Analysis of Artisanal and Small-Scale Gold Mining in Peru under Climate Impacts Using System Dynamics Modeling

In this paper, we propose a system dynamics (SD) model to examine the dynamics of an informal artisanal and small-scale gold mining (ASGM) supply chain that has interactions with the illegal gold supply chain in the Amazon rainforest region, Madre de Dios (MdD), Peru. In order to examine the system under climate impacts and validate the model, we run it under a flood scenario, which is one of the main climate impacts that causes disruption in mining activities. Our findings suggest that the dynamics of informal mines are highly affected by the illegal mercury supply, fuel supply, and availability of workers. In addition, the model under the flood scenario suggests that any external variable that could directly affect fuel and mercury supply would result in a disruption of informal and illegal gold production

Aggregometry Response to Half-dose Prasugrel in Flow-diverting Stent Implantation

Gok, Mustafa/0000-0001-7021-0984WOS: 000566420700006PubMed: 31165176Purpose the aim of this study was to determine whether half-dose loading (30/mg) of prasugrel is sufficient to achieve adequate platelet inhibition, and whether such a loading dose of prasugrel together with aspirin followed by a 10/mg/day prasugrel maintenance, could serve as a first-line antiplatelet strategy for patients undergoing flow-diverting stent (FDS) implantation. Methods Data from a group of consecutive patients treated for intracranial aneurysm with FDS were retrospectively collected. Platelet P2Y12 receptor responsiveness was assessed by a rapid platelet function test just prior to the procedure. All ischemic and hemorrhagic complications as well as morbidity and mortality rates were documented. Results A total of 138 patients with 153 aneurysms (32 were symptomatic and 121 were incidental) underwent FDS treatment in a total of 147 loading sessions. Adequate platelet inhibition was obtained in 136/138 (98.5%) patients and 145/147 (98.6%) loading sessions. Overall, there was one case of (hemorrhagic) mortality (0.7%), one of (ischemic) morbidity (0.7%), one of symptomatic (hemorrhagic) clinical complications without permanent deficits (0.7%), and six transient ischemic attacks (4.1%). the 6-month control angiography, available for all patients, revealed a 95.4% aneurysm occlusion rate. Conclusion Half-dose (30/mg) prasugrel loading results in effective platelet P2Y12 receptor inhibition in more than 98% of patients. Dual antiaggregant loading with half dose prasugrel followed by prasugrel maintenance as a first-line therapy appears to be feasible in patients treated with FDS implantation for intracranial aneurysm

Inguinoscrotal Bladder Hernia Mimicking Testicle Tumor

Bladder hernias usually begin asymptomatically and are discovered incidentally at the time of discovery. Preoperative diagnosis of bladder hernias is important to reduce the risk of bladder injury during surgery. Although F-18 FDG PET/CT is applied for oncological purposes, benign conditions should also be taken into account when evaluating the implants. In this article, a case of bladder hernia, which can be confused with pathological cancer involvement, with the diagnosis of F-18 FDG PET/CT performed in a 73-year-old male patient with renal cell carcinoma is presented

Progressive spinal epidural hemangioma in pregnancy

WOS: 000381714300020PubMed ID: 2685171

Comparison of the Efficacy of the Two Tetracycline-Containing Sequential Therapy Regimens for the Eradication of Helicobacter Pylori: 5 days Versus 14 days Amoxicillin

Aim

A Novel Integron Gene Cassette Harboring VIM-38 Metallo-beta-lactamase in a Clinical Pseudomonas aeruginosa Isolate

DUZGUN, AZER OZAD/0000-0002-6301-611X; DUZGUN, AZER OZAD/0000-0002-6301-611X; SANDALLI, Cemal/0000-0002-1298-3687WOS: 000383248900017PubMed: 27578518[No abstract available

A mass screening survey of cystic echinococcosis by ultrasonography, Western blotting, and ELISA among university students in Manisa, Turkey

