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Yayın Angiotensin-converting enzyme inhibitor captopril ameliorates renal damage in a rat model of thermal injury(WALTER DE GRUYTER GMBH, 2013) Emekli-Alturfan, Ebru; Ozdemir, Gulsen; Saglam, Esra; Ozdamar, Emine Nur; Sehirli, Ozer; Sener, GokselBackground: Burn is a posttraumatic inflammatory condition accompanied by both local and distant effects leading to intense inflammation, tissue damage, and infection. Acute renal failure is a well-known complication of severe burns and is an important factor leading to an increase in mortality. Objective: To determine the effect of captopril treatment on renal damage in a rat model of thermal injury by evaluating oxidant antioxidant system parameters, sialic acid levels, glutathione-S-transferase (GST), and tissue factor (TF) activities. Methods: Under ether anesthesia, the shaved dorsum of the rats was exposed to a 90 degrees C water bath for 10 seconds to induce burn injury. Captopril (1 mg/kg) or saline was administered intraperitoneally immediately after, and at 24 hours after burn injury. Rats were decapitated at 48 hours following the burn injury and trunk blood was collected to assay blood urea nitrogen (BUN) and creatinine concentrations. To evaluate the presence of oxidant injury, kidney tissue samples were taken to determine malondialdehyde (MDA), glutathione (GSH), sialic acid levels, and the activities of superoxide dismutase (SOD), catalase, GST, and TF. In the sham group the same protocol was applied except that the dorstun was dipped in a 25 degrees C water bath for 10 seconds. Results: Severe skin scald injury (30% of total body surface area) caused significant decreases in GSH level, SOD and catalase activities, and significant increases in TF and GST activities, and sialic acid levels. Treatment of rats with captopril (1mg/kg) significantly elevated the reduced GSH levels, SOD and catalase activities, while it decreased MDA, sialic acid levels, GST and TF activities. Conclusions: The present study showed for the first time that, captopril scavenging of reactive free radicals, normalizing the activities of TF and GST seems to be a promising agent for restoring renal damage following thermal trauma.Yayın Anti-proliferative effects of paroxetine alone or in combination with sorafenib in HepG2 cells(Univ Sao Paulo, Conjunto Quimicas, 2022) Çakıl, Yaprak Dönmez; Güneş Özünal, Zeynep; Kayali, Damla Gokceoğlu; Aktas, Ranan Gülhan; Saglam, EsraHepatocellular carcinoma (HCC) is a common cause of cancer-related death. Sorafenib is the first approved drug for the treatment of advanced HCC. Depression is frequent in cancer patients. Moreover, sorafenib might exert depression as an adverse drug reaction and paroxetine, a selective serotonin reuptake inhibitor, is a recommended pharmacotherapy. This study aimed to investigate the potential synergistic effects of paroxetine and sorafenib on HepG2 cell proliferation and death. Paroxetine and sorafenib were administered to HepG2 cells as singleagents or in combination. Cell viability was determined with XTT cell viability assay. Cellular apoptosis and DNA content were assessed by flow cytometry. The expression of anti-apoptotic Bcl-2 was examined by immunofluorescence confocal microscopy. A lower dose of sorafenib was found to be required to inhibit cell proliferation when in combination with paroxetine. Similarly, the coadministration enhanced cellular apoptosis and resulted in cell cycle arrest. Confocal imaging revealed a remarkably lower cell density and increased expression of Bcl2 following combined treatment of paroxetine with sorafenib. To our knowledge, this is the first study demonstrating the synergistic effect of paroxetine and sorafenib in HCC and might provide a potentially promising therapeutic strategy.Yayın Captopril