Background: Tramadol binds to opioid receptors and inhibits norepinephrine and serotonin reuptake, causing serotonin syndrome. Tianeptine stimulates serotonin reuptake and reduces serotonin levels. The aim of this study was to investigate whether tianeptine is effective against serotonin syndrome that may occur with serotoninergic drugs such as tramadol and citalopram. Methods: Rats were divided into eight groups (n = 6) that received tramadol (50 mg/kg), citalopram (10 mg/kg), or tianeptine (5 mg/kg) alone or a combination of tramadol + citalopram, tramadol + tianeptine, citalopram + tianeptine or tramadol + citalopram + tianeptine at the same doses administered to the stomach by oral gavage for 3 weeks. The healthy control group was given saline. Malondialdehyde, total glutathione, superoxide dismutase, and catalase levels were measured in removed brain tissues. The tissues were also examined histopathologically. Results: In the tramadol, tramadol + citalopram, and tramadol + citalopram + tianeptine groups, malondialdehyde levels were found to be higher compared to the control group, while glutathione, superoxide dismutase, and catalase levels were found to be lower. In other groups, values close to the control group were measured. Morphological degeneration was observed in neurons in the tramadol + citalopram group. The swelling of astrocytes and pericellular edema in oligodendrocytes were also observed. A significant population increase was noted in microglial cells. Blood vessels belonging to the tissue were observed to be severely dilated and congested. Histopathological damage was partially resolved in the group given tramadol + citalopram + tianeptine. Conclusions: The tramadol + citalopram combination caused severe oxidative stress in brain tissue. Tramadol alone caused mild damage in brain tissue, whereas tianeptine prevented the brain damage caused by tramadol.

Background: This study compared the effects of ketamine and dexmedetomidine (Dex) on inflammation and pain in liver resection surgery. Methods: Forty-five American Society of Anesthesiologists class III patients aged 18 to 65 scheduled for liver resection surgery were randomized into 3 equal groups. The ketamine group received an intravenous ketamine bolus (0.5 mg/kg) during anesthesia induction and continuous low-dose infusion at 0.25 mg/kg/hour. In the Dex group, intravenous infusion was initiated at a 1 µg/kg bolus for the first 10 minutes, and at 0.5 µg/kg/hour after intubation. The control group patients were infused crystalloid solution at 8 mL/kg/hour from induction. Venous blood was collected at postoperative hours 1 and 12 for pentraxin 3, serum amyloid A, hepcidin, and inflammatory marker analysis. Visual analogue scale (VAS) values were recorded. Results: Pentraxin 3, serum amyloid A, and hepcidin continued to rise at 12 hours in the control group, but began declining in the Dex and ketamine infusion groups (P < .05). VAS levels and fentanyl consumption decreased in the ketamine and Dex groups compared to the control group (P < .05). The decreases in inflammatory parameters, VAS scores, and fentanyl consumption were similar between the ketamine and Dex groups (P > .05). A positive correlation was observed between inflammation levels and pain severity (P < .001). There was no difference in liver function tests between any of the groups (P < .05). Conclusion: Ketamine and Dex infusions were both effective in reducing inflammation and pain following liver resection, with no obvious superiority of one over the other.

Purpose: This study aimed to contribute to the current literature by focusing on admitting to emergency department patients’ s habits related to cigarette consumption and general approaches of smoking cessation in 2024’s conditions and to test the variables statistically, compare the results with similar studies, and interpret the changes over time. Materials and Methods: This study included 1996 patients who presented to the emergency department in XXX hospital over a period of 3 days . Than a questionnaire was applied them. The respective rate of current and former smokers was 28.2% and 12.02%. Smokers were most likely to quit smoking when they had an illness (51.9%), and this was most frequently seen after ≥25 years of smoking (70.1%). Total percentage of individuals who quit smoking using Alo171, electronic cigarette (E cigarette), medication, applying o KETEM, nicotine patch as a method was 3.8%. Among current smokers, 63.8% had never attempted at to quit smoking. Comparing the results of the present study with that of similar studies, the current smoking rate was similar. Although ½ pack/day cigarette use is more prevalent in most studies, one pack/day was the most frequent amount in this study. There was no difference based on the maximum age range of smoking initiation. The smokers tended to quit smoking after falling ill, whereas similar studies have reported to decide to and suddenly quit smoking was the most common. The rate of cessation attempts was consistent, but the number of participants who considered quitting smoking was lower. Conclusion: The proportionally high tendency to quit smoking after becoming ill and the lower percentage of participants who planned to quit smoking suggested that it might be useful to increase awareness-raising activities and smokers should be encouraged to use helper methods.

