Approaches to the low grade metamorphic history of the karakaya complex by chlorite mineralogy and geochemistry

In this study, chlorite is used to investigate the diagenetic-metamorphic evolution and accurate geological history of the different units belonging to the Karakaya complex, Turkey. Primary and secondary chlorite minerals in the very low-grade metamorphic rocks display interference colors of blue and brown and an appearance of optical isotropy. Chlorites are present in the matrix, pores, and/or rocks units as platy/flaky and partly radial forms. X-ray diffraction (XRD) data indicate that Mg-Fe chlorites with entirely IIb polytype (trioctahedral) exhibit a variety of compositions, such as brunsvigite-diabantite-chamosite. The major element contents and structural formulas of chlorite also suggest these were derived from both felsic and metabasic source rocks. Trace and rare earth element (REE) concentrations of chlorites increase with increasing grade of metamorphism, and these geochemical changes can be related to the tectonic structures, formational mechanics, and environments present during their generation. © 2015 by the authors; licensee MDPI, Basel, Switzerland

The incidence of pneumatised inferior turbinate and relation to close anatomic structures

Background: Pneumatisation of the inferior turbinate (PIT) is a rare abnormality of the paranasal sinus. It is very difficult to differentiate from the hypertrophia of the inferior turbinate clinically. Thus, it is important to be considered, especially in cases with no response to medical treatments. We aimed to investigate the presence and the frequency of PIT by computed tomography (CT). Materials and methods: A total of 2905 cases (1381 female, 1524 male) with an age range between 16 and 84 were included. Results: The pneumatisation of the inferior turbinate was observed in 1.72% of the cases with a percentage of 1.88% in women and 1.57% in men. In PIT (+) cases the bilaterality was found in 54% of them. According to the subtypes, 70% was lamellar, 28% was bullous and 2% was extensive. No statistically significant difference was found for age distribution. The most commonly associated variations were the pneumatisation of the middle and upper turbinate and the septal deviation. Conclusions: The pneumatisation of the inferior turbinate is a rare variation with a similar frequency among men and women. It is diagnosed by CT and when symptomatic, the optimal treatment is surgery

Efficacy and safety of oral semaglutide with flexible dose adjustment versus sitagliptin in type 2 diabetes (PIONEER 7): a multicentre, open-label, randomised, phase 3a trial

Background: Oral semaglutide is the first oral formulation of a glucagon-like peptide-1 (GLP-1) receptor agonist developed for the treatment of type 2 diabetes. We aimed to compare the efficacy and safety of flexible dose adjustments of oral semaglutide with sitagliptin 100 mg. Methods: In this 52-week, multicentre, randomised, open-label, phase 3a trial, we recruited patients with type 2 diabetes from 81 sites in ten countries. Patients were eligible if they were aged 18 years or older (19 years or older in South Korea), had type 2 diabetes (diagnosed ≥90 days before screening), HbA1c of 7·5–9·5% (58–80 mmol/mol), and were inadequately controlled on stable daily doses of one or two oral glucose-lowering drugs (for 90 days or more before screening). Participants were randomly assigned (1:1) by use of an interactive web-response system, stratified by background glucose-lowering medication at screening, to oral semaglutide with flexible dose adjustments to 3, 7, or 14 mg once daily or sitagliptin 100 mg once daily. To approximate treatment individualisation in clinical practice, oral semaglutide dose could be adjusted on the basis of prespecified HbA1c and tolerability criteria. Two efficacy-related estimands were prespecified: treatment policy (regardless of treatment discontinuation or use of rescue medication) and trial product (on treatment and without use of rescue medication) for participants randomly assigned to treatment. The primary endpoint was achievement of HbA1c of less than 7% (53 mmol/mol) at week 52 and the confirmatory secondary efficacy endpoint was change in bodyweight from baseline to week 52. Safety was assessed in all participants who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, number NCT02849080, and European Clinical Trials Database, EudraCT number 2015-005593-38, and an open-label extension is ongoing. Findings: Between Sept 20, 2016, and Feb 7, 2017, of 804 patients assessed for eligibility, 504 were eligible and randomly assigned to oral semaglutide (n=253) or sitagliptin (n=251). Most participants were male (285 [57%] of 504) with a mean age of 57·4 years (SD 9·9). All participants were given at least one dose of their allocated study drug except for one participant in the sitagliptin group. From a mean baseline HbA1c of 8·3% (SD 0·6%; 67 mmol/mol [SD 6·4]), a greater proportion of participants achieved an HbA1c of less than 7% with oral semaglutide than did with sitagliptin (treatment policy estimand: 58% [134 of 230] vs 25% [60 of 238]; and trial product estimand: 63% [123 of 196] vs 28% [52 of 184]). The odds of achieving an HbA1c of less than 7% was significantly better with oral semaglutide than sitagliptin (treatment policy estimand: odds ratio [OR] 4·40, 95% CI 2·89–6·70, p<0·0001; and trial product estimand: 5·54, 3·54–8·68, p<0·0001). The odds of decreasing mean bodyweight from baseline to week 52 were higher with oral semaglutide than with sitagliptin (estimated mean change in bodyweight, treatment policy estimand: −2·6 kg [SE 0·3] vs −0·7 kg [SE 0·2], estimated treatment difference [ETD] −1·9 kg, 95% CI −2·6 to −1·2; p<0·0001; and trial product estimand: −2·9 kg [SE 0·3] vs −0·8 kg [SE 0·3], ETD −2·2 kg, −2·9 to −1·5; p<0·0001). Adverse events occurred in 197 (78%) of 253 participants in the oral semaglutide group versus 172 (69%) of 250 in the sitagliptin group, and nausea was the most common adverse event with oral semaglutide (53 [21%]). Two deaths occurred in the sitagliptin group during the trial. Interpretation: Oral semaglutide, with flexible dose adjustment, based on efficacy and tolerability, provided superior glycaemic control and weight loss compared with sitagliptin, and with a safety profile consistent with subcutaneous GLP-1 receptor agonists. Funding: Novo Nordisk A/S

by Chlorite Mineralogy and Geochemistry

In this study, chlorite is used to investigate the diagenetic-metamorphic evolution and accurate geological history of the different units belonging to the Karakaya complex, Turkey. Primary and secondary chlorite minerals in the very low-grade metamorphic rocks display interference colors of blue and brown and an appearance of optical isotropy. Chlorites are present in the matrix, pores, and/or rocks units as platy/flaky and partly radial forms. X-ray diffraction (XRD) data indicate that Mg-Fe chlorites with entirely IIb polytype (trioctahedral) exhibit a variety of compositions, such as brunsvigite-diabantite-chamosite. The major element contents and structural formulas of chlorite also suggest these were derived from both felsic and metabasic source rocks. Trace and rare earth element (REE) concentrations of chlorites increase with increasing grade of metamorphism, and these geochemical changes can be related to the tectonic structures, formational mechanics, and environments present during their generation

by Chlorite Mineralogy and Geochemistry

Chlorite minerals are commonly found in the units of Karakaya Complex that reflect different tectonic settings and evolution. In this study, the availability of chlorites has been investigated as a parameter on the interpretation of the diagenetic-metamorphic evolution and revealing the geological history from the different units of the complex. Primary and secondary chlorite minerals in the low-very low-grade metamorphic rocks have interference colors of blue and brown and an optical isotropic appearance with very low birefringence. Chlorites are seen in the matrix, pores and/or pods of rocks as platy/flaky and partly radial forms. According to X-ray diffraction (XRD) data; Mg-Fe chlorites with entirely IIb polytype (trioctahedral) exhibit various compositions such as brunsvigite-diabantite-chamosite. Furthermore, chlorite minerals correspond to felsic and metabasic origins in terms of the rocks from which they derived. Similarly, geochemical data such as the major element contents and structural formulas of chlorites also suggest a different composition and origin. Trace and especially rare earth element (REE) concentrations of chlorite minerals increase from schist towards slate depending on their degree of metamorphism and nature of the host rocks. This relationship can be significantly noticed in the chondrite-normalized REE and trace element patterns. These changes show that are they are related to the structures, formation mechanisms and tectonic environments of the chlorite minerals. In other words, they suggest that chlorites may play a key role in distinguishing of units with different geological history

Comparison of the Efficiency of Anti-Androgenic Regimens Consisting of Spironolactone, Diane 35, and Cyproterone Acetate in Hirsutism

PubMedID: 12866746The aim of the present study was to evaluate the effects of three different anti-androgenic drug-therapy regimens, Diane 35 (cyproterone acetate (CPA) [2 mg] and ethinyl estradiol [35 µg]) plus CPA, Diane 35 plus spironolactone, and spironolactone alone, in patients with hirsutism. In this prospective, randomized clinical study, 79 subjects with idiopathic hirsutismus were studied. The patients were divided into 3 groups. Group I patients (n = 32) were treated with Diane 35 plus CPA, group II patients (n = 25) with Diane 35 plus spironolactone [100 mg], and group III patients (n = 22) with spironolactone [100 mg] alone. Serum FSH, LH, testosterone (T), and DHEAS levels were analyzed before and after treatment at 6 and 12 months. Hirsutism scores were graded according to the Ferriman-Gallwey scoring system, and side effects were monitored. All treatment regimens were found to be efficient and well-tolerated, and none of the patients stopped therapy due to any adverse event. However, in hormone screening, only patients on the Diane 35 plus CPA regimen revealed a decrease in serum T levels after therapy. As such, treatment of each hirsute patient should be planned individually, but with regard to both cost-efficiency and potential side effects, we recommend spironolactone alone in the treatment of hirsutismus

Rhabdomyolysis and acute renal failure due to honeybee stings as an uncommon cause [7]

PubMedID: 8302430[No abstract available

Comparison of the efficiencv of anti-androgenic regimens consisting of spironolactone, Diane 35, and cyproterone acetate in hirsutism

WOS: 000182520400004PubMed ID: 12866746The aim of the present study was to evaluate the effects of three different anti-androgenic drug-therapy regimens, Diane 35 (cyproterone acetate (CPA) [2 mg] and ethinyl estradiol [35 mug]) plus CPA, Diane 35 plus spironolactone, and spironolactone alone, in patients with hirsutism. In this prospective, randomized clinical study, 79 subjects with idiopathic hirsutismus were studied. The patients were divided into 3 groups. Group I patients (n=32) were treated with Diane 35 plus CPA, group II patients (n=25) with Diane 35 plus spironolactone [100 mg], and group III patients (n=22) with spironolactone [100 mg] alone. Serum FSH, LH, testosterone (T), and DHEAS levels were analyzed before and after treatment at 6 and 12 months. Hirsutism scores were graded according to the Ferriman-Gallwey scoring system, and side effects were monitored. All treatment regimens were found to be efficient and well-tolerated, and none of the patients stopped therapy due to any adverse event. However, in hormone screening, only patients on the Diane 35 plus CPA regimen revealed a decrease in serum T levels after therapy. As such, treatment of each hirsute patient should be planned individually, but with regard to both cost-efficiency and potential side effects, we recommend spironolactone alone in the treatment of hirsutismus

RENAL AMYLOIDOSIS AND RHEUMATIC HEART-DISEASE

WOS: A1994PD89800032PubMed ID: 7991034

Diagenesis/Metamorphism History of Lower Triassic Cigli Group Rocks in Uludere-Uzungecit (Sirnak) area (Eastern Part of the Southeast Anatolian Autochthone)

This study aims to reveal the mineralogical characteristics of the carbonate and pelitic rocks in the Lower Triassic Cigli Group in the Uludere-Uzungecit (Sirnak) region from Southeast Anatolian Autochthone (SEAA). Cigli Group is represented by Yoncali Formation (dolomite-siltstone-shale with limestone intercalation), Uludere Formation (shale/shale with carbonate-clayey limestone intercalated with dolomite) and Uzungecit Formation (limestone with chert nodule-dolomitic limestone-shale) from bottom to top. In order of abundances of minerals obtained by XRD investigations as follows; Yoncali Formation contains carbonate (calcite, dolomite), feldspar, phyllosilicate (illite, chlorite) and goethite minerals, and Uludere Formation is made up of carbonate (calcite, dolomite), quartz, feldspar, phyllosilicate (illite, chlorite, mixed-layered chlorite-vermiculite/C-V, and very minor amount of kaolinite in only a sample) and hematite minerals. Uzungecit Formation has carbonate (dolomite, calcite), silica (quartz, opal-CT, moganite), phyllosilicate (chlorite, illite), and feldspar and hematite minerals. On the basis of illit Kubler Index values; Yoncali Formation reflects the degrees of anchizone; as for Uludere and Uzungecit formations, they have the degrees of anchizone-high diagenesis, respectively. Similarly, Chlorite Arkai Index (AI, degrees 2 theta) values indicate the grades of anchizone-diagenesis. Illites exhibit 2M(1) ve 2M(1) + 1M + 1M(d) polytypes and the values of b unit-cell distances show a composition close to ideal muscovite and low pressure conditions.The rocks of the Cigli Group offer differences in terms of rare occurrence of kaolinite, appearance of moganite and C-V and the dominance of dolomite and hematite in most levels, and diagenesis/metamorphism grades are also high, when compared with the equivalent units in the Diyarbakir-Hazro area. Lower Triassic series regionally seem to have a deeper depositional environment, and have relatively higher maturation because of the volcanic feeding and tectonic burial in the Diyarbakir-Sirnak direction from west to east