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The Effect of Alendronate on Bone Mineral Disorder in Renal Transplant Patients
No full textPurpose: In this study, we aimed to investigate the effect of long-term administration of alendronate to treat bone loss in renal transplant patients. Methods: Eighty-two renal transplant recipients were divided into 3 groups. Group 1 included patients who were treated with calcium, vitamin D3, and alendronate; group 2 included patients who were treated with calcium and vitamin D3; and group 3 included patients who did not receive these medications. All patients' sociodemographic data, biochemical parameters, and bone mineral density (BMD) measurements were recorded. Results: There were no significant differences between sociodemographic and laboratory findings at the beginning of study in all groups. The BMD of lumbar spine and femoral neck was significantly less in group 1 at the beginning, 12 and 24 months of the study when compared with other group. At 12 and 24 months of the study, the BMD levels were decreased both group 2 and group 3, whereas in group 1, it was stable at 12 months and increased thereafter. In group 1, the initial femoral neck BMD was negatively correlated with parathormone, sex, and body mass index, and positively correlated with creatinine level. While there was a positive correlation between basal body mass index and femur neck BMD in group 2, there was no correlation between baseline parameters, demographic data, and bone mineral density in group 3 patients. Conclusions: In conclusion, bone loss is inevitable despite calcium and vitamin D replacement. However, bone loss can be stopped and even reversed with alendronate therapy. © 2022 Elsevier Inc
Radiographical and clinical results of a new conservative treatment algorithm in Legg-Calve-Perthes disease: A retrospective study
No full textObjective: This study aimed to establish a feasible conservative treatment algorithm for Legg-Calve-Perthes Disease (LCPD), clarify its limitations, and evaluate the correlations between radiographical and clinical results. Methods: Patients diagnosed with LCPD and treated conservatively were evaluated retrospectively; 39 hips from 35 patients were included. The treatment protocol consisted of intermittent manual traction, range of motion exercises, activity limitation, bed rest, NSAID (ibuprofen 100mg/5mL), and ASA (100mg/day) during attack periods. The treatment protocol was standardized, and an algorithm was established for all the patients. Results: The mean follow-up was 13.7 (range = 8-22) years. According to the Stulberg classification, 26 (67%) hips were good, 6 (15,3%) were fair, and 7 (17%) were poor. No activity-limiting pain was detected in any patient. The mean Harris score was 90.5 +/- 5.3 for Stulberg type 1, 2, and 3 hips, but 84.2 +/- 8.8 for Stulberg type 4 and 5 hips. When the patients were evaluated in terms of pain, activity, and function, it was seen that pain and activity were not different, especially in the Stulberg 1, 2, 3, and 4 patients during the mid-term follow-up. The function was the main factor correlating with the Stulberg classification. Twenty-nine (82.8%) families defined the applicability of the treatment protocol as easy, 4 (10.3%) defined it as moderate, and 2 (6.2%) defined it as difficult. Conclusion: The present study demonstrated that the treatment protocol was successful and easily applicable to LCPD. Although lateral pillar classification was efficient to predict radiographic results, the Stulberg classification was not correlated with the clinical results for every subgroup
Two cases with mitochondrial membrane protein-associated neurodegeneration: genetic features and long-term clinical follow-up
No full textMitochondrial membrane protein-associated neurodegeneration (MPAN) is a rare neurological disease with childhood or adult onset. It is a subtype of clinically and genetically heterogeneous group of disorders, collectively known as neurodegeneration with brain iron accumulation . MPAN is generally associated with biallelic pathogenic variants in C19orf12. Herein, we describe genetic and clinical findings of two MPAN cases from Turkey. In the first case, we have identified the relatively common pathogenic variant of C19orf12 in the homozygous state, which causes late-onset MPAN. The second case was homozygous for an essential splice-site variation.Istanbul University Scientific Research Fund [TSA-2018-27512]This work was partially supported by the Istanbul University Scientific Research Fund (Project no.: TSA-2018-27512). The authors also thank to Turkish Academy of Sciences for the 2019 Distinguished Young Scientist Award to SAUI
Noise levels in the dialysis unit and its relationship with sleep quality and anxiety in patients receiving HD: A pilot study
No full textIntroduction: HD unit is a noisy environment for patients, and noise can affect anxiety levels and sleep quality. Methods: The aim of the study is to determine noise level, the relationship between noise levels, and sleep quality and anxiety in patients in HD unit. A descriptive and observational study design was used. Three Benetech GM1351 manual sound-level meters were used to measure noise. A patient information form, the State Anxiety Inventory, and the modified Post-Sleep Inventory were used for data collection. Results: The noise range detected in the HD unit ranges from 48.40 to 72 dB(A). Our findings show that patients in the HD unit are exposed to high noise levels and the noise significantly negatively impacts quality of sleep and anxiety level of the patients. Conclusions: It is important to be aware that HD patients are constantly exposed to high levels of noise and to plan nursing interventions to reduce this noise level. © 2022 International Society for Apheresis and Japanese Society for Apheresis
