Cheap and Efficient Method for Domestic Wastewater Treatment (Constructed Wetlands)

Together with ever-increasing populations, water and food demand of people are also increasing. Such demands then exert a serious threats on limited water resources. Pollution, limited nature of water resources, climate change and resultant global warming have brought the water and treatment technologies into the first place of the world’s agenda. Wastewaters are most of the time discharged into receiving bodies without any treatments due to high treatment costs of conventional treatment systems. On the other hand, constructed wetlands, also called as natural treatment system, provide a cheap and efficient way for wastewater treatment. These systems are specially designed systems imitating natural wetlands and including soil, plant and microorganisms to remove pollutants from wastewaters. They are commonly used for treatment of domestic and industrial wastewater in specially designed basins with aquatic plants and easily be used for small-to-medium sized communities. Constructed wetlands with their cheaper and easy construction, low energy and labor costs, easy operation, maintenance and monitoring are attracting great attentions in several parts of the world. In this study, general information was provided about the design, construction, operation and maintenance of constructed wetlands for domestic wastewater treatment, potential mistakes were pointed out and possible solutions were proposed to overcome these problems.</p

Effect of Heart Rate-Oriented Therapy on Diastolic Functions in Patients with Heart Failure with Reduced Ejection Fraction

Background: Resting heart rate (HR) is a strong predictor of cardiovascular mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF). However, the effects of HR-lowering therapy on diastolic function in HFrEF patients are not well described. In this study, we aimed to investigate the effect of lowering HR on diastolic function in HFrEF patients with sinus rhythm

Impact of Severe Tricuspid Regurgitation on Accuracy of Echocardiographic Pulmonary Artery Systolic Pressure Estimation

Introduction: Transthoracic Doppler echocardiography (DE) is recommended for screening and monitorization of pulmonary arterial hypertension (PAH). However, some recent studies have suggested that Doppler echocardiographic pulmonary artery systolic pressure (PASP) estimates may frequently be inaccurate. Some hemodynamic and echocardiographic factors are known to contribute to discordant results. The aim of this study was to determine whether severe tricuspid regurgitation (TR) has any impact on true estimation of PASP by DE. Materials and Methods: We retrospectively identified all PAH patients who underwent right heart catheterization (RHC) and had an echocardiogram within the same hospitalization period. Patients were divided into two groups according to the presence of severe TR: Group 1 consisted of 36 patients with mild-moderate TR and group 2 of 36 patients with severe TR. For these two groups, the agreement between echocardiographic and catheterization PASP measurements was evaluated by Bland-Altman analysis, separately. Results: In group 1, the bias for the echocardiographic estimates of the PASP was 2.5 mmHg and 62.5% of the echocardiographic estimates were accurate (10 mmHg difference with RHC measurement). In group 2, the bias was 16.25 mmHg and echocardiography was accurate in 37.5% of the patients. To clarify the association between PASP overestimation on DE and the presence of severe TR, regression analysis was performed. Severe TR was found as the only independent predictor of PASP overestimation on echocardiography after multivariate analysis. Conclusion:The results of the study show that in patients with PAH, the presence of severe TR is associated with an overestimated PASP measurement on echocardiography

Prognostic value of neutrophil-to-lymphocyte ratio in pulmonary arterial hypertension

Objective To evaluate the prognostic value of baseline neutrophil-to-lymphocyte ratio (NLR) in the prediction of long-term mortality in patients with pulmonary arterial hypertension (PAH)

Prognostic value of neutrophil-to-lymphocyte ratio in pulmonary arterial hypertension

Objective To evaluate the prognostic value of baseline neutrophil-to-lymphocyte ratio (NLR) in the prediction of long-term mortality in patients with pulmonary arterial hypertension (PAH)

Does "smoker's paradox" exist in clopidogrel-treated Turkish patients with acute coronary syndrome

Previously conducted studies revealed that smoking enhanced the efficacy of clopidogrel by increasing formation of the active metabolite (AM) from the prodrug through induction of the cytochrome CYP1A2. The expression of cytochrome enzymes depends on genotype and no data exists in literature conducted in Turkish patients comparing the clopidogrel responsiveness between active smokers and non-active smokers treated with clopidogrel. In this study, our aim was to investigate the clopidogrel responsiveness in clopidogrel-treated Turkish acute coronary syndrome (ACS) patients according to their smoking status. We retrospectively enrolled 258 patients who were hospitalized due to ACS. Clinical variables of the patients, especially smoking status were recorded. Clopidogrel resistance was evaluated by using adenosine diphosphate (ADP) induced platelet aggregometry. Clopidogrel resistance was detected as a change in maximal aggregation 612.5 predicted the clopidogrel resistance with a sensitivity of 60% (OR: 100.65, %95 CI = 19.996-506.615 p < 0.001). Results of this study demonstrated that ADP responses were lower in smokers receiving clopidogrel and aspirin than in non-smokers receiving the same drug regimen. This finding indicates that smoking was related to an enhanced clopidogrel responsiveness in Turkish patients hospitalized due to ACS, suggesting that "smoker's paradox" probably exists in Turkish ACS patients

Platelet-to-lymphocyte ratio but not neutrophil-to-lymphocyte ratio predicts high on-treatment platelet reactivity in clopidogrel-treated patients with acute coronary syndrome

Conclusions: We suggest that more attention should be paid to the PLR values of these patients on admission to identify individuals who may not benefit from clopidogrel during the course of ACS