İlhami Çelik

Trace elements in viral hepatitis

In this study, serum trace elements, including selenium (Se), zinc (Zn), copper (Cu), were determined by using Atomic Absorption Spectrophotometer (SpectrAA 250 Plus Zeeman, Varian, Australia) in sera of patients with viral hepatitis (A, B, C, D, E) cases (n = 102), and statistically compared with the controls (n = 52). In viral hepatitis, Cu levels were found as 3.23 +/- 1.02 mg/L, and this value was significantly higher than the control group (1.13 +/- 0.21) (p < 0.01). Both, Se and Zn levels found to be significantly low in viral hepatitis cases (p < 0.01). While Se level was 81.4 +/- 26.01 microg/L in viral hepatitis (n = 101), it was found to be 166.15 +/- 4.58 microg/L in healthy individuals. Meanwhile, Zn levels were 0.230 +/- 0.081 mg/L and 0.748 +/- 0.392 mg/L in hepatitis cases (n = 101) and the control group, respectively. There was no difference amongst viral hepatitis groups classified in regard with agents and clinical manifestation, such as A, acute hepatitis B, chronic hepatitis B, C, D and E. Previously, it was indicated that absorption disorders in gastrointestinal system, especially in chronic cases, were not main causes of decrease of trace elements by iron and several other parameters in sera of the cases. Therefore, we suggest that decrease in Zn and Se levels and elevation in Cu levels are probably resulted from defence strategies of organism and induced by the hormone-like substances.

Lymphocyte Subpopulations in Pulmonary Tuberculosis Patients

Protection against Mycobacterium tuberculosis is based on cell-mediated immunity, most importantly involving CD4+ and CD8+ T-cell subsets. The aim of this study was to evaluate CD4+ and CD8+ T-cell profiles and CD19+ and CD3−CD(16+56)+ populations in patients with pulmonary tuberculosis. CD4+ and CD8+ T cells, B-lymphocytes, and natural killer (NK) cells were evaluated in 75 active (APTB) and 25 inactive (IPTB) pulmonary tuberculosis cases and 20 healthy subjects (HCs). The results were compared at different stages of antituberculosis treatment in the APTB patients and also according to X-ray findings in the newly diagnosed APTB patients. The percentages of CD4+ T cells were significantly lower (P < .01) and those of CD3−CD(16 + 56)+ cells were significantly higher (P < .01) in APTB patients than in HCs. CD8+ T cells were significantly decreased (P < .05), and CD3−CD(16+56)+ cells were significantly increased (P < .01), in IPTB patients compared to HCs. The percentages of CD4+, CD8+, CD3−CD19+, and CD3−CD(16+56)+ cells showed no differences at different times of the antituberculosis regimen, and different stages of newly diagnosed APTB patients. APTB patients have a reduced percentage of circulating CD4+ T cells and an increased percentage of NK cells compared with healthy individuals. These cells could play important roles in the immune response to M tuberculosis infection.

Effects of Ibuprofen on the physiology and outcome of rabbit endotoxic shock

BackgroundDespite major developments in the management of septic shock, the mortality rate had progressively increased. Ibuprofen has been shown to have beneficial physiological effects when used as a treatment. However, there are conflicting results with respect to survival. This study aims to investigate the effect of ibuprofen on vital functions, various physiological parameters and survival during endotoxic shock in rabbits.MethodsTwenty-eight New Zealand rabbits were randomly separated into four groups. The first group received only saline, the second was given 2 mg/kg intravenous endotoxin at t0, the third received 30 mg/kg ibuprofen 30 minutes after endotoxin administration, whilst the fourth group received ibuprofen 30 minutes before the endotoxin. Respiratory and heart rate, mean arterial blood pressure and rectal temperature were recorded. Complete blood counts were performed and thromboxane B2 was measured every 30 minutes for the first two hours, and then hourly over the course of the experiment. Urine samples were collected at the same time points for the measurement of prostaglandin E2.ResultsIbuprofen was found to improve respiratory rate, heart rate, and arterial pressure. However, it did not improve the negative effects of endotoxin on body temperature, haematocrit values, white blood cell count, and thrombocyte number. Thromboxane B2 levels in group IV were significantly lower than in the other groups, and the increase started at a later timepoint. In ibuprofen-treated animals, Prostaglandin E2 levels stayed low for at least 90 minutes, but started to rise thereafter. While the average survival in Group II animals was 192.9 ± 46.9 minutes, those of groups III and IV were 339.1 ± 33.5 minutes (p < 0.05) and 383.0 ± 39.6 minutes (p = 0.01), respectively.ConclusionsIbuprofen appears to increase survival in endotoxic shock-induced animals. Therefore, it may be helpful for the prophylaxis and treatment of patients with, or who are likely to develop, septic shock.

Effects of ibuprofen on plasma endothelin levels and some vital parameters during endotoxin shock in rabbits

BACKGROUND There is evidence that septic shock results from breakdown in the balance between vasodilators such as prostacyclin, prostaglandin E(2), and nitric oxide, and the vasoconstrictors thromboxane A(2), serotonin, and endothelin. Increased plasma endothelin (ET) concentrations during septic shock were found. Inducing phospholipase A(2), ET causes release of arachidonic acid and production of prostaglandins. Ibuprofen is nonsteroidal anti-inflammatory drug inhibiting prostaglandin synthesis. There are no any information about the effects of ibuprofen on ET production in endotoxemia. In the present study we aimed to determine the effects of ibuprofen on plasma ET concentrations in an animal model of endotoxin shock. METHODS A total of 28 rabbits were randomly allocated into four groups. The first group only received saline and served as controls. The rest of the animals (groups 2, 3, and 4) were injected intravenously with endotoxin at a dose of 2 mg/kg. To the third group, ibuprofen at 30 mg/kg dosage was given, 30 min following endotoxin administration, whereas in the fourth group animals, ibuprofen was administered 30 min before endotoxin administration. Animals were monitored through the canulation of femoral arteries and venules under the complete anaesthesia. At 0, 30, 60, 90, 120, 180, and 240 min, arterial blood pressure, heart rate, and ET determinations were carried out. RESULTS Ibuprofen before the endotoxin administration was more effective in controlling the increase in heart rate. Ibuprofen was also effective in inhibiting the sudden reductions in blood pressure if administered before endotoxin. However, if administered after endotoxin injection, ibuprofen precipitated the reduction in blood pressure further. Ibuprofen reduced the ET production which was induced by the endotoxin administration. CONCLUSIONS Ibuprofen administration during endotoxin shock seems to decrease the elevated ET concentrations, and increase the blood pressure.

Evaluation of major and minor lower extremity amputation in diabetic foot patients

Background/aim: We evaluated the existing risk factors with clinical results in patients who underwent major and minor amputation of the lower extremity as a result of diabetic foot ulcers (DFUs). Materials and methods: We retrospectively studied 107 patients who had undergone lower extremity amputation. The patients were divided into minor (Group 1, n = 75) and major (Group 2, n = 32) amputation groups. On clinical evaluation, the type of surgery performed, smoking history, comorbidities, duration of diabetes mellitus (DM) diagnosis, duration of DFU presence, peripheral neuropathy, peripheral arterial disease, results of deep tissue culture, length of hospitalization, and blood parameters were investigated. Results: In Group 2, mean hospitalization time was significantly longer than in Group 1 (P < 0.05). The proportion of patients with Wagner Grade 4 was significantly higher in Group 2 than in Group 1 (P < 0.05). The duration of DM and DFU was significantly longer in Group 2 (P < 0.05). The number of polymicrobial agents was significantly higher in Group 1 (P < 0.05). Conclusion: In our study, the most important risk factors that led to major amputation in patients with DFU were age, Wagner classification, duration of DM, duration of DFU, and C-reactive protein level.