Association of PD-1 and PDL-1 gene polymorphisms with colorectal cancer risk and prognosis
No full textBackground Programmed Cell Death-1 (PD-1) together with Programmed Death Ligand 1 (PDL-1) have crucial roles in anti-tumor immune response, cancer susceptibility and prognosis. Since PD-1 and PDL-1 have been considered as important genetic risk factors in cancer development and their functions can be affected by polymorphic sites, we investigated the effects of PD-1 rs2227981, rs2227982, rs36084323 and PDL-1 rs2282055, rs822336 gene polymorphisms on colorectal cancer (CRC) risk and prognosis in Turkish subjects. Methods and results Our study group consisted of 5-FU or Capacitabine prescribed CRC diagnosed patients and healthy controls. Genotype analyses of PD1 and PDL-1 polymorphisms were performed with Agena MassARRAY platform. rs36084323 CT genotype frequency was found to be higher in controls compared to cases (p C polymorphism might be useful in predicting CRC prognosis. PDL-1 rs2282055 T > G polymorphism might be useful in predicting both CRC risk and prognosis. Further studies should be conducted in larger and different populations to clear the roles of PD-1 and PDL-1 polymorphisms in CRC risk and prognosis.Marmara University Scientific Research Projects Coordination Unit [FEN-C-DRP-110718-0407]This study was supported by Marmara University Scientific Research Projects Coordination Unit. Project No. FEN-C-DRP-110718-0407
Analysis of Distress in Patients with Gynecological Cancers During the COVID-19 Pandemic: A Telephone Survey
No full textObjective: To investigate distress levels in patients with gynaecological cancers during the coronavirus disease-2019 (COVID-19) pandemic and identify factors associated with distress. Material and Methods: A total of 193 patients who underwent cytoreductive surgery for gynaecological cancer were included in our research. The patients were contacted by phone and provided detailed information about our study and the questionnaire that was to be applied. We performed distress screening using The National Comprehensive Cancer Network Distress Thermometer and Problem List (PL), developed for cancer patients. Results: In the study group, 51% of patients were categorized in the high-stress group. As practical problems, childcare (p<0.001), insurance/financial (p<0.033), work/school (p<0.001), treatment decisions (p<0.001), have significant differences between 2 groups in the present study. As family problems dealing with children (p<0.001), family health issues (p<0.014) have significant differences between the low-stress group and the high-stress group. All the emotional parameters evaluated by PL questionnaire have significant difference between the groups. The emotional significance levels of the parameters are as follows: depression (p<0.001), fears (p<0.001), nervousness (p<0.002), sadness (p<0.001), worry (p<0.012), loss of interest (p<0.001). Conclusion: Our results send a message to the gynaecological cancer healthcare world about what conditions may plague the gynaecological cancer patient in COVID-19 pandemic. Identifying problem areas for patients in our study constitutes the first step in the intervention. Copyright © 2022 by Türkiye Klinikleri
Investigation of DPYD, MTHFR and TYMS polymorphisms on 5-fluorouracil related toxicities in colorectal cancer
No full textAim: To investigate the association of DPYD, MTHFR and TYMS polymorphisms on 5-fluorouracil (5-FU) related toxicities and patient survival. Materials & methods: A total of 103 colorectal cancer patients prescribed 5-FU were included in the study. Genotyping was conducted for several DPYD, MTHFR and TYMS polymorphisms using a microarray analyzer. Results: DPYD 496A>G polymorphism was found to be significantly associated with 5-FU related grade 0-2, but not severe toxicities (p = 0.02). Furthermore, patients with DPYD 85TC and CC genotypes had longer progression and overall survival times compared to TT genotypes in our study group (log rank = 6.60, p = 0.01 and log rank = 4.40, p = 0.04, respectively). Conclusion: According to our results, DPYD 496AG and GG genotypes might be protective against severe adverse events compared to the AA genotype. Another DPYD polymorphism, 85T>C, may be useful in colorectal cancer prognosis. Further studies for both polymorphisms should be conducted in larger populations to achieve accurate results. Plain language summary 5-fluorouracil (5-FU) is a widely used drug for chemotherapy in colorectal cancer. In this study, we investigated the relationship between the severity of 5-FU induced adverse events and several variations in DPYD, MTHFR and TYMS genes, which encode the enzymes involved in 5-FU metabolism in a total of 103 colorectal patients. We also examined the relationship between the polymorphisms and progression-free and overall survival times of the patients in our study group. Among the variations, DPDY 496A>G polymorphism was found to be associated with 5-FU induced adverse events. Also, the DPYD 85T>C polymorphism was detected to be associated with longer progression-free and overall survival times.Marmara University Scientific Research Projects Coordination Unit [FEN-C-DRP-1107180407]This study was supported by Marmara University Scientific Research Projects Coordination Unit. Project no: FEN-C-DRP-1107180407. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed
Splint efficacy in chronic post-stroke spasticity: a pilot study
No full textIntroduction. Hand spasticity after stroke is a serious issue and may lead to hygiene problems, range of motion limitations, or contractures. Hand splints are often used to reduce spasticity and prevent movement limitations; however, there is little research available on the efficacy of splints in spasticity. The study aimed to investigate the efficacy of a reflex inhibitory splint (RiS) for upper extremity spasticity in stroke patients by using clinical and electrophysiological studies. Methods. Stroke patients with elbow and hand spasticity were allocated into 2 groups. The splint group (n = 16) wore RiS. The control group (n = 13) did not wear any upper extremity splint. Both groups received the same rehabilitation program during this period. They were evaluated for motion in the upper extremity with the Brunnstrom scale and Fugl-Meyer upper extremity scale. Electrophysiological measurements showing motor neuron excitability such as the ratio between the maximum amplitude of H-reflex and the maximum amplitude of M-response (Hmax/Mmax ratio), H-reflex latency, and F-wave persistence and latency were also studied. All clinical and electrophysiological measurements were performed in both groups on days 0 and 15. Results. At the end of the treatment, elbow and finger flexion tonus decreased and active wrist extension angle increased in the splint treatment group compared with both baseline and the control group. Compared with the pre-treatment status, a correlation was detected between the Hmax/Mmax ratio and the wrist flexion tonus in the splint group. Conclusions. RiS may be useful for the management of post-stroke upper-limb spasticity. © Wroclaw University of Health and Sport Science
The effect of cognitive performance on self-management behavior of multiple sclerosis patients
No full textBackground: Difficulties of self-management in people with MS (pwMS) is considered as one of the most important factors contributing to low rehabilitation efficacy, more severe long-term complications and increase in healthcare costs. Despite the emergence of research in the last decade documenting causes, types, and course of cognitive difficulties in MS disease subtypes, limited evidence is available in the literature for direct comparison of self-management and cognitive deficits. In this study we aimed to investigate the relationship between cognitive performance and self-management in pwMS. Methods: PwMS who applied to neurology out-patient clinics of seven different centers were included into study. Multiple Sclerosis Self-Management Scale- Revised (MSSM-R) was used for the assessment of self-management behaviors and Multiple Sclerosis inventory cognition scale (MUSIC) was used for the assessment of cognitive performance and fatigue. Results: In this study, 194 (144 female and 50 male) pwMS participated (mean age = 38.9 years). The course of the disease was RRMS in 173 patients and mean EDSS was 2.0. 68.5% of the participants were married, 32.5% were employed, and 57.2% had secondary education. The MSSM-R mean score of the study group was 42.6 +/- 10.4 (1-81). There was a positive correlation between MSSM-R and MUSIC-cog scores (r = 0.21, p = 0.003). A hierarchical multiple regression revealed that income level (beta = 0.196, t = 2.692, p = 0.008) and cognitive performance (beta = 0.167, t = 2.063, p = 0.041) together with control variables (gender, age, educational status, employment status, duration of disease, EDSS and fatigue) explained 5.5% of the variance in self-management. Conclusion: Cognitive performance is a predictor of self-management in pwMS. Better self-management behavior is also related with employment and income level in pwMS. Studies evaluating patients' cognitive abilities and evaluating the effectiveness of adapted self-management training programs are needed
Similar bacterial signatures in the gut microbiota of type 1 and type 2 diabetes patients and its association with G protein-coupled receptor 41 and 43 gene expression
No full textPurpose There are conflicting reports regarding the abundance of short-chain fatty acids producing bacteria in the gut microbiota in patients with type 1 and type 2 diabetes. We aimed to determine the amount of Akkermansia muciniphila, Anaerobutyricum hallii, Bifidobacterium adolescentis, Bifidobacterium longum, Collinsella aerofaciens, Faecalibacterium prausnitzii, Lacticaseibacillus rhamnosus, and Parabacteroides distasonis in the gut microbiota in patients with type1 and type2 diabetes, compared with the healthy controls and analyze the correlation between the gene expression levels of two short-chain fatty acids receptors GPR41 and GPR43. Methods Forty type 1, 40 type 2 stool and blood samples of diabetes patients, and 40 healthy control samples were studied. DNA and RNA were extracted, and bacteria were detected using a Microbial DNA qPCR Assay kit. Gene expressions were detected with GPR41 and GPR43 primers via in-house qPCR. Results Compared with healthy controls, B.longum and F.prausnitzii abundance were significantly decreased in patients with type1 and type2 diabetes, A.hallii abundance was increased in patients with type1 and decreased in type2 diabetes contrarily A.muciniphila abundance was decreased in patients with type1 and increased in type2 diabetes. GPR43 gene expression was upregulated in both patients group, however GPR41 was upregulated only in patients with type2 diabetes. Conclusions Elevated B. longum and F. prausnitzii abundances were detected in the gut microbiota of patients with type1 and type2 diabetes and compared with healthy controls. B. longum and F.prausnitzii abundances were also correlated with the GPR43 gene expression level in type1 diabetes patients. Extensive studies determining bacteria producing short-chain fatty acids in gut microbiota, and their contribution in the pathogenesis of diabetes, are needed to understand better the mechanism of these diseases