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Ultrastructural examination of testicular tissues and evaluation of ZO-1 protein levels obtained from azoospermic cases
No full text2-s2.0-85105271433Spermatogenesis is a process that involves cellular and biochemical processes. The purpose of this study is to understand the role of tight junctions in spermatogenesis by evaluating Zonula occludens-1 (ZO-1) protein levels of cells from the testicular sperm extraction (TESE) biopsies in patients with azoospermia. The study included 40 infertile men with azoospermia. They were divided into two groups, as spermatozoa positive (n=20) and spermatozoa negative (n=20). Testis tissues were examined morphologically, immunohistochemically and ultrastructurally by using transmission electron microscopy (TEM). The structure of seminiferous tubules was deteriorated, degenerated and hyalinized in spermatozoa negative group. ZO-1 expression level was normal in blood-testis barrier of spermatozoa positive group in comparing to lateral surfaces of Sertoli cells spermatozoa negative group. The ultrastructural results were also supported with light microscopy findings. These findings suggest that decrease of the ZO-1 protein expression level in Sertoli cells might be one of the factors involved in the impairment of spermatogenesis in spermatozoa negative group. Therefore, we suggest that tight junctions may have crucial roles in spermatogenesis. © 2021 Ondokuz Mayis Universitesi. All rights reserved
European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) SLE classification criteria item performance
No full textIzmirly, Peter/0000-0001-5445-2182; Doria, Andrea/0000-0003-0548-4983PubMed: 33568386WOS:000654337600032Background/objectives The European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 classification criteria for systemic lupus erythematosus system showed high specificity, while attaining also high sensitivity. We hereby analysed the performance of the individual criteria items and their contribution to the overall performance of the criteria. Methods We combined the EULAR/ACR derivation and validation cohorts for a total of 1197 systemic lupus erythematosus (SLE) and n=1074 non-SLE patients with a variety of conditions mimicking SLE, such as other autoimmune diseases, and calculated the sensitivity and specificity for antinuclear antibodies (ANA) and the 23 specific criteria items. We also tested performance omitting the EULAR/ACR criteria attribution rule, which defines that items are only counted if not more likely explained by a cause other than SLE. Results Positive ANA, the new entry criterion, was 99.5% sensitive, but only 19.4% specific, against a non-SLE population that included other inflammatory rheumatic, infectious, malignant and metabolic diseases. The specific criteria items were highly variable in sensitivity (from 0.42% for delirium and 1.84% for psychosis to 75.6% for antibodies to double-stranded DNA), but their specificity was uniformly high, with low C3 or C4 (83.0%) and leucopenia 80% for all items, explaining the higher overall specificity of the criteria set.EULAR; ACR; Intramural Research Programme of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of HealthThe classification criteria project has been jointly funded by EULAR and the ACR. This research was supported in part by the Intramural Research Programme of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health
Evaluation of Thiol/Disulfide Homeostasis and Other Oxidative Stress Markers in Patients Undergoing Hemodialysis
No full textWOS:000624452900003Objective: To investigate the potential role of thiol/disulphide homeostasis as a novel biomarker of oxidative stress in patients with diabetes and undergoing hemodialysis (HD) and its correlation with other oxidative stress markers. Materials and Methods: This study included 82 patients with end-stage renal disease undergoing HD for four hours, three times weekly for more than 24 months in the dialysis center. Of the 82 patients, 47 were non-diabetic and 35 were diabetic. Blood samples were collected from the patients before and after the HD sessions. The thiol/disulfi de pair tests were performed and total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), ischemia-modified albumin (IMA) levels, albumin levels, ceruloplasmin, catalase activity (CAT), and myeloperoxidase (MPO) activity were determined in the serum. Results: The TAS values in all the patients, both diabetic and non-diabetic, decreased significantly after HD (p<0.001, p=0.003, and p<0.001; respectively). The TOS, albumin, native thiol (p=0.001, p=0.007, p=0.001, respectively), OSI, CAT, ceruloplasmin, IMA, MPO, and total thiol (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, and p<0.001, respectively) values increased significantly in all the patients after the HD session. The TOS, OSI, CAT, IMA, albumin, MPO, native thiol, and percentages of native/total thiol, ceruloplasmin, and total thiol values (p=0.002, p=0.002, p=0.002, p=0.001, p=0.008, p=0.001, p=0.001, p=0.003, p=0.023, and p<0.001; respectively) increased significantly in patients with diabetes after the HD session. Conclusion: In this study, we demonstrated the relationship between oxidative stress markers, which play a significant role in the pathogenesis of diabetes, and thiol/disulfide balance undergoing HD patients
Clinical, radiological and HRQoL outcomes after selective thoracic fusion with minimum 15-year follow-up
No full textPubMed: 339051002-s2.0-85105277984Introduction: The purpose of the study was to provide a 15-year natural history evaluation of the radiographic appearance of uninstrumented compensatory lumbar curves in patients who had undergone selective thoracic fusion (STF) for scoliosis, measure any changes in health-related quality of life scores (HRQoL) and compare them with controls matched for age, gender and body-mass index (BMI). Methods: STF group included 43 female adolescent idiopathic scoliosis (AIS) patients who underwent STF with mean age 33(27–42) years and a mean follow-up of 18.7 (15–28) years, mean BMI 22(18–29). Preop, early postop and follow-up radiographs were reviewed for behavior of lumbar curves. Control group included a random selection of healthy volunteers with no history of back pain and with mean age 33(27–41), and mean BMI 22(17–33). HRQoL scores were compared between two groups in latest f/up. Radiographs including low dose biplanar imaging with EOS were used to measure disc heights and assess for radiographic evidence of degenerative changes. Various parameters were statistically compared. Results: Posterior fusion was performed in all 43, with all pedicle screws used in 41 and all-hook constructs in 2. Main thoracic curve correction was improved from pre-op to early-post-op and maintained at latest f/up (55.6°–16.1°–16.9°). Spontaneous lumbar curve correction (SLCC) was also maintained beyond 15 years (39.9°–16.6°–17.1°). Two patients developed coronal decompensation following surgery, but improved with time and were well compensated at final follow-up. Mean HRQoL scores, self-image and mental health scores were higher in STF group than control group (p 0.05). All disc heights except L5-S1 were significantly lower in STF group (p < 0.05). There was no significant difference between the groups for degenerative changes in the latest radiographs. Conclusion: In this group of patients, the uninstrumented lumbar curve spontaneously corrected and the correction was maintained after 18 years following surgery using STF. Mild degenerative changes were seen radiographically and HRQoL scores suggest that the psychological-functional well-being are quite good in the long term in AIS patients who have undergone STF when compared with an age–gender–BMI-matched population. © 2021, Scoliosis Research Society
Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregnancy
No full textKaymakcalan, Hande/0000-0001-7736-7634WOS:000614328300004Objective: Our aim is to investigate whether there is a correlation of pregnancy-associated plasma protein A (PAPP-A) values with other variables in pregnancy and maternal characteristics. Materials and Methods: We retrospectively analyzed the relation between the PAPP-A levels, demographics, biochemical and ultrasonographic markers of the first trimester screening of 11,842 pregnant women seen at a tertiary hospital between November 2002 and November 2008. Results: A significant difference between PAPP-A values of the diabetic and non-diabetic pregnant women were observed (p=0.0005, Mann-Whitney U test). In terms of weight, crown-rump length, Beta-hCG values, significant differences were observed between low and medium level PAPP-A subgroups and between low and high level PAPP-A subgroups. PAPP-A levels were found to differ significantly between the pregnant women of Caucasian origin and other racial origins. Conclusions: Pregnant women with different ethnic and medical backgrounds have different PAPP-A values and other markers of the aneuploidy screening. 'lb make patient specific risk predictions, understanding these interactions and differences is important. Future studies are needed to understand the pathopyhsiology behind these differences
Identification of Psychological and Social Problems in Caregivers of Individuals Diagnosed with Hematologic Malignancy
No full textPubMed: 33688570WOS:000613832100014Objective: Caring for patients with hematological malignancy could lead to many problems in different aspects regarding the lives of caregivers. However, there is limited data on the emotional and social problems of caregivers, who deal with patients of hematological malignancy. The aim of this study is to determine the emotional and social problems in caregivers of individuals diagnosed with hematological malignancy. Methods: The study was carried out descriptively to identify the emotional and social problems in the relatives of the patients diagnosed with hematological malignancy as their caregivers, as well as the factors affecting these problems. The data of the study were collected with the Introductory Information Form and Identification of Emotional and Social Problems Form that were administered to the relatives of the patients. The data were evaluated by using Spearman's Rho correlation analysis and the Logit analysis in Statistical Package for the Social Sciences software. Results: Among the caregivers, 59.8% were in the age group of 30-51 years, and 66.2% were female. Of the caregivers, 70.1% had difficulty in fulfilling their responsibilities. Spiritual distress had the highest score among the emotional problems, and experiencing caregiver strain had the highest score among the social problems. In the Logit model, the changes in the professional life was the variable that affects the emotional and social problems the most and significantly. In addition, emotional problems were affected by the financial problems at a statistically significant level. Conclusions: In this study, it is suggested that the caregivers should be provided with certain conveniences in their professional lives based on the fact that the problem, which affected emotional and social problems the most, is the change in the professional life; it is recommended that further studies should be carried out on the caregivers
The reliability and validity of the Turkish version of the postdialysis fatigue scale
No full textAim Haemodialysis (HD) commonly leads to postdialysis fatigue (PDF) and, thus, worsens the quality of life and the clinical outcomes. The aim of this study was to translate, linguistically validate and determine the psychometric properties of the Postdialysis Fatigue Scale for Turkish patients with HD. Study Design A methodological study. Methods The standard lingual translation and validation methods for the initial translation of the PDF Scale and then assessed the psychometric properties of reliability and validity of the translated scale. Visual analogue scale (VAS) and Piper Fatigue Scale were used to assess concurrent and construct validity. In addition, postdialysis recovery time was used it as an indirect measurement method for PDF. Results A total of 93 patients participated in the study. The Cronbach's alpha coefficient of PDF was 0.773. There was a statistically significant relationship between the test and retest scores (ICC: 0.973; P < .001). PDF Scale was acceptable with 11 items. There was a positive correlation with a statistically significant relationship was present between the PDF scores and Piper Fatigue Scale (r = .488; P < .001) and VAS score (r = .656; P < .001). There was a statistically significant positive correlation between the PDF Scale and the postdialysis recovery time (r = .270; P = .009), Conclusion The study results have shown that the Turkish form of the PDF Scale is a valid and reliable tool in patients undergoing HD treatment. Postdialysis recovery time may be used as an indirect measurement method to evaluate PDF
Detection of visual and frontoparietal network perfusion deficits in Parkinson's disease dementia
No full textMild cognitive impairment of Parkinson's disease (PD) may be an early manifestation that may progressively worsen to dementia. Cognitive decline has been associated with changes in the brain perfusion pattern. This study aimed to evaluate cerebral blood flow (CBF) deficits specific to different stages of cognitive decline. Seventeen patients with cognitively normal PD (PD-CN), 18 patients with PD with mild cognitive impairment (PD-MCI), and 16 patients with PD with dementia (PDD) were included in this study. The participants were scanned using a 3 T Philips MRI scanner. Arterial spin labelling magnetic resonance (ASL-MR) images were acquired, followed by calculation of the CBF maps, and registration onto the MNI152 brain atlas. A whole-brain voxel-based CBF comparison was performed among the patient groups using age as a covariate. The mean age of patients with PDD was significantly higher than that of patients with PD-MCI (P = 0.015) and PD-CN (P = 0.001). The CBF values of the three groups were significantly different in the left cuneus of the visual network (VN), left inferior frontal gyrus of the frontoparietal network (FPN), and left dorsomedial nucleus of the thalamus. PDD had lower perfusion values than PD-MCI group in the same regions detected in the main group analysis. Additionally, comparison of PDD with PD-CN and non-demented groups revealed that the perfusion reduction extended into the bilateral cuneus of the VN, bilateral thalami, and left inferior frontal gyrus of the FPN. PDD could be separated from PD-MCI and PD-CN stages with CBF deficits in non-dopaminergically mediated posterior and dopaminergically mediated frontal networks. © 202
Cognitive Impairment in Neuromyelitis Optica
No full textAmaç: Nöromiyelitis optika (NMO) hastalarında kognisyonudeğerlendirmek üzere yapılan az sayıda çalışma mevcuttur. Bu nedenleNMO tanısı olan Türk hastalarda kognitif fonksiyon bozukluğunun(KFB) sıklığı ve bununla ilişkili olabilecek etkenlerin değerlendirilmesiamaçlanmıştır.Yöntem: NMO tanısıyla izlenmekte olan 22 olgu retrospektif olarakdeğerlendirilmiştir. Hastalara Kısa Tekrarlanabilir Test Bataryası (BRB-N),Beck Depresyon Envanteri (BDE) ve Addenbrooke Kognitif Değerlendirme(ACE-R) testleri uygulanmış; KFB olan ve olmayan gruplar yaş, cinsiyet,eğitim düzeyi, NMO Ig G sonucu, EDSS skoru, kraniyal MRG’de lezyonolup olmamasına göre karşılaştırılmıştır. Hastaların demografik, klinikve radyolojik verilerinin depresyonla ilişkisi değerlendirilmiştir. ACE-Rtestinin skorları incelenerek NMO hastalarında ACE-R testinin KFBsaptamada duyarlılığı ve özgüllüğü değerlendirilmiştir.Bulgular: Olguların ortalama yaşı 42,8±10,9 yıldır. Hastaların %45,5’inde(n=10) KFB; %50’sinde ise (n=11) depresyon saptanmıştır. KFB olanolgularda istatistiksel olarak anlamlı bir şekilde yaşın daha yüksek olduğu,eğitim düzeyinin daha düşük olduğu, EDSS ve BDE skorlarının dahayüksek olduğu saptanmıştır (p<0,05). Hastalarda en sık etkilenen kognitifalanın; bellek kusuru, dikkat ve yürütücü işlevlerde bozulma olduğuizlenmiştir. ACE-R testinin NMO hastalarında duyarlılığı ve özgüllüğüdeğerlendirildiğinde ACE-R testinin tanı değerinin istatistiksel olarakiyi seviyesinde olduğu; 82,5 kesme değerinde, %88 duyarlılık ve %75özgüllük ile KFB saptayabileceği bulunmuştur.Sonuç: Çalışmamızda BRB-N ve BDE testleri ile kognitif bozukluk vedepresyon NMO hastalarının yaklaşık yarısında saptanmıştır. ACE-Rtestinin de klinik pratikte NMO’da KFB tanısında kullanılabileceğikanısına varılmıştır. NMO’da KFB ve depresyon sıklıkla eşlik eden tablolarolması nedeni ile hastaların bu yönden mutlaka değerlendirilmesi vetedavilerinin düzenlenmesi, hastaların yaşam kalitesinin yükseltilmesiaçısından büyük önem arz etmektedir.Introduction: There are few studies on cognitive impairment in neuromyelitis optica (NMO). The purpose of this study is to assess the factors that may be related with the frequency and level of cognitive impairment in Turkish NMO patients. Methods: 22 patients with the diagnosis of NMO are evaluated retrospectively. Cognitive function was evaluated with Brief Repeatable Battery of Neuropsychological tests (BRB-N), Beck Depression Inventory (BDI) and Addenbrooke Cognitive Evaluation (ACE-R). The groups with and without cognitive impairment were compared according to age, sex, level of education, pathologic findings on cranial MRI, NMO Ig existence and EDSS score. The relation of the clinical, radiological and demographic values and patients’ depression level was evaluated. The specificity and sensitivity of ACE-R test on detecting cognitive impairment were assessed through ACE-R test results. Results: The mean age of the patients was 42.8±10.9.45.5% (n=10) of the patients had cognitive impairment and 50% (n=11) had depression. The group with cognitive impairment had significantly older age, lower educational status, higher EDSS and BDI scores (p<0.05). The mostly affected cognitive domains were memory impairment, attention and processing dysfunction. When the specificity and sensitivity of ACE-R test on NMO patients were evaluated, diagnostic level of the test was found to be statistically good since it could detect cognitive impairment with a sensitivity of 88% and specificity of 75% on a cut off level of 82.5. Conclusion: In our study, cognitive impairment and depression were detected in approximately half of the patients with BRB-N and BDI tests. It can be concluded that ACE-R test can be used to detect cognitive impairment in NMO patients. Since cognitive impairment and depression are frequent in NMO patients, it is important to assess the patients’ cognitive functions and arrange the treatments to improve their quality of life,
A Rare Rectosigmoid Mass Mimicking Cancer; Solitary Rectal Ulcer
No full textSolitary rectal ulcer (SRU) is a rare, benign disease that has a rate of 1-3.6/100000. Perineal pain, rectal bleeding, mucosal discharge accompanied by incomplete defecation, rectal prolapse, obstructive symptoms, such as constipation and obstipation, may occur as clinical findings in SRU. Different methods, ranging from medical treatment to surgery, can be applied according to the severity of the disease and clinical findings. A 36-year-old female patient, who did not have any chronic disease or previous surgical operation, was admitted to our outpatient clinic due to complaints of abdominal pain, anorexia, constipation, occasional rectal bleeding, and weight loss, which had been ongoing for about 2 months. An obstructive polypoid mass was detected in colonoscopy. Low anterior resection was performed. The pathology result was SRU. The patient was discharged on the 12th day after healing without any complication. SRU should always be considered in patients who present lower gastrointestinal system symptoms. Surgery may be preferred in patients who do not respond to medical treatment or have an obstructive lesion and suspected malignancy