PubMed Kapalı Erişimli Yayınlar

Permanent URI for this collectionhttps://hdl.handle.net/11727/10764

Browse

Now showing 1 - 20 of 803

Adrenergic receptor behaviors of mesenchymal stem cells obtained from different tissue sources and the effect of the receptor blockade on differentiation
(2021) Maytalman, Erkan; Alizadeh Yegani, Arash; Kozanoglu, Ilknur; Aksu, Fazilet; 0000-0002-5268-1210; 34323168; AAE-1241-2021
In this study, it was aimed to analyze behavioral changes of adrenergic receptors (ARs) in first three passages and osteogenic/adipogenic differentiation of mesenchymal stem cells (MSCs) derived from placenta fetal membrane (FM) and bone marrow (BM). It was also aimed to evaluate effects of receptor blockade on differentiation. We obtained first three passages of MSCs from placenta and BM samples. For cell identification, the cells were analyzed by flow cytometry using CD34, CD45 and CD3, CD105 antibodies in each passage. The effects of propranolol and phenoxybenzamine at incremental doses were analyzed by MTT. In addition, cell cultures were separately maintained with the blockers or without after second passage. After each passage and differentiation, alpha 1A, alpha 1B, alpha 2A, alpha 2B, beta 1, beta 2, beta 3 AR-mRNA expressions analyzed by RT-qPCR technique. BMP6 and PPARG mRNA expressions only after differentiation and passage 3 were analyzed. A microscopic examination was also performed. Our results showed that AR expression behaviors were different in MSCs obtained from different tissue sources. In particular, alpha(1A)-AR and alpha(2A)-AR were expressed with considerably high coefficients in differentiation under blocker effect in BM-derived MSCs. No such coefficients were observed in any group of placental MSCs. In addition, it was found that the blockers stimulated adipogenesis in BM-derived MSCs during osteogenic differentiation. MSCs exhibit protein expressions that vary according to source of tissue and differentiation. Given that MSCs from different sources are used for repair and modulation, our study makes implications of this variable expression intriguing in the clinical practice.
Age estimation in Turkish children and young adolescents using fourth cervical vertebra
(2020) Gulsahi, Ayse; Cehreli, Sevi Burcak; Galic, Ivan; Ferrante, Luigi; Cameriere, Roberto; 31915966
This study aimed to test radiographic projections of the posterior and anterior sides of the C4 vertebral body for age estimation in a cross-sectional sample of Turkish children and adolescents from the Baskent University Faculty of Dentistry. A sample of 232 x-rays from individuals aged between 5 and 15 years (101 boys and 131 girls) was analysed to investigate the correlation of age and changes in the projection ratio of the anterior and posterior sides of the body of the fourth cervical vertebra (Vba) in lateral cephalograms. The Normal Bayesian Calibration (NBC) model for age estimation was used to assess the relationship between Vba and age. The intra-observer repeatability and inter-observer agreement were 0.95 and 0.94, respectively. Age distribution gradually increased as Vba increased up to 14 years in both sexes. The difference between chronological and estimated ages did not increase with the increase in age. Calibration distributions of the dataset by the evaluation of Vba suggested mean absolute errors (MAEs) of 0.879 years and 0.906 years (mean interquartile ranges (MIQRs) 1.290 and 1.435 years)) in boys and girls, respectively. The biases of the estimates (beta(ERR)) were 0.013 and 0.027 for boys and girls, respectively. In conclusion, the NBC method on Vba variable appears to be suitable for age estimation in Turkish children and adolescents.
Age- and Gender-Related Variability in Nasal Tip Support
(2020) Koycu, Alper; Erol, Ozan; Buyuklu, Fuat Adnan; Jafarov, Sabuhi; Berker, Sinem; 0000-0003-1528-0036; 0000-0003-1290-3509; 0000-0002-7302-4199; 31834522; W-5941-2018; AAF-3650-2021; AAI-8044-2021
Background The age at which nasal tip support changes start to occur is unknown. Evaluation of nasal tip support is difficult, especially as the ideal nasal tip support pressure remains elusive. The aim of this study is to determine the nasal tip support pressure alterations relative to age and sex. Objectives The aim of this study is to determine the changers in resistance of the nasal tip support in relation to age and sex. Methods This prospective clinical study was conducted between January and April 2019 at a tertiary health facility. Nasal tip resistances were measured in four different age-groups (20-29, 30-39, 40-64, and > 65 years) with a digital Newton meter. A total of 159 patients with a minimum of 36 patients per group were included in the study. Nasal tip resistance measurements were compared among nasal tip displacement distances of 2, 3, and 4 mm, focusing on age and sex. Results The nasal tip resistance of the 20-29 age-group was significantly higher at 2, 3, and 4 mm nasal tip displacement distances, when compared with the 30-39 and 40-64 age-groups, whereas compared to the > 65 years group, it was significantly higher at 3 and 4 mm nasal tip displacement distances (p < 0.005). Nasal tip resistance of males was found to be significantly higher than that of females, at 3 and 4 mm nasal tip displacement distances (p < 0.001). Conclusions Nasal tip resistance is higher in males and universally decreases significantly after 30 years of age while remaining constant at later ages. Therefore, surgeons should prefer nasal tip resistance increasing techniques in the rhinoplasty operations that are performed on patients even from early years of age, in order to maintain and strengthen the nasal tip resistance.
