The frequency and costs of intravitreal therapy agents in retinal diseases

Background: The aim of this study is to analyze the numbers and the economic burden of intravitreal anti-VEGF agents and intravitreal dexamethasone (IVD) implants administered to patients with diabetic retinopathy (DR), age-related macular degeneration (AMD) and retinal vein occlusion (RVO). Material and methods: The retrospective case-control study included 1525 patients diagnosed with DME, neovascular AMD and RVO, and received intravitreal anti-VEGF and IVD between January 2016 and December 2018. Intravitreal anti-VEGF administration was performed within the framework of the Pro Re Nata (PRN) regimen. The prices of anti-VEGF agents and IVDs were calculated on the average of the prices in the relevant year. Results: The total number of intravitreal injections in 3 years was 5864. During the 3-year follow-up, on average,ranibizumab (Lucentis) was applied 3.56 ± 2.25 times, alfibercept (Eylea) was applied 3.31 ± 2.16 times, and IVD(Ozurdex) was applied 1.70 ± 0.83 times. The anti-VEGF numbers in 2016, 2017 and 2018 were 1997, 1801, 2066,respectively. In total, the 3-year drug cost was 3,587,812.44 USD. Conclusions: The economic burden of intravitreal anti-VEGF and IVD treatment for retinal diseases is so important to developing countries such as Turkey. The economic burden created by anti-VEGF agents and IVDs in Turkey will reduce in a serious sense, and the legal concerns of physicians will decrease thanks to the decision taken by the Turkish Medicines and Medical Devices Agency (TMMDA)

The frequency of refractive errors required to be corrected in childhood among Turkish children

Background: The aim of this study is to investigate the distribution of refractive errors needed to be correct in childhood. Material and methods: Children applied and received glasses prescriptions were recruited. Age, gender, spherical, cylindrical error, and spherical equivalent (SE) were noted. The refractive errors were classified as myopic, hyperopic and cylindrical errors according to the SE and prescriptions. Cylindrical errors were subdivided into myopic, hyperopic. Children were classified into 4 groups. Group 1, 2, 3 and 4 composed of children whose ages were between 0–5, 6–10, 11–15 and 16–18 years, respectively. Results: There were 846 children in group 1, 3931 in group 2, 5948 in group 3, 3896 in group 4, and a total of 14621 children. The rates of myopia and hyperopia were 72.4% and 27.6%. Myopic and hyperopic astigmatism were found in 29.1% and 11.3% of children. Myopia, myopic astigmatism increased with age (p < 0.05). The hyperopia rate decreased with decreasing age (p < 0.05). The frequency of myopia, myopic astigmatism was higher in both male and female children (p < 0.05). The rate of myopia was higher in females (p < 0.05). There was no statistically significant difference in terms of cylindrical value between genders. The statistically significant difference was found in terms of mean SE among all groups and a negative correlation was present between age and mean SE. A lower negative correlation was stated between age and cylindrical value. Conclusion: Corrected myopic and myopic astigmatism errors were higher than hyperopic refractive errors. The prevalence of myopia increased by age and was higher in females. The need for glasses was highest in children whose age range was between 11 and 15 years

Determination of fuel properties of wood pellet’s made from poplar wood resudies

Günümüzde iklim değişikliği küresel ölçekte ciddi bir tehdit olarak karşımıza çıkmaktadır. Fosil yakıtların kullanımı sera gazı salınımlarını arttırmakta, bu da küresel ısınmaya neden olmaktadır. Her geçen gün enerjiye olan talebin artmasına karşın; fosil yakıt rezervlerinin hızla tükenmesi, fosil yakıtlar bakımından dışarıya bağımlı olmamız ve döviz kurlarındaki ani değişiklikler, fosil yakıtların çevresel olarak ciddi hasarlara sebep olması yenilenebilir enerji kaynaklarına olan ihtiyacı daha da önemli kılmaktadır. Orman atıkları, zirai atıklar ve bunun yanı sıra ülkemiz şartlarında kolaylıkla yetiştirilebilen ve hızlı büyüyen türlerden olan kavak odun artıklarının biyoyakıt olarak kullanılması büyük öneme sahiptir. Bu çalışmada; Bayburt yöresinden temin edilen karakavak (Populus nigra) atıkları KTÜ Orman Endüstri Mühendisliği pilot tesislerinde yongalanarak uygun boyuta getirildikten sonra, Karadeniz Tarımsal Araştırma Enstitüsü Müdürlüğü (KTAEM) biyokütle ünitesinde pelet üretimi gerçekleştirilmiştir. Üretilen peletlerin; ısıl değer, kül içeriği, nem oranının belirlenmesi, baca gazı emisyonlarının ölçülmesi ve elementel analizleri KTAEM. laboratuvarlarında yapılmıştır. Kavak odun atıklarından elde edilen peletlerinin ısıl değeri ve kül yüzdesi sırasıyla 18.91 MJ/kg (4515 cal/g) ve %2.59 dur. N, C, H, O miktarları sırasıyla %0.52, %47.44, %5.92 ve %46.11 olarak bulunmuştur. Baca gazı emisyon değerleri; O2, CO2, CO, NO, NOx, SO2 sırasıyla %15.70, %5.06, 1279 ppm, 64 ppm, 66.67 ppm ve 23 ppm olarak tespit edilmiştir. Kavak odun atıklarından yapılan odun peleti; EN 14961-2’ye göre; nem içeriği, kül içeriği, ısıl değer, S (%) ve N (%) parametreleri bakımından EN-B kategorisinde yer almaktadır.Today, climate change is a serious threat on the global scale. The use of fossil fuels is one of the most important causes of global warming. Despite the increasing demand for energy every day; rapid depletion of fossil fuel reserves, in terms of its reliance on foreign fossil fuels and the need for renewable energy sources becomes even more important as fossil fuels cause serious environmental damage are making the need for renewable energy sources even more important. The use of poplar wood residues, which are easily grown in our own conditions and fast growing species, as biofuels has great importance. In this study; Poplar wood resudies were obtained from Bayburt. These materials chipped in the appropriate size at pilot plant of KTU Faculty of Forestry, Forest Industry Engineering. Pellets were produced in the biomass pellet production unit of the Black Sea Agriculture Research Institute Directorate. The produced pellets; calorific value, ash content, to determine the moisture content of the flue gas emission measurement and elemental analysis will be made in the Black Sea Institute of Agricultural Waste Management laboratory. The thermal value and ash content of the pellets obtained from poplar wood waste were 18.91 MJ/kg (4515 cal/g) and 2.59%respectively. The amounts of N, C, H, O were 0.52%, 47.44%, 5.92%and 46.11%, respectively. The thermal value and ash content of the pellets obtained from poplar wood waste were 18.91 MJ/kg (4515 cal/g) and 2.59%respectively. The amounts of N, C, H, O were 0.52%, 47.44%, 5.92%and 46.11%, respectively. The emission values of the flue gas (O2, CO2, CO, NO, NOx, SO2) were also determined 15.70%, 5.06%, 1279 ppm, 64 ppm, 66.67 ppm and 23 ppm respectively. Wood pellets made of poplar wood waste; According to EN 14961-2; moisture content, ash content, thermal value, S (%) and N (%) in terms of parameters are in the EN-B category

Increased levels of cell wall degrading enzymes and peptidases are associated with aggressiveness in a virulent isolate of Pyrenophora teres f. maculata

Pyrenophora teres f. maculata (Ptm) is a fungal pathogen that causes the spot form of net blotch on barley and leads to economic losses in many of the world's barley-growing regions. Isolates of Ptm exhibit varying levels of aggressiveness that result in quantifiable changes in the severity of the disease. Previous research on plant -pathogen interactions has shown that such divergence is reflected in the proteome and secretome of the path-ogen, with certain classes of proteins more prominent in aggressive isolates. Here we have made a detailed comparative analysis of the secretomes of two Ptm isolates, GPS79 and E35 (highly and mildly aggressive, respectively) using a proteomics-based approach. The secretomes were obtained in vitro using media amended with barley leaf sections. Secreted proteins therein were harvested, digested with trypsin, and fractionated offline by HPLC prior to LC-MS in a high-resolution instrument to obtain deep coverage of the proteome. The subsequent analysis used a label-free quantitative proteomics approach with relative quantification of proteins based on precursor ion intensities. A total of 1175 proteins were identified, 931 from Ptm and 244 from barley. Further analysis revealed 160 differentially abundant proteins with at least a two-fold abundance difference between the isolates, with the most enriched in the aggressive GPS79 secretome. These proteins were mainly cell-wall (carbohydrate) degrading enzymes and peptidases, with some oxidoreductases and other pathogenesis-related proteins also identified, suggesting that aggressiveness is associated with an improved ability of GPS79 to overcome cell wall barriers and neutralize host defense responses

A Case of Measles with Encephalomyelitis

Measles is one of the contagious infections and is the major causes of morbidity and mortality in the world. It is a serious disease with high complication rate and mortality in adulthood period. Encephalomyelitis is one of the fatal complications of measles infection. In this article, we aimed to present a rare case of measles encephalomyelitis with unconsciousness and partial motor deficit during measles epidemic in our region

Mikrokalsifikasyonların Tanısında Vakum Destekli Stereotaktik Meme Biyopsisi:Üç Yıllık Deneyimlerimiz

Amaç: Vakum destekli stereotaktik meme biyopsisi VDSB , günümüzde giderek artan sıklıkla kullanılan, gereksiz eksizyonel biyopsileri önleyebilecek, basit, güvenli, minimal invaziv bir perkütan biyopsi yöntemidir. Bu geriye dönük çalışmanın amacı, mikrokalsifikasyonların tanısında kullandığımız VDSB ile ilgili deneyimlerimizi sunmaktır. Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi Hastanesi’nde, 2010-2013 yılları arasında mamografisinde mikrokalsifikasyon saptanmış ve VDSB uygulanmış 46 olgunun dosya bilgileri geriye dönük olarak incelenmiştir. Mikrokalsifikasyonların özellikleri, VDSB uygulamaları sırasında ve sonrasında karşılaşılan erken ve geç dönem komplikasyonlar, histopatolojik sonuçlar, takip sonuçları değerlendirilmiş ve sonuçlar hasta sayısı, yüzde ve ortalama ± standart sapma olarak sunulmuştur. Bulgular: VDSB yapılan 46 olguya ait mamogramlarda en çok küme oluşturan pleomorfik %32,6 mikrokalsifikasyonlar görülmüştür.VDSB’ye bağlı erken dönem komplikasyonlar %15,2 olguda ağrı, %2,2 olguda hematom, % 2,2 olguda ise ekimozdur. Olguların hiç birisinde geç dönemde komplikasyon ile karşılaşılmamıştır. 29 olguda % 63 histopatoloji benign, 17 olguda %37.0 ise malign olarak sonuçlanmıştır. 11 %23,9 olguda saptanan duktal karsinoma insitu, bir olguda %2,2 saptanan lobüler karsinoma insitu, dört %8,7 olguda saptanan atipik duktal hiperplazi göz önüne alındığında, toplam 16 olguda %34,7 tümör henüz prekürsor iken veya hücre içi aşamada yakalanmıştır. Sonuç: VDSB, özellikle mamografik mikrokalsifikasyonların tanısında cerrahi biyopsilere göre öncelikle tercih edilebilecek minimal invaziv bir yöntemdir. Benign olgularda hasta için anksiyete ve morbidite kaynağı olabilecek gereksiz cerrahi girişimleri önlemekte malign olgularda ise klinisyene tedavi planında yol gösterici olmaktadı

Mycobiome in the Middle Ear Cavity with and Without Otitis Media with Effusion

Objective:No data have yet been published revealing the composition and the diversity of fungal communities (mycobiome) in the human middle ear cavity. The presented study investigated the mycobiome in the middle ear cavities of individuals with healthy middle ears and patients with otitis media with effusion.Methods:A total of 77 middle ear and four adenoid samples were collected from 47 individuals (35 children and 12 adults) in Group 1 and from 20 children in Group 2. The mycobiome profile was analyzed with nuclear ribosomal internal transcribed spacer 2 (ITS2) based metabarcoding using an Illumina MiSeq metagenomics kit.Results:ITS2-based metabarcoding detected 14 different genera and 17 different species with a mean relative abundance of ≥1% in the samples analyzed. Mycobiome profile was similar between the adenoid tissue and the middle ear cavity, between Groups 1 and Group 2, and between children and adults. Fusarium, Stemphylium, Candida, and Cladosporium were the most abundant genera detected in all samples. The mean relative abundances of the genera Candida and Fusarium were remarkably higher in Group 2 compared to Group 1.Conclusion:The species Candida glaebosa, Candida cretensis, Aspergillus ruber, Penicillium desertorum, and Rhizopus arrhizus were significantly more abundant in patients with otitis media with effusion (OME), raising the possibility that they affect the pathogenesis of OME

Impact of the COVID-19 Pandemic on Inherited Metabolic Diseases: Evaluation of Enzyme Replacement Treatment Adherence with Telemedicine

Aim:During the coronavirus disease-2019 (COVID-19) pandemic, visiting the hospital and getting regular infusions can be difficult for patients with chronic illnesses. Telemedicine may offer a good option for the management of chronic diseases such as lysosomal storage diseases (LSD).Materials and Methods:LSD patients at the Unit of Metabolic Diseases of Ege University were contacted by phone between April, 2020 and March, 2021 during the COVID-19 pandemic. Telemedicine appointments were performed at intervals every month or three months, depending on the patients’ compliance with their treatment.Results:Ninety-two LSD patients [Mucopolysaccharidosis (MPS) I, MPS II, MPS IVA, MPS VI, MPS VII, Gaucher, Fabry, and Pompe] were included in this study. The total skipped treatment rate within one year was 17.1%. Most of the months of interruption were consonant with the time of social isolation. The treatment interruption in patients under 18 years was lower than in patients over 18 years. A positive correlation was detected between the age of patients and the interruption of treatment.Conclusion:The curfew periods might be one of the causes of missed treatment sessions. Telemedicine is a good method to improve the continuity of treatment. This study showed that the number of interrupted enzyme replacement treatments could be decreased via ongoing telemedicine appointments