Kardiyak resenkronizasyon tedavisine yanıtın öngörülmesinde sistemik bağışıklık-inflamatuvar indeksinin rolü

Aim: Cardiac resynchronization therapy (CRT) is a reliable treatment modality in patients with systolic dysfunction. However, not every patient appears to benefit from CRT. The systemic immune inflammation index (SII) is closely linked to the poor prognosis of various cardiovascular disorders. However, there is no study investigating whether SII has predictive value in determining response to CRT in dilated cardiomyopathy patients. Therefore, we intend to investigate the association between SII and response to CRT. Methods: A total of 220 patients (mean age 61.2±10.8 years; 120 men) implanted with CRT were involved in this study. Echocardiographic and laboratory measurements were evaluated prior to CRT. Response to CRT was determined as a≥ 15% decrease in left ventricular end-systolic volume at one-year follow-up. Results: Patients grouped as CRT responders and non-responders. Of these, 143 (64.6%) were considered to be CRT responders, while the remaining 77 (33.4%) were non-responders. Female sex (OR: 3.823, CI: 1.568-9.324 p=0.003), QRS duration (OR: 1.224, CI: 1.158-1.335 p<0.001), and SII (OR: 0.996 CI: 0.995-0.997 p<0.001) were shown to be independent predictors of CRT response in multivariate analysis. A cut-off value of SII >825 estimated no response to CRT with 80% sensitivity and 75% specificity. Conclusions: SII was associated with unresponsiveness to CRT. Therefore, it may be used to determine optimal patient selection for CRT implantation in routine clinical practice.Amaç: Kardiyak resenkronizasyon tedavisi (KRT), sistolik disfonksiyonu olan hastalarda güvenilir bir tedavi yöntemidir. Ancak, KRT'nin faydası belli hasta grupları ile sınırlıdır. Sistemik immün inflamatuvar indeks (SII), çeşitli kardiyovasküler bozuklukların kötü prognozu ile ilişkilidir. Bununla birlikte, dilate kardiyomiyopati hastalarında SII'nin KRT'ye yanıtı belirlemede prediktif değeri olup olmadığını araştıran bir çalışma bulunmamaktadır. Bu nedenle, bu çalışmada SII ile KRT'ye yanıt arasındaki ilişkiyi araştırmak amaçlandı. Yöntemler: Bu çalışmaya KRT implante edilen toplam 220 hasta (ortalama yaş 61,2±10,8 yıl; 120 erkek) dahil edildi. KRT öncesi ekokardiyografi ve laboratuvar ölçümleri değerlendirildi. KRT'ye yanıt, bir yıllık takipte sol ventrikül sistol sonu hacminde ≥ %15 azalma olarak belirlendi. Bulgular: Hastalar, KRT'ye yanıt verenler ve yanıt vermeyenler olarak gruplandırıldı. Bunlardan 143'ü (%64,6) KRT'ye yanıt veren olarak kabul edilirken, kalan 77'si (%33,4) yanıt vermeyendi. Kadın cinsiyet (OR: 3.823, CI: 1.568-9.324 p=0.003), QRS süresi (OR: 1.224, CI: 1.158-1.335 p<0.001) ve SII (OR: 0.996 CI: 0.995-0.997 p<0.001) çok değişkenli analizde KRT yanıtının bağımsız öngörücüleri olarak bulundu. SII >825'lik bir sınır değeri, %80 duyarlılık ve %75 özgüllük ile KRT'ye yanıt olmadığını öngördürmüştür. Sonuç: Bu çalışmada SII’nin KRT'ye yanıtsızlığı öngördüğü gösterilmiştir. Bu nedenle SII rutin klinik uygulamada KRT implantasyonu için optimal hasta seçimini belirlemede kullanılabilir

Quantitative assessment of left atrial functions by speckle tracking echocardiography in hypertensive patients with and without retinopathy

Purpose:The association between hypertensive retinopathy and left atrial(LA) impairment is unknown. Accordingly, it was aimed to investigate the possiblerelationship between hypertensive retinopathy and LA phasic functions by means oftwo-dimensional speckle-tracking echocardiography (2D-STE).Methods:A total of 124 hypertensive patients and 27 control subjects were includedin the study. LA reservoir strain (LAS-S), LA conduit strain (LAS-E), and LA boosterstrain (LAS-A) parameters were used to evaluate LA myocardial functions.Results:Hypertensive patients (with and without retinopathy) displayed an obviousreduction in the LA reservoir strain (LAS-S),and LA conduit strain (LAS-E). Moreover,further impairment in LA reservoir and conduit strain was found in patients withhypertensive retinopathy than in the isolated hypertensive patients. There were nosignificant differences in LA booster strain (LAS-A) among the three groups. ImpairedLAS-S(OR: 0.764, CI: 0.657–0.888, andp< 0.001), LAS-E(OR: 0.754, CI: 0.634–0.897,andp=0.001), and hypertension (HT) duration (OR: 2.345, CI: 1.568–3.507, andp< 0.001) were shown to be independent predictors of hypertensive retinopathy.Conclusion:Impaired LA reservoir and conduit strain may be used to predict hyper-tensive patients at higher risk of developing hypertensive retinopathy, and to deter-mine which patients should be followed more closely for hypertensive retinopath

Skin Type Detection with Deep Learning: A Comparative Analysis

There are many factors that can change and affect appearance, including age and environment. Knowing the skin type helps to choose the products best suited to the needs of the skin and therefore the right skin care. Recently, the increasing demand for cosmetics and the scarcity of well-equipped cosmetologists have encouraged cosmetology centers to meet the need by using artificial intelligence applications. Deep learning applications can give high accuracy results in determining the skin type. Recent research shows that learning performs better on nonlinear data than machine learning methods. The aim of this study is to find the best classification model for skin type prediction in skin analysis data with deep learning. For this purpose, 4 different optimization algorithms as Sgd, Adagrad, Adam and Adamax; Tanh and ReLU activation functions and combinations of different neuron numbers using, 16 different models were created.In experimental studies, the performance of the models varies according to the parameters, and it has been observed that the most successful deep neural network model is the model consisting of 64 neurons, Sgd optimization function and ReLU activation function combination with a success rate of 93.75. The accuracy result obtained has a higher classification success compared to other methods, and shows that deep neural networks can make an accurate skin type classification

ANTI-SACCHAROMYCES CEREVISIAE [ASCA] AND ANTI-NEUTROPHIL CYTOPLASMIC [ANCA] ANTIBODIES ARE NOT INCREASED IN TAKAYASU ARTERITIS

Objectives: Takayasu arteritis (TA) may be associated with inflammatory bowel disease (IBD). As there is such an overlap and since both diseases show granulomatous histopathological lesions we reasoned similar biological pathways might be implicated in both conditions. Therefore, we investigated the prevalence of anti-Saccharomyces cerevisiae (ASCA) and anti-neutrophil cytoplasmic (ANCA) antibodies - serological markers for IBD-among patients with TA

Critical thinking disposition of nursing students and affecting factors

Amaç: Bu araştırmanın amacı hemşirelik öğrencilerinin eleştirel düşünme eğilimlerini ve etkileyen faktörleri belirlemektir. Yöntemler: Kesitsel tipte tanımlayıcı araştırma, Bülent Ecevit Üniversitesi Hemşirelik Bölümü öğrencileriyle (n=323) gerçekleştirildi. Veriler Kişisel Bilgi Formu ve Kalifornia Eleştirel Düşünme Eğilimi Ölçeği ile toplandı. Veriler sayı, yüzde, ortalama, standart sapma, student t testi, tek yönlü ANOVA testi, Mann Whitney U testi, Kruskal Wallis testi ve Pearson Korelasyon analizi ile değerlendirildi. Bulgular: Öğrencilerin eleştirel düşünme eğilimi puan ortalamaları 239.70±27.24 olarak belirlendi. Bayan öğrencilerin (p=0.03), ikinci sınıf öğrencilerinin (p=0.002), öğrenci kulüplerine üye olan (p=0.007), kitap okumayı seven (p=0.000), kütüphaneye giden (p=0.03), yılda 4 ve üzeri bilimsel etkinliğe katılan öğrencilerin (p=0.002) eleştirel düşünme eğilimleri toplam puan ortalamasının en yüksek olduğu bulundu. Sonuç: Hemşirelik öğrencilerinin eleştirel düşünme eğilimlerinin düşük düzeyde olduğu ve yaş, cinsiyet, sınıf, kitap okuma, kütüphaneye gitme gibi demografik özelliklerinin eleştirel düşünme eğilimlerini etkilediği saptandıThe purpose of this study was to determine the dispositionsof critical thinking of nursing students and affecting factors.Methods:This cross-sectional descriptive study wasconducted with Nursing Department students (n= 323) of Bulent Ecevit University. Data werecollected by Personality Survey Form and The California Thinking Disposition Inventory. Data wereevaluated by percentage, mean, standard deviation, student t test, one way ANOVA, Mann Whitney U test, Kruskal Wallis, and Pearson correlation analyze.Results:The critical thinking disposition mean score of the nursing students wasdetermined as 239.70±27.24.It was found that female students(p=0.03), 2ndyear students (p=0.002), studentswho are members ofclubs(p=0.007), students who like to read the book (p=0.000) students who are going to library (p=0.03), students who have participated four and more scientific activity (p=0.002)a year were higherthe dispositions of critical thinking.Conclusion:It wasfound that nursing students had low levelthe critical thinking disposition and had demographic features such as age, gender, class, like to read the book and go to library of nursing students wereeffect the critical thinking disposition

The effects of agomelatine in cisplatin-induced toxicity on the kidney and liver tissues: In vivo study

