Pinar Kuru

Quality of life improves after minimally invasive repair of pectus excavatum

Background Pectus excavatum is the most common chest wall deformity. This deformity may cause physical limitations and psychosocial problems. In this study, we aimed to investigate the effect of minimally invasive repair of pectus excavatum on the quality of life. Methods This study included 88 patients, aged 18.44 ± 3.93 years (85.2% male), who underwent minimally invasive repair of pectus excavatum; 40.9% had an associated anomaly or disease, and 17.0% had scoliosis. The patients and their parents completed the patient and parent forms of the Nuss questionnaire modified for adults preoperatively and 6 months after the operation. Results The patients’ median Nuss score increased from 31 (interquartile range 31–35) preoperatively to 43 (interquartile range 43–46) at 6 months after the operation (p = 0.000). The parents’ preoperative score of 33 (interquartile range 29–36) increased to 38 (interquartile range 34–41; p = 0.000). Improvements in the physical and psychosocial component scores of the Nuss questionnaire were also significant in the patient (p = 0.000, p = 0.000, respectively) and parent forms (p = 0.005, p = 0.000, respectively). Conclusions Minimally invasive repair of pectus excavatum significantly improved the physical and psychosocial wellbeing of patients. Longitudinal studies are needed to determine the long-term changes related to quality of life.

Tamarindus indica and its health related effects

ABSTRACT Tamarindus [Tamarindus indica L. ( T. indica )], belongs to the family Leguminosae (Fabaceae), commonly known as Tamarind tree, is one of the fruit tree species that is used as traditional medicine. The aim of this article is to review the current literatue on health related effect of T. indica . Literature review about this plant was conducted between 2003 and 2014 through Pubmed and Google. The keywords Tamarind, T. indica were used for search. Only the health related articles selected. Tamarind tree is found especially in the Indian subcontinent, Africa, Pakistan, Bangladesh, Nigeria and most of the tropical countries. It is preferred to be used for abdominal pain, diarrhea and dysentery, some bacterial infections and parasitic infestations, wound healing, constipation and inflammation. It is a rich source of most of the essential amino acids and phytochemicals, and hence the plant is reported to possess antidiabetic, antimicrobial, antivenomic, antioxidant, antimalarial, cardioprotective, hepatoprotective, antiasthmatic, laxative and anti-hyperlipidemic activity. T. indica has ameliorative effects on many diseases. It can also be preferred as a nutritious support for malnourished patients as it is cheap and easy to access. Those effects should be clarified with further research.

Pectus Excavatum and Pectus Carinatum: Associated Conditions, Family History, and Postoperative Patient Satisfaction

Background Pectus excavatum (PE) and pectus carinatum (PC) are the most common chest wall deformities. In this study, we aimed to characterize how patients obtained information about these deformities, as well as patients’ family history, associated medical problems, and postoperative satisfaction after the Nuss and Abramson procedures. Methods This cross-sectional retrospective study included patients who were operated by a single surgeon between 2006 and 2013. Follow-up calls were made after approval of our institution’s ethics committee. We reached 207 of the 336 PE patients (61.6%) and 73 of the 96 PC patients (76%). Results The majority of the patients were male (85% of the PE patients and 91.8% of the PC patients). The age of diagnosis of PE was 14.52±0.51 years and the age at the time of operation was 17.89±0.42 years; for PC patients, the corresponding ages were 15.23±0.55 years and 16.77±0.55 years, respectively. A total of 70% of the PE patients and 63.8% of the PC patients obtained information about pectus deformities through the Internet. In 27.1% of the PE patients with an associated anomaly, 57.1% (n=13) had scoliosis, while 41.1% of the PC patients with an associated anomaly had kyphosis (n=5). Postoperative satisfaction, as evaluated on a scale from 0 to 10, was 8.17±0.15 for PE patients and 8.37±0.26 for PC patients. The postoperative pain duration was 51.93±5.18 days for PE patients and 38.5±6.88 days for PC patients. Conclusion In this study, we found that most patients with pectus deformities were male. The Internet was an important resource for patients to learn about their deformities. Family history and associated anomalies were identified as important aspects for consideration in the clinical setting. The patients reported high levels of postoperative satisfaction, and pain management was found to be one of the most important elements of postoperative care.

Ameliorative Effect of Chronic Moderate Exercise in Smoke Exposed or Nicotine Applied Rats from Acute Stress

INTRODUCTION Physical activity has been found to be related with many health benefits. Our aim was to investigate the effect of chronic moderate exercise from acute stress on nicotine and cigarette smoke exposed rats. METHODS Male Sprague Dawley rats (200-250g, n = 48) were divided into 6 groups as non-exercised, exercised, smoke exposed, smoke exposed and exercised, nicotine applied, and nicotine applied and exercised. Nicotine bitartarate was applied intraperitoneally (0.1mg/kg/day) for 5 weeks, and cigarette smoke was exposed in a ventilated chamber. After 1 week of nicotine application or smoke exposure, moderate exercise training protocol was applied to exercise groups. At the end of the experiments, acute stress induction was made to all groups by electric foot shock. Holeboard tests were performed before and after the experiments. Biochemical and histological analyses were performed in lung, liver, colon, stomach, and gastrocnemius tissues. RESULTS Malondialdehyde levels were increased in all tissues of smoke exposed group (p < .05-.01) except gastrocnemius tissue compared to non-exercised group and were decreased with exercise (p < .05-.001). Myeloperoxidase levels were increased in lung, liver and colon tissues of smoke exposed group (p < .05-.001) and liver and colon tissues of nicotine applied rats (p < .01-.001) and decrease with exercise in liver and colon tissues of both smoke exposed or nicotine applied groups (p < .05-.01). In all tissue samples, increased histological injury scores (p < .05-.001) decreased significantly with exercise (p < .01-.001). CONCLUSION Biochemical parameters and histological scoring indicated increased tissue injury due to nicotine application and cigarette smoke exposure and exercise training ameliorated these effects in most of the tissues of acute stress induced rats.

Systematic Review of Central Post Stroke Pain: What Is Happening in the Central Nervous System?

ABSTRACTCentral poststroke pain (CPSP) is one of the most common central neuropathic pain syndromes seen after stroke. It is mainly related with vascular damage at certain brain territory and pain related to corresponding body areas. In the past, it was described as one of the definitive symptoms of thalamic lesion. However, recent findings suggest that it is not only seen after thalamic lesions but also seen after vascular lesions in any part of the central nervous system. Although there are certain hypotheses to explain physiopathologic mechanisms of CPSP, further evidence is needed. The majority of the cases are intractable and unresponsive to analgesic treatment. Electrical stimulation such as deep brain stimulation and repetitive transcranial magnetic stimulation seems to be effective in certain cases. In this systematic review, recent advancements related to CPSP mechanisms have been evaluated. Further investigations are needed in order to reveal the mystery of the pathophysiologic mechanisms of CPSP.

Reconstruction of sternal cleft with autologous cartilage graft in an adult

Sternal cleft is a rare chest wall deformity associated with various malformations. Primary closure is the gold standard in the newborn period. Alternative techniques are possible for older patients. A 23-year-old woman with a partial sternal cleft and no additional deformity, underwent reconstruction using costal cartilage grafts. Postoperative physical and functional were excellent.

Nicotine alleviates colitis-induced damage in rats via its anti-oxidative activity

Amac: Epidemiyolojik calismalar ulseratif kolitin sigara kullanmayanlarda daha sik goruldugunu bildirmektedir. Bu calismada kolitle olusan oksidan hasar ve anksiyete uzerine nikotin on tedavisinin ve/veya kolit sonrasi tedavinin olasi yararli etkilerinin arastirilmasi amaclanmistir. Gerec ve Yontem: Wistar Albino (250-300 g) sicanlar (n=40), serum fizyolojik (SF) verilen, on-tedavili, tedavili ve on-tedavi+ tedavili kolit grubu ve kontrol grubu olmak uzere bese ayrildi. Kolit oncesi 15 gun ve kolit sonrasinda 3 gun sicanlara intraperitoneal SF ya da nikotin (0,1 mg/kg/gun) uygulandi. Kolon orneklerinde oksidan hasari belirlemek icin malondialdehid (MDA), miyeloperoksidaz (MPO) aktivitesi, glutatyon (GSH), superoksit dismutaz (SOD), katalaz ve DNA fragmantasyonu olcumleri ile histolojik skorlama yapildi. Delikli kutu testi ile anksiyete seviyeleri belirlendi. Sonuclar ANOVA ve Mann Whitney U testi ile analiz edildi. Bulgular: Kolitte artan anksiyetenin nikotin ile degismedigi gozlendi. SF verilen kolit grubunda kolon MPO ve MDA duzeyleri ile DNA fragmantasyonunun ve hasar skorunun kontrol grubuna kiyasla arttigi, nikotin verilen tum kolit gruplarinda ise bu hasar gostergelerinin anlamli sekilde dustugu gozlendi. Histolojik doku hasari skorunun nikotin uygulanan kolit grubunda daha az oldugu gozlendi. SOD, katalaz ve GSH duzeylerindeki azalmanin nikotin tedavisiyle anlamli sekilde arttigi gozlendi. Sonuc: Calismada asetik asitle olusturulan kolit modelinde, nikotin tedavisinin doku antioksidan kapasitesini arttirarak, inflamasyon sonucu notrofil gocunu ve membran hasarini azaltarak antioksidan etki olusturdugu gosterildi.