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The role of monoamine oxidases in diabetic nephropathy rat model

Aim: Diabetic nephropathy (DN) is a serious complication that can lead to renal failure in many diabetic patients. Although there are multiple mechanisms related to the pathogenesis of the disease, reactive oxygen species (ROS) play an important role in its etiology. It has been suggested that monoamine oxidases (MAOs) as an intracellularly important ROS source may cause nephropathy by contributing to redox state imbalance in the kidney of diabetics. We investigated the role of monoaminoxidase-A (MAO-A) and monoaminoxidase-B (MAO-B) in the pathogenesis of diabetic nephropathy (DN) induced by streptozotocin (STZ) in rats. We also tried to demonstrate the importance of MAO-A or MAO-B inhibition to prevent the development and progression of DN. Material and Method:  Twenty-eight male Wistar albino rats were divided into four groups as normal control and three diabetic groups. A single dose of STZ was given to the peritoneal cavity of rats to induce diabetes. One of the diabetic groups was treated with MAO-A inhibitor(moclobemide, 5 mg/kg/day), another group MAO-B inhibitor, (rasagiline, 10 mg/kg/day), while those included in the DN group were not treated. After the eight-week treatment period, urine samples were collected with a metabolic cage to measure N -acethyl-b-glucosaminidase (NAG), g-glutamyltranspeptidase (GGT), creatinine, glucosuria and proteinuria, and then the animals were anesthetized and sacrificed by cardiac puncture and the kidneys were taken. Blood glucose, BUN, serum creatinine, renal MAO-A, MAO-B, superoxide dismutase (SOD) and catalase (CAT) activity and lipid peroxidation (MDA) were determined by spectrophotometric or ELISA method. Results: The untreated diabetic rats showed nephropathy symptoms such as high serum creatinine, proteinuria, glucosuria and high urinary NAG and GGT. However, renal MAO-A, MAO-B, SOD and CAT activity and MDA levels increased in DN rats. Although moclobemide or rasagiline treatment significantly reduced nephropathic findings and high renal MAO-A and MAO-B activity in diabetic rats, MAO-A inhibition showed more effect than MAO-B. Discussion: The results indicate that the renal MAO-A and MAO-B activity playsan important pathophysiological role, which is responsible for the development and progression of DN, and that MAO-A inhibition is more effective than MAO-B to prevent the formation of DN in diabetic rats.

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Probiotic use in acute viral gastroenteritis: Is it really effective?

Aim: Acute diarrhea in childhood is the second most common cause of high morbidity and mortality and occurs mostly due to viral agents. The aim of this study is to determine the effect of probiotics on the severity and duration of the complaints of children aged between 2 and 5 years who were treated in our clinic with the diagnosis of acute viral gastroenteritis in early childhood morbidity and mortality. Material and Method: Children aged between 2 and 5 years who were hospitalized in the Pediatric Clinic with acute viral gastroenteritis between October 2017 and October 2018 were included in the study. The patients were divided into groups of those taking probiotic treatment (Group 1) and not taking probiotic treatment (Group 2). Results: Total of 316 stool samples were examined and viral agents were determined in 125 patients (39.55%). Discussion: Especially in the treatment of diarrhea related to viral gastroenteritis, it was found that probiotics could reduce the mean duration of diarrhea until one day independently of the strain and also significantly decrease the number of watery diarrhea.

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Preoperative visits versus midazolam premedication during spinal anesthesia for TURP

Aim: Patients undergoing surgery experience acute psychological distress in the preoperative period. In this study, we aimed to investigate whether preoperative informing without midazolam was as effective as midazolam premedication in adult male patients undergoing TURP under spinal anesthesia. Material and Method: The preliminary study was performed in 36 adults scheduled for transurethral prostate resection (TURP) under spinal anesthesia. Age ranged from 25-61 years (ASA physical status I–II). Patients were randomized into two groups to receive either 0.04 mg/kg of midazolam (Group M, n=18) or placebo intravenously (Group T, n=18) 15 minutes before spinal anesthesia. The patients in Group T were informed at night and 15 min before the anesthetic procedure. Perioperative measurements included blood pressure, heart rate, numeric rank score, verbal rating scale, agitation, sedation and satisfaction scores.  Results: There was no significant difference between the groups regarding hemodynamics, numeric rank score, agitation, sedation, and satisfaction scores. The postoperative verbal rating scales at 60th and 90th minutes in Group T were significantly higher than in the Group M (p=0.006 and p=0.006 respectively).  Discussion: The anxiety experienced at the night before the surgery often relates to pain5 and the mutilation associated with the surgical procedures such as prostatectomy, hysterectomy, mastectomy13. Anxiety may be because of the uncertainty of surgical procedure, postoperative results and expectations14 and psychological factors play a major role in pain perception15. We can suggest the first preoperative visit at night before the surgery and the second one 15-20 minutes before the surgery to provide a good satisfaction and sedation score. Conclusion: Preoperative information is as effective as sedative doses of midazolam in providing perioperative safe hemodynamics, satisfactory sedation, and satisfaction scores in adult male patients under spinal anesthesia.

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