WOS: 000327824800020PubMed ID: 23978681Cystic echinococcosis (CE) is one of the most important zoonotic diseases in a wide geographic area, including Turkey. In the present project, a total of 4275 students from Celal Bayar University, Manisa, Turkey, were screened by ultrasonography (US) and specific antibodies for CE were examined by Western blotting (WB) and ELISA in finger prick blood samples of 2034 of 4275 volunteered students. We aimed to report the apparent prevalence of CE based on different diagnostic procedures and to compare WB and ELISA with US in diagnosis of CE in a mass screening setting. Six new cases were diagnosed as CE by US during the survey. In addition to these cases, three students were also detected to have been previously operated and pathologically confirmed for hepatic CE. US revealed parenchymal changes in these cases in concordance with their operation history; so, the prevalence of CE by US was calculated as 0.21% (9/4275) (95%CI, 0.11-0.39%) among university students in Manisa. Bands were detected at 8, 28, 32, 38, 42, 47, 70 and 90 kDa by WB and the cases were considered to be positive for CE when at least three of the bands were seen together. Apparent prevalence of CE by ELISA and WB were found to be 2.11% (43/2034) (95%CI, 1.57-2.83%) and 0.25% (5/2034) (95%CI, 0.10-0.57%), respectively. Of the six US positive cases, WB was positive in only one case with two cysts in the liver. All of four cases with liver involvement were positive by ELISA. The high prevalence of CE among university students in Manisa indicated that CE is a major health problem in this area of Turkey. Our results supported that WB is rather difficult and not feasible as a mass screening test and may not be effective for confirmation especially in asymptomatic cases. As a result, we recommend US to be used initially in mass screening surveys for CE followed by confirmation by ELISA for suspected cases. Further examination primarily by chest X-ray followed by computed tomography and/or magnetic resonance imaging, if needed, should be recommended for US negative, ELISA and WB positive individuals who may have non-abdominal cysts. (C) 2013 Elsevier B.V. All rights reserved.Scientific Research Projects Committee of Celal Bayar UniversityCelal Bayar UniversityThe authors would like to thank all the students who participated in the study, the manager and lecturers of the faculties and schools for their support, to Enis Cezayirli for proof-reading the manuscript and particularly Kehriba Kirbas for her excellent technical laboratory assistance. We also thank Scientific Research Projects Committee of Celal Bayar University for financial support

Diagnostic value of platelet/lymphocyte ratio and neutrophil/lymphocyte ratio in investigations for helicobacter pylori gastritis

Helicobacter pylori (HP) can cause many diseases and malignant conditions. In the stomach, HP causes mucosal injury and inflammation. We determined the association of the platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) with HP-positive and HP-negative gastritis severity. We retrospectively reviewed 234 patients who had undergone upper gastrointestinal endoscopy for the investigation of dyspepsia and reflux symptoms. The patients were divided into three groups according to the results of the histopathologic evaluation: HP-negative gastritis group, HP-positive gastritis group and control group (neither HP positivity nor gastritis). We routinely collected laboratory data, including complete blood count, from all the patients. The mean neutrophil count was higher and the mean lymphocyte count was lower in the HP-positive gastritis group than in the other groups. The mean platelet count was increased in all groups, but the lowest increase was seen in the HP-positive gastritis group. Both the NLR and PLR were higher in the HP-positive gastritis group than in the other groups. This is first study to determine that the PLR is a biomarker for HP-positive gastritis. Moreover, the PLR is superior to the NLR in patients with HP-positive gastritis

clinical features

Patients with primary Sjogren's syndrome (pSS) may go undiagnosed or be misclassified due to the insidious nature and wide spectrum of the disease. The available several classification criteria emphasize glandular findings. We aimed to analyze the efficiency of various classification criteria sets in patients diagnosed on the clinical basis by expert opinion and to compare those pSS patients who fulfilled these criteria with those who did not. This is a multicenter study in which 834 patients from 22 university-based rheumatology clinics are included. Diagnosis of pSS was made on the clinical basis by the expert opinion. In this study, we only interviewed patients once and collected available data from the medical records. The European criteria, American-European Consensus Group (AECG) and American College of Rheumatology (ACR) Sjogren's criteria were applied. Majority of the patients were women (F/M was 20/1). The median duration from the first pSS-related symptom to diagnosis was significantly shorter in men (2.5 +/- 2.3 vs 4.3 +/- 5.9 years) (p = 0 < 0.016). When the European, AECG and ACR Sjogren's criteria were applied, 666 patients (79.9%) satisfied at least one of them. In total, 539 patients (64.4%) satisfied the European, 439 (52.6%) satisfied the AECG, and 359 (43%) satisfied the ACR criteria. Among the entire group, 250 patients (29.9%) satisfied all and 168 (20.1%) met none of the criteria. The rates of extraglandular organ involvements were not different between patients who met at least one of the criteria sets and those who met none. There is an urgent need for the modification of the pSS criteria sets to prevent exclusion of patients with extraglandular involvements as the dominant clinical features