A Review on Machine Learning Applications: CVI Risk Assessment

Comprehensive literature has been published on the development of digital health applications using machine learning methods in cardiovascular surgery. Many machine learning methods have been applied in clinical decision-making processes, particularly for risk estimation models. This review of the literature shares an update on machine learning applications for cardiovascular intervention (CVI) risk assessment. This study selected peer-reviewed scientific publications providing sufficient detail about machine learning methods and outcomes predicting short-term CVI risk in cardiac surgery. Thirteen articles fulfilling pre-set criteria were reviewed and tables were created presenting the relevant characteristics of the studies. The review demonstrates the usefulness of machine learning methods in high-risk CVI applications, identifies the need for improvement, and provides efficient support for future prediction models for the healthcare system

Evaluation of protein and lipid oxidative stress in the patients with postmenopausal osteoporosis

Objective: Oxidative stress may change cellular function in multiple pathological conditions, including osteoporosis. We aimed to determine malondialdehyde (MDA) levels, advanced oxidation protein pruducts (AOPP), levels end products of protein oxidation, thiol as known antioxidant, serum paraoxonase 1 (PON1) activities as known lipid antioxidant, induced by reactive oxygen species (ROS) for evaluating oxidative stress in osteoporotic patients. Methods: 59 patients diagnosed with postmenopaual osteoporosis were included in the study and compared with 21 healthy controls. Serum AOPP, MDA, thiol levels and PON1 activity were measured according to an enzymatic spectrophotometric method. Results: The serum MDA, AOPP, and thiol levels was significantly higher in the patient group than controls (p<0.05). PON1 activity was found lower in the patients group than the control group. Conclusion: Increased ROS levels in osteoporotic patients may result in a pro-oxidation environment, which in turn could result in increased MDA, AOPP. As a result, lipid peroxidation and protein oxidation may have a role in the pathogenesis of the osteoporotic patients

Retrospective radiological analysis of cemento-osseous dysplasia

Background. Osseous dysplasia (OD) is a form of fibro-osseous lesion located in the jaws that may interfere with the adjacent anatomical structures. Objectives. The aim of the present study was to evaluate the distribution of radiographic imaging features, the morphological characteristics and the lesion volume of OD with the use of cone-beam computed tomography (CBCT). Material and methods. The study included radiologically diagnosed lesions followed up for at least 1 year. The prevalence and distribution of the OD types were defined in terms of age, sex, lesion location, teeth, relationship with the anatomical structures, and lesion volume. Results. The mean age gradually increased from the periapical group to the florid group (p = 0.018). It was observed that the mandible was the most frequently affected bone (85.5%) (p < 0.05). The margins of the lesions were well defined, and had an irregular or circular shape. The buccal cortical bone was the most affected structure (84.5%), and the damage in the cortical bone increased with an increase in the lesion volume. With regard to teeth, the most frequent disorder was a discontinuous lamina dura (83.0%). Conclusions. Osseous dysplasia lesions affect a wide range of different anatomical areas, and show different volume and morphometric characteristics

Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial

Objectives: The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment. Materials and methods: A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone–beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven’s criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05). Conclusions: Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems. Clinical relevance: In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation

Single-center experience with routine clinical use of 3D technologies in surgical planning for pediatric patients with complex congenital heart disease

PURPOSEThis study was planned to assess the application of three-dimensional (3D) cardiac modeling in preoperative evaluation for complex congenital heart surgeries.METHODSFrom July 2015 to September 2019, 18 children diagnosed with complex congenital heart diseases (CHDs) were enrolled in this study (double outlet right ventricle in nine patients, complex types of transposition of the great arteries in six patients, congenitally corrected transposition of the great arteries in two patients, and univentricular heart in one patient). The patients’ age ranged from 7 months to 19 years (median age, 14 months). Before the operation, 3D patient-specific cardiac models were created based on computed tomography (CT) data. Using each patient’s data, a virtual computer model (3D mesh) and stereolithographic (SLA) file that would be printed as a 3D model were generated. These 3D cardiac models were used to gather additional data about cardiac anatomy for presurgical decision-making.RESULTSAll 18 patients successfully underwent surgeries, and there were no mortalities. The 3D patient-specific cardiac models led to a change from the initial surgical plans in 6 of 18 cases (33%), and biventricular repair was considered feasible. Moreover, the models helped to modify the planned biventricular repair in five cases, for left ventricular outflow tract obstruction removal and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defect and great vessels, and they help surgeons identify risk structures more clearly for detailed planning of surgery. There was a strong correlation between the models of the patients and the anatomy encountered during the operation.CONCLUSION3D cardiac models accurately reveal the patient’s anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy

Post-covid interstitial lung disease: how do we deal with this new entity?

Background: In the postacute phase of coronavirus disease-2019 (COVID-19), survivors may have persistent symptoms, lung function abnormalities, and sequelae lesions on thoracic computed tomography (CT). This new entity has been defined as post-COVID interstitial lung disease (ILD) or residual disease. Aims: To evaluate the characteristics, risk factors and clinical significance of post-COVID ILD. Study design: Multicenter cross-sectional analysis of data from a randomized clinical study. Methods: In this study, patients with persistent respiratory symptoms 3 months after recovery from COVID-19 were evaluated by two pulmonologists and a radiologist. post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive defect on lung function tests, and interstitial changes on follow-up high-resolution computed tomography (HRCT). Results: At the three-month follow-up, 375 patients with post-COVID-19 syndrome were evaluated, and 262 patients were found to have post-COVID ILD. The most prevalent complaints were dyspnea (n = 238, 90.8%), exercise intolerance (n = 166, 63.4%), fatigue (n = 142, 54.2%), and cough (n = 136, 52%). The mean Medical Research Council dyspnea score was 2.1 ± 0.9, oxygen saturation was 92.2 ± 5.9%, and 6-minute walking distance was 360 ± 140 meters. The mean diffusing capacity of the lung for carbon monoxide was 58 ± 21, and the forced vital capacity was 70% ± 19%. Ground glass opacities and fibrotic bands were the most common findings on thoracic HRCT. Fibrosis-like lesions such as interlobular septal thickening and traction bronchiectasis were observed in 38.3% and 27.9% of the patients, respectively. No honeycomb cysts were observed. Active smoking [odds ratio (OR), 1.96; 95% confidence interval (CI), 1.44-2.67), intensive care unit admission during the acute phase (OR, 1.46; 95% CI, 1.1-1.95), need for high-flow nasal oxygen (OR, 1.55; 95% CI, 1.42-1.9) or non-invasive ventilation (OR, 1.31; 95% CI, 0.8-2.07), and elevated serum lactate dehydrogenase levels (OR, 1.23; 95% CI 1.18-1.28) were associated with the development of post-COVID ILD. At the 6-month follow-up, the respiratory symptoms and pulmonary functions had improved spontaneously without any specific treatment in 35 patients (13.4%). The radiological interstitial lesions had spontaneously regressed in 54 patients (20.6%). Conclusion: The co-existence of respiratory symptoms, radiological parenchymal lesions, and pulmonary functional abnormalities which suggest a restrictive ventilatory defect should be defined as post-COVID-19 ILD. However, the term “fibrosis” should be used carefully. Active smoking, severe COVID-19, and elevated lactate dehydrogenase level are the main risk factors of this condition. These post-COVID functional and radiological changes could disappear over time in 20% of the patients

SYNTHESIS OF AZO DYES PREPARED FROM SOME 2- AMINOTHIOPHENE DERIVATIVES WITH CARBOCYCLIC AND HETEROCYCLIC AMINES AND INVESTIGATION OF THEIR SPECTROSCOPIC PROPERTIES

Bu çalışmada etil 2-amino-4-feniltiyofen karboksilat türevleri kenetlenme bileşeni olarak kullanılarak, çeşitli sübstitüe karbosiklik ve heterosiklik aminlerin diazonyum tuzları ile kenetlendi ve dört seri azo boyarmadde sentezlendi. Bu bileşiklerin yapıları FT-IR, 1H-NMR ve kütle spektrometresi ile aydınlatıldı. Bileşiklerin DMSO, metanol, asetik asit ve kloroform içindeki absorpsiyon spektrumları incelendi. Ayrıca bu boyarmaddelerin rengi üzerine çözücü, sübstitüent ve asit-baz etkisi ayrıntılı olarak incelendi. Karbosiklik aminlerden sentezlenen bileşiklerin absorpsiyon maksimumları ile Hammett sübstitüent sabitleri arasında doğrusal bir ilişki olduğu gözlendi. Ayrıca sübstitüent etkilerinin çözücüden çok fazla etkilenmediği belirlendi.In this study, Four series of azo dyes were synthesized by using some ethyl 2- amino-phenylthiophene carboxylate derivatives as coupling components and coupling them with diazonium salts of various substituted carbocyclic and heterocyclic amines. The structures of the compounds were evaluated by using FT-IR, 1H-NMR and mass spectroscopic techniques. The absorption spectra of these compounds in DMSO, methanol, acetic acid and chloroform were investigated. The solvent, substituent and acid-base effects on the absorption spectra of the dyes were also examined in detail. A linear correlation was observed between the Hammett substituent constants and the absorption maxima of the dyes which are synthesized from carbocyclic amines. It was also determined that substituent effect was not affected by the solvent

Doğumsal kalp hastalıklarının tamiri için akışkanlar dinamiği hesaplamaları ile ameliyat öncesi planlama

The treatment of complex congenital heart diseases (CHD) requires a careful patient-specific approach and surgical correction plan. In this thesis, a large radiological database was created to provide supportive information for the treatment planning of patients undergoing aortic hypoplasia, pulmonary stenosis, ventricular septal defect (VSD) and Fontan procedure. State-of-the-art repair alternatives using customized baffle and patch designs were virtually generated in the computer through image-based three-dimensional (3D) modeling, and their structural and hemodynamic analysis are evaluated. In aortic repair section, different virtual repair methods were performed for each selected hypopilastic aortic arch models. Blood flow analyzes were compared in preoperative, postoperative and virtual repair models. The methods were examined by computational fluid dynamics analysis in terms of velocity, wall shear stress and pressure distributions. In the pulmonary artery stenosis section, the deformation of the patch material was evaluated by computational structural analysis. In Fontan cases, the aim was to determine the geometry giving the optimum flow distribution from hepatic veins to the lungs. In VSD cases, virtual models obtained after segmentation provided information that could not be obtained from the image data to facilitate the decision whether the obtimum treatment by catheter intervention or surgery. It has been observed that the findings obtained by 3D modeling, virtual repair and numerical analysis can make significant contributions to the process of determining the repair method. Overall this dissertation aims to provide solution-oriented information to planning procedures in CHD treatment and to present more objective, case-specific and reproducible planning options with computerized modeling and numerical simulation techniques in the light of concrete data.Kompleks doğumsal kalp hastalıklarının (CHD) tedavisi hastaya özel dikkatli bir yaklaşım ve onarım planı gerektirir. Bu tez çalışmasında, geniş bir radyolojik veri tabanı oluşturulmuş; aort hipoplazisi, pulmoner darlık, ventrikül septal defekt (VSD) ve Fontan prosedürü uygulanan hastaların tedavi planlamasına mühendislik yaklaşımlarıyla destekleyen yardımcı bilgi sağlamak amaçlı bir yöntem geliştirilmiştir. Görüntü tabanlı üç boyutlu (3B) modelleme, yapıya özel şant ve yama tasarımı, hızlı prototipleme, bilgisayarlı yapısal ve hemodinamik analiz yardımı ile çeşitli sanal tamir yöntemleri ile oluşturulan modeller sonlu eleman analizleri sonrasında karşılaştırılmıştır. Seçilen aort hipopilazisi vakalarının her biri için birbirinden farklı sanal tamirler uygulanarak; kan akışı analizleri ameliyat öncesi, sonrası ve sanal tamir modellerinde karşılaştırılmıştır. Hastaya özel damar geometrisine uygun tamir yöntemi hız, kayma gerilimi ve basınç dağılımları açısından hesaplamalı akışkanlar dinamiği analizi ile irdelenmiştir. Pulmoner arter darlığı bölümünde hastaya özel yamanın deformasyonu da hesaplamalı yapısal analiz ile değerlendirilerek elde edilen modellerde akış simülasyonları yapılmıştır. Fontan vakalarında hasta için ortalama on farklı sanal şant konfigürasyonu oluşturlarak hesaplamalı akış görelleştirmeleri ile optimum akış dağılımını veren geometrinin belirlenmesi amaçlanmıştır. VSD vakalarında segmentasyon sonrası elde edilen sanal modeller ile görüntü verisinden sağlanamayan enformasyon sağlanabilmiş ve tedavinin kateter girişimi ile ya da cerrahi olarak çözümlenmesi kararını kolaylaştıracak bulgular elde edilmiştir. Üç boyutlu modelleme, sanal tamir ve sonlu eleman analizi ile elde edilen bulguların CHD tedavisini belirleme sürecine anlamlı katkılar sağlayabildiği birbirinden farklı hastalıklarda ve farklı damarlarda örnekler ile gözlemlenmiştir. Bu tez, CHD tedavisinde planlama prosedürlerine çözüm odaklı bilgi sağlamayı, bilgisayarlı modelleme ve nümerik simülasyon teknikleriyle daha objektif, vakaya özel ve tekrarlanabilir planlama seçeneklerini somut veriler eşliğinde sunmayı amaçlamaktadır

TBMM'deki cenaze töreninde ilk kez sloganlar atıldı:Meclis'te tarihi protesto

Taha Toros Arşivi, Dosya No: 161/A-Ahmet Taner KışlalıUnutma İstanbul projesi İstanbul Kalkınma Ajansı'nın 2016 yılı "Yenilikçi ve Yaratıcı İstanbul Mali Destek Programı" kapsamında desteklenmiştir. Proje No: TR10/16/YNY/010