Agreement of Turkish Physiatrists with the Assessment in Spondyloarthritis International Society and the European League Against Rheumatism Recommendations for the Management of Ankylosing Spondylitis and Rheumatoid Arthritis

Background: New developments in the field of targeted therapies or biologic agents led more effective management of ankylosing spondylitis (AS) and rheumatoid arthritis (RA). Recommendations for the management of rheumatic diseases propose to reduce inappropriate use of medications, minimize variations among countries, and enable cost-effective use of health care resources. Objective: The aim this study was to evaluate conceptual agreement of ASsessment in SpondyloArthritis International Society (ASAS) and the EUropean League Against Rheumatism (EULAR) recommendations for the management of AS and EULAR recommendations for RA and to assess the rate of application among Turkish physiatrists in daily clinical practice. Methods: An online survey link has been sent to 1756 Turkish physiatrists with e-mails asking to rate agreement on 11-item ASAS/EULAR AS recommendations and 15-item EULAR RA recommendations with synthetic and biological disease-modifying anti-rheumatic drugs. Also barriers and difficulties for using biologic agents were assessed. Results: Three hundred nine physiatrists (17.5%) completed the survey. The conceptual agreement with both recommendations was very high (Level of agreement; mean 8.35±0.82 and 8.90± 0.67 for RA and AS recommendations, respectively), and the self-declared application of overall recommendations in the clinical practice was also high for both RA and AS (72.42% and 75.71%, respectively). Conclusion: Turkish physiatrists are in good conceptual agreement with the evidence-based recommendations for the management of AS and RA. These efforts may serve to disseminate the knowledge and increase the current awareness among physicians who serve to these patients and also implementation of these recommendations is expected to increase as well.PubMedScopu

The Total Oxidant Levels (TOS), Total Antioxidant Levels (TAS), Oxidative Stress Index (OSI), Urotensin II Levels and Arginase Levels in The Serums of Attention Deficit Hyperactivity Disorder Diagnosed Patients and The Roles of These Parameters in The Etiopathogenesis

Bu çalışma Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi‘nin 2015TPF014 nolu kararı ile desteklenmiştir.Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB), etiyolojisi henüz net olarak aydınlatılamamış, nörobiyolojik, genetik ve çevresel faktörlerin etyolojide birlikte rol aldığı düşünülen nörogelişimsel bir hastalıktır. Bu çalışmada; total oksidan seviye, total antioksidan seviye, oksidatif stres indeksi, Ürotensin-II düzeyleri ve Arjinaz düzeylerinin DEHB etyopatogenezindeki rolü araştırılmıştır. Çalışmaya 30 DEHB tanılı hasta ve 30 sağlıklı gönüllü kontrol dahil edilmiş, katılımcılar 6-17 yaĢ aralığında, başka herhangi bir fiziksel ya da psikiyatrik hastalık öyküsü olmayan ve son altı ay içinde psikotrop ilaç tedavisi almamış olan çocuk ve ergenler arasından seçilmiştir. Serum TOS, TAS, Ürotensin-II ve Arjinaz düzeylerinin her biri Enzyme-Linked Immunosorbent Assay (ELISA) yöntemi ile değerlendirilmiş, OSI değerleri ise TOS değerlerinin TAS değerlerine bölünmesiyle elde edilmiĢtir. Katılımcıların belirti düzeyleri, Çocuk ve Ergenlerde Yıkıcı Davranım Bozuklukları İçin DSM-IV‘e Dayalı Tarama ve Değerlendirme Ölçeği ile değerlendirilmiĢtir. TOS, TAS ve OSI düzeyleri açısından olgu ve kontrol grupları arasında anlamlı bir iliĢki bulunamamıştır. Serum Ürotensin-II düzeyleri olgu grubunda kontrollere göre anlamlı olarak yüksek bulunmuş, serum Arjinaz düzeyleri ise olgu grubunda anlamlı olarak düşük bulunmuştur. Bu parametrelerden hiçbirinin cinsiyet veya yaş ile ilişkisi bulunamamıştır. Ürotensin-II düzeylerinin ölçek puanları ile pozitif, Arjinaz düzeylerinin ise negatif iliĢkisi olduğu belirlenmiştir. Oksidatif stres ile ilişkili bu ve benzeri parametrelerin DEHB etyopatogenezindeki rolünün anlaşılması için daha geniş örneklemde, DEHB alt tipleriyle birlikte genetik ve nörokimyasal etkenlerin de değerlendirildiği çalışmalara ihtiyaç vardır.Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder whose etiology has not been identified definitely. Neurobiological, genetic and environmental factors are thought to play a role in the etiology collectively. In this study, the role of the total oxidant levels (TOS), the total antioxidant levels (TAS), the oxidative stress index (OSI), Urotensin II levels and Arginase levels in the etiopathogenesis of ADHD have been investigated. 30 ADHD diagnosed patients, and 30 healthy controls were included in the study. The participants were selected among 6-17 years old children and adolescents who had no other physical or psychiatric disorder history and who had not used any psychotropic drugs in the last six months. Each of the levels of serum TOS, TAS, Urotensin II and Arginase were evaluated with Enzyme-Linked Immunosorbent Assay (ELISA) method, and OSI levels were obtained by way of dividing the TOS levels by TAS levels. The symptom ratings of the participants were assessed by using The DSM- IV Based Disruptive Behavior Disorders Screening Scale. Regarding the TOS, TAS and OSI levels; a statistically significant relationship between the control and patient groups could not be detected. Serum Urotensin-II levels were found to be statistically significantly higher in the patient group than the control group, and serum Arginase levels were found to be statistically significantly lower in the patient group in comparison to control group. None of these parameters were found to be correlated with gender or age. The scale scores were detected to have a positive correlation with Urotensin II levels and negative correlation with Arginase levels. To better understand the role of oxidative index related these and similar parameters in the ADHD etiopathogenesis, further studies with larger sample sizes are needed to be conducted, which evaluated ADHD subtypes separately and assessed genetic and neurochemical parameters concomitantly

