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Öğe Trace elements (Al, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn) in Mytilus galloprovincialis and Tapes decussatus from Faro and Ganzirri Lakes (Sicily, Italy): Flow cytometry applied for hemocytes analysis(Elsevier GmbH, 2021) Parrino, Vincenzo; Costa, Gregorio; Giannetto, Alessia; De Marco, Giuseppe; Cammilleri, Gaetano; Acar, ÜmitBackground: Trace elements present in sessile molluscs, are important because they are used in human consumption and it has significantly increased in recent years. While their filtering of the water can lead to their build-up of organic and inorganic materials that can be sampled and analyzed, this can also lead to bioaccumulation of harmful substances, such as essential and non-essential elements, that can harm the human health if in taken in high concentrations or for a long period of time. Methods: In the present study, the trace metal content (Al, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn) of two sessile crustaceans, 20 Mytilus galloprovincialis (mussel) and 20 Tapes decussatus (clam) in Faro and Ganzirri Lakes (Messina, Sicily, Italy) were analyzed. Haemolymph samples were taken on both molluscs in order to analyze the haemocyte population by flow cytometric analysis. Unpaired t-tests were used to determine significant differences for the essential and non-essential metallic elements concentrations in the lake waters and in the tissues of M. galloprovincialis and T. decussatus and for hemocyte populations R1 (halinocytes) and R2 (granulocytes). Results: The results suggested that that in Faro Lake, the tissue Al, Cr and Pb levels in M. galloprovincialis were higher than those for T. decussatus, in contrast to Mn, Fe, Ni, Cu, Zn and Cd, which were higher in T. decussatus. Unpaired t-tests showed that there were significantly higher proportions of halinocytes in M. galloprovincialis versus T. decussatus for both Faro Lake (41.8 % vs. 24.3 %; P < 0.001) and Ganzirri Lake (43.0 % vs. 22.4 %; P < 0.001). In contrast, while there were significantly higher proportions of granulocytes in Faro Lake (21.2 % vs. 9.1 %; P < 0.001), this difference was not seen for the granulocytes of M. galloprovincialis versus T. decussatus in Ganzirri Lake (9.6 % vs. 13.0 %). Conclusion: This study shows that M. galloprovincialis and T. decussatus can indeed bioaccumulate some of these metal, such that activation of the immune responses is specific to certain cell types. Future research must focus on the balance of trace elements in the consumption of these shellfish, and analyzes with more sophisticated tools can be used to diagnose the increased concentration of trace elements and the quantification of trace metals from shellfish to clams.Öğe The impact of acute cold water stress on blood parameters, mortality rate and stress-related genes in Oreochromis niloticus, Oreochromis mossambicus and their hybrids(Elsevier Ltd, 2021) Yılmaz, Sevdan; Ergün, Sebahattin; Çelik, Ekrem Şanver; Banni, Mohamed; Ahmadifar, Ehsan; Dawood, Mahmoud A. O.This study aims to evaluated the response of Oreochromissp. to cold stress. Two experiments were conducted involving a total of 1080 juvenile Oreochromis niloticus, O. mossambicus, O. niloticus♂ × O.mossambicus♀=F1♂ × O.mossambicus ♀ (Hybrid 1; H1) and O. mossambicus♂ × O. niloticus♀ (Hybrid 2; H2). In the 1st experiment, fish were exposed to cold water (12 °C) for 24 h and then hematological parameters, serum biochemical variables, innate immune responses, antioxidant status, and liver gene expression responses (hsp70, hsp27, hsp90, hsp40, cat, sod, eef1a1 and calreticulin) were analyzed. Hematological and serum biochemical responses involved species-specific differences. At optimal temperatures (28 °C), respiratory burts activity (RBA) and myeloperoxidase (MPO) values of H1, H2 and O. mossambicus were significantly higher than O. niloticus (p< 0.05). While the RBAvalue of O. mossambicus decreased after exposure to cold water (p< 0.05), lysozyme activities of O. niloticus and H2 and MPO activities of all experimental fish increased significantly (p< 0.05). At control conditions (28 °C), cortisol levels were found to be higher in O. mossambicus than in H1 and O. niloticus (p< 0.05). A significant increase in cat and sod transcripts was observed in liver of fish being very pronounced in O. mossambicus and H2. The highest up-regulation was observed for hsp70 target where the lowest but significant up-regulation was observed for hsp90 gene. In 2nd experiment, water temperature was gradually decrease from 28 °C to 12 °C (average, 1 °C/1 h).Survival rates of H1 and H2 were found to be different compared to O. mossambicus and O. niloticus (p< 0.05) after 20 days of cold water challenge.O. mossambicus was the most cold-sensitive group, followed by the H2, H1 and O. niloticus. Our data should be carfully considered in view of the possible physiological and anti-stressor responses being species-specific in fish.Öğe Deep neural network ensemble for on-the-fly quality control-driven segmentation of cardiac MRI T1 mapping(Elsevier B.V., 2021) Hann, Evan; Popescu, Iulia A.; Zhang, Qiang; Gonzales, Ricardo A.; Barutcu, AhmetRecent developments in artificial intelligence have generated increasing interest to deploy automated image analysis for diagnostic imaging and large-scale clinical applications. However, inaccuracy from automated methods could lead to incorrect conclusions, diagnoses or even harm to patients. Manual inspection for potential inaccuracies is labor-intensive and time-consuming, hampering progress towards fast and accurate clinical reporting in high volumes. To promote reliable fully-automated image analysis, we propose a quality control-driven (QCD) segmentation framework. It is an ensemble of neural networks that integrate image analysis and quality control. The novelty of this framework is the selection of the most optimal segmentation based on predicted segmentation accuracy, on-the-fly. Additionally, this framework visualizes segmentation agreement to provide traceability of the quality control process. In this work, we demonstrated the utility of the framework in cardiovascular magnetic resonance T1-mapping - a quantitative technique for myocardial tissue characterization. The framework achieved near-perfect agreement with expert image analysts in estimating myocardial T1 value (r=0.987, p<.0005; mean absolute error (MAE)=11.3ms), with accurate segmentation quality prediction (Dice coefficient prediction MAE=0.0339) and classification (accuracy=0.99), and a fast average processing time of 0.39 second/image. In summary, the QCD framework can generate high-throughput automated image analysis with speed and accuracy that is highly desirable for large-scale clinical applications.Öğe Evaluation of DNA damages in congenital hearing loss patients(Elsevier B.V., 2021) Çağlar, Özge; Çobanoğlu, Hayal; Uslu, Atilla; Çayır, AkınIn the current study, we aimed to compare the level of genetic damages measured as micronucleus (MN), nucleoplasmic bridge (NPB), and nuclear bud formation (NBUD) in congenital hearing loss patients (n = 17) and control group (n = 24). The cytokinesis-blocked micronucleus assay (CBMN) was applied to the blood samples to measure the frequency of the markers in both groups. The frequencies of MN of hearing loss patients were found to be consistently significantly higher than those obtained for the control group (p < 0.0001). Similarly, we found significantly higher frequency of NPB in patients was obtained for the patient group (p < 0.0001). Finally, the frequencies of NBUD in patients is significantly higher than the level measured in the control group (p < 0.0001). Furthermore, the age-adjusted MNL, BNMN, NPB, and NBUD frequencies in the patients were significantly higher than those obtained in the control group. We observed that the frequency of MN in patients was positively correlated with NBUD frequency which may indicate a common mechanism for these biomarkers in the patient group. We found, for the first time, that there were statistically significant higher levels of MN, NPB, and NBUD in sensorineural hearing loss patients. Since the markers we evaluated were linked with crucial diseases, our findings might suggest that sensorineural hearing loss patients are susceptible to several crucial diseases, especially cancer. Furthermore, the results demonstrated the significance of the MN, NPB, and NBUD level and thus provides a potential marker for the diagnosis of congenital hearing loss patients.