Browsing by Publisher "W.B. Saunders"

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    Congenital malformations of middle and inner ears of parabiotic twins
    (W.B. Saunders, 2000) Mutlu C.; Djeric D.R.; Paparella M.M.; Schachern P.A.; Fulton S.
    We describe herein the congenital malformations of the middle and inner ears in temporal bones of parabiotic, monozygotic twins. Temporal bones were removed from twin B, who had no fetal cardiac activity and was born dead at 23-4/7 weeks, and twin A, the donor or 'pump' twin in intrauterine life, who died shortly after birth at 20-6/7 weeks. The temporal bones were processed routinely in celoidin, stained with hematoxylin and eosin, and examined by light microscopy. We found that twin B had Mondini's dysplasia with associated deformities of the middle ear and in general showed more developmental anomalies than twin A, and we conclude that Mondini's dysplasia with anomalies of the middle ear may occur in the parabiotic twin syndrome, and the abnormalities may be explainable as the result of vascular disturbance, which also causes other lesions in these unusual cases.
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    Bilateral discoid medial menisci
    (W.B. Saunders, 2000) Pinar H.; Akseki D.; Karaoǧlan O.; Özkan M.; Uluç E.
    This article adds 2 more cases of bilateral discoid medial menisci to the previously reported 9 cases. The radiographs of the first case revealed bilateral cupping of the medial tibial plateaus and a small lytic lesion of the left distal medial femoral metaphysis. Beside the posteriorly unstable incomplete type discoid medial meniscus, the left knee had several associated arthroscopic findings: depression of the medial tibial plateau with exposed subchondral bone, anomalous insertion of the anterior horn of the discoid meniscus to the anterior cruciate ligament, a pathological medial plica, and longitudinal deep fissures in the trochlea. The second case was a complete type with peripheral horizontal cleavage tears. Following arthroscopic surgery, magnetic resonance imaging (MRI) scans of the contralateral knees were obtained in both cases to search for bilaterality. MRI revealed discoid medial menisci in the unoperated knees as well. The short-term results of arthroscopic meniscectomy may not be as satisfactory as those reported for normal menisci.
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    Pyloric atresia associated with multiple intestinal atresias and pylorocholedochal fistula
    (W.B. Saunders, 2002) Sencan A.; Mir E.; Karaca I.; Gunsar C.; Sencan A.; Topcu K.
    Although congenital pyloric atresia commonly occurs in isolation, it has rarely been reported in association with other alimentary tract atresias. This is a report of a newborn with congenital pyloric atresia associated with duodenal atresia, jejunal atresia, apple-peel ileal atresia, and pylorocholedochal fistula. Preoperative diagnosis was duodenal atresia because of bilious vomiting, and erect radiogram showed double bubble sign. The presented case is the first report of such an association. Copyright 2002, Elsevier Science (USA). All rights reserved.
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    Isolated esophageal atresia with spontaneous recanalization: Case report
    (W.B. Saunders, 2002) Gunsar C.; Sencan A.; Karaca I.; Mir E.
    Isolated esophageal atresia is characterized by a long segment between the 2 esophageal pouches. The authors describe a case of pure esophageal atresia that showed spontaneous recanalization in the waiting period for primary esophageal anastomosis. Regurgitation of gastrostomy formula surprisingly was seen in her mouth. The patency of the esophagus was confirmed with thoracic computed tomography (CT) and an esophagogram. A strictured area in the proximal upper third of the esophagus was managed with baloon dilatation. She was discharged in normal condition, feeding by mouth, and with a normal esophagogram. This interesting event led us to speculate about a different type of pure esophageal atresia with the feasibility of the ends recanalizing after some events such as inflammation. This could be the subtype 115 of type 2 in Kluth's atlas of esophageal atresia in which they described 2 blind esophageal ends and a cyst occupying the intervening space. Another speculation about this subject is the presence of double membranes associated with esophageal atresia with a normal outer appearance of the esophagus as was first described by A. F. van Loosbroek. Copyright 2002, Elsevier Science (USA). All rights reserved.
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    Effects of amnio-allantoic fluid exchange on bowel contractility in chick embryos with gastroschisis
    (W.B. Saunders, 2002) Şencan A.; Gümüştekin M.; Gelal A.; Arslan O.; Özer E.; Mir E.
    Background/Purpose: Intestinal damage in patients with gastroschisis is characterized by bowel wall thickening, intestinal dilatation, mesenteric shortening, and a fibrous peel. The prevention of intestinal damage in gastroschisis by amnio-allantoic fluid (AAF) exchange has been reported using histologic and macroscopic evaluation of intestines, but the effects of this treatment on bowel contractility have not been investigated. The current study was performed to determine the effect of AAF exchange on the intestinal contractility in chick embryos with gastroschisis. Methods: Thirteen-day-old fertilized chick eggs were used. Gastroschisis was created through amnio-allantoic cavity. There were 3 study groups: control group, gastroschisis-only group, and gastroschisis-plus-exchange group. The bowels were evaluated by an in vitro muscle strip technique, and the response was expressed as a percentage of the maximum acetylcholine evoked contraction (Emax) in each tissue obtained. Additionally, parasympathetic ganglion cells per 10 plexus at the intestinal wall were counted. Differences between groups were analyzed by analysis of variance (ANOVA) followed by Tukey-Kramer. Probabilities of less than 5% were considered significant. Results: The intestines were thickened and covered by fibrous peel in the gastroschisis-only group when compared with the control group and the gastroschisis exchange group morphologically. There was a statistically significant decrease in contractility in the gastroschisis-only group compared with the control group (P < .05). It exerted 42.03 ± 46.73% contraction of control group's Emax. This decrease in contractility was significantly reversed in the exchange group (P < .05; Emax value of gastroschisis plus exchange group was 71.45 ± 23.54% of control group's Emax). Although the number of ganglia per 10 plexus was 76.7 ± 4.3 in the control group, it was measured 28% less in the gastroschisis-only group (P < .05). There was no significant difference between the ganglion numbers of control and exchange groups. Conclusions: Prenatal AAF exchange treatment prevents decreased bowel contractility in gastroschisis. Gastroschisis does not affect intestinal ganglia morphology, but the number of ganglion cells decreases. AAF exchange prevents these functional and morphologic adverse effects of disease. By these findings the expectancy of a better clinical result in gastroschisis with intrauterine pretreatment by amniotic fluid exchange increases. Copyright 2002, Elsevier Science (USA). All rights reserved.
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    Is skin disinfection with 10% povidone iodine sufficient to prevent epidural needle and catheter contamination?
    (W.B. Saunders, 2003) Yentur E.A.; Luleci N.; Topcu I.; Degerli K.; Surucuoglu S.
    Background and Objectives: Epidural space infection is a potential complication of epidural catheter placement. In this study, we investigated the incidence of epidural needle and catheter contamination after skin surface disinfection with 10% povidone-iodine (PI). Methods: Sixty seven patients having surgery under epidural anesthesia were enrolled in this prospective study. After preparation with 10% PI, skin swab cultures were taken from the site of catheter insertion. Epidural needles were cultured immediately after epidural catheters were placed. Catheters were removed at 48 hours and 2 to 3 cm of the distal tips were cultured as well. Results: Fifty-six skin swabs, 52 epidural needles, and 48 catheters were cultured. Although only 3.5% (2) colonization was observed on skin surface cultures, 34.6% (18) of the epidural needles and 45.8% (22) of the catheters were colonized. No systemic or local infection was observed. Conclusion: Our results suggest that despite skin surface disinfection with PI, there is still significant risk for contamination of needles and catheters during epidural catheterization.
