Acıbadem Üniversitesi Açık Erişim Sistemi
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Femoral and Tibial Bony Risk Factors for Anterior Cruciate Ligament Injuries Are Present in More Than 50\% of Healthy Individuals
No full textBackground: Anterior cruciate ligament (ACL) injuries are multifactorial events that may be influenced by morphometric parameters. Associations between primary ACL injuries or graft ruptures and both femoral and tibial bony risk factors have been well described in the literature. Purpose: To determine values of femoral and tibial bony morphology that have been associated with ACL injuries in a reference population. Further, to define interindividual variations according to participant demographics and to identify the proportion of participants presenting at least 1 morphological ACL injury risk factor. Study Design: Cross-sectional studyLevel of evidence, 3. Methods: Computed tomography scans of 382 healthy participants were examined. The following bony ACL risk factors were analyzed: notch width index (NWI), lateral femoral condylar index (LFCI), medial posterior plateau tibial angle (MPPTA), and lateral posterior plateau tibial angle (LPPTA). The proportion of this healthy population presenting with at least 1 pathological ACL injury risk factor was determined. A multivariable logistic regression model was constructed to determine the influence of demographic characteristics. Results: According to published thresholds for ACL bony risk factors, 12\% of the examined knees exhibited an intercondylar notch width <18.9 mm, 25\% had NWI <0.292, 62\% exhibited LFCI <0.67, 54\% had MPPTA <83.6 degrees, and 15\% had LPPTA <81.6 degrees. Only 14.4\% of participants exhibited no ACL bony risk factors, whereas 84.5\% had between 2 and 4 bony risk factors and 1.1\% had all bony risk factors. The multivariate analysis demonstrated that only the intercondylar notch width (P < .0001) was an independent predictor according to both sex and ethnicitythe LFCI (P = .012) and MMPTA (P = .02) were independent predictors according to ethnicity. Conclusion: The precise definition of bony anatomic risk factors for ACL injury remains unclear. Based on published thresholds, 15\% to 62\% of this reference population would have been considered as being at risk. Large cohort analyses are required to confirm the validity of previously described morphological risk factors and to define which participants may be at risk of primary ACL injury and reinjury after surgical reconstruction.14DEC3816-38244
Aldol Reactions of Conformationally Stable Axially Chiral Thiohydantoin Derivatives
No full textTwo novel axially chiral ortho-trifluoromethylphenyl thiohydantoin derivatives have been prepared atroposelectively from the reaction of R and S alanine methyl ester HCl salts with ortho-trifluoromethylphenyl isothiocyanate in the presence of triethyl amine. It was found that after purification of the crude product by simple recrystallization, the R amino acid esters yielded thiohydantoins having solely M axial chirality whereas the S ones returned the P isomers only. This result prompted us to perform sterically controlled aldol reactions on M and P thiohydantoin atropisomers. It was found that during the aldol reaction of 3-o-trifluoromethyl-5-methylthiohydantoins, the o-trifluoromethyl group of the M isomers efficiently shielded the Si face of the intermediate and in this way, enabled the selective formation of only the R configured aldol products at C5 of the heterocyclic ring. The P thiohydantoins, on the other hand, yielded only the S C5 configured aldol products as a result of the Re face shielding of the orthotrifluoromethyl group of intermediate enolates. A noteworthy face selectivity of the benzaldehyde molecule was not observed (anti/syn only 3/2) during the aldolization of trifluoromethylphenyl derivatives of thiohydantoins. Aldol reactions were also done using the previously synthesized axially chiral thiohydantoins with ortho-Cl, Br, and I phenyl substituents which had predominantly P conformations (P/M ratios > 95\%), and the stereochemical outcomes were compared with those of the ortho-trifluoromethyl substituted ones. 80-90\% face selectivity of the benzaldehyde molecule was observed for the axially chiral o-halophenyl substituted thiohydantoins. The syntheses done with axially chiral 3-ortho-trifluoromethylphenyl- and 3-ortho-iodophenyl-5-methyl thiohydantoins enabled stereoselective formation of quaternized chiral carbon centers at C5 of the thiohydantoin ring.42OCT 2627823-27832
Evaluating Oxygen Tensions Related to Bone Marrow and Matrix for MSC Differentiation in 2D and 3D Biomimetic Lamellar Scaffolds
No full textThe physiological O-2 microenvironment of mesenchymal stem cells (MSCs) and osteoblasts and the dimensionality of a substrate are known to be important in regulating cell phenotype and function. By providing the physiologically normoxic environments of bone marrow (5\%) and matrix (12\%), we assessed their potential to maintain stemness, induce osteogenic differentiation, and enhance the material properties in the micropatterned collagen/silk fibroin scaffolds that were produced in 2D or 3D. Expression of osterix (OSX) and vascular endothelial growth factor A (VEGFA) was significantly enhanced in the 3D scaffold in all oxygen environments. At 21\% O-2, OSX and VEGFA expressions in the 3D scaffold were respectively 13,200 and 270 times higher than those of the 2D scaffold. Markers for assessing stemness were significantly more pronounced on tissue culture polystyrene and 2D scaffold incubated at 5\% O-2. At 21\% O-2, we measured significant increases in ultimate tensile strength (p < 0.0001) and Young's modulus (p = 0.003) of the 3D scaffold compared to the 2D scaffold, whilst 5\% O-2 hindered the positive effect of cell seeding on tensile strength. In conclusion, we demonstrated that the 3D culture of MSCs in collagen/silk fibroin scaffolds provided biomimetic cues for bone progenitor cells toward differentiation and enhanced the tensile mechanical properties.8APR2
