Acute pancreatitis,treatment,agmatine,cerulein,rat

Background and Objectives: This study was designed to evaluate the potential cardioprotective effect of Exenatide against doxorubicin (DOX)-induced myocardial injury in rats by assessing scintigraphic alterations together with oxidative stress and inflammation. Materials and Methods: This study included 28 adult male Wistar albino rats that were randomized to 4 groups (n = 7): control, Exenatide alone, DOX (receiving DOX (18 mg/kg, i.p) on days 5–7; Exenatide + DOX (treated with Exenatide together with the DOX). On day 8, ECG, 99mTc-PYP scintigraphy, and biochemical parameters were evaluated. Results: DOX caused ECG abnormalities—bradycardia, significant QT prolongation, and elevated ST-segment amplitude—along with increased myocardial PYP uptake. Exenatide + DOX group significantly improved ECG changes. Biochemically, DOX markedly increased cardiac injury biomarkers (cTnT, CK, CK-MB), hepatic and renal injury markers (ALT, AST, LDH, BUN, creatinine), SIRT-1 level, inflammatory marker (NF-κB, TNF-α, IL-6, NO) and oxidative stress indicators (MDA, TOS), while decreasing antioxidant defenses (GSH, TAS, Nrf2). Exenatide co-treatment significantly attenuated all DOX-induced changes. Conclusions: Exenatide markedly attenuates DOX-induced cardiotoxicity by improving electrical conduction, reducing myocardial radiotracer uptake, and restoring oxidative–inflammatory balance through partial recovery of the SIRT-1/Nrf2/NF-κB pathway.

Resolvin D1 (RvD1), a specialized pro-resolving lipid mediator, has been associated with liver injury in experimental models of alcohol-associated liver disease (ALD). This study aimed to evaluate the relationship between serum RvD1 levels and clinical phenotypes of ALD. This case-control study included 82 patients with ALD and 48 healthy controls (HCs). The ALD patients were categorized into three subgroups: alcohol-associated steatotic liver (ASL), alcohol-associated hepatitis (AH), and alcohol-associated cirrhosis (AC). Serum RvD1 levels were measured using the enzyme-linked immunosorbent assay (ELISA) test. The Fibrosis-4 (Fib-4) index was used to assess liver fibrosis in all participants. For the AH and AC groups, the Model for End-stage Liver Disease Sodium (MELD-Na) scores were calculated. Child-Pugh classification was applied to the AC patients and Maddrey’s Discriminant Function was applied to the AH patients. An esophagogastroduodenoscopy was performed in the AH and AC patients to evaluate portal hypertension. The serum RvD1 levels were significantly lower in the AH and AC groups compared to the ASL and HC groups (p < 0.001), with no significant difference between the AH and AC groups or between the ASL groups and the HC group. In the AC group, patients with ascites and/or esophageal/gastric varices had lower serum RvD1 levels compared to those without (p = 0.013 and p = 0.004, respectively). Additionally, the serum RvD1 levels decreased with advancing Child-Pugh class (p = 0.004). The serum RvD1 levels were inversely correlated with the Fib-4 scores, the MELD-Na and Child-Pugh scores in both the AC group (p < 0.05 for all). Serum RvD1 levels are associated with the severity of ALD and may represent a promising non-invasive biomarker. However, due to the absence of an external validation cohort, these findings should be interpreted as exploratory. Further validation in independent populations is warranted to confirm the clinical utility of RvD1 in ALD.

Introduction: Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up. Materials and Methods: This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017. The clinical research was planned as observational, multicenter, cross-sectional. Results: A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the "0" the worst probability "5" being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r: -0.488; p< 0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% Cl: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively. Conclusion: In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician's opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters.

Background: Heterotaxy syndrome, a condition in which the internal organs are abnormally arranged in the thorax or abdomen, is generally diagnosed early in life, often during the neonatal period. Case Report: We present the case of a 42-year-old male who was incidentally diagnosed with polysplenia syndrome and subsequently diagnosed with heterotaxy syndrome. Upon further investigation, he was determined to have a sinus venosus type atrial septal defect. Furthermore, the patient9s inferior vena cava was interrupted in the infrarenal region and continued as the azygos vein with a coincidental retroaortic left renal vein, an anatomic variation unrelated to heterotaxy syndrome. Because of his minimal cardiac anomalies, the patient remained undiagnosed until adulthood. Conclusion: According to our research, this case is the first report of a patient with heterotaxy syndrome and a sinus venosus type atrial septal defect. This case augments the available information about the variations of this rare syndrome.

Aims: There is evidence of anti-inflammatory qualities associated with a soluble receptor for advanced glycation end products (sRAGE). We aimed to evaluate whether serum sRAGE levels of patients with inflammatory bowel diseases (IBDs) could serve as a biomarker by utilizing several clinical and laboratory models of disease activity for these individuals. Methods: This case-control study included 77 ulcerative colitis (UC) patients (51 males and 26 females), 49 Crohn’s disease (CD) patients (33 males and 16 females) and 54 healthy controls (38 males and 16 females). In UC, the UC Mayo Clinical Scoring system (MCS) was used for the clinical and endoscopic features. The histological activity index (HAI) of UC patients was determined by Truelove and Richards method. The Crohn's disease activity index (CDAI) was utilized for CD patients. Results: In comparison to the control group, the median sRAGE concentrations in UC patients were significantly lower. [911.17 ng/L (322.91-1682.19 vs 1420.96 ng/L (816.68-2320.08), respectively, p=0.008)]. The patients with CD did not significantly differ from the other groups. The MCS and HAI values of UC patients negatively correlated to the serum sRAGE values (rho=-0,610, p<0.001 vs rho=-0,742 respectively, p<0.001). CD patients in remission had higher sRAGE values than patients having active disease [1720.42 ng/L (1005.68-2414.41) vs. 923.36 ng/L (601.61-1361.22 respectively, p=0.002]. CD patients under treatment had higher sRAGE values than patients without any treatment [1361.22 ng/L (821.26-1944.2) vs. 879.38 ng/L (601.61-1239.41) respectively, p=0.033] Conclusion: Serum sRAGE might be an auxiliary biomarker for the clinical and laboratory traits of UC. Giriş: Serum ileri glikasyon son ürünleri reseptörlerinin (sRAGE) anti-inflamatuar özellik gösterdikleri bilinmektedir. Amaçlar: Çalışmamızda inflamatuvar barsak hastalığı (İBH) vakalarında, serum sRAGE düzeylerinin bu hastalarda farklı klinik ve laboratuvar hastalık aktivite modelleri ile ilişkili bir biyobelirteç olup olamayacağını araştırdık. Yöntemler: Bu vaka kontrol çalışmasına 77 ülseratif kolit (ÜK) hastası (51 erkek ve 26 kadın), 49 Crohn hastalığı (CH) vakası (33 erkek ve 16 kadın) ile 54 sağlıklı kontrol (38 erkek ve 16 kadın) dahil edilmiştir. ÜK’de klinik ve endoskopik aktivite değerendirmesi için Mayo Klinik Skorlama (MKS) sistemi kullanıldı. UK hastalarının histolojik aktivite indeksi (HAİ) Truelove ve Richards yöntemi ile belirlendi. CH klinik aktivitesi için Crohn hastalığı aktivite indeksi (CHAİ) kullanıldı. Bulgular: Medyan sRAGE düzeyleri ÜK hastalarında kontrol grubuna göre düşük bulundu [911.17 ng/L (322.91-1682.19 ve 1420.96 ng/L (816.68-2320.08), sırasıyla, p=0.008)]. CH'li vakalar ile diğer gruplar arasında anlamlı fark yoktu. ÜK hastalarının MKS ve HAİ değerleri ile serum sRAGE konsantrasyonları arasında negatif korelasyon saptandı (rho=-0,610, p<0.001 ve rho=-0,742 sırasıyla, p<0.001). Klinik olarak remisyondaki CH vakaları, aktif hastalığı olanlardan daha yüksek sRAGE değerlerine sahipti [1720.42 ng/L (1005.68-2414.41) ve 923.36 ng/L (601.61-1361.22) sırasıyla, p=0.002]. Tedavi altındaki CH vakalarının sRAGE değerleri, herhangi bir tedavi almayanlardan daha yüksekti [1361.22 ng/L (821.26-1944.2) ve 879.38 ng/L (601.61-1239.41) sırasıyla, p=0.033]. Sonuç: Serum sRAGE, ÜK 'in klinik ve laboratuvar özelliklerinin tespiti için yardımcı bir biyobelirteç olabilir.