1.Dexpanthenol protects against lipopolysaccharide-induced acute kidney injury by restoring aquaporin-2 levels via regulation of the silent information regulator 1 signaling pathway
Eyyüp Sabri ÖZDEN ; Halil AŞCI ; Halil İbrahim BÜYÜKBAYRAM ; Mehmet Abdulkadir SEVÜK ; Orhan Berk İMECI ; Hatice Kübra DOĞAN ; Özlem ÖZMEN
Korean Journal of Anesthesiology 2023;76(5):501-509
Background:
Acute kidney injury (AKI) is a serious pathology that causes dysfunction in concentrating urine due to kidney damage, resulting in blood pressure dysregulation and increased levels of toxic metabolites. Dexpanthenol (DEX), a pantothenic acid analog, exhibits anti-inflammatory and anti-apoptotic properties in various tissues. This study investigated the protective effects of DEX against systemic inflammation-induced AKI.
Methods:
Thirty-two female rats were randomly assigned to the control, lipopolysaccharide (LPS), LPS+DEX, and DEX groups. LPS (5 mg/kg, single dose on the third day, 6 h before sacrifice) and DEX (500 mg/kg/d for 3 d) were administered intraperitoneally. After sacrifice, blood samples and kidney tissues were collected. Hematoxylin and eosin, caspase-3 (Cas-3), and tumor necrosis factor alpha (TNF-α) staining were performed on the kidney tissues. The total oxidant status (TOS) and total antioxidant status were measured using spectrophotometric methods. Aquaporin-2 (AQP-2), silent information regulator 1 (SIRT1), and interleukin-6 (IL-6) were detected using quantitative reverse transcription-polymerase chain reaction analysis.
Results:
Histopathological analysis revealed that DEX treatment ameliorated histopathological changes. In the LPS group, an increase in the blood urea nitrogen, creatinine, urea, IL-6, Cas-3, TNF-α, and TOS levels and oxidative stress index was observed compared with the control group, whereas AQP-2 and SIRT1 levels decreased. DEX treatment reversed these effects.
Conclusions
DEX was found to effectively prevent inflammation, oxidative stress, and apoptosis in the kidneys via the SIRT1 signaling pathway. These protective properties suggest DEX’s potential as a therapeutic agent for the treatment of kidney pathologies.
2.Cemented Versus Uncemented Reverse Shoulder Arthroplasty Treatment of Proximal Humerus Fractures: National Shoulder Arthroplasty Data from Türkiye
Özlem ORHAN ; İbrahim KAYA ; İzzet BINGÖL ; Baran SARIKAYA ; Mustafa Okan AYVALI ; Naim ATA ; M. Mahir ÜLGÜ ; Şuayip BIRINCI ; Fatih KARAASLAN ; H. Çağdaş BASAT ;
Clinics in Orthopedic Surgery 2024;16(4):602-609
Background:
This study evaluated national trends in cemented and uncemented reverse shoulder arthroplasty (RSA) for proximal humerus fractures using a comprehensive national surgical database. This study aimed to compare RSA used in the treatment of proximal humerus fractures with the literature and to determine the country's trend.
Methods:
A cross-sectional study was conducted using the health records of individuals aged ≥ 18 years who underwent RSA for proximal humerus fractures between 2016 and 2022. Patients were divided into cemented and uncemented groups, and demographic data (age, sex), duration of hospital stay, transfusions, revisions, mortality, and Charlson Comorbidity Index (CCI) scores were analyzed.
Results:
A total of 618 cemented RSA and 1,364 uncemented RSA procedures were reviewed. Patients who underwent cemented RSA were significantly older than those who had uncemented RSA (p = 0.002). Transfusion rates were higher in the cemented RSA group (p = 0.006). The frequency of revision surgery was 6.1%. Younger age and male sex were associated with revision (p < 0.001). CCI scores were higher among transfused patients than non-transfused patients (p < 0.001). The incidence of cemented RSA was 11.7% and 49% in 2016 and 2022, respectively. Differences were found among hospital types and geographical regions.
Conclusions
While cemented RSA has been gaining attention and increased application in recent years for proximal humerus fractures, uncemented RSA still predominates. The choice between these 2 methods is largely influenced by regional and hospitallevel factors. The type of RSA and high CCI scores were found to have no significant impact on the risk of surgical revision.