29 results on '"Medical parameters"'
Search Results
2. AN APPLICATION FOR MONITORING AND DIAGNOSIS THE HEALTH OF A HUMAN SUBJECT
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Madalina Carbureanu and Petrus Bratu
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monitoring ,diagnosis ,neuro-fuzzy inference systems ,fuzzy rules ,medical parameters ,Technology (General) ,T1-995 ,Science - Abstract
The paper presents an application developed for monitoring the health of a human subject, respectively for monitoring a set of critical medical parameters (blood glucose, cholesterol, blood pressure, pulse and oxygen saturation) while the diagnosis is made based on the application supplied results. The field of artificial intelligence is a very wide one, providing to the user a set of various techniques such as: fuzzy logic, artificial neural networks, adaptive neuro-fuzzy systems, expert systems, data mining, genetic algorithms. To develop the application software (the necessary decision rules, in fact the fuzzy rules) was used one of the most efficient (due to the multiple advantages supplied by the usage of fuzzy logic together with artificial neural networks) artificial intelligence technique, respectively the neuro-fuzzy inference systems, while the application interface was developed using the Visual Studio programming environment (respectively the C# language). A set of simulation results related to the developed application are presented for different test cases, such as: a healthy human subject, a human subject with diabetes, a human subject with high cholesterol, with high blood pressure, with lower level of blood oxygen and also with hypoxemia.
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- 2020
3. An Innovative Method for Predicting and Classifying Inadequate Accuracy in Heart Disease by Using Decision Tree with K-Nearest Neighbors Algorithm.
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Rajesh, Mandhapati and Malathi, K.
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DECISION trees , *K-nearest neighbor classification , *SUPERVISED learning , *HEART diseases , *ALGORITHMS , *MACHINE learning - Abstract
Aim: Predicting the Heartdiseases using medical parameters of cardiac patients to get a good accuracy rate using machine learning methods like innovative Decision Tree (DT) algorithm. Materials and Methods: Supervised Machine learning Techniques with innovative Decision Tree (N = 20) and K Nearest Neighbour (KNN) (N = 20) are performed with five different datasets at each time to record five samples. Results: The Decision Tree is used to predict heart disease with the help of various medical conditions, the accuracy is achieved for DT is 98% and KNN is 72.2%. The two algorithms Decision Tree and KNN are statistically insignificant (=.737) with the independent sample T-Test value (p<0.005) with a confidence level of 95%. Conclusion: Prediction and classification of heart disease significantly seem to be better in DT than KNN. [ABSTRACT FROM AUTHOR]
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- 2021
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4. DYNAMICS ANALYSIS OF MEDICAL-DEMOGRAPHIC PARAMETERS IN THE KYRGYZ REPUBLIC
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R. M. Atambaeva, G. S. Kitarova, and E. Y. Kondratyeva
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kyrgyz republic ,demography ,medical parameters ,children’s nutrition ,abject poverty level ,Pediatrics ,RJ1-570 ,Therapeutics. Pharmacology ,RM1-950 - Abstract
The article presents results of demographic status assessment of the Kyrgyz Republic, discusses trends of the main medicaldemographic parameters characterizing the nation and shows that the socioeconomic changes that have been taking place in the recent decades continue having considerably effect on population health formation and change of demographic processes.
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- 2014
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5. Improving acute stroke care in regional hospitals: clinical evaluation of the Victorian Stroke Telemedicine program.
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Cadilhac D.A., Rabl J., O'Shea M., Groot P., Bolitho L., Campbell B.C.V., Dewey H.M., Donnan G.A., Vu M., Bladin C.F., Kim J., Bagot K.L., Moloczij N., Denisenko S., Price C., Pompeani N., Arthurson L., Hair C., Cadilhac D.A., Rabl J., O'Shea M., Groot P., Bolitho L., Campbell B.C.V., Dewey H.M., Donnan G.A., Vu M., Bladin C.F., Kim J., Bagot K.L., Moloczij N., Denisenko S., Price C., Pompeani N., Arthurson L., and Hair C.
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Objectives: To evaluate the impact of the Victorian Stroke Telemedicine (VST) program during its first 12 months on the quality of care provided to patients presenting with suspected stroke to hospitals in regional Victoria. Design(s): Historical controlled cohort study comparing outcomes during a 12-month control period with those for the initial 12 months of full implementation of the VST program at each hospital. Setting(s): 16 hospitals in regional Victoria that participated in the VST program between 1 January 2010 and 30 January 2016. Participant(s): Adult patients with suspected stroke presenting to the emergency departments of the participating hospitals. Main Outcome Measure(s): Indicators for key processes of care, including symptom onset-to-arrival, door-to-first medical review, and door-to-CT times; provision and timeliness of provision of thrombolysis to patients with ischaemic stroke. Result(s): 2887 patients with suspected stroke presented to participating emergency departments during the control period, 3178 during the intervention period; the patient characteristics were similar for both periods. A slightly larger proportion of patients with ischaemic stroke who arrived within 4.5 hours of symptom onset received thrombolysis during the intervention than during the control period (37% v 30%). Door-to-CT scan time (median, 25 min [IQR, 13-49 min] v 34 min [IQR, 18-76 min]) and door-to-needle time for stroke thrombolysis (73 min [IQR, 56-96 min] v 102 min [IQR, 77-128 min]) were shorter during the intervention. The proportions of patients who received thrombolysis and had a symptomatic intracerebral haemorrhage (4% v 16%) or died in hospital (6% v 20%) were smaller during the intervention period. Conclusion(s): Telemedicine has provided Victorian regional hospitals access to expert care for emergency department patients with suspected acute stroke. Eligible patients with ischaemic stroke are now receiving stroke thrombolysis more quickly and safely.Cop
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- 2020
6. Serum levels of perfluoroalkyl acids (PFAAs) with isomer analysis and their associations with medical parameters in Chinese pregnant women.
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Jiang, Weiwei, Zhang, Yifeng, Zhu, Lingyan, and Deng, Jimin
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PREGNANT women , *FETUS , *ALKYL compounds , *ISOMERS , *BLOOD serum analysis , *CARBOXYLIC acids , *IMMUNOTOXICOLOGY , *HEALTH - Abstract
Abstract: Perfluoroalkyl acids (PFAAs) are a group of chemicals used for many applications and widely present in the environment and humans. In this study, serum levels of PFAAs and isomers of perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA) were analyzed in 141 Chinese pregnant women. Among all the samples, total PFOS (∑PFOS, mean concentration 7.32ng/mL) was predominant, followed by ∑PFOA (mean 4.78ng/mL) and perfluorodecanoate (PFDA, mean 1.45ng/mL). On average, the proportion of linear PFOS (n-PFOS) was 66.7% of ∑PFOS, which was higher than the general population, implying that maternal women could excrete branched PFOS isomers to the fetus by transplacental transfer. Moreover, the proportion of n-PFOS decreased significantly with the increasing concentration of ∑PFOS in the serum samples (r=−0.342, p <0.001). The mean proportion of n-PFOA in the serum samples was 99.0%, which was much higher than the technical ECF (electrochemical fluorination) products (ca. 70%). The small proportion of branched isomers of PFOA suggests that there is still a source of ECF PFOA in China. Significant correlations (p <0.005) were observed between the concentrations of some PFAAs with certain medical parameters in the pregnant women. For example, the levels of most perfluorinated carboxylic acids (PFCAs) were found to correlate with albumin significantly, which might be a sign of immunotoxicity of these chemicals. The adverse effects of PFAA exposure to pregnant women may increase the health risk of the fetus. Interestingly, not only the PFAA concentrations but also the percentages of PFOS and PFOA isomers were correlated with certain medical parameters. This implies that the compositions of PFOS or PFOA should be considered in human health risk assessment in the future. [Copyright &y& Elsevier]
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- 2014
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7. A Measurement System to Realize 3-D Carotid Occlusion Measurement From 2-D Conventional Ultrasonography.
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Capriglione, Domenico, Ferrigno, Luigi, Miele, Gianfranco, Paciello, Vincenzo, Paolillo, Alfredo, and Sommella, Paolo
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A novel measurement system for the 3-D reconstruction of occlusions of the carotid artery is presented. The proposed system can be added onto a conventional diagnostic ultrasonographic system, so that it can be considered as an upgrade for preexisting equipments. It retrieves information from a set of ordinary 2-D ultrasound images and spatial sensors in order to build a 3-D representation of the vessel and of a possible occlusion and to extract measurements of important medical parameters from them. The geometrical modeling of carotid is dealt with. This paper is also concerned with a metrological characterization of the measurement procedure, including the development of a model for the estimation of the uncertainty according to international standards. Experimental results are also reported and discussed. [ABSTRACT FROM PUBLISHER]
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- 2014
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8. Epileptic seizures in cerebral venous sinus thrombosis: Subgroup analysis of VENOST study
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Birsen Ince, Serkan Demir, Seden Demirci, Hamit Genc, Hakan Ekmekçi, Hesna Bektas, Gülnur Tekgöl Uzuner, Bijen Nazliel, Taskin Gunes, Nevzat Uzuner, Uygar Utku, Taskin Duman, Ozge Yilmaz Kusbeci, Nilgun Cinar, Mustafa Bakar, Hakan Tekeli, Ahmet Tufekci, Nida Tascilar, Ali Yavuz Karahan, Derya Uluduz, Vedat Ali Yürekli, Hayriye Kucukoglu, Dilek Necioglu Orken, Eylem Ozaydin Goksu, Nilufer Yesilot, Mustafa Acikgoz, Ipek Midi, Hasan Hüseyin Kozak, Arda Yilmaz, Mustafa Gokce, Mehmet Ali Sungur, Hale Zeynep Batur Caglayan, Firdevs Ezgi Ucan Tokuc, Sena Colakoglu, Nazire Afsar, Necdet Mengulluoglu, Serdar Oruc, Yüksel Kablan, Ufuk Aluclu, Baki Göksan, Fatih Ozdag, Aysel Milanlioglu, Mehmet Yaman, Murat Cabala, Osman Özgür Yalın, Fusun Mayda Domac, Vildan Yayla, Cemile Handan Misirli, Başak Karakurum Göksel, Hatice Kurucu, Sevim Baybaş, Şerefnur Öztürk, Sevki Sahin, Mehmet Güney Şenol, Emrah Aytaç, Uluduz, Derya, Midi, Ipek, Duman, Taskin, Yayla, Vildan, Karahan, Ali Yavuz, Afsar, Nazire, Goksu, Eylem Ozaydin, Mengulluoglu, Necdet, Aytac, Emrah, Sungur, Mehmet Ali, Yesilot, Nilufer, Ince, Birsen, Yalin, Osman Ozgur, Oruc, Serdar, Senol, Mehmet Guney, Yilmaz, Arda, Gokce, Mustafa, Demirci, Seden, Kusbeci, Ozge Yilmaz, Uzuner, Gulnur, Caglayan, Hale Zeynep Batur, Acikgoz, Mustafa, Kurucu, Hatice, Ozdag, Fatih, Baybas, Sevim, Ekmekci, Hakan, Cabala, Murat, Yaman, Mehmet, Yurekli, Vedat Ali, Tekeli, Hakan, Genc, Hamit, Utku, Uygar, Sahin, Sevki, Tokuc, Firdevs Ezgi Ucan, Uzuner, Nevzat, Bektas, Hesna, Kablan, Yuksel, Goksel, Basak Karakurum, Milanlioglu, Aysel, Orken, Dilek Necioglu, Aluclu, Ufuk, Colakoglu, Sena, Tufekci, Ahmet, Bakar, Mustafa, Nazliel, Bijen, Tascilar, Nida, Goksan, Baki, Kozak, Hasan Huseyin, Demir, Serkan, Misirli, Cemile Handan, Kucukoglu, Hayriye, Cinar, Nilgun, Domac, Fusun Mayda, Ozturk, Serefnur, Gunes, Taskin, Maltepe Üniversitesi, Tıp Fakültesi, [Belirlenecek], Acibadem University Dspace, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı., and EKN-8251-2022
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Male ,Neurologic disease ,Pediatrics ,Focal neurologic deficit ,Oral contraceptive agent ,Cerebral venous sinus thrombosis ,Cerebral hemorrhage ,Epilepsy ,0302 clinical medicine ,Observational study ,Middle aged ,Cerebrovascular disease ,Priority journal ,Medical parameters ,Brain radiography ,General Medicine ,Brain hemorrhage ,Prognosis ,Seizure ,Thrombosis ,Multicenter study ,Clinical trial ,Nuclear magnetic resonance imaging ,Retrospective study ,PUERPERIUM ,PREGNANCY ,Neurology ,Brain vein ,Clinical neurology ,Cohort ,Cerebral infarction ,Subgroup analysis ,Female ,Cohort analysis ,Infection ,Sinus thrombosis, intracranial ,Brain infarction ,Human ,Adult ,medicine.medical_specialty ,Family history ,Early seizure ,Neuroimaging ,Consciousness disorders ,Major clinical study ,Neurosciences & neurology ,Pathophysiology ,Article ,Cortical vein ,03 medical and health sciences ,Magnetic resonance imaging ,Age ,Seizures ,medicine ,Humans ,In patient ,Prospective study ,Demography ,Disease duration ,Cerebral Sinus Thrombosis ,Vein Thrombosis ,Superior Sagittal Sinus ,Consciousness disorder ,business.industry ,Neurosciences ,Methodology ,VEIN ,Gender ,Anticonvulsive agent ,medicine.disease ,Retrospective studies ,Malignant neoplasm ,SSS ,Clinical feature ,Sagittal sinus thrombosis ,Cerebral sinus thrombosis ,RISK-FACTORS ,Risk factor ,Neurology (clinical) ,business ,Prospective studies ,Controlled study ,Complication ,030217 neurology & neurosurgery - Abstract
Çalışmada 38 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. Purpose: The aim of this study is to evaluate the presence and prognostic impact of early seizures in cerebral venous sinus thrombosis patients (CVST). Method: VENOST is a retrospective and prospective national multicenter observational study. CVST patients with or without epileptic seizures (ES) were analyzed and compared in terms of demographic and imaging data, causative factors, clinical variables, and prognosis in a total of 1126 patients. Results: The mean age of the patients in the ES group was 39.73 +/- 12.64 and 40.17 +/- 14.02 years in the non-ES group (p > 0.05). Epileptic seizures were more common (76.6 %) in females (p < 0.001). Early ES occurred in 269 of 1126 patients (23.9 %). Epileptic seizures mainly presented in the acute phase (71.4 %) of the disease (p < 0.001). Majority of these (60.5 %) were in the first 24 h of the CVST. The most common neurological signs were focal neurologic deficits (29.9 %) and altered consciousness (31.4 %) in the ES group. Superior sagittal sinus (SSS) and cortical veins (CV) involvement were the most common sites of thrombosis and the mostly related etiology were found puerperium in seizure group (30.3 % vs 13.9 %). Patients with seizures had worse outcome in the first month of the disease (p < 0.001) but these did not have any influence thereafter. Conclusions: In this largest CVST cohort (VENOST) reported female sex, presence of focal neurological deficits and altered consciousness, thrombosis of the SSS and CVs, hemorrhagic infarction were risk factors for ES occurrence in patients with CVST.
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- 2020
9. The effects of vibration on efficiency in off-road cyclists
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Ozgur Ozkaya, Arzu On, Tolga Akşit, Gorkem Aybars Balci, and Ege Üniversitesi
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cycling ,off road cyclist ,workload ,human experiment ,beta elastomer ,lung gas exchange ,heart rate ,Graded exercise test ,Borg dyspnea scale ,Respiratory exchange ratio ,endurance ,Rating of perceived exertion ,exercise ,adult ,Rehabilitation ,mountain biking ,oxygen consumption ,Oxygen uptake ,unclassified drug ,volume of carbon dioxide output ,respiratory tract parameters ,volume of oxygen uptake ,young adult ,Original Article ,vibration ,Cycling ,ventilation threshold ,performance ,prospective study ,medicine.medical_specialty ,medical parameters ,whole body vibration training ,Physical Therapy, Sports Therapy and Rehabilitation ,Article ,whole body vibration ,male ,exhaustion ,Heart rate ,medicine ,polyester ,cyclist ,human ,normal human ,Gross efficiency ,business.industry ,carbon dioxide ,physical performance ,Vibration ,oxygen uptake ,Physical therapy ,bicycle exercise test ,athletic performance ,business ,human activities - Abstract
Objectives: The aim of this study was to investigate whether vibration significantly affected the efficiency of off-road cyclists. Patients and methods: Eight male mountain cyclists (mean age 21.1-1 years; range, 19 to 22 years) between August 2017 and November 2017 were included. The experimental protocol included four testing sessions with a one-day interval between testing sessions: A familiarization session; performance of submaximal tests; performance of maximal graded exercise test; and a 30-min mountain bike trial performed with vibration or without vibration. Physiological measures including volume of oxygen uptake (VO2), volume of carbon dioxide output (VCO2), VO2, VCO2, heart rate, respiratory exchange ratio, rating of perceived exertion, and gross efficiency (GE) were compared between the trials performed with vibration or without vibration. Results: There was a significant increase in the GE with the addition of intermittent vibration, particularly over the last 15 min of the cycling trial (p 0.05). There were no significant effects of vibration on other parameters. Conclusion: This study demonstrates that addition of intermittent vibration may provide positive benefits in improving GE during a 30-min submaximal cycling trial. © 2021 Turkish Society of Physical Medicine and Rehabilitation. All rights reserved.
