(3aR,6S,7aR)-7a-Bromo-2-methyl­sulfonyl-1,2,3,6,7,7a-hexa­hydro-3a,6-ep­oxy­isoindole

In the title compound, C9H12BrNO3S, the two tetra­hydro­furan rings adopt envelope conformations, the pyrrolidine ring adopts a half-chair conformation and the six-membered ring is in a boat conformation. In the crystal, weak inter­molecular C—H⋯O hydrogen bonds link the mol­ecules into R 2 2(8) and R 2 2(14) rings along the b-axis direction

Relationship between carotid intima-media thickness and coronary angiographic findings: a prospective study

<p>Abstract</p> <p>Background</p> <p>Since cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of coronary artery disease (CAD) and is widely used in practice as an inexpensive, reliable, and reproducible method. In the current study, we aimed to investigate prospectively the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography for stable angina pectoris.</p> <p>Methods</p> <p>One hundred consecutive patients with stable angina pectoris and documented ischemia on a stress test were included in the study. The patients were divided into two groups according to the result of the coronary angiography: group 1 (39 patients) without a noncritical coronary lesion, and group 2 (61 patients) having at least one lesion more than 50% within the main branches of the coronary arteries. All of the patients underwent carotid Doppler ultrasound examination for measurement of the CIMT by a radiologist blinded to the angiographic data.</p> <p>Results</p> <p>The mean CIMT was 0.78 ± 0.21 mm in Group 1, while it was 1.48 ± 0.28 mm in Group 2 (p = 0.001). The mean CIMT in patients with single vessel disease, multi-vessel disease, and left main coronary artery disease were significantly higher compared to Group 1 (1.2 ± 0.34 mm, p = 0.02; 1.6 ± 0.32 mm, p = 0.001; and 1.8 ± 0.31 mm, p = 0.0001, respectively). Logistic regression analysis identified CIMT (OR 4.3, p < 0.001) and hypertension (OR 2.4, p = 0.04) as the most important factors for predicting CAD.</p> <p>Conclusions</p> <p>The findings of this study show that increase in CIMT is associated with the presence and extent of CAD. In conclusion, we demonstrated the usefulness of carotid intima-media thickness in predicting coronary artery disease but large-scale studies are required to define its role in clinical practice.</p

Survival results according to Oncotype Dx recurrence score in patients with hormone receptor positive HER-2 negative early-stage breast cancer: first multicenter Oncotype Dx recurrence score survival data of Turkey

BackgroundThe Oncotype Dx recurrence score (ODx-RS) guides the adjuvant chemotherapy decision-making process for patients with early-stage hormone receptor-positive, HER-2 receptor-negative breast cancer. This study aimed to evaluate survival and its correlation with ODx-RS in pT1-2, N0-N1mic patients treated with adjuvant therapy based on tumor board decisions.Patients and methodsEstrogen-positive HER-2 negative early-stage breast cancer patients (pT1-2 N0, N1mic) with known ODx-RS, operated on between 2010 and 2014, were included in this study. The primary aim was to evaluate 5-year disease-free survival (DFS) rates according to ODX-RS.ResultsA total of 203 eligible patients were included in the study, with a median age of 48 (range 26-75) and median follow-up of 84 (range 23-138) months. ROC curve analysis for all patients revealed a recurrence cut-off age of 45 years, prompting evaluation by grouping patients as ≤45 years vs. &gt;45 years. No significant difference in five-year DFS rates was observed between the endocrine-only (ET) and chemo-endocrine (CE) groups. However, among the ET group, DFS was higher in patients over 45 years compared to those aged ≤45 years. When stratifying by ODx-RS as 0-17 and ≥18, DFS was significantly higher in the former group within the ET group. However, such differences were not seen in the CE group. In the ET group, an ODx-RS ≥18 and menopausal status were identified as independent factors affecting survival, with only an ODx-RS ≥18 impacting DFS in patients aged ≤45 years. The ROC curve analysis for this subgroup found the ODx-RS cut-off to be 18.ConclusionThis first multicenter Oncotype Dx survival analysis in Turkey demonstrates the importance of Oncotype Dx recurrence score and age in determining treatment strategies for early-stage breast cancer patients. As a different aproach to the literature, our findings suggest that the addition of chemotherapy to endocrine therapy in young patients (≤45 years) with Oncotype Dx recurrence scores of ≥18 improves DFS

Conversion in Turkish : an overview

This paper presents an overview of possible cases of conversion in Turkish. I argue that apparent cases of conversion between nouns and adjectives are cases of syntactic transposition, and apparent cases of conversion between nouns/adjectives and verbs are end products of phonological changes in the history of the language, which resulted in pairs of lexemes that are formally identical synchronically, but not historically. This does not mean that no cases of morphological conversion can be traced in the language. I will present two cases of secondary word-class conversion from derived, inflected and uninflected words to toponyms which might be taken as instances of morphological conversion or derivation by zero-affixation

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Nonperfore akut apandisitte tek doz antibiyotik profilaksisi'nin yara enfeksiyonunu önlemekteki yeri

TEZ1063Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1992.Kaynakça (s. 43-45) var.45 s. : rnk. res. ; 30 cm.

Current treatment options in graves disease

Graves hastalığı diffüz guatr, tirotoksikoz, oftalmopati ve dermatopatiyle seyreden sistemik ve otoimmün bir hastalıktır. Hipertiroidizmin en sık nedenidir. Anti-Tiroid ilaç (ATİ) tedavisi, radyoaktif iyot (RAİ) ve cerrahi tedavi, Graves hastalığında kullanılan temel tedavi yöntemleridir. Tedavinin hedefi, minimal morbidite ve mortalite ile hastalık semptomlarının ve hipertiroidinin hızla kontrol altına alınması olmalıdır. Bu tanımı tek başına karşılayan ideal bir tedavi yöntemi bulunmadığı gibi, tedavi yöntemlerinin kullanımları arasında da halen ortak bir fikir birliği de sağlanamamıştır. Graves oftalmopatisi, hastalardaki morbidite ve yaşam konforundaki düşüşün en sık nedenidir. Oftalmopati yokluğunda Graves hastalarının tedavi seçenekleri arasında halen üstünlük gösteren bir tedavi modeli yoktur. Ancak graves oftalmopatili hastalar için önerilen ise total tiroid ablasyonu ve glukokortikoid tedavisidir. Graves hastalığının tedavisi cerrah, endokrinolog, nükleer tıp ve göz hastalıkları uzmanı tarafından oluşturulan multidisipliner bir ekip tarafından yapılmalıdır. Tedavide öncelikle antitiroid ilaçlar kullanılmalı, RAİ ve cerrahi tedavi hastanın özelliklerine göre seçilmelidir.Graves disease, the most common cause of hyperthyroidism, is an autoimmune and systemic disease characterized by diffusing goiter, thyrotoxicosis, ophtalmopathy and dermopathy. The treatment alternatives for Graves disease are anti-thyroid drugs, radioiodine therapy and surgery. The primary goal of the treatment is to limit hyperthyroidism and take the symptoms under control rapidly with minimum morbidity and mortality. However no ideal treatment alternative dealing with all of the the above mentioned options has been described yet. Graves ophtalmopathy is the main reason for morbidity and the decrease in quality of life. Total thyroid ablation or glucocorticoid medication is recommended for the patients with Graves ophtalmopathy, whereas, in the abscence of ophtalmopathy, no treatment option is standardized. The treatment of Graves disease should be planned by a multidisciplinary approcah including general surgeons, endocrinologists, nuclear medicine specialists and ophtalmologists. The application of anti-thyroid medications should be the first step of the treatment plan and radioiodine therapy and surgery should be selected according to the charasteristics of the patient

Evaluation of lamina cribrosa thickness in patients diagnosed with central retinal vein occlusion

Purpose To evaluate the thickness of lamina cribrosa (LC) in both eyes of patients with unilateral central retinal vein occlusion (CRVO) and to compare with eyes of age-matched healthy control subjects. Methods This prospective case-control study included a total of 38 patients with unilateral CRVO and 42 healthy control subjects. The LC thickness was measured at the center of the optic disc using an enhanced depth imaging with the spectral domain optical coherence tomography in both eyes of patients with unilateral CRVO and eyes of healthy control subjects. The LC thickness of CRVO patients was evaluated one month after dexamethasone intravitreal implant (Ozurdex) injection. Results The mean LC thickness in affected eyes of patients with CRVO was significantly thinner than that of the healthy eyes (204.4 +/- 8.8 and 228.0 +/- 7.1 mu m, p < 0.001, respectively). Also, the unaffected fellow eyes had significantly thinner LC compared with eyes of healthy subjects (205.3 +/- 9.3 and 228.0 +/- 7.1 mu m, p < 0.001, respectively). There was no statistically significant difference in the thickness of LC between the affected and unaffected fellow eyes (p = 0.669). Conclusions The LC thickness in both eyes of CRVO patients was thinner than that of the healthy eyes. This finding suggests that thin LC may contribute to the development of CRVO as an ocular risk factor in addition to systemic factors

5-bromo-10-oxa-3-thiatricyclo[5.2.1.0(1,5)]-dec-8-ene 3,3-dioxide

WOS: 000240227400274In the title compound, C8H9BrO3S, the six-membered ring has a boat conformation, the two O-containing five-membered rings have envelope conformations and the tetrahydrothiophene ring has a twist conformation. The molecules are linked only by weak van der Waals interactions