Search

SUMMARY OBJECTIVE: The purpose of our research was to observe the effects of miR-21, miR-221, and miR-222, as well as their target genes on oxidative stress, lung cancer formation, and metastasis. METHODS: Positron emission tomography/computed tomography, fiberoptic bronchoscopy, and/or endobronchial ultrasonography were performed on a total of 69 lung cancer patients to detect the presence or absence of metastasis, and the patients were classified based on the types of cancer. Total RNA and miRNA were isolated from the obtained biopsy samples. The quantitative analysis of hsa-miR-21-5p, hsa-miR-222-3p, and hsa-miR-221-3p and their target genes was performed by the RT-qPCR method. In determining oxidative stress, total antioxidant status and total oxidant status in tissue and total thiol and native thiol in blood were determined spectrophotometrically. OSI and disulfide were calculated. RESULTS: We discovered that the metastasis group had higher levels of hsa-miR-21-5p, hsa-miR-221-3p, and hsa-miR-222-3p (p0.05). CONCLUSION: Our findings show that upregulation of hsa-miR-21-5p, hsa-miR-221-3p, and hsa-miR-222-3p effectively contributes to both proliferation and invasion by influencing oxidative stress and mitochondrial apoptosis.

Background: This study aimed to assess the safety and tolerability of nebivolol in hypertensive patients with coronary artery disease and left ventricular ejection fraction ?40% in a Turkish cohort. Methods: A total of 1015 hypertensive patients and coronary artery disease with left ventricular ejection fraction ?40% were analyzed from 29 different centers in Turkey. Primary outcomes were the mean change in blood pressure and heart rate. Secondary outcomes were to assess the rate of reaching targeted blood pressure (, Baskent Üniversitesi, Funding: This study was supported by Baskent University Research Fund.

Resumo A doença de coronavírus 2019 (COVID-19) foi relatada em quase todos os países do mundo desde dezembro de 2019. A infecção por SARS-CoV-2 é frequentemente assintomática ou com sintomas leves, mas também pode levar à hipóxia, um estado hiperinflamatório e coagulopatia. Os parâmetros de coagulação anormais estão associados a complicações trombóticas, incluindo embolia pulmonar na COVID-19, mas pouco se sabe sobre os mecanismos. A semelhança dos sintomas iniciais de ambas as doenças também pode ser confusa, portanto, os médicos devem estar cientes do potencial para condições concomitantes. Apresentamos aqui um caso que não apresentava opacidades em vidro fosco nos pulmões, mas apresentava embolia pulmonar e derrame pleural em associação com infecção por COVID-19. Abstract Coronavirus disease 2019 (COVID-19) has been reported in almost every country in the world since December 2019. Infection with SARS-CoV-2 is often asymptomatic or with mild symptoms, but it may also lead to hypoxia, a hyperinflammatory state, and coagulopathy. The abnormal coagulation parameters are associated with thrombotic complications, including pulmonary embolism in COVID-19, but little is known about the mechanisms. The similarity of initial symptoms of both diseases can also be confusing, therefore the physicians should be aware of the potential for concurrent conditions. Herein, we present a case who did not have ground-glass opacities in the lungs, yet presented with pulmonary embolism and pleural effusions in association with COVID-19 infection.

Introduction:The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diag-nosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the cent-ers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total me-dian cost from the patient's admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.

Objectives: Inflammation and coagulation perform a substantial act in the pathophysiology of COVID-19 cases. The systemic immune-inflammation index (SII) is a novel prognosis and inflamation index. In this study, we aimed to research the relation between SII and prognosis in COVID-19 patients. Methods: 315 cases (males, 136 ; females, 179 ; 63.2 ± 11.4 years) with positive PCR and lung tomography evidences compatible with COVID-19 pneumonia were recorded in the research. Patients were separated into 2 groups according to the mortality (Group 1; Surviving patients, Group 2; Ex patients). Clinical, demographic, and laboratory datas for whole patients were registered Laboratory datas were measured from blood parameters taken during hospitalization. The SII was calculated as “ SII = neutrophil count × platelet count / lymphocyte count ”. Results: The mean hospital stay of the patients is 12 (5-26) days. When the patients were assessment of according to clinical features, an important distinction was found between the two groups according to age, gender, cardiovascular disease, chronic renal failure, neurolvascular disease, and diabetes mellitus. When the patients were evaluated according to laboratory parameters, white blood cells, neutrophils, creatinine, D-Dimer, ferritin, CRP values were observed to be significantly higher in Group 2 patients than Group-1 patients. However, lymphocyte count, serum potassium level, albumin and calcium levels were observed to be significantly lower in Group-2 patients than in Group-1 patients. SII level was significantly higher in Group 2 patients than Group-1 patients (1813.4 ±118.7 vs 978.2 ± 93.1, p

Background: Hydroxychloroquine (HCQ) treatment is frequently prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitorization is recommended because HCQ causes QT interval prolongation. The index of cardioelectrophysiological balance (iCEB), calculated as the ratio of QT interval / QRS duration. In recent years, iCEB has been described as an important marker for dysrhthmias. Decreased or increased iCEB is related with lethal ventricular arrhythmias. Aim of the study: In our research, we purposed to investigate the relationship between iCEB and HCQ in patients with COVID-19. Methods: 200 patients (males, 84 ; females, 116 ; 60.4 ± 13.8 years) with PCR positive and chest tomography findings compatible with COVID-19 pneumonia were registered in the research. Demographic, clinical, and laboratory data for all patients were collected. ECG was recorded from all patients on admission to COVID-19 clinic, in oral treatment with HCQ (200 mg, twice daily) for at least 5 days. iCEB (QT/QRS) was calculated from the 12-lead electrocardiogram.Results: The mean age of the patients was 60.4 ± 13.8 years. Compared to admission ECG, ECG on day 5 showed significant increases in heart rate, QT interval, corrected QT (QTc) interval, and iCEB. Conclusions: Our results suggested that iCEB is related with HCQ treatment in patients with COVID-19. Previous studies have show that high iCEB is related with torsade de Pointes (TdP), ventricular tachycardia.

Objective: This study was conducted to investigate the awareness levels of family physicians about sleep disorders before training.Materials and Methods: In our cross-sectional study; A questionnaire consisting of 11 questions including sociodemographic information, sleep physiology, knowledge and awareness levels of family physicians who received training was used.Results: Among family physicians, 38 women (42.7%) and 51 men (57.3%) participated. Body Mass Index (BMI) was 26.66±6.27, mean age was 44.95±7.69, and 19.75±7.94 years as years of work. 43 (49.4%) of the participants stated the information about physiological sleep duration as eight hours. When asked whether they had received training on sleep disorders before, 74 people (83.1%) did not receive training, and therefore 7 (10.1%) people answered the question of sleep disorder defined in the International Classification of Sleep Disorders (ICSD) correctly. There were 42 people (47.2%) previously diagnosed with sleep disorders, and sleep apnea was the most frequently diagnosed sleep disorder in 24 (66.7%). When the level of knowledge about sleep physiology and sleep disorders was questioned, 63 (70.8%) people were found to be inadequate. Likewise, when asked whether they had sleep disorders, 42 (47.2%) answered no, and 31 (34.8%) partly answered.Conclusion: The awareness levels of the family physicians participating in the training on sleep physiology and sleep disorders were found to be quite low., Amaç: Bu çalışma, aile hekimlerinin eğitim öncesi uyku bozuklukları konusundaki farkındalık düzeylerini araştırmak amacıyla yapılmıştır.Gereç ve Yöntem: Kesitsel çalışmamızda; eğitim alan aile hekimlerinin sosyodemografik bilgileri, uyku fizyolojisi, bilgi ve farkındalık düzeylerini içeren 11 sorudan oluşan anket formu kullanıldı.Bulgular: Aile hekimlerinden 38 kadın (%42,7) ve 51 erkek (%57,3) katıldı. Vücut Kitle İndeksi (VKİ) 26,66±6,27, yaş ortalamaları 44,95±7,69, meslekte çalışma yılı olarak 19,75±7,94 yıl olarak saptandı. Katılımcılardan 43'ü (%49,4) fizyolojik uyku süresi ile ilgili bilgileri sekiz saat olarak belirtmiştir. Daha önce uyku bozuklukları konusunda eğitim alıp almadıkları sorulduğunda (n:74, %83,1) eğitim almamış aile hekimleri vardı ve bu sebeple 7 (%10,1) kişi Uluslararası uyku bozuklukları sınıflamasında (ICSD) tanımlanan uyku bozukluğu sorusuna doğru cevap vermiştir. Daha önce uyku bozukluğu teşhisi konulan (n:42, %47,2) vardı ve en fazla teşhis edilen uyku bozukluğu 24 (%66,7) olarak uyku apnesi bulundu. Uyku fizyolojisi ve uyku bozuklukları ile ilgili bilgi düzeyi sorgulandığında 63 (%70,8) kişinin yetersiz olduğu görüldü. Yine aynı şekilde kendilerinde uyku bozukluğu olup olmadığı sorulduğunda 42 (%47,2) kişi hayır, 31 (%34,8) kişi kısmen yanıtlamıştır.Sonuç: Eğitime katılan aile hekimlerinin uyku fizyoloji ve bozuklukları konusundaki bilinçlilik seviyeleri epeyce düşük bulunmuştur.

