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Vücut Ağırlığı Yönetiminde Yeni Diyet Yaklaşımları
Get PDFSağlığı olumsuz yönde etkileyecek şekilde vücutta fazla miktarda yağ birikmesi, obezite olarak tanımlanmaktadır ve çok faktörlü ve kompleks bir hastalık olan obezite dünya genelinde 600 milyon insanı etkilemektedir. Ancak obezitenin tedavisi oldukça güç ve karmaşıktır. Hem literatürde hem de medyada lanse
edilen çok sayıda diyet bulunmaktadır ve bu diyetlerin bugüne kadar hiçbirinin ağırlık kaybını tetiklemede
ve sürdürmede evrensel olarak başarı göstermediği belirtilmiştir. Günümüzde, obezite tedavisinde makro
mikro besin ögelerinin alımının ve enerji alımı ve harcamasının dışında, öğün saati konusunda da çalışmalar yapılmaktır. Bir diyet türü olarak tanımlanmayan, birbirini takip eden yeme ve açlık modellerinden
oluşan beslenme döngüsü olan aralıklı açlık üzerine pek çok çalışma yapılmaktadır. Aralıklı açlık, genel
olarak, günlük açlık ve haftalık açlık olarak ikiye ayrılmaktadır. Günlük ritimler; 12:12 Ritmi, 8:16 Ritmi, 6:18
Ritmi ve 23:1 Ritmi ve haftalık ritimler 6:1 Ritmi; 5:2 Ritmi ve İki Günde Bir Ritmi şeklindedir. Açlık dönemlerinde hem keton kullanımında metabolik değişiklikler hem de beynin besin yokluğuna karşı adaptasyonu
nedeniyle bu diyetlerinin sağlığı destekleyici ve hastalıklara karşı önleyici etkileri olduğu araştırmalarla
saptanmıştır. Ayrıca bu diyetler ile insanların daha az öğün tüketerek, daha az enerji aldığı belirlenmiştir.
Aralıklı açlık diyetlerinin, enerji homeostazı ilkesine dayanan diyetlerin yerine geçip geçemeyeceğini, ağırlık kaybında sürekliliğin sağlayıp sağlamadığını anlamak için çalışmalar devam etmektedir. Genel olarak,
hiçbir ağırlık kaybı diyetinin klinik çalışmalarda üstünlüğü kanıtlanmamıştır. Ağırlık kaybı diyetlerinde tüm
besin ögelerinin yeterli ve dengeli olması, sürdürülebilir ve kişiye özel olarak diyetisyen tarafından hazırlanması gereklidir.Obesity is defined as excessive accumulation of fat in the body, which negatively affects health, and obesity,
which is a multifactorial and complex disease, affects 600 million people worldwide. However, the treatment of obesity is very difficult and complex. There are numerous diets touted both in the literature and
in the media, and none of these diets to date have been shown to be universally successful in inducing and
maintaining weight loss. Today, in the treatment of obesity, besides the intake of macro-micro nutrients and
energy intake and expenditure, studies are also carried out on mealtime. There are many studies on intermittent fasting, which is not defined as a diet type but consists of successive eating and hunger patterns.
Intermittent fasting is generally divided into two as daily fasting and weekly fasting. It is divided into 12:12 Rhythm, 8:16 Rhythm, 6:18 Rhythm, and 23:1 Rhythm and is divided into 5:2 Rhythm and a Fortnightly Rhythm.
Studies have shown that these diets have health-supportive and preventive effects against diseases, due
to both metabolic changes in ketone use and the adaptation of the brain to nutrient deficiency during fasting periods. In addition, it has been determined that with these diets, people consume less meals and get
less energy. Studies are ongoing to understand whether intermittent fasting diets can replace diets based
on the principle of energy homeostasis, and whether they provide continuity in weight loss. In general, no
weight loss diet has been proven superior in clinical studies. All nutrients should be adequate and balanced
in weight loss diets, and should be prepared by a dietitian in a sustainable and personalized manner
Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study
Get PDFStudy Objective: Aim of this study was to evaluate antimicrobial effects and interaction between analgesic
combinations of fentanyl citrate, dexmedetomidine hydrochloride and tramadol hydrochloride on
Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Candida
albicans which are some of the most common nosocomial infection related microorganisms. Design: In
vitro prospective study. Setting: University Clinical Microbiology Laboratory. Measurements: In order to
evaluate in vitro antimicrobial effects and interaction between analgesic combinations, tramadol
hydrochloride, fentanyl citrate and dexmedetomidin were used against S. aureus ATCC 29213, K.
pneumoniae, E. coli ATCC 25922, P. aeruginosa ATCC 27853 and C. albicans ATCC 10231 standard strains by
microdilution method. Main Results: According to microdilution assays tramadol has shown the most
efficient antimicrobial activity also it has been observed that 10 g/ml concentrated dexmedetomidine has
antimicrobial effects on S. aureus, K. pneumoniae and P. aeruginosa. Fentanyl has displayed evident
inhibitory potency on the pathogens except for Klebsiella pneumoniae, nevertheless our predefined
minimum concentration inhibited growth by 9.5 %. Fentanyl and dexmedetomidine together exhibited
more antimicrobial effect on P. aeruginosa and E. coli growth. Additionally, when the three drugs
examined together, microbial inhibition occurred more than expected on E. coli again and also on C.
albicans growth. Conclusions: Our results revealed the antimicrobial properties and synergy with the
different combinations of fentanyl, dexmedetomidine and tramadol against the most common nosocomial
infection agents in the ICU. This is the first study in the literature looking into the microbial “interactions”
of opioids and sedative drugs but more research is needed in order to define clinico-laboratory correlation
Association between the Trp64Arg polymorphism of the ADRB3 gene and overactive bladder
No full textArka Plan Beta(3)-adrenerjik reseptör (ADRB3), insan detrüsör kas fonksiyonunun düzenlenmesinde çok önemlidir. ADRB3 geninin iyi bilinen triptofan64arginin polimorfizmi, reseptörün adrenalin ve noradrenalin dahil olmak üzere çeşitli uyaranlara tepkisini değiştirir ve aşırı aktif mesane (OAB) geliştirme duyarlılığını artırabilir. Bu nedenle ADRB3 Trp64Arg polimorfizminin OAB sendromu patofizyolojisi ile ilişkili olup olmadığını belirlemek amacıyla bu çalışma yapıldı. Yöntemler Çalışma grubu (n = 150), AAM'li 72 hasta ve AAM'siz 78 kontrolden oluşmaktadır. ADRB3 geni Trp64Arg polimorfizmini polimeraz zincir reaksiyonu (PCR)-kısıtlama parça uzunluğu polimorfizmi (RFLP) testi kullanılarak analiz etmek için tüm katılımcılardan venöz kan örnekleri alındı. Sırasıyla chi(2) testi ve Mann-Whitney U testini kullanarak hem AAM hem de AAM olmayan kişilerde Trp64Arg polimorfizminin dağılımını ve semptom şiddetini karşılaştırdık. Sonuçlar 64Arg varyantının (heterozigot artı homozigot) OAB'li ve OAM olmayan kişilerde sıklığı sırasıyla %15,3 ve %14,1 idi. ADRB3 Trp64Arg polimorfizminin dağılım sıklığı açısından OAB'li ve OAB'siz gruplar arasında istatistiksel olarak anlamlı fark yoktu. Arg64 varyant alelinin toplam sıklığı (OAB + OAB olmayan, 76 kadın ve 74 erkek) kadınlarda ve erkeklerde sırasıyla %5,9 ve %10,8 idi. Arg64 varyantının görülme sıklığı erkeklerde kadınlara göre neredeyse iki kat daha fazla olmasına rağmen aradaki fark istatistiksel olarak anlamlı değildi. Sonuçlar Bu sonuçlar, Türk AAM hastalarından oluşan bir örneklemde ADRB3 Trp64Arg polimorfizminin OAB sendromu ile anlamlı düzeyde ilişkili olmadığını göstermiştir.Background The beta(3)-adrenergic receptor (ADRB3) is very important in the regulation of the human detrusor muscle function. The well-known tryptophan64arginine polymorphism of the ADRB3 gene alters the response of the receptor to various stimuli, including adrenalin and noradrenalin, and may increase the susceptibility to develop overactive bladder (OAB). Therefore, this study was performed to determine whether ADRB3 Trp64Arg polymorphism is associated with the pathophysiology of OAB syndrome. Methods The study group (n = 150) consists of 72 patients with OAB and 78 controls without OAB. Venous blood samples were taken from all participants to analyze the ADRB3 gene Trp64Arg polymorphism using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) assay. We compared the distribution of Trp64Arg polymorphism and symptom severity in both OAB and non-OAB subjects using chi(2) test and Mann-Whitney's U test, respectively. Results The frequency of the 64Arg variant (heterozygous plus homozygous) in OAB and non-OAB subjects was 15.3% and 14.1%, respectively. There was no statistically significant difference between the OAB and non-OAB groups in regard to the distribution frequency of ADRB3 Trp64Arg polymorphism. The total frequency (OAB + non-OAB, 76 women and 74 men) of the Arg64 variant allele was 5.9% and 10.8% in women and in men, respectively. Although the frequency of the Arg64 variant was nearly twofold higher in men compared to women, the difference was not statistically significant. Conclusions These results demonstrated that the ADRB3 Trp64Arg polymorphism is not significantly associated with OAB syndrome in a sample of Turkish OAB patients
Cordycepin prevents the esophageal stricture formation in the alkali-burn rat model by exerting anti-inflammatory and antifibrotic effects
Get PDFPurpose: To investigate the efficacy of cordycepin, an adenosine analogue, on prevention of esophageal damage and stricture formation due to esophageal caustic burns in rat model comparing with prednisolone. Methods: Caustic esophageal burn was introduced by 37.5% of NaOH to distal esophagus. Thirty-two Wistar albino rats were divided in four groups: sham rats undergone laparotomy, treated with 0.9% NaCl; control rats injured with NaOH without cordycepin treatment; cordycepin group injured with NaOH, treated with 20 mg/kg cordycepin; prednisolone group injured with NaOH, treated with 1 mg/kg prednisolone for 28 days. Efficacy wasassessed by histopathological and immunohistochemical analysis of esophageal tissues. Results: Cordycepin treatment significantly decreased inflammation, granulation tissue and fibrous tissue formation and prevented formation of esophageal strictures shown by histopathological damage score and stenosis indexes compared to control group (p < 0.01). These effects are relatively more substantial than prednisolone, probably based on attenuation of elevation of proinflammatory cytokines hypoxia-inducible factor 1-alpha (HIF-1 alpha), tumor necrosis factor alpha (TNF-alpha), proliferative and fibrotic factor fibroblast growth factor 2 (FGF2) and angiogenic factor vascular endothelial growth factor A (VEGFA) (p < 0.05). Conclusion: The findings suggest that cordycepin has a complex multifactorial healing process in alkali-burned tissue, more successful than prednisolone in preventing the formation of esophageal strictures and may be used as a therapeutic agent in the acute phase of esophageal alkali-burn
Self reported knowledge, attitudes, and practice of final year dental students in relation to child abuse: A multi centre study
