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Identification of metabolic correlates of mild cognitive impairment in Parkinson's disease using magnetic resonance spectroscopic imaging and machine learning
No full textObjective To investigate metabolic changes of mild cognitive impairment in Parkinson's disease (PD-MCI) using proton magnetic resonance spectroscopic imaging (H-1-MRSI). Methods Sixteen healthy controls (HC), 26 cognitively normal Parkinson's disease (PD-CN) patients, and 34 PD-MCI patients were scanned in this prospective study. Neuropsychological tests were performed, and three-dimensional H-1-MRSI was obtained at 3 T. Metabolic parameters and neuropsychological test scores were compared between PD-MCI, PD-CN, and HC. The correlations between neuropsychological test scores and metabolic intensities were also assessed. Supervised machine learning algorithms were applied to classify HC, PD-CN, and PD-MCI groups based on metabolite levels. Results PD-MCI had a lower corrected total N-acetylaspartate over total creatine ratio (tNAA/tCr) in the right precentral gyrus, corresponding to the sensorimotor network (p = 0.01), and a lower tNAA over myoinositol ratio (tNAA/mI) at a part of the default mode network, corresponding to the retrosplenial cortex (p = 0.04) than PD-CN. The HC and PD-MCI patients were classified with an accuracy of 86.4% (sensitivity = 72.7% and specificity = 81.8%) using bagged trees. Conclusion H-1-MRSI revealed metabolic changes in the default mode, ventral attention/salience, and sensorimotor networks of PD-MCI patients, which could be summarized mainly as 'posterior cortical metabolic changes' related with cognitive dysfunction.Scientific and Technological Research Council of Turkey (TUBITAK) 1001 Grant [115S219]; Istanbul University [1567/42362]This study was funded by The Scientific and Technological Research Council of Turkey (TUBITAK) 1001 Grant #115S219 and Istanbul University Scientific Research Projects Unit project #1567/42362
Development and validation of the Turkish version of the Mobile App Rating Scale - MARS-TR
No full textBackground: The number of mobile health apps (MHAs) is growing rapidly. MHAs have great potential to improve health and health care. However, the quality of available MHAs remains unknown due to the lack of quality assessment regulations and standards for MHAs. The Mobile Application Rating Scale (MARS) is the most widely used instrument to assess the quality of MHAs, and available in English, Italian, Spanish, German, French, Arabic and Japanese. However, the scale is currently not available in the Turkish language. Objective: This study aimed to cross-culturally adapt the MARS into Turkish and evaluate the validity and reliability of the scale. Methods: The MARS was translated and adapted into Turkish according to the international guidelines. A total of 52 pregnancy tracking apps were evaluated by two independent raters. Internal consistency (Cronbach???s alpha), inter-rater reliability (Intraclass Correlation Coefficient [ICC]), convergent validity and concurrent validity were explored. Regarding convergent validity, MARS-TR scores were compared with the ENLIGHT scale. Results: The MARS-TR was highly aligned with the original MARS. The MARS-TR showed excellent internal consistency (Cronbach???s alpha of 0.95 for both raters) and excellent inter-rater reliability (ICC = 0.94; SEM = 0.02), with a smallest detectable change (95 % confidence level) of 0.05 points for the total score. Cronbach???s alphas for the subscales ranged from 0.76 to 0.94 for the two raters. Correlations between the MARS-TR and ENLIGHT demonstrated adequate convergent validity (P < 0.05). No ceiling or floor effects were observed. Conclusion: The results provide evidence that the Turkish version of MARS is a valid and reliable tool for researchers and experts to assess the quality of MHAs in Turkey
Effect of different storage solutions on oxidative stress in human saphenous vein grafts
No full textBackground: Ischemia–reperfusion injury of saphenous vein grafts (SVG) during coronary artery bypass grafting surgery negatively impacts endothelial integrity and functionality and is associated with vein graft failure. The aim of this study was to evaluate the level of oxidative stress in human SVG segments following ischemic storage in three intraoperative graft storage solutions: saline (S), autologous heparinized blood (HB) and DuraGraft (DG). Methods: 3 mm tissue rings derived from surplus SVG segments from 50 patients were stored at room temperature for 30 min in DG, S or HB. Total oxidative status (TOS) and total antioxidant status (TAS) levels were determined from which the oxidative stress index (OSI: TOS/TAS ratio) was calculated. A p-value < 0.017 was considered significant implementing a Bonferroni correction. Results: TOS values were significantly lower for DG stored samples in comparison to both S and HB; there was no difference between S and HB (DG: 32.6 ± 1.8, S: 39.6 ± 2.8 and HB: 40.6 ± 2.4 µmol H2O2 eqv.; DG vs. S and DG vs. HB p < 0.0001, S vs. HB p = 0.047). TAS was higher for both DG and HB in comparison to S (DG: 8.9 ± 0.9, S: 6.9 ± 1.0 and HB: 8.6 ± 0.9 mmol Trolox eqv.; DG vs S p < 0.0001, DG vs. HB p = 0.263, S vs. HB p < 0.0001). OSI differed between all groups with the lowest value for DG (DG: 3.7 ± 0.2, S: 5.8 ± 0.4 and HB: 4.7 ± 0.2 µmol H2O2 eqv./mmol Trolox eqv.; all p < 0.0001). Conclusions: Saphenous veins grafts stored in DuraGraft had a lower oxidative level, higher antioxidant level and a lower oxidative stress index in comparison to saphenous vein grafts stored in saline or heparinized blood. ClinicalTrials.gov Identifier NCT02922088. © 2022, The Author(s).Illinois Department of Public Health, IDPH; Akdeniz ÜniversitesiMestan Emek, Department of Public Health, Akdeniz University Faculty of Medicine, Antalya, Turkey performed the statistical analysis. Marizyme prepared the figure
IS HYPOXIA A CAUSE OR A CONSEQUENCE? THE MEDICO-LEGAL CONSIDERATIONS OF NEONATAL ENCEPHALOPATHY AND CEREBRAL PALSY
No full textNeonatal encephalopathy (NE) occurs in the first month after birth of infants and progresses with seizures, respiratory depression and hypotonia. NE is multifactorial, however hypoxia is the first considered cause. Our study aims to discuss medicolegal processes behind the etiological and clinical features of NE and cerebral palsy (CP) over cases evaluated by the specialized board of malpractice of the Council of Forensic Medicine. The 130 cases in the judicial process claimed to be from lack of oxygen at birth, were evaluated retrospectively. The cases were categorized into two groups as evidenced with hypoxic-ischemic encephalopathy (HIE) and not evaluated evidence with HIE, by using blood gas evaluations and brain MRI findings. All risk factors related to labor, resuscitation, intubation, and referral to other NICUs, and presence of seizure were documented in both groups. We found no evidence of intrapartum hypoxia in about 70% of NE and it is suggesting that the causes of NE may have started in the antepartum period. It is necessary to focus on other inherent diseases that play a role in the etiology in medicolegal process, as well as investigate the presence of hypoxia and whether the correct intervention is made
Prediction of Prostate Cancer Aggressiveness Using a Novel Multiparametric Magnetic Resonance Imaging Parameter: Tumor Heterogeneity Index
No full textBackground and Aims: The aim of this study was to evaluate if the tumor heterogeneity index can predict the aggressiveness of prostate cancer (PCa) in patients diagnosed by magnetic resonance imaging (MRI) fusion biopsy. Material and Methods: Patients who underwent MRI fusion prostatic biopsy between July 2019 and December 2020 were retrospectively reviewed. Tumor heterogeneity index (coefficient of variation [CV]) and PI-RADS v2.1 scoring were analyzed by using multiparametric MRI. The patients were divided into 3 groups according to the risk classification, and the correlation between tumor heterogeneity index and PCa aggressiveness was studied by using apparent diffusion coefficient (ADC(mean) and ADC(cv)), Gleason score (GS), and risk classifications. Results: One hundred two patients were included in this study. Patients were evaluated as low-risk (group 1) (n = 35), moderate-risk (group 2) (n = 37), and high-risk (group 3) (n = 30). ADC(mean) values for all groups were significantly different (p < 0.0001). ADC(cv) tumor heterogeneity index values were higher in group 2 and group 3 by the score increases in subgroups according to GS, while being higher than group 1 (p < 0.001). The multivariate analysis revealed that prostate-specific antigen, PI-RADS, ADC(mean), and ADC(cv) values were predictive for tumor aggressiveness. Conclusion: ADC(cv) value as a tissue texture parameter can be used as a new biomarker to evaluate tumor aggressiveness in patients with PCa
Qui a été le plus traumatisé pendant la pandémie ? Évaluation des réponses aux traumatismes liés au COVID-19
No full textBackground and Objective: To evaluate the effect of cognitive and sociodemographic characteristics of healthcare and non-healthcare workers on their traumatic responses to the COVID-19 pandemic. Methods: Data were collected using an online survey between August-September 2020. The survey included the following scales: Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), and Impact of Event Scale-Revised (IES-R). Traumatic responses were categorized into three types: avoidance (IES-R_A), intrusion (IES-R_I), and hyperarousal (IES-R_H). Results: The study included a total of 672 participants, comprised of 399 (59.4%) men, and 273 (40.6%) women with a mean age of 39.25 ± 933 years. The results indicated that women had higher IES-R_I (r = .5.78, p < 0.001), IES-R_A (r = 4.47, p < 0.001), and IES-R_H (r = .5.20, p < 0.001) scores compared to men. Patients with a history of psychiatric diseases had significantly higher IES-R_I (r = −3.82, p < 0.001), IES-R_A (r = −2.00, p < 0.05), and IES-R_H (r = −4.06, p < 0.001) scores compared to patients with no history of psychiatric diseases. Non-healthcare workers had significantly higher IES-R_A (r = −2.69, p < 0.01) scores compared to healthcare workers. Conclusion: Female gender and a positive history of psychiatric diseases were found to lead to an increase in the frequency of all three traumatic responses to COVID-19. Contrary to expectation, being a healthcare worker was not found as a factor facilitating trauma response formation in our study. © 2022 Elsevier Masson SASThis study was performed without financial support
Anti-Inflammatory Effects of Melatonin in Rats with Induced Type 2 Diabetes Mellitus
No full textIntroduction: Insulin resistance is associated with a pro-inflammatory state increasing the risk for complications in patients with type 2 diabetes mellitus (T2DM). In addition to its chronobiotic effects, the pineal hormone melatonin is known to exert anti-inflammatory and antioxidant effects. Melatonin was also suggested to affect insulin secretion. The aim of this study was therefore to investigate the effect of melatonin on inflammation in diabetic rats and to study the possible involvement of the melatonin receptor, MT2. Materials and Methods: Male Sprague Dawley rats were randomly divided into four experimental groups (n = 10 per group): (1) control, (2) streptozotocin/nicotinamide induced diabetes type 2 (T2DM), (3) T2DM treated with melatonin (500 mu g/kg/day), and (4) T2DM treated with melatonin (500 mu g/kg/day for 6 weeks) and the selective MT2 receptor antagonist luzindole (0.25 g/kg/day for 6 weeks). Blood samples were taken for biochemical parameters and various tissue samples (liver, adipose tissue, brain) were removed for immunohistochemistry (IHC), Western blot (WB), and Q-PCR analyses, respectively. Results: Melatonin significantly reduced increased blood levels of liver transaminases (AST, ALT), blood urea nitrogen (BUN), triglyceride, very low-density lipoprotein (VLDL), and cholesterol in diabetic rats with luzindole treatment partly reversing this effect regarding the lipids. Furthermore, the liver and adipose tissues of T2DM rats treated with melatonin showed lower expression of the inflammatory markers IL-1 beta, IL-6, TNF-alpha, and NF-kappa B as compared to the T2DM group without melatonin. The results also showed that the MT2 receptor is at least partly involved in the protective effects of melatonin. Conclusions: Our results suggest that melatonin exerts relevant anti-inflammatory effects on various tissues in type 2 diabetic rats.Scientific and Technological Research Council of Turkey (TUBITAK) [114S852]This research was funded by the Scientific and Technological Research Council of Turkey (TUBITAK; grant number: 114S852)
Symptomatic COVID-19 Reinfection with Pericardial and Pleural Involvement
No full textCoronavirus disease 2019 (COVID-19) is a contagious acute coronavirus first discovered in Wuhan, China in late 2019. COVID-19 is spreading rapidly globally and has been officially declared a pandemic by the World Health suggest that immunity can develop after an episode of severe acute respiratory syndrome Infections. There are few cases with severe symptomatic reinfection. Here we present the case of a healthy 46-year-old man with pericardial-pleural and lung involvement in the setting of COVID-19 infection first, and severe symptomatic reinfection thereafter
Covid-19 Pandemisinde Sağlık Bilimleri Öğrencilerinin Psikolojik Dayanıklılıklarının Bazı Değişkenler Açısından İncelenmesi
No full textPsychological resilience is defined as the ability to recover from difficult life experiences or the ability to effectively deal with changes or disasters. The unexpectedly high rate of COVID-19 disease spread and quarantine policies can escalate stress levels and lead to emotional problems. It is crucial to equip health sciences students with proper knowledge, attitudes and behaviors on COVID-19, as they will serve in the frontlines of the campaign against the pandemic and proper training comes with resilience. This research, which aims to examine the psychological resilience of health sciences faculty students in the Covid-19 pandemic in terms of some variables, was carried out with 426 students studying at the Faculty of Health Sciences of a university located in the southeast region of Turkey. Personal Information Form, Coronavirus Information Form and the Adult Psychological Resilience Scale were used as data collection tools. After the analysis of normality, Student t Test, One way ANOVA ve Multiple Lineer Regresyon analyses were used, the means were given with standard deviations, and p<0.05 was accepted as statistically significant. More than half of the students (55.6%) were female, 93.9% were single and their mean age was 20.65 +/- 2.25 years. The nursing students got the lowest scale score, nutrition and dietetics students; the psychological endurance of singles, unemployed people, and those who constantly wash their hands and clean their surroundings were higher. It was concluded that the pandemic affected the resilience of health sciences faculty students in different ways, and that the resilience of students was above the average
Pushing the boundaries of minimally invasive repair of pectus excavatum: first experience with a 4-bar technique
No full textSeveral modifications to minimally invasive repair of pectus excavatum have been reported to date. Of these, the use of multiple bars was a major development. At present, there are 2 established techniques: cross-bar and parallel bar placement. We used a combination of both parallel and cross-bar techniques in a 25-year-old male patient with deep, Grand-Canyon type pectus excavatum, placing a total of 4 bars and 4 stabilizers. The patient had no complications during the 7 months of postoperative follow-up. We share this case report as the first experience using this modified technique in the literature