Reply: Pseudoexfoliation syndrome and cardiovascular disease: studies must control for all cardiovascular risk factors

[No Abstract Available

A Comparison of Clinical and Radiological Outcomes of Different Anatomical Regions Plate osteosynthesis in Cats with Body of Ilium Fractures

Pelvis fractures in cats are one of the most common orthopedic problems that cause serious injuries. Pelvic fractures are between 20-32% out of all fractures in cats. Os Ilium fractures constitute 18-46% of pelvic fractures. In the presented study, the post-operative clinical and radiological results of placing the plate on the dorsal, ventral and lateral of the corpus ossis ilii in cats with os ilium fractures were evaluated.Twenty three cats (different races, ages and sex) with corpus ossis ilium and multiple fractures (sacro-iliac joint luxation, acetabulum fractures, os ischium fractures) were used as a materials. Anamnesis, clinical and neurological examinations of patients were taken and 3 groups were formed for this study. Group 1; In 7 cases, the plate was placed in the dorsal of the body of ilium, in group 2, 7 cases in the lateral of body of ilium and in Group 3; in 6 cases, in the ventral of the body of ilium. Operations were performed under general anesthesia. LC-DCP plate or reconstruction plates were used for fixation. There was no narrowing in the pelvic canal and no screw loosening in cases applied dorsally and ventrally. In 6 (85.7%) of 7 cases, there was no narrowing in the pelvic canal in lateral application. Only one case had problem. Recovery rate (85.7%) in all cases.In conclusion, in cases of os ilium fracture in cats, no difference was observed between the clinical and radiological (narrowing in the pelvic canal) results of placing LC-DCP or reconstruction plates on the dorsal, lateral and ventral of the bone in the post-operative period. Thus, screw loosening did not occur. But, case selection is important in the lateral, dorsal or ventral application of the plate in os ilium fractures. If the surgical intervention has passed 5-6 days, double plate application provides a better prognosis. Dorsale plate application provides ease of manipulation when compared to ventral application. Also, if the fracture line close to the acetabulum, lateral application should be preferred

The Factors Affecting the Organizational Silence of the Nurses And The Other Clinical-care Providers in Turkey,

The organizational silence of nurses, midwives, and health-care assistants who play a key role to establish the communication in the health-care team is relatively more significant when compared to other occupations. The results of organizational silence can be examined in organizational, individual and social scale. The purpose of this study is to find out the reasons of organizational silence and the relations among these reasons. In the scope of analysis, descriptive statistcs, reliability analysis, correlation analysis, ANOVA analysis and Regression analyses have been used by using PASW 18.0 package software to analyze the data gathered from 256 nurses, midwives and health-care assistants in a university hospital. In this study it has been found out that the organizational silence reasons differ according to age, education status, working year, occupation, working department and gender. It has also been determined that the administrative and organizational reasons, the fears related to work, the lack of experience, the fear of isolation and the fear of disturbing relations differ according to demographical variables. Since there is generally not a compensantion for a mistake in health-care service, to remove the damages of the reasons of organizational silence in health-care sector which is relatively more significant than the other sectors is possible when the necessary precautions are taken and the reasons are identified correctly. The relations, similarities and the differences among the sectors can be presented, if the organizational silence studies both in health-care sector and in different sectors are carried out more

Rapid temporal changes in the expression of a set of neuromodulatory genes during alcohol withdrawal in the dorsal vagal complex: molecular evidence of homeostatic disturbance.

