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Öğe The effect of hesperetin on ischemia-reperfusion injury in rat ovary(Springer Heidelberg, 2014) Gungor, Ayse Nur Cakir; Gencer, Meryem; Karaca, Turan; Hacivelioglu, Servet; Uysal, Ahmet; Korkmaz, Fatma; Demirtas, SelimHesperidin (HES), a citrus fruit extract, has beneficial effects on various ischemia/reperfusion (I/R) models. We aimed to evaluate the possible positive effects of hesperetin (HPT), an active metabolite of HES, on a rat ovarian I/R model. We divided 24 Wistar Albino rats into four groups. Group I (n = 6) was sham operated, Group II (n = 6) was the I/R group, Group III (n = 6) was the I/R + solvent group and Group IV (n = 6) was the I/R + HPT group. Three hours of ischemia and 3 h of reperfusion were performed on each rat in Groups II, III, and IV. Dimethyl sulfoxide (DMSO) was given intraperitoneally to the rats in the III. Group, and 50 mg/kg of HPT dissolved in DMSO was given intraperitoneally to the rats in the IV. Group 30 min before reperfusion. After 3 h of reperfusion, the ipsilateral ovaries of the rats were examined immunohistochemically to detect apoptosis. Hematoxylin and eosin (H and E) staining demonstrated less edema and hemorrhage in the group where HPT was applied. Caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining showed significantly lower apoptosis in the group where HPT was used when compared to either the I/R or solvent group. To the best of our knowledge, this is the first study that shows the beneficial effects of HPT in an ovarian I/R injury. HPT improved tissue damage and apoptosis caused by I/R injury. To identify the possible positive effects of HPT in ovarian torsion of humans and use in clinical practice, more studies must be performed.Öğe Geç Dönemde Hastanede Gelişen Pnömoni Etkenlerinin Hızlı Moleküler Biyolojik Yöntemlerle Saptanması(2021) Uysal, Ahmet; Taşbakan, M. Sezai; Aydemir, Şöhret; Pullukçu, Hüsnü; Çilli, Feriha; Bacakoğlu, FezaGiriş: Hastaneye yatışı takip eden beşinci günden sonra ortaya çıkan geç dönemde hastanede gelişen pnömonilere (HGP) genellikle çok ilaca dirençli bakteriler neden olmaktadır. Etkenlerin geç saptanması, uygun antibiyotiğin zamanında başlanamaması HGP prognozunu olumsuz olarak etkilemektedir. Son yıllarda infeksiyon etkeni mikroorganizmaların hızlı moleküler yöntemlerle kısa sürede izole edilmesi, tedavinin daha erken ve etkin olarak başlanmasını sağlamaktadır. Bu çalışmada, HGP’de etkenlerin hızlı moleküler yöntemlerle saptan-ması ve sonuçların konvansiyonel yöntemlerle karşılaştırılması amaçlanmıştır.Materyal ve Metod: Ocak 2014 ile Ocak 2016 tarihleri arasında göğüs hastalıkları ile anestezi ve reanimasyon yoğun bakım ünitelerinde izlenen ve 2005 yılında yayımlanan ATS-IDSA kriterlerine göre HGP tanısı alan altmış iki hasta çalışmaya alınmıştır. HGP tanısı düşü-nüldüğü anda hastalardan bronkoskopik (BAL, BASP) ve nonbronkoskopik (mini-BAL) yöntemlerle alt solunum yolu örnekleri alınmıştır. Alınan örnekler hem konvansiyonel yöntemler ve hem de hızlı moleküler yöntemlerle bakteriyolojik etkenler açısından incelenmiştir.Bulgular: Hastanede gelişen pnömoni tanısı alan altmış iki hasta (kırk iki erkek, yaş ortalaması 69.7 ± 15.6) alınmıştır. Hastaların %95.2’sinde ek hastalık olup, otuz üç hastaya invaziv mekanik ventilasyon (İMV), 28 hastaya İMV + non-invaziv mekanik ventilasyon (NİV) uygulanmıştır. Konvansiyonel yöntem ile altmış iki hastanın kırkında (%64.5) bakteriyel etken saptanırken, polimeraz zincir reaksiyon (PZR) ile altmış iki hastanın elli yedisinde (%91.9) bakteriyel etken izole edilmiştir. Etken saptanması açısından konvansiyonel yöntem ile PZR yönteminin birbiriyle uyumlu olduğu gözlenmiştir (kappa: 0.797). Ayrıca, PZR ile etken saptanma oranının anlamlı olarak yüksek olduğu görülmüştür (p= 0.0004). Her iki yöntem ile en sık Acinetobacter baumannii saptanmıştır. İzlemde altmış iki hastanın kırk beşinde (%72.6) mortalite izlenmiştir.Sonuç: Geç dönemde ortaya çıkan HGP etkenlerinin saptanmasında konvansiyonel yöntemler ile PZR arasında uyumun iyi olduğu ve PZR ile daha fazla hastada etken saptanabileceği bu çalışmada gösterilmiştir.Öğe The protective effect of quercetin on IMA levels and apoptosis in experimental ovarian ischemia-reperfusion injury(Elsevier Science Bv, 2014) Gencer, Meryem; Karaca, Turan; Gungor, Ayse N. C.; Hacivehoglu, Servet O.; Demirtas, Selim; Turkon, Hakan; Uysal, AhmetObjective: To investigate the protective effect of quercetin (QE), an anti-inflammatory and anti-oxidant agent, on torsion-detorsion induced histopathological changes and blood IMA levels in experimental ovarian ischemia-reperfusion (IR) injury. Study design: Twenty-four female Wistar rats were randomly divided into four groups in this study (n = 6). Group I, (sham operation); Group II, torsion-detorsion plus saline (IR); Group III, torsiondetorsion plus solvent (dimethylsulfoxide: DMSO, IR + DMSO); Group IV, torsion-detorsion plus 15 mg/kg/bw quercetin (IR + QE) injected intraperitoneally 30 min prior to detorsion. After 3 h of reperfusion, the right ovaries were removed surgically. The ovary tissue samples were fixed in 10% formalin solution for histopathological and immunohistochemical examination. Blood samples were obtained at the end of the procedures for each group of animals. Results: Ovarian sections in Groups II and III showed higher follicular cell degeneration, hemorrhage, vascular congestion and edema when compared with Group I. Administration of quercetin in rats significantly prevented degenerative changes in the ovary. Significantly less histopathological changes were found in Group IV compared with Groups II and III. Caspase-3 and TUNEL positive cells were detected in the ovarian surface, follicle epithelium, and stromal cells in all experimental groups, and there was a significant increase in Groups II and III compared with Group I (P < 0.05). Treatment with quercetin decreased the number of caspase-3 and TUNEL positive cells. IR increased the ischemia modified albumin (IMA) levels in comparison to the sham group (1.06 +/- 0.10 ABSU and 0.92 +/- 0.08 ABSU, P < 0.05). Quercetin administration before IR reduced the levels of IMA (0.93 + 0.08 ABSU, P < 0.05). Conclusion: Administration of quercetin is effective in preventing tissue damage induced by IR injury in ovaries. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Öğe Rox Index Dynamics According to High Flow Nasal Cannula Success in Intensive Care Unit Patients with COVID-19-Related Acute Respiratory Failure(Galenos Publ House, 2023) Hancl, Pervin; Uysal, Ahmet; Yuksel, Beyza; Inal, VolkanBackground: High-flow nasal cannula therapy has been shown to be useful in the treatment of patients with acute respiratory failure caused by severe acute respiratory syndrome-coronavirus disease-2. The ROX index can help predict the success of high-flow nasal cannula in coronavirus disease-19-related acute respiratory failure. However, the timing of ROX-index assessment is still unclear to protect the patients from complications due to early or delayed intubation.Aims: To evaluate the relation between ROX index patterns within the first 48 hours of the therapy and high-flow nasal cannula success rates. The secondary aim was to determine other possible predictors of high -flow nasal cannula failure.Study design: A cross-sectional study.Methods: Patients admitted to the intensive care unit between April 2020 and January 2022 with coronavirus disease-19-related acute respiratory failure and treated with high-flow nasal cannula were included in the study. Patients' demographics, clinical characteristics and laboratory findings at intensive care unit admission; ROX indices at initiation, 2nd, 8th, 12th, 24th and 48th hours of high-flow nasal cannula; and outcomes were recorded.Results: In the study period, 69th patients were managed with high -flow nasal cannula for at least 2 hours. While 24 patients (34.7%) were successfully weaned from high-flow nasal cannula, 45 (65.3%) patients failed. Overall mortality at day 28 was 44.9%. ROX indices were lower in the high-flow nasal cannula failure group through the 12th, 24th, and 48th hours of the therapy, no significant change was observed (P = 0.33). While an overall increase in ROX index patterns were detected in patients weaned from high-flow nasal cannula (P = 0.002). Pairwise analyses revealed that ROX indexes remain stable during the first 8th hours in both groups, then improved to 12th hours of the therapy in successfully high-flow nasal cannula-weaned patients.Conclusion: Dynamic assessments of the ROX indexes could be more suggestive rather than a point assessment to identify patients who would benefit from the high-flow nasal cannula or deteriorate in coronavirus disease-19 related acute respiratory failure.
