Evaluation of Nutritional Status in Cancer Patients Underwent Radiotherapy: The Results of Biochemical, Body Composition with Bioelectrical Impedance Analysis, Anthropometric Measurements, and Patient-Generated Subjective Global Assessment

Aim: This study aims to evaluate the nutritional status and the effect of radiotherapy (RT) on nutrition in all ambulatory cancer patients. Material and Method: In this prospective observational study 105 cancer patients with various diagnoses treated between 2013 and 2014 were evaluated. All patients were ≥18 years old and had Karnofsky Performance Status ≥70. Anthropometric measurements, body composition with bioelectric impedance, and patient-generated Subjective Global Assessment (PG-SGA) tools were used. The height, weight, body mass index (BMI), triceps skin fold thickness, mid-upper arm circumference, hemoglobin, and serum albumin levels were determined twice before and after RT. Additionally, nutrition-related symptoms and short-term weight loss results were determined by PG-SGA questionnaires. Results: The patients’ median age was 53 years (range, 18-82 years). At initial evaluation 74 patients were well nourished using the PG-SGA global rating. Malnutrition developed in totally 33 of these 74 patients after RT. The PG-SGA results after RT were significantly worse than before treatment. PG-SGA revealed no significant relationship between nutritional status prior to RT and the parameters including gender, age, mean weight, BMI, disease duration, pre-RT hemoglobin and albumin levels. Post-RT evaluation showed a significant relationship between deterioration (PG-SGA B-C) and mean weight, BMI, serum albumin, hemoglobin levels, and concomitant chemotherapy. Gastrointestinal and head and neck cancer patients had the most deterioration after RT. The patients' weight, BMI, fat-free mass, total body water, and the percentage weight loss at the end of RT were significantly lower than the initial assessment. Conclusion: It is considerable to use multiple tools for nutritional monitoring. Patients who received RT to the head and neck and upper abdomen region had a high risk of deterioration after treatment. These patients should be monitored carefully during all treatment periods

Assessment of serum GLP-1 and DPP-4 levels in patients with migraine

Migren, dünyada bir milyar kişiyi etkileyen ve günlük yaşamda kısıtlılığa yol açan nörovasküler bir bozukluktur. Patofizyolojisi hakkında birçok teori öne sürülse de halen kesin bir tedavisi bulunmamaktadır. Ataklar sırasında oluşan baş ağrısı, trigeminal sinir uçlarının aktivasyonu ile ilişkilidir. Glukagon benzeri peptid-1 (GLP-1), insülinin parçalanmasını engellediği düşünülen bir hormondur. İnce bağırsaklardaki L hücrelerinde, pankreasta alfa hücrelerinde ve beyin sapındaki nukleus traktus solitarius (NTS) gibi birçok beyin bölgesinde reseptörleri bulunmaktadır. Merkezi sinir sisteminde nöroprotektif birçok mekanizmada rol oynamaktadır. Aynı zamanda çeşitli nörodejeneratif hastalıkların tedavisinde GLP-1 analogları kullanılmaktadır. Dipeptidil peptidaz-4 (DPP-4), GLP-1' i parçalayan proteaz ailesine ait bir enzimdir. İnkretinleri ve iştah baskılayıcı nöropeptidleri bileşenlerine ayırarak inaktif hale getirmektedir. Bu çalışmanın amacı, migren hastalarında GLP-1 ve DPP-4 enzim düzeylerinin migren patofizyolojisi ile ilişkili olup olmadığını göstermek ve migren tedavisinde yeni bir yaklaşım sağlayabilmektir. Çalışmamızda, migren tanısı almış 42 hasta migrenli grup olarak; migren tanısı almamış ve hastanedeki diğer polikliniklere başvurmuş 42 kişi kontrol grubuna seçilerek 2 grup oluşturulmuştur. Gönüllülerden en az 8 saat açlıktan sonra kanları alınarak serumlarında çalışma yapılmıştır. Serum GLP-1 ve DPP-4, ELİSA metodu ile ölçülüp istatistiksel analiz SPSS 22.0 programı ile yapılmıştır. Elde edilen sonuçlar migren hastalarının serumlarında, kontrol grubuna göre GLP-1 ve DPP-4 düzeylerinin anlamlı derecede düşük olduğu bulunmuştur (p<0,001). Bu bilgiler ışığında GLP-1' in ve DPP-4' ün migrenli hastalarda azalmış olması, baş ağrısının oluşumunda bir faktör olarak değerlendirilebilir. Bu durum migrenli hastalarda diyabetin daha fazla görülme sıklığını açıklayabilir.Migraine is a neurovascular disorder that affects one billion people in the world and causes limitations in daily life. Although many theories have been suggested about its pathophysiolgy, there is still no definitive treatment. Headache occuring during attacks is associated with activation of trigeminal nerve endings. Glucagon-like peptide-1 (GLP-1) is a hormone that is thought to inhibit the breakdown of insulin. It has receptors in many brain regions, such as the nucleus tractus solitarius (NTS) in the brainstem and L-cells in the small intestine, alpha cells in the pancreas. It plays a role in many neuroprotective mechanisms in the central nervous system. At the same time, GLP-1 analogs are used in the treatment of various neurodegenerative diseases. Dipeptidyl peptidase-4 (DPP-4) is an enzyme belonging to the protease family that degrades GLP-1. It decomposes incretins and appetite suppressing neuropeptides and renders them inactive. The aim of this study is to show whether GLP-1 and DPP-4 enzyme levels are associated with migraine pathophysiology in migraine patients and to provide a new approach in the treatment of migraine. In this study, 42 patients diagnosed with migraine as the migraine group; 42 people who were not diagnosed with migraine and applied to other outpatient clinics in the hospital were selected as the control group. After fasting for at least 8 hours, blood samples were taken from the volunteers and their serums were studied. Serum GLP-1 and DPP-4 were measured by ELISA method and statistical analysis was performed with SPSS 22.0 program. The results obtained showed that the serum levels of GLP-1 and DPP-4 were significantly lower in the sera of migraine patients compared to the control group (p<0.001). In the light of this information, the decrease in GLP-1 in patients with migraine can be considered as a factor in the formation of headache. This may explain the higher incidence of diabetes in patients with migraine

