Purpose: It is unclear whether the tissue source of mesenchymal stem cells (MSCs) influences their activity in diabetic wounds. This study aimed to compare the effects of dental pulp–derived and adipose tissue–derived MSCs on wound healing and on the cutaneous expression of tumor necrosis factor-α (TNF-α), interleukin (IL)-1, IL-6, and IL-10 in streptozotocin (STZ)-induced diabetic rats.To compare the effects of dental pulp–derived and adipose tissue–derived MSCs on diabetic wound healing and on the cutaneous expression of TNF-α, IL-1, IL-6, and IL-10 in a streptozotocin (STZ)-induced diabetic rat model.Materials and methods: Twenty-four male rats were allocated to four groups (n=6 each): non-diabetic control, diabetic control, and diabetic wounds treated with dental pulp–derived or adipose tissue–derived MSCs. Diabetes was induced with STZ (55 mg/kg, intraperitoneally). A 5 mm full-thickness wound was created, and 1×10⁶ MSCs were applied topically in the treatment groups. On day 10, skin sections were evaluated by hematoxylin–eosin and Masson's trichrome staining, and cytokine expression was scored immunohistochemically using the H-score.Results: Wound diameter did not differ significantly between the non-diabetic control and the MSC-treated groups, whereas the diabetic control showed significantly larger wounds. Histologically, both MSC-treated groups showed a thicker, better-organized epidermis and denser dermal collagen than the diabetic control. Compared with the diabetic control, both MSC-treated groups showed significantly lower IL-1 and IL-6 expression and higher IL-10 expression, whereas TNF-α expression did not change significantly. No significant differences were observed between the dental pulp– and adipose tissue–derived MSC groups for any marker except IL-10, which was higher in the adipose tissue–derived MSC group.Conclusion: Topical application of dental pulp– or adipose tissue–derived MSCs supported diabetic wound healing through an anti-inflammatory shift characterized by lower IL-1 and IL-6 and higher IL-10 expression, without significantly affecting TNF-α.
Purpose: Subclinical inflammation may persist in some patients with Familial Mediterranean Fever despite colchicine treatment. Pentraxin-3 is used as a potential biomarker of inflammatory activity in various inflammatory diseases. This study aimed to evaluate serum PTX-3 levels during attack and attack-free periods in children with Familial Mediterranean Fever and to investigate the possible association between serum PTX-3 levels and subclinical inflammation.Materials and methods: Forty-five children diagnosed with Familial Mediterranean Fever and receiving colchicine treatment and 40 healthy controls were included. Serum pentraxin-3 levels and conventional acute-phase reactants were measured during attack and attack-free periods. Patients with at least one elevated acute-phase reactant during the attack-free period were considered to have subclinical inflammation.Results: Pentraxin-3 levels and conventional acute-phase reactants were significantly higher during attack periods compared with attack-free periods and healthy controls (3.21±0.67 vs 1.90±0.15 vs 0.88±0.39 ng/mL, respectively; p<0.001). Serum pentraxin-3 levels were similar between patients with and without subclinical inflammation (1.9±0.05 vs 1.8±0.03 ng/mL; p=0.29); however, both subgroups had significantly higher pentraxin-3 levels than healthy controls (p=0.001). ROC analysis showed excellent diagnostic performance of PTX-3 for differentiating FMF patients from healthy controls, with an AUC of 1.000 (cut-off ≥1.80 ng/mL, sensitivity 100%, specificity 100%) during the attack period and 0.997 (cut-off ≥1.64 ng/mL, sensitivity 97.8%, specificity 100%) during the attack-free period.Conclusion: Pentraxin-3 levels remained elevated in children with Familial Mediterranean Fever during both attack and attack-free periods compared with healthy controls, and PTX-3 discriminated FMF patients from healthy controls with excellent diagnostic accuracy during both the attack period (AUC=1.000) and the attack-free period (AUC=0.997). These findings suggest that PTX-3 may reflect persistent inflammatory activity in pediatric FMF patients and could serve as a useful marker of disease activity beyond overt clinical episodes. Larger prospective studies are needed to confirm these findings.
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder characterized by progressive proximal muscle weakness and atrophy. Anesthetic management in obstetric patients with neuromuscular conditions requires careful planning, particularly in the presence of previous postdural puncture headache (PDPH) and concurrent respiratory symptoms. A pregnant woman with SMA carrier status was scheduled for cesarean section due to repeat cesarean delivery, gestational hypertension, and premature rupture of membranes. Her obstetric history included a missed abortion at 12 weeks and PDPH following spinal anesthesia during a prior cesarean section. She also presented with a five-day history of cough and postnasal drip. Considering her refusal of spinal anesthesia and the potential risks associated with general anesthesia, epidural anesthesia was administered, avoiding neuromuscular blocking agents and tracheal intubation. Epidural anesthesia may represent a safe and effective alternative for cesarean delivery in selected obstetric patients with SMA carrier status and prior PDPH history.
Abstract Purpose: Emergency department (ED) overcrowding is a significant challenge worldwide. Triage systems categorize patients according to the urgency of their clinical conditions to ensure patient safety and minimize the risk of clinical errors. The aim of this study was to evaluate the utility of decision trees, an artificial intelligence-based model, in emergency medicine triage.Materials and methods: This prospective, cross-sectional study was conducted in the ED of a tertiary care hospital. A total of 1,999 patients aged >17 years were included. Prior to the study, triage staff received training on the Australasian Triage Scale (ATS). Two independent observers assessed the final triage category of each patient. A new triage algorithm was developed using a decision tree model.Results: Mean age of the study population was 41.1±17.2 years, and 49.1% (n=981) were male. A total of 867 patients (43.3%) were assigned to triage category 5, whereas 14 patients (0.7%) were assigned to category 1. The most common clinical descriptors were minimal pain with no high-risk features (n=409, 20.5%) and minor symptoms of low-risk conditions (n=362, 18.1%). There was excellent agreement between the independent observers (κ=0.997). The decision tree algorithm incorrectly classified only one patient, yielding an accuracy rate of 99.9%. Agreement between the ATS and the decision tree algorithm was also excellent (κ=0.999). Agreement between physicians and paramedics was moderate (κ=0.541).Conclusion: Decision tree models may be used to develop practical triage algorithms as decision-support tools in ED triage. Artificial intelligence-based decision trees have the potential to support triage practices.
Purpose: To overcome the rapid oxidation and low stability of Ferulic Acid (FA), this study designed and characterized FA-loaded Zeolitic imidazol framework -8 (FA-ZIF-8) nanoparticles, evaluating their selective cytotoxic, anti-proliferative, anti-migratory, and apoptotic effects on OVCAR-3 and SKOV-3 ovarian cancer cells alongside healthy primary dental pulp stem cells (DPSCs).Materials and methods: FA-ZIF-8 nanoparticles were synthesized and characterized. OVCAR-3, SKOV-3, and DPSC cohorts were treated with varying concentrations of FA (5 μM–1 mM) and FA-ZIF-8 (25–500 μg/mL) for up to 72 h. Cell viability and 48-h half-maximal inhibitory concentrations IC50 were quantified using the XTT assay. Transcriptional and translational expressions of apoptotic markers were analyzed via qRT-PCR and immunocytochemistry and TUNEL analysis. Long-term survival and lateral cell motility were monitored via coloni and scratch wound healing assays.Results: FA exhibited a non-toxic profile, actively stimulating the proliferation of both cancer lines and DPSCs. FA-ZIF-8 inverted this response, yielding 48-h IC50 values of 308.2098 μg/mL for OVCAR-3 and 336.3022 μg/mL for SKOV-3. FA-ZIF-8 upregulated Bax expression and Caspase-3 levels while suppressing Bcl-2, driving a significant increase in the Bax/Bcl-2 (p=0.0024). These results were confirmed by an increase in TUNEL-positive apoptotic cell. Furthermore, FA-ZIF-8 inhibited colony formation and significantly reduced lateral migration indices, particularly in SKOV-3 lines.Conclusion: FA acts as a proliferative ligand, its strategic formulation into FA-ZIF-8 nanoparticles enables a, "Trojan Horse" effect, delivering selective cytotoxicity, anti-metastatic suppression, pH-responsive apoptotic induction to epithelial ovarian cancer cells.
