Repositorio de la Asociación Española de Neuropsiquiatría
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The real-life efficacy and safety of osimertinib in pretreated advanced non-small cell lung cancer patients with T790M mutation: a Turkish Oncology Group Study
No full textIntroduction Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation. Materials and methods This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety. Results Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3-4 adverse events were seen in 11.7% of the patients. Conclusion Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile
Production of epsilon toxin secreted by Clostridium perfringens type D under different culture conditions
No full textClostridium perfringens hayvanlarda ve insanlarda dizanteri, gazlı kangren gibi çeşitli hastalıklara neden olan Gram pozitif, çubuk şeklinde, anaerobik, spor oluşturan patojenik bir bakteridir. C. perfringens tip B ve tip D tarafından salgılanan epsilon () toksini, koyun, keçi ve sığırlarda bağırsaklardan emilmesiyle ortaya çıkan ve dünya çapında enterotoksemi olarak bilinen hastalığa neden olur. Hastalığın hızlı ve şiddetli seyri nedeniyle aşılama, hastalıkla mücadelede önemlidir. Enterotoksemik hastalıkları kontrol etmenin bir yolu, "toksoidler" adı verilen inaktive edilmiş toksinler veya inaktive edilmiş bakteri hücreleri kullanılarak aşılamadır. C. perfringens tip D toksoid preparatları ile aşılamalar, bu suşun neden olduğu enterotoksemik hastalıkların bir dereceye kadar kontrol altına alınmasını mümkün kılmıştır. Bu toksoid preparasyonunun potensini artırmak için, yüksek derecede antikor yanıtı sağlayan toksini elde etmek gerekir. Daha önceki çalışmalarda epsilon toksini elde edilmesine rağmen toksin seviyeleri düşük olmuştur. Bu çalışmada, C.perfringens tip D tarafından salgılanan epsilon toksini üretimi üzerine sıcaklık, pH, çinkonun (ZnSO4) etkisi araştırıldı. Kültür ortamındaki bakteri yoğunluğu ile epsilon toksin üretimi arasında herhangi bir ilişki olup olmadığını anlamak için bu tür değişken kültür koşulları altında bakterilerin büyüme dinamikleri incelendi. Toksinin kantitatif ve kalitatif tespiti SDS-PAGE analizi ile belirlendi. Bulgularımız optimum -toksin üretiminin 37 oC, pH 6.8'de olduğunu ve bakteri biyokütlesi ile toksin üretimi arasında bir korelasyon olmadığını gösterdi.Clostridium perfringens is a Gram-positive, rod-shaped, anaerobic, spore-forming pathogenic bacterium that causes various diseases such as dysentery and gas gangrene in animals and humans. Epsilon () toxin secreted by C. perfringens type B and type D causes a worldwide disease known as enterotoxemia, which occurs when the toxin is absorbed from the intestines in sheep, goats and cattle. Owing to the rapid and severe course of the disease, vaccination is important to fight the disease. One way to control enterotoxemic diseases is vaccination using inactivated toxins called "toxoids" or inactivated bacterial cells. Immunization with C. perfringens type D toxoid preparations has made it possible to control the enterotoxemic diseases caused by this strain to a certain extent. To increase the potency of this toxoid preparation, it is necessary to obtain the toxin that provides a high degree of antibody response. In previous studies, although -toxin was obtained, the toxin levels were low. In this study, the effect of temperature, pH, zinc (ZnSO4) on epsilon toxin production by C. perfringens type D were investigated. The growth dynamics of bacteria under such varying culture conditions were studied to understand whether any relationship exists between the density of bacteria in the culture medium and epsilon toxin production. Quantitative and qualitative determination of the toxin was determined by SDS-PAGE analysis. Our findings showed optimum production of -toxin was observed at 37 oC, pH 6.8 and there was no correlation between bacterial biomass and toxin production
Examining of some physical and physiological parameters of 10-18 years old male skiers to seasonal cycles