Peripheral nerve injuries are particularly important in terms of their frequency and complications. The purpose of this experimental study was to investigate the neuroprotective effects of pregabalin and methylprednisolone administered at different doses and in combination in an axonotmesis model and to establish whether pregabalin can represent an alternative to methylprednisolone. Fifty-six adult male Sprague-Dawley rats were assigned to control, sham (axonotmesis only), axonotmesis + pregabalin 30 mg/kg (low dose), axonotmesis + pregabalin 60 mg/kg (high dose), axsonotmezis + 1 mg/kg methylprednisolone, axonotmesis + pregabalin 30 mg/kg + 1 mg/kg methylprednisolone (low-dose combination), and axonotmesis + pregabalin 60 mg/kg + 1 mg/kg methylprednisolone (high-dose combination) groups. Following axonotmesis, the treatment groups received oral treatment once daily for one week. Sciatic functional index, electromyography, biochemical (NGF, TGF-β, CNTF, MBP), immunohistochemical, histomorphological and immunofluorescence analyses were performed to assess the neuroprotective effects of the treatments. Immunohistochemical, electrophysiological, and biochemical analyses demonstrated that the separate or combined use of pregabalin and methylprednisolone may have positive effects on nerve regeneration. Low-dose pregabalin and methylprednisolone alone exhibited similar effects on peripheral nerve regeneration and functional healing. Pregabalin may represent an alternative to steroids due to its fewer side effects. Although direct pain behavior assessment was not performed in this study, the effect of pregabalin on neuropathic pain may be additionally beneficial in combined use. These results demonstrate that pregabalin offers comparable neuroregenerative effects to methylprednisolone, with combination therapy proving superior. This positions pregabalin as a promising steroid-sparing agent for peripheral nerve injury, warranting further clinical investigation.

The increase in cyclooxygenase-2 (COX-2) activity and the decrease in COX-1 activity were associated with increased intracellular calcium. Lacidipine, a calcium channel blocker, can protect gastric tissue from aspirin-induced damage while potentiating the analgesic and anti-inflammatory properties of aspirin. This study, it was aimed to investigate the anti-inflammatory, analgesic, and gastric tissue effects of using lacidipine and aspirin combination, and separately. (LA). Twenty-four rats were randomly divided into CG (carrageenan control), LCG (carrageenan+lacidipine), ACG (carrageenan+aspirin), and LACG (carrageenan+LA) groups. Lacidipine 4 mg/kg, aspirin 100 mg/kg were given orally to the animals on an empty stomach. ,Carrageenan was injected into the foot paws of rats to induce inflammation and pain. Paw volumes were measured at 0, 1, and 4 hours after carrageenan administration, and paw pain thresholds were measured at 1 and 4 hours. After euthanasia (thiopental sodium, 50 mg/kg), paw and gastric tissues were excised and biochemically analyzed. Gastric tissues were also examined macroscopically. In the paw tissues of animals receiving lacidipine, malondialdehyde (MDA) was lower than in the CG and AG, while total glutathione (tGSH) was higher (p<0.05). Lacidipine inhibited COX-2, but not COX-1 isoenzyme. LA, lacidipine, and aspirin inhibited inflammation and hyperalgesia at 1 and 4 hours, respectively. Lacidipine prevented aspirin-induced COX-1 inhibition and gastric ulcer formation. Lacidipine combined with aspirin may be beneficial in initiating its anti-inflammatory activity early, achieving a potent analgesic effect, and preventing aspirin-induced gastric injury.

Nonspesifik karın ağrısı (NSKA), acil servis başvurularının en sık nedenlerinden biri olup tanısal belirsizliklerle karakterizedir. NSKA, özgül bir hastalıktan ziyade, yeterli klinik değerlendirme sonrası ulaşılan geçici ve güvenlik temelli bir klinik sonuç olarak kabul edilmelidir. Gelişmiş görüntüleme yöntemlerine rağmen NSKA oranlarında anlamlı bir azalma sağlanamamış; seri klinik muayene ve gözlem güvenli yaklaşımın temelini oluşturmaya devam etmiştir. Karın duvarı ağrısı ve özellikle Anterior Kutanöz Sinir Tuzaklanma Sendromu (ACNES), NSKA ile sık karışan ancak tanınabilir ve tedavi edilebilir önemli nedenler arasındadır. Çoğu hastada prognoz benign olmakla birlikte, ileri yaş grubunda altta yatan ciddi patolojiler açısından dikkatli izlem gereklidir.