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1.
J Med Virol ; 95(1): e28109, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36043339

RESUMO

The aim of this study is to investigate the relationship between the model for end-stage liver disease (MELD) score and disease progression and mortality in COVID-19 patients. The files of 4213 patients over the age of 18 who were hospitalized with the diagnosis of COVID-19 between March 20, 2020 and May 1, 2021 were retrospectively scanned. Sociodemographic characteristics, chronic diseases, hemogram and biochemical parameters at the time they were diagnosed with COVID-19 of the patients, duration of hospitalization, duration of intensive care unit (ICU), duration of intubation, in-hospital mortality from COVID-19 and outside-hospital mortality for another reason (within the last 1 year) and recurrent hospitalization (within the last 1 year) were recorded. The MELD scores of the patients were calculated. Two groups were formed as MELD score < 10 and MELD score ≥ 10. The rate of ICU, in-hospital mortality from COVID-19 and outside-hospital mortality from other causes, intubation rate, and recurrent hospitalization were significantly higher in the MELD ≥ 10 group. The duration of ICU, hospitalization, intubation were significantly higher in the MELD ≥ 10 group (p < 0.001). As a result of Univariate and Multivariate analysis, MELD score was found to be the independent predictors of ICU, in-hospital mortality, intubation, and recurrent hospitalization (p < 0.001). MELD score 18.5 predicted ICU with 99% sensitivity and 100% specificity (area under curve [AUC]: 0.740, 95% confidence interval [CI]: 0.717-0.763, p < 0.001) also MELD score 18.5 predicted in-hospital mortality with 99% sensitivity and 100% specificity (AUC: 0.797, 95% CI: 0.775-0.818, p < 0.001). The MELD score was found to be the independent predictors of in-hospital mortality, ICU admission, and intubation in COVID-19 patients.


Assuntos
COVID-19 , Doença Hepática Terminal , Humanos , Adulto , Pessoa de Meia-Idade , Doença Hepática Terminal/diagnóstico , Índice de Gravidade de Doença , Estudos Retrospectivos , Prognóstico , COVID-19/diagnóstico , COVID-19/complicações , Hospitais
2.
Prep Biochem Biotechnol ; 53(4): 454-463, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35848985

RESUMO

The development of new starter cultures is a crucial task for the food industry to meet technological requirements and traditional products are important reservoirs for new starter cultures. In this respect, this study aimed to isolate, identify, and determine the technological characteristics of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus strains originated from traditional yogurt samples. Genotypic discrimination of 200 isolates revealed the presence of distinct 19 S. thermophilus and 11 Lb. delbrueckii subsp. bulgaricus strains as potential starter cultures. Strain-specific properties determined the acidification capacity of the yogurt starter cultures and a higher acidification capacity was observed for S. thermophilus strains compared to Lb. delbrueckii subsp. bulgaricus strains. Proteolytic activity was found between 0.012-0.172 and 0.078-0.406 for S. thermophilus and Lb. delbrueckii subsp. bulgaricus strains, respectively. 4 of S. thermophilus and 3 of Lb. delbrueckii subsp. bulgaricus strains were found resistant to all tested bacteriophages. The antibiotic susceptibility tests of the isolates revealed that a very low antibiotic resistance was observed for the yogurt starter cultures. Finally, the growth kinetics of selected strains were determined and the maximum specific growth rate of selected S. thermophilus and Lb. delbrueckii subsp. bulgaricus was calculated as 0.527 h-1 and 0.589 h-1, respectively.


Assuntos
Lactobacillus delbrueckii , Iogurte , Fermentação , Cinética , Indústria Alimentícia
3.
Int J Clin Pract ; 75(7): e14219, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33848382

RESUMO

OBJECTIVE: The aim of this study was to investigate the effects of the COVID-19 pandemic on anxiety depression and intention to go to the hospital in chronic patients. METHODS: The Bostan Intention to Go to Hospital Scale developed by one researcher (SB) as the data collection tool and the Beck Anxiety-Depression Inventories were used. RESULTS: Of all patients, 56.8% stated that they would go to the hospital in case of emergency and 28.3% expressed that they did not want to go to the hospital even in this case. 50% of the participants said that they did not want to go to the hospital under any circumstances during the pandemic process. As a result of the correlation analysis, there was an inverse correlation between the anxiety-depression levels and encountering COVID-19 patients and having a relative with COVID-19 (P = .001). Inverse correlation was found between intention to go to hospital and encountering COVID-19 patients (P = .001). CONCLUSION: It was revealed that chronic patients did not have any intentions to go to hospital during the COVID-19 pandemic and only half of the people were willing to go to the hospital in case of emergency. Anxiety and depression levels were found to increase when COVID-19 patients were encountered or a relative had COVID-19.


Assuntos
COVID-19 , Intenção , Ansiedade/epidemiologia , Depressão/epidemiologia , Hospitais , Humanos , Pandemias , SARS-CoV-2
4.
J Electrocardiol ; 62: 10-13, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32736117

RESUMO

OBJECTIVE: The aim of the study is to determine the frequency of fragmented QRS (FQRS) in patients with SARS - COV - 2. METHODS: A total of 125 consecutive patients over 20 years of age who were hospitalized for SARS - COV - 2 between 20th March 2020 and 18th May 2020 were included in the study. The data of the patients in the inpatient ward and in the intensive care unit were recorded separately. The duration of QRS and presence of FQRS were evaluated by two experienced cardiologists. The patients were divided into two groups as FQRS positive and FQRS negative considering presence of FQRS. Moreover, the frequency of FQRS in the patients in the inpatient ward and in the intensive care unit were compared with each other. RESULTS: FQRS was found in 24% of the patients who had SARS-COV-2. There was no difference between FQRS positive and negative groups in terms of age and gender. Heart rate was higher in FQRS positive group. C-reactive protein (7.25 ±â€¯6.65 mg/dl vs. 4.80 ±â€¯4.48 mg/dl; p = .02) levels were also significantly higher in the FQRS positive group. In patients with SARS-COV-2, intensive care unit requirement increased with increasing levels of troponin (p < .000). A positive correlation was detected between serum CRP levels and FQRS (r = 0.204, p = .024). CONCLUSIONS: The frequency of FQRS is high in patients with SARS - COV - 2. Serum CRP levels increase with increasing frequency of FQRS in patients with SARS - COV - 2 indicating that patients with FQRS are exposed to more inflammation. Presence of FQRS in SARS - COV - 2 patients may be useful in predicting cardiovascular outcomes.


Assuntos
COVID-19/complicações , Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Idoso , Biomarcadores/sangue , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , SARS-CoV-2 , Turquia/epidemiologia
5.
Bull Environ Contam Toxicol ; 102(2): 252-258, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30666389

RESUMO

In this study, pharmaceutically active compounds (PhACs) were analyzed in the influent and effluent of a domestic wastewater treatment plant in Turkey and a municipal wastewater treatment plant in Germany and the toxicity of these wastewaters were estimated using a toxic unit (TU) approach. A total of 21 and 32 PhACs were detected in the domestic wastewater and the municipal wastewater, respectively. The TUs estimated for PhACs in municipal wastewater were higher than the TUs estimated for PhACs present in domestic wastewater. The levels of the anti-anxiety drug, oxazepam were estimated to be in the high risk category (HQ > 10) in both wastewaters. In bench-scale tests with ozonation, the removals of four PhACs in the municipal wastewater were investigated. At a dose of 2 mg/L ozone, 97%-98% of diclofenac and carbamazepine were removed. The lowest removal rate at 71% was observed for metoprolol.


Assuntos
Preparações Farmacêuticas/análise , Águas Residuárias/química , Poluentes Químicos da Água/análise , Alemanha , Turquia
7.
Ren Fail ; 40(1): 410-415, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30012025

RESUMO

PURPOSE: Today, the long-term effects of partial exposure of cholinesterase on the kidney continue to be a research topic. In this study, we aimed to histopathologically investigate the possible effect of acute toxicity due to fenthion, an organophosphate (OP) compound, on the kidneys. METHODS: In all, 21 rats were randomly divided into three groups. Experimental group was each administered intraperitoneal 0.8 g/kg fenthion within physiologic serum. Sham group was only administered intraperitoneal physiologic serum. The control group continued normal nutrition with no procedure performed. After 24 h, all rats were sacrificed by cervical dislocation. Half of the recipient kidney tissues were examined histopathologically and the other half biochemically. RESULTS: No histopathological findings were found in the control group. Rats in the experimental group were observed to have epithelial cell disorganization in tubules, moderate epithelial cell loss, and degeneration. Again, expansion of tubules, vacuolization of tubular epithelial cells, and tubular structure approaching atrophy were observed, with cells approaching apoptosis and common hemorrhage noted although rats in the sham group were observed to have mild tubular degeneration. CONCLUSIONS: It should not be forgotten that one of the causes of systemic complaints linked to acute toxicity exposed to the OP compound of fenthion may be cellular injury to glomerular and tubular structures in the kidneys.


Assuntos
Injúria Renal Aguda/patologia , Inibidores da Colinesterase/toxicidade , Fention/toxicidade , Túbulos Renais/patologia , Intoxicação por Organofosfatos/patologia , Injúria Renal Aguda/induzido quimicamente , Animais , Modelos Animais de Doenças , Feminino , Humanos , Túbulos Renais/efeitos dos fármacos , Intoxicação por Organofosfatos/etiologia , Ratos , Ratos Wistar
8.
J Environ Manage ; 212: 186-197, 2018 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-29428653

RESUMO

In this study, a lab-scale anaerobic sequencing batch reactor (AnSBR) was used for the acidification of a pharmaceutical wastewater sourced from etodolac chemical synthesis tanks. The effects of the organic loading rate (OLR), and etodolac and sulfate concentrations on the acidification rate and microbial community in AnSBR were investigated at 35 °C with a hydraulic retention time (HRT) of 37 h, a pH of 5, and OLRs up to 5.2 kgCOD/m3·day. The AnSBR accomplished a 60% acidification ratio and 50-60% etodolac removal at OLRs up to 2.6 kgCOD/m3·day. However, at OLR = 3.9 kgCOD/m3·day, acidification was not achieved due to sulfite inhibition; pre-ozonation was applied to overcome this sulfite inhibition. Although etodolac and COD removals were improved, the wastewater was not successfully acidified. Real-time polymerase chain reaction (Q-PCR) and fluorescent in situ hybridization (FISH) analyses revealed that acidification was inhibited by the dominance of sulfate reducing bacteria (SRB) over acidification bacteria in the AnSBR. However, increasing the OLR to 5.2 kgCOD/m3·day led to toxicity stress in the SRB due to increased sulfite concentrations. Sulfate load fundamentally affected acidification process and microbial community composition. The presence of etodolac with concentration up to 56 mg/L did not have a significant effect on VFA production and the microbial community.


Assuntos
Preparações Farmacêuticas/química , Águas Residuárias , Bactérias Anaeróbias , Reatores Biológicos , Hibridização in Situ Fluorescente , Eliminação de Resíduos Líquidos , Purificação da Água
9.
J Electrocardiol ; 50(6): 889-893, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28754308

RESUMO

BACKGROUND: Metabolic syndrome (MetS) is an endocrinological disease with both metabolic and physiological components. Previous studies have shown a relationship between MetS and left ventricular (LV) dysfunction. A fragmented QRS (fQRS) is a reliable electrocardiogram (ECG) finding with the importance of an indicator of myocardial fibrosis and scarring. In this study, we examined the utility of speckle tracking echocardiography (STE) in assessing LV function in MetS patients with fQRS. METHODS: The 164 consecutive MetS patients included in the study. They were separated into two groups; those with (n=33) and those without (n=131) fQRS. The two groups were compared by obtaining LV strain values with STE. RESULTS: Statistically significant differences between the fQRS (-) and fQRS (+) groups were identified for LV global longitudinal strain (LV-GLS) (p<0.001), maximum left atrial volume index (maxLAVI) (p≤0.001), strain rate during isovolumic relaxation period (SRivr) (p<0.001), and the E/SRivr ratio (p<0.001). In the multiple linear regression analysis, fQRS (ß=-1.456, p=0.003), diabetes mellitus (ß=-0.973, p=0.015), hypertension (ß=-0.820, p=0.015) and MaxLAVI (ß=-0.142, p=0.018) were independent predictors of LV-GLS. However, fQRS (ß=21.995, p<0.001), MaxLAVI (ß=3.090, p<0.001), and E/Em ratio (ß=3.326, p<0.001) were also independent predictors of E/SRivr. CONCLUSIONS: The results of this study showed that LV dysfunction was more common in MetS patients with fQRS. MetS patients, and especially those who are fQRS (+), should thus be closely monitored for subclinical LV systolic and diastolic dysfunction.


Assuntos
Ecocardiografia/métodos , Eletrocardiografia , Síndrome Metabólica/fisiopatologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
J Environ Manage ; 200: 380-390, 2017 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-28600935

RESUMO

The present study was conducted to investigate the electrochemical treatment of carwash wastewater using electrocoagulation (EC) process with Fe and Al electrodes. The effects of operating conditions such as initial pH (2-10), current density (0.1-5 mA/cm2) and operating time (5-50 min) on chemical oxygen demand (COD), oil-grease, chloride removal efficiencies as well as total operating costs were studied. The optimum conditions that achieve higher removal efficiencies were found as pH: 8, current density: 3 mA/cm2, operating time: 30 min for Fe electrode and pH: 6, current density: 1 mA/cm2, operating time: 30 min for Al electrode. The removal efficiencies for COD, oil-grease and chloride were obtained as 88%, 90% and 50% for Fe and 88%, 68% and 33% for Al electrodes under the optimum conditions. The total operating costs at the optimum conditions were calculated as 0.6 $/m3 and 0.3 $/m3 for Fe and Al electrodes, respectively. The sludge samples generated after EC process were characterized with Fourier transform infrared (FTIR) spectroscopy and zeta potential measurements for both electrodes. The analyses showed the presence of hydroxides and oxyhydroxides in the sludge samples and the surface of the sludge samples was negatively charged in the wide range of pH. As a conclusion, this study revealed that EC process using Fe electrode should be a feasible technology for higher COD and oil-grease removals from carwash wastewaters.


Assuntos
Eliminação de Resíduos Líquidos , Águas Residuárias , Eletrodos , Concentração de Íons de Hidrogênio , Resíduos Industriais , Esgotos
11.
Environ Monit Assess ; 189(2): 55, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28083795

RESUMO

The aim of the study was to present first preliminary characterization of Turkish hospital wastewaters, their environmental risk, and a method for toxicity assessment. The hospital wastewater samples were collected from two of the largest medical faculty hospitals and a training and research hospital in Istanbul, Turkey. The samples from the selected hospitals were taken as grab samples on March 2014. Overall, 55 substances including pharmaceuticals and their metabolites, pesticides, and corrosion inhibitors were analyzed in all hospital wastewaters. Analysis of toxicity and the antibiotic resistance bacteria were investigated in addition to the chemical analysis in the wastewater of one hospital. Hazard quotients (HQs) and toxic units (TUs) were calculated as basis of the environmental risk assessment. Fourteen pharmaceuticals in hospital wastewater (HWW) were classified as "high risk" with HQ > 10. HQHWW values higher than 100 were determined for five antibiotics and one analgesic, namely, ofloxacin, clarithromycin, ciprofloxacin, sulfapyridine, trimethoprim, and diclofenac. Ofloxacin with an HQHWW of 9090 was observed to be the most hazardous compound. HQ and TU values of the wastewater treatment plant (WWTP) effluent dropped significantly due to dilution in the sewer. Further elimination by biological degradation or adsorption was observed only in some cases. However, the decreased HQWWTPeffluent values do not the change environmental load significantly. Therefore, advanced treatment processes should be applied to remove the persistent compounds. In combination with the results on antibiotic resistance, we would prefer on-site treatment of hospital wastewater. Toxicological assessment was performed using cytotoxic and mutagenic screening tests. The results of the Ames assay showed that the native hospital wastewaters had strongly mutagenic activity with a ≤10-fold increase relative to negative controls. The mutagenic potentials of the samples were generally concentration and metabolic activation dependent. Multiple antibiotic resistances were demonstrated with the tested isolates to ciprofloxacin, trimethoprim, and ceftazidime. This study demonstrates that the hospital wastewaters in Istanbul exhibit strong environmental and toxicological risks, as well as high multiple drug resistance to commonly used antibiotics.


Assuntos
Monitoramento Ambiental , Hospitais , Eliminação de Resíduos de Serviços de Saúde , Eliminação de Resíduos Líquidos , Águas Residuárias/química , Poluentes Químicos da Água/análise , Antibacterianos/análise , Antibacterianos/toxicidade , Resistência Microbiana a Medicamentos , Praguicidas/análise , Medição de Risco , Turquia , Poluentes Químicos da Água/toxicidade
12.
Clin Auton Res ; 26(3): 205-9, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27188193

RESUMO

OBJECTIVE: Age at onset in Parkinson's disease (PD) seems to be related nonmotor symptoms. In this study we investigated the effect of the age at onset on symptoms of sexual dysfunction (SSD) in patients with PD. METHODS: This prospective study comprised 22 consecutive outpatients with early onset PD (EOPD-onset of the disease before 55 years), and 66 outpatients with late onset PD (LOPD-onset of PD over 55 years). They were all recruited from the Department of Movement Disorders, Clinic of Neurology. The diagnosis was established according to the UK PD Brain Bank Criteria by a movement disorders specialist. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr (H&Y) stage was used to establish disease severity. The sexual functions of the patients were rated by applying the Arizona Sexual Experiences Scale (ASEX). RESULTS: Thirteen EOPD patients (59.09 %) and 53 of the LOPD patients (80.3 %) (p 0.047) reported dissatisfaction with at least one item of ASEX. There were no differences between H&Y stages (p 0.205) UPDRS total (p 0.267) and motor scores (p 0.100) between groups. LOPD patients had significantly higher ASEX scores than EOPD patients (p 0.001). INTERPRETATION: Sexual dysfunciton occurs more frequently and more severely in LOPD than EOPD patients. PD patients with different ages at onset clinically present differently in terms of SSD.


Assuntos
Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Disfunções Sexuais Fisiológicas/complicações , Disfunções Sexuais Fisiológicas/fisiopatologia , Idade de Início , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
13.
Bioprocess Biosyst Eng ; 39(4): 661-76, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26846538

RESUMO

In this study, the effects of organic loading rate (OLR) and the addition of powdered activated carbon (PAC) on the performance and membrane fouling of MBR were conducted to treat real pharmaceutical process wastewater. Over 145 days of operation, the MBR system was operated at OLRs ranging from 1 to 2 kg COD m(-3) day(-1) without sludge wasting. The addition of PAC provided an improvement in the flux, despite an increase in the OLR:PAC ratio. The results demonstrated that the hybrid PAC-MBR system maintained a reduced amount of membrane fouling and steadily increased the removal performance of etodolac. PAC addition reduced the deposition of extracellular polymeric substance and organic matter on the membrane surface and resulted an increase in COD removal even at higher OLRs with low PAC addition. Membrane fouling mechanisms were investigated using combined adsorption fouling models. Modified fouling index values and normalized mass transfer coefficient values indicated that predominant fouling mechanism was cake adsorption.


Assuntos
Reatores Biológicos , Carvão Vegetal , Indústria Farmacêutica , Membranas Artificiais , Águas Residuárias , Purificação da Água/métodos
14.
Arch Ital Urol Androl ; 88(4): 270-273, 2016 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-28073191

RESUMO

AIM: The aim of this study was to investigate whether there is a relationship between erectile dysfunction (ED), thought to be a vascular disease, and AB0 blood group. MATERIAL AND METHOD: The study included 350 people abiding by the study criteria who applied to our clinic from April 2012-April 2015. The patients were divided into two groups including those with ED (Group 1) and those without (Group 2). Age, blood group, IIEF-5 score and presence of additional diseases were recorded. Erectile functions were analyzed according to blood group. RESULTS: There was no difference between the mean age of 111 patients with ED and that of 239 patients without ED included in the study (p = 0.284). There was no difference between patients in the two groups in terms of smoking, alcohol use, hypertension and diabetes (p > 0.05). Among patients in the ED group, the mean IIEF-5 score according to blood group was 19.8 ± 5.04 in the 0 blood group, 16.5 ± 5.2 in the A blood group, 17.2 ± 5.3 in the B blood group and 13.3 ± 3.02 in the AB blood group. The IIEF-5 scores of individuals in the 0 blood group were significantly high compared to individuals in other blood groups (p = 0.004). Logistic regression analysis found that compared to the 0 blood group, the erectile dysfunction risk was 3.9 times greater for the A blood group, 3.5 times greater for the B blood group and 4.7 times greater for the AB blood group (p = 0.001) (Table 3). CONCLUSION: The risk of erectile dysfunction was significantly increased for individuals in the A, B and AB blood groups compared to individuals in the 0 blood group.


Assuntos
Sistema ABO de Grupos Sanguíneos , Disfunção Erétil/sangue , Disfunção Erétil/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade
15.
Childs Nerv Syst ; 31(3): 355-8, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25194856

RESUMO

Charles Harrison Frazier (1870-1936) was a visionary neurosurgeon of his time. He devoted himself almost exclusively to neurosurgery based on his training in Germany on neurology, surgery, and surgical pathology and his accomplishments as a military physician during war years. The authors reviewed his life with a special emphasis on his legacy to neurosurgery.


Assuntos
Neurologia/história , Neurocirurgia/história , Idoso , Alemanha , História do Século XVIII , História do Século XIX , Humanos , Masculino
16.
Childs Nerv Syst ; 31(2): 177-80, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25269543

RESUMO

Sir Herbert Seddon was a visionary neuroscientist and surgeon. Internationally, he is best known for his classification of the peripheral nerve injury, now known as Seddon's classification. The authors reviewed his life with a special emphasis on his legacy to neuroscience.


Assuntos
Neurologia/história , Traumatismos dos Nervos Periféricos/história , História do Século XX , Humanos , Traumatismos dos Nervos Periféricos/classificação , Reino Unido
17.
Arthroscopy ; 31(10): 1974-80.e6, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26033463

RESUMO

PURPOSE: To investigate the site of pudendal nerve compression and the relation between traction force and abduction angle regarding pressure levels at setup for hip arthroscopy. METHODS: A total of 17 hips from 9 fresh-frozen cadavers (6 male and 3 female cadavers) were used. The pudendal nerves were dissected, and 3 FlexiForce force sensors (Tekscan, Boston, MA) were implanted on the pudendal nerve where the inferior rectal nerve, perineal nerve, and dorsal nerve of the clitoris/penis emerge. A custom-made traction table in a supine position was used with a padded perineal post of 9 cm. Recordings were made at 0, 10, 20, 30, and 40 kg of traction at varying hip abduction angles of 0°, 15°, 30°, and 45°. RESULTS: The tuber ischiadicum (perineal nerve) and genital region (dorsal nerve of penis/clitoris) had statistically higher pressure values when compared with the pudendal canal (inferior rectal nerve) (P < .05). There was a significant increase in forces acting on the pudendal nerve with increasing application of 0 to 40 kg of traction in steps of 10 kg, with the exception of the pudendal canal sensor and reading of the perineal nerve sensor at 45° of hip abduction (P < .004 with Bonferroni correction for significant values). On the contrary, hip abduction angle had no statistically significant effect on pudendal nerve compression. (All specific P values with Bonferroni correction were greater than .003.) CONCLUSIONS: To avoid nerve palsy completely, the etiopathogenesis of compressive neuropathy should be identified. The location for compression and relation between different traction positions and forces are clarified in this study. This information can be used for further research and prevention. CLINICAL RELEVANCE: This study adds objective data on the etiopathogenesis of pudendal nerve compression, which potentially contributes to prevention of pudendal nerve palsy as a common complication of hip arthroscopy.


Assuntos
Artroscopia/efeitos adversos , Articulação do Quadril , Neuralgia do Pudendo/etiologia , Tração/métodos , Cadáver , Clitóris/inervação , Feminino , Humanos , Masculino , Pênis/inervação , Neuralgia do Pudendo/prevenção & controle , Decúbito Dorsal , Tração/efeitos adversos
18.
Multivariate Behav Res ; 50(3): 265-84, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26610029

RESUMO

Observational studies of multilevel data to estimate treatment effects must consider both the nonrandom treatment assignment mechanism and the clustered structure of the data. We present an approach for implementation of four propensity score (PS) methods with multilevel data involving creation of weights and three types of weight scaling (normalized, cluster-normalized and effective), followed by estimation of multilevel models with the multilevel pseudo-maximum likelihood estimation method. Using a Monte Carlo simulation study, we found that the multilevel model provided unbiased estimates of the Average Treatment Effect on the Treated (ATT) and its standard error across manipulated conditions and combinations of PS model, PS method, and type of weight scaling. Estimates of between-cluster variances of the ATT were biased, but improved as cluster sizes increased. We provide a step-by-step demonstration of how to combine PS methods and multilevel modeling to estimate treatment effects using multilevel data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K).


Assuntos
Modelos Estatísticos , Análise Multinível/métodos , Estudos Observacionais como Assunto , Pontuação de Propensão , Simulação por Computador , Humanos , Funções Verossimilhança , Método de Monte Carlo , Viés de Seleção
19.
Acta Neuropsychiatr ; 27(1): 33-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25385451

RESUMO

OBJECTIVE: In this study, we aimed to find out whether sexual dysfunction in patients with Parkinson's Disease (PD) was associated to PD-related disability and whether this relationship was modulated by depressive and anxiety symptoms. METHODS: Eighty-nine consecutive patients with idiopathic PD who attended to our movement disorders outpatient clinics between January 2011 and June 2014 were included in this study. The diagnosis of PD was confirmed by a movement disorders specialists in Neurology, according to UK Parkinson's Disease Society Brain Bank Criteria. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr stage (H&Y) was used to establish disease severity. Cognitive function was assessed by the Mini-Mental State Examination. Patients were also administered the Hamilton depression (HAMD) and anxiety (HAMA) rating scales. The sexual functions of the patients were rated by applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). RESULTS: The mean age at the time of the study visit was 67.74±9.05. Male/female ratio was 1.87. Mean UPDRS total was 29.06±13.96 and mean UPDRS motor was 17.62±9.07. Mean HAMD score was 13.92±10.86, 58.4% of the patients had minor or major depression; and mean HAMA score was 7.94±6.49, 56.2% of the patients had minor or major anxiety. The mean ASEX score was 18.54±7.27 out of a maximum of 30. ASEX total scores were correlated with age, H&Y stage and HAMA scores. Age and also age at onset were correlated with ASEX subdomains except sexual desire. There was no correlation between disease duration and ASEX subdomains. UPDRS motor score was correlated with erection/lubrication. HAMD was only correlated with orgasm satisfaction. HAMA score was correlated with stimulation and orgasm. CONCLUSION: In patients with PD, there may be a common factor that modulates both depression, anxiety and sexual function. Further studies are needed to clarify the exact relationship.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Doença de Parkinson/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Idade de Início , Idoso , Comorbidade , Feminino , Humanos , Masculino , Prevalência , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Fatores Sexuais , Turquia/epidemiologia
20.
Childs Nerv Syst ; 30(10): 1679-86, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25119150

RESUMO

PURPOSE: The aquaporin family comprises a large family of integral membrane proteins that enable the movement of water and other small, neutral solutes across plasma membranes. Although function and mechanism of aquaporins in central nervous system injury have been reported, the pathophysiologic role of aquaporin 1 (AQP1) in peripheral nerve has not been extensively documented. In the present study, we aimed to study the temporal and spatial distribution of AQP1 in spinal cord and dorsal root ganglia after sciatic nerve injury. METHODS: Forty-eight adult female mice were randomly divided into four groups (intact controls, sham operated, cut injury, and crush injury). Animals receiving cut or crush injuries were sacrificed at the 2nd, 24th, and 48th postoperative hours. Spinal cord samples at the level of lumbosacral intumescences and corresponding dorsal root ganglia on the experimental and contralateral side were dissected free and proceeded to AQP1 immunohistochemistry. RESULTS: Our quantitative estimations revealed that a sharp increase in AQP1 immunoreactivity at the 24th postoperative hour was observed. This sharp increase was no more evident at 48 h after sciatic nerve injury. Identical peak was observed after both cut and crush injuries. CONCLUSIONS: We demonstrated that there was a temporal relationship with an increased expression of AQP1 following injury sustained to the sciatic nerve that was significantly observed in dorsal root ganglia and spinal cord. Those expressions were also subsided over time.


Assuntos
Aquaporina 1/metabolismo , Gânglios Espinais/metabolismo , Regulação da Expressão Gênica/fisiologia , Neuropatia Ciática/patologia , Medula Espinal/metabolismo , Animais , Carbocianinas , Modelos Animais de Doenças , Feminino , Processamento de Imagem Assistida por Computador , Camundongos , Camundongos Endogâmicos BALB C , Fatores de Tempo
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