Aralık 2019'da Wuhan şehrinde ortaya çıkan ve tüm dünyaya yayılan koronavirüs hastalığı (COVID-19) akciğerde oluşturduğu hasar sonucu hastalar, en sık nefes darlığı (dispne) şikayeti ile başvurmakta ve hipoksemi varlığında hastaneye yatırılarak tedavi edilmektedirler. Hastalığın prognozunu da etkileyen ve mortal seyretmesine yol açan hipokseminin oluşum mekanizması ile oksijen tedavisinin kime, ne zaman ve nasıl verilmesi bu makalede açıklanmaya çalışılmıştır., The coronavirus disease (COVID-19), which emerged in the city of Wuhan in December 2019 and spread all over the world, especially infected the lungs. As the result of damage to the lungs, the patients most often apply with the complaint of shortness of breath (dyspnea) and are hospitalized in the presence of hypoxemia. The mechanism of hypoxemia, which also affects the prognosis of the disease and leads to mortality, and to whom, when, and how the oxygen therapy should be given, has been tried to be explained in this article.

Aralık 2019'da Wuhan şehrinde ortaya çıkan ve tüm dünyaya yayılan koronavirüs hastalığı (COVID-19) akciğerde oluşturduğu hasar sonucu hastalar, en sık nefes darlığı (dispne) şikayeti ile başvurmakta ve hipoksemi varlığında hastaneye yatırılarak tedavi edilmektedirler. Hastalığın prognozunu da etkileyen ve mortal seyretmesine yol açan hipokseminin oluşum mekanizması ile oksijen tedavisinin kime, ne zaman ve nasıl verilmesi bu makalede açıklanmaya çalışılmıştır., The coronavirus disease (COVID-19), which emerged in the city of Wuhan in December 2019 and spread all over the world, especially infected the lungs. As the result of damage to the lungs, the patients most often apply with the complaint of shortness of breath (dyspnea) and are hospitalized in the presence of hypoxemia. The mechanism of hypoxemia, which also affects the prognosis of the disease and leads to mortality, and to whom, when, and how the oxygen therapy should be given, has been tried to be explained in this article.

AmaçBu çalışmada vücut analizi (TANİTA) verileri ile apne-hipopne indeksine (AHİ) göre obstrüktif uyku apne sendromu (OSAS) şiddetinin tahmin edilmesi amaçlandı.MetodBu çalışmada OSAS tanısı konulan ve diyet polikliniğine başvuran 239 adet hastanın, her biri için 23 adet vücut analizi verisi kullanılmıştır. Farklı vücut analizi verisi seçimi algoritmaları çalıştırılarak, veri madenciliği modellemeleri yapılmıştır. Sonuç olarak en başarılı sonuçların elde edildiği metod; Korelasyon Tabanlı Öznitelik Seçimi yöntemidir (CFS). CFS yöntemine göre bu çalışmada dört adet öznitelik, sınıflandırma işleminde en başarılı sonucu verdirmiştir. Seçilen öznitelikler Kilo, Metabolizma Yaşı, Hücre Dışı Sıvı ve Bel çevresi olmuştur. Bu çalışmada altı adet sınıflandırma yöntemi (Bayes Sınıflandırıcı Algoritması, Destek Vektör Makineleri, K* Algoritması, Reptree Algoritması, ZeroR Algoritması, Yapay Sinir Ağları) kullanılarak sonuçların başarısı karşılaştırılmıştır. BulgularHer bir sınıflandırma yönteminden elde edilen en iyi sonuçlar verilmiştir. Burada tüm gruplar için AHİ’yi tahmin etme oranı %65 olarak bulundu ve en iyi tahmin yapay zeka modelinde oldu. Modeller kullanılarak AHI’ye göre yapılan sınıflandırmada; hafif OSAS 153 hasta, orta OSAS 43 hasta, ağır OSAS 43 hasta bulundu. DVM %100, ZeroR %100, YSA %100 90,85 olarak bulunmuştur. Burada en iyi hafif OSAS’ı tahmin etmede etkili olmuştur.SonuçSonuçlar incelendiğinde sınıflandırma yöntemleri kullanılarak vücut analizi verileri ile AHI tahmininin yapılabileceği öngörülmektedir. En iyi sınıflandırma yöntemi Yapay Sinir Ağları, ZeroR ve DVM modelleri ile elde edilmiştir. Sonuçların daha iyi tahmin yüzdesine sahip olabilmesi için daha geniş hasta sayıları ile yeni çalışmalara ihtiyaç olduğunu düşünmekteyiz., AimIn this study, it was aimed to predict the severity of obstructive sleep apnea syndrome (OSAS) according to apnea-hypopnea index (AHI) by body analysis (TANITA) data.Material and MethodTwenty-three parameters of body analysis were used for each patient who had been diagnosed as OSAS and admitted to diet polyclinic. Data mining modeling has been done by running different body analysis data selected algorithms. As a result, the most successful result was obtained by Correalation – based Feature Selection (CFS). According to the CFS method, four features resulted successfully in the classification process in this study. Selected features included of model were Weight, Metabolism Age, Extracellular Fluid and Waist circumference. The success of the results was compared by using six classification methods (Naive Bayes Classifier Algorithm, Support Vector Machine, K* Algorithm, Reptree Algorithm, ZeroR Algorithm, Artificial Neural Network) in this study. ResultsThe best results obtained from each classification method. The estimated ratio of AHI for all groups was 65% for YSA model. The classification was done according to AHI by using the models; mild OSAS (153 patient), moderate OSAS (43 patient), severe OSAS (43 patient), and powerfull estimate are shown DVM %100, ZeroR %100, YSA %100 90,85 for mild OSAS.ConclusionWhen the results are examined, it is predicted that the AHI estimation can be performed by using body composition data with the classification methods. The best classification method was obtained with Artificial İntelligence Networks, ZeroR and DVM models. We think that new studies are needed with larger populations to obtain better estimate percentages.

Study Objectives: Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder that occurs in approximately 5-10% of the general population, and characterized by excessive daytime sleepiness, disruptive snoring, recurrent episodes of apnea or hypopnea and nocturnal hypoxemia. The subtypes of positional OSAS (PPs) are defined by conventional classification determined by the apnea-hypopnea index (AHI). However, there were not enough studies about the classification and characterization of PPs in the literature. The aim of this study is to determine the new subtypes of PPs by data mining algorithms. Methods: 'The study was admitted by 514 patients with OSAS with 24 attributes which was analysed by K-means clustering, C&RT and CHAID decision tree algorithms by RStudio programming. Chi-square test was used for cross validation and Kappa statistics were used to compare the re-evaluated values with classical values. Results: In all methods, two clusters for PPs were obtained and the CHAID algorithm gave us the most accurate results. The value for AHI nodes in CHAID was considered as a cut-off value, and cross-validated with the cut-off value obtained by AUC-ROC analysis with high accuracy (92%). Conclusion: It can be concluded that specific treatments should be developed for new subtypes of PPs considering the centroids of 14 significant attributes.

