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Comparison of Bipolar vascular sealing and conventional back-table dissection in terms of post-renal transplant drainage and back-table preparation times. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:6223-6228. [PMID: 37458629 DOI: 10.26355/eurrev_202307_32981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE The usage of vessel sealing devices has been gaining popularity in all surgical specialties. Post-renal transplant drain placement is a common practice among transplant surgeons. However, prolonged drainage accompanied by surgical wound complications and perirenal fluid collections is a frequent complication experienced by the recipients. This study aimed to compare Bipolar vascular sealing with conventional back-table dissection in terms of post-renal transplant drainage duration, amount, surgical wound complication, and back-table preparation time. PATIENTS AND METHODS A double-blind clinical study randomizes recipients into 2 groups, using Bipolar vascular sealing (Group 1) and conventional ligation (Group 2) back-table dissection. Variables such as recipient age, gender, body mass index (BMI), cause of end-stage renal disease, amount and duration of surgical drainage, back-table time, and cold ischemia time (CIT) were collected prospectively. RESULTS Ninety-eight consecutive living donor (M/F: 69/29) renal transplant recipients were enrolled in this prospective randomized clinical trial. There were 49 patients in each group. The mean BMI was 26.76±4.57. There was no difference among the groups regarding recipient age, BMI, total drainage, and surgical drainage duration. The surgical site infection rate was not different between the two groups. Group 1 had significantly shorter back-table time, with mean back-table time being 15.26±2.51 minutes in Group 1 and 28.83±6.27 minutes in Group 2 (p<0.001). The CIT was also significantly different between the 2 groups (p<0.001). In Group 1, the recorded CIT was 43.3±11.4, and in Group 2, 57.1±13.3 minutes. CONCLUSIONS The use of Bipolar vascular sealing to seal lymphatic vessels at the back-table is feasible, safe, and easy to perform. It also expedites the dissection and shortens the time required for back-table graft preparation.
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Analgesic effect of erector spinae plane block after cesarean section: A randomized controlled trial. Niger J Clin Pract 2023; 26:153-161. [PMID: 36876603 DOI: 10.4103/njcp.njcp_1636_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Background Ultrasound-guided bilateral erector spinae plane block is also a technique for providing analgesia after a cesarean section. Aim We hypothesized that bilateral erector spinae plane block applied from the transverse process of T9 who underwent elective cesarean section could provide effective postoperative analgesia. Patients and Methods Fifty parturients who were scheduled to undergo elective cesarean section under spinal anesthesia were included in the study. Group SA (n = 25) was categorized as the group in which spinal anesthesia alone (SA) was performed, and Group SA+ESP (n = 25) was categorized as the group in which SA + ESP block was performed. All patients were given a solution containing 7 mg isobaric bupivacaine + 15 μg fentanyl intrathecally through spinal anesthesia. In the SA + ESP group, the bilateral ESPB was performed at level T9 with 20 ml 0.25% bupivacaine + 2 mg dexamethasone immediately after the operation. Total fentanyl consumption in 24 h, the visual analogue scale for pain, and time to the first analgesic request were evaluated postoperatively. Results The total fentanyl consumption in 24 h was statistically significantly lower in the SA + ESP group than the SA group (279 ± 242.99 μg vs. 423.08 ± 212.55 μg, respectively, P = 0.003). The first analgesic requirement time was statistically significantly shorter in the SA group than the SA + ESP group (150.20 ± 51.83 min vs. 197.60 ± 84.49 min, respectively, P = 0.022). Postoperative VAS scores at 4th, 8th, and 12th h at rest were statistically significantly lower in group SA + ESP than in group SA (P = 0.004, P = 0.046, P = 0.044, respectively). VAS scores during the postoperative 4th, 8th, and 12th h cough were statistically significantly lower in group SA + ESP than in group SA (P = 0.002, P = 0.008, P = 0.028, respectively). Conclusion Ultrasound-guided bilateral ESP provided adequate postoperative analgesia and significantly decreased postoperative fentanyl consumption in patients having cesarean section. Also, it has a longer analgesia time than the control group, and it has been shown to delay the first analgesic requirement.
