Histološko i histomorfometrijsko istraživanje kore malog mozga i srebrom obojenih regija nukleolusne organizacije Purkinjeovih neurona u štakora kronično tretiranim morfinom

The effects of chronic morphine administration on the rat cerebellum and silver stained nucleolus organizer regions in Purkinje cells were investigated by means of histological, histochemical and histometrical techniques. Thirty-two young (30-32 days of age) Wistar rats (equal numbers of both genders) were randomly divided into 2 groups, as control and morphine-treated, each having equal numbers of both genders, a total of 16 animals. The control animals were injected subcutaneously with 1mL/kg physiological saline, and the morphine-treated rats received 5 mg/kg morphine hydrochloride subcutaneously at daily intervals for 30 days. The thickness of the molecular and granular layers of the cerebellum, the diameters of the nuclei and nucleoli of cerebellar Purkinje neurones, and the number and size of the silver staining nucleolus organizer regions of the Purkinje cell nuclei were determined histomorphometrically. The morphine administration caused slight histological changes in the cerebellum. The molecular layer thickness of the cerebellum was significantly (P<0.05) reduced, and the decrease was mainly in the male animals. In contrast, the layer thickened insignificantly in the morphine-treated females. The granular layer thickened slightly but insignificantly in both genders of the morphine-treated group. The Purkinje cell count significantly decreased with morphine treatment. Nucleus size did not change with morphine treatment. However, morphine-treated animals had smaller nucleoli. It was concluded that morphine treatment caused significant histomorphological changes in the cerebellar cortex in a sexually dimorphic manner.Učinci kronične primjene morfina na mali mozak štakora i na srebrom obojene regije nukleolusne organizacije Purkinjeovih neurona istraživani su histološkim, histokemijskim i histometrijskim tehnikama. Trideset i dva mlada Wistar štakora (dob 30 - 32 dana), u jednakom omjeru spolova, metodom slučajnog izbora podijeljena su u dvije skupine s po 16 jedinki u svakoj skupini. Životinjama u kontrolnoj skupini potkožno je primijenjen 1 mL/kg fiziološke otopine, dok su životinje u pokusnoj skupini dobile 5 mg/kg morfin hidroklorida, potkožno, svaki dan tijekom 30 dana. Za određivanje zadebljanja molekularnih i granulacijskih slojeva maloga mozga, promjera jezgre i nukleolusa Purkinjeovih neurona u malom mozgu te broja i veličine srebrom obojenih regija nukleolusne organizacije Purkinjeovih neurona primijenjena je histomorfometrijska metoda. Davanje morfina izazvalo je blage histološke promjene u malom mozgu. Debljina molekularnog sloja maloga mozga značajno je smanjena (P<0,05). To je ponajprije bilo izraženo kod životinja muškoga spola, dok je molekularni sloj kod ženki tretiranih morfinom bio tek neznatno zadebljan. Granulirani sloj bio je blago i nesignifikantno zadebljan u oba spola unutar skupine tretirane morfinom. Broj Purkinjeovih stanica značajno je smanjen nakon primjene morfina, dok to nije bio slučaj s veličinom jezgre koja se nije mijenjala. No, životinje koje su dobivale morfin imale su manje nukleole. Zaključeno je da liječenje morfinom uzrokuje značajne histomorfološke promjene u kori maloga mozga, pri čemu važnu ulogu ima spol jedinke

La integración de los refugiados en el mercado laboral turco

La concesión en Turquía del derecho de acceso al trabajo formal a los refugiados sirios fue un primer paso hacia su integración económica, pero sigue habiendo retos. Con el apoyo de la comunidad internacional, el Gobierno turco está tomando medidas para superar algunos de ellos

Incidence of coronary bifurcation lesion as a culprit lesion in patients with acute myocardial infarction: impact of treatment strategy on short- and long-term outcomes

Background: Although, there are several studies comparing single and two-stent techniques in patients with bifurcation lesions, evidence in patients presenting with myocardial infarction (MI) is still insufficient.1-3 We aimed to assess the short- and long-term outcomes of provisional and two-stent techniques of bifurcation lesions in patients with acute coronary syndromes (ACS). Patients and Methods: 2992 patients with MI who underwent percutaneous coronary intervention (PCI) were enrolled in the present study. Of 2992 patients, 385 patients with MI had bifurcation lesions. The Synergy between PCI with TAXUS™ and Cardiac Surgery (SYNTAX) score, pre-PCI Thrombolysis in Myocardial Infarction (TIMI) flow, post-PCI TIMI flow, duration of procedure, angiographic features, post-PCI side branch loss, 1- and 12-month mortality rates were noted. Results: 169 (43.9%) patients had ST-segment elevation MI, whereas 216 (56.1%) patients had non-STsegment elevation MI. 355 (92.2%) patients underwent provisional stenting and 30 (7.8%) patients underwent two-stent technique. Side branch loss was observed in 40 patients (11.2%) in the provisional group and 1 patient (3.3%) in the two-stent group (p=0.2). Compared to provisional group, durations of angiography and revascularization in two-stent group were significantly longer (p<0.001 and p<0.001). Both 1-month and 12-month mortality rates were similar in provisional and two-stent groups (4.2% vs. 3.3%, p=0.8 and 11.5% and 13.3%, p=0.7; respectively). Conclusion: In patients presenting with ACS and bifurcation lesions, procedural success, side branch loss, as well as short- and long-term mortality were similar in both provisional and two-stent techniques

Novel Dynamic Partial Reconfiguration Implementation of K-Means Clustering on FPGAs: Comparative Results with GPPs and GPUs

K-means clustering has been widely used in processing large datasets in many fields of studies. Advancement in many data collection techniques has been generating enormous amounts of data, leaving scientists with the challenging task of processing them. Using General Purpose Processors (GPPs) to process large datasets may take a long time; therefore many acceleration methods have been proposed in the literature to speed up the processing of such large datasets. In this work, a parameterized implementation of the K-means clustering algorithm in Field Programmable Gate Array (FPGA) is presented and compared with previous FPGA implementation as well as recent implementations on Graphics Processing Units (GPUs) and GPPs. The proposed FPGA has higher performance in terms of speedup over previous GPP and GPU implementations (two orders and one order of magnitude, resp.). In addition, the FPGA implementation is more energy efficient than GPP and GPU (615x and 31x, resp.). Furthermore, three novel implementations of the K-means clustering based on dynamic partial reconfiguration (DPR) are presented offering high degree of flexibility to dynamically reconfigure the FPGA. The DPR implementations achieved speedups in reconfiguration time between 4x to 15x

Recurrent Intestinal Intussuseption in Adult: A Case Report

Intussusseption is an usually incident that may present in pediatric patients but we encounter rarely in adults. It leads to obstruction of the gastrointestinal tract. In pediatric patients, etiological factors are due to benign incidents usually, but in adults, often depends on tumors. Etiological factors should be investigated after obtaining the reduction of intussusception and intraluminal pathologies should be excluded. It will cause to intussusseption recurrence after years if reduction perform without treating etiological factors

Are the single-step resection and primary anastomosis suitable for obstructıve colorectal patients in older cases?

Aim To investigate the efficacy and safety of the single-step surgery in elderly patients with obstructive colorectal cancer. Methods All patients who underwent single-step surgery and primary anastomosis for obstructive colorectal cancer in the period between January 2012 December 2017 were evaluated in this study. The patients were divided into two groups: younger than 65 (Group Young) and older than 65 (Group Old). Demographic data, American Society of Anesthesiologists scores (ASA) scores, comorbidities, preoperative albumin levels, type of surgery, postoperative morbidity and mortality, pathological stages, and overall survival rates were investigated. Results A total of 89 patients were included: 49 (54%) were older than 65 (Group Old). In Group Old, the mean age was 75 (65-97), of which 28 (58.3%) were males. There were 41 patients younger than 65 (Group Young) with the mean age of 52.6 (41-64 years of age), of which 21 (51.2%) were males. There was no difference between groups according to albumin level. There was no statistical difference between two groups according to tumour localization, pathological stage and type of surgery, as well as according to surgical complications. The median overall survival rate was 11 months in both groups (0-66) (p=0.320). Conclusion Meticulous preparation of older patients (correction of anaemia, electrolyte levels and pH ) paves the road for successful surgeries, including single-step resection and primary anastomosis

Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study

Regorafenib, an oral multikinase inhibitor, has improved survival in metastatic colorectal cancer (mCRC) patients who have progressed on standard therapies. Our study aimed to evaluate prognostic factors influencing regorafenib treatment and assess the optimal dosing regimen in a real-life setting. We retrospectively analysed 263 patients with mCRC from multiple medical oncology clinics in Turkey. Treatment responses and prognostic factors for survival were evaluated using univariate and multivariate analysis. Of the patients, 120 were male, and 143 were female; 28.9% of tumors were located in the rectum. RAS mutations were present in 3.0% of tumors, while BRAF, K-RAS, and N-RAS mutations were found in 3.0%, 29.7%, and 25.9% of tumor tissues, respectively. Dose escalation was preferred in 105 (39.9%) patients. The median treatment duration was 3.0 months, with an objective response rate (ORR) of 4.9%. Grade ≥ 3 treatment-related toxicity occurred in 133 patients, leading to discontinuation, interruption, and modification rates of 50.6%, 43.7%, and 79.0%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.0 and 8.1 months, respectively. RAS/RAF mutation (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1-2.3; P = 0.01), pretreatment carcinoembryonic antigen (CEA) levels (HR 1.6, 95% CI 1.1-2.3; P = 0.008), and toxicity-related treatment interruption or dose adjustment (HR 1.6, 95% CI 1.1-2.4; P = 0.01) were identified as independent prognostic factors for PFS. Dose escalation had no significant effect on PFS but was associated with improved OS (P < 0.001). Independent prognostic factors for OS were the initial TNM stage (HR 1.3, 95% CI 1.0-1.9; P = 0.04) and dose interruption/adjustment (HR 0.4, 95% CI 0.2-0.9; P = 0.03). Our findings demonstrate the efficacy and safety of regorafenib. Treatment line influences the response, with dose escalation being more favorable than adjustment or interruption, thus impacting survival

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)