Apgar alternatifi olarak doğum öncesi sınıflandırma yaklaşımları

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Hızlı ve etkin bir yöntem olan apgar skorlaması yeni doğan bebeklerin sağlıklı olup olmadığının anlaşılması için kullanılır. Bebeğe herhangi bir müdahalenin (resusitasyon veya entübasyon) yapılıp yapılmayacağına apgar skorlaması ve çeşitli fizyolojik verilerin incelenmesi sonucunda karar verilmektedir. Müdahale süresinin kısalması bebek için hayati önem taşımaktadır. Bu çalışmada, anne ve fetüsten alınan fizyolojik veriler ile FHR (fetal kalp atım hızı) ve UC (rahim kasılması) sinyallerinden çıkartılan öznitelikler, yeni doğan bebeğe bir müdahale gerekip gerekmeyeceğinin doğumdan önce belirlenmesi için incelenmiş ve apgar skorlamasına yönelik çalışma yapılmıştır. Çalışmada müdahale gerekir ve müdahale gerekmez şeklinde iki sınıf kullanılmıştır. Veriler Mann-Whitney U testi kullanılarak analiz edilmiştir. Bu sınıflar istatistiksel veriler, FHR ve UC sinyalleri açısından karşılaştırılmış, elde edilen sonuçlara göre k en yakın komşu sınıflandırma algoritması kullanılarak bebekler müdahale gerekir ve müdahale gerekmez sınıflarına ayrılmıştır.Apgar scoring is a method which is a fast and a effective way of understanding whether newborn babies are healthy or not. Any intervention to the baby such as resuscitation or intubation is done, if necessary, after evaluating the Apgar score and examining various physiological data. Shortening the response time for medical support is vitally important for babies. In this study, the physiological data gathered from mother and fetus along with the features extracted from FHR (fetal heart rate) and UC (uterus contraction) signals were examined in order to determine whether the newborn will have any immediate problems that will need medical support before the baby was actually born and a study towards Apgar scoring was made. There were two classes (intervention, non-intervention) used in this study. Data was analyzed by using Mann-Whitney U test. The classes were compared in terms of statistical data, FHR and UC signals and according to the obtained the results, intervention and non-intervention classes have been devoted using k nearest neighbor classification algorithm

TranSMS: Transformers for Super-Resolution Calibration in Magnetic Particle Imaging

Magnetic particle imaging (MPI) offers exceptional contrast for magnetic nanoparticles (MNP) at high spatio-temporal resolution. A common procedure in MPI starts with a calibration scan to measure the system matrix (SM), which is then used to set up an inverse problem to reconstruct images of the MNP distribution during subsequent scans. This calibration enables the reconstruction to sensitively account for various system imperfections. Yet time-consuming SM measurements have to be repeated under notable changes in system properties. Here, we introduce a novel deep learning approach for accelerated MPI calibration based on Transformers for SM super-resolution (TranSMS). Low-resolution SM measurements are performed using large MNP samples for improved signal-to-noise ratio efficiency, and the high-resolution SM is super-resolved via model-based deep learning. TranSMS leverages a vision transformer module to capture contextual relationships in low-resolution input images, a dense convolutional module for localizing high-resolution image features, and a data-consistency module to ensure measurement fidelity. Demonstrations on simulated and experimental data indicate that TranSMS significantly improves SM recovery and MPI reconstruction for up to 64-fold acceleration in two-dimensional imaging

DEQ-MPI: A Deep Equilibrium Reconstruction with Learned Consistency for Magnetic Particle Imaging

Magnetic particle imaging (MPI) offers unparalleled contrast and resolution for tracing magnetic nanoparticles. A common imaging procedure calibrates a system matrix (SM) that is used to reconstruct data from subsequent scans. The ill-posed reconstruction problem can be solved by simultaneously enforcing data consistency based on the SM and regularizing the solution based on an image prior. Traditional hand-crafted priors cannot capture the complex attributes of MPI images, whereas recent MPI methods based on learned priors can suffer from extensive inference times or limited generalization performance. Here, we introduce a novel physics-driven method for MPI reconstruction based on a deep equilibrium model with learned data consistency (DEQ-MPI). DEQ-MPI reconstructs images by augmenting neural networks into an iterative optimization, as inspired by unrolling methods in deep learning. Yet, conventional unrolling methods are computationally restricted to few iterations resulting in non-convergent solutions, and they use hand-crafted consistency measures that can yield suboptimal capture of the data distribution. DEQ-MPI instead trains an implicit mapping to maximize the quality of a convergent solution, and it incorporates a learned consistency measure to better account for the data distribution. Demonstrations on simulated and experimental data indicate that DEQ-MPI achieves superior image quality and competitive inference time to state-of-the-art MPI reconstruction methods

