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Alkan M, Yüksek H, Manap S, Ozdemir G, Beytur M, Aytemız F, Şahin N, Ağirbaş H, Gursoy-Kol O. Synthesis and Antioxidant and Antibacterial Activities of Novel 4-({[3-Alkyl(aryl)-5-oxo-4,5-dihydro-1H-1,2,4-triazol-4-yl]imino}methyl)phenyl 4-Nitrobenzoate Derivatives. Russ J Org Chem 2022. [DOI: 10.1134/s1070428022120132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Kaplan M, Arslan A, Duman H, Karyelioğlu M, Baydemir B, Günar BB, Alkan M, Bayraktar A, Tosun Hİ, Ertürk M, Eskici G, Duar RM, Henrick BM, Frese SA, Karav S. Production of Bovine Colostrum for Human Consumption to Improve Health. Front Pharmacol 2022; 12:796824. [PMID: 35046820 PMCID: PMC8762312 DOI: 10.3389/fphar.2021.796824] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022] Open
Abstract
Colostrum contains all essential nutrients for the neonate during the first days of life, with impacts that continue far beyond these first days. Bovine colostrum has been used for human consumption due to the high concentrations of bioactive proteins, vitamins, minerals, growth factors, as well as free and conjugated oligosaccharides. Processes involved in the preparation of bovine colostrum for human consumption play a pivotal role in preserving and maintaining the activity of the bioactive molecules. As bovine colostrum is a multifunctional food that offers a myriad of benefits for human health, assessing the main processes used in preparing it with both advantages and disadvantages is a crucial point to discuss. We discuss major processes effects for colostrum production on the nutritional value, some advanced technologies to preserve processed bovine colostrum and the end-product forms consumed by humans whether as dairy products or dietary supplements.
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Affiliation(s)
- Merve Kaplan
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ayşenur Arslan
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Hatice Duman
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Melda Karyelioğlu
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Barış Baydemir
- Department of Coaching Education, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Bilgetekin Burak Günar
- Department of Physical Education and Sports Teaching, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Merve Alkan
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
- Uluova Dairy, Canakkale, Turkey
| | - Ayşe Bayraktar
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
- Uluova Dairy, Canakkale, Turkey
| | | | | | - Günay Eskici
- Department of Coaching Education, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | | | - Bethany M. Henrick
- Evolve Biosystems, Inc., Davis, CA, United States
- Department of Food Science and Technology, University of Nebraska Lincoln, Lincoln, NE, United States
| | - Steven A. Frese
- Department of Nutrition, University of Nevada Reno, Reno, NV, United States
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
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Arslan A, Duman H, Kaplan M, Uzkuç H, Bayraktar A, Ertürk M, Alkan M, Frese SA, Duar RM, Henrick BM, Karav S. Determining Total Protein and Bioactive Protein Concentrations in Bovine Colostrum. J Vis Exp 2021. [PMID: 34958072 DOI: 10.3791/63001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Colostrum is a complex biological fluid produced by mammals immediately after parturition. It meets all the nutritional requirements for neonates as a good source of macro- and micronutrients, bioactive peptides, and growth factors. Bovine colostrum is also a potential source of nutrition and bioactive because of its rich protein content that includes immunoglobulin G (IgG) and lactoferrin. However, the level of lactoferrin and IgG in bovine colostrum changes markedly during the lactation period. Therefore, monitoring the concentration of IgG and lactoferrin for the use of bovine colostrum as a protein source is an important question to study. Methods in this article describe how to determine protein content, as well as specific concentrations of lactoferrin and IgG. These methods include the following steps: Isolation of bovine colostrum proteins, Determination of protein concentration via Bicinchoninic acid assay (BCA), Visualization of proteins via SDS-PAGE, Determination of lactoferrin, and IgG concentration using an ELISA Assay.
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Affiliation(s)
- Ayşenur Arslan
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University
| | - Hatice Duman
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University
| | - Merve Kaplan
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University
| | - Hasan Uzkuç
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University
| | - Ayşe Bayraktar
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University; Uluova Dairy Farm
| | | | - Merve Alkan
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University; Uluova Dairy Farm
| | - Steven A Frese
- Department of Nutrition, University of Nevada, Reno; Department of Food Science and Technology, University of Nebraska, Lincoln
| | | | - Bethany M Henrick
- Department of Food Science and Technology, University of Nebraska, Lincoln; Evolve BioSystems Inc
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Çanakkale Onsekiz Mart University;
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Alkan M, Bierbrauer A, Kunz L, Axmacher N, Jessen F. Using a virtual reality path integration task to investigate entorhinal functioning in individuals with and without subjective cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.055231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | - Nikolai Axmacher
- Institute of Cognitive Neuroscience, Ruhr University Bochum Bochum Germany
| | - Frank Jessen
- Department of Psychiatry, University Hospital Cologne Cologne Germany
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Kundes MF, Kement M, Yegen F, Alkan M, Kaya S, Kaptanoglu L. Effects of clinical factors on quality of life following curative gastrectomy for gastric cancer. Niger J Clin Pract 2019; 22:661-668. [PMID: 31089021 DOI: 10.4103/njcp.njcp_181_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim We aimed to assess the factors which may affect the quality of life (QoL) of the patients who underwent curative gastrectomy for gastric cancer. Subjects and Methods Patients with gastric cancer, who underwent gastrectomy with curative intent at Department of Gastrointestinal Surgery, Kartal Training and Research Hospital from January 2013 to December 2015, were retrospectively reviewed. Gastrointestinal Quality of Life Index was utilized for this research. The clinical factors that might affect QoL after gastrectomy were selected. They were demographic data (age and gender), the American Society of Anesthesiologists classification, body mass index (BMI), operative variables (level and type of resection, type of dissection [D1, D2], type of reconstruction, and additional organ resections), postoperative appetite level, type of oncological treatment, and pathological stages. One hundred and eighteen patients were included in this study. Results Eighty-seven (73.7%) of them were male and mean age was 59.4 ± 10.2 (36-74). Mean follow-up period was 25.7 ± 11.3 (6-42) months. According to multivariate analysis, advanced stage, neoadjuvant therapy, lower BMI, poor appetite, and shorter follow-up were independently associated with poorer cumulative scores. Conclusions Advanced stage, application of neoadjuvant therapy, low BMI level, and poor postoperative appetite may deteriorate the postoperative QoL of the patients with gastric cancer.
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Affiliation(s)
- M F Kundes
- Department of General Surgery, Kartal Training and Research Hospital, Istanbul, Turkey
| | - M Kement
- Department of General Surgery, Bahcesehir University VM Medical Park Hospital, Istanbul, Turkey
| | - F Yegen
- Department of General Surgery, Kartal Training and Research Hospital, Istanbul, Turkey
| | - M Alkan
- Department of General Surgery, Kartal Training and Research Hospital, Istanbul, Turkey
| | - S Kaya
- Department of General Surgery, Kartal Training and Research Hospital, Istanbul, Turkey
| | - L Kaptanoglu
- Department of General Surgery, Bahcesehir University VM Medical Park Hospital, Istanbul, Turkey
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Ozer A, Comu FM, Kucuk A, Kilic Y, Alkan M, Oktar L, Arslan M, Ozturk L. Effects of dexmedetomidine and thymoquinone on erythrocyte deformability in lower limb ischemia reperfusion injury in streptozotocin-induced diabetic rats. ACTA ACUST UNITED AC 2019; 119:642-645. [PMID: 30345772 DOI: 10.4149/bll_2018_115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In this study we aimed to evaluate the effect of dexmedetomidine and thymoquinone on erythrocyte deformability in lower limb ischaemia-reperfusion (IR) injury in streptozotocin-induced diabetic rats. MATERIAL AND METHODS Thirty Wistar albino rats were equally divided into 5 groups (n = 6); randomized control group (Group C), diabetes control group (Group DC), DIR group (Group DIR), DIR group with thymoquinone 25 mg.kg‒1 intraperitoneally (Group DIRT) and Group DIR with dexmedetomidine 100 µg.kg‒1 intraperitoneally (Group DIRD). Erythrocyte packs were prepared from heparinized blood samples and deformability measurements were performed. RESULTS IR significantly increased the relative resistance, a marker of erythrocyte deformability when compared to control group (p < 0.05). There were significant differences among the groups in comparisons with ANOVA test (p < 0.0001). Comparisons of the groups DIRD and DIRT revealed similar results (p = 0.824). The values of Group DIR were significantly higher than those of the control, DC, DIRD and DIRT groups (p < 0.0001, p = 0.001, p = 0.004, p = 0.002, respectively). The values of the DC, DIR, DIRD and DIRT groups were significantly higher than those of the control group (p < 0.0001, all). CONCLUSION Erythrocyte deformability may cause more problems in microcirculation. Dexmedetomidine and thymoquinone may be useful in reducing the adverse effects of this type of injury (Fig. 1, Ref. 41).
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Alkan M, Erkent FD, Celik A, Gokce A, Arslan M, Unal Y. Effects of thoracic epidural or intravenous analgesia on the neutrophil-to-lymphocyte ratio in thoracotomy cases. Niger J Clin Pract 2018; 21:1337-1340. [PMID: 30297568 DOI: 10.4103/njcp.njcp_106_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background and Purpose Postoperative pain is a significant problem in thoracotomy patients. Our aim in this study was to investigate the relationship between postoperative pain and neutrophil-to-lymphocyte ratio (NLR) which is a marker of acute inflammatory response. Materials and Methods Thoracic epidural or intravenous analgesia was administered to thoracotomy patients who elected to undergo a planned surgery. Patients were divided into two groups according to the analgesia method applied postoperatively. Thoracic epidural analgesia was recorded as Group 1 and intravenous analgesia as Group 2. Whole blood counts were recorded from preoperative and postoperative 24th- and 48th-hour routine blood samples, and NLRs were recorded as retrospective file scanning. Postoperative 24th- and 48th-hour NLRs and preoperative NLR values were recorded. Results Demographic data of the patients included in the study were similar except for age. Preoperative NLR was significantly higher in Group 1 at 3.50 (P = 0.004) than in Group 2 at 2.51. Postoperative NLRs were similar among both groups. Postoperative NLR values at both the 24th- and 48th-hour increased by4.9 times in Group 1 and 9.23 times in Group 2 from the 24th-hour preoperative period, when the preoperative NLRs were evaluated. The rate of increase in Group 1 was significantly lower than in Group 2 (P = 0.006). Conclusion Postoperative NLR alterations when compared with preoperative values were related to the analgesic regimen used.
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Affiliation(s)
- M Alkan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - F D Erkent
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ali Celik
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - A Gokce
- Department of Thoracic Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - M Arslan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Y Unal
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Ankara, Turkey
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Alkan M, Yavuz I. Intrinsic charge-mobility in benzothieno[3,2-b][1]benzothiophene (BTBT) organic semiconductors is enhanced with long alkyl side-chains. Phys Chem Chem Phys 2018; 20:15970-15979. [DOI: 10.1039/c8cp01640b] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Longer alkyl side-chains in BTBTs regulate structural order, cause balanced transport and lead to enhanced intrinsic charge-carrier mobility.
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Affiliation(s)
- M. Alkan
- Physics Department
- Marmara University
- Ziverbey
- Turkey
| | - I. Yavuz
- Physics Department
- Marmara University
- Ziverbey
- Turkey
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Demirkol I, Tel E, Arasoǧlu A, Özmen A, Şarer B, Acir A, Alkan M. The Neutron Production Cross Sections for Pb, Bi, and Au Targets and Neutron Multiplicity for Nuclear Spallation Reaction Induced by 20- to 1600-MeV Protons. NUCL SCI ENG 2017. [DOI: 10.13182/nse04-a2421] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- I. Demirkol
- Gazi Üniversity, Faculty of Art and Science, Department of Physics Teknikokullar-Besevler Ankara, Turkey
| | - E. Tel
- Gazi Üniversity, Faculty of Art and Science, Department of Physics Teknikokullar-Besevler Ankara, Turkey
| | - A. Arasoǧlu
- Gazi Üniversity, Faculty of Art and Science, Department of Physics Teknikokullar-Besevler Ankara, Turkey
| | - A. Özmen
- Gazi Üniversity, Faculty of Art and Science, Department of Physics Teknikokullar-Besevler Ankara, Turkey
| | - B. Şarer
- Gazi Üniversity, Faculty of Art and Science, Department of Physics Teknikokullar-Besevler Ankara, Turkey
| | - A. Acir
- Gazi Üniversity, Teknik Eğitim Fakültesi, Teknikokullar, Ankara, Turkey
| | - M. Alkan
- Niğde Üniversity, Faculty of Engineering, Niğde, Turkey
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Sivgin V, Kucuk A, Comu FM, Kosem B, Kartal S, Turgut HC, Arpaci H, Aydin ME, Koc DS, Ozer A, Arslan M, Alkan M. Effects of intravenous ibuprofen and lornoxicam on erythrocyte deformability in rats undergoing hind limb ischemia reperfusion injury. ACTA ACUST UNITED AC 2017; 117:722-725. [PMID: 28127969 DOI: 10.4149/bll_2016_138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND AIM Acute hind limb ischemia reperfusion (I/R) injury is a common consequence of abdominal aorta cross‑clamping during aortic surgery. Erythrocyte deformability is affected by I/R process and may lead to increased tissue and organ injury. Lornoxicam and intravenous ibuprofen are becoming commonly used as non-steroidal anti-inflammatory drugs (NSAID) for postoperative analgesia. In this study, we aimed to investigate the effects of lornoxicam (2 mg/kg iv) and intravenous ibuprofen (30 mg/kg iv) on erythrocyte deformability in I/R model in rats. MATERIALS AND METHODS Four study groups, each containing 6 Wistar rats were created. Laparotomy was performed in all groups under general anesthesia with ketamine and xylazine. In all groups except sham group, ischemia and reperfusion were achieved by clamping and declamping the infrarenal abdominal aorta for 120 minutes. Rats in Group IR+L received intravenous infusion of lornoxicam (2 mg/kg) while rats in Group IR+I received intravenous infusion of ibubrofen (30 mg/kg) following 2 hours of ischemic period. At the end of reperfusion period, erythrocyte packs were prepared from heparinized blood samples. Erythrocyte suspensions with hematocrit at a concentration of 5% in a phosphate‑buffered saline (PBS) were used in order to perform deformability measurements. The value of p<0.05 was considered statistically significant. RESULTS Relative resistance has increased in ischemia reperfusion group when compared to control group (p < 0.0001). Lornoxicam or ibuprofen intravenous treatments did not change the erythrocyte deformability during ischemia reperfusion period in rats (p=0.851, p=0.690). CONCLUSION Intravenous ibuprofen or lornoxicam administrations during ischemia reperfusion period in rats have no negative effect on erythrocyte deformability. The findings of the study should be supported with more detailed and extensive clinical/experimental studies in the future (Fig. 1, Ref. 18).
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Turgut HC, Alkan M, Ataç MS, Altundağ SK, Bozkaya S, Şimşek B, Işik B, Arslan M. Neutrophil lymphocyte ratio predicts postoperative pain after orthognathic surgery. Niger J Clin Pract 2017; 20:1242-1245. [DOI: 10.4103/1119-3077.181399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kuskonmaz SM, Kurtipek Ö, Aydın ME, Erbatur ME, Alkan M, Ünal Y, Arslan M. A retrospective analysis of blood gases with two different insulin infusion protocols in patients undergoing cardiovascular surgery. Niger J Clin Pract 2016; 19:742-746. [PMID: 27811445 DOI: 10.4103/1119-3077.178943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM Intraoperative blood glucose concentration is known to be an independent risk factor for morbidity and mortality in patients undergoing cardiovascular surgery. Arterial blood gas analysis is an important investigation to monitor the acid-base balance and gas exchange in these patients. Hyperglycemia leads to a series of metabolic changes which affect acid-base balance and serum electrolytes. In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb). MATERIALS AND METHODS We collected data from diabetic patients who underwent cardiovascular surgery between 2010 and 2014. The patients were divided into two groups according to the insulin infusion protocols applied such as with conventional (180-250 mg/dl) (n = 17) (Group 1) and tighter glycemic targets (121-180 mg/dl) (n = 51) (Group 2). We retrospectively analyzed arterial blood gas results taken at different perioperative time points from these patients. RESULTS We found that pH HCO3and base excess, serum sodium, potassium, calcium, and Hb were similar in both groups. CONCLUSION Our study showed that a tighter intraoperative glycemic control does not affect arterial blood gas parameters, serum electrolytes, or Hb when compared to the conventional glycemic control.
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Affiliation(s)
- S M Kuskonmaz
- Department of Endocrinology and Metabolism, Medical Faculty, Gazi University, Ankara, Turkey
| | - Ö Kurtipek
- Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey
| | - M E Aydın
- Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey
| | - M E Erbatur
- Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey
| | - M Alkan
- Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey
| | - Y Ünal
- Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey
| | - M Arslan
- Department of Anaesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, Turkey
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Kip G, Turgut HC, Alkan M, Aydin ME, Erbatur ME, Kiraz HA, Kartal S, Boyunaga H, Comu FM, Erdem O, Arslan M, Unal Y. The effects of low and high doses of sugammadex on kidney tissue in streptozotocin-induced diabetic rats. ACTA ACUST UNITED AC 2016; 116:746-50. [PMID: 26924146 DOI: 10.4149/bll_2015_146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sugammadex is primarily excreted via renal route. We investigated effects of low and high doses of sugammadex (16 mg/kg versus 96 mg/kg) on renal tissue samples of streptozotocin-induced diabetic rats. MATERIAL AND METHODS Twenty-four Wistar albino rats were divided into 4 groups. Group C (control - 0.9 % NaCl), Group DC (diabetes control; 55 mg/kg streptozotocin, IP, only), Group DR-16S (diabetes-rocuronium - 16 mg sugammadex, IV.) and Group DR-96S (diabetes- rocuronium - 96 mg sugammadex, IV). Renal tissue histopathological evaluation and antioxidant status (measurements of MDA levels and NO activities) were studied. RESULTS Significantly higher levels of all inflammation parameters (inflammation, degeneration/necrosis, tubular dilatation, tubular cell degeneration, dilatation in Bowman's space, tubular hyaline casts, and lymphocyte infiltration) were found in the 96 mg/kg sugammadex group. Higher MDA tissue levels and lower NO activity were found in the 96 mg/kg sugammadex group. DISCUSSION We can conclude that high-dose (96 mg/kg) sugammadex administration resulted in significant renal tissue damage in diabetic rats. As a consequence, low doses of sugammadex have to be preferred in diabetic patients (Tab. 2, Fig. 4, Ref. 26).
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Arslan M, Comu FM, Alkan M, Kiraz HA, Kip G, Ozer A, Sivgin V. Effect of levosimendan on erythrocyte deformability during myocardial ischaemia-reperfusion injury. BRATISL MED J 2015; 116:47-50. [PMID: 25666962 DOI: 10.4149/bll_2015_009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED Diabetes mellitus (DM) is a chronic metabolic disorder accompanied by an increase in oxidative stress. Ischaemia-reperfusion (IR) injury is a cascade of events initiated by tissue ischaemia. The cellular damage produced by reperfusion leads to an active inflammatory response. Erythrocyte deformability and plasma viscosity are of crucial importance for the perfusion of tissues and organs. The aim of this study was to evaluate the effect of levosimendan on erythrocyte deformability during IR myocardial injury in diabetic rats. METHODS Twenty-four Wistar albino rats were included in the study after streptozocin (55 mg/kg) treatment for 4 weeks to observe the existence of diabetes. The animals were randomly assigned to one of four experimental groups. In Group C and DC (sham-control group), the coronary artery was not occluded or reperfused in the control rats. Myocardial IR was induced by ligation of the left anterior descending coronary artery for 30 min, followed by 2 h of reperfusion in the diabetes-IR (DIR) and diabetes-IR-levosimendan (DIRL) group. Deformability measurements were performed in erythrocyte suspensions containing Htc 5 % in a phosphate-buffered saline (PBS) buffer. RESULTS The deformability index was significantly increased in the diabetic rats. It was similar in Group DC and DIRL It was significantly increased in the DIR group compared to Group C, DIRL and DC. The relative resistance was increased in the IR models. CONCLUSION Erythrocyte deformability was decreased in rats with diabetes and IR injury. This injury might lead to further problems in microcirculation. Levosimendan may be useful in enhancing the adverse effects of this type of injury (Fig. 2, Ref. 41). KEYWORDS erythrocyte deformability, myocardial ischaemia reperfusion, experimental diabetes, levosimendan, rat.
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Abstract
AbstractOf 386 consecutive patients whose wounds were sutured at the emergency ward of the Soroka Medical Center, 228 returned for a follow-up visit during which pus was observed in 40 sutured wounds. Most of the patients were males, 50% lived in the city, and 13% were Beduin. Fifty percent of the wounds were dressed prior to admission. All wounds were rinsed prior to suture, 78% in a cetrimide-chlorhexidine HC1 solution and in 71% an irrigation with a povidone-iodine solution was performed. The physicians who performed the procedure were graded by their medical experience; 43% of the sutures were performed by interns, 32% by junior residents, 19% by senior residents and 6% by a specialist. Silk thread was the most commonly used suture material (79%). Wounds were classified according to size, depth and state of the margins of the wound. It was noted whether an excision was performed and the type of treatment that was prescribed after the procedure. None of the above-mentioned criteria identified a group as high-risk. Experienced physicians sutured the more serious wounds, but their infection rate did not differ significantly from other physicians.
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Arslan M, Comu FM, Kip G, Alkan M, Kiraz HA, Ozer A, Sivgin V. Effect of dexmedetomidine on erythrocyte deformability during ischaemia-reperfusion injury of heart in diabetic rats. ACTA ACUST UNITED AC 2014; 115:494-7. [PMID: 25246286 DOI: 10.4149/bll_2014_096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED The aim of this study is to evaluate the effect of dexmedetomidine on erythrocyte deformability during IR heart injury in diabetic rats. METHODS Eighteen Wistar Albino rats were included in the study after streptozocin (55 mg/kg) treatment for four weeks. In the Group C and DC (sham-control group), the coronary artery was not occluded or reperfused in the control rats. In the Group DIR, a branch of the left coronary artery was occluded for 30 minutes followed by two hours of reperfusion to produce IR. In the Group DIRD, a branch of the left coronary artery was occluded for 30 minutes followed by two hours of reperfusion to produce IR, and dexmedetomidine was administrated via 100 µg/kg IP route 30 minutes before ligating the left coronary artery. Deformability measurements were performed in erythrocyte suspensions containing Htc 5 % in a PBS buffer. RESULTS The deformability index was significantly increased in diabetic rats; however, it was similar in the Group DC and DIRD. It was significantly increased in the Group DIR when compared to the Group C, DIRD and DC. The relative resistance was increased in IR models. CONCLUSION Erythrocyte deformability was decreased in rats having diabetes and IR injury. This injury might lead to further problems in microcirculation. It was shown that dexmedetomidine might be useful in enhancing the adverse effects of this type of injury (Fig. 1, Ref. 39).
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Unal Y, Pampal HK, Arslan M, Demirel CB, Alkan M. The effects of dexmedetomidine on pulmonary artery pressure in experiment. ACTA ACUST UNITED AC 2014; 115:272-4. [PMID: 25174057 DOI: 10.4149/bll_2014_056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM The primary purpose of this study is to assess the effects of dexmedetomidine (DEX) infusion on pulmonary artery pressures (PAP), heart rate (HR), and mean arterial pressure (MAP) in pigs. The secondary purpose is to evaluate whether DEX infusion via the pulmonary artery has any beneficial effect over the peripheral IV route. MATERIALS AND METHODS Sixteen healthy male pigs (25-35 kg) scheduled for laparoscopy training were used in this study. The animals were randomly allocated into two groups: Group I (n = 9): A loading dose of 1 μg/kg DEX was administered over 10 minutes followed by an infusion of 0.5 μg/kg/hr for one hour via the pulmonary artery catheter. Group II (n = 7): A loading dose of 1 μg/kg DEX was administered over 10 minutes followed by an infusion of 0.5 μg/kg/hr for one hour via the peripheral venous catheter. Mean PAP, HR, MAP, SpO2, and ETCO2 were recorded at 5, 10, 15, 30, 45, and 60 minutes after the initiation of the DEX infusion. RESULTS Heart rate and MAP were similar in both groups at all time points. Also, neither the HR nor the MAP deviated from the basal values in Groups I and II at any time point. The mean PAP values were similar in Groups I and II, and in Group I, the mean PAP values were similar to Group I's basal value at all time points. However, in Group II, the mean PAP values at 5, 45, and 60 minutes were significantly lower than Group II's basal value (p = 0.023, p = 0.041, p = 0.015, respectively). CONCLUSION DEX infusion did not elevate the mean PAP and the results from the administration of DEX through the peripheral vein and pulmonary artery were similar (Tab. 3, Ref. 13).
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Comu FM, Ozturk L, Alkan M, Pampal K, Arslan M, Isik B, Atac MS, Yilmaz D. Investigation of the effects of propofol and vitamin C administration on erythrocyte deformability in rats with streptozotocin-induced diabetes mellitis. BRATISL MED J 2014; 115:400-4. [PMID: 25077361 DOI: 10.4149/bll_2014_0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE In the current study we aim to investigate the effects of vitamin C and profol on red blood cell deformability in diabetic rats. MATERIALS AND METHODS Twenty- eight Wistar Albino rats were included in the study after streptozocin (60 mg/kg) treatment for 4 weeks of observation for diabetes presence. Twenty-eight rats were allocated to 4 groups. In group DP (n = 7) 150 mg.kg-1 of propofol was injected intraperitoneally. In group DP-vit C (n = 7) rats 100 mg/kg of vitamin C (Ascorbic acid, Redoxon® 1000 mg/5 mL - Roche) were applied one hour before administrating 150 mg.kg-1 of propofol, while rats in control group (n = 7), and diabetic control group (n = 7) received intraperitoneally physiological saline. Deformability measurements were achieved by using erythrocyte suspensions with hematocrit level of 5 % in PBS buffer. RESULTS Erythrocyte deformability was significantly higher in diabetic control group than in control and vitamin C plus propofol groups (p = 0.00, p = 0.025, respectively). Erythrocyte deformability indexes were found similar in control group and vitamin C plus propofol group (p = 0.949). Relative resistance was increased in diabetic rat model. CONCLUSIONS Erythrocyte deformability was damaged in rats with diabetes. This injury might lead to further problems in microcirculation. Application of propofol did not alter red cell deformability in diabetic rats. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability (Fig. 2, Ref. 57).
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Unal Y, Comu FM, Emik U, Alkan M, Pampal HK, Arslan M. The effects of propofol and memantine on erythrocyte deformability. ACTA ACUST UNITED AC 2014; 115:253-5. [DOI: 10.4149/bll_2014_052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Alkan M, Kaya K. Postoperative analgesic effect of epidural neostigmine following caesarean section. Hippokratia 2014; 18:44-49. [PMID: 25125952 PMCID: PMC4103042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to evaluate the analgesic effects of postoperative epidural administration of neostigmine and morphine in patients scheduled for caesarean section under epidural anaesthesia. MATERIAL AND METHODS Sixty ASA I-II patients, scheduled for caesarean section under epidural anaesthesia, were randomly allocated into three groups. Neostigmine (10 μg/kg), morphine (3 mg), and saline (6 mL) were administered to the neostigmine, morphine, and control groups, respectively, 30 minutes after the surgery via the epidural catheter. Afterwards, postoperative pain treatment was administered to all patients with a patient-controlled epidural analgesia (PCEA) device, using 0.125% bupivacaine. The patients were followed up for 24 hours. The total volume of local anaesthetics used, the time to first analgesic requirement, analgesic requirements, VAS scores, analgesia quality, first passage of bowel gas, ambulation times, haemodynamic parameters and side effects were evaluated. RESULTS The time to first analgesic requirement was significantly longer in the morphine group than in the neostigmine and control groups (p<0.01), and in the neostigmine group compared to the control group (p<0.05). The total local anaesthetic consumption and the number of bolus injections were significantly higher in the control group than in the other groups (p<0.01). The first passage of bowel gas occurred significantly sooner in the neostigmine group than in the morphine (p<0.01) and the control (p<0.05) groups. Itching frequency was significantly higher in the morphine group than in the other two groups (p<0.05). VAS scores were similar in the morphine and neostigmine groups. CONCLUSION Postoperative single-dose epidural neostigmine reduced the 24-hour analgesic requirements but in the chosen doses presented an analgesic effect significantly lower than morphine. Hippokratia 2014; 18 (1): 44-48.
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Affiliation(s)
- M Alkan
- Anesthesiology and Reanimation Department of Medicine Faculity, University of Gazi, Ankara, Turkey"
| | - K Kaya
- Anesthesiology and Reanimation Department of Medicine Faculity, University of Gazi, Ankara, Turkey"
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Arslan M, Donmez T, Erer D, Tatar T, Comu FM, Alkan M. Effect of iloprost on erythrocyte deformability in rat's lower extremity undergoing an ischemia reperfusion injury. ACTA ACUST UNITED AC 2013; 114:189-91. [PMID: 23514550 DOI: 10.4149/bll_2013_040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
AIM Ischemia reperfusion injury (I/R) in lower extremity is a frequent and important clinical phenomenon. The protective effect of iloprost on local and distant organ injury due to I/R has been well documented but its effect on erythrocyte deformability needs further investigation. Our aim was to investigate the effect of iloprost on erythrocyte deformability in the infrarenal aorta of rats undergoing I/R. MATERIALS AND METHODS Our study was conducted with 18 Wistar albino rats. Rats were divided into the 3 groups; the randomized control group (group C; n=6), I/R group without iloprost (group I/R; n=6) and I/R group with iloprost - 10 mcg.kg-1, 30 min infusion (group I/R-I; n=6). Packs of erythrocytes were prepared from heparinized blood samples and deformability measurements were done. RESULTS The comparisons of the control and I/R-I groups revealed similar results (p=0.951). The values of the IR group were significantly higher than those of the control and IR-I groups (p=0.006, p=0.011, respectively). CONCLUSION In our study, we detected the unfavourable effects of I/R on erythrocyte deformability, which may lead to disturbance in blood flow and hence tissue perfusion in the infrarenal rat aorta. We also found that Iloprost had beneficial effects by reversing the undesirable effects of I/R (Fig. 1, Ref. 15).
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Affiliation(s)
- M Arslan
- Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey.
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Ramadan A, Pham Van L, Machavoine F, Dietrich C, Alkan M, Karasuyama H, Schneider E, Dy M, Thieblemont N. Activation of basophils by the double-stranded RNA poly(A:U) exacerbates allergic inflammation. Allergy 2013; 68:732-8. [PMID: 23621380 DOI: 10.1111/all.12151] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND It is commonly acknowledged that asthma is exacerbated by viral infections. On the other hand, basophil infiltration of lung tissues has been evidenced postmortem in cases of fatal disease, raising the question of a possible link between these two observations. OBJECTIVES Herein, we addressed the relationship between asthma exacerbation by viral infection and basophil activation and expansion by investigating how stimulation with the dsRNA polyadenylic/polyuridylic acid [poly(A:U)] affected basophil activities and recruitment in an allergic airway inflammation model. METHODS The effect of dsRNA on basophils was assessed by measuring the cytokine levels produced upon stimulation. We used an OVA-induced experimental model of allergic asthma. Airway hyperreactivity, recruitment of infiltrating cells, and cytokine production were determined in the lung of mice having received poly(A:U), as compared with untreated controls. The exacerbating effect of basophils was assessed both by adoptive transfer of poly(A:U)-treated basophils and by their in vivo depletion with Ba103 antibody. RESULTS We found that in vitro treatment with poly(A:U) increased basophil functions by inducing TH 2-type cytokine and histamine production, whereas in vivo treatment increased peripheral basophil recruitment. Furthermore, we provide the first demonstration for increased infiltration of basophils in the lung of mice suffering from airway inflammation. In this model, disease symptoms were clearly exacerbated upon adoptive transfer of basophils exposed to poly(A:U), relative to their unstimulated counterpart. Conversely, in vivo basophil depletion alleviated disease syndromes, thus validating the transfer data. CONCLUSIONS Our findings provide the first evidence for airway inflammation exacerbation by basophils following dsRNA stimulation.
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Affiliation(s)
| | | | | | | | | | - H. Karasuyama
- Department of Immune Regulation; Tokyo Medical and Dental University Graduate School; Tokyo; Japan
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Karaoguz M, Kocaman S, Dinçer I, Baysan O, Bozbaş H, Alkan M, Altuner T, Korkmaz M. OP-132 PREVALENCE OF LEFT VENTRICULAR DYSFUNCTION AND HEART FAILURE IN PATIENTS WITH BRADYCARDIA REFERRED TO NEW IMPLANTATION OR REPLACEMENT FOR PACEMAKER. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70133-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kara D, Ozsavaşçi C, Alkan M. Investigation of suitable digestion methods for the determination of total phosphorus in soils. Talanta 2012; 44:2027-32. [PMID: 18966949 DOI: 10.1016/s0039-9140(97)00014-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/1996] [Revised: 12/29/1996] [Accepted: 12/29/1996] [Indexed: 11/15/2022]
Abstract
Total phosphorus in five soils with different compositions which were obtained from different places were extracted by using Na(2)CO(3) fusion, HClO(4) digestion, HClO(4) + HNO(3) digestion, HF + HClO(4) digestion or NaOBr oxidation methods. In order to test the suitability of the HF + HClO(4) digestion the results obtained by this method were compared with the others above, especially the Na(2)CO(3) fusion which is accepted as a standard method. The phosphorus amount found with the HF + HClO(4) digestion method were almost the same as the phosphorus amount by the Na(2)CO(3) fusion method, while the superiority in extracting phosphorus when compared to other methods were obvious. The methods used in the study were evaluated according to the recovery of total phosphorus, ease of application and rapidity with which they were performed. Orthophosphate in the soil extracts was determined by the molybdenum blue colour method. The relationships between methods are examined statistically.
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Affiliation(s)
- D Kara
- Department of Chemistry, Faculty of Art and Science, University of Balikesir, Balikesir, Turkey
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Kurtipek O, Comu FM, Ozturk L, Alkan M, Pampal K, Arslan M. Does vitamin C prevent the effects of high dose dexmedetomidine on rat erythrocyte deformability? BRATISL MED J 2012; 113:135-8. [PMID: 22428760 DOI: 10.4149/bll_2012_033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE Dexmedetomidine is an anesthetic agent frequently used for sedation at the intensive care units and during general anesthesia. The purpose of our study was to investigate whether vitamin C prevents the effect of high dose dexmedetomidine on erythrocyte deformability in rats. METHODS The study was performed on 21 male rats, with 7 rats in each study groups and the control group. The rats in the study groups were treated with intraperitoneal dexmedetomidine (10 µg/kg) and intraperitoneal dexmedetomidine plus Vitamin C (ascorbic acid) (100 mg/kg ascorbic acid administered 1 hour before administration of 10 µg/kg dexmedetomidine), respectively. Intraperitoneal physiological saline was administered in the control group. Erythrocyte packs were prepared using heparinized total blood samples. Deformability measurements were done by erythrocyte suspensions in phosphate buffered saline (PBS) buffer. A constant flow filtrometer system was used to measure erythrocyte deformability and the relative resistance was calculated. RESULTS Erythrocyte deformability was significantly higher in dexmedetomidine group than in control and vitamin C plus dexmedetomidine groups (p=0.003, p=0.013, respectively). Erythrocyte deformability indexes were found similar in the control group and in the vitamin C plus dexmedetomidine group (p=0.383). CONCLUSIONS High dose dexmedetomidine may cause functional deterioration in blood flow and tissue perfusion with negative effects in erythrocyte deformability. Vitamin C supplementation seems to reverse those negative effects and variations in erythrocyte deformability. However, our preliminary results should be confirmed in wider serious of experimental and clinical trials (Fig. 1, Ref. 27).
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Affiliation(s)
- O Kurtipek
- Gazi University Medical University, Department of Anesthesiology and Reanimation, Ankara, Turkey
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Abstract
BACKGROUND Tinea pedis is a common infection in soldiers. However, prevalence and risk factors for tinea pedis in soldiers were investigated in only a few studies. OBJECTIVES To investigate the prevalence and risk factors for tinea pedis in Israeli soldiers. METHODS A cross-sectional study including interviews, clinical skin examination and mycological tests was performed in Israeli soldiers. The presence of tinea pedis was assessed using the Athlete's Foot Severity Index (AFSI), a scoring system that was developed in order to evaluate the presence and severity of tinea pedis. In soldiers with clinical evidence of tinea pedis (AFSI > 1), scrapings were taken for direct microscopic examination (20% KOH preparation) and fungal culture. Statistical analyses were performed using chi-square or Fisher's exact test for dichotomous variables (as needed), or t-tests for continuous variables. Logistic regression was used for multivariate analyses of dichotomous variables. RESULTS Two hundred and twenty-three soldiers were included in the study: 205 men (91.9%) and 18 women (8.1%). Mean age was 19.6 years (SD 1.0 year). Clinical point prevalence was 60.1%. Mycological point prevalence was 27.3%. Further analyses were performed using the clinical point prevalence. Univariate analyses demonstrated that the prevalence of tinea pedis varied with the setting of military training (basic training: 70.3%, advanced infantry training: 81.5%, armor commander training: 56.4% and armor officer training: 34.8%) and was associated with male gender, frequency of sock changes and the length of military service. A multivariate analysis demonstrated that tinea pedis was associated with the setting of the military training (OR 1.6, 95% CI 1.2-2.1) and male gender (OR 4.3, 95% CI 1.4-13.8); however, there was no association with hygiene measures (e.g. frequency of changing socks or sleeping with socks) or the length of military service. CONCLUSION Tinea pedis is highly prevalent in Israeli soldiers. Association of tinea pedis with the setting of military training suggests that contagious spread may be an important risk factor. We suggest that environmental interventions should be planned to in order to decrease the morbidity of tinea pedis among soldiers.
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Affiliation(s)
- A D Cohen
- Dermatology Center, Clalit Health Services, Southern District, Internal Medicine E and Infectious Diseases Institute, Soroka University Medical Center, Faculty of Health Sciences, Ben-Guion University of the Negev, Beer-Sheva, Israel.
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Abstract
OBJECTIVE i) To investigate the subtle ToM (theory of mind) deficits in euthymic patients with bipolar disorder. ii) To investigate the impact of non-ToM cognitive deficits on ToM abilities. METHOD Forty-three euthymic patients with bipolar disorder and 30 healthy control subjects were involved in this study. ToM was assessed by the Eyes test and the Hinting task. Both groups were also evaluated with a comprehensive neuropsychological battery including tasks for basic emotion and face recognition. RESULTS The patient group was impaired on both of the ToM tasks. The patient group also showed impairment in many cognitive tasks including tasks related to sustained attention. CONCLUSION Even euthymic patients with bipolar disorder may be impaired in advanced ToM tasks. Executive dysfunction and some other cognitives deficits such as basic emotion recognition may be at least partly responsible for this result.
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Affiliation(s)
- E Bora
- Psikiyatri anabilimdali, Ege university, Izmir, Turkey.
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Abstract
Ingestion of a disc battery can lead to hazardous complications including tracheoesophageal fistula (TEF), especially when the battery is impacted in the esophagus. Urgent esophagoscopic removal of the battery is essential in all cases. Persisting respiratory symptoms and/or feeding difficulty after removal should alert the surgeon to evaluate for TEF. Esophagography and/or esophagoscopy should be performed. Once the TEF is identified, conservative management is the initial treatment of choice. Delayed primary repair can be tried if spontaneous closure does not occur. The authors present a case of TEF secondary to disc-battery ingestion with review of the current literature and discuss the management of this rare but potentially life-threatening complication.
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Affiliation(s)
- M Alkan
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Alkan M, Karnak I, Ciftci AO, Tanyel FC. Thymic teratoma or thymic remnant attached to mediastinal teratoma? The cellular origin of mediastinal teratomas revisited. Eur J Pediatr Surg 2004; 14:117-9. [PMID: 15185159 DOI: 10.1055/s-2004-817842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Thymic tissue can be encountered in about 20 % of mediastinal teratomas. It is found located at the periphery of the teratoma mass. Although rare, mediastinal teratoma arising within the thymus can be seen. It has not been defined yet whether the thymus is an organ simply attached to the teratoma or whether the teratoma arises from the thymus. The authors present here two illustrative cases of mediastinal teratoma, one raised within the thymus and the other closely attached to the thymic remnant, to discuss the cellular origin of mediastinal teratomas.
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Affiliation(s)
- M Alkan
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Deger Y, Dede S, Belge A, Mert N, Kahraman T, Alkan M. Effects of X-ray radiation on lipid peroxidation and antioxidant systems in rabbits treated with antioxidant compounds. Biol Trace Elem Res 2003; 94:149-56. [PMID: 12958406 DOI: 10.1385/bter:94:2:149] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2002] [Accepted: 11/10/2002] [Indexed: 11/11/2022]
Abstract
The aim of this study was to investigate the effects of supplemental antioxidant vitamins and minerals on lipid peroxidation and on the antioxidant systems in rabbits exposed to X-rays. The rabbits were divided into two experimental groups and one control group, each group containing seven rabbits. The first group (VG) received daily oral doses of vitamin E (460 mg/kg live weight) and vitamin C (100 mg/kg live weight). The second group (MG) was fed a mineral-enriched diet that contained 60 mg manganese chloride, 40 mg zinc sulfate, and 5 mg copper sulfate per kilogram of feed. The third group served as controls and received only a standard diet. Blood samples were obtained before and after the supplementation with vitamins or minerals, as well as before and after irradiation with a total dose of 550-rad X-rays. The blood samples were analyzed for their content of malondialdehyde (MDA), plasma vitamins C and E, retinol, reduced glutathione (GSH), and glutathione peroxidase activity (GPx). After irradiation, the control group showed increased levels of MDA and activity of GPx (p<0.05), whereas the levels of GSH, vitamin C, and vitamin E were decreased. In the VG, the concentration of MDA was lower (p<0.05), and the concentration of GSH and vitamins C and E were higher (p<0.05) when compared to controls. In the MG, the concentrations of MDA, GSH, vitamin C, and retinol were not affected by the mineral administration and radiation. The level of vitamin E in the MG increased with mineral administration (p<0.05), but decreased after irradiation (p<0.05). For the control group, the level of GSH was higher than in the two experimental groups. After irradiation, the VG animals had vitamin E and C levels that were higher than in MG and control groups (p<0.05). The activity of GPx was not affected by vitamin or mineral supplementation or by irradiation. We conclude that the supplementation with antioxidant vitamins and minerals may serve to reinforce the antioxidant systems, thus having a protective effect against cell damage by X-rays.
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Affiliation(s)
- Y Deger
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Yuzuncu Yil, Van, Turkey
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Gorenek B, Kudaiberdieva G, Goktekin O, Cavusoglu Y, Birdane A, Alkan M, Unalir A, Ata N, Timuralp B. Cardiac biomarkers after internal cardioversion for atrial fibrillation: detection of myocardial injury. Int J Cardiol 2003; 90:115-6. [PMID: 12821226 DOI: 10.1016/s0167-5273(02)00537-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- B Gorenek
- Osmangazi University School of Medicine Department of Cardiology, 26311 Eskisehir, Turkey.
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Smolyakov R, Borer A, Riesenberg K, Schlaeffer F, Alkan M, Porath A, Rimar D, Almog Y, Gilad J. Nosocomial multi-drug resistant Acinetobacter baumannii bloodstream infection: risk factors and outcome with ampicillin-sulbactam treatment. J Hosp Infect 2003; 54:32-8. [PMID: 12767844 DOI: 10.1016/s0195-6701(03)00046-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The emergence of multidrug-resistant (MDR) Acinetobacter baumannii poses a therapeutic problem. The aim of this study was to assess the risk factors for nosocomial MDR-A. baumannii bloodstream infection (BSI) and the efficacy of ampicillin-sulbactam (A/S) in its treatment. Of 94 nosocomial A. baumannii BSI during the year 2000, 54% involved MDR strains, 81% of which were genetically related. Various risk factors for MDR-A. baumannii were found, of which intensive-care unit admission and prior aminoglycoside therapy were independently associated with MDR-A. baumannii acquisition on multivariate analysis. Of MDR-A. baumannii BSI cases, 65% received A/S and 35% inadequate antibiotic therapy, whereas of 43 non-MDR cases, 86% were treated according to susceptibility and 14% inappropriately with antibiotics to which these organisms were resistant. Crude mortality was comparable in the adequately treated groups. Respective mortalities among patients treated adequately and inadequately were 41.4 and 91.7% (p<0.001). Among severely ill patients, A/S therapy significantly decreased the risk of death (P=0.02 OR=7.64). MDR-A. baumannii has become highly endemic in our institution. A/S appears to be one of the last effective and safe empirical resorts for treatment of MDR A. baumannii BSI.
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Affiliation(s)
- R Smolyakov
- Infectious Disease Institute, Soroka University Medical Centre and the Faculty for Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Dede S, Deger Y, Mert N, Kahraman T, Alkan M, Keles I. Studies on the effects of x-ray on erythrocyte zinc and copper concentrations in rabbits after treatment with antioxidants. Biol Trace Elem Res 2003; 92:55-60. [PMID: 12721404 DOI: 10.1385/bter:92:1:55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to investigate the effect of supplemental antioxidant vitamins and minerals on the erythrocyte concentrations of zinc and copper in rabbits after exposure to X-rays. The animals were divided into two experimental and one control group (CG). The first group (VG) was given daily oral doses of vitamins E and C; supplemental amounts of manganese, zinc, and copper were mixed with the feed and given to the second group of experimental animals (MG). Blood samples were taken from all groups before and after 4 wk of vitamin and mineral administration and after irradiation with a total dose of 550-rad X-rays. The administration of minerals caused the most significant increases of Zn and Cu. Even after irradiation, the zinc levels in the irradiated animals were higher than in the nonirradiated vitamin-supplemented animals (p<0.05). The results suggest that supplementation with antioxidant vitamins and minerals may have a protective effect against X-ray-induced damage.
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Affiliation(s)
- S Dede
- Department of Biochemistry, University of Yuzuncu Yil, Van 65080 Turkey
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Alkan M. Spectrophotometric determination of molybdenum with Alizarin Red S in the presence of poly(sulfonylpiperidinylmethylene hydroxide). Talanta 2003; 59:605-11. [DOI: 10.1016/s0039-9140(02)00570-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2002] [Revised: 10/22/2002] [Accepted: 10/24/2002] [Indexed: 10/27/2022]
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Alkan M, Ramelli GP, Hirsiger H, Keser I, Remonda L, Bühler EM, Moser H. Presumptive monosomy 21 with neuronal migration disorder re-diagnosed as de novo unbalanced translocation t(18p;21q) by fluorescence in situ hybridisation. Genet Couns 2003; 13:151-6. [PMID: 12150215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
We present clinical and cytogenetic data of a one year old boy with partial monosomy for both 21q and 18p, resulting from a de novo unbalanced translocation. The initial diagnosis of a seemingly full monosomy 21 was revised after fluorescence in situ hybridisation (FISH) with whole chromosome painting probes and a locus-specific chromosome 21 probe. The karyotype was reinterpreted as 45,XY,der(18)t(18;21)(p11.2;q22.1),-21. This karyotype, to our knowledge, has not been previously described. The boy presented with a spectrum of clinical features previously described for (partial) monosomy 18p only, for monosomy 21q only, or for both of these aneusomies. The radiological finding of a neuronal migration disorder with localised polymicrogyria (cortical dysplasia) has not been described for either monosomy before.
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Affiliation(s)
- M Alkan
- Department of Paediatrics, Inselspital, and Institute of Pathology, University of Bern, Switzerland
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Abstract
We developed a simple scoring system to evaluate the severity of tinea pedis (Athlete's foot severity score, AFSS). The AFSS consists of a clinical evaluation, using a three-point scale, of erythema and scaling in the plantar and interdigital spaces of the feet, and counts of interdigital spaces involved. Each foot is evaluated separately. The validity of the AFSS was assessed in 224 soldiers of the Israel Defense Force using mycological cultures as the main outcome measure and subjective assessment of pruritus as the secondary outcome measure. Mycological examinations were performed in 106 patients who had clinical evidence of tinea pedis. AFSS was significantly associated with culture results (P<0.0001), as well as with the presence of pruritus (P=0.002), and pruritus scores (P=0.025). We conclude the AFSS is valid for the clinical evaluation of tinea pedis severity in military settings. The application of AFSS to civilian morbidity should be subjected to further evaluation. AFSS: Schweregrad-Beurteilung des Athletenfusses. Ein Vorschlag
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Affiliation(s)
- A D Cohen
- Dermatological Institute, Clalit Health Services, Department of Dermatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Alkan M. [A case of infective endocarditis]. Anadolu Kardiyol Derg 2001; 1:313-4. [PMID: 12101845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Cohen AD, Reuvni H, Goldstein N, Alkan M. [Overuse of antibiotics with upper respiratory tract infections in a primary care clinic]. Harefuah 2001; 140:810-2, 896. [PMID: 11579726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
UNLABELLED In the majority of cases upper respiratory tract infections (URI's) are caused by viruses. Nonetheless, in many instances, patients with URI's are over-treated with antibiotics. In order to evaluate the use of antibiotic therapy in patients with URI's, we recorded medications prescribed for URI's in 394 young adults seeking care in a primary care clinic. The following parameters were assessed: rhinnorhea, cough, sore throat, dysphagia, tonsillar exudates, tonsillar enlargement and cervical lymphadenopathy. Throat cultures were taken from all the patients. RESULTS Antibiotic therapy was prescribed for 99 of the 370 patients (26.8%) with URI's and negative throat cultures. Among these patients, a high prevalence of the following findings was evident: tonsillar enlargement (66.7%), tonsillar exudates (48.5%), cervical lymphadenopathy (42.4%), lack of rhinorrhea (40.4%), lack of cough (32.0%) and fever (31.3%). CONCLUSIONS Excess antibiotic therapy was prescribed for patients with URI's. Possible explanations are: clinical findings that suggest a diagnosis of follicular tonsillitis, early antibiotic treatment that is not based on throat cultures or antigen detection tests, and multiple treating physicians. RECOMMENDATIONS We recommend that in cases of patients with URI's, antibiotics should not be prescribed unless diagnosis of a streptococcal infection is supported by results of throat cultures or antigen detection tests. Furthermore, in primary care clinics with a number of physicians, treatment should guarantee appropriate medical follow-up.
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Affiliation(s)
- A D Cohen
- Infectious Diseases Institute, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba
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Borer A, Gilad J, Meydan N, Riesenberg K, Schlaeffer F, Alkan M, Schlaeffer P. Impact of active monitoring of infection control practices on deep sternal infection after open-heart surgery. Ann Thorac Surg 2001; 72:515-20. [PMID: 11515891 DOI: 10.1016/s0003-4975(01)02812-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Deep-sternal infection is a devastating complication after open-heart surgery. However, the association between infection control practices and deep-sternal infection rates is unclear. METHODS To identify contributors to increased deep-sternal infection rates in our institution, consecutive open-heart surgery patients were prospectively studied during two periods (75 and 40 days), including 66 and 40 patients, respectively. Active monitoring including 149 infection control practices was performed in the operating room and intensive care unit. End-points were deep-sternal infection rates and their relation to infection control practices. RESULTS Mean age was 62+/-11 years and 68% were males. Coronary bypass was performed in 82%. Clinical and surgical features were comparable, except that patients in period 2 were more likely to have heart failure (15% vs 1.5%, p = 0.01) and had a longer mean duration of surgery (277 vs 217 minutes, p < 0.005). Only 57 practices (38%) were adequately performed. The main categories showing inadequate practices were disinfection, traffic, hand-washing, and surgical attire of nonscrubbed personnel, anesthesiologists, and pump technicians. Many categories showed a statistically significant improvement between periods. Deep-sternal infection rates in prestudy and poststudy periods were 10% and 2.8%, respectively (p = 0.007). CONCLUSIONS Active monitoring among personnel involved in open-heart surgery resulted in a significant and sustained decrease in deep-sternal infection rates, through modification of human behavior and improvement of performance standards, probably mediated by the Hawthorne effect. Periodic active monitoring may be a valuable tool to achieve and even sustain such a decrease with tremendous implications on morbidity, costs, and quality of care.
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Affiliation(s)
- A Borer
- Infectious Disease Institute, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Gunaydin B, Akcali D, Alkan M. Epidural anaesthesia for Caesarean section in a patient with Devic's Syndrome. Anaesthesia 2001; 56:565-7. [PMID: 11412164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The anaesthetic management of a 29-year-old paraplegic woman suffering from Devic's Syndrome scheduled to undergo Caesarean section under epidural anaesthesia is presented. The case is discussed with particular reference to the risk of autonomic hyperreflexia.
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Affiliation(s)
- B Gunaydin
- Assistant Professor, and Resident, Department of Anaesthesiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
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Gilad J, Borer A, Hallel-Halevy D, Riesenberg K, Alkan M, Schlaeffer F. Post-kala-azar dermal leishmaniasis manifesting after initiation of highly active anti-retroviral therapy in a patient with human immunodeficiency virus infection. Isr Med Assoc J 2001; 3:451-2. [PMID: 11433642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- J Gilad
- Infectious Disease Institute, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Urkin J, Alkan M, Henkin Y, Baram S, Deckelbaum R, Cooper P, Margolis CZ. Integrating global health and medicine into the medical curriculum. Educ Health (Abingdon) 2001; 14:427-431. [PMID: 14742007 DOI: 10.1080/13576280110085481] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- J Urkin
- Curriculum Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba,
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Reuveni H, Hadar A, Greemberg L, Alkan M, Cohen R, Elhayany A. A screening process predicts success rates in residency re-training among new immigrant physicians in Israel. Educ Health (Abingdon) 2001; 14:97-108. [PMID: 14742048 DOI: 10.1080/13576280010021897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES To evaluate predictors of success in training programs for Israeli international medical graduates (IMGs) from the former USSR. SUBJECTS IMGs up to the age of 45 who passed a national licensing examination and a Hebrew knowledge exam were eligible for participation. INTERVENTION Each IMG participated in one of three programs that offered similar academic activities. In two programs there was a preliminary selection process and one program had supplementary teaching hours. MAIN OUTCOME MEASURES Resident's self-evaluation of skills compared with evaluation by department heads. The evaluation included eight clinical skills, a general evaluation, and the passing rate for Phase I of the National Certification Exam. FINDINGS A total of 176 IMGs, all graduates from medical schools in USSR who immigrated to Israel from 1990 to 1996, and 20 heads of the participating departments completed the questionnaires. The response rate was 64% among the residents and 71% among the department heads. All residents had a similar level of self-esteem regarding clinical skills and considered themselves equal to or better than Israeli-trained residents. The department heads did not concur with this assessment, particularly for residents who participated in the program with no preliminary selection. Participants in the programs with preliminary selection received better evaluations from department heads than those in the program without and had significantly greater success in the written part of the board certification examination (p < 0.05). DISCUSSION AND CONCLUSIONS Re-training programs for IMGs should include a preliminary process for participant selection. The training program should be implemented in academic departments, in which case supplementary teaching hours are not required.
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Affiliation(s)
- H Reuveni
- Soroka Medical Center, Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Kara D, Alkan M. Determination of acidity constants of acid-base indicators by second-derivative spectrophotometry. Spectrochim Acta A Mol Biomol Spectrosc 2000; 56:2753-2761. [PMID: 11145342 DOI: 10.1016/s1386-1425(00)00319-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A method for calculation of acid-base dissociation constants of monoprotic weak organic acids whose acid and base species have overlapping spectra from absorptiometric and pH measurements is described. It has been shown that the second-derivative spectrophotometry can effectively be used for determining the dissociation constants, when dissociation constants obtained for methyl orange and bromothymol blue were compared with the values given in the literature.
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Affiliation(s)
- D Kara
- Department of Chemistry, Faculty of Art and Science, University of Balikesir, Turkey.
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Crystal E, Borer A, Gilad J, Haick I, Weber G, Alkan M, Riesenberg K, Schlaeffer F, Battler A, Ilia R, Gilutz H, Leor J. Incidence and clinical significance of bacteremia and sepsis among cardiac patients treated with intra-aortic balloon counterpulsation pump. Am J Cardiol 2000; 86:1281-4, A9. [PMID: 11090812 DOI: 10.1016/s0002-9149(00)01223-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this prospective study, a significant incidence of fever (47%), true bacteremia (15%), and sepsis (12%), were found in 60 cardiac patients treated with an intra-aortic balloon counterpulsation pump. The benefit of antibiotic prophylaxis in this setting should therefore be evaluated.
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Affiliation(s)
- E Crystal
- Cardiology Department and Infectious Disease Institute, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Abstract
An X chromosome gene is assumed to be responsible for the cause of Rett syndrome (RS). However, new genealogical observations suggest involvement of autosomal recessive gene(s) as well, at least in familial cases. To account for these and other recent observations, the theoretical model presented in 1990 by the authors of this paper is applied to the calculation of gene frequencies. Observed frequencies of sporadic and familial cases of RS are used, taking into account genetic drift in inbreeded areas. Moreover, an attempt is made to use the proportion of RS variants in familial and sporadic cases for the explanation of so called 'formes frustes', and as evidence for the existence of female as well as male carriers. The estimated frequency of the recessive autosome mutation, or possibly a frequent polymorphism, is 22.5%.
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Affiliation(s)
- E M Bühler
- Department of Medical Genetics, Basel University Children's Hospital, Switzerland
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Borer A, Metz I, Gilad J, Riesenberg K, Weksler N, Weber G, Alkan M, Horowitz J. Massive pulmonary haemorrhage caused by leptospirosis successfully treated with nitric oxide inhalation and haemofiltration. J Infect 1999; 38:42-5. [PMID: 10090507 DOI: 10.1016/s0163-4453(99)90029-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A patient with leptospirosis who developed oliguric renal failure, massive pulmonary haemorrhage and respiratory failure is described. The patient's clinical condition and arterial oxygenation failed to improve despite vigorous supportive measures. Nitric oxide inhalation and haemofiltration resulted in a marked clinical improvement and subsequent full recovery. We suggest that the addition of haemofiltration and nitric oxide inhalation therapy should be considered in patients with pulmonary haemorrhage and renal failure caused by leptospirosis, in whom conventional therapy fails.
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Affiliation(s)
- A Borer
- Infectious Disease Institute, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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