Importance of Source Control in the Subgroup of Intra-Abdominal Infections for Septic Shock Patients: Analysis of 390 Cases.

Background: This study aimed to evaluate the epidemiology of septic shock (SS) associated with intraabdominal infections (IAI) as well as associated mortality and efficacy of early source control in a tertiary-care educational hospital. Methods: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 during night shifts in our centre were analyzed retrospectively. Results: A total number of 390 patients were included. Overall, 30-day mortality was 42.5% on day 3, while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%), and the mortality rate was significantly lower in cases that were performed source control at any time during SS (65/123-52.8% vs 213/267-79.8%, p<0.001). In 44 of 123 cases (35.7%), source control was performed during the first 12 hours, and mortality was significantly lower in this group versus others (24/44-54.5% vs 254/346-73.4%, p=0.009). On the other hand, female gender (p<0.001, odds ratio(OR)= 2.943, 95%CI=1.714-5.054), diabetes mellitus (p= 0.014, OR=2.284, 95%CI=1.179-4.424), carbapenem-resistant Gram-negative etiology (p=0.011, OR=4.386, 95%CI=1.398-13.759), SOFA≥10 (p<0.001, OR=3.036, 95%CI=1.802-5.114), lactate >3 mg/dl (p<0.001, OR=2.764, 95%CI=1.562-4.891) and lack of source control (p=0.001, OR=2.796, 95%CI=1.523-5.133) were significantly associated with 30-day mortality in logistic regression analysis. Conclusion: Source control has a vital importance in terms of mortality rates for IAI-related septic shock patients. Our study underscores the need for additional research, as the present analysis indicates that early source control does not manifest as a protective factor in logistic regression.

The effect of exogenous melatonin administration before superovulation on embryo yield in Assaf ewes.

The aim of this study was to determine the effect of exogenous melatonin administration on transferable embryos by increasing total antioxidant status before superovulation in Assaf ewes. Selected ewes were randomly divided into two equal groups: melatonin (n = 9) and control (n = 9). In the melatonin group, a melatonin implant (18 mg melatonin, Regulin®, Ceva, Turkey) was placed under the skin of the ear 7 days prior to insertion of the progesterone-containing sponge. In the control group, a physiological saline solution was injected under the skin of the ear on the same day. The same superovulation protocol was used in both groups. In addition, blood samples for determination of Glutathione peroxidase, superoxide dismutase, total antioxidant status and total oxidant status concentrations were collected on five different days, including the day of melatonin implant placement (Day-7), vaginal sponge insertion (Day 0), vaginal sponge removal (Day 11), mating (Day 12-13) and uterine flushing (Day 19). Embryos were collected by laparotomy on the 7th day after mating. Uterine flushing taken into petri dishes were scanned under a stereomicroscope, and the quality and developmental stages of the embryos were recorded. In the study, total corpus luteum count and total cell count were found to be higher in the control group than in the melatonin group (p < .05). When the results were evaluated in terms of oxidative stress index, a negative correlation was found between the total number of corpus luteum, number of cells obtained, count of transferable embryos and number of Grade 1 embryos on Day 0. There was also a positive correlation oxidative stress index and the number of unfertilized oocytes on Day-7. As a result, exogenous melatonin administration prior to superovulation during the breeding season is thought to have a negative effect on embryo yield and quality. Therefore, the use of exogenous melatonin in MOET studies during the breeding season is recommended to be investigated in new studies.

Evaluation of antibody responses in healthcare workers before & after meningococcal vaccine and determination of meningococcal carriage rates.

The rates of nasopharyngeal meningococcal carriage in healthcare workers are unknown. Meningococcal vaccine is recommended for risk groups but healthcare workers are not included in risk groups for many countries. Herein, we aimed to investigate the nasopharyngeal meningococcal carriage rates, basal and after one dose of Men-ACWY-DT vaccine response on the 30th day by evaluating meningococcus IgG antibody levels and decolonization at month six after vaccination among the detected carriers. Nasopharyngeal swab samples were taken before vaccination to evaluate meningococcal carriage in healthcare workers. All participants received a single dose of Men-ACWY-DT vaccine. Serum samples were collected immediately before vaccination and again on day 30 post-vaccination. Antibodies in the stored sera were analyzed using the ELISA method. Participants who were determined to carry meningococci at the initial visit underwent another round of nasopharyngeal swab tests six months post-vaccination to check for decolonization. Between November 2020 and May 2021, we evaluated samples from 100 physicians [52 % females, 28.28 ± 4.45 (min: 24, max: 49)]. The majority of the physicians worked in the emergency department (45 %), followed by the infectious diseases clinic (14 %). Fifty-eight physicians had a history of at least one contact with a meningococcus-infected patient, and 53 (91.4 %) had used prophylactic antibiotics at least once due to this exposure. None of the study group nasopharyngeal swab cultures were positive for Neisseria meningitidis. Before the Men-ACWY-DT vaccine, anti-meningococcus IgG positivity was detected in the serum samples of only 3 (3 %) participants. By day 30 after vaccination, 48 % of participants showed positive for antibodies. As we didn't detect nasopharyngeal carriage in any participants, we didn't evaluate decolonization among carriers six months post-vaccination. Notably, detection of antibodies was evident in about half of the participants on day 30 after receiving a single dose of the Men-ACWY-DT vaccine.

Investigation of the morphometric characteristics of internal carotid artery between sexes and in patients with intracranial aneurysms.

PURPOSE: The purpose of this study is to investigate the morphometric properties of the internal carotid artery (ICA) by measuring the diameters and angles of its segments and exploring variations related to sex and the presence of aneurysms. METHODS: Digital subtraction angiography (DSA) images were utilized from 130 aneurysm patients and 75 non-aneurysm individuals to create 3D ICA models using 3D Slicer software. Segment diameters were measured via Autodesk Meshmixer 3.5.474 and angles were evaluated using ImageJ software. RESULTS: In total, DSA images of 130 aneurysm patients and 75 individuals with normally reported carotid systems were evaluated. It was found that the intracranial aneurysms (IAs) were predominantly formed on the anterior cerebral artery (ACA) in males (%43), whereas in females IAs were frequently localized in the C6 segment (31.7%) and middle cerebral artery (MCA) (30.2%). In the control group, the evaluation of gender differences in segment diameters and angles revealed that males had significantly larger C4 and C5 segment diameters (4.62 vs. 4.32 mm and 4.41 vs. 4.09 mm, respectively) and a greater C6 angle (146.9° vs. 139.7°) compared to females. Comparisons between patients with an aneurysm at the anterior cerebral artery (ACA) and the control group revealed that the ACA group had wider diameters in the C1 (4.88 vs. 4.53 mm), C3 (4.65 vs. 4.4 mm), C5 (4.51 vs. 4.25 mm), and ACA (2.36 vs. 2.06 mm) segments. Additionally, the ACA group had wider angles in the ACA (104.1° vs. 94.1°) and C6 segments (147.7° vs. 143.3°), whereas the control group exhibited wider angles in the middle cerebral artery (MCA) segment (141.5° vs. 135.5°) compared to the ACA aneurysm group. Patients with anterior cerebral artery (ACA) aneurysms exhibited larger diameters in C1, C3, C5, C6, and ACA segments compared to the control group. Additionally, while the control group had larger MCA angle, patients with ACA aneurysms had larger angles in C6 segment and ACA. CONCLUSION: Our results demonstrated that formation of aneurysms is affected by anatomical configuration of the ICA as well as sex characteristics, particularly regarding the ACA and MCA bifurcation angles, which showed associations with aneurysms in the respective branches.

Genetic characterization of Toxoplasma gondii strains isolated from humans living in Izmir, Türkiye.

PURPOSE: Toxoplasma gondii is an obligate intracellular zoonotic parasite that can infect all warm-blooded animals, including humans. Currently, clinical findings of toxoplasmosis are being related to T. gondii strains such as Type I genotype may cause high pathogenicity and Type II genotype causes a milder clinical presentation. We have showed in our previous that Type II genotype is the most frequent strain detected in stray cats and wild birds living in natural life of Izmir. The aim of this study was to assess toxoplasmosis seroprevalence in immunocompromised patients, investigate the presence of T. gondii DNA in their blood samples, and genotype the PCR positive ones. METHODS: The 42 buffy-coat and serum samples were collected from immunocompromised patients who were from various clinics. Thereafter, Real-Time PCR targeting RE gene of T. gondii was performed with DNA samples obtained from buffy-coat samples. Genotyping was performed by sequencing of GRA6 and GRA7 gene regions of positive DNA samples obtained from tissues of bioassay and PCR positive samples. RESULTS: According to Real-Time PCR results, T. gondii DNA was detected in 23.8% (10/42) samples. Among these 10 samples, two samples were determined as T. gondii Type II genotype. Anti-Toxoplasma IgG antibodies were detected in 28.57% (12/42) samples. CONCLUSIONS: Overall, the detection of Type II genotype in humans in Izmir province suggested that T. gondii infection in humans, stray cats, and wild animals may be associated to each other in terms of transmission.

The clinical features, treatment and prognosis of neutropenic fever and Coronavirus disease 2019 results of the multicentre teos study.

This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639-16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137-20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528-404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592-88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469-707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164-75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360-548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229-112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509-20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.

Some Welfare Assessment Traits and Quantitative-Qualitative Milk Parameters as Affected by Supplementary Feeding at Milking and Parity in Anatolian Buffalo Cows.

This study aimed to evaluate whether supplemental feeding at milking (SFAM) positively influences the quantitative-qualitative milk parameters due to improving some welfare assessment traits of multiparous Anatolian buffalo cows confined in semi-open free-stall barns. A total of 76 Anatolian buffalo cows at approximately 90 days in milk were selected to encompass four groups (OSF-2nd, NSF-2nd, OSF-≥3rd and NSF-≥3rd), considering offering (OSF) or not (NSF) supplemental feed at milking and the parity (2nd) and (≥3rd). Data of evaluated variables such as the following ones-(i) subjectively scored welfare assessment traits (temperament, udder hygiene and body condition), (ii) milk yield per milking (MYM), (iii) milk components, and (iv) milk physical traits-were analysed using a linear mixed model and principal component (PC) analysis. The OSF improved the temperament, udder hygiene and body condition scores compared to the NSF. The MYM, the fat content and the fat-to-protein ratio of the OSF were higher than those of the NSF, but milk mineral and electrical conductivity of the OSF were lower than those of the NSF. The parity of cows did not affect the evaluated variables. Four parameters (milk density value and lactose, solids-not-fat and protein contents) could be identified in the PC2 versus PC1 plot. In conclusion, the SFAM enhanced the milk yield and qualitative milk parameters due to improving the welfare status of indoor buffalo cows, regardless of parity.

Welfare assessment traits, milk quantity and quality, and profitability of Anatolian buffalo cows confined in closed-tied or semi-open free-stall barns can be affected by supplementary feeding at milking.

OBJECTIVE: This study was conducted to evaluate the effect of offering (OSF) or not (NSF) supplemental feed at milking on temperament (TS), udder hygiene (UHS) and body condition (BCS) scores, and milk yield per milking (MYM), milk quality traits, and profitability of primiparous Anatolian buffalo cows at 90 days of lactation confined in closed-tied (CB) or semi-open free-stall (OB) barns. METHODS: In Experiment I, 108 cows were selected to encompass four treatments (OBOSF, OB-NSF, CB-OSF, and CB-NSF) of 27 cows, considering barn type (OB and CB) and supplementary feed (OSF and NSF) at milking. In Experiment II, 60 OB cows were selected to encompass one of five groups of 12 cows each: i) no supplemental feed (CON), ii) commercial concentrate (CC), iii) CC + corn silage (CCS), iv) CCS + alfalfa hay (CSA), or v) CC + ryegrass silage (CRS) at milking. RESULTS: The TS and UHS of the OB and OSF cows were lower (better) than those of the CB and NSF cows, respectively. The OSF increased milk protein, lactose, and solids-not-fat but decreased milk freezing point and electrical conductivity compared with the NSF. The MYM and milk fat of the OB-OSF cows were higher than those of the OB-NSF and CBNSF cows. The TS and UHS of the cows negatively correlated with MYM and some milk chemicals (fat, protein, and solids-not-fat), but BCS correlated positively. The TS and milk electrical conductivity of the CCS, CSA, and CRS cows were lower than those of the CON and CC cows, but BCS, MYM, and milk fat were higher. Partial budget analysis identified a higher net profit for supplemental feed-offered groups (OB-OSF, CCS, CSA, and CRS). CONCLUSION: Offering roughage with concentrates at milking for indoor primiparous buffalo cows is more conducive to well-being, milk yield, milk quality, and economy.

Three-Dimensional (3D) Analysis of Orbital Morphometry in Healthy Anatolian Adults: Sex, Side Discrepancies, and Clinical Relevance.

Background and objective The complex structural integrity of the orbit is crucial for visual functions. Three-dimensional (3D) reconstructions from radiological images have revolutionized anatomical understanding, eliminating the limitations of two-dimensional (2D) imaging and offering intricate spatial details for complex structures. The aim of this study was to analyze the detailed morphometry of the orbit in healthy Anatolian adults, considering sex, side discrepancies, and clinical relevance using 3D models reconstructed from multidetector computed tomography (MDCT) images. Materials and methods Fifty-six (44.44%) males and 70 (55.56%) females (total: 126, mean age: 48.62) MDCT images were randomly selected and 3D skull models were reconstructed using 3D Slicer software. Measurements were conducted in millimeters (mm) for transverse and vertical diameters, circumference of the orbital opening, orbital wall lengths, as well as intraorbital and extraorbital distances. Results The method of measurements showed high reproducibility of results. The mean values for transverse and vertical diameters, circumference of the orbital opening, medial and lateral wall lengths, roof and floor lengths, and intraorbital and extraorbital distances were 40.23±2.12 mm (p<0.001), 34.94±2.16 mm (p=0.365), 44.74 ±3.02 mm (p<0.001), 46.30±2.69 mm (p<0.001), 51.26±2.91 mm (p<0.001), 49.01±3.22 mm (p<0.001), 126.10±5.71 mm (p<0.001), 19.63±2.35 mm (p=0.026), and 94.09±4.84 mm (p<0.001), respectively. Conclusion The study's high measurement reproducibility contributes significantly to the existing literature and clinical practice. These findings offer specific insights into Anatolian orbital morphometry, aiding in surgical planning, implant placement, and diagnostic assessments. The precise measurement values serve as a reliable reference for clinicians, facilitating the identification of normal and abnormal orbital anatomy and enhancing patient care. We believe this study provides valuable data for craniofacial and ophthalmological research, benefiting both clinical practice and future research endeavors in these fields.

Evaluation of lumbar lordosis in symptomatic individuals and comparative analysis of six different techniques: a retrospective radiologic study.

PURPOSE: The aim of this study; evaluate lumbar lordosis (LL) in symptomatic individuals with six different techniques and to examine the techniques comparatively. Thus, to provide an overview of lumbal lordosis and techniques. METHODS: Cobb L1-L5, Cobb L1-S1, Posterior Tangent, tangential radiologic assessment of lumbar lordosis (TRALL), vertebral centroid measurement of lumbar lordosis (CLL) and Risser Ferguson measurement techniques were used to assess LL from radiographs of 175 symptomatic adults. Correlations between techniques and relationship between the measurements obtained, gender and age were analyzed. Also interclass correlation (ICC) analyzed. Bland-Altman plots were performed to compare the techniques with Cobb. RESULTS: ICC for all methods were greater than 0.96. For each method, no difference in LL was observed with respect to gender or age (p > 0.05). High positive correlation was observed between the Risser Ferguson, Posterior Tangent, Cobb L1-L5, Cobb L1-S1 and CLL techniques (p < 0.001), and moderate positive correlation between TRALL and all other techniques (p < 0.001). CONCLUSION: In this study, it was found that the mean lumbar lordosis values of symptomatic participants were lower than most of the other asymptomatic studies in the literature and there was no significant difference in lumbar lordosis values in terms of gender and age in symptomatic individuals. Based on statistical findings, Risser Ferguson can be used to assess LL. These results and the data obtained as a result of the comparative examination of techniques according to age groups and gender will benefit clinicians and those working in the field by providing a better understanding LL.

Ertapenem plus meropenem combination treatment in carbapenem-resistant Klebsiella pneumoniae bacteremia: an analysis of 53 cases.

Herein, we aimed to describe the outcomes of patients with blood stream infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) who received ertapenem plus meropenem combination treatment (EMCT). A total of 53 patients with culture proven CR-Kp bacteremia treated with ertapenem + meropenem were included. The patients with secondary bacteremia due to urinary tract infection exhibited a significantly lower 1-month mortality (OMM), particularly in those with microbiological eradication and those with end-of-treatment success. Salvage EMCT resulted in 49% 1-month survival.

Empirical cefepime+vancomycin versus ceftazidime+vancomycin versus meropenem+vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter ephesus study.

BACKGROUND: Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). MATERIALS/METHODS: This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. RESULTS: Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p < 0.05). Microbiological success on Day 3-5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). CONCLUSIONS: Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.

Safe Use of Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers: A Multidisciplinary Approach to Minimize Adverse Effects.

Purpose: The purpose of this study is to evaluate the side effects associated with hyperbaric oxygen therapy and provide recommendations to prevent them in patients with diabetic foot ulcers. Introduction: The use of hyperbaric oxygen therapy in the treatment of diabetic foot ulcers remains a contentious issue, and minimizing side effects is critical. While the incidence of side effects related to hyperbaric oxygen (HBO2) therapy is low, it is essential to evaluate cases in a multifaceted and interdisciplinary manner to prevent adverse outcomes. Methods: A retrospective cohort study was conducted over the period of 2018-2020, involving a dataset of 100 patients. The primary objective of the study was to examine the frequency and types of side effects experienced by patients who underwent hyperbaric oxygen therapy (HBO) for diabetic foot ulcers (DFUs). In addition, we analyzed various wound characteristics, characteristics of hospitalizations, the surgical or medical interventions received by patients, and laboratory parameters including CRP levels, total blood count, culture results, HbA1c levels, duration of diabetes, treatment received for diabetes, and antibiotic therapy regimens. Results: The percentage of patients who experienced side effects was as low as 6%, and none of them were critical. The most common side effect was discomfort due to the confined space in the chamber. Conclusion: Appropriate patient selection, combined with a multidisciplinary approach to evaluate eligibility, is crucial to avoid adverse side effects. Patient education and early screening for side effects are also essential. Since various treatment protocols exist for HBO2 therapy, pooled data from different protocols may be misleading. Further studies focused on side effects with specific indications are necessary.

Multidrug resistance in pathogens of community-acquired urinary tract infections in Turkey: a multicentre prospective observational study

BACKGROUND: To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options. METHODS: We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed. RESULTS: Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advancedage, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions. DISCUSSION: The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factorsfor antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.

Unilateral Absence of the Latissimus Dorsi: A Report of a Rare Case.

The latissimus dorsi is the largest muscle in the human body, located in the lower posterior thorax, and it contributes to motion in the upper extremity and provides assistance in respiration. This case report describes a rare occurrence of a unilateral absence of the latissimus dorsi accompanied by contralateral scoliosis in a 73-year-old female cadaver. The absence of the muscle along with the absence of the thoracodorsal nerve and branches of the subscapular and axillary arteries was identified during a standard dissection course. The implications of this rare case extend to an array of surgical interventions, including head, neck, breast, and torso reconstructive applications. It is important to investigate potential anomalies of the latissimus dorsi, while planning or performing free flap transfers. The report also highlights the importance of understanding this variation for educational and research purposes.

Efficacy of telemedicine applications in patients with diabetic foot ulcers: A focus on mortality and major amputation rates.

Amputations related to diabetic foot ulcers (DFU) are associated with high morbidity and mortality rates. Glycaemic control and close follow-up protocols are essential to prevent such ulcers. Coronavirus disease (COVID) related restrictions and regulations might have a negative impact on patients who are with DFU or candidates for DFU. We retrospectively analysed 126 cases that had DFU underwent amputation surgery. Comparative analyses were done between cases that were admitted before COVID restrictions (Group A) and cases admitted after COVID restrictions (Group B). Two groups were homogenic demographically. There was no significant difference between groups in terms of mortality (p = 0.239) and amputation rates (p = 0.461). The number of emergent cases in the pandemic period doubled the number in pre-pandemic period even though this finding was not statistically significant (p = 0.112). Fastly adapted consulting practice and follow-up protocols to compensate for the problems created by COVID-related regulations seem to be effective in terms of mortality and amputation rates.

Does using microfluidic sperm sorting chips in bovine IVEP affect blastocyst development?

This study aimed to determine the effect of microfluidic sperm sorting chip on embryo development and quality in the sperm treatment step in in vitro embryo production in cattle. Only A-quality oocytes obtained from the ovaries of Holstein cattle were included in the study. These oocytes were first placed in in vitro maturation medium, and matured oocytes were randomly divided into two groups at the 24th hour of maturation. Oocytes in the first group with the Microfluidic Sperm Sorting Chip (MFSC, n = 154) were put into a fertilization medium with spermatozoa prepared with microfluidic sperm sorting device. Oocytes in the second group (Con, n = 169) were fertilized with spermatozoa prepared by the routine sperm treatment step of the commercial company. The rate of cleavage (85.71% vs. 76.33%, respectively) and of reaching the blastocyst (44.15% vs. 32.54%, respectively) in the MFSC group were higher than the control group. In addition, it was determined that the numbers of ICM (45.8 ± 2.04 vs. 39.2 ± 1.85, respectively), TE (122.13 ± 2.19 vs. 115.0 ± 2.61, respectively), TC (167.93 ± 2.89 vs. 154.2 ± 2.62, respectively) increased in the MFSC group compared to the control group. A statistically significant difference was found in the number of cells with apoptosis per embryo (5.14 ± 0.77 vs. 11.91 ± 0.79) and apoptotic index rates (3.06 ± 0.47 vs. 7.72 ± 0.55%) of the MFSC and Con groups. As a result, we concluded that using microfluidic sperm sorting chips during sperm treatment in bovine IVEP increases the rate of reaching the blastocyst, embryo development, and quality and reduces the possibility of apoptosis in developing blastocysts. For this reason, it is also thought that the use of microfluidic sperm sorting devices during sperm treatment in bovine IVEP may be a new alternative in this field.

Morphometric analysis of the infratemporal fossa using three-dimensional (3D) digital models.

PURPOSE: The infratemporal fossa contains important neurovascular components and is directly related to other anatomical regions and structures. The morphometric distances between the bones forming its borders have not been thoroughly investigated. The aim of this study was to determine the morphometry of the infratemporal fossa. METHODS: 3D models of the skull of 83 individuals were reconstructed from DICOM datasets, from which length, depth and width measurements were determined and compared between genders and the right and left sides. RESULTS: All measurements obtained were significantly different between males and females. There were also significant differences between the left and right sides for depth and width measurements. CONCLUSION: This is the first study to determine and investigate measurements of the infratemporal fossa; as such it provides a comprehensive view of the morphology of the fossa. It provides valuable information for surgical interventions and differential diagnoses of pathologies in this region, as well as enhancing its understanding in medical education.

Vitamin D3 Promotes Structural and Functional Recovery After Vincristine-Induced Peripheral Neuropathy in Rats: An Experimental Study.

Background Vincristine-induced peripheral neuropathy (VIPN) is a distal axonopathy characterized by the loss of distal myelinated axons. This study aimed to assess the potential neuroregenerative roles of vitamin D3 using functional and electron microscopic analyses in a rat model of VIPN. Methodology A total of 40 female Wistar rats were randomly divided into four main groups: Group 1 (control, n = 10), Group 2 (vincristine, n = 10), Group 3 (vincristine + vitamin D3, n = 10), and Group 4 (vincristine + vehicle, n = 10). Vincristine was administered intraperitoneally at a dose of 0.15 mg/kg, for two weeks, to induce peripheral neuropathy. Following successful induction, vitamin D3 (500 IU/kg/day) and vehicle treatments were applied weekly over four weeks. Structural (electron microscopic analysis) and functional analysis (von Frey test, pinch test, and electrophysiological analysis) were performed to assess functional recovery after peripheral nerve impairment. Results Withdrawal responses to mechanical allodynia and pinch tests were significantly higher in the vitamin D3-treated group (P < 0.05). The electrophysiological analysis also supported these results. Electron microscopic evaluation revealed that the remyelinated nerve fibers in the vitamin D3-treated group (Group 3) had thick myelin sheaths and normal axonal morphology. Conclusions Our study demonstrated that vitamin D3 could promote functional and structural recovery in a rat model of VIPN. Further studies should be conducted to elucidate the underlying mechanisms by which vitamin D3 exerts its regenerative effects in VIPN, using alternative administration protocols.

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.