Background:The humoral system is activated and various cytokines are released due to infections in tissues and traumatic damage. Nuclear factor-kappa B dimers are encoded by nuclear factor-kappa B genes and regulate transcription of several crucial proteins of inflammation such as tumour necrosis factor-alpha.Aims:To investigate the possible effect of polymorphisms on tumour necrosis factor-alpha serum levels with clinical and prognostic parameters of sepsis by determining the nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A) gene polymorphisms and tumour necrosis factor-alpha serum levels.Study Design:Case-control study.Methods:Seventy-two patients with sepsis and 104 healthy controls were included in the study. In order to determine the polymorphisms of nuclear factor-kappa B-1-94 ins/del ATTG and tumour necrosis factor-alpha (-308 G/A), polymerase chain reaction–restriction fragment length polymorphism analysis was performed and serum tumour necrosis factor-alpha levels were determined using an enzyme-linked immunosorbent assay.Results:We observed no significant differences in tumour necrosis factor-alpha serum levels between the study groups. In the patient group, an increase in the tumour necrosis factor-alpha serum levels in patients carrying the tumour necrosis factor-alpha (-308 G/A) A allele compared to those without the A allele was found to be statistically significant. Additionally, an increase in the tumour necrosis factor-alpha serum levels in patients carrying tumour necrosis factor-alpha (-308 G/A) AA genotype compared with patients carrying the AG or GG genotypes was statistically significant. No significant differences were found in these 2 polymorphisms between the patient and control groups (p>0.05).Conclusion:Our results showed the AA genotype and the A allele of the tumour necrosis factor-alpha (-308 G/A) polymorphism may be used as a predictor of elevated tumour necrosis factor-alpha levels in patients with sepsis.
Isolation and identification of Avibacterium paragallinarum, the causative agent of infectious coryza, is considered a challenging task in laboratories with limited specialties. In the present study, 14 commercial layer fowls showing the typical symptoms of infectious coryza were subjected to primary isolation followed by polymerase chain reaction confirmation of suspect colonies (culture-PCR). Direct PCR assays on infraorbital sinus swab samples were also carried out. Thirty-five suspected cases of infectious coryza in commercial broiler chickens were also screened using direct PCR on infraorbital sinus swabs. In culture-PCR, only 1 of the 4 suspected isolates was confirmed as Av. paragallinarum. In comparison, in direct PCR, 5 layer samples were shown to be positive for Av. paragallinarum. All of the broiler samples were negative in the direct PCR assay. Our findings indicate that primary isolation in combination with PCR can be a simple method for diagnosis of infectious coryza, although with a lower sensitivity than direct PCR. While direct PCR is comparably the more rapid and sensitive test, there will be instances in which the bacterial isolate is needed for further use. Hence, the culture-PCR method can be a practical and simple approach, especially in laboratories with limited specialty in identification of this fastidious organism.
Background/Aim: Our aim was to determine serum TLR-9 levels in sepsis and evaluate the relationship between sepsis and serum TLR-9 levels. Materials and Methods: The study group consisted of 80 consecutive patients with sepsis and 100 healthy individuals. The demographic characteristics, co-morbidities and hemodynamic data of all patients were recorded. Results: TLR-9 serum levels in sepsis were statistically significantly lower compared to the control group. It was also seen that when the lactate level was >5 mmol/l in patients in the sepsis group, the serum TLR-9 levels were substantially higher. Conclusion: There is a relationship between sepsis-induced immunosuppression and serum TLR-9 levels. The host immunity system can be activated by means of TLR-9-related systems, while hyperlactatemia may play a stimulating role in the re-activation of the immune system.Sepsis is a serious clinical problem worldwide (1-3). Severe sepsis and septic shock lead to significant morbidity and mortality in critically-ill patients despite improvements in intensive care and treatment methods (4). Sepsis is characterized by an uncontrolled systemic inflammatory response in the immune system as a result of complex interactions between host and infectious agents (5). Sepsis, serious sepsis, and septic shock represent increasingly severe degrees of systemic inflammatory responses to infection (6). Increased uncontrolled inflammatory response leads to increased mortality from sepsis.Toll-like receptors (TLRs) have been recognized as a component of the innate immune system. TLRs have an important role in the innate immune system to recognize many pathogens and create a host immune response through production of necrosis factor-α, interleukin (IL)-1, IL6 and other pro-inflammatory cytokines (7, 8). In our study, serum TLR9 levels in sepsis were analyzed in relation to clinical and prognostic parameters. Patients and MethodsThis prospective study was approved by the Ethics Committee of the Istanbul University, Turkey (Approval number 1341). All the procedures followed in the study were in accordance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study. A total of 180 patients were enrolled in the study. The study group consisted of 80 consecutive patients with diagnosis of sepsis at the intensive care unit. In each case, diagnoses were established with histological examination. The control group comprised 100 healthy individuals. The demographic characteristics, co-morbidities and hemodynamic data of all patients were recorded. Blood gas samples and laboratory data of the cases were collected. Microbial cultures of blood, sputum, a wound swab, abscess, and urine from each patient were performed. Blood samples were collected in EDTA-coated tubes by standard venipuncture method. The serum samples of the participants were stored at −20˚C until analysis. TLR9 levels were
Background: Postoperative nausea and vomiting (PONV) is one of the complications that can occur frequently in the first 24 hours postoperatively. We aimed to investigate the parameters that could predict PONV in patients who underwent thoracoscopic wedge resection for pneumothorax.Materials and Methods: After obtaining the approval of the ethics committee (ID: 2012-KEAK-15/2358, Date: 14.09.2021), the records of patients who underwent elective video-assisted thoracic surgery (VATS) between January 2018 and June 2021 were analyzed retrospectively. The patients who underwent elective thoracoscopic wedge resection for pneumothorax, who were between the ages of 18-65, American Society of Anesthesiologists (ASA) I-III, and whose body mass index (BMI) was between 18-30 kg/m 2 were included in the study. However, patients who received a blood transfusion or used antiemetics, anticholinergic drugs, and analgesics continuously were not included. In addition, patients with a history of chronic pain were not included in the study. The patients were divided into two groups, the PONV group (Group 1) and the control group (Group 2). The PONV incidence, visual analog scale (VAS) scores, 24-hour morphine consumption, additional analgesic requirement, neutrophil/lymphocyte ratios (NLR), and platelet/lymphocyte ratios (PLR) were evaluated.Results: The groups were similar in terms of demographic data (p > 0.05). Additional analgesic requirement and 24-hour morphine consumption were significantly higher in the PONV group (p: 0.005, p < 0.001, respectively). Preoperative NLR (p < 0.001), postoperative NLR (p < 0.001), preoperative PLR (p < 0.022), the VAS scores of the first hour (p: 0.004), and 24 th hour (p < 0.001) were statistically significantly higher in the PONV group compared to the control group.Conclusions: NLR parameters can be effective with high sensitivity and specificity in predicting PONV during the preoperative and postoperative period. Besides, preoperative PLR may also be effective in predicting PONV. A treatment that can be planned according to these parameters may play a key role in preventing PONV. In addition, efficient perioperative analgesia management may be effective in reducing PONV by limiting the emetogenic analgesics.
Aim: Psychiatric disorders are common in patients with advanced respiratory diseases. The prevalence of primary spontaneous pneumothorax ranges from 1.2-37 per 100,000 population per year, and the risk of recurrence causes anxiety and depression for the patients. Material and Method: The Hospital Anxiety and Depression (HAD) scale was applied to 50 patients with a primary spontaneous pneumothorax that underwent treatment in our clinic and a control group of 50 individuals. The study and control group had similar participants (50 patients, 9 women and 41 men). The control group comprised otherways healthy participans aged between 18-40 who had admitted to the smoking cessation clinic. Results: While the study group's mean age was 25.2, it was 29 in the control group (covariance analysis used for the correction). On anxiety scale, the study group's mean score was calculated as 8.6, while it was 5.7 in the control group. The difference was found to be significantly higher in the patient group. The depression scale score of the study group was 5.8, and the control group's score was 5.7. There was no statistically significant difference between the groups. Conclusion: Since pneumothorax is a sudden, recurring, and severe illness that can cause respiratory distress, it may lead to anxiety or depression in patients. Without treatment, life-threatening consequences such as dyspnea and cardiac collapse may occur. Furthermore, the painful procedure of tube thoracostomy increases the patients' anxiety. Our objective is to identify potential anxiety-depression in pneumothorax patients, leading to improved mental health outcomes, increased satisfaction, lower readmission rates, and reduced care costs.
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