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Leukotrienes, free oxygen radicals, tumor necrosis factor-alpha, and inflammatory mediators play major roles in the development of necrotizing enterocolitis (NEC). Rhus coriaria (RC: sumac) extracts may enhance cell viability by reinforcing defensesagainst free radical species in several progressive diseases as well as inflammatory diseases. The aim of the present study was to evaluate the effects of RC in a rat NEC model in terms of intestinal damage. Newborn pups were separated into three groups: control, NEC, and NEC treated with RC. Mortality and clinical sickness scores were evaluated. At the end of the study, ileum and proximal colon were obtained from all rats and histopathological and immunohistochemical studies were performed. In this study, the anti-inflammatory, antioxidant, immunomodulatory, and anti-apoptotic activities of RC were demonstrated in a rat NEC model, which suggests RC as a promising treatment option for preventing intestinal tissue damage. Practical applicationsFree oxygen radicals, tumor necrosis factor-alpha, and inflammatory mediators play major roles in the development of NEC. Intestinal tissue damage is caused by necrosis and apoptosis as a result of intestinal inflammation and release of pro-inflammatory cytokines. Anti-inflammatory, antioxidant, immunomodulatory, and anti-apoptotic activities of RC are especially due to its phenolic compounds. In this study, the antiinflammatory, antioxidant, immunomodulatory, and anti-apoptotic activities of RC were demonstrated in a rat NEC model. RC can suggest as a new treatment option for preventing intestinal injury. K E Y W O R D Santi-

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Objectives During the pandemic, anxiety, stress, and depression may occur increasingly in the whole society. To evaluate the possible cause, incidence and levels of anxiety and depression in the relatives of the patients in the ICU in accordance with the patients’ SARS‐CoV‐2 PCR result. Materials and Method The study was prospectively conducted on relatives of patients admitted to tertiary intensive care units during COVID‐19 pandemic. Sociodemographic characteristics of the patients and their relatives were recorded. “The Turkish version of the Hospital Anxiety and Depression Scale” survey was applied twice to the relatives of 120 patients to determine the symptoms of anxiety and depression in accordance with the PCR results of the patients (PCR positive n=60, PCR negative n=60). Results The ratios above cut‐off values for anxiety and depression among relatives of the patients were 45.8% and 67.5% for the first test and 46.7% and 62.5% for the second test respectively. The anxiety and depression in the relatives of PCR positive patients was more frequent than the PCR negative (p< 0.001 for HADS‐A and p=0.034 for HADS‐D). The prevalence of anxiety and depression was significantly higher in female participants (p=0.046 for HADS‐A and p=0.009 for HADS‐A). There was no significant correlation between HADS and age of the patient or education of the participants. The fact that the patients were hospitalized in the ICU during the pandemic was an independent risk factor for anxiety (AUC = 0.746) while restriction of patient visiting in the ICU was found to be an independent risk factor for depression (AUC= 0.703). Conclusion While patient with positive PCR and participant with female gender is responsible for both anxiety and depression, hospitalization in the ICU due to COVID‐19 is an independent risk factor for anxiety and restriction of patient visiting in the ICU is an independent risk factor for depression.

The aim of our study is to investigate the prognostic value of Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in determining mortality in patients hospitalized for intensive care unit (ICU) sepsis. Materials and Methods: This study retrospectively evaluates all patients hospitalized with sepsis in our ICU between February 2017 and April 2018. In addition to the demographic and clinical characteristics of the patients, complete blood count parameters were also recorded. Demographic and clinical characteristics, mainly NLR, MLR and PLR results, and other laboratory results of patients with sepsis were compared between the ones with and without mortality. Results: Four hundred and eleven patients were included in the study. 55.7% (229/411) of patients with sepsis died and 44.3% (182/411) were discharged alive. NLR, MLR and PLR were higher in the group with mortality compared to the survivor group. The cut-off value for predicting mortality in patients with sepsis was 9.2 for NLR, ≥0.8 for MLR, and ≥187.3 for PLR. The area under the curve (AUC) value for NLR was 0.825, the AUC value for MLR 0.835 and the AUC value for PLR was 0.720. Conclusion: High NLR, MLR and PLR values are associated with mortality in sepsis patients hospitalized in ICU, and the most significant parameter for mortality indicator among the three rates was found to be MLR with the highest AUC value. Amaç: Çalışmamızın amacı, yoğun bakım ünitesinde (YBÜ) sepsis nedeniyle yatan hastalarda nötrofil lenfosit oranı (NLO), monosit lenfosit oranı (MLO) ve trombosit lenfosit oranı (TLO mortaliteyi belirlemedeki prognostik değerini araştırmaktır. Gereç ve Yöntem: Çalışmamızda, Şubat 2017 -Nisan 2018 tarihleri arasında YBÜ'de yatan tüm sepsisli hastalar retrospektif olarak değerlendirilmiştir. Hastaların demografik ve klinik özelliklerine ek olarak tam kan sayımı parametreleri kayıt edildi. Mortalite olan ve olmayan sepsisli hastaların başlıca NLO, MLO ve TLO sonuçları olmak üzere demografik ve klinik özellikleri ile diğer laboratuvar sonuçları karşılaştırıldı. Bulgular: Çalışmaya 411 hasta dahil edildi. Sepsisli hastaların %55,7'si (229/411) öldü ve %44,3 hasta (182/411) sağ taburcu edildi. Mortalite olan grupta yaşayan gruba göre NLO, MLO ve TLO daha yüksek bulundu. Sepsisli hastalarda mortalite tahmini için eşik NLO için ≥9,2, MLO için ≥0,8, TLO için ≥187,3 olarak bulundu. Nötrofil lenfosit oranı için eğri altında kalan alana (AUC) değeri 0,825, MLO için AUC değeri 0,835 ve TLO için AUC değeri 0,720 olarak bulundu. Sonuç: Yoğun bakım ünitesinde yatan sepsis hastalarında yüksek NLO, MLO ve TLO değerleri mortalite ile ilişkili olup, üç oran arasından mortalite göstergesi için en anlamlı parametre AUC değeri en yüksek olan MLO olarak bulundu.

Background: Activated inflammation and oxidant stress during cerebral ischemia reperfusion injury (IRI) lead to brain damage. Astaxanthin (ASX) is a type of carotenoid with a strong antioxidant effect. Objective: The aim of this study was to investigate the role of ASX on brain IRI. Methods: A total of 42 adult male Sprague-Dawley rats were divided into 3 groups as control (n=14) group, IRI (n=14) group and IRI + ASX (n=14) group. Cerebral ischemia was instituted by occluding middle cerebral artery for 120 minutes and subsequently, reperfusion was performed for 48 hours. Oxidant parameter levels and protein degradation products were evaluated. Hippocampal and cortex cell apoptosis, neuronal cell count, neurological deficit score were evaluated. Results: In the IRI group, oxidant parameter levels and protein degradation products in the tissue were increased compared to control group. However, these values were significantly decreased in the IRI + ASX group (p<0.05). There was a significant decrease in hippocampal and cortex cell apoptosis and a significant increase in the number of neuronal cells in the IRI + ASX group compared to the IRI group alone (p<0.05). The neurological deficit score which was significantly lower in the IRI group compared to the control group was found to be significantly improved in the IRI + ASX group (p<0.05). Conclusion: Astaxanthin protects the brain from oxidative damage and reduces neuronal deficits due to IRI injury.