Acıbadem Üniversitesi Açık Erişim Sistemi
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Farklı spor dalları ile ilgilenen sporcularda COVİD-19'a yakalanma kaygısının beslenme durumu ve diyet kalitesi üzerine etkisi
No full textMelatonin in preservation solutions prevents ischemic injury in rat kidneys
No full textTransplantation is lifesaving and the most effective treatment for end-stage organ failure. The transplantation success depends on the functional preservation of organs prior to transplantation. Currently, the University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) are the most commonly used preservation solutions. Despite intensive efforts, the functional preservation of solid organs prior to transplantation is limited to hours. In this study, we modified the UW solution containing components from both the UW and HTK solutions and analyzed their tissue-protective effect against ischemic injury. The composition of the UW solution was changed by reducing hydroxyethyl starch concentration and adding Histidine/Histidine-HCI which is the main component of HTK solution. Additionally, the preservation solutions were supplemented with melatonin and glucosamine. The protective effects of the preservation solutions were assessed by biochemical and microscopical analysis at 2, 10, 24, and 72 h after preserving the rat kidneys with static cold storage. Lactate dehydrogenase (LDH) activity in preservation solutions was measured at 2, 10, 24, and 72. It was not detectable at 2 h of preservation in all groups and 10 h of preservation in modified UW+melatonin (mUW-m) and modified UW+glucosamine (mUW-g) groups. At the 72nd hour, the lowest LDH activity (0.91 IU/g (0.63-1.17)) was measured in the mUW-m group. In comparison to the UW group, histopathological damage score was low in modified UW (mUW), mUW-m, and mUW-g groups at 10, 24, and 72 hours. The mUW-m solution at low temperature was an effective and suitable solution to protect renal tissue for up to 72 h.8AUG 311
Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)
No full textObjectives Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue. Methods This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases. Results Of 5896 analyzed patients, 2763 (46.9\%) had conventional imaging only (noMRI group), and 3133 (53.1\%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692/3133 women (22.1\%), with preoperative intent in 2441/3133 women (77.9\%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers >= 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (p < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4\% (MRI group) versus 14.4\% (noMRI group) (p < 0.001). The additional planned mastectomy rate in the MRI group was 11.3\%. The overall performed first- plus second-line mastectomy rate was 36.3\% (MRI group) versus 18.0\% (noMRI group) (p < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5\% versus 11.7\%, p < 0.001). Conclusions Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3\% more mastectomies, and with 3.2\% fewer reoperations in the breast conservation subgroup.3MAR1611-16233
Myocarditis following COVID-19 mRNA (mRNA-1273) vaccination
No full textIn this case report, we presented a case of myocarditis as a rare complication that developed after Covid mRNA-1273 vaccine. Cases of post-vaccine myocarditis usually progress with mild symptoms. However, it should be a situation that healthcare workers should keep in mind, that myocarditis may develop after vaccination.4APR1
How should Travel-Related Malaria Management in Emergency Departments of Non-endemic Countries? Single-center Study
No full textABSTRACT
Purpose: Advancements in air travel enabled an increase in traveling to malaria-endemic countries such as those in sub Saharan Africa. An increase in the incidence of imported malaria accompanied these advancements. This study aims to
summarize how malaria patients who have imported the disease into non-endemic countries present to the emergency
departments and to enlighten physicians in emergency departments by providing suggestions for practical approaches
to handling such situations.
Methods: This study was conducted retrospectively in a university hospital, from January 1, 2014 to March 1, 2022. Eight
years of emergency department records of patients who were examined in the emergency department with a suspected,
or definitive diagnosis of malaria were included in the study. Epidemiological and clinical characteristics were evaluated.
Results: 892 patients were admitted to the emergency department with suspicion of malaria. Thirty of these patients
were diagnosed with malaria, and 846 of the 892 patients were members of airline cabin crews. 94.3% (n=798) of the
cabin crew did not use prophylactic medication for malaria. The mean age of the patients was 33.2±8.5. Twenty-five
patients were diagnosed via peripheral blood smears, and the remaining three patients were diagnosed with polymerase
chain reaction (PCR). Rapid diagnostic tests were positive in 26 out of 28 patients.
Conclusion: The risk of acquiring malaria is still high despite short-term visits and airport-limited stays. Travel history
should be routinely asked of patients with fever by emergency physicians. Education of people traveling to malaria endemic countries, including cabin crew, regarding malaria prophylaxis and protective measures to prevent mosquito
bites plays a crucial role in preventing malaria
Evaluation of chronic inflammation in the aetiology of venous insufficiency by investigating cytomegalovirus DNA
No full textIntroduction: Lower extremity venous insufficiency is a significant health problem with economic and sociological consequences, lowering the quality of life, and sometimes leading to serious complications. The aim of this study is to evaluate the cytomegalovirus (CMV) effect on chronic inflammation in the aetiology of chronic venous insufficiency. Material and methods: Between November 2017 and August 2018, 468 patients who underwent radio-frequency ablation therapy and phlebectomy were included in the study. PCR analyses for CMV DNA were performed on the venous tissue samples. Patients with post-thrombotic syndrome were excluded from the study. After ethical approval, the relationship between the presence of CMV DNA, gender, body mass index, and bilaterality of chronic venous insufficiency were investigated. Results: When the relationship between CMV DNA and gender or body mass index was examined, a significant relationship was not detected. But when the patients with bilateral chronic venous insufficiency and patients with unilateral chronic venous insufficiency were compared regarding CMV DNA positivity, the patients with bilateral chronic venous insufficiency had significantly higher CMV DNA positivity (p = 0.002). Also, the incidence of venous ulcers in the CMV DNA exposed group was significantly higher. Conclusions: In the literature there are many studies showing that CMV triggers atherosclerosis, but there is no study in which CMV directly produces chronic venous insufficiency. The high rates of positivity suggest that CMV, which is the basis of chronic inflammation, may be a significant factor in the aetiology of chronic venous insufficiency.1JAN 1129-1321
Management of Pregnancy and Childbirth in a Cervical Dystonia Patient with an Implanted Deep Brain Stimulation System: A Case Report
No full textDeep brain stimulation (DBS) can lead to psychosocial and functional improvement in medically refractory cervical, segmental, or generalized moderate to severe dystonia. After treatment with DBS in women with dystonia, pregnancy can be planned. However, in the literature, there are no standardized clinical guidelines for the management of movement disorder treated with DBS during pregnancy. Herein, we report a 24-year-old female patient with cervical dystonia (CD) who have an implanted bilateral globus pallidus intema (GPi)-DBS. The patient got pregnant during the 5-year follow-up period after DBS surgery and then delivered a healthy baby via cesarean section under general anesthesia. A patient with CD who have a DBS system with a rechargeable battery could be managed safely during pregnancy and childbirth.1JAN-FEB121-1232