protects against burn-induced cardiopulmonary injury in rats(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2014) Saglam, Esra; Sehirli, Ahmet Ozer; Ozdamar, Emine Nur; Contuk, Gazi; Cetinel, Sule; Ozsavci, Derya; Suleymanoglu, Selami; Sener, GokselBACKGROUND: This study was designed to determine the possible protective effect of captopril treatment against oxidative damage in heart and lung tissues induced by burn injury. METHODS: Under ether anesthesia, the shaved dorsum of Wistar albino rats was exposed to 90 C water bath for 10 seconds. Captopril was administered intraperitoneally (10 mg/kg) after the burn injury and repeated twice daily. In the sham group, the dorsum was dipped in a 25 C water bath for 10 seconds. At the end of the 24 hours, echocardiographic recordings were performed, then animals were decapitated and heart and lung tissue samples were taken for the determination of tumor necrosis factor-alpha (TNF-alpha) as a pro-inflammatory cytokine, malondialdehyde and glutathione levels and myeloperoxidase, caspase-3, and Na+, K+-ATPase activity in addition to the histological analysis. RESULTS: Burn injury caused significant alterations in left ventricular function. In heart and lung tissues, TNF-a and malondialdehyde levels and myeloperoxidase and caspase-3 activities were found to be increased, while glutathione levels and Na+, K+-ATPase activity were decreased due to burn injury. Captopril treatment significantly elevated the reduced glutathione level and Na+, K+-ATPase activity, and decreased cytokine and malondialdehyde levels and myeloperoxidase and caspase-3 activities. CONCLUSION: Captopril prevents burn-induced damage in heart and lung tissues and protects against oxidative organ damage.Yayın Depressive symptoms associated with dabigatran: a case report(WILEY, 2015) Eryilmaz, Gul; Enez Darcin, Asli; Saglam, Esra; Gogcegoz Gul, IsilSeveral studies have reported that depression and anxiety are very common in atrial fibrillation due to impaired quality of life. Dabigatran is an anti-aggregation agent used for the treatment of atrial fibrillation. In terms of drug interactions during treatment with dabigatran, patients suffering from minor depression are reported to be a population at risk. This report is about a 68-year-old man whose depressive symptoms were aggravated after taking dabigatran for atrial fibrillation. The case is discussed in terms of his aggravated depressive symptoms and the interaction between his prescription medications.Yayın The Effect of Captopril on Brain Apoptosis After Burn Injury in Rats(TURKISH NEUROSURGICAL SOC, 2013) Saglam, Ibrahim Yaman; Ozdamar, Emine Nur; Demiralay, Ebru; Sehirli, Ahmet Ozer; Sener, Goksel; Saglam, EsraAIM:The purpose of this study was to determine the possible protective effects of captopril treatment against apoptosis in the brain induced by burn injury. MATERIAL and METHODS: Under ether anaesthesia, Wistar albino rats (200-250 g) were exposed to a 900C (burn) or 250C (sham) water bath for 10 s. The ACE group was treated with i.p. 10 mg/kg captopril immediately after burn injury and this treatment was repeated twice daily. At the end of the 24 hour, brain samples were taken. Apoptotic brain cells marked by terminal deoxynucleotidyl transferase-mediated d-UTP-nick end labeling (TUNEL) were evaluated in the cerebellum and midbrain of rats. RESULTS: Apoptotic cells in the cerebellum were significantly decreased after captopril treatment and found to be lower when compared to the burn group (p<0.001). In the midbrain of rats, the numbers of TUNEL-positive cells and apoptotic bodies were significantly increased in the burn group when compared to the control group (p<0.001).The burn-induced changes were reduced in the captopril-treated burn group (p<0.01). CONCLUSION: Captopril has beneficial effects in burn injury and should be assessed as a therapeutic agent in the management of this condition.Yayın Effects of escitalopram on ethanol withdrawal syndrome in rats(PERGAMON-ELSEVIER SCIENCE LTD, 2006) Saglam, Esra; Kayir, Hakan; Celik, Turgay; Uzbay, TayfunThe present study was designed to investigate the effects of escitalopram, a selective serotonin reuptake inhibitor, on ethanol withdrawal syndrome in rats. Adult male Wistar rats (266-278 g) were subjects. Ethanol (7.2%, v/v) was given to rats by a liquid diet for 21 days. Control rats were pair fed with an isocaloric liquid diet containing sucrose as a caloric substitute to ethanol. Escitalopram, (2.5, 5 and 10 mg/kg) and saline were injected to rats intraperitoneally just before ethanol withdrawal. After the second and sixth hours of ethanol withdrawal, rats were observed for 5 min, and withdrawal signs that included locomotor hyperactivity, agitation, stereotyped behavior, wet dog shakes, tremors and audiogenic seizures were recorded or rated. A second series of injections was given 30 min before sixth hour of withdrawal test. Effects of escitalopram on the locomotor activities of the naive (no ethanol-dependent) rats were also evaluated. Escitalopram (5 mg/kg) reduced the increased stereotyped behaviors at the sixth hour of ethanol withdrawal. It inhibited tremors at the second hour of ethanol withdrawal at doses of 5 and 10 mg/kg. Escitalopram (2.5 and 5 mg/kg) also produced some significant attenuations in the incidence of wet dog shakes at the second and sixth hours of the observation period. It was found ineffective on locomotor hyperactivity, agitation and audiogenic seizures. Escitalopram (2.5 and 5 mg/kg) did not cause any significant effect on locomotor activities of the naive rats. Our results suggest that acute escitalopram treatment has some limited beneficial effects on ethanol withdrawal syndrome in rats. (c) 2006 Elsevier Inc. All rights reserved.Yayın Effects of olanzapine on ethanol withdrawal syndrome in rats(ELSEVIER SCIENCE BV, 2008) Unsalan, Nasibe; Saglam, Esra; Kayir, Hakan; Uzbay, TayfunThe present study was designed to investigate the effects of olanzapine, a serotonin-dopamine antagonistic atypical antipsychotic agent, on ethanol withdrawal syndrome in rats. Adult male Wistar rats were subjects. Ethanol (7.2%, v/v) was given to rats by a liquid diet for 21 days. Control rats were pair fed with an isocaloric liquid diet containing sucrose as a caloric substitute to ethanol. After 2nd, 4th and 6th h of ethanol withdrawal, rats were observed for 5 min, afterwards withdrawal signs that included locomotor hyperactivity, agitation, stereotyped behavior, tremor, wet dog shakes, abnormal posture and abnormal gait were recorded or rated. Olanzapine (0.5, 1 and 2 mg/kg) and saline were injected to the rats intraperitoneally 30 min before ethanol withdrawal assessment. A second series of injections was also given 30 rain before the 6th-h-observation, and subjects were then tested for audiogenic seizures. Olanzapine (2 mg/kg) produced significant inhibitory effects on stereotyped behaviors and wet dog shakes at the 6th h of ethanol withdrawal. Contrary, the same dose caused some increases in the intensity of posture and gait impairments at the 2nd h of ethanol withdrawal. In addition, that dose was found to be ineffective on agitation, tremor, tail stiffness and audiogenic seizures. Our results suggest that acute olanzapine treatment has beneficial effects on stereotyped behavior and wet dog shakes, but it also has some adverse effects on posture and gait during ethanol withdrawal in rats. Overall, olanzapine does not seem to be an adequate and suitable drug in controlling of ethanol withdrawal syndrome. (c) 2007 Elsevier B.V. All rights reserved.Yayın Escitalopram increases cortical nitric oxide synthase (NOS) in rat brain during ethanol withdrawal(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2008) Saglam, Esra; Ates, Lora Esberk; Kayir, Hakan; Celik, Turgay; Terzioglu, Berna; Uzbay, TayfunThe effect of escitalopram on ethanol withdrawal syndrome (EWS) and involvement of nitric oxide system in rats was investigated. Male Wistar rats divided into five experimental groups of eight animals each: (a) control group; (b) EWS (saline) group; (c) escitalopram 2.5 mg group; (d) escitalopram 5 mg group and (e) escitalopram 10 mg group. Ethanol dependence was induced in rats by ethanol-containing liquid diet and ethanol withdrawal was precipitated by replacing ethanol free diet. Ethanol receiving rats in individual groups were decapitated on 21st day of ethanol ingestion and at sixth hour of ethanol withdrawal. Brains were removed and dissected. Five regions of the brain were dissected: the frontal cortex, cerebellum, striatum, hippocampus and hypothalamus. Immunohistochemical NOS staining was performed. The NOS staining intensity in cortex and hypothalamus regions were significantly lower in EWS group than control group. During EWS period, in rats given 2.5 and 10 mg/kg escitalopram, the staining intensity in cortex, striatum and hippocampus were found to be 11.492, 8.519 and 11.234, respectively, and was statistically different than the control group. The hippocampal NOS staining intensity was found to be significantly decreased with 2.5 mg/kg escitalopram, whereas the cortex, striatum and hippocampal staining intensity were increased significantly with 5 mg/kg. In 10 mg/kg escitalopram group, staining properties were not different than those of the control group. Our results suggest that NOS decreases during ethanol withdrawal in cortex and hypothalamus of rat brain and treatment with escitalopram reverses the enzyme density in cortex but not hypothalamus. (c) 2008 Elsevier Inc. All rights reserved.Yayın Investigation of Drug Dose Calculation Skills and Self-Ratings Among Nursing Students(Yerküre Tanıtım & Yayıncılık Hizmetleri, 2020) Özünal, Zeynep Güneş; Boran, Tuğce; Saglam, EsraObjective: Medication errors are important concerns in terms of patient safety. Dose calculation skills contribute to medication errors. The aim of this study is to evaluate the calculation skills and self-ratings of nursing students. Method: Four multiple-choice questions with five alternative responses were asked and an electronic questionnaire form was used for the assessment of their perceptions of their self-competencies. Results: The rates of correct answers to the questions varied between 20% and 63%. In their self-assessments, 26.4% of them stated that they had sufficient dose calculation skills. Conclusion: The results of the study showed that skills should be improved. Drug dose calculation skills should be improved, and further education should be provided on this issue.Yayın Kemoterapi Almakta Olan Onkoloji Hastalarında İlaç-ilaç, İlaç-besin Etkileşimlerinin Değerlendirilmesi(2020) Akgun, Feride Sinem; Saglam, Esra; Güneş Özünal, Zeynep; Türken, OrhanAmaç: Kanser tanısı almış hastalarda bitkisel ve destek ürünlerinin kullanımı yaygındır. Bitkisel ve destek ürünlerinin hastalara faydası olabileceği gibi direk toksik etkileri ve ilaç etkisini değiştirebilme olasılıkları da bulunmaktadır. Bu potansiyel etkileşimler acile başvurulara neden olabilmektedir. Bu çalışmada kemoterapi almakta olan hastaların bitkisel ve destek ürünlerinin kullanım sıklığının, ilaç-besin etkileşimi olasılığının değerlendirilmesi planlanmıştır. Yöntem: Kemoterapi alan hastaların tanıları, ilaç tedavileri, bitkisel ve destek ürünlerinin kullanımı ile ilgili bilgiler retrospektif olarak değerlendirildi. Potansiyel ilaç-besin etkileşimi, ilaç-ilaç etkileşimleri Lexicomp® programı ile analiz edildi. İlaç-besin etkileşim riski tespit edilen hastaların acile başvuruları ve acil servisteki tedavileri elektronik kayıtlardan incelendi. Bulgular: Onkoloji servisinde 1-31 Mart 2018 tarihleri arasında kemoterapi alan 38 hastanın verilerine ulaşıldı. Hastaların %57’si bitkisel ve destek ürünleri aldıklarını bildirdi. İlaç dışında kullanılan ajanların %50’sinin bitkisel destek ürünü; %31’inin propolis, arı sütü ve bal gibi arı ilişkili ürünler olduğu belirtildi. Toplam üç hastada ilaç-besin etkileşim riski bulundu. Bu hastaların acil servise başvuruları öngörülen advers etkiler açısından değerlendirildi. Sonuç: Kemoterapi alan hastalarda bitkisel ve destek ürünleri kullanımı sıktır. Potansiyel ilaç-ilaç dışı kullanılan besin desteği etkileşimi, hastanın tedavisi ve genel sağlık durumu açısından önemlidir. Hastanın ilaç dışı destek ürünü kullanımı hekim tarafından mutlaka sorgulanmalı ve potansiyel ilaç-ilaç ve ilaçbesin etkileşimleri çok disiplinli bir ekip tarafından değerlendirilmelidir.Yayın nNOS expression in the brain of rats after burn and the effect of the ACE inhibitor captopril(ELSEVIER SCI LTD, 2013) Demiralay, Ebru; Saglam, Ibrahim Yaman; Ozdamar, Emine Nur; Sehirli, Ahmet Ozer; Sener, Goksel; Saglam, EsraObjective: To investigate the role of endogenous neuronal nitric oxide synthase (nNOS) on brain injury after burn and the effects of the captopril. Methods: Wistar albino rats (200-250 g) were exposed on the dorsal surface to 90 degrees C (burn) or 25 degrees C (sham) water for 10 s. The ACE group was treated with intraperitoneal 10 mg/kg captopril immediately after burn and this treatment was repeated twice daily. At the end of the 24 h brain samples were taken. nNOS was studied in brain areas by immunohistochemistry. Results: There was no difference between the cerebellar and hypothalamic areas the nNOS expression of all groups. nNOS expression increased in the frontal cortex, striatum and midbrain in the burn group compared to the control group. In the frontal cortex, nNOS expression significantly decreased after ACE inhibitor treatment (p < 0.05). The striatal nNOS of the ACE group significantly increased when compared to the control group (p = 0.001). In the midbrain of the animals, nNOS decreased in the ACE group. Hippocampal nNOS expression did not change after burn and significantly increased after ACE inhibitor therapy (p < 0.05). Conclusions: Our data showed that the pathophysiological events following burn appear to be related to an acute inflammatory reaction which is associated with nNOS in the frontal cortex, striatum and midbrain, and captopril treatment abrogates the nNOS response in the frontal cortex and midbrain. (C) 2012 Elsevier Ltd and ISBI. All rights reserved.Yayın Tıp Fakültelerinde Empati Eğitimine Genel Bir Bakış, Geliştirmek İçin Neler Yapılabilir?(2019) Saglam, EsraEmpati tıpta vazgeçilmez bir beceridir ve profesyonelliğin ayrılmaz birparçasıdır. Dünya tıp literatürü incelendiğinde, empati, yeterli bilimselilgiyi görmemiş ve tıbbın biyomedikal parçasının gölgesinde kalmaktaolmasına rağmen etkili iletişim becerileri açısından tıp disiplinlerindegiderek önem kazanan bir kavram haline gelmektedir. Günümüzde,iletişim becerileri ve onun bir parçası olan empati eğitimi dünyanınpekçok ülkesinde, tıp fakültelernin akademik programlarında yeralmaktadır. Empati konusunda yapılan çalışmalar, bazı tutarsızlıklartaşısa da, tıp eğitimi süreci ve sonrasında empatide önemli kayıplarolduğunu ortaya koymaktadır. Bu olumsuz durumun eğitim müfredatındayapılacak değişiklikler ile telafi edilebileceği düşünülse de, bu konudayapılan çalışmalar, empati yeteneğini geliştirmek için yapılacak müfredatreformları ve revizyonların, tıbbın özündeki modernist paradigmaya değil, insani ilişkiler, empati veşefkat üretmeye dayanan felsefi paradigmaya dayandırılması gerektiğini düşündürmektedir.
