Department of Clinical and Experimental Medicine

Silver nanoparticles (AgNPs) are more often used in various products, and consequently the potential deleterious effects associated with exposure to them are of concern. Several lines of evidence have demonstrated that the toxicity of AgNPs affects different organs and leads to some side effects, including weight loss, inflammation and cell death. The aim of this study was to evaluate the effect of different concentrations of AgNPs on sperm parameters and testicular histology. In the present study, 28 male adult Wistar rats were categorized into a control group and 3 experimental groups (AgNP-1, AgNP-2 and AgNP-3), intraperitoneally (i.p.) receiving 30, 125 and 300 mg/kg of AgNPs, respectively. Twenty-eight days after injection the epididymes and the testes of each rat were dissected in order to evaluate sperm parameters, sperm chromatin integrity and histomorphometric changes in the testicular tissue. The results showed a significant decrease in sperm count (p < 0.0001), vitalit...

Objectives. The aim of this study is to evaluate the effects of hormone replacement therapy using dienogest and medroxyprogesterone acetate on psychological symptoms in perimenopausal and postmenopausal women. Material and Methods. A total of 73 patients who sought treatment at the menopause units of the authors' gynecology and obstetrics clinics between of November 2003 and October 2004 complaining of vasomotor symptoms were included in the study prospectively. The cases were divided into two groups: Group I (37 patients) was given 2 mg estradiol valerate and 2 mg dienogest, and Group II (36 patients) was given 2 mg estradiol valerate and 10 mg medroxyprogesterone acetate. The groups' results in months 0 and 6 were compared through the evaluation of vasomotor and psychological symptom levels. Results. No significant difference was found between the groups when the initial levels of vasomotor and psychological symptom subtypes were compared (p = 0.16). It was observed that all the psychological symptoms decreased in the 6th month in the group using dienogest in comparison with the initial situation, and that psychological symptoms increased in the group using medroxyprogesterone acetate in the evaluation performed in the 6th month compared with the initial levels. It was also found out that there was a statistically significant difference between the two groups when compared in terms of these symptoms (p < 0.0001). Conclusions. While the use of dienogest normalizes the general psychological situation and sleep, it was observed that the use of medroxyprogesterone acetate (MPA) worsens the general psychological situation (Adv Clin Exp Med 2014, 23, 1, 63-67).

Although COVID-19 presents primarily as a lower respiratory tract infection transmitted via air droplets, increasing data suggest multiorgan involvement in patients that are infected. This systemic involvement is postulated to be mainly related to the SARS-CoV-2 virus binding on angiotensin-converting enzyme 2 (ACE2) receptors located on several different human cells. Lung involvement is the most common serious manifestation of the disease, ranging from asymptomatic disease or mild pneumonia, to severe disease associated with hypoxia, critical disease associated with shock, respiratory failure and multiorgan failure or death. Among patients with COVID-19, underlying cardiovascular comorbidities including hypertension, diabetes and especially cardiovascular disease, has been associated with adverse outcomes, whereas the emergence of cardiovascular complications, including myocardial injury, heart failure and arrhythmias, has been associated with poor survival. Gastrointestinal symptoms are also frequently encountered and may persist for several days. Haematological complications are frequent as well and have been associated with poor prognosis. Furthermore, recent studies have reported that over a third of infected patients develop a broad spectrum of neurological symptoms affecting the central nervous system, peripheral nervous system and skeletal muscles, including anosmia and ageusia. The skin, the kidneys, the liver, the endocrine organs and the eyes are also affected by the systemic COVID-19 disease. Herein, we provide a comprehensive overview of the organ-specific systemic manifestations of COVID-19.

BACKGROUND Crimean-Congo hemorrhagic fever (CCHF) is known to be associated with cardiac damage. Brain type natriuretic peptide (BNP) is secreted from stressed myocardium. OBJECTIVES This study investigated that BNP levels in CCHF and its association with clinical course of disease. METHODS Consecutive CCHF diagnosis confirmed patients were enrolled to the study. Results of patients were compared with age-sex-matched healthy volunteers. Blood samples for BNP levels were collected from the patients during emergency room applications. Mortality, hospitalization duration and other disease severity predictors (thrombocyte count, hemoglobin, white blood cell count, alanine aminotransferase, aspartate aminotransferase, prothrombin time, lactate dehydrogenase, international normalized ratio, activated partial thromboplastin time) were recorded. These parameters&#39; correlations with BNP levels were analyzed. RESULT Forty-three CCHF patients and 28 control subjects recruited to the study. ...

Sonoelastography is a modern ultrasound method, which enables the representation of tissues and organs with the evaluation of their elasticity, &quot;stiffness&quot;. The principle of elastography is to use repeated, slight pressure on the examined organ with the ultrasound transducer. Changes in elasticity and deformation of tissues arising whilst the compression is processed and presented in real time with color-coded maps, is called elastograms. The method is applicable mainly in diagnosing malignant lesions. Tumor tissues have different elasticity and undergo different deformations under pressure than healthy tissues. As a result of computer analysis, images in various colors are generated. Based on the nature of areas of normal and increased stiffness classifications of the images in point scales have been developed. Ultrasound devices equipped with sonoelastography option enable more accurate imaging and evaluation of the nature of lesions situated at small depth, e.g. breast,...

The current mode of treatment of various diseases based on synthetic drugs is expensive, alters genetic and metabolic pathways and also shows adverse side effects. Thus, safe and effective approach is needed to prevent the diseases development and progression. In this vista, Natural products are good remedy in the treatment/management of diseases and they are affordable and effective without any adverse effects. Dates are main fruit in the Arabian Peninsula and are considered to be one of the most significant commercial crops and also have been documented in Holy Quran and modern scientific literatures. Earlier studies have shown that constituents of dates act as potent antioxidant, anti-tumour as well as anti-inflammatory, provide a suitable alternative therapy in various diseases cure. In this review, dates fruits has medicinal value are summarized in terms of therapeutic implications in the diseases control through anti-oxidant, anti-inflammatory, anti-tumour and ant-diabetic eff...

