Multiple sclerosis prevalence study the comparison of 3 coastal cities, located in the black sea and mediterranean regions of Turkey

The prevalence of multiple sclerosis (MS) has significantly increased all over the world. Recent studies have shown that Turkey has quite a high prevalence. The aim of this study is to estimate prevalence in the Mediterranean and Black Sea regions of Turkey and to compare the results. This study was designed as a door to door survey in 3 cities. One is located in the Mediterranean region (South), 2 are located in the Black Sea region (North). A previous validated form was used for screening in the field. The patients were examined first in the field, then in the regional health facility. McDonald criteria were used for the diagnosis. In total, 26 patients were diagnosed with MS. The prevalence was found to be 18.6/100,000 in Artvin (Black Sea region), 55.5/100,000 in Ordu, (Black Sea region), 52.00/100,000 in Gazipasa (Mediterranean region). The female/male ratio was 2.25. This study is the first prevalence study which was conducted in the Mediterranean City (South) of Turkey. The prevalence rate was found to be higher than expected in the Mediterranean city of Gazipasa. The results showed that the prevalence varies from region to region. Latitude difference was not observed

Structure-property relationships of novel phosphonate-functionalized networks and gels of poly(β-amino esters)

pH sensitivity, biodegradability and high biocompatibility make poly(β-amino esters) (PBAEs) important biomaterials with many potential applications including drug and gene delivery and tissue engineering, where their degradation should be tuned to match tissue regeneration rates. Therefore, we synthesize novel phosphonate-functionalized PBAE macromers, and copolymerize them with polyethylene glycol diacrylate (PEGDA) to produce PBAE networks and gels. Degradation and mechanical properties of gels can be tuned by the chemical structure of phosphonate-functionalized macromer precursors. By changing the structure of the PBAE macromers, gels with tunable degradations of 5–97% in 2 days are obtained. Swelling of gels before/after degradation is studied, correlating with the PBAE identity. Uniaxial compression tests reveal that the extent of decrease of the gel cross-link density during degradation is much pronounced with increasing amount and hydrophilicity of the PBAE macromers. Degradation products of the gels have no significant cytotoxicity on NIH 3T3 mouse embryonic fibroblast cells

Quality of life among patients with age-related severe macular degeneration assessed using the NEI-VFQ, HADS-A, HADS-D and SF-36 tests. A cross-sectional study

ABSTRACT BACKGROUND: Exudative age-related macular degeneration (e-AMD) may cause severe central vision loss. Patients with e-AMD can experience difficulties in daily basic activities and suffer from psychological problems. Our aim was to assess quality of life (QoL) and anxiety and depression status among patients with e-AMD. DESIGN AND SETTING: Cross-sectional study in a state university. METHODS: We included 200 e-AMD patients and 120 age and gender-matched controls. We assessed QoL using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and the Short Form (SF)-36 test; and anxiety and depression status using the Hospital Anxiety Depression Scales A and D (HADS-A and HADS-D). RESULTS: The mean ages in the e-AMD and control groups were 68.40 ± 9.8 and 66.31 ± 8.98, respectively. Visual acuity among e-AMD patients was 0.37 ± 0.31 and 0.39 ± 0.32 in the right and left eyes, respectively. The e-AMD patients performed significantly worse than the controls in NEI-VFQ-25 (P < 0.05 for all items). The proportions of e-AMD patients scoring higher than the cutoffs in HADS-A and HADS-D were significantly higher than among the controls (41.5% versus 12.5% and 63.5% versus 27.5%; P < 0.001). The e-AMD patients had significantly lower mean scores than the controls for each of the SF-36 QoL items (P < 0.001). The NEI-VFQ-25 scores were significantly lower among patients with bilateral e-AMD than among those with unilateral disease (P < 0.05 for all). The HADS scores were positively correlated with duration of e-AMD and patient age, but negatively with vision levels (P < 0.05 for all items). CONCLUSION: The e-AMD patients had higher depression and anxiety scores and lower QoL scores

Clinical Outcomes of Synchronous Laparoscopic Cholecystectomy with Coronary Artery Revascularization

WOS: 000475389300004PubMed ID: 31237549Background: There are limited data about the results of simultaneous coronary revascularization, either with coronary artery bypass grafting (CABG) surgery or percutaneous coronary intervention (PCI), and cholecystectomy operations. Here we present clinical outcomes of the patients who underwent simultaneous laparoscopic cholecystectomy (LC) and coronary revascularization at the same session. Patients and Methods: We included a total of 19 patients who underwent simultaneous LC and CABG or PCI. Thirteen of them had been hospitalized because of acute cholecystitis prior to coronary angiography. Simultaneous CABG and LC were performed in 10 patients (group I). LC was performed immediately after CABG surgery at the same session. PCI (group II) was performed in 9 patients. In the PCI group, LC was performed under general anesthesia 2 or 3 days after PCI. Results: No mortality was seen after the procedures. In the CABG group, the mean number of bypass grafts was 3.4 +/- 1.9. The mean extracorporeal circulation and the total operation times were 95 +/- 13.5 minutes and 259 +/- 18.9 minutes, respectively; the mean intubation duration was 17 +/- 4.8 hours. In the PCI group, the mean number of stents per patient was 2.1 +/- 0.7; LC was performed 2 or 3 days after the PCI without the cessation of clopidogrel and acetylsalicylic acid. The mean operation times for LC were 56.5 +/- 15.6 minutes and 51.3 +/- 17.6 minutes in the CABG and PCI groups, respectively (P=.86). In the CABG group, the mean durations of ICU and hospital stays were 3.1 +/- 1.4 and 14.2 +/- 3.7 days, respectively. In the PCI group, the mean durations of ICU stay and hospitalization were 1.7 +/- 0.4 and 7.4 +/- 2.2 days, respectively. Significant differences were found between the 2 groups in terms of the intubation time, duration of ICU stay, and hospitalization periods (P=.001, P=.0001, and P=.001, respectively). No intra-abdominal complications or bleeding was encountered in any group. Postoperative complications of the abdominal wall or mediastinitis were not seen in the setting of concomitant procedures in the CABG group. Conclusion: Simultaneous CABG or PCI with LC may be performed safely in patients with cholecystitis. The durations of postcholecystectomy ICU stay and the intubation time were significantly lower in the PCI group. According to our results, PCI may be the first choice of revascularization procedure in selected patients requiring cholecystectomy prior to discharge

One-step injectable and bioreducible poly(β-amino ester) hydrogels as controlled drug delivery platforms

A one-step synthesis strategy based on aza-Michael reaction of poly(ethylene glycol) diacrylate (PEGDA) or PEGDA/1,6-hexanediol diacrylate (HDDA) mixture and cystamine was employed to fabricate injectable, biocompatible and degradable novel poly(β-amino ester) (PBAE) hydrogels. The gelation was monitored by real-time dynamic rheological measurements in order to follow formation of the PBAE hydrogel networks. The obtained hydrogels were responsive to both pH and redox state which enabled the control of swelling, degradation and release properties by external triggers. Degradation products of the hydrogels were shown to have no significant cytotoxicity on A549 adenocarcinomic human alveolar basal epithelial cells and MCF-7 human breast cancer cells. The hydrogels were loaded with a photosensitizer, methylene blue (MB), as a model compound by simply adding the MB molecules into the precursor mixture. The activity of released MB was assessed by in vitro photodynamic therapy (PDT) studies conducted with A549 cells