BACKGROUND: Chronic alcohol exposure produces neuroadaptation, which increases the risk of cellular excitotoxicity and autonomic dysfunction during withdrawal. The temporal progression and regulation of the gene expression that contributes to this physiologic and behavioral phenotype is poorly understood early in the withdrawal period. Further, it is unexplored in the dorsal vagal complex (DVC), a brainstem autonomic regulatory structure. METHODS: We use a quantitative polymerase chain reaction platform to precisely and simultaneously measure the expression of 145 neuromodulatory genes in more than 100 rat DVC samples from control, chronically alcohol-exposed, and withdrawn rats. To gain insight into the dynamic progression and regulation of withdrawal, we focus on the expression of a subset of functionally relevant genes during the first 48 hours, when behavioral symptoms are most severe. RESULTS: In the DVC, expression of this gene subset is essentially normal in chronically alcohol-exposed rats. However, withdrawal results in rapid, large-magnitude expression changes in this group. We observed differential regulation in 86 of the 145 genes measured (59%), some as early as 4 hours into withdrawal. Time series measurements (4, 8, 18, 32, and 48 hours after alcohol removal) revealed dynamic expression responses in immediate early genes, γ-aminobutyric acid type A, ionotropic glutamate, and G-protein coupled receptors and the Ras/Raf signaling pathway. Together, these changes elucidate a complex, temporally coordinated response that involves correlated expression of many functionally related groups. In particular, the expression patterns of Gabra1, Grin2a, Grin3a, and Grik3 were tightly correlated. These receptor subunits share overrepresented transcription factor binding sites for Pax-8 and other transcription factors, suggesting a common regulatory mechanism and a role for these transcription factors in the regulation of neurotransmission within the first 48 hours of alcohol withdrawal. CONCLUSIONS: Expression in this gene set is essentially normal in the alcohol-adapted DVC, but withdrawal results in immediate, large-magnitude, and dynamic changes. These data support both increased research focus on the biological ramifications of alcohol withdrawal and enable novel insights into the dynamic withdrawal expression response in this understudied homeostatic control center

Health Tourısm In Turkey And Practıcal Example Of Its Economıc Dımensıons,

Turkey has made significant progress in health tourism within the last 20 years and began to compete with the most successful countries in health tourism. Also, the income obtained from health tourism has an important impact on the income obtained in health sector in Turkey and makes great contribution to the economy. This study aims to investigate the place of health tourism in health sector and its impacts on it. Within this context, various statistical data regarding the spending on health and health tourism between 2004-2013 was used. The data obtain from TUIK (Turkish Statistical Institute) was analysed via PASW Statistics 18 (SPSS-Statistical Package for Social Sciences) package program. Within the scope of the analysis, frequency tables and regression tests were used. The research findings illustrated that private hospitals were preferred more in health tourism, Germany, Bulgaria and Iraq are among the countries that send most health tourists, service is obtained more in other branches and eye and oncology fields and health tourism income is affected by the number of the tourists. The results of the study indicated that foreigners make up 70% of total health tourists in 2013, the rate of health spending in health tourism is 2.3% and health tourism income increased total heath income significantly

Kamu Ve Özel Sağlık Kurumlarında Çalışan Personelin Ücret Beklenti Düzeylerinin Uygulamalı Örneği,

Günümüzde daha kaliteli, etkin, verimli ve sürekli bir sağlık hizmeti sunumunda sağlık kurumu çalışanlarının kurum amaçları doğrultusunda etkin ve verimli bir biçimde organize edilmeleri gerekmektedir. İyi bir personel yönetimine sahip kurumlar çalışanlarının özelliklerini ve beklentilerini değerlendirerek bu yönde tedbirler almalı ve iyileştirmelerde bulunmalıdırlar. Sağlık kurumlarında hem iş doyumu hem de örgütsel bağlılığın artmasında çalışanların beklentilerinin karşılanması ve uygun çalışma koşulları göz ardı edilmemesi gereken bir konudur. Özellikle İş doyumunu etkileyen çevresel ve örgütsel faktörlerden biride ücret-maaş faktörüdür. Çalışanların ücret yönünden tatmin edilmelerinin iş doyumunu artıracağı söylenebilir. Bu çalışmada katılımcı görüşleri doğrultusunda başta ücrete yönelik olmak üzere çalışma koşullarının kalite ve yeterliliği, iş değişikliği ve ücretle ilişkili olarak sosyal hayattaki olumsuzluk konularına dair genel bir durum değerlendirmesi yapılması amaçlanmıştır. Bu bağlamda araştırmaya rast gele yöntemle seçilmiş toplam 1350 özel ve kamu sağlık kurumlarında çalışan sağlık personeli katılım sağlamıştır. Araştırma Türkiye evreni içerisinde İstanbul, İzmir, Bursa, Ankara, Diyarbakır, Trabzon, Tekirdağ, Adana, Edirne ve Çorum illeri örneklemi çerçevesinde gerçekleştirilmiştir. Araştırmada 5’li likert ölçekten oluşan 30 soruluk bir anket kullanılmıştır. Kullanılan anketin Cronbach’s Alpha değeri 0.872 bulunmuştur. Analize tabi tutulan veriler SPSS 18 İstatistik programı ile analiz edilmiştir. Analiz kapsamında, güvenilirlik analizi, frekans tabloları, betimleyici istatistikler, faktör analizi ve Kruskal Wallis analizlerinden faydalanılmıştır. Araştırma sonunda, katılımcıların cinsiyet, yaş, eğitim, iş tecrübesi ve kurumdaki konum değişkenlerine göre çalışma koşulları, iş değişimi, ücret ve gelir düzeyinin sosyal hayattaki olumsuz etkileri boyutlarında etkili olduğu, kurum tipi değişkeninin ise sadece çalışma koşuları boyutunda etkili olduğu saptanmıştır

Sağlık Pazarlaması Ve Uygulamaları,

Özel alanda sağlık sektöründeki gelişmeler ve özel sağlık kuruluşlarının hızla artması beraberinde artan rekabet ve maliyetler, müşteri memnuniyeti, kaliteli hizmet talepleri vb. nedenlerle sağlık sektöründe pazarlama faaliyetleri her geçen gün daha da önem kazanmaktadır. Bu bağlamda pazarlama anlayışı kapsamında hizmet kalitesi ve sağlık turizmine yönelik olarak katılımcılara 35 sorudan oluşan anket uygulanmıştır. Araştırma Denizli, Ankara, Afyon ve İstanbul ili kapsamında 892 katılımcı ile gerçekleştirilmiştir. araştırmada kullanılan anketin güvenirlik katsayısı 0.896 olarak bulunmuştur. Araştırmadan elde edilen verilerin analizinde SPSS 18 İstatistik programı kullanılmıştır. Analiz kapsamında, güvenilirlik analizi, frekans tabloları, betimleyici istatistikler, Korelasyon analizlerinden faydalanılmıştır. Araştırma sonunda, katılımcıların Türk sağlık turizmine ilişkin görüşleri, alınan hizmet ve tesis fiyatlandırması, sağlık kurumlarının hijyen ve genel özellikleri ile genel bilgi ve görüşler faktörleri arasında cinsiyet, milliyet, hizmet tipi, ülke ve gelire göre orta ve kuvvetli düzeyde pozitif yönlü ilişki bulunmuştur

lba62health related quality of life hrqol for pembrolizumab or placebo plus carboplatin and paclitaxel or nab paclitaxel in patients with metastatic squamous nsclc data from keynote 407

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A unique serum IgG glycosylation signature predicts development of Crohn’s disease and is associated with pathogenic antibodies to mannose glycan