To retrospectively assess the impact of regular yearly administration of recombinant influenza and single administration of pneumococcal conjugate vaccines on the occurrence of serious respiratory infection including COVID-19 in patients with type 2 diabetes mellitus. Hundred patients with type 2 diabetes mellitus were given Vaxigrip and Prevnar13 ® vaccines and were evaluated by comprehensive clinical review, airflow screening questionnaire, and routine laboratory investigations with follow-up during the COVID-19 pandemic and compared to a control group of diabetic patients with the same inclusion criteria (n = 100). After Vaxigrip and Prevnar13, there is a significant improvement in respiratory symptoms and a decrease in the airflow screening questionnaire (p = 0.0001) with a significant improvement in inflammatory parameters as neutrophillymphocyte ratio, ESR, CRP, and platelet count. Four patients had mild COVID-19 (4%), mainly gastrointestinal with no complications. Twenty-one out of 32 (65.6%) patients in the control group had severe COVID-19. The hazard ratios of significant respiratory tract infection and death due to COVID-19 were 2.29 and 10.24 in the non-vaccinated control (p = 0.001). The severity of COVID-19 in diabetes correlated with HBA1C (p = 0.007), combined Vaxigrip and Prevnar13 vaccination (p = 0.0001), serum creatinine (p = 0.001), neutrophil-lymphocyte ratio (p = 0.001), and thrombocytopenia (p = 0.003). The present study suggested that the combination of Prevnar13 and Vaxigrip may be related to decreased occurrence of serious respiratory infections including COVID-19. Further randomized control trials may be needed to establish a direct causation between the two and clarify these associations.

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted through respiratory droplets and contact routes, hence the demand for personal protective equipment (PPE) has increased during the outbreak of coronavirus disease 2019 (COVID-19). Among the most noticeable shortages was the lack of face shields. The urgent demand for PPE induced interdisciplinary cooperation to overcome the shortages, and additive manufacturing proved to be ideal for the crisis situation. Objectives. To investigate the possibilities of implementing additive manufacturing technologies in the interventional fabrication of protective face shields for medical staff. Material and methods. An Ender 3 Pro 3D printer was used to print headbands and Cura 4.4 was chosen as the slicing software. Open source face shield designs were downloaded as standard tessellation language (STL) files and compared. Only models with scientific support were taken under consideration. Results. The mean time for producing the headbands tested ranged from 59 min to almost 3 h, depending on the design. After setting up our low budget printer and choosing the Prusa RC 3 protective face shield as the main product, we were able to fabricate about 30 face shields per week at a cost of about €1 each. During 4 weeks, 126 face shields were produced and delivered to various hospital wards, which substantially eased the shortages. Conclusions. Additive manufacturing enables immediate responses to needs in emergency situations, and allows for mass production of personal protective equipment in a short time due the rapid exchange of data among printer users. Despite the unregulated legal situation and insufficient scientific evidence, such protective equipment has been approved by clinicians and is currently used by medical personnel around the world.

Background. Gamma-glutamyl transpeptidase (GGT) is a glycoprotein of the external surface of various cell types. The activity of GGT has been observed in cells and tissues with secretory activity, such as the proximal tubular cells in kidneys. GGT also plays an important pro-oxidant role, stimulating the generation of hydroxyl radicals, and increases membrane lipid peroxidation. Objectives. In this study we examined whether the monitoring of GGT activity in urine may be a prognostic factor of kidney allograft function. The study enrolled 107 Caucasian renal transplant recipients. Material and Methods. Urine samples were collected for GGT and creatinine analysis on the 1 st day after transplantation, and then in the 3 rd and 12 th month. Results. Higher urine GGT activity in the 3 rd month after transplantation was associated with significantly higher risk of graft failure (HR = 1.063 per each U/g creatinine; 95%Cl:1.004-1.127; p = 0.037) in the Cox proportional hazards model. Moreover, there were positive correlations between urine GGT and the grade of interstitial fibrosis (Rs = 0.64, p = 0.01) and tubular atrophy (Rs = 0.54, p = 0.056) in specimens collected in the 3 rd month after transplantation. Conclusions. Our results suggest that higher urine GGT activity in the 3 rd month after transplantation may be a prognostic factor of graft failure (Adv Clin Exp Med 2014, 23, 6, 947-952).

Background. Disorders in the orofacial complex as well as muscle hypotension in children with Down syndrome can be corrected through orofacial therapy that makes use of a palatal plate. Objectives. The aim of this paper was to present how parents of children with DS assess the availability of treatment and the therapeutic effects of orthodontic palatal plate therapy on the tongue position and mimetic muscle tension in their children; and to determine whether implementing full Castillo-Morales therapy and using only a palatal plate lead to substantially different results. Material and Methods. The study was conducted on 100 children with DS between the ages of two months and two years (44 boys, 56 girls) who were treated by means of stimulating plate therapy. The study analyzed responses obtained from the parents to questions included in a questionnaire completed at every visit over a period of two years. Results. The study found that in 50 patients with DS who underwent palatal plate rehabilitation there was a visible improvement of the mimetic muscles, tongue retraction and lip closure. Conclusions. Early orthodontic palatal plate therapy ought to be an integral part of the multidisciplinary rehabilitation of patients with DS (Adv Clin Exp Med 2015, 24, 2, 301-305).

