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Öğe Adjuvant Abemaciclib Plus Endocrine Therapy for Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative, High-Risk Early Breast Cancer: Results From a Preplanned monarchE Overall Survival Interim Analysis, Including 5-Year Efficacy Outcomes(Lippincott Williams and Wilkins, 2024) Rastogi, P.; O'shaughnessy, J.; Martin, M.; Boyle, F.; Cortes, J.; Rugo, H.S.; Goetz M.P.Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical trial updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.Two years of adjuvant abemaciclib combined with endocrine therapy (ET) resulted in a significant improvement in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) that persisted beyond the 2-year treatment period in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer (EBC). Here, we report 5-year efficacy results from a prespecified overall survival (OS) interim analysis. In the intent-to-treat population, with a median follow-up of 54 months, the benefit of abemaciclib was sustained with hazard ratios of 0.680 (95% CI, 0.599 to 0.772) for IDFS and 0.675 (95% CI, 0.588 to 0.774) for DRFS. This persistence of abemaciclib benefit translated to continuous separation of the curves with a deepening in 5-year absolute improvement in IDFS and DRFS rates of 7.6% and 6.7%, respectively, compared with rates of 6% and 5.3% at 4 years and 4.8% and 4.1% at 3 years. With fewer deaths in the abemaciclib plus ET arm compared with the ET-alone arm (208 v 234), statistical significance was not reached for OS. No new safety signals were observed. In conclusion, abemaciclib plus ET continued to reduce the risk of developing invasive and distant disease recurrence beyond the completion of treatment. The increasing absolute improvement at 5 years is consistent with a carryover effect and further supports the use of abemaciclib in patients with high-risk EBC. © 2024 American Society of Clinical Oncology.Öğe In vivo and in vitro effects of cord blood hematopoietic stem and progenitor cell (HSPC) expansion using valproic acid and/or nicotinamide(Elsevier Masson s.r.l., 2024) Gencer, E.B.; Akin, H.Y.; Toprak, S.K.; Turasan, E.; Yousefzadeh, M.; Yurdakul-Mesutoglu, P.; Cagan M.Background: High self-renewal capacity and most permissive nature of umbilical cord blood (CB) results with successful transplant outcomes but low hematopoietic stem and progenitor cell (HSPC) counts limits wider use. In order to overcome this problem ex vivo expansion with small molecules such as Valproic acid (VPA) or Nicotinamide (NAM) have been shown to be effective. To the best of our knowledge, the combinatory effects of VPA and NAM on HSPC expansion has not been studied earlier. The aim of this study was to analyze ex vivo and in vivo efficacy of VPA and NAM either alone or in combination in terms of expansion and engraftment. Methods: A total of 44 CB units were included in this study. To determine the ex vivo and in vivo efficacy, human CB CD34+ cells were expanded with VPA and/or NAM and colony forming unit (CFU) assay was performed on expanded HSPC. Xenotransplantation was performed simultaneously by intravenous injection of expanded HSPC to NOD-SCID gamma (NSG) mice (n = 22). Significance of the difference between the expansion groups or xenotransplantation models was analyzed using t-test, Mann-Whitney, ANOVA or Kruskal-Wallis tests as appropriate considering the normality of distributions and the number of groups analyzed. Results: In vitro CD34+ HSPC expansion fold relative to cytokines-only was significantly higher with VPA compared to NAM [2.23 (1.07–5.59) vs 1.48 (1.00–4.40); p < 0.05]. Synergistic effect of VPA+NAM has achieved a maximum relative expansion fold at 21 days (D21) of incubation [2.95 (1.00–11.94)]. There was no significant difference between VPA and VPA+NAM D21 (p = 0.44). Fold number of colony-forming unit granulocyte-macrophage (CFU-GM) colonies relative to the cytokine-only group was in favor of NAM compared to VPA [1.87 (1.00–3.59) vs 1.00 (1.00–1.81); p < 0.01]. VPA+NAM D21 [1.62 (1.00–2.77)] was also superior against VPA (p < 0.05). There was no significant difference between NAM and VPA+NAM D21. Following human CB34+ CB transplantation (CBT) in the mouse model, fastest in vivo leukocyte recovery was observed with VPA+NAM expanded cells (6 ± 2 days) and the highest levels of human CD45 chimerism was detectable with VPA-expanded CBT (VPA: 5.42 % at day 28; NAM: 2.45 % at day 31; VPA+NAM 1.8 % at day 31). Conclusion: Our study results suggest using VPA alone, rather than in combination with NAM or NAM alone, to achieve better and faster expansion and engraftment of CB HSPC. © 2024 Elsevier Masson SASÖğe Chemical characterization of Thymus zygis L. (thyme) and Elettaria cardamomum L. (cardamom) essential oils and investigation of their inhibitory potentials against cervicovaginal Escherichia coli isolates(Elsevier GmbH, 2024) Sahal, G.; Donmez, H.G.; Beksac, M.S.Introduction: The cervicovaginal microbiota plays a crucial role in women's well-being and reproductive health. This study initially focuses on identifying the chemical components of the essential oils (EOs) from Elettaria cardamomum L. (cardamom) (Ec) and Thymus zygis L. (thyme) (Tz). Subsequently, this study aims to determine the antimicrobial and biofilm inhibitory effects of these EOs against both cervicovaginal mixed cultures and the microbial strains isolated from them. Methods: The compositions of EOs were determined by GC–MS analysis using an Agilent 7890B GC/5977A Series MSD System. Cervicovaginal samples were obtained from two women presenting complaints of a strong odor and vaginal discharge. Samples were collected from the cervix using a sterile cytobrush, ensuring no contact with the urethra, rectum, or external parts of the vagina. The cytological examination was conducted using Papanicolaou staining. Isolated microorganisms were identified through 16S Ribosomal RNA Gene Sequence Analysis and characterized using antibiogram tests. Antimicrobial tests of the EOs were performed by broth microdilution and disc diffusion methods. Biofilm formation was assessed using a crystal violet binding assay. Results: The major components of Ec EO were ?-terpinyl acetate (41.95 %) and eucalyptol (28.58 %), whereas Tz EO contained significant amounts of o-cymene (38.76 %), carvacrol (22.66 %), and thymol (20.69 %). Escherichia coli codes OR651248 and OR651249 were isolated from CV 6 and CV 7 mixed cultures, respectively. E. coli OR651248 demonstrated a higher antibiotic resistance level than E. coli OR651249. Biofilm formation by mixed cultures was significantly higher than that by E. coli isolates (P < 0.05). The Ec EO displayed minimal to no effect against both mixed cultures, showing zero inhibition zone, 500 ?L/mL minimum inhibitory concentrations (MICs), and 500 ?L/mL minimum microbicidal concentrations (MMCs). However, the Tz EO exhibited antimicrobial activity against both mixed cultures and the E. coli isolates, with inhibition zones > 15 mm and MICs/MMCs < 4 ?L/mL (P < 0.05). In all microbial cultures, 0.5 MIC of both EOs inhibited biofilm formation by more than 80 %. Conclusion: The Tz EO exhibits promising potential as an antimicrobial and biofilm inhibitory agent for managing cervicovaginal E. coli infections. © 2024 Elsevier GmbHÖğe Diagnostic Role of Opsonic Activity in Acinetobacter baumannii Ventilator-Associated Pneumonia(Elsevier Inc., 2024) Karakullukçu, A.; Akker, M.; Kuşkucu, M.A.; Dikmen, Y.; Aygün, G.In this study, we investigated the diagnostic value of opsonic activity against Acinetobacter baumannii in Ventilator-Associated Pneumonia (VAP) among 50 patients, compared to 102 negative and positive controls. Out of the 50 patients, only 33 (66 %) were diagnosed with VAP using the Clinical Pulmonary Infection Score (CPIS). The opsonic activity assay demonstrated three key findings: (i) 95 % sensitivity and 91.7 % specificity, with a Receiver Operating Characteristic (ROC) area of 0.976 for distinguishing A. baumannii culture positives from negatives; (ii) 95 % sensitivity and 78.7 % specificity, with a 0.915 ROC area, in differentiating VAP/blood culture positive patients from colonized/negative groups; (iii) An ROC area of 0.553 for VAP and colonization, as identified by CPIS alone, indicating an indeterminate threshold. These results highlight that CPIS, microbiological, and clinical evaluations were not correlated, suggesting that opsonic activity against A. baumannii could be a potential VAP diagnostic tool, with the need for large-scale validations. © 2024Öğe Serum salusin-? and salusin-? levels in patients with psoriatic arthritis(NIH NLM, 2022) Kobak, Şenol; Atabay, Tennur; Akyıldız, Muhittin; Gökduman, Ayşe; Vural, HüseyinIntroduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease characterized by skin lesions and joint involvement. Salusin-? and salusin-? are two new bioactive molecules. It is reported that salusins may have role in regulation of the immune system and inflammation. The aim of our study was to evaluate the serum salusin-? and salusin-? levels in PsA patients and to establish the possible relationship with the disease features. Material and methods: Our study included 40 PsA patients who fulfilled the CASPAR criteria and 40 healthy volunteers. Demographic, clinical, laboratory and radiological data and disease activity indices (PASI, BASDAI, BASFI, HAQ) were recorded in all patients. The enzyme-linked immunosorbent assay (ELISA) method was used to measure serum salusin-? and salusin-? levels. Results: The demographic data were as follows: 13 patients (32.5%) were males and 27 (67.5%) were female, mean age was 48.5 years and mean disease duration was 2.4 years. Patients' history was taken and clinical assessment was performed; 20 (50%) patients had a family history, 18 (45%) patients were smoker, 19 (47.5%) patients had HLA-B27 positivity, 33 (82.5%) had sacroiliitis, 36 (90%) had enthesitis, 23 (57.5%) had distal interphalangeal (DIP) joint and nail involvement, 26 (65%) had wrist involvement, and 11 (27.5%) had ankle involvement. Laboratory data of the patients were recorded; 20 (50%) patients had elevated CRP level and 25 (62.5%) patients had an elevated ESR level. The study results showed that PsA patients had an elevated serum salusin-? level when compared with the control group (p = 0.004). The association between serum salusin-? level and ankle arthritis was found (p = 0.04). Serum levels of salusin-? were similar in PsA patients and controls both (p = 0.285). Conclusions: We found elevated serum salusin-? in PsA patients while the serum salusin-? levels were normal. Salusin-? may have a possible role in disease pathogenesis and it may be use as a reliable biomarker in PsA patients. Multicenter prospective studies are needed in this regard.Öğe Kardiyovasküleri işlemlerde görüntüleme(Archives of the Turkish Society of Cardiology, 2022) Vatansever Ağca, Fahriye; Babur Güler, Gamze; Gürsoy, Mustafa Ozan; Özden, Özge; Altın, Mert Pehlivan; Kahveci, GökhanKardiyovasküler İşlemlerde GörüntülemeÖğe Increased visinin-like protein-1, YKL-40, lipocalin-2, and IL-23 levels in patients with migraine(TAYLOR & FRANCIS LTD, 2022) Dündar, Ahmet; Cafer, Vugar; Aslanhan, Hamza; Özdemir, Hasan Hüseyin; Yılmaz , Ahmet; Çevik, Mehmet UğurBackground: Migraine is a type of primary headache caused by changes in the trigeminal system and has been reported to be associated with neurovascular inflammation of cerebral and extracerebral vessels. Objective: It is known that inflammation is an important process in the pathogenesis of migraine. It has been shown that the molecules of visinin-like protein 1 (Vilip-1), YKL-40, lipocalin-2 and interleukin (IL)-23 play a role in the inflammatory process. Our aim is to investigate the role of this molecule in the metabolic pathway of migraine disease. Methods: Fifty migraine patients with and without aura in the interictal period were included in the study. Vilip-1, YKL-40, lipocalin-2, and IL-23 levels were measured by ELISA method. Results: Serum vilip-1, YKL-40, lipocalin-2, and IL-23 levels were found to be significantly higher in migraine patients compared to the control group. We found that this molecule increased significantly in migraine subgroups compared to the control group (p < 0.001). A positive significant correlation was found between vilip-1 level and YKL-40 and lipocalin-2 levels in migraine patients. In addition, a positive correlation was observed between visual analogue scale score, number of days with pain and vilip-1 level (p < 0.01). The results of our study showed that activation of inflammatory mediators may play a role in the pathogenesis of migraine disease. In addition, our study is valuable in that inflammatory molecules are high in the interictal period and these biomarkers have never been analyzed in migraine patients. However, we still believe that larger studies are needed to explain the role of vilip-1, YKL-40, lipocalin-2, and IL-23 in the molecular mechanism of migraine disease.Öğe Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients(WILEY, 2022) Urfalı, Mine; Yılmaz, Gürkan; Özkul, Bahattin; Urfalı, Furkan ErtürkObjectiveThe most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non-invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis. Method42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography. ResultsBoth parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p < 0.001). ConclusionOur study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients.Öğe Prognostic factors affecting survival in breast cancer patients age 40 or younger(Ondokuz Mayis Universitesi, 2022) Kuru, Bekir; Yürüker, Savaş; Akgün, Can; Karabacak, Ufuk; Özen, NecatiThe aims of this study were to identify the factors affecting survival and disease-free survival (DFS) in invasive breast cancer patients who underwent surgery for breast cancer age 40 or younger. Medical records of 216 women with breast carcinoma at age 40 or younger who underwent surgery at our Institution between October 2005 and May 2017 were retrospectively reviewed. One hundred and eighty eight invasive breast cancer patients that were eligible were categorized according to their clinical and pathological features. Univariate analyses of survival and DFS were performed by the Kaplan-Meier method and the log-rank test. Independent prognostic and predictive factors affecting survival and DFS were assessed by Cox regression proportional hazard method. 10-year survival and DFS were 85 and 74%, respectively. Axillary involvement, pathologic tumor size, HER 2 + subtype and Triple Negative subtype were found to be the prognostic factors that independently affected survival and DFS. The prognosis is worse in patients with axillary involvement, tumors larger than 2 cm, and HER 2+ and Triple Negative subtypes. These adverse prognostic factors should be considered during treatment and follow-up of patients age 40 or younger. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Novel magnetic embolic MRI imageable particles with anticancer drug release for transcatheter arterial embolization and magnetic ablation(WILEY, 2022) Bekaroğlu, Maide Gökçe; Nurili, Fuad; Caymaz, İsmail; Baş, Ahmet; İşçi, SevimThe aim of the study is to prepare embolic hydroxyl ethyl cellulose (HEC)-polyvinyl prolidone (PVP)-magnetic particles suitable for transcatheter arterial chemoembolization (TACE) procedures, drug delivery, and magnetic hyperthermia. Two different sizes (microsized and nanosized) of iron oxide particles were used to prepare the embolic particles to investigate the embolization and drug delivery properties. Iron oxides were linked with PVP via bridging flocculation process, then outermost layer of the linked particles was coated with HEC in order to load drugs to particles and reach size requirements for a successful TACE procedure. Size of each particle was calibrated to the range that allows easy injections through microcatheters (40-500 mu m). The results showed that the size of the final embolic particles reached around 70 mu m with 82 W/g specific absorption rate (SAR) values for nano-iron oxide particles and 45 mu m with 77 W/g SAR values for micro-iron oxide particles, which are quite suitable for TACE applications. Furthermore, an anticancer drug doxorubicin (DOX) was successfully loaded onto these particles in order to achieve localized chemotherapy at the tumor site. Particles produced in this study, loaded DOX successfully and prolonged drug release time, performed similarly to pure DOX at higher concentration treatments against human breast cancer cell lines, were heatable under applied alternating magnetic fields. In addition, in vivo embolization studies performed using a rabbit renal embolization model, indicated that these particles were easily delivered through microcatheters and were able to embolize the target.Öğe Clinical reflection of pre- and post-COVID-19 symptoms in COVID-19 patients(2022) Demirkol, Barış; Gül, Şule; Çortuk, Mustafa; Koç, Aysu Sinem; İlhan, Umut; Baydili, Kürşad Nuri; Çetinkaya, Erdoğan; Koç, Aysu SinemBackground: Hospitalized or non-hospitalized patients with Coronavirus disease-2019 (COVID-19) may exhibit different symptoms. Different symptoms of patients can give us an idea about the course of the disease. Materials and Methods: A cross-sectional questionnaire study was conducted between August and October 2021. The questionnaire was sent online to patients who had COVID-19 infection with polymerase chain reaction positivity. The following categories were included in the questionnaire: Demographic characteristics, diagnosis date, initial symptoms, predominant symptoms, treatments, presence of hospitalization requirement, ongoing symptoms after the treatment, and symptom duration. Results: Of the 596 patients, 574 (92.4%) were symptomatic at the beginning of the disease. Myalgia, fatigue, and headache were the most prominent initial symptoms. Fever and dyspnea were the most predominant symptoms that compel the patients to apply to the hospital. While dyspnea was significantly higher in hospitalized patients, fever was more common in non-hospitalized patients. Higher mean age, male gender, and comorbidity (especially chronic obstructive pulmonary disease) were found to be factors that increased hospitalization (p<0.01). Fever and fatigue were mostly seen among females, while myalgia was most prominent among men. Four hundred and seventy-seven patients (80%) had post-COVID symptoms and the most common symptoms were getting tired easily, fatigue, myalgia, and cough. However, post-COVID symptoms were most intense in the second month and there were cases with complaints up to one year. Conclusion: The majority of the COVID-19 patients in our study were symptomatic. Dyspnea and fever with higher mean age were more common in patients requiring hospitalization. Post-COVID symptoms may persist for a long time, and long-term monitoring may be beneficial.Öğe Effectiveness of preemptive chlorhexidine digluconate-flurbiprofen spray on postoperative sore throat and hoarseness in patients undergoing rhinoplasty: a retrospective study(PMC PubMed Central, 2022) Kartufan, Fatma Ferda; Yıldırım, Alpaslan; Morkoç, Okan; Çiçek, MüslümBackground In this retrospective study, we aimed to investigate the effect of chlorhexidine digluconate-flurbiprofen spray (Klorhex Plus® oral spray) on postoperative sore throat (POST) and hoarseness (POH) in patients undergoing rhinoplasty. Methodology Patients who underwent rhinoplasty alone in our clinic between April 01, 2021, and February 28, 2022, were enrolled in the study. Patients' demographics such as age, gender, height, and smoking status that could affect sore throat, difficult intubation, and operation time were recorded from the patients' files. Patients were grouped as those who received Klorhex Plus oral spray before the surgery (Klorhex P group) and those who did not (control group). POST and POH were recorded from the patients' postoperative surgery files. Postoperative pain evaluation was performed using the Numerical Rating Scale (NRS) at the postoperative first hour (PPL1h), 12th hour (PPL12h), and first day (PPL1d) from the postoperative nursing files. Results A total of 354 patients who underwent rhinoplasty alone were included in this study. No significant difference was found between the groups in terms of the demographic data. Statistically, PPL1h, PPL12h, and PPL1d were significantly lower in the Klorhex P group compared to the control group (for all, p < 0.001). POST and POH were also significantly higher in the control group (both, p < 0.001). Conclusions The results of this study indicate that Klorhex Plus oral spray is an efficient agent for preemptive analgesia before rhinoplasty. It significantly decreases the postoperative pain level, POST, and POH. However, further comprehensive prospective studies are needed to introduce Klorhex Plus oral spray to rhinology practice.Öğe Akut lösemide nüks öngörüsünde olası şüpheli: trombositopeni(2022) Çetin, İpek Dokurel; Özdemir, Gül Nihal; Çelkan, Tülin Tiraje; Erdoğan, Mehmet Sarper; Apak, HilmiAmaç: Çocukluk çağında, akut lösemi hastalarında nüks gelişmesi s ık olmamakla birlikte, mortalitesi yüksek bir komplikasyon olarak kar şımıza ç ıkmaktadır. Çalışmamızda, çocukluk çağı akut lösemi hastalar ının nüks riskinin öngörüsünde kolaylıkla kullanılabilecek kan belirteçlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde, 20 y ıllık süreçte akut lösemi tanısı alan 279 çocuğun verileri geriye dönük tarandı. Tüm verilerine ulaşılabilen 42 nüks gelişmiş ve 37 nüks gelişmemiş akut lösemi olgusu çalışmaya dahil edildi. Tüm hastaların, tan ı esnasındaki ve takip sürecindeki kan say ımı belirteçleri ve fizik muayene bulguları geriye dönük olarak değerlendirildi. Say ısal değişkenlerin kar şılaştırılmasında, Mann- Whitney U ve T- test kullanıldı. Kategorik değişkenlerin karşılaştırılmasında ise, Ki- kare testi kullanıldı. Bulgular: Nüks gelişen çocuk değerlendirildiğinde; yirmidört çocuk B-hücreli ALL, 10 çocuk T-hücreli ALL, 8 çocuk AML tanısı almıştı. Nüks gelişmeyen olguların ise; 26 çocuk B-hücreli ALL, 10 çocuk T- hücreli ve 1 çocuk AML tanısı almıştı. Remisyon sağlandıktan sonraki izlemde, nüks gelişen 24 hastada ve nüks gelişmeyen dokuz hastada tr ombositopeni görüldü. Tüm hastalar değerlendirildiğinde; remisyon sonrasında, trombositopeni görülen olgularda nüks gelişme riski istatistiksel olarak anlamlı şekilde yüksekti. Remisyon döneminde, ortalama 3.86 hafta devam eden trombositopeni görülen tüm hastalarda nüks geliştiği gözlenmiştir. Sonuç: Çocukluk çağı akut lösemi hastalarının, remisyon dönemindeki iz lemleri esnasında trombositopeni gözlenmesi, öncelikle tedavide kullanılan kemoteröpetiklerin ve olası gelişen infeksiyonların kemik iliğine olan etkisi ile açıklanabilir. Ancak, çalışmamız göstermiştir ki; remisyon dönemi sonrasında geli şen ve üç haftadan uzun süren trombositopeni varlığı nüks gelişiminin öngörüsünde, ulaşımı kolay bir kan belirteci olarak kullanılabilir.Öğe Alpha-lipoic acid intoxication in an adolescent girl:case report and review of the literature(2022) Polat, Sinem; Sönmez, Feruze Turan; Kılıçaslan, ÖnderAlpha-lipoic acid is a widely used medication that does not need a prescription. Although it is safely used in adults, hitherto no safe dose for children has been reported, and there is no known antidote. The medical literature provides four reports of alpha-lipoic acid intoxication in the pediatric population to date. This case-report is the lowest known dose of alpha-lipoic acid intake leading to poisoning in a teenager.Öğe The effect of periodic examination time interval and frequency after “percutaneous coronary intervention” on experiencing second "acute coronary syndrome"(2022) Balaban, Yakup; Coşansu, KahramanThe Effect of Periodic Examination Time Interval and Frequency After “Percutaneous Coronary Intervention” on Experiencing Second "Acute Coronary Syndrome"Öğe Venous leg symptoms in migraineurs: a potential clue on the pathophysiology of migraine(Edizioni Minerva Medica, 2022) Çuğlan, Bilal; Önalan, Ayşenur; Öztürk, Selçuk; Altuntaş, Emine; Demiral, Ahmet B.; Atmaca, Hasan; Altıntaş, Sait; Yetkin, ErtanBACKGROUND: Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. METHODS: The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine and age-, sex- matched healthy subjects without migraine. All participants were examined for the presence of chronic venous disease (CVD). VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. RESULTS: Participants were classified into two groups as migraine-positive group (N.=130) and migraine-negative group (N.=130). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. Total VEINES-Sym score was lower in patients with migraine compared to control group (34.4±8.7, 37.6±8.12, P=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=-0.33, P<0.001) and MIDAS severity levels (little or no, mild, moderate, severe) (r=-0.266, P=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR=0.95, 95% CI:0.92-0.98, P=0.001). CONCLUSIONS: We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. Further studies are warranted to figure out the pathophysiological associations between migraine and venous vascular pathology and peripheral varicose vein. © 2022 EDIZIONI MINERVA MEDICA.Öğe Humoral and cellular immunity to SARS-COV-2 vaccination with BNT162B2 MRNA vaccine in pediatric kidney transplant and dialysis patients(Springer, 2022) Gülmez, Rüveyda; Özbey, Doğukan; Ağbaş, Ayşe; Aksu, Bağdagül; Yıldız, Nurdan; Üçkardeş, Diana; Saygılı, Seha; Yıldırım, Zeynep Yürük; Taşdemir, Mehmet; Kıykım, Ayça; Çokuğraş, Haluk; Canpolat, Nur; Nayır, Ahmet; Kocazeybek, Bekir S.; Çalışkan, SalimHumoral And Cellular Immunity To Sars-Cov-2 Vaccination With Bnt162b2 Mrna Vaccine In Pediatric Kidney Transplant And Dialysis PatientsÖğe COVID-19 infection frequency and clinical course in patients with liver transplantation: results of a single transplant center in Turkiye(TURKISH SURGICAL ASSOC, 2022) Aydın, Osman; Çolakoğlu, Muhammet Kadri; Öter, Volkan; Özgün, Yiğit Mehmet; Pişkin, Erol; Arı, Derya; Kayhan, Meral Akdoğan; Özmen, Mehmet Mahir; Bostancı, Erdal BirolObjective: In this paper, it was tried to determine the incidence of COVID-19, course of the disease, and mortality rate in liver transplant patients by evaluating all patients operated on in our center. In addition, the results of liver transplantation performed in our center during the pandemic period were also presented. Material and Methods: All patients who had undergone liver transplantation in our liver transplant center were questioned about their history of COVID-19 either at their routine controls in the clinic or by phone interview. Results: Our liver transplant unit had 195 registered liver transplantation patients (2002-2020), and 142 of these were still alive and under follow-up. During the pandemic period, 80 patients referred to our outpatient clinic for follow-up, and their records were evaluated retrospectively in January 2021. Among 142 liver transplant patients, a total of 18 (12.6%) COVID-19 patients were identified. While 13 of these patients were males, mean age of the patients at the time of interviews was 48.8 years (22-65 years). Nine of the patients had living donor liver transplant, and the rest had cadaveric liver transplant. The most common COVID-19 associated symptom in the patients was fever. During the pandemic period, 12 liver transplant operations were performed in our center. Nine of them were living donor liver transplantation and the remainder were cadaveric liver transplantations. Two of our patients got COVID-19 positive during this period. One of them who was transplanted after COVID treatment was followed-up in intesive care for a long time and was lost not related to COVID-19. Conclusion: The incidence of COVID-19 is higher in liver transplant patients than in the general population. Nonetheless, mortality rates are low. During the pandemic period, liver transplantation can be continued by following general precautions.Öğe Comparing the success rate of natural cycle and modified natural cycle protocols for frozen-thawed embryo transfer(TAYLOR & FRANCIS LTD, 2022) Aydın, Turgut; Kalem, Müberra Namlı; Bakırarar, Batuhan; Aygün, Elif Ganime; Kalem, ZiyaObjective: The aim of the present study is to compare the effects of Natural Cycle and modified Natural Cycle protocols for frozen-thawed embryo transfer on clinical pregnancy rate and live birth rate. Methods: This prospective randomized controlled trial comprised 145 patients scheduled for frozen-thawed embryo transfer and was conducted at a university hospital between 2019 and 2021. The Natural Cycle protocol was administered to 73 patients and the modified Natural Cycle protocol to 72 patients and the clinical outcome was compared between the groups. The main outcome measure was live birth rate. Results: Baseline characteristics and cycle parameters were similar in both groups. There was no difference in clinical pregnancy rate (58.9% and 54.2%, respectively; p = .565) and live birth rate between the Natural Cycle and modified Natural Cycle groups (49.3% and 48.6% respectively; p = .932). Conclusion: This study established that clinical pregnancy and live birth rates were not affected by natural cycle ovulation being spontaneous or hCG-triggered among patients undergoing frozen-thawed embryo transfer. Thus, the protocol for natural cycle frozen-thawed embryo transfers should be chosen according to the priorities of the patient and the physician.Öğe Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022) Sağlık, Ali; Şencan, Fahir; Giray, Tufan Akın; Ocak, TarıkAcute non-traumatic spinal subdural hematoma (SSDH) is a rare clinical condition in the emergency medicine practice and difficult to diagnose during the primary physical examination. It mostly occurs at thoracal vertebra levels due to trauma, use of anticoagulants, medical procedures such as acupuncture, arteriovenous malformations, hematological disorders or space-occupying lesions. Here, we discussed an elderly female patient who was not on anticoagulant and described sudden loss of muscle strength and sensation in both lower extremities. Initial laboratory and imaging including brain computerized tomography (CT) and magnetic resonance imaging (MRI) were in normal range. Patient's secondary examination revealed anesthesia under the T4 dermatome level. Cervical spine-MRI in Spin Eco (SE) T1, Fast Spin Eco (FSE) T2 in sagittal plane; SE T1 weighted in axial and sagittal planes revealed a subdural hematoma significantly compressing the spinal cord on the C7-T1 dermatome segments. Any emergency neurosurgical intervention was not considered and the patient was interned in the neurosurgical clinic for conservative treatment and further examination. Patient, with no progress seen in consecutive MRI scans, was discharged after offering an outpatient check-up. We recommend secondary physical examination in emergency department (ED). In the case of appearance of sensory deficits of certain dermatomes, spine-MRI may lead to put the diagnose early in ED.
