In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Using FEM and artificial networks to predict on elastic buckling load of perforated rectangular plates under linearly varying in-plane normal load

WOS: 000276433500002Elastic buckling load of perforated steel plates is typically predicted using the finite element or conjugate load/displacement methods. In this paper an artificial neural network (ANN)-based formula is presented for the prediction of the elastic buckling load of rectangular plates having a circular cutout. By using this formula, the elastic buckling load of perforated plates can be calculated easily without setting up an ANN platform. In this study, the center of a circular cutout was chosen at different locations along the longitudinal x-axis of plates subjected to linearly varying loading. The results of the finite element method (FEM) produced by the commercial software package ANSYS are used to train and test the network. The accuracy of the proposed formula based on the trained ANN model is evaluated by comparing with the results of different researchers. The results show that the presented ANN-based formula is practical in predicting the elastic buckling load of perforated plates without the need of an ANN platform

Maturation effect on strength of high-strength concretes which produced with different origin aggregates

This paper presents an application of the maturation effect on the strength of high-strength concrete which is produced with different origin aggregates. While investigating the maturation effect on HSC 384 specimens were prepared with 22 different origin aggregates. These prepared specimens were subjected to the standard compressive tests which were applied after curing for 2, 7, 28, and 56 days under appropriate conditions. The test results revealed that bright surface-low adherence behavior is valid in normal strength concretes, but is not as effective as expected in high-strength concretes. The application of artificial neural networks (ANNs) to predict 2, 7, 28, and 56 day compressive strength of HSC is also investigated in this paper. An ANN model is built, trained, and tested using the available test data gathered from experimental studies. The ANN model is found to predict 2, 7, 28, and 56 days of compressive strength of high-strength concrete well within the ranges of the input parameters considered. These comparisons show that ANNs have strong potential as a feasible tool for predicting the compressive strength of high-strength concrete within the range of the input parameters considered

ÇOcukluk ÇA���Ndaki Akut Myeloid L�Semi Tedavisinde Azalt�Lm��� Doz İDarubisin Ve Parenteral Beslenme Tedavisi

Aim: Disease free survival rate for acute myeloid leukemia (AML) is still below 50% for the last 30 years. Our objective was to compare the results of two different dosages of idarubicin (12 mg/m2 versus 8 mg/m2) therapy for newly diagnosed AML patients. Method: Sixty eight patients with AML were treated between February, 1998 and January, 2005. We designed two therapy groups comprising of 12 mg/m2/day idarubicin therapy (group I), 8 mg/m2/day idarubicin therapy and when oral nutrition is broken, we have given parenteral nutrition (group II). Overall survival (OS), event free survival (EFS), disease free survival (DFS) data were assessed and other tests were performed when needed. Result: There were 26 patients (38.2%) in group I and 42 patients (61.8%) in group II. After the first induction therapy, 20 patients (76.9%) in group I and 36 in group II (85.7%) had CR or partial remission. After two courses of induction, treatment-related mortality (TRM) was 34.6% in group I and 7.1% in group II (p: 0.006). OS of the patients in group I/II were 44/81% for 12 months, 34/54% for 24 months, 29/48% for 36 months. EFS were 43/65% for 12 months, 34/50% for 24 months, and 29/50% for 36 months. OS and DFS rates were statistically significant but EFS rates were not, in group I and II. Conclusion: The protocol with idarubicin dose of 8 mg/m2/day has less TRM in comparison to that of 12 mg/m2/day and has better OS and EFS.Amaç: Akut myeloid lösemi (AML) hastalığı için sağkalım oranı, son 30 yıldır % 50’nin hala altındadır. Amacımız, idarubicinin iki farklı dozları ile tedavi edilen (12 mg/m2 karşı 8 mg/m2) yeni tanı AML hastalarının sonuçları karşılaştırmaktır. Metod: Altmış sekiz AML hastası Şubat 1998 ve Ocak 2005 tarihleri arasında tedavi edildi. İki tedavi grubu; idarubicin tedavisi 12 mg/m2/gün (grup I), 8 mg/m2/gün ve oral beslenme bozulduğunda parenteral beslenme verilen hastalar (grup II) olarak şekillendirildi. Genel sağkalım (OS), olaysız sağkalım (EFS), hastalıksız sağkalım (DFS) verileri değerlendirildi ve diğer testler gerektiğinde yapıldı. Bulgular: Grup I’de 26 hasta (% 38.2) ve grup II’de 42 hasta (% 61.8) vardı. İlk tedavi kürü sonrası grup I’deki hastaların 20’sinde (% 76.9), grup II’deki hastaların ise 36’sında (% 85.7) tam ya da kısmi düzelme vardı. İki kür sonra, tedaviye bağlı mortalite (TRM) grup I’de % 34.6 ve grup II’de ise % 7.1 idi (p: 0.006). OS grup I/II hastalarda 12 ay, 24 ay, 36 ay için sırasıyla % 29/48, %34/54 ve % 44/81 olduğu saptandı. EFS 12 ay, 24 ay için %34/50 için 43/65 ve% 29/50% 36 ay idi. Grup I ve II için OS ve DFS oranları istatistiksel olarak anlamlı, fakat EFS oranı için anlamlı değildi. Sonuç: İdarubisinin 8 mg/m2/gün dozu verilen protokolü, 12 mg/m2/gün doz verilen protokole göre daha az tedavi ilişkili mortalite olduğu ve OS ve EFS oranlarının daha iyi olduğu saptand

Effect of aggregate mineralogical properties on high strength concrete modulus of elasticity

Aggregates mineralogical, and petrographic properties directly affect the mechanical properties of the produced high strength. This study is focused on the effects of magmatic, sedimentary, and metamorphic aggregates on the performance of high strength concrete. In this study, the effect of the mineralogical properties of aggregates on the compressive strength and modulus of elasticity of high-strength concrete was estimated by Artifical Neural Network (ANN). To estimate the compressive strength and elasticity modules, 96 test specimens were produced. After 28 days under suitable conditions, tests were carried out to determine the compressive strength and modulus of elasticity of the test specimens. This study also focused on the application of artificial neural networks (ANN) to predict the 28-day compressive strength and the modulus of elasticity of high-strength concrete. An ANN model is developed, trained, and tested by using the available test data obtained from the experimental studies. The ANN model is found to predict the modulus of elasticity, and 28 days compressive strength of high strength concrete well, within the ranges of the input parameters. These comparisons show that ANNs have a strong potential to predict the compressive strength and modulus of elasticity of high-strength concrete over the range of input parameters considered

Heart failure and priapism due to scorpion stings

Akrep sokması vakaları, özellikle Çukurova Bölgesi’nde sık karşılaşılan hasta grubundadır. Bu tür vakalarda kalp yetmezliği ve priapizm ender görülmektedir. Çalışmamızda akrep sokması sonucu kalp yetmezliği ve priapizm gelişen olgunun takip ve tedavi aşamalarını incelemeyi amaçladık.Cases of scorpion stings are common especially in patients living in the Cukurova region. Heart failure and priapism rarely occurs in these patients. The aim of the study is to review the stages of follow up and treatment of a case who develops heart failure and priapism as a result of scorpion sting

A Rare Cause Of Thrombocytopenia In Infants: Vitamin B12 Deficiency

Thrombocytopenia is the reduction of platelet number to below normal level. It may be due to the decrease in production, increase in destruction, abnormal spreading in the body or the laboratory errors. B12 deficiency is a rarely seen vitamin deficiency in childhood. It presents with megaloblastic anemia and is difficult to diagnose because of various clinical findings. Here we would like to present two cases which were hospitalized to investigate the etiology of anemia and thrombocytopenia. Cases were detected to have vitamin B12 deficiency which is rarely seen in infantile period. A 12-month old male and a 16-month old female admitted with complaints of weakness, bruise and pallor. On physical examination, there was tremor of upper extremities. Anemia, thrombocytopenia and in peripheral blood macrocytes were detected as laboratory findings. B12 vitamins were found to be low. Patients recovered clinically after parenteral vitamin B 12 administration. Laboratory findings also changed into normal

Milroy disease: Case report

Milroy hastalığı; lenfatik damarların konjenital gelişimsel anomalisine bağlı olarak ortaya çıkan ve her iki ayak sırtından başlayıp alt ekstremiteye doğru ilerleyen ödem ile karakterizedir. Yedi aylık kız hasta doğumundan itibaren her iki ayak ve bacak bölgesinde şişlik yakınması ile poli-kliniğimize getirildi. Fizik muayenesinde her iki ayak sırtı ve bacaklarda gode bırakan ödem mevcuttu. Alt ekstremite lenfosintigrafisinde enjeksiyon bölgesi proksimalinde lenfatik klerens izlenmeyen vakaya Milroy hastalığı tanısı konuldu. Doğumda alt ekstremitelerde ödemi olan vakalarda ayırıcı tanıda Milroy hastalığının düşünülmesi gerektiği vurgulandı.Milroy disease is characterized by edema that starts from the dorsum of foot and progresses to lower extremities due to a congenital anomaly of lenfatic vessels. A 7-month-old girl was brought to our outpatient clinic with complaints of bilateral swelling of the legs and feet. At physical examination edema was present on the dorsum of feet and legs. In lymphoscintigraphy lymphatic clearance was not detected in the proximal injection region and the case was diagnosed as Milroy disease. Milroy disease should be thought in the differential diagnosis of cases with edema in the lower extremities at birth

Heart failure and priapism due to scorpion stings

Akrep sokması vakaları, özellikle Çukurova Bölgesi’nde sık karşılaşılan hasta grubundadır. Bu tür vakalarda kalp yetmezliği ve priapizm ender görülmektedir. Çalışmamızda akrep sokması sonucu kalp yetmezliği ve priapizm gelişen olgunun takip ve tedavi aşamalarını incelemeyi amaçladık.Cases of scorpion stings are common especially in patients living in the Cukurova region. Heart failure and priapism rarely occurs in these patients. The aim of the study is to review the stages of follow up and treatment of a case who develops heart failure and priapism as a result of scorpion sting