This survey was designed to determine the association between knowledge, locus of control and health belief with self-management, Hb A1c level and Number of attendances in type 1 diabetic patients in Rasht, Guilan Province - North of Iran. Data was derived from chart reviews of 92 patients. Patients&#39; glycosylated hemoglobin level and their number of health care attendances during the last 6 months were recorded. The four part questionnaires covered patients&#39; demographic data, knowledge, perceived control and health belief of diabetes. A blood sample was taken from each patient. There was no significant relationship between demographic data such as gender, age, marital status, education, occupation, duration of the disease, place of living and family history with knowledge, health belief and locus of control (P &gt; 0.05). Also the results didn&#39;t show any significant association between the complicated group and their knowledge and health belief (P &gt; 0.05) while it was...

Chromogranin A is a cellular marker for neuroendocrine tumors. Elevated levels of chromogranin A are also found in patients with cancers of epithelial origin when neuroendocrine differentiation occurs, which is associated with a poor prognosis. We investigated the prevalence of serum levels of chromogranin A in patients with primary liver cancer. Seventy-nine patients (65 males, mean age 67.6 years, range 48-88 years) with liver cirrhosis and hepatocellular carcinoma were studied. The etiology of cirrhosis was identified as due to hepatitis C virus infection in 47 patients, to hepatitis C virus and alcohol in 7, to alcohol alone in 14, to hepatitis C and B virus in 2, and to hepatitis B virus alone in 4. Of the remaining patients, 2 suffered from hemochromatosis and 3 had cryptogenic cirrhosis. According to the Child-Pugh's score, 54 patients belonged to class A, 22 to class B, and 3 to class C. The concentration of chromogranin A was measured in serum with a commercial solid-phase two-site immunoradiomet-ric assay. Elevated serum levels of chromogranin A were found in 32 of 79 patients (43%). Levels over 600 ng/ml were present in 7 of 76 patients (9.2%), all of whom had very high serum levels of alpha-fetoprotein. Hence, elevated serum levels of chromogranin A are present in over onethird of patients with hepatocellular carcinoma. It is therefore possible that some hepatocellular carcinomas could acquire a neuroendocrine differentiation. We propose further studies to ascertain whether serum levels of chromogranin A are useful as a prognostic marker for hepatocellular carcinoma as in prostate cancer.

The aim of this study was to evaluate the need for medical education about patient rights among hospital staff and in the light of the study findings a curriculum map were designed on this issue. A self-administered questionnaire about patient&#39;s rights was hand-delivered to 124 university hospital personnel who accepted to fill a questionnaire before education program settled in 29 March 2012. Ninety-two (74.2%) respondents were female and thirty-two (25.8%) were male. The mean age was 34.71±7.5 years. 80 personnel (64.5%) stated that they have received training concerning patient rights during their education while 40 personnel (34.5%) stated that they did not. Sixty tree (50.8%) of the participants stated that they had not read any legislation related to patient&#39;s rights. In the light of present study findings, it is important to do postgraduate training activities about patient rights. Considering that there are 1727 non-doctors personnel working in Ondokuz Mayıs Universi...

During a standard obstetrical sonogram, the assessment of placental location (PL) is often limited to a mere notional description without formulating any association to possible implications on pregnancy and childbirth. The aim of the study was to speculate if different sites of PL may have a role in influencing fetal presentation-(FP) at birth and if certain pregnancy-complications may be more closely associated with one rather than with another PL. We conducted an observational-prospective-cohort study on pregnant women referred to the Ob/Gyn Unit of Padua University for routine third-trimester ultrasound scan. For all eligible patients we evaluated the correlation between sites of PL and perinatal maternal/fetal outcomes. Non-cephalic presentation was found in 1.4% of anterior, 8.9% of posterior, 6.2% of fundal and 7.2% of lateral insertions. FP at the beginning of the third trimester as opposed to presentation at birth was concordant in 90.3% of anterior, 63.3% of posterior and ...

Background. The current level of knowledge indicates a relationship between periodontitis and diabetes and/or cardiovascular diseases (CVD). Periodontitis can be not only a risk factor for these diseases, but also a condition modifying other primary risk factors associated with the occurrence of cardiovascular complications (lipid disorders, arterial hypertension, etc.) or diabetes. Objectives. The aim of the study was an analysis of the correlation between the state of periodontal tissues and selected risk factors for myocardial infarction (MI) in patients after recent myocardial infarction. Material and methods. The study included 417 patients (92 women, 325 men) hospitalized due to recent MI. The inclusion criteria were MI history and age below 70 years. The state of periodontal tissues (plaque index, bleeding on probing, pocket depth and clinical attachment loss, CPI index) and selected risk factors for periodontitis and CVD were recorded. Results. An analysis of the results showed no statistically significant correlation between the depth, the number, percentage of periodontal pockets and the average clinical attachment level on one hand and BMI on the other hand. Whereas a statistically significant correlation was observed between tobacco smoking and the degree of severity of periodontal diseases measured by the average pocket depth, the number and percentage of pockets above 4 mm and the average clinical attachment loss, as well as between hypertension and the state of oral hygiene and between diabetes and the number of preserved teeth and the number of pockets above 4 mm. Conclusions. The degree of severity of periodontal disease can impact hypertension and diabetes, which could potentially influence the occurrence and course of CVD.

BACKGROUND Very often it is necessary to make a decision or to establish a diagnosis on the basis of great amounts of different kinds of data. In this paper the principal component analysis procedure was applied to anthropometrical data analysis. OBJECTIVES The aim was to simplify the process of decision making by data dimensionality reduction. A second aim was to check how the reduction affected an analysis of the pubertal growth process. MATERIAL AND METHODS A group of 400 boys was investigated. Three main components were calculated and interpreted. In order to investigate growth changes, the variability of each component was approximated by fourth order polynomials. RESULTS It was shown that the loss of information resulting from data dimensionality reduction is about 25%, so the three calculated principal components contained 75% of the entire information. It seems possible to make an appropriate decision on the basis of that amount of information. CONCLUSIONS The results obtain...

