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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure in which endoscopy and fluoroscopy are used together to diagnose and treat problems in the pancreatic and biliary ductal systems. According to published studies, the frequency of perforation associated with ERCP is reported to be less than 1%. In our study, we aimed to retrospectively analyze the data of patients we followed after ERCP perforation to examine treatment approaches. In this study, data from 33 patients who underwent ERCP at a tertiary stage education and research hospital between November 2016 and April 2021 and were identified to have developed perforation during or after the procedure were retrospectively evaluated. The indications and outcomes of ERCP for patients, as well as laboratory and imaging findings, were analyzed in detail. The age distribution of the 33 patients included in the study ranged from 20 to 83 years, with a mean age of 57.1±17.6 years. Perforation developed during the initial ERCP procedure in 66.7% of the patients, and on seven of the ten patients in whom perforation was detected during the procedure, interventions were performed during the procedure. Although the mortality rate in patients with Stapfer type 1 or type 2 perforations (33.3%) was higher compared to the patients with type 3 or type 4 perforations (11.1%), the observed difference was not found to be statistically significant. In conclusion, the management of patients with ERCP perforation should be approached in a multidisciplinary manner, and non-operative approaches should always be considered in the appropriate patient population. Closely and dynamically monitoring of patients and algorithmic approaches should standardized. [Med-Science 2024; 13(3.000): 736-42]

Vascular inflammation has a pivotal role in the progression of atherosclerosis and major cardiovascular events (MACE). However, there is limited data concerning to role of changes in inflammatory markers in predicting MACE. In the current study, it was investigated whether the difference between high sensitive C-Reactive Protein (hs-CRP) and systemic immune-inflammatory index values (Δhs CRP and ΔSII) measured before and after the procedure and residual SYNTAX score (rSS) in stable coronary artery patients underwent percutaneous coronary intervention (PCI) could predict MACE. 203 patients (mean age: 62.11±9.20, 75% male) were included in the study. Before the first procedure and at the 1st month after the procedure(s), their blood was drawn. rSS was calculated. MACE was determined as cardiovascular mortality, target vessel revascularization non-fatal myocardial infarction, and ischemic stroke. MACE was observed in 20 patients (9.9%). Of these patients, 3 (1.5%) had cardiovascular mortality, 3 (1.5%) had a non-fatal myocardial infarction, 12 (5.9%) had target vessel revascularization due to unstable angina, and the remaining 2 (1.0%) had an ischemic stroke. The area under the curve (AUC) to predict MACE diagnosis was 0.548 for ΔSII and 0.647 for Δhs-CRP and 0.766 for rSS. In multiple regression analysis, only rSS > 4 was an independent predictor for MACE (HR=3.41, 95% CI: 1.39-8.35, p=0.007). The change in SII and hs-CRP after PCI was found to be insufficient to predict MACE, while rSS was the only independent predictor for MACE. [Med-Science 2023; 12(2.000): 536-41]

Catestatin (CST) is a metabolite of chromogranin A, a soluble protein in catecholamine storage vesicles acting as a feedback inhibitor of catecholamine secretion. This study aims to investigate the correlation of catestatin with dipper and non-dipper status in hypertensive patients. Hypertensive (n=355) and healthy subjects (n=129) were randomly selected at an outpatient clinic. Blood pressure and heart rate were measured according to relevant guidelines. Plasma catestatin level, plasma glucose, lipid levels were measured. An ambulatory blood pressure monitor was performed to determine the dipping patterns in hypertensive subjects. Univariate and multivariate analyses were conducted to assess factors affecting catestatin levels. Left ventricular mass was higher among hypertensives compared with healthy controls (178±47 g versus 213±52 g in healthy controls and hypertensives, p [Med-Science 2022; 11(4.000): 1402-8]

The aim of our study was to compare the parameters of optical coherence tomography angiography between eyes with clinically significant macular edema (CSME) and without (w/o) CSME in patients diagnosed with diabetic macular edema (DME). Sixty-eight eyes of 34 patients with DME were included in the cross-sectionally designed study. The eyes of the patients with DME were divided into 2 groups, including the eyes with CSME and the eyes w/o CSME. Optical coherence tomography (OCTA) parameters, including central macular thickness, superficial and deep capillary plexus, and choriocapillaris flow area were evaluated between these two groups. Eyes with CSME had a thicker central retinal thickness (CRT), (P≤0.001) and worse visual acuity (VA), (P=0.002), and there was a strong negative correlation between CRT and VA among patients with CSME (r=-0.616, P≤0.001). We observed increases in the vessel density (VD) measurements of the superficial fovea (P=0.006) and deep fovea areas (P=0.036), whereas reductions in the VD measurements of other deeper plexuses in the comparison of eyes with CSME and w/o CSME in patients with diagnosis of DME. We did not note significant differences between FAZ metrics. OCTA could be used as a noninvasive modality to assess and compare the structural and vasculature changes in diabetic patients with or/and w/o CSME. [Med-Science 2022; 11(1.000): 208-13]

To analyze prognostic factors associated with functional and anatomical results in closed globe injuries (CGIs) and open globe injuries (OGIs). One hundred and twenty patients who applied due to globe injuries were retrospectively examined in terms of prognostic factors affecting final visual acuity (FVA). The demographic features and clinical characteristics of the patients were evaluated in various parameters. Most traumas were open globe injuries (82.50%) and occurred at work (50%). CGIs had better baseline visual acuity (BVA) values and also showed better FVA outcomes. Among patients with OGIs, Intraocular foreign body (53.33%) and penetrating (36.11%) OGIs had the highest ratios for FVA ≥ 1/10. Eyes with zone II + III wounds had a tendency of FVA [Med-Science 2021; 10(3.000): 804-11]

Alzheimers Disease (AD), which is the most common reason for dementia, is an irreversible neurodegenerative brain disease. FEZ1 is a protein expressed in the brain. High expressions of FEZ1 mRNA have been interpreted as an indicator of high neural plasticity for memory and learning. This study was planned to determine the effect of melatonin deficiency (pinealectomy; PnX) on AD and to reveal its association with FEZ1. 30 male rats were used in the study. The rats were divided into three as SHAM, PnX+streptozotocin (STZ) and PnX+STZ+melatonin (MLT) groups. The pineal glands of rats were surgically removed (except SHAM group) and STZ was intracerebroventricularly (icv) administrated at the first and third days. MLT (10 mg/kg/day) was intraperitoneally (ip) injected 1 hour before the first STZ application and it was continued for 14 days. STZ and MLT solvents were applied to the rats in the SHAM group. At the end of the applications, Morris water maze (MWM) test was carried out the rats. At the end of MWM tests, the rats were sacrificed and their blood and hippocampus tissues were taken. FEZ1 gene expression and protein levels were determined from hippocampus tissue, while serum nonadrenaline, dopamine and serotonin levels were detected from blood samples. FEZ1 protein levels of PnX+STZ+MLT group were found to be statistically significantly lower than those of SHAM and PnX+STZ groups (p [Med-Science 2017; 6(2.000): 217-23]

In this study, we prospectively investigated the histopathological features of the removed appendix tissue in pediatric patients who were operated on with the preliminary diagnosis of appendicitis. A catarrhal appendicitis group (n=43), a phlegmonous appendicitis group (n=28), a gangrenous appendicitis group (n=19), a perforated appendicitis group (n=35), and an appendicitis +COVID-19 group (n=7) were formed. The control group consisted of 21 children. A section of each patient's appendix tissue from the part with the highest diameter was taken for histopathological examination. The sections were routinely stained with hematoxylin and eosin (H&E). The two pathologists evaluated all H&E sections in a light microscope. The evaluation results were analyzed statistically. No significant differences in age and gender were found between all groups. The results of neutrophil and lymphocyte counts in all tissue layers of all groups were significantly different. Neutrophil count in the mucosa and muscularis propria in the appendix tissues of the control group were found to be zero. Among all groups, the highest number of neutrophil counts in the mucosa and muscularis propria were found in the perforated group. Among all groups, the highest number of lymphocyte counts in mucosa and muscularis propria were found in the Covid-19 group. The mucosal erosion, intraluminal neutrophils, and reactive lymphoid hyperplasia were negative in all samples in the control group. Neutrophil accumulation in the mucosa and muscularis propria layers in appendix tissue together with other inflammation findings are important in the histopathological diagnosis of appendicitis. In patients with Covid-19 infection, appendicitis may occur, in which case, severe accumulation of lymphocytes appears in the mucosal layer in addition. [Med-Science 2022; 11(4.000): 1527-33]