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- 2019
10. An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation
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Omer Erdeve, Emel Okulu, Gaffari Tunc, Yalcın Celik, Ugur Kayacan, Merih Cetinkaya, Gokhan Buyukkale, Hilal Ozkan, Nilgun Koksal, Mehmet Satar, Mustafa Akcali, Canan Aygun, Servet Ozkiraz, Umut Zubarioglu, Sezin Unal, Hatice Turgut, Kurthan Mert, Tulin Gokmen, Barıs Akcan, Begum Atasay, Saadet Arsan, Rescue-HFOV Trial Group, Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri/Çocuk Sağlığı Ve Hastalıkları Bölümü., Özkan, Hilal, Köksal, Nilgün, OMÜ, and Çukurova Üniversitesi
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Male ,Science & technology - other topics ,Intermittent positive pressure ventilation ,Turkey ,medicine.medical_treatment ,Failure ,Patent ductus arteriosus ,Social Sciences ,Procedures ,Pediatrics ,Trial ,High frequency ventilation ,Families ,Sociology ,Observational study ,Medicine ,Birth Weight ,Prospective Studies ,Children ,education.field_of_study ,Medical parameters ,Schools ,Clinical outcome ,Respiration ,Lung Injury ,Neonatal respiratory distress syndrome ,Arterial gas ,Multicenter study ,Management ,Clinical trial ,High-Frequency Ventilation ,Ventilator-Induced Lung Injury ,Artificial Ventilation ,Chronic lung disease ,Breathing ,Population study ,Engineering and Technology ,Factor analysis ,Human ,Death Rates ,Science ,Major clinical study ,Article ,Treatment duration ,Education ,Neonatal intensive care unit ,Population Metrics ,Intensive care ,Intensive Care Units, Neonatal ,Humans ,education ,Demography ,Biology and Life Sciences ,Neonates ,Infant ,Nitric oxide ,Respiration, Artificial ,Population Groupings ,Extracorporeal oxygenation ,Neonatology ,Complication ,Reference value ,Developmental Biology ,Data base ,Respiratory failure ,Intermittent Positive-Pressure Ventilation ,Mechanical ventilation ,Artificial ventilation ,Arterial oxygen saturation ,Controlled clinical trial ,Turkey (bird) ,Medicine and Health Sciences ,Prospective cohort study ,Multidisciplinary ,Congenital diaphragmatic-hernia ,Gestational age ,Brain hemorrhage ,Register ,Laboratory Equipment ,Multidisciplinary Sciences ,Air conditioning ,Anesthesia ,Newborn mortality ,High frequency oscillatory ventilation ,Female ,Respiratory Insufficiency ,Infants ,Research Article ,Term infants ,Population ,Ventilators ,Equipment ,Gestational Age ,Lung injury ,Blood gas analysis ,Extracorporeal Membrane Oxygenation ,Extracorporeal membrane oxygenation ,Prospective study ,Mortality ,Disease severity ,Respiratory Distress Syndrome, Newborn ,Retrolental fibroplasia ,Population Biology ,business.industry ,Infant, Newborn ,Newborn ,Online system ,Ventilation ,Age Groups ,People and Places ,Low birth weight ,business ,Controlled study - Abstract
Atasay, Fatma Begum/0000-0002-9114-5293; AYGUN, CANAN/0000-0002-7955-5943; Okulu, Emel/0000-0002-1101-3355; ERDEVE, OMER/0000-0002-3193-0812 WOS: 000470854200027 PubMed: 31181092 Background To achieve gas exchange goals and mitigate lung injury, infants who fail with conventional ventilation (CV) are generally switched to high-frequency oscillatory ventilation (HFOV). Although preferred in many neonatal intensive care units (NICUs), research on this type of rescue HFOV has not been reported recently. Methods An online registry database for a multicenter, prospective study was set to evaluate factors affecting the response of newborn infants to rescue HFOV treatment. The study population consisted of 372 infants with CV failure after at least 4 hours of treatment in 23 participating NICUs. Patients were grouped according to their final outcome as survived (Group S) or as died or received extracorporeal membrane oxygenation (ECMO) (Group D/E). Patients' demographic characteristics and underlying diseases in addition to their ventilator settings, arterial blood gas (ABG) analysis results at 0, 1, 4, and 24 hours, type of device, ventilation duration, and complications were compared between groups. Results HFOV as rescue treatment was successful in 58.1% of patients. Demographic and treatment parameters were not different between groups, except that infants in Group D/E had lower birthweight (BW) (1655 +/- 1091 vs. 1858 +/- 1027 g, p = 0.006), a higher initial FiO2 setting (83% vs. 72%, p < 0.001), and a higher rate of nitric oxide exposure (21.8% vs. 11.1%, p = 0.004) in comparison to infants who survived (Group S). The initial cut-offs for a successful response on ABG were defined as pH > 7.065 (OR: 19.74, 95% CI 4.83-80.6, p < 0.001), HCO3 > 16.35 mmol/L (OR: 1.06, 95% CI 1.01-1.1, p = 0.006), and lactate level < 3.75 mmol/L (OR: 1.09% 95 CI 1.01-1.16, p = 0.006). Rescue HFOV duration was associated with retinopathy of prematurity (p = 0.005) and moderate or severe chronic lung disease (p < 0.001), but not with patent ductus arteriosus or intraventricular hemorrhage, in survivors (p > 0.05). Conclusion Rescue HFOV as defined for this population was successful in more than half of the patients with CV failure. Although the response was not associated with gestational age, underlying disease, device used, or initial MV settings, it seemed to be more effective in patients with higher BW and those not requiring nitric oxide. Initial pH, HCO3, and lactate levels on ABG may be used as predictors of a response to rescue HFOV. Turkish Neonatal Society [5-2016] This study was supported by the Turkish Neonatal Society, number 5-2016, received by OE. Turkish Neonatal Society funded the study's online registry system. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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- 2019
11. Pulmonary function, aerobic capacity and related variables in patients with ankylosing spondylitis
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Macit Kalçık, Yusuf Karavelioğlu, Çağliyan Türk A, Fusun Sahin, Arslan S, Sumru Özel, Ahmet Musmul, Çağlıyan Türk, Ayla, Arslan, Sertaç, Kalçık, Macit, and Özel, Sumru
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Bath ankylosing spondylitis disease activity index ,Ankylosing Spondylitis ,peak expiratory flow ,spirometry ,spine mobility ,functional status ,Metabolic equivalent ,Pulmonary function testing ,workload ,Pulmonary Function Test ,0302 clinical medicine ,Quality of life ,heart rate ,030212 general & internal medicine ,C reactive protein ,exercise ,adult ,Pulmonary function test ,VO2 max ,Ankylosing Spondylitis Quality of Life ,forced expiratory volume ,metabolic equivalent ,oxygen consumption ,aged ,female ,Cardiology ,Original Article ,medicine.symptom ,cardiopulmonary exercise test ,medicine.medical_specialty ,medical parameters ,Ankylosing Spondylitis Quality of Life Questionnaire ,electrocardiography ,Article ,03 medical and health sciences ,Rheumatology ,male ,Bath Ankylosing Spondylitis Metrology Index ,forced vital capacity ,Internal medicine ,Heart rate ,ankylosing spondylitis ,medicine ,controlled study ,human ,bicycle ergometry ,030203 arthritis & rheumatology ,Ankylosing spondylitis ,cardiopulmonary function ,Cardiopulmonary Exercise Testing ,occiput to wall distance ,business.industry ,questionnaire ,Enthesitis ,hemoglobin ,medicine.disease ,major clinical study ,Cardiopulmonary exercise testing ,aerobic capacity ,disease assessment ,Maastricht Ankylosing Spondylitis Enthesitis Score ,age ,Bath ankylosing spondylitis functional index ,Quality of Life ,erythrocyte sedimentation rate ,blood cell count ,business ,disease activity - Abstract
Objectives: This study aims to evaluate the cardiopulmonary functions and exercise performance of patients with ankylosing spondylitis (AS) and to investigate the relationship between these parameters and disease activity, spine mobility and quality of life (QoL). Patients and methods: Forty-five patients with AS (group 1; 33 males, 12 females; mean age 43.1±12.1 years; range 22 to 70 years) and 30 control subjects (group 2; 23 males, 7 females; mean age 42.8±10.0; range 23 to 70 years) were included in the study. Disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility measures with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) were used. The pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET) were performed. Results: There was no significant difference between groups 1 and 2 in terms of mean age. The peak expiratory flow value in PFT was significantly lower in group 1 (p
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- 2019
12. The impact of sleep disordered breathing on cardiovascular health in overweight children.
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Tamanyan K., Weichard A., Odoi A., Biggs S.N., Davey M.J., Nixon G.M., Walter L.M., Horne R.S.C., Shandler G., Tamanyan K., Weichard A., Odoi A., Biggs S.N., Davey M.J., Nixon G.M., Walter L.M., Horne R.S.C., and Shandler G.
- Abstract
Background Up to 50% of overweight/obese children have obstructive sleep apnea (OSA) compared to up to 6% of normal weight children. We compared cardiovascular variables between normal weight and overweight/obese children with and without OSA, and controls. Methods Seventy-four referred children and 24 normal weight non-snoring controls (8-18 years) were recruited. Referred children were grouped according to their obstructive apnea hypopnea index (OAHI): OSA (>1 event/h) or primary snoring (PS <= 1 event/h) and whether they were normal weight (BMI z-score <1.04) or overweight/obese (BMI z-score >= 1.04). Wake blood pressure (BP), heart rate (HR), and pulse transit time (PTT, an inverse continuous surrogate measure of blood pressure) during sleep were recorded. Results Wake BP was higher in the overweight/obese OSA group than in the control, normal weight PS, and overweight/obese PS groups (p < 0.05 for all). During sleep, BP, and HR were elevated in the overweight/obese OSA group compared to those in non-snoring controls (p < 0.05). More children who were overweight/obese had reduced BP and HR dipping from wake to sleep than normal weight children. The BMI z-score predicted HR and PTT when asleep and both age and BMI z-score predicted BP when awake. Conclusion This study showed that BMI has both combined and independent effects on BP and HR in children with OSA. We have previously shown that treatment of OSA reduces BP and suggest that treatment of OSA in the growing number of overweight/obese children may improve cardiovascular outcomes.Copyright © 2017
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- 2018
13. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS).
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Morand E.F., Chen S.L., Jin O., Morton S., Hoi A., Huq M., Nikpour M., Franklyn K., Lau C.S., Navarra S.V., Louthrenoo W., Lateef A., Hamijoyo L., Wahono C.S., Morand E.F., Chen S.L., Jin O., Morton S., Hoi A., Huq M., Nikpour M., Franklyn K., Lau C.S., Navarra S.V., Louthrenoo W., Lateef A., Hamijoyo L., and Wahono C.S.
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Aims Treating to low disease activity is routine in rheumatoid arthritis, but no comparable goal has been defined for systemic lupus erythematosus (SLE). We sought to define and validate a Lupus Low Disease Activity State (LLDAS). Methods A consensus definition of LLDAS was generated using Delphi and nominal group techniques. Criterion validity was determined by measuring the ability of LLDAS attainment, in a single-centre SLE cohort, to predict non-accrual of irreversible organ damage, measured using the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Results Consensus methodology led to the following definition of LLDAS: (1) SLE Disease Activity Index (SLEDAI)-2K <=4, with no activity in major organ systems (renal, central nervous system (CNS), cardiopulmonary, vasculitis, fever) and no haemolytic anaemia or gastrointestinal activity; (2) no new lupus disease activity compared with the previous assessment; (3) a Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI physician global assessment (scale 0-3) <=1; (4) a current prednisolone (or equivalent) dose <=7.5 mg daily; and (5) well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents. Achievement of LLDAS was determined in 191 patients followed for a mean of 3.9 years. Patients who spent greater than 50% of their observed time in LLDAS had significantly reduced organ damage accrual compared with patients who spent less than 50% of their time in LLDAS (p=0.0007) and were significantly less likely to have an increase in SDI of >=1 (relative risk 0.47, 95% CI 0.28 to 0.79, p=0.005). Conclusions A definition of LLDAS has been generated, and preliminary validation demonstrates its attainment to be associated with improved outcomes in SLE.Copyright © 2016 Published by the BMJ Publishing Group Limited.
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- 2016
14. Subgingival microbiota in health compared to periodontitis and the influence of smoking
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Camelo-Castillo AJ, Mira A, Pico A, Nibali L, Henderson B, Donos N, and Tomás I
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medical parameters ,polymerase chain reaction ,Anaeroglobus ,Haemophilus ,tooth plaque ,bleeding on probing ,Article ,smoking ,Veillonella ,TM7 ,male ,Gemella ,controlled study ,Treponema ,human ,Porphyromonas ,Filifactor ,clinical attachment level ,DNA extraction ,periodontitis ,Bacteria (microorganisms) ,Leptotrichia ,Tannerella ,nonhuman ,Mogibacterium ,Eubacterium ,Peptostreptococcus ,adult ,mouth flora ,Bulleidia extructa ,Streptococcus ,Desulfobulbus ,chronic periodontitis ,Granulicatella adiacens ,Schwartzia (Bacteria) ,Fusobacterium ,major clinical study ,Paenibacillus durus ,female ,pyrosequencing ,Bulleidia ,microbial diversity ,probing pocket depth ,Capnocytophaga - Abstract
The etiology of periodontitis has traditionally been associated to a consortium of three bacterial species-the so-called "red-complex" of periodontal disease-which has been the target for most diagnostic and therapeutic strategies. However, other species have also been found to correlate with disease severity. In addition, the influence of smoking on periodontal microbiota is poorly understood. In the current manuscript, the composition of the subgingival microbiota in healthy individuals vs. patients with chronic periodontitis has been investigated using 16S pyrosequencing and the influence of smoking on periodontal composition has been examined. Subgingival bacterial communities were sampled from 82 patients: 22 non-smoking healthy controls, 28 non-smoking periodontal patients, and 32 smoking periodontal patients. Bacterial diversity was higher in periodontal patients than in healthy subjects, which could be interpreted as the consequence of a nutritionally richer environment or a reduced immune competence. Periodontal patients showed a significantly higher prevalence/relative abundance of "established" periopathogens but also other taxa whose role is not well-established and that should be targets for future research. These include Anaeroglobus, Bulleidia, Desulfobulbus, Filifactor, Mogibacterium, Phocaeicola, Schwartzia or TM7. The microbial community of smoking-associated periodontitis is less diverse and distinct from that of non-smokers, indicating that smoking has an influence on periodontal ecology. Interestingly, the high sequencing coverage allowed the detection at low proportions of periodontal pathogens in all healthy individuals, indicating that chronic periodontitis cannot be strictly considered an infectious disease but the outcome of a polymicrobial dysbiosis, where changes in the proportions of microbial consortia trigger the inflammatory and tissue-degradation responses of the host. © 2015 Camelo-Castillo, Mira, Pico, Nibali, Henderson, Donos and Tomás.
- Published
- 2015
15. Sperm Morphology Analysis with CNN based algorithms
- Author
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Mustak E. Yalcin, Vedat Tavsanoglu, Evren Cesur, O. Levent Savkay, Işık Üniversitesi, Mühendislik Fakültesi, Elektrik-Elektronik Mühendisliği Bölümü, Işık University, Faculty of Engineering, Department of Electrical-Electronics Engineering, and Tavşanoğlu, Ahmet Vedat
- Subjects
Morphology ,CASA ,Computer science ,ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION ,Shape characteristics ,CNN based algorithms ,Cellular Nanoscale Network ,Image processing ,Biomedical imaging ,Spatial image processing blocks ,Algorithm design and analysis ,Image processing algorithms ,Computer architecture ,Medical image processing ,Cellular biophysics ,Medical parameters ,Computer aided analysis ,Shape ,SoC architecture ,Sperm shape ,Sperm morphology analysis ,Computer-aided sperm analysis system ,Sperm morphology ,Algorithm steps ,Head ,Algorithm ,Morphology analysis ,System-on-chip - Abstract
In this paper Morphological Analysis part of our proposed computer-aided sperm analysis system (CASA) is simulated and the results beside the algorithm steps are presented. The morphology analysis is simply dealing with shape of the sperms and extracting the shape characteristics in medical parameters. The characteristics are obtained by image processing algorithms which utilizes Cellular Nanoscale Network (CNN) based and spatial image processing blocks. The following calculation of medical parameters are obtained from the outputs of image processing blocks. The algorithm is so designed to adapt the final SoC architecture such as Xilinx Zynq7000 device. Publisher's Version
- Published
- 2014
16. Gait in Huntington's disease and the stride length-cadence relationship.
- Author
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Iansek R., Danoudis M., Iansek R., and Danoudis M.
- Abstract
Background: The progressive deterioration of gait in Huntington's disease (HD) leads to functional decline and loss of function. To understand the underlying mechanisms responsible for the gait changes in HD, we examined the automatic control of gait by measuring the relationship between stride length and cadence. The relationship is strongly linked in healthy adults during automatic gait but disrupted in pathological gait disorders, such as Parkinson's disease (PD). Method(s): The stride length cadence relationship was compared between seventeen participants with HD, twenty with PD and twenty one healthy older adults (HOA). Participants had their gait recorded at self-selected preferred, very slow, slow, fast and very fast speeds. Linear regression analysis was used to determine the slope and intercept of the relationship which were compared between groups. The adjustment of stride length and cadence when changing gait speeds was measured and compared within and between groups. Result(s): Linearity was strong in all but two participants with HD and one with PD. Slope did not differ between groups (p > 0.05) but intercept was lower in the HD and PD groups compared to HOA (p < 0.05). Stride length was shorter in the HD and PD groups compared to controls at preferred and most adjusted speed conditions (p < 0.05) but cadence did not differ between groups (p > 0.05) regardless of speed. The HD group adjusted stride length and cadence similar to HOA when changing speed. The range of cadence across speed conditions did not differ between groups. Conclusion(s): Scaling of stride length but not the regulation of cadence was found to be disrupted in participants with HD.Copyright © 2014 Danoudis and Iansek; licensee BioMed Central Ltd.
- Published
- 2014
17. Developmental immunotoxicity of ethanol in an extended one-generation reproductive toxicity study
- Author
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Tonk, E.C.M., Groot, D.M.G. de, Wolterbeek, A.P.M., Penninks, A.H., Waalkens-Berendsen, I.D.H., Piersma, A.H., and Loveren, H. van
- Subjects
Male ,Reproductive toxicity ,Biomedical Innovation ,Wistar rat ,Cytokine production ,Immunological parameters ,EELS - Earth, Environmental and Life Sciences TNO Bedrijven ,Concanavalin A ,Immunotoxicity ,Cell proliferation ,Priority journal ,Innate immunity ,Medical parameters ,Mating ,Cell stimulation ,Life Triskelion BV ,Benchmark dose approach ,Keyhole limpet hemocyanin ,Spleen cell ,Developmental immunotoxicity ,QS - Quality & Safety TARA - Toxicology and Risk Assessment RAPID - Risk Analysis for Products in Development ,Female ,Alcohol ,Healthy Living ,Adult animal ,Cell subpopulation ,Adaptive immunity ,chemical and pharmacologic phenomena ,Lipopolysaccharide ,Chemical parameters ,Immunomodulation ,blood cell ,Drinking water ,Lactation ,Animal model ,Animal experiment ,Immune response ,Biology ,Ethanol ,Tumor necrosis factor alpha ,Cell adhesion ,Nitric oxide ,biochemical phenomena, metabolism, and nutrition ,Rattus norvegicus ,Developmental parameters ,Extended one-generation reproductive toxicity study ,Developmental toxicity ,Perinatal period ,Toxicity testing ,Rat ,Immunization ,Controlled study - Abstract
The susceptibility of developing immune system to chemical disruption warrants the assessment of immune parameters in reproductive and developmental testing protocols. In this study, a wide range of immune endpoints was included in an extended one-generation reproduction toxicity study (EOGRTS) design to determine the relative sensitivity of immune and developmental parameters to ethanol (EtOH), a well-known developmental toxicant with immunomodulatory properties. Adult Wistar rats were exposed to EtOH via drinking water (0, 1.5, 4, 6.5, 9, 11.5 and 14 % (w/v EtOH)) during premating, mating, gestation and lactation and continuation of exposure of the F1 from weaning until killed. Immune assessments were performed at postnatal days (PNDs) 21, 42 and 70. Keyhole limpet hemocyanin (KLH)-specific immune responses were evaluated following subcutaneous immunizations on PNDs 21 and 35. EtOH exposure affected innate as well as adaptive immune responses. The most sensitive immune parameters included white blood cell subpopulations, ConA-stimulated splenocyte proliferation, LPS-induced NO and TNF-α production by adherent splenocytes and KLH-specific immune responses. Most parameters showed recovery after cessation of EtOH exposure after weaning in the 14 % exposure group. However, effects on LPS-induced NO and TNF-α production by adherent splenocytes and KLH-specific parameters persisted until PND 70. The results demonstrate the relative sensitivity to EtOH of especially functional immune parameters and confirm the added value of immune parameters in the EOGRTS. Furthermore, this study identified an expanded KLH-specific parameter set and LPS-induced NO and TNF-α production by adherent splenocytes as valuable parameters that can provide additional information on functional immune effects. © 2012 Springer-Verlag.
- Published
- 2013
18. Developmental immunotoxicity of ethanol in an extended one-generation reproductive toxicity study
- Subjects
Male ,Reproductive toxicity ,Biomedical Innovation ,Wistar rat ,Cytokine production ,Immunological parameters ,Concanavalin A ,Immunotoxicity ,Cell proliferation ,Priority journal ,Innate immunity ,Medical parameters ,Mating ,Cell stimulation ,Life Triskelion BV ,Benchmark dose approach ,Keyhole limpet hemocyanin ,Spleen cell ,Developmental immunotoxicity ,QS - Quality & Safety TARA - Toxicology and Risk Assessment RAPID - Risk Analysis for Products in Development ,Female ,Alcohol ,Healthy Living ,Adult animal ,Cell subpopulation ,Adaptive immunity ,chemical and pharmacologic phenomena ,Lipopolysaccharide ,Chemical parameters ,Environmental and Life Sciences TNO Bedrijven ,EELS - Earth ,Immunomodulation ,blood cell ,Drinking water ,Lactation ,Animal model ,Animal experiment ,Immune response ,Biology ,Ethanol ,Tumor necrosis factor alpha ,Cell adhesion ,Nitric oxide ,biochemical phenomena, metabolism, and nutrition ,Rattus norvegicus ,Developmental parameters ,Extended one-generation reproductive toxicity study ,Developmental toxicity ,Perinatal period ,Toxicity testing ,Rat ,Immunization ,Controlled study - Abstract
The susceptibility of developing immune system to chemical disruption warrants the assessment of immune parameters in reproductive and developmental testing protocols. In this study, a wide range of immune endpoints was included in an extended one-generation reproduction toxicity study (EOGRTS) design to determine the relative sensitivity of immune and developmental parameters to ethanol (EtOH), a well-known developmental toxicant with immunomodulatory properties. Adult Wistar rats were exposed to EtOH via drinking water (0, 1.5, 4, 6.5, 9, 11.5 and 14 % (w/v EtOH)) during premating, mating, gestation and lactation and continuation of exposure of the F1 from weaning until killed. Immune assessments were performed at postnatal days (PNDs) 21, 42 and 70. Keyhole limpet hemocyanin (KLH)-specific immune responses were evaluated following subcutaneous immunizations on PNDs 21 and 35. EtOH exposure affected innate as well as adaptive immune responses. The most sensitive immune parameters included white blood cell subpopulations, ConA-stimulated splenocyte proliferation, LPS-induced NO and TNF-α production by adherent splenocytes and KLH-specific immune responses. Most parameters showed recovery after cessation of EtOH exposure after weaning in the 14 % exposure group. However, effects on LPS-induced NO and TNF-α production by adherent splenocytes and KLH-specific parameters persisted until PND 70. The results demonstrate the relative sensitivity to EtOH of especially functional immune parameters and confirm the added value of immune parameters in the EOGRTS. Furthermore, this study identified an expanded KLH-specific parameter set and LPS-induced NO and TNF-α production by adherent splenocytes as valuable parameters that can provide additional information on functional immune effects. © 2012 Springer-Verlag.
- Published
- 2013
19. Trashepatic central venous catheters for long-term hemodialysis
- Author
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Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı., Uludağ Üniversitesi/Tıp Fakültesi/Kalp Damar Cerrahisi Anabilim Dalı., Erdoğan, Cüneyt, Aktaş, Nimet, Duşak, Abdurrahim, Şenkaya, Işık, and A-7826-2019
- Subjects
Böbrek diyalizi ,Catheters ,Catheter infection ,Clinical article ,Repeat procedure ,Santral venöz ,Catheter thrombosis ,Central venous catheterization ,Liver injury ,Article ,Catheterization ,Central venous ,Kateterler, kalıcı ,Device safety ,Long term care ,Renal dialysis ,Placement ,Stenosis ,Catheter complication ,Medical parameters ,Kateterizasyon ,Functional status ,Transhepatic central venous catheterization ,Access ,Medicine, general & internal ,Patient safety ,Retrospective study ,Indwelling ,Hemodialysis ,Catheter migration ,Heart Atrium Septum Defect ,Dialysis Catheter ,Inferior Cava Vein ,Vascular access ,General & internal medicine ,Catheter patency ,Central venous catheter ,Human - Abstract
Objective: Retrospective analysis of hemodialysis catheters implanted using transhepatic venous route in terms of safety and functionality in patients with exhausted conventional venous access routes. Material and Methods: Ten patients underwent placement of 22 transhepatic 14F tunneled hemodialysis catheters at our center in the period 2007-2011. Catheter safety was assessed by means of complications encountered. Catheter functionality was assessed by means of the data derived from the electronic documents and digital images captured during the device problems and catheter revisions. Catheter patency was described using Kaplan-Meier survival curve. Results: Technical success was achieved in all patients. There was no hepatic injury or bleeding related to the procedure. Catheter functionality was impared due to the complications such as thrombosis, migration and infection. The catheter thrombosis rate was 0.18, the catheter migration rate was 0.12, and catheter-related infection rate was 0.08 per 100 catheter-days. Mean device patency was 132 (28-214) catheter days. Fifty percent of the catheters functioned longer than 182 catheter days. Mean catheter stay in-situ was 283 (20-629) catheter days. Mean single access patency was 217 (20-571) catheter days. Conclusion: By using transhepatic venous route, effective and safe hemodialysis can be performed in long term in patients with limited venous access. Geleneksel venöz erişim yolları tükenmiş olgularda transhepatik venöz yolla yerleştirilen hemodiyaliz kateterlerinin güvenilirliği ve işlevselliğinin geriye dönük değerlendirilmesi. Ge reç ve Yön tem ler: Merkezimizde 2007-2011 yılları arasında yaşları 23-71 arasında değişen 10 olguya 22 adet 14F tünelli diyaliz kateteri transhepatik yolla yerleştirildi. Kateter güvenilirliği, gelişen komplikasyonlar analiz edilerek değerlendirildi. Kateterlerin işlevselliği için, kateter problemleri ve değişimlerinde tutulan elektronik doküman ve dijital görüntü kayıtlarına ait veriler kullanıldı. Kateterlerin işlevselliği kateterin işlev gördüğü gün temel alınarak Kaplan-Meier analizi ile değerlendirildi. Bul gu lar: Tüm girişimlerde teknik başarı sağlandı. İşleme ait masif kanama ya da parankimal yaralanma gelişmedi. Kateter işlevinin kateter trombozu, migrasyon ve enfeksiyon gibi komplikasyonlara bağlı bozulduğu görüldü. Her 100 kateter günü için kateter tromboz oranı 0,18, migrasyon oranı 0,12, enfeksiyon oranı 0,08 bulundu. Ortalama kateter açıklığı 132 (28-214) gün bulundu. Kateterlerin %50’sinin 182. günde işlevsel olduğu görüldü. Bir hastanın ortalama kateterli kaldığı süre 283 (20-629) gün olarak bulundu. Tek giriş hattından sağlanan ortalama açıklık 217 (20-571) kateter günü idi. Sonuç: Venöz erişimi kısıtlı olgularda uzun sü
- Published
- 2012
20. Conjunctival impression cytology, ocular surface and tear-film changes in patients with lichen planus
- Author
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Şanlı, Berna, Çetin, Ebru Nevin, Bir, Ferda, Taşlı, Levent, Yaldızkaya, Filiz, and Yaylalı, Volkan
- Subjects
Adult ,Male ,medical parameters ,lissamine green scoring ,impression cytology ,Conjunctival Diseases ,dry eye ,fluorescence analysis ,Young Adult ,Humans ,controlled study ,human ,tear film ,Aged ,clinical article ,ocular surface ,lichen planus ,Lacrimal Apparatus Diseases ,article ,scoring system ,Middle Aged ,eye diseases ,human tissue ,priority journal ,Schirmer test ,Case-Control Studies ,Tears ,blepharitis ,Female ,sense organs - Abstract
Background. Lichen planus (LP) is an immune-mediated chronic mucocutaneous disease. Rarely, LP affects the conjunctiva, resulting in conjunctival inflammation, cicatrization and scarring of the subepithelium and cornea, causing keratitis and keratoconjunctivitis sicca. To date, there has been no case-control study examining the ocular findings in LP. Aim. To assess ocular surface health and tear-film changes in patients with LP. Methods. In total, 20 patients and 24 healthy controls were enrolled in the study. Ocular surface changes were evaluated by conjunctival impression cytology, while tear-film functions were measured by the Schirmer test, break-up time, and fluorescein and lissamine green scoring. Results. There was a significant difference in Schirmer test results, conjunctival lissamine green staining scores, and conjunctival impression-cytology grades between the groups. Conclusions. LP may cause ocular surface changes and reduction in tear production, therefore it seems reasonable to evaluate these patients for symptoms and signs of dry-eye disease. We consider that LP should be included in the differential diagnosis of dry-eye disease, as this has important therapeutic and prognostic implications. CED © 2012 British Association of Dermatologists.
- Published
- 2012
21. Stanford Type A Aortic Dissection in Pregnancy: A Diagnostic and Management Challenge.
- Author
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Smith J.A., Ch'ng S.L., Cochrane A.D., Goldstein J., Smith J.A., Ch'ng S.L., Cochrane A.D., and Goldstein J.
- Abstract
Background: In women under the age of 40, over 50% of type A aortic dissections occur in the obstetric population. This is a complex situation, with potential catastrophic outcomes for mother and child. Time to diagnosis is often delayed by a low degree of suspicion, atypical presentation and difficulties investigating pregnant women. Management requires early involvement of multiple teams and appreciation of potential complications. We report our experience (the largest series described) and describe our surgical strategy. Method(s): A retrospective search of the cardiothoracic surgical database at our centre from 2002 to 2010 identified five pregnant women with type A dissections. Result(s): Median time to diagnosis was 18.5. h (range 5.5-150. h) and median time from diagnosis to arrival in the operating theatre was 1.5. h (range 0.5-54. h). Four patients underwent concomitant Caesarean section and dissection repair. There was one maternal death and one unrelated foetal death. Conclusion(s): Occurrence of type A aortic dissection in pregnant women is uncommon but potentially catastrophic. A high index of suspicion and timely investigations are necessary to expedite definitive management. Sound surgical strategies and collaboration with appropriate teams are necessary to optimise outcome. © 2012 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
- Published
- 2013
22. A four year follow-up of sleep and respiratory measures in elementary school-aged children with sleep disordered breathing.
- Author
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Horne R.S.C., Vlahandonis A., Nixon G.M., Davey M.J., Walter L.M., Horne R.S.C., Vlahandonis A., Nixon G.M., Davey M.J., and Walter L.M.
- Abstract
Objective: Little is known of the long-term prognosis of children treated for sleep disordered breathing (SDB) and even less of children with milder forms of SDB who remain untreated. We aimed to investigate the long-term sleep and respiratory outcomes of children with a range of SDB severities. Method(s): 41 children with SDB and 20 non snoring controls (mean age, 12.9+/-0.2. y), underwent repeat overnight polysomnography (PSG) 4.0+/-0.3 years after initial diagnosis. SDB severity, presence of snoring, sleep and respiratory parameters, sleep fragmentation index (SFI), the Pediatric Daytime Sleepiness Scale (PDSS), Sleep Disturbance Scale for Children (SDSC), and obstructive sleep apnea 18-item quality of life questionnaire were re assessed. Children with SDB were grouped into resolved (no snoring and obstructive apnea-hypopnea index [OAHI] <1) and unresolved (snoring or an OAHI >=1). Result(s): At follow-up OAHI was reduced in both SDB groups (p<0.05); however, 54% (n=22) of children still continued to snore, having either persistent or new OSA (n=4). In this unresolved group, sleep was significantly disrupted; % nonrapid eye movement stage 1 (NREM1) sleep and SFI were increased (p<0.05), and total sleep time (TST) and sleep efficiency were decreased compared to the resolved and control groups (p<0.05). Overall, 29% of children were treated, and of these, 67% had resolved SDB. SDB groups had higher PDSS, SDSC, and OSA-18 scores compared to controls at follow-up (p<0.01). Conclusion(s): Our study demonstrated that although SDB improved in the long-term, more than 50% of children had residual SDB (mostly primary snoring) and sleep disturbance. As even mild forms of SDB are known to have adverse cardiovascular, learning, and behavioral outcomes, which have implications for the health of these children. © 2013.
- Published
- 2013
23. Defining barriers to discharge from inpatient rehabilitation, classifying their causes, and proposed performance indicators for rehabilitation patient flow.
- Author
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Olver J.H., Stoelwinder J.U., New P.W., Cameron P.A., Olver J.H., Stoelwinder J.U., New P.W., and Cameron P.A.
- Abstract
There is little research literature on patient flow in rehabilitation. Accepted definitions of barriers to discharge and agreed performance measures are needed to support research and understanding of this topic. The potential of improved patient flow in rehabilitation to assist relieving demand pressures in acute hospitals underscores its importance. This study develops a definition of barriers to discharge from postacute care and classifies their causes using a multiphased iterative consultation and feedback process involving physiatrists, aged-care physicians, and senior nursing and allied health clinicians. Key performance indicators (KPIs) for postacute patient flow are then proposed, the development of which were informed by the available literature and a survey (n=101) of physiatrists, aged-care physicians, and hospital managers with responsibility for patient flow who were questioned about the use of relevant KPIs in this setting. Most (>70%) respondents believed that using KPIs (eg, waiting time from acceptance by postacute care and ready for transfer until admission, percentage of postacute bed days occupied by inpatients with a discharge barrier) to measure aspects of patient flow could improve processes, but few reported collecting this information (45% admission KPIs, 19% discharge KPIs). By using the definition and classification of discharge barriers prospectively to document and address barriers, in conjunction with appropriate KPIs, postacute patient flow and the efficiency of hospital resource utilization can potentially be improved. Our commentary aims to stimulate interest among others to develop a more robust evidence base for improved flow through postacute care. © 2013 American Congress of Rehabilitation Medicine.
- Published
- 2013
24. Enhanced expression and activation of pro-inflammatory transcription factors distinguish aneurysmal from atherosclerotic aorta: IL-6- and IL-8-dominated inflammatory responses prevail in the human aneurysm
- Subjects
Male ,Vasa vasorum ,transcription factor T bet ,Physiology ,Enzyme linked immunosorbent assay ,Interleukin 6 ,Plasma cell ,Interleukin 8 ,Real time polymerase chain reaction ,Interleukin 2 ,Interleukin 4 ,Western blotting ,Interleukin 13 ,Interleukin 10 ,Interleukin 1alpha ,Diagnosis ,transcription factor GATA 3 ,transcription factor ,Medical parameters ,tumor necrosis factor alpha ,Th1 cell ,Reverse Transcriptase Polymerase Chain Reaction ,Messenger RNA ,adult ,Neutrophil ,transcription factor AP 1 ,Middle Aged ,CCAAT enhancer binding protein delta ,biological marker ,Immunohistochemistry ,Cellular immunity ,Aortic Aneurysm ,CCAAT enhancer binding protein alpha ,aged ,Health ,Reverse transcription polymerase chain reaction ,Female ,Differential diagnosis ,Biological Markers ,Inflammation Mediators ,Human ,autacoid ,Clinical article ,Immunology ,transcription factor RelA ,Biosynthesis ,Th2 Cells ,STAT3 protein ,Genetics ,Humans ,Abdominal ,Human tissue ,Cytokine ,Gamma interferon ,Inflammation ,Cytotoxic T lymphocyte ,B lymphocyte ,Perforin ,Gene Expression Profiling ,Methodology ,Aortic Valve Stenosis ,Interleukin ,CCAAT enhancer binding protein beta ,Th1 Cells ,Atherosclerosis ,abdominal aorta aneurysm ,Aorta valve stenosis ,Th2 cell ,Metabolism ,aorta atherosclerosis ,aorta wall ,Differential ,Abdominal aortic aneurysm ,Protein expression ,Controlled study ,Transcription Factors - Abstract
Inflammation plays a key role in the pathogenesis of an AAA (abdominal aortic aneurysm); however, the nature of the inflammatory factors and cellular response(s) involved in AAA growth is controversial. In the present study, we set out to determine the aortic levels of inflammatory cytokines in relation to downstream inflammatory transcription factors and cellular responses. A comparison of AAA wall samples with atherosclerotic wall samples taken from the same aortic region allowed AAA-specific inflammatory parameters to be identified that distinguish AAAs from ASD (aortic atherosclerotic disease). RT-PCR (real-time PCR), ELISA, Western blotting and immunohistochemistry were combined to assess cytokines and transcription factors at the mRNA and protein level, and their activation status. Compared with ASD, inflammatory parameters associated with Th1-type [T-bet, IL (interleukin)-2, IFN-γ (interferon-γ), TNF-α (tumour necrosis factor-α), IL-1α and cytotoxic T-cells] and Th2-type [GATA3, IL-4, IL-10, IL-13 and B-cells] responses were all increased in AAA samples. Evaluation of major downstream inflammatory transcription factors revealed higher baseline levels of C/EBP (CCAAT/enhancer-binding protein) α;, β and δ in the AAA samples. Baseline p65 NF-κB (nuclear factor κB) and c-Jun [AP-1 (activator protein-1)] levels were comparable, but their activated forms were strongly increased in the AAA samples. Downstream target genes of p65 NF-κB, c-Jun, IL-6 and IL-8 were hyperexpressed. Molecular and cellular processes associated with IL-6 and IL-8 hyperactivation were enhanced in the AAA samples, i.e. the expression of phospho-STAT-3 (signal transducer and activator of transcription-3) and perforin were elevated, and the content of plasma cells, neutrophils and vasa vasorum was increased. In conclusion, our findings demonstrate that an AAA is a general inflammatory condition which is characterized by enhanced expression and activation of pro-inflammatory transcription factors, accompanied by IL-6 and IL-8 hyperexpression and exaggerated downstream cellular responses, which together clearly distinguish an AAA from ASD. © The Authors. Chemicals / CAS: gamma interferon, 82115-62-6; interleukin 13, 148157-34-0; interleukin 2, 85898-30-2; interleukin 8, 114308-91-7; perforin, 119332-27-3; transcription factor GATA 3, 137878-55-8; Biological Markers; Inflammation Mediators; Interleukin-6; Interleukin-8; Transcription Factors
- Published
- 2008
25. Enhanced expression and activation of pro-inflammatory transcription factors distinguish aneurysmal from atherosclerotic aorta: IL-6- and IL-8-dominated inflammatory responses prevail in the human aneurysm
- Author
-
Lindeman, J.H.N., Abdul-Hussien, H., Schaapherder, A.F.M., Bockel, J.H. van, Thüsen, J.H. vonder, Roelen, D.L., and Kleemann, R.
- Subjects
Male ,Vasa vasorum ,transcription factor T bet ,Physiology ,Enzyme linked immunosorbent assay ,Interleukin 6 ,Plasma cell ,Interleukin 8 ,Real time polymerase chain reaction ,Interleukin 2 ,Interleukin 4 ,Western blotting ,Interleukin 13 ,Interleukin 10 ,Interleukin 1alpha ,transcription factor GATA 3 ,transcription factor ,Medical parameters ,tumor necrosis factor alpha ,Th1 cell ,Reverse Transcriptase Polymerase Chain Reaction ,Messenger RNA ,adult ,Neutrophil ,transcription factor AP 1 ,Middle Aged ,CCAAT enhancer binding protein delta ,biological marker ,Immunohistochemistry ,Cellular immunity ,CCAAT enhancer binding protein alpha ,aged ,Health ,Reverse transcription polymerase chain reaction ,Female ,Differential diagnosis ,Biological Markers ,Inflammation Mediators ,Human ,autacoid ,Clinical article ,Immunology ,transcription factor RelA ,Biosynthesis ,Diagnosis, Differential ,Th2 Cells ,STAT3 protein ,Genetics ,Humans ,Human tissue ,Cytokine ,Gamma interferon ,Inflammation ,Cytotoxic T lymphocyte ,B lymphocyte ,Perforin ,Gene Expression Profiling ,Methodology ,Aortic Valve Stenosis ,Interleukin ,CCAAT enhancer binding protein beta ,Th1 Cells ,Atherosclerosis ,abdominal aorta aneurysm ,Aorta valve stenosis ,Th2 cell ,Metabolism ,aorta atherosclerosis ,aorta wall ,Abdominal aortic aneurysm ,Protein expression ,Controlled study ,Aortic Aneurysm, Abdominal ,Transcription Factors - Abstract
Inflammation plays a key role in the pathogenesis of an AAA (abdominal aortic aneurysm); however, the nature of the inflammatory factors and cellular response(s) involved in AAA growth is controversial. In the present study, we set out to determine the aortic levels of inflammatory cytokines in relation to downstream inflammatory transcription factors and cellular responses. A comparison of AAA wall samples with atherosclerotic wall samples taken from the same aortic region allowed AAA-specific inflammatory parameters to be identified that distinguish AAAs from ASD (aortic atherosclerotic disease). RT-PCR (real-time PCR), ELISA, Western blotting and immunohistochemistry were combined to assess cytokines and transcription factors at the mRNA and protein level, and their activation status. Compared with ASD, inflammatory parameters associated with Th1-type [T-bet, IL (interleukin)-2, IFN-γ (interferon-γ), TNF-α (tumour necrosis factor-α), IL-1α and cytotoxic T-cells] and Th2-type [GATA3, IL-4, IL-10, IL-13 and B-cells] responses were all increased in AAA samples. Evaluation of major downstream inflammatory transcription factors revealed higher baseline levels of C/EBP (CCAAT/enhancer-binding protein) α;, β and δ in the AAA samples. Baseline p65 NF-κB (nuclear factor κB) and c-Jun [AP-1 (activator protein-1)] levels were comparable, but their activated forms were strongly increased in the AAA samples. Downstream target genes of p65 NF-κB, c-Jun, IL-6 and IL-8 were hyperexpressed. Molecular and cellular processes associated with IL-6 and IL-8 hyperactivation were enhanced in the AAA samples, i.e. the expression of phospho-STAT-3 (signal transducer and activator of transcription-3) and perforin were elevated, and the content of plasma cells, neutrophils and vasa vasorum was increased. In conclusion, our findings demonstrate that an AAA is a general inflammatory condition which is characterized by enhanced expression and activation of pro-inflammatory transcription factors, accompanied by IL-6 and IL-8 hyperexpression and exaggerated downstream cellular responses, which together clearly distinguish an AAA from ASD. © The Authors. Chemicals / CAS: gamma interferon, 82115-62-6; interleukin 13, 148157-34-0; interleukin 2, 85898-30-2; interleukin 8, 114308-91-7; perforin, 119332-27-3; transcription factor GATA 3, 137878-55-8; Biological Markers; Inflammation Mediators; Interleukin-6; Interleukin-8; Transcription Factors
- Published
- 2008
26. Caloric test and simultaneous recording of sympathetic skin response
- Author
-
Fazıl Necdet Ardıç
- Subjects
Male ,Questionnaires ,Sympathetic nervous system ,correlation analysis ,latent period ,Nystagmus ,Audiology ,Severity of Illness Index ,Cohort Studies ,Surveys and Questionnaires ,Vertigo ,Vestibular system ,clinical article ,vestibular ,biology ,Sympathetic skin response ,article ,food and beverages ,clinical trial ,General Medicine ,Galvanic Skin Response ,Middle Aged ,symptom ,Vestibular ,medicine.anatomical_structure ,female ,priority journal ,lavage ,disease severity ,diagnostic value ,medicine.symptom ,Cohort study ,nystagmus ,Adult ,medicine.medical_specialty ,velocity ,Autonomic system ,medical parameters ,warming ,autonomic system ,dizziness ,sympathetic skin response ,vertigo ,Visual analogue scale ,sex difference ,Dizziness ,Sensitivity and Specificity ,Severity of illness ,medicine ,Caloric Tests ,Humans ,controlled study ,human ,intermethod comparison ,Probability ,caloric vestibular test ,controlled clinical trial ,business.industry ,questionnaire ,visual analog scale ,Electronystagmography ,biology.organism_classification ,cold ,Surgery ,Autonomic nervous system ,Otorhinolaryngology ,measurement ,business ,autonomic neuropathy ,sympathetic tone - Abstract
Conclusions. It was found that there was a close correlation between sympathetic skin response (SSR) parameters and nystagmus parameters obtained in caloric tests. Further studies are needed to investigate the clinical correlation of these findings. Objectives. To investigate whether the caloric response creates a measurable SSR and, if so, to compare the SSR parameters with the nystagmus parameters and the feelings of the patient. Material and methods. Patients completed an autonomic symptom questionnaire (ASQ) regarding their past history of autonomic symptoms. They used a visual analog scale (VAS) to assess the severity of symptoms during simultaneous SSR and caloric tests. Symptoms were also noted separately by the investigator. Results. Eighteen patients were included in the study (13 females, 5 males). Eight of the patients had central and 10 had peripheral vertigo. The mean VAS score was 6.6 +/- 1.9 and the mean ASQ score was 7.2 +/- 3.6. In terms of the recorded parameters, there were no significant differences between patients with central and peripheral vertigo, males and females or warm and cold irrigation. The number of SSR waves increased significantly when the slow-phase velocity was > 26 degrees/s (p < 0.01) and the nystagmus latency was
- Published
- 2006
27. Malnutrition in critically ill children: From admission to 6 months after discharge
- Subjects
Male ,Adolescent ,Critical Illness ,Newborn intensive care ,Nutritional Status ,Major clinical study ,Anamnesis ,Neonatal ,Humans ,Intensive care unit ,Prospective study ,Hospital discharge ,Child ,Preschool ,Children ,Premature ,Child nutrition ,Clinical observation ,Medical parameters ,Standard deviation scores ,Anthropometry ,Follow-up ,Malnutrition ,Intensive Care ,Infant ,Length of Stay ,Nutritional assessment ,Hospital admission ,Newborn ,Patient Discharge ,Hospitalization ,Outcomes research ,Female ,Prematurity ,Controlled study - Abstract
Background & Aims: Little is known about the nutritional status of critically ill children during hospitalisation in and after discharge from an intensive care unit. We set up a prospective, observational study to evaluate the nutritional status of children in an intensive care unit from admission up to 6 months after discharge. A secondary aim was identifying patient characteristics that influence the course of the various anthropometric parameters. Methods: The nutritional status of 293 children - 104 preterm neonates, 96 term neonates and 93 older children - admitted to our multidisciplinary tertiary pediatric and neonatal intensive care unit was evaluated by anthropometry upon and during admission, at discharge and 6 weeks and 6 months following discharge. Results: Upon admission, 24% of all children appeared to be undernourished. Preterm and term neonates, but not older children, showed a decline in nutritional status during admission. At 6 months after discharge almost all children showed complete recovery of nutritional status. Length of stay and history of disease were the parameters that most adversely affected the nutritional status of preterm and term neonates at discharge and during follow-up. Conclusion: While malnutrition is a major problem in pediatric intensive care units, most children have good long-term outcome in terms of nutritional status after discharge. © 2003 Elsevier Ltd. All rights reserved.
- Published
- 2004
28. Malnutrition in critically ill children: From admission to 6 months after discharge
- Author
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Wim C. J. Hop, Jessie M. Hulst, Koen F. M. Joosten, Luc J I Zimmermann, Hans A. Büller, Dick Tibboel, Johannes B. van Goudoever, Stef van Buuren, TNO Preventie en Gezondheid, Pediatric Surgery, Pediatrics, Epidemiology, and General Paediatrics
- Subjects
Male ,Pediatrics ,Neonatal intensive care unit ,Newborn intensive care ,Anamnesis ,Critical Care and Intensive Care Medicine ,law.invention ,law ,Medicine ,Prospective cohort study ,Hospital discharge ,Child ,Children ,Clinical observation ,Medical parameters ,Nutrition and Dietetics ,Anthropometry ,Follow-up ,Nutritional assessment ,Intensive care unit ,Patient Discharge ,Hospitalization ,Outcomes research ,Child, Preschool ,Female ,Prematurity ,Infant, Premature ,medicine.medical_specialty ,Critical Care ,Adolescent ,Critical Illness ,Nutritional Status ,Major clinical study ,Intensive care ,Humans ,Prospective study ,SDG 2 - Zero Hunger ,Child nutrition ,Standard deviation scores ,business.industry ,Malnutrition ,Infant, Newborn ,Intensive Care ,Infant ,Length of Stay ,medicine.disease ,Hospital admission ,El Niño ,Intensive Care, Neonatal ,business ,Controlled study - Abstract
Background & Aims: Little is known about the nutritional status of critically ill children during hospitalisation in and after discharge from an intensive care unit. We set up a prospective, observational study to evaluate the nutritional status of children in an intensive care unit from admission up to 6 months after discharge. A secondary aim was identifying patient characteristics that influence the course of the various anthropometric parameters. Methods: The nutritional status of 293 children - 104 preterm neonates, 96 term neonates and 93 older children - admitted to our multidisciplinary tertiary pediatric and neonatal intensive care unit was evaluated by anthropometry upon and during admission, at discharge and 6 weeks and 6 months following discharge. Results: Upon admission, 24% of all children appeared to be undernourished. Preterm and term neonates, but not older children, showed a decline in nutritional status during admission. At 6 months after discharge almost all children showed complete recovery of nutritional status. Length of stay and history of disease were the parameters that most adversely affected the nutritional status of preterm and term neonates at discharge and during follow-up. Conclusion: While malnutrition is a major problem in pediatric intensive care units, most children have good long-term outcome in terms of nutritional status after discharge. © 2003 Elsevier Ltd. All rights reserved.
- Published
- 2004
29. Successful treatment of rheumatoid arthritis is associated with a reduction in serum sE-selectin and thrombomodulin level
- Author
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Meral Calguneri, Veli Cobankara, Sedat Kiraz, Düzgün Özatli, Ibrahim C. Haznedaroglu, Ihsan Ertenli, S Apras, Tufan Turk, and Mehmet Akif Ozturk
- Subjects
rheumatoid arthritis ,Male ,patient monitoring ,Health Status ,Thrombomodulin ,drug response ,Arthritis ,Gastroenterology ,Severity of Illness Index ,Arthritis, Rheumatoid ,nonsteroid antiinflammatory agent ,endothelium cell ,Prospective Studies ,Prospective cohort study ,clinical article ,C reactive protein ,physician ,medicine.diagnostic_test ,adult ,E-selectin ,article ,endothelial leukocyte adhesion molecule 1 ,General Medicine ,Middle Aged ,female ,Treatment Outcome ,priority journal ,laboratory test ,Erythrocyte sedimentation rate ,Rheumatoid arthritis ,Antirheumatic Agents ,Biological Markers ,Drug Therapy, Combination ,Female ,Adult ,Antirheumatic Agents/*therapeutic use ,Arthritis, Rheumatoid/*blood/*drug therapy/physiopathology ,Biomarkers/analysis ,E-Selectin/*blood ,Humans ,Hydroxychloroquine/therapeutic use ,Methotrexate/therapeutic use ,Sulfasalazine/therapeutic use ,Thrombomodulin/*blood ,E-Selectin ,arthropathy ,medicine.drug ,Hydroxychloroquine ,medicine.medical_specialty ,medical parameters ,side effect ,salazosulfapyridine ,Therapeutics ,volunteer ,methotrexate ,Rheumatology ,Internal medicine ,medicine ,controlled study ,human ,cell marker ,medical assessment ,business.industry ,morning stiffness ,hemoglobin ,medicine.disease ,diclofenac ,cell damage ,Sulfasalazine ,Methotrexate ,protein blood level ,antirheumatic agent ,Immunology ,erythrocyte sedimentation rate ,business ,disease activity ,edema ,Biomarkers - Abstract
The aim of this study was to investigate the changes in serum levels of endothelial cell injury markers, soluble (s) E-selectin and thrombomodulin (TM), in patients with rheumatoid arthritis (RA) before and after antirheumatic drug treatment and to assess the relationship between these changes and clinical responses to the drug treatment. Eleven patients with RA having active arthritis and 12 healthy volunteers were enrolled in the study. They were monitored by clinical and laboratory parameters while receiving a combination of methotrexate, hydroxychloroquine and sulphasalazine. Pre- and post-treatment clinical and laboratory parameters, including sE-selectin and sTM levels, were measured. The ages of the patients were comparable with those of the control groups. Significant improvements were detected in erythrocyte sedimentation rate, C-reactive protein, hemoglobin, morning stiffness, patients' global assessment, physicians' global assessment, number of tender joints and number of swollen joints improved at the end of the therapy (for each parameter p < 0.05). Significant improvements were detected in clinical and laboratory parameters. In the patient group there were significant decreases in the levels of sTM and sE-selectin after treatment (p < 0.05). The patient group had significantly higher sTM and sE-selectin levels than the control group at the beginning of the study (p < 0.01), but the difference returned to normal after the treatment (p > 0.05). The sE-selectin and sTM levels significantly correlated with each other, and also with clinical and laboratory findings. Combination treatment successfully treated RA patients. sE-selectin and sTM levels probably reflect disease activity and can be helpful in monitoring disease status and response to therapy. © Clinical Rheumatology 2004.
- Published
- 2003
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