Nephrotoxicity and hepatotoxicity are frequently seen adverse effects during cisplatin chemotherapy. In this study, we investigated the effects of agomelatine on cisplatin-induced toxicity in the kidney and liver. Animals were administered with a single dose of cisplatin (7 mg/kg, i.p.) and treated with agomelatine (20 and 40 mg/kg, p.o) for seven days. Renal and hepatic functions were evaluated by measuring concentrations of creatinine, BUN, AST and ALT in the serum. Oxidative stress and protein peroxidation were assessed by measuring SOD, CAT, GSH and AOPP levels in both tissues. Serum PON-1 levels were also evaluated. Histopathological analysis was performed to determined structural changes in the kidney and liver. Agomelatine (20 mg/kg) treatment approximately halved cisplatin-related increase in serum creatinine, BUN, AST and ALT levels. Agomelatine (20 mg/kg) significantly prevented the cisplatin-induced excessive decrease in SOD, CAT, GSH in both tissues and serum PON-1 levels. Agomelatine (20 and 40 mg/kg) protected the structural integrity of the kidney against cisplatin-insult. Although agomelatine (40 mg/kg) protected the kidney and showed parallel results with 20 mg/kg biochemically, it failed to show the same liver tissue effects in both analyses. Although agomelatine protected against cisplatin-induced toxicity in the kidney and liver, care should be taken with higher doses for possible hepatotoxicity

Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary microvascular dysfunction

Background: A history of preeclampsia (pPE) and gestational diabetes (pGDM) are female-specific risk markers for atherosclerosis and future cardiovascular risk. In addition to increasing the risk of established risk factors for atherosclerosis, such as hypertension or diabetes, evidence suggests that pregnancy-related complications can also directly accelerate atherosclerosis by inducing endothelial dysfunction. A combination of both conditions is seen in a subset of patients with pregnancy, though it is not known whether this combination increases the overall risk for cardiovascular events. Aims: Present study aimed to find the impact of combined pPE/pGDM on the prevalence of coronary micro vascular dysfunction (CMD). Methods: A total of 24 patients with combined pPE/pGDM, 19 patients with isolated pPE and 63 patients with pGDM were included to the present study and a further 36 healthy women with no previous pregnancy-related complications served as controls. Coronary flow reserve was measured using echocardiography and CMD was defined as a coronary flow reserve <= 2.5. Results: Patients with combined pPE/pGDM had a high prevalence of CMD (91%), which was significantly higher than controls (5.6%, p < 0.001) and patients with pGDM (55%, p = 0.01). A history of pPE on top of pGDM was associated with an increased risk of CMD (HR:6.28, 95%CI:1.69-23.37, p = 0.006) after multivariate adjustment, but pGDM did not increase the odds for CMD in those with pPE. Conclusions: Combined pPE/pDM is associated with a very high prevalence of CMD, which may indicate an increased risk for future cardiovascular events.WOS:0006131998000152-s2.0-85096641950PubMed: 3318973

Early neonatal outcomes of very-low-birth-weight infants in Turkey: A prospective multicenter study of the Turkish Neonatal Society

Beken, Serdar/0000-0002-8609-2684; BAS, AHMET YAGMUR/0000-0002-1329-2167; Bulbul, Ali/0000-0002-3510-3056; Karatekin, Guner/0000-0001-7112-0323WOS: 000534242500056PubMed: 31851725Objective To investigate the early neonatal outcomes of very-low-birth-weight (VLBW) infants discharged home from neonatal intensive care units (NICUs) in Turkey. Material and methods A prospective cohort study was performed between April 1, 2016 and April 30, 2017. the study included VLBW infants admitted to level III NICUs. Perinatal and neonatal data of all infants born with a birth weight of.1500 g were collected for infants who survived. Results Data from 69 NICUs were obtained. the mean birth weight and gestational age were 1137 +/- 245 g and 29 +/- 2.4 weeks, respectively. During the study period, 78% of VLBW infants survived to discharge and 48% of survived infants had no major neonatal morbidity. VLBW infants who survived were evaluated in terms of major morbidities: bronchopulmonary dysplasia was detected in 23.7% of infants, necrotizing enterocolitis in 9.1%, blood culture proven late-onset sepsis (LOS) in 21.1%, blood culture negative LOS in 21.3%, severe intraventricular hemorrhage in 5.4% and severe retinopathy of prematurity in 11.1%. Hemodynamically significant patent ductus arteriosus was diagnosed in 24.8% of infants. Antenatal steroids were administered to 42.9% of mothers. Conclusion the present investigation is the first multicenter study to include epidemiological information on VLBW infants in Turkey. Morbidity rate in VLBW infants is a serious concern and higher than those in developed countries. Implementation of oxygen therapy with appropriate monitoring, better antenatal and neonatal care and control of sepsis may reduce the prevalence of neonatal morbidities. Therefore, monitoring standards of neonatal care and implementing quality improvement projects across the country are essential for improving neonatal outcomes in Turkish NICUs.Turkish Neonatal Society [2-2016]; Turkish Neonatal SocietyThis study was supported by the Turkish Neonatal Society, http://www.neonatology.org.tr, number 2-2016, received by AYB. Turkish Neonatal Society funded the study's online registry system. the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript