The aim of this study was to identify the potential prognostic roles of the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) in patients with laryngeal squamous cell carcinoma (LSCC). 81 patients who underwent surgery for the larynx carcinoma were enrolled in the study. NLR, PLR and RDW were used as outcome measures. Local recurrence was detected in 30 (37.0 %) patients and neck lymph node metastasis was detected 6 (7.4 %) patients during follow-up period. Mortality was seen in 7 (8.6 %) patients. The mean PLR in the T1 and T2 stage tumors were significantly lower than the T4 stage. The mean RDW and PLR were significantly higher in the exitus group than the survivor group. The mean NLR in the patients with local recurrence was significantly higher than the non-recurrent patients. Progression-free survival (PFS) was lower in patients with high NLR. When analyzed by the Cox regression analysis of factors affecting the local recurrence, NLR was found to significantly affect the recurrence. According to ROC analysis for mortality, NLR was not found to be a prognostic factor, although the PLR and RDW were significant prognostic factors. According to Cox regression analysis, a high PLR increases mortality 4.2 times and a high RDW 4.6 times. Although in univariate analysis MCV, RDW and tumor grade were predictors of mortality, RDW and tumor grade independent predictors were found. Further studies involving large patient groups are required.

Objectives:To evaluated Fetuin-A levels of patients admitted in the intensive care unit with a diagnosis of sepsis.Methods:This study was conducted at the Faculty of Medicine, Çanakkale Onsekiz Mart University Hospital, Çanakkal, Turkey, between February 2015 and October 2015. Forty septic patients were included in the study. Subsequent to clinical suspicion of sepsis, serum levels of C-reactive protein (CRP) and procalcitonin; and white blood cell (WBC) counts were evaluated at 3 time-points: 0 (basal), 24, and 72 hours.Results:The mean Fetuin-A levels at the 3 time-points were 58.5 ± 29.2 ng/mL, 40.9 ± 23.6 ng/mL, and 47.8 ± 25.7 ng/mL, respectively. Fetuin-A levels at 24 hours were significantly lower than the basal level (p<0.05), where as no significant difference was observed between the basal levels and those at 72 hours (p>0.05). Correlation between the temporal changes in Fetuin-A levels and the changes in other inflammatory markers (CRP, procalcitonin and WBC) was examined. Fetuin A was found to have only a negative correlation with serum procalcitonin level (p<0.05).Conclusion:In this study, serum Fetuin-A levels in septic patients decreased significantly in the first 24 hours, followed by an insignificant increase at 72 hours. These findings suggest that monitoring of Fetuin-A levels may help predict the time of occurrence of sepsis and prognosis of sepsis.

PURPOSE:To investigate the effects of preoperative rectal ozone insufflation on surgical wound healing over the proinflammatory cytokines and histopathological changes. METHODS:Twenty one rabbits were divided into 3 groups. Sham, surgical wound, and ozone applied (6 sessions, every other day 70 µg/mL in 12 mL O2-O3 mixture rectally) surgical wound groups were created. TNF-alpha and IL-6 levels from all rabbits were studied at the basal, 24th hour, and 72nd hour. The histopathological examination was done by removing the surgical scar tissue at the end of 72nd hour. RESULTS:TNF-alfa and IL-6 levels were significantly lower compared to the control group, in the rabbits treated with ozone.The increase in angiogenesis, the decrease in the number of inflammatory cells, epidermal and dermal regeneration, better collagen deposition, and increased keratinisation in stratum corneum were observed in the histopathological examination. It was determined that the wound healing noticeably accelerated in the ozone group. CONCLUSION: Preoperative rectal ozone insufflation had a positive effect on surgical wound healing in acute period.

Central venous access plays an increasingly important role in the delivery of modern care. Many studies on the venous access sites for central venous catheterization have been conducted. [1][2][3][4][5] The preferred access site for central venous catheter placement continues to be the right internal jugular vein (IJV).When the right IJV is not available for central venous access, the second access site remains variable. Although the left IJV and the subclavian veins (SCV) have been used for second access, several studies suggest that both SCVs and the left IJV should be avoided because of a high incidence of procedural complications (pneumothorax, arterial puncture) as well as central venous stenosis and thrombosis. [2][3][4][5][6] The left IJV is also related with a high incidence of catheter malfunction. 6 Some authors believe that the second venous access after the right IJV should be the right external jugular vein (EJV). 3,7 One reason for use of the right EJV is its relatively straightforward course and short length, which are very similar to those of right IJV. A second reason is that the EJV is easily accessed, given its superficial location on the neck.7 However, it is suggested that the incidence of malpositioned catheters via the EJV approach makes this route unreliable. 8 To decrease the incidence of catheter dislodgement, vessel wall erosion, thromboembolism and catheter malfunction, accurate positioning of the catheter tip near or at the junction of the superior vena cava (SVC) and right atrium (RA) is necessary.9 It is possible to decrease the incidence of malposition with the use of additional techniques. French) under intra-atrial ECG guidance. The presence of an increase in P-wave size was recorded. Just after the surgery, a portable chest X-ray was taken. The method was considered to be successful when a change in P-wave could be seen and the catheter was in the superior vena cava, as well as when there was no change in P-wave and the catheter was not in the superior vena cava. Results: In six patients (12%), we were not able to advance the guidewire. In the remaining 44 patients, the catheter was inserted without problem. Eight of these 44 catheters were positioned in the innominate vein, with a malposition ratio of 18%. The success rate of external jugular vein cannulation with intra-atrial ECG was 95%. No complications occured related to the EJV cannulation. Conclusion: Considering that it is easily accessed without complication, and the malposition is successfully detected by intra-atrial ECG, EJV is a suitable access for central venous cannulation when internal jugular vein (IJV) is not usable.

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