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Introduction: Multidrug-resistant bacterial infections such as pseudomonas aeruginosa, acinetobacter baumannii, klebsiella pneumoniae are common in Intensive Care Units. Colistin is preferred today due to limited treatment options sensitive to these pathogens. However, colistin has a high potential for nephrotoxicity. Some classifications (KDIGO, RIFLE, AKIN) are used for the diagnosis of Acute Kidney Injury (AKI). The incidence of AKI varies according to these classifications. In our study, we aimed to evaluate and compare the development of Acute Kidney Injury according to KDIGO criteria and RIFLE classification in patients followed up in the intensive care unit and started colistin therapy. Materials and Methods: The data of 145 patients who started colistin treatment in the Internal Medicine Intensive Care Unit between January 2016 and December 2019 were retrospectively reviewed. Patients were grouped as those with Acute Kidney Injury and those without. Acute Kidney Injury evaluation was made according to RIFLE classification and KDIGO criteria. Results: In patients who received colistin treatment, 75 patients were evaluated as AKI when KDIGO criteria were used for the AKI diagnosis, and 54 patients were evaluated as AKI when the RIFLE classification was used. While the number of KDIGO Stage 1 patients was 44, the number of patients in the RIFLE classification risk group was determined as 23. The mean SOFA score was calculated as 7.91±2.8 and the mean APACHE II score as 22.77±5.3. The duration of stay in the ICU was 22.60±9.04. The duration of stay in the ICU was shorter in the group who developed AKI. 44.8% of the patients included in the study died. 52% of patients who developed AKI and 37.1% of those who did not develop AKI died. 30-day mortality in patients with AKI was significantly higher than both KDIGO staging and RIFLE classification (p=0.03, p=0.005, respectively). Mortality rate increased 1.42 times in KDIGO Stage 1, 2.79 times in KDIGO Stage 2 and 2.10 times in KDIGO Stage 3. When evaluated by the RIFLE classification, the mortality rate increased 2.32 times in the Risk group, 3.12 times in the Injury group, 2.06 times in the Failure group and 2.15 times in the Loss group. Conclusion: We observed an increase in the frequency of AKI in patients using colistin in the ICU, both according to KDIGO criteria and the RIFLE classification. This situation also increases the 30-day mortality. We think that the KDIGO criteria are more sensitive to diagnose AKI in these patients.

Introduction We aimed to investigate the relationship between Vitamin D level and quality of life in patients undergoing peritoneal dialysis as renal replacement therapy. Methods 50 peritoneal dialysis patients aged between 18 and 73 years were included in this study. KDQOL-36 questionnaire was applied to rate the quality of life of the patients. This questionnaire consisted of 36 questions divided into five subscales. The patients were divided into two groups according to serum vitamin D levels. Patients with a serum 25(OH) D level < 20 ng/mL were identified as vitamin D deficiency group and those with a serum 25(OH)D level >= 20 ng/mL were identified as normal vitamin D group. Results The patients had a mean age of 41.16 +/- 16.05 years, 56% of them were females. The mean 25(OH) D levels of patients with 25 (OH) D levels < 20 ng/mL and those with >= 20 ng/mL were 10.50 +/- 4.62 ng/mL and 25.55 +/- 4.11 ng/mL, respectively. We found that all subscales of KDQOL-36 were lower with statistically significance in the group with Vitamin D (Vit-D) deficiency. Hemoglobin level was detected as independent risk factor for Symptom and problem list subscales and SF-12 physical component summary subscale (PCS) (P = 0.029, P = 0.047). Vit-D deficiency was detected as independent risk factors for kidney disease burden subscale and PCS (P = 0.035, P = 0.019). Hypertension was detected as independent risk factor for kidney disease burden subscale (P = 0.015). Conclusion Our study is the first to investigate the relationship between serum Vit-D level and quality of life by KDQOL-36 scale in peritoneal dialysis patients. We revealed that patients with low Vit-D levels had worse quality of life in all subscales.

WOS:000648071100001 PMID: 33955313 Introduction We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients. Material and method Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters. Results Median age was 68 (60-76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049-1.083; p < .001), DM (OR: 1.682, 95%CI: 1.238-2.286; p = .001), neutrophil (OR: 1.041, 95%CI: 1.007-1.077; p = .019), creatinine (OR: 1.178, 95%CI: 1.048-1.325; p = .006), CRP (OR: 1.008, 95%CI: 1.006-1.010; p < .001), ACEI (OR: 0.718, 95%CI: 0.521-0.988; p = .042), AST (OR: 1.005, 95%CI: 1.001-1.010; p = .010) were found associated with in-hospital mortality. Conclusion In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.

A good glycemic regulation should be provided to reduce mortality and morbidity in patients with end-stage renal failure due to diabetes mellitus. However, the use of insulin therapies in patients with renal failure is troublesome due to the increased rate of side effects. In our study, we investigated the frequency of hypoglycemia and its symptoms in patient groups receiving intensive and mixed insulin therapies. This prospective study included 89 hemodialysis patients with DM-related stage 5 chronic kidney disease who were followed up in a nephrology clinic of a university hospital between January 2013 and August 2015. Our study group was divided into two groups as those receiving intensive insulin therapy and mixed insulin therapy. Group 1 and group 2 consisted of 46 patients and 43 patients, respectively. Hypoglycemia (glucose 0.05). Hypoglycemia was detected in 27 patients (58.7%) in the intensive insulin therapy group and 14 patients (32.6%) in the mixed insulin therapy group. There was a significant level of hypoglycemia in the group receiving intensive insulin therapy (p < 0.05). In our study, the group receiving intensive insulin therapy had higher frequency and severity of common hypoglycemia symptoms such as confusion, sweating, weakness, dysphasia, palpitations, blurred vision, and feeling hungry. There was a higher frequency of hypoglycemia under intensive insulin therapy in patients undergoing dialysis due to chronic kidney failure, which suggests that mixed insulin therapy is the ideal treatment to avoid hypoglycemia in this group of patients.

