Fournier's gangrene current approaches Ozkan, Omer F; Koksal, Neset; Altinli, Ediz ...
International wound journal,
October 2016, Letnik:
13, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Fournier's gangrene is a rare but highly mortal infectious disease characterised by fulminant necrotising fasciitis involving the genital and perineal regions. The objective of this study is to ...analyse the demographics, clinical feature and treatment approaches as well as outcomes of Fournier's gangrene. Data were collected retrospectively from medical records and operative notes. Patient data were analysed by demographics, aetiological factors, clinical features, treatment approaches and outcomes. Twelve patients (five female and seven male) were enrolled in this study. The most common aetiology was perianal abscess (41·6%). Wound cultures showed a mixture of microorganisms in six (50%) patients. For faecal diversion, while colostomy was performed in six cases (50%), Flexi‐Seal was used in two cases (16·6%). In four patients (33·4%), no faecal diversion was performed. Negative pressure wound therapy (NPWT) system was effective in the last four patients (33·4%). The mean hospitalisation period in patients who used NPWT was 18 days, while it was 20 days in the others. NPWT in Fournier's gangrene is a safe dressing method. It promotes granulation formation. Flexi‐Seal faecal management is an alternative method to colostomy and provides protection from its associated complications. The combination of two devices (Flexi‐Seal and NPWT) is an effective and comfortable method in the management of Fournier's gangrene in appropriate patients.
The aim of the this study is to evaluate the intubation success rates of emergency medical technicians using a Macintosh laryngoscope (ML), McCoy laryngoscope (MCL), and C MAC D-Blade (CMDB) video ...laryngoscope on manikin models with immobilized cervical spines. This randomized crossover study included 40 EMTs with at least 2 years’ active service in ambulances. All participating technicians completed intubations in three scenarios—a normal airway model, a rigid cervical collar model, and a manual in-line cervical stabilization model—with three different laryngoscopes. The scenario and laryngoscope model were determined randomly. We recorded the scenario, laryngoscope method, intubation time in seconds, tooth pressure, and intubation on a previously prepared study form. We performed Friedman tests to determine whether there is a significant change in the intubation success rate, duration of tracheal intubation, tooth pressure, and visual analog scale scores due to violations of parametric test assumptions. We performed the Wilcoxon test to determine the significance of pairwise differences for multiple comparisons. An overall 5 % type I error level was used to infer statistical significance. We considered a
p
value of less than 0.05 statistically significant. The CMDB and MCL success rates were significantly higher than the ML rates in all scenario models (
p
< 0.05). The CMDB intubation duration was significantly shorter when compared with ML and MCL in all models. CMDB and MCL may provide an easier, faster intubation by prehospital emergency health care workers in patients with immobilized cervical spines.
Corrosive esophagitis injuries are a serious clinical problem with many agents used for diagnosis and treatment. Experimental esophagus burn models use a method described mainly in studies by Gehanno ...and Guedon, and modified by Liu and Richardson.
The aim of this study was to describe a new esophagitis model that prevents tracheal aspiration.
In this study we used 16 Wistar albino rats weighing between 220-240 g. The experimental animals were randomly divided into two groups: the model group (group M, n: 8) and control group (group C, n: 8). The necessary anesthesia was administered. Passing through a median laparotomy incision, the abdomen was entered and in group M and C the esophagus was freed and held by a suture at the gastroesophageal junction. After this procedure, about 1 cm proximal to the gastroesophageal junction, the esophagus was suspended by a suture. The esophagus segment between the two sutures was exposed to 0.1 mL 10% NaOH in group M and 0.1 mL saline in group C for 20 s. Ten days later all experimental animals were sacrificed and their esophagus removed. After dying with hematoxylin and eosine trichrome, the histopathological evaluation results for the rats in all groups were investigated with a light microscope.
