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OBJECTIVE: Our study aims to determine the frequency and types of GTD (Gestational Trophoblastic Disease) in our clinic, to evaluate its relationship with clinical parameters, and the consistency of clinical prediagnosis and pathological definitive diagnosis. PATIENTS AND METHODS: In the present study, hospital records of 120 patients with gestational trophoblastic disease between January 2019 and August 2022 were obtained and evaluated retrospectively. Demographic, hematological, biochemical, and clinical data were collected in detail, and the data were analyzed statistically. RESULTS: Our study included a total of 120 female patients, with an average age of 31.16±9.70. The average number of patients was 3. The average time for women to receive the diagnosis was 9.80±2.45 weeks, with the most frequent complaint on our part being bleeding (85.8%). When the pathology outcomes of the patients we included in our study were examined, it was found that the number of patients diagnosed with incomplete abortion was 34, the number of patients diagnosed with complete abortion was 82, the number of invasive moles diagnosed was 3, and the number of patient diagnosed with choriocarcinoma was 1. Kappa ratio was calculated as 0.419 (p<0.001) when the compliance of the clinical diagnosis was assessed. This value was consistent with median level alignment. In a study that examined the three years of our calism in our bulk, 1.8 per 1,000 births were followed frequently. CONCLUSIONS: We should inform patients in detail about gestational trophoblastic diseases and warn patients not to delay their consequences. We should recommend that pregnancy be avoided for 12 months for low-risk patients and 18 months for high-risk patients after GTD.
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Enfermedad Trofoblástica Gestacional , Humanos , Femenino , Enfermedad Trofoblástica Gestacional/diagnóstico por imagen , Enfermedad Trofoblástica Gestacional/diagnóstico , Embarazo , Estudios Retrospectivos , Adulto , Adulto JovenRESUMEN
OBJECTIVE: Due to infectious complications of transrectal prostate biopsy (TRBx), the transperineal prostate biopsy (TPBx) technique is gaining popularity and is the first-line method in many institutions. We share our experience of the first 100 patients with TPBx, performed using the coaxial needle technique under local anesthesia. PATIENTS AND METHODS: We retrospectively reviewed the records of the first 100 patients who had undergone TPBx between December 2022 and September 2023. Complication rates, cancer detection rates, patient tolerance, and pain response to the TPBx under local anesthesia at different steps of the procedure were collected. RESULTS: The mean age, total prostate-specific antigen (PSA), prostate volume, and PSA density were 64.5±7.5 years, 8.82±12 ng/mL, 58.4±26.4 mL, and 0.17±0.18 ng/mL2. Prostate cancer (PCa) was detected at histopathological evaluation in 51 patients. The mean positive core number and percentage of cancer involvement per core in patients who have PCa were 5.4±3.2 and 68.5±29.1, respectively. The mean pain score during the entire procedure was 2.85±1.48. When the steps are evaluated separately, the mean pain score during the probe placement step, local anesthetic, and sampling steps were 3.35±1.65, 2.54±1.45, and 0.9±0.82, respectively. CONCLUSIONS: Transperineal prostate biopsy with coaxial needle technique under local anesthesia is a well-tolerated procedure with feasible complication rates and patient discomfort.
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Anestesia Local , Próstata , Neoplasias de la Próstata , Humanos , Masculino , Persona de Mediana Edad , Anestesia Local/efectos adversos , Anestesia Local/métodos , Estudios Retrospectivos , Anciano , Neoplasias de la Próstata/patología , Próstata/patología , Perineo , Antígeno Prostático Específico/sangre , Biopsia con Aguja/efectos adversos , Biopsia con Aguja/métodosRESUMEN
SrGd2O4 phosphors doped with Eu3+ were successfully synthesized through a sol-gel combustion method, covering a range of dopant concentrations from 0.25 mol% to 3 mol%. The structural analysis of these phosphor materials was comprehensively conducted utilizing various techniques, including X-ray powder diffraction analysis (XRD), Energy Dispersive X-ray (EDX), and Fourier-transform infrared spectroscopy (FTIR). In addition to unveiling the structural characteristics, these analyses provide valuable insights into the compositional aspects, enhancing our understanding of the synthesized SrGd2O4:Eu3+ phosphors across different doping levels. XRD analysis findings validate the successful generation of the intended SrGd2O4 host, demonstrating orthorhombic system structures consistent with JPCD card number 98-019-3592. FTIR analyses conducted on the phosphor samples not only identify bending modes but also reveal intricate details about small vibration bonds within the material. When excited by the 349 nm laser, SrGd2O4:xEu3+ phosphors exhibit distinct photoluminescence (PL) properties like red emission at 614 nm from Eu3+. From the emission spectra, one can clearly observe that Eu3+ with an ionic radius close to the Gd3+ ion preferentially occupies the symmetry sites of the host lattice. The optimal doping concentration was determined to be 0.5 mol%, as revealed by the data in our study. Additionally, a deeper understanding of the luminescence quenching mechanism was attained, pinpointing the involvement of dipole-dipole (d-d) energy transfer in this intriguing phenomenon. This optimal concentration not only enhances the material's properties but also underscores the pivotal role of d-d interactions in governing the luminescence behavior within the doped system.
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OBJECTIVE: Diabetes is a chronic disease that can cause various complications and has a high prevalence. Evidence increasingly shows that acid-base homeostasis is critical to maintaining normal metabolic function. This case-control study aims to evaluate the relationship between dietary acid load and the risk of type 2 diabetes. PATIENTS AND METHODS: This study recruited 204 participants, 92 of whom had just been diagnosed with type 2 diabetes, and 102 healthy controls who were matched in age and gender as controls. Twenty-four dietary recall was used for dietary intake assessments. Dietary acid load was approximated using two different methods: potential renal acid load (PRAL) and net endogenous acid production (NEAP), both calculated from dietary recalls. RESULTS: In the case and control groups, the dietary acid load mean scores were 4.18±26.8, 20.84±29.54 mEq/day for PRAL, and 55.11±29.23, 68.43±32.23 mEq/day for NEAP, respectively. When it came to the multiple possible confounders, the participants in the highest tertile of PRAL (OR 4.43, 95% CI: 1.38-23.81, ptrend<0.001) and NEAP (OR: 3.15, 95% CI: 1.53-9.59, ptrend<0.001) had a significantly higher risk of developing type 2 diabetes compared to those in the lowest tertile. CONCLUSIONS: The findings of the present study suggest that a high acid load in the diet may increase the risk of type 2 diabetes. Therefore, it is possible that limiting dietary acid load could lower type 2 diabetes risk in vulnerable individuals.
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Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/metabolismo , Estudios de Casos y Controles , Dieta/efectos adversos , Riñón/metabolismo , Ácidos/metabolismoRESUMEN
OBJECTIVE: Metabolic syndrome is a condition characterized by metabolic abnormalities. Its overall prevalence increases with age, in turn resulting in a substantial burden of disease all around the world. The aim of this study is to evaluate the efficacy of several anthropometric indices for predicting metabolic syndrome among the elderly people. SUBJECTS AND METHODS: This study was conducted on 348 elderly people aged 65 and over, including those who were diagnosed with metabolic syndrome based on the National Cholesterol Education Program's Adult Treatment Panel III criteria and those who did not suffer from metabolic syndrome. A trained dietitian performed body weight, height, waist circumference, and hip circumference measurements. Furthermore, body mass index, waist-hip ratio, waist-height ratio, conicity index, abdominal volume index, body shape index, and body roundness index values were measured. The receiver operating characteristic (ROC) curve was applied to assess the capability of these indices to predict metabolic syndrome. RESULTS: Of the 348 subjects recruited, 56.0% had metabolic syndrome. Body Roundness Index had the largest area under the curve for predicting metabolic syndrome in both males and females (0.678 and 0.645, respectively), followed by abdominal volume index (0.673 and 0.626, respectively) and waist circumference (0.672 and 0.626, respectively). CONCLUSIONS: Body roundness index was more effective compared to the other seven indices for predicting metabolic syndrome in the elderly population in Turkey.
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Síndrome Metabólico , Adulto , Femenino , Masculino , Anciano , Humanos , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Antropometría , Circunferencia de la Cintura , Relación Cintura-Cadera , Índice de Masa CorporalRESUMEN
Methotrexate is used for cure of many cancer types. It has many side effects. For this reason, obtaining a nephroprotective agent is obligatory. In the study, our aim is to determine probable effects of Vitamin B12 on MTX caused kidney damages in rats. Rats were randomly divided into 4 groups, including 8 animals in each group. Control group, VitB12 group (3 µg-kg-ip B12 throughout 15 days), MTX group (at the 8th day of experiment, a single dose of 20 mg-kg-ip MTX), Vit B12 + MTX group (3 µg-kg-ip B12 throughout 15 days and at the 8th day of experiment, a single dose of 20 mg-kg-ip MTX) Animals were anesthetized and kidney tissues were removed to evaluate biochemically, immunohistochemically and histopathologycally. There were histopathological deteriorations, rises of apoptotic cells, expressions of heat shock proteins, endoplasmic reticulum stress and inflammation markers in the MTX group. In the MTX group, Superoxide Dismutase (SOD), Total Antioxidant Status (TAS) and Catalase (CAT) levels decreased, but Total Oxidant Status TOS, Malondialdehyde (MDA) and interleukin-6 (IL6) levels increased. In addition, there was amelioration in kidney tissue in Vit B12 + MTX group compared to the MTX group. We suggest that Vit B12 can be used to reduce the toxic effects of MTX.
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Antimetabolitos Antineoplásicos/toxicidad , Enfermedades Renales/prevención & control , Metotrexato/toxicidad , Vitamina B 12/uso terapéutico , Complejo Vitamínico B/uso terapéutico , Animales , Apoptosis , Catalasa/metabolismo , Ensayo de Inmunoadsorción Enzimática , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Interleucina-6/metabolismo , Enfermedades Renales/inducido químicamente , Enfermedades Renales/enzimología , Masculino , Malondialdehído/metabolismo , Ratas , Ratas Wistar , Superóxido Dismutasa/metabolismoRESUMEN
In Turkey, cyst hydatid disease (CHD) or cystic echinococcosis (CE) is publicly known as "dog cyst", a fatal and serious disease not only affects livestock husbandry and human health but also brings about economic loss to our country. According to the data of the Ministry of Health; number of annual cases was 408 in 2008, and this number reached 1,867 by the end of 2019. Cystic echinococcosis is especially taken up during childhood and emerged at an older age. They become exposed to the eggs of the tapeworm after close contact with an infected dog or its contaminated environment. The infected dogs also pass in their feces E. granulosus eggs that adhere to the dogs' hairs, and pass on to the children who are in the course of playful and intimate contact with the infected dogs. This study was to create the awareness of risk factors of CE among 10 different districts of Izmir province. Awareness raising seminars are essential component of this study because local people living in CE endemic areas, are crucial to continue and sustain the long-time effort that is needed to tackle this disease. In each district, 3 awareness raising seminars were held to the target groups: (a) in schools for students, teachers, administrators, (b) for general public, (c) for healthcare professionals. 4090 students attended to the trainings, 242 administrators and teachers who attended to the presentations together with the students, 524 people were attended to the trainings and 327 health workers attended to the trainings from different institutions. This study helped improving this situation by organising educational events for the rural populations for preventing transmission of the disease. This is the first educational intervention study regarding creating awareness on CE in Izmir Province which includes 10 districts between January 2019 to January 2020.
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BACKGROUND: Parkinson's Disease (PD) and sarcopenia share a number of common pathways, and they can potentially affect each other. OBJECTIVE: We aimed to investigate the relationship between dysphagia and sarcopenia in elderly patients with PD compared to healthy controls. METHODS: This case-control study was conducted on 54 elderly PD patients and age-, sex- and body mass index-matched 54 healthy elder persons. Demographic and disease characteristics such as disease duration, stage of disease and Unified Parkinson's disease rating scale were recorded. All subjects were assessed by 10- item Eating Assessment Tool, Gugging Swallowing Screen tests and flexible fiberoptic endoscopic evaluation of swallowing (FEES) as well as Mini nutritional test short form. Also, A simplified screening tool for assessing sarcopenia (SARC-F), five times sit-to-stand and gait speed tests as well as lumbar magnetic resonance imaging (MRI) cross-sectional area of psoas and paraspinal muscles were used for evaluation of sarcopenia. Patients were divided as «with normal swallowing¼ or «with dysphagia¼ according to the FEES results. Three groups were compared among themselves in terms of evaluation methods. RESULTS: Sarcopenia evaluation parameters were significantly higher in patient groups compared to the control group. Moreover, muscle measurements evaluated by MRI in patients with dysphagia are lower than both patients with normal swallowing and control group (p value between 0.001 and 0.011). CONCLUSIONS: Patients with PD have lower muscle mass compared to healthy controls, and the situation is more pronounced in dysphagic PD patients.
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Trastornos de Deglución , Enfermedad de Parkinson , Sarcopenia , Anciano , Estudios de Casos y Controles , Deglución , Trastornos de Deglución/etiología , Humanos , Enfermedad de Parkinson/complicaciones , Sarcopenia/complicacionesRESUMEN
BACKGROUND AND PURPOSE: Flow-diverter deployment within a stent remains controversial, but flow-diverter deployment within a scaffolding stent has been performed occasionally. To date, an analysis of this scaffolding technique has not been reported. We aimed to evaluate whether the scaffolding technique adversely affects the outcomes of flow diversion. MATERIALS AND METHODS: Patients who had undergone intracranial aneurysm treatment using a Silk flow diverter with (scaffolding group) or without (bare flow-diverter group) a scaffolding stent were identified retrospectively and compared. Propensity score matching was used to match the aneurysms in both groups for variables with a significant difference between groups. Aneurysm occlusion rates and clinical outcomes were compared. RESULTS: There were 84 patients (105 aneurysms) in the bare flow-diverter group and 21 patients (22 aneurysms) in the scaffolding group (using 20 LEO stents and 1 Enterprise stent). The aneurysms in the scaffolding group were larger (mean, 13.1 [SD, 10.7] versus 7 [SD, 4.5] mm, P = .001) and more likely to be fusiform (40.9% versus 5.7%, P < .001) than in the bare flow-diverter group. After 2:1 propensity score matching, 24 aneurysms in the bare flow-diverter group and 15 in the scaffolding group were matched. Aneurysm occlusion rates did not significantly differ between groups at 1-3 months (41.2 versus 33.3%, P > .99), 3-6 months (55.5 versus 75.0%, P = .44), 7-12 months (65.0 versus 90.0%, P = .21), or beyond 1 year (73.6 versus 91.6%, P = .36). There was no difference in complication rates between the groups (P > .99). CONCLUSIONS: Placement of a scaffolding stent before flow diversion does not adversely affect aneurysm occlusion or complication rates.
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Stents , Adolescente , Adulto , Anciano , Procedimientos Endovasculares , Femenino , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Persona de Mediana Edad , Puntaje de Propensión , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
Cities are currently at the core of air quality (AQ) improvement. The present work provides an overview of AQ management strategies and outcomes in 10 European cities (Antwerp, Berlin, Dublin, Madrid, Malmö, Milan, Paris, Plovdiv, Prague, Vienna) in 2018, and their evolution since 2013 (same cities, plus Ploiesti and Vilnius), based on first-hand input from AQ managers. The status of AQ mitigation in 2018, and its evolution since 2013, were assessed. While results evidenced that the majority of mitigation strategies targeted road traffic, emerging sources such as inland shipping, construction/demolition and recreational wood burning were identified. Several cities had in 2018 the ambition to continue decreasing air pollution concentrations to meet WHO guidelines, an ambition which had not yet been identified in 2013. Specific needs identified by all of the cities assessed were tools to quantify the effectiveness of mitigation strategies and for cost-benefit analysis, as well as specific and up to date technical guidance on real-world road vehicle emissions. The cities also requested guidance to identify mitigation measures promoting co-benefits, e.g., in terms of AQ, climate change, and noise. Support from administrations at local-regional-national-EU scales, and especially involving local policy-makers early on in the air quality management process, was considered essential. This work provides insight into the drivers of successful/unsuccessful AQ policies as well as on the challenges faced during their implementation. We identify knowledge gaps and provide input to the research and policy-making communities as to specific needs of cities.
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Contaminantes Atmosféricos , Contaminación del Aire , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Contaminación del Aire/prevención & control , Ciudades , Cambio Climático , ParisRESUMEN
AIM: In order to determine the possible effects of diabetes, we aimed to investigate the expression of extracellular matrix proteins in the theca and granulosa layers in different follicular stages. METHODS: Thirty-two adult Wistar albino male rats were divided into 4 groups as control and sampled groups. Four, eight and twelve weeks after inducing diabetes with an intraperitoneal injection of streptozotocin (40 mg/kg), the expressions of laminin, type IV collagen and α3ß1 integrin in ovarian tissues were evaluated by immunohistochemical method. RESULTS: In our study, in the first month of diabetes, a significant increase was observed in laminin, type IV collagen and α3ß1 integrin expressions in all follicle types compared to the control group in both the theca and granulosa layers. Laminin and type IV collagen immunoreactivity tended to increase in D2 and D3 groups also. Integrin expression did not change in the newly formed follicles in the D2 and D3 groups, however, it tended to change and increase in the developing follicles. CONCLUSIONS: The changes in the expression of laminin, type IV collagen and α3ß1 integrin, which are the extracellular matrix proteins in the follicle, along with diabetes, show that diabetes plays a role in the regulation of follicular development (Tab. 4, Fig. 36, Ref. 29).
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Diabetes Mellitus , Laminina , Folículo Ovárico , Animales , Colágeno Tipo IV/inmunología , Diabetes Mellitus/inmunología , Femenino , Integrina alfa3beta1/inmunología , Laminina/inmunología , Masculino , Folículo Ovárico/inmunología , Ratas , Ratas WistarRESUMEN
BACKGROUND: Doxorubicin (DOX) is used for treatment of many cancer types. Thymoquinone (THQ) is a powerful antioxidant agent used for reducing side effects of several drugs. The aim of this study is to determine possible therapeutic effects of THQ on doxorubicin-induced testicular toxicity in rats. METHODS: Rats were divided into five groups (n = 8): control, THQ, olive oil, DOX (a single dose of 15 mg/kg intraperitoneally (i.p.) on seventh day of the experiment), and DOX + THQ (10 mg/kg THQ per day and 15 mg/kg DOX i.p. on seventh day). Animals were euthanized, and testis tissues were evaluated histopathologically. Caspase 3 and HSP90 immunostaining were performed to determine the expression levels of these proteins among groups. Terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick-end labeling method was used for evaluation of apoptotic index. Moreover, serum testosterone levels and total antioxidant status (TAS) and total oxidant status (TOS) in testicular tissue were measured by ELISA assay. RESULTS: The DOX group had histopathological deterioration compared to the control group. There was an increase in apoptotic index, caspase 3 and HSP90 expressions in the DOX group. While TAS level of the DOX group decreased, TOS level increased when compared with the other groups. Serum testosterone levels in the DOX group decreased compared to the control group. However, there was improvement in testicular tissue in DOX + THQ group compared to the DOX group. There was a decrease in apoptotic index, caspase 3, and HSP90 expressions in DOX + THQ group compared to the DOX group. Testosterone level of DOX + THQ significantly increased compared to the DOX group. CONCLUSION: We suggest that THQ can be used as a protective agent to reduce the toxic effects of DOX.
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Antibióticos Antineoplásicos/toxicidad , Benzoquinonas/farmacología , Doxorrubicina/toxicidad , Sustancias Protectoras/farmacología , Testículo/efectos de los fármacos , Animales , Apoptosis/efectos de los fármacos , Masculino , Ratas , Testículo/patología , Testosterona/sangreRESUMEN
AIM: The aim was to compare the pathological complete response (pCR) rate at 8 compared to 12 weeks' interval between completion of neoadjuvant chemoradiotherapy (CRT) and surgery in patients with locally advanced rectal cancer. METHOD: This was a randomized trial which included a total of 330 patients from two institutions. Patients with locally advanced (T3-4N0M0, TxN+M0) rectal cancer were randomized into 8- and 12-week interval groups. All the patients received long-course CRT (45 Gy in 1.8 Gy fractions and concomitant oral capecitabine or 5-fluorouracil infusion). Surgery was performed at either 8 or 12 weeks after CRT. The primary end-point was pCR. Secondary end-points were sphincter preservation, postoperative morbidity and mortality. RESULTS: Two-hundred and fifty-two patients (n = 125 in the 8-week group, n = 127 in the 12-week group) were included. Demographic and clinical characteristics were similar between groups. The overall pCR rate was 17.9% (n = 45): 12% (n = 15) in the 8-week group and 23.6% (n = 30) in the 12-week group (P = 0.021). Sphincter-preserving surgery was performed in 107 (85.6%) patients which was significantly higher than the 94 (74%) patients in the 12-week group (P = 0.016). Postoperative mortality was seen in three (1.2%) patients overall and was not different between groups (1.6% in 8 weeks vs 0.8% in 12 weeks, P = 0.494). Groups were similar in anastomotic leak (10.8% in 8 weeks vs 4.5% in 12 weeks, P = 0.088) and morbidity (30.4% in 8 weeks and 20.1% in 12 weeks, P = 0.083). CONCLUSION: Extending the interval between CRT and surgery from 8 to 12 weeks resulted in a 2-fold increase in pCR rate without any difference in mortality and morbidity.
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Terapia Neoadyuvante , Neoplasias del Recto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Capecitabina , Quimioradioterapia , Fluorouracilo , Humanos , Estadificación de Neoplasias , Neoplasias del Recto/patología , Neoplasias del Recto/terapia , Recto/patología , Resultado del TratamientoRESUMEN
CONTEXT: Primary hyperparathyroidism (PHPT), characterized by the inappropriate secretion of parathyroid hormone (PTH) with respect to the extracellular calcium concentration. Curative treatment of PHPT is surgery and bilateral neck exploration has been replaced by minimally invasive parathyroidectomy (MIP), with the advanced imaging technologies combined with radio-guided occult lesion localization (ROLL). OBJECTIVES: The present study analyzes the MIP data from 45 patients who underwent surgery for parathyroid adenoma and debates if MIP is a feasible technique for the treatment of PHPT. DESIGN: The study presents the MIP excision data of 45 hyperparathyroidism patients with a 58-month follow up period. RESULTS: Forty-five operations were performed for 48 parathyroid adenomas. The mean duration of operation was 22.7 (12-55) minutes. Mean follow-up was 14.2 (6-26) months. All patients had normal postoperative calcium levels and PTH levels were normal in the follow-up period, except for one persistent hyperparathyroidism. CONCLUSIONS: ROLL-guided MIP is a feasible technique for parathyroid surgery and reduces surgeon based failure. It also provides the widespread application of parathyroid surgery by decreasing the need for specific experience.
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OBJECTIVE: To determine cochlear duct mid-scalar length in normal cochleae and its role in selecting the correct peri-modiolar and mid-scalar implant length. METHODS: The study included 40 patients with chronic otitis media who underwent high-resolution computed tomography of the temporal bone. The length and height of the basal turn, mid-modiolar height of the cochlea, mid-scalar and lateral wall length of the cochlear duct, and the 'X' line (the largest distance from mid-point of the round window to the mid-scalar point of the cochlear canal) were measured. RESULTS: Cochlear duct lateral wall length (28.88 mm) was higher than cochlear duct mid-scalar length (20.08 mm) (p < 0.001). The simple linear regression equation for estimating complete cochlear duct length was: cochlear duct length = 0.2 + 2.85 × X line. CONCLUSION: Using the mid-scalar point as the reference point (rather than the lateral wall) for measuring cochlear duct mid-scalar length, when deciding on the length of mid-scalar or peri-modiolar electrode, increases measurement accuracy. Mean cochlear duct mid-scalar length was compatible with peri-modiolar and mid-scalar implant lengths. The measurement method described herein may be useful for pre-operative peri-modiolar or mid-scalar implant selection.
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OBJECTIVE: To investigate whether assessment of longitudinal change in Doppler variables in small-for-gestational-age (SGA) fetuses improves the prediction of those at risk of stillbirth. METHODS: This was a longitudinal study of two cohorts of singleton pregnancies, which included SGA and appropriate-for-gestational-age (AGA) fetuses, respectively. The inclusion criteria for the SGA cohort were singleton pregnancy at ≥ 20 weeks' gestation, classified as SGA (estimated fetal weight < 10th centile). The AGA cohort consisted of singleton pregnancies deemed at high risk of being SGA, which were followed up longitudinally but remained AGA. Fetal middle cerebral artery (MCA) pulsatility index (PI) and umbilical artery (UA)-PI were measured longitudinally and cerebroplacental ratio (CPR) was calculated, and values were converted to multiples of the median. The last two measurements prior to delivery were included in the analysis. Longitudinal models for Doppler variables were developed using linear-mixed models and their accuracy in the prediction of stillbirth was tested using generalized linear models. A Bayesian framework was employed to compare the accuracy of longitudinal and standard (last-scan measurement) models. RESULTS: In total, 1549 AGA and 941 SGA pregnancies were included in the analysis. There were 30 (3.2%) and no stillbirth cases in the SGA and AGA groups, respectively. Change in MCA-PI, UA-PI and CPR with advancing gestation was significantly different between liveborn AGA and SGA fetuses, with a less pronounced difference with advancing gestation. Using the last measurement, the best models for the prediction of stillbirth in SGA pregnancies were those based on CPR (accuracy, 75.0%; 95% CI, 72.6-77.2%) and UA-PI (accuracy, 71.0%; 95% CI, 68.6-73.4%). The posterior probability of the standard CPR model having a higher accuracy compared with the UA-PI model was 97.2% (magnitude of change (MC), 3.9%; 95% credible interval (CrI), 0.5-7.3%). The accuracies of the standard, compared with the longitudinal, models for UA-PI (71.0% vs 72.8%), MCA-PI (64.6% vs 63.8%) and CPR (75.0% vs 74.9%) in the prediction of stillbirth were not significantly different. The posterior probabilities for improvement in accuracy using longitudinal, compared with standard, assessment were 50.1% (MC, < 0.1%; 95% CrI, -3.3 to 3.3%), 35.2% (MC, -0.1%; 95% CrI, -4.5 to 2.8%) and 82.2% (MC, 1.9%; 95% CrI, -1.5 to 5.3%) for CPR, MCA-PI and UA-PI models, respectively. Therefore, change in Doppler parameters did not improve the accuracy of the prediction of stillbirth, compared with that of the last-scan measurement. CONCLUSION: Longitudinal assessment of Doppler parameters was not useful in improving the detection of stillbirth in SGA pregnancies, as compared with a single-point assessment. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Feto/diagnóstico por imagen , Recién Nacido Pequeño para la Edad Gestacional/sangre , Mortinato/epidemiología , Ultrasonografía Doppler/instrumentación , Femenino , Peso Fetal , Feto/irrigación sanguínea , Edad Gestacional , Humanos , Recién Nacido , Nacimiento Vivo/epidemiología , Estudios Longitudinales , Arteria Cerebral Media/diagnóstico por imagen , Muerte Perinatal/etiología , Valor Predictivo de las Pruebas , Embarazo , Flujo Pulsátil/fisiología , Medición de Riesgo , Ultrasonografía Doppler/métodos , Arterias Umbilicales/diagnóstico por imagen , Adulto JovenRESUMEN
PURPOSE: To investigate the effect of Phonophoresis (PP) with the combination of nonsteroidal anti-inflammatory drugs (NSAID's) and myorelaxant versus routine Ultrasound (US) treatment with non-therapeutic gel on the patients with acute low back pain (ABP). METHODS: Sixty patients with ABP were randomly assigned into 2 groups. In Group 1 (nâ¯=â¯30) US was applied using diclofenacâ¯+â¯Thiocolchicoside gel for 10â¯min and for a total of 10 sessions. In Group 2 (nâ¯=â¯30) the same US protocol was applied with the same setting and timing with Group 1 using US gel that does not contain any pharmaceutical ingredient. Evaluation parameters were Visual numeric scale (VNS), Oswestry Disability Index (ODI), and Shober test. RESULTS: Comparison of the results obtained from the two groups before treatment and at second (W2) and sixth weeks (W6) posttreatment showed significant improvement in all parameters in both groups (pâ¯<â¯0.05). Comparison of the groups showed significantly superior improvement in Group 1 for ODI while there was no difference in other parameters at W2. At W6, there was significantly superior improvement in all parameters (pâ¯<â¯0.05) except for Shober test in Group1. CONCLUSION: Our results showed that PP treatment is superior than conventional US therapy at short term in ABP patients.
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Antiinflamatorios no Esteroideos/administración & dosificación , Colchicina/análogos & derivados , Diclofenaco/administración & dosificación , Dolor de la Región Lumbar/terapia , Fonoforesis , Terapia por Ultrasonido , Enfermedad Aguda , Adulto , Colchicina/administración & dosificación , Método Doble Ciego , Combinación de Medicamentos , Femenino , Geles , Humanos , Dolor de la Región Lumbar/fisiopatología , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Umbral del Dolor , Estudios Prospectivos , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
In this work, Eu, Nd co-doped MAl2O4:Eu, Nd (Mâ¯=â¯Ca, Sr, Ba) phosphors were synthesized at low temperatures (550⯰C) by the combustion method. The crystallinity of the phosphors was monitored by X-ray diffraction (XRD) and the morphology was examined by scanning electron microscope (SEM). Synthesis of phosphors, the effect of lanthanide concentrations on light emission intensity and duration investigated by using photoluminescence (PL) measurements. Narrow orange-red emissions from 500 to 750â¯nm in the PL spectra are assigned to 5D0 â 7Fj (jâ¯=â¯0,1,2,3, ) transitions of Eu3+ ion. In contrast, the broad luminescence band of the samples in the range of 400-500â¯nm are attributed to the 5d-4â¯f transitions of Eu3+ ion in the same host materials. Investigated the effects of radiation on the severity of the trap depths of these structures. The decay curves of these phosphors show how long the phosphors are attenuated. Thermoluminescence (TL) glow curves have been recorded from room temperature to 300⯰C at a constant heating rate of 1⯰C/s after preheat process at 130⯰C for 10â¯s using lexsyg smart TL/OSL reader. Nd3+ trap levels can be thought of as the lanthanide element that causes long composition in the phosphorescence structure at room temperature.
RESUMEN
PURPOSE: The purpose of this study was to investigate the feasibility and safety of percutaneous transhepatic endobiliary radiofrequency ablation (RFA) combined with biliary stenting in palliative treatment of malignant biliary obstructions. MATERIALS AND METHODS: Twenty-one patients who had undergone percutaneous transhepatic endobiliary RFA as an adjunct to biliary stenting were included. There were 12 men and nine women with a mean age of 67±13.6 (SD) years (range: 34-86 years). Demographic data, procedure details and follow-up data including complications, survival time and stent patency time were documented. The median stent patency time and survival time, as well as the 30- day and 180-day cumulative survival and stent patency rates were estimated using the Kaplan-Meier method. RESULTS: Twenty-four percutaneous transhepatic endobiliary RFA procedures were performed. There were no procedure-related major complications or death. Three patients who had developed stent reocclusion underwent a second endobiliary RFA, without insertion of a new stent. The most common complications were post-procedural pain and cholangitis. Overall survival and stent patency times ranged between 5-542 days and 5-251 days, respectively. The median survival time was 76 days (95%CI: 0-233 days) and stent patency time was 133 days (95% CI: 25-240 days). The 30- and 180- day cumulative stent patency rates were 75% and 34%, respectively. CONCLUSION: Percutaneous transhepatic endobiliary RFA is a feasible, safe and cost-effective method in restoration of biliary drainage in patients with malignant biliary obstruction.