Keratokonus hastalarında Mini-Skleral lens kullanımı

Amaç: Keratokonus hastalarında mini-skleral lensin görsel performansını ve lens uyumunu optik koherens tomografi (OKT) ile değerlendirmek.Gereç ve Yöntem: Yirmi dört keratokonus hastasının 29 gözüne mini-skleral lens (Esclera; Mediphacos Ltd., Belo Horizonte, Brezilya) uygulandı. Başlangıç uyumunun değerlendirilmesinde, deneme lensleri kullanıldı. Lens uyumu, floresein paterni ve ön segment OKT (RTVue, Optovue Inc., Fremont, CA) görüntülemesi ile değerlendirildi. Lens uygulandıktan 30-45 dakika sonra korneal-limbal açıklık ve periferik yerleşim bölgesinin uyumunu içeren lens uyum parametreleri, OKT ile değerlendirildi. Lens uygulamasının öncesinde ve sonrasında; yüksek ve düşük kontrastlı görme keskinliği (GK), konfor, görmenin subjektif performansı (5 puanlı Likert skalası) ve genel memnuniyeti [100 mm görsel analog skalası (GAS)] değerlendirildi.Bulgular: Lens uygulaması sonrasında; ortalama desimal yüksek kontrastlı GK (en iyi düzeltilmiş gözlükle GK: 0,40±0,14 vs skleral lens ile GK: 0,93±0,12 p<0,0001) ve ortalama düşük kontrastlı GK’deki (en iyi düzeltilmiş gözlükle GK: 0,60±0,24 vs skleral lens ile 1,15±0,18, p<0,0001) artışın istatistiksel olarak anlamlı olduğu görüldü. Ortalama santral korneal açıklık 120,7±24,5 µm idi. Keratometrik değerler ile skleral lensin sagital derinliği arasında korelasyon görülmedi. Başarılı uyum için gereken ortalama lens deneme sayısı 2,2 lens (aralık: 1-8) idi. Hastalar lens ile yüksek skorda konfor (ortalama skor: 4,69; aralık: 4-5), görme (ortalama skor: 4,62; aralık: 3-5) ve genel memnuniyet (ortalama GAS skor: 88,1; aralık: 70-100) bildirdi.Sonuç: Keratokonus hastalarında, mini-skleral lens ile yüksek ve düşük kontrastlı GK değerlerinde artış ve yüksek hasta memnuniyeti sağlandı. Ön segment OKT görüntülemesi, lens uyumunun değerlendirilmesini kolaylaştırdı.Amaç: Keratokonus hastalarında mini-skleral lensin görsel performansını ve lens uyumunu optik koherens tomografi (OKT) ile değerlendirmek.Gereç ve Yöntem: Yirmi dört keratokonus hastasının 29 gözüne mini-skleral lens (Esclera; Mediphacos Ltd., Belo Horizonte, Brezilya) uygulandı. Başlangıç uyumunun değerlendirilmesinde, deneme lensleri kullanıldı. Lens uyumu, floresein paterni ve ön segment OKT (RTVue, Optovue Inc., Fremont, CA) görüntülemesi ile değerlendirildi. Lens uygulandıktan 30-45 dakika sonra korneal-limbal açıklık ve periferik yerleşim bölgesinin uyumunu içeren lens uyum parametreleri, OKT ile değerlendirildi. Lens uygulamasının öncesinde ve sonrasında; yüksek ve düşük kontrastlı görme keskinliği (GK), konfor, görmenin subjektif performansı (5 puanlı Likert skalası) ve genel memnuniyeti [100 mm görsel analog skalası (GAS)] değerlendirildi.Bulgular: Lens uygulaması sonrasında; ortalama desimal yüksek kontrastlı GK (en iyi düzeltilmiş gözlükle GK: 0,40±0,14 vs skleral lens ile GK: 0,93±0,12 p<0,0001) ve ortalama düşük kontrastlı GK’deki (en iyi düzeltilmiş gözlükle GK: 0,60±0,24 vs skleral lens ile 1,15±0,18, p<0,0001) artışın istatistiksel olarak anlamlı olduğu görüldü. Ortalama santral korneal açıklık 120,7±24,5 µm idi. Keratometrik değerler ile skleral lensin sagital derinliği arasında korelasyon görülmedi. Başarılı uyum için gereken ortalama lens deneme sayısı 2,2 lens (aralık: 1-8) idi. Hastalar lens ile yüksek skorda konfor (ortalama skor: 4,69; aralık: 4-5), görme (ortalama skor: 4,62; aralık: 3-5) ve genel memnuniyet (ortalama GAS skor: 88,1; aralık: 70-100) bildirdi.Sonuç: Keratokonus hastalarında, mini-skleral lens ile yüksek ve düşük kontrastlı GK değerlerinde artış ve yüksek hasta memnuniyeti sağlandı. Ön segment OKT görüntülemesi, lens uyumunun değerlendirilmesini kolaylaştırdı

Staged, Open, No-Ischemia Nephron-Sparing Surgery for Bilateral-Multiple Kidney Tumors in a Patient with Birt-Hogg-Dubé Syndrome

Hereditary kidney cancer patients with bilateral multiple kidney tumors represent challenges in the era of rapidly growing minimal invasive treatment techniques. Birt-Hogg-Dubé Syndrome (BHDS) is an autosomal dominant genodermatosis characterized by a triad of benign skin tumors (fibrofolliculomas, trichodiscomas, acrochordons) together with an increased risk of developing malignant renal tumors and pulmonary disease such as pneumothoraces and multiple lung cysts. The morbidity and mortality of the affected patients is determined by the presence of the kidney tumors, which tend to be multifocal and bilateral, as observed in other hereditary kidney cancer syndromes like von Hippel-Lindau disease, familial leiomyomatosis, and hereditary papillary renal cell carcinoma. Herein, a patient with BHDS, presenting with synchronous bilateral multiple kidney tumors, is reported. The report describes the management of kidney tumors with two-stage open nephron-sparing surgery in which the nonvascular clamping technique was utilized

Bidirectional switching of near IR emitting boradiazaindacene fluorophores

(Graph Presented) Two novel distyryl-boradiazaindacene dyes with dimethylaminostyryl and pyridylethenyl substituents display opposite spectral shifts on protonation with TFA in organic solvents. This bidirectional switching of the dyes can be shown to be directly related to ICT donor and acceptor characteristics of the substituents attached to the BODIPY core. The observed spectral response of these dyes could be very useful in the design of novel NIR fluorescent ratiometric probes for pH. © 2008 American Chemical Society

Isıtma İşleminin Çekişte Zeytinyağının Kalite, Oksidatif Stabilite ve Yağ Asidi Bileşimine Etkisi

Çalışmanın amacı Çekişte çeşidi zeytinlerden elde edilen zeytinyağlarının ısıtma işlemi sırasında temel kalite kriterleri, oksidatif stabilite ve yağ asidi bileşiminde meydana gelen değişimlerin belirlenmesidir. Bu amaçla Aydın ilinden 2017 yılında hasat edilmiş olan Çekişte çeşidi zeytinlerden elde edilmiş olan zeytinyağı, 100°C sıcaklıkta ve 20 L/saat hava akışı altında toplamda 50 saat süreyle ısıtılmıştır ve 10 saatlik aralıklarla serbest yağ asidi oranı, peroksit sayısı, dien ve trien (K232 ve K270) değerleri, toplam fenol miktarı, antioksidan aktivite, klorofil ve karotenoid miktarları ile yağ asidi kompozisyonları yönünden analiz edilmiştir. Ayrıca örneklerin indüksiyon periyodu olarak ifade edilen oksidatif stabiliteleri belirlenmiştir. Çalışma sonunda temel kalite parametrelerinden serbest yağ asidi miktarı, peroksit sayısı, dien ve trien (K232 ve K270) değerlerinin ısıtma işlemi ile birlikte artış gösterdiği saptanmıştır. Örneklerin toplam fenol, antioksidan aktivite, klorofil ve karotenoid miktarları ise ısıtma süresinin artmasıyla birlikte kademeli olarak azalmıştır. Benzer şekilde indüksiyon periyodunun da işlem süresinin artmasıyla birlikte azaldığı tespit edilmiştir. Zeytinyağı örneklerinde tespit edilen yağ asitlerinden linolenik asit miktarının ise işlem sonunda önemli düzeyde arttığı, oleik asit miktarının ise işlem öncesine göre azalma eğiliminde olduğu saptanmıştır

Over restrictive elimination of foods in children with foodallergy

Background. Previous studies demonstrated critical deficits in diagnosis and management of childhood foodallergy (FA), and recent developments in FA research support adopting a proactive approach in FA management.Our objective was to describe FA knowledge and management patterns of pediatricians.Method. We applied a 24-item survey to 170 general pediatricians, pediatric allergists and pediatricgastroenterologists practicing in Turkey.Results. Some IgE-mediated symptoms of FA such as cough, urticaria, wheezing and anaphylaxis were falselyrecognized as symptoms of non-IgE-mediated FA by 30%, 29%, 25% and 19% of the participants, respectively.By contrast, 50% of the participants falsely recognized bloody stool, a finding of IgE-mediated FA. Mostfrequently and least frequently used diagnostic tools were specific IgE (30.5%) and oral food challenge test(1.7%), respectively. Maternal diet restrictions and infant diet restrictions were advised by 82% and 82%,respectively. Percentages of physicians eliminating only 1 food were 21%, 19%; 2 foods were 15%, 11%; 3 foodswere 7%, 8%; 4-5 foods were 8%, 11%; 5 to 10 foods were 21%, 26%; and >10 foods were 28%, 25% from thematernal and infant diet, respectively. Cow’s milk, cheese, butter, yoghurt, baked milk products and hen’s eggwere the most commonly restricted items.Conclusion. Overall, FA knowledge of pediatricians was fair. Pediatricians utilize an overly restrictive approachwhen advising diet eliminations in FA. Recent developments favor a more proactive approach to induce immunetolerance and need to be encouraged in pediatric clinical practice. Future educational efforts should focus onemphasizing the deleterious effects of injudicious and extensive eliminations

Dysregulation of miRNA-30e-3p targeting IL-1β in an international cohort of systemic autoinflammatory disease patients

Abstract: Autoinflammation is the standard mechanism seen in systemic autoinflammatory disease (SAID) patients. This study aimed to investigate the effect of a candidate miRNA, miR-30e-3p, which was identified in our previous study, on the autoinflammation phenotype seen in SAID patients and to analyze its expression in a larger group of European SAID patients. We examined the potential anti-inflammatory effect of miR-30e-3p, which we had defined as one of the differentially expressed miRNAs in microarray analysis involved in inflammation-related pathways. This study validated our previous microarray results of miR-30e-3p in a cohort involving European SAID patients. We performed cell culture transfection assays for miR-30e-3p. Then, in transfected cells, we analyzed expression levels of pro-inflammatory genes; IL-1β, TNF-α, TGF-β, and MEFV. We also performed functional experiments, caspase-1 activation by fluorometric assay kit, apoptosis assay by flow cytometry, and cell migration assays by wound healing and filter system to understand the possible effect of miR-30e-3p on inflammation. Following these functional assays, 3'UTR luciferase activity assay and western blotting were carried out to identify the target gene of the aforementioned miRNA. MiR-30e-3p was decreased in severe European SAID patients like the Turkish patients. The functional assays associated with inflammation suggested that miR-30e-3p has an anti-inflammatory effect. 3'UTR luciferase activity assay demonstrated that miR-30e-3p directly binds to interleukin-1-beta (IL-1β), one of the critical molecules of inflammatory pathways, and reduces both RNA and protein levels of IL-1β. miR-30e-3p, which has been associated with IL-1β, a principal component of inflammation, might be of potential diagnostic and therapeutic value for SAIDs. Key Messages: miR-30e-3p, which targets IL-1β, could have a role in the pathogenesis of SAID patients.miR-30e-3p has a role in regulating inflammatory pathways like migration, caspase-1 activation.miR-30e-3p has the potential to be used for future diagnostic and therapeutic approaches.</p

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Wireless Inspirational Bits for Facilitating Early Design

Proof of concept systems are the significant examples of technology designs to test and analyze technology ideas. Toolkits enable technology developers to decrease the complexity and time to create draft designs with many iterations. Toolkits with combinations of sensors and actuators may lead technology designers to new design spaces and opportunities by decreasing design difficulties. This thesis proposes a new wireless toolkit, called Earl, for beginner level technology designers. Without being experienced on engineering skills Earl allows technology designers to create proof of concept systems in shorter time than implementing the system from scratch. For experiencing with sensors and actuators, this toolkit has a vision to design plug and experience systems. By using Earl, designers can connect analog actuators and sensors by plugging them to toolkit. Additionally, Earl is designed to increase the experience time by lowering the power consumption as much as possible. Therefore, application developers can use Earl portably in long term experiments. Furthermore, Earl is designed in Internet of Things concept. By using Earl web services, technology designer can access the data sent from the sensors and can control the actuators connected to hardware toolkit from a web browser. Earl hardware toolkit aims to provide long experiment time as much as possible. This is why, Earl hardware toolkit is designed to lower the power consumption if hardware toolkit is not actively handling processes. In sensing only mode, technology developers can use Earl hardware toolkit more than 1 month without recharging the toolkit battery. Using actuators in application may change power consumption of the hardware toolkit. Therefore, applications with actuators may have lower experiment time