•Co-inhibition of BET proteins and anti-apoptotic BCL-2 proteins induces apoptosis in RMS.•JQ1 and BH3-mimetics synergistically induce cell death in RMS.•Cell death is caspase-dependent and displays ...hallmarks of intrinsic apoptosis.•JQ1/A-1331852-mediated apoptosis is dependent on BIM and NOXA.•JQ1/S638450-mediated apoptosis is dependent on BIM but not NOXA.
BH3 mimetics are promising novel anticancer therapeutics. By selectively inhibiting BCL-2, BCL-xL, or MCL-1 (i.e. ABT-199, A-1331852, S63845) they shift the balance of pro- and anti-apoptotic proteins in favor of apoptosis. As Bromodomain and Extra Terminal (BET) protein inhibitors promote pro-apoptotic rebalancing, we evaluated the potential of the BET inhibitor JQ1 in combination with ABT-199, A-1331852 or S63845 in rhabdomyosarcoma (RMS) cells. The strongest synergistic interaction was identified for JQ1/A-1331852 and JQ1/S63845 co-treatment, which reduced cell viability and long-term clonogenic survival. Mechanistic studies revealed that JQ1 upregulated BIM and NOXA accompanied by downregulation of BCL-xL, promoting pro-apoptotic rebalancing of BCL-2 proteins. JQ1/A-1331852 and JQ1/S63845 co-treatment enhanced this pro-apoptotic rebalancing and triggered BAK- and BAX-dependent apoptosis since a) genetic silencing of BIM, BAK or BAX, b) inhibition of caspase activity with zVAD.fmk and c) overexpression of BCL-2 all rescued JQ1/A-1331852- and JQ1/S63845-induced cell death. Interestingly, NOXA played a different role in both treatments, as genetic silencing of NOXA significantly rescued from JQ1/A-1331852-mediated apoptosis but not from JQ1/S63845-mediated apoptosis. In summary, JQ1/A-1331852 and JQ1/S63845 co-treatment represent new promising therapeutic strategies to synergistically trigger mitochondrial apoptosis in RMS.
Purpose
The aim was to compare the density of ghrelin-expressing cells (GECs) in morbid obese patients with or without intestinal metaplasia (IM).
Materials and Methods
The study included 48 patients ...out of 244 who underwent laparoscopic sleeve gastrectomy between 2015 and 2019. IM was detected in the sleeve gastrectomy specimens of 24 of these 244 patients. The study group consisted of all of the patients with IM. It was a case matched study. Matching factors were age and gender. Ghrelin was stained with a Leica semiautomatic immunohistochemical–staining machine. Stained preparations with ghrelin were subjected to light microscopic examination.
Results
The number of GECs in cases with IM was significantly lower than the cases without IM (
p
= 0.001). The number of GECs was significantly higher in cases with chronic inactive superficial gastritis than cases with chronic active superficial gastritis (
p
= 0.033).
Conclusion
We found that there was a decrease in the number of GECs in the corpus and fundus of the stomach in cases with gastric IM as a contribution to the literature. IM cause a decrease in the number of GECs in the gastric oxyntic glands. In addition, chronic active superficial gastritis is also associated with a decrease in the number of GECs. We can say that the common feature of all of these factors may be gastric mucosal damage. Consequently, damage to the gastric mucosa appears to reduce the number of GECs.
Graphical abstract
The Covid-19 pandemic spread rapidly throughout Turkey from March 2020 onward, and despite modified working conditions in the surgical clinics of our hospitals, some surgical patients became infected ...with the coronavirus during their perioperative period.
The present study investigates the impact of the novel coronavirus on patients undergoing general surgical operations in our clinics during the Covid-19 pandemic.
A retrospective analysis was conducted of all surgeries performed in the general surgery clinics of two 'pandemic hospitals' between March 19 and April 30, 2020 - a period when all elective surgeries were suspended in hospitals within Turkey. Demographic data, comorbidities, choice of anesthesia method, blood parameters, duration of stay in hospital and the intensive care unit and mortality rates were compared statistically with the frequency of postoperative Covid-19 positivity in these patients.
A total of 275 surgical operations were performed during this period. Covid-19 was identified in seven patients during the postoperative period, and was more commonly diagnosed in those who were elderly and those with comorbidities. (p=0.02, p=0.02). Statistically significant correlations were found between a Covid-19 diagnosis and admission to the intensive care unit, the length of hospital stay and the length of stay in intensive care (p<0.001, p<0.001, p=0.01). Mortality was observed in two patients who developed Covid-19 postoperatively (p= 0.03).
The Covid-19 pandemic has had a significant impact on patients undergoing operations in our general surgery clinics. Precautionary measures taken during postoperative care should be maximized for high-risk patients.
Covid-19 pandemic, General surgery clinics, Novel coronavirus, Gastrointestinal system surgery.
Background/Aims: There are a variety of factors that affect the quality of colonoscopy bowel preparations, although the relationship between the level of health literacy (HL) and the quality of bowel ...preparations has yet to be clarified. The present study evaluated the effect of HL on the quality of bowel preparation prior to a colonoscopy. Materials and Methods: The data of 150 patients who underwent a colonoscopy for colorectal cancer screening and in whom the quality of bowel preparation was scored during the colonoscopy were recorded prospectively. The European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to evaluate HL prior to the colonoscopy, and the Boston bowel preparation scale was used to evaluate the quality of the bowel preparation during the colonoscopy. The demographic characteristics of the patients, the presence of comorbidities, socioeconomic characteristics (marital status, income level, and educational level), HLS-EU-Q47 questionnaire, and Boston bowel preparation scale scores were recorded and evaluated. Results: A significant linear relationship was identified between the general HL index score, the cleanliness of the colonic segments (right, transverse, and left colon) and the total Boston bowel preparation scale score (p=0.013, p=0.010, p=0.008, p=0.001, respectively). In a HL subgroup analysis, a significant linear relationship was noted between disease prevention and health promotion index, the cleanliness of the colonic segments (right, transverse, and left colon), and the total Boston bowel preparation scale score. It was observed that an increase in the health care index resulted in an increase in the cleanliness of the relevant colonic segments and the total Boston bowel preparation scale score. No relationship was found between the right, transverse, and left colon and the total Boston bowel preparation scale scores and gender, age, Body Mass Index (BMI), comorbidity, marital status, level of income, or educational level. Conclusion: The level of HL affects the quality of colonoscopy bowel preparations. Keywords: Health literacy, HLS-EU-Q47, bowel preparation, colonoscopy
Aim: Schools are the most effective environments for health screenings for children and adolescents. The aim of school health screenings is to contribute to the protection and maintenance of ...children's health status by early diagnosis and treatment of diseases. We aimed to reveal the health screening findings of children whose lifestyles changed during the pandemic period, and to compare according to socioeconomic status.
Material and Method: Students from three different schools which were grouped as low, middle and high socioeconomic status were included. Hearing test, visual acuity examination, orthopedic examination, blood pressure measurements, height, weight and anthropometric measurements were performed. Descriptive statistical methods were used in the evaluation of the data.
Results: 1322 students with parental consent were included in our study. 667 (50.5%) of the students were female, mean age was 11.4±1.1, and mean body mass index score was 19.6±4.0. When body mass index scores were evaluated, 202 (15.3%) students were overweight and 189 (14.3%) were obese. Visual acuity defect was found in 257 (19.4%) of the students and hearing loss in 309 (23.4%). As a result of orthopedic examination and blood pressure measurements, 67 (5.1%) scoliosis and 131 (9.9%) high blood pressure were determined. The rate of hypertension was found to be significantly higher in school students with high socioeconomic status compared to the others (p
Aim: The aim of this study was to evaluate the psychoeducation sessions we held with the caregivers of advanced terminal cancer patients in our palliative care center in terms of the physical, ...psychological, social and economic problems experienced by the participants.
Material and Methods: It is a qualitative study in which the impressions of the palliative care team were evaluated in the psychoeducation sessions held with the caregiver relatives of terminal cancer patients between September 1 and December 31, 2019 at Tokat Gaziosmanpaşa University Palliative Care Center. A total of 68 caregiver relatives attended 11 sessions. In the sessions, notes were taken by the palliative care team with the permission of the participants. By categorizing the data, the most common problems and needs of the relatives of the patients were determined.
Results: The mean age of the participants was 47.8±13.9 and 60.3% were female. The most common physical problems in the participants; insomnia, headache and loss of appetite were observed. Participants stated their emotional changes as helplessness, stress, anger, sadness and loneliness. The lack of knowledge about the disease and treatment process was observed in the majority of the participants. In our psychoeducation sessions, the participants stated that talking about their feelings and experiences and feeling that they were understood made them 'very comfortable and realized that they desperately needed it'.
Conclusion: Meeting with the relatives of patients who have similar problems and enabling them to express their problems in the presence of experts will be beneficial in terms of awareness, insight and education.
Mini/one anastomosis gastric bypass (MGB-OAGB) is a bariatric surgery procedure that has proved effective for weight loss and the resolution of metabolic disorders. The present study evaluates the ...effect on postoperative outcomes of resecting the corpus and fundus as an addition to OAGB.
This retrospective study recorded and evaluated the data of 83 patients who underwent laparoscopic OAGB due to morbid obesity (Body Mass Index-BMI ≥ 40 kg/m2 ) in our clinic between January 2018 and January 2020. The patients were divided into two groups: the first group comprised patients undergoing standard OAGB (n = 49), while the second group included those undergoing OAGB plus (OAGB with additional corpus and fundus resection) (n = 34). The patient data recorded for comparison included demographic characteristics, comorbidities, preoperative and postoperative weight (at 6 and 12 months), body mass index (BMI), excess weight loss% (EWL%), excess BMI loss% (EBL%), and total body weight loss% (TBWL%), hemoglobin, fasting blood glucose (FBG), albumin and HbA1c levels.
There was no statistically significant difference between the two groups with regard to age, gender or comorbidities. The operating time, the number of cartridges used during the operation and the length of hospital stay were statistically higher in the OAGB plus group (p = 0.039, p < 0.001, p < 0.001, respectively). No statistically significant difference was seen between the groups regarding weight, BMI, EBL% and TBWL% preoperatively and at 6- and 12-months postsurgery. There was also no statistically significant difference in preoperative and postoperative (at months 6 and 12) levels of hemoglobin, FBG, albumin, and HbA1c between the two groups.
The addition of resection of the gastric fundus and corpus to an OAGB has no impact on postoperative weight loss or metabolic outcomes.
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