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Computational modeling of vascular growth in patient-specific pulmonary arterial patch reconstructions
No full textPekkan, Kerem/0000-0001-7637-4445PubMed: 33540217WOS:000626266300011Recent progress in vascular growth mechanics has involved the use of computational algorithms to address clinical problems with the use of three-dimensional patient specific geometries. The objective of this study is to establish a predictive computational model for the volumetric growth of pulmonary arterial (PA) tissue following complex cardiovascular patch reconstructive surgeries for congenital heart disease patients. For the first time in the literature, the growth mechanics and performance of artificial cardiovascular patches in contact with the growing PA tissue domain is established. An elastic growing material model was developed in the open source FEBio software suite to first examine the surgical patch reconstruction process for an idealized main PA anatomy as a benchmark model and then for the patient-specific PA of a newborn. Following patch reconstruction, high levels of stress and strain are compensated by growth on the arterial tissue. As this growth progresses, the arterial tissue is predicted to stiffen to limit elastic deformations. We simulated this arterial growth up to the age of 18 years, when somatic growth plateaus. Our research findings show that the non-growing patch material remains in a low strain state throughout the simulation timeline, while experiencing high stress hot-spots. Arterial tissue growth along the surgical stitch lines is triggered mainly due to PA geometry and blood pressure, rather than due to material property differences in the artificial and native tissue. Thus, nonuniform growth patterns are observed along the arterial tissue proximal to the sutured boundaries. This computational approach is effective for the pre-surgical planning of complex patch surgeries to quantify the unbalanced growth of native arteries and artificial non-growing materials to develop optimal patch biomechanics for improved postoperative outcomes. (c) 2021 Published by Elsevier Ltd.European Research Council (ERC) Proof of Concept Grant KidsSurgicalPlan; ERCEuropean Research Council (ERC)European Commission [307460]; TUBITAK 1003 priority-research programTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [115E690]Funding was provided by Grants from the European Research Council (ERC) Proof of Concept Grant KidsSurgicalPlan, ERC Starting Grant 307460, TUBITAK 1003 priority-research program Grant 115E690. We Thank the reviewers whose comments and suggestions helped to improve and clarify this manuscript
Evaluation of hydration status of children with obesity-a pilot study
No full textPubMed: 33675213WOS:000626416000002Objectives: To compare the hydration status between children with obesity and normal-weighted children and to determine whether obesity is related to less water consumption. Methods: Children aged between 7 and 18 years with obesity (Group 1, n=31) were compared with nonobese healthy volunteers (Group 2, n=30) in terms of body composition analysis, urine density and daily fluid intake. Results: The fluid intake per body surface of Group 1 was found significantly less than Group 2 (p<0.001). The urine density was found significantly higher in Group 1 (1020 (10) vs. 1015(10), p<0.001). Subjects in Group 1 had a higher percentage of body fat (p<0.001), lower percentages of total body water and fat-free mass (p=0.007 and <0.001, respectively). While 55% of subjects in Group 1 satisfied the recommended daily fluid intake, this was 80% in Group 2 (p=0.036). The consumption of SSBs was 71% in Group 1 and 20% in Group 2, with higher amount in Group 1 (median 200 vs. 0 mL, p<0.001). Conclusions: Children with obesity had less fluid consumption, lower TBW percentages and higher urine density. The results of this cross-sectional study showed that children with obesity were less hydrated than normal weighted children
European women in neurosurgery: I - A chronology of trailblazers
No full textKarampouga, Maria/0000-0001-7737-1422PubMed: 33551325WOS:000634503700012Neurosurgery as a distinct speciality has been around for 100 years. Some of the earliest women neurosurgeons were European, emerging from the 19200s onwards. Here we detail the rise of women in neurosurgery across Europe with a decade by decade account of big events and firsts across the continent. The emerging themes are seen in stories of pioneers with enormous resilience, camaraderie, trailblazing and triumphing in a system with great obstacles and challenges. Our journey through this chronology brings us to the modern day, where most European countries have or have had a woman neurosurgeon and the future for women in neurosurgery in the continent is very bright. (C) 2021 Published by Elsevier Ltd
Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients
No full textSousa, Clemente/0000-0003-2654-0497; Teles, Paulo/0000-0001-7969-1403; Garcia Nicole, Andressa/0000-0003-1791-0580; Barroso Pinto, Cristina/0000-0002-6077-4150PubMed: 33269608WOS:000599224900001This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) (n = 48) or to a control group (CG) (n = 41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p < .001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p = .004) and the prevention of complications (72.7% and 89.5%, respectively, p < .001). The study results suggest that the SISC-AVF had positive effects on patients in the IG
Are Intensive Care Unit Patients Undergoing Enteral Nutrition Therapy Sufficiently Fed? A Prospective, Descriptive Study
No full textWOS:000636538700005Underfeeding is prevalent in intensive care unit (ICU) patients receiving enteral nutrition (EN). This study aimed to investigate whether ICU patients were fed adequately on the third day of EN. One hundred ten patients who were hospitalized in the 3 mixed ICUs were evaluated for nutrition adequacy. Patient nutritional status was monitored by a nutrition support team. Nutrition provision was found to be adequate in 95.5% (n = 105) and inadequate in 4.5% (n = 5) of patients. A multidisciplinary approach should be employed to ensure that patients receive maximum benefit from EN
Turkish language validity and reliability of the Control of Allergic Rhinitis and Asthma Test and its comparison with other scales
No full textObjectives Patients with asthma often suffer from concomitant allergic rhinitis (AR). The Control of Allergic Rhinitis and Asthma Test (CARAT) is a validated tool to assess asthma and rhinitis multimorbidity. Turkish language validity and reliability of CARAT and its compatibility with other scales were evaluated in the study. Methods Patients with asthma and concomitant AR were tested with CARAT. Pulmonary function tests, Asthma Control Test (ACT), Assessment Tool for Asthma (ATA) questionnaire and visual analogue scale (VAS) were also used at the same day. With the VAS, patients determined their rhinitis symptom levels, and asthma specialist determined the rhinitis and asthma control levels separately. These questionnaires were repeated in 14 +/- 2 days. Results Three quarters (77%) of the 100 patients were female (mean age 46.5 years). The mean CARAT score was 19.6 +/- 7.2. The Cronbach's alpha coefficient of the Turkish version of the CARAT scale was 0.83, showing a high level of internal consistency. Test-retest reliability coefficient was determined as r = 0.98 (p 0.05). Conclusion The Turkish version of the CARAT is a reliable alternative tool for physicians in determining disease control in adult patients with asthma and AR
Successful Sleeve Resection as a Marker for Proficiency for Robotic Pulmonary Resection
No full textBackground Robot technology is a revolutionary technique to overcome limitations of minimal invasive surgery. The proficiency level varies from study to study. We considered the first sleeve lobectomy as a benchmark procedure to evaluate the proficiency level. Methods We retrospectively analyzed 197 patients who underwent robot-assisted thoracoscopic surgery (RATS) for primary lung cancer between December 2011 and May 2018. Patients were divided into two groups based on undergoing surgery earlier period (EP) or later period (LP) than the first sleeve lobectomy by RATS (May 25, 2015). The preoperative, operative, and short- and long-term postoperative outcomes were compared. Seven-year survival was also compared between two periods for T1N0 and T2N0 diseases. Results Preoperative features were similar. The mean operative time was 166.855.1 and 142.4 +/- 43.9minutes in EP and LP, respectively ( p =0.005). The mean number of dissected lymph nodes in LP was also significantly higher than that in EP (24.4 +/- 9.4 vs. 20.8 +/- 10.4, p =0.035). The complication rate was significantly lower in LP (29/86 vs. 25/111, p =0.048). The extended resection (ER) rate was significantly higher in LP ( p =0.023). The 7-year survival was comparable in EP and LP in both patients with T1N0 and T2N0 ( p =0.28 and p =0.11, respectively). Conclusion Perioperative outcomes, such as duration of surgery, number of dissected lymph nodes, complications, and ERs are favorable in patients who underwent surgeries after the first sleeve resection. The first sleeve lobectomy may be considered as the benchmark procedure for the proficiency level in RATS
Protective effects of dichloroacetic acid on endometrial injury and ovarian reserve in an experimental rat model of diabetes mellitus
No full textAim To study (1) ovarian and endometrial damage caused by the hyperglycemia and (2) the effects of dichloroacetic acid (DCA) on follicular reserve and endometrial damage in streptozocin induced diabetic rats. Methods This study consisted 24 rats randomly separated into three groups. A diabetes model was achieved in 16 rats experimentally, and normoglycemic eight rats were assigned as control group (Group 1). The rats with diabetes were randomly separated to two groups: 1 mL/kg/day intraperitoneal 0.9% NaCl was given to eight rats as diabetic vehicle (Group 2) and 10 mg/kg/day DCA was given to other eight rats as DCA treated group (Group 3). Hysterectomy with bilateral oophorectomy was performed for histopathological evaluation and blood samples were collected after 4 weeks. Results Diabetes caused ovarian and endometrial damage (p < 0.0001). Pentraxin-3 (PTX-3), lactic acid, and transforming growth factor-beta (TGF-beta) were higher (p < 0.05, p < 0.05, and p < 0.0001, respectively), whereas anti-Mullerian hormone (AMH) was lower in diabetic rats (p < 0.05). These findings reflected the diabetic damage in the genital tract and diminished ovarian reserve occurred via fibrosis, severe inflammation, and oxidative stress. DCA improved the histopathological fibrosis and degeneration in the ovaries and endometrium (p < 0.05). There was a concominant decrease of TGF-beta and lactic acid levels with DCA treatment (p < 0.05). DCA also improved ovarian reserve with higher AMH levels (p < 0.05). Conclusions The several unfavored changes in the endometrium and ovaries due to diabetes have been determined in this present study. DCA might provide the continuity of the endometrial cycle, physiological endometrial structure, ovarian follicular growth, oocyte maturation, and physiological ovarian function by decreasing the lactate levels via inhibiting pyruvate dehydrogenase kinase enzyme
Antioxidant and Anti-cancer Activity of Boric Acid in 8305C Anaplastic Thyroid Cancer Cells
No full textBu çalışmanın amacı, borik asitin 8305C insan anaplastik tiroit kanseri (ATK) hücrelerinde sitotoksik, anti-proliferatif, apoptotik ve antioksidan etkilerini değerlendirmektir. Borik asitin sitotoksisitesi 0-1000 ?g/mL doz aralığında (24, 48 ve 72 saat) 8305C insan ATK hücrelerinde bir tetrazolyum testiyle (MTT) belirlendi. Hücrelerdeki proliferasyon ve apoptoz incelendi. Biyokimyasal parametreler spektrofotometrik olarak tespit edildi. 24, 48 ve 72 saat borik asit ile muamele edilen 8305C insan ATK hücrelerinin yarı-maksimum inhibisyon konsantrasyon (IC50) değerleri sırasıyla 238 µg/mL, 116 µg/mL ve 70 µg/mL olarak hesaplandı (p<0,05). Prolifere olan hücre çekirdek antijeni (PCNA) pozitif hücrelerin yüzdesi 200, 250, 300 µg/mL konsantrasyonda borik asit ile 48 saat muamele edilen hücrelerde anlamlı azalma gösterdi (p<0,01). Borik asitin 250 ve 300 µg/mL konsantrasyonlarında 24 ve 48 saatlik muamelesi, kontrol hücrelerine kıyasla 8305C ATK hücrelerinde apoptotik hücre sayısında anlamlı artış gösterdi (p<0,01). En düşük malondialdehit seviyesi 48 saat 300 µg/mL konsantrasyonda uygulanan hücrelerde saptandı (p<0,01). En yüksek süperoksit dismutaz aktivitesi 48 saat 250 µg/mL borik asit uygulanan hücrelerde olurken (p<0,01), glutatyon seviyesi 300 µg/mL borik asit uygulanan hücrelerde kontrol hücrelerine göre anlamlı olarak arttı (p<0,05). Bu çalışma ile elde edilen sonuçlar, borik asitin 8305C insan ATK hücrelerinde anti-proliferatif ve apoptotik aktiviteye sahip umut verici yeni bir terapötik ajan olabilirliğini gösterir. Çalışma in vivo deneylerle desteklenmelidir.The aim of this study is to evaluate the cytotoxic, anti-proliferative, apoptotic and antioxidant effects of boric acid in 8305C human anaplastic thyroid cancer (ATC) cells. The cytotoxicity of boric acid was determined at a dose range of 0-1000 ?g/mL in the human ATC cells (24, 48, and 72 hours) by a tetrazolium test (MTT). Proliferation and apoptosis in the cells were examined. Biochemical parameters were determined spectrophotometrically. The halfmaximal inhibitory concentration (IC50) values of cells treated with boric acid for 24, 48, and 72 hours were calculated as 238 µg/mL, 116 µg/mL, and 70 µg/mL, respectively (p<0.05). The percentage of proliferating cell nuclear antigen (PCNA) positive cells showed a significant decrease in the cells treated with boric acid at 200, 250, and 300 µg/mL concentrations for 48 hours (p<0.01). Boric acid administered at 250 and 300 µg/mL showed a significant increase in the percentage of apoptotic cells of 8305C ATC cells compared to control cells (p<0.01). The lowest malondialdehyde level was detected in cells treated with boric acid at 300 µg/mL for 48 hours (p<0.01). While the highest superoxide dismutase level was in cells treated with 250 µg/mL boric acid for 48 hours (p<0.01), glutathione level increased significantly in cells treated with 300 µg/mL boric acid compared to control cells (p<0.05). The results obtained from this study demonstrate that boric acid can be a promising new therapeutic agent in terms of anti-proliferative and apoptotic activities in 8305C human ATC cells. The study should be supported by in vivo experiments