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    Curcumin attenuates the organ dysfunction caused by endotoxemia in the rat
    (Elsevier Science Inc, 2008) Memis, Dilek; Hekimoglu, Sevtap; Sezer, Atakan; Altaner, Semsi; Sut, Necdet; Usta, Ufuk
    Objective: Curcumin has antioxidant, antitumor, and anti-inflammatory properties. However, it remains unknown whether curcumin has any protective effects on sepsis. The purpose of this study was to demonstrate whether curcumin prevents organ dysfunction in animals with sepsis. Methods: Rats were randomized into four groups. The control group (group I, n = 7) did not receive any treatment. The curcumin group (group II. n = 10) only received 1.2 g/kg of curcumin. Escherichia coli were injected into the remaining groups intraperitoneally after general anesthesia. Five hours after injection, 12 rats received placebo (group III), and 10 rats received 1.2 g/kg of curcumin (group IV) for 7 d. All rats were sacrificed on postsepsis day 8 and it midline laparotomy was performed. Livers, kidneys, and small bowels were excised for evaluation of the degree of inflammation and tissue alterations histopathologically. Results: In the liver, widespread hydropic degeneration of hepatocytes were seen in the sepsis group. There was no hydropic degeneration of hepatocytes and no portal inflammation ill the sepsis/curcumin group. With respect to the small bowel, the sepsis group showed edema and prominent intraepithelial infiltration of neutrophil leucocytes and plasma cells. Inflammation and hyperemia in the lamina propria in the sepsis/curcumin group were less than those in the sepsis group, With respect to the kidneys, the sepsis group showed severe acute tubular necrosis that was more restricted in the sepsis/curcumin group than in the sepsis group. Conclusion: curcumin reduced organ dysfunction in rats with experimentally formed sepsis. We propose that curcumin may he useful in the therapy of organ dysfunction due to sepsis, shock, and other diseases associated with local or systemic inflammation. (C) 2008 Elsevier Inc. All rights reserved.
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    Efficacy of levobupivacaine wound infiltration with and without intravenous lornoxicam for post-varicocoele analgesia - A randomized, double-blind study
    (Adis Int Ltd, 2008) Memis, Dilek; Hekimoglu, Sevtap; Kaya, Gaye; Atakan, Huseyin I.; Kaplan, Mustafa
    Background and objective: The oxicam NSAID lornoxicam is a potent analgesic with excellent anti-inflammatory properties in a range of painful and/or inflammatory conditions, including postoperative pain. Levobupivacaine, the S-(-)-isomer of bupivacaine, is a long-acting local anaesthetic that can be infiltrated into wounds for management of postoperative pain. We assessed the analgesic efficacy of lornoxicam when administered as an adjuvant to levobupivacaine wound infiltration after varicocoele operation. Methods: Sixty patients who underwent varicocoele surgery were randomly assigned to three different treatment groups. Before skin closure, patients received the following treatments: group I (n = 20) patients received normal saline 20 mL wound infiltration and intravenous lornoxicam (Xefo(R), Nycomed Pharma AS, Roskilde, Denmark) 2 mL (8 mg); group II (n = 20) patients received 0.25% levobupivacaine (Chirocaine(R), Abbott Scandinavia AB, Solna, Sweden) 10mL with normal saline 10 mL wound infiltration and intravenous normal saline 2 mL; group III (n = 20) patients received 0.25% levobupivacaine 10 mL with normal saline 10 mL wound infiltration and intravenous lornoxicam 2 mL (8 mg). Pain scores and total pethidine (meperidine) consumption were measured at 1, 2, 4, 6, 12 and 24 hours postoperatively. Time to first analgesic requirement and patient satisfaction were also compared post-surgery. Results: Pain scores during the first 6 hours postoperatively were significantly lower in group III than in group I and group II (p < 0.01). Total pethidine consumption was significantly lower in group HI (34.0 +/- 28.0 mg) than in group I (74.0 +/- 25 mg) and group II (76.0 +/- 29 mg) [p < 0.01]. Time to first analgesic was also significantly longer in group III (14.8 +/- 8.4 hours) than in group I (6.2 +/- 5.2 hours) and group II (5.8 +/- 7.1 hours) [p < 0.01]. The incidence of postoperative nausea and vomiting was significantly lower in group III than in group I and group II (p < 0.05). More patients in group III described their analgesia as good or excellent than in group I or group II (p < 0.01). Conclusion: In this study, levobupivacaine wound infiltration with adjuvant intravenous lornoxicam administration was associated with better postoperative analgesia during the early postoperative hours after varicocoele surgery than that induced by lornoxicam alone or levobupivacaine wound infiltration alone.