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Nodular fasciitis of the breast: Case reports of a male and a female patient [Memede Nodüler Fasiit: Bir Erkek ve Bir Kadin Hastanin Olgu Sunumu]
No full textFactors preventing materno-fetal transmission of SARS-CoV-2
No full textAlthough many pregnant women have been infected by coronavirus, the
presence of intrauterine vertical transmission has not been conclusively
reported yet. What prevents this highly contagious virus from reaching
the fetus? Is it only the presence of a strong placental barrier, or is
it the natural absence of the some receptor that the viruses use for
transmission? We, therefore, need to comprehensively understand the
mechanism of action of the mammalian epithelial barriers located in two
different organs with functional similarity. The barriers selected as
potential targets by SARS-CoV-2 are the alveolo-capillary barrier (ACB),
and the syncytio-capillary barrier (SCB). Caveolae are omega-shaped
structures located on the cell membrane. They consist of caveolin-1
protein (Cav-1) and are involved in the internalisation of some viruses.
By activating leukocytes and nuclear factor-.B, Cav-1 initiates
inflammatory reactions. The presence of more than one Cav-1 binding
sites on coronavirus is an important finding supporting the possible
relationship between SARS-CoV-2-mediated lung injury. While the ACB
cells express Cav-1 there is no caveolin expression in
syncytiotrophoblasts. In this short review, we will try to explain our
hypothesis that the lack of caveolin expression in the SCB is one of the
most important physiological mechanisms that prevents vertical
transmission of SARS-CoV-2. Since the physiological Cav-1 deficiency
appears to prevent acute cell damage treatment algorithms could
potentially be developed to block this pathway in the non-pregnant
population affected by SARS-CoV-2
Oxıdatıve Methane Actıvatıon Wıth Catıonıc Lıgand – Metal Complexes
No full textKüçük molekül aktivasyonu (KMA), doğadan kolayca elde edilebilen, az sayıda atomdan oluşan (su, oksijen, azot, karbondioksit, basit hidrokarbonlar vb.) bileşikleri daha karmaşık ve değerli kimyasallara çevirme süreçlerinin ilk basamağıdır ve çevresel, endüstriyel ile doğal enerji kaynaklarıyla alakalı uygulamaları sebebiyle katalitik kimya alanında önemli bir yere sahiptir. Küçük moleküller oldukça kararlıdırlar. KMA tepkimeleri bu kararlı yapılara önemli bir müdahale olması nedeniyle büyük bir enerji engeliyle karşılaşırlar. Bu sebeple KMA’da en zor adım küçük molekülde bir kovalent bağın kırıldığı ve “aktivasyon” diye adlandırılan basamaktır. Bu tez, KMA’da “aktivasyon” olarak adlandırılan basamağı kolaylaştıracak çalışmalar üzerinedir. Geçiş metali (GM) merkezli aktivatör kompleksler ile bu komplekslerin kimyasal sistemlere uygulanabilirliği açısından birinci sıra geçiş metalleri (Cr, Mn, Fe, Co, Ni) ile çalışılmıştır. Bu komplekslerin düşük reaktifliğe sahip olan metan C–H bağının kırılmasını kolaylaştırması hedeflenmektedir. Tüm bu detaylar gözönünde bulundurulduğunda C–H bağının kırıldığı basamağı bir molekül içi asit-baz tepkimesi olarak değerlendirip bu tepkimeyi kolaylaştıracak katyonik ligandlar (LK) tasarlanmıştır. Ligandlardaki katyonik halkaların metanı polarize ederek C–H aktivasyon bariyerini (TS1/2) düşürmesi hedeflenmektedir. Burada yoğunluk fonksiyoneli teorisi (DFT) ile yapılan çalışmalar ile tepkimenin seyrine ilişkin genel bir bakış sağlanmıştırSmall molecule activation (SMA) is easily obtainable from nature, consisting of a small number of atoms (water, oxygen, nitrogen, carbon dioxide, simple hydrocarbons, etc.) is the first step of the processes of converting compounds into more complex and valuable chemicals and it has an important place in the field of catalytic chemistry due to its applications related to environmental, industrial and natural energy resources. Small molecules are very stable. KMA reactions are a major energy barrier due to the significant interference in these stable structures. For this reason, the most difficult step in SMA is the step in which a covalent bond is broken in the small molecule and called “activation”. This thesis is about the studies that will facilitate the step called “activation’ in SMA. The transition metal (TM) based activator complexes and the first order transition metals (Cr, Mn, Fe, Co, Ni) were studied in terms of their applicability to chemical systems. These complexes are intended to facilitate the breakage of the low-reactivity methane C-H bond. In view of all these details, cationic ligands (LC) were designed to facilitate the reaction by evaluating the C-H bond breaking step as an intramolecular acid-base reaction. The cationic rings in the ligands are intended to reduce the C – H activation barrier (TS1/2) by polarizing methane. Here, an overview of the course of the reaction is provided by studies with density functional theory (DF
The Geographical Distribution of Morbidity Caused By Chronic Obstructive Pulmonary Disease in Turkey: COPDTURKEY-2
No full textBackground: Chronic obstructive pulmonary disease (COPD) is one of the
most prevalent causes for morbidity and mortality, and it creates a
cumulative economic and social burden.
Aims: To determine the distribution of the prevalence of patients in
Turkey who were diagnosed with COPD and their morbidity rates, according
to the regions and cities they belong to. Moreover, the study
contributes to the prevention and cure services of COPD that should be
planned in the future.
Study Design: A retrospective cohort.
Methods: The database of the Social Security Institution from 2016 has
been scanned. All the data with prescription registration, with the code
ICD-10, J44.0-J44.9, which were aimed for diagnosing and/or cure, have
been evaluated with a retrospective cohort.
Results: In 2016, 955,369 patients who were admitted as outpatients to
the hospitals were diagnosed with COPD. The average number of annual
COPD cases that were admitted was 2.09. Twenty percent (20\%) of the
outpatient applications were via emergency room. The rate of
hospitalization among the applicants was 17.75\%. with a total of
1,994,325. The average annual number of hospitalizations of men was
higher than that of women. The average number of hospitalization days
was 6.52. The region with the highest prevalence of outpatient admission
and hospitalization was the Black Sea Region.
Conclusion: The high rate of hospitalization was considered to be the
outcome of the insufficient ``outpatient{''} management
Value of prognostic scores in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis patients in intensive care unit: a multicenter retrospective cohort study from Turkey
No full textBackground/aim: There is a need for a scoring system for predicting ICU
prognosis of patients with ANCA-associated vasculitis (AAV), but there
are limited data on it in the literature. Therefore, we aimed to
determine the scores that can estimate the prognosis of patients with
AAV during intensive care follow up.
Materials and methods: All adult patients admitted to the medical ICUs
of 4 reference university hospitals in Turkey due to AAV activation
and/or disease/treatment complications in the last 10 years were
included in this study. Demographic data, treatments before ICU, the
Birmingham Vasculitis Activity Score (BVAS) score at the time of
vasculitis diagnosis, and BVAS, APACHE II, SOFA, and SAPS II scores at
the ICU admission, treatments, procedures, and complications during ICU
stay were recorded for all AAV patients.
Results: Thirty-four patients were included in the study. The median age
of the patients was 60 (42-70) years, and 64.7\% were male. Twenty-five
patients were diagnosed with Granulomatosis with polyangiitis, and 9
were diagnosed with Microscopic polyangiitis. The most common ICU
admission causes were hemorrhage (85.3\%) and sepsis/septic shock
(67.6\%). Twenty patients (58.8\%) died in the ICU follow up. There were
significant differences in APACHE II (P = 0.004) and SAPS II (P = 0.044)
scores between survivors and nonsurvivors, while there were no
significant differences in BVAS (during diagnosis P = 0.089 and ICU
admission P = 0.539) and SOFA (P = 0.097) scores. APACHE II score was
found to be an independent risk factor for ICU mortality (OR = 1.231, CI
95\% = 1.011-1.498, P = 0.038) according to logistic regression
analysis. An APACHE II score of greater than 20.5 predicted ICU
mortality with 80\% sensitivity and 70\% specificity (AUC = 0.8, P =
0.004, Likelihood ratio = 2.6) according to the ROC curve analysis.
Conclusion: APACHE II score can be used for the prediction of ICU
mortality in AAV patients
EVALUATION OF PATIENTS WITH LYMPOCELE AFTER RENAL TRANSPLANTATION
No full textIntroduction: The lymphocele is a common complication following renal
transplantation and may cause significant clinical problems especially
when reachs to big volumes. The aim of this study is to present the
clinical characteristics, diagnostic approaches, and therapeutic
strategies of lymphocele formations in a group of Turkish patients.
Methods: A total of 244 renal transplantations were included in this
retrospective study. Data of patients who were diagnosed with lymphocele
during the postoperative period were analyzed. Results: Ten (2.4\%)
patients have been diagnosed with lymphocele. There were six males and 4
females, with a mean age of 46 years. The median onset was 19 days
posttransplantation. The median size of the lymphoceles was 53 mm. All
lymphoceles were localizated between the lower pole of the transplanted
kidney and urine bladder. On presentation, one patient had
hydronephrosis and three patients had elevated serum creatinine while
the remaining six ones were asymptomatic. Five patients were
successfully treated by percutaneous aspiration whereas two patients
required surgery. Three patients' lymphoceles dissolved spontaneously.
Conclusion: Preventive strategies including preserving the lymphatics of
the recipient, careful organ retrieval and `back table' work are of
great importance to reduce the incidence of lymphocele. Early decision
of radiological or surgical intervention should be considered in
patients with symptomatic lymphoceles in order to prevent further
complications
Association of Serum Ferritin Levels Before Start of Conditioning With Mortality After alloSCT - A Prospective, Non-interventional Study of the EBMT Transplant Complications Working Party
No full textElevated serum ferritin levels occur due to iron overload or during
inflammation and macrophage activation. A correlation of high serum
ferritin levels with increased mortality after alloSCT has been
suggested by several retrospective analyses as well as by two smaller
prospective studies. This prospective multicentric study aimed to study
the association of ferritin serum levels before start of conditioning
with alloSCT outcome. Patients with acute leukemia, lymphoma or MDS
receiving a matched sibling alloSCT for the first time were considered
for inclusion, regardless of conditioning. A comparison of outcomes
between patients with high and low ferritin level was performed using
univariate analysis and multivariate analysis using cause-specific Cox
model. Twenty centers reported data on 298 alloSCT recipients. The
ferritin cut off point was determined at 1500 mu g/l (median of measured
ferritin levels). In alloSCT recipients with ferritin levels above cut
off measured before the start of conditioning, overall survival (HR =
2.5, CI = 1.5-4.1, p = 0.0005) and progression-free survival (HR = 2.4,
CI = 1.6-3.8, p < 0.0001) were inferior. Excess mortality in the high
ferritin group was due to both higher relapse incidence (HR = 2.2, CI =
1.2-3.8, p = 0.007) and increased non-relapse mortality (NRM) (HR = 3.1,
CI = 1.5-6.4, p = 0.002). NRM was driven by significantly higher
infection-related mortality in the high ferritin group (HR = 3.9, CI =
1.6-9.7, p = 0.003). Acute and chronic GVHD incidence or severity were
not associated to serum ferritin levels. We conclude that ferritin
levels can serve as routine laboratory biomarker for mortality risk
assessment before alloSCT