Acıbadem Üniversitesi Açık Erişim Sistemi
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Relationship between disease severity and serum IL-6 levels in COVID-19 anosmia
No full textBackground: An association between IL-6 levels and cytokine storm syndrome in COVID-19 patients has been suggested. Cases with higher IL-6 levels have more rapid progression and a higher complication rate. On the other hand, COVID-19 cases with anosmia have a milder course of the disease. Objective: We aimed to investigate whether there is a relationship between serum IL-6 levels and presence of anosmia in COVID-19 patients. Methods: Patients with a confirmed diagnosis of COVID-19 based on laboratory (PCR) were stratified into two groups based on presence of olfactory dysfunction (OD). In all cases with and without anosmiapsychophysical test (Sniffin' Sticks test) and a survey on olfactory symptoms were obtained. Threshold (t) - discrimination (d) - identification (i), and total (TDI) scores reflecting olfactory function were calculated. Clinical symptoms, serum IL-6 levels, other laboratory parameters, and chest computed tomography (CT) findings were recorded. Results: A total of 59 patients were included, comprising 23 patients with anosmia and 36 patients without OD based on TDI scores. Patients with anosmia (41.39 +/- 15.04) were significantly younger compared to cases without anosmia (52.19 +/- 18.50). There was no significant difference between the groups in terms of comorbidities, smoking history, and symptoms including nasal congestion and rhinorrhea. Although serum IL-6 levels of all patients were above normal values (7 pg/mL), patients with anosmia had significantly lower serum IL-6 levels (16.72 +/- 14.28 pg/mL) compared to patients without OD (60.95 +/- 89.33 pg/mL) (p = 0.026). Conclusion: Patients with COVID-19 related anosmia tend to have significantly lower serum levels of IL-6 compared to patients without OD, and the lower IL-6 levels is related to milder course of the disease. With the effect of low cytokine storm and IL-6 level, it may be said that anosmic cases have a milder disease in COVID-19.1JAN-FEB4
The importance of dysregulated miRNAs on ovarian cysts and epithelial ovarian cancer
No full textObjective: Benign ovarian cysts (BOC) are the most common tumors in women of reproductive age. Usually, these cysts are harmless, but, a small number of them occasionally progress to malignancy. Among ovarian malignancies, epithelial ovarian cancer (EOC) comprises 90\% and is the most important cause of gynecologic cancerrelated deaths. We aimed to identify dysregulated miRNAs in patients with benign ovarian cysts (n = 11) compared to EOC (n = 10) and to healthy individuals (HI) (n = 15). Methods: The serum samples from EOC and BOC patients were collected before operation. We studied three different sample groups (serum of EOC (n = 8), HI (n = 8), and BOC (n = 8) patients) that contained the highest-quality of RNA. Microarray data were analyzed according to expression of miRNAs and target genes by bioinformatics tools. Results: When compared to EOC samples, 75 miRNAs were dysregulated in BOC samples. Sixty-six miRNAs from BOC were dysregulated when compared to HI samples. Bioinformatics analysis of BOC vs. EOC and BOC vs. HI showed that 46 miRNAs were congruent and their expression alterations were similar (up- or down-regulated). Further analysis showed that these 46 miRNAs are associated to one of three pathways involved in cancer pathogenesis. Conclusion: Several miRNAs might playa role in BOC formation and/or malignant transformation. These dysregulated miRNAs could potentially be a biomarker to distinguish between a completely BOC and one that is malignant or has potential for malignant transformation.1FEB 1566-724
Laparoskopik Sleeve Gastrektomi Operasyonunun Kısa Dönemde Besin Alımı, Biyokimyasal Kan Parametreleri ve Antropometrik Ölçümlere Etkisinin Değerlendirilmesi
No full textÖZET
Amaç: Laparoskopik sleeve gastrektominin ameliyat sonrası kısa dönemde (6 ay) besin alımı, antropometrik ölçümleri ve biyokimyasal
kan parametrelerine etkisinin değerlendirilmesidir.
Gereç-Yöntem: Bu çalışmaya Acıbadem Taksim hastanesine Haziran 2018 – Eylül 2018 tarihleri arasında laparoskopik sleeve gastrektomi
operasyonu geçiren 21 gönüllü kadın birey katılmıştır. Çalışmaya katılan kadınların genel özelliklerini belirlemeye yönelik anket formu
uygulanmış, operasyon öncesi ve operasyondan 6 ay sonraki besin tüketimleri, vücut ağırlıkları ve biyokimyasal kan parametreleri
değerlendirilmiştir. Verilerin değerlendirilmesinde SPSS Windows 22.0 istatistik paket programı kullanılmıştır. Bu çalışma Acıbadem
Mehmet Ali Aydınlar Üniversitesi tıbbi araştırmalar değerlendirme kurulu tarafından değerlendirilmiş 2017-4/20 karar numarası ile tıbbi
etik yönden uygun bulunmuştur.
Bulgular: Çalışmaya katılan kadınların yaş ortalaması 42.04 yıldır. Operasyon öncesi BKI değerleri ortalaması 40.7±8.0 kg/m2 iken altı
ayın sonunda 28.9±5.7 kg/m2 olarak belirlenmiş ve aradaki fark istatiksel olarak anlamlı bulunmuştur (p<0.01). Altı ayın sonunda açlık
kan glukozu, trigliserit, LDL-kolesterol, total kolesterol, ALT ve AST değerlerinde azalma, HDL-kolesterol değerinde ise artmanın olduğu
ve aradaki farkın istatiksel olarak anlamlı olduğu bulunmuştur (p<0.05). Operasyon sonrasında kadınların total enerji ve makro besin
öğelerinin alımında önemli azalmanın olduğu belirlenmiştir (p<0.05).
Sonuç: Çalışmanın sonunda laparoskopik sleeve gastrektomi operasyonu sonrasında kısa dönemde biyokimyasal kan parametrelerinde
ve antropometrik ölçümlerde operasyon öncesi dönem ile karşılaştırıldığında önemli azalmaların olduğu bu durumun uzun dönem
devam etmesi ve kaybedilen ağırlığın korunması durumunda obezite kaynaklı hastalıklara yakalanma olasılığının azalabileceği sonucuna
varılmıştır
The Carotid Endarterectomy Cadaveric Investigation for Cranial Nerve Injuries: Anatomical Study
No full textCerebral stroke continues to be one of the leading causes of mortality and long-term morbiditytherefore, carotid endarterectomy (CEA) remains to be a popular treatment for both symptomatic and asymptomatic patients with carotid stenosis. Cranial nerve injuries remain one of the major contributor to the postoperative morbidities. Anatomical dissections were carried out on 44 sides of 22 cadaveric heads following the classical CEA procedure to investigate the variations of the local anatomy as a contributing factor to cranial nerve injuries. Concurrence of two variations was found to be important in hypoglossal nerve injury: the presence of a direct smaller vein in proximity of the carotid bifurcation, and the intersection of the hypoglossal nerve (HN) with this vein. Based on the sample investigated, this variation was observed significantly higher on the right side. Awareness of possible anatomical variations and early ligation of any small veins can significantly decrease iatrogenic injury risk.2FEB1
Penile Mondor's in a Covid-19 patient on prophylactic anti-thrombosis with rivaroxaban: a case report
No full textBackground Penile Mondor's disease (PMD) is thrombophlebitis of the superficial dorsal vein of the penis. Following the occurrence of thrombotic events in the affected veins, the lumen often becomes occluded with fibrin and inflammatory cells. A hyper-coagulative state is one of the underlying causes although most cases of PMD are idiopathic. Coronavirus disease-2019 infection (COVID-19) is associated with frequent thrombotic events. Inflammation and thrombosis play a central role in the course and outcome of COVID-19, which can predispose to both venous and arterial thromboembolism. In this report, we present a 33-year-old male patient diagnosed with PMD during the subacute phase of COVID-19 infection while on prophylactic antithrombotic treatment. Case Presentation A 33-year-old male patient was diagnosed as PMD which occurred during the subacute phase of COVID-19 infection, while he was on active treatment of COVID-19 by prophylactic antithrombotic Rivaroxaban 15 mg therapy and curative antiviral medication. There was no recent sexual intercourse or trauma to the genitals. His PCR test for COVID-19 had become negative, and antibody test was positive at the time of his PMD's onset. Rivaroxaban was replaced by Enoxaparin (8000 IU/0.8 ml.), a low molecular weight heparin administered subcutaneously and twice daily. On the third day of this medication, all coagulative measurements returned to normal. PMD disappeared in the second week. Conclusion Low-dose Rivaroxaban 15 mg is not safe for some COVID-19-associated thromboembolism prophylaxis, and careful follow-up is critical due to the possibility of a wide range of pathologic thrombotic manifestations in COVID-19 infection.1DEC2
Correlation between corneal thickness, keratometry, age, and differential pressure difference in healthy eyes
No full textTo determine the use of differential pressure difference (DPD), in air-puff differential tonometry, as a potential biomechanical measure of the cornea and elucidate its relationship with the intraocular pressure (IOP), central corneal thickness, corneal curvature, and age. This study comprised 396 eyes from 198 patients and was conducted at Acibadem University, School of Medicine, Department of Ophthalmology, Istanbul, Turkey. The central corneal curvature and refraction of the eyes were measured using an Auto Kerato-Refractometer (KR-1Topcon Corporation, Tokyo, Japan). IOP and central corneal thickness were measured using a tono-pachymeter (CT-1PTopcon Corporation, Tokyo, Japan), wherein two separate readings of IOP were obtained using two different modes: 1-30 and 1-60. The difference between these two readings was recorded as the DPD. The factors affecting the DPD were determined by stepwise multiple linear regression analysis. DPD varied over a dynamic range of - 3.0 to+5.0 mmHg and was weakly correlated with the central corneal thickness (r=0.115, p0.05). A weak but statistically significant (p<0.05) positive correlation of DPD was observed with age (r=0.123), Kavg (r=0.102), and the CCT (r=0.115). There was a significant correlation between DPD and Kavg, CCT, and age. There was no significant correlation between DPD and IOP 1-30. Age-related changes in the corneal ultrastructure may be a plausible explanation for the weak positive association between age and DPD. The proposed method may prove a valid non-invasive tool for the evaluation of corneal biomechanics and introduce DPD in the decision-making of routine clinical practice.1FEB 181
Intrahospital Transport of a Critically Ill Patient on Extracorporeal Membrane Oxygenation Support with Severe Acute Respiratory Distress Syndrome due to COVID-19
No full textPatients who do not respond to conventional mechanical ventilation (MV) support for respiratory failure due to the Coronavirus disease-19 may require the support of extracorporeal membrane oxygenation (ECMO). Intrahospital transportation of critically ill patients under MV and ECMO support carries potential risks that could be life-threatening. A structured process performed by a professional team plays a vital role in improving patient safety during transportation of the patient. In this presentation, we aim to share our experiences during the intrahospital transportation of a patient on ECMO support with appropriate equipment and a team of experienced personel.4DEC432-4351
Climate change and epilepsy: Insights from clinical and basic science studies
No full textClimate change is with us. As professionals who place value on evidence-based practice, climate change is something we cannot ignore. The current pandemic of the novel coronavirus, SARS-CoV-2, has demonstrated how global crises can arise suddenly and have a significant impact on public health. Global warming, a chronic process punctuated by acute episodes of extreme weather events, is an insidious global health crisis needing at least as much attention. Many neurological diseases are complex chronic conditions influenced at many levels by changes in the environment. This review aimed to collate and evaluate reports from clinical and basic science about the relationship between climate change and epilepsy. The keywords climate change, seasonal variation, temperature, humidity, thermoregulation, biorhythm, gene, circadian rhythm, heat, and weather were used to search the published evidence. A number of climatic variables are associated with increased seizure frequency in people with epilepsy. Climate change-induced increase in seizure precipitants such as fevers, stress, and sleep deprivation (e.g. as a result of more frequent extreme weather events) or vector-borne infections may trigger or exacerbate seizures, lead to deterioration of seizure control, and affect neurological, cerebrovascular, or cardiovascular comorbidities and risk of sudden unexpected death in epilepsy. Risks are likely to be modified by many factors, ranging from individual genetic variation and temperature-dependent channel function, to housing quality and global supply chains. According to the results of the limited number of experimental studies with animal models of seizures or epilepsy, different seizure types appear to have distinct susceptibility to seasonal influences. Increased body temperature, whether in the context of fever or not, has a critical role in seizure threshold and seizure-related brain damage. Links between climate change and epilepsy are likely to be multifactorial, complex, and often indirect, which makes predictions difficult. We need more data on possible climate-driven altered risks for seizures, epilepsy, and epileptogenesis, to identify underlying mechanisms at systems, cellular, and molecular levels for better understanding of the impact of climate change on epilepsy. Further focussed data would help us to develop evidence for mitigation methods to do more to protect people with epilepsy from the effects of climate change. (C) 2021 Elsevier Inc. All rights reserved.MAR11
