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International Alliance of Urolithiasis (IAU) guidelines on the metabolic evaluation and medical management of urolithiasis
Get PDFAbstract The aim of this study was to construct the fourth in a series of guidelines on the treatment of urolithiasis by the International Alliance of Urolithiasis (IAU) that by providing a clinical framework for the metabolic evaluation, prevention, and follow-up of patients with urolithiasis based on the best available published literature. All recommendations were summarized following a systematic review and assessment of the literature in the PubMed database from January 1976 to June 2022. Each generated recommendation was graded using a modifed GRADE methodology. Guideline recommendations were developed that addressed the following topics: initial evaluation, metabolic testing, dietary measures, medical management, and follow-up of recurrent stone formers. It was emphasized by the Panel that prevention of new stone formation is as important as the surgical removal of the stones. Although general preventive measures may be efective in reducing stone recurrence rates in some patients, specifc medical and dietary management should be well considered and eventually applied in an individualized manner based on the outcomes of metabolic work-up, stone analysis and some certain patient related factors. A detailed follow-up of each case is essential depending on the metabolic activity of each individual patient
Diyabeti olan kolesistitli/kolelitiazisli hastaların beslenme davranışları ve diyabet özyönetimlerinin incelenmesi
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Dünya genelinde ve ülkemizde safra taşı prevalansı hızlı bir biçimde artmaktadır. Maddi ve manevi anlamda bireyleri zorlayan bu hastalık maddi açıdan devletleri de zorlamaya başlamıştır. Araştırma diyabeti olan kolesistitli/ kolelitiazisli bireylerin beslenme davranışları ve diyabet özyönetimlerini incelemek amacıyla gerçekleştirildi. Araştırma tanımlayıcı ve kesitsel tipte olup, örneklemini bir eğitim ve araştırma hastanesinin genel cerrahi servisinde Ocak - Kasım 2022 tarihleri arasında yatan 249 diyabetli ve kolesistit/ kolelitiazisli hasta oluşturdu. Veri toplama araçları olarak Kişisel Bilgi Formu, Yeme Davranış Modeli Ölçeği, Tip 2 Diyabet Özyönetim Ölçeği kullanıldı. Araştırmanın istatistiksel analizleri için Mann Whitney U Testi, Kruskal Wallis Testi ve Spearman Korelasyon Analizlerinden faydalanıldı. Katılımcıların %65,9'u (164 kişi) kadındır. Kadınların yaş ortalaması 61,8±13,21; erkeklerin yaş ortalaması 61,32±11,69'dir. Araştırmaya katılanların yalnızca %21,3'ünün (53 kişi) beden kitle indeksi (BKİ) normal aralıktadır. Araştırma sonucunda kadınların duygusal durumlarının erkeklere nazaran yeme davranışlarını daha fazla etkilediği (p<0,05), BKİ yüksek olan katılımcıların yağlı beslenme alışkanlıklarının olduğu (p,<0,01), tatlı ve bisküvi tüketimi fazla olan bireylerin safra kesesindeki rahatsızlıktan kaynaklı daha fazla hastaneye yattığı (p<0,001), erkeklerin kadınlara nazaran daha fazla sağlıklı yaşam biçimi davranışı (SYBD) sergiledikleri, BKİ yüksek olan bireylerin kan şekeri yönetimi (KŞY) ve SYBD'ye daha az dikkat ettikleri ve diyabetten kaynaklı hastane yatışı olan bireylerin KŞY'ye daha fazla dikkat ettikleri bulundu. Anahtar kelimeler : Kolesistit, Kolelitiazis (Safra Kesesi Taşı), Diyabet, Beslenme Davranışı, Diyabet Özyönetimi
The prevalence of gallstones is increasing rapidly worldwide and in our country. This disease, which forces individuals materially and spiritually, has also started to force states financially. The study was conducted to examine the nutritional behaviors and diabetes self-management of individuals with cholecystitis/cholelithiasis. Our study is descriptive and cross-sectional, and its sample consisted of 249 patients with diabetes and cholecystitis/cholelithiasis hospitalized in the general surgery service of a training and research hospital between January and November 2022. Personal Information Form, Eating Behavior Model Scale, and Type 2 Diabetes Self-Management Scale were used as data collection tools. Mann Whitney U Test, Kruskal Wallis Test, and Spearman Correlation Analysis were used for statistical analysis of the study. 65.9% (164 people) of the participants were female. The average age of women is 61.8±13,21; the average age of men is 61.32±11,69. Only 21.3% (53 people) of the participants had a normal body mass index (BMI). As a result of the research, it was found that the emotional state of women affected their eating behaviors more than men (p<0.05), participants with high BMI had fatty eating habits (p, <0.01), individuals with high consumption of sweets and biscuits were hospitalized more due to the discomfort in the gallbladder (p<0.001), men exhibited more healthy lifestyle behaviors (HLB) than women, individuals with high BMI paid less attention to blood sugar management (BSM) and HLB, and individuals with hospitalization due to diabetes paid more attention to BSM. Keywords: Cholecystitis, Cholelithiasis (Gallbladder Stone), Diabetes, Nutritional Behavior, Diabetes Self-Managemen
