Covid-19 Pandemisinde İyileşme Süreçleri Ve Hastaların Evden Takibi

1 Aralık 2019 tarihinde Çin’in Wuhan kentinde ortaya çıkan kişiden kişiye hızla yayılan SARS-CoV-2(Covid-19) olarak adlandırılan yeni koronavirüs hastalığı çok geçmeden tüm dünyayı etkisi alına aldı. Bunun üzerine 11 Mart 2020’de Dünya Sağlık Örgütü pandemi (küresel salgın) ilan etti. Türkiye’de tespit edilen ilk COVID-19 vakası da Sağlık Bakanlığı tarafından aynı tarihte açıklandı.11 Mart 2020 tarihinden itibaren tüm dünya ile birlikte ülkemiz de pandemi sürecine girdi. Ülkemizde hemen tüm hastaneler pandemi hastanesi ilan edilirken eğitim-öğretim, sosyal, ekonomik, siyasi, iktisadi, idari, hukuki, askerî, dinî ve kültürel alanlarda birçok radikal kararlar alındı. Bezmiâlem Vakıf Üniversitesi Tıp Fakültesi olarak pandemi sürecine girer girmez bilinmezlikler içeren ve tedavisinde zorluklar yaşadığımız Covid-19 hastalığının yakınma, bulgu tedavisi ve korunma önlemlerine yönelik bir kitap yazmayı planladık. Süreç ilerledikçe hastalığın sadece bir pnömoniden ibaret olmadığını, hastalığın birden fazla evresinin olduğunu, birçok organ ve sistemleri etkilediğini ve bu durumla ilişkili olarak pek çok farklı klinik bulguya yol açtığını öğrendik. Öte yandan bu pandemi sürecinde aciliyet gerektiren ve travmaya bağlı operasyonlar da kaçınılmaz olarak devam etmek zorundaydı. Sürecin başından itibaren Bezmialem Üniversitesi Tıp Fakültesi Hastanesi olarak bir taraftan pandemiyi yönetirken bir taraftan hayati önem arz eden durumlara, acil ve travma hastalarına da müdahale etmeye çalıştık. Bu nedenle bu kitapta Covid-19 hastalığının etkilediği sistem ve organlarla ilgili tüm disiplinlerle beraber pandemi döneminde yönetimi özellik gösteren disiplinlere de yer vermeyi amaçladık. Ayrıca pandemilerin tarihçesine değinmek istedik ki bu sürecin aşılmasında geçmişteki pandemiler bize yol göstersin. Yeni mutasyonların gelişimi ve varyantların ortaya çıkma olasılığı nedeni ile sürecin bir süre daha izlenmesi gerekliliği, kitabın basımını geciktirdi. 2021 yılının ilk aylarında ülkemizde aşılanma sürecine girilmesi ve öncelikli olarak sağlık personeli ve yaşlı nüfusdan başlanarak genç nüfusa kadar aşılanmanın uygulanması COVID-19 mücadelesinde oldukça umut vericidir. İngiltere, Güney Amerika, Hindistan ve son olarak delta varyantının ortaya çıkması virüsün mutasyona uğrayıp bulaştırıcılığının artarak devam ettiğinin göstergeleridir. En kısa sürede aşılanma sürecinin tamamlanarak ülkemiz ve dünyamızdan bu hastalığın eradikasyonu temenni ediyoruz. COVID-19 pandemisinin başlangıcından itibaren böyle bir kitabın yazılması planlanmış olup kitabın bu süreç içerisinde yayın hazırlıkları devam etmiştir. Pandemi sürecini yürüten, bu süreçten etkilenen ve bu süreci yöneten tüm tıp disiplinlerine yer verilmiştir. Bu kitaptaki bilgi paylaşımı ve deneyimler son derece önemlidir. Kitabın hazırlanmasında emeği geçen tüm öğretim üyelerimize, meslektaşlarımıza üstün çabalarından dolayı teşekkür ederiz. Bu kitabın sizlere ve tıp dünyasına faydalı ve yol gösterici olmasını dileriz. Prof. Dr. Ramazan ÖZDEMİR / Dekan Prof. Dr. Teoman AYDIN / Dekan Yardımcısı Prof. Dr. Özlem SU KÜÇÜK / Dekan Yardımcıs

Frequency and determinants of erectile dysfunction in Turkish diabetic men

Background: Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance. ED is observed more frequently and manifests earlier in diabetic patients compared to the normal population.Material and Methods: One hundred and seventeen consecutive male type 2 diabetes patients seen in our Diabetes Outpatient Clinic were included in our study and these patients were evaluated in terms of the presence and duration of ED, treatment and response to treatment of ED, duration of diabetes mellitus, HbA1c levels, and the presence of microalbuminuria, estimated from 24‑hour urine collections.Results: The patients included in our study were divided into three groups: Patients with no ED, mild‑to‑moderate ED, and severe ED. Twenty‑nine patients (24.8%) fell in the no ED group, 28 (23.9%) in the mild‑to‑moderate ED group, and 60 (51.3%) in the severe ED group. There were statistically significant differences between these three groups in terms of age (P = 0.015) and duration of diabetes mellitus (P = 0.03). The groups were similar in terms of microalbuminuria measured from 24‑hour urine collections and HbA1c levels (P = 0.328 and P = 0.905, respectively). Twenty‑three of the 88 patients with ED (26.1%) were on ED treatment and 43.5% of these patients reported benefit from the therapy.Conclusion: Age and duration of diabetes were the main determinants of the presence and severity of ED in male Turkish type 2 diabetic patients. The HbA1c levels were higher in patients with ED, but the differences in levels between the groups did not reach statistical significance.Key words: Diabetes mellitus, erectile dysfunction, microalbuminuri

