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Öğe Cytoprotective effects of molsidomine against methotrexate-induced hepatotoxicity: an experimental rat study(Dove Medical Press Ltd, 2019) Samdanci, Emine Turkmen; Huz, Mustafa; Ozhan, Onural; Tanbek, Kevser; Pamukcu, Esra; Akatli, Ayse Nur; Parlakpinar, HakanIntroduction and aim: Methotrexate (Mtx) is an antineoplastic and immunosuppressive drug that may cause hepatotoxicity, whereas molsidomine (Mol) is a vasodilating and antioxidant agent. This study aimed to investigate the potential protective effects of Mol in Mtx-induced liver toxicity in rats. Materials and methods: Forty Wistar albino rats were equally divided into five groups: control, Mol, Mtx, Mol Mtx, and Mtx Mol. Following treatment, the animals were sacrificed, and liver tissue samples were histopathologically evaluated using Roening grading and Bcl-2 antibody staining. Tissue oxidants, antioxidants, and serum transaminases were measured and statistically compared across all groups. Results: No hepatic fibrosis or steatosis was observed in any of the groups. In the Mtx group, grade 2 liver injury and score 2 Bcl-2 antibody staining were observed; however, in the Mol-Mtx group, these were lower (grade 1, score 1). There were no statistically significant differences in serum transaminase levels among groups. Malondialdehyde levels were higher in all rats that received Mtx, but no differences in myeloperoxidase levels were observed among the groups. Levels of tissue antioxidants, including superoxide dismutase, glutathione (GSH) peroxidase (GSH-Px), and reduced GSH, were significantly higher in the Mol-treated and Mol pre-treated groups. Catalan (CAT) levels were elevated in all Mol-treated groups, but only in that group were CAT levels statistically significantly higher than in the control group. Conclusion: Our results suggest that some oxidant levels could increase following Mtx administration in the liver, possibly contributing to liver damage, whereas Mol could mitigate the histopathological and biochemical effects of hepatotoxicity. However, molecular studies are required to understand the exact mechanisms of these alterations.Öğe Demographic features of acute drug poisoning admitted to Inonu University Hospital in Malatya, Turkey(Academic Journals, 2010) Oguzturk, Hakan; Turtay, Muhammet Gokhan; Pamukcu, Esra; Ciftci, OsmanIn this study, the patients appealed to Emergency Medicine Department, Faculty of Medicine, University of Inonu, Malatya, Turkey because the acute drug poisoning in the period from 01/01/2008 to 31/12/2009 were evaluated retrospectively. Demographic features of the patients, the agent responsible for poisoning and hospitalization rates were assessed. In this aim, we evaluated 178 patients, ages ranged from 18 to 77.79 (44.4%) were men and 99 (55.6%) patients were women. The mean ages of male and female were found to be 32.2 +/- 12.2 and 31.3 +/- 12.0, respectively. 91(51.1%) patients were living in rural areas and 87 patients (48.9%) were living in urban centers. It was found that 156 (87.6%) of these patients had first poisoning whilst 19 (10.7%) patients experienced second poisoning event and 3 (1.7%) patients had third poisoning event. The type of the poisoning was ingestion of drugs for suicidal intent in 146 (82%) cases and accidental ingestion in 32 (18%) cases. Poisoning most commonly occurred as ingestion of multiple drugs. Seven patients (3.9%) were discharged from the emergency service (ED), while 132 patients (74.2%) were hospitalized in intensive care unit of anesthesiology and 39 patients (21.9%) in the department of internal medicine. Average duration of hospitalization of all patients was 3.46 +/- 2.22 days. Drugs poisoning occur most frequently as ingestion of multiple drugs in young individuals and female.Öğe Histopathological evaluation of autopsy cases with isolated pulmonary fat embolism (IPFE): is cardiopulmonary resuscitation a main cause of death in IPFE?(Dove Medical Press Ltd, 2019) Samdanci, Emine Turkmen; Celik, Muhammet Reha; Pehlivan, Sultan; Celbis, Osman; Turkkan, Dilhan; Kara, Dogus Ozdemir; Pamukcu, EsraBackground: Fat embolism (FE) may develop following many traumatic and atraumatic clinical conditions; however, fewer data exist regarding the occurrence of isolated pulmonary FE (IPFE). Cardiopulmonary resuscitation (CPR) is an emergency procedure for maintaining blood circulation and oxygenation during cardiac arrest. In this study, we aimed to evaluate the association of CPR with IPFE in autopsy cases. Methods: A total 402 cases among 4,118 autopsies were diagnosed with IPFE, and the medical background of these cases was retrospectively evaluated. Diagnosis of FE and FE grading were performed with histopathological examinations of postmortem tissue samples, and injury-severity scores of traumatic cases were assessed. Data of traumatic and atraumatic cases were statistically compared. Results: Of the IPFE cases, 298 (741%) were male and 104 (25.9%) female, with overall mean age 53.7 (2-99) years. Causes of death of studied subjects were traumatic for 302 (75.1%) and atraumatic reasons for 100 (24.9%) cases. CPR was performed for 277 cases of which 177 (63.9%) were traumatic and 100 (36.1%) were non-traumatic. In comparison to traumatic cases, significantly higher CPR frequency was determined in atraumatic IPFE (P=0.001). High grade FE in the traumatic cases, and mild-moderate grade of FE in the nontraumatic cases were found statistically significant (P=0.001). Conclusion: This study indicates that CPR may be one of the leading factors in the development of IPFE in atraumatic conditions, and this procedure was related to mild-moderate IPFE manifestations. Regardless of whether conditions were traumatic or atraumatic, in patients who survive following CPR for manifest ventilation/perfusion problems, it should be remembered that IPFE may have developed due to CPR.Öğe Prospective Evaluation of Clinical and Laboratory Profiles of Febrile and Afebrile Immunosuppressed Patients Presenting to the Emergency Department(Mdpi, 2025) Topal, Tugrul; Pamukcu, Esra; Turtay, Muhammet Gokhan; Yalcin, Gulsen; Sahingil, Harun Kursat; Sezer, MehmetBackground and Objectives: Immunosuppressed patients are at higher risk of delayed diagnosis and atypical presentations in the emergency department (ED), requiring prompt management. This study compares febrile (>= 37.5 degrees C) and afebrile (<37.5 degrees C) immunosuppressed patients admitted to the ED regarding clinical and laboratory parameters, including blood and urine tests, vital signs, final diagnoses, outcomes, and mortality. Materials and Methods: Eighty immunosuppressed patients aged 18-82 were prospectively evaluated from May 2019 to May 2020. Data on blood and urine tests, final diagnoses, outcomes, and mortality were recorded using a standardized form. Results: Among the 80 patients, 44 (55%) were female and 36 (45%) were male, with a mean age of 58.5 +/- 14.72 years. The febrile patients showed higher admission levels of lactate dehydrogenase (LDH), interleukin-6 (IL-6), procalcitonin (PCT), and longer hospital stays than the afebrile patients. Mortality correlated with low albumin, oxygen saturation, platelet count, and total protein levels and elevated PCT and lipase levels. ICU admissions were linked to low albumin, total protein, and systolic blood pressure levels and elevated LDH, blood urea nitrogen, neutrophil count, and PCT levels. The fever status (febrile versus afebrile) had no significant relationship with the immunosuppression type, complaints, diagnoses, outcomes, or mortality. Final diagnoses varied by immunosuppression type: cholangitis in liver transplant recipients, respiratory infections in cancer patients, and urinary tract infections in kidney transplant recipients. Conclusions: Immunosuppressed patients can present with severe conditions, even without fever. Based on our findings, our study emphasizes that measuring PCT in immunosuppressed patients presenting to the emergency department with various complaints but without fever may help reduce the risk of delayed diagnosis.
