Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 296
Filtrar
1.
Environ Monit Assess ; 196(11): 1005, 2024 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-39358577

RESUMO

Regulating services are the advantages that humans receive from regulating ecosystem processes. These services include, but are not limited to pollination, climate regulation, water purification, carbon sequestration, and erosion control. Quantifying and mapping ecosystem services in agroecosystems is one of the main effective actions to increase pay attention to these services and adopt suitable approaches to direct sustainability. The purpose of the study was quantification, and mapping of regulating ecosystem services in canola agroecosystems of Gorgan County, north of Iran. For this purpose, some regulating services such as carbon sequestration, climate regulation, soil microbial respiration, soil aggregate stability, and pollination by insects were evaluated based on the Common International Classification of Ecosystem Services framework. The information and data required for each of these services were collected through field measurements, laboratory experiments, and field surveys. After quantifying, the surveyed services in canola agroecosystems were presented on geospatial maps generated by ArcGIS software, version 10.3. Results showed that agroecosystems in the west and north of the studied region provided the more regulating services. Also, the results of the pollination showed that pollinating insects belonged to four orders and 13 families. The majority of the pollinators were Hymenoptera (44.74%), especially honey bees (Apis mellifera L.), Diptera (5.26%), Butterflies (Lepidoptera; 25%), and the beetles (Coleoptera; 25%), and Anthophora sp. and Andrena sp. were the second and the third most abundant pollinating species after honey bees. Generally, the canola agroecosystems close to the rivers and the natural ecosystems provided more services than other regions.


Assuntos
Ecossistema , Monitoramento Ambiental , Polinização , Irã (Geográfico) , Animais , Monitoramento Ambiental/métodos , Agricultura/métodos , Sequestro de Carbono , Conservação dos Recursos Naturais/métodos , Brassica napus , Insetos , Solo/química , Clima
2.
J Clin Med ; 13(19)2024 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-39407953

RESUMO

Background: The accurate segmentation of the appendix with well-defined boundaries is critical for diagnosing conditions such as acute appendicitis. The manual identification of the appendix is time-consuming and highly dependent on the expertise of the radiologist. Method: In this study, we propose a fully automated approach to the detection of the appendix using deep learning architecture based on the U-Net with specific training parameters in CT scans. The proposed U-Net architecture is trained on an annotated original dataset of abdominal CT scans to segment the appendix efficiently and with high performance. In addition, to extend the training set, data augmentation techniques are applied for the created dataset. Results: In experimental studies, the proposed U-Net model is implemented using hyperparameter optimization and the performance of the model is evaluated using key metrics to measure diagnostic reliability. The trained U-Net model achieved the segmentation performance for the detection of the appendix in CT slices with a Dice Similarity Coefficient (DSC), Volumetric Overlap Error (VOE), Average Symmetric Surface Distance (ASSD), Hausdorff Distance 95 (HD95), Precision (PRE) and Recall (REC) of 85.94%, 23.29%, 1.24 mm, 5.43 mm, 86.83% and 86.62%, respectively. Moreover, our model outperforms other methods by leveraging the U-Net's ability to capture spatial context through encoder-decoder structures and skip connections, providing a correct segmentation output. Conclusions: The proposed U-Net model showed reliable performance in segmenting the appendix region, with some limitations in cases where the appendix was close to other structures. These improvements highlight the potential of deep learning to significantly improve clinical outcomes in appendix detection.

3.
J Neurosurg ; : 1-9, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39151192

RESUMO

OBJECTIVE: To optimize surgical positioning for posterior fossa surgery (PFS) using the semisitting position (SSP) to avoid venous air embolism (VAE) and its possible life-threatening consequences, the authors evaluated their experiences with the SSP by analyzing a large cohort of PFS patients. METHODS: A retrospective analysis of the charts of 202 consecutive PFS patients (median age 54 years, IQR 41-61 years; 121 females) with various tumor or vascular conditions who underwent surgery in an SSP between 2019 and 2022 was performed. Age, sex, weight, height, BMI, American Society of Anesthesiologists (ASA) class, histology, duration of surgery, and length of hospital stay were assessed. Transesophageal echocardiography was used pre- and intraoperatively to monitor for and assess the degree of VAE. RESULTS: Altogether, VAE occurred in 30 of 202 (14.9%) patients, with clinically relevant VAE occurring in 14 of 202 (7%) patients. The grades of VAE were I, III, and IV in 16 (8%), 4 (2%), and 10 (5%) patients, respectively. Patient height (p = 0.04), ASA class (p = 0.03), and ASA class ≤ II (p = 0.02) remained the only preoperative statistically significant risk factors for intraoperative VAE, with a median height of 178 cm (IQR 172-184 cm) in patients with clinically relevant VAE compared with 170 cm (IQR 164-176 cm) in those without VAE. CONCLUSIONS: In summary, the data demonstrate that SSP can be used safely for PFS when taking special care to optimize positioning in tall and lower-grade ASA patients intraoperatively.

4.
Eur Geriatr Med ; 2024 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-39128969

RESUMO

BACKGROUND: With population aging and advances in surgical and anesthetic procedures, the incidence of surgery in patients over the age of 65 years is increasing. One post-operative complication often encountered by older surgical patients is post-operative cognitive dysfunction (POCD). Preoperative exercise training can improve the overall physiological resilience of older surgical patients, yet its impact on post-operative cognition is less well-established. METHODS: Six databases (Medline (OVID); EMBASE (OVID); EMCARE (OVID); CINAHL (EBSCOHost), the Cochrane Library, and PubMed) were searched for studies reporting the effect of pre-operative physical training on post-operative cognition. The quality of evidence was assessed using the Mixed Methods Assessment Tool. RESULTS: A total of 3983 studies were initially identified, three of which met the inclusion criteria for this review. Two studies were pilot randomized trials, and one was a prospective randomized trial. Two of the studies were high-quality. Each study used a different type of physical exercise and cognition assessment tool. Across the studies, post-operative cognition (p = 0.005) and attention (p = 0.04) were found to be better in the intervention groups compared to control, with one study reporting no difference between the groups. CONCLUSION: Preoperative physical training may improve post-operative cognitive function, although more research with a consistent endpoint is required. Future studies should focus on patients at high risk of POCD, such as older adults, and explore the impact of different exercise regimes, including frequency, intensity, time, and type.

5.
J Plast Reconstr Aesthet Surg ; 95: 106-113, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38889588

RESUMO

BACKGROUND: Correction of asymmetry and irregularity deformities with autologous grafts, without osteotomies, offers advantages to both plastic surgeons and patients with severe deviation. Various autologous tissues such as fat, bone, and cartilage grafts are viable options for this purpose. OBJECTIVES: This study aimed to compare the efficacy of 3 autologous filling materials in patients with bone asymmetry. METHODS: A retrospective evaluation was conducted on 297 patients seeking aesthetic nose surgery between 2015 and 2022. Only primary patients without prior surgery and those with bone asymmetry from trauma, with dorsum protrusion <3 mm, and without osteotomy were included. Patients were divided into fat, cartilage, and bone groups. Grafts were applied to the concave side during closed rhinoplasty, and evaluations were done 12 months after surgery by blinded plastic surgeons and patients using established assessment tools. RESULTS: Fat, cartilage, and bone grafts were utilized in 74, 127, and 96 patients, respectively, with a mean follow-up of 19 months. The mean graft volumes were 1.0 cc (bone), 1.3 cc (cartilage), and 1.6 cc (fat). The patient self-assessment scores were 75%, 84.9%, and 86.6%, respectively. The Asher-McDade averages were 77.2%, 86.7%, and 88.4%, respectively. Cartilage and bone graft results were statistically similar in patients' self-evaluation and significantly higher than those of fat grafts. Blinded assessments showed no significant difference between the cartilage and bone groups. CONCLUSION: Placing autologous grafts on the concave side for patients with minimal nasal bone protrusion (<3 mm) yields successful results. Cartilage grafts offer advantages in volume, result estimation, and preparation time, making them suitable for larger patient cohorts.


Assuntos
Tecido Adiposo , Transplante Ósseo , Cartilagem , Rinoplastia , Humanos , Masculino , Feminino , Rinoplastia/métodos , Estudos Retrospectivos , Adulto , Tecido Adiposo/transplante , Transplante Ósseo/métodos , Cartilagem/transplante , Deformidades Adquiridas Nasais/cirurgia , Transplante Autólogo , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Adolescente , Nariz/cirurgia , Nariz/lesões
6.
Ann Nucl Med ; 38(10): 825-834, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38880859

RESUMO

PURPOSE: The current study is intended to investigate the effect of new organ involvement on overall survival (OS) and modify the Response Evaluation Criteria in PSMA Imaging (RECIP) by including new organ involvement to RECIP 1.0. MATERIALS AND METHODS: This retrospective study includes 114 patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC) between September 2017 and June 2022 who had received docetaxel treatment and had baseline and post-treatment prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) images. The inclusion criteria were patients with pre- and post-treatment [18F]FDG PET/CT images and whose [18F]FDG PET images were negative. Those whose data were unavailable, who had additional malignancy, or who received abiraterone, enzalutamide, or Lutetium (Lu)-177 treatment were excluded. Age, Gleason score (GS), TPSA (total prostate-specific antigen) levels, surgical history, and OS information were recorded for each patient. RESULTS: The 114 patients herein had a median age of 72.5 (51-91) years and a median GS of 8 (7-10). New lesions were observed in 59 patients (51.7%) and new organ PSMA uptake was observed in 14 patients (12.2%). In the multivariate Cox regression analysis, volume-based treatment response (vTR)-total lesion PSMA (TLP), RECIP PSMA-VOL, modified RECIP (mRECIP) PSMA-VOL, and mRECIP TLP were independent prognostic factors for mortality (p < 0.001, p = 0.006, p = 0.003, and p = 0.003, respectively). The median OS of patients with new organ involvement and new lesion with PSMA uptake was 9.3 months (95% CI 2.1-16.5 months) and 11.8 months (95% CI 7.4-16.2 months), respectively. CONCLUSION: The study concluded that new organ involvement had a shorter OS than new lesion involvement. In the mRECIP that we developed, unlike RECIP, we demonstrated that both PSMA-VOL and TLP value were independent prognostic factors for mortality.


Assuntos
Antígenos de Superfície , Glutamato Carboxipeptidase II , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias de Próstata Resistentes à Castração , Humanos , Masculino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Glutamato Carboxipeptidase II/metabolismo , Antígenos de Superfície/metabolismo , Idoso de 80 Anos ou mais , Neoplasias de Próstata Resistentes à Castração/diagnóstico por imagem , Neoplasias de Próstata Resistentes à Castração/patologia , Metástase Neoplásica
7.
Cogn Neuropsychol ; 41(3-4): 148-170, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38942485

RESUMO

We present a case study detailing cognitive performance, functional neuroimaging, and effects of a hypothesis-driven treatment in a 10-year-old girl diagnosed with complete, isolated corpus callosum agenesis. Despite having average overall intellectual abilities, the girl exhibited profound surface dyslexia and dysgraphia. Spelling treatment significantly and persistently improved her spelling of trained irregular words, and this improvement generalized to reading accuracy and speed of trained words. Diffusion weighted imaging revealed strengthened intrahemispheric white matter connectivity of the left temporal cortex after treatment and identified interhemispheric connectivity between the occipital lobes, likely facilitated by a pathway crossing the midline via the posterior commissure. This case underlines the corpus callosum's critical role in lexical reading and writing. It demonstrates that spelling treatment may enhance interhemispheric connectivity in corpus callosum agenesis through alternative pathways, boosting the development of a more efficient functional organization of the visual word form area within the left temporo-occipital cortex.


Assuntos
Agenesia do Corpo Caloso , Agrafia , Dislexia , Humanos , Feminino , Agrafia/etiologia , Agrafia/fisiopatologia , Agrafia/diagnóstico por imagem , Criança , Dislexia/diagnóstico por imagem , Dislexia/fisiopatologia , Dislexia/diagnóstico , Dislexia/terapia , Agenesia do Corpo Caloso/complicações , Agenesia do Corpo Caloso/diagnóstico por imagem , Agenesia do Corpo Caloso/fisiopatologia , Leitura , Imagem de Difusão por Ressonância Magnética , Testes Neuropsicológicos , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/fisiopatologia , Substância Branca/diagnóstico por imagem
8.
BMC Emerg Med ; 24(1): 101, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38886641

RESUMO

BACKGROUNDS: Acute Appendicitis (AA) is one of the most common surgical emergencies worldwide. This study aims to investigate the predictive performances of 6 different Machine Learning (ML) algorithms for simple and complicated AA. METHODS: Data regarding operated AA patients between 2012 and 2022 were analyzed retrospectively. Based on operative findings, patients were evaluated under two groups: perforated AA and none-perforated AA. The features that showed statistical significance (p < 0.05) in both univariate and multivariate analysis were included in the prediction models as input features. Five different error metrics and the area under the receiver operating characteristic curve (AUC) were used for model comparison. RESULTS: A total number of 1132 patients were included in the study. Patients were divided into training (932 samples), testing (100 samples), and validation (100 samples) sets. Age, gender, neutrophil count, lymphocyte count, Neutrophil to Lymphocyte ratio, total bilirubin, C-Reactive Protein (CRP), Appendix Diameter, and PeriAppendicular Liquid Collection (PALC) were significantly different between the two groups. In the multivariate analysis, age, CRP, and PALC continued to show a significant difference in the perforated AA group. According to univariate and multivariate analysis, two data sets were used in the prediction model. K-Nearest Neighbors and Logistic Regression algorithms achieved the best prediction performance in the validation group with an accuracy of 96%. CONCLUSION: The results showed that using only three input features (age, CRP, and PALC), the severity of AA can be predicted with high accuracy. The developed prediction model can be useful in clinical practice.


