Tenofovir disoproxil fumarate in the treatment of COVID-19: Evaluation of 78 patients.

One of the drugs that has been suggested for the treatment of SARS-CoV-2 infection is tenofovir disoproxil (TDF). Herein, it was aimed to evaluate the outcomes of TDF receiving COVID-19 cases in terms of day 7-10 PCR negativity and day 30 survival. Patients who received TDF due to PCR-confirmed COVID-19 between 27.04.2021 and 31.12.2021 were included in our study. The primary outcome was considered to be 7-10 days of PCR negativity, while the secondary outcome was considered 30-day survival after diagnosis of COVID-19. Patients who died before completing the treatment period (7-10 days) were also considered as PCR failures. Data were analyzed both in terms of intention to treat basis and in the subgroup that survived to the end of treatment. A total of 78 patients (30 women, mean age: 61.15±18.5 years) met the inclusion criteria. In the intention to treat analysis group, one-month-mortality was 44.87% (35/78) in the overall cohort. In the end of treatment analysis group, one-month-mortality was 29.5% (18/61) in the overall cohort. Day 7-10 PCR negativity was detected in 55.7% of the overall EOT cohort. Our data suggest that TDF may be an alternative salvage treatment option in antiviral unresponsive patients. We suggest evaluating TDF in well-designed controlled trials involving treatment-naïve cases.

Parenteral nutrition consensus report from KEPAN.

OBJECTIVES: Medical nutrition therapy is one of the core components of patient management, although its implication is still limited in Daily practice globally. Clinicians are in need of guidance that will ease the application of medical nutrition therapy. The pre- and post-graduate curriculum for medical nutrition therapy is limited in most regions, worldwide. A report that is short, clear, and having clear-cut recommendations that will guide the primary healthcare professionals in indications, choice, practical application, follow-up, and stopping parenteral nutrition (PN) would facilitate the application and success of medical nutrition therapy. KEPAN is the Clinical Enteral and Parenteral Nutrition Society of Turkey and is an active member of the European Society for Clinical Nutrition and Metabolism (ESPEN). METHOD: In this study, we present the KEPAN PN consensus report on optimal PN use in medical nutrition therapy as outlined by the works of academicians experienced in the clinical application of PN (nine working group academicians and 10 expert group academicians). RESULTS: This report provides 22 clear-cut recommendations in a question-answer format. CONCLUSIONS: We believe that this report could have a significant impact on the optimum use of PN in the context of medical nutrition therapy when clinicians manage everyday patients.

Determining the prevalence of people's knowledge that third-hand smoke is harmful to health: A meta-analysis study.

INTRODUCTION: Although the health effects of first-hand smoke and second-hand smoke are well known, third-hand smoke (THS) is a relatively new concept. We estimated the prevalence of people's knowledge that THS is harmful to health, including for some subgroups, in a meta-analysis. METHODS: We searched PubMed, Web of Science, Scopus, EBSCO Host, ProQuest, and YOKTEZ databases for the prevalence of people's knowledge that THS is harmful to health using specified search words. A total of 12 publications (n = 8549 people) were included in the meta-analysis. The random effect model was used for meta-analysis, and Cochran's Q test and I2 values were used to determine heterogeneity. Subgroup analyzes and meta-regression were also performed. RESULTS: The prevalence of people's knowledge that THS is harmful was 80.1%. The prevalence of people's knowledge that THS is harmful for children was 82%, and the prevalence of people's knowledge that THS is harmful for adults was 70.4%. For health professionals, the prevalence of people's knowledge that THS is harmful for children was 89.8%, the highest prevalence value calculated in this meta-analysis. Cochran's Q test and I2 values indicated that the included studies were heterogeneous. CONCLUSIONS: In this meta-analysis, the overall prevalence of people's knowledge that THS is harmful was 80.1%, but large variations were found between samples.

Global availability of parenteral nutrition: Pre- and post-COVID-19 pandemic surveys.

