Evaluation of the maternal and fetal risk factors associated with neonatal care unit hospitalization time

Objective: To evaluate maternal and neonatal risk factors associated with the length of hospital stay in the neonatal intensive care unit (NICU).

Material and method: This retrospective observational study was based on 3607 newborns who were admitted to the NICU of a tertiary teaching hospital from January 2012 through December 2014. Known obstetric risk factors associated with duration of hospitalization in NICUs were assessed including intrauterine growth restriction, maternal diabetes, oligohydramnios, chorioamnionitis, premeture rupture of membranes, preeclampsia, congenital malformations, neonatal sepsis, premature retinopathy, intracranial bleeding, necrotizing enterocolitis, meconium aspiration, maternal hypertension, fetal congenital cardiac malformations, congenital metabolic diseases, congenital hypothyroidism, pneumonia, pulmonary hypertension, bronchopulmonary dysplasia, pneumothorax and respiratory distress syndrome.

Results: Gestational age (beta coefficient:??0.244, p<0.001) and birth weight (beta coefficient:??0.237, p<0.001) were significant confounders for duration of hospitalization in newborns.

Conclusion: Gestational age and the birth weight were the most important confounders for duration of hospitalization. Neonate care in developing countries would further benefit from additional large population-based long-term studies with broad parameters.     

Does platelet mass influence the effectiveness of ibuprofen treatment for patent ductus arteriosus in preterm infants?

Objective: The aim of this study is to evaluate whether the platelet mass in the first 24?h of life is effective on closure of patent ductus arteriosus (PDA) or not.

Study design: Preterm infants with a gestational age of?<?32 weeks, hospitalized at a tertiary neonatal intensive care unit (NICU) and requiring medical treatment (intravenous or oral ibuprofen) for hemodinamically significant PDA (hsPDA) were enrolled in this study. The patients were divided into two groups after first course of pharmacologic treatment according to closure of PDA (Group 1: PDA closure, Group 2: PDA without closure). Groups were compared in terms of demographics findings, morbidities, platelet measurements like counts, mean platelet volume (MPV) and platelet mass (platelet count?×?mean platelet volume).

Results: The study included 77 preterm newborns in Group 1, and 30 preterms in Group 2. There were no differences in birth weight, gestational age, gender and maternal risk factors between the study groups. The mean platelet count in the first postnatal blood count was in Group 1: 211.3?±?89.2?×?10³/mm³ and in Group 2: 216.5?±?26?×?10³/mm³, respectively (p?=?0.783). The mean platelet volumes (MPV) were similar in both groups (p?=?0.535). No statistically significant difference between platelet mass values was detected (Group 1: 1811?±?884 fl/nl, Group 2: 1868?±?717 fl/nl) (p?=?0.753).

Conclusion: Our data suggest that platelet count, MPV and platelet mass did not affect the closure of hsPDA with ibuprofen.     

Aliskiren – a promising strategy for ovarian ischemia/reperfusion injury protection in rats via RAAS

The aim of this study was to evaluate the effects of aliskiren, direct renin inhibitor, as an antioxidant and tissue protective agent and evaluate the molecular, biochemical, and histopathological changes in experimental?ischemia?and?ischemia/reperfusion injury in rat ovaries. Forty-eight female rats were randomly divided into eight groups: in Group 1, only sham operation was performed. Group 2 received 100?mg/kg aliskiren and sham operated. In Group 3, 3?h-period of bilateral ovarian?ischemia?was applied. Group 4 received a 3-h period of?ischemia?followed by 3?h of reperfusion. Groups 5 and 6 received 50 and 100?mg/kg, respectively, of aliskiren and bilateral ovarian?ischemia?was applied (after a 3-h period of ischemia, both ovaries were surgically removed). To Groups 7 and 8, 50 and 100?mg/kg of aliskiren were administered, respectively, and the induction of?ischemia was performed. At the end of a 3-h period of?ischemia, bilateral vascular clips were removed, and 3?h of reperfusion continued. After the experiments, IL-1β, IL-6, TNF-α, and iNOS mRNA expressions and SOD, GSH, MDA, renin, and angiotensin-II levels were determined and histopathological changes were examined in rat ovaries. Aliskiren treatment normalized excessive changes in cytokine and oxidative stress markers in both ischemia and ischemia/reperfusion injury. Histopathologically, treatment with aliskiren ameliorated the development of?ischemia?and/or ischemia/reperfusion tissue injury. This study concluded that aliskiren treatment is effective in reversing ischemia and/or ischemia/reperfusion induced ovary damage via the improvement of oxidative stress, reduction of inflammation, and suppression of the renin-angiotensin aldosterone system.     