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    MURCS association and rectovestibular fistula: Case report of a patient treated with one-stage posterior sagittal anorectoplasty and sigmoid loop vaginoplasty
    (W.B. Saunders, 2003) Günşar C.; Genç A.; Şencan A.; Daǧlar Z.; Alparslan O.; Mir E.
    MURCS association is rare, first described by Duncan in 1979, including nonrandom association of Mullerian duct aplasia or hypoplasia (MU), renal agenesis or ectopy (R), and cervicothoracic somite dysplasia. A 5-year-old girl was admitted to the clinic with a complaint of anteriorly located anus. Physical and radiologic examination of the patient found MURCS association with anorectal malformation (ARM) of rectovestibular-type fistula. She had multiple vertebral anomalies, left renal agenesis, vaginal and uterine agenesia, with a normal female 46,XX karyotype. Posterior sagittal anorectoplasty (PSARP) and sigmoid loop vaginal reconstruction was performed as a one-stage operation for the treatment of vaginal agenesis and ARM, There were no complications in the postoperative period. This combined one-stage operation can be used easily in the treatment of some components of the MURCS association such as vaginal agenesis and ARM as an associated anomaly. Copyright 2003, Elsevier Science (USA). All rights reserved.
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    The association of jejunal atresia and cystic lymphangioma in the same location
    (W.B. Saunders, 2003) Şencan A.; Akçora B.; Mir E.
    Cystic lymphangiomas, which are localized on the mesentery of the intestine, are rarely seen. The presence of intestinal atresia together with cystic lymphangioma in the same location has never been described before. In this study, a premature girl weighing 2,630 g who had jejunal atresia, cystic lymphangioma localized in the mesentery of the distal atretic jejunal segment, and multiple rib anomalies is presented. The association of jejunal atresia and cystic lymphangioma may be coincidental, or jejunal atresia may be caused by an intrauterine vascular compression of volvuled cystic lymphangioma. Such an association is being reported for the first time in the literature. © 2003 Elsevier Inc. All rights reserved.
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    A new weight-bearing meniscal test and a comparison with McMurray's test and joint line tenderness
    (W.B. Saunders, 2004) Akseki D.; Özcan O.; Boya H.; Pinar H.
    Purpose: The purpose of this study was to describe a new weight-bearing McMurray's test (Ege's test) and to compare its diagnostic value with McMurray's test and joint line tenderness (JLT). We also aimed to determine if associated lesions had any effect on the diagnostic values of the 3 tests. Type of Study: Prospective controlled trial, clinical study. Methods: The study group consisted of 150 consecutive patients who had had symptoms related to intra-articular knee pathology, and arthroscopic diagnoses were used as the gold standard. Results: There were a total of 211 diagnoses on arthroscopy. A meniscus tear was found in 127 of the 150 patients; 90 had medial, 28 had lateral, and 9 had tears of both menisci. There were no statistically significant differences between the 3 tests in detecting a meniscal tear (P >. 05). However, better accuracy, sensitivity, and specificity rates were obtained with Ege's test for medial meniscal lesions (71%, 67%, and 81%, respectively). JLT also gave superior accuracy rates (71%), but the specificity of Ege's test was apparently higher than JLT (81% v 44%). The highest positive predictive value was also obtained with Ege's test (86%), whereas a superior negative predictive value was obtained with JLT (67%) in medial meniscal tears. Lateral meniscal tears were diagnosed more accurately than medial meniscal tears, and Ege's test gave results superior to the others (84%, 64%, 90% for accuracy, sensitivity, and specificity, respectively). Higher positive predictive values were obtained with McMurray's and Ege's tests than with JLT, but similar negative predictive values were achieved in all. A torn anterior cruciate ligament did not decrease the diagnostic values of the 3 tests, whereas the number of associated lesions in the knee negatively affected the diagnostic capabilities of the tests. Conclusions: Accuracies of traditional clinical meniscus tests may be improved by including Ege's test in the clinical examination. Level of Evidence: Level II, diagnostic.
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    Atresia of the colon
    (W.B. Saunders, 2005) Etensel B.; Temir G.; Karkiner A.; Melek M.; Edirne Y.; Karaca I.; Mir E.
    Background/Purpose: Colonic atresia (CA) is one of the rarest causes of neonatal intestinal obstructions, and no large series can be reported. Therefore, we did perform a retrospective clinical trial to delineate our CA cases and carry out a literature survey. Methods: We reviewed the charts of CA cases treated in our center between 1992 and 2002. We aimed to collect all reported cases in Medline, and personal communications with the authors of published series were used to reach the missing data. Results: The chart review revealed 9 newborns with CA treated in our center (6 cases of type III, 2 cases of type II, and 1 case of type IV). These accounted for 3.7% of all gastrointestinal atresias managed in our center. Of the CA cases, 3 were isolated and 6 had at least one or more associated congenital anomalies. The preferred surgical technique at the initial treatment of CA was performing a proximal stoma and distal mucous fistula in an average of postnatal 59.4 hours. The literature survey enabled us to reach 224 cases of CA, including our cases. Conclusions: Because of the low incidence of CA, delay in diagnosis and treatment may occur. The mortality is statistically higher when the surgical management is performed after 72 hours of age. However, the prognosis of CA is satisfactory if diagnosis and surgical management could be made promptly and properly. © 2005 Elsevier Inc. All rights reserved.
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    The protective role of thymoquinone in the prevention of gentamicin ototoxicity
    (W.B. Saunders, 2014) Sagit M.; Korkmaz F.; Gürgen S.G.; Kaya M.; Akcadag A.; Ozcan I.
    Objective To investigate the potential protective effect of thymoquinone in gentamicin-induced ototoxicity through auditory brain stem responses (ABR) testing and histomorphological evaluation of the cochlea.; Methods This study was conducted on 48 adult female Sprague-Dawley rats that were randomized into 4 groups. Group 1 received intraperitoneal gentamicin; group 2 received intraperitoneal gentamicin plus corn oil solution; group 3 received intraperitoneal thymoquinone; and group 4 received intraperitoneal gentamicin plus thymoquinone. All groups received the drugs (once daily) in the above-mentioned protocols over 15 days. After conducting repeated ABR measurements, the rats were sacrificed, and their cochleae were isolated.; Results ABR thresholds were preserved in the gentamicin plus thymoquinone group when compared with the group receiving gentamicin alone. There were fewer TUNEL-positive cells and caspase-3 and caspase-9 expressions were weaker in the inner and outer hairy cells of the organ of Corti in the gentamicin plus thymoquinone group compared with the group receiving gentamicin alone.; Conclusion The ABR values and number of apoptotic cells did not significantly increase in the group receiving gentamicin plus thymoquinone when compared to the group receiving gentamicin alone. Again, the cochlear histomorphological findings were supportive of the auditory findings. In light of these findings, we conclude that gentamicin-induced ototoxicity may be prevented by thymoquinone use in rats. © 2014 Elsevier Inc.
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    N-terminal pro-B-type natriuretic peptide is also related to increased mortality
    (W.B. Saunders, 2015) Golcuk Y.; Golcuk B.; Sozen S.
    [No abstract available]
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    Effect of regular marijuana smoking on platelet function
    (W.B. Saunders, 2015) Golcuk Y.; Golcuk B.; Sozen S.
    [No abstract available]
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    Combination of mean platelet volume and the CURB-65 score better predicts 28-day mortality in patients with community-acquired pneumonia
    (W.B. Saunders, 2015) Golcuk Y.; Golcuk B.; Bilge A.; Irik M.; Dikmen O.
    Objective: This study aims to investigate whether mean platelet volume (MPV) is correlated with the CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, > 65 years of age) score, and whether a combination of the CURB-65 score with MPV could better predict the 28-day mortality in patients with community-acquired pneumonia (CAP). Methods: This prospective, observational, single-center, and cross-sectional study was conducted at emergency department (ED) between September 1, 2013, and July 31, 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results: A total of 174 patients (mean age, 66.7 ± 15.8 years; 66.1% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 16.1%. A significant and inverse correlation between MPV and CURB-65 score was found (R = -.58, P <.001). We determined that the optimal MPV cutoff for predicting 28-day mortality at the time of ED admission was 8.55 fL, with a 75.0% sensitivity and a 75.3% specificity. For the prediction of 28-day mortality, the area under the receiver operating characteristic curve was 0.819 (95% confidence interval [CI], 0.740-0.898; P <.001) when the CURB-65 score was used alone, whereas it increased to 0.895 (95% CI, 0.819-0.936; P <.001) with the addition of MPV to the score. Conclusions: Mean platelet volume level is valuable for predicting mortality and the severity of disease among patients with CAP at ED admission. Furthermore, a combination of CURB-65 score and MPV can enhance the predictive accuracy of 28-day mortality. © 2015 Elsevier Inc.
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    Effects of Reiki on Post-cesarean Delivery Pain, Anxiety, and Hemodynamic Parameters: A Randomized, Controlled Clinical Trial
    (W.B. Saunders, 2015) Midilli T.S.; Eser I.
    The aim of this study was to investigate the effect of Reiki on pain, anxiety, and hemodynamic parameters on postoperative days 1 and 2 in patients who had undergone cesarean delivery. The design of this study was a randomized, controlled clinical trial. The study took place between February and July 2011 in the Obstetrical Unit at Odemis Public Hospital in Izmir, Turkey. Ninety patients equalized by age and number of births were randomly assigned to either a Reiki group or a control group (a rest without treatment). Treatment applied to both groups in the first 24 and 48 hours after delivery for a total of 30 minutes to 10 identified regions of the body for 3 minutes each. Reiki was applied for 2 days once a day (in the first 24 and 48 hours) within 4-8 hours of the administration of standard analgesic, which was administered intravenously by a nurse. A visual analog scale and the State Anxiety Inventory were used to measure pain and anxiety. Hemodynamic parameters, including blood pressure (systolic and diastolic), pulse and breathing rates, and analgesic requirements also were recorded. Statistically significant differences in pain intensity (p = .000), anxiety value (p = .000), and breathing rate (p = .000) measured over time were found between the two groups. There was a statistically significant difference between the two groups in the time (p = .000) and number (p = .000) of analgesics needed after Reiki application and a rest without treatment. Results showed that Reiki application reduced the intensity of pain, the value of anxiety, and the breathing rate, as well as the need for and number of analgesics. However, it did not affect blood pressure or pulse rate. Reiki application as a nursing intervention is recommended as a pain and anxiety-relieving method in women after cesarean delivery. © 2015 American Society for Pain Management Nursing.
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    Prognostic value of serum pregnancy-associated plasma protein A level at the initial ED presentation in elderly patients with CAP
    (W.B. Saunders, 2015) Golcuk Y.; Golcuk B.; Bilge A.; Korkmaz A.; Irik M.; Hayran M.; Ozdemir A.T.; Kurtulmus Y.
    Objective This study aims to compare serum pregnancy-associated plasma protein A (PAPP-A) levels in surviving and nonsurviving elderly patients with community-acquired pneumonia (CAP), investigating whether PAPP-A is correlated with CAP prediction scores and whether PAPP-A can successfully predict 28-day mortality rates in elderly patients. Methods This prospective, observational, single-center, cross-sectional study was conducted at the emergency department (ED) of Celal Bayar University Hospital in Manisa, Turkey, between January and September 2014. All patients underwent follow-up evaluations 28 days after admission. The end point was defined as all-cause mortality. Results A total of 100 elderly patients (mean age, 77.3 ± 7.6 years [range, 65-94 years]); 60% men) with CAP were enrolled in this study. All-cause mortality at the 28-day follow-up evaluation was 22%. Admission PAPP-A levels were significantly higher in nonsurvivors compared with 28-day survivors (10.3 ± 4.5 vs 3.8 ± 2.6 ng/mL, P <.001). A significant and positive correlation between admission PAPP-A levels and pneumonia severity index; confusion, oxygen saturation, respiratory rate, blood pressure, and age 75 years or older; and confusion, urea, respiratory rate, blood pressure, and age older than 65 years scores was found (r =.440, P <.001; r =.395, P <.001; and r =.359, P <.001, respectively). Moreover, we determined that the optimal PAPP-A cutoff for predicting 28-day mortality at the time of ED admission was 5.1 ng/mL, with 77.3% sensitivity and 77.9% specificity. Conclusions Serum PAPP-A level is valuable for predicting mortality and the severity of the disease among elderly patients with CAP at ED admission. Thus, PAPP-A might play a further role in the clinical assessment of the severity of CAP. © 2015 Elsevier Inc.
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    Temperament characteristics in patients with panic disorder and their first-degree relatives
    (W.B. Saunders, 2015) Altinbaş G.; Altinbaş K.; Gülöksüz S.A.; Gülöksüz S.; Aydemir Ö.; Özgen G.
    Aim Panic disorder is one of the highly heritable anxiety disorders; and temperament characteristics are considered predicting liability to panic disorder. Accumulating evidence suggests temperament characteristics are intermediate phenotypes for clinical conditions. Given this background, we aimed to investigate temperament characteristics in patients with panic disorder, their first-degree relatives, and healthy controls. Method Study sample was consisted 60 patients with panic disorder, 37 first-degree relatives of these patients, and 37 age, gender, and education level matched healthy controls (HC). SCID-I, the Panic Agoraphobia Scale, and the State and Trait Anxiety Inventory were applied to assess clinical characteristics of the patient group. Temperament characteristics were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A). Results Anxious, depressive, cyclothymic, and irritable temperament scores of patients were higher than those of HC. There was no difference between the patients and the relatives, with the exception of higher anxious temperament scores in patients. Conclusion Overall, our findings suggest that anxious temperament characteristic might be a trait marker for liability to panic disorder. Further research with a prospective design in a larger sample is required to confirm our findings. © 2015 Elsevier Inc.
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    Is "attenuation of Oxidative Stress" Helpful to Understand the Mechanism of Remote Ischemic Preconditioning in Cardiac Surgery?
    (W.B. Saunders, 2016) Yildirim F.; Iskesen I.; Kurdal A.T.; Ozturk T.; Taneli F.; Gozukara C.; Ozbakkaloglu A.
    Objectives The aim of this study was to determine the effect of remote ischemic preconditioning (RIPC) on markers of cardiac ischemia and response to oxidative stress in patients undergoing coronary artery bypass grafting (CABG) surgery. Design A prospective, randomized, and blinded study. Setting A single-center university hospital. Participants This study included patients who underwent isolated CABG surgery with cardiopulmonary bypass who were selected carefully to prevent confounding with factors known to affect markers of ischemia-reperfusion and response to oxidative stress. Interventions The authors randomly assigned patients to RIPC to the left lower extremity using a blood pressure cuff (study group) or a cuff that was applied but not inflated or deflated (control group). Measurements and Main Results At 6 hours after CABG surgery, high-sensitivity cardiac troponin T levels were significantly lower in the study group than in the control group. Levels of superoxide dismutase, an antioxidant enzyme, were significantly greater 15 minutes after release of the cross-clamp in the study group, whereas malondialdehyde levels were lower (not significantly) at 1 and 15 minutes after release of the cross-clamp. Hemodynamic parameters were not significantly different at any time point during the study. Conclusions The authors' method of RIPC before CABG surgery resulted in less myocardial ischemia, as indicated by lower troponin levels. Changes in levels of endogenous antioxidant enzymes supported the hypothesis that this protection from ischemia-reperfusion injury was related to scavenging of free oxygen radicals. Future studies might include a more heterogeneous population and medications that lower the body's response to oxidative stress. © 2016 Elsevier Inc.
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    Acute and Chronic Pretreatment With Atenolol Attenuates Intestinal Ischemia and Reperfusion Injury in Hypercholesterolemic Rats
    (W.B. Saunders, 2016) Öztürk T.; Vural K.; Tuğlu İ.; Var A.; Kurdal T.; Aydemir I.
    Objective To evaluate the protective effects of preinjury atenolol (acute v chronic) on apoptosis, contractility, oxidative stress, and inflammatory markers in hypercholesterolemic rats undergoing intestinal ischemia-reperfusion (I/R) injury. Design Prospective, experimental animal study. Setting University laboratory. Participants Male Wistar rats (n = 32). Interventions Rats were divided into the following 4 groups: 1 group was fed a normal diet (ND) (group ND+NoAT [no atenolol]), and the other 3 groups were fed a high-cholesterol diet (HCD)—group HCD+NoAT, group HCD+ChAT (chronic atenolol, 3 mg/kg/day for 8 weeks), and group HCD+AcAT (acute atenolol, 1.5 mg/kg, given 5 minutes before intestinal clamping). All rats underwent I/R injury. The superior mesenteric artery was clamped for 60 minutes, then opened for 120 minutes (reperfusion). Apoptotic cells and stimulated contractions of ileal segments were examined. Tissue markers of intestinal I/R injury were examined. Intestinal malondialdehyde, superoxide dismutase, and nitrate/nitrite levels were measured. Measurements and Main Results The chronic atenolol group had fewer apoptotic cells and higher superoxide dismutase activity compared with the other groups. Intestinal contraction was higher in both atenolol pretreatment groups compared with the NoAT groups. Chronic and acute atenolol resulted in lower ileal levels of malondialdehyde and immunolabeling-positive cells (intestinal inducible nitric oxide synthase, endothelial nitric oxide synthase, interleukin-1, and interleukin-8) after I/R injury compared with the no atenolol groups. Conclusions Both chronic and acute pre-I/R injury treatment with atenolol attenuated I/R injury in this hypercholesterolemic rat model. These findings should encourage future studies of atenolol in hypercholesterolemic patients undergoing procedures with a high risk of intestinal ischemia. © 2016 Elsevier Inc.
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    Ketoprofen gel improves low back pain in addition to IV dexketoprofen: a randomized placebo-controlled trial
    (W.B. Saunders, 2016) Serinken M.; Eken C.; Tunay K.; Golcuk Y.
    Objective Oligoanalgesia is common in emergency departments (EDs), and pain management is of concern for ED physicians. The aim of this study was to reveal the effect of ketoprofen gel in patients presenting with mechanical low back pain to the ED. Method All the study patients received intravenous dexketoprofen additional to study drugs. After dexketoprofen, 2 g of 2.5% ketoprofen gel or placebo was administered to the site with pain and tenderness. Pain relief at 15 and 30 minutes was measured by visual analog scale scores. Rescue drug need and adverse effects were also recorded. Results A total of 140 patients were enrolled into the study. The mean age of the study patients was 35 ± 12, and 56% (n = 79) of them were male. The mean pain reduction at 30 minutes was 52 ± 18 for ketoprofen gel and 37 ± 17 for placebo, and ketoprofen gel was better than placebo at 30 minutes (mean difference, 16 mm; 95% confidence interval, 10-21). Ten patients (14%) in the placebo group and 2 patients (3%) in the ketoprofen gel group needed rescue drug (P = .35). Conclusion Ketoprofen gel improves pain in patients presenting with mechanical low back pain to ED at 30 minutes in addition to intravenous dexketoprofen when compared to placebo. © 2016 Elsevier Inc.