Objective: To investigate mortality in patients undergoing surgical treatment for spontaneous intracranial hemorrhage (sICH) and to identify the predictive factors. Materials and Methods: The medical records of 164 patients with sICH who underwent surgery at two institutions between 2010 and 2017 were retrospectively examined and analyzed. Results: Among 164 patients who received surgical treatment, 83 (50.6%) were women and 81 (49.4%) were men. The mean patient age was 56±14.54 years. Of all patients, 109 (66.4%) had hypertension. Hematoma was intraparenchymal in 69 (42.1%) patients, thalamic in 33 (20.1%), intraventricular in 33 (20.1%), and cerebellar in 29 (17.7%) patients. The mortality rate among patients who underwent surgery within the first 8 h of hematoma occurrence was 55.4%; this rate was 73% among those who underwent surgery 8-24 h after diagnosis, and 72.7% among those who underwent surgery 24-48 h after diagnosis. Conclusion: Prognosis and mortality associated with sICH are usually affected by patient age, hematoma location and volume, intraventricular hemorrhage, and patient’s initial neurologic status. We found no significant relationship between surgical treatment 8 h after hemorrhage and mortality. There are still discussions about the indications of surgical treatment in intracranial hematomas.

Introduction: Human Immunodeficiency virus is a chronic infection that attacks the immune system of the human body, particularly CD4 T lymphocytes. Combined antiretroviral therapies are highly effective in virological suppression of human immunodeficiency virus infection. It has been shown that some retroviral therapies have a higher nephrotoxicity potential. As a result of renal injury, serum creatinine increases, and the estimated glomerular filtration rate is reduced. The aim of our study was to assess changes in kidney function during a 24-month period in HIV-positive patients who were begun on combined antiretroviral therapy. Material-method: A total of 127 HIV positive patients were enrolled. The patients were divided into five groups; patients who received no therapy were designated as Group 1; those that received Dolutegravir/Abacavir/Lamivudine combination as Group 2; those that received Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Fumarate combination as Group 3; those that received Emtricitabine/Tenofovir Disoproxil Fumarate/Dolutegravir combination as Group 4; and those that received Emtricitabine/Tenofovir Disoproxil Fumarate/Raltegravir combination as Group 5. We compared the effects of these drugs on estimated glomerular filtration rate during a 24-month follow-up period. Results: At the 24th month of therapy, a significant difference was observed between the eGFR levels of the study groups (p:0.05). Serum creatinine level was significantly higher in Groups 4 and 5 compared to the other groups (p

Background: There are limited data on long-term outcome and mortality predictors of COVID-19 from different parts of the world. The aim of this study was to determine risk factors of 90-day mortality in critically-ill patients infected with SARS-CoV-2 in Turkish ICUs. Methods: This multicenter, retrospective study was performed in 26 ICUs in Turkey. All patients with confirmed SARS-CoV2 infection, requiring more than 24 hours of ICU follow-up were included in the study. Demographics, clinical characteristics, laboratory variables, respiratory support, treatment types, and survival data were recorded. Results: A total of 421 patients were included in the study. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. 90-day mortality rate was 55.1%. Factors independently associated with 90-day mortality were receiving invasive mechanical ventilation (HR 4.09 [95% CI: 2.20-7.63]), admission lactate level > 2 mmol/L (2.78 [1.93-4.01]), age ≥ 60 years (2.45 [1.48-4.06)]), having cardiac arrhythmia during ICU stay (2.01 [1.27-3.20]), receiving vasopressor treatment (1.94 [1.32-2.84]), positive fluid balance of ≥ 600 ml/per day during ICU follow-up (1.68 [1.21-2.34]), admission PaO2/FiO2 ratio of ≤ 150 mmHg (1.66 [1.18-2.32], and baseline ECOG score ≥ 1 (1.42 [1.00-2.02]. Conclusion: This study has shown that long-term mortality was high in critically-ill COVID-19 patients in Turkish ICUs. Invasive mechanical ventilation, high lactate level, older age, presence of cardiac arrhythmia, need for vasopressor treatment, positive fluid balance, severe hypoxemia and not having fully-active performance were related with mortality.

Objective: The aim of this study is to examine and evaluate the clinical findings and affecting factors related to graft and patient survival in kidney transplant patients at Dicle University Hospital. Method: 72 patients who underwent kidney transplantation at Dicle University Medical Faculty Hospital between January 2012 and September 2019 were included in the study. Demographic characteristics of patients, transplantation types, clinical and laboratory findings, pre-transplant dialysis types, renal failure etiologies, post-transplant complications, average patient and graft survival times and patient characteristics at the time of diagnosis, laboratory values, and treatment modalities were investigated. Results: In this study, the data collected from 72 patients who had kidney transplantation and 68 donors was analysed. The mean age of the patients was 32,7±13,8 years. 31 of patients were female, 41 were male. 56 of the transplants were performed living donors and 12 from cadavers. 9 patients died. The mean of patient survival was 94±3,4 months. Graft loss occured in 15 patients. The mean of graft survival was 86±4,3 months. Acute rejection occured in 10 patients. Chronic allograft nephropathy occured in 19 patients. Chronic allograft nephropathy was found more frequently in patients with acute rejection (p=0.017). In addition, graft loss was more common in patients with chronic allograft nephropathy (p=0.002). The dialysis duration was less than 12 months, and the BMI of the recipient was below 30 had a positive effect on patient survival. Conclusion: Recipient obesity and long-term dialysis programs reduce patient survival. In addition, prevention of rejection has a positive effect on patient and graft survival. Amaç: Bu çalışmanın amacı Dicle Üniversitesi Hastanesi’nde böbrek nakli yapılan hastalarda greft ve hasta sağkalımına ilişkin klinik bulguları ve etki eden faktörleri incelemek ve değerlendirmektir. Yöntemler: Çalışmaya Ocak 2012- Eylül 2019 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Hastanesi’nde böbrek nakli yapılan 72 hasta dahil edildi. Çalışmaya dahil edilen hastaların demografik özellikleri, nakil tipleri, klinik ve laboratuvar bulguları, nakil öncesi diyaliz tipleri, böbrek yetmezliği etyolojileri, nakil sonrası gelişen komplikasyonlar, ortalama hasta ve greft sağkalım süreleri ve bu süreleri etkileyen tanı anındaki hasta özellikleri, laboratuvar değerleri, tedavi modaliteleri araştırıldı. Bulgular: Çalışmamızda böbrek nakli yapılan 72 hastanın ve 68 vericinin verileri analiz edildi. Hastaların ortalama yaşı 32,7±13,8 yıldı. 31 kadın, 41 erkek hasta vardı. Nakillerin 56’sı canlıdan, 12’si kadavradan yapılmıştı. Ortalama hasta sağkalımı 94±3,4 aydı. 15 hastada greft kaybı gelişmişti. 9 hasta eksitus olmuştu. Ortalama greft sağkalımı 86±4,3 aydı. 10 hastada akut rejeksiyon gelişmişti. 19 hastada kronik allograft nefropatisi gelişmişti. Kronik allograft nefropatisi, akut rejeksiyon gelişen hastalarda (p=0,017) daha sık saptandı. Ayrıca kronik allograft nefropatisi gelişen hastalarda greft kaybı daha sık olmaktaydı (p=0,002). Alıcının diyaliz süresinin ≤12 ay ve BKİ≤30 olması hasta sağkalımını olumlu etkilemişti. Sonuç: Alıcı obezitesi ve uzun süreli diyaliz programları hasta sağkalımını azaltmaktadır. Ayrıca rejeksiyonun önlenmesinin, hasta ve greft sağkalımına olumlu etkisi olmaktadır.

Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P2 mmol/L (2.78 [1.93-4.01], P= 60 years (2.45 [1.48-4.06)], P= 600 mL/day (1.68 [1.21-2.34], P=.002), PaO2/FiO(2) ratio of = 1 (1.42 [1.00-2.02], P=.050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality. WOS:000700853600007 2-s2.0-85115428262 PubMed: 34558415

WOS: 000456394800006, Pregnancy-induced hypertensive complications (pre-eclampsia, eclampsia, and HELLP syndrome) contribute to a significant public health threat worldwide. HELLP syndrome is a life-threatening condition, usually seen in the last trimester in pregnant women. Elevation of liver enzymes, anemia due to hemolysis, and decrease in platelet count are the diagnostic triad. HELLP syndrome is especially associated with intracranial hemorrhage, which may increase mortality. This report presents successful treatment of a complicated patient with HELLP syndrome and intracranial hemorrhage.

The objective of our study is to detect the patient group that will most benefit from intravenous (IV) thrombolytic therapy by showing predictive factors of good functional outcomes. The present study covers 88 patients who were admitted to our clinic within the first 4.5 hours from the onset of stroke symptoms, diagnosed with acute ischemic stroke and who received IV thrombolytic therapy between May 2014 and June 2017 as a result of a retrospective analysis of a database prospectively collected. The patients with a score of ≤2 on modified Rankin scale within 3 months were accepted as good functional outcome and those with a score of >2 were accepted as poor functional outcome. As a result, within the period of 3 months posttreatment, good functional outcomes were obtained in 45 (51.1%) patients and poor functional outcomes were obtained in 43 (48.9%) patients. In comparisons, cardioembolic stroke group was statistically significantly higher in the good functional outcome group ( P = .03). Pretreatment National Institute of Health Stroke Scale (NIHSS) scores ( P < .001), presence of proximal hyperintense middle cerebral artery sign in noncontrast computed brain tomography ( P = .03), and being aged ≥80 and older ( P = .04) were markedly higher in the group with poor functional outcomes. In conclusion, our study demonstrated that cardioembolic strokes may have an impact on good functional outcomes and being aged 80 and older, presence of proximal HMCAS in computed brain tomography, and pretreatment NIHSS scores may have an impact on poor functional outcomes.

Background and Aim: Instrumentation is commonly used in spinal surgery to stabilize the fracture. In the present study, we aimed to compare the early and late changes seen in bone production and degradation products in patients with traumatic spinal fracture who had been treated surgically or conservatively. Materials and Methods: Forty-three patients were admitted to the Neurosurgery Department with thoracolumbar or lumbar fracture in this prospective study. Patients were divided into two groups of surgically treated (n = 23) and nonsurgically/conservatively treated (n = 20) patients. The early and late changes seen in bone production and degradation products were compared in patients with traumatic spinal fracture who had been treated surgically or conservatively. Results: In conservatively treated patients, although osteocalcin level was slightly increased and deoxypiridinoline (DPD)/creatinine was slightly decreased after the treatment, the difference was not statistically significant (P = 0.08 and P = 0.539, respectively). There is no significant difference between admission time, posttreatment late period osteocalcin level, and DPD/creatinine ratio between the two group of patients (P = 0.215 and P = 0.236, respectively). Conclusion: We suggest that the healing and fusion processes in fractured vertebrae not only followed by the radiological examination but also by noninvasive biochemical changes seen in the serum levels of bone formation and resorption markers.

WOS: 000403158600013, PubMed: 28490163, Objective : The aim of this study to investigate the normal values of erythropoietin (EPO) and neuroprotective effects of quercetin and mannitol on EPO and hematocrit levels after acute severe traumatic brain injury (TBI) in rat model. Methods : A weight-drop impact acceleration model of TBI was used on 40 male Wistar rats. The animals were divided into sham (group I), TBI (group II), TBI+quercetin (50 mg/kg intravenously) (group III), and TBI+mannitol (1 mg/kg intravenously) (group IV) groups. The malondialdehyde, glutathione peroxidase, catalase, EPO, and hematocrit levels were measured 1 and 4 hour after injury. Two-way repeated measures analysis of variance and Tukey's test were used for statistical analysis. Results : The malondialdehyde levels decreased significantly after administration of quercetin and mannitol compared with those in group II. Catalase and glutathione peroxidase levels increased significantly in groups III and IV. Serum EPO levels decreased significantly after mannitol but not after quercetin administration. Serum hematocrit levels did not change significantly after quercetin and mannitol administration 1 hour after trauma. However, mannitol administration decreased serum hematocrit levels significantly after 4 hour. Conclusion : This study suggests that quercetin may be a good alternative treatment for TBI, as it did not decrease the EPO levels.

INTRODUCTION: Sepsis is an important cause of mortality and morbidity, and inflammatory response and oxidative stress play major roles underlying its pathophysiology. Here, we evaluated the effect of intraperitoneal etanercept administration on oxidative stress and inflammation indicators in the kidney and blood of experimental sepsis-induced rats. METHODS: Twenty-eight adult Sprague Dawley rats were classified into Control (Group 1), Sepsis (Group 2), Sepsis+Cefazolin (Group 3), and Sepsis+Cefazolin+Etanercept (Group 4) groups. Kidney tissue and serum samples were obtained for biochemical and histopathological investigations and examined for the C reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), triggering receptor expressed on myeloid cells (TREM), and malondialdehyde (MDA) levels. RESULTS: The levels of TNF-α, TREM, and MDA in serum and kidney samples were significantly higher in rats from sepsis group than in rats from control group (p < 0.05). Group 3 showed a significant reduction in serum levels of TNF-α, CRP, and TREM as compared with Group 2 (p < 0.05). Serum TNF-α, CRP, TREM, and MDA levels and kidney TNF-α and TREM levels were significantly lower in Group 4 than in Group 2 (p < 0.05). Serum TNF-α and TREM levels in Group 4 were significantly lower than those in Group 3, and histopathological scores were significantly lower in Group 3 and Group 4 than in Group 2 (p < 0.05). Histopathological scores of Group 4 were significantly lower than those of Group 3 (p < 0.05). CONCLUSIONS: Etanercept, a TNF-α inhibitor, may ameliorate sepsis-induced oxidative stress, inflammation, and histopathological damage.

WOS:000614471900004 Background and Aims: Cancer patients are admitted to intensive care units (ICU) due to primary diseases, treatment-related conditions or comorbid diseases. Acute kidney injury (AKI) and infections appear to be factors affecting mortality and morbidity in ICU follow-up. Therefore, in our study, we investigated the effect of AKI and inflammation-based parameters on mortality in cancer patients admitted to the ICU. Materials and Methods: In this study, 386 patients diagnosed with malignancy hospitalized between 2010 and 2014 in Dicle University Medical Faculty Internal Medicine ICU were included. The study was designed retrospectively. The demographic characteristics and clinical information of the patients were obtained from the files. Subsequently, patients were classified as non-survivors (group 1) and survivors (group 2). Both groups were compared in terms of the presence and stage of AKI by KDIGO definition, neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR). Results: Creatinine, CRP, neutrophil counts were found to be significantly higher and albumin, hemoglobin, platelet and lymphocyte counts were found to be lower in group 1 (n=276) compared to group 2 (n=110). Length of ICU was longer in group 2 patients. There was a positive correlation between mortality and KDIGO stages and NLR. Mortality rate was increased 1.9 fold in KDIGO stage 1, 2.3 fold in stage 2, 2.4 fold in stage 3 and 1.5 fold if NLR>5. There was no statistically significant relationship between PLR and mortality. Conclusion: The presence of AKI and elevated inflammation-based parameters were associated with mortality in oncologic patients admitted to the ICU.

AIM To investigate the acute effects of sildenafil citrate in an experimental model of severe head trauma, and to compare it with the efficacy of mannitol, which is an osmotically active agent frequently used in clinical treatment of traumatic brain injury (TBI). MATERIAL AND METHODS Twenty-eight Wistar-derived albino strain female rats were randomized into four groups comprising seven rats each. These groups were designated as follows: Group I: sham; Group II: TBI; Group III: TBI + mannitol (20% 1 gr/ kg, intraperitoneal); and Group IV: TBI + sildenafil citrate (10 mg/kg, intraperitoneal). Sections prepared following the tissue processing of samples obtained from the right prefrontal cortex and right hippocampal regions of the brains of sacrificed rats were histopathologically evaluated. Fractionator method via the Stereo Investigator software program (Micro Bright Field) was used to count the neurons. Pyknotic neuron count and pyknotic / total neuron count were compared between the groups. RESULTS In the comparison of Group II and IV, pyknotic neuron count (prefrontal; group II: 116.00 ± 30.50, group IV: 80.00 ± 19.47) and pyknotic/ total neuron count (prefrontal; group II: 0,30 ± 0.08, group IV: 0.21 ± 0.02) were significantly lower in Group IV in both regions (p < 0.05). Similarly, in the comparison of Group II and III, the values in Group III were lower in both regions (p < 0.05). CONCLUSION Sildenafil citrate decreases neuronal death in the acute phase and produces similar results with mannitol. Therefore, we believe that sildenafil citrate can be a useful adjunct or alternative agent for the clinical treatment of patients with acute TBI.

WOS:000513527600001 PMID: 32029697 Background: The main cause of mortality among chronic kidney disease (CKD) patients is cardiovascular disease (CVD). Epicardial adipose tissue (EAT) is considered to be novel cardiovascular risk factor. We assessed EAT in non-dialyzed stage 5 CKD patients and explored the association of EAT with body composition as determined by multi-frequency BIA. Material/Methods: The present included 70 stage 5 CKD patients who had not undergone dialysis and 40 healthy control subjects. EAT thickness was assessed by echocardiography. Hydration status and body composition were evaluated by multi-frequency bioelectrical impedance analysis. Results: Stage 5 CKD patients had significantly higher EAT thickness than healthy subjects (6.56±1.18 vs. 4.05±1.45, p

INTRODUCTION: Diabetic chronic kidney disease has more fatal clinical progresses and this situation can be related to volume overload, which is seen more commonly in diabetic chronic kidney disease patients than in non-diabetic chronic kidney disease patients. Therefore, we examined the effect of diabetes mellitus on volume overload in newly diagnosed stage 5 chronic kidney disease patients whose volume overloads were not showing signs of improvement from renal replacement therapy. METHOD: One hundred and five patients (46 diabetic, 59 non-diabetic) with end-stage chronic kidney disease, who had glomerular filtration rate (GFR) under 15 mL/min for at least three months were enrolled in this prospective study. We determined the body volume overload and configuration using a bioimpedance device. NT-proBNP levels were recorded. RESULTS: There was a statistically significant difference between diabetic and non-diabetic groups according to overhydration (OH, p=0.003), extracellular water (ECW, p=0.045), intracellular water (ICW, p

Cranioplasty is a reconstruction operation made to protect intracranial structures. It is applied for the closure of bone defects occurring due to causes such as trauma, tumor, infection, and infarct. Many different products changing from autologous bone grafts to synthetic materials are used for cranioplasty. Three-dimensional printers that are among the popular innovations of today are used gradually more in medical area as in every field of life and they make the surgical operation easier. When customizable materials are combined with technology, the authors come across successful results and less complications. The aim of the authors' study was to show a 3-dimensional modeling method in 2 patients the authors applied cranioplasty and the advantages provided by this method for the surgeon and the patient. © 2019 by Mutaz B. Habal, MD

Background/aim: The aim of this study was to investigate the effects of valproic acid (VPA) and a new-generation antiepileptic drug called brivaracetam (BRV) on the brain damage occurring after status epilepticus (SE) in rats.Materials and methods: In our study, an experimental animal model of SE, generated by stereotaxically injecting 0.4-2 μg of kainic acid into the rat hippocampus, was used. The laboratory animals were divided into 4 groups: the first group was a sham group that was subjected to anesthesia and SE was not induced; the second group was a SE group, in which SE was induced using kainic acid but subjects were not treated; the third group was the VPA group, in which SE was induced using kainic acid and subjects were treated with VPA; and the fourth group was the BRV group, in which SE was induced using kainic acid and subjects were treated with BRV.Results: Annexin V and p53 levels were statistically higher in the SE group than in the sham group (P < 0.001). Following the treatment with VPA and BRV, a substantial decrease was observed in the annexin V and p53 levels compared to those of the SE group (P < 0.001). There was a statistically significant increase in Bcl-2 levels after VPA and BRV treatment compared to the SE group (P < 0.001). Conclusion: Our study showed that VPA and BRV are protective against neuronal damage occurring after SE in rats due to the increase in Bcl-2.

WOS: 000445434700010, Aim: Brain abscess is a serious, life-threatening infection. Although a brain abscess could arise without any predisposing risk factors, the well-known risk factors are diabetes mellitus, head trauma, history of cranial surgery, and immunosuppression. For surgical treatment, aspiration and total excision are the techniques used. Material and Method: This study was conducted in two different neurosurgery clinics between 2008-2016 with 21 patients treated for brain abscess. Age, sex, the localization of the abscess, number of foci, preoperative and postoperative Glascow Coma Scale, the size of the abscess, the surgical technique performed, the duration of hospitalization, the duration of antibiotic treatment, and culture results of the patients were compared. Results: In our study 15 (71.4%) patients were males and 6 (28.6%) patients were females. Mean age was 44.57 +/- 23.40 (range 4-86). Mean abscess volume was 46.85 +/- 41.19 cm'. There was no significant difference regarding mortality when the two surgical techniques were compared (p=0.486). As the volume of the abscess increases the duration of hospitalization (p=0.003), the duration of antibiotic treatment also increases (p=0.002). Discussion: Although rare, intracranial abscesses have clinical significance due to high morbidity and mortality rates. The success of treatment has significantly increased due to improvements in imaging, surgical technique, bacteriological culture techniques, and antibiotic therapy. A muitidiciplinary approach should be considered in managements of patients with brain abscess.

WOS: 000457328100078, PubMed: 31108080, BACKGROUND: Vertebroplasty and kyphoplasty are minimally invasive techniques used to treat vertebral compression fractures. The etiology of vertebral compression fractures varies among patients. Although osteoporosis and trauma are major etiologic factors in patients with a vertebral compression fracture, unexpected results were found in 11 patients in the present study. The aim of the present retrospective study was to determine the incidentally detected pathology results of patients with vertebral fracture treated by vertebroplasty and kyphoplasty. METHODS: From February 2010 to November 2015, 616 patients with a vertebral compression fracture were treated by kyphoplasty and vertebroplasty at our institution. Vertebral biopsies were obtained from 533 patients during a vertebral augmentation technique. The average patient age was 62.4 years. Of the 616 patients, 388 were female and 228 were male. Histological evaluation of the biopsy specimens from the vertebral compression fractures was performed. RESULTS: The biopsy results of 505 patients showed various stages of bone healing. Among these patients, malignancy was identified in 23 patients, and 43 patients had a history of malignancy. In 6 patients, an unsuspected malignancy was found, and 1 patient had Paget's disease. Infection was detected in 4 patients. In our study, the rate of unsuspected malignancy was 1.1%. CONCLUSIONS: Tissue examination is useful and could reveal pathologic fractures. An incidentally detected biopsy result could change the treatment of patients; however, bone biopsy should be reserved for those patients whose preoperative radiological diagnosis raises suspicion of a nonosteoporotic etiology.

Background : Cerebral ischemia is as a result of insufficient cerebral blood flow for cerebral metabolic functions. Resveratrol is a natural phytoalex in that can be extracted from grape’s skin and had potent role in treating the cerebral ischemia. Apoptosis, a genetically programmed cellular event which occurs after ischemia and leads to biochemical and morphological changes in cells. There are some useful markers for apoptosis like Bcl-2, bax, and p53. The last reports, researchers verify the apoptosis with early markers like Annexin V. Methods : We preferred in this experimental study a model of global cerebral infarction which was induced by bilateral common carotid artery occlusion method. Rats were randomly divided into 4 groups : sham, ischemia-reperfusion (I/R), I/R plus 20 mg/kg resveratrol and I/R plus 40 mg/kg resveratrol. Statistical analysis was performed using Sigmastat 3.5 ve IBM SPSS Statistics 20. We considered a result significant when p

These days, as a consequence of the improvement in technology and increase in the use of motor vehicles, spine injuries have become common. Spine traumas, which often occur after motor vehicle accidents, are observed mostly in cervical regions, particularly in the subaxial cervical region, which is also known as the subcervical region, and neurological damage occurs in 70% of the patients. Despite still being controversial, the common ranging for neurological evaluation is the American Spinal Injury Association ranging, which includes the motor and sensory loss and accordingly, the impairment rate. In subaxial cervical traumas, acute neurological deterioration is an indication and therefore requires urgent surgical treatment. The choice of anterior or posterior approach substantially depends on the traumatization mechanism, affected tissues, and neurological deterioration occurring after. The state of patient and instability are the most two important factors affecting the treatment decision. Although the anterior approach is accepted as a routinely available and easily applicable surgical technique, it lacks in the burst fractures involving the three colons, which shows a stabilization disorder. The anterior plate screw technique and posterior lateral mass screw application applied in our clinic are reviewed in literature and are discussed in two cases. Although the best clinical results are achieved in cases where only anterior surgery is performed and in cases where instability is excessive, in unstable compression and blow-out fractures, even if neurological deficit and three colon involvement are not observed in the patient, the requirement of posterior fusion is observed.

Superficial temporal artery (STA) aneurysms are very infrequent. Moreover, true aneurysms, which are not pseudoaneurysms associated with trauma or previous surgery are even rarer. With this manuscript, authors present a case of a 79-year-old woman suffering from subarachnoid hemorrhage whose radiological examinations revealed multiple intracranial aneurysms along with an STA aneurysm. This very rare case, to the best of our knowledge, the second case reported so far, might contribute to the literature and lead further investigations toward the rare association between intracranial aneurysms and STA aneurysms.

Purpose To establish the frequency of IDH1 mutations and MGMT methylation in primary glioblastomas. Experimental design We screened primary glioblastoma multiforme (GBM) in a population-based study for IDH1 mutations and MGMT methylation and correlated them with clinical data. Results IDH1 mutations were detected in 5 of 40 primary glioblastomas (12,5%). Primary GBM patients carrying IDH1 mutations were significantly younger, mean age of 41 ± 5.06 years, than patients with wild-type IDH1, mean age of 57 ± 2,29 years, p = 0.011. The mean survival time of all GBM patients with and without IDH1 mutations was 19 months (5 cases) and 16 months (35 cases), respectively (p > 0,05). MGMT methylation was detected in 13 of the 40 patients (32,5%). MGMT-promoter methylation did not correlate with overall survival (OS; p > 0,05). Conclusion In summary, our study is the first study to investigate the IDH1 mutation status and MGMT methylation in primary GBMs in Turkish population and confirmed IDH1 mutation as a genetic marker for also primary GBMs. Our data are still insufficient for definite ascertainment; and our preliminary results suggest: IDH1 status shows an association with younger age and there is a lack of association between IDH1 mutation and survival time. Furthermore MGMT promoter methylation had no prognostic value and lower frequency in primary glioblastomas.

Aim: The present study aimed to report the peri- and postoperative complications in patients undergoing third ventricular colloid cyst resection using a microsurgical approach.Materials and Methods: A total of 29 patients with symptomatic third ventricular colloid cysts were operated upon via the microsurgery method at two different neurosurgery clinics, and their data were analyzed retrospectively.Results: Among them, 12 (41.4%) were men, and 17 (58.6%) were women. The mean age was 34.24 ±16.43 years, and the age range was 1–70 years. Headache was the most common symptom at reference and occurred in 21 (72.4%) patients. Also, ataxia was the presenting symptom in 7 (24.1%) of our patients, vomiting in 6 (20.7%), visual loss in 6 (20.7%), epileptic seizures in 4 (13.8%), incontinence in 4 (13.8%), and loss of consciousness in 1 (3.4%). Moreover, 19 (65.5%) had hydrocephalus, and two of them with weak consciousness were operated after the application of a preoperative external ventricular drainage systemConclusion: The interhemispheric transcallosal approach is the most commonly used method in colloid cyst microsurgery, and the most frequent surgical complication is venous infarction secondary to this approach. Thus, the significant results of infarct that occurred in patients with preoperative hydrocephalus suggest that this complication could be controlled more easily if the hydrocephalus and intracranial pressure are followed up more carefully in the pre- and perioperative periods.

Aneurysmal subarachnoid haemorrhage which has a serious mortality and morbitity ratio, occurs approximately 10/100.000 population per year and it is usally caused by rupture of a cerebral artery aneurysm. Aneurysms are classified saccular, fusiform or dissecan by morphological description. Vascular congenital anomalies of the cerebral vessels contribute to saccular aneurysm formation by increasing hemodynamic stress on the vessel wall. Although anterior communicating artery (ACoA) is the most seen site of vascular anomalies associated with aneurysmal formation, the agenesis of the anterior commmunicating artery is very rare. Here, we present unusual anatomical variations of ACoA detected by three-dimensional CT angiography after subarachnoid hemorrhage.

RESULTS: Dialysis patients showed signifi cantly higher QTcd than control subjects (55.75±36.48 versus 28.73±28.27; p=0.001). Patients with QTcd >50 ms had signifi cantly higher SBP, urea and ferritin levels, but signifi cantly lower iron binding capacity and calcium levels compared those with QTcd ≤ 50 ms(p

WOS: 000419248500006, Objective: Stroke is a serious cause of mortality and disability. The caregiver of the patients may be adversely affected by this situation as well. In addition, stroke has a great economic burden on healthcare. Significant improvement has been achieved in the field of diagnosis, treatment, and care in the acute phase of the ischemic stroke in recent years. Thrombolysis with intravenous (IV) recombinant tissue type plasminogen activator (r-tPA) is the main treatment option in selected patients. The aim of our study was to share the results of intravenous (IV) thrombolytic therapy applied to patients with acute ischemic stroke in our clinic. Materials and Methods: We evaluated the clinical data of 52 patients who were admitted to our clinic with ischemic stroke within the first 4.5 hours after onset of stroke symptoms, and were treated with IV thrombolytic therapy, between the May 2014 and June 2016. Demographic characteristics and clinical data were recorded. Results: Twenty-three of the patients were male and 29 were female. The mean age was 70.7 +/- 12.8 years (range, 41-92 years). Intracranial hemorrhage after treatment was observed in 8 patients (15.4%). Of these, 6 patients (11.5%) had asymptomatic hemorrhage, 2 patients (3.8%) had symptomatic hemorrhage. The mean score of modified Rankin Scale (mRS) was 0-1 in 16 (30.8%) patients, 2-3 in 10 (19.2%) patients, and 4-5 in 13 (25%) patients. The mean mRS score of 7 (20%) patients with total anterior circulation infarct was 0-1. The mean mRS score of 8 (57.1%) patients with partial anterior circulation infarct was 0-1. Thirteen (25%) patients died within 3 months of the treatment. Conclusion: Intravenous thrombolytic therapy is an effective and safe treatment that is easy to administer within 4.5 hours in patients with acute ischemic stroke. This treatment increases the number of ambulatory patients and reduces disability in selected patients.

We present two cases of progressive isolated damage to the lateral branch of the pectoral nerve with marked atrophy of the clavicular portion of the major pectoral muscle. In our patients, the mechanism of isolated lesions of lateral pectoral nerves have been attributed to repetitive external microtraumas and pressure on the nerve trajectory between the chest and shoulder during sports or occupational activities.

Objective: Low back pain in adults is the most commonly reported cause of the pain. After the surgery, some patients may have low back pain that is different from that seen before the surgery. The aim of the present study was to demonstrate that this post-fusion pain is originated from the sacroiliac joint. Methods: This study was carried out on 93 patients previously underwent lumbar or lumbosacral fusion surgery and admitted to our outpatient clinic between July 2011 and September 2014 with postoperative persistent chronic pain (for more than 3 months) which is different from the preoperative pain. Results: The VAS scores in patients having fusion ending at L5 and S1, respectively. Mean pre-procedural VAS scores of the patients from S1 and L5 groups suggest that patients having fusion ending at S1 have admitted to our clinic with a more severe pain. Conclusion: The percutaneous tripolar electrode RF device designed as a safe, easily applied and encouraging method will eliminate the unnecessary and in accurate surgical interventions and revision surgeries. This will also increase the success of the surgeon.

Aim: To investigate the effects of genistein in a rat model of sciatic nerve crush injury and complete sciatic nerve transection. The effects of genistein were compared with those of gabapentin, which is widely used in clinical practice for peripheral nerve injury. Material and Methods: Forty-eight rats were randomly divided into six groups (8 rats in each group): group 1 (sham); group 2, sciatic nerve crush injury (control); group 3, sciatic nerve crush injury+genistein 20 mg/kg; group 4, sciatic nerve crush injury+gabapentin 90 mg/kg; group 5, sciatic nerve transection+genistein 20 mg/kg; group 6, sciatic nerve transection+gabapentin 90 mg/kg. The effects of genistein and gabapentin were assessed with immunohistochemical staining for growth associated protein-43 (GAP-43) and myelin basic protein (MBP). Interleukin-1ß and tumor necrosis factor a levels in the injured nerve specimens were assessed as a measure of inflammatory response; walking track analysis and sciatic function index for neurological recovery and the paw mechanical withdrawal threshold were examined for neuropathic pain. Results: On histopathological examination, genistein use was associated with a greater immunoreactivity for GAP-43 and MBP compared with that associated with gabapentin. Genistein and gabapentin had similar effects on anti-inflammatory activity, functional recovery, and neuropathic pain. ConclusIon: Genistein and gabapentin exhibit positive effects on histopathology, inflammation, and clinical findings of peripheral nerve injury. When the systemic side effects of gabapentin are considered, genistein (a basic soy isoflavone that has no side effects) can be used as an alternative to medical treatment in peripheral nerve injury., 2013-358, This work was supported by Eskisehir Osmangazi University, Scientific Research Coordination Unit (Project Number: 2013-358).

Objective. The purpose of this study was to determine the frequency of childhood traumatic events, to investigate its relationship with dissociation and other psychiatric symptoms and to examine the potential effect of family functioning on dissociative symptoms and general psychopathology in a Turkish university student sample. Methods. All participant completed Brief Physical and Sexual Abuse Questionnaire, Symptom Checklist-90-Revised (SCL-90-R), Dissociative Experiences Scale (DES) and Family Assessment Device (FAD). Results. The most frequent childhood trauma type was separation from caretaker (46.1%). Witnessing violence (33.1%), harsh punishment (21.2%) and substance abuse in family (10.5%) followed. Sexual abuse of incest type was seen in 6.3%. Students who reported childhood traumatic events had higher DES and SCL-90-R scores compared to those who did not. There were fair relationships between SCL-90-R and FAD scores. Conclusion. A history of childhood traumatic events may be related to increased level of dissociation and general psychopathology in university students. Other pathogenic family factors also may contribute to the development of psychiatric symptoms.

Introduction: Dural injuries are encountered generally as trauma, spinal tumor excision or postop complications. It is a major problem leads to cerebrospinal fluid leakage meningitis. The method used often in repair is applying the watertight suture to the damaged area with appropriate measures of fascia and dural grafts. The used grafts can be ranged as bovine pericardium, synthetic collagen matrices, fibrin tissue adhesive, vicryl, and polydioxanone graft. In the studies, it is observed that there is still no significant difference between grafts and fascia. Material-Methods: In our study, 60 Spraque Dawley rats whose weights are ranging from 200-250 gr were used. The solution consists of the ketamine hydrochloride (60 mg/kg) and xylazine (12 mg/kg) was injected intraperitoneally to the subjects and the subjects were taken into anesthesia. The subjects were divided into 5 groups. In the first group no extra action was taken, in the second group, fibrin tissue adhesive was applied on the dural injury and in the third group collagen matrix was applied on the dural injury, in the fourth group bovine pericardium was applied on the dural injury, in the fifth group subcutaneous fascia (autogenetic graft) was applied on the dural injury. Surgical Operation: After providing the sterile conditions and operating the anesthesia agents, the experimental animals were laid down on the operating table in the prone position for surgical operation. Following the local area cleaning and environment isolation, subcutaneous incision was applied. Fascia was opened and paravertebral muscles were scarred subperiostally. After applying L1-4 laminectomy, approximately 2 cm linear incision was made with bistoury and cerebrospinal fluid leakage was observed from the dural injury. Analgesia was applied with 10 mg/kg paracetamol on the subjects which survived approximately 6 weeks after the operation. On the 7th day (early group) after the operation, 6 animals from each group and 6 animals from each group after 6 weeks from the operation were injected 100 mg/kg phenobarbital intraperitoneally and scarification operation was completed. Former incision was opened and spinal cord under the laminectomy area was removed with the dural graft as a block and histopathological findings was provided. Histopathological findings: The incisions from this area were stained with Hematoxylin Eosin and Masson Trichrome. In the examination, collagen, vascular diagenesis and necrosis from histopathological findings were examined in early period (first week) and late period (sixth) week. It was observed that in the groups.

Objective: Acute kidney injury (AKI) is an important clinical entity that is known to increase mortality in patients with sepsis. Erythrocyte maturation and proliferation are inhibited by pro-inflammatory cytokines; these cytokines exert effects on red cell distribution width (RDW) well. Based on this knowledge; our aim in this study was to evaluate the impact of RDW on acute kidney injury in patients with sepsis. Methods: 120 patients diagnosed with sepsis and admitted to intesive care unit (ICU) and treated between 2009-2013 were retrospectively evaluated. Patients were divided into two groups as follows: group 1 (RDW≥16.8) and group 2 (RDW

Cerebral vasospasm, especially delayed cerebral ischemia following subarachnoid hemorrhage (SAH) is the most important complication that effects mortality and morbidity of patients with intracranial aneurysms. The presence of cerebral vasospasm has been correlated with an increase in mortality in the first 2 weeks after SAH. Despite clinical studies and research, the etiopathogenesis of cerebral vasospasm is not understood exactly and there is not yet an effective therapy. The aim of our study was to investigate the effect of application of lumber drainage on vasospasm and delayed cerebral infarction following SAH and to examine the incidence of complications. Patient groups were determined by retrospective screening of 70 patients who underwent a surgical operation at the Osmangazi University Medical Faculty Department of Neurosurgery between 2009 and 2013 after a diagnosis of ruptured aneurysmal SAH. After the application of lumbar drainage, the complications and mortality after aneurysm surgery was significantly decreased and correlated with the amount of hemorrhagic cerebrospinal fluid drainage.

Background and objective: Fluid overload is a common and serious problem that leads to severe complications in dialysis patients. We aimed to compare hydration status as measured with bioimpedance analysis (BIA) method in hemodialysis (HD) and peritoneal dialysis (PD) patients, as well as investigating the association between blood pressure, left ventricular mass index (LVMI) and hydration status. Materials and methods: We examined 43 HD and 33 PD patients. Blood pressure was recorded. In each group, echocardiographic examinations were performed on all patients. Hydration status was assessed using multifrequency bioelectrical impedance analysis. Overhydration was defined as an overhydration (OH)/extracellular water (ECW) ratio of &gt, 0.15. Results: The OH/ECW ratio was significantly higher in PD patients compared to post-HD patients. Overhydration was statistically more frequent in PD than in post-HD patients (30.3% vs. 11.6%, P = 0.043). Systolic blood pressure (SBP) in both post-HD and PD groups, and LVMI in the PD group were found to be significantly higher in overhydrated patients than non-overhydrated patients. In multiple linear regression analyses, increased OH/ECW ratio was independently associated with higher SBP and LVMI. Conclusions: Fluid overload may be an even more prevalent and serious problem in PD patients. Overhydration is closely associated with increased blood pressure and LVMI. OH/ ECW ratio, a derived parameter of fluid load measured by BIA, was a significant and independent determinant of SBP and LVMI.

Determination of fluid overload is important in chronic kidney disease. Early diagnosis and treatment of volume overload may decrease morbidity and mortality. We aimed to determine body composition by using bioelectrical impedance analysis, and studying other clinical characteristics, inferior vena cava diameter, and N-terminal pro-B natriuretic peptide associated with hydration status in chronic kidney disease Stages 34 and 5 in patients not undergoing dialysis.We examined 62 patients with Stages 34 and 68 patients with Stage 5 chronic kidney disease. Plasma NT-proBNP was measured and analyzed after log transformation. Inferior vena cave diameter was measured with echocardiography and indexed for body surface area. Hydration status was assessed using multi-frequency bioelectrical impedance analysis. Overhydration was defined as overhydration/extracellular water0.15.Overhydration was more frequent in Stage 5 than in Stages 34 patients. Systolic and diastolic blood pressure, inferior vena cava index, and log NT-proBNP were higher in overhydrated compared to non-overhydrated patients. A significant positive correlation existed between overhydration/extracellular water and log NT-proBNP, systolic and diastolic blood pressures, and inferior vena cava index. In multiple linear regression analysis, the variables associated with hydration status were male sex, extracellular water/total body water, and extracellular water/intracellular water (greater overhydration), while serum albumin levels had a negative association with overhydration.Overhydration is more prevalent in Stage 5 chronic kidney disease patients than in Stages 34 patients. Bioelectrical impedance analysis, inferior vena cava diameter, and NT-proBNP analysis in chronic kidney disease are useful methods to determine the volume overload.

AIM Spinal cord injuries negatively affect the individuals and the life quality of their families due to neurological deficits caused by trauma. The prevalence of spinal cord injury is 15-45/1 million in the world. Caffeic acid phenethyl ester (CAPE) is the most active component of propolis and has neuroprotective, anti-oxidant and anti-apoptotic effects. Our aim was to determine the effects of CAPE on the prevention of secondary injury and to compare with methylprednisolone. MATERIAL AND METHODS Forty rats were divided into 4 groups. The control group did not undergo surgery (Group I), only trauma group (Group II), trauma+CAPE treatment group (Group III), and trauma+methylprednisolone treatment group (Group IV). Histopathological assessment was performed with two staining methods as hematoxylin-eosin (HE) and terminal deoxynucleotidyl Transferase Biotin - dUTP Nick End Labeling (TUNEL). The groups were statistically compared. RESULTS The apoptotic cells decreased in treatment groups compared with the trauma. CAPE has more anti-apoptotic effect than methylprednisolone. The histological difference between the Group II, and Groups III and IV was statistically significant. CONCLUSION CAPE has a positive effect on spinal cord injuries by preventing apoptosis.

Background: We screened RARβ methylation in primary glioblastoma multiforme (GBM) and the results were evaluated based on the clinical data and treatment type. Objective: The objective of this study was to find new areas for the usage of MS HRM applications in the determination of methylation levels in primary GBM samples and it shows the association of RARβ methylation with the clinical outcome. Methods: In our study, tumor samples were collected during surgical resection by the Department of Neurosurgery. The clinical and radiologic data was carefully reviewed, compared, and evaluated with the histological results. The methylation status of RARβ was determined by using MS-HRM. Results: RARβ gene methylation was detected in 24 out of 40 cases (60%), with different quantitative methylation levels. The mean survival time was 19 months form ethylated cases and 15 months for the non-methylated cases. The survival time of the patients who received treatment was 25 months and the survival time of the patients who received radiotherapy alone or where no treatment protocol applied was 15-20 months. Therefore, a significant difference in survival rates has been observed (P

WOS: 000374928100013, Hydatid cyst (CH), which is quite common in the world, mostly transmitted by dog faeces, is a parasitic disease caused by Echinococcus granulosus. CH often infects the liver and lungs. During the clinical course, renal involvement is rarely seen. In this article; due to liver hydatid disease, mezengioproliferatif glomerulonephritis case is presented.