TR-Dizin Kapalı Erişimli Yayınlar
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Item An add-on therapy for neuropathic pain: Infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue(2019) Eker, Hatice Evren; Yalcin Cok, Oya; Bozdodan Ozyilkan, Nesrin; Aribodan, Anis; 30633313In some situations, the cause of the supposed neuropathic pain might be related to abnormal tissue recovery such as scar formation due to wound retraction that might create mechanical compression on the nerve tissue. In this report we describe infiltration block with diclofenac sodium and lidocaine through the hypertrophic scar tissue to reduce mechanical stress in 3 patients. The infiltration technique might resolve the tension of the contracted scar tissue by tearing the adhesions and the eliminated mechanical compression would reduce the pressure on nerve tissue and hence neuropathic pain symptoms.Item Altered pulmonary functions due to biomass smoke in a rural population of Turkish women: a descriptive study(2018) Ozsancak Ugurlu, Aylin; Balcan, Baran; Akan, Selcuk; Ceyhan, Berrin; 30246655; A-4721-2018Introduction: Wood or other organic sources of fuel are used as source of energy for heating or cooking particularly in developing countries. The aim of the current study was to evaluate the association between biomass exposure time and parameters of pulmonary function tests. Materials and Methods: Four hundred twenty-four consecutive women who lived and exposed to biomass smoke in a small province in Eastern Turkey were involved. This study was performed with women who had come to pulmonology out-patient clinic with symptom of dyspnea. Results: The independent variables assessed in the study patients were age, BMI, starting age of cooking, hours per day and weeks per month spent cooking, and cooking years; the dependent variables were PFT parameters. Ninety-two (21.6%) patients had an obstructive PFT pattern. Sixty-seven (73%) of these patients were classified as GOLD 2 and 25 (27%) patients were classified as GOLD 3. Seventy-five (17.6 %) of the patients had restrictive lung disease; 54 (72%) of these patients were found to have a mild and 21 (27%) had a moderate restrictive pattern. Increased number of years in cooking and to start cooking at younger ages were a risk factors for the development of obstructive and restrictive disease. There was a statistically significant and negative correlation between increased number of years and the value of FEV1 (r=-0.917; p=<0.001), FEV1/FVC (r=-0.739; p<0.001), and FVC (r=-0.906; p<0.001). The median time of cooking required was 23 years for the development of obstruction, and 25 years for restriction, respectively. Conclusion: Cumulative biomass exposure time is associated with impairment in PFT parameters; results in both obstructive and restrictive lung disease. Biomass exposure is a public health problem and pre-cautions should be taken in order to prevent impaired pulmonary functions.Item Applicability of the Vienna Sale Agreement (CISG) for Advanced Purchase Agreements of COVID-19 Vaccines in EU Member States(2022) Cortoglu Koca, SemaThe European Commission has signed advanced purchase agreements with various vaccine manufacturers for the production, purchase and supply of the COVID-19 vaccine in the EU. Some parts of the agreement texts with AstraZeneca, CurevacAg and Pfizer Inc./BioNTech have been blacked out. In these agreements, it is understood that Belgian courts are competent and Belgian law is chosen. In a dispute, it is possible for the competent courts to apply CISG since Belgium is a party to the CISG. Even if choice of law hasn't been made, the fact that the workplaces of all parties to these ageements are party to CISG, makes the CISG applicable. This study evaluates the applicability of the CISG to advanced purchase agreements (especially made with AstraZeneca) in EU Member States.Item Arf numerical semigroups with multiplicity 11 and 13(2022) Karakas, Halil Ibrahim; Ilhan, Sedat; Suer, Meral; AAY-4394-2021Item Budget impact of incorporating non-invasive prenatal testing in prenatal screening for Down syndrome in Turkey(2019) Okem, Zeynep Guldem; Orgul, Gokcen; Kasnakoglu, Berna Tari; Cakar, Mehmet; Beksac, Mehmet SinanObjectives: To provide information to the government about the budget impact of implementing non-invasive prenatal testing (NIPT) into prenatal screening strategies to detect Down syndrome (DS) in singleton pregnancies in Turkey; the likely costs or savings associated with NIPT in comparison to the current practice were calculated. Methods: A decision-analytic model was developed to calculate the cost estimates for 1,309,771 women who gave birth in 2016; 84.8% of whom were <35-years-of-age. The superior combined test (CT) among current strategies is compared with contingent NIPT for women <35-years-of-age; and usual practice of amniocentesis (AC) for women >= 35 years-of-age was replaced with universal NIPT. Results: When the market price of NIPT (1,077 PPPUS$) is used, contingent NIPT offered to high-risk women <35-years-of-age adds 34,907,225 PPPUS$; and for women-35 >= years-of-age the universal NIPT leads to 142,785,818 PPPUS$ more cost to the government compared to current strategies. The additional costs with NIPT are partially compensated by the cost-savings due to reduction of the number of invasive tests and procedure related losses (17,826,476 PPPUS$ for women <35-years-of-age and 37,070 PPPUS$ for women >= 35-years-of-age). Results are sensitive to the NIPT costs; with a lower cost of NIPT, a total saving would be 33,116,046 PPPUS$ with new strategies. Conclusions: NIPT might be the choice of prenatal screening strategies if its price is lowered to economically acceptable levels. Until that time, currently accepted protocols seem to be more realistic. On the other hand, decision makers should also consider possible savings and the women's quality of life that can be improved with the new technology. (C) 2019 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.Item Burnout Syndrome Among Physicians: The Role of Socio-Demographic Characteristics(2017) Ozkula, Guler; Durukan, Elif; 0000-0002-8579-5564; AAJ-8621-2021Objective: Burnout is a syndrome that occurs in occupational groups, which are in close relation with people and includes dimensions of; emotional exhaustion, depersonalization and low sense of personal accomplishment. The aim of the present study is to investigate the relationship between socio-demographic characteristics and burnout syndrome in academic personel working at a hospital of Faculty of Medicine. Method: 258 physicians working at Baskent University Ankara Hospital have been included in the present study voluntarily, between January - April 2014 and they have been administered Socio-Demographic Data Form and Maslach Burnout Inventory. Results: Age, academic title, time span in the profession and at the institution, the number of patients daily examined, administrative tasks, receiving research supports, the number of lectures given were related to all dimensions of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Personnel assignment, the number of monthly shifts, daily duration of work were related to emotional exhaustion and depersonalization. Specialty preferences and intention to continue on the profession were associated with emotional exhaustion and personal accomplishment. Personnel assignment criteria and time reserved for academic study were related to only emotional exhaustion whereas accessibility to scientific literature was linked to personal accomplishment. Conclusion: Older age, having an academic title, longer time span in the profession and at the institution, concidering the long term consequences of specialty selection are all individual factors that can be related to burnout syndrome. Developing health policies for an optimal organization of daily work duration, number of patients daily examined and personnel assignment criteria could prevent burnout. Also developing organizational climate to create time for academic study, supporting researches, increasing accessibility to scientific literature and optimization of education seminars in academic physicians could protect them from burnout syndrome. Prospective studies modeling individual and organizational risk factors for burnout on academic physicians will help to further illuminate the measures to protect physicians from burnout syndrome and also contribute to the enhancement of treatment service quality and foster the contribution to academic arena.Item Cephalometric Mandibular Dimensions in Growing Turkish Children: Trends of Change, Sex-Specific Differences, and Comparisons with Published Norms(2022) Pamukcu, Hande; Tuncer, Nilufer Irem; Pelin, Ismail Can; Zengin, Hatice Yagmur; 36155404Objective: The aims of this study were to investigate cephalometric mandibular dimensions in growing Anatolian Turkish children and to identify the periods of rapid growth for boys and girls. Furthermore, the secondary aim was to compare obtained values with published standards in the literature. Methods: A total of 528 pretreatment lateral cephalometric radiographs, grouped according to age and sex, were analyzed. Effective mandibular length, ramus height, and corpus lengths were comparatively evaluated within age groups for boys and girls and between sexes for the same age group. Data acquired from this study were compared with American, Canadian, Chinese, and European norms. Growth curves for mandible were constructed for each sex group. Results: Effective mandibular length was almost always significantly longer in boys, except for 9- and 12-year-age groups. Effective mandibular length in girls increased significantly between ages 8 and 10, 10 and 12, and 11 and 13 years, while in boys between ages 8 and 10, 9 and 11, and 13 and 15 years. Turkish girls had significantly shorter effective mandibular lengths than American girls at age 14. No significant difference was found between Turkish and Chinese girls and boys. Turkish girls and boys had significantly shorter corpus lengths from their Norwegian counterparts at age 12. Conclusion: Except for 9- and 12-year-age groups, effective mandibular length was almost always significantly longer in boys compared to the girls. It is suggested to use norm values from more recently conducted studies and which are representative of the studied population. Growth curves can be used to predict the approximate mandibular dimensions at a particular age.Item Clinical features and immunoglobulin replacement therapy outcomes of adults with common variable immunodeficiency: a single centre experience(2021) Musabak, Ugur; Erdogan, Tuba; 0000-0002-3143-2442; 34022776; ABH-5354-2020Background/aim: Common variable immunodeficiency (CVID) characterized by defective immunoglobulin production is the most prevalent form of symptomatic primary immunodeficiency (PID) in adults. We aimed to reveal the clinical features of adults with CVID and to evaluate the effects of immunoglobulin replacement treatment (IRT) on hemato-immunological findings. Materials and methods: This study included 26 adult patients receiving IRT. Two measurements of complete blood counts and major immunoglobulin levels obtained at the beginning-end of follow up period were used for comparisons. Lymphocyte subsets and B-cell subgroups were measured only at the time of presentation. Results: The most common complications were related to respiratory and digestive systems and organomegaly. Chronic diarrhoea and low body weight were positively correlated with the percentage of CD8(+) T cells (p = 0.019 and p = 0.003, respectively) but negatively correlated with the CD4/CD8 ratio and the percentage of CD19(+) B cells (p = 0.019 and p = 0.005 for both parameters, respectively). At the end of period, the distribution of haematological parameters significantly improved, and immunoglobulin M (IgM) level increased to detectable levels (p = 0.035). Conclusions: There are apparent relationships among chronic diarrhoea and low body weight, and deterioration of T and B cell immunity in adults with CVID. IRT improves the whole blood parameters and stimulates immunoglobulin M (IgM) production. The later effect supports the immunomodulatory feature of this therapy.Item Comparison of Long-term Clinical Outcomes of the Preferred Surgical Techniques in Secondary Hyperparathyroidism Cases(2022) Karakaya, Emre; Erkent, Murathan; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-3592-5092; AAD-5466-2021; CAA-2756-2022Objective: Secondary hyperparathyroidism (SHPT), that progresses with the deterioration of calcium-phosphorus metabolism detected in chronic kidney disease patients. Recurrence of SHPT may result in the recurrence of symptoms. Our aim was to compare the 5-year clinical results of autotransplantation after total parathyroidectomy (PTX-AT) with subtotal parathyroidectomy (SPTX). Materials and Methods: We analyzed 140 patients retrospectively from January 2000 and October 2020 who were operated due to SHPT. Clinical and demographic characteristics of the patients, preoperative and postoperative (1st day, 1st month, 6th month, 1st year, 5th years) serum PTH, calcium (Ca), phosphorous (P) values and length of hospital stay (LOS) were compared in terms of operations performed. The Shapiro-Wilks test was used for analyzing normally distributed datas. Mann Whitney U test used to evaluate of comparison of numerical data. Fisher's Exact or chi-square test was used for ratio comparisons or correlation. P<0.05 was considered statistical significance level. Results: Of these 140 patients, 106 (75.7%) had SPTX. On the other hand, 34 patients (24.3%) underwent PTX-AT surgery. When the groups were compared in terms of the gender, age and comorbidities, the differences were statistically significant. Additionally, no statistically significant difference was found between the groups in terms of postoperative complications (p=0.206). The difference between the weights and sizes of the parathyroid glands removed between the operation groups was not statistically significant (p=0.751, p=0.176). The difference was not statistically significant between the groups in terms of PTH, Ca and P levels measured. LOS was statistically significantly longer in PTX-AT patients (p=0). Conclusion: The surgical methods in the treatment of SHPT have no difference each other. Depending on the surgeon's preference, both surgical methods can be safely applied with high success rates.Item Comparison of obese and non-obese patients in terms of self-esteem, body perception, body weight perception and sociodemographic components(2019) Engur, Sevgi; Karagol, ArdaObjective: The aim of the study is to compare the randomly selected obese patients from the endocrinology outpatient clinic of a university hospital and the randomly selected non-obese patients from the general internal diseases outpatient clinic of the same hospital in the sense of self-esteem, body perception, body weight perception and some other sociodemographic features. Methods: The study included a total of 350 patients, of whom 175 were obese (147 female patients, 84%) and 175 were non-obese (115 female patients, 65.7%). The body mass indexes of the patients who were included in the study were measured. While the Rosenberg Self Esteem Scale was used to assess self-esteem, the body perception scale was used to assess the body perception of these patients. The consistency between the body mass index classifications and the self-body weight perceptions of the patients was also assessed. Results: The obese patients were found to have lower self-esteem and be less pleased about their bodies, and tend to perceive their body weights lower than their actual body weight when compared with the non-obese group. The non-obese patients in our study were found to be more pleased about their bodies whereas they showed higher levels of self-esteem and perceived their body weights more accurately. Discussion: In the light of these findings, obese patients should be evaluated in terms of psychiatry and get psychiatric help if needed. Eventually, obesity is an important issue which should be addressed multidisciplinary.Item Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes(2021) Altay, HakanAn array of medical practitioners, including endocrinologists, family physicians, internal medicine specialists in nephrology and cardiology, unceasingly investigate, diagnose and treat over 8 million diabetic patients in Turkey. Apart from routine glycemic regulation, several frequent coexisting comorbidities such as obesity, hypertension, dyslipidemia, and their associated complications should also be promptly managed. Due to the concomitant occurrence of complications, the involvement of additional specialties in the precise management of such conditions becomes indispensable. Owing to the ever-expanding knowledge about the prevalence and clinical manifestations of diabetes, various international medical societies publish annual diabetes guidelines, which makes it too cumbersome as well as challenging for the practicing physicians to follow these comprehensive guidelines in clinical practice. There is an unmet need for an easyto-read and concise document for all physicians working for diabetes management for a standardized approach for better management of diabetes and improved patient care. This consensus report was prepared collectively by the Society of Endocrinology and Metabolism Turkey, Turkish Society of Cardiology, Turkish Society of Nephrology, Turkish Society of Hypertension and Renal Diseases to prevent cardiac and renal complications of diabetes, to timely detect these complications by using pertinent measures and to develop, implement and monitor strategies for managing them effectively.Item Dabigatran for Stroke Prevention in Real Life in a Sample of Population from Turkey: D-SPIRIT Registry(2021) Altin, Cihan; 34881702Objective: The D-SPIRIT registry is designed to investigate the safety and effectiveness of dabigatran etexilate in patients with atrial fibrillation in routine clinical practice. Methods: D-SPIRIT is the first national, multicenter, prospective, observational, postmarketing registry that investigates the usage of dabigatran in real life. A total of 326 noveloral anticoagulant-eligible patients with atrial fibrillation who have been taking dabigatran etexilate therapy for stroke prevention at least 6 months from 9 different centers were enrolled into the registry. Patients were followed up for 2 years to evaluate the effectiveness and safety of the treatment. All adverse clinical events including bleeding, thromboembolic events, stroke, systemic embolism, transient ischemic attack, myocardial infarction, and all-cause death were recorded. Results: The mean age was 71.1 +/- 9.6 years, and 57.4% of the study participants were female. The mean CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age >= 75 years, diabetes mellitus, stroke or transient ischemic attack [TIA], vascular disease, age 65-74 years, sex category) score was 3.4 +/- 1.6. The cumulative adverse clinical events rate was 6.30% per year. The rate for embolic events including TIA, ischemic stroke, and peripheral embolism was 1.26% per year. The rate for major bleeding was 2.20% per year, and the mortality rate was 0.94% per year. Conclusion: This registry obtained an important overview of the current safety and effectiveness of the dabigatran etexilate in Turkey. Our results indicate similar rates of thromboembolic and bleeding events with pivotal phase 3 trial and other real-life registries. However, rate of undertreatment usage of dabigatran etexilate in real life was found to be considerable.Item Differences in Physical Activity and Physical Fitness Level in Patients with Fibromyalgia Syndrome and Healthy Individuals(2017) Ozkoslu, Manolya Acar; Tonga, Eda; Daskapan, Arzu; Karatas, Metin; Tekindal, M. Agah; 0000-0002-4060-7048; U-9270-2018Objective: The aim of this study was to investigate the physical activity and physical fitness levels in patients with fibromyalgia syndrome (FMS) and to compare the data with those in healthy individuals. Methods: The study included 82 patients with FMS and 110 healthy individuals. In order to compare physical activity levels, all the subjects responded to the International Physical Activity Questionnaire, Long Form (IPAQ). The health-related physical fitness of the subjects was evaluated by body composition, muscle endurance, cardiorespiratory endurance, flexibility, and balance. Body mass index (BMI), sit-up test, 6-min walk test, sit and reach test, body lateral flexion, and Kinesthetic Ability Trainer 3000 (KAT 3000) were used to determine body composition, muscle endurance, cardiorespiratory endurance, flexibility, and balance, respectively. Results: Of the patients with FMS, 36.6% were inactive, 45.1% were insufficiently active, and 18.3% were active. Of the healthy individuals, 40.9% were active, 36.4% were insufficiently active, and 22.7% were inactive. Significant differences were found (p<0.05) in IPAQ walking and total scores between the groups. The sit-up test scores (p<0.001) and right and left body lateral flexion scores (p<0.001) were significantly different between the FMS patient and control groups. Conclusion: Our results showed that the physical activity and physical fitness levels of patients with FMS were lower than those of healthy individuals.Item The differences in the expression of fractalkine and its receptor in conditions of tonsillar hypertrophy and chronic tonsillitis(2019) Hetemoglu, Elif Koclu; Babakurban, Seda Turkoglu; Terzi, Yunus Kasim; Sahin, Feride Iffet; Erbek, Selim Sermed; 0000-0001-5612-9696; 0000-0001-7308-9673; 30554983; B-4372-2018; AAC-7232-2020Objective: Fractalkine, member of chemokine family, is involved in many inflammatory processes in the human body. The aim of this study is to compare expression levels of fractalkine ligand and its receptor in chronic tonsillitis and hypertrophic tonsil samples. Methods: The study was conducted at Baskent University Departments of Otorhinolaryngology and Medical Genetics. It is designed as a prospective, non-randomized, controlled clinical study. Total 97 samples, obtained from adenotonsillectomy due to chronic tonsillitis or tonsillar hypertrophy, were participated in the study. Fractalkine and its receptor expression levels were determined and comparison was made between the tissue groups. c.839C > T (T280 M) polymorphism of fractalkine receptor was analyzed, then relationship between polymorphism and the expression level of fractalkine receptor was investigated. Results: Fractalkine receptor expression was significantly higher in the hypertrophic tonsil group than chronic tonsillitis group (p < 0.05). Conclusion: Fractalkine, member of chemokine family, and its receptor may play role in preventing chronic-recurrent tonsillitis. (C) 2019 Elsevier B.V. All rights reserved.Item Direct aortic transcatheter aortic valve implantation(2021) Karacaglar, Emir; Akgun, Arzu Neslihan; Aydinalp, Alp; Beyazpinar, Deniz Sarp; Sezgin, Atila; Muderrisoglu, Haldun; 34623302Transcatheter aortic valve implantation (TAVI) is a safe and effective alternative to surgical valve replacement in intermediate and even in low-risk patient cohorts. Direct aortic (DAo) route may be used in patients with severe peripheral vascular disease. Here, we present an 88-year old patient hospitalized with cardiogenic shock. Echocardiography revealed severe aortic valve stenosis with aortic valve area 0.5 cm(2), mean gradient of 55 mmHg, and peak gradient 92 mmHg. TAVI was considered by the Institutional Heart Team. Multislice computed tomography (MSCT) revealed severe peripheral vascular disease, decreased calibration of abdominal aorta, and multiple large vulnerable atherosclerotic plaques. The patient was scheduled for a DAo TAVI. A 26-mm Medtronic CoreValve Evolut R valve was implanted after predilatation with median sternotomy. The patient was discharged after 96 hours. Although transfemoral (TF) access is used as the default approach for TAVI, it was contraindicated in our patient owing to severe peripheral vascular disease and decreased calibration of the abdominal aorta at its narrowest point (4.5 mm) with multiple large vulnerable atherosclerotic plaques. Careful preprocedural MSCT evaluation is essential and directly affects the success of the procedure. MSCT is also mandatory to confirm the best cannulation zone that must be met for a successful DAo TAVI.Item Does an infra pectineal plate alone provide adequate fixation in anterior column posterior hemitransverse acetabular fractures? A comparative biomechanical study(2022) Simsek, Ekin Kaya; Haberal, Bahtiyar; Mahmuti, Ates; Balcik, Bedi Cenk; Demirors, Huseyin; 0000-0002-1668-6997; 35920432; W-9080-2019BACKGROUND: The purpose of this study is to compare biomechanical properties of suprapectineal (SP) plate fixation, infrapectineal (IP) plate fixation, and both SP and IP plate fixation in anterior column posterior hemitransverse (ACPHT) fractures of the acetabulum using posterior and anterior column screws. METHODS: In 21 hard plastic left hemipelvis models, ACPHT fractures of the acetabulum were created, and in three different fixation groups, the methods were compared: Group 1: SP plating using a 3.5 mm reconstruction plate and cortical screw fixation, Group 2: Infrapectineal plating using 3.5 mm reconstruction plate and cortical screws combined with posterior and anterior column screws, and Group 3: Combined fixation with SP and IP plating using 3.5 mm reconstruction plates and cortical screws. Maximum load to failure (strength) of these three groups was compared between groups. RESULTS: The mean maximum load of failure for three groups was 2921 N, 2018 N, and 3658 N, respectively. When strength was compared considering the force that causing implant failure, it was determined that the strongest fixation was achieved when SP and IP fixation method were applied together, followed by SP only fixation and IP fixation supported by anterior and posterior column screws, respectively. CONCLUSIONS: The combined application of SP and IP fixation provides the most stable fixation of the ACPHT acetabular fractures, and IP fixation does not provide comparable biomechanical stability despite reinforcement with three-column screws placed away from the plate. Although IP fixation supported by anterior and posterior column screws with the limited combined approach is less invasive approach for patients, SP fixation should be included in the surgical treatment method to ensure adequate stability.Item Effect of Informative Seminars During National Acne Week On Participants' Knowledge About Acne in Turkey(2021) Ozden, Hatice Kaya; Gunduz, Kamer; Ozcan, Hamdi; Akturk, Aysun Sikar; Demir, Filiz Topaloglu; Akbulut, Tugba Ozkok; Karadag, Ayse SerapBackground and Design: To investigate the contribution of informative presentations about acne vulgaris and questionnaires administered before and after informative meetings on patients' awareness and consciousness. Materials and Methods: Participants were asked to fill out a 20-question survey before and after informative seminars in hospitals and secondary and high schools as part of National Acne Week. The level of statistical significance was set as p <= 0.05. Results: A total of 466 participants completed the survey before and after the seminar, and the mean age of the participants was 17.4 +/- 6.9. Before the seminar, 31.1% of participants thought that acne is originated from the liver, whereas this figure decreased to 16.7% after the seminar. In all, 47.6% of participants consulted doctors and 23.9% consulted social media to seek information about acne; however, after receiving training, 77% preferred to consult a doctor. Of the participants, 51.1% were expecting to see the results of acne treatment in 1 or 2 weeks, whereas 83.3% stated that the effects would be seen in 2 or 3 months after the seminar. When the participants' educational background was grouped as "secondary-high school-other," a statistically significant difference was obtained (p<0.05). Conclusion: Our study features both patients' misconceptions and their incorrect attitudes about acne, and their level of knowledge improved significantly as a result of educational seminars. The relative benefit derived from educational seminars was positively related to the participants' highest level of education.Item Effect of L-arginine on Hemodynamic, Biochemical, and Histopathological Outcomes in a New Zealand Rabbit Model of Renal Ischemia-Reperfusion Injury(2016) Ozulku, Mehmet; Aygun, FatihObjective: In this study, we investigated the effect of L-arginine on hemodynamic, biochemical, and histopathological changes in a rabbit model with renal ischemia. Methods: Forty white New Zealand rabbits were used. The rabbits were divided into two groups as the control group (n=20) and L-arginine group (n=20). They were monitored by cannulating the auricular and femoral arteries. An aortic occlusion catheter was inserted through the contralateral femoral artery and was extended to the distal aspect of the left subclavian artery; it was then inflated, and occlusion was performed for 30 min. All rabbits received 4 mL/kg/h of NaCl infusion during the course of occlusion and within the first 60 min of reperfusion. In the L-arginine group, L-arginine was infused at a dosage of 3 mg/kg/h through the auricular vein during the first 60 min of occlusion and perfusion. Blood samples for biochemical parameters [glucose, lactate, hematocrit, blood urea nitrogen (BUN), and serum creatinine] were obtained in the peri-ischemic period, in the 20th minute of reperfusion, and just before sacrificing (48th hour). A histopathological examination was performed in both renal tissues. Histopathological scoring was performed by taking tubular epithelial cell flattening, brush border loss, cytoplasmic vacuolization, cell necrosis, and tubular lumen obstruction into consideration. All animals were sacrificed 48 h after the procedure. Results: A significant difference was found between the L-arginine and control groups in terms of the hemodynamic outcomes and 48th hour BUN and serum creatinine levels (p<0.05). The histopathological examination revealed a mean score of 3.2 +/- 0.89 in the control group and 2.60 +/- 0.68 in the L-arginine group (p<0.05) (p=0.022). Conclusion: It can be suggested that L-arginine reduces renal ischemia-reperfusion injury and in particular, the histopathological effects.Item Effects of Algan Hemostatic Agent on bleeding time in a rat tail hemorrhage model(2020) Totuk, Ozgan Melike Gedar; Guzel, Sevket Ergun; Ekici, Husamettin; Kumandas, Ali; Aydingoz, Selda Emre; Yilmaz, Enis Cagatay; Kirdan, Taylan; Midi, Ahmet; 0000-0001-7823-7620; 33107963; ABA-4291-2020BACKGROUND: Algan Hemostatic Agent (AHA) is a multi-herbal extract containing a standardized amount of Achillea millefolium, Juglans regia, Lycopodium clavatum, Rubus caesius or Rubis fruciosus, Viscum album, and Vitis vinifera, each of which is effective in hemostasis. In this study, we aimed to investigate the effects of AHA on bleeding time in a rat tail hemorrhage model. METHODS: Forty-eight Sprague Dawley rats (5-7 weeks old, 180-210 g) were randomly and equally allocated to six groups as follows: heparin plus saline (heparinized control), heparin plus AHA-soaked sponge, heparin plus liquid form of AHA, saline (non-heparinized control), AHA-soaked sponge and liquid form of AHA. Heparin (640 IU/kg) was administered intraperitoneally three times a day for three days in heparinized groups. For the bleeding model, the tail of rats was transected. According to the study group, either saline- or AHA-soaked sponge or liquid form of AHA was applied over the hemorrhage area. In AHA- or saline-soaked sponge groups, once the bleeding time had started, it was checked every 10 seconds. If the bleeding did not stop after 40 seconds, it was accepted as a failure. In liquid AHA group, the duration of bleeding was measured using a chronometer and defined as the time (seconds) from wounding until the bleeding stopped. RESULTS: Bleeding time in the heparinized and non-heparinized control groups was over 40 seconds. After applying the sponge form of AHA on the wound area, bleeding time was significantly shortened to less than 20 seconds in both heparinized and non-heparinized rats (p<0.001 for both). The liquid form of AHA stopped bleeding in 5.0 +/- 1.2 seconds and 8.0 +/- 1.3 seconds in heparinized and non-heparinized groups, respectively. CONCLUSION: AHA is a highly effective topical hemostatic agent in a rat tail hemorrhage model, thus may provide for a unique clinically effective option for control of bleeding during surgical operations or other emergencies.Item The effects of menstrual cycle on sympathetic skin response and strength-duration properties(2021) Keskin, Ahmet Onur; Yerdelen, Vahide DenizBackground: Sympathetic control of the circulation is considerably affected by female reproductive hormones. Sudomotor function can be easily evaluated with sympathetic skin response (SSR). Although studies reveal that SSR amplitude decreases with hormone replacement therapy, the effect of estrogen on SSR is unclear. Measuring axonal excitability provides information about the physiological and physical properties of axonal ion channels and nerves. Axonal excitability tests may also give valuable information about the pathophysiology underlying neuronal disorders. In this study, we investigate the influence of female hormones, especially estrogen, on neuronal excitability and the sympathetic nervous system. Methods: SSR and strength-duration time constant (SDTC) tests were conducted on healthy women with a mean age of 26 +/- 4 years with regular menstrual cycles. The tests were performed during the first 3 days of the menstrual cycle when the level of estrogen is at its lowest and 2 days before ovulation when the estrogen is at its highest level. Results: SDTC, rheobase, and the latency of SSR were found to be relatively shorter at 2 days before ovulation when compared with the values of the first 3 days of the menstrual cycle. However, the difference was not statistically significant (P > 0.05). Discussion: The SDTC and SSR values in the 2 days before ovulation and the first 3 days of the menstrual cycle did not show any significant differences. We suggested that these parameters do not affect neuronal excitability associated with varied estrogen levels. Conclusion: Further research will be required to fully understand the influence of sex hormones on the nervous system in menstrual cycles, which can suggest underlying mechanisms of various diseases that are linked with autonomic and hormonal alterations.