hibitors, androgen deprivation therapy, heparin, calcineurin inhibitors and some chemotherapies are among the drugs increasing the risk of osteoporotic fractures [1]. The mechanisms of the regulation of bone turnover involved in the etiology and pathology of osteoporosis seem to be very complex. Recent papers have revealed that various nuclear receptors are involved in the regulation of bone metabolism, its physiology and pathology. Many studies suggest Osteoporosis is defined as pathological bone microarchitecture making bones prone to low-energy fractures. In recent decades it has become one of the major health and socioeconomic problems in many countries. Drug-induced osteoporosis is a significant health problem, as many drugs have deleterious effects on bone metabolism. Glucocorticoids, proton pump inhibitors, selective serotonin receptor inhibitors, thiazolidinediones, anticonvulsants, medroxyprogesterone acetate, aromatase in

rarely PHPT is part of genetically acquired endocrine diseases: multiple endocrine neoplasia type 1 (MEN1), MEN2A, MEN1-like syndromes, etc. [3]. PHPT is a common endocrine disorder that is still rarely taken into account by clinicians. Its prevalence varies from 1 to 4.3/1000, depending on sex, age and the screening threshold for hypercalcemia [1]. The incidence is higher in women than in Primary hyperparathyroidism (PHPT) is hypersecretion of parathormone (PTH) from the parathyroid glands, resulting in persistent hypercalcemia and usually hypercalciuria. It frequently occurs as the effect of single or multiple adenomas (80-85%); less often, it is the result of parathyroid hyperplasia (15-20%); in very rare cases it is caused by parathyroid carcinoma (< 1%) [1, 2]. Even more

The SARS-CoV-2 virus has spread to all corners of the world. Thrombosis is the cause of organ failure and subsequent death in COVID-19. The pathophysiology of thrombosis in COVID-19 needs to be further explored to shed light on its downside. For this reason, this meta-analysis of Von Willebrand Factor profile (VWF: Ag, VWF: activity, VWF: RCo), ADAMTS-13, and factor VIII levels in COVID-19 was performed. To obtain data on the status of the aforementioned hemostatic factors, a systematic literature review and meta-analysis were performed on COVID-19. After reviewing the evaluation of 348 papers, 28 papers included in the meta-analysis, which was performed using STATA. The analysis showed an increase in VWF: Ag levels in COVID-19 patients. VWF: Ac was higher in all COVID-19 patients, while it was lower in the COVID-19 ICU patients. The pooled mean of VWF: RCO in all patients with COVID-19 was 307.94%. In subgroup analysis, VWF: RCO was significantly higher in ICU patients than in all COVID-19 patients. The pooled mean of ADAMTS-13 activity was 62.47%, and 58.42% in ICU patients. The pooled mean of factor VIII level was 275.8%, which was significantly higher in ICU patients with COVID-19 than all patients with COVID-19. Levels of VWF: Ag, VWF: activity, VWF: ristocetin, and factor VIII are increased in patients with COVID-19. The elevated levels in ICU patients with COVID-19 suggest that these markers may have prognostic value in determining the severity of COVID-19. New therapeutic programs can be developed as a result.

Viruses are chemical particles of genetic material, where very virulent families and genera are found. The world is facing a new highly pathogenic coronavirus, the clinical picture of which changes dramatically depending on the immune status of the patient. The objective of this article was to capture the biological generalities and particularities of the new coronavirus (COVID-19). Likewise, the clinical manifestations of this virus and the prophylactic measures issued by the health agencies in charge of combating this pandemic are detailed.

Introduction Spinal cord injuries (SCI) are injuries with a high clinical importance due to serious resulting consequences. Acute spinal cord injuries occur at a rate of 2-4/100.000 in many countries. The annual incidence of SCI ranges between 7500-10.000 (Li et al., 2000; Baron et al., 2011). SCI occurs most often between the ages of 16 and 30. Motor vehicle accidents (40%), acts of violence (25%) falls (20%) and sports accidents (5-10%) are prominent causes in the United States (Raineteau and Schwab, 2001; Baron et al., 2011). The rates of sports accidents in European countries are higher while injuries associated with acts of violence are less common (Raineteau and Schwab, 2001). The rate of spinal cord injuries in our country is 1.2/100.000 and the annual incidence is reported to be 500-600 cases. It is reported that the male/female rate ratio is 4/1 and the most common cause of spinal cord injuries is motor vehicle accidents (48.8%) (Dryden et al., 2003). Almost two of three spinal injuries occur in cervical spine (Fehlings et al., 2001). Today there is no effective medical treatment agent to preserve neurological function in patients with complete injury, except for methylprednisolone (Bracken et al., 1984; Tator and Fehlings, 1991; Hurlbert, 2000). Depending on the actions such as timely and properly rendered first aid, better resuscitation and fastening seat belts, the incidence of complete spinal cord injuries has decreased. All such factors positively influence recovery process (Tator, 2002). 2. Patient Management In acute SCI, patient management involves airway, respiratory and oxygenation protection and maintaining optimal blood pressure by controlling blood loss as well as early mechanical and surgical stabilization (Stahel et al., 2012). Unstable injuries with neurological signs require urgent treatment. If a patient has no neurological signs, the process of diagnosis Review

Background. One of the methods to treat chronic wounds is the use of hyperbaric oxygen (HBO). Objective measurement of the wound surface is an important element in the process of monitoring and predicting the progress of treatment. Objectives. The aim of the study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on ulcer wound healing in patients with chronic venous insufficiency ulcers and diabetic foot syndrome using thermal imaging and computerized planimetry. Material and methods. During a 3-year period, 284 digital computer planimetry measurements were gathered from 142 patients treated for leg ulcers caused by chronic venous insufficiency and ulcers from diabetic foot syndrome at HBOT Unit of the Dr Stanisław Sakiel Centre for Burns Treatment in Siemianowice Śląskie (Poland). Each patient took 30 HBOT sessions using a Haux multiplace HBO chamber at a pressure of 2.5 atmospheres absolute (ATA). The results of the treatment were monitored by thermovision and computerassisted planimetry measurements performed before and after HBOT. Results. Both groups of patients exhibited a reduction in the surface and perimeter of the wound after HBOT. The treatment effects were also confirmed by thermal imaging. The areas calculated from thermal imaging and planimetry are different but correlated. Conclusions. It seems that a combination of thermal imaging and planimetry may enhance the diagnosis as well as provide the physician with more information about therapy effects.

Septicaemia is an acute inflammatory reaction in the bloodstream to the presence of pathogen-associated molecular patterns. Whole blood stimulation assays capture endotoxin-induced formation of aggregates between platelets and leucocytes using flow cytometry. We wanted to assess extent of spontaneous aggregate formation in whole blood stimulation assays and compare the effects of endotoxin and heat-killed, clinically relevant, bacterial pathogens on aggregate formation and then on adhesion of aggregates to TNFα-stimulated endothelial cells. We found that endotoxin (from Escherichia coli or Salmonella enteritidis) was not a suitable stimulus to provoke platelet-leucocyte aggregates in vitro, as it did not further increase the extent of aggregates formed spontaneously in stasis of hirudin-anticoagulated blood. Specifically, whole blood samples stimulated with or without LPS produced aggregates with a mean surface area of 140.97 and 117.68 μm 2 , respectively. By contrast, incubation of whole blood with heat-killed Klebsiella pneumoniae or Staphylococcus aureus produced significantly enhanced and complex cellular aggregates (with a mean surface area of 470.61 and 518.39 μm 2 , respectively) which adhered more frequently to TNFα (and free fatty acid)-stimulated endothelial cells. These were reliably captured by scanning electron microscopy. Adhesion of cellular aggregates could be blocked by incubation of endothelial cells with a commercial P-selectin antibody and an angiopoietin-2 ligand trap. In conclusion, we have developed an in vitro method that models the acute inflammatory reaction in whole blood in the presence of sepsis-relevant bacterial pathogen surfaces.

Background. The loss of physical properties of orthodontic chains has been a topic of discussion among scientists and clinicians, motivating efforts to improve elastic materials and minimize the decrease of force. Orthodontic companies have introduced memory elastomers, which, according to the manufacturers, have improved mechanical properties.

Background. Microwaves from mobile phones are one of the environmental toxicants that are capable of compromising male fertility by inducing oxidative stress and apoptosis in the testes. Melatonin is a lipophilic tryptophan indole amine and a potent antioxidant. Objectives. The aim of the study was to evaluate the effect of melatonin treatment on oxidative stress parameters and DNA fragmentation in the testicular tissue of rats exposed to microwave radiation (4 h/day). Material and Methods. Adult Wistar rats were divided in 4 groups: I -treated with saline; II -treated with melatonin; III -exposed to microwaves; IV -exposed to microwaves and treated with melatonin. The melatonin (2 mg/kg ip) was administered daily. The animals were sacrificed after 20, 40 and 60 days. Results. Melatonin treatment prevented previously registered increases in malondialdehyde after only 20 days. Furthermore, it reversed the effects of microwave exposure on xanthine oxidase (after 40 days) and acid-DNase activity (after 20 days). However, neither protein carbonyl content nor catalase and alkaline Dnase activity were changed due to melatonin treatment. Conclusions. Melatonin exerts potent antioxidant effects in the testes of rats exposed to microwaves by decreasing the intensity of oxidative stress; it also reduces DNA fragmentation (Adv Clin Exp Med 2015, 24, 3, 429-436).

Abstract: Aim: To evaluate platelet function in patients with a history of surgical treatment for hepatic hydatid disease (HD). Methods: This retrospective case-controlled study was performed in a state hospital in Turkey from January 2009 to November 2013. The patients were divided into two groups: those evaluated in the preoperative period (Group 1) and those evaluated in the postoperative period (Group 2). The patient groups were compared with a control group (Group 3). All three groups were evaluated using laboratory records from day 1 of the preoperative period and day 30 of the postoperative period. The haematocrit level (HTC), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and percentage of eosinophils (EOS) were compared among the groups. Results: Fifty-three patients who had undergone surgical treatment of hepatic HD and 55 healthy controls were included in the study. The mean follow-up time for all patients was 45 (14-70) months. The p...

Background. Colorectal cancer (CRC) remains a major source of cancer-related mortality, accounting for 10% of all cancer-related deaths. DNA mismatch repair mechanism (MMR) responsible for correcting errors generated during DNA replication and its deficiency is associated with both hereditary and sporadic CRC. Single-nucleotide polymorphisms (SNPs) are the most common forms of genetic variation, and it has been shown that the SNPs in MMR genes may modify CRC risk. Objectives. The aim of the study was to determine the relationship between gene polymorphism Glu39Gly (c. 116G>A) of the hMSH6 gene and the modulation of the risk of sporadic colorectal cancer in the Polish population. Material and methods. A total of 128 patients with resectable colorectal carcinoma as well as 189 sex-, age-, and ethnicity-matched control subjects without cancer history were enrolled in this study. Patients with a family history of CRC or inflammatory bowel diseases were excluded from this study. The DNA was isolated from peripheral blood lymphocytes of enrolled patients, and gene polymorphisms were analyzed by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Results. We observed that the genotype G/A variant of Glu39Gly (c. 116G>A) genotype is associated with an increased risk of colorectal cancer (OR 1.65; 95% CI: 1.01-2.69; p = 0.44). The presence of A allele was also significantly higher in patients with CRC (OR 1.57; 95% CI: 1.04-2.38; p = 0.032). When comparing the prevalence of genotypes with clinical staging, genotype G/A and A allele were significantly less frequent in stage III-IV than in I (OR 0.3409; 95% CI: 0. 124-0.939; p = 0.0375, and OR 0.4462; 95% CI: 0.201-0.991; p = 0.044, respectively). Conclusions. These findings suggest that hMSH6 Glu39Gly polymorphism is associated with the risk of developing colorectal cancer in the Polish population, probably due to a defective mismatch repair system. The presence of G/A genotype and A allele is, however, associated with less advanced disease.

Bu çalışmada Çocuk Hematoloji-Onkoloji Bilim Dalı'nda takip ve tedavi edilen 27 Ewing Sarkomlu olgunun epidemiyolojik ve klinik özellikleri, tedavi sonuçları, uzun dönem komplikasyonları retrospektif olarak incelenmiştir. Olguların (n=27) ortalama tanı yaşı 11,36 ± 3,98 yıl (8 ay-17,9) olup, erkek/kız oranı 1,7 olarak saptandı. En sık başvuru yakınmalarının lokalize ağrı (%96,3) ve şişlik (%100) olduğu görüldü. Primer tümör bölgesi 16 olguda (%59,3) uzun kemiklerde, 11 olguda (%40,7) aksiyel kemiklerde saptandı. Primer lezyonun yerleştiği kemikler sırasıyla femur (%26), tibia (%14,8), pelvis (%14,8) ve fibula (%11,1) idi. Başvuru anında 3 olguda (%11,1) kemik iliği tutulumu tespit edildi. Toplam 9 olguda (%33,3) tanı sırasında uzak yayılım saptandı. 23 olguya (%92) neoadjuvan kemoterapi, 17 olguya (%77,2) adjuvan kemoterapi uygulandığı tespit edildi. Olguların 13'üne ekstremite koruyucu cerrahi, 2'sine amputasyon yapıldığı saptandı. Radyoterapi olguların %65,3'ünde uygulandı (n=17) ve radyoterapi yeri 11 olguda primer tümör bölgesine, 5 olguda metastaz bölgesine, 1 olguda hem primer tümör hem metastaz bölgesine yönelik idi. Olgularının ortalama ve ortanca izlem süreleri sırasıyla 35,5 ve 19 ay (en fazla 355 ay) idi. Sağ kalım analizleri sonucunda toplam sağ kalım oranı %22,4 ±10,9 olarak saptandı.

BACKGROUND Endovenous laser ablation (EVLA) is a treatment option for lower extremity varicose veins. In the present study, we investigate to the genetic changes and possibility of living tissue in the saphenous vein wall after the EVLA procedure. METHODS Eleven saphenous vein grafts were randomized in two groups: (1) 4 cm SVG segments of performed EVLA procedure in study group, (2) 4 cm segments of SVG none performed EVLA procedure in control group. SVG were taken from the remnants of distal saphenous vein grafts prepared for the bypass procedure but not used. SVG was approximately 8 cm in length and was divided into two parts 4 cm in length. One half was exposed to laser energy, while the other half of the same vein graft was untreated as a control. EVLA was performed on complete saphenous veins in the study group. Abnormal genetic changes of the SVG were observed with a Tri-Reagent method and quantified with a Nanodrop™ spectrophotometer. RESULTS Histopathological changes indicat...

Background. The objective was to identify the microorganisms present on polyglycolic−acid braided suture mate− rial coated with triclosan used in the oral cavity and the in vitro evaluation of the bactericidal properties of tri− closan−coated material. Material and Methods. Material was collected from 11 patients subjected oral surgery. The first material was non− absorbable monofilamen the second triclosan−coated multifilament. Both threads were sutured simultaneously to the same wound. The suture materials were excised 7 days after surgery and placed onto transport medium plates. Identification was carried out with commercial API tests. Most of the isolated strains were classified as Streptococcus. In vitro tests were performed in two stages. The first test was carried out with the coated materials placed directly onto plates inoculated with microbes isolated from the patients. In the second test the sutures were first rinsed for 24 h in isotonic salt solution. Zones of growth inh...

Background. The need to obtain successful surgical hemostasis had a significant impact on the development of electrosurgery. Innovative technical solutions necessitate the continuous training of surgeons in the use of more modern technologies. The diversity of solutions is also associated with the need to adapt the methods for obtaining hemostasis to the type of operation. Each time, the introduction of new technologies requires a critical evaluation of the results of surgical treatment. The most important measure of quality in thyroid surgery is the presence of chronic complications, such as the recurrent laryngeal nerve palsy and parathyroid insufficiency. Transient disorders also have a significant impact on the patient's comfort and quality of life. The report is preliminary in nature and it requires further investigation. Objectives. The aim of the study was to evaluate the effect of three methods for obtaining hemostasis on the occurrence of hypoparathyroidism, recurrent laryngeal nerve palsy, bleeding and the surgical site infection after thyroid surgery. Material and Methods. A retrospective analysis included patients who underwent thyroidectomy (n = 654). Three methods of hemostasis were used. The first group (n = 339) had blood vessels tied off. In the second (n = 192) bipolar electrocoagulation was used and in the third one (n = 123) bipolar electrocoagulation with integrated cutting mechanism. Results. The transient hypoparathyroidism was found in 1.4% patients in the first group, 8.3% in the second and 27.6% in the third one. Chronic hypoparathyroidism was found in 0.29% in the first group, 0% in the second group and 2.4% in the third group. Significantly statistical differences were found in the incidence of transient hypoparathyroidism. Conclusions. Significant statistical differences were found in incidences of transient hypoparthyroidism in the group where bipolar electrosurgery was used (Adv Clin Exp Med 2015, 24, 2, 275-278).

Oxidative stress has been associated with pathological processes involved in acoustic trauma. In this prospective experimental study, we investigated the potential preventive effect of N-acetyl cysteine (NAC) in rats exposed to acoustic trauma (AT). Light microscopic and scanning electron microscopic (SEM) evaluations were performed. Healthy Wistar albino rats (n = 18) were divided into 3 groups: group 1 (control group, n = 6), group 2 (acoustic trauma group, n = 6), and group 3 (AT+NAC group, n = 6). The rats in group 2 were exposed to AT. The rats in group 3 received NAC at a dose of 100 mg/kg/day by gavage for 7 days, and then 10 min after the 7th-day dose, they were exposed to AT. From light and scanning electron microscopy evaluations in the control group, the cochlear structure and epithelium were normal. In group 2 (AT group), extensive hair cell loss was observed in the cochlea by light microscopy evaluation. In the SEM evaluation, various epithelial damage and loss of stere...

Background. Cisplatin, used in cancer treatment, has toxic and apoptotic effects on the peripheral nervous system. Rutin, also known as vitamin P, has antioxidant and antiapoptotic activity. Objectives. The purpose of this study was to investigate the biochemical and histopathologic efficacy of rutin on neurotoxic and apoptotic effects caused by cisplatin in the peripheral nervous system. Material and methods. Twenty-four albino Wistar male rats were divided into the following 4 groups: control group (CG), only cisplatin-injected group (CIS), cisplatin and rutin 50 mg/kg (RG-50)-injected group, and cisplatin and rutin 100 mg/kg (RG-100)-injected group. Analyses were performed on sciatic nerve tissue of experimental animals. Analyses of malondialdehyde (MDA), total glutathione (tGSH), glutathione reductase (GSHRd), glutathione-s-transferase (GST), and superoxide dismutase (SOD) were performed. Caspase-3 expression in nerve tissue was also investigated. The analyzed groups were compared with CG. Results. Biochemical investigation shows that there is a statistically significant difference between CG and only CIS and RG-50. Control group and RG-100 were found to be similar. Cisplatin-induced changes were observed in histopathological analysis of the nerve tissue. The RG-100 and CG were found to be similar. The caspase-3 expression in the neural tissue was compared between groups. Control group and CIS were found to be different. Control group and RG-100 were found to be similar. Conclusions. Antioxidant and antiapoptotic effectiveness of rutin was detected against the toxic effects caused by cisplatin in the peripheral nerve tissue.

people, and the prevalence increases in the fifth decade of life. Cervical radiculopathy is the result of cervical nerve root pathology, often caused by space-occupying lesions such as cervical disc herniation, spondylosis, or osteophytosis. These space-occupying lesions produce upper extremity radicular symptoms such as pain, numbness, weakness and paresthesia. The C6 and C7 nerve roots are most commonly involved in cervical radiculopathy [3]. The aim of the present study was to define the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain. Mastalgia, which is the reason for 50% of all referrals to breast clinics, affects up to 75% of women during their lives. It is a common and enigmatic condition, the cause and optimal treatment of which are still inadequately defined. It may be severe enough to affect the patient's usual daily activities, and its effect on quality of life is often underestimated. Evaluations of breast pain vary depending on whether it is classified as cyclic mastalgia, noncyclic mastalgia or extramammary pain. This distinction is important because the evaluation and the response to interventions vary among the different types of breast pain [1, 2]. Cervical radiculopathy is frequently encountered, with an annual incidence of 83.2 per 100,000

Background. Interdisciplinary physical therapy together with pharmacological treatment constitute conservative treatment strategies related to low back pain (LBP). There is still a lack of high quality studies aimed at an objective evaluation of physiotherapeutic procedures according to their effectiveness in LBP. Objectives. The aim of this study is to carry out a prospective, randomized, single-blinded, and placebocontrolled clinical trial to evaluate the effectiveness of magnetic fields in discopathy-related LBP. Material and methods. A group of 177 patients was assessed for eligibility based on inclusion and exclusion criteria. In the end, 106 patients were randomly assigned into 5 comparative groups: A (n = 23; magnetic therapy: 10 mT, 50 Hz); B (n = 23; magnetic therapy: 5 mT, 50 Hz); C (n = 20; placebo magnetic therapy); D (n = 20; magnetic stimulation: 49.2 μT, 195 Hz); and E (n = 20; placebo magnetic stimulation). All patients were assessed using tests for pain intensity, degree of disability and range of motion. Also, postural stability was assessed using a stabilographic platform. Results. In this study, positive changes in all clinical outcomes were demonstrated in group A (p < 0.05). The most effective clinical effect was observed for pain reduction (p < 0.05), improvement of the range of motion (p < 0.05) and functional ability of the spine (p <0.05). It is also worth noting that the effects in the majority of the measured indicators were mostly short-term (p > 0.05). Conclusions. It was determined that the application of magnetic therapy (10 mT, 50 Hz, 20 min) significantly reduces pain symptoms and leads to an improvement of functional ability in patients with LBP.

Background. Crystalloids are frequently used for the correction of spinal anesthesia-induced hypotension, intraoperative bleeding, or vaporisation from surgical wounds. Objectives. The aim of this study was to observe the effect of perioperative crystalloid infusion on intraabdominal pressure (IAP), volume excess (VE), total body water (TBW), and extracellular body water (ECW) in patients undergoing elective orthopedic surgery under spinal anesthesia. Material and methods. Adult patients undergoing hip or knee replacement were studied. Changes in VE, TBW, ECW, and IAP were observed in patients who received restrictive fluid therapy (group R) and in patients who received liberal fluid therapy (group L). IAP was measured in the urinary bladder. All parameters were measured at 4 points in time: just before anesthesia (baseline value, A); just after surgery (B); 3 h after surgery (C); and on the morning of postoperative day 1 (D). Additionally, IAP was measured after anesthesia, just before surgery (A1). Results. The mean baseline values of IAP, ECW, TBW, and VE were comparable between groups L and R. The induction of anesthesia reduced IAP in both groups (p < 0.001). IAP and VE increased in both groups after surgery. Significantly higher values of IAP, however, were noted in group L at time points B, C, and D. TBW and ECW increased after surgery in group L. In group R, ECW slightly increased only at time point C. IAP strongly correlated with ECW in group L (p < 0.001, r = 0.62). Conclusions. Spinal anesthesia reduces IAP. A perioperative increase in body water content and IAP mainly depends on the volume of the infused crystalloids.

Type 1 diabetes (T1D) is an autoimmune disorder characterized by the immune destruction of the insulin producing beta cells of the pancreatic islets. Autoimmunity towards pancreatic antigens results from complex interactions between multiple genes, environmental factors and the immune system. The autoimmune process may occur many years before the onset of clinical diabetes and this long asymptomatic period provides excellent opportunities for the prediction and prevention of the disease. Research in past four decades has identified a number of risk factors including susceptibility genes, gene and protein expression changes, cellular changes as well as environmental triggers, which may serve as excellent biomarkers for risk assessment. Furthermore, demographic and clinical parameters such as age and family history of diabetes and other autoimmune diseases are also important for risk assessment. Despite the identification of multiple useful biomarkers, the existing tests for T1D predi...

Background. This study was performed to better understand the best surgery timing for gallbladder polyps (GP). Objectives. The objective was to determine the potential for malignant transformation and the best timing for surgery in GP, based on an assessment of the clinical symptomatology and on the results of the imaging and histopathological examinations. Material and methods. Age, gender, clinical symptoms, preoperative ultrasound findings, and the results of the postoperative histopathological examination were retrospectively assessed in a total of 2,656 patients undergoing cholecystectomy in

The pathogenesis of T2DM involves secretion of several pro-inflammatory molecules by the dramatically increased adipocytes, both by number and size, and associated macrophages of adipose tissue. Since T2DM is usually preceded by obesity and chronic systemic inflammation, the objective of this study was to explore for any association between genetic variants of previously established 36 T2DM-associated SNPs and altered serum adipocyto-kine levels and metabolic syndrome phenotypes. Study consisted of 566 subjects (284 males and 282 females) of whom 147 were T2DM patients and 419 healthy controls. Study subjects were genotyped for 36 T2DM-linked single nucleotide polymorphisms (SNPs) using the KASPar SNP Genotyping System and grouped into different genotypes for each SNP. Various anthropometric and biochemical parameters were measured following standard procedures. The mean values of serum levels of individual adipocytokines and the presence/absence of metabolic syndrome phenotypes cor...

The development of inhibitors is the most severe complication of treating hemophilia patients with Factor VIII or IX, and providing effective hemostasis for inhibitor patients is challenging. Patients with high responding inhibitors (titer &gt;5 BU/mL) are usually treated with recombinant activated Factor VII (rFVIIa), 90-120 microg/kg every 2-3 hours, or plasma-derived activated prothrombin complex concentrate. The aim of this study was to assess the efficacy and safety of a single dose of 270 microg/kg rFVIIa in inhibitor patients with joint or soft tissue bleeds treated at the Department of Paediatric Hematology and Oncology and the Department of Hematology and Transplantology. 7 inhibitor patients (3 adults aged 23-33 and 4 children aged 3-14) were included in the study. The hemostatic efficacy and tolerability of a single high dose of rFVIIa for home treatment of moderate or severe bleeds was evaluated. Treatment with rFVIIa effectively stopped bleeding in all patients without ...

Ischemia causes reversible or irreversible cell or tissue damage and reperfusion can exaggerate cellular damage. Microvascular dysfunction is induced and causes enhanced fluid filtration in capillaries. At the acute phase of reperfusion more oxygen radicals are activated. Nesfatin-1 protects brain against oxidative damage and heart against ischemia/reperfusion damage. In our study, we aimed to investigate the acute effect of chronic peripheral nesfatin-1 administration in intestinal ischemia/reperfusion created rats. Two-months-old, 28 Wistar Albino male rats, weighing an average of 200-250 g, were used and randomly divided into four experimental groups (n=7) as; Laparotomy, Ischemia/Reperfusion, Nesfatin-1+Laparotomy, Nesfatin-1+Ischemia/Reperfusion. Serum levels of total oxidant status (TOS) and total antioxidant status (TAS) were determined by colorimetric measurement method. The plasma levels of endotelin-1 and endothelial nitric oxide syntheses (eNOS) were analyzed by rat ELISA...

Hemorrhage still continues to be reported as one of the leading causes of maternal mortality and morbidity. Intraoperative estimation of the blood loss seems to be complex and misleading as it is impaired by the amount of amniotic fluid and blood from the placenta. The present study was aimed to investigate the safety of intraoperative deciding on an uneventful cesarean section in a low risk patient population. One hundred patients free from hemorrhage risks and experienced an uneventful elective cesarean section, were included to the study. The decline in hemoglobin and hematocrit values, calculated blood loss, transfusion rate and presence of hemorrhage related symptoms and signs were accepted as the main outcomes of the study. The average preoperative and postoperative hemoglobin values were detected as 12.09±0.18 g/dl and 10.72±1.39 g/dl, respectively. The average decrease in hemoglobin was 1.36±1.06 g/dl. The observed decrease in hemoglobin values were less than 10% in 34.4% of...

Head and neck tumors comprise a wide spectrum of heterogeneous neoplasms for which biomarkers are needed to aid in earlier diagnosis, risk assessment and therapy response. Personalized medicine based on predictive markers linked to drug response, it is hoped, will lead to improvements in outcomes and avoidance of unnecessary treatment in carcinoma of the head and neck. Because of the heterogeneity of head and neck tumors, the integration of multiple selected markers in association with the histopathologic features is advocated for risk assessment. Validation of each biomarker in the context of clinical trials will be required before a specific marker can be incorporated into daily practice. Furthermore, we will give evidence that some proteins implicated in cell-cell interaction, such as CD44 may be involved in the multiple mechanism of the development and progression of laryngeal lesions and may help to predict the risk of transformation of the benign or precancerous lesions to can...