Electromechanical delay detected by tissue Doppler echocardiography is associated with the frequency of attacks in patients with lone atrial fibrillation

Background: Our main purpose in this study is to compare atrial (inter-atrial, intra-leftatrial, intra-right atrial) electromechanical delays of patients with lone atrial fibrillation (LAF) with healthy individuals and examine the relationship of annual LAF attack frequency.Methods: 32 entirely healthy individuals and 32 patients who have presented with tachycardia and complying with LAF criteria have been included in the study. The time passing from the beginning of the P wave on electrocardiography to the A’ wave on tissue Doppler trace was accepted as the atrial conduction time (PA’). The PA’ time difference between the mitral annulus of left ventricle (ML) and the tricuspid annulus of right ventricle (TL) was defined as inter-atrial electromechanical delay (IA-EMD), the PA’ time difference between the ML and septal mitral annulus (MS) as intra-left electromechanical delay (ILeft-EMD), the PA’ time difference between MS and the TL as intra-right electromechanical delay (IRight-EMD).Results: ILeft-EMD (21.8 ± 9.1 vs. 14.1 ± 4.9, p < 0.001), IRight-EMD (9.3 ± 6.8 vs. 5.9 ± 4.9, p = 0.03) and IA-EMD times (24.7 ± 11.2 vs. 11.9 ± 7.1, p < 0.001) were significantly longer in LAF patients. In multivariate regression analysis, using a model including age, gender and left atrium (LA) volumes, ILeft-EMD times (OR 1.14, 95% CI 1.03–1.27,p = 0.012), IA-EMD times (OR 1.12, 95% CI 1.03–1.23, p = 0.007) and LA volumes (OR 1.18, 95% CI 1.05–1.32, p = 0.005) were independent predictors of LAF. In LAF group, the frequency of AF episodes was significantly correlated with ILeft-EMD (r = 0.90, p < 0.001) and IA-EMD times (r = 0.36, p < 0.004), whereas, IRight-EMD times and LA volumes were not correlated with recurrence rates.Conclusions: ILeft-EMD and IA-EMD may increase in the early stages of atrial fibrillation even without the left atrial dilation and may be more valuable than left atrial area and volume in predicting atrial fibrillation

Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention

Background: Concomitant thyroid and heart disease are frequently encountered in clinical practice. There are many studies evaluating thyroid function in acute and critical conditions. Information on thyroid dysfunction in ST-segment elevation myocardial infarction (STEMI) is limited; its correlation with short and long-term outcome is not fully known.Methods: Four hundred and fifty seven patients diagnosed with STEMI in our emergency department were included in the study. Patients were divided into two groups: patients with normal thyroid function (euthyroid) and patients with thyroid dysfunction. STEMI was diagnosed with 12 derivation surface electrocardiogram. Thyroid hormone levels (TSH, free T3 and free T4) were measured. Patients with other acute coronary syndromes and endocrine pathologies except diabetes mellitus were excluded. Two patient groups were compared in terms of in-hospital and long-term outcome.Results: Out of 457, 72 (15%) patients with thyroid dysfunction were detected. The other patients were euthyroid and constituted the control group. In-hospital cardiogenic shock (15% vs. 3% in the control group; p < 0.01) and death (7% vs. 1% in the control group; p < 0.01) were more frequently observed in the thyroid dysfunction group. In the subgroup analysis, it was observed that patients with sick euthyroid syndrome have the poorest outcome. Other markers for poor outcome were anemia and renal failure.Conclusions: Thyroid dysfunction, particularly sick euthyroid syndrome, was found to be related to in-hospital and long term mortality in patients with STEMI undergoing primary percutaneous intervention

Kapsaisin Katkılı Tris Sulandırıcı Kullanılarak Koç Spermasının Dondurularak Saklanması

In this study, it was designed to reveal the effects of capsaicin on oxidative stress and freezability of ram semen. Ejaculates were taken from Sönmez rams and divided into five specimens and diluted with extender at different rates (4 mM, 2 mM, 1 mM, 500 μM) with and without capsaicin (control; C). Semen samples were thawed with a 37°C water bath for 30 seconds for post-thawed analysis. At the end of the study, sperm motility and kinetic parameters, plasma membrane acrosome integrity (PMAI), mitochondrial membrane potential (MMP), DNA damage, oxidant and antioxidant parameters were analyzed. A decrease was observed in the groups containing capsaicin compared to the C in terms of progressive, total motility and kinetic parameters (p<0.05). Besides, positive results were not obtained DNA integrity, PMAI and MMP (p<0.05). In conclusion; it was determined that capsaicin added to Tris extender did not have a positive effect on oxidative stress and freezing of ram semen.Bu çalışmada, kapsaisinin oksidatif stres ve koç spermasının dondurulabilirliği üzerine etkilerinin ortaya konması tasarlandı. Ejakülatlar Sönmez ırkı koçlardan alınarak beş eşit kısma ayrıldı ve farklı oranlarda (4 mM, 2 mM, 1 mM, 500 μM) kapsaisin içeren ve içermeyen (kontrol) sulandırıcı ile sulandırıldı. Sperma örnekleri çözüm sonu spermatolojik analizler için 37°C sıcaklıklta 30 saniye süre ile çözdürüldü. Çalışma sonunda spermatozoa hareketliliği ve kinetik parametreleri, plazma membran akrozom bütünlüğü (PMAI), mitokondrial membran potansiyeli (MMP), DNA hasarı, oksidan ve antioksidan parametreler analiz edildi. Progresif, total motilite ve kinetik parametreler bakımından kontrol grubuna göre kapsaisin içeren guruplarda azalma görüldü (p<0.05). Ayrıca DNA bütünlüğü, PMAI ve MMP'de olumlu sonuçlar elde edilmedi (p<0.05). Sonuç olarak; Tris sulandırıcısına ilave edilen kapsaisinin, oksidatif stres ve koç spermasının dondurulması üzerine olumlu bir etki göstermediği belirlendi

Increased level of resistin predicts development of atrial fibrillation

AbstractBackgroundResistin is a peptide hormone that is secreted from lipid cells and is linked to type-2 diabetes, obesity, and inflammation. Being an important adipocytokine, resistin was proven to play an important role in cardiovascular disease. We compared resistin levels in patients with and without atrial fibrillation (AF) to demonstrate the relationship between plasma resistin levels and AF.MethodOne hundred patients with AF and 58 control patients who were matched in terms of age, gender, and risk factors were included in the trial. Their clinical risk factors, biometric measurements, echocardiographic work up, biochemical parameters including resistin and high-sensitivity C-reactive protein (hs-CRP) levels were compared.ResultsIn patients with AF, plasma resistin levels (7.34±1.63ng/mL vs 6.67±1.14ng/mL; p=0.003) and hs-CRP levels (3.01±1.54mg/L vs 2.16±1.28mg/L; p=0.001) were higher than control group. In subgroup analysis, resistin levels were significantly higher in patients with paroxysmal (7.59±1.57ng/mL; p=0.032) and persistent AF (7.73±1.60ng/mL; p=0.006), but not in patients with permanent AF subgroups (6.86±1.61ng/mL; p=0.92) compared to controls. However, hs-CRP levels were significantly higher only in permanent AF patients compared to control group (3.26±1.46mg/L vs 2.16±1.28mg/L; p=0.02). In multivariate regression analysis using model adjusted for age, gender, body mas index, hypertension, diabetes mellitus, and creatinine levels, plasma resistin levels [odds ratio (OR): 1.30; 95% confidence interval (CI): 1.01–1.70; p=0.04] and hs-CRP levels (OR: 1.44; 95% CI: 1.12–1.86; p=0.004) were the only independent predictors of AF.ConclusionThe elevated levels of plasma resistin were related to paroxysmal AF group and persistent AF group, but not to permanent AF group

Evaluation of the rate of thrombocytosis in lower respiratory tract and upper urinary system ınfections

Alt solunum yolu enfeksiyonları ve üst üriner sistem enfeksiyonlarında trombositoz oranlarının çıkarılması ve degerlendirilmesi amaçlanmıstır. Bu çalısmada “GATAHaydarpasa Egitim Hastanesi Çocuk Klinigi'nde” 1 Ocak 2006- 1 Ocak 2009 yılları arasında yatırılarak tedavi verilen 20 alt solunum yolu enfeksiyonu (ASYE) ve 22 üst üriner sistem enfeksiyonu (ÜÜSE) tanısı alan hastanın dosyaları retrospektif olarak incelendi. Reaktif trombositoz, genel olarak kabul gören trombosit sayısının 500.000/mm üzeri olması kabul edildi. Istatistiksel veriler SPSS 13.0 ile degerlendirildi. Çalısmamızda trombositoz tanı anında üst üriner sistem enfeksiyonlarında daha fazla bulundu (ASYE %25, ÜÜSE %36). Üst üriner sistem enfeksiyonlarında en sık üreyen mikroorganizma Escherichia coli (n:12 %54) olarak tespit edildi. Çalısmamızda, alt solunum yolu enfeksiyonu ve üst üriner sistem enfeksiyonunda tanı anında görülen reaktif trombositoz ile hastalık siddeti karsılastırılmıs, arasında istatistiksel olarak anlamlı bir iliski bulunamamıstır.To evaluate the rates of thrombocytosis in lower respiratory tract (LRTI) and upper urinary system infections (UUSI). In this study, rates of thrombocytosis were evaluated in patients hospitalized and treated with the diagnosis of LRTI (n=20) or UUSI (n=22) in “GATA Haydarpasa Teaching Hospital, Department of Pediatrics” between 2006-2009, retrospectively. Reactive thrombocytosis is defined as the platelet count over 500.000/mm . Statistical analysis was performed by SPSS forWindows version 13.0. p'0.05 was accepted as statistically significant. Thrombocytosis was found to be higher in the UUSI (%36) at the time of the diagnosis compared to the LRTI group (25%). The most common microorganism identified in the UUSI was Escherichia coli (n=12, 54%). There was no significant relationship between the reactive thrombocytosis observed at the time of the diagnosis and the severity of the disease in theLRTI and the UUSI

The association between TAPSE and right atrial contractile strain

BACKGROUND: In the descending arm of tricuspid annular plane systolic excursion (TAPSE) there is a notch formation which corresponds to the contractile phase of the atrial strain curve. Theoretically, this notch formation stands for atrial contraction. AIMS: We aim to characterize the notch formation on the TAPSE, the predictors of its existence, its relationship with the right ventricle and right atrial strain (RAS) parameters. METHODS: Retrospectively selected 240 patients were investigated for the determinants of the notch formation on TAPSE and the relation between RAS and TAPSE. RAS was analyzed using 2D speckle tracking in a dedicated mode for atrial analysis and reported separately for the reservoir, conduit, and contractile phases. RESULTS: 71.7% (n = 172) of patients had the notch formation on the TAPSE and 70.4% (n = 169) had a normal value of right atrial contractile strain (RASct). Most of the patients with a notch formation also had preserved RASct (95.9%; P &lt;0.001). In multivariable analysis, RASct (odds ratio [OR], 1.45; 95% confidence interval [CI]: 1.13­­‒1.77; P = 0.020) remained significant with the notch formation. Receiver operator characteristic (ROC) analysis demonstrated that a RASct of ‒19% was found as a cut-off for presence of notch formation. ROC area was 0.897 (95% CI 0.844–0.951; P &lt;0.001). CONCLUSIONS: The changes in TAPSE configuration represents the changes in atrial contractile phase. The descending arm of the TAPSE indicates the RASct as whether it is preserved or not. The notch formation persists if the RASct is above ‒19%. So, an easier, more applicable, and more effortless tool TAPSE can be used as an indicator of atrial contractile phase by its configuration in daily routine

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF