Course of Encephalopathy in a Cirrhotic Dialysis Patient Treated Sequentially with Peritoneal and Hemodialysis

End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient

Factors affecting mortality at home and hospital in oncology patients and the effect of age

Objective: Several factors assessing cancer mortality and impacting the choice of place of death for terminally ill patients have been previously documented. We examined the relationships between several oncological factors, including age, on cancer mortality and the choice of place of death. Material and Methods: All patient data were collected retrospectively from hospital computer records and medical chart reviews. A total of 2,183 patients admitted to our hospital over 6 years (September 2013-December 2019) were included. Results: A total of 2,183 patients were analyzed, of which 58.5% (n=1,277) of patients died. More deaths occurred in the hospital than at home (n=1,032 vs. n=245). The mean age of patients who died at home was more than those who died in the hospital (mean ages: 68.4±12.5 vs. 63.5±12.5; median ages: 69, range 24-100 vs. 63, range 19-97). The hospital mortality rate of patients <65 years old was statistically higher than patients ≥65 years old. Conclusion: We found that a second primary cancer, metastasis, diagnosis from the primary mass, certain cancer diagnoses (such as lungs, stomach, and brain cancers), locally advanced and metastatic stage cancers, certain histological types, late diagnosis (the first application to branches such as chest diseases, emergency, neurosurgery) negatively affected mortality. In addition, we determined that metastatic, locally advanced stage. and patients aged <65 years of age died more frequently in the hospital

INVESTIGATION OF AQUATIC TOXICITY OF CERIUM AND LITHIUM TECHNOLOGY CRITICAL ELEMENTS

Bu Yüksek Lisans Tezi kapsamında, teknoloji kritik elementleri olarak da bilinen nadir dünya elementlerinin en önceliklileri olan Lityum ve Seryum’u Daphnia magna ve Artemia salina akut ve kronik toksisite testleri ile çevresel etkileri incelenmiştir. Sonuçlara göre hem Lityum hem de Seryum hem ışıksız hem de ışık altındaki numunelerde çok daha düşük konsantrasyonlarda Daphnia magna’ya toksik etki etmiş, ışık şiddeti arttıkça toksisitenin çok düşük oranda düştüğü gözlenmiştir. Artemia salina kronik toksisite test sonuçlarına göre, ışık ve doğal organik maddenin etkisinin olmadığı gözlenmiştir. Bunun yanında Artemia salina için kronik toksisite deneylerinde ışık şiddeti arttıkça toksisite azalmış ve doğal organik maddelerin etkileri araştırıldığı numunelerde anlamlı bir etkinin olmadığı gözlenmiştir.This work aimed to investigate aquatic acute and chronic toxicity of two technology critical elements, namely Cerium and Lihium, to Daphnia magna and Artemia salina. Results showed that both Lithium and Cerium exhibited severe toxicity to Daphnia magna at lower concetrations than Artemia salina prior and post illumination excitation. Toxicity was slightly decreased under post illumination conditions. Artemia salina chronic test results revealed a non-effect of both humic acid and illumination. Similar to acute test results toxicity decreased with the increasing photon flow while presence of humic acid did not show any significant effect on the toxicity of both elements to Artemia salina

Akciğer Kanseri Tanılı Hastalarda Koagülasyon Test Değerlerinin Tanı Anındaki Evreyle İlişkisi

INTRODUCTION: In this study, the effects of changes in coagulation tests on survival and distant organ metastasis in lung cancer patients were investigated. METHODS: We retrospectively evaluated the data of patients who were diagnosed with primary lung cancer by our radiation oncology clinic. The relationship between age, sex, histopathological diagnosis, metastasis status and coagulation test values and lifespan were analyzed. RESULTS: A total of 342 patients were included in the study. 18,4% of the patients had small cell lung cancer (SCLC), and 81,6% had non-small cell lung cancer (NSCLC). Adenocarcinoma (45.0%) was the most common histopathological subtype in patients with NSCLC. When distant organ metastasis rates were handled for all patients, while there weren’t distant organ metastasis in 44.4% of patients, distant organ metastasis was found out in 55.6% of the patients. 65.1% of patients with SCLC and 53.4% of patients with SCLC were in advanced stages with distant organ metastasis. 18.4% of the patients had brain metastasis, and 81.6% had no brain metastasis. There was no statistically significant effect of APTT, PT, INR, % PT which are among the coagulation tests, and fibrinogen values on brain metastasis status and survival (p> 0.05). However, in patients with brain metastases, increase in the ratio close to statistical significance the INR and% PT values was found (p = 0.068, p = 0.059, respectively) when compared to the non-men. DISCUSSION AND CONCLUSION: In the case of lung cancer, an increase in the frequency of brain metastasis may be associated with the hypothesis that prolongation of the coagulation test and deterioration of the blood-brain barrier, but there is a need for extensive studies with more patients.GİRİŞ ve AMAÇ: Bu çalışmada akciğer kanserli hastalarda koagulasyon testlerindeki değişikliklerin sağkalım ve uzak organ metastazı üzerine etkisi araştırıldı. YÖNTEM ve GEREÇLER: Çalışmamız, hastanemiz radyasyon onkolojisi kliniğine başvuran primer akciğer kanseri tanısı almış hastaların verileri retrospektif değerlendirilerek yapıldı. Ya?, cinsiyet, histopatolojik tanı, metastaz durumu ile koagulasyon test değerleri ve yaşam süresi arasında ilişki analiz edildi. BULGULAR: Çalışmaya toplam 342 hasta dahil edildi. Hastaların %18.4’ü küçük hücreli akciğer kanseri (KHAK) iken %81.6 küçük hücreli dışı akciğer kanseri (KHAK) tanısına sahipti. KHDAK’li hastalarda en sık görülen histopatolojik alt tip Adenokarsinom (%45.0) idi. Tüm hastalar için uzak organ metastaz oranlarına bakıldığında hastaların %44.4’ünde uzak organ metastazı yokken, %55.6’sında uzak organ metastazı vardı. KHAK’li hastaların %65.1’i, KHDAK’lı hastaların ise %53.4’ü uzak organ metastazı olan ileri evre olgulardı. Hastaların %18.4’ünde beyin metastazı varken, %81.6’sında ise beyin metastazı yoktu. Koagulasyon testlerinden APTT, PT, INR, %PT ve fibrinojen değerlerinin beyin metastazı durumu ve sağkalım üzerine istatistiksel anlamlı etkisi saptanmadı (p>0.05). Ancak beyin metastazı olanlarda, olmayanlarla karşılaştırıldığında INR ve %PT değerlerinde istatiksel olarak anlamlılığa yakın oranda artış tespit edildi (sırasıyla p=0.068, p=0.059). TARTIŞMA ve SONUÇ: Akciğer kanseri olgularında koagulasyon testlerindeki uzama ile kan beyin bariyerinin de bozulduğu hipotezi ile ilişkili olarak beyin metastazı sıklığında artış oluşabilir ancak daha fazla hasta sayısının olduğu geniş kapsamlı çalışmalara ihtiyaç vardır

A review on aquatic and photoxicity effect of cerium and lithum from rare earth elements

Dünya yüzeyinde çok az bölgede ve az miktarda bulunan elementler (Nadir Toprak Elementleri-REE) teknolojik gelişmelere paralel olarak hızla kullanılıp tüketilmektedir. Diğer genel ismi Teknoloji Kritik Elementler (TKE) olan bu elementlerin kullanım oranlarının artması ile çevrede bulunma sıklıkları ve miktarları da artmıştır. TKE’ler, mühendislik nanopartikülleri arasında yer almakta olup çevre ortamlarında güneş ışığı altında oldukça reaktif ve fizikokimyasal olarak dinamik bir hale gelmekte ve çevrede risk oluşturmaktadır. Dolayısıyla, bu nanopartiküllerin neden olacağı çevresel risklerin anlaşılması amacıyla ekotoksisite çalışmaları yoğun olarak sürdürülmektedir. Bu çalışmada, TKE’ler arasında ilk dikkat çeken metallerden olan, Lityum (Li) (çoğunlukla uzun ömürlü pillerden kaynaklanan) ve Seryum (Ce) (elektronik sanayiinde vazgeçilmez hale gelen ve özellikle yarı iletkenlerde kullanılan) ile ilgili sucul ve fitotoksik bulgular değerlendirilmiştir.There are in very few regions and few amounts elements (Rare Earth Elements-REE) on the surface of the earth are rapidly used and consumed in parallel with technological developments. Another common name of these elements is the Technology Critical Elements (TCE) have increased their frequency and quantity with increasing their usage rates. TCEs are among the engineered nanoparticles become highly reactive under sunlight in environmental areas and physicochemically dynamic and pose a risk to the environment. Therefore, ecotoxicity studies are intensively carried out in order to understand the environmental risks caused by these nanoparticles. In this study, amongst the TCE, Lithium (Li) (originated mostly from batteries), and Cerium (Ce) (indispensable in electronic industry and used especially in semiconductors) have been evaluated according to aquatic and phytotoxic findings

Vision Transformer Based Classification of Neurological Disorders from Human Speech

In this study, we introduce a transformative approach to achieve high-accuracy classification of distinct health categories, including Parkinson's disease, Multiple Sclerosis (MS), healthy individuals, and other categories, utilizing a transformer-based neural network. The cornerstone of this approach lies in the innovative conversion of human speech into spectrograms, which are subsequently transformed into visual images. This transformation process enables our network to capture intricate vocal patterns and subtle nuances that are indicative of various health conditions. The experimental validation of our approach underscores its remarkable performance, achieving exceptional accuracy in differentiating Parkinson's disease, MS, healthy subjects, and other categories. This breakthrough opens doors to potential clinical applications, offering an innovative, non-invasive diagnostic tool that rests on the fusion of spectrogram analysis and transformer-based models

Comparison of ketamine-propofol and remifentanil in terms of hemodynamic variables and patient satisfaction during monitored anaesthesia care

  BACKGROUND: This study aimed to compare remifentanil and ketamine-propofol in terms of hemodynamic response, duration of recovery and patient satisfaction in operative hysteroscopy cases who underwent monitored anaesthesia care in combination with paracervical block. METHODS: Monitored anaesthesia care was used in 60 ASA I-II female patients. The patients were divided into two groups as remifentanil (Group R) and ketamine-propofol (Group K-P). The hemodynamic effects of remifentanil and ketamine-propofol, and duration of recovery were recorded and compared. The patient satisfaction was also recorded and the two groups were compared. RESULTS: Age, body mass, ASA status, duration of anaesthesia and type of surgery were found to be similar between groups. The time of the Aldrete score reaching ≥ 9 was found to be shorter in Group R when compared with Group KP (Group R: 4.1 ± 1.9 min, Group K-P: 6.1 ± 2.6 min) (P &lt; 0.05). The incidence of postoperative nausea and vomiting was found to be significantly higher in the remifentanil group (P ≤ 0.05). When the groups were compared in terms of patient satisfaction, in both groups this was found to be similar. CONCLUSION: Sedation with remifentanil combined with a paracervical block during monitored anaesthesia care provides early recovery with effective sedation and analgesia in hysteroscopy procedures.  BACKGROUND: This study aimed to compare remifentanil and ketamine-propofol in terms of hemodynamic response, duration of recovery and patient satisfaction in operative hysteroscopy cases who underwent monitored anaesthesia care in combination with paracervical block. METHODS: Monitored anaesthesia care was used in 60 ASA I-II female patients. The patients were divided into two groups as remifentanil (Group R) and ketamine-propofol (Group K-P). The hemodynamic effects of remifentanil and ketamine-propofol, and duration of recovery were recorded and compared. The patient satisfaction was also recorded and the two groups were compared. RESULTS: Age, body mass, ASA status, duration of anaesthesia and type of surgery were found to be similar between groups. The time of the Aldrete score reaching ≥ 9 was found to be shorter in Group R when compared with Group KP (Group R: 4.1 ± 1.9 min, Group K-P: 6.1 ± 2.6 min) (P &lt; 0.05). The incidence of postoperative nausea and vomiting was found to be significantly higher in the remifentanil group (P ≤ 0.05). When the groups were compared in terms of patient satisfaction, in both groups this was found to be similar. CONCLUSION: Sedation with remifentanil combined with a paracervical block during monitored anaesthesia care provides early recovery with effective sedation and analgesia in hysteroscopy procedures

Wood and Bamboo-PP Composites: Fungal and Termite Resistance, Water Absorption, and FT-IR Analyses

This study evaluated biological resistance of composites produced from polypropylene and either wood or bamboo by using two different levels of particle content and three different particle sizes. Composite specimens containing higher particle content and smaller particle size resulted in increased mass losses in decay resistance tests against Tyromyces palustris, a standardized test fungus, Schizophyllum commune, and Pycnoporus coccineus. As particle content increased, mass losses in laboratory termite resistance tests increased; however, decreased particle size caused slightly decreased mass losses. Higher mass losses in bamboo-composites were obtained compared to mass losses in wood-composites in biological resistance tests. There is no significant effect of particle size on water absorption and thickness swell. The IR spectrums of composite specimens showed that significant changes were seen in the wood components following the application of heat during the manufacturing process. While the IR spectrum of WPC specimens with 70% wood was similar to the wood, the composite specimen with 50% wood displayed similarities to polypropylene