Inflammatory bowel disease (IBD) is characterized by chronic inflammation in the gut. There is growing evidence in Crohn’s disease (CD) of the existence of a preclinical period characterized by immunological changes preceding symptom onset that starts years before diagnosis. Gaining insight into this preclinical phase will allow disease prediction and prevention. Analysis of preclinical serum samples, up to 6 years before IBD diagnosis (from the PREDICTS cohort), revealed the identification of a unique glycosylation signature on circulating antibodies (IgGs) characterized by lower galactosylation levels of the IgG fragment crystallizable (Fc) domain that remained stable until disease diagnosis. This specific IgG2 Fc glycan trait correlated with increased levels of antimicrobial antibodies, specifically anti-Saccharomyces cerevisiae (ASCA), pinpointing a glycome–ASCA hub detected in serum that predates by years the development of CD. Mechanistically, we demonstrated that this agalactosylated glycoform of ASCA IgG, detected in the preclinical phase, elicits a proinflammatory immune pathway through the activation and reprogramming of innate immune cells, such as dendritic cells and natural killer cells, via an FcγR-dependent mechanism, triggering NF-κB and CARD9 signaling and leading to inflammasome activation. This proinflammatory role of ASCA was demonstrated to be dependent on mannose glycan recognition and galactosylation levels in the IgG Fc domain. The pathogenic properties of (anti-mannose) ASCA IgG were validated in vivo. Adoptive transfer of antibodies to mannan (ASCA) to recipient wild-type mice resulted in increased susceptibility to intestinal inflammation that was recovered in recipient FcγR-deficient mice. Here we identify a glycosylation signature in circulating IgGs that precedes CD onset and pinpoint a specific glycome–ASCA pathway as a central player in the initiation of inflammation many years before CD diagnosis. This pathogenic glyco-hub may constitute a promising new serum biomarker for CD prediction and a potential target for disease prevention.We wish to acknowledge the Gastroenterology Department of Centro Hospitalar Universitário de Santo António, in particular P. Lago, for providing samples from individuals with established CD. We kindly thank J. Rojo from the Instituto de Investigaciones Químicas (Universidad de Sevilla) for providing us with the di-GlcNAc glycodendrimer. We would also like to acknowledge J. V. Ravetch (Rockefeller University) and M. S. Cragg (University of Southampton) for kindly providing us with the FcγR-deficient mice used in the in vivo studies. S.S.P. acknowledges funding from the US Department of Defense, US Army Medical Research Acquisition Activity and FY18Peer-Reviewed Medical Research Program Investigator-Initiated Research Award (award number W81XWH1920053). S.S.P. also acknowledges funding from the European Crohn’s and Colitis Organisation (ECCO) Pioneer Award 2021, the International Organization for the study of Inflammatory Bowel Disease (IOIBD) and the Portuguese Foundation for Science and Technology (FCT; EXPL/MED-ONC/0496/2021). J.G. acknowledges funding from European Society of Clinical Microbiology and Infectious Diseases (ESCMID ResearchGrant 2022), European Crohn’s and Colitis Organisation (ECCO Grant 2023) and FCT (2020.00088.CEECIND). C.S.R. thanks FCT forfunding (2020.08422.BD). I.A. acknowledges funding from FCT (2022.00337.CEECIND) and the BIAL Foundation and PortugueseMedical Association (Maria de Sousa Award 2023). E.L.-G. thanks FCT for funding (UI/BD/152866/2022). F.P. and Z.H.G. were partially supported by the Kenneth-Rainin Foundation (20210021). B.C. acknowledges funding from FCT(CEECINST/00123/2021/CP1772/CT0001). J.T. acknowledges funding from the Portuguese Society of Gastroenterology and from Luz Saúde (Grupo dE iNvestIgação em Patologia Digestiva LUz Saúde LH.INV.F2019015). This study was also cofunded by the EuropeanUnion (GlycanTrigger, grant agreement number 101093997). The views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Research Council Executive Agency. Neither the European Union nor the granting authority can be held responsible for them. This study was conducted under support of Peer-Reviewed Medical Research Program (PR180831P1). The views expressed in this article reflect the results of the research conducted by the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, the Henry M. Jackson Foundation for the Advancement of Military Medicine or the US Government. There are no restrictions on its use. This article was prepared while R.M.L. was employed at Henry M. Jackson Foundation for the Advancement of Military Medicine. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services or the US Government. C.K.P. is an employee of the US Government. This work was prepared as part of official duties. Title 17 U.S.C. §105provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. §101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties