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Comprehensive research on past and future therapeutic Strategies devoted to treatment of amyotrophic lateral sclerosis
No full textAmyotrophic lateral sclerosis (ALS) is a rapidly debilitating fatal neurodegenerative disorder, causing muscle atrophy and weakness, which leads to paralysis and eventual death. ALS has a multifaceted nature affected by many pathological mechanisms, including oxidative stress (also via protein aggregation), mitochondrial dysfunction, glutamate-induced excitotoxicity, apoptosis, neuroinflammation, axonal degeneration, skeletal muscle deterioration and viruses. This complexity is a major obstacle in defeating ALS. At present, riluzole and edaravone are the only drugs that have passed clinical trials for the treatment of ALS, notwithstanding that they showed modest benefits in a limited population of ALS. A dextromethorphan hydrobromide and quinidine sulfate combination was also approved to treat pseudobulbar affect (PBA) in the course of ALS. Globally, there is a struggle to prevent or alleviate the symptoms of this neurodegenerative disease, including implementation of antisense oligonucleotides (ASOs), induced pluripotent stem cells (iPSCs), CRISPR-9/Cas technique, non-invasive brain stimulation (NIBS) or ALS-on-a-chip technology. Additionally, researchers have synthesized and screened new compounds to be effective in ALS beyond the drug repurposing strategy. Despite all these efforts, ALS treatment is largely limited to palliative care, and there is a strong need for new therapeutics to be developed. This review focuses on and discusses which therapeutic strategies have been followed so far and what can be done in the future for the treatment of ALS
Effect of vertical and lateral offset restoration on clinical outcomes in intracapsular and extracapsular hip fractures undergoing hemiarthroplasty
No full textObjective We aimed to investigate whether there is a change in the postoperative lateral and vertical femoral offset (FO) in patients who underwent bipolar straight stem hemiarthroplasty (SSHA) and calcar stem hemiarthroplasty (CRHA) and whether this change makes a difference in the comparison of both groups. Material and methods This study included 109 patients who met these criteria. Patients are divided into two groups according to treatment methods. There were 58 patients (group 1) who underwent SSHA due to intracapsular (AO type 31- B neck and 31-C head fracture) femur fracture, and there were 51 patients (group 2) who underwent CRHA due to extracapsular (AO type 31-A intertrochanteric) femur fracture. We analyzed femoral vertical and lateral femoral offset, Wiberg angle, and head-neck angle difference in both groups. Results The median age was significantly higher in the CRHA group (p=0.042). The Harris hip score (HHS) was significantly higher in the SSHA group (p=0.023). The femoral offset difference was 5 mm in the SSHA group, while it was significantly lower (-6 mm) in the CRHA group (p<0.001). The Wiberg angle difference did not differ significantly between patient groups (p=0.214). The limb length difference was found to be similar in both surgical groups (p=0.483). Conclusions The study results show that there was no negative correlation between clinical and radiological outcomes in the SSHA group, whereas there was a negative correlation between clinical and radiological outcomes in the CRHA group. It is very difficult to control vertical and lateral offset reconstruction, especially in extracapsular hip fractures reconstructed by hemiarthroplasty. Deficiencies in lateral and vertical stabilization restoration may be associated with poor clinical outcomes in CRHA patients. Orthopedic surgeries should be performed carefully when restoring leg length and femoral offset, especially calcar replacement hemiarthroplasties
The Prognostic and Diagnostic Value of Plasma D-Dimer Levels in Elderly Patients with Community-Acquired Pheumonia
No full textIntroduction: This study aimed to investigate the relationship between community-acquired pneumonia severity and D-dimer levels in individuals older than 65. We also investigated the relationship between D-dimer levels and the adverse outcomes in patients with community-acquired pneumonia after excluding all other potential causes of high D-dimer levels. Materials and Methods: Patients older than 65 who were admitted to the emergency service of a tertiary chest diseases training and research hospital between January 1, 2019, and October 1, 2020, were evaluated. Patients who met the diagnostic criteria for community-acquired pneumonia were included. In clinically questionable cases of coexistence of pulmonary embolism and community-acquired pneumonia, D-dimer levels and pulmonary computerize tomography angiography or ventilation-perfusion scintigraphy were examined. Confirmed pulmonary embolism patients were excluded. Of 4,608 patients evaluated, 82 had a diagnosis of community-acquired pneumonia with no comorbidity. The severity of these cases was determined with the CURB-65 score and pneumonia severity index score. Results: The mean age of the cases was 73.83±6.67 years, while their gender was predominantly male (n=51, 62.2%). A statistically significant correlation was found between D-dimer levels and both the CURB-65 and pneumonia severity index high-risk groups (p=0.001 and p=0.001, respectively). The adverse outcomes were statistically higher in both the CURB-65 and pneumonia severity index high-risk groups (p<0.001). Conclusions: D-Dimer is an easy-to-interpret, fast, inexpensive, highly sensitive, and simple test widely used in clinics. We found that high levels of D-dimer can predict the need for intensive care unit care, disease severity, and mortality of elderly community-acquired pneumonia patients
CT Angiography and Doppler Ultrasound Evaluation of Congenital Portosystemic Shunts
No full textAim: The aim of the study was to describe the Doppler ultrasonography and computed tomography findings that should be considered in the diagnosis and treatment of congenital portosystemic shunts. Methods: Archive retrospectively scanned. In consideration of shunts: communication type and aneurysm were defined. Additional imaging modalities were utilized. Results: 11 patients were included in the study. The ages ranged from 0 to 158 months. There were two patients with shunt connecting segment-4 portal vein - middle hepatic vein, two patients with segment-3 portal vein - left hepatic vein, two patients with left portal vein – middle hepatic vein, two patients with portal vein - left renal vein, two patients with portal vein -inferior vena cava, and one patient with portal vein - perirectal venous plexus. Conclusion: Some classifications used in congenital portosystemic shunts are insufficient in guiding treatment. Elaborate definition of the imaging findings including the involved vessels, type of communication, and presence of aneurysm or dilated vessels is of the prime importance for tailoring clinical management of the patients
Investigation of the correlation between cardiac parameters and aortic diameter in patients with ascending aortic aneurysm
No full textBackground: Aortic aneurysms (AA) are enlargement of the aorta silently until diagnosing, not detectable on physical examination, and usually incidentally discovered during radiologic scanning for other reasons. It can get bigger sizes and can result in life-threatening outcomes if not detected early on. In this study, we aimed to determine the relationship between ascending aortic diameter and cardiac parameters that can be detected with tomography or/and echocardiography. Newly diagnosed (n: 85) ascending AA patients and healthy individuals (n: 86) who have not any thoracic pathology in computed tomography (CT) scans included to the study. Echocardiographically determined left atrial dimension (LAD), left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left ventricular ejection fraction (LVEF) and the left ventricular posterior wall thickness (LVPWd) values of each patient were recorded. The thorax diameters, ascending aorta diameters and cardiac volume values recorded from CT scans. The obtained findings were statistically compared. Results: Positive correlation was found between aortic diameter and aging (p: 0.000). Increased thorax diameter and cardiac volume values were detected in ascending AA cases (p < 0.05). It was found to be ascending aortic diameter was positively correlated with thorax diameter and cardiac volume (0.50 < r ? 0.70) values and higher aortic diameter, cardiac volume, thorax diameter values were detected in male individuals when compared with the female gender. There was no significant correlation between LVEF, LVDd, and LVDs values and aortic diameter. Conclusions: Cardiac volume and thorax diameter were found as strongly correlated with the diameter of the ascending aorta. The clarifying of these parameters with larger cohorts might be beneficial for the estimation of the progression of ascending AA
Örgütsel Sinizmin Zaman Hırsızlığı Üzerindeki Etkisinde İşe Yabancılaşmanın Aracı Rolü: Bir Hastane Örneği
No full textBu çalışmada örgütsel sinizm, zaman hırsızlığı ve işe yabancılaşma kavramları arasındaki ilişkiler kapsamlı bir biçimde incelenmiştir. Araştırma da öncelikle kavramlar arasındaki ilişkileri ele alan çalışmalar incelenmiş ve bu çalışmalar doğrultusunda araştırma modeli geliştirilerek hipotezler belirlenmiştir. Araştırma verileri Kahramanmaraş ilindeki 160 sağlık çalışanından anket yöntemiyle elde edilmiştir. Elde edilen veriler SPSS ve AMOS programlarıyla analiz edilmiştir. Yapılan analizler neticesinde örgütsel sinizm ve zaman hırsızlığı arasında olumlu bir ilişkinin var olduğu ve işe yabancılaşmanın modele katılmasıyla bu ilişkinin tamamen ortadan kalktığı görülmüştür. Dolayısıyla çalışmada elde edilen bulgular işe yabancılaşmanın örgütsel sinizm ve zaman hırsızlığı arasındaki ilişkide tam aracı bir rol üstlendiğini göstermektedir
The effetcs of insomnia, apathy and depression on cognitive functions of alzheimer's patients and Healthy Elderly
Get PDFBu araştırmanın amacı insomnia, apati ve depresyonun Alzheimer hastalığı ile ilişkisini incelemektir. Böylece, kognitif yeti kaybını yavaşlatacak önlemlerin alınması mümkün kılınabilir. Bu amaçla Alanya Alaaddin Keykubat Üniversitesi Eğitim ve Araştırma Hastanesi bünyesinde, Alzheimer hastaları ve selim yaşlılardan oluşan bir katılımcı grubu çalışmaya dahil edilmiştir. Çalışma 2 ayrı deney grubu (toplam 32 katılımcı) ve kontrol grubundan (20 katılımcı) oluşmaktadır. Katılımcılar objektif olarak Addenbrooke Kognitif Değerlendirme Bataryası (ACE-R); Promis DSM-5 Düzey 2 Uyku Bozukluğu Ölçeği-Yetişkin Formu (D-UBÖ); Apati Değerlendirme Ölçeği (ADÖ) ve Montgomery Asberg Depresyon Ölçeği (MADDÖ) ile değerlendirilmiştir. ACE-R skorlarından ayrıca mini-mental (SMMT) skorları da elde edilip değerlendirmeye alınmıştır. Veriler değerlendirilirken bağımsız örneklemler t-test; Pearson Korelasyonu; basit doğrusal regresyon analizi ve grup puan farklılıklarının incelenmesi için ise MANOVA analizi uygulanmıştır. Sonuçlar: Bulgulara göre kognitif skorlar (p<0,001) kontrol grubundaki katılımcılarda her iki ATD grubuna kıyasla anlamlı düzeyde daha yüksek bulunmuştur. ADÖ puanları her iki ATD grubunda kontrol grubuna kıyasla anlamlı düzeyde daha yüksek bulunmuştur (p<0.05). D-UBÖ puanları ATD-İn grubunda (p<0,05) ve Non-İn grubunda (p<0,01) kontrol grubuna kıyasla anlamlı düzeyde daha yüksek bulunmuştur. MADDÖ puanları (p<0,05) ATD-İn grubunda kontrol grubuna kıyasla anlamlı düzeyde daha yüksek bulunmuştur. Tartışma: Sonuçlara göre nörokognitif işlevler apati ve depresyonun varlığına ve şiddetine göre farklılaşmaktadır. Apati ve depresyonun şiddetinin azalması kognitif performans artışını güçlü şekilde yordamaktadır. Sonuçlar apati ve depresyonun kognitif işlevlerle ilişkili olduğuna işaret etmiştir.The aim of this study is to investigate the relationship and the nature of the relationship between Alzheimer's disease (AD) and insommia, apathy and depression to able to asses whether insomnia, apathy and/or depression is a risk factor for AD. Determining the risk factors may allow for interventions to slown down the cognitive loss. This research has been conducted in Alanya Alaaddin Keykubat Üniversity Training and Research Hospital with AD patients and a healthy cohort. Research groups consist of 2 separate experimental groups (total of 32 participants) and 1 control group (20 participants). Participants have been evaulated by using Addenbrooke’s Cognitive Examination-Revised (ACE-R) and also mini-mental (MMSE) score has been calculated from ACE-R; Montgomery-Åsberg Depression Rating Scale (MADRS); Apathy Evaluation Scale (AES); LEVEL 2—Sleep Disturbance—Adult (PROMIS—Sleep Disturbance—Short Form). The statistical analyzes that conducted is independent t-test, Pearson correlation; simple linear regression and MANOVA analyze. Results: The cognitive scores are statistically significantly higher (p<0,001) in control group comparing to ATD groups. AES scores are statistically significantly higher (p<0,05) in ATD groups comparing to control group. PROMIS scores are statistically significantly higher in ATD-In group (p<0,05) and Non-In group (p<0,01) comparing to control group. MADRS scores are statistically significantly higher in ATD-In group (p<0,05) comparing to control group. Conclusion: According to results cognitive performances show differences based on the severity of apathy and depression syptoms. The decreas in severity of apathy and depression succesfully preditcs the increase in cognitive performance. These results suggest apathy and depression is related to cognitive functioning
SWARA Ağırlıklı Bulanık COPRAS Yöntemi ile Tedarikçi Seçimi
Get PDFDünya nüfusunun giderek artış gösterdiği günümüzde enerjiye olan ihtiyaç da her geçen gün artmaktadır. Geleneksel enerji kaynağı olarak kullanılan fosil yakıtların azalması ve karbondioksit (CO2) salınımının çok yüksek olması işletmeleri yeni enerji arayışına sokmuştur. Bu bağlamda biyogaz üretimi yenilenebilir enerji kaynağı olması ve çevreye zarar vermemesi açısından oldukça önemlidir. Bu çalışmada biyogaz enerji üretimi sektöründe faaliyet gösteren bir işletmenin tedarikçi seçim süreci ÇKKV (Çok Kriterli Karar Verme) yöntemlerinden SWARA ve Bulanık COPRAS yöntemleri kullanılarak incelenmiştir. Çalışmada ilk olarak tedarikçi seçimi sürecinde kullanılan kriterler belirlenmiş ve SWARA yöntemi kullanılarak bu kriterlerin önem dereceleri tespit edilmiştir. Yapılan analiz sonucunda gazlaşma oranı kriteri işletmenin tedarikçi seçim sürecinde en çok önem verdiği kriter, en az öneme sahip kriter ise vade kriteri olmuştur. Tedarikçi alternatiflerin değerlendirilmesinde Bulanık COPRAS yöntemi kullanılmıştır. Analiz sonucuna göre en iyi tedarikçi alternatifi A3 olarak bulunmuştur
The effect of Resveratrol on sphingosine-1 and Oxidative/ Nitrosative stress in an experimental heart ischemia reperfusion model
Get PDFObjectives: Resveratrol (RSV) is a natural polyphenolic compound showing significant antioxidant effects. In this study, we aimed to investigate the effects of resveratrol on the sphingosine-1-phosphate (S1P) and oxidative stress biomarkers in hearth ischemia-reperfusion (I/R). Materials and Methods: The biochemical and histopathological effects of RSV on cardiac ischemia-reperfusion injury were investigated through ELISA- and light microscope. Results: We observed statistically significant differences between the treatment group and the control group in terms of malondialdehyde (MDA) level, catalase (CAT) and superoxide dismutase (SOD) activities (p<0.05). Histopathologically, we also observed decreased Polymorphonuclear Leucocyte (PMNL) infiltration, myocardial edema, miyositolysis in the treatment group compared to the I/R and sham groups. Conclusion: Resveratrol may play an important role in cardiac I/R injury through its anti-inflammatory and antioxidant effects which were biochemically and histopathologically confirmed in the present study
13. Entropi Temelli TOPSIS ve BORDA Sayım Yöntemleri ile Gıda İşletmelerinin Performanslarının Değerlendirilmesi
Get PDFİşletmelerin sektör içindeki finansal performans sıralamasının belirlenmesi hem işletme yöneticileri hem de yatırımcıların alacakları kararlar açısından önemlidir. Bu çalışmanın amacı, Entropi Temelli TOPSIS ve BORDA Sayım yöntemlerini kullanarak Borsa İstanbul’da işlem gören Gıda İşletmelerinin finansal performanslarını analiz etmektir. Entropi yöntemi ile elde edilen ağırlıklar TOPSIS yöntemine aktarılarak yıllık bazda gıda işletmelerinin finansal performans sıralaması yapılmıştır. TOPSIS yöntemi sonuçlarına göre Ülker Bisküvi işletmesi 2015, 2016, 2017 ve 2018 yıllarında en yüksek finansal performansa sahip iken 2019 yılında Ekiz Kimya Sanayi işletmesi, 2020 yılında Altınyağ işletmesi en yüksek finansal performansa sahiptir. TOPSIS yöntem sıralamaları ile birlikte Borda skorları elde edilerek tek bir bütünleşik sıralama hesaplanmıştır. Elde edilen sıralamada 2015-2020 dönemi için en yüksek finansal performansa sahip olan işletme ÜLKER Bisküvi işletmesi olarak belirlenmiştir