Existence of approximate solutions to nonlinear lorenz system under caputo-fabrizio derivative
No full textIn this article, we developed sufficient conditions for the existence and uniqueness of an approximate solution to a nonlinear system of Lorenz equations under Caputo-Fabrizio fractional order derivative (CFFD). The required results about the existence and uniqueness of a solution are derived via the fixed point approach due to Banach and Krassnoselskii. Also, we enriched our work by establishing a stable result based on the Ulam-Hyers (U-H) concept. Also, the approximate solution is computed by using a hybrid method due to the Laplace transform and the Adomian decomposition method. We computed a few terms of the required solution through the mentioned method and presented some graphical presentation of the considered problem corresponding to various fractional orders. The results of the existence and uniqueness tests for the Lorenz system under CFFD have not been studied earlier. Also, the suggested method results for the proposed system under the mentioned derivative are new. Furthermore, the adopted technique has some useful features, such as the lack of prior discrimination required by wavelet methods. our proposed method does not depend on auxiliary parameters like the homotopy method, which controls the method. Our proposed method is rapidly convergent and, in most cases, it has been used as a powerful technique to compute approximate solutions for various nonlinear problems
The renaissance of male infertility management in the golden age of andrology
No full textInfertility affects nearly 186 million people worldwide and the male partner is the cause in about half of the cases. Meta-regression data indicate an unexplained decline in sperm concentration and total sperm count over the last four decades, with an increasing prevalence of male infertility. This suggests an urgent need to implement further basic and clinical research in Andrology. Andrology developed as a branch of urology, gynecology, endocrinology, and, dermatology. The first scientific journal devoted to andrological sciences was founded in 1969. Since then, despite great advancements, andrology has encountered several obstacles in its growth. In fact, for cultural reasons, the male partner has often been neglected in the diagnostic and therapeutic workup of the infertile couple. Furthermore, the development of assisted reproductive techniques (ART) has driven a strong impression that this biotechnology can overcome all forms of infertility, with a common belief that having a spermatozoon from a male partner (a sort of sperm donor) is all that is needed to achieve pregnancy. However, clinical practice has shown that the quality of the male gamete is important for a successful ART outcome. Furthermore, the safety of ART has been questioned because of the high prevalence of comorbidities in the offspring of ART conceptions compared to spontaneous conceptions. These issues have paved the way for more research and a greater understanding of the mechanisms of spermatogenesis and male infertility. Consequently, numerous discoveries have been made in the field of andrology, ranging from genetics to several "omics" technologies, oxidative stress and sperm DNA fragmentation, the sixth edition of the WHO manual, artificial intelligence, management of azoospermia, fertility in cancers survivors, artificial testis, 3D printing, gene engineering, stem cells therapy for spermatogenesis, and reconstructive microsurgery and seminal microbiome. Nevertheless, as many cases of male infertility remain idiopathic, further studies are required to improve the clinical management of infertile males. A multidisciplinary strategy involving both clinicians and scientists in basic, translational, and clinical research is the core principle that will allow andrology to overcome its limits and reach further goals. This state-of-the-art article aims to present a historical review of andrology, and, particularly, male infertility, from its "Middle Ages" to its "Renaissance", a golden age of andrology
Does taping have an immediate effect on shooting the target?
No full textAbstract
In overhead shooting athletes may have increased activity of the upper trapezius and inhibition of other shoulder muscles active during upper extremity elevation. In this study, we aimed to increase target retention and shoulder proprioception sense accuracy by taping in a way that would activate the lower trapezius muscle in elite adolescent archers. Our participants were 43 elite young athletes, aged 11-14 years, from the Archers Foundation Sports Club. We gathered athletes' sociodemographic information (age, height, weight, gender, the time they were engaged in archery, and other sports they were involved in), and we assessed their posture via the New York Posture Scale (NYPS) before taping. We evaluated them for the presence of scapular asymmetry using the Lateral Scapular Slide Test (LSST) and assessed their proprioception with the active displacement test and their target-reaching performances with the Archery Shooting Score (ASS). Since testing and scoring with the ASS is different for 11-12 and 13-14 age groups, we divided this sample into two different age groups for all analyses. There were significant changes in ASS and proprioception in both age groups, with medium to large effect sizes. There were between intragroup pre- and post-taping changes in classification according to the presence of scapular asymmetry, and there were significant changes in the archery shooting score and proprioception in both groups, with medium to large effect sizes (p < 0.05). Thus, taping applied to the lower part of the trapezius had a large to medium effect on proprioception and shooting accuracy improvement in these young archers
Evaluation of laboratory and clinical results of embryos obtained after icsi procedure with frozen/thawed testicular sperm
No full textÖZET Dünya çapında erkek infertilitesi prevalansı her yıl giderek artmaktadır. Bu doğrultuda, erkek infertilitesinin hem tanısal hem de terapötik yönetimindeki ilerlemelere rağmen bu konuda araştırmalar devam etmektedir. Bu çalışma, dondurulmuş-çözülmüş ejakülat spermi (kontrol grubu) veya azoospermi tanısı almış mikro-TESE (m-TESE) uygulanan hastalarda dondurulmuş-çözülmüş testis spermi ile gerçekleştirilen intrasitoplazmik sperm enjeksiyonu (ICSI) sonrası embriyo kalitesi ve klinik performans sonuçlarını karşılaştırmayı amaçlamaktadır. Çalışmada, Bahçeci Umut Tüp Bebek Merkezi’nde (örnek ve veri toplama- 01.01.2016 ile 31.12.2019 tarihleri arasında) azoospermi tanısı sonucunda mikro-TESE işlemi uygulanmış hasta grubu (Grup AZO-TESE) ve kontrol grubu (Grup EJ) olarak ejakülat spermi kullanılan bireylerin ICSI işlemi sonrası fertilizasyon/blastosist oranları ve demografik özellikleri retrospektif olarak incelenmiştir. Dondurulmuş çözülmüş ejakülat sperm ile ICSI prosedüründen sonraki fertilizasyon oranı, mTESE’den sonraki ICSI’den istatistiksel olarak anlamlı derecede yüksekti. Grup EJ için fertilize oosit oranı %80 iken Grup AZO-TESE için %60’tı. Daha düşük bir fertilizasyon oranına rağmen azoospermik hasta grubundaki fertilizasyon başarısı literatürle uyumluydu. İki grup arasında blastosist oranları karşılaştırıldığında istatiksel olarak anlamlı bir fark yoktu. Blastosist oranı Grup EJ’de %46 iken Grup AZO-TESE’de %40 olarak hesaplandı. Bu durum ejekülattan veya mikro-TESE (mTESE) işlemi yapılmış azoospermli hastalardan elde edilen dondurulmuş-çözünmüş sperm ile fertilizasyon sonrasında blastosist oluşum oranlarının hemen hemen aynı olduğunu ortaya koydu.ABSTRACT The prevalence of male infertility worldwide is increasing every year. In this direction, despite advances in both the diagnostic and therapeutic management of male infertility, research on this subject continues. This study aims to compare the embryo quality and clinical performance results after the intracytoplasmic sperm injection (ICSI) performed by frozen-thawed ejaculate sperm (control group) or by frozen-thawed testicular sperm in patients who underwent the micro-TESE (mTESE) procedure with the diagnosis of azoospermia. In the study, fertilization/blastocyst rates after the ICSI procedure and demographic characteristics of patients who underwent the micro-TESE procedure due to azoospermia diagnosis (group AZO-TESE) and individuals who used ejaculate sperm as a control group (Group EJ) in Bahçeci Umut IVF Center (sample and data collection between 01.01.2016 and 31.12.2019) were examined retrospectively. The fertilization rate after the ICSI procedure with frozen-thawed ejaculate sperm was statistically significantly higher than the ICSI after m-TESE. Fertilized oocyte rate was 80% for Group EJ and 60% for Group AZO-TESE. Despite a lower fertilization rate, fertilization success in the azoospermic patient group was consistent with the literature. There was no statistically significant difference when the blastocyst rates were compared between the two groups. While the blastocyst rate was 46% in Group EJ, it was 40% in Group AZO-TESE. This revealed that blastocyst formation rates were almost the same after fertilization with frozen-thawed sperm obtained from ejaculate or patients with azoospermia who underwent the micro-TESE (m-TESE) procedure
Angiographic features and clinical outcomes of balloon uncrossable lesions during chronic total occlusion percutaneous coronary intervention
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Background: Balloon uncrossable lesions are defined as lesions that cannot be crossed with a balloon after successful guidewire crossing. Methods: We analyzed the association between balloon uncrossable lesions and procedural outcomes of 8671 chronic total occlusions (CTOs) percutaneous coronary interventions (PCIs) performed between 2012 and 2022 at 41 centers. Results: The prevalence of balloon uncrossable lesions was 9.2%. The mean patient age was 64.2 +/- 10 years and 80% were men. Patients with balloon uncrossable lesions were older (67.3 +/- 9 vs. 63.9 +/- 10, p < 0.001) and more likely to have prior coronary artery bypass graft surgery (40% vs. 25%, p < 0.001) and diabetes mellitus (50% vs. 42%, p < 0.001) compared with patients who had balloon crossable lesions. In-stent restenosis (23% vs. 16%. p < 0.001), moderate/severe calcification (68% vs. 40%, p < 0.001), and moderate/severe proximal vessel tortuosity (36% vs. 25%, p < 0.001) were more common in balloon uncrossable lesions. Procedure time (132 (90, 197) vs. 109 (71, 160) min, p < 0.001) was longer and the air kerma radiation dose (2.55 (1.41, 4.23) vs. 1.97 (1.10, 3.40) min, p < 0.001) was higher in balloon uncrossable lesions, while these lesions displayed lower technical (91% vs. 99%, p < 0.001) and procedural (88% vs. 96%, p < 0.001) success rates and higher major adverse cardiac event (MACE) rates (3.14% vs. 1.49%, p < 0.001). Several techniques were required for balloon uncrossable lesions. Conclusion: In a contemporary, multicenter registry, 9.2% of the successfully crossed CTOs were initially balloon uncrossable. Balloon uncrossable lesions exhibited lower technical and procedural success rates and a higher risk of complications compared with balloon crossable lesions
Case report: Treatment of major aphthous lesions of Behçet’s disease with immunomodulatory effects of low-dose antibiotic treatment
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Aim Behçet’s disease (BD) is a multisystemic inflammatory disease. The most common symptoms are recurrent major aphthous lesions in mouth. It is the initial symptom in most (about 80%) of the cases. It is very crucial to treat oral symptoms in order to minimize oral discomfort caused by inflammatory lesions in BD patients. The aim of this case report is to ameliorate the oral symptoms of BD by using the immunomodulatory effects of antibiotics. Case Report We present treatment of BD’s oral symptoms by using the immunomodulatory effects of antibiotics. A 30-year-old patient presented to our clinic with 2 major aphthae and discomfort in eating. The patient was treated with low-dose azithromycin for 3 weeks. Discussion The low-dose antibiotic therapy is a proven treatment modality for relieving oral symptoms of BD. Low-dose azithromycin was successful in relieving the oral symptoms of BD within 3 weeks. In the treatment of advanced aphthous lesions, the completion of the healing in 3 weeks of treatment and the absence of recurrence of aphthous lesions in 2 months proves the success of the treatment. Conclusion One week after starting the treatment, improvement was observed in the lesions. After 3 weeks of treatment, the aphthous lesions were completely healed. It was observed that oral symptoms did not return at the end of the 2-month treatment follow-up. Although azithromycin is used in the treatment of aphthous lesions caused by BD, more research is needed in this area
Synthesis of benzimidazole-1,2,4- triazole derivatives as potential antifungal agents targeting 14α-demethylase
Get PDFInvasive fungal infections (IFIs) are increasing as major infectious diseases around the world, and the limited efficacy of existing medications has resulted in substantial morbidity and death in patients due to the lack of effective antifungal agents and serious drug resistance. In this study, a series of benzimidazole-1,2,4-triazole derivatives (6a-6l) were synthesized and characterized by 1H NMR, 13C NMR, and HR-MS spectral analysis. All the target compounds were screened for their in vitro antifungal activity against four fungal strains, namely, C. albicans, C. glabrata, C. krusei, and C. parapsilopsis. The synthesized compounds exhibited significant antifungal potential, especially against C. glabrata. Three compounds (6b, 6i, and 6j) showed higher antifungal activity with their MIC values (0.97 μg/mL) compared with voriconazole and fluconazole. Molecular docking provided a possible binding mode of compounds 6b, 6i, and 6j in the 14α-demethylase active site. Our studies suggested that the benzimidazole-1,2,4-triazole derivatives can be used as a new fungicidal lead targeting 14α-demethylase for further structural optimization. In addition, their effects on the L929 cell line were also investigated to evaluate the cytotoxic effects of the compounds. SEM analyses were performed to examine the effects of compounds 6a, 6i, and 6j on C. glabrata cells under in vivo experimental conditions
Association between vitamin D status and secondary infections in patients with severe COVID-19 admitted in the intensive care unit of a tertiary-level hospital in Turkey
Get PDFAbstract: There are several studies showing that the vitamin D status can determine risk of COVID19 infections, severity and mortality from coronavirus disease 2019 (COVID-19). However, the association between vitamin D (25(OH)D) and secondary infections in the prognosis of COVID-19 patients has not been reported yet. The aim was to investigate whether the vitamin D status affects the rates of secondary infections in patients with severe COVID-19 hospitalized in the intensive care unit (ICU) of a tertiary-level hospital in Turkey. The data of 194 patients with diagnosis of severe COVID-19 who were admitted to the ICU from March 2020 to June 2021 and older than 18 years were evaluated in this retrospective study. The patients were divided into two groups according to total serum 25(OH)D level as normal group (≥20 ng/mL) and low group (< 0.05). The mortality rate was 79.7% in the low group and 22.4% in the normal group (p < 0.001). Microbiological growth was observed in 68.6% of the normal group and 52.6% of the normal group (p = 0.025). The number of cultures with resistant bacteria was significantly higher in the low group (25.9%) than that in the normal group (17.5%) (p = 0.035). The severe COVID-19 patients hospitalized with vitamin D deficiency may have increased risks of poor prognosis and mortality due to secondary infections in the ICU