Assuntos
Apendicite , Aprendizado de Máquina , Índice de Gravidade de Doença , Humanos , Apendicite/diagnóstico , Feminino , Masculino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Proteína C-Reativa/análise , Curva ROC , Algoritmos , Adolescente , Doença Aguda , Adulto Jovem , Idoso
9.
Turk Neurosurg ; 34(4): 600-606, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38874238

RESUMO

AIM: To evaluate the relationship between the surgical techniques, the waiting time for surgery, postoperative distance between the graft-bone margin and the percentage of bone resorption, we analyzed patients who underwent cranioplasty. Cranioplasty is a necessary surgery to preserve brain tissue and provide an appropriate microenvironment. MATERIAL AND METHODS: In this study, patients who underwent autologous bone grafting after decompressive craniectomy by the Neurosurgery Clinic of University of Health Sciences Ankara Training and Research Hospital between 2018 and 2021 were examined. RESULTS: Thirty-nine patients who underwent autologous cranioplasty following decompressive craniectomy were included in the study. The average expected time for cranioplasty surgery following decompressive craniectomy was 16.97±13.478 weeks (min:2 max:62 weeks). The expected time between decompressive craniectomy and cranioplasty surgeries and resorption rates were compared. The resorption rate was above 30% in 7 of 10 patients with 24 weeks or more between craniectomy and cranioplasty, and less than 30% in 17 of 25 patients in surgeries less than 24 weeks (p=0.04). Following cranioplasty surgery, the distance between the graft-bone margin and the resorption rates were also compared. In this analysis, statistically significant differences were detected between the distance between the graft-bone border and the resorption rates. Resorption rates increased in 15 of 19 patients with a postcranioplasty distance of 1 mm or more (p < 0.00001). CONCLUSION: Early cranioplasty surgery is important in order to reduce complications that may occur after craniectomy. In addition, it is important to keep the defect area small in size during craniectomy surgery and to keep the cutting edge thinner when the bone graft is taken, in order to reduce the development of bone graft resorption.


Assuntos
Reabsorção Óssea , Transplante Ósseo , Craniectomia Descompressiva , Procedimentos de Cirurgia Plástica , Complicações Pós-Operatórias , Crânio , Transplante Autólogo , Humanos , Transplante Ósseo/métodos , Masculino , Feminino , Craniectomia Descompressiva/efeitos adversos , Craniectomia Descompressiva/métodos , Pessoa de Meia-Idade , Adulto , Reabsorção Óssea/etiologia , Transplante Autólogo/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Crânio/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Idoso , Estudos Retrospectivos , Adulto Jovem , Resultado do Tratamento
10.
Front Surg ; 11: 1357492, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38800629

RESUMO

Objective: The efficacy of non-invasive mechanical ventilation (NIMV) on the postoperative ARF is conflicting and the failure rate of NIMV in this patient population is high. In our study, we hypothesized that the use of dexmedetomidine during NIMV in major abdominal surgical patients can reduce NIMV failure without significant side affect. Methods: Medical records of patients who underwent major abdominal surgery, admitted to our general surgery intensive care unit (ICU), developed postoperative ARF, received NIMV (with oro-nasal mask) and dexmedetomidine infusion were enrolled in this study. The infusion rate was adjusted to maintain a target sedation level of a Richmond Agitation-Sedation Scale (RASS) (-2)-(-3). The sedation was stopped when NIMV was discontinued. Results: A total of 60 patients, 42 (70.0%) male, and 18 (30.0%) female, with a mean age of 68 ± 11 years were included in the study. The mean APACHE II score was 20 ± 6. Dexmedetomidine was infused for a median of 25 h (loading dose of 0.2 mcg/kg for 10 min, maintained at 0.2-0.7 mcg/kg/h, titrated every 30 min). RASS score of all study group significantly improved at the 2 h of dexmedetomidine initiation (+3 vs. -2, p = 0.01). A targeted sedation level was achieved in 92.5% of patients. Six (10.0%) patients developed bradycardia and 5 (8.3%) patients had hypotension. The mean NIMV application time was 23.4 ± 6.1 h. Seven (11.6%) patients experienced NIMV failure, all due to worsening pulmonary conditions, and required intubation and invasive ventilation. Fifty-three (88.3%) patients were successfully weaned from NIMV with dexmedetomidine sedation and discharged from ICU. The duration of NIMV application and ICU stay was shorter in NIMV succeded group (21.4 ± 3.2 vs. 29.9 ± 6.4; p = 0.012). Conclusion: Our study suggests that dexmedetomidine demonstrates effective sedation in patients with postoperative ARF during NIMV application after abdominal surgery. Dexmedetomidine can be considered safe and capable of improving NIMV success.

11.
Cereb Cortex ; 34(5)2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38715405

RESUMO

OBJECTIVES: This retrospective study aimed to identify quantitative magnetic resonance imaging markers in the brainstem of preterm neonates with intraventricular hemorrhages. It delves into the intricate associations between quantitative brainstem magnetic resonance imaging metrics and neurodevelopmental outcomes in preterm infants with intraventricular hemorrhage, aiming to elucidate potential relationships and their clinical implications. MATERIALS AND METHODS: Neuroimaging was performed on preterm neonates with intraventricular hemorrhage using a multi-dynamic multi-echo sequence to determine T1 relaxation time, T2 relaxation time, and proton density in specific brainstem regions. Neonatal outcome scores were collected using the Bayley Scales of Infant and Toddler Development. Statistical analysis aimed to explore potential correlations between magnetic resonance imaging metrics and neurodevelopmental outcomes. RESULTS: Sixty preterm neonates (mean gestational age at birth 26.26 ± 2.69 wk; n = 24 [40%] females) were included. The T2 relaxation time of the midbrain exhibited significant positive correlations with cognitive (r = 0.538, P < 0.0001, Pearson's correlation), motor (r = 0.530, P < 0.0001), and language (r = 0.449, P = 0.0008) composite scores at 1 yr of age. CONCLUSION: Quantitative magnetic resonance imaging can provide valuable insights into neurodevelopmental outcomes after intraventricular hemorrhage, potentially aiding in identifying at-risk neonates. Multi-dynamic multi-echo sequence sequences hold promise as an adjunct to conventional sequences, enhancing the sensitivity of neonatal magnetic resonance neuroimaging and supporting clinical decision-making for these vulnerable patients.


Assuntos
Tronco Encefálico , Recém-Nascido Prematuro , Imageamento por Ressonância Magnética , Humanos , Masculino , Feminino , Imageamento por Ressonância Magnética/métodos , Recém-Nascido , Estudos Retrospectivos , Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/crescimento & desenvolvimento , Lactente , Hemorragia Cerebral Intraventricular/diagnóstico por imagem , Hemorragia Cerebral/diagnóstico por imagem , Transtornos do Neurodesenvolvimento/diagnóstico por imagem , Transtornos do Neurodesenvolvimento/etiologia , Idade Gestacional
12.
Turk Neurosurg ; 34(3): 415-422, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38650555

RESUMO

AIM: To investigate the relationship among the modified Rankin scores of patients who had intracerebral hematomas at discharge, demographic characteristics of the patients, and the characteristics of the hematoma. MATERIAL AND METHODS: In this study, patients diagnosed with intracerebral hematoma and treated at the Ministry of Health Ankara Training and Research Hospital Neurosurgery Clinic between January 2010 and December 2020 were examined retrospectively. The age, gender, comorbidity, anticoagulant?antiaggregant use, and Glasgow Coma Scale score of the patients were obtained from hospital records. The modified Rankin scale (mRS) was used to assess patients at discharge. RESULTS: Herein, a total of 114 patients with supratentorial intracerebral hematoma were evaluated. The modified Rankin score ranged from 0 to 6, with a mean score of 3.47 ± 2.26. When the patients were evaluated based on their discharge status, the mortality rate was 33.3% (n=38). Fifty percent of the patients who used anticoagulant?antiaggregant died. High mRS scores were seen more frequently in advanced age. Among the other diseases of the patients, hypertension and the use of anticoagulant? antiaggregant were found to be statistically significant with high mRS scores (p < 0.001). Patients with low Glasgow Coma Scale score at the time of admission had significantly higher mRS scores (p < 0.001). CONCLUSION: Patients with advanced age, hypertension, and anticoagulant?antiaggregant use had a higher mRS score after hematoma formation. Preventable risk factors for spontaneous intraparenchymal hematomas are among the leading causes of disability, and early detection and treatment of underlying diseases are critical for hematoma prevention. Awareness about risk factors should be the priority to improve early diagnosis and reduce treatment disability rates.


Assuntos
Escala de Coma de Glasgow , Humanos , Masculino , Feminino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Adulto , Hemorragia Cerebral/diagnóstico por imagem , Anticoagulantes/uso terapêutico , Idoso de 80 Anos ou mais , Hematoma
13.
Clin Neuroradiol ; 34(3): 663-673, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38639770

RESUMO

PURPOSE: Pre-surgical information about tumor consistency could facilitate neurosurgical planning. This study used multi-dynamic-multi-echo (MDME)-based relaxometry for the quantitative determination of pituitary tumor consistency, with the aim of predicting lesion resectability. METHODS: Seventy-two patients with suspected pituitary adenomas, who underwent preoperative 3 T MRI between January 2020 and January 2022, were included in this prospective study. Lesion-specific T1-/T2-relaxation times (T1R/T2R) and proton density (PD) metrics were determined. During surgery, data about tumor resectability were collected. A Receiver Operating Characteristic (ROC) curve analysis was performed to investigate the diagnostic performance (sensitivity/specificity) for discriminating between easy- and hard-to-remove by aspiration (eRAsp and hRAsp) lesions. A Mann-Whitney-U-test was done for group comparison. RESULTS: A total of 65 participants (mean age, 54 years ± 15, 33 women) were enrolled in the quantitative analysis. Twenty-four lesions were classified as hRAsp, while 41 lesions were assessed as eRAsp. There were significant differences in T1R (hRAsp: 1221.0 ms ± 211.9; eRAsp: 1500.2 ms ±â€¯496.4; p = 0.003) and T2R (hRAsp: 88.8 ms ± 14.5; eRAsp: 137.2 ms ± 166.6; p = 0.03) between both groups. The ROC analysis revealed an area under the curve of 0.72 (95% CI: 0.60-0.85) at p = 0.003 for T1R (cutoff value: 1248 ms; sensitivity/specificity: 78%/58%) and 0.66 (95% CI: 0.53-0.79) at p = 0.03 for T2R (cutoff value: 110 ms; sensitivity/specificity: 39%/96%). CONCLUSION: MDME-based relaxometry enables a non-invasive, pre-surgical characterization of lesion consistency and, therefore, provides a modality with which to predict tumor resectability.


Assuntos
Adenoma , Neoplasias Hipofisárias , Humanos , Feminino , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Neoplasias Hipofisárias/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Adenoma/patologia , Sensibilidade e Especificidade , Imageamento por Ressonância Magnética/métodos , Adulto , Cuidados Pré-Operatórios/métodos , Idoso
14.
Mil Med ; 189(9-10): e2200-e2205, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-38587902

RESUMO

INTRODUCTION: Health services in the theater/district areas often contain difficulties. Although telemedicine has a huge potential to support medics in the area, there are challenges as well. Our aim is to evaluate the telemedicine support that can be provided to the medics from the perspective of course instructors. MATERIALS AND METHODS: Our study was carried out in The University of Health Sciences, Türkiye. All of the instructors of a medic course were asked to fill a 13-question questionnaire and Likert-type scale, sent via e-mail. Among 79 instructors, 71 of them (55 physicians, 16 nonphysicians) responded and were included in the study. The distributions of the categorical variables in the groups were analyzed with the Pearson Chi-square. RESULTS: Of the 71 participants, 37 (52.11%) stated that there is a need for legal and ethical regulations for telemedicine (medical liability, malpractice, obtaining consent from the casualties, civilians, cross border missions, and rank-related problems) and patients' rights, additionally, to clarify the responsibilities of the doctors giving telemedicine support and the medics in the area. It was observed that physicians' and nonphysician group's opinions about the telepsychotherapy were statistically significantly different (χ2 = 8.675, P = .013). CONCLUSIONS: Most of the instructors believed that telemedicine could carry the knowledge and skills of specialist physicians to the field of operation. Access to high-quality health services in a short time through telemedicine support can increase the courage and commitment of the personnel. It is thought that with telemedicine, medics will not feel alone in the field, their worries about making wrong decisions will decrease, and their knowledge and skills will increase. Participants were particularly concerned about who will be held responsible for problems arising from interventions carried out using telemedicine, and strict legal and medical regulations are needed.


Assuntos
Telemedicina , Humanos , Telemedicina/normas , Inquéritos e Questionários , Masculino , Feminino , Adulto , Turquia , Pessoa de Meia-Idade
15.
Arch Psychiatr Nurs ; 48: 20-29, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38453278

RESUMO

OBJECTIVE: The level of intercultural sensitivity is important for nurses to approach the individual's culture in care and treatment without prejudice. In this study, it was aimed to determine the effect of nurses' intercultural sensitivity level on xenophobic attitude. METHODS: This quantitative cross-sectional study was conducted at Van Training and Research Hospital between January and June 2022. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. SPSS-25 package program and R programming language 4.1.3 are used. RESULTS: This study was conducted with 235 nurses. According to the findings obtained in our study, the regression model determine the effect of intercultural sensitivity on xenophobia level was found to be F(1,233) = 69.857, p = 0.001, and 23.1 % (R2 = 0.231) of the variance in the dependent variable was explained by the independent variable. Intercultural sensitivity has a negative and significant effect on the level of xenophobia (ß = -0.480; t (233) = -8.358, p = 0.001). When comparing the performance of all variables with machine learning algorithms for the prediction model, the best performing algorithm was found to be Random Forest (RF). The contributions of these variables to the model were calculated with Shapley Additive Explanations (SHAP) values. The most important variables that should be included in the model to predict the xenophobia variable are the respect for cultural differences sub-dimension and intercultural sensitivity variables. CONCLUSION: It was determined that as the level of intercultural sensitivity of the nurses increased, their xenophobic attitudes decreased. Longitudinal studies on xenophobic attitude in nurses are recommended. It is recommended to make predictions with different machine learning models.


Assuntos
Atitude , Xenofobia , Humanos , Estudos Transversais , Preconceito , Hospitais
16.
Burns ; 50(4): 966-979, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38331663

RESUMO

AIM: This study was conducted to determine the segmentation, classification, object detection, and accuracy of skin burn images using artificial intelligence and a mobile application. With this study, individuals were able to determine the degree of burns and see how to intervene through the mobile application. METHODS: This research was conducted between 26.10.2021-01.09.2023. In this study, the dataset was handled in two stages. In the first stage, the open-access dataset was taken from https://universe.roboflow.com/, and the burn images dataset was created. In the second stage, in order to determine the accuracy of the developed system and artificial intelligence model, the patients admitted to the hospital were identified with our own design Burn Wound Detection Android application. RESULTS: In our study, YOLO V7 architecture was used for segmentation, classification, and object detection. There are 21018 data in this study, and 80% of them are used as training data, and 20% of them are used as test data. The YOLO V7 model achieved a success rate of 75.12% on the test data. The Burn Wound Detection Android mobile application that we developed in the study was used to accurately detect images of individuals. CONCLUSION: In this study, skin burn images were segmented, classified, object detected, and a mobile application was developed using artificial intelligence. First aid is crucial in burn cases, and it is an important development for public health that people living in the periphery can quickly determine the degree of burn through the mobile application and provide first aid according to the instructions of the mobile application.


Assuntos
Inteligência Artificial , Queimaduras , Aplicativos Móveis , Queimaduras/classificação , Queimaduras/diagnóstico por imagem , Queimaduras/patologia , Humanos , Fotografação/métodos
17.
Clin Neuroradiol ; 34(2): 421-429, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38289377

RESUMO

PURPOSE: Neonates born at < 28 weeks of gestation are at risk for neurodevelopmental delay. The aim of this study was to identify quantitative MR-based metrics for the prediction of neurodevelopmental outcomes in extremely preterm neonates. METHODS: T1-/T2-relaxation times (T1R/T2R), ADC, and fractional anisotropy (FA) of the left/right posterior limb of the internal capsule (PLIC) and the brainstem were determined at term-equivalent ages in a sample of extremely preterm infants (n = 33). Scores for cognitive, language, and motor outcomes were collected at one year corrected-age. Pearson's correlation analyses detected relationships between quantitative measures and outcome data. Stepwise regression procedures identified imaging metrics to estimate neurodevelopmental outcomes. RESULTS: Cognitive outcomes correlated significantly with T2R (r = 0.412; p = 0.017) and ADC (r = -0.401; p = 0.021) (medulla oblongata). Furthermore, there were significant correlations between motor outcomes and T1R (pontine tegmentum (r = 0.346; p = 0.049), midbrain (r = 0.415; p = 0.016), right PLIC (r = 0.513; p = 0.002), and left PLIC (r = 0.504; p = 0.003)); T2R (right PLIC (r = 0.405; p = 0.019)); ADC (medulla oblongata (r = -0.408; p = 0.018) and pontine tegmentum (r = -0.414; p = 0.017)); and FA (pontine tegmentum (r = -0.352; p = 0.045)). T2R/ADC (medulla oblongata) (cognitive outcomes (R2 = 0.296; p = 0.037)) and T1R (right PLIC)/ADC (medulla oblongata) (motor outcomes (R2 = 0.405; p = 0.009)) revealed predictive potential for neurodevelopmental outcomes. CONCLUSION: There are relationships between relaxometry­/DTI-based metrics determined by neuroimaging near term and neurodevelopmental outcomes collected at one year of age. Both modalities bear prognostic potential for the prediction of cognitive and motor outcomes. Thus, quantitative MRI at term-equivalent ages represents a promising approach with which to estimate neurologic development in extremely preterm infants.


Assuntos
Lactente Extremamente Prematuro , Imageamento por Ressonância Magnética , Humanos , Recém-Nascido , Feminino , Masculino , Imageamento por Ressonância Magnética/métodos , Transtornos do Neurodesenvolvimento/diagnóstico por imagem , Transtornos do Neurodesenvolvimento/etiologia , Cápsula Interna/diagnóstico por imagem , Valor Preditivo dos Testes
18.
Ir J Med Sci ; 193(2): 1073-1077, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37737915

RESUMO

INTRODUCTION: The aim of this study is to examine the effects of Ramadan fasting on melatonin, cortisol, and serotonin levels. METHODS: In this study, the blood of 19 healthy male individuals between the ages of 26 and 51, registered in Agri (Turkey) Family Health Center and fasting during Ramadan, was studied. The study was carried out in 2021-2022. The SPSS-22 package program was used in the analysis of the data. Wilcoxon analysis was used in the study. RESULTS: It was determined that the pre-test-post-test melatonin and cortisol levels of the individuals were not statistically significant (p>0.05). It was determined that the pre-test-post-test serotonin difference of the individuals was statistically significant (p<0.05). CONCLUSION: It has been determined that Ramadan fasting increases the serotonin level of individuals but does not change the levels of melatonin and cortisol. It was determined that the level of happiness of individuals increased after Ramadan fasting. Longitudinal studies on the effects of Ramadan fasting are recommended.


Assuntos
Melatonina , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Hidrocortisona , Serotonina , Turquia , Islamismo , Jejum
19.
Chronic Illn ; 20(1): 86-95, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-36883242

RESUMO

OBJECTIVES: To evaluate the presence of chronic critical illness (CCI) in COVID-19 patients and compare clinical characteristics and prognosis of patients with and without CCI admitted to intensive care unit (ICU). METHODS: It was a retrospective, observational study at a university hospital ICU. Patients were accepted as CCI if they had prolonged ICU stay (≥14 days) and got ≥1 score for cardiovascular sequential organ failure assessment (SOFA) score and ≥2 score in other parameters on day 14 of ICU admission which was described as persistent organ dysfunction. RESULTS: 131 of 397 (33%) patients met CCI criteria. CCI patients were older (p = 0.003) and frailer (p < 0.001). Their Acute Physiology and Chronic Health Evaluation (APACHE) II and SOFA scores were higher, PaO2/FiO2 ratio was lower (p < 0.001). Requirement of invasive mechanical ventilation (IMV), steroid use, and septic shock on admission were higher in the CCI group (p < 0.001). CCI patients had higher ICU and hospital mortality than other patients (54.2% vs. 19.9% and 55.7% vs. 22.6%, p < 0.001, respectively). Regression analysis revealed that IMV (OR: 8.40, [5.10-13.83], p < 0.001) and PaO2/FiO2 < 150 on admission (OR: 2.25, [1.36-3.71], p = 0.002) were independent predictors for CCI. DISCUSSION: One-third of the COVID-19 patients admitted to the ICU were considered as CCI with significantly higher ICU and hospital mortality.


Assuntos
COVID-19 , Humanos , Estado Terminal , Estudos Retrospectivos , APACHE , Unidades de Terapia Intensiva , Prognóstico
20.
Acta Microbiol Immunol Hung ; 70(4): 348-352, 2023 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-38063902

RESUMO

Hepatitis C virus (HCV) can cause both acute and chronic hepatitis infections. Gaziantep is located southeast part of Turkey and has a border with Syria. More than 400,000 Syrian refugees live in Gaziantep. The aim of this study was to evaluate distribution of HCV genotypes among Syrian patients and in people who inject drugs.Serum samples form 1,628 individuals (786 female, 842 male) which were sent to our laboratory for genotyping between January 2013 and December 2022, were analyzed retrospectively. Three different HCV genotyping assays (Qiagen, RTA and Abbott) were used during the 10-year study period.Out of the 1,628 patients, genotype 1 was detected in 51.5%, genotype 3 in 21.4%, genotype 4 in 20%, genotype 5 in 4.6%, genotype 2 in 1.3%. Mixed genotype was found in 20 patients. Of the patients, 1,143 were Turkish patients and among those patients genotype 1 (66.8%) was the most common genotype followed by genotype 3 (29%). Among Syrian patients (n = 477), genotype 4 (64.2%) was predominant genotype followed by genotype 1 and genotype 5. Genotype 3 was detected in 277 (79.6%) prisoners. All of them were male and probably the main source of HCV infection was intravenous drug abuse. While genotypes 1 and 4 were common in females, genotypes 1 and 3 were common in males.In the future genotype 3 may become an increasing problem due to the persons who inject drugs. Less frequent genotypes such as 4 and 5 may become more frequent due to Syrian patients.


Assuntos
Usuários de Drogas , Hepatite C , Abuso de Substâncias por Via Intravenosa , Humanos , Masculino , Feminino , Hepacivirus/genética , Estudos Retrospectivos , Hepatite C/epidemiologia , Genótipo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA