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RELATIONSHIP BETWEEN TSH LEVEL AND CARDIOMETABOLIC RISK FACTORS IN OVERWEIGHT AND OBESE TURKISH ADOLESCENTS
No full textWOS: 000541963200858[No abstract available
The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass
No full textYAPICI, Nihan/0000-0002-7684-8177; orhan, gokcen/0000-0003-4809-6139; Kudsioglu, Sefika Turkan/0000-0003-4109-3170WOS: 000466108900006PubMed: 32082848Background: This study aims to investigate the effects of partial pressure of venous-arterial carbon dioxide changes in the early period after cardiopulmonary bypass in patients who did or did not receive inotropic support therapy and the effect of these changes on tissue perfusion. Methods: A total of 100 consecutive patients (70 males, 30 females; mean age 61.8 +/- 2.3 years; range, 20 to 75 years) who underwent open heart surgery were divided into two groups as those who did not receive any inotropic agent (group 1, n=50) and those who received at least one inotropic agent (group 2, n=50) during the early postoperative period. Heart rate, blood oxygen saturation level, mean arterial pressure, central venous pressure and urine volume, lactate and base excess levels were recorded during the postoperative first 24 hours. At the same timeframe, partial pressure of venous-arterial carbon dioxide level was calculated from central venous and peripheral blood samples. Results: in both groups, partial pressure of venous-arterial carbon dioxide were significantly higher in the postoperative fourth hour compared with basal values. This significant difference continued for the postoperative first 24 hours. Partial pressure of venous-arterial carbon dioxide in group 2 was significantly higher at the 12th-hour measurement (p=0.002). Lactate levels at zeroth and eighth hours were significantly higher in group 2 (p=0.012 and p=0.017, respectively). Fourth-hour urine excretion volumes were significantly lower in group 1 (p=0.010). Mean arterial pressure at zeroth, 12th and 20th hours was significantly higher in group 2 (p=0.001, p=0.016, and p=0.027, respectively). At the eighth-hour measurement, a positive weak relationship was detected between partial pressure of venous-arterial carbon dioxide and lactate levels (r=0.253 and p=0.033). Conclusion: This study demonstrated that partial pressure of venous-arterial carbon dioxide increased in the first few hours and remained to be high for 24 hours after cardiopulmonary bypass independently of the use of inotropic support. However, in the postoperative period, even after lactate and base excess levels return to baseline values, partial pressure of venous-arterial carbon dioxide may continue to remain at high values, which may indicate impaired perfusion in some tissues
Intravoxel Incoherent Motion Parameters for Assessing the Efficiency of Locoregional Bridging Treatments before Liver Transplantation
No full text1st International Transplant Network Congress -- OCT 17-21, 2018 -- Antalya, TURKEYWOS: 000487349900059PubMed: 31474296Objective. To evaluate the diagnostic accuracy of Intravoxel Incoherent Motion (IVIM) parameters for assessment of tumor response after locoregional treatment (LRT) of hepatocellular carcinoma (HCC). Methods. Fifteen patients with HCC who had undergone LRTs (11 transarterial radioembolization, 4 transarterial chemoembolization) were included. in addition to routine upper abdominal magnetic resonance imaging sequences, IVIM with 16 different b values and conventional diffusion weighted imaging with 3 different b factors were obtained immediately before and 8 weeks after LRTs. Magnetic resonance imaging response was evaluated according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) and HCCs were categorized into 2 subgroups, responders and nonresponders. Quantitatively, the number of diffusion-changes were calculated with apparent diffusion coefficient (ADC) and IVIM parameters, including mean D (true diffusion coefficient), pseudo-diffusion coefficient associated with blood flow, and f (perfusion fraction) values. Subsequently, the pre- and post-treatment parameters were compared using the Mann-Whitney U test. Results. Considering all HCCs, a significant decrease was observed according to mRECIST criteria (-38.43 +/- 16.49). the ADC and D values after LRTs were significantly higher than those of the preceding ones. the f values after LRTs were significantly lower than those of pre-treatment. in the responders group, ADC and D values were significantly increased and f values were significantly decreased after LRTs. No difference of statistical significance was achieved in the nonresponders group. Conclusions. ADC values and IVIM parameters appear to reflect the response of LRTs as effectively as those of mRECIST. This promises new horizons in the management of pretransplant patients, especially in renal insufficiency clinical settings, owing to the elimination of contrast media administration
Utility of Polyethylene Terephthalate (Dacron) Vascular Grafts for Venous Outflow Reconstruction in Living-Donor Liver Transplantations
No full textBackground: Venous outflow reconstruction of modified right-lobe liver grafts has been shown to prevent the occurrence of graft congestion and subsequent complications, including graft loss. In the present study, we aimed to investigate the safety and efficacy of Dacron grafts for venous reconstruction in living donor liver transplantation (LDLT). Methods: Between January 2016 and January 2018, Dacron grafts were used in 148 liver transplants. Of these, 104 patients who had a follow-up computerized tomography (CT) scan were enrolled into the study. A total of 179 outflow hepatic veins including V5, V8, partial middle hepatic vein, and accessory inferior right hepatic veins (IRHV) were reconstructed using synthetic Dacron grafts. Graft patency was evaluated with both intraoperative Doppler ultrasonography following reconstruction, and a follow-up CT was performed on the postoperative day 7 (±1). Retrospective data collection included demographics, parameters for small-for-size (laboratory tests [bilirubin, International Normalized Ratio] and ascites) syndrome, postoperative morbidity, and mortality. Results: Follow-up CT revealed graft patency in 155 out of 179 (86.6%) vascular grafts. Postoperative seventh-day patency rates for each reconstructed vein were as follows: V5, 87.5% (70/80); V8, 87.7% (50/57); partial middle hepatic vein, 100% (11/11); and IRHV, 77.4% (24/31). No major graft-related complications (early graft dysfunction, graft infection) or graft-related mortality were observed. None of the recipients developed small-for-size syndrome based on laboratory tests and clinical findings. Conclusions: Dacron vascular grafts appear as an advantageous and useful alternative for venous outflow reconstruction in LDLT. © 2019 Elsevier Inc
Assessment of Mean Platelet Volume in Patients with AA Amyloidosis and AA Amyloidosis Secondary to Familial Mediterranean Fever: A Retrospective Chart - Review Study
No full textWOS: 000469780200001PubMed ID: 31123243Background: Amyloidosis is a protein-misfolding disease characterized by the deposition of aggregated proteins in the form of abnormal fibrils that disrupt tissue structure, ultimately causing disease. Amyloidosis is very frequent in untreated familial Mediterranean fever (FMF) patients and it is the most important feature that determines the prognosis of FMF disease. The mean platelet volume (MPV) in FMF has been previously studied. However, whether MPV level in FMF patients is lower or higher compared to healthy controls remains a topic of ongoing debate. In this study, we aimed to investigate MPV values and to assess the correlation between MPV and proteinuria in patients with AA amyloidosis and AA amyloidosis secondary to familial Mediterranean fever (AA-FMF) through a retrospective chart-review. Material/Methods: This study was carried out on 27 patients with AA amyloidosis, 36 patients with AA amyloidosis secondary to FMF (a total of 63 patients with AA), and 29 healthy controls. There was no statistically significant difference between the AA patients and the control group (p=0.06) or between the AA-FMF group and the control group in terms of MPV values (p=0.12). Results: We found a statistically significant negative correlation between MPV and thrombocyte count in all groups (p<0.05 for all groups), but there was no correlation between MPV and proteinuria levels in AA patients (p=0.091). Conclusions: While similar results also exist, these findings are contrary to the majority of previous studies. Therefore, further controlled clinical prospective trials are necessary to address this inconsistency
The effects of delta-9-tetrahydrocannabinol on Krüppel-like factor-4 expression, redox homeostasis, and inflammation in the kidney of diabetic rat
No full textPubMed ID: 31081965Diabetes mellitus is a complex, multifactorial disorder that is attributed to pancreatic ? cell dysfunction. Pancreatic ? cell dysfunction results in declining utilization of glucose by peripheral tissues as kidney and it leads to nephropathy. Excessive production and accumulation of free radicals and incapable antioxidant defense system lead to impaired redox status. Macromolecular damage may occur due to impaired redox status and also immune imbalance. ?9-Tetrahydrocannabinol (THC) is the main active ingredient in cannabis. THC acts as an immunomodulator and an antioxidant agent. Our aim was to evaluate the effects of THC in the diabetic kidney. We analyzed macromolecular damage biomarkers as protein carbonyl (PCO), lipid hydroperoxide (LHP), malondialdehyde (MDA), 8-hydroxy-2?-deoxyguanosine (8-OHdG), and antioxidant defense system biomarkers as thiol fractions (T-SH, NP-SH, P-SH) and Cu/Zn-superoxide dismutase activity for the antioxidative effects of THC. Furthermore, mRNA expression of Krüppel-like factor-4, secreted immunopositive cell number changes of interleukin-6, nuclear factor ?? (NF-??), and peroxisome proliferator-activated receptor-? and tumor necrosis factor ? (TNF-?) levels were analyzed for the immunomodulatory activity of THC. Diabetic rats showed significantly increased levels of PCO, LHP, MDA, and 8-OHdG when compared with controls (P < 0.05 for each parameter). THC significantly reduced the elevated levels of PCO and 8-OHdG (P < 0.05 for both parameters) and also LHP and MDA levels were insignificantly reduced by THC. Also, thiol fractions insignificantly increased in THC administered diabetic kidney when compared with diabetic rats. The NF-?? cell number significantly decreased in the diabetic rats treated with THC compared with the diabetic group. According to our data, THC has ameliorative effects on the impaired redox status of diabetic kidney and also it acts as an immunomodulator. Therefore, THC might be used as a therapeutic agent for diabetic kidneys but its usage in the healthy kidney may show adverse effects. © 2019 Wiley Periodicals, Inc.Firat University Scientific Research Projects Management UnitThis study was supported by the Scientific Research Project Coordination Unit of Istanbul University, project no: 7823
Evaluation of Electroencephalography Findings in Isolated Hypocalcemia Patients
No full textWOS: 000461743400010Aim: In our study, we aimed to analyze electroencephalography (EEG) findings in patients with hypocalcemia and to investigate possible relationship between calcium (Ca) level and EEG abnormalities and whether there was any change in EEG findings when serum Ca level returns to normal. Methods: Seventeen consecutive patients, who were admitted to the Endocrinology, Neurology and General Surgery Clinics at Istanbul Sisli Hamidiye Etfal Training and Research Hospital with a corrected serum Ca level of 8.5 mg/dL) in follow-up. Results: EEG abnormalities were detected in nine (53%) of 17 patients. EEG examination revealed slow background activity in seven patients (41%) and epileptiform abnormalities in two (12%) patients. In follow-up, normocalcemic period was observed in seven patients. EEG findings were improved in two of eight patients who had slow background activity and one of two patients with epileptiform activity in the normocalcemic period. Conclusion: Our study showed that various EEG findings, such as slowed background activity and epileptiform abnormalities, may be seen in isolated hypocalcemia patients even in the absence of clinical findings and these EEG findings may improve in normocalsemic period
Outcome of Desensitization Therapy in Immunologically High-Risk Kidney Transplantation: Single-Center Experience
No full textAim: Sensitization to HLA antigens creates an immunologic barrier, linked to an increased risk of antibody-mediated rejection and poorer graft survival, that remains a persistent and often impenetrable deterrent to transplantation. Desensitization can improve transplantation rates in broadly sensitized kidney transplant recipients. We aimed to compare the clinical outcomes of immunologic high-risk kidney recipients who had desensitization treatment with the outcomes of those who did not. Materials And Methods: We retrospectively evaluated patients who underwent desensitization protocol due to immunologic risk between 2010 and 2018. Living-donor transplantation patients with panel reactive antibody positivity, retransplantation, donor specific antibody, and/or single antigen bead positivity were included in the study. We excluded deceased-donor transplantation recipients. Demographic data (age, sex, etiology of end-stage renal disease, blood transfusions, pregnancy, etc), immunologic status (HLA-mismatch [HLA-MM], panel reactive antibody, donor specific antibody, etc), induction and maintenance of immunosuppressive medications, and complications (all-cause hospitalizations, episodes of acute rejections, etc) were noted. We compared data and clinical outcomes of patients who had desensitization (Group 1) with data and clinical outcomes of patients who had not had desensitization (Group 2). Findings: There were 124 living-kidney donors (49 female, mean age 43.7 ± 12.2 years, mean body mass index [BMI] 25.8 ± 5.8 kg/m2, mean follow-up time 20.9 ± 14.6 months). Thirty-four of these patients (25 female, mean age 43.7 ± 12.5 years, mean follow-up time 26.1 ± 17.7 months, mean BMI 27 ± 6.5 kg/m2) had desensitization treatment (rituximab+plasmapheresis for 19 patients, rituximab for 11 patients, rituximab+plasmapheresis+intravenous immunoglobulin for 4 patients). Ninety patients (24 female, mean age 43.7 ± 12.2 years, mean follow-up time 18.9 ± 12.9 months, mean BMI 25.3 ± 5.4 kg/m2) had not had desensitization. There was no statistical difference between groups for age, sex, hepatitis serology, history of blood transfusion, history of pregnancy, or history of dialysis (P < .05 for all parameters). While scores for HLA-MM and HLA-relative intensity scale (RIS) were 2.7 ± 1.6 and 7.86 ± 6.2, respectively, in Group 1, in Group 2 the same scores were 2.1 ± 1.1 and 3.6 ± 2.5, respectively (P: .053 and .03). Delayed graft function, acute rejection episodes, and hospitalizations were similar between groups (P: .47, .29, and .34, respectively). Follow-up time and length of hospitalization were longer in Group 1 (P: .013 and .001, respectively). Total doses of ATG were higher in Group 1 patients (P: .007). Conclusion: Despite the higher HLA-MM and RIS scores, clinical outcomes in desensitized patients were found to be similar to those in nondesensitized patients for acute rejection episodes and hospitalizations. Desensitization with rituximab in patients with high HLA-RIS scores can prevent acute rejection and hospitalization. © 2019 Elsevier Inc
