Bezmialem Vakıf Üniversitesi Kurumsal Akademik Arşiv
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Healthcare professional education in shared decision making in the context of chronic kidney disease: a scoping review.
No full textRationale & objective: Shared decision making (SDM) is a collaborative effort between healthcare professionals, individuals with CKD whereby clinical evidence, expected outcomes and potential side-effects are balanced with individual values and beliefs to provide the best mutually decided treatment option. Meaningful SDM is supported by effective training and education. We aimed to identify the available evidence on SDM training and education of healthcare professionals caring for people with chronic kidney disease. We aimed to identify existing training programs and to explore what means are used to evaluate the quality and effectiveness of these educational efforts.
Methodology: We performed a scoping review to study the effectiveness of training or education about shared decision making of healthcare professionals treating patients with kidney disease. EMBASE, MEDLINE, CINAHL and APA PsycInfo were searched.
Results: After screening of 1190 articles, 24 articles were included for analysis, of which 20 were suitable for quality appraisal. These included 2 systematic reviews, 1 cohort study, 7 qualitative studies, and 10 studies using mixed methods. Study quality was varied with high quality (n = 5), medium quality (n = 12), and low quality (n = 3) studies. The majority of studies (n = 11) explored SDM education for nurses, and physicians (n = 11). Other HCP profiles included social workers (n = 6), dieticians (n = 4), and technicians (n = 2). Topics included education on SDM in withholding of dialysis, modality choice, patient engagement, and end-of-life decisions.
Limitations: We observed significant heterogeneity in study design and varied quality of the data. As the literature search is restricted to evidence published between January 2000 and March 2021, relevant literature outside of this time window has not been taken into account.
Conclusions: Evidence on training and education of SDM for healthcare professionals taking care of patients with CKD is limited. Curricula are not standardized, and educational and training materials do not belong to the public domain. The extent to which interventions have improved the process of shared-decision making is tested mostly by pre-post testing of healthcare professionals, whereas the impact from the patient perspective for the most part remains untested
Synthesis and Evaluation of Quinazolin-4(3H)-one Derivatives as Multitarget Metabolic Enzyme Inhibitors: A Biochemistry-Oriented Drug Design
No full textIn this study, imines bearing quinazolin-4(3H)-one were synthesized and their inhibitory properties were investigated against some metabolic enzymes including Acetylcholinesterase (AChE), Butyrylcholinesterase (BChE), & alpha;-Glycosidase (& alpha;-Gly), and human Carbonic Anhydrase I-II (hCA I-II). All compounds had inhibitory strength with K-i values in the range of 38.55 & PLUSMN;4.08-159.05 & PLUSMN;10.68 nM and 41.04 & PLUSMN;6.73-177.12 & PLUSMN;8.06 nM against hCA I and hCA-II, respectively in comparison to the standard acetazolamide (AZA) K-i=125.15 & PLUSMN;0.78 nM (for hCA-I) and K-i=148.75 & PLUSMN;0.92 nM (for hCA-II). The compounds showed potent inhibitory activity against & alpha;-Gly enzyme with IC50 value 0.34-2.28 nM (standard inhibitor acarbose (ACR): 3.18 nM). Also, these analogs had potent inhibitory strength with K-i values in the range of 4.20 & PLUSMN;0.15-26.10 & PLUSMN;2.36 nM against AChE and 1.22 & PLUSMN;0.05-16.09 & PLUSMN;0.88 nM against BChE in comparison to the standard tacrine (TAC) K-i=37.62 & PLUSMN;6.86 nM (for AChE) and K-i=26.75 & PLUSMN;5.79 nM (for BChE). Additionally, the molecular docking and molecular dynamics simulation study was carried out for the determination of ligand-enzyme interactions. The docking scores of the most active compound were calculated as -7.31, -7.59, -6.66, -6.93 and -7.11 kcal/mol for AChE, BChE, hCA I, hCA II, and & alpha;-Gly, respectively
Effect of insomnia and excessive daytime sleepiness on cardiac functions in older adults.
No full textBackground: We investigated the potential harmful effect in older adults of insomnia and excessive daytime sleepiness (EDS) on myocardial functions and electrophysiologic changes of the heart in terms of heart rate and QT intervals corrected for heart rate (QTc).
Methods: The study included 32 insomnia patients and 30 control subjects. An Insomnia Severity Index score of ≥15 indicated insomnia, while a score of <8 was accepted as the control group. The Epworth Sleepiness Scale was used to assess EDS, with a score of ≥11/24 points indicating EDS. Diastolic and systolic functions were evaluated in each patient by transthoracic two-dimensional, conventional and tissue Doppler echocardiography. Heart rate and QTc were calculated for electrophysiologic changes.
Results: The mean age was 73.2 ± 7.9 years, with 59.7% being female. Biventricular systolic and diastolic functions were impaired in the insomnia patients. The E' value for diastolic function was lower in the patients with insomnia than the controls (5.99 ± 1.59 vs. 6.88 ± 0.97, P = 0.053). Furthermore, values for the systolic function parameters Lateral-S (7.41 ± 1.92 vs. 9.37 ± 1.83, P < 0.001), Septal-S (6.69 ± 1.40 vs. 8.10 ± 1.30, P = 0.001), and Tricuspid-S (12.25 ± 2.00 vs. 14.37 ± 3.13, P = 0.004) were lower for insomnia patients than for controls. In the case of EDS coexistence, the heart rate and QTc values were higher than the controls (76.47 ± 7.18 vs. 71.03 ± 10.95, P = 0.001, and 413.72 ± 28.24 vs. 394.67 ± 24.47, P = 0.015, respectively).
Conclusion: Insomnia is associated with impaired systolic-diastolic functions, independent of EDS. The co-existence of insomnia and EDS may lead to electrophysiological changes in older adults, including increased heart rate and longer QTc
Surgical correction of the lower lateral cartilage protrusion and external nasal valve pinching with lateral crural resection technique.
No full textSulforaphane, a Chemopreventive Compound Induces Necrotic Behavior and Inhibits S-phase of Cell Cycle in Human Kidney Cells in Vitro
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In situ formation of biocompatible and ductile protein-based hydrogels via Michael addition reaction and visible light crosslinking
No full textKeratin, a biological polymer with high sulfur content, is the main component of hair, feathers and wool. Human hair is the cheapest natural source of keratin. In this study, an optimized and very effective reduction reaction method was used to obtain keratin from human hair. During this process, the disulfide bridge of keratin was reduced in the presence of sodium sulfide to form free sulfhydryl (thiols) that would act as a strong nucleophile. The results of FTIR spectroscopy, Tricine-SDS-PAGE and MALDI-TOF/MS verified the successful extraction of the reduced human hair keratin. A well-interconnected structure with three-dimensional (3D) scaffolds was prepared using keratin and methacrylated gelatin (GelMA), KeratinGel, for tissue engineering and other biomedical applications. KeratinGel hydrogels were in situ prepared via Michael addition reaction and visible light crosslinking. Two complementary crosslinking reactions were combined to enhance the network structure and provide ductility. With the targeted two-step method, the reactivity of vinyl groups of GelMA to photocrosslinking and thiol groups in keratin to the Michael addition reaction was exploited. Rheological monitoring of the Michael addition reaction was performed for KeratinGel hydrogels in a basic reaction environment at pH 7.4 with a constant concentration of GelMA (10% w/v) and different amounts of reduced human hair keratin (5, 7.5 and 10% w/v) at room temperature. The physical properties, swelling and degradation rates of KeratinGel hydrogels were determined to understand their suitability for tissue regeneration. We finalize that KeratinGel hydrogels would be better in minimally invasive surgeries, soft tissue engineering, especially with in situ gelling features, and favourable for the preparation of complex shapes and applications
Phenolic content determination by LC-HRMS and cytotoxicity assessment of Sambucus nigra leaf, flower and fruit extracts
No full textSambucus nigra L. (Adoxaceae) –common names include black elder and European elder– is a plant native to northern hemisphere which has a high commercial value due to the large amounts of anthocyanins and other polyphenols found in its fruits [1]. All parts of the plant are sources of flavonoids while rutin (quercetin-3-O-rutinoside) is the primary flavonoid in all of them. In addition, fruits contain the anthocyanins cyanidin-3-O-glucoside and cyanidin-3-Osambubioside [2]. The present study was undertaken to determine the phenolic compounds of leaf, flower and fruit extracts made of S. nigra which were collected from Balıkesir, Türkiye and to assess the cytotoxicity of the aforementioned extracts using human breast adenocarcinoma (MCF-7), human alveolar adenocarcinoma (A549) and human brain glioma (U-118 MG) cell lines. Hydroalcoholic extracts were obtained and their phenolic contents were determined by LCHRMS. Consistent with the data in the literature, the highest amount of flavonoid in leaf, flower and fruit extracts was detected as rutin while anthocyanins cyanidin-3-O-glucoside and cyanidin-3-O-sambubioside were also detected in the fruit extract. The cytotoxic effect of Sambucus nigra fresh fruit, dried leaf and dried flower extracts were evaluated in MCF-7, A549 and U-118 MG cell lines using MTT assay. Cytotoxicity test results show that U-118 MG cells were more sensitive than the other cell lines. In U-188 MG cells the IC50 values were calculated as 97.06 and 124.6 µg/mL for leaves and flowers, respectively, while the maximum cell death was 32.9% at 150 µg/mL fruit extracts. In A549 cell line the maximum cell death rate was 21% at 150 µg/mL leaf extracts and in MCF-7 cell line the maximum cell death rate was 25.5% at 150 µg/mL leaf extracts. In both A549 and MCF-7 cell lines, the fruit and flower extracts didn’t show significant cytotoxicity (p<0.05)
Propolis Enhances 5-Fluorouracil Mediated Antitumor Efficacy and Reduces Side Effects in Colorectal Cancer; an in vitro and in vivo study.
No full textComparison of Glasgow Blatchford and New Risk Scores to Predict Outcomes in Patients with Acute Upper GI Bleeding
No full textObjective: Upper gastrointestinal (GI) bleeding constitutes a significant number of admissions to the emergency department, and it has high rates of morbidity and mortality. In this study, the contribution of new scores, such as The International Bleeding Risk Score (ABC score) and the Horibe GI bleeding prediction score (HARBINGER), to clinical practice was investigated. Using scores that are easy to calculate and memorable when used in the emergency department enables a more efficient use of medical resources. In addition, it may contribute to solving the problems regarding determining the need for intensive care in patients with upper GI bleeding.
Methods: This study was conducted retrospectively on patients over the age of 18 who were admitted to the emergency department between September 1, 2018 and August 31, 2019. The HARBINGER and ABC scores and the Glasgow Blatchford score (GBS) were calculated for each patient. Following that, the need for intensive care, mortality, re-bleeding rate, and transfusion need were compared.
Results: This study included 184 patients. When predicting the need for intensive care, the ABC score had a higher AUC value than the GBS and HARBINGER score, even when there was a low cut-off value (cut-off value >4). (AUC =0.944, specificity =0.74, sensitivity =0.83).
Conclusion: This study found that the ABC score could be used to predict the need for intensive care in upper GI bleeding, and that it outperformed other scores. Additionally, we concluded that the HARBINGER score, which had a “shock index” among its parameters, was not effective in predicting in-hospital adverse event