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OBJECTIVE: This study endeavors to assess the clinical and radiologic findings of Ecchordosis physaliphora (EP) in patients under long-term observation at our clinic, as well as in cases reviewed from the existing literature. METHODS: In our study, we evaluated EP lesions in a total of 16 patients, who underwent follow-up and treatment in the neurosurgical unit. We conducted a retrospective review using magnetic resonance imaging (MRI) and computed tomography (CT) studies to confirm the diagnoses as EP. We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, encompassing a database search from inception to January 2024. We included confirmed cases of EP from both surgically and conservatively reported studies. RESULTS: Our study included a total of 16 patients, consisting of 9 (56.25%) men and 7 (43.75%) women, with an average age of 45±17.3 years. Among them, 7 (43.75%) patients presented with headaches, while 3 (18.75%) reported hearing loss. Incidental EP was detected in 6 (37.5%) patients in the study during imaging performed for different indications. The key radiological features of EP comprised hypointensity on T1, hyperintensity on T2, and an absence of MRI gadolinium enhancement. In one out of the sixteen cases, we employed an endoscopic endonasal approach for resection, and there was no recurrence observed over an average postoperative follow-up period of 24 months. Among the 15 patients, who underwent conservative follow-up, 12 (80%) had the classical Type B EP, one (10%) patient exhibited BNCT in the C2 vertebra, and another (10%) patient presented with a variant type EP. CONCLUSIONS: Utilizing a combination of imaging modalities, ensuring a clear radiological distinction between EP and chordoma, can offer substantial advantages in this context. Given that EP might be incidentally discovered, and non-resistant symptoms may resolve on their own, considering conservative treatment before surgery may be a viable option in all cases.
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In this study, CH4 production capacity of nitrification bacteria (NB) obtained from the submerged biofilter in the laboratory was investigated. Biochemical methane potential (BMP) test was carried out with the NB amount of zero (control, CR), 5% (R1), 10% (R2), and 15% (R3) at a temperature of about 37 ± 0.5°C. Compared to the CR, significantly higher cumulative CH4 volume of about 290, 490, and 715 mL were determined in the R1, R2, and R3, respectively. All the applied kinetic models gave good results (R2 ≥0.97), while the Transference Function and First-order models provided the better R2 values. The delay phase (λ) was not observed in the AD process, and CH4 production started immediately on the first day of operation. The predicted k value of 0.133 day-1 was high in CR, while it was approximately between 0.078 and 0.112 day-1 for the higher amount of NB containing BMP units, which indicated that the AD required long reaction time.
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The waste biological sludge disintegration by using microwave irradiation was investigated at a ramping rate of 2°C/min and 5 min holding time at various target temperatures. Significant disintegration of biosludge was observed and the highest disintegration degree was determined about 82% at the temperature of 110°C. Increase of target temperature elevated the energy needs to 98, 123 and 148 kWh/kg TS at the temperatures of 75°C, 90°C and 110°C, respectively. The gradual increase of sugar and protein in the sludge slurry with increasing temperatures indicates successful degradation. The microwave pretreatment increased the specific surface area of the sludge by particle size reduction. The specific surface area of raw sludge was 70 m2/kg and rose to approximately 253.7 m2/kg at 110°C with an increment ratio of 260%. Although a significant NH4-N release was not observed, PO4-P concentrations increased from 11.0 mg/L to 16.3, 20.7 and 29.2 mg/L at the temperatures of 75°C, 90°C, 110°C, respectively. While the specific filter resistance of waste biological sludge was about 1.0 × 1013, increasing the microwave target temperature, the ability of dewatering decreased and the highest SFR value of 5.1 × 1014 was observed at the temperature of 110°C.
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Imidazole derivatives display extensive applications in pharmaceutical chemistry and have been investigated as bioactive compounds for medicinal chemistry. In this study, besides the starting materials (3a-c and 4a-c), synthesis, characterization, and biological activity studies were conducted on a total of 18 compounds, nine of which are known and the other nine are original. The compounds investigated in the study are a series of alkyl (7-15) and aryl (16-24) ether derivatives bearing substituted phenyl and imidazole rings, which were characterized using various methods including 1H NMR, 13C NMR, FT-IR analysis, elemental analysis, and mass spectroscopy. Computer-aided drug design studies have been carried out to predict the biological activities of compounds. Besides DFT calculations, the binding affinities of the compounds to EGFR, VEGFR2, FGFR1, HSP90, hCA I, and hCA II were investigated. Additionally, drug-likeness and ADME analyses were performed on the compounds. Anticancer, antioxidant, and enzyme inhibition activity tests were performed in biological activity studies on the synthesized compounds. Among the synthesized compounds, compounds 17 and 19-24 generally exhibited inhibition profiles against the widespread cytosolic hCA I isozyme with IC50 values ranging from 4.13 to 15.67 nM and cytosolic hCA II isozyme with IC50 values ranging from 5.65 to 14.84 nM. L929 (mouse fibroblast cell line) was used as the control healthy cell line, and MCF7 (breast cancer), C6 (rat glioblastoma), and HT-29 (colon cancer) cells were used in cell culture studies as cancer cell lines. Before the study on cancer cells, all compounds were examined on healthy cells, and their cytotoxicity was determined. As a result of these data, studies continued with six compounds determined to be nontoxic. On cancerous cells, it was determined that compounds 3a, 3b, 4a, 4b, 4c, and 7 had cytotoxic effects on both colon cancer and brain tumors. It was found that compound 3b had a more toxic effect than cisplatin on the glioma cell line with an IC50 value of 10.721 ± 0.38 µM, and compound 3a had a more toxic effect on the colon cancer cell line with an IC50 value of 20.88 ± 1.02 µM. However, it was determined that the same compounds did not have a statistically significant effect on breast cancer. Flow cytometry studies also showed that when the IC50 dose of compound 3b was applied to the C6 cell line, the cells tended to early and late apoptosis. Additionally, it has been shown by flow cytometry that the cell cycle stops in the G0/G1 phase. A similar effect was observed in the colon cancer cell line with compound 3a. Compound 3b caused early and late apoptosis of the colon cancer cell line with the applied IC50 dose and stopped the cell cycle in the G0/G1 phase. Finally, the FRAP method studied all synthesized compounds' antioxidant effects. According to the measured antioxidant power results, it was determined that no compound had a more effective reducing power than vitamin E.
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INTRODUCTION: Although the health effects of first-hand smoke and second-hand smoke are well known, third-hand smoke (THS) is a relatively new concept. We estimated the prevalence of people's knowledge that THS is harmful to health, including for some subgroups, in a meta-analysis. METHODS: We searched PubMed, Web of Science, Scopus, EBSCO Host, ProQuest, and YOKTEZ databases for the prevalence of people's knowledge that THS is harmful to health using specified search words. A total of 12 publications (n = 8549 people) were included in the meta-analysis. The random effect model was used for meta-analysis, and Cochran's Q test and I2 values were used to determine heterogeneity. Subgroup analyzes and meta-regression were also performed. RESULTS: The prevalence of people's knowledge that THS is harmful was 80.1%. The prevalence of people's knowledge that THS is harmful for children was 82%, and the prevalence of people's knowledge that THS is harmful for adults was 70.4%. For health professionals, the prevalence of people's knowledge that THS is harmful for children was 89.8%, the highest prevalence value calculated in this meta-analysis. Cochran's Q test and I2 values indicated that the included studies were heterogeneous. CONCLUSIONS: In this meta-analysis, the overall prevalence of people's knowledge that THS is harmful was 80.1%, but large variations were found between samples.
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Conhecimentos, Atitudes e Prática em Saúde , Poluição por Fumaça de Tabaco , Humanos , Poluição por Fumaça de Tabaco/efeitos adversos , PrevalênciaRESUMO
BACKGROUND: Earthquakes are natural disasters that can often cause severe injuries and traumatic situations. These injuries can include crush injuries, fractures, tissue damage, and blood circulation problems. Hyperbaric oxygen therapy (HBOT) has recently become a frequently used treatment modality for individuals suffering from severe injuries. HBOT is a form of treatment that involves administering pure oxygen to the patient under high pressure. This treatment aims to promote tissue healing by increasing cellular oxygenation. It is thought to have a positive effect on factors such as accelerating tissue healing, reducing inflammation, and controlling infection in severe post-earthquake injuries, particularly crush injuries. This study aimed to retrospectively evaluate the clinical effects, contributions to the healing process, and potential advantages of HBOT in 35 patients with severe injuries after the Kahramanmaras earthquake that occurred on 06.02.2023 and to contribute to the development of emergency intervention strategies. METHODS: This study was carried out after ethics committee approval. In the study, the data of patients with a MESS Score between 7-14 who were admitted as earthquake victims and treated in the HBOT Unit due to severe earthquake-related injuries were obtained from records and retrospectively analyzed. Demographic information, general distribution of patient data, mean values, number of HBOT sessions, and functional outcomes were recorded. RESULTS: The gender distribution of the 35 patients who received HBOT was 31.4% male and 68.6% female. 45.7% of patients were aged 18 years or younger, and 54.3% were aged 19 years or older. The most common injuries in the treated patients were observed in the lower extremities. After HBOT, sensory recovery (54.3%) and functional recovery (51.4%) were achieved in the majority of patients. The minor amputation rate was 20.0% and the major amputation rate was 11.4% after HBOT. CONCLUSION: This study evaluated the possible effects of HBOT on patients with severe earthquake injuries in Türkiye, and the results showed that HBOT may have a beneficial effect on critical factors such as sensory recovery, functional recovery, and amputation rates in this particular group of patients, and that this benefit may be more pronounced in those who started treatment early.
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Lesões por Esmagamento , Terremotos , Oxigenoterapia Hiperbárica , Humanos , Masculino , Feminino , Oxigenoterapia Hiperbárica/efeitos adversos , Oxigenoterapia Hiperbárica/métodos , Estudos Retrospectivos , CicatrizaçãoRESUMO
Background COVID-19 is a multisystemic disease that affects many organs, and the use of some parameters is recommended both during hospitalization and follow-up. In this study, we investigated the relationship between blood (liver and kidney function tests, lactate, and D-dimer), infection (C-reactive protein (CRP), lymphocyte count, ferritin, and albumin), and cardiac (creatine kinase-myocardial band (CK-MB), troponin, and brain natriuretic peptide (BNP)) parameters with intensive care unit (ICU) admission and mortality. Materials and methods Patients hospitalized in Erzurum City Hospital with the diagnosis of COVID-19 between April 2020 and November 2022 were included in this retrospective study. The patient's files and electronic media records were retrospectively reviewed, and the patient's anamnesis, physical examination, clinical findings, biochemical parameters, and treatment methods were recorded. The ICU needs of the patients and the treatment processes in intensive care were found in the in-hospital records. The hospital records and six-month mortality data were obtained retrospectively with the necessary permissions. Thus, blood parameters and their relation to each other in terms of prognosis were evaluated in determining the six-month mortality rates of the patients and estimating the need for ICU. Results A total of 5100 patients were included in the study. The mean age of patients with mortality was 74.2 ± 11.2 and that without mortality was 59.9 ± 15.7 (p < 0.001). In the mortality (+) group, 61.5% of patients were male, and in the mortality (-) group, 47.4% of the patients were male (p < 0.001). The mean age of patients with ICU admission was 69.6 ± 13.6 and without ICU admission was 60.3 ± 15.9 years (p < 0.001). In the ICU admission (+) group, 60.5% of patients were male; and in the ICU admission (-) group, 47.2% of patients were male (p < 0.001). Death and ICU admission were observed more frequently in elderly and male patients (p < 0.001 for both mortality and ICU admission). Blood parameters were evaluated both in the mortality and ICU groups, and organ function tests, blood count parameters, inflammatory markers, and cardiac parameters were significantly associated with poor outcomes. Cox regression analysis showed that lactate, albumin, Ln(troponin), and Ln(BNP) were independent predictors of mortality and ICU admission. Receiver operating characteristics (ROC) curve analysis showed that Ln(troponin) and Ln(BNP) levels predicted the development of mortality and ICU admission better than other parameters. Discussion COVID-19 can cause problems in different systems as a result of an inflammatory response, secreted cytokines, hypercoagulability, and direct tissue damage. When treating patients, a more appropriate approach is to evaluate different parameters together rather than focusing on a single parameter and deciding accordingly. However, evaluating alterations in many parameters in a disease that affects many systems is difficult and increases the risk of mistakes. Although each blood parameter separately is important, it was observed that the cardiac parameters troponin I and BNP have better predictive values than others in predicting the course and prognosis of COVID-19. Conclusion Blood parameters are used in COVID-19 diagnosis, treatment, and follow-up. Although it is not primarily a cardiac disease, cardiac markers can provide better results in showing the course and prognosis of COVID-19.
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BACKGROUND: Gonadotrophin-releasing hormone agonist (GnRHa) downregulates gonadotropin secretion in the pituitary gland. It is used both in ovulation induction protocols and in artificial endometrium preparation. Frozen-thawed embryo transfer to artificially prepared endometrium (FET-APE) is a frequent procedure in vitro fertilization (IVF) which requires GnRHa. It can be used either as a daily low-dose injection or as a single depot injection. It is unclear which of these two regimens is superior for artificial endometrium preparation. METHODS: We evaluated the data of 72 patients who had undergone frozen embryo transfer following the 5th day Preimplantation Genetic Test-aneuploidy (PGT-A) between 2018-2021. All embryos were genetically screened, and euploid single embryos were transferred. Group 1 (n: 36) used depot GnRHa, and Group 2 (n: 36) used single daily injections for artificial endometrial preparation. The outcomes for Beta Human Chorionic Gonadotrophin (BHCG) positivity and live birth rates (LBR) was compared. RESULTS: The BHCG positivity for Group 1 and Group 2 was 75% and 80.6%, respectively. The LBR for Group 1 and Group 2 were found to be 58.3% and 63.9%, respectively. There was no statistically significant differences between the two groups. CONCLUSIONS: In artificial endometrium preparation, depot GnRHa offers cheaper and more convenient alternative to single daily dose injections, particularly in busy clinical settings.
Gonadotrophin-releasing hormone agonist (GnRHa) is used to Frozenthawed embryo transfer to artificially prepared endometrium (FET-APE). However, it is not known which of the depot and daily preparations is more effective. Our study to exclusively compare 5th day euploid single embryos transferred in FET-APE cycles using depot or daily injections of GnRHa to avoid any influences of oocyte or spermatozoa dependent factors on Beta Human Chorionic Gonadotrophin (BHCG) positivity and live birth rates (LBR). The results were similar. Since the results are similar, the depot GnRHa form can be preferred for ease of use. However, future studies on larger series and patients with different clinical characteristics may effects the results.
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Coeficiente de Natalidade , Hormônio Liberador de Gonadotropina , Nascido Vivo , Feminino , Humanos , Gravidez , Transferência Embrionária/métodos , Endométrio/fisiologia , Fertilização in vitro/métodos , Indução da Ovulação/métodos , Taxa de Gravidez , Estudos RetrospectivosRESUMO
We aimed to compare repeated LPP (luteal phase oestradiol LPP/GnRH antagonists protocol) treatment with different protocol results with poor ovarian response (POR) patients. Two hundred and ninety-three cycles with poor ovarian reserve who underwent LPP, microdose flare up protocol and antagonist protocol were included in the study. Of these, 38 patients were applied LPP in the first cycle and LPP in the second cycle. After the microdose or antagonist protocol applied in the first cycle, LPP was applied to 29 patients in the second cycle. There are 128 patients who received LPP only once and 31 patients who received microdose flare up only once. The clinical pregnancy rate was monitored higher in LPP application group in the second cycle than the patients who received only LPP and patients who received LPP after different protocols (p = .035). b-hCG positivity per embryo and clinical pregnancy rate were found to be significantly higher with the LPP application in the second protocol (p = .000, p = .001). Repeated LPP may be the first choice protocol for low ovarian reserve patients.
What is already known on this subject? There is no standard treatment protocol applied to patients with low ovarian reserve. In this patient group, the rate of lack of response to stimulation and cycle cancellation is high. Increasing FSH level in patients with poor ovarian reserve causes the formation of larger follicles by increasing the sensitisation of follicles in the late luteal phase.What do the results of this study add? Our study was conducted for the first time in the literature. We compared the results of second cycle LPP (luteal phase oestradiol LPP/GnRH antagonists protocol) application in patients with low ovarian reserve who resulted in failed IVF after commonly used LPP, microdose flare up protocol and antagonist protocols.What are the implications of these findings for clinical practice and/or further research? Luteal phase oestrogen LPP/GnRH antagonist may be the first choice in patients with poor ovarian reserve patients. In unsuccessful cases, the LPP protocol should be considered in the retreatment for the second time.
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Estradiol , Reserva Ovariana , Feminino , Gravidez , Humanos , Fase Luteal , Hormônio Liberador de Gonadotropina , Fertilização in vitro/métodos , Indução da Ovulação/métodos , Taxa de Gravidez , Antagonistas de Hormônios/uso terapêuticoRESUMO
OBJECTIVE: To examine the age, gender, and chronic disease status of patients who died due to coronavirus disease 2019 (COVID-19) during the pandemic process and the effects of these diseases on their deaths. METHODS: It was a retrospective retrospective analysis with 2715 patients. The statistics of the patients who met the research criteria were evaluated from the hospital database. Patients were evaluated in terms of age, gender, length of hospital stay, presence of chronic disease, and Modified Comorbidity Index Scores. RESULTS: It was determined that the Modified Charlson Comorbidity Index (MCCI) score mean of the patients was 4.74 ± 2.07 and MCCI scores of 56.9% were serious. There was a statistically significant difference in the length of hospital stay according to the number of diseases the patient had, age, and MCCI score. It was determined that there was a statistically significant, negative and high-level correlation between MCCI score and the length of hospital stay (r = -0.075: P = 0.001). CONCLUSIONS: Age, comorbidity score, and the number of comorbidities were found to affect the length of hospital stay, ie death. For this reason, it is recommended to use comorbidity indices in health protection and development studies, in the field, as well as in the clinics.
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COVID-19 , Humanos , Estudos Retrospectivos , COVID-19/epidemiologia , Comorbidade , Doença Crônica , Tempo de InternaçãoRESUMO
This study was conducted to assess the phytoremediation potential of Pistia stratiotes for post-treatment of Ni(II) and Cr(III)-containing industrial wastewater effluents in mono (synthetic wastewater) and bimetallic systems (real wastewater). Differences were seen in metal uptake, growth performance, and metal accumulation of the plants. In the monometallic system, the highest removal efficiency was calculated as 77.50% for Cr(III) and 70.79% for Ni(II) at 5 mg L-1 concentration. At 1.25 mg L-1 concentration, the bioconcentration factor of P. stratiotes was calculated as 734.2 for Ni(II) and 799.0 for Cr(III). To assess the effects of metal stress on plants, photosynthetic pigments and percent growth rates were also investigated. The percent growth rate increased from 38.22 to 81.74% for Ni and decreased from 87.53 to 43.18% for Cr(III) when the metal concentrations increased from 1.25 to 5 mg L-1. Toxicity symptoms were less severe in plants exposed to low Ni concentrations. The greatest reduction in chlorophyll was observed at 5 mg L-1 Ni concentration. P. stratiotes showed better performance in the monometallic system. It was concluded based on present findings that P. stratiotes could potentially be used for the post-treatment of wastewaters containing Ni and Cr.Novelty Statement Previous phytoremediation studies were mostly conducted only in either mono- or multi-metallic systems. In this study, mono- and bimetallic systems were assessed together and the feasibility of research findings on a large scale was investigated in detail. Present findings may also aid in the development of phyto-remedial strategies and the identification of Ni and Cr toxicity in macrophytes. Pistia stratiotes are already known for its incredible potential in removing metals and other contaminants from wastewater effluents. However, most studies only present data regarding the plant performance in laboratory studies (synthetic wastewater), while this study provides some important additional information on natural effluent conditions, which transform the presented data more interesting from a practical point of view.
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Araceae , Poluentes Químicos da Água , Cromo , Níquel , Águas Residuárias , Biodegradação Ambiental , Poluentes Químicos da Água/análise , MetaisRESUMO
Many complications can be observed after ST-elevation myocardial infarction (STEMI). The systemic immune-inflammatory index (SII) is a sensitive indicator of the inflammatory state, and this parameter may also be associated with cardiovascular diseases. In this study, we investigated the relationship between malignant ventricular arrhythmias (MVA) development and SII in STEMI patients. A total of 1708 STEMI patients were included in the study. Propensity score matching (PSM) analysis was performed. Patients were divided into 2 groups according to the development of MVA, and predictors of MVA development were investigated. After the PSM analysis, the mean age of 158 patients was 61.6 years, and 68.4% were male. In the univariate analysis, neutrophil count, SII, C-reactive protein (CRP), albumin, and CRP/albumin ratio (CAR) were associated with the development of MVA; while in the regression analysis, CAR and SII was found to be independent predictors of the development of MVA. In this study, we demonstrated that SII is a better independent predictor than other inflammatory parameters for predicting the development of MVA. This index may be useful in clinical use.
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Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Masculino , Feminino , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Proteína C-Reativa/metabolismo , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiologia , Albuminas , Contagem de LeucócitosRESUMO
Q fever is a zoonotic disease that is known to be widespread throughout the world by many researches since its discovery in 1935 and it is important in terms of animal and public health. Coxiella burnetii, which is the etiological agent of the disease, is an obligate intracellular pathogen. While the disease generally manifests itself with abortion in animals, disease manifests as atypical pneumonia or granulomatous hepatitis in the acute form and as endocarditis in the chronic form in humans. Its presence in Turkey has been shown with a large number of studies. The aim of this study was to show the genotypic relationship with MLVA analysis of C. burnetii samples found in cattle, sheep and goat samples in Erzurum and Samsun Veterinary Control Institutes and blood samples collected from humans with atypical pneumonia findings. In the study, MLVA analyses of 100 positive samples from 50 cows, 41 sheep and 9 goats from Northeast Anatolia and Black Sea regions and C. burnetii positive samples found in 6 individuals with atypical pneumonia were performed. As a result of the study, it was found that 106 C. burnetii samples had belong to 16 genotype groups. It was found that genotype XVI was the most prevalent among these groups and it was seen in both regions. In addition to this, genotype IX profile was the second largest group with 83.3% (5/6) of human samples. In this study, the genotypes common in the regions were determined and a data source was created for possible outbreaks.
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Doenças dos Bovinos , Coxiella burnetii , Doenças das Cabras , Pneumonia , Febre Q , Doenças dos Ovinos , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Coxiella burnetii/genética , Feminino , Doenças das Cabras/epidemiologia , Cabras , Humanos , Epidemiologia Molecular , Pneumonia/veterinária , Gravidez , Febre Q/epidemiologia , Febre Q/veterinária , Ruminantes , Ovinos , Doenças dos Ovinos/epidemiologia , Turquia/epidemiologiaRESUMO
The present work evaluates the possibility of using laser-induced breakdown spectroscopy (LIBS) coupled with chemometric methods to classify cheese samples (namely Kashar cheese and processed cheese) based on their cooking/stretching process. Chemometric analysis of the data provided by LIBS and ICP-OES/AAS analyses made it possible to discriminate between the two cheese types regarding their elemental profiles. The principal component analysis model was able to discriminate the Kashar cheese with an explained variance of 97.02%. Furthermore, the partial least squares discriminant analysis model perfectly classified the Kashar samples with a prediction ability of 100%. Furthermore, calibration and validation models for Mg, Ca, Na, P, Zn, and K elements for both Kashar and processed cheese samples were developed using partial least square regression yielding high correlation coefficients and low root mean square errors. Overall, this study indicates that LIBS with chemometrics can be an easy-to-use and rapid monitoring system for cheese classification.
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Queijo , Queijo/análise , Culinária , Lasers , Análise dos Mínimos Quadrados , Análise Espectral/métodosRESUMO
Although COVID-19 disease primarily affects the respiratory system, it has been seen in many studies that it causes thromboembolic (TE) events in many tissues and organs. So that, to prevent TE can reduce mortality and morbidity. In this context, this study aimed to investigate the relationship between the previous use of warfarin or other new direct oral anticoagulants (OAC) and mortality in patients hospitalized with a diagnosis of COVID-19 before hospitalization. A total of 5575 patients who were diagnosed with COVID-19 were hospitalized and started treatment between March 21 and November 30, 2020 were included in the study. The primary outcome was in-hospital all-cause mortality. A retrospective cohort study design was planned. Patients were followed up until death or censoring on November 30, 2020. The candidate predictors for primary outcome should be clinically and biologically plausible, and their relationships with all-cause death should be demonstrated in previous studies. We considered all candidate predictors included in the model in accordance with these principles. The main candidate predictor was previous OAC use. The primary analysis method was to compare the time to deaths of patients using and not using previous OAC by a multivariable Cox proportional hazard model (CPHM). In the CPHM, previous OAC use was found to be associated with a significantly lower mortality risk (adjusted hazard ratio 0.62, 95% CI 0.42-0.92, p = 0.030). In hospitalized COVID-19 patients, in patients who previously used anticoagulantswas associated with lower risk of in-hospital death than in those who did not.
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Anticoagulantes , COVID-19 , Mortalidade Hospitalar , Tromboembolia , Anticoagulantes/uso terapêutico , COVID-19/mortalidade , Hospitalização , Humanos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de RiscoRESUMO
PURPOSE: There is evidence that follicular phase progesterone rise [FPPR] adversely affects fresh in vitro fertilization [IVF] cycles. A single daily dose of cetrorelix has been used to prevent early luteinizing Hormone (LH) surge. We speculated that doubling the daily dose might have a positive effect in patients who have early LH surges despite receiving the single daily dose treatment. However, a double daily dose of cetrorelix seems to cause FPPR in poor ovarian response (POR) patients. MATERIALS AND METHODS: On human chorionic gonadotropin [hCG] injection days, the progesterone levels of POR patients who received a single daily dose of cetrorelix (group 1, n = 59) were compared with progesterone levels of the patients who received a double daily dose of cetrorelix (group 2, n = 75). The two groups had statistically similar demographic data. The patients who had FPPR were detected, and a comparison of progesterone levels, using 0.8, 1.0, and 1.2 [ng/mL] of progesterone as cut-off levels, was made between patients of both groups. RESULTS: FPPR patients in group 2 had significantly higher progesterone levels during hCG day, contrary to expectations. When progesterone cut-off levels of 0.8, 1.0, and 1.2 [ng/mL] were used for group 1 patients, 15.3%, 13.6%, and 6.8% of the patients developed FPPR, respectively When the progesterone cut-off levels of 0.8, 1.0, and 1.2 [ng/mL] were used for group 2, the results detected were 45.3%, 30.7%, and 21.3%, respectively. A significant statistical difference in progesterone levels was observed between the groups. CONCLUSION: While the double daily dose of cetrorelix was initially thought to more effectively suppress early LH rise by some authors, we have seen that it increases the FPPR more when compared to a single daily dose regime. We suggest using frozen cycles instead of fresh cycles in order to have better endometrial receptivity in patients who seem to benefit from higher daily doses of cetrorelix.
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Hormônio Liberador de Gonadotropina/análogos & derivados , Indução da Ovulação/normas , Progesterona/análise , Fase Folicular/efeitos dos fármacos , Fase Folicular/metabolismo , Hormônio Liberador de Gonadotropina/administração & dosagem , Hormônio Liberador de Gonadotropina/uso terapêutico , Humanos , Indução da Ovulação/métodos , Indução da Ovulação/estatística & dados numéricos , Progesterona/sangue , Estatísticas não ParamétricasRESUMO
OBJECTIVES: Acute decompensated heart failure (ADHF) is a clinical condition that requires urgent diagnosis and treatment. Patients present with pulmonary capillary wedge pressure, pulmonary arterial pressure, and venous pressure elevation. Along with the progressive deterioration observed in the clinical picture, impairment or deterioration of kidney function may also occur. In this study, we evaluated the B-type natriuretic peptide (BNP)/ferritin ratio as a predictor of the risk of developing acute renal injury (ARI) in ADHF. METHODS: A total of 157 patients with a diagnosis of ischemic dilated cardiomyopathy for more than 6 months that presented to our clinic with ADHF were included in this cohort study. After the treatment protocol was applied, the sample was divided into two groups as patients with and without ARI. The BNP and ferritin levels were examined along with the routine blood parameters (BNP), and the BNP, ferritin, and BNP/ferritin values were compared between the groups. RESULTS: ARI was present in 34.3% (n = 54) of the patients, who were also found to have higher BNP (892.76 vs. 817.54), lower ferritin (86.78 ± 57.2 vs. 105.46 ± 38.3), and higher BNP/ferritin (10.48 ± 2.14 vs. 7.89 ± 1.89). The multivariate logistic regression analysis revealed the BNP/ferritin ratio as an independent risk factor for ARI (odds ratio = 3.19; 95% CI, 1.92-6.54; P = 0.001). Using the receiver operating characteristic curve, a cutoff value of 9.32 for BNP/ferritin ratio had a sensitivity of 81.8% and a specificity of 93.5% (area under the curve 0.842, P < 0.001) for the prediction of ARI. CONCLUSION: The BNP/ferritin ratio is a new parameter that can be used to draw attention to the severity of the treatment and renal function in ADHF cases in emergency situations.
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PURPOSE: The primary objective of this study was to evaluate the prevalence, characteristics and the most frequently used complementary and alternative medicine (CAM) methods among infertile couples. A secondary aim was to assess predictors and patients' attitude to disclose the usage of CAM. METHODS: This study was designed as a cross-sectional survey and conducted on patients admitted to infertility clinics of two hospitals. RESULTS: The overall prevalence of CAM among 324 infertile participants (162 couples) was 25.6 % (n = 83). 48 % of the infertile couples had experience with at least one type of CAM method and the most commonly used CAM was herbal products (84 %). The frequency of CAM tended to be higher among females compared to males (33 % versus 17 %, respectively; p = 0.02). Patients who failed to conceive with previous medical therapies were more inclined to use CAM (p = 0.01). After logistic regression analyses, only gender and previous unsuccessful ART treatment were found to be associated independently with CAM use. CONCLUSION: CAM use is common among infertile population. CAM users were more likely to be women at any age who had failed to achieve a pregnancy with previous artificial reproductive treatment(s), mainly used herbal products and mostly reluctant to report the use of CAM.
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Terapias Complementares/estatística & dados numéricos , Infertilidade/terapia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
AIM: The aim of this study was to determine the effect of Ramadan fasting on blood pressure (BP), fatigue, sleeping and physical activity among hypertensive patients. SUBJECTS AND METHODS: A cross-sectional study was conducted from April 2019 to July 2019. Of the total 1500 hypertensive patients approached, 1118 (74.5%) gave their consent. Data analysis included sociodemographics, lifestyle habits, anthropometric measurements and clinical biochemistry parameters at baseline, and after 3 months. RESULTS: Out of 1118 subjects, 593(47.6%) were male and 653(52.4%) were female. There were statistically significant differences between males and females regarding age groups in years, educational level, occupational status, income, smoking habits, physical exercise, sports activities and fatigue. There were statistically significant differences for the biochemistry parameters regarding vitamin D, blood glucose, HbA1c level, creatinine, bilirubin, albumin, total cholesterol, triglycerides, HDL-C, LDL-C, uric acid and SBP for both males and females after the holy month of Ramadan as compared to before Ramadan. Also, BMI was significantly lower during the after month of Ramadan as compared to before Ramadan (P < 0.001). Multiple linear regression analysis results revealed that less hours of sleeping (P < 0.001), SBP (mmHg) (P < 0.001), DBP (mmHg) (P < 0.001), family size (P = 0.002), obesity BMI (kg/m2) (P = 0.013), fatigue (P = 0.022) and smoking cigarette (P = 0.029) were identified as statistically significant predictors of hypertensive patients with Ramadan fasting as contributing at higher risk factors. CONCLUSION: This study confirmed that fasting during Ramadan has no effect on the BP, blood glucose, HbA1C level, sleep quality, fatigue and BMI among hypertensive patients.
Assuntos
Jejum , Hipertensão , Glicemia , Pressão Sanguínea , Estudos Transversais , Fadiga , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Masculino , SonoRESUMO
We investigated the role of vitamin D on glycemic regulation and cardiac complications in patients with type 2 diabetes mellitus (T2DM). A total of 1139 patients (49.3% males vs 50.7% females) were included. Information on sociodemographic lifestyle, family history, blood pressure (BP), and coronary heart disease (CHD) complications was collected. Significant differences were found between males and females regarding age-groups (P = .002), body mass index (BMI; P = .008), physical activity (P = .010), sheesha smoking (P = .016), cigarette smoking (P = .002), hypertension (P = .050), metabolic syndrome (P = .026), and CHD (P = .020). There were significant differences between vitamin D deficiency, insufficiency, and sufficiency in relation to age-group (P = .002), income (P = .002), waist circumference (P = .002), hip circumference (P = .028), waist-hip ratio (P = .002), and BMI (P = .002). Further, mean values of hemoglobin, magnesium, creatinine, hemoglobin A1c (HbA1c), total cholesterol, uric acid, and diastolic BP were significantly higher among patients with vitamin D deficiency compared with those with insufficiency and sufficiency. Multiple logistic regression analysis revealed that 25-hydroxy vitamin D, 25(OH)D, HbA1c, waist circumference, uric acid, duration of T2DM, total cholesterol, systolic and diastolic BP, and BMI were strong predictor risk factors for CHD among patients with T2DM. The present study supports that 25(OH)D may have a direct effect on CHD and on its risk factors.