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    Evaluation of hepatic and remote organ injury in an experimental liver ischemia-reperfusion model in rats and the effects of quercetin on this damage
    (Turkish Assoc Trauma Emergency Surgery, 2025) Ari, Neziha Senem; Yulug, Esin; Ari, Bunyamin; Kaya, Cansu; Kose, Goksen Derya Reis; Zengin, Tugba; Keskin, Oguzhan
    BACKGROUND: This study aims to show the changes in the liver, lung, kidney, and heart in the liver ischemia-reper fusion model rats and the effect of quercetin on these changes histopathologically and immunohistochemically. METHODS: Eighteen Sprague Dawley rats were classified into three groups: Group 1 sham, Group 2 ischemia-reper fusion Group 3 ischemia-reper fusion + quercetin (IR+Q). For three days, distilled water was given to Group 1, and quercetin was given Group 3 via gavage. At the end of the third day, abdominal opening-closing was applied to Group 1, and 4 hours of reperfusion applied to Groups 2 and 3 after 1 hour of ischemia by clamping the hepatoduodenal ligament, and all rats were euthanized. Liver, kidney, and heart tissue samples were stained with Hematoxylin Eosin (HE), Masson Trichrome, Periodic Acid-Schiff (PAS), and TUNEL (Terminal deoxynucleotidyl transferase (TdT) deoxyuridine triphosphate nick end labeling assay) to assess apoptosis and examined histopathologically and immunohistochemically under a light microscope. RESULTS: In the liver, the damage score was significantly higher in the IR group than in the sham group, while it was significantly in the IR+Q group than in the IR group. While there was no significant difference between the groups in semi-quantitative scoring parameters, the Apoptotic Index was significantly higher in the IR group than in the sham group and significantly lower in the group than in the IR group. In the lung, no significant difference in lung damage scores between the groups was observed. While Apoptotic Index was significantly higher in the IR group than in the sham group, it was significantly lower in the IR+Q group than IR group. In the kidneys, tubular cell degeneration and intertubular vascular congestion were significantly higher in the IR group than the sham group. While the Apoptotic Index was higher in the IR group than in the sham and IR+Q groups, it was higher in the group than in the sham group. In the heart, there was no difference between the groups in terms of myocardial cell degeneration vascular damage. The apoptotic index was significantly higher in the IR group than in the sham and IR+Q groups. CONCLUSION: Our results indicate that histopathological damage occurs in the liver, lung, kidney, and heart in the experimentally created IR model, and quercetin application decreases IR-related damage and apoptosis in these organs.
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    Risk of Latent Tuberculosis Infection Reactivation in Patients Treated with Tumor Necrosis Factor Antagonists: A Five-Year Retrospective Study
    (Mdpi, 2025) Aliravci, Isil Deniz; Mutlu, Pinar; Oymak, Sibel; Guney, Ufuk Ilter; Keskin, Oguzhan
    Background: This study aims to reveal the demographic and clinical data of patients receiving TNF-alpha blockers, to compare the characteristics of those who received latent tuberculosis infection (LTBI) treatment and those who did not, and to evaluate and determine potential risk factors for developing active TB disease. Methods: A systematic retrospective study was conducted in a tertiary university hospital examining all patients receiving at least one TNF-alpha blocker between January 2019 and October 2024. The incidence of tuberculosis (TB) was analyzed across various TNF-alpha blocker medications in patients, both with and without LTBI treatment. Results: A total of 519 patients had TNF-alpha blockers: 452 (87.09%) underwent TST, 193 (37.1%) underwent booster TST, and 33 (6.3%) underwent IGRA/TST; 362 (69.7%) were treated for LTBI, and 7 (1.3%) developed TB. Comparing all TNF-alpha blockers, adalimumab showed a higher risk of TB. Patients with and without LTBI treatment did not significantly differ in TB incidence after biologic therapy. Conclusions: The incidence of TB in people taking TNF-alpha blockers was higher compared to the incidence in the general population. LTBI screening, including both TST and IGRA, should be performed with TST and IGRA tests, and LTBI-positive individuals should be started on preventive treatment. However, it should not be forgotten that active TB disease may also develop in LTBI-negative individuals.