Histopathological examination indicated submucosal collagen increase, damage to muscularis mucosa and tunica muscularis and collagen deposition. In the model group, the rats had high neutrophils and tissue damage accompanied by necrosis. In the control group, the rats had minimal or no tissue damage and fibrosis was not observed.
Our procedure is relatively less invasive and easy to apply with corrosive esophagitis only in the required region, and at the same time treatment medications can be easily administered.
To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery.
This study was completed at the Faculty of Medicine, Çanakkale Onsekiz Mart ...University, Çanakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded.
Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was lower (7.7 ± 4.0) versus 21.6 ± 12.4 mg, p less than 0.001) in the 24 hours after surgery.
As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls.
Abstract
Background
Hydroxyethyl Starch (HES) 130/0.4 (6%) is a commonly used intravascular volume expander with anti-inflammatory and antioxidant properties. In this study, we aimed to compare the ...histopathologic activity of HES 130/0.4 (6%) with various widely-used agents in pleurodesis.
Methods
Forty male Wistar-Albino rats were divided into five groups: controls, povidone-iodine recipients (PI group), sterile talcum recipients (Talcum group), autologous blood recipients (AB group) and HES 130/0.4 (6%) recipients (HES group). Thirty days after application of agents, pleural and lung tissues were resected. Evaluation was performed via macroscopic scoring (adhesion) and specimens were stained with H&E for microscopic examination (inflammation and fibrosis).
Results
HES recipients had significantly higher adhesion compared to controls (lower grade 0, higher grade 1 frequency vs. controls), they were found to have significantly lower frequency of grade 2 adhesion (vs. PI, Talc and AB) and grade 3 adhesion (vs. AB), indicating that the adhesion-generating properties of HES were only superior to the control group. HES recipients had significantly higher inflammatory grades compared to controls (lower grade 0, higher grade 1 frequency), while they had lower grades compared to the PI, Talc and AB groups. Although the PI, Talc and AB groups were statistically similar in most comparisons, we observed a trend towards higher success with the use of Talc and especially AB.
Conclusion
Our results do not support a role for HES in pleurodesis. We believe that the autologous blood method remains as an effective and successful procedure without side effects.
OBJECTIVEAloe vera is known for its antioxidant properties. In this experimental study, we aimed to investigate the efficacy of Aloe vera in ischemia-reperfusion (I/R) liver injury in rats. ...METHODSMale Wistar Albino rats were divided into three groups, where the sham group (n=7) underwent no medication or surgical procedures, the I/R group (n=7) was the control group that received 45 minutes of applied abdominal aorta ischemia and rats were sacrificed 24 hours after reperfusion, and the I/R+AV group (n=7) was the treatment group that was given Aloe vera (30 mg/kg) every day followed by gastric lavage for a month before applying ischemia and performing sacrifice as in the previous group. Before sacrifice, all the liver tissues were removed. Tissues were examined for histopathological investigation, iNOS immunoreactivity and tissue biochemistry, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities. RESULTSThe SOD, CAT, and GSH-Px levels of the I/R+AV group were not significantly different from the sham group (p>0.05) but were significantly higher when compared to the I/R group. MDA levels of liver tissues were significantly lower (p<0.05) in the I/R+AV group as compared to the I/R group. Disrupted hepatic cords, sinusoidal dilatation, hemorrhage, cytoplasmic vacuolization of hepatocytes, and intensive iNOS immunoreactivity were detected in the I/R group. Decreased histopathological change score and iNOS immunoreactivity score were noticed in the I/R+AV group as compared to the I/R group. CONCLUSIONIt was found that Aloe vera showed a hepatoprotective effect against I/R injury. Further research is required to determine the effective dose, administration method, and effects of Aloe vera for liver transplantation.
Background: The Karacadağ Mountains are of extinct volcanic origin and cover a large area in the triangle between Diyarbakır (Center, Nar and Ergani districts), Şanlılurfa (Siverek and Viranşehir ...districts) and Mardin (Derik district). Agricultural activities are limited due to the stony structure of the region; therefore, small animal husbandry is intensively practiced in the villages of the region. Mahalli goats, which are morphologically new domestic goats, are distinguished from other domestic goats by their spiral horn structure. They are not only resistant to cold weather conditions, but also resistant to diseases. Therefore, present study aimed to determine the genetic diversity and phylogenetic relationships of Mahalli goats in Diyarbakır region. Methods: The study was carried out at Şanlıurfa, Harran University of Agricultural Faculty, Laboratory of Animal Biotechnology and Molecular Genetics, in 2019-2020. Out of 24 Mahalli goats, forward and reverse primers were used to amplify the 598 bp region over the mtDNA D-loop region encompassing the 481 bp most variable region (HVR1). Analysis of goat D-loop sequences revealed 481 regions of 0.378 G+C, 97 polymorphic regions and 19 haplotypes. The phylogenetic analysis of Mahalli goats was carried out using molecular genetic techniques. Result: As a result of data analysis, both haplotype diversity (HD) and nucleotide diversity (ND) were calculated to be 1.000±0.0039 and 0.0375±0.00209, respectively. The genetic distance between the haplotypes of Mahalli goat ranged from 0.003 to 0.087 and the genetic distance between the haplotypes of Mahalli goat and other domestic goat breeds in Turkey ranged from 0.016 to 0.027. All 19 haplotypes used in this study were represented in the lineage A phylogenetic tree.
Abstract Purpose This experimental sepsis model created with Escherichia coli aimed to investigate the histopathological effects of two different doses of ozone combined with antibiotherapy on lung ...tissue. Methods Rats were divided into 5 groups. Then sepsis was induced intraperitoneally in the first 4 groups. The 1st group was treated with cefepime, the 2nd and 3rd groups were treated with cefepime combined with ozone at a dose of 0.6 mg/kg and 1.1 mg/kg. Lung tissue sections were stained with hematoxylin-eosin and assessed under light microscope and scored between 0-4 in terms of histopathological findings. Results In the comparisons between Group 1 and Group 4 in terms of cellular damage (p=0.030), inflammation (p=0.000) and overall score (p=0.007), statistically significant positive effects were observed in favor of Group 1. In the comparisons of Groups 2 and 3 with Group 4, only positive effects were observed in terms of inflammation (p=0.020, p=0.012, respectively). Conclusion Although negative histopathological effects of ozone on tissue injury were detected, it was noteworthy that the increase in the ozone dose reduced the number of damaged parameters.
The aim of this study was to investigate the possible protective role of antioxidant treatment with syringic acid (SA) on l-arginine-induced acute pancreatitis (AP) using biochemical and ...histopathologic approaches. A total of 30 rats were divided into 3 groups. The control group received normal saline intraperitoneally. The AP group was induced by 3.2 g/kg body weight l-arginine intraperitoneally, administered twice with an interval of 1 hour between administrations. The AP plus SA group, after having AP induced by 3.2 g/kg body weight l-arginine, was given SA (50 mg kg(-1)) in 2 parts within 24 hours. The rats were killed, and pancreatic tissue was removed and used in biochemical and histopathologic examinations. Compared with the control group, the mean pancreatic tissue total oxidant status level, oxidative stress index, and lipid hydroperoxide levels were significantly increased in the AP group, being 30.97 ± 7.13 (P < 0.05), 1.76 ± 0.34 (P < 0.0001), and 19.18 ± 4.91 (P < 0.01), respectively. However, mean total antioxidant status and sulfhydryl group levels were significantly decreased in the AP group compared with the control group, being 1.765 ± 0.21 (P < 0.0001) and 0.21 ± 0.04 (P < 0.0001), respectively. SA reduces oxidative stress markers and has antioxidant effects. It also augments antioxidant capacity in l-arginine-induced acute toxicity of pancreas in rats.
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