Economic Growth and Financial Development: Evidence from Panel Cointegration Tests in Emerging Countries

In This study analyzes the long-run relationship between economic growth (EG) and financial development (FD) in 27 emerging countries over the period 1980 to 2018 by employing the Johansen-Fisher panel cointegration method. The study also performs the vector error correction model (VECM) to determine the direction of a causal relationship among the variables. Two components of the index of financial development introduced by Svirydzenka (2016), financial markets and financial institutions indices, are employed to reveal through which channels EG has a long-term association with FD. Empirical findings show a significant long-run association between EG, the overall index of FD, and its lower-indices. Furthermore, the results from panel VECMs indicate a one-way unidirectional causality between EG and the FD index, while there is a two-way causality between EG and financial markets as well as between EG and financial institutions indices in the short run. We obtain similar results with Kao and Pedroni panel cointegration tests. We also show that financial institutions and financial markets indexes significantly affect economic growth in the long run. Thus, policy makers in emerging markets should take actions that facilitate the development of financial markets and institutions to increase GDP per capita

Numerical modeling of fluid flow and heat transfer in Kursunlu geothermal field-KGF (Salihli, Manisa/Turkey)

Nowadays, the need for energy is increasing more and more. It is more difficult to acquire new resources in various fields than to preserve existing energy resources. Although Turkey is a very rich state in terms of various energy resources, misuse of these resources can even lead to conflicts that may occur between the states in forthcoming years. In today's economic conditions, we can only protect our energy resources with the correct way of management. In this context, it is very important to reveal the mechanisms that make up the geothermal systems, which are very common in Western Anatolia. In this study, how the fluid circulation mechanism in the geothermal system takes place, and under which conditions the infiltrating water is heated in the Kursunlu geothermal field (KGF) have been examined. FEFLOW software was used in numerical modeling. Fluid flow and heat transfer equations are solved on a two-dimensional vertical model using FEFLOW software. A variable-width finite element mesh consisting of 55,590 elements was created in this scope. Since triangular meshes are preferred in vertical models, the mesh produced according to the Delaunay method was used. All lateral boundaries are designed as a no-flow boundary condition. For boundary conditions, hydraulic heads on top of the model and temperature values at both the top and bottom of the model are defined. Additionally, initial values were produced for the entire Kursunlu geothermal system under steady-state conditions, and a transient model was built to run for 700,000 days. The regional flow direction is towards to the North. The fluids are transmitted deeply and heated through fault zones and transported towards the surface. Convective flows start to form below -1000 m altitudes in the fault zones and in the geothermal aquifer widespread convective flows in deeper regions were formed, while smaller spread convective flows were formed near the surface and shallow depths of the aquifer. In the process of convective flow, heated fluids reach to Kursunlu region and forms the spring. Finally, two more possible high-temperature areas have been identified, indicating that the flow vectors point to the surface

