliorated all these changes. MLT has an anti-inflammatory, antioxidant, antiapoptotic effects on HFCS-induced cardiovascular toxicity through enhancing the expression of SIRT-1.

What are the indications for a stoma in Fournier's gangrene?

AIM: This study examined the indications for a stoma in patients with Fournier's gangrene and its impact on outcome. METHOD: Patients with Fournier's gangrene were retrospectively reviewed for indications for a stoma. Patients with and without a stoma were compared, based on demographics, disease severity, surgical therapy, length of hospital stay, clinical outcome and cost. RESULTS: Forty-four patients (median age 57 years, range 28-77 years) were evaluated. Eighteen had a temporary stoma and 26 did not. A stoma was 5 times more likely in males. Patients with Fournier's gangrene originating from an anorectal disorder received a stoma more often than patients with disease originating from an urogenital disorder. Clinical outcomes were similar for patients with or without a stoma. Stoma closure was associated with an extra cost of about $6650 per patient. CONCLUSION: Stoma creation in the management of Fournier's gangrene was needed for selected patients. Having a stoma did not appear to affect outcomes and resulted in a significant increase in cost of care.

Attitude and behavior related to organ donation and affecting factors: a study of last-term students at a university.

AIM: The aim of this study was to detect the behavior and attitude of our last-term students. METHODS: The study group for this cross-sectional research consisted of 1690 last-term students. We applied a questionnaire about sociodemographic features, behaviors, and attitudes about organ donation. Data were evaluated with SPSS 11.0. RESULTS: We accessed 1287 students among whom 1.3% stated that they would donate their organs. Among students who did not agree, 58.7% were considering donation. The main reasons for not agreeing to donation were fear of commercial use (45.7%) and the belief of inappropriateness related to religion (25.7%). In contrast, 62.3% stated that they would donate their organ when needed for their relatives. Also, 50.6% indicated that if one of their relatives died, they would donate their relative's organs; there was no significant difference based on gender. In addition, favorable thoughts about donation were significantly more prevalent for female subjects (P = .001). Organ donation behavior and thoughts were significantly higher among the group with better economic position (P = .001, .018); and for students whose mother had an education higher than high school (P = .003, .004). Higher donation ratios were observed for students who had a relative working in the medical field (P = .04) and the group who stated they were well informed about organ donation (P < .001). CONCLUSION: When we take into account that our study group consisted of university students, organ donation rates were low. To overcome the difficulties, we have to inform the community and collaborate with religious organizations. To prevent fear that organs will be used commercially we must prove confidence in the system.

Short-term effects of periodontal therapy as an adjunct to anti-lipemic treatment.

OBJECTIVE: This study was conducted to assess the effect of improved periodontal health following periodontal treatment on metabolic lipid control of patients on anti-lipemic treatment. MATERIALS AND METHODS: The study population consisted of 20 patients aged 34-62 years with diagnoses of hyperlipidemia and chronic periodontitis. All patients used statin to treat their elevated levels of low-density lipoprotein cholesterol. Blood samples were obtained for measurement of serum lipids, fasting plasma glucose, and high sensitive C-reactive protein. Periodontal parameters, including plaque index, gingival index, probing pocket depth, clinical attachment level, and percentage of bleeding on probing, were evaluated. All parameters were assessed in each subject at baseline, after 3 months as a control (at the time of periodontal treatment), and 3 months after the non-surgical periodontal treatment that included scaling and root planning. RESULTS: All lipid parameters decreased after the periodontal treatment, but only the decreases in total cholesterol and low-density lipoprotein cholesterol levels reached statistical significance compared to baseline (P = 0.002 and P = 0.003, respectively). CONCLUSION: Improved periodontal health may influence metabolic control of hyperlipidemia and could be considered as an adjunct to the standard measures of hyperlipidemic patient care.

A national survey of Turkish emergency physicians perspectives regarding family witnessed cardiopulmonary resuscitation.

We investigated Turkish emergency physicians' views regarding family witnessed resuscitation (FWR) and to determine the current practice in Turkish academic emergency departments with regard to family members during resuscitation. A national cross-sectional, anonymous survey of emergency physicians working in academic emergency departments was conducted. Nineteen of the 23 university-based emergency medicine programs participated in the study. Two hundred and thirty-nine physicians completed the survey. Of the respondents, 83% did not endorse FWR. The most common reasons for not endorsing FWR was reported as higher stress levels of the resuscitation team and fear of causing physiological trauma to family members. Previous experience, previous knowledge in FWR, higher level of training and the acceptance of FWR in the institution where the participant works were associated with higher rates of FWR endorsement for this practice among emergency physicians.

Follow-up results of synthetic vascular grafts in children undergoing hemodialysis.

Polytetrafluoroethylene (PTFE) grafts were inserted in the thigh of 14 children (7 boys and 7 girls, age 12 +/- 1.8 years) who were undergoing chronic hemodialysis for endstage renal disease. Removal of grafts was necessary in three patients within three months of implantation. In a fourth case it was indicated in the fifteenth month. In two cases thrombectomy was necessary. Echocardiography was performed in 10 patients before and three and 12 months after surgery. Cardiac performance followed by echocardiography did not change after one year. After two years the survival of grafts was 71%. It appears that synthetic grafts offer advantages for pediatric hemodialysis patients with arteriovenous fistula failure. On the other hand, this technique entails serious risks.

The effect of prostaglandin E1 on colonic anastomotic healing. A comparison study.

In an attempt to show the effect of prostaglandin E1 (PGE1) on colonic anastomotic healing the authors measured collagen synthesis and counted inflammatory cells (polymorphonuclear leukocytes "PMN," histiocytes, lymphocytes, and plasma cells) and compared the results to those of aprotinin and control groups. The authors performed colonic anastomoses on 45 male albino rats, which were divided into three groups. Measurements of collagen synthesis and counts of inflammatory cells in the first group were evaluated as control data. They administered 2000 units aprotinin daily for two days in the second group and 2 micrograms PGE1 daily for two days in the third group. Collagen content as hydroxyproline in the resected anastomotic part of the colon was measured and the inflammatory cells were counted on the first, third, fifth, and tenth days. The results showed that PGE1-administered rats had significantly higher collagen levels (5.21 +/- 1.35 micrograms hydroxyproline/mgr tissue, P less than 0.05 and 3.81 +/- 0.63 micrograms/mg, P less than 0.05) on the third and fifth days, respectively, compared with the control and aprotinin groups. The aprotinin group also had higher collagen levels (3.34 +/- 0.27 micrograms/mg, P less than 0.05 and 3.07 +/- 0.40 micrograms/mg, P less than 0.05) on the third and fifth days, respectively, compared with the control group. There were no statistically important differences in the collagen contents of the control, aprotinin, and PGE1 groups on the tenth day and there was an increase in the collagen content in all groups (P less than 0.05). The inflammatory cells, including PMNs, histiocytes, lymphocytes, and plasma cells, which play an important role in the inflammatory stage of colonic anastomotic healing, were also counted. The cells were counted on the third, fifth, and tenth days and the results were evaluated as (+) positive and more positive. The results of the control and aprotinin groups were found as ( ), ( ), and (++) on the third, fifth, and tenth days, respectively. In the PGE1-administered group the inflammatory cells were counted as (+), (++), and (++) on the third, fifth, and tenth days, respectively. In addition, there was an increase in fibroblast synthesis and new vessel formation on the tenth day. Thus, it was shown that PGE1 decreased inflammatory cells and increased collagen synthesis in the early stage of colonic anastomoses and fibroblasts in the late stage more effectively when compared with the control and aprotinin groups.(ABSTRACT TRUNCATED AT 400 WORDS)