Clinical and Demographic Characteristics and Two-Year Efficacy and Safety Data of 508 Multiple Sclerosis Patients with Fingolimod Treatment

Introduction: Fingolimod is the first oral immunomodulatory treatment used as secondary care therapy in the treatment of multiple sclerosis for the last 10 years. The objective of our study is to reveal the experiences of the first generic fingolimod active ingredient treatment in different centers across Turkey. Method: The first generic fingolimod efficacy and safety data of patients followed-up in 29 different clinical multiple sclerosis units in Turkey were analyzed retrospectively. Data regarding efficacy and safety of the patients were transferred to the data system both before the treatment and on the 6th, 12th and 24th month following the treatment. The data were analyzed using the IBM SPSS 20.00. P value of <0.05 was considered to be statistically significant. Results: A total of 508 multiple sclerosis patients, 331 of whom were women, were included in the study. Upon comparing the Expanded Disability Status values before and after the treatment, a significant decrease was observed, especially at month 6 and thereafter. Since bradycardia occurred in 11 of the patients (2.3%), the first dose had to be longer than 6 hours. During the observation of the first dose, no issues that could prevent the use of the drug occured. Side effects were seen in 49 (10.3%) patients during the course of fingolimod treatment. Respectively, the most frequent side effects were bradycardia, hypotension, headache, dizziness and tachycardia. Conclusion: The observed results regarding efficacy and safety were similar to clinical trial data in the literature and real life data in terms of the first equivalent with fingolimod active ingredient. © 2023, Turkish Neuropsychiatric Society. All rights reserved.Thanks to SANOVEL for funding the publication process

The Effect of High Dose Melatonin on Cardiac Ischemia-reperfusion Injury

Purpose: Melatonin, the most potent scavenger of toxic free radicals, has been found to be effective in protecting against pathological states due to the release of reactive oxygen species. This study was performed to establish the effect of high dose melatonin on protection against ischemia-reperfusion (I/R) injury in rat hearts. Materials and Methods: Forty male Sprague-Dawley rats were used in this study. They were separated into four groups of ten rats each. A left coronary artery occlusion was induced in the rats by ligating the artery for 20 minutes and then releasing the ligation (reperfusion) afterwards. The control group was Group A. Group B was subjected to myocardial ischemia-reperfusion without any treatment, while Group C underwent myocardial ischemia-reperfusion with a melatonin treatment before the ischemia. Group D was subjected to myocardial ischemia-reperfusion with a melatonin treatment before the reperfusion. After 20 minutes of reperfusion, blood samples were obtained from each group for biochemical studies, and the animals were sacrificed for histological and, immunohistochemical examinations of the myocardial tissue. Results: We found that the cardiac troponin T(cTn-T) levels were significantly increased in Group B when all groups were compared. In the Group C rats treated with melatonin, the cTn-T values were significantly lower than those in Groups B and D. In addition, malondialdehyde (MDA) and antioxidant enzymes including, superoxide dismutase (SOD) and myeloperoxidase (MPO) were lower than those in Group B in the melatonin treated groups. The differences were statistically significant (p < 0.05). Histopathologic and immunohistopathologic studies also supported the effectiveness of melatonin. Conclusion: Our study suggests that high dose melatonin, appears to offer protection against cardiac ischemia-reperfusion injuries in rats by scavenging the free radicals and could have a potential clinical use in the management of myocardial ischemia.PURPOSE:Melatonin, the most potent scavenger of toxic free radicals, has been found to be effective in protecting against pathological states due to the release of reactive oxygen species. This study was performed to establish the effect of high dose melatonin on protection against ischemia- reperfusion (I/R) injury in rat hearts.MATERIALS AND METHODS:Forty male Sprague-Dawley rats were used in this study. They were separated into four groups of ten rats each. A left coronary artery occlusion was induced in the rats by ligating the artery for 20 minutes and then releasing the ligation (reperfusion) afterwards. The control group was Group A. Group B was subjected to myocardial ischemia-reperfusion without any treatment, while Group C underwent myocardial ischemia-reperfusion with a melatonin treatment before the ischemia. Group D was subjected to myocardial ischemia-reperfusion with a melatonin treatment before the reperfusion. After 20 minutes of reperfusion, blood samples were obtained from each group for biochemical studies, and the animals were sacrificed for histological and, immunohistochemical examinations of the myocardial tissue.RESULTS:We found that the cardiac troponin T(cTn-T) levels were significantly increased in Group B when all groups were compared. In the Group C rats treated with melatonin, the cTn-T values were significantly lower than those in Groups B and D. In addition, malondialdehyde (MDA) and antioxidant enzymes including, superoxide dismutase (SOD) and myeloperoxidase (MPO) were lower than those in Group B in the melatonin treated groups. The differences were statistically significant (p < 0.05). Histopathologic and immunohistopathologic studies also supported the effectiveness of melatonin.CONCLUSION:Our study suggests that high dose melatonin, appears to offer protection against cardiac ischemia-reperfusion injuries in rats by scavenging the free radicals and could have a potential clinical use in the management of myocardial ischemia

Rhetorical-Performative Analysis of the Urban Symbolic Landscape : Populism in Action

This chapter introduces a rhetorical-performative analysis as a tool for exploring urban symbolic landscape and populism and hence deals with relationality and materiality from the postfoundational perspective. It connects the articulation theory of cultural theorists Stuart Hall or political theorists Ernesto Laclau and Chantal Mouffe and spatial analysis of cultural geographer Doreen Massey to the study of populism. The case of Hungary shows how political frontiers have been articulated in the public space, contestable interpretations of the past are deliberately used and key symbolic urban landscapes transformed radically to articulate a political ‘us’—and ‘them.’ In the 2010s, in the Hungarian capital Budapest, the top-down process transforming urban space faced bottom-up movements which reproduce the populist logic of articulation.Peer reviewe

Operating conditions of a peanut sizing machine for optimum performance

The study analyzed the performance and estimated the optimum operating conditions of a peanut-sizing machine prototype based on a counter-rotating cylinder pair, developed for small- and medium-sized enterprises. To this end, the tests were conducted to determine the performance and power consumption of the prototype. The performance tests were done at nine different mixture rates based on peanut size (small or medium) and over-all separating efficiency. The theoretical capacity of the machine was found to be 123, 234.8 and 321 kg h-1 for small, medium and large-size peanuts, respectively. In the preliminary tests, the average damage percentage and feeding capacity were found to be 1.76% and 126.3 kg h-1, respectively. The over-all efficiency of the peanut sizing machine decreased as the proportion of small peanuts in the material increased, with values ranging from 0.87 to 0.97. The power consumption of the separating cylinders ranged from 0.46 to 0.76 kW. The average torque value was also calculated as 25 Nm.This study was conducted to analyze the performance and to estimate the optimum operating conditions of a sizing machine prototype based on a counter-rotating cylinder pair, developed within the framework of a project conducted to make this machine available to small-and medium-sized enterprises

oNature Knows No Boundarieso: A Critical Reading of UNDP Environmental Peacemaking in Cyprus

This is an Accepted Manuscript of an article published by Taylor & Francis Group in Annals of the Association of American Geographers on 10/11/2009 available online: http://www.tandfonline.com/10.1080/00045600903245938In 2005, the UNDP set up in Cyprus a peace building project called Action for Cooperation and Trust (ACT). This project has aimed to create opportunities for bi-communal partnerships on environmental protection as a way to promote inter-communal tolerance. The present article aims to critically discuss the efficacy of this project in order to contribute to the debate on the significance of environmental cooperation in transforming ethno-territorial conflicts. Our empirical basis relies on both survey data and the qualified opinions of Cypriot environmental stakeholders. Our analysis shows that, in the case of Cyprus, successful environmental peacemaking strategies are dependent on widespread environmental awareness, trust in the ‘third party’ (UNDP), and civil society’s empowerment, which, however, should complement and not substitute intervention at a state level. There is also evidence to suggest that the UNDP discourse about ‘nature knows no boundaries’ is most effective when it succeeds to generate solutions which are perceived to be beneficial to all the parties involved, rather than when it uses the environment to discursively construct a common ‘patriotism’ beyond ethnic identities

Comparative analysis of fingolimod versus teriflunomide in relapsing–remitting multiple sclerosis

Background: Fingolimod and teriflunomide are commonly used in the treatment of relapsing-remitting multiple sclerosis (RRMS). These have not been compared in controlled trials, but only in observational studies, with inconclusive results. 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 and teriflunomide in reducing disease activity in RRMS. Methods: This multicenter, retrospective observational study was carried out with prospectively collected data from 15 centers. All consecutive RRMS patients treated with teriflunomide or fingolimod 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), disability accumulation, percentage of patients with active MRI and treatment discontinuation over a median 2.5-year follow-up period were compared. Results: Propensity score matching retained 349 out of 1388 patients in the fingolimod group and 349 out 678 in the teriflunomide group for final analyses. Mean ARR decreased markedly from baseline after 1 and 2 years of treatment in both the fingolimod (0.58–0.17 after 1 year and 0.11 after 2 years, p < 0.001) and teriflunomide (0.56–0.29 after 1 year and 0.31 after 2 years, p < 0.001) groups. Mean ARR was lower in fingolimod-treated patients than in those treated with teriflunomide at years 1 (p = 0.02) and 2 (p = 0.004). Compared to teriflunomide, the fingolimod group exhibited a higher percentage of relapse-free patients and a lower percentage of MRI-active patients after 2.5-year follow-up. Disability worsening was similar between the two groups. Patients were less likely to discontinue fingolimod than teriflunomide (p < 0.001). Conclusion: Fingolimod was associated with a better relapse control and lower discontinuation rate than teriflunomide. The two oral therapies exhibited similar effects on disability outcomes. © 2019 Elsevier B.V