Therapeutic potential of cristobalite in the treatment of calf diarrhea

Calf diarrhea continues to be the major problem of calves in the neonatal period. The effect of zeolites has been increasingly studied in ruminant health in recent years. In the present study, the efficacy of cristobalite, a zeolite, in neonatal calf diarrhea was studied first time. For this purpose, twenty-five neonatal calves with diarrheas were divided into two groups, and Group 1 (n=12) received conventional treatment and Group 2 (n=13) received cristobalite (Zoosorb 10 mg/kg) orally 3 times a day in addition to conventional treatment. Escherichia coli k99 and CS31a, bovine rotavirus and bovine coronavirus were isolated from fecal samples at the beginning of the treatment, on the third day and before discharge. It was determined that the recovery period in Group 2 was 0.95 (20.6%) days shorter than in Group 1 (p⟨0.05) while no viral agents were found on the fifth day in Group 2, viral shedding continued in 4 of 5 calves in Group 1. In conclusion, the study revealed that cristobalite speeds the recovery time and possibly decreases viral shedding in neonatal calf diarrhea, demonstrating a remarkable efficiency in the treatment.

Efficiency of intravenous iron carboxymaltose in patients with iron-deficiency anemia due to heavy menstrual bleeding: a single-center experience

OBJECTIVE

Heavy menstrual bleeding (HMB) is the most common cause of iron deficiency anemia (IDA) in premenopausal women. Clinical studies have shown that iron carboxymaltose (ICM) is an appropriate, effective, and well-tolerated treatment option for clinical situations associated with iron deficiency (ID).

PATIENTS AND METHODS

This study took 78 out of 400 consecutive patients diagnosed with IDA due to HMB and intolerant or insufficient response of oral iron. All patients were administered the total calculated dose of ICM separately, based on the body weight and current hemoglobin (Hb) level. All the anemia parameters of the patients were compared before and after treatment.

RESULTS

All anemia parameters, including median Hb, ferritin, and transferrin saturation, significantly increased four weeks after treatment. Pre- and post-treatment mean Hb levels were 8.9 (± 1.7) g/dL and 12.3 (± 1.2) g/dL, respectively. The mean ferritin level of the patients before treatment was 3.93 (± 2.7) ng/mL. After treatment, the mean ferritin level was 244 (± 185) ng/mL. The mean transferrin saturation levels before and after treatment were 5.7% (± 5.0) and 43.1% (± 20.9), respectively. Although no serious side effects were observed in all patients, headache was detected in 2 patients (2.6%), urticaria in 3 patients (3.8%), and flushing in 2 patients (2.6%).

CONCLUSIONS

ICM is an effective and safe treatment option for patients with IDA due to HMB, in which oral iron therapy is insufficient or intolerant. In fact, without waiting for the failure or intolerance of oral iron therapy, moving ICM to the frontline could be cost-effective and more convenient to patients with HMB and health care providers.

Risk factors for post-ERCP pancreatitis: it depends on the ERCP indication

BACKGROUND AND AIMS

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive modality, and has a high risk of causing post-ERCP pancreatitis (PEP). Risk factors of PEP have been investigated and conflicting results are present for most risk factors. The aim of this study was to evaluate the risk factors for PEP and to determine whether the risk factors differ due to the ERCP indication.

PATIENTS AND METHODS

A retrospective study was conducted which included 666 patients with 968 ERCP procedures. Some risk factors were evaluated for PEP, and they were also evaluated separately for patients with bile duct stones and patients who underwent ERCP for other reasons than bile duct stones.

RESULTS

In patients with bile duct stones detected on ERCP ; female gender, lower diameter of the common bile duct, placing a biliary plastic stent and not having a cholecystectomy history were risk factors for PEP, whereas in patients without bile duct stones the only risk factor for PEP was not having a prior endoscopic sphincterotomy.

CONCLUSIONS

Our study revealed that PEP risk factors depend on the indication of ERCP. To the best of our knowledge our study is the first study defining cholecystectomy as a protective factor for PEP in patients with bile duct stones and endoscopic sphincterotomy history as a protective factor for PEP in patients without bile duct stones. Our study also showed that female gender, lower diameter of the common bile duct and placing a plastic biliary stent were risk factors for PEP in patients with bile duct stones.

MEAN PLATELET VOLUME: AN OVERLOOKED HERALD OF MALIGNANT THYROID NODULES

Physicians and surgeons pay much attention to evaluating thyroid nodules due to the malignant potential of these growths. Inflammation has a crucial role in the development of cancer. Increase in the mean platelet volume (MPV) has been described in various inflammatory conditions. Since some of thyroid nodules are malignant, we aimed to compare MPV values between patients with malignant and benign thyroid nodules after precise pathologic diagnosis. We retrospectively analyzed hemograms of patients having undergone thyroid surgery for thyroid nodule between January 2013 and January 2015, and compared them to those recorded in healthy subjects. MPV was higher in the malignant thyroid nodule group than in the benign nodule group (9.1±1 fL vs. 7.8±0.8 fL). The difference was statistically significant (p<0.001). Increased MPV should be considered as an assistive diagnostic tool in differentiating malignant and benign thyroid nodules. However, further prospective studies are required to confirm its usefulness in this population.

Neutrophil to Lymphocyte Ratio is Useful in Differentiation of Malign and Benign Thyroid Nodules

OBJECTIVE

Significant amount of thyroid nodules are malignant. Inflammation plays crucial role in the pathogenesis of many disorders, including cancer. Neutrophil to lymphocyte ratio (NLR), has been suggested as an index of inflammatory response and association between increased NLR and cancer has also been reported. In this retrospective analysis, we aimed to study NLR levels in patients with malign and benign thyroid nodules and healthy control subjects.

METHODS

The patients who underwent surgery for nodular goiter in general surgery clinics of our university hospital between June 2012 and June 2015 and 68 healthy volunteers were included. Patients with thyroid nodules divided into malign or benign nodule groups according to the pathology report. Thyroid carcinomas other than micropapillary tumor were excluded. Preoperative hemogram parameters of these groups were compared.

RESULTS

Mean NLR of malign nodule group (2.1±0.9%) was significantly higher than both those in benign nodule (1.7±0.9%) and control groups (1.7±0.6%).

CONCLUSION

We suggest that elevated NLR in patients with thyroid nodules in preoperative period may be an indicator of underlying malign nodular disease. Increased NLR in such patients should encourage physician to perform cancer screening in thyroid gland.

Effect of iloprost on contractile impairment and mitochondrial degeneration in ischemia-reperfusion of skeletal muscle

Purpose Acute lower extremity ischemia is still a main cause of mortality and morbidity in orthopedic traumatology and reconstructive surgery. In acute lower extremity ischemia, the skeletal muscles are the tissues that are the most vulnerable to ischemia. The aim of this study was to evaluate the effects of iloprost (IL) therapy on skeletal muscle contractile impairment and mitochondrial degeneration in an acute lower extremity ischemia-reperfusion rat model. Main Methods Forty Wistar albino rats were randomly divided into a control group and four experimental groups. Experimental groups were either subjected to 2 h of lower extremity ischemia followed by a 4-h reperfusion period or to 4 h of ischemia followed by an 8-h reperfusion period. Except for the animals in the control group, all animals received IL (1 ng/kg/min) or saline (1 ml/kg) by intraperitoneal infusion for 10 min immediately before reperfusion. At the end of the recording of skeletal muscle electrical activity and contractility, all rats were sacrificed by decapitation and muscle samples of lower extremity were immediately harvested for histopathologic analyses. Results After ischemia-reperfusion, a breakdown in the force-frequency curves of extensor digitorum longus muscle was observed, showing the diminished muscle contractility. However, IL significantly improved muscle contractility following injury induced by 2 h of ischemia followed by a 4-h reperfusion period. In addition, IL partially ameliorated mitochondrial degeneration in the muscle cells of ischemia groups. Conclusion This study indicates that immediate IL therapy repairs muscle damage especially after 2 h of ischemia and 4 h of reperfusion and therefore that IL improves contractile function.

Could Red Cell Distribution Width be a Marker of Thyroid Cancer?

OBJECTIVE

To study red cell distribution width (RDW) values, a novel inflammatory marker in routine hemogram, of patients with benign or malignant thyroid nodules and to compare with healthy population.

STUDY DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

Abant Izzet Baysal University Hospital, Bolu, Turkey, from November 2015 and February 2017.

METHODOLOGY

The hemogram values of patients undergone thyroid surgery for thyroid nodule between November 2015 and February 2017 were retrospectively analyzed, and compared to those in healthy subjects. Subjects with infectious or inflammatory diseases were excluded. Patients' characteristics and laboratory data were obtained from institutional computerized database. Preoperative hemogram values of thyroid nodule patients were recorded. One-way ANOVAand Kruskal-Wallis tests were performed to compare variables with significance at p<0.05.

RESULTS

Median RDW of malignant nodule group was 15.8 (12.9-19.5) and was significantly higher than both of those in benign nodule (15) and control groups (14), (p<0.001).

CONCLUSION

Elevated RDW in patients with thyroid nodules in preoperative period should alert the physician for possible malignancy and this cost-effective marker also can help support other modalities (ultrasound scan, and fine needle aspiration biopsy) to distinguish malignant from benign nodules.

Is torrefaction of polysaccharides-rich biomass equivalent to carbonization of lignin-rich biomass?

Waste biomass species such as lignin-rich hazelnut shell (HS) and polysaccharides-rich sunflower seed shell (SSS) were subjected to torrefaction at 300°C and carbonization at 600°C under nitrogen. The structural variations in torrefied and carbonized biomasses were compared. Also, the burning characteristics under dry air and pure oxygen (oxy-combustion) conditions were investigated. It was concluded that the effects of carbonization on HS are almost comparable with the effects of torrefaction on SSS in terms of devolatilization and deoxygenation potentials and the increases in carbon content and the heating value. Consequently, it can be proposed that torrefaction does not provide efficient devolatilization from the lignin-rich biomass while it is relatively more efficient for polysaccharides-rich biomass. Heat-induced variations in biomass led to significant changes in the burning characteristics under both burning conditions. That is, low temperature reactivity of biomass reduced considerably and the burning shifted to higher temperatures with very high burning rates.

Evaluation of the renal function using cystatin C level in the patients receiving cisplatin-based chemotherapy

OBJECTIVE

There are some data regarding the role of cystatin C, a cysteine proteinase inhibitor, in determining the glomerular filtration rate (GFR) more accurately. We aimed to evaluate the correlation of serum cystatin C levels with the serum creatinine levels and GFR calculated by Cockcroft-Gault and modification of diet in renal disease (MDRD) formulations in the patients who received cisplatin-based chemotherapy. We also intended to demonstrate its potential use in the early prediction of the renal function changes in these patients.

MATERIALS AND METHODS

In the study, 34 patients receiving cisplatin-based chemotherapy with various malignancies were included. The levels of cisplatin were determined prior to the chemotherapy and at the end of cisplatin infusion during the therapy. GFR was calculated by Cockcroft-Gault and MDRD formulations prior to the therapy and at the end of the third course.

RESULTS

A statistically significant linear correlation was found between the serum levels of cystatin C and creatinine prior to the chemotherapy (r = 0.42, p = 0.013). However, there was no correlation among the level of cystatin C subsequent to the cisplatin infusion and serum creatinine level following the third course and MDRD and creatinine clearance-Cockcroft-Gault formulations.

CONCLUSION

Even though the serum cystatin C levels were correlated with the serum creatinine levels in our study, it was concluded that it was not an appropriate parameter to predict the potential impairments in the renal function during the chemotherapy.

Administration of contrast media just before cisplatin-based chemotherapy increases cisplatin-induced nephrotoxicity

PURPOSE

There is a clinical need to predict the probability of cisplatin-induced nephrotoxicity (CIN) in order to make decisions about patient management and relevant preventive measures. The purpose of this study was to develop a risk prediction methodology of CIN.

METHODS

197 consecutive cancer patients, whose serum creatinine was measured at least 48 h before every cycle of cisplatin-based chemotherapy, were included in the study. Demographic and clinical data were collected from the patient medical records. Renal function was evaluated at least 48 h before treatment (day 0) of each cycle, based on the Modification of Diet in Renal Disease (MDRD) formula. CIN was defined as a decrease of ≥ 25% in glomerular filtration rate (GFR) compared to baseline GFR values.

RESULTS

The mean age of the study population was 54.5±9.6 years. Fifty-eight patients (29.4%) whose GFR had decreased by at least 25% compared to baseline values formed the CIN group, and the remaining 139 patients formed the non-CIN group. No significant differences were noted between the CIN and non-CIN groups in terms of age, gender, body mass index and smoking history. Metastatic disease was similar in both groups (p=0.86). History of hypertension (p=0.81), diabetes mellitus (p=0.72), and cardiovascular disease (p=0.58) were similar in the two groups. Chemotherapeutic agents used concurrently with cisplatin were similar in both groups. Significantly more radiologic examinations using contrast media were performed in the CIN group compared with the non-CIN group (p=0.01). In patients exposed to contrast media within a week before cisplatin administration, the risk of CIN was 2.56-fold higher (957 percent; CI 1.28-5.11) than in patients without such exposure (p=0.009).

CONCLUSION

In patients with exposure to contrast media within a week before cisplatin administration, the risk of CIN was significantly higher than in patients without such an exposure. No additional risk factors for CIN were found in this retrospective observational study.

Endocrine therapy alone vs. chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: a retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology)

PURPOSE

The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs. chemotherapy plus endocrine therapies (Chemo/ET) in such patients.

METHODS

In this retrospective multicenter study 191 patients ≥ 70 years with operated hormone receptor breast cancer, who were administered adjuvant ET or Chemo/ET were assessed.

RESULTS

The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051).

CONCLUSION

The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.

ERCC1 expression in triple negative breast cancer

PURPOSE

Excision repair cross-complementation group 1 (ERCC1), which is a component of nucleotide excision repair (NER) pathway, removes platinum-induced DNA adducts. Overexpression of ERCC1 has been associated with resistance to platinum-based chemotherapy in ovarian and lung cancers. Detecting ERCC1 overexpression is important in considering treatment options for triple negative breast cancer (TNBC), and in conducting and interpreting trials that search to find specific chemotherapy regimens for TNBC. In this study we aimed to study ERCC1 overexpression in patients with TNBC.

METHODS

A monoclonal antibody against ERCC1 was used for immunohistochemical (IHC) analysis of tumor samples. Tumor samples from 45 patients were evaluated by two experienced pathologists who were blinded to clinical data. A semi-quantitative H score (intensity staining scale ranging from no staining/0 to very intense staining/3+) was calculated by multiplying staining intensity with extent score. Tumors with H score ≥ 1 were classified as ERCC1-positive.

RESULTS

ERCC1 expression was positive in 73.3% of the tumor samples with an H score ≥ 1 and 26.7% of the tumor samples stained negative with an H score lt; 1. Of the tumor samples 15.5% stained diffusely and intensively.

CONCLUSION

Our study demonstrated that about two thirds of the TNBC showed positive expression of ERCC1, which may be predictive of a poor response to platinum-based chemotherapy.

The Frequency and Determinants of Metabolic Syndrome in Patients with Operable Stage I-III Breast Cancer

Background: Metabolic syndrome is a cluster of multiple risk factors including obesity, insulin resistance, hypertriglyceridemia, low HDL (high density lipoprotein), and hypertension. Metabolic syndrome is associated with an increased risk of breast cancer. We evaluated the frequency and determinants of metabolic syndrome in patients with operable stage I-III breast cancer.Methods: In this cross-sectional study we analyzed the frequency and determinants of metabolic syndrome in patients with stage I-III breast cancer. Metabolic syndrome was defined according to NCEP (National Cholesterol Education Program) definitions. Data on metabolic syndrome criteria were collected along with demographic data, tumor size, grade, lymph node, estrogen, progesterone, HER2 status, grade and history of chemotherapy/endocrine therapy.Results: A total of 331 patients were analyzed. Median age was 50.0 years (range 20-84 years). Eighty-five patients were using tamoxifen, 98 patients were using aromatase inhibitors and the remaining 148 patients were not receiving hormonal therapy (newly diagnosed and/or triple-negative patients). According to the NCEP criteria 48.0% of the patients had metabolic syndrome. More patients receiving aromatase inhibitors had metabolic syndrome than those receiving tamoxifen (60.2% vs. 37.6%, p = 0.008). The frequency of MS among those not taking any hormonal therapy was 45.9%. Additionally, post-menopausal patients had higher rate of MS compared to pre-menopausal ones (53.4% vs. 25.0% p=&lt;0.001). Patients with HER2 positive tumors and patients who had a history of oral contraceptive use had lower rates of metabolic syndrome than those with HER2 negative tumors and no oral contraceptive use, respectively (40,0% vs. 53,7% for HER2, p=0.028 and 32,6% vs. 50,3% for oral contraceptive use, p=0.034).There was no significant correlation between the presence of metabolic syndrome and estrogen/progesterone receptor status, tumor size, nodal status, stage, grade, adjuvant chemotherapy, hormone replacement therapy, smoking history.Conclusions: Nearly half of the patients with stage I-III breast cancer had metabolic syndrome. Adjuvant aromatase inhibitor therapy was found to be associated with higher rate of metabolic syndrome whereas history of oral contraceptive use and HER2 positivity were associated with lower rate. Whether the aromatase inhibitors contribute the development of metabolic syndrome or not needs to be elucidated by future prospective studies.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5121.

Effect of co-combustion on the burnout of lignite/biomass blends: a Turkish case study

Co-combustion of Turkish Elbistan lignite and woody shells of hazelnut was performed in a TGA up to 1173 K with a heating rate of 20 K/min. SEM images of each fuel revealed the differences in their physical appearances. Hazelnut shell was blended with lignite in the range of 2-20 wt% to observe the co-combustion properties. Maximum burning rates (Rmax), temperatures of the maximum burning rates (T(R-max)), and the final burnout values of the parent samples and the blends were compared. The results were interpreted considering lignite properties and the major biomass ingredients such as cellulosics, hemicellulosics, and lignin. Deviations between the theoretical and experimental burnout values were evaluated at various temperatures. Burnout characteristics of the blends up to 10 wt% were concluded to have a synergistic effect so the addition of hazelnut shell up to 8 wt% provided higher burnouts than the expected theoretical ones, whereas addition of as much as 10 wt% led to a decrease in the burnout. However, the additive effects were more favorable for the blend having a biomass content of 20 wt%. Apparent activation energy, Rmax, and T(R-max), were found to follow the additive behavior for the blend samples.

Thermal reactivity of rapeseed (Brassica napus L.) under different gas atmospheres

Non-isothermal thermogravimetric method was applied to rapeseed to investigate its thermal reactivity under both individual dynamic atmospheres of nitrogen, steam, carbon dioxide and dry air, and under several mixtures of these gases (nitrogen+steam), (steam+dry air), and (nitrogen+carbon dioxide+steam). In this method, the sample was heated from ambient to 1273 K with a constant heating rate of 20 K/min. The trend of the TGA curves and the derived DTG profiles were interpreted regarding the conversion yields and the reactivity of the samples. Conversion yields of biomass to gaseous products changed in the range of 75-94% on original basis, with respect to the atmosphere under which the experiment was carried out. The maximum rates of the mass losses from the sample were found between 2.6 and 4.3 mg/min. The activation energies were calculated using the method of Coats-Redfern, and varied between 21.3 and 96.0 kJ/mol.

[Reconstruction of the distal lower extremity defects with distal pedicled fasciocutaneous flaps]

Soft-tissue coverage of defects in the distal lower extremity has its limitations because of minimal blood supply to the skin and the thin muscle layer. Split-thickness skin grafting is impossible in cases of defects of tendons or bones. Local flaps are applicable only for smaller defects. With the cross-leg flaps, it is necessary to immobilize the patient for a long time. Special microsurgical technique and knowledge are needed for the free flaps. Fasciocutaneous flaps of the lower extremity after Donski and Fodgestam are simpler and safer than the other methods. From 1987 to 1992, this method was successfully used on 15 patients in the Department of Plastic Surgery of Sişli Etfal Hospital in Istanbul. In the two-thirds of those patients, accidents were the cause of the defects. The advantages of this methods are: simpler technique, larger flap-surface, earlier mobilisation of patients, better adaptation of the flap to its neighbourhood regarding colour and thickness.

Application of ice water to the face in initial treatment of supraventricular tachycardia

Supraventricular tachycardia (SVT) is a life-threatening dysrhythmia in childhood. Initial treatment includes classic vagal maneuvers, some pharmacological agents, cardioversion and application of ice water to the face. In this paper we report our results of ice water application to the face in SVT. The study included ten patients between the ages of seven days and 15 years who were admitted to our hospital with supraventricular tachycardia in the previous year. Ice water was applied to their faces for five seconds immediately and all of them were digitalized. This procedure was utilized in 28 out of 36 SVT attacks, and was found to be effective in restoring sinus rhythm on 27 of 28 occasions (96%). Tachycardia recurred a total of 18 times in three of the ten patients. There was no recurrence in six patients. No response was noted in only one patient. Application of ice water to the face is an easy, safe, effective and repeatable procedure in the initial treatment of supraventricular tachycardia.

Investigations of the frequency of DNA strand breakage and cross-linking and of sister chromatid exchange frequency in the lymphocytes of female workers exposed to benzene and toluene

Peripheral lymphocyte DNA damage as measured by the method of alkaline filter elution and the frequency of sister chromatid exchange (SCE) in lymphocytes was investigated for a group of 20 female workers of a shoemaking plant who were exposed to benzene and toluene, primarily below the German threshold limit value of 5 and 100 p.p.m. respectively; the results were compared with those from a control group. In the female workers significantly raised (P less than 0.05) SCE values were found. The relative DNA elution rate through polycarbonate filters was significantly increased (P less than 0.001). The elution rate through polyvinylidene fluoride (HVLP) filters showed a tendency to increase (P = 0.052), which must be interpreted as indicating increased DNA strand breakage. The SCE rates of the female workers were significantly correlated (P less than 0.01) with the relative DNA elution rate through HVLP filters. There was no correlation with the actual benzene and toluene uptake measured by personal air monitoring. Four months after cessation of work, DNA strand breakage decreased significantly (P less than 0.05) in blood samples of six reinvestigated female workers.

Intrascrotal extratesticular malignant schwannoma

We report a rare case of intrascrotal extratesticular malignant schwannoma with rhabdomyoblastic features in a 48-year-old man. Malignant schwannomas, which arise from the peripheral nerves, usually occur in the extremities, the trunk or paravertebral areas. The patient had no manifestation of von Recklinghausen's disease. To our knowledge, there has been no intrascrotal extratesticular malignant schwannoma reported.

Emphysematous pyelonephritis with pneumocystitis

Emphysematous pyelonephritis is an acute infectious process mostly associated with diabetes and obstruction. It is a life-threatening illness and treatment generally involves antibiotic therapy, surgical drainage and nephrectomy. The prognosis is poor regardless of therapy. Herein, we present a case with pneumocystitis. To our knowledge, there have been 54 cases previously reported. There is no doubt that emphysematous pyelonephritis with pneumocystitis as in our case is less frequent.