Adjustment disorder after botulinum toxin injection in an adolescent palatal myoclonus case: The importance of informed consent in the treatment of neuropsychiatric disorders in children and adolescents

No Abstrac

Systemic immune-inflammation index: A novel marker for predicting response to cardiac resynchronization therapy in patients with heart failure

Aim: To investigate the utility of systemic immune-inflammation index (SII) in predicting response to cardiac resynchronization therapy (CRT) among patients with heart failure (HF). Method: A total of 78 patients with HF who underwent CRT device implantation were included in this 6-month follow up study. Data on laboratory findings including complete blood count, blood biochemistry and SII as well as the transthoracic echocardiography findings were recorded at baseline prior to CRT device implantation and 6 months after CRT. Results: The criteria for response to CRT including improvements in New York Heart Association (NYHA), left ventricular end-systolic volume (LVESV) (decreased by ≥15%) and ejection fraction (EF) (increased by≥10%) were met by 73.1%, 65.4% and 69.2% of patients, respectively. In patients with decreased vs. increased SII values during 6-month therapy, the likelihood of meeting LVESV (84.3 vs. 15.7%, p<0.001), EF (81.5 vs. 18.5%, p<0.001) and NYHA (77.2 vs. 22.8%, p<0.001) response criteria for successful CRT were significantly higher. Multivariate analysis revealed that decrease in SII (OR 0.982, 95% CI: 0.970 to 0.995, p=0.006) and TAPSE (OR 0.602, 95% CI. 0.396 to 0.916, p=0.018) during treatment as the only significant determinants of presence of response to CRT in heart failure (HF) patients. Conclusions: Our findings seem to indicate the favorable utility of SII, as a non-invasive readily available marker, in predicting response to CRT and thus enabling a beneficial reverse remodeling process via timely implementation of advanced treatments in HF patients

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Synthesis and characterization of zinc(II) complexes with new pyridine-based ligands: crystal structure, Hirshfeld surface analysis, and molecular docking study of lung cancer cell

The new ligands 2-chloro-6-{2-[(2,4,6-trimethylphenyl)methylidene]hydrazinyl}pyridine and 2-chloro-6-{2-[1-(4-nitrophenyl)ethylidene]hydrazinyl}pyridine and their Zn(II) complexes were synthesized and characterized by elemental analysis, LC/MS-MS, thermal analysis, UV-vis spectroscopy, molar conductivity, 1H NMR, 13C NMR, FT-IR, X-ray diffraction, as well as single-crystal X-ray crystallography. Hirshfeld surface analysis with 2-D fingerprint plots was carried out to estimate intermolecular interactions in the crystal and molecular electrostatic potential (MEP) diagrams of ligands were mapped by using Hartree-Fock theory STO-3G base set of Hirshfeld surface. Additionally, it is suggested that both Zn(II) complexes have a distorted octahedral geometry as a result of spectroscopic and analytical data. For 1, two HL1 ligands act as tridentate while in 2, Zn is coordinated with aromatic pyridine nitrogen, imine nitrogen of two bidentate HL2 ligands, one nitrate group and one oxygen atom from the aqua ligand. The molecular docking studies of the synthesized compounds were carried out. The complexes showed better binding affinity compared to the ligands and hydrophobic interactions of the compounds against targeted protein residues played an important role. Remarkably, it can be suggested that 1 is a very suitable drug candidate for lung cancer. © 2020 Informa UK Limited, trading as Taylor & Francis Group

Characterization of natural organic matter (NOM) by resin adsorption method in drinking waters

İçme sularında dezenfeksiyon ve oksidasyon amacıyla kullanılan klor, sudaki doğal organik maddelerle (DOM) reaksiyona girerek dezenfeksiyon yan ürünleri (DYÜ) olarak adlandırılan ve insan sağlığı açısından kanserojen etkiye sahip olduğu tahmin edilen trihalometanlar (THM) ve haloasetik asitler (HAA) gibi bileşikleri oluşturmaktadır. Klor bu dezavantajına rağmen ülkemizde ve dünya çapında hala çok yaygın bir şekilde içme suyu arıtımında ön oksidasyon ve dezenfeksiyon işlemlerinde kullanılmaktadır. Klorun su arıtımında fazla ilgi görmesinin nedeni, çok etkili bir dezenfektan olmasının yanı sıra kullanım kolaylığı ve düşük maliyete sahip olmasıdır. AB’ye üyelik süreci kapsamında ülkemizde, İÇME SUYU DAĞITIM SİSTEMİNDE (ŞEBEKESİNDE) THM limiti 150 μg/L olarak yürürlüğe girmiş ve bu THM limit değerinin 2012’den itibaren 100 μg/L’ye indirileceği belirtilmiştir. Amerika Birleşik Devletleri’nde THM’lerin 4 ve HAA’ların 5 türünün toplamı için EPA maksimum kirletici seviyesini (MCLs) TTHM’ler için 80 μg/L ve HAA5 için 60 μg/L olarak belirlemistir. ABD’deki içme suyu yönetmelikleri bu limitlerin sağlanması için içme suyu arıtma tesislerinin dezenfeksiyon yan ürünleri oluşumunda en önemli rol oynayan ve öncü bilesikler (precursor) olarak adlandırılan toplam organik karbon (TOK) konsantrasyonunu 2 mg/L’nin altına çekmelerini zorunlu kılmaktadır. Bu çalışmada İstanbul’a su sağlayan Terkos, B.Çekmece ve Ömerli Barajı’ndan alınan ham su numunelerindeki, doğal organik maddeler XAD reçineleri kullanılarak karakterize edilmiş ve her fraksiyon ayrı ayrı klorlanarak dezenfeksiyon yan ürünü olan trihalometanlar (THM) ve haloasetik asitlerin (HAA) oluşumları ile Ultraviyole absorban (UV) parametresi arasındaki ilişki incelenmiştir.When chlorine is applied to drinking water processes, it reacts with natural organic matter (NOM) and forms various types of chlorinated disinfection by-products (DBPs). These halogenated by-products are considered to be possible human carcinogens and named as trihalomethanes (THMs) and haloacetic acids (HAAs). Although chlorine has several disadvantages in water treatment, it is widely used for disinfection and oxidation purposes. Chlorine is preffered in water treatment mainly due to its high oxidation state, practical use, and low operation and maintenance cost. In Turkey, the current THM limit is 150 μg/l within WATER DISTRIBUTION SYSTEM until 2012, after this date, the THM limit will be reduced to 100 μg/l regulated limit of European Union (EU). USEPA regulated THM 4 and HAA 5 species of in potable water units at a level of 80 μg/L and 60 μg/L, respectively. US Drinking Water Regulations force water utilities to further increase DBP precursor removal with removing TOC below 2 mg/L. In this study, using XAD resins, we investigated changes on NOM fractions between THM formation and HAA formation with Ultraviyole absorban (UV) in drinking water samples taken from Terkos, B.Çekmece and Ömerli Dam in İstanbul

Synthesis, characterization of new homo and heteronuclear Schiff base copper(II) complexes

This article describes the synthesis of isonitrosomethyl-p-tolyl ketone [HL] as the starting material and then we prepared the schiff base ligand from the reactions of the amine compounds with o-phenylenediamine [H2L1]. A new series of mono-, homo and heterodinuclear copper(II)/nickel(II) complexes have been synthesized using an oxime ligand. The complexes were characterized by IR, elemental analysis, magnetic moment measurements, molar conductivity, mass spectra and TGA studies. The free ligand were also described 13C and 1H-NMR spectra. For complexes using stoichiometric and spectroscopic data of the metal complexes showed that metal:ligand ratio of mononuclear copper(II) complex was found to be 1:1 while this ratio was 2:1 in homo- and heterodinuclear copper(II) complex and 3:2 in the trinuclear copper (II) complex and metal ions are coordinated to the imine and oxime nitrogen atoms

Determination of Heavy Metals and Pesticides in Different Types of Fish Samples Collected from Four Different Locations of Aegean and Marmara Sea

Heavy metals and pollutants cause serious damage to the ecological environment and accumulate in marine species in the seas. These pollutants and heavy metals accumulating in living species are a serious source of danger for human health. For this purpose, in this study, heavy metal (lead, mercury, copper, zinc, arsenic, cadmium, silver, manganese, and nickel) and pesticide (p-p′-DDE, α-BHC, endosulfan, endosulfan sulfate, endrin, aldrin, heptachlor, heptachlor epoxide, methoxychlor, p-p′-DDD, p-p′-DDT, β-BHC, cypermethrin, and dieldrin) analyses of four different fish species (Pomatomus saltatrix, Dicentrarchus labrax, Mugil cephalus, and Sparus aurata) collected from the Aegean and Marmara seas were carried out by gas chromatography-mass spectroscopy and using an inductively coupled plasma-mass spectrometer. We observed serious and remarkable arsenic, lead, and cadmium concentrations in the muscle meat of fish sample. p-p′-DDE and endosulfan were determined in every fish sample of each region. Heptachlor concentration was determined as 0.0598 μg/g in Dicentrarchus labrax sample from Marmara Sea, which is nearly nine thousand times more than the maximum allowable concentration of environmental quality standards biota of heptachlor listed in 2013/39/EU. The results show an indication of the significant health risks associated with the consumption of these contaminated fish in the Aegean and Marmara seas. In the Turkish food codex and in the 2013/39/EU directive, some heavy metals that do not have the maximum allowable concentration limits should be urgently indicated. © 2020 Tufan Topal and Canan Onac

Seasonal variations of NOM composition and their reactivity in a low humic water

Natural organic matter (NOM) and its potential to form disinfection by-products (DBPs) during water treatment are of great public health concern. Understanding the seasonal changes in NOM composition and their reactivity in DBP formation could lead to a better treatment of drinking water and a more consistent water quality. NOM from the Terkos Lake was fractionated and characterized by XAD resin adsorption and ultrafiltration (UF) techniques during four different seasons within a year. XAD fraction analysis indicates that the HPI (38%) and the TPI (21%) were the dominant chemical fractions as DOC masses across the sampling period. Moreover, the fractions contributing to the most UV254 absorbance were HPO, which accounted for more than 72% of total UV254. It was found that the percentages of UV254 of HPI and TPI showed significant amount of variation with coefficients of variation of 48% (HPI) and 35% (TPI), respectively. Moreover, it was concluded that the HPO fraction was the primary THM precursor, which contributed more than 48%, and while the primary fraction of HAA precursors was found to be TPI, accounting for more than 47% of total HAAFP with exceptions in January 2011. As obviously seen in this study, the hydrophobic constituents in Terkos Lake water are on the low end of the spectrum in terms of their reactivity to form HAAs. In the context of THM reactivity, the physical properties (i.e., moleculer size) of Terkos Lake NOM are more important than their chemical properties (i.e., aromaticity). On the other hand, the predominant fraction as the source of HAAs precursors was found to be with the TPI and HPI chemical fractions. © 2013 American Institute of Chemical Engineers

Iron and Ferritin Levels of Children and Adolescents with Attention Deficit Hyperactivity Disorder and Attention Deficit Hyperactivity Disorder-Not Otherwise Specified

Aim: The study aimed to compare the levels of iron and ferritin in children with Attention Deficit Hyperactivity Disorder (ADHD) and Attention-Deficit Hyperactivity Disorder-Not Otherwise Specified (ADHD-NOS) and to assess the relationship between ADHD symptom severity and anxiety symptom severity with iron and ferritin levels

Relationships between Vitamin B12, Folate Levels and Clinical Features in Attention Deficit Hyperactivity Disorder and Attention Deficit Hyperactivity Disorder-Not Otherwise Specified

Aim: In this study, we aimed to compare the levels of vitamin 812 and folate in children with Attention Deficit and Hyperactivity Disorder (ADHD) and Attention Deficit and Hyperactivity Disorder-Not Otherwise Specified (ADHD-NOS)