High arsenic and boron concentrations in groundwaters related to mining activity in the Bigadic borate deposits (Western Turkey)

This study documents the environmental impacts of borate mines in Bigadic district, which are the largest colemanite and ulexite deposits in the world. Borate-bearing formations have affected the concentrations of some contaminants ill groundwater. Groundwater quality is directly related to the borate zones in the mines its it result of water-rock interaction processes. Calcium is the dominant cation and waters are Ca-SO4 and HCO3 type in the mine (TOM borate mine) from which colemanite is produced. However in the Simav and Acep Borate Mines, ulexite and colemanite minerals are produced and waters from these open pit mines are Na-HCO3-SO4 types. High SO4 concentrations (reaching 519 mg/L) might be explained by the existence of anhydrite, gypsum and celestite minerals in the borate zone. Groundwater from tuff and borate strata showed relatively low pH values (7-8) compared to surface and mine waters (> 8). EC values ranged from 270 to 2850 mu S/cm. Boron and As were the two important contaminants determined in the groundwaters around the Bigadic borate mines. Arsenic is the major pollutant and it ranged from 33 to 911 mu g/L in the groundwater samples. The concentrations of B in the study area ranged from 0.05 to 391 mg/L. The highest B concentrations were detected at the mine areas. The extension of the borate zones in the aquifer systems is the essential factor in the enrichment of B and As, and some major and trace elements in groundwaters are directly related to the leaching of the host rock which are mainly composed of tuffs and limestones. According to drinking water standards, all of the samples exceed the tolerance limit for As. Copper, Mn. Zn and Li values are enriched but do not exceed the drinking water standards. Sulfate, Al and Fe concentrations are above the drinking water standard for the groundwater samples. (c) 2008 Elsevier Ltd. All rights reserved

Factors controlling the element distribution in farming soils and water around the abandoned Halikoy mercury mine (Beydag, Turkey)

Acid mine drainage, downstream transport of metal-rich water and sediment runoff adversely effect the environment surrounding the Hahkoy Hg mine. This study focuses on the environmental effects of the Hahkoy Hg mine on soil, stream sediment and water because the area is used for agricultural purposes. Stream sediment and farming soil have been polluted by contaminants derived from the mine. The effects of Hg mining and the distribution of contaminants in soil and stream sediment were evaluated by calculation of enrichment factors (EFs) which indicated enrichments for As, Hg, Sb and Pb. Other metals Cd, Co, Cr, Cu, Fe and Zn show moderate enrichment in soil close to the mine. EFs indicate soil contamination in the order of: Hg > As > Sb > Ni > Co > Cu > Fe > Zn > Cr > Pb > Cd. The greatest contamination was found near mine wastes, decreasing with increasing distance from the mine site. Concentrations of As, Cd, Cu, Ni, Pb and Zn are enriched in mine water. Acidic mine water samples have low pH (2.5-3.0) and high dissolved solids with electrical conductivity (EC) of about 3800 mu S/cm. Low pH in the groundwater (as low as 3.7) was also observed close to the stream draining of the mine. The source of acidity is the oxidation Fe-sulfides (dominantly pyrite) which release Fe, SO42- and H+ forming acid in mine water runoff. Concentrations of Hg are elevated (0.04-1.2 mu g/L) in acidic mine water and groundwater exceeding the US Environmental Protection Agency (USEPA) aquatic life Hg standard of 12 ng/L by as much as 100 times. (C) 2009 Elsevier Ltd. All rights reserved