No full textSkiing can be identified as a branch with the most important representative power of winter sports. Further, it has been characterized by high popularity and population, branching off in itself. During the year, different physical performance and physiological indicators are sometimes encountered in athletes depending on seasonal cycles, training levels, and living conditions. The aim of this study is to examine some physical performance parameters and the determined hormone levels to seasonal cycles. Methods: 15 male skiers with a mean age of 14.53 +/- 2.61 (years), a mean height of 158.53 +/- 9.66 (cm), and a mean body mass of 54.20 +/- 10.85 (kg) participated in the study. The information about participants' age, height, and body mass was determined by standard methods. Various measurement tools were used including a digital hand dynamometer (TKK 5401) for hand grip strength, a digital dynamometer (TKK 5402) for back and leg strength, a jump meter (Takei TKK 5406) for vertical jump height, and an electronic hand spirometer (firstMED) for respiratory functions. The Wingate anaerobic power test (Monark 894 E bicycle ergometer) was performed to determine the anaerobic power level. Additionally, to determine somatotypes (ectomorph, mesomorph, endomorph) and body fat percentage; skinfold caliper (Holtain), tape measure, and digital caliper (Holtain) were respectively utilized for skinfold thickness measurement, circumference measurements, and diameter measurements. Blood samples (hemogram test, vitamin D, cortisol, and testosterone to be checked) were taken from the antecubital vein in the sitting position. From the blood samples, serum plasma was separated and preserved by centrifugation (+4o) and all samples were analyzed at once. All tests were performed once in September, December, March, and June at an altitude of 2,000 and in pre-season and mid-season. The data were analyzed through IBM SPSS 24.0 package program. Shapiro-Wilk was used to determine the distribution of the data, descriptive and frequency analysis was used to determine the mean of the variables, and one-way analysis of variance (ANOVA) was used to determine the differences between measurements. The results were presented as arithmetic mean and standard deviation ((X) over bar +/- Ss). Results: In 10-18 years old male skiers, it was determined that vitamin D reached its highest level in autumn, testosterone in summer, and cortisol in winter. In the inter-test comparison results, significant differences were determined in the vertical jump, right and left-hand grip strength, leg strength, testosterone, vitamin D, HCT, FVC, FEV1, and anaerobic power parameters. Conclusions: The results of the study have mostly supported the literature
Geometry of statistical manifolds with contact structures
No full textYüksek lisans tezi olarak sunulan bu çalışma beş bölümden oluşmaktadır. Birinci bölüm giriş kısmıdır ve bu bölümde konuyla ilgili daha önce yapılan çalışmalardan bahsedilmiştir. İkinci bölümde, diğer bölümlerde kullanılacak bazı temel kavramlara yer verilmiştir. Üçüncü bölümde, Sasakian manifoldlar başlığı altında kontakt manifoldlar, hemen hemen kontakt manifoldlar, hemen hemen kontakt metrik manifoldlar, kontakt manifoldlarda temel 2-form, hemen hemen kontakt manifoldların torsiyon tensörü, K-kontakt manifoldlar ve Sasakian manifoldlar verilmiştir. Dördüncü bölümde, istatistiksel manifoldlar ele alınmıştır. Beşinci ve son bölümde ise kontakt istatistiksel manifoldlar başlığı altında hemen hemen kontakt metrik istatistiksel manifoldlar ve bunların bazı sınıfları ile ilgili kavramlara yer verilmiştir.The first chapter is the introcdution and this chapter mentions previous work in the subject. In the second chapter, some basic concepts that will be used in other parts are given. In the third chapter, under the title of Sasakian manifolds, contact manifolds, almost contact manifolds, almost contact metric manifolds, basic 2-form in contact manifolds, torsion tensor of almost contact manifolds, K-contact manifolds and Sasakian manifolds are given. In the fourth chapter, statistical manifolds are discussed. In the fifth and last chapter, the concepts related to almost contact metric statistical manifolds and some of their classes are given under the title of contact statistical manifolds
he effect of therapeutic touch and music listening on sleep quality, menopausal symptoms and quality of life in menopausal women
No full textAmaç: Menopozal kadınlarda terapötik dokunma ve müzik dinletisinin uyku kalitesi, menopozal semptomlar ve yaşam kalitesine etkisini incelemek amacıyla yapılmıştır. Materyal ve Metot: Araştırma ön test son test kontrol gruplu deneysel modelde gerçekleştirilmiştir. Çalışma terapötik dokunma (TD), müzik dinletisi ve kontrol gruplarındaki toplam 108 menopozal kadın ile tamamlanmıştır. Veriler, Katılımcı Tanıtım Formu, Pittsburgh Uyku Kalitesi İndeksi (PUKİ), Menopoz Semptomları Değerlendirme Ölçeği (MSDÖ) ve Menopoza Özgü Yaşam Kalitesi Ölçeği (MÖYKÖ) kullanılarak toplanmıştır. Terapötik dokunma grubuna dört hafta boyunca hafta bir kez TD uygulanmış, müzik dinletisi grubuna ise dört hafta boyunca her gün uyuma saati öncesi 30 dakika müzik dinlemeleri istenmiştir. Son test verileri girişimler tamamlandıktan bir ay sonra toplanmıştır. Verilerin analizinde Ki-Kare, Fisher Exact Test, tek Yönlü ANOVA, ilişkili örneklemler için t-testi, Cohen d ve Eta Kare kullanılmıştır. Bulgular: Gruplar arası karşılaştırmada; PUKİ, MSDÖ ve MÖYKÖ son test puanlarında kontrol grubundan kaynaklı anlamlı farklılık olduğu belirlenmiştir (p<0.05). Araştırmada TD ve müzik dinletisi grubundaki kadınların ön test son test karşılaştırmasında; PUKİ, MSDÖ ve MÖYKÖ puan ortalamalarında anlamlı düşüş olduğu belirlenmiştir (p<0.05). Sonuç: Terapötik dokunma ve müzik dinletisinin uyku ve yaşam kalitesini artırdığı, menopozal semptomları azalttığı ancak TD'nin olumlu etkisinin müzik dinletisine göre daha fazla olduğu belirlenmiştir.Aim: It was conducted to examine the effects of therapeutic touch and music listening on sleep quality, menopausal symptoms and quality of life in menopausal women. Material and Method: The research was carried out in an experimental model with a pre-test and post-test control group. The study was completed with a total 108 menopausal women in the therapeutic touch (TT), music listening and control groups. Data were collected using the Participant Identification Form, Pittsburgh Sleep Quality Index (PSQI), Menopausal Symptoms Rating Scale (MRS), and Menopause-Specific Quality of Life Scale (MENQOL). Therapeutic touch was applied to the TT group once a week for four weeks, and the music listening group was asked to listen to music for 30 minutes before bedtime every day for four weeks. Post-test data were collected one month after the interventions were completed. Chi-Square, Fisher's Exact Test, one-way ANOVA, Paired-Sample T test, Cohen's d and Eta Square were used to analyze the data. Results: In the comparison between groups; It was determined that there was a significant difference in the post-test scores of PSQI, MRS and MENQOL originating from the control group (p<0.05). In the pre-test and post-test comparison of the women in the TT and music listening groups; It was determined that there was a significant decrease in the mean scores of PSQI, MSDS and MENQOL (p<0.05). Conclusion: It has been determined that therapeutic touch and listening to music increase sleep and quality of life and reduce menopausal symptoms, but the positive effect of TT is more than music listening
Evaluation of Knowledge on Emergency Management of Avulsed Teeth Among Turkish Medical and Dental Students
No full textObjective: To evaluate the knowledge of medical and dental students regarding the emergency management of avulsed teeth. Material and Methods: This cross-sectional survey study was performed on 1841 students. Medical (n=746) and dental (n=845) students from different universities were included in this study. A questionnaire about the emergency management of avulsed teeth was conducted on the students. Also, 250 medical students from 3rd grade were included in the study and trained. The questionnaire was applied twice, before and after the training on the subject. Results: The mean correct answer scores were similar among the medical students in different grades (p>0.05). There were no statistically significant differences between the trained medical students and clinical dental students' correct answer scores, but there was a significant difference between the pre-clinical (1st-2nd-3rd years) and clinical (4th-5th years) dental students (p<0.01). Conclusion: Medical and preclinical dental students had lack of knowledge about the emergency management of avulsed teeth, while clinical dental and trained medical students were very knowledgeable. This result indicates the importance of education
Preparation of 10-undecenoic acid based polyurethane/PCL fibers by electrospinning method and investigation of their antifungal properties
No full textNowadays, in the treatment of such fungal infections, antifungal drugs in various forms are one of the most preferred methods. These medications can be in the form of creams and lotions, shampoos, pills, suppositories, powders, or sprays. The dose of the drugs is adjusted according to the type and growth area of the fungus, the severity of the symptoms, and the medical history of the patients. Dressing materials with antifungal properties are an alternative treatment method used for the treatment of fungal skin infections. These covers not only treat fungal infections but also prevent their spread. Within the scope of this study, polyurethane-based wound dressing materials (PU-UDA/PCL) with antifungal properties were developed. Electrospining method was used to produce these dressing materials and the surface area of the wound dressing material was increased, thereby increasing the effect of antifungal property. Polypropylene glycol, glycerol, and catechin as polyol were preferred in polyurethane (PU) synthesis. These structures were polymerized with isophorone diisocyanate and modified with 10-undecenoic acid. Obtained 10-undecenoic acid modified polyurethane (PU-UDA) structures were transformed into wound dressing structure with polycaprolactone (PCL) by electrospinning method. Structural, morphological, and thermal properties of the wound dressing materials were analyzed with different instrumental analysis methods. The antifungal activities of PU-UDA/PCL were tested. Antifungal tests were performed on C. albicans and C. tropicalis. Therefore, PU-UDA/PCL series could be used as an efficient antifungal agent. Finally, it was determined that the obtained 10-undecenoic acid-based polyurethane fibers have a suitable structure and feature for the treatment of many fungal infections
Comparison of the nutritional parameters of patients newly diagnosed in hematology and oncology clinics before and after chemotherapy, radiotherapy and surgical treatment
No full textNütrisyonel değerlendirme kanser hastalarında temel roldedir ve kas kütlesi kaybı başta olmak üzere beden kompozisyonunun değerlendirilmesi bunun ayrılmaz parçası niteliğindedir. Hematoloji ve Onkoloji kliniklerinde yeni tanı almış hastaların tedavi sürecindeki beslenme durumu değişimini değişik tarama araçları ve ölçümler ile prospektif olarak değerlendirip her bir aracın ve ölçümün hem kendi içindeki değişimini hem de birbiri ile olan ilişkilerini incelemeyi amaçladık. Gereç ve yöntem: İnönü Üniversitesi İç Hastalıkları Hematoloji ve Onkoloji kliniklerinde yaptığımız çalışmada tedavi öncesi ve sonrası MNA, SGA, CONUT, NRS-2002 testleri ile yeni tanılı hastaların beslenme durumu hakkında bilgi topladık. Hastalarımızı 18 yaş üzeri yeni tanı almış hematoloji ve onkoloji hastalarında seçtik. Toplam 76 hastayı çalışmamıza kattık. Hastaların tanı anındaki ve tanıdan sonraki tedavi sürecinin üçüncü ayındaki antropometrik ölçümlerini(üst orta kol ve baldır çevresi, el kavrama gücü, beden kitle indeksi), tam kan sayımını, elektrolitlerini, karaciğer ve böbrek fonksiyon testlerini, kolesterol düzeyini kayıtlarımıza ekledik. Bulgular: Hastaların yaş ortalaması 56,0±15,3 idi. Hastaların %51,3'ünde hematolojik, %48,7'sinde onkolojik solid malignite tanısı vardı. Hastaların tedavi sonrasında öncesine göre MNA, SGA, CONUT, NRS-2002 skorlarında, antropometrik ölçümlerinde( el kavrama gücü, üst orta kol ve baldır çevresi, ağırlık, BKİ), laboratuvar ölçümlerinde(total lenfosit sayısı, hemoglobin, trombosit, magnezyum ve kalsiyum) anlamlı bir değişiklik izlendi. MNA testi referans alınarak yapılan analizde SGA'nın malnütrisyonu göstermedeki duyarlılığının diğer iki testten daha yüksek olduğu görülmüştür. Sonuç: Hastaların MNA testine göre tanı anında %43,4'ünde, tedavi sonrası ise %70,6'sında malnütrisyon vardı. Testler arasında; malnütrisyonu, laboratuvar ve antropometri ölçümlerindeki değişimi göstermede istatistiksel olarak anlamlı ilişki vardı. Yeni tanı almış hematoloji ve onkoloji hastalarının malnütrisyon durumu tedavi sonrası değişebildiğinden bu konuda hastaların özellikle MNA, NRS-2002 ve SGA ile düzenli olarak, laboratuvar tetkikleri ve antropometrik ölçümlerle değerlendirilmesi yararlı bilgiler sağlamaktadır
Psychosocial factors and health practices in pregnancy: A cross-sectional study
No full textAim The aim of this study was to investigate psychosocial, demographic and obstetric factors that affect health practices in pregnancy. Methods This cross-sectional study was conducted with pregnant women selected by using random sampling in a public hospital in Turkey. The pregnant women (n = 383) completed the Health Practices Questionnaire in Pregnancy, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Multidimensional Scale of Perceived Social Support. Multiple linear regression was used to examine predictors of participation in health practices. The variables were subjected to multiple linear regression analysis to estimate the effect of each independent variable (depression, anxiety, perceived social support, age, educational level, gestational week and parity) on the dependent variable (health practices). Results Depression and anxiety were not significantly related to gestational health practices. The multiple linear regression model showed that inadequate social support, low education level, early gestational week and high parity were significant predictors of nonengagement in favourable health practices during pregnancy. Conclusions Pregnant women with inadequate social support and specific demographic and obstetric characteristics are less likely to participate in gestational health practices. This study suggests that more attention should be paid to these groups to improve the health practices of pregnant women