The effectiveness of basic life support training on nursing students' knowledge and basic life support practices: a non-randomized quasi-experimental study
No full textAkin, Semiha/0000-0002-1901-2963; Mendi, Onur/0000-0003-4112-7035WOS: 000482191800051PubMed: 31656511Background: Provision of up-to-date information and skills training related to basic life support practices is very important for nursing students' professional development and practitioner and education related roles. Objective: the purpose of the study was to examine the effectiveness of basic life support training on knowledge and practices among nursing students. Methods: A non-randomized quasi-experimental design (One group pre-test-post-test) was used in this study. the study was conducted in the laboratory of an undergraduate nursing school. the sample consisted of a convenience sample of 1st-year students enrolled in the undergraduate nursing class. the study sample consisted of 65 nursing students. Basic life support training included both theoretical and practical components. the students' knowledge and practices were assessed before basic life support training. Data were collected using the knowledge assessment questionnaire. the practical skills for basic life support were observed and assessed using a checklist. the pre- and post-assessment practice scores were compared. Results: After basic life support training, level of knowledge and practical skill scores were higher compared to pre-training scores (t= -12.442, p=0.000; t= -22.899, p=0.000). There was a significant and moderate association between the adult basic life support Knowledge Form scores and the adult basic life support practice assessment form scores obtained after the training (r = 0.39, p<0.01). Conclusion: the study showed that basic life support training improved knowledge and skills related to basic life support practices in nursing students. Periodic basic life support training is very important for competency in this area among nursing students
Mental Distress Symptoms and Life Satisfaction Among Living Kidney Donors: Frequency and Association With Subjective Evaluations
No full textPubMed: 31399201The aims of this study were to (1) determine psychological states and wellbeing of living kidney donors and (2) assess their interaction and association with subjective evaluations of donors. This retrospective, cross-sectional study was conducted with 208 living kidney donors (123 women; 59.1%), aged between 22 and 79 years (48.74 ± 11.78) who underwent a nephrectomy between 2006 and 2017. All donors were evaluated face-to-face. the sociodemographic data collection form, a 4-question survey developed by researchers for subjective evaluations, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and Contentment with Life Assessment Scale (CLAS) were administered. Only few donors, 3.8% and 7.2% respectively, were above the clinical cut off scores of the BDI and BAI. This was equivalent to the normal population. Eighty percent of respondents were satisfied with life. Only 5 donors (2.4%) claimed to have any regrets about their experience and scored higher for depression and lower for life satisfaction (P < .001). Similarly, 33 (15.9%) donors having thoughts of getting ill easily after the operation were found to be more depressive and anxious, with lower life satisfaction (P < .001). in most cases their relationship to the recipient was reported not to be changed (64.4%) or even improved (32.5%), and that was found to be related to lower depression scores (P < .001). Respondents within the first year of donation reported higher depression (P = .019) and lower life satisfaction (P = .001) scores. Finally, postoperative complications were found to increase anxiety and lower life satisfaction (P = .018, P = .026). Degree of affinity between donors and recipients showed no difference in postoperative psychological outcomes and life satisfaction. These results suggest that overall, living kidney donation does not have a negative impact on donors’ life satisfaction and mental status in the long term. However, the results of the unvalidated additional survey questions underlined the importance of follow-up of donors, especially in the first year, and screening of donors’ subjective experiences in gaining additional insight about donors' mental well-being. © 2019 Elsevier Inc