Ostomy in Nontraumatic Conditions: Our Experience and Review of the Literature

A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann’s procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy. We retrospectively analysed 105 cases of nontraumatic acute abdomen, resulted in a procedure requiring colostomy. American Society of Anesthesiologists (ASA) scoring and Mannheim Peritonitis Index (MPI) were used in the evaluation of the risk of mortality and morbidity. There were colonic perforations of rectosigmoid tumor in 66 cases (62.8 %), sigmoid volvulus in 10 cases (9.5 %), colonic anastomotic leakage in 9 cases (8.5 %), intestinal adhesions in 8 cases (7.6 %), mesenteric ischemia in 5 cases (4.7 %), gynecological diseases in 3 cases (2.85 %), strangulated hernias in 3 (2.85 %), and Ogilvie syndrome in 1 case (0.95 %). Rate of morbidity was found to be 25.7 %, while mortality occurred in 2.8 % of the cases. Cases with mortality and morbidity had ASA scores above two and MPI scores above 23. Anastomotic leakage was the only reason of mortality. In nontraumatic occasions, the management and prognosis of cases with peritonitis, general status of the patients play major roles. The prognosis rates of morbidity and mortality can be highly predicted when ASA and MPI scores are evaluated together.     

The value of plasma netrin-1 in non-small cell lung cancer patients as diagnostic and prognostic biomarker

Tumor Biology - Netrin-1 is found to be elevated and purposive as a diagnostic biomarker in many human cancers. We evaluated serum netrin-1 concentrations in patients with advanced non-small cell...     

Histopathological effects of 4-tert-octylphenol treatment through the pregnancy period, on the pituitary, adrenal, pancreas, thyroid and parathyroid glands of offspring rats at adulthood

The present study was carried out to investigate the effects of 4-tert-octylphenol (OP) exposure at fetal period on adrenal, pituitary, thyroid+parathyroid and pancreas tissues of male and female offsprings. Pregnant rats were treated with OP (100 or 250mg/(kgday)) in vehicle (corn oil) or vehicle alone daily from day 1 to 20 of pregnancy. After birth, young rats were allowed to growth until adulthood. While there were no differences in data of organ weight between control and treatment groups, in contrast, a decrease of relative organ weights of thyroid+parathyroid and adrenal in high dose treatment group in male rats, otherwise an increase of final body weights was found in 250mg/(kgday) treatment group in all rats. Also, a lot of histopathological findings were observed in investigated tissues. The results of this study suggest that, the octylphenol which was applied in fetal period causes negative effects on the adrenal, pituitary gland, thyroid+parathyroid and pancreas in rats.     

Bilateral oroantral fistulas following devitalization of teeth by arsenic trioxide: a case report

Although it is well known that prolonged application or leakage of arsenic trioxide can cause severe damage to the periodontal tissues, the substance is still used by some dentists. This paper describes a case of arsenical necrosis of the jaws affecting the right and the left side of the maxilla. As a result of leakage into the tissues of an arsenical paste from the pulp chamber of endodontically treated teeth, bilateral oroantral fistula (OAF) occurred. It is concluded that there is no justification, whatsoever, for the use of arsenic in modern dental practice. In the following case, buccal advancement flap and submucosal palatal island flap techniques were used for to close the OAF. The submucosal palatal island flap technique resulted in successful closure of the OAF.