Altered pulmonary functions due to biomass smoke in a rural population of Turkish women: a descriptive study
(2018) Ozsancak Ugurlu, Aylin; Balcan, Baran; Akan, Selcuk; Ceyhan, Berrin; 30246655; A-4721-2018
Introduction: Wood or other organic sources of fuel are used as source of energy for heating or cooking particularly in developing countries. The aim of the current study was to evaluate the association between biomass exposure time and parameters of pulmonary function tests. Materials and Methods: Four hundred twenty-four consecutive women who lived and exposed to biomass smoke in a small province in Eastern Turkey were involved. This study was performed with women who had come to pulmonology out-patient clinic with symptom of dyspnea. Results: The independent variables assessed in the study patients were age, BMI, starting age of cooking, hours per day and weeks per month spent cooking, and cooking years; the dependent variables were PFT parameters. Ninety-two (21.6%) patients had an obstructive PFT pattern. Sixty-seven (73%) of these patients were classified as GOLD 2 and 25 (27%) patients were classified as GOLD 3. Seventy-five (17.6 %) of the patients had restrictive lung disease; 54 (72%) of these patients were found to have a mild and 21 (27%) had a moderate restrictive pattern. Increased number of years in cooking and to start cooking at younger ages were a risk factors for the development of obstructive and restrictive disease. There was a statistically significant and negative correlation between increased number of years and the value of FEV1 (r=-0.917; p=<0.001), FEV1/FVC (r=-0.739; p<0.001), and FVC (r=-0.906; p<0.001). The median time of cooking required was 23 years for the development of obstruction, and 25 years for restriction, respectively. Conclusion: Cumulative biomass exposure time is associated with impairment in PFT parameters; results in both obstructive and restrictive lung disease. Biomass exposure is a public health problem and pre-cautions should be taken in order to prevent impaired pulmonary functions.
Analysis of Probiotic Bacteria Genomes: Comparison of CRISPR/Cas Systems and Spacer Acquisition Diversity
(2021) Ilikkan, Ozge Kahraman; 0000-0001-5843-6868; 35068602; Q-9641-2019
Clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated (Cas) genes constitute an adaptive (acquired) defense system of bacteria and archaea. Here 72 probiotic bacteria genomes were investigated in terms of the presence of CRISPR/Cas systems and phage/plasmid invaders through spacer analysis. 49 CRISPR/Cas systems were detected within probiotic strains, namely,17 type II-A, 10 type I-C, 8 type I-E, 5 Type I-U (I-G), 4 type III-A, 2 type I-B, 1 type I-A, 1 type IV-B, and 1 type II-C. The predicted target of spacers was determined in 25 strains and consequently, three different spacer and target patterns were revealed. The diversity of CRISPR spacers provides insight and understanding to determine strain-specific invaders of probiotic bacteria as well as their relationships between strains. CRISPR systems were clarified in many studies for genomic characterization. However, recently, endogenous genome editing with CRISPR has provided an approach for various genome editing projects. Thus, in the future, producing strain-specific phage-resistant starter cultures or probiotics by endogenous genome editing methods according to phage/plasmid survey can be utilized for industrial and pharmaceutical applications. Therefore, this study intended a comprehensive investigation of CRISPR systems of probiotic bacteria.
Anocutaneous Reflex Revisited: How Valuable Is Its Determination in Children with Spina Bifida? A Descriptive Study in A Cohort of 217 Patients
(2022) Ozel, Kerem; Canmemis, Arzu; Goknar, Nilufer; Candan, Cengiz; Alizada, Orkhan; Alatas, Ibrahim; 35147971
AIM: To determine the clinical value of anocutaneous reflex (AR) in children with neurogenic bladder due to spina bifida (SB). MATERIAL and METHODS: Patients who were diagnosed with SB were prospectively evaluated; moreover, AR and bulbocavernous reflex were examined. Patients were divided into those with and without AR. Age, gender, diagnosis, ventriculoperitoneal shunt presence, symptomatic urinary tract infections, leg movements, clean intermittent catheterization and anticholinergic therapy, lesion level, urodynamic detrusor, and sphincter activity were evaluated. Chi-square test and univariate regression analysis were done. The AR value was evaluated by two by two contingency table. RESULTS: This study evaluated 217 patients (109 boys and 108 girls). AR was present and absent in 53 and 164 patients, respectively. Anticholinergic therapy was necessary in 37.7% and 23.8% of patients with and without AR (p=0.015), respectively. Patients with AR had higher lesion level (p=0.005), more detrusor overactivity, and less detrusor underactivity (p=0.007). Less detrusor sphincter dyssynergia (DSD) was noted in patients with AR (p=0.029). AR specificity was 83%, and positive predictive value in predicting detrusor overactivity and DSD was 76% and 80, respectively. CONCLUSION: AR determination is a valuable and simple tool in neurogenic bladder. This report delineates the clinical significance of this reflex and is the largest cohort describing this significance. This simple examination should not be skipped in the initial evaluation and follow-up of these patients
Anterior Spinal Artery Syndrome: Rare Precedented Reason of Postoperative Plegia After Spinal Deformity Surgery: Report of 2 Cases
(2020) Bahadir, Sinan; Nabi, Vugar; Adhikari, Prashant; Ayhan, Selim; Acaroglu, Emre; 0000-0003-0153-3012; 32502625; U-5409-2018
BACKGROUND: Complications in spinal deformity surgery vary from insignificant to severe. Apart from direct mechanical insult, ischemia can also cause spinal cord injury. Ischemic injury may be detected during surgery or may manifest itself postoperatively. We present 2 cases of anterior spinal artery syndrome. CASE DESCRIPTION: In the first case, a 12-year-old girl developed anterior spinal artery syndrome resulting in total quadriplegia 8 hours after spinal deformity surgery. She was treated with a steroid, immunoglobulin, and lowmolecular-weight heparin. She showed complete recovery at 1 year postoperatively both clinically and radiographically. In the second case, a 62-yearold woman experienced sudden loss of motor evoked potentials intraoperatively during dural tear repair after sagittal and coronal alignment was established. The paraplegic patient was diagnosed with anterior spinal artery syndrome at the thoracic level postoperatively. She was treated with a steroid and heparin. At 1 year postoperatively, she has gained much of her strength and has myelomalacia in her spinal cord. CONCLUSIONS: Anterior spinal artery syndrome is a serious condition with a generally poor prognosis. Though treatment should be directed at the underlying cause, the best strategy is to prevent it from occurring. Peroperative blood pressure control, intraoperative neuromonitoring, avoidance from mechanical stress during surgery, and close neurologic and hemodynamic monitorization postoperatively should be performed.
Anticoagulation strategy in patients with atrial fibrillation after carotid endarterectomy
(2019) Ugurlucan, Murat; Akay, Hakki Tankut; Erdinc, Ibrahim; Oztas, Didem Melis; Conkbayir, Cenk; Aslim, Erdal; Yildiz, Cenk Eray; Aydin, Kubilay; Alpagut, Ufuk; 30189792
Aim: Carotid artery stenosis and atrial fibrillation are diseases of the aging patient population. Literature lacks precise anticoagulation treatment protocols for patients with atrial fibrillation following carotid endarterectomy. We present our experiences with anticoagulation strategy in this particular patient population.Patients and methods: Between June 2001-September 2017, 165 patients with chronic or paroxysmal atrial fibrillation out of 1594 cases from three different institutions whom received Coumadin and aspirin and required carotid endarterectomy were reviewed, respectively. Mean age was 63.47.9 years. Male/female ratio was 102/63. There were 67 diabetic and 138 hypertensive cases.Results: Patients are followed a mean of 64.4 +/- 16.9 months. Early mortality occurred in two patients due to intracranial bleeding and heart failure. Another patient was lost due to intracerebral hemorrhage and 16 other patients died due to various causes in the late follow-up. Three patients required exploration against bleeding.Conclusion: Combination of warfarin with an aim to keep the INR value between 2 and 3, and aspirin at a dosage of 100mg per day seemed feasible and in our modest patient cohort. Further studies including multicenter larger data are warranted in order to establish a precise anticoagulation treatment protocol for patients with atrial fibrillation after carotid endarterectomy.
Antiproliferative and anti-apoptotic effect of astaxanthin in an oxygen-induced retinopathy mouse model
(2019) Kucukoduk, Ali; Helvacıoglu, Fatma; Haberal, Nihan; Dagdeviren, Atilla; Bacanli, Didem; Yilmaz, Gursel; Akkoyun, Imren; 0000-0001-8990-8282; 30851776; P-2877-2014
Objective: To evaluate the impact of intravitreal (IV) and intraperitoneal (IP) astaxanthin (AST) injections on neovascular development (ND), retinal morphology, and apoptotic activity in a C57BL/6J mouse model with hyperoxia-induced retinopathy (HIR). Design: C57BL/6J mouse model. Methods: Two negative control groups (n = 6 each; one of which received IV sterile dimethyl sulfoxide [DMSO]) of C57BL/6J-type mice were exposed to room air. The HIR groups included 36 C57BL/6J-type mice exposed to 75% +/- 2% oxygen from postnatal day (PD) 7 to PD 12. On PD 12, these mice were randomized into 6 groups (n = 6 each): 2 HIR control groups (one of which received IV-DMSO), 2 IV-AST groups (10 and 100 mu g/mL), and 2 IP-AST groups (0.5 and 5 mg/kg). We measured ND by counting neovascular tufts in cross sections and examined histological, ultrastructural changes via light and electron microscopy. Apoptosis was detected using terminal deoxynucleotidyl transferase-mediated nick end-labeling. Results: No ND was detected in the negative control groups. ND levels were not significantly different between high- and low-dose AST for either means of administration. However, ND levels were significantly lower in the AST groups, regardless of delivery, compared to the control groups. The means of delivery (IP versus IV) also yielded significant differences in ND. The incidence of mitochondrial dysmorphology and apoptosis were lower in groups receiving AST. Conclusions: AST seems to suppress ND and has anti-apoptotic activity in the HIR mouse model.
Antiproliferative and Mitochondrial Protective Effects of Apigenin in an Oxygen-Induced Retinopathy In Vivo Mouse Model
(2021) Sezenoz, Almila Sarigul; Akkoyun, Imren; Helvacioglu, Fatma; Haberal, Nihan; Dagdeviren, Attila; Bacanli, Didem; Yilmaz, Gursel; Oto, Sibel; 0000-0002-2860-7424; 34665015; AAK-7713-2021
Purpose: To investigate the effects of a common dietary flavonoid apigenin on retinal endothelial cell proliferation, retinal morphological structure, and apoptotic cell death in an oxygen-induced retinopathy (OIR) mouse model to evaluate the possibility of the use of apigenin in the treatment of ocular neovascular diseases (ONDs). Methods: Ninety-six newborn C57BL/6J mice were included. Eight groups were randomized, each including 12 mice. Two negative control groups were kept in room air: the first without any injection and the second received intravitreal (IV) dimethyl sulfoxide (DMSO), which is the solvent we used. The OIR groups were exposed to 75% +/- 2% oxygen from postnatal days (PD) 7 to 12. On PD 12, the mice were randomly assigned to 6 groups: 2 OIR control groups (1 received no injection, 1 received IV-DMSO), 2 IV-apigenin groups (10 and 20 mu g/mL), and 2 intraperitoneal (IP)-apigenin groups (10 and 20 mg/kg). We quantified retinal endothelial cell proliferation by counting neovascular tufts in cross-sections and examined histological and ultrastructural changes through light and electron microscopy. We evaluated apoptosis by terminal deoxynucleotidyl transferase-mediated nick end-labeling (TUNEL). Results: We detected a significant increase in endothelial cell proliferation in the OIR groups. Groups receiving apigenin, both IP and IV, had significant decreases in endothelial cells, atypical mitochondrion count, and apoptotic cells compared with the groups receiving no injections. None of the apigenin-injected groups revealed cystic degeneration or cell loss. Conclusions: Apigenin suppresses neovascularization, has antiapoptotic and antioxidative effects in an OIR mouse model, and can be considered a promising agent for treating OND. Clinical trial (Project number: DA15/19).
Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey
(2022) Sancakli, Ozlem; Tuncel, Tuba; Eren Akarcan, Sanem; Kanik, Ali; Ozyurt, Gonca; Ozdogru, Emine Ece; 35290751
Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey.Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children.Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups.In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar.Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.
Aortic arch calcification: a novel parameter for prediction of masked hypertension
(2021) Akbay, Ertan; Coner, Ali; Akinci, Sinan; Adar, Adem; Cakan, Fahri; Muderrisoglu, Haldun; 0000-0002-9146-0621; 0000-0002-5711-8873; 0000-0001-5250-5404; 0000-0002-5427-3480; 33734125; AAD-5479-2021; ABD-7321-2021; AAD-5564-2021; GPT-4057-2022
Background Masked hypertension is directly related to increased cardiovascular morbidity and mortality but remains underdiagnosed in clinical practice. The aim of the study was to search the role of aortic arch calcification (AAC) in the diagnosis of masked hypertension. Methods and results Among the patients who underwent ambulatory blood pressure monitoring (ABPM) in our clinic, those with office blood pressure (OBP) <140/90 mmHg were included in the study population. According to OBP, they were divided into two groups as normal (<130/85 mmHg) and high normal (130-139/85-89 mmHg) OBP groups. Subjects were also investigated for the presence of masked hypertension with ABPM and searched in masked hypertension and control groups. Masked hypertension was defined as in the latest 2017 ACC/AHA Hypertension guideline and was diagnosed as the daytime BP >= 135/85 mmHg and nighttime BP >= 120/70 mmHg. AAC was evaluated on direct X-ray telecardiography. Diagnosis of masked hypertension was searched depending on the presence of AAC and OBP measurements as well. A total of 216 volunteers were involved in the study [mean age 45.2 +/- 12.2 years; female gender 120 (55.5%)]. One hundred ten volunteers (50.9%) had masked hypertension according to the ABPM. AAC was significantly more common in the masked hypertension group (44.5% vs. 26.4%) (P = 0.005). AAC had a positive predictive value of 79% in those with high normal OBP in the diagnosis of masked hypertension, and also AAC had a negative predictive value of 74% in those with normal OBP. Conclusion AAC can be used as a reliable diagnostic tool to exclude and predict masked hypertension during office examination.
Apparently We Cannot Live, We are like Infectious Zombies: A Qualitative Research on Personal and Familial Experiences of Health Workers in the Filiation Teams in Turkey during the COVID-19 Pandemic
(2022) Karatas, Mustafa; Gure, Merve Deniz Pak; Duyan, Veli; https://orcid.org/0000-0002-0998-2552; 35658819
This study aims to examine the experiences of health workers in filiation teams in Turkey. The qualitative research model has been used. 375 health workers have participated using a non-probability sampling method. The data were collected over the internet using the questionnaire. The data have been analyzed with the MAXQDA and various code-sub codes-segment maps and code matrices have been used. The results expressed in two dimensions: instrumental and emotional areas. It has been observed that issues such as burnout, loss of motivation, and future anxiety have often been coded due to poor working conditions of the filiation teams, lack of rewards, and other factors. They have been determined as experiencing social stigma along with fear of infecting their families, and therefore have problems with child care, visiting adult family members in the risk group. It is recommended to develop psychosocial support services and improve organizational conditions.
Application of the international classification of diseases-perinatal mortality (ICD-PM) system to stillbirths: A single center experience in a middle income country
(2022) Dagdeviren, Gulsah; Uysal, Nihal Sahin; Dilbaz, Kubra; Celen, Sevki; Caglar, Ali Turhan; 34890860
Objective: The present study is intended to investigate the causes of stillbirth and its relationship with maternal conditions using the International Classification of Diseases-Perinatal Mortality (ICD-PM) system.Material and methods: All early and late fetal deaths between 2015 and 2020 were analyzed. Time of death, fetal causes, and the maternal conditions involved were identified using the ICD-PM classification system.Results: During the study period, out of 74,102 births a total of 475 stillbirths were recorded (6.4 per 1000 births), of which 83.6% of the cases were antepartum and 11.8% were intrapartum fetal deaths, and the time of death could not be determined in 4.6% of the cases. Fetal developmental disorder was the most common cause of antepartum fetal death (24.2%). Intrapartum deaths were mostly due to extremely low birth weight (44.6%). The most common maternal conditions involved were complications of placenta, cord, and membranes (19.8%).Conclusion: The applicability of the ICD-PM classification system for stillbirths is easy. It was observed that fetal deaths mostly occurred in the antepartum period and the cause of death could not be identified in over half of these antepartum fetal deaths. In over half of the stillbirths, there is at least one maternal condition involved. The most common maternal conditions involved are complications of placenta, cord, and membranes. The most common maternal medical problem is hypertensive diseases of pregnancy. (c) 2021 Elsevier Masson SAS. All rights reserved.
