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Does Adequate Hemodialysis Prevent Symptoms?: A National Cross-Sectional Survey
No full textThe aim of this study was to identify the relationship between dialysis adequacy and the incidence of symptoms in subjects treated with HD. This descriptive and cross-sectional study was conducted at two HD centers. the data were collected with the ‘Descriptive Characteristics Form of the Participants’ and the ‘Dialysis Symptom Index (DSI)’. the study was reported according to the STROBE Declaration. the study was completed with 120 patients. the most common symptom reported was feeling tired or decreased energy and the least common was difficulty concentrating. No statistically significant relationship was found between DSI results and the Kt/V or urea reduction rate levels used to evaluate dialysis adequacy. Dialysis-related symptoms can also be seen in patients with adequate dialysis levels. It is therefore necessary to query the symptoms experienced by the patients at regular intervals. © the Author(s) 2020
Effect of the brain-derived neurotrophic factor gene Val66Met polymorphism on sensory-motor integration during a complex motor learning exercise
No full textPubMed: 31926908The brain-derived neurotrophic factor (BDNF) gene Val66Met polymorphism may cause impairment in short-term motor learning by reducing activity-dependent BDNF expression, which causes alterations in synaptic plasticity by changing glutamatergic and GABAergic synaptic transmissions. Sensory-motor integration (SMI) plays an important role in motor learning. in this study, we investigated the role of this polymorphism on SMI during a complex motor learning practice. Forty-three healthy participants performed standardized 5-day basketball shooting exercises under supervision. Electrophysiologic SMI studies were performed before the first day exercise (T0) and after the first and fifth day exercises (T1 and T2, respectively). SMI was studied using electrical median nerve stimulation at the wrist, followed by transcranial magnetic stimulation (TMS) of the contralateral motor cortex with various inter-stimulus intervals (ISIs). Recordings were made from the thenar and forearm flexor muscles. Participants were divided into two groups according to their BDNF genotype. Group 1 consisted of 26 subjects with the Val66Val genotype and group 2 included 17 subjects with the BDNF Met allele. Group 2 had a lower increase in basketball scores at day 5. Moreover, they had higher afferent facilitation for the responses recorded from both thenar and forearm flexor muscles at T1, but these changes could not be maintained until T2. This non-persistent early hyper-responsivity of the sensory-motor cortex in subjects with the BDNF Met allele might be explained by a transient upsurge of cortical excitability to compensate the insufficient cortical plasticity during motor learning, which could be considered as a sign of lower performance in motor skill learning. © 2020 Elsevier B.V.Istanbul Üniversitesi: 49434This work was supported by a grant from Scientific Research Projects Coordination Unit of Istanbul University , Project Number: 49434
Lymphopenia as a risk factor for neurologic involvement and organ damage accrual in patients with systemic lupus erythematosus: A multi-center observational study
No full textObjective: Detailed analysis of hematological manifestations (HM) in systemic lupus erythematosus (SLE) are limited and their clinical impact on disease remain obscure. Here, we aimed to decipher factors associated with different hematological abnormalities in SLE patients and to assess their impact on disease related outcomes. Methods: A dataset (GIPT) originating from SLE patients of six European tertiary centers was assessed. Six-monthly visits of each patient for at least 2 years were registered. the association between hematologic manifestations (HM; per ACR-1997criteria) and clinical/serologic variables, as well as the impact of HM on disease related outcomes (damage, infection and hemorrhage) were explored. Scores on the Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI2K), the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) and events for any infection and hemorrhage were recorded. Results were compared with a cross-sectional, well-characterized SLE dataset from Sweden. Descriptive