East Turkestan policy of Russia (1911 and after)

Türklerin anayurdu olan Doğu Türkistan, yüzyıllar boyunca pek çok devletin hâkimiyet kurmak için mücadele ettiği bir bölge olmuştur. Doğu Türkistan'a hâkim olmak isteyenlerden biride Ruslardır. Ruslar, Batı Türkistan topraklarını birer birer ele geçirmişlerdir. Hemen akabinde gözlerini Doğu Türkistan'a dikmişlerdir. 1911 yılında Qing İmparatorluğu'nun yıkılması ile Çin'de iç savaş çıkmıştır. Bu sebeple Çin, Doğu Türkistan ile ilgilenememiştir. Bu dönemde Doğu Türkistan valileri Çin'den bağımsız hareket etmişlerdir. Rusya kimi zaman Umumî Valileri kimi zaman bölgedeki Türkleri kimi zamansa Çin'i destekleyerek Doğu Türkistan'ı sömürmeye çalışmıştır. Doğu Türkistan valilerini askeri ve ekonomik olarak sıkıştıran Rusya, antlaşmalarla kendine bağlamıştır. Rusya, genel valileri destekleyerek Doğu Türkistan'ın Çin ile bağlantısını koparmaya çalışmıştır. Öte taraftan Çin, Doğu Türkistan'da hâkimiyet kurarak Rusya'yı kızdırmak istememiştir. Her iki devlette Doğu Türkistan'ı tampon bölge olarak kullanmıştır. Guomindang'ın Doğu Türkistan'da hâkim olduğu dönemde Rusya, Doğu Türkistan'daki Rus yandaşı Doğu Türkistanlıları desteklemiştir. Aynı dönemde Rusya, tampon bölge politikasına devam etmiştir. 1949 yılında, Komünist Çin Hükûmeti Doğu Türkistan'ı istila etmiştir. Tampon bölge politikasında ısrar eden Rusya ile Çin arasındaki ilişkiler, 1961 yılında tamamen kopmuştur. Rusya, 1981 yılına kadar tampon bölge politikasına devam etmiştir. Sovyetler Birliği'nin yıkılması sonrasında Rusya, tampon bölge politikasından vazgeçmiştir. Daha sonra Rusya ile Çin, karşılıklı olarak azınlık hakları konusunda birbirlerini destekleme politikasına başlamışlardır.East Turkestan, mainland of the Turkish people, has been a region that a great deal of states have struggled to exert dominance throughout the centuries. One of those which wanted to dominate East Turkestan were the Russians. The Russians captured territories of West Turkestan one by one. Immediately after, they stared at East Turkestan. With destruction(fall) of Qing Empire(Dynasty) in 1911, civil war broke out in China. For this reason, China could not concern with(pay attention to) East Turkestan. During this period, governors of East Turkestan acted independently of China. Russia tried to exploit East Turkestan by supporting in turn Governors General, Turkish people in the region and China sometimes. By squeezing(compressing) governors of East Turkestan economically and military, Russia affiliated(subordinated) them to itself by agreements. Russia supported the general governors to sever(cut off) the connection between East Turkestan and China. On the other hand, China did not want to anger Russia by dominating East Turkestan. Both states used East Turkestan as a buffer zone. During the Guomindang rule in East Turkestan, Russia supported the pro-Russians in East Turkestan. In the same period, Russia continued its buffer zone policy. In 1949, the Communist Chinese Government invaded East Turkestan. Relations between Russia, which insists on buffer zone policy, and China, were completely severed in 1961. Russia had continued its buffer zone policy until 1981. Then Russia and China began a policy of mutually supporting each other on minority rights

Demirin indüklediği serebellar purkinje hücre kaybının flunarizin tarafından iyileştirilmesi

Aim: In this study, we investigated the effect of intracerebroventricular-injected iron neurotoxicity on the total number of cerebellar Purkinje cells in rats and the possible neuroprotective effect of flunarizine, a piperazinederived calcium channel blocker. Materials and Methods: Rats were divided into four groups: control, flunarizine, iron, and iron + flunarizine groups. Rats in the iron and iron + flunarizine groups received intracerebro-ventricular iron (FeCl36H2O, 200 mM, 2.5 &amp;#956;l), while those in flunarizine and iron + flunarizine groups were intraperitoneally injected with flunarizine (10 mg/kg/day) once a day after the operation for 10 days. After 10 days, all rats were perfused intracardially and then sacrificed. Brain tissues were removed and standard histological techniques were performed. The total numbers of Purkinje cells were estimated using unbiased stereological techniques. Results: Means of the total numbers of Purkinje cells in the cerebellum were estimated as 310441 &plusmn; 6558, 298658 &plusmn; 9636, 200201 &plusmn; 6822 and 282658 &plusmn; 6327 in the control, flunarizine, iron, and iron + flunarizine groups, respectively. Comparison between iron and iron + flunarizine groups revealed that flunarizine significantly attenuates the iron-induced neuron loss from 35.5% to 8.9% (P &lt; 0.05). Conclusions: Findings of the present study suggest that flunarizine has a neuroprotective effect on ironinduced Purkinje cell loss in the rat cerebellum via blocking influx of calcium ions into neurons.Amaç: Bu çalışmada, intraserebroventriküler olarak verilen demirin, sıçan serebellar Purkinje hücrelerinde oluşturduğu nörotoksisiteyi ve bir piperazin derivesi kalsiyum kanal blokörü olan flunarizinin muhtemel nöroprotektif etkisini araştırdık. Yöntem ve Gereç: Sıçanlar, kontrol, flunarizin, demir ve demir + flunarizin grupları olmak üzere dört gruba ayrıldı. Demir ve demir + flunarizin gruplarındaki sıçanlara intraserebroventriküler olarak demir (FeCl36H2O, 200 mM, 2.5 ?l) verildi. Flunarizin ve demir + flunarizin gruplarındaki sıçanlara operasyonu takiben on gün süreyle 10 mg/kg/gün dozunda flunarizin intraperitoneal olarak verildi. On günün sonunda, hayvanlar intrakardiyak yolla perfüze edildikten sonra dekapite edildiler. Beyin dokuları çıkarılarak standart histolojik doku takibi uygulandı. Toplam Purkinje hücre sayıları tarafsız sayım metodu olan stereolojik yöntemle hesaplandı. Bulgular: Ortalama toplam Purkinje hücre sayıları, kontrol, flunarizin, demir ve demir + flunarizin gruplarında sırasıyla 310441 ± 6558, 298658 ± 9636, 200201 ± 6822 ve 282658 ± 6327 olarak bulundu. Demir ve demir + flunarizin grupları karşılaştırıldığında, flunarizin demirin indüklediği Purkinje hücre kaybını % 35.5’den % 8.9’a anlamlı olarak gerilettiği bulundu (P < 0.05). Sonuç: Bu çalışmanın sonuçları, sıçan serebellumunda demirin indüklediği Purkinje hücre kaybı üzerine flunarizinin nöroprotektif etkisinin, kalsiyumun nöron içine girişinin bloklanması yoluyla olabileceğini göstermektedir

A Digital Forensics Approach for Lost Secondary Partition Analysis using Master Boot Record Structured Hard Disk Drives

The development and widespread use of computer systems has increased the need for secure storage of data. At the same time, the analysis of digital data storage devices is very important for forensic IT professionals who aim to access information to clarify the crime. File systems of disk drives use partition structures to securely store data and prevent problems such as corruption. In this study, deletion or corruption of partitions on commonly used DOS / Master Boot Record (MBR) configured hard disk drives are investigated by using forensic tools. In order to analyze hard disk drives, Forensic Tool Kit (FTK), Magnet AXIOM, Encase, Autopsy and The Sleuth Kit (TSK), which are widely used as commercial and open source, are analyzed by using a presented scenario. In the scenario, the primary partition and the extended partition are created using the DOS / MBR partitioning structure on the test disk. Test files are added to the sections and the sections are deleted. The digital forensics tools were tested on the presented scenario. According to the obtained results, TSK and Encase are successful tools for DOS / MBR structured HDD analysis. However, FTK, Magnet AXIOM and Autopsy could not achieve information detection on DOS/MBR structured disks. These results clearly demonstrated that crime data can be hidden in MBR structured HDD. To carve these data, the correct methodology should be selected

Differences Between General Neurologists and Multiple Sclerosis Specialists in the Management of Multiple Sclerosis Patients: A National Survey

Introduction: The management of multiple sclerosis (MS) has become more complicated after the introduction of new diagnostic and treatment options. Despite the abundance of guidelines, the experience of physicians still plays a major role in the management of patients. This study aimed to define differences in behavior patterns between general neurologists (GNs) and MS specialists (MSSs)

The comparative effectiveness of fingolimod, natalizumab, and ocrelizumab in relapsing-remitting multiple sclerosis

© 2023, Fondazione Società Italiana di Neurologia.Background: Fingolimod, natalizumab, and ocrelizumab are commonly used in the second-line treatment of relapsing-remitting multiple sclerosis (RRMS). However, these have only been compared in observational studies, not in controlled trials, with limited and inconclusive results being reported. A comparison of their effect on relapse and disability in a real-world setting is therefore needed. Objectives: The objective of this study was to compare the efficacy of fingolimod, natalizumab, and ocrelizumab in reducing disease activity in RRMS. Methods: This multicenter, retrospective observational study was carried out with prospectively collected data from 16 centers. All consecutive RRMS patients treated with fingolimod, natalizumab, and ocrelizumab were included. Data for relapses, Expanded Disability Status Scale (EDSS) scores, and brain magnetic resonance imaging (MRI) scans were collected. Patients were matched using propensity scores. Annualized relapse rates (ARR), time to first relapse, and disability accumulation were compared. Results: Propensity score matching retained 736 patients in the fingolimod versus 370 in the natalizumab groups, 762 in the fingolimod versus 434 in the ocrelizumab groups, and 310 in the natalizumab versus 310 in the ocrelizumab groups for final analyses. Mean ARR decreased markedly from baseline after treatment in all three treatment groups. Mean on-treatment ARR was lower in natalizumab-treated patients (0.09, 95% confidence interval (CI), 0.07–0.12) than in those treated with fingolimod (0.17, 0.15–0.19, p<0.001), ocrelizumab (0.08, 0.06–0.11), and fingolimod (0.14, 0.12–0.16, p=0.001). No significant difference was observed in mean on-treatment ARR between patients treated with natalizumab (0.08, 0.06–0.11) and ocrelizumab (0.09, 0.07–0.12, p=0.54). Compared to fingolimod, the natalizumab and ocrelizumab groups exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients at year 1. No significance differences in disability accumulation were determined between the therapies. Conclusion: Natalizumab and ocrelizumab exhibited similar effects on relapse control, and both were associated with better relapse control than fingolimod. The effects of the three therapies on disability outcomes were similar

Clinical characteristics, disease activity, functional status, and quality of life results of patients with psoriatic arthritis using biological and conventional synthetic disease-modifying antirheumatic drugs

Objectives: This study aims to compare the clinical characteristics, disease activity, and quality of life (QoL) of patients with psoriatic arthritis (PsA) who use biological and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) in a nationwide cohort throughout Turkey. Patients and methods: A total of 961 patients (346 males, 615 females; mean age: 46.9±12.2 years; range, 18 to 81 years) with PsA according to the classification criteria for PsA were included in the study. The patients’ demographic and clinical characteristics, physical examination results, Disease Activity Score 28, Disease Activity Index for Psoriatic Arthritis and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, Psoriatic Arthritis Quality of Life (PsAQoL), and Short Form-36 scores were all recorded. Results: Of the patients, 23% underwent biological DMARD (bDMARD) monotherapy, 42% underwent conventional synthetic DMARD (csDMARD) monotherapy, 10% underwent a csDMARD combination therapy, and 10% underwent a combination bDMARD and csDMARD treatment. The Visual Analog Scale (VAS pain), patient global assessment, physician global assessment, and BASDAI scores were found to be lower among patients using combination treatment of csDMARD and bDMARD, while the swollen joint count was found to be lower among patients using bDMARD. The PsAQoL score was found to be the lowest among patients not using any medication and the highest among those using bDMARD. Conclusion: In our study, patients with PsA were successfully treated with both csDMARD and bDMARD monotherapy. When the biological treatments used for PsA were compared with csDMARD, it was found that biological treatments had a positive effect on both disease activity and the QoL. Combinations of csDMARDs and bDMARDs were preferred in cases in which the disease activity was still high or increased. Because of the highest efficacy of the combined treatment, we highly suggest increasing the number of patients on combined treatment