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Comparison of the effects of exenatide and insulin glargine on right and left ventricular myocardial deformation as shown by 2D-speckle-tracking echocardiograms. Niger J Clin Pract 2022; 25:1094-1101. [DOI: 10.4103/njcp.njcp_1640_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Prevalence of obesity in women of reproductive age group and related factors. A study from Southeastern Turkey. Niger J Clin Pract 2022; 25:801-808. [DOI: 10.4103/njcp.njcp_1587_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Preliminary results regarding assessment of the association between muscle mass and fibrosis-4 index among patients with chronic liver disease. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mandibular anterior segmental subapical osteotomy for incisor axis correction. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017. [DOI: 10.1016/j.jormas.2017.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Impaired myocardial deformation in psoriatic arthritis patients assessment by speckle tracking echocardiography. ACTA REUMATOLOGICA PORTUGUESA 2016; 41:131-137. [PMID: 27606472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We aimed to evaluate left ventricular (LV) mechanics of patients diagnosed with PsA and no clinical evidence for cardiovascular disease (CVD) using a novel, more sensitive technique which evaluates myocardial deformation in multidimensional planes for the detection of impaired LV function. METHODS The study enrolled 31 PsA patients and sex-age matched 19 healthy controls. All participants underwent conventional echocardiography and 2-dimensional speckle tracking echocardiography (STE). Global longitudinal, circumferential, and radial strain were measured. RESULTS Although patients with PsA had normal LV ejection fraction, the myocardial deformation in multidimensional planes was impaired. STE analysis results showed that PsA patients had significantly lower global longitudinal strain (mean±S.D. -17.11±2.83 % and -19.29±2 % respectively, p=0.005), global circumferential strain (mean±S.D. -14.28±3 % and -20.34±4.78 % respectively p<0.001) and global radial strain (mean±S.D. 29.26±10 % and 46.54±17 % respectively, p<0.001) versus control group. However, no correlation was found between longitudinal, radial, and circumferential strains and disease-related risk factors. CONCLUSION Subclinical impaired myocardial deformation was common in patients with PsA even with no clinical evidence for CVD. Thus, the use of this novel imaging technique could provide additional benefits for determining cardiovascular involvement at an early stage and risk stratification in PsA patients.
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Effects of rosmarinic acid on oxidative stress parameters in livers and kidneys of sepsis induced wistar albino rats. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Strain wave elastography for evaluation of renal parenchyma in chronic kidney disease. Br J Radiol 2015; 88:20140714. [PMID: 25806412 DOI: 10.1259/bjr.20140714] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Chronic kidney disease (CKD) is an important and costly health problem in developed countries and has a tendency to progress to end-stage renal disease regardless of the aetiology. This progress ends in interstitial fibrosis, which decreases the elasticity of tissue. Elastography is a developing technique to assess tissue elasticity. The aim of this study was to determine the difference of strain index (SI) value of renal parenchyma between patients with CKD and healthy individuals. In addition, SI differences of inter-stages were studied. METHODS Toshiba (Toshiba Medical Systems Corporation, Otawara, Japan) Aplio™ 500 ultrasound device and 3.5- to 5.0-MHz convex probe were used for the elastography examinations. RESULTS A total of 58 patients with CKD from nephrology and endocrinology clinics (30 males and 28 females; mean age, 56.14 ± 11.60 years) and 40 normal healthy individuals (19 males and 21 females; mean age, 51.70 ± 11.71 years) were included in this prospective study. The mean SI of normal healthy individuals and patients with CKD (regardless of stages) was 0.42 ± 0.30 and 1.81 ± 0.88, respectively (p < 0.001). SI values were not statistically significant among the CKD stages (except CKD Stages 1 and 3). The area under the receiver operating characteristic curve was 0.956 for SI. The optimal cut-off value for the prediction of CKD was 0.935 (sensitivity, 88% and specificity, 95%). CONCLUSION SI value of sonoelastography can be used to differentiate patients with CKD and healthy individuals. Sonoelastography is an acceptable technique to approach patients with CKD, but we have not shown that it can reliably differentiate different stages. ADVANCES IN KNOWLEDGE Determining a cut-off SI value between normal and diseased renal parenchyma can help in the diagnosis of CKD.
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INTENSIVE CARE ADMISSION IN PATIENTS WITH HELLP SYNDROME IN A TERTIARY REFERRAL HOSPITAL. Intensive Care Med Exp 2015. [PMCID: PMC4796200 DOI: 10.1186/2197-425x-3-s1-a909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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The value of real-time ultrasound elastography in chronic autoimmune thyroiditis. Br J Radiol 2014; 87:20140604. [PMID: 25315887 DOI: 10.1259/bjr.20140604] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Chronic autoimmune thyroiditis (CAT) (chronic lymphocytic thyroiditis-Hashimoto's thyroiditis), which is the most common inflammatory disorder of the thyroid gland, causes hypothyroidism. Ultrasound elastography is a newly developed sonographic technique that provides an estimation of tissue elasticity by measuring the degree of tissue displacement under the application of an external force. In this study, our aim was to evaluate the accuracy of strain index ratio with real-time ultrasound elastography and to calculate the cut-off point for the diagnosis of CAT. Our aim was also to lead further studies on other pathological changes such as lymphoma, malign nodules etc. based on CAT by using this cut-off point. The gains from this study and further studies will assist clinical diagnoses and follow-up. METHODS Aplio™ 500 ultrasound machine (Toshiba Medical Systems Co. Ltd, Otawara, Japan) with linear 4.8-11.0 MHz transducers and elastography software was used. Routine B-mode (dimensions and parenchymal echogenicity) ultrasound evaluation was performed prior to the ultrasound elastography. RESULTS A total of 31 randomized patients (3 males, 28 females) with a mean age of 39.13 ± 10.16 years (range, 16-58 years) with CAT and 21 healthy controls (6 males, 15 females) with mean age of 34.67 ± 16.31 years (range, 14-81 years) were prospectively examined. The mean values of thyroid-stimulating hormone (TSH; normal TSH value is 0.27-4.20 IU ml(-1)) and anti-thyroid peroxidase (anti-TPO; normal anti-TPO value is 0-34 IU ml(-1)) were 3.40 ± 2.70 and 373.66 ± 148.94 IU ml(-1), respectively. No correlation was detected between serum TSH and thyroid tissue strain index (Spearman r coefficient of TSH was -0.290). Positive-sided correlation was detected between anti-TPO values and thyroid tissue strain index ratio (Spearman r coefficient of anti-TPO was 0.682). The median strain index ratio of patients with CAT (1.39 ± 0.72) was significantly higher than the mean ratio of the controls (0.76 ± 0.55). The area under the receiver operating characteristic curve was 0.775 (95% confidence interval). The optimal cut-off value (in which the sum of sensitivity and specificity was highest) for the prediction of diffuse thyroid pathology was 0.677. For this cut-off ratio, thyroid stiffness had 96% sensitivity and 67% specificity. A total of 30 of 31 patients (96%) and a total of 7 of 21 healthy controls (33%) exceeded the cut-off points. CONCLUSION The strain index ratio was higher in CAT than in normal thyroid parenchyma in real-time ultrasound elastography. Thus, it seems to be a useful method for the assessment of CAT with real-time ultrasound elastography, and further studies assessing the correlation of sonoelastography findings and histopathological subtypes of CAT would enrich the findings of the present study. ADVANCES IN KNOWLEDGE In our study, we detected the stiffness ratio of the thyroid tissue in patients with CAT. The cut-off value should be helpful for diagnosis or follow-up of the recently developed lesions such as lymphoma, malign nodule, etc. based on CAT. This study should also encourage new studies about CAT and ultrasound elastography.
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Is thrombin-activatable fibrinolysis inhibitor antigen (TAFIag) level significant in recurrent miscarriage? CLIN EXP OBSTET GYN 2014. [DOI: 10.12891/ceog17352014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Is thrombin-activatable fibrinolysis inhibitor antigen (TAFIag) level significant in recurrent miscarriage? CLIN EXP OBSTET GYN 2014; 41:448-450. [PMID: 25134296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the plasma thrombin-tat fibrinolysis inhibitor antigen (TAFIag) levels in women with recurrent miscarriage (RM) and age-matched healthy parous women as controls. MATERIALS AND METHODS A total of 80 patients were enrolled in this study. As a study group (group 1), the authors evaluated 49 RM patients who had two or more consecutive abortions with unknown etiology before 12 weeks of gestation. The remaining 31 patients (group 2) were age-matched healthy parous women with no history of miscarriage and experienced at least one live baby. RESULTS Comparisons of blood TAFIag levels revealed no statistically significant difference between women with recurrent miscarriages and control group. CONCLUSIONS The findings of the present study indicated that TAFIag level was not associated with recurrent miscarriages.