statistics, the generalized estimating equations (GEE), general linear models (GLM), Cox regression models were applied. Results: We monitored 1425 longitudinal visits in 286 SLE patients with HM (GIPT dataset: 88% female, 95% Caucasian, 68% dsDNA positive). Thrombocytopenia (regression coefficient [95% confidence interval] 1.86[1.1–3.13]) and neurologic involvement (ACR-8) (2.1[1.10–3.89]) were associated with lymphopenia (<1000/mm3); the latter was an independent predictor of organ damage accrual (1.68[1.2–2.62]). These associations were confirmed in an independent dataset of 1348 SLE patients (86% female, 93% Caucasian, 61% dsDNA positive) in Sweden.Severe lymphopenia (<500/mm3) and severe thrombocytopenia (<20 K/mm3) were associated with increased risk for infection (hazard ratio [95% confidence interval] 2.56[1.23–5.31]) and hemorrhage (4.38[2.10–11.1]), respectively, independent of the effect of other predictors. Conclusion: : Lymphopenia in SLE is independently associated with neurologic involvement and organ damage accrual, and thus, may be considered as a marker of severe/progressive disease. © 2020 Elsevier Inc.Stiftelsen Konung Gustaf V:s 80-årsfond RAED-AD110 Uppsala UniversitetThis project was funded by Turkish Society for Rheumatology (RAED-AD110) and by the Swedish Research Council for Medicine, Swedish Society of Medicine and Ingegerd Johansson donation, Swedish Rheumatism Foundation, King Gustaf V's 80-year Foundation and Uppsala University
Hemodynamics of neonatal double lumen cannula malposition
No full textSalihoglu, Ece/0000-0002-7170-7877; Jamil, Muhammad/0000-0001-7482-5396; Rezaeimoghaddam, Mohammad/0000-0002-0539-1616WOS: 000536568300007PubMed: 31580212Objective: Malposition of dual lumen cannula is a frequent and challenging complication in neonates and plays a significant role in shaping the in vitro device hemodynamics. This study aims to analyze the effect of the dual lumen cannula malposition on right-atrial hemodynamics in neonatal patients using an experimentally validated computational fluid dynamics model. Methods: A computer model was developed for clinically approved dual lumen cannula (13Fr Origen Biomedical, Austin, Texas, USA) oriented inside the atrium of a 3-kg neonate with normal venous return. Atrial hemodynamics and dual lumen cannula malposition were systematically simulated for two rotations (antero-atrial and atrio-septal) and four translations (two intravascular movements along inferior vena cava and two dislodged configurations in the atrium). A multi-domain compartmentalized mesh was prepared to allow the site-specific evaluation of important hemodynamic parameters. Transport of each blood stream, blood damage levels, and recirculation times are quantified and compared to dual lumen cannula in proper position. Results: High recirculation levels (39 +/- 4%) in malpositioned cases resulted in poor oxygen saturation where maximum recirculation of up to 42% was observed. Apparently, Origen dual lumen cannula showed poor inferior vena cava blood-capturing efficiency (48 +/- 8%) but high superior vena cava blood-capturing efficiency (86 +/- 10%). Dual lumen cannula malposition resulted in corresponding changes in residence time (1.7 +/- 0.5 seconds through the tricuspid). No significant differences in blood damage were observed among the simulated cases compared to normal orientation. Compared to the correct dual lumen cannula position, both rotational and translational displacements of the dual lumen cannula resulted in significant hemodynamic differences. Conclusion: Rotational or translational movement of dual lumen cannula is the determining factor for atrial hemodynamics, venous capturing efficiency, blood residence time, and oxygenated blood delivery. Results obtained through computational fluid dynamics methodology can provide valuable foresight in assessing the performance of the dual lumen cannula in patient-specific configurations
Preventive effect of trimetazidine against ischemia-reperfusion injury in rat epigastric island flaps: an experimental study
No full textuyanikgil, yigit/0000-0002-4016-0522WOS: 000588865000001Background For plastic surgery, ischemia-reperfusion (I-R) injury is a critical problem that results in partial or total flap necrosis. Trimetazidine (TMZ) is a drug used in the treatment of angina pectoris. This study investigated the effect of TMZ on I-R injury in epigastric island flaps using a rat model. Methods Sixteen Sprague-Dawley rats were assigned to two groups, each with eight rats. the sham group comprised of saline-treated rats, while the TMZ group had TMZ-treated rats. An epigastric flap measuring 6 x 4 cm in size was created 30 min after the intraperitoneal administration of either physiological saline or TMZ in both groups. Ischemia was induced on the flaps for 10 h, followed by reperfusion. the flaps were then inset to the original position. Samples were obtained 24 h after reperfusion for biochemical analysis and on day 7 for histopathological analysis. Also, flap survival was evaluated on day 7 using Image-Pro Express. Results the TMZ group had a significantly greater flap survival area compared to the sham group. on histopathological examination, the two groups showed significant differences. the TMZ group had a higher epidermal thickness. on biochemical examination, there were significantly higher levels of malondialdehyde and myeloperoxidase activity in the sham group, while the TMZ group showed significantly greater glutathione and nitric oxide levels. Conclusions in the present study, TMZ administration was found to reduce I-R injury macroscopically, histopathologically, and biochemically in a rat epigastric island flap model. Level of evidence: Not ratable
The Relationship Between Serum Uric Acid Levels and Clinical Features in Essential Tremor
No full textWOS: 000531813000008PubMed: 32110148Introduction: in this study, we aimed to investigate the effect of uric acid on the disease, its severity and progression in ET patients with partially co-clinical features with Parkinson's disease (PD). Methods: Serum UA levels of 87 consecutive ET patients were measured and were matched according to age and sex with 87 healthy controls. Fahn-Tolosa-Marin scale was used for the severity of tremor. Sociodemographic characteristics, type of ET, duration of disease, and treatment modalities were evaluated. Results: the mean uric acid level was calculated as 4.986 +/- 2.1458 mg/c11.. and 6.004 +/- 1.523 mg/dL in the patient and control groups, respectively (p = 5 years; 6.438 +/- 0.286 <= 5 years) (P=0.001). Conclusion: We hypothesize that as a result of high antioxidant properties of high serum uric acid levels, it is a biomarker that can show disease risk and progression in patients with ET as well as PD
Cytotoxic and apoptotic effects of ethanolic propolis extract on C6 glioma cells
No full textcoskun, zeynep mine/0000-0003-4791-6537WOS: 000513379500001PubMed: 32061154Propolis is a natural resinous substance obtained from beehives, and emerging evidence supports that it has antitumor, antiinflammatory, antioxidant, and antimicrobial activities. the aim of the study is to examine the cytotoxic, antioxidant, and apoptotic features of ethanolic propolis extract (PE) on C6 glioma cells. the cells were treated with ethanolic PE at various concentrations for 24 hours, after which the total antioxidant status (TAS) and total oxidant status; malondialdehyde, protein carbonyl, 8-hydroxy-2 '-deoxyguanosine, and glutathione (GSH) levels; Cu/Zn-superoxide dismutase (Cu/Zn-SOD) activity; and apoptotic markers were measured. Ethanolic PE at 100, 250, and 500 mu g/mL concentrations showed optimal activity on C6 glioma cells. TAS and GSH levels were significantly increased in C6 glioma cells treated with 100 and 500 mu g/mL PE compared to control cells (P < .05). Similarly, the activity of Cu/Zn-SOD was higher in C6 glioma cells treated with 250 or 500 mu g/mL ethanolic PE compared to control cells (P < .05), as was the caspase-3 mRNA expression level. the highest levels of caspase-8 and -9 expression were in C6 glioma cells treated with 500 mu g/mL PE. Collectively, our results indicate that ethanolic PE has cytotoxic and apoptotic effects on C6 glioma cells. Furthermore, it may provide a protective role in the antioxidant defense system. PE shows potential for development as a natural antioxidant and apoptotic agent for the treatment of brain tumors
Neuromyelitisoptica spectrum disorders: the evaluation of 66 patients followed by Istanbul Bilim University, Department of Neurology
No full textConference of the Pan-Asian-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (PACTRIMS) -- NOV 13-15, 2019 -- Singapore, SINGAPOREWOS: 000556862300090[No abstract available]Pan Asian Comm Treatment & Res Multiple Sclerosi
A follow-up study on outcomes of endoscopic transsphenoidal approach for acromegaly
No full textPubMed: 32927330Objective: A thorough follow-up study in which the same clinic presents the change in the surgical outcomes of acromegaly over the years, is still lacking in the endoscopic era. in this study, we intended to evaluate the clinical characteristics, radiological features, surgical and late remission rates of newly diagnosed acromegaly patients treated in our clinic between 2014 and 2019 in order to delineate the surgical remission status according to radiological, microscopic, and hormonal features. As a follow-up to our initial report, we also aimed to display the change of surgical remission rates over time in a tertiary center. Methods: A total of newly diagnosed 106 patients with acromegaly, who underwent endoscopic endonasal trans-sphenoidal approach (EETSA) in the last five years were retrospectively analyzed and presented in this study. Medical records were reviewed in clinical, biochemical, pathological, and radiological aspects to assess the relationship of preoperative patient characteristics with surgical remissions. Results: the percentages of the giant pituitary adenomas (?4 cm), adenomas with suprasellar extension and adenomas with surgically proven invasion of the cavernous sinus in the present series were 13%, 34%, and 20%, respectively. Gross total resection was achieved in 80% of the patients. Surgical remission and late remission rates were 66% and 86%, respectively. Nine (9.4%) patients in our current report had postoperative transient diabetes insipidus. the mean follow-up period in this series was 36.1 ± 18.1 (range 12–59) months. Conclusion: the presented surgical results are considerably better than our published initial series of acromegaly patients operated in the same clinic between 2007 and 2014. the improvement in surgical remission rate support a positive surgical volume - remission rate relationship for acromegaly in the era of endoscopic endonasal skull base approaches. One possible factor for better results may be the increasing surgical experience in EETSA, which follows a trend toward gradual improvement of long-term late remissions via a multidisciplinary approach. © 2020 Elsevier B.V.The authors would like to thank Esra Gungormus, Registered Nurse (RN) in Cerrahpasa Pituitary Center, for providing pre- and postoperative critical care to our patients with pituitary pathologies
G-protein Coupled Estrogen Receptor Expression in Growth Hormone Secreting and Non-Functioning Adenomas
No full textFirtina, Sinem/0000-0002-3370-8545WOS: 000586879900001PubMed: 33091936Purpose To evaluate the expression of G-protein coupled estrogen receptor (GPER1), aromatase, estrogen receptor alpha (ER alpha), estrogen receptor beta (ER beta), pituitary tumor transforming gene (PTTG), and fibroblast growth factor 2 (FGF2) in GH-secreting and non-functioning adenomas (NFA). Methods Thirty patients with acromegaly and 27 patients with NFA were included. Gene expression was determined via quantitative reverse transcription polymerase chain reaction (QRT-PCR). Protein expression was determined via immunohistochemistry. Results There was no difference, in terms of gene expression of aromatase, ER alpha, PTTG, and FGF2 between the two groups (p> 0.05 for all). ERR gene expression was higher and GPER1 gene expression was lower in GH-secreting adenomas than NFAs (p 0.05 for all). GPER1 gene expression was positively correlated to ER alpha, ER beta, PTTG, and FGF2 gene expression (p < 0.05 for all). There was a positive correlation between aromatase and GPER1 protein expression (r = 0.31; p = 0.04). Conclusions GPER1 is expressed at both gene and protein level in a substantial portion of GH-secreting adenomas and NFAs. the finding of a positive correlation between GPER1 and ER alpha, ER beta, PTTG, and FGF2 gene expression and aromatase and GPER1 protein expression suggests GPER1 along with aromatase and classical ERs might mediate the effects of estrogen through upregulation of PTTG and FGF2.Research Fund of the Istanbul University, Istanbul, Turkey [46991]The study was supported by the Research Fund of the Istanbul University, Istanbul, Turkey, project number 46991