An Examination of the Factors Affecting Community Pharmacists' Knowledge, Attitudes, and Impressions About the COVID-19 Pandemic
No full textObjectives: Coronavirus disease-2019 (COVID-19)-related cases and deaths are ongoing throughout the world, but there is still no effective drug in its treatment, and the vaccine supply is not adequate for the global population. It is important that pharmacists have sufficient knowledge and awareness to prevent and control the disease. COVID-19 has been widely covered in the media, which has been a source widely used by healthcare professionals. This study aimed to assess the knowledge, attitudes, and impressions of community pharmacists about COVID-19 and the factors affecting them. Materials and Methods: The questions in this survey were formed using the guideline created by the World Health Organization, a guide composed by the Turkish COVID-19 Scholarly Commission, and data disclosed to the public on the website of the Ministry of Health. The questionnaire was designed with Google forms and then applied to community pharmacists all over Turkey by sharing the survey link. Results: Analyses of 393 questionnaires showed that Ministry of Health/government statements, the internet (scientific sources), and the media were the preferred sources of information (96.7\%, 89.6\%, and 84\%, respectively). ``Ways to avoid COVID-19{''} was the most searched title (96.9\%). It was determined that the names of the two drugs most frequently mentioned by the participants to be used in the treatment of COVID-19 in Turkey were hydroxychloroquine and azithromycin (57.5\%50.1\%, respectively). Participants who received information from the media gave less education to patients/customers on personal protection measures against COVID-19 (83.3\%) and symptoms of COVID-19 (78.8\%)however, their behavior regarding the training of pharmacy personnel was found to be the opposite. It has been determined that about half of the participants (46.6\%) mostly trust the Ministry of Health regarding the COVID-19 pandemic. Conclusion: Media and other sources influence the knowledge, behavior and impressions of pharmacists'. Having a high level of knowledge positively affects people's behavior. It is important for pharmacists to have accurate information about COVID-19 and to transfer their knowledge to the community to provide patient education and to prevent/control the spread of COVID-19.5OCT530-5401
Deprescribing for all: a narrative review identifying inappropriate polypharmacy for all ages in hospital settings
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The Changing Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Turkey in the Last Decade
No full textBackground: The true prevalence of non-alcoholic fatty liver disease (NAFLD) is unknown in Turkey due to a lack of population-based studies. The aim of this study was (i) to determine the overall and region-specific prevalence of NAFLD in Turkey(ii) to analyze the factors associated with the prevalenceand (iii) to determine the nationwide change in the prevalence of NAFLD in the last decade. Methods: The 10-year data (2007-2016) of 113 239 apparently healthy subjects visiting the check-up clinics of Acibadem Hospitals Group were retrospectively analyzed. A subgroup of patients (n=8120) statistically representing the bigger cohort was selected. The prevalence was analyzed according to ultrasound findings, age, sex, body mass index (BMI), geographical region, and time periods trisected as 2007-2010, 2011-2013, and 2014-2016. Results: The overall prevalence of NAFLD in Turkey was found to be 48.3\%. It was highest among people >50 years of age (65.6\%), male sex (64.0\%), with a BMI>25 kg/m(2) (63.5\%), and in Central and Eastern Anatolia regions (57.1\% and 55.7\%, respectively). The prevalence of NAFLD was 43.5\% between 2007 and 2010, 47.6\% between 2011 and 2013, and 53.1\% between 2014 and 2016, and the rate of increase was 22\%. Multivariate analysis showed that male sex serum alanine aminotransferase level, older age, BMI, type-II diabetes mellitus, hypertension, and dyslipidemia were independent factors associated with NAFLD. Conclusion: NAFLD is a highly prevalent disease affecting almost half of the Turkish population (48.3\%). We are faced with a dramatic increase in NAFLD prevalence in the past 10 years.3MAR302-3123
The Impact of Job Satisfaction on Organizational Commitment Among Generation Y Healthcare Employees
No full textABSTRACT
Objective: This study reported on the knowledge on the factors impacting job satisfaction and organizational commitment in the
healthcare sector. It critically examined the relationship between job satisfaction and organizational commitment among Generational
Y healthcare workers.
