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Alpha-lipoic acid could be a promising treatment in steroid-induced osteonecrosis
No full textOBJECTIVE: Glucocorticoid-induced osteonecrosis is a serious debilitating health problem. In the present study, we investigated the effects of alpha-lipoic acid on glucocorticoid-induced osteonecrosis in rats.
MATERIALS AND METHODS: A total of 40 male Wistar albino rats were equally assigned to 4 groups as control, methylprednisolone acetate (MPA), alpha-lipoic acid (ALA), and methylprednisolone acetate with alpha-lipoic acid (MPA+ALA). The animals in MPA group subcutaneously received 15 mg/kg/week for 2 weeks, whereas 100 mg/kg/day alpha-lipoic acid was intraperitoneal administered for 4 weeks to ALA group. The MPA+ALA group was subjected to both treatments in same doses. Osteonecrosis was confirmed and graded histologically. The serum concentrations of glucose, total cholesterol, low- and high-density lipoprotein, triglyceride, as well as the total oxidant and antioxidant status, oxidative stress index, prothrombin time and activated partial thromboplastin time were evaluated. Also, lipid peroxidation and DNA damage were immunohistochemically assessed in the bone.
RESULTS: Osteonecrotic lesions were narrower in the MPA+ALA group than in the MPA group (p<0.05). As compared to the controls, the biochemical parameters in MPA and MPA+ALA groups were significantly increased (p<0.001). The oxidative stress index was significantly higher in the groups with MPA than the controls (p=0.002), but the animals treated with ALA alongside MPA displayed lesser scores than the ones injected with solely MPA (p=0.03). The administration of MPA elevated lipid peroxidation and DNA damage, which were successfully alleviated by ALA.
CONCLUSIONS: Alpha-lipoic acid may be suggested to be a protective supplement in glucocorticoid-induced osteonecrosis in rats. The antioxidant capacity of alpha-lipoic acid may involve its beneficial effects
Permanent impairment of language functions in an adolescent case of autoimmune encephalitis
Get PDFÖzet Giriş: Pediatrik ve ergen popülasyonda otoimmün ensefalit (AE), bilişsel gerilemenin eşlik ettiği dil becerileri kaybı da dahil olmak üzere çok çeşitli semptomlarla ortaya çıkabilir. AE'deki yüksek prevalansa rağmen, dilsel işlevler kapsamlı bir şekilde araştırılmamıştır. Olgu: Ön hastalık öyküsü olmayan ve okul performansı normal olan 12 yaşında bir kız çocuğu ateş, aşırı uyku, gece miyoklonusu ve davranış değişiklikleriyle başvurdu. Nörolojik muayenesi normal olmasına rağmen psikiyatrik değerlendirmede öfori, hafif irritabilite ve görsel halüsinasyonlar mevcuttu. Kranyal MRG normaldi, beyin omurilik sıvısı (BOS) analizinde protein konsantrasyonu ve lenfosit sayısında artış görüldü, elektroensefalogramda (EEG) yaygın yavaş dalgalar görüldü. Anti-nöronal antikorlara yönelik bir panel, serumda glutamik asit dekarboksilaz (GAD) antikorlarını gösterdi. İmmünoterapinin ardından tüm nörolojik ve davranışsal semptomlar ortadan kalktı. Ancak hastanın okul performansında önemli bir kötüleşme yaşandı. Psikiyatrik değerlendirmede şiddetli depresyon olduğu ortaya çıktı. Takibinin 10. ve 18. aylarında yapılan zeka değerlendirmesinde zeka geriliği düzeyinde anlamlı derecede düşük puanlar elde edildi. Dilsel değerlendirme tüm alanlarda, özellikle de anlambilimde önemli bozulma gösterdi. Sonuç: Olgumuz, MR/nörolojik muayene bulguları normal olan ve tedaviye yanıt veren nispeten hafif hastalık seyrine sahip hastalarda bile AE'nin kalıcı bilişsel işlev bozukluğu ve dil bozukluğuna neden olabileceğini vurgulamaktadır.Abstract Introduction: In pediatric and adolescent population, autoimmune encephalitis (AE) may present with a wide variety of symptoms including cognitive regression accompanied with loss of language skills. Despite its high prevalence in AE, linguistic functions have not been investigated in extensive detail. Case: A 12-year-old girl with no significant premorbid history and normal school performance presented with fever, hypersomnia, nocturnal myoclonus and behavioral changes. Although neurological examination was normal, psychiatric evaluation revealed euphoria, mild irritability and visual hallucinations. Cranial MRI was normal, whereas cerebrospinal fluid (CSF) analysis showed elevated protein concentration and lymphocyte count, electroencephalogram (EEG) showed diffuse slow waves. A panel for anti-neuronal antibodies demonstrated glutamic acid decarboxylase (GAD) antibodies in the serum. Following immunotherapy, all neurological and behavioral symptoms vanished. However, the patient suffered from significant worsening of school performance. Psychiatric evaluation revealed severe depression. Assessment of intelligence done on the 10th and 18th month of follow-up yielded significantly low scores at mental retardation level. Linguistic assessment showed significant impairment in all domains but especially in semantics. Conclusion: Our case emphasizes the fact that AE may cause permanent cognitive dysfunction and language impairment even in patients with normal MRI/neurological examination findings and relatively mild treatment-responsive disease course
Association between history of polymerase chain reaction-verified covid-19 ınfection and outcomes of subsequent st-elevation myocardial ınfarction
Get PDFEarly AccessWhile the acute phase of coronavirus disease 2019 (COVID-19) is associated with worsening cardiac outcomes, it is unclear
whether it affects the outcome of patients with ST-segment elevation myocardial infarction (STEMI) after the acute phase. In
addition, while many studies compared the course of STEMI during the COVID-19 pandemic with the years before the
outbreak, we evaluated the course of STEMI during the pandemic according to whether or not patients had history of COVID19. Patients diagnosed with STEMI during the ongoing COVID-19 pandemic were included in the study. The Ministry of Health
database was analyzed retrospectively, and patients with (n = 191) and without (n = 127) a history of polymerase chain reaction
(PCR) confirmed COVID-19 infection were divided into groups. Clinical and angiographic characteristics were assessed. The
rates of in-hospital major adverse cardiac events (MACE) were higher in those who had a history of PCR-verified COVID-19
infection. Angiographic and procedural findings indicating successful reperfusion were better in patients without a history of
COVID-19. A history of COVID-19 infection (odds ratio 1.40, 95% confidence interval 1.25–1.60, P < .01) independently
predicted MACE. A history of COVID-19 infection is a predictor of worse outcomes following coronary intervention and inhospital MACE among patients with STEMI
Jejunal Divertikuloz Perforasyonu: Nadir Bir Akut Karın Nedeni Jejunal Diverticulosis Perforation: A Rare Cause of Acute Abdomen
No full textJejunal divertikülozis tanısı zor konabilen, yüksek morbidite ve mortaliteye neden olabilen nadir lezyonlardır.
Genellikle asemptomatiktir, ancak bazen ishal, kronik karın ağrısı, şişkinlik, akut divertikülit, kanama, bağırsak tıkanıklığı ve delinme ile kendini gösterir.
Bu yazıda jejunumda divertikül perforasyonu sonucu akut karın gelişen ve opere edilen bir hasta sunuldu.
Acil servise ani başlayan karın ağrısı, ateş ve çarpıntı şikayetleri ile başvuran 67 yaşında kadın hastanın
fizik muayenesinde yaygın karın hassasiyeti, defans ve rebound mevcuttu.
Kan testlerinde WBC 15.480/ml, CRP 36 mg/l idi. Batın BT’de karında barsak ansları arasında serbest hava
kesecikleri, jejunumda divertikül, diffüz kolon divertikülü, peritoneal kontaminasyon izlendi.
İki ameliyat yaptık.Önce diagnostik laparaoskopi ile teşhis konarak konservatif tedavi yapıldı. Fakat iki
hafta sonra karın içi apse oluştu.Tanısal laparatomi yaptık ve divertikülozisli jejunal ansı rezeke ettik.
Hasta postoperatif 7. gün taburcu edildi.Jejunal diverticula are rare lesions that can be difficult to diagnose and can cause high morbidity and
mortality
It is usually asymptomatic,but it sometime presentation diarrhea, chronic abdominal pain, bloating, acute
diverticulitis, bleeding, intestinal obstruction, and perforation.
In thise article, we present a patient who was operated on for acute abdomen due to diverticulum perforation
in the jejunum
A 67-year-old female patient, who presented to the emergency clinic with sudden onset of abdominal pain,
fever, and palpitation had widespread abdominal tenderness, abdominal defense and rebound on physical
examination.
There is some abnormal blood tests. WBC was 15.480/ml, C-reactive protein was 36 mg/l.Free air sacs
between the bowel loops in the abdomen, diverticula in the jejunum, diffuse colon diverticula,peritoneal
contamination were observed in the abdominal CT.
We made two operation.Firsly,we made diagnos and decide conservative aproch.But two weeks
later,intraabdominal abscess occurred.We made diagnostic laparatomi and resected the jejunal part with
jejunal divertikülozis.
The patient was discharged on the 7th postoperative day
Experimental verification of the feasibility of the CFD approach in an air-knife
Get PDFAir knives with very different nominal values are used for various purposes in the industry. The uses of air knives include the painting and coating stages of automobile semi-finished products, as well as many stages related to food production. One of the important sectors among these is the continuous hot-dip galvanizing process, which is a coating technique in the steel industry. In addition, the chemical coating process on paper as a very thin layer is another research topic. The most critical process needed in these sectors is to ensure a homogeneous air-flow at the expected air speed of the air-knife. These determine whether the coating on the steel or the chemical layer on the paper is homogeneous at the desired thickness. In this study, it is aimed that the air-knife can reach the expected values (speed and homogeneous distribution) with the expected tolerances, the shortest time, cost, and the least production process error. First, a design has been made so that this knife can blow air at the desired speed and homogeneously. For this, the most appropriate modeling and design values were created and analyzed with the CFD. The analysis and evaluations of the design were confirmed as a result of the measurements made on the prototype. This study shows that the inclusion of this type of modeling and analysis in the rapid product development process has an important role in minimizing cost and time
Robust nonlinear non-referenced ınertial frame multi-stage pıd controller for symmetrical structured uav
Get PDFThe design and implementation of a multi-stage PID (MS-PID) controller for non-inertial referenced UAVs are highly complex. Symmetrical multirotor UAVs are unstable systems, and it is thought that the kinematics of the symmetrical UAV rotor, such as the quadrotor and hexacopter resembles the kinematics of an inverted pendulum. Several researchers have investigated the structure and design of PID controllers for high-order systems during the last decade. The designs were always concerned with the enhanced response, robustness, model reduction and performance of PID controllers. An accurate tuning process of such a controller depends on the engineer’s experience level. This is due to the number of variables and hyperparameters tuned during the process. An adaptive genetic algorithm (AGA) is utilized to optimize the MS-PID controllers for controlling the quadrotor in this study. The proposed method optimizes the offline-planned approach, providing several possibilities for adapting the controllers with various paths and or varying weather conditions. The MS-PID parameters are optimized in parallel, as every PID controller affects the other controller’s behavior and performance. Furthermore, the proposed AGA generates new chromosomes for “new solutions” by randomly developing new solutions close to the previous best values, which will prevent any local minima solution. This study intends to investigate the design and development of a highly tuned robust multi-stage PID controller for a symmetrical multirotor UAV. The work presents a model for a non-referenced inertial frame multirotor UAV (quadcopter). Once the model is defined, a robust multi-stage PID controller for the non-inertial referenced frame symmetrical multirotor UAV is designed, tuned, and tested. A genetic algorithm (GA) will be used to tune the MS-PID controller. Finally, the performance comparison between the proposed and conventional methods is presented. The results show that the proposed method provides stability improvement, better transient response, and power consumption
Abdominal Surgery in Pregnancy and Care of the Pregnant Patient
Get PDFDuring pregnancy, surgical intervention may be required for reasons that are not related to pregnancy but are frequently seen. Diseases that require surgical intervention for non-obstetric reasons during pregnancy include acute appendicitis, acute pancreatitis, cholecystitis, trauma, and intestinal obstruction. The incidence of non-obstetric surgical interventions during pregnancy is reported as 1% or 2%. Physiological changes during pregnancy require a significantly different approach both in the diagnosis and treatment processes. Physiological, biochemical, anatomical, and immunological changes should be considered to ensure an accurate and fast diagnosis and treatment. Furthermore, it should be kept in mind that late diagnosis may lead to maternal morbidity, mortality, fetal loss, and the risk of premature birth. Balancing the health and well-being of the fetus against the mother's need for surgical intervention is a most important focus of care. In a surgical intervention during pregnancy, the risks involved for the mother and the baby vary depending on the type of intervention needed, the trimester of the pregnancy in question, and the health status of the mother and the fetus. A multidisciplinary teamwork as well as preliminary evaluations and preparations are essential to ensure optimal safety for both the mother and the fetus. The aim of this study is to provide information for midwives and nurses on various diagnoses requiring surgical procedures during pregnancy albeit unrelated to pregnancy, on the differences in diagnosis and treatment processes due to physiological changes in pregnancy, and the nursing care of pregnant patients before, during, and after surgery
Association between serum irisin concentration and ischemic stroke: From etiology to clinic
Get PDFBackground: To investigate the relationship between irisin levels in serum and classification of subtype of acute ischemic stroke, National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Score (mRS) at the time of discharge from the hospital in Turkish patients who had their first acute ischemic stroke (AIS).
Methods: Serum irisin levels were measured using enzyme linked immunosorbent assay (ELISA) 180 patients who applied to emergency department with the diagnosis of AIS from May 2021 to November 2021.
Results: A significant relationship was found between serum irisin levels and ischemic stroke aetiological factors (TAOST) (p=0.017). Increased serum irisin levels were detected in patients without neurological deficits with localization value than those with it (p<0.01). Serum irisin levels also have a negative correlation with high-density lipoprotein (HDL) value in ischemic stroke (r: -0.272, p<0.01).
Conclusions: High serum irisin levels found in patients with stroke attributed to small vessel disease and in patients with ischemic stroke in whom we did not find any neurological deficits with a localization value. The results of the study show that serum irisin levels have an important role in the etiology of ischemic stroke. Although the question how the irisin is involved in the course of ischemic stroke and what the clinical reflection has not been answered, these findings are a pioneering study on this subject
Tam Katılımlı Sanal Gerçekliğin Rehabilitasyon Kullanımının İncelenmesi
No full textSanal gerçekliğin tanımı günümüze gelene kadar birçok değişime uğramıştır. Bu değişimin temel sebebi sanal gerçekliğin kullanım önceliğinin devamlı değişmesidir. Sanal gerçeklik (SG) kaskı tipi teknolojileri (KT) (Virtual reality–head mount display/KT) geçtiğimiz yıllarda tekrardan karşımıza çıkan popüler bir
market ürünüdür. Bu popülerlik bazı teknoloji firmalarının sanal gerçeklik teknolojisine yatırım yapması
ve tüketicinin ilgisini ve isteklerini dikkate almasından kaynaklanmaktadır. Bu cihazlardan gelişmişi olan
kask tipi sanal gerçeklik teknolojileri, en derin gerçekliğe sahip SG teknolojisini temsil etmektedir. Sağlık
alanında kullanılan sanal gerçeklik teknolojileri rehabilitasyon için özelleştirilmiş sistemler olarak kategorilendirilebilir. SG, nörolojik rehabilitasyonda hastaların fonksiyonel yeteneklerini geliştirebilen, hedefe yönelik görevler ve tekrar gibi çeşitli özellikler sunan yeni ve etkili terapötik araçlarla alternatif rehabilitasyon
programları sunar. Egzersiz için sanal gerçeklik ortamlarının kullanımının, yaşlı yetişkinlerde egzersiz davranışını artırma potansiyeline sahip olduğu son zamanlarda önerilen sanal gerçeklik etkilerindendir. Sanal
gerçeklik teknolojisi gün geçtikçe gelişen ve kullanılabilirliği artan bir teknolojidir. Yapılan araştırmalar da
göstermektedir ki kullanımı arttıkça sanal gerçekliğin kullanımına yönelik problemler ve avantajlar artmaktadır. Bu yüzden kullanılabilirliği arttıkça sınırlarının tanımlanması ve standardize bir uygulama şablonunun oluşturulması oldukça zaman alacaktır. Hem katılımcının hem de fiziksel çevrenin özel koşullarına
uyum sağlayan bir sanal gerçeklik teknolojisinin sağlanması için teknolojik donanımların gelişmesi ve bu
özel koşullara uyum sağlayabilir hale gelmesi gerekmektedir.
Rehabilitasyon alanında kullanılacak sanal gerçeklik sistemlerinin özellikle terapötik amaçla üretilen ciddi
oyunların tasarımının artması ve artan bu yazılımların çeşitliliğinin artması gerekmektedir. Bu etkili çalışma için multidisipliner sanal gerçeklik uygulamaları tasarım imkanlarının artırılması gerekmektedir. Sanal
gerçeklik teknolojilerinden olan kask timi tam katılımlı sağlayan sanal gerçeklik sistemleri (KT-SG) eski
sanal gerçeklik platformlarına göre daha çok kullanılmakta ve daha geniş bir kullanıcı kitlesine ulaşmaktadır. Bu erişilebilirlik kask tipi sanal gerçeklik sistemlerinin klinik araştırmalarda yıl geçtikçe daha büyük
bir vizyona sahip olduğu görülmektedir.The definition of virtual reality has undergone many changes until today. The main reason for this change is
the constant change in the priority of use of virtual reality. Virtual reality (VR) head mount display type technologies (HMD) (Virtual reality – head mount display / HMD) is a popular market product that has appeared
again in recent years. This popularity is due to the fact that some technology companies invest in virtual
reality technology and take into account the interests and wishes of the consumer. Head Mount Display-type virtual reality technologies, which are developed from these devices, represent VR technology with the
deepest reality. Virtual reality technologies used in the field of health can be categorized as customized
systems for rehabilitation. SG offers alternative rehabilitation programs with new and effective therapeutic
tools that can improve the functional abilities of patients in neurological rehabilitation, offering a variety of
features such as goal-directed tasks and repetition. One of the recently suggested virtual reality effects is
that the use of virtual reality environments for exercise has the potential to increase exercise behavior in
older adults. Virtual reality technology is a technology that is developing day by day and its usability is increasing. Studies Show that as its use increases, the problems and advantages of using virtual reality increase.
Therefore, as its usability increases, it will take a lot of time to define its limits and create a standardized
application template. In order to provide a virtual reality technology that adapts to the special conditions of
both the participant and the physical environment, technological equipment needs to be developed and become adaptable to these special conditions. It is necessary to increase the design of virtual reality systems
to be used in the field of rehabilitation, especially for serious games produced for therapeutic purposes, and
to increase the diversity of these increasing software. For this effective study, it is necessary to increase the
design possibilities of multidisciplinary virtual reality applications. Virtual reality systems (HMD-VR), which is
one of the virtual reality technologies with full participation of the helmet team, are used more than the old
virtual reality platforms and reach a wider user base. These accessibility helmet type virtual reality systems
seem to have a greater vision in clinical research year by year
Fibromiyaljide Güncel Beslenme Yaklaşımları
No full textFibromyalji % 2- 8 oranında görülen önemli bir sağlık sorunudur. Halk sağlığı açısından önemli bir konu
olduğu gibi yaşam aktivitelerini etkilemesi nedeniyle üretkenlik iş ve güç kaybı meydana getirmektedir.
Hastaların, kaliteli uyku, fiziksel-duygusal ve zihinsel işlevlerde düzelme sağlamaya yönelik tedavileri
önemli harcamalar oluşturmaktadır.Tedavi süreçleri,hastalık karekteristikleri ile ilgili eğitimin önemli bir
etkisi olduğu gözlemlenmiştir.
Multidisipline yaklaşımın önemli olduğu görülmektedir. Doğru beslenme stratejileri oluşturmak tedavi planında önemlidir. Bu yazıda güncel beslenme yaklaşımlarının fibromiyalji tedavisindeki yeri değerlendirilmiştirFibromyalgia is an important health problem with a rate of 2-8%. As it is an important issue in terms of
public health, it causes loss of productivit yand work because it affects on life activities.
Treatment of patients for quality sleep, improvement in physical-emotional and mental functions constitute significant expenditures. It has been observed that education about treatment processes and disease characteristics has a significant effect.
A multidisciplinary approach seems to be important. Establishing the right nutritional strategies is important in the treatment plan. In this article, the place of current nutritional approaches in the treatment
of fibromyalgia is evaluated