OBJECTIVE: Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of parenteral nutrition in all parts of the world, to better comprehend the global situation, and to prepare an action plan to increase access to parenteral nutrition. METHODS: An international survey using an electronic questionnaire was conducted in August 2019 and repeated in May 2022. An electronic questionnaire was sent to 52 members or affiliates of the International Clinical Nutrition Section of the American Society for Parenteral and Enteral Nutrition. Questions addressed the availability of parenteral nutrition admixtures and their components, reimbursement, and prescribing pre- and post-COVID-19 pandemic. All participating countries were categorized by their economic status. RESULTS: Thirty-six country representatives responded, answering all questions. Parenteral nutrition was available in all countries (100%), but in four countries (11.1%) three-chamber bags were the only option, and in six countries a multibottle system was still used. Liver-sparing amino acids were available in 18 (50%), kidney-sparing in eight (22.2%), and electrolyte-free in 11 (30.5%) countries (30.5%). In most countries (n = 28; 79.4%), fat-soluble and water-soluble vitamins were available. Trace elements solutions were unavailable in four (11.1%) countries. Parenteral nutrition was reimbursed in most countries (n = 33; 91.6%). No significant problems due to the coronavirus pandemic were reported. CONCLUSIONS: Despite the apparent high availability of parenteral nutrition worldwide, there are some factors that may have a substantial effect on the quality of parenteral nutrition admixtures. These shortages create an environment of inequality.

Development of an Attitude Scale for the Use of Telemedicine Services.

Abstract Introduction: This study aimed to develop a scale to assess attitudes toward the use of telemedicine services, to study the reliability and validity of the developed scale, and to determine the characteristics that may be associated with the scores obtained from the scale. Methods: This study, which was conducted with 600 people older than 18 years, who applied to Family Health Centers in Meram district of Konya province, was designed in a methodological type. The sociodemographic characteristics form and the candidate scale form designed in a 5-point Likert structure were used to collect data in the study. The data collection forms were applied to the participants under observation. SPSS and R programs were used for data analysis. Statistically, cases with p < 0.05 were considered significant. Results: Two hundred fifty people (n = 250) for reliability and explanatory factor analysis and 350 people for confirmatory factor analysis, 600 people in total, were included in the study. The results of all reliability and validity analyses of the candidate scale were found to be sufficient. The explained variance of the one-dimensional 18-item scale was 53.8% and the Cronbach's alpha coefficient was 0.947. There was a significant difference between the score obtained from the scale and work status and presence of chronic disease (p < 0.05). Conclusion: As a result of the research, a new measurement tool called "Attitude Scale Towards the Use of Telemedicine Services" consisting of 18 questions was developed, reliability and validity analyses were performed, and it was shown that it is suitable for use in individuals older than 18 years.

Fetal and maternal outcomes of segmental uterine resection in emergency and planned placenta percreta deliveries.

OBJECTIVE: This study evaluated maternal and fetal outcomes of emergency uterine resection versus planned segmental uterine resection in patients with placenta percreta (PPC) and placenta previa (PP). METHODS: Patients with PP and PPC who underwent planned or emergency segmental uterine resection were included in this study. Demographic data, hemorrhagic morbidities, intra- and postoperative complications, length of hospital stay, surgical duration, and peri- and neonatal morbidities were compared. RESULTS: A total of 141 PPC and PP cases were included in this study. Twenty-five patients (17.73%) underwent emergency uterine resection, while 116 (82.27%) underwent planned segmental uterine resections. The postoperative hemoglobin changes, operation times, total blood transfusion, bladder injury, and length of hospital stay did not differ significantly between groups (P=0.7, P=0.6, P=0.9, P=0.9, and P=0.2, respectively). Fetal weights, 5-minute Apgar scores, and neonatal intensive care unit admission rates did not differ significantly between groups. The gestational age at delivery of patients presenting with bleeding was lower than that of patients who were admitted in active labor and underwent elective surgery (32 weeks [95% confidence interval [CI], 26-37] vs. 35 weeks [95% CI, 34-35]; P=0.037). CONCLUSION: Using a multidisciplinary approach, this study performed at a tertiary center showed that maternal and fetal morbidity and mortality did not differ significantly between emergency versus planned segmental uterine resection.

Impact of the empirical therapy timing on the clinical progress of septic shock patients.

AIM: To evaluate the effect of timing of antimicrobial therapy on clinical progress of patients with septic shock. MATERIALS AND METHOD: We included 204 adult patients diagnosed with septic shock according to Sepsis-3 criteria between March 2016 and April 2021. One-month survival was evaluated using univariate and logistic regression analysis. RESULTS: Antibiotic treatment was initiated within 1 h of the vasopressors in 26.4 % of patients. One-month mortality did not differ significantly between patients with and without empirical therapy coverage on etiological agents. Univariate factors that significantly affected one-month survival were starting antibiotics at the first hour, the unit where the case was diagnosed with septic shock, SOFA scores, qSOFA scores, and lactate level. In multivariate analysis, diagnosis of septic shock in the Emergency Service, SOFA score ≥11, qSOFA score of three and lactate level ≥4 were significantly associated with one-month mortality. CONCLUSION: Training programs should be designed to increase the awareness of septic shock diagnosis and treatment in the Emergency Service and other hospital units. Additionally, electronic patient files should have warning systems for earlier diagnosis and consultation.

Changes in Energy Expenditure Determined by Indirect Calorimetry in Severe Burn Patients During the Acute Phase.

BACKGROUND: Severe burn injuries are a major health problem globally. A profound and prolonged hypermetabolic response develops in severe burn injuries and it is crucial to monitor the patients' energy requirements in order to meet them adequately. The aim of the present study was to examine the energy changes during the acute phase using the indirect calorimetry (IC) method in severe burn patients. METHODS: The study included 15 severe burn patients. Patients with FiO2 >60%, tube thoracostomy, closed underwater drain (CUWD) and air leakage were excluded from the study. Patients' demographic data, burn percentages, burn types, duration of stay in intensive care, mortality and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were recorded. Indirect calorimeter measurements were taken once from the patients upon their first arrival and during the following four weeks. Resting energy expenditure (REE), basal metabolic rate (BMR), oxygen consumption (VO2), carbon dioxide production (VCO2), body temperatures, presence of sepsis, Sequential Organ Failure Assessment (SOFA) and Modified Nutrition Risk in Critically Ill (mNUTRIC) scores were recorded. The data were analysed using SPSS 24 and p-values <0.05 were considered statistically significant. RESULTS: In the study, 13 (86.67%) of the patients were male. Patients' mean age was 45.27±18.16 years, and mean BMI 25.99±4.22 kg/m2. Five patients (33.33%) had chronic diseases. The average burn percentage was 45%, with 7 (46.67%) patients having a burn percentage of ≤40%, while 8 (53.33%) had a burn percentage of >40%. A total of 14 (93.33%) had flame burns; 3 (20.00%) patients deceased, and 12 (80.00%) were discharged. The mean APACHE II score was 11.53±6.83. The measured mean values of REE, VO2, VCO2 and fever were seen to be the highest in the first week after admission and decreases were observed in the subsequent weeks. SOFA score averages were the highest at admission, and decreased in the following weeks. CONCLUSION: Severe burn patients were observed to go through the hypermetabolic process in the acute phase and their energy requirements were high particularly in the first week. It was concluded that regular IC monitoring can be beneficial to fully meet the energy requirements of severe burn patients due to the prolonged hypermetabolic process.

Implementation of the ESPEN guideline on clinical nutrition in the intensive care unit (ICU): It is time to move forward!: A position paper from the 'nutrition in the ICU' ESPEN special interest group.

Nutritional assessment and provision of nutritional therapy are a core part of intensive care unit (ICU) patient treatment. The ESPEN guideline on clinical nutrition in the ICU was published in 2019. However, uncertainty and difficulties remain regarding its full implementation in daily practice. This position paper is intended to help ICU healthcare professionals facilitate the implementation of ESPEN nutrition guidelines to ensure the best care for their patients. We have aimed to emphasize the guideline recommendations that need to be implemented in the ICU, are advised, or are optional, and to give practical directives to improve the guideline recommendations in daily practice. These statements were written by the members of the ICU nutrition ESPEN special interest group (SIG), based on a survey aimed at identifying current practices relating to key issues in ICU nutrition. The ultimate goal is to improve the ICU patients quality of care.

Acute kidney injury in burns in the intensive care unit: A retrospective research.

BACKGROUND: Acute kidney injury (AKI) is one of the common complications, associated with high mortality and morbidity in patients with burn injuries. This study aimed to determine the frequency of AKI development, its affective factors, and mortality rates according to kidney disease improving global outcomes (KDIGO) criteria in the burn patients. METHODS: The study included patients who are hospitalized for at least 48 h and aged >18 years, whereas patients with a renal transplant, chronic renal failure, undergoing hemodialysis, <18 years of age, with a glomerular filtration rate of <15 on admission, and toxic epidermal necrolysis was excluded from the study. KDIGO criteria were used to evaluate the occurrence of AKI. Burn mech-anism, total body surface area, inhalation injury respiratory tract burn, fluid replacement at 72 h with Parkland Formula, mechanical ventilator support, inotrope/vasopressor support, intensive care unit, lenght of stay, mortality, abbreviated burn severity index (ABSI), acute physiology, and chronic health evaluation II (APACHE II) ve Sequential organ failure assessment (SOFA) were recorded. RESULTS: A total of 48 patients were included in our study, of which 26 (54.2%) developed AKI (+), whereas 22 (45.8%) did not (-). The mean total burn surface area was 47.30% in the AKI (+) group and 19.88% in the AKI (-) group. Mean scores of ABSI, II (APACHE II), and SOFA, the mechanical ventilation and inotrope/vasopressor support and the presence of sepsis were significantly higher in the AKI (+). No mortality was determined in the AKI (-) group, whereas 34.6% in the AKI (+) group which was significantly high. CONCLUSION: AKI was related to high morbidity and mortality in patients with burns. Using KDIGOs, classification in daily fol-low-up is useful in early diagnosis.

Carbapenem-resistant Gram-negative pathogens associated with septic shock: a review of 120 cases.

This study aimed to evaluate the influencing variables for outcomes in patients with septic shock having culture-proven carbapenem-resistant Gram-negative pathogens. It included 120 patients (mean age 64.29 ± 1.35 years and 58.3% female). The mean Sequential Organ Failure Assessment score during septic shock diagnosis was found to be 11.22 ± 0.43 and 9 ± 0.79 among the patients with mortality and among the survivors, respectively (P = 0.017). The logistic regression analysis showed that empirical treatment as mono Gram-negative bacteria-oriented antibiotic therapy (P = 0.016, odds ratio (OR) = 17.730, 95% confidence interval (CI): 1.728-182.691), Charlson Comorbidity Index >2 (P = 0.032, OR = 7.312, 95% CI: 5.7-18.3), and systemic inflammatory response syndrome score 3 or 4 during septic shock diagnosis (P = 0.014, OR = 5.675, 95% CI: 1.424-22.619) were found as independent risk factors for day 30 mortality. Despite early diagnosis and effective management of patients with septic shock, the mortality rates are quite high in CRGNP-infected patients.

Should evidence generated in well developed countries inform critical care nutrition in all countries?

PURPOSE OF REVIEW: Critically ill patients who survive the ICU face issues such as reduced quality of life and increased disability and nutritional therapy during ICU stay may be used to reduce these adverse effects. Although evidence and guidelines are available to direct clinical nutrition for ICU patients, critical care practices and settings differ substantially between developed and developing countries. RECENT FINDINGS: The implementation of evidence generated in well developed countries regarding critical care nutrition depends heavily on factors such as operation model, the structure of the unit, different care processes, hospital size and country income. SUMMARY: Guidelines and evidence generated by various societies, agencies and trials, which are focused towards developed world may not be fully appropriate and executable in the developing world. Also, the developing world is heterogenous. Hence, 'one size fits all' approach may not be appropriate. A holistic approach to guideline and evidence generation and its appropriate utilization in the developing world is binding on caregivers in both the developing and developed world so as to benefit the critically ill patient.

The effect of oropharyngeal aspiration before position change on reducing the incidence of ventilator- associated pneumonia.

The aim of this study was to investigate the effect of oropharyngeal aspiration on ventilator-associated pneumonia (VAP) incidence just prior to changing patient position. This randomized controlled experimental study was conducted between July 2015 and April 2019 in anesthesiology and reanimation of intensive care unit (ICU). The patients of experimental group underwent oropharyngeal aspiration under surgical aseptic conditions before each position change. Patients of the control group received oropharyngeal aspiration only as needed. The mean age of the patients was 62.87 ± 17.33 years. The mean and median duration of stay in the ICU were 27.28 ± 30.69 and 18.00 days respectively. The mean and median of duration of the mechanical ventilation support were 26.72 ± 30.65 and 18.00 (min 4; max 168) days respectively. Thirty percent of the patients were VAP. The mean duration of VAP development was 7.50 ± 5.07 days. The rate of VAP development was 11.23/1000 mechanical ventilator days. Only 8.3% of the experimental group patients developed VAP; 91.7% of the control group patients developed VAP. The VAP rate in the control group was 16.82/1000 mechanical ventilator days and the VAP rate in the experimental group was 2.41/1000 mechanical ventilator days. Most VAP agents were multidrug resistant. Distribution of isolated microorganisms was as Acinetobacter baumannii, Pseudomonas aeruginosa, Corynebacterium striatum, Staphylococcus aureus, Providencia stuartii, Serratia marcescens, Stenotrophomonas maltophilia, and Aspergillus flavus. In our study, it was concluded that oropharyngeal aspiration performed prior to patient position change prevented the development of VAP.

Is prenatal testosterone-estrogen balance associated with psoriasis?

The etiopathogenesis of psoriasis is not understood; however, psoriasis is affected by hormones, particularly the sex steroids. The second-to-fourth digit (2D:4D) ratio, which is an indicator of prenatal sex hormone balance, has been studied in various diseases that are affected by hormones. A total of 369 individuals comprising 172 patients with psoriasis and 197 healthy volunteers were included in the study. Patients with psoriasis were divided into type-1 and type-2, according to age of onset and family history. The 2D:4D ratio of both hands was recorded for all participants. Females in the psoriasis group had a lower 2D:4D ratio in both hands compared with those in the control group, with no significant difference. Males in the psoriasis group had a higher 2D:4D ratio for both hands compared with those in the control group (P = .009 and P < .001 for the right and left hands, respectively). Further, male patients with type-1 psoriasis had a lower 2D:4D ratio compared to those with type-2 psoriasis. Our results suggest that an alteration of the estrogen-testosterone balance due to prenatal testosterone activity is an independent predisposing factor for psoriasis in males.

The effect of smoking on the psoriasis: Is it related to nail involvement?

Psoriasis is a chronic inflammatory skin disease that negatively affects the quality of life with remissions and relapses. Smoking, which is known to accelerate the development of comorbidities that can accompany psoriasis such as atherosclerotic heart disease, metabolic syndrome, is also an independent risk factor for psoriasis. In our study, we aimed to investigate the relationship between smoking and psoriasis. The study included a total of 476 participants with 276 psoriasis patients and 200 healthy volunteers. One hundred and thirty-nine (69.5%) cases in the psoriasis group and 61 (30.5%) cases in the control group were smoking. Patients with psoriasis had more cigarette smoking than the control group (P < .001). Smoking was present in 100 cases (61%) of 164 cases with nail psoriasis and psoriatic nail was significantly more frequently observed in patients with psoriasis when smoking was present (P < .001). It was observed that systemic treatment requirements were higher in smoking psoriasis patients (P = .04). It is known that cigarette use increases in patients with psoriasis compared to the normal population, and cigarette use also increases the psoriasis area severity index (PASI). In our study, a significant relationship was found between smoking and psoriasis nail involvement first in the literature. Furthermore, the need for systemic treatment was higher in smokers.

Prognostic Importance of Ki-67 in Breast Cancer and Its Relationship with Other Prognostic Factors.

OBJECTIVE: The clinical feature of breast cancer is very heterogeneous because of the variable prognostic factors impact its behaviour. The aim of study is to find the prognostic importance of Ki-67 and to analyse the correlation between Ki-67 index and the other conventional prognostic factors in breast cancer patients. MATERIALS AND METHODS: Between 2010 and 2017, patients with invasive ductal carcinoma who received radiotherapy after surgery were included in study. A single pathologist re-defined of all cases retrospectively. Ki-67 were established three categories based on Ki-67 levels: low (<10%), intermediate (10-25%) and high (>25%). RESULTS: A total of 258 patients were included. 46 of 258 (18%) patients were in low, 82 of 258 (32%) patients were in intermediate and 130 of 258 (50%) patients were in high Ki-67 group. There were no correlations between menopausal status, age, and Ki-67 level. Low-pT stages tended to have low Ki-67 expression (p=0.07). Low-pN stages correlated with low Ki-67 values (p=0.007). Patients with ECE (+) were prone to have higher Ki-67 values (p=0.02). The significant correlation was seen between Ki-67 and tumour grading (p=<0.0001). Patients with LVI (+) had higher Ki-67 expression (p=0.007). Luminal A tumours were correlated with low Ki-67 group (p=<0.0001). Ki-67 values had significant effect on DFS (p=0.03) but not OS (p=0.09). CONCLUSION: This study showed that high Ki-67 expression is associated with higher pT-stage, higher pN-stage, higher grade, ER/PR negativity, HER2/neu positivity, ECE and LVI positivity. The prognostic impact of Ki-67 was only demonstrated for DFS.

Patient Knowledge, Attitudes, and Behaviors Associated with Organ Donation.

BACKGROUND This study compared the knowledge, attitudes, and behaviors associated with organ donation and transplantation among patients undergoing dialysis versus those visiting family health centers (FHCs). MATERIAL AND METHODS This cross-sectional study included patients undergoing hemodialysis treatment at the Meram Medical Faculty and those visiting FHCs in Meram district for other reasons. RESULTS The study participants were 128 individuals visiting FHCs and 111 patients undergoing dialysis. Of these, 169 individuals (70.7%) correctly answered the question "What is brain death?" The knowledge level in the FHC group was higher than that in the dialysis group. Less than half of the individuals indicated willingness to donate an organ. Furthermore, subjects in the dialysis group were more likely than those in the FHC group to answered "no" to the question "Would you be willing to donate an organ to someone of a different religion?" CONCLUSIONS Positive attitude towards organ transplantation and donation does not necessarily reflect positive behavior these 2 groups.

Prevalence of sarcopenia and related factors in community-dwelling elderly individuals.

OBJECTIVES:  To determine the prevalence of sarcopenia and related factors in individuals aged ≥65 years living in the Bornova district of Izmir, Turkey. Sarcopenia is one of the most serious health problems among elderly individuals. METHODS:  This cross-sectional study was conducted in the Bornova district of Izmir, Turkey, between February-July 2015. This study participants were comprised of 909 individuals aged ≥65 years. The dependent variable was the presence of sarcopenia and the European Working Group on Sarcopenia in Older People (EWGSOP) approach was used for determining sarcopenia. The independent variables were socio-demographic and economic characteristics, healthy life behaviors and health status/condition. Data were collected at home through face-to-face interviews and measurements, analysed using chi-square test, t-test and logistic regression analysis. RESULTS:  The participants' mean age was 72.8±6.2 (range: 65-100) years, and 60.2% were female (n=582). The prevalence of sarcopenia was 5.2% and that of low gait speed was 41.0%, low grip strength was 57.0%, low calf circumference was 6.1% and the combination of low gait speed and low grip strength was 14.3%. Risk factors of sarcopenia included increasing age, physical inactivity, low body mass index and the presence or risk of malnutritionConclusion: The prevalence of sarcopenia was 5.2% in this population and increased with age, physical inactivity, low body mass index and the presence or risk of malnutrition.

Neuroprotective Effects of Tocilizumab on Experimentally-Induced Spinal Cord Ischemia-Reperfusion Injury.

OBJECTIVES: We aimed to evaluate neuroprotective effects of tocilizumab on spinal cord ischemia-reperfusion (I/R) injury. Our study design was an experimental rabbit spinal cord I/R injury model, and the setting was at the Animal Research Laboratory, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey. METHODS: Twenty-four adult New Zealand rabbits were randomly divided into 3 groups: Group 1, control group (n = 8); Group 2, I/R group, and Group 3 (n = 8) I/R injury + tocilizumab (4 mg/kg, ip) treatment group. Spinal cord I/R injury repair was performed by infrarenal aortic cross clamping. On neurologic evaluation, spinal cord tissue plasma tumor necrosis factor alpha (TNFα), total antioxidant status (TAS), total oxidant status (TOS), thiobarbituric acid reactive substances (TBARS), interleukin 6 (IL-6), interleukin 10 (IL-10) levels were analyzed. Spinal cord neuronal damage score and apoptotic cell count were also investigated. RESULTS: I/R injury significantly increases the plasma and spinal cord tissue TNFα, TOS, TBARS, and IL-6 levels and decreases the plasma and spinal cord tissue TAS and IL-10 levels. Tocilizumab treatment significantly reduces the plasma and spinal cord tissue TNFα, TOS, TBARS, IL-6 levels and increases plasma and tissue TAS and IL-10 levels. I/R injury significantly increases spinal cord neuronal damage score and apoptotic cell count. Tocilizumab treatment significantly reduces spinal cord neuronal damage score and apoptotic cell count. Neurologic examination scores at 24, 48, and 72 hours were significantly better in the treatment group when compared with the I/R group. CONCLUSIONS: This study shows significant neuroprotective effects of tocilizumab on rabbit spinal cord I/R injury.

Results of 1001 liver transplantations in 23 years: Ege University experience.

BACKGROUND/AIMS: Liver transplantation (LT) is now the standard of care for most end-stage liver diseases. Over the next 30 years, advances in medicine and technology will greatly improve the survival rates of patients after this procedure. The aim of the present study was to analyze retrospectively the results of 1001 patients withLT. MATERIALS AND METHODS: Medical reports of 989 patients were analyzed retrospectively. Data were obtained from the patient's data chart. Descriptive statistics were used to describe continuous variables (mean, median, and standard deviation). RESULTS: A total of 1001 LTs for 989 recipients were performed at Ege University Organ Transplantation and Research Center between 1994 and 2017. Therewere 639 male and 350 female recipients. Among 1001 LTs, there were 438 deceased donors and 563 living donors. The age interval of the patients was 4 months to 71 years old. The median Model for End-Stage Liver Disease score was 20. There were 12 deceased liver donors using the split method. There were 12 cases subject to retransplantation. In living donor LT grafts, 423 right lobes, 46 left lobes, and 94 left lateral sectors were used. In the first monitoring,the total annual mortality rate was 130 cases (13%). The mortality rate in retransplantation was found to be 66%. A 1-year survival rate of 87% was generally stablished. CONCLUSION: LThas been improving consistently over the last two decades. Ege University is one of the biggest liver transplant centers in Turkey for both technical and educational perspective.