Get PDFArka plan: Dünya çapında çocuk istismarı vakalarının sayısı artıyor; bu nedenle çocuklarla teması olan bireylerin bu konuda eğitilmesi önemlidir. Buna çocuk istismarının tespit edilmesinde ve bildirilmesinde önemli rol oynayan diş hekimleri de dahildir. Amaç: Diş hekimliği son sınıf öğrencisinin çocuk istismarına ilişkin bilgi, tutum ve uygulamalarını belirlemek ve karşılaştırmak. Tasarım: 10 ülkedeki 11 diş hekimliği okulunun öğrencilerine 38 maddelik ve dört bölümden oluşan çevrimiçi bir anket dağıtıldı. Veri analizi için SPSS ve GraphPad Prism kullanıldı. İstatistiksel anlamlılık düzeyleri ki-kare testi kullanılarak belirlendi. P ≤.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Anketi toplam 660 öğrenci tamamladı. Öğrencilerin yüzde 56'sı çocuk istismarı konusunda örgün eğitim almış, yüzde 86'sı ek eğitim istiyordu. Çocuk istismarına ilişkin bilgi Avustralya, ABD ve Ürdün'de diğer ülkelerle karşılaştırıldığında önemli ölçüde daha yüksekti. İnternet (%60,3) çocuk istismarı konusunda bilgi kaynağı olarak en sık kullanıldı. Sonuç: Araştırma, diş hekimliği öğrencilerinin çocuk istismarını tanıma ve bildirme konusunda bilgi ve deneyime sahip olmadıklarını gösterdi. Yanıt verenlerin çoğu ek eğitim alma isteğini belirtti; bu nedenle diş hekimliği okulları halihazırda öğrettiklerini gözden geçirmeli ve uygun değişiklikleri yapmalıdır.Background: The number of child abuse cases is increasing worldwide; therefore, it is important to educate individuals having contact with children about it. This includes dentists who play a pivotal role in detecting and reporting child abuse. Aim: To identify and compare the final- year dental student's knowledge, attitudes, and practice in relation to child abuse. Design: A 38- item and four- part online questionnaire was distributed to students of 11 dental schools in 10 countries. SPSS and GraphPad Prism were used for data analysis. The levels of statistical significance were determined using a chi- square test. P ≤.05 was considered to be statistically significant. Results: A total of 660 students completed the survey. Fifty- six percent of the students received formal training on child abuse, and 86% wanted additional training. The knowledge of child abuse was significantly higher in Australia, the United States, and Jordan compared with other countries. Internet (60.3%) was commonly used as an information source for child abuse. Conclusions: The study showed that dental students lack knowledge and experience in recognizing and reporting child abuse. Most respondents indicated a desire for additional training; therefore, dental schools should review what they are currently teaching and make changes as appropriate
New geodetic constraints to reveal seismic potential of central Marmara region, Turkey
No full textThe North Anatolian Fault (NAF) is a fault zone that produced destructive earthquakes (Erzincan 1939 and 1992, Ladik 1943, Gerede 1944, Duzce 1999, Izmit 1999) in the last century. After this destructive earthquake migration, it is forecasted that the next seismic event on the NAF could be in the western part of the fault, which passes through the Marmara region. Due to the possibility of an earthquake in Istanbul, the most crowded and historical city in Turkey, researchers have increasingly paid attention to the western segment of the NAF within the Marmara Sea since the 1999 earthquakes. Many scientists from different disciplines such as geodesy, geology, geophysics, etc. have been trying to understand this phenomenon. However, it is understood from the literature that a comprehensive geodetic study is crucial to constrain the NAF segment between Istanbul and Tekirdag provinces. Therefore, we created a new network consisting of continuous GPS stations with 10-km interdistances along the shoreline, which was integrated with existing GNSS networks in the Marmara region. Data acquisition was carried out between August 2017 and February 2020. In this study, preliminary results obtained from the integration of the newly established network with the other GNSS networks are presented
The Potential Therapeutic Effects of Agmatine, Methylprednisolone, and Rapamycin on Experimental Spinal Cord Injury
Get PDFAmaç: Omurilik yaralanmasında (SCI), birincil mekanik hasar nöroinflamatuar bir yanıta yol açar ve ikincil nöronal hasar, reaktif oksijen türlerinin (ROS) salınmasına yanıt olarak ortaya çıkar. Enflamasyonun baskılanmasına ek olarak otofaji, ikincil SCI sırasında nöronların hayatta kalmasında önemli bir rol oynar. Bu çalışmada agmatin ve rapamisinin SCI'deki antiinflamatuar ve otofajik etkilerinin incelenmesi ve sonuçların klinikte kullanılan metilprednizolon (MP) ile karşılaştırılması amaçlandı. Gereç ve Yöntem: Hayvan bazlı bu deneysel çalışmada, otuz adet yetişkin erkek Sprague-Dawley sıçanı sham-kontrol, yaralanma, yaralanma+MP, yaralanma+rapamisin, yaralanma+agmatin grupları olmak üzere rastgele beş gruba ayrıldı. Bir dakika boyunca bir anevrizma klipsi kullanılarak omuriliğin T7-8-9 segmentlerinin sıkıştırılmasıyla SCI indüklendi ve ardından sıçanlar 7 gün boyunca günlük olarak tedavi edildi. Tedaviden yedi gün sonra, histopatolojik ve transmisyon elektron mikroskobu (TEM) skorları kullanılarak mikroskobik ve biyokimyasal incelemeler için kurban edilen sıçanların hasarlı omurilik dokuları toplandı. Malondialdehit (MDA) ve glutatyon peroksidaz (GPx) düzeyleri spektrofotometrik olarak ölçüldü. Bulgular: Bu çalışmanın sonuçları rapamisin grubunda hasarlı alanın MP grubuna göre daha küçük olduğunu gösterdi. Rapamisin grubunda çok sayıda otofajik vakuol ve makrofaj gözlendi. Elektron mikroskobik gözlemlerde SCI'de akson, miyelin dejenerasyonu ve geniş ödem gözlendi. Parçalanmış miyelin lamelleri ve kasılmış aksonlar da kaydedildi. Yaralanma grubunda MDA ve GPx düzeyleri artarken, agmatin ve MP gruplarında MDA düzeyleri anlamlı düzeyde azalırken, rapamisin grubunda GPx düzeyleri anlamlı olarak azaldı. Sonuç: Çalışmamızın sonuçları rapamisin ve agmatinin omurilik yaralanmasının sekonder hasarında etkili bir tedavi olabileceğini doğruladı.Objective: In spinal cord injury (SCI), the primary mechanical damage leads to a neuroinflammatory response and the secondary neuronal injury occurs in response to the release of reactive oxygen species (ROS). In addition to the suppression of inflammation, autophagy plays a significant role in the survival of neurons during secondary SCI. The present study aimed to examine the anti-inflammatory and autophagic effects of agmatine and rapamycin in SCI and to compare the results with methylprednisolone (MP) used in the clinic. Materials and Methods: In this animal-based experimental study, thirty adult male Sprague-Dawley rats were randomly divided into five groups as sham-control, injury, injury+MP, injury+rapamycin, injury+agmatine groups. SCI was induced by compressing the T7-8-9 segments of the spinal cord, using an aneurysm clip for one minute, and then rats were treated daily for 7 days. Seven days post-treatment, damaged spinal cord tissues of sacrificed rats were collected for microscopic and biochemical examinations using histopathologic and transmission electron microscope (TEM) scores. Malondialdehyde (MDA) and glutathione peroxidase (GPx) levels were spectrophotometrically measured. Results: The results of this study showed that the damaged area was smaller in the rapamycin group when compared to the MP group. Many autophagic vacuoles and macrophages were observed in the rapamycin group. Degeneration of axon, myelin, and wide edema was observed in SCI by electron microscopic observations. Fragmented myelin lamellae and contracted axons were also noted. While MDA and GPx levels were increased in the injury group, MDA levels were significantly decreased in the agmatine and MP groups, and GPx levels were decreased in the rapamycin group. Conclusion: The results of our study confirmed that rapamycin and agmatine can be an effective treatment for secondary injury of SCI
Influence of abutment design on stress distribution in narrow implants with marginal bone loss: a finite element analysis
Get PDFPurpose: The aim of this study was to determine the effect of solid (one-piece) and two-piece abutments on the stress profile of narrow implants with marginal bone loss. Materials and Methods: Solid and two-piece abutments were connected to a conical internal octagon-connection implant (3.3 mm in diameter, 10 mm in length) and restored with a single crown. Three-dimensional finite element analysis was used to simulate the stress distribution in implant models with different levels of marginal bone resorption (0, 1, 2, and 3 mm). The effect of the design variables under increased bone resorption scenarios, including abutment screw length and diameter, was assessed. Static loading was applied to determine the mechanical response of the implant and cortical and trabecular bone. Results: Marginal bone resorption levels dominated the mechanical response under static loading conditions. A marginal bone loss of 3 mm significantly increased stress values in the implant vicinity and abutment screw. Both abutment designs displayed similar stress distribution in the surrounding bone, but lower stress values were observed in the implant body with two-piece abutments. The abutment screw length was more effective in the resultant stress, as the longer screws reduced the stress in the implants. Conclusion: Marginal bone resorption magnitude is the crucial parameter in biomechanics to determine the mechanical behavior. As bone loss increases, resultant stress around implants under mastication forces may lead to implant failure, regardless of abutment type
Çoklu Organ Tutulumu Olan Langerhans Hücreli Histiositozis; Olgu Sunumu
Get PDFLangerhans Hücreli Histiositozis (LHH) sebebi tam olarak bilinmeyen nadir görülen bir hastalıktır. Epitel yüzeylerde bulunan, dendritik hücrelerin alt tipi olan monoklonal langerhans hücrelerinin anormal çoğalması ile karakterizedir. Sıklıkla çocuk yaş grubunda gözlenir ancak nadiren erişkin yaş grubunda da gözlenebilmektedir. LHH sıklıkla tek organ tutulumu ile seyreder fakat akciğer, kemik, hipofiz bezi, deri, karaciğer gibi çok sayıda organ tutulumu da gözlenebilir. Organ tutulumlarına göre klinik seyirde farklılıklar ortaya çıkmaktadır. LHH nadir görülen bir hastalık olması ve hastamızda akciğer, karaciğer ve yaygın cilt tutulumu olması nedeniyle sunulmuştur.Langerhans Cell Histiocytosis (LCH) is a rare disease of exactly unknown cause. It is characterized by the
abnormal proliferation of monoclonal langerhans cells, a subtype of dendritic cells located on epithelial
surfaces. It is often observed in children but rarely can be observed in the adult age group. LCH often
progresses with single organ involvement, but many organ involvement such as lung, bone, pituitary gland,
skin, and liver can be observed. The clinical course of LCH differs according to system involvement. It is
presented because LCH is a rare disease and our patient has multiple organ involvement such as lung, liver
and skin
Inverted colonic diverticulum: An endoscopic examination and presentation
No full textPubMed: 335593972-s2.0-85102265783Objective: We aimed to determine the frequency, morphological features, differential diagnosis, possible adverse events of inverted colonic diverticulum (ICD), which may be misdiagnosed as polyps. Methods: In all, 810 patients who underwent a colonoscopy between April 2016 and November 2019 were included in the study, and their data were evaluated retrospectively. Colonoscopic procedures were performed at a single center by the same endoscopist. Results: Among all the 810 patients, the prevalence of diverticulum was 29.58% (121/409) in men and 25.19% (n = 101/401) in women, respectively. ICD was observed in 1.73% (n = 14) of all patients, including 11 (78.57%) men (aged 63.2 ± 12.95 years [range 47–90 years]) and three women (60.3 ± 4.04 years [range 58–65 years]). Most (63.16% [12/19]) ICD lesions were localized in the sigmoid colon. And the diagnosis was confirmed by eversion using biopsy forceps in 78.95% of them. One patient developed perforation after polypectomy with hot biopsy forceps and was treated by surgical operation. Conclusions: ICD is a common lesion that may lead to serious adverse events if misdiagnosed as polyps. Differential diagnosis of ICD is crucial during the colonoscopy. © 2021 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Lt