Phytochemical Profiles, Antioxidant, Cytotoxic, and Anti-Inflammatory Activities of Traditional Medicinal Plants: Centaurea pichleri subsp. pichleri, Conyza canadensis, and Jasminum fruticans

Centaurea pichleri subsp. pichleri, Conyza canadensis, and Jasminum fruticans are traditionally used plants grown in Turkey. Methanol extracts were obtained from these plants and pharmacological activity studies and phytochemical analyses were carried out. To evaluate the phytochemical composition, spectrophotometric and chromatographic techniques were used. The extracts were evaluated for antioxidant activity by DPPH●, ABTS●+ radical scavenging, and FRAP assays. The cytotoxic effects of the extracts were investigated on DU145 prostate cancer and A549 lung cancer cell lines. The anti-inflammatory effects of extracts were investigated on the NO amount, TNF-α, IFN-γ, and PGE 2 levels in lipopolysaccharide-stimulated Raw 264.7 cells. The richest extract in terms of phenolic compounds (98.19 ± 1.64 mgGAE/gextract) and total flavonoids (21.85 ± 0.64 mgCA/gextract) was identified as C. pichleri subsp. pichleri methanol extract. According to antioxidant activity determinations, the C. pichleri subsp. pichleri extract was found to be the most active extract. Finally, the C. pichleri subsp. pichleri methanol extract was revealed to be the most effective inhibitor of viability in the cytotoxic activity investigation, and the extract with the best anti-inflammatory action. The findings point to C. pichleri subsp. pichleri as a promising source of bioactive compounds in the transition from natural sources to industrial uses, such as new medications, cosmeceuticals, and nutraceuticals

Value of Perineural Edema/Inflammation Detected by Fat Saturation Sequences in Lumbar Magnetic Resonance Imaging of Patients with Unilateral Sciatica

WOS: 000263560200010PubMed ID: 19096956Background: Routine lumbar spine magnetic resonance imaging (MRI) may not show any evidence of the cause of sciatica in some cases. The relationship between nerve root compression detected on lumbar MRI and sciatica is also sometimes uncertain. Purpose: To ascertain whether axial (and, when necessary, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted MRI findings can be used to study the level of sciatica in patients with a non-yielding routine MRI examination. Material and Methods: A total of 215 patients with unilateral sciatica underwent MRI. All patients were asked to complete pain drawing forms describing their pain dermatomal distributions. Perineural edema/inflammation corresponding to the pain location indicated by the pain drawings was sought on short-tau inversion recovery or fat-saturated T2-weighted images. Results: Routine MRI findings revealed that 110 of the 215 patients had nerve root compromise related to the patients' symptoms. Routine MRI could not ascertain the cause of these symptoms in the remaining 105 patients. In 31 (29.5%) of these 105 patients, short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images revealed perineural edema/inflammation surrounding the nerve roots related to the pain locations indicated in the pain drawings. Conclusion: Axial (and, when required, sagittal and coronal) short-tau inversion recovery or fat-saturated T2-weighted magnetic resonance images may be helpful for revealing additional findings in cases of unexplained sciatica in standard magnetic resonance imaging. However, the value of this imaging may be not great enough to justify routine use of these additional sequences to study the level of sciatica

Is emodin with anticancer effects completely innocent? Two sides of the coin

Many anticancer active compounds are known to have the capacity to destroy pathologically proliferating cancer cells in the body, as well as to destroy rapidly proliferating normal cells. Despite remarkable advances in cancer research over the past few decades, the inclusion of natural compounds in researches as potential drug candidates is becoming increasingly important. However, the perception that the natural is reliable is an issue that needs to be clarified. Among the various chemical classes of natural products, anthraquinones have many biological activities and have also been proven to exhibit a unique anticancer activity. Emodin, an anthraquinone derivative, is a natural compound found in the roots and rhizomes of many plants. The anticancer property of emodin, a broad‐spectrum inhibitory agent of cancer cells, has been detailed in many biological pathways. In cancer cells, these molecular mechanisms consist of suppressing cell growth and proliferation through the attenuation of oncogenic growth signaling, such as protein kinase B (AKT), mitogen‐activated protein kinase (MAPK), HER‐2 tyrosine kinase, Wnt/‐catenin, and phosphatidylinositol 3‐kinase (PI3K). However, it is known that emodin, which shows toxicity to cancer cells, may cause kidney toxicity, hepatotoxicity, and reproductive toxicity especially at high doses and long‐term use. At the same time, studies of emodin, which has poor oral bioavailability, to transform this disadvantage into an advantage with nano‐carrier systems reveal that natural compounds are not always directly usable compounds. Consequently, this review aimed to shed light on the anti‐proliferative and anti‐carcinogenic properties of emodin, as well as its potential toxicities and the advantages of drug delivery systems on bioavailability