Transkraniyal magnetik stimulasyon fibromiyalji hastalarında ek bir tedavi yöntemi mi?

WOS: 000343521400006Objective: To investigate the effectiveness of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) to the motor cortex area in fibromyalgia patients who are resistant to medical treatment. Material and Methods: A total of 25 patients were randomly assigned to the study, who were in the active rTMS (n=13) or sham stimulation (n=12) group. For the rTMS group, the main stimulation parameters were 90% of motor threshold for 60 seconds at 1 Hz and a 45-second interval between each train. Ten sessions of low-frequency rTMS, which had a total of 1200 pulses at each session, were applied to the left primary motor cortex area daily over a period of 2 weeks. For the sham group, the same parabolic coil was placed at 90 degrees angles to the motor cortex area, and the patients received 10 sessions of sham stimulation. The outcome parameters were pain intensity, which was measured by visual analog scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), and the Beck Depression Inventory (BDI). Results: A significant improvement in pain intensity, FIQ, and BDI scores was seen at the 10th day and first and third months in both groups. Although the mean of parameters of the rTMS groups was better than the sham group, the difference did not reach statistical significance, except FIQ scores at the 10th day in the real rTMS group. Conclusion: Patients with fibromyalgia who enroll in real TMS did not present significant differences in long-term follow-ups with respect to those who enrolled in the sham TMS group.Amaç: Medikal tedaviye dirençli fibromiyalji hastalarında motor korteks alana uygulanan düşük frekanslı tekrarlayıcı transkraniyal manyetik stimülasyonun (tTMS) etkinliğini araştırmak. Gereç ve Yöntemler: Toplam 25 hasta randomize olarak aktif ve plasebo gruplarına ayrılarak çalışmaya alındı. Aktif tTMS grubu için stimülasyon sol primer motor korteks üzerinden motor eşik değerin %90’ı hesaplanarak 1 Hz ve 20 dakika uygulandı. Her seansta 1200 uyarı olmak üzere, iki hafta boyunca toplam 10 seans tedavi uygulandı. Plasebo grup için, parabolik koil 90° açı ile motor kortekse yerleştirildi ve aynı şekilde toplam 10 seans stimülasyon uygulandı. Sonuçlar, ağrı için vizüel analog skalası (VAS), Fibromiyalji Etkinlik Anketi (FIQ) ve Beck Depresyon Skalası (BDS) ile değerlendirildi. Bulgular: Her iki grupta da tedavi sonunda, 1 ve 3. ay sonunda ağrı derecesinde, FIQ ve BDS’de anlamlı iyileşme gözlendi. Ancak, aktif tTMS grubunda iyileşme plasebo gruba göre daha iyiydi. Tedavi sonu FIQ skorlarında aktif grupta, plasebo gruba göre istatistiksel olarak anlamlı iyileşme gözlendi. Diğer değerlendirmelerde gruplar arasında istatistiksel farklılık saptanmadı. Sonuç: Primer motor korteks üzerine düşük doz tTMS uygulamasının uzun süreli takiplerde fibromiyalji hastalarında plaseboya göre anlamlı iyileşme göstermediği görülmüştü

Multiproduct biorefinery from defatted olive mill waste: preparation of hemicellulose-based biodegradable films and instant controlled pressure drop (DIC)-assisted isolation of value-added products

The olive oil extraction industry generates huge amounts of olive mill waste (OMW) which is an excellent source of several biocompounds. The aim of this study is to investigate the viability of a multiproduct biorefinery approach to valorize OMW as a source of hemicelluloses for the production of biodegradable films and extraction of other valuable compounds by taking advantage of the instant controlled pressure drop (DIC) technique. Glycerol, sorbitol, and xylitol at a concentration of 30% (w/w) were found as suitable plasticizers for biodegradable film preparation. Films with glycerol showed the lowest solubility in water (73.25 ± 0.83%) and the lowest biodegradability in soil, while showing the highest water vapor permeability (1.82 ± 0.1 g mm m−2 h−1 kPa−1), and lowest solubility in different media at pH of 3–12. Xylitol-plasticized films exhibited the highest tensile strain (10.17 ± 0.85 MPa) which is 43% higher than that of unplasticized film. Overall, the glycerol-plasticized films showed a potential for food packaging applications where low solubility and high water vapor permeability are required. Xylitol-plasticized films could be advantageous where higher solubility and mechanical strength are expected. DIC pretreatment performed at 5 bar steam pressure for 10 min resulted in a destructured OMW with lower crystallinity providing higher extraction yields of value-added products. An increase of 37.5% in total phenolics content and 22.1% in hemicellulose extraction yield were obtained after DIC pretreatment, respectively. In addition, app. 3-fold antioxidant activity and 2.2-fold reducing sugar concentration were reached, as compared to unpretreated OMW

Clinical Features of 294 Turkish Patients with Chronic Myeloproliferative Neoplasms

Objective: Myeloproliferative neoplasms (MPNs) share common clonal stem cells but show significant differences in their clinical courses. The aim of this retrospective study was to evaluate thrombotic and hemorrhagic complications, JAK2 status, gastrointestinal and cardiac changes, treatment modalities, and survival in MPNs in Turkish patients. Materials and Methods: Medical files of 294 patients [112 essential thrombocythemia (ET), 117 polycythemia vera (PV), 46 primary myelofibrosis, and 19 unclassified MPN cases] from 2 different universities in Turkey were examined. Results: Older age, higher leukocyte count at diagnosis, and JAK2 mutation positivity were risk factors for thrombosis. Platelet count over 1000x109/L was a risk factor for hemorrhagic episodes. Hydroxyurea treatment was not related to leukemic transformation. Median follow-up time was 50 months (quartiles: 22.2-81.75) in these patients. Patients with primary myelofibrosis had the shortest survival of 137 months when compared with 179 months for ET and 231 months for PV. Leukemic transformation, thromboembolic events, age over 60 years, and anemia were found to be the factors affecting survival. Conclusion: Thromboembolic complications are the most important preventable risk factors for morbidity and mortality in MPNs. Drug management in MPNs is done according to hemoglobin and platelet counts. Based on the current study population our results support the idea that leukocytosis and JAK2 positivity are more important risk factors for thrombosis than hemoglobin and platelet values

Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality