Acute effects of cardiac resynchronization therapy on arterial distensibility and serum norepinephrine levels in advanced heart failure

Background: Cardiac resynchronization therapy (CRT) has become an accepted method fortreating refractory heart failure (HF). Arterial distensibility is an index of arterial stiffnessand a surrogate marker for atherosclerosis. The present study aims to assess the acute effects of ventricular resynchronization therapy with biventricular stimulation on arterial distensibility, echocardiographic parameters and serum norepinephrine levels in patients with drugrefractory HF.Methods: Fourteen cardiac HF patients (53.6 ± 9.1; 39–67 years, 7 woman) were enrolled for CRT. Patients had an advanced cardiac HF (NYHA III–IV functional class) due to non-ischemic dilated cardiomyopathy, with a left ventricular ejection fraction (LVEF) < 35% and QRS duration ≥ 120 ms. Blood samples for norepinephrine and B-type natriuretic peptidewere collected before 24 h biventricular implantation and after 48 h of CRT. Transthoracic echocardiography was used to evaluate arterial distensibility and cardiovascular condition.Results: Although systolic blood pressure, diastolic blood pressure, LV end-diastolic diameter, LV end-systolic diameter, serum B-type natriuretic peptide, and serum norepinephrine levels significantly decreased after CRT implantation; EF and aortic distensibility significantly increased (p < 0.05). There was no significance in the hemodynamic and echocardiographic values, norepinephrine and B-type natriuretic peptide levels in pre- and post-CRT between man and woman.Conclusions: The major findings of this study are that in patients with cardiac HF in acute period, after implantation of CRT serum norepinephrine levels decrease and the arterial distensibility improves

Güney Marmara Şartlarında Organik Koyun Yetiştiriciliği ve Kuzu Besisi Üzerine Bir Araştırma

Bu araştırma, Marmara Hayvancılık Araştırma Enstitüsü’nde organik ve konvansiyonel sistemlerde yetiştirilen Kıvırcık koyunların döl verimi; kuzuların büyüme özellikleri ve besi performansları ile bazı kesim, karkas ve et özelliklerini karşılaştırmak amacıyla düzenlenmiştir. Organik yetiştiricilik Kıvırcık koyunların döl verimini ve kuzuların büyüme özelliklerini olumlu yönde etkilemiş; organik koyunlar konvansiyonellere göre daha yüksek doğum oranına sahip olmuşlardır. Konvansiyonel beside kuzular, konvansiyonel arpaya dayalı karma yemle ad-libitum düzeyde beslenmiş, ayrıca kuzu başına günde 100 g yonca kuru otu verilmiştir. Organik besi grupları merada otlatılmış, barınak içerisinde organik arpaya dayalı karma yemle beslenmişlerdir. Meranın yetersiz olduğu dönemde ise organik arpa hasılı verilmiştir. Denemede ortalama canlı ağırlığı 35 kg’a ulaşan gruplardaki tüm kuzular kesime gönderilmiştir. Organik kuzular, konvansiyonellere göre hedeflenen besi sonu canlı ağırlığa daha kısa sürede ulaşmışlardır. Organik kuzularda besi süresince günlük ortalama canlı ağırlık artışı konvansiyonellere göre daha yüksek olmuştur (P<0.05). Besleme sistemi sırt yağı kalınlığı üzerine etkili olmuş; organik kuzularda sırt yağı kalınlığı konvansiyonelden daha düşük bulunmuştur (P<0.05). Öte yandan, organik üretim özellikle erkek hayvan etlerindeki kolesterol düzeyini düşürmüştür

Evaluation of self-esteem and dermatological quality of life in adolescents with atopic dermatitis

Background and Design: Atopic dermatitis is a chronic, inflammatory skin disease characterized by itchy skin lesions. Since adolescents are intensely interested in their physical appearance, chronic skin diseases in this period can adversely affect the development of self esteem. Atopic dermatitis is a skin disease that affects the appearance and there is an heightened attention to the body image in adolescence which is an important period of time in the development of self-esteem. Therefore, we aimed to investigate self-esteem and dermatological quality of life in adolescents with atopic dermatitis. Materials and Methods: Thirty-three patients with atopic dermatitis and 33 healthy controls were included in the study. The Piers-Harris Children’s Self-Concept Scale and the Children’s Dermatology Life Quality Index (CDLQI) were used for determining self-esteem and quality of life. The Scoring of Atopic Dermatitis (SCORAD) Index was used to assess the severity of atopic dermatitis. Results: It was found that patient group had lower self-esteem than healthy controls according to the Piers-Harris Children’s Self-Concept Scale. A statistically significant difference was observed in happiness/satisfaction and anxiety subscale scores between the patients and healthy controls while there was no significant difference between the other sub-scale scores. Mean value of dermatological quality of life in patients with atopic dermatitis was significantly lower than in healthy controls. A moderate negative correlation was found between self-esteem and CDLQI scores among adolescents with atopic dermatitis. Discussion: This study results have shown that self-esteem and dermatological quality of life were adversely affected in adolescents with atopic dermatitis irrespective of gender. These patients should be examined psychiatrically besides dermatological examination and treatment. We suggest that improvement will be observed in self-esteem and quality of life of adolescents with atopic dermatitis by providing the necessary psychosocial support

Live Cell Imaging of Bone Marrow Stromal Cells on Nano-pitted and Polished Titanium Surfaces: A Micro-Incubator in vitro Approach

Current orthopedic implants are not conducive for optimal integration of the biomaterial with newly-formed tissue (osseointegration) inside a patient’s body. In this study, medical-rade Ti-6Al-4V was used as a substrate due to its biocompatibility and ability to facilitate cellular adhesion and proliferation. Live cell imaging was conducted on bone marrow stromal cells, genetically modified to express the green fluorescent protein (GFP), from the 24-96 hours growth period, with the first 24 hours of growth being held inside a lab-scale incubator. Periodic images were recorded on nanopitted anodized and polished Ti-6Al-4V substrates to study how substratestiffness influences adhesion and proliferation. Collected images were analyzed for mitosis, adhesion, and filopodia-stretchability using ImageJ, an image processing program. Images were enhanced in order to perform cell counts at 24, 48, 72, and 96 hours of growth. Continuous recordings were produced to account for the number of mitosis occurrences and cellular migration on each of the substrates. Based on the conducted experiments, it appears that polished Ti-6Al-4V has a higher cell adherence than “nanopitted” anodized surface and an improved rate of proliferation which may be because the cells once adhered on the nano-pitted surface have less ability to detach in-order to undergo mitosis.https://engagedscholarship.csuohio.edu/u_poster_2014/1004/thumbnail.jp

Elderly and aged asthma have different characteristics: results of a multicenter study

Background/aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and ≥60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was ≥60 in 146 (36.6%) patients. Patients diagnosed ≥60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first-degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well-controlled asthma (odds ratio = 1.61, CI = 1.04-2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48-4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed ≥60 years of age did not have more severe disease

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Ambulans diversiyonu: Çözüm mü yoksa problem mi?

Aim: Ambulance diversion (AD) is defined as redirection of ambulance to an emergency department (ED) different from the initially intended ED with the purpose of both appropriate use of hospital sources for selected patients and relief of ED overcrowding. In the present study, the authors sought to perform a comprehensive analysis of ADs in Ankara, the capital city of Turkey. Materials and Methods: In this retrospective study, a comprehensive analysis of reasons for AD and the disposition data in the receiving hospital of patients diverted by ambulances of Ankara 112 Emergency Medical Service throughout 2014 (01 January-31 December 2014) was performed. Results: A total of 174.669 patients were transferred by ambulance to EDs and of those 1.300 ADs (0.74%) occured. The causes of AD were respectively lack of bed in intensive care unit (ICU), inpatient care ward or EDs (639 AD, 49.1%), shortage of on-call specialist doctors (242 AD, 18.6%), and insufficent radiology, laboratory equipment and other resources (174 AD, 13.3%). Conclusion: Unavailability of patient beds in EDs, ICUs or inpatient clinics are the most common causes of AD.Amaç: Ambulans diversiyonu (AD) acil servislerin (AS) aşırı yoğunluğunu hafifletmek ve hastane kaynaklarının en uygun şekilde kullanılması amacıyla ambulansla alandan nakledilen seçilmiş bazı hastaların başlangıçta götürülmesi planlanan hastane AS’den farklı bir hastanenin AS’e yeniden yönlendirilmesi olarak tanımlanır. Bu çalışmada Türkiye’nin Başkenti Ankara’da hastanelerin AS’lerinden yapılan AD’larının kapsamlı analizi yapıldı. Gereç ve Yöntem: Bu retrospektif çalışmada 1Ocak 2014-31 Aralık 2014 tarihleri arasında Ankara 112 Acil Sağlık Hizmetleri Ambulansları’yla başka hastane acil servisine yönlendirilen hastaları alan hastane sonuçları, AD nedenleri, tanı ve demografik özellikleri araştırıldı. Bulgular: Toplam 174.669 hasta ambulanslarla hastane AS’lerine nakledildi ve 1.300 (%0,74) AD’u yapıldı. Kadın hastaların sayısı 692 idi (%53,2). Başlıca hasta AD sebepleri yoğun bakımlarda, hastane servislerinde ve AS’lerinde yer olmaması (639 AD, %49,1), nöbetçi uzman doktorun olmaması (242 AD, %18,6), ve radyoloji, laboratuvar tetkikleri ve diğer kaynakların yetersizliğiydi (174 AD, %13,3). Sonuç: AS’lerde, yoğun bakımlarda ve hastane servislerinde yer olmaması AD’nun en sık nedenidir

Examination of Information and Communication Technologies Competencies of Teacher Candidates Studying at the Faculty of Sport Sciences

The aim of this study is to examine, in terms of some variables, the "Information and Communication Technology Competencies" regarding physical education teacher candidates studying in the Faculties of Sport Sciences, and to identify the problems for adapting themselves to the developing technologies and to present solutions in this age where information and communication technologies are changing rapidly, epigenetics, robots, cyborgs, nano technologies, metaverse, and virtual reality platforms are mentioned. A total of 432 male (n=206) and female (n=226) teacher candidates aged 12-18 participated in the research voluntarily. To collect data in the research, the “Information and Communication Technology Competencies Scale” which is adapted into Turkish by Gökçearslan et al. (2019) was used. Descriptive statistics were made for demographic variables in the analysis of the research data. The data acquired from the scale were analyzed using the IBM SPSS Statistics 26 program. When the scale scores were examined, there was no significant difference between male and female students in the dimension of using information and communication technologies for instructional design (p&gt;0.05) in accordance with the gender variable of physical education teachers, whereas a difference was found in favor of girls (X=3.34) in the dimension of information and communication technology competency (p&lt;0.05). Significant differences were detected between the sub-dimensions of the scale according to the teacher candidates' grades and the departments they studied (p&lt;0.05). A difference in the information and communication technologies competency dimension was found in favor of the senior year Physical Education Teaching candidates. A significant difference was found in favor of those who have a personal computer (x=3.41) in accordance with the variable of owning a personal computer in the dimension of self-efficacy to use communication technologies for instructional design (x=3.46) and Information and Communication competencies. In line with that, it can be said that the variables of having a personal computer and gender of sports teacher candidates‘ are factors that affect ICT competencies, and the variable of having a personal computer is a factor that affects the self-efficacy of using Information technologies for instructional design