Methods: The study involved 236 healthcare professionals working in a private healthcare group in Istanbul, The primary method of
data collection was a questionnaire composed of three sections. The first section recorded data concerning participants’ demographic
information. The second and third sections aimed to assess the participant’s job satisfaction and organizational commitment by applying
the Minnesota Job Satisfaction scale and the Organizational Commitment scale developed by Meyer and Allen. In data analysis and
evaluations, frequency tables, central and prevalence criteria, Pearson’s correlation test and simple linear regression analysis were
employed and analysed in the SPSS 20 statistical package program.
Results: Of 236 healthcare workers, 49.4% of the participants expressed that they have been working in the organization for 1 to 5
years. Among those healthcare workers who belonged to generation Y, a significant and positive relationship was found between job
satisfaction and organizational commitment (r = 0.719, p = 0.000).
Conclusion: Our study results demonstrated a positive and significant relationship between job satisfaction and their organizational
commitment among Generation Y healthcare workers. Among the factors identified, it was observed that pecuniary and moral support
received by employees have increased the perception of job satisfaction, whereas economic security and rewards associated with the
employment strengthened organizational commitment. The study discussed human resources practices that will strengthen job
satisfaction and organizational commitment
Ekstrakorporeal dolaşımda kullanılan arteriyel kanül çaplarının vücut yüzey alanına oranla hemoliz üzerine etkilerinin araştırılması
No full textComparison of the Efficacy of Video Head Impulse and Bi-Thermal Caloric Tests in Vertigo
No full textObjective: To compare video head impulse test (vHIT) and caloric test efficacy in decompensated and compensated vertigo patients and to further investigate whether vHIT alone can be used as a diagnostic tool in vertigo. Methods: This study included 25 patients diagnosed with vertigo and without any previous history of vertigo or hearing loss before their admission to our clinic. The control group consisted of 16 healthy adult volunteers. Patients were classified into 2 groups, compensated and decompensated. Video head impulse test and caloric tests were performed and the results were compared between the groups. Results: The difference of caloric test values between control-compensated groups and compensated-decompensated groups was statistically significant (P < .001, Pearson chi(2)). However, there was no statistically significant difference between the compensated and control groups according to vHIT gain asymmetry values (P = .087). In the very early stages of the disease with spontaneous nystagmus, the diagnostic significance of vHIT was similar to that of the caloric test. When both sides were compared, vHIT gain asymmetry values were close to the caloric test asymmetry values. In the compensated stage, caloric test was superior to vHIT in differentiating compensated vestibular pathologies. When vHIT sensitivity was evaluated according to the bi-thermal caloric test results, the sensitivity of the vHIT gain asymmetry value was 85.71\% and 23.08\% for decompensated and compensated patients respectively. Conclusion: In the early decompensated stages of the disease with spontaneous nystagmus, vHIT shows similar diagnostic accuracy to that of the caloric test. Since patients can tolerate vHIT more easily, our results suggest that vHIT can be considered as a primary evaluation method in the early (decompensated) period of the disease and should be preferred over the caloric test during the acute phase. Caloric test is more reliable at the compensated stage. Video head impulse test is inadequate in evaluating the compensated vestibular hypofunctional states after compensation has been restored.10DEC742-74810
Correlation of Copeptin with N-terminal pro-brain natriuretic peptide in predicting the severity and prognosis of acute pulmonary embolism Copeptin in acute pulmonary embolism
No full textAim: In this study, we aimed to compare copeptin with N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I for predicting severity and 3-month mortality in acute PE in the emergency department (ED). Material and Methods: All ED patients older than 18 years who were confirmed to have acute PE within six hours of diagnostic work-up were enrolled and prospectively screened. Risk stratification was made according to the 2014 European Society of Cardiology guideline on PE. The study endpoints were defined as 3-month mortality, presence of non-low risk PE, and presence of right ventricular (RV) dysfunction. The Mann-Whitney Ll test was used for the comparison of medians. Receiver operating characteristic curves were generated and the area under the curve (AUC) was calculated to determine the best cut-off values of copeptin and NT-proBNP. A P value < 0.05 was considered statistically significant. Results: The study enrolled 82 patients. Twelve patients who died during 3 months had higher concentrations of NT-proBNP and copeptin, but not troponin I. The AUCs of NT-proBNP and copeptin to accurately predict the 3-month mortality were 0.73 +/- 0.09 (95\% CI, 0.62 - 0.82p = 0.013) and 0.78 +/- 0.09 (95\% CI, 0.68 - 0.86p = 0.003), respectively. Low-risk patients, according to Pulmonary Embolism Severity Index, had lower concentrations of copeptin and NT-proBNP compared to intermediate-high risk patients. All three markers discriminated the presence of RV dysfunction truly. Discussion: Copeptin correlates with NT-proBNP and appears beneficial for early risk stratification of acute pulmonary embolism in the ED.S4SEP 15472-4771