Protective and Therapeutic Effect of Molsidomine on Bleomycin-Induced Lung Fibrosis in Rats

We aimed to investigate the preventive and treatment effect of molsidomine (MOL) on bleomycin (BLC)-induced lung injury in rats. Rats were assigned into groups as follows: control group; MOL group, 10 mg/kg MOL was continued orally for 29 day; BLC group, a single intratracheal injection of BLC (2.5 mg/kg), MOL+BLC-preventive group, 10 mg/kg MOL was administered 1 day before the intratracheal BLC injection and continued for 14 days; BLC+MOL-treatment group 10 mg/kg MOL was given on 14th day after the intratracheal BLC injection and continued until sacrifice. All animals were sacrificed on 29th day after BLC administration. The semiquantitative histopathological assessment, tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS), myeloperoxidase (MPO), and oxidative stress index (OSI) were measured. BLC-provoked histological changes were significantly detected compared to the control group. MOL restored these histological damages in different quantity in the treatment and preventive groups. BLC administration significantly decreased levels of GSH and TAS when compared to controls and these reductions was significantly ameliorated by MOL given prophylactic setting. However, therapeutic MOL administration significantly increased the TAS level decreased by BLC. The levels of MDA, MPO, and TOS were significantly increased with BLM, and these augmentations of MDA and TOS were significantly reduced by MOL given prophylactic setting. Furthermore, the OSI was higher in the BLC group, and this increase was reversed by the MOL administration before and after BLC treatment. In this study, both protective and therapeutic effects of MOL against BLC-induced lung fibrosis were demonstrated for the first time.     

Increased red cell distribution width predicts occlusion of the infarct-related artery in STEMI

Objective Infarct-related artery (IRA) patency yields a better outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Red cell distribution width (RDW) emerges as a marker of adverse cardiovascular events and mortality in STEMI. Therefore, we aimed to assess the relationship between IRA patency and RDW value on admission in patients with STEMI undergoing primary PCI. Methods A total of 564 patients with STEMI undergoing primary PCI were recruited in this study. According to thrombolysis in myocardial infarction (TIMI) flow grade in the IRA before PCI, the study population was divided into two groups as TIMI 0 or 1 group (occluded IRA, n?=?398) and TIMI 2 or 3 group (patent IRA, n?=?166). Results RDW was significantly higher in the occluded IRA group (15.1?±?1.7 versus 13.4?±?1.3, p?<?0.001) as compared to the patent IRA group. White blood cell (WBC) count, platelet count, creatine kinase-myocardial band (CK-MB) and troponin-I levels were also significantly higher in the occluded IRA group (p?<?0.05). Moreover, RDW showed positive correlations with troponin-I (r?=?0.397, p?<?0.001), CK-MB (r?=?0.344, p?<?0.001) and WBC (r?=?0.219, p?<?0.001). In multivariate regression analysis, RDW (OR: 0.483, 95% CI: 0.412–0.567, p?<?0.001) and WBC count were significantly and independently associated with IRA patency. Conclusions Our findings suggested that RDW value and WBC count on admission were independent predictors of IRA patency in patients with STEMI. As RDW is an easily available, simple and cheap biomarker, it can be used in daily practice as a novel predictor for IRA patency.     

An evaluation of the protective effect of esomeprazole in an experimental model of renal ischemia–reperfusion

Purpose

The ischemia and subsequent reperfusion (IR) which occurs in partial nephrectomy used in the treatment of renal tumors causes loss of parenchyma in the damaged kidney. The aim of this study is to evaluate, both biochemically and histologically, the efficacy of esomeprazole in an ischemia–reperfusion model in rat kidneys.

Methods

The rats were randomized into three groups of seven animals each, referred to as the sham, control, and PPI groups. In the sham group, only a laparotomy was performed. In the control group, following laparotomy the left renal artery was dissected and tied for 30-min ischemia. In the PPI group, a vascular route to the tail vein was opened, and 10 mg/kg esomeprazole was administered. After 1 h, the same procedures described for the control group were performed. All the animals were killed 24 h after the procedure. Biochemical analyses were applied for evaluation of oxidant and antioxidant agents in the blood and left kidney of each subject (oxidative markers: malondialdehyde, myeloperoxidase; antioxidant marker: superoxide dismutase). In the histological examination of the kidney tissues stained with hematoxylin–eosin, the TUNEL method was applied in the evaluation of apoptosis.

Results

No statistically significant biochemical difference was determined in the blood and tissue samples. In the histological and apoptosis evaluations, a statistically significant difference was determined between the sham, control, and PPI groups. The median (IQR) values of the TUNEL-positive cells were counted as 1.50 (4) in the sham group, 11.50 (12) in the control group, and 6.00 (9) in the PPI group (p < 0.001).

Conclusions

A protective effect of esomeprazole was confirmed in renal ischemia–reperfusion damage created in an experimental rat model.

     

Assessing medical student competency in communication in the pre-clinical phase: objective structured video exam and SP exam

Objective

The aim of our study was to present the structure, process and results of the objective structured video exam and One-Station standardized patient exam that have been used to assess second year medical students’ communication skills.

Methods

Scores of 1137 students between the years 2007 and 2010 were analyzed. Means and standard deviations were calculated for scores and ratings. Internal consistency was assessed using Cronbach's alpha coefficient. To analyze reliability and generalizability, multivariate generalizability theory was employed.

Results

Students’ total and item scores on the objective structured video exam (60.5–68.8) were lower than on the One-Station standardized patient exam (90.4–96.6). Internal consistencies of both exams were moderate. Generalizability analysis and D-study results showed that both the objective structured video exam and the One-Station standardized patient exam need improvement.

Conclusion

Both exams need measures to improve them, such as increasing the number of video cases or stations, and further standardization of raters.

Practice Implications

This study might encourage medical teachers to consider assessing validity and reliability of written and performance exams on the basis of generalizability theory, and to find out feasible actions to improve assessment procedures by conducting a D-study.     

A comparative study on oxidative and antioxidative markers of serum and follicular fluid in GnRH agonist and antagonist cycles

Objective

To determine whether concentrations of oxidative stress markers of follicular fluid and serum are different in GnRH agonist protocol from GnRH antagonist protocol.

Material and method

This was a cross-sectional study. Eighty-four women undergoing controlled ovarian stimulation with either GnRH agonist (n = 39) or GnRH antagonist protocols (n = 45) for IVF/ICSI treatment were assigned by a physician. Blood was obtained at the time of oocyte retrieval, and follicular fluid (FF) from the mature follicles of each ovary was centrifuged and frozen until analysis. Malondialdehyde (MDA), nitric oxide (NO), protein carbonyl (PC), hydroxyl proline (OH-P), sodium oxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), adenosine deaminase (ADA) and xanthine oxidase (XO) were assessed in the serum and follicular fluid of each participants.

Results

The mean serum concentrations of GSH-Px, GSH and MDA were lower in the GnRH antagonist group compared to GnRH agonist group, but mean serum SOD was higher in the GnRH antagonist group. The mean follicular SOD, ADA and NO were higher in GnRH antagonist group than GnRH agonist group. The IVF/ICSI outcomes were similar in both groups.

Conclusion(s)

GnRH antagonist protocol is associated with increased oxidative stress. The relation of GnRH analogues with oxidative stress and its implication in follicular growth needs to be addressed in further studies.     

Does physical therapy and rehabilitation improve outcomes for diabetic foot ulcers?

One of the most common and serious complications of diabetes mellitus is ulceration of the foot. Among persons with diabetes, 12%-25% will present to a healthcare institution for a foot disorder during their lifespan. Despite currently available medical and surgical treatments, these are still the most common diabetes-related cause of hospitalization and of lower extremity amputations. Thus, many adjunctive and complementary treatments have been developed in an attempt to improve outcomes. We herein review the available literature on the effectiveness of several treatments, including superficial and deep heaters, electro-therapy procedures, prophylactic methods, exercise and shoe modifications, on diabetic foot wounds. Overall, although physical therapy modalities seem to be useful in the treatment of diabetic foot wounds, further randomized clinical studies are required.