Amaç: Bu çalışmada OUAS (obstrüktif uyku apne sendromu) tanısı konulan hastaların fonksiyonel lateralite düzeyleri ile hastalığın şiddeti ve uyku parametreleri arasındaki ilişki araştırılmıştır. Materyal Metod: Çalışmaya tek gece PSG (polisomnografi) yapılan ve OUAS tanısı konulan 88 hasta dahil edilmiştir. Hastalar Geschwind skoruna göre gruplandırılarak, PSG verileri ile lateralite arasındaki farklılıklar Kruskal Wallis, Mann Whitney U, Pearson Korelasyon ve Ki-kare testleri kullanılarak değerlendirildi.Bulgular: Yaş ortalamaları 50,74±11,77 olan 69 erkek (%78,4), 19 kadın (%21,6) çalışmaya alındı. Hastaların 42’si (%47,7) aşırı sağ elini kullanan, 11’i (%12,5) yalnızca sağ elini kullanan, 2’si (%2,3) sol elini kullanan, 33 kişi (%37,5) ise her iki elini kullanmaktaydı. Aşırı sağ elini kullananlar ile yalnızca sağ elini kullananlar arasında ortalama oksijen desatürasyonu (p:0,015), uykuya dalma süresinde (p:0,027) istatistiksel olarak anlamlı fark mevcuttu. Aşırı sağ elini kullanan ve sol elini kullanan bireyler arasında uykunun REM evresinde (p:0,040) anlamlı fark bulundu. Aşırı sağ elini kullanan ve her iki elini kullanan bireyler arasında PLM (p:0,000) ve total apne indeksinde (p:0,027) anlamlı fark saptandı. Sağ ve sol elini kullanan bireyler arasında REM uykusu (p:0,048), VKİ (p:0,048) anlamlı fark mevcuttu. Sağ elini ve her iki elini kullanan bireyler arasında total apne indeksi (p:0,010), AHİ (p:0,014), bruksizm (p:0,041), ODİ (p:0,035) anlamlı fark mevcuttu. Sol el ve her iki elini kullanan bireyler arasında toplam apne indeksi (p:0,007), AHİ (p:0,003), toplam uyku süresi (p:0,030), PLM (p:0,040) parametrelerinde anlamlı fark bulunmuştur.Sonuç: Sağ elini, sol elini kullanan kişilerle ile her iki elini kullanan kişiler arasında AHİ’lerinin farklı olması fonksiyonel lateralite ile OUAS arasında beyinde bir ilişki olduğunu düşündürmektedir.

Acute stroke is an important cause of morbidity and mortality. Prediction tools are especially helpful in this situation in guiding for medical treatment decision. It is found that prognostic index is predictor of mortality and heart failure in patients with ischemic heart failure implanted with an ICD, the prognostic index (PI) being built according to the formula: 120 - age + mean 24 h systolic blood pressure - (creatinine * 10). However, a mean 24 h systolic blood pressure calculation is not clinically easy. Therefore, we propose a new modified prognostic index (Musekna Index). Musekna Index (MI) was calculated as “120 - age + mean arterial pressure - (creatinine * 10)”. In this study, we aimed to investigate the relationship between MI and stroke severity in patients with acute ischemic stroke. This cross-sectional study included 162 patients (males, 64; females, 98; 67 ± 15 years) with acute ischemic stroke. Patients were divided into two groups based on the calculated National Institutes of Health Stroke Scale (NIHSS) score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Musekna Index (Modified Prognostic Index) was calculated as “120 - age + mean arterial pressure - (creatinine * 10)”. MI index was calculated admission to the neurology care unit. Echocardiographic examinations were performed using the parasternal longitudinal axis and apical 4-chamber windows in accordance with the recommendations of the American Echocardiography Committee. There were no significant differences among the demographic parameters of patients. MI was significantly higher in Group 1 patients than in Group 2 patients (139±15.6 vs 132±13.7, p=0.028). Our results suggest that MI is associated with stroke severity on admission in patients with acute ischemic stroke.

Background Collagen-based synthetic bone grafts which contain tricalcium phosphate (TCP) and hydroxyapatite (HA), and collagen-based synthetic bone grafts containing only TCP have some advantages compared to autografts. Therefore, these grafts are frequently used to fill bone defects and pseudoarthrosis. Objectives The aim of this study was to evaluate and compare the clinical, radiological and histopathological effects of TCP-HA and TCP alone + Type-1 collagen in healing lower extremity fractures in a pseudoarthrosis model in rat femurs. Material and methods A total of 36 female Wistar rats were randomly separated into 4 groups. Group 1 (n = 10) was the control group. A femur pseudoarthrosis model was created in Groups 2, 3 and 4. On the 90th day after the 1st surgery in Group 2 (n = 10), TCP-HA + Type-1 collagen was applied, in Group 3 (n = 10), TCP alone + type-1 collagen was applied, and in Group 4 (n = 6, the placebo group), saline solution was applied. Fixation was performed with an intramedullar pin. After 60 days and clinical and radiological scoring, all animals were sacrificed and a histopathological evaluation of the pseudoarthrosis areas was conducted. Results In all the clinical, radiological and histopathological measurements used in the evaluations of the differences between the groups, a higher rate of union was determined in Group 2 (TCP-HA). No significant difference was determined between Group 3 and Group 4 in terms of union rates. Conclusions The clinical, radiological and histopathological results of this study showed that TCP alone was less effective than TCP-HA in the union of a femur pseudoarthrosis model in rats. The reason for this difference was considered to be hydroxyapatite (HA).