Approach To Optimal Assessment Of Right Ventricular Remodelling In Heart Transplant Recipients: Insights From Myocardial Work Index, T1 Mapping, And Endomyocardial Biopsy
(2023) Colak, Ayse; Duzgun, Selin Ardali; Hazirolan, Tuncay; Sezgin, Atilla; Donal, Erwan; Butcher, Steele C.; Ozdemir, Handan; Pirat, Bahar; Eroglu, Serpil; Muderrisoglu, Haldun; Sade, Leyla Elif; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0003-3737-8595; 35666833; X-8540-2019; AAQ-7583-2021
Aims Right ventricular (RV) dysfunction is an important cause of graft failure after heart transplantation (HTx). We sought to investigate relative merits of echocardiographic tools and cardiac magnetic resonance (CMR) with T1 mapping for the assessment of functional adaptation and remodelling of the RV in HTx recipients. Methods and results Sixty-one complete data set of echocardiography, CMR, right heart catheterization, and biopsy were obtained. Myocardial work index (MWI) was quantified by integrating longitudinal strain (LS) with invasively measured pulmonary artery pressure. CMR derived RV volumes, T1 time, and extracellular volume (ECV) were quantified. Endomyocardial biopsy findings were used as the reference standard for myocardial microstructural changes. In HTx recipients who never had a previous allograft rejection, longitudinal function parameters were lower than healthy organ donors, while ejection fraction (EF) (52.0 +/- 8.7%) and MWI (403.2 +/- 77.2 mmHg%) were preserved. Rejection was characterized by significantly reduced LS, MWI, longer T1 time, and increased ECV that improved after recovery, whereas RV volumes and EF did not change MWI was the strongest determinant of rejection related myocardial damage (area under curve: 0.812, P < 0.0001, 95% CI: 0.69-0.94) with good specificity (77%), albeit modest sensitivity. In contrast, T1 time and ECV were sensitive (84%, both) but not specific to detect subclinical RV damage. Conclusion Subclinical adaptive RV remodelling is characterized by preserved RV EF despite longitudinal function abnormalities, except for MWI. While ultrastructural damage is reflected by MWI, ECV, and T1 time, only MWI has the capability to discriminate functional adaptation from transition to subclinical structural damage.
Approach to recurrence of atrial fibrillation after catheter ablation
(2021) Yilmaz, Mustafa; Candemir, Basar; 33691388
Atrial fibrillation (AF) is the most commonly observed sustained rhythm disorder during adult ages. Since it has been shown that the ectopic beat initiating AF is usually caused by pulmonary veins, AF ablation has become the mainstay of therapy worldwide. Cryoballoon and radiofrequency ablation are the most commonly used methods in today's technologies. However, despite technological advances, the success of a single procedure in AF ablation is still limited and multiple procedures may be required for the majority of patients. In cases in which a redo ablation is required, pulmonary vein isolation is still the main target, but non-pulmonary vein targets should also be considered in AF episodes that continue despite multiple ablations. Many issues are still unclear as to which energy to choose in the first procedure, and what ablation strategy will be utilized when a redo ablation is required. The studies on this subject are very limited but, it still seems feasible and a rational approach to utilize a customized treatment strategy in each specific patient subgroup.
Are There Any Predictors of Endometrial Premalignancy/Malignancy within Endometrial Polyps in Infertile Patients?
(2019) Tohma, Yusuf Aytac; Onalan, Gogsen; Esin, Sertac; Sahin, Hanifi; Aysun, Dide; Kuscu, Esra; Haberal, Ali; Zeyneloglu, Hulusi Bulent; 0000-0001-9418-4733; 31311015
Background: In the literature, there is no detailed analysis on the prediction factors for premalignancy/malignancy within endometrial polyps (EPs) in infertile patients. In this study, we aimed to determine the frequency of endometrial premalignancy/malignancy within EPs in infertile patients undergoing office hysteroscopic polypectomy and identify the factors that can potentially predict an endometrial premalignancy/malignancy within EPs. Method: A total of 957 infertile patients undergoing office hysteroscopy were diagnosed with EPs between February 2011 and August 2018. Patients were divided into 2 groups according to the pathological examination of EPs as benign (Group 1; n = 939) and premalignant/malignant (Group 2; n = 18). The medical records of all patients included in the study were reviewed retrospectively. Results: In this cohort, prevalence of endometrial premalignancy/malignancy within EPs was 18/957 (1.88%). On univariate analysis, age, polyp size, diabetes, hypertension, and causes of infertility did not differ between the 2 groups. On multivariate analysis, diffuse polypoid appearance of the endometrial cavity on office hysteroscopy (hazard ratio [HR] 4.1; 95% CI 1.576-10.785), duration of infertility, (HR 4; 95% CI 1.279-12.562), and body mass index (HR 7.9; 95% CI 2.591-24.258) were found to be independent predictors of endometrial premalignancy/malignancy within polyps in infertile patients. Conclusion: When diffuse polypoid appearance of the endometrial cavity is detected in an infertile patient during office hysteroscopy, hysteroscopy-guided resection and endometrial curettage should be performed. The pathological specimen should be sent for histopathological evaluation to diagnose possible endometrial premalignancy/malignancy within polyps.
Assesment Of Attainment Of Recommended TSH Levels And Levothyroxine Compliance In Differentiated Thyroid Cancer Patients
(2022) Yavuz, Dilek Gogas; Yazan, Ceyda D.; Hekimsoy, Zeliha; Aydin, Kadriye; Gokkaya, Naile; Ersoy, Canan; Akalin, Aysen; Topaloglu, Omercan; Aydogan, Berna I.; Dilekci, Esra N. A.; Alphan Uc, Ziynet; Cansu, Guven B.; Ozsari, Levent; Iyidir, Ozlem T.; Olgun, Mehtap E.; Keskin, Lezzan; Mert, Meral; Can, Bulent; Gungor, Kaan; Galip, Tayfun; Canturk, Zeynep; Elbuken, Gulsah; Pekkolay, Zafer; Kutbay, Nilufer O.; Yorulmaz, Goknur; Kalkan, Ahmet T.; Unsal, Yasemin A.; Yay, Adnan; Karagun, Baris; Bozkur, Evin; 35639050
Objective Thyroid-stimulating hormone (TSH) suppression treatment can induce signs and symptoms of hyperthyroidism and hypothyroidism due to inappropriate treatment or poor compliance to the treatment. The current study aimed to investigate TSH levels, frequency of being on target TSH, adherence to levothyroxine (LT4) suppression treatment in differentiated thyroid cancer (DTC) patients after surgery in a multicentric setting. Design and Patients This multicentric cross-sectional study was conducted at 21 medical centres from 12 cities in Turkey. DTC patients followed at least one year in the same center included in the study. Clinical data, serum TSH, free thyroxine (FT4), thyroglobulin (Tg) and anti-Tg levels were recorded during the most recent visit. Body mass index, systolic and diastolic blood pressures, pulse rate were measured. LT4 doses were recorded and doses per kilogram of bodyweight were calculated. Pill ingestion habits recorded and adherence to the therapy were evaluated using the Morisky Medication Adherence Scale and categorized as good, moderate or poor compliant based on their scores. Risk stratification forpredicting the disease persistance and/or reccurence was assessed using the American Joint Committee on Cancer-7th edition thyroid cancer staging calculator. TSH serum concentrations were classified as severe suppression (TSH < 0.01 mU/L), moderate suppression (TSH: 0.01-0.1 mU/L), mild suppression (TSHL 0.1-0.5 mU/L), euthyroid (TSH: 0.5-4 mU/L) and hypothyroid (TSH > 4 mU/L). TSH levels can also be classified as on being on target, under the target, or beyond over the target, according to the American Thyroid Association recommendations. Results A group of 1125 patients (F/M: 941/184, 50.7 +/- 11.7 years) were included in the study. The mean LT4 daily dosage was 132.4 +/- 39.6 mcg/day. TSH levels showed severe suppression in 99 (%8.8) patients, moderate suppression in 277 (%24.6) patients and mild suppression in 315 (%28) patients and euthyroid range in 332 (%29.5) patients and hypothyroid range in 97 (8.6%). TSH levels were in target in 29.2% of the patients 20.4% of the patients were undertreated, 50.4% overtreated. The daily LT4 dose and LT4 dose/kg were significantly higher in the severe suppression group (p < .001, p < .001). According to the Morisky scale, 564 patients (50.1%) were good compliant, 368 patients (32.7%) were moderate compliant, and 193 patients (17.1%) were noncompliant. Patients with poor compliance need a higher dose of LT4 compared to the good compliance group (p < .001). TSH levels of patients with good compliance were 0.67 +/- 1.96 mU/L and TSH with poor compliance was 2.74 +/- 7.47 mU/L (p < .001). TSH levels were similar in patients on fixed and alternating dosages. Conclusion In 29.2% of the DTC patients, serum TSH levels were at target levels. Remaining of the study group have TSH levels under or over treatment range, exposing the patient to medication side effects. Majorty of the study group 82.8% have good or moderate adherence to LT4 therapy. Reaching TSH targets requires simplified and applicable guidelines and following the guideline recommendations.
Assessing risk factors for postoperative hypotony in Ahmed glaucoma valve implantation surgery
(2021) Kaderli, Ahmet; Demirok, Gulizar; Uney, Guner; Yakin, Mehmet; Gunal, Berku; Eksioglu, Umit; 34019191
Purpose To assess the risk factors associated with the development of hypotony after Ahmed glaucoma valve (AGV) implantation. Methods One hundred and ninety-three eyes of 177 patients with various types of glaucoma that were treated with AGV implantation were retrospectively evaluated. Intraocular pressure lower than 6 mmHg related to the surgery is defined as postoperative hypotony. Patients' demographic characteristics, type of glaucoma, preoperative and postoperative visual acuity, necessity of antiglaucoma treatments, lens status, previous ocular surgeries, intraocular pressure (IOP) measurements before and after surgeries, the need for additional procedures and postoperative complications were recorded from the patients' charts. Results Hypotony was seen in 68 of 193 eyes (35.2%) postoperatively. In 45 eyes (23.3%), it has occurred in first postoperative day and in 23 eyes (11.9%) after the first day within the first week. There was no difference in intraocular pressures between two groups in the first year follow-up. Pre- and postoperative best-corrected visual acuities, age and gender were not statistically different between hypotony and no hypotony groups (p > 0.05). Also, lens status, history of previous ocular surgery, type of glaucoma and number of preoperative glaucoma medication usage were not found to be different between groups (p > 0.05). Conclusions Potential risk factors such as age, sex, lens status, history of previous ocular surgeries, preoperative glaucoma medication usage or glaucoma type are not found to influence upon postoperative hypotony prevalence for AGV surgery. Surgery type and personal ocular factors, which could not be determined beforehand, could be more important than demographic features.
Assessing the knowledge in primary health care following an educational course structured in the context of GARD chronic airway diseases national control program
(2017) Balkan, Arzu; Oner Erkekol, Ferda; Kokturk, Nurdan; Mungan, Dilsad; Sackesen, Cansin; Onen, Zeynep Pinar; Ozkan, Secil; Ergun, Pinar; Kocabas, Can Naci; Baran Aksakal, Nur; Ekici, Banu; Ozkan Altunay, Zubeyde; Gemicioglu, Bilun; Yorgancioglu, Arzu; 0000-0002-4032-0944; 28990886; AAC-7548-2020
Introduction: Chronic obstructive pulmonary diseases are common causes of disease in the community and account for considerable percent of the caseload in primary health care facilities. For this reason, it is important to question and improve the knowledge of primary health care physicians. This study is designed to assess the level of knowledge for bronchial asthma and COPD of the primary healthcare physicians, both before and immediately after an educational course structured in the context of GARD Chronic Airway Diseases National Control Program. Materials and Methods: The participating physicians attended an intensive educational course on asthma and COPD. Twenty five item questionnaires for asthma and COPD were administered to the participants both before and immediately after the end of the course. Contribution of education to the level of knowledge was investigated by comparing the percentages of the correct answers in the pre-and post-test. Results: From 11 different cities, 1817 and 1788 primary health care physician were attended to the asthma and COPD educations, respectively. The accuracy rate of >= 75% was obtained from only 4 questions in pre-test asthma questionnaire. On the contrary, in 15 questions the accuracy rate was < 50%. The mean accuracy rate for the whole asthma test was 45.8%, and this rate raised to 69.6% after education course. The accuracy rate of >= 75% could not be obtained from any of the questions in pre-test COPD questionnaire. On the contrary, in 19 questions the accuracy rate was < 50%. The mean accuracy rate for the whole asthma test was 42.0%, and this rate raised to 71.3% after education course. Conclusion: It has been shown that, in primary care settings, the level of knowledge in asthma and COPD should be enhanced and that this increase can be achieved with an education course.