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Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Poster session Thursday 12 December - AM: 12/12/2013, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Moderated Posters session * The prognostic value of myocardial deformation imaging in cardiomyopathy: 12/12/2013, 08:30-12:30 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Poster session Wednesday 11 December all day display: 11/12/2013, 09:30-16:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Impairment in aortic elastic properties and mechanics of ascending aorta in patients with bicuspid aortic valve. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Left ventricular rotational deformation is impaired in pulmonary hypertension: a speckle tracking- based study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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FRI0497 Subclinical left ventricular systolic dysfunction is present in patients with systemic lupus erythematosus with normal conventional echocardiographic assessment: a speckle tracking and real time three dimensional echocardiographic study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Poster session Thursday 6 December - AM: Other myocardial diseases. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pulmonary tuberculosis in an adult patient with tetralogy of Fallot. Hippokratia 2012; 16:286. [PMID: 23935302 PMCID: PMC3738742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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The value of serum tumour markers in the prediction of aetiology and follow up of patients with pericardial effusion. Cardiovasc J Afr 2012; 23:143-6. [PMID: 22555638 PMCID: PMC3721908 DOI: 10.5830/cvja-2011-029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 06/03/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the value of tumour markers in the differential diagnosis of pericardial effusions and to assess their changing levels during follow up. METHODS Sixty-nine patients who were admitted to hospital with a diagnosis of pericardial effusion were included in the study. Serum tumour markers were measured on admission and after a mean of 18 ± 7 months' follow up. An aetiological diagnosis was made on clinical evaluation, imaging techniques and biochemical, microbiological and pathological analysis. The patients were divided into five groups according to the aetiology of their pericardial effusions. RESULTS Carbohydrate antigen (CA) 12-5 and CA 15-3, and carcinoembryonic antigen (CEA) levels were significantly higher in patients with malignancies than in those with viral/idiopathic pericarditis. With multivariate analysis, CA 15-3 levels were found to be the most significant determinant (p = 0.027). In the ROC curve analysis, CA 15-3 values above 25 U/ml predicted a malignancy with 71% sensitivity and 78% specificity. CONCLUSION Tumour markers, particularly CA 15-3, may be useful in the differential diagnosis and prediction of malignancies in patients with pericardial effusion. In patients with viral/idiopathic aetiology, these serum tumour markers were slightly elevated in the acute phase, but after a mean of one year of follow up, their levels returned to normal, contrary to those with malignancies.
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Cardiac Resynchronization Therapy. Europace 2011. [DOI: 10.1093/europace/euq477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Reliability and validity of the Turkish version of the ECOS 16 questionnaire in postmenopausal osteoporosis. Eur J Phys Rehabil Med 2009; 45:521-526. [PMID: 20032911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM The purpose of this study was to develop a Turkish version of ECOS 16 Questionnaire and assess its reliability and validity. METHODS Sixty four women with postmenopausal osteoporosis were included in the study. It was mandatory for all patients to be Turkish literate and without symptoms of dementia. Patients who were diagnosed as secondary osteoporosis by clinical and laboratory examinations were excluded from the study. After translation process, the Turkish version of the scale was applied to each participant twice with an interval of 2 weeks. For reliability study, internal consistency (Chronbach alpha) of ECOS 16 total score and test-retest intraclass correlation coefficient (ICC) were calculated. Validation study was assessed by correlating the scale with QUALEFFO 41. RESULTS The mean age at menopause and age of patients were 45.61+/-6.04 years and 59.91+/-8.69 years respectively. Chronbach alpha of the Turkish version of the ECOS 16 was 0.90. The test-retest reliability (ICC) of the Turkish version of the ECOS 16 was determined as 0.83 for the total score, and ranged between 0.72-0.88 for individual items. In terms of validity; the Turkish version of ECOS 16 correlated significantly with QUALEFFO 41 (r=0.844 P<0.0001). CONCLUSIONS . The Turkish version of the ECOS 16 is a reliable and valid questionnaire to be used in the evaluation of Turkish women with postmenopausal osteoporosis.
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Comparison of the effects of left vs. right ventricular pacing on left ventricular remodelling. Europace 2008; 10:1387-91. [DOI: 10.1093/europace/eun306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Retrorectal cyst-hamartoma: a case report. Acta Chir Belg 2008; 108:759-60. [PMID: 19241935 DOI: 10.1080/00015458.2008.11680333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Retrorectal cyst-hamartoma is a relatively rare disease. Total excision of the cyst is indicated to prevent infection and malign proliferation. We present a case of retrorectal cyst-hamartoma in a 55-year-old woman that was successfully treated by complete surgical excision.
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Abstract
BACKGROUND The components of the metabolic syndrome are closely related with endothelial dysfunction, which is a pathophysiological issue of cardiovascular diseases. Non-alcoholic fatty liver disease (NAFLD) is considered as one of the components of the metabolic syndrome. The aim of this study was to evaluate the endothelial-dependent dilatation (EDD) and endothelial-independent dilatation (EID) of the brachial artery in NAFLD. METHODS Fifteen non-alcoholic steatohepatitis (NASH), 17 patients with simple steatosis and 16 healthy subjects formed the study group. Non-alcoholic fatty liver disease group was composed of patients admitted to the gastroenterology outpatient clinic because of increased liver enzymes. Endothelial functions of the brachial artery were evaluated by vascular ultrasound. EDD was assessed by establishing reactive hyperaemia, and EID was determined by using sublingual nitrate. RESULTS No statistical difference for the basal diameter of brachial artery was found between the groups (P = 0.49). The values for EDD and EID were significantly different across all three groups (P < 0.0001 and P < 0.0001, respectively). EDD and EID were significantly lower in NASH compared with simple steatosis (P = 0.01 and P < 0.01, respectively). However, there was no statistical significance for EDD and EID in simple steatosis groups compared with controls (P = 0.58 and P = 0.98, respectively). CONCLUSIONS Our study showed that patients with NASH had significantly worse endothelial dysfunction compared with patients with simple steatosis and healthy subjects. The treatment strategies with ameliorative effects for endothelial dysfunction might be effective for delaying the development of cardiovascular complications in NAFLD.
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Hydrated sodium calcium aluminosilicate for reduction of aflatoxin in quails (Coturnix coturnix japonica). DTW. DEUTSCHE TIERARZTLICHE WOCHENSCHRIFT 2007; 114:252-9. [PMID: 17724933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The purpose of the present study was to evaluate the toxic effects of aflatoxin (AF) on growth performance and various processing parameters of quails and to determine the preventive efficacy of hydrated sodium calcium aluminosilicate (HSCAS). One hundred and eighty 1-d-old quails of both sexes were randomly divided into 4 experimental groups with 5 replicates and 45 birds following weighing. The experimental design consisted of four dietary treatments: 1) control with 0 mg AF/kg of diet and 0% HSCAS; 2) 0.5% HSCAS; 3) 2.5 mg AF/kg of diet; 4) 2.5 mg AF/kg of diet plus 0.5% HSCAS. The chicks were housed in electrically heated battery cages and exposed to light for 24 h from hatching to 3 weeks of age. Quails consumed the diets and water ad libitum. Body weight (BW) was significantly (p < 0.001) increased by addition of HSCAS to AF diet. The lowest BW gains in groups received AF alone was observed at all periods. The reduction in BW gain caused by 2.5 mg AF/kg of diet was significantly (p < 0.001) diminished by the addition of 0.5% HSCAS to the diet. The addition of HSCAS to the AF diet significantly (p < 0.001) protected against decrease of feed intake at all periods with exception of the first period. None of the treatments altered significantly the feed conversion ratio (FCR). The relative weights of the liver, kidney and spleen were increased in the chickens consuming the AF alone diet. However, light microscopic examination demonstrated the addition of HSCAS to quail feed to partially decrease fat deposition caused by the toxin, and besides, electron microscopic examination of indicated a reorganization in the endoplasmic reticulum and increase in the number of ribosomes and polisomes. Furthermore, the decrease in the antibody titre induced by Newcastle vaccine, due to aflatoxins, was relatively prevented. No significant differences were observed for serum total protein, total cholesterol and glucose levels. The results of indicate that HSCAS is effective in preventing the deleterious effects of AF.
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Relation between proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome. Heart 2006; 92:1041-6. [PMID: 16547209 PMCID: PMC1861097 DOI: 10.1136/hrt.2005.080382] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate the relation between serum high sensitivity (hs) C reactive protein (CRP), proinflammatory cytokine concentrations, proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome (NSTEACS). DESIGN Prospective follow-up study for the first six months and then for the first year after admission to hospital. SETTING Tertiary referral centre. PATIENTS 80 patients (60 men, 20 women, mean age 60 (SD 10) years) with NSTEACS and moderate to high TIMI (Thrombolysis In Myocardial Infarction) risk scores. INTERVENTIONS Blood samples from patients with NSTEACS were obtained at the time of admission. Serum concentrations of hs-CRP, (hs) pro-inflammatory (interleukin (IL) -1beta, IL-6, tumour necrosis factor alpha) and (hs) anti-inflammatory (IL-10) cytokines were analysed and proinflammatory to anti-inflammatory cytokine ratios were calculated by dividing proinflammatory cytokine concentrations by anti-inflammatory cytokine IL-10. MAIN OUTCOME MEASURE The primary end point of the study was new coronary events (NCE) defined as the combination of cardiac death, non-fatal myocardial infarction and recurrent rest angina that required hospitalisation within 12 months of follow up. RESULTS During the one-year follow-up period, 23 patients (29%) met the NCE criteria. Concentrations of hs-CRP, IL-1beta and IL-6 and ratios of IL-1beta:IL-10 and IL-6:IL-10 were significantly higher in patients with NCE than in patients without NCE. In the logistic regression analysis, IL-6:IL-10 ratio was the most important predictor for NCE (p = 0.006) with an odds ratio of 2.24 (95% CI 1.26 to 3.97). CONCLUSIONS Cytokine concentrations and proinflammatory to anti-inflammatory cytokine ratios may be useful markers for predicting vascular risk in patients with NSTEACS.
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Abstract
To determine whether combination treatment of HBeAg(-) chronic hepatitis B is beneficial we studied 78 patients with HBeAg(-), HBV DNA-positive chronic hepatitis B who were randomized to lamivudine, 100 mg, qd, for 12 months or lamivudine-interferon (9 MU, t.i.w.) in combination. In the combination arm, 2 months of lamivudine treatment preceded 10 months of combination treatment. Biochemical, virologic and histologic responses were assessed at the end of treatment, after six and a median 27 months of drug-free follow-up (short- and long-term follow-up, respectively). Virologic response was defined as undetectable HBV DNA with a hybridization assay and biochemical response as normal alanine aminotransferase (ALT). Change in HBV DNA was also assessed by real-time polymerase chain reaction (PCR). Presence of YMDD mutants at the end of treatment was investigated with a line probe assay. Both treatment regimes led to a median 2 log decline in HBV DNA levels. Virologic end of treatment responses were 90 and 92% with mono- and combination treatment, respectively. Corresponding virologic responses at short- and long-term follow-up were 59 and 54%, and 27 and 25%, respectively. Patients having a baseline HBV DNA value > or =200 pg/mL were more likely to relapse within 6 months off therapy than those patients with a baseline HBV DNA level <200 pg/mL (P = 0.041). YMDD mutants were observed in 53% of patients receiving lamivudine compared with 24% of patients receiving the combination regime (P = 0.017). In conclusion, efficacy of combination treatment is similar to lamivudine monotherapy. However, combination treatment decreases the development of YMDD mutant strains compared with lamivudine monotherapy.
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Abstract
The emergence of drug-resistant virus in hepatitis B virus (HBV) patients treated with lamivudine is well documented. In this study, we determined the mutations occurring in the tyrosine-methionine-aspartate-aspartate (YMDD) amino acid motif of the HBV DNA polymerase gene, as well as upstream and downstream of this region, in patients with breakthrough virus during lamivudine therapy. Thirty-one Turkish patients (20 patients HBeAg positive, 11 patients HBeAg negative and anti-HBe positive) with chronic HBV infection who completed at least 104 weeks of lamivudine treatment were investigated. All patients received lamivudine, (150 mg/day), for 104 weeks, with or without 4 months of interferon (IFN) combination. HBV-specific sequences were amplified by polymerase chain reaction (PCR) from sera of patients with breakthrough virus, and the PCR products were directly analysed by sequencing. Breakthrough virus was detected in seven of the 31 patients (22.6%) between 9 and 18 months of therapy. Of the seven patients, six were HBeAg positive at baseline, and four had a double mutation consisting of rtM204V and rtL180M, while two had an rtM204I change. In one patient, two base substitutions at rt204 (ATG --> AGT; T to G and G to T) lead to a methionine to serine change (YMDD --> YSDD). This novel DNA pol mutation was detected at month 18 of lamivudine treatment. In addition, this new variant had the rtL180M mutation and a 12 base pair deletion in the pre-S1 region between nucleotides 43-54. The YSDD mutation was still present 6 months after lamivudine discontinuation. In vitro transfection studies also confirmed that the YSDD strain is resistant to lamivudine. In conclusion, the results indicate that, in addition to a Met --> Val and Met --> Ile change in YMDD, a Met --> Ser change at rt204 (YMDD --> YSDD) associated with the rtL180M change can also emerge during lamivudine treatment, which confers lamivudine resistance in vivo and in vitro, leading to virological breakthrough and ALT increases.
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[The effect of an oral zinc substitution on some biochemical blood serum parameters in pregnant sheep and their lambs as well as on the birth weights of the lambs]. DTW. DEUTSCHE TIERARZTLICHE WOCHENSCHRIFT 2001; 108:449-53. [PMID: 11765599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The aims of this study were to demonstrate the effects of zinc sulphate administration (2 g/week p.o., 2% solution) on zinc, copper, iron, calcium and magnesium levels in blood serum of 20 pregnant Ivesi sheep during the last 2 month of pregnancy, immediately post partum as well as in their newborn lambs. In these 20 lambs, also total serum protein, gamma globulin and birth weight were determined. The control group consisted of 15 pregnant sheep and their 15 lambs housed under the same conditions. Zinc sulphate administered to sheep caused significant increases in their serum levels of zinc as well as in those of their lambs. The lambs of the zinc supplemented group had also slightly higher birth weights (not significant) and significant higher gamma globulin levels, whereas the total protein values was almost identical in both groups.
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Immediate postabortal contraception with the levonorgestrel intrauterine device, Norplant, and traditional methods. Contraception 2001; 63:309-14. [PMID: 11672552 DOI: 10.1016/s0010-7824(01)00212-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Women seeking legal first trimester abortion were counseled concerning contraception methods available for use immediately postabortion. Fifty women each accepted hormonal methods that were available only in the clinic and were novel to the country, the levonorgestrel IUD and Norplant implants, whereas another 50 chose either coitus interruptus or abstinence. All were experienced contraceptors, but larger percentages of women selecting the levonorgestrel IUD or implants had used the pill or IUDs previously, were under age 30, and weighed less than 60 kg compared to the other study participants. In the initial 2-6 weeks postabortion, women using the long-acting hormonal methods resumed sexual activity earlier and experienced more bleeding and spotting days than did other study participants, but their hematocrits were not adversely affected. No clinically significant side effects were noted in any group in the 6 weeks following the abortion. At the end of 1 year of follow-up, women using the hormonal methods had experienced no pregnancies and had high rates of continuation. IUD and implant participants had greater weight gain than did the other participants, but their mean weight remained below that of participants using traditional methods. No significant between-group differences in levels or changes in levels from admission were noted in hematocrit and blood pressure. The women found the levonorgestrel implants and IUDs easy and safe to use and highly effective. Bleeding disturbances, including amenorrhea, were the principal features the women disliked.
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Abstract
The contribution of hepatitis B, hepatitis C, and excess alcohol intake to the development of hepatocellular carcinoma in Turkey was assessed. The study was conducted through a questionnaire sent to seven major medical referral centers in different regions of Turkey and is based on 207 patients seen in the period 1994-1997. Of the seven centers, two were located in West Turkey (54 patients), two were in Central Turkey (85 patients), and two were in south and southeast Turkey (68 patients). In 196 of the 207 patients (94.7%), there was a history of chronic liver disease, and in 180 patients (87%) liver cirrhosis was documented. Of the 207 patients, 116 (56%) had hepatitis B, 48 (23.2%) had hepatitis C, and 33 (15.9%) had a history of excess alcohol intake. Anti-delta testing was available in 69 of 116 patients with hepatitis B, and anti-HDV was positive in 13 of these patients (13/69, 18.8%). Of the 33 patients with a history of heavy alcohol intake, 18 had concomitant chronic viral hepatitis infection, and alcohol alone was the etiology of hepatocellular carcinoma in only 15 cases (7.2%). The distribution of etiologic factors was not homogenous in different geographical regions in Turkey. In central, south, and southeastern Turkey, the predominant etiology of hepatocellular carcinoma was hepatitis B, whereas in western Turkey the impact of hepatitis B, hepatitis C, and alcohol was similar. This study indicates that hepatitis B virus infection is the leading cause of hepatocellular carcinoma in Turkey, followed by hepatitis C infection and alcoholic liver disease.
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Abstract
PURPOSE The effects of midazolam-thiopental coinduction on recovery were investigated and compared with thiopental induction. METHODS Fifty patients, ASA 1 or 2, undergoing minor orthopedic surgery, were randomly divided into coinduction and thiopental groups. During preoxygenation, the patients received midazolam 0.1 mg.kg(-1) (coinduction group) or saline (thiopental group) 1 min before induction of anesthesia with thiopental. Isoflurane and nitrous oxide were used to maintain anesthesia. Isoflurane concentration was adjusted to keep blood pressure within +/-20% of the preoperative value. The time to awaken (open eyes, give name and birth-date) and the time to discharge readiness were recorded. Psychomotor tests, including simple light reaction time (SLRT), sedation analogue scale (SAS), and digit span test, were performed pre- and postoperatively. RESULTS The induction dose of thiopental was significantly lower in the coinduction group. End-tidal isoflurane concentration during surgery was also lower in the coinduction group. There were no significant differences in awakening times and discharge readiness between the two groups. Although SAS values were lower in the coinduction group than in the thiopental group 8 and 24 h after anesthesia, other test results were similar in both groups. The frequency of nausea and vomiting in the recovery period was lower in the coinduction group. CONCLUSION We conclude that midazolam-thiopental coinduction is a suitable technique when used in conjunction with isoflurane in day-case surgery.
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Influence of viral load and alanine aminotransferase on viral genetic heterogeneity in patients with chronic hepatitis C virus infection. Intervirology 2000; 43:61-6. [PMID: 10773739 DOI: 10.1159/000025024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM Hepatitis C virus (HCV) populations in vivo consist of genetically different heterogeneous mixtures defined as 'quasispecies', which vary in the hypervariable region 1 (HVR1) mostly. To further address the role of quasispecies diversity in hepatitis C infection, this study aimed to evaluate the influence of ALT, viral load and genotypes on quasispecies heterogeneity in patients with HCV infection. METHODS Thirty-six chronic hepatitis C patients with high levels of alanine aminotransferase (ALT) were studied. None of them received any antiviral therapy. HCV RNA serum levels, genotype and genetic heterogeneity were determined by branched-chain DNA assay, restriction fragment length patterns and RT-PCR single-strand conformational polymorphism analysis of HVR1, respectively. RESULTS Twenty-eight patients had genotype 1b (28/36; 78%), 6 patients had genotype 1a (6/36; 17%), 1 patient was 2a (1/36; 3%) and genotype could not be determined in 1 patient. The patients were categorized into two groups according to the number of bands representing the dominant strains in the circulation: group A with 2 bands having 1 strain (14/36 patients; 39%) and group B with more than 2 bands indicating more than 1 strain (22/36 patients; 61%). The serum viremia and ALT levels for these groups were 11 +/- 8.8 and 5.3 +/- 4.6 mEq/ml (p < 0.05), and 79 +/- 20, and 127 +/- 80 IU/l (p < 0.05), respectively. CONCLUSION The results of this study suggest that hepatitis C patients having 1 dominant strain in the circulation may show a relatively weaker immune response resulting in lower ALT and higher viremia levels, whereas patients with high degrees of virus quasispecies diversity have higher ALT levels and a more active immune response causing the selection of new genome variants and depressing viral replication partly.
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Pulp and paper from blue agave waste from tequila production. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 1999; 47:4450-4455. [PMID: 10552832 DOI: 10.1021/jf990045n] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Pulping of blue agave waste, from the production of tequila, was evaluated by both chemical and biomechanical pulping processes. Two conventional and two organosolv systems were used to pulp the agave waste under a standard set of conditions. The soda-ethanol process was superior in terms of delignification and pulp properties in comparison to the soda and ethanol organosolv processes for pulping of agave waste; however, the kraft process gave the best strength properties. In general, the strength of the agave waste pulps was rather poor in comparison to wood and other agro-based pulps; however, the tear strength was relatively high. This result is typical of poorly bonded sheets and may be due to the coarseness of the agave fibers and/or loss of hemicelluloses in the steaming process for the tequila production. Fungal treatment of the agave waste with Ceriporiopsis subvermispora reduced the energy consumption for mechanical refining but gave biomechanical pulps with inferior strength properties. The blue agave chemical pulps should be suitable for blending with softwood kraft pulps for publication grade paper.
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Cutis laxa acquisita: is there any association with Borrelia burgdorferi? Eur J Dermatol 1999; 9:561-4. [PMID: 10523738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We report the first case of an acquired form of generalized cutis laxa which has positive serology and a positive polymerase chain reaction (PCR) result for lyme borreliosis. A 44-year-old man complained of excessively loose skin for four years and had no family history of any skin disease. Dermatological examination showed lax and wrinkled skin all over the body (especially on the cheeks and the intertriginous areas). Positive serology for lyme borreliosis and the presence of Borrelia burgdorferi DNA which was demonstrated by nested PCR in this acquired form of cutis laxa is interesting since it has not been reported in literature previously.
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Abstract
We report a case of congenital arterioportal fistula presenting with upper gastrointestinal bleeding from oesophageal varices. The fistula was successfully treated with surgical ligation of the left hepatic artery.
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Abstract
We describe a patient with persistent papular acantholytic dermatosis provoked by phototoxic reaction to his usual perfumed soap and shaving foam. Therapy with systemic and topical corticosteroids failed to improve the patient. Treatment with cyclosporine was found to be effective.
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