Öğe A rare presentation of Susac syndrome: Report of three pediatric cases(Elsevier B.V., 2021) Çitçi Yalçınkaya, Beyza; Ertürk Çetin, Özdem; Kılıç, Hüseyin; Demirci, Onat; Çokyaman, Turgay; Uygunoğlu, UğurSusac syndrome is a rare disorder that is clinically characterized by encephalopathy, retinopathy and hearing loss. Most of the reported cases in the literature are adult patients, pediatric presentation is extremely rare. Here we present three pediatric patients aged between 10-15; diagnosed as Susac syndrome. They all had thalamic involvement in addition to typical callosal lesions. All of the three patients had a monophasic course and good treatment response.Öğe Synthesis and characterization of biodegradable and antioxidant phosphazene-tannic acid nanospheres and their utilization as drug carrier material(Elsevier Ltd, 2021) Önder, Alper; Özay, HavaIn this study, hexachlorocyclotriphosphazene (HCCP) and tannic acid (TA) were used at different stoichiometric ratios to synthesize cyclomatrix-type polymeric materials with different surface features and dimensions. Using different reactive ratios, the structure and surface functional groups of the synthesized polymeric particles were explained using Fourier-Transform Infrared Spectroscopic (FTIR), Scanning Electron Microscope (SEM), Energy-dispersive X-ray spectroscopy (EDX), X-ray Photoelectron Spectroscopy (XPS) and Thermogravimetric (TG) analysis techniques. With morphologically fully spherical structure and mean 234.82 ± 49.37 nm dimensions, Phz-TA (4:1) nanospheres were researched for in vitro biodegradability, antioxidant features, and usability as a drug release system. In vitro biodegradability of Phz-TA (4:1) nanospheres was investigated at pH = 7.0 and pH = 1.2. Determined to degrade in 8–10 h at these pH values, nanospheres were used for releasing of Rhodamine 6G as a model drug. Due to the rich phenolic structure of the contained tannic acid units, nanospheres were determined to simultaneously have antioxidant features. Thus, this study determined that Phz-TA nanospheres with in vitro biodegradability and antioxidant features are promising polymeric materials for use as a potential drug-carrier in the future.Öğe The Effect of Kangaroo Care on Breastfeeding and Development in Preterm Neonates(Elsevier Inc., 2021) Küçükoğlu, Sibel; Kurt, Fatma Yılmaz; Özdemir, Aynur Aytekin; Özcan, ZekiyePurpose: This study investigated the effect of kangaroo care (KC) on breastfeeding rate and development in preterm neonates in the first six months of life. Design: The study was conducted using a quasi-experimental method with a pretest-posttest control group design. The sample consisted of preterm neonates in the NICU of two state hospitals of Turkey. The experimental group (n =30) was provided with KC by their mothers for 30 min once a day during a postnatal month. The control group (n = 30) received routine care. Feeding patterns and physical development parameters were determined during the transition to exclusive breastfeeding and at discharge, and in the first, third, and sixth postnatal months. Data were collected using a descriptive characteristics questionnaire, a nutrition and physical development follow-up form, and a home KC follow-up form. Percentage distribution, mean, chi-square test, and t-test were used for analysis. Results: The KC group had a significantly higher mean body weight than the control group in the third and sixth postnatal months (p < .05). The KC group had higher breast milk intake and breastfeeding rates than the control group during the transition to exclusive breastfeeding and at discharge, and in the first, third, and sixth postnatal months (p < .05). Conclusion: The KC neonates were breastfed for a more extended period of time than controls. This result suggests that KC improves breast milk intake and breastfeeding rates. Therefore, mothers should be trained in KC in the postnatal period. Practice implications: Healthcare professionals should encourage and follow mothers for kangaroo care.Öğe Design of EM-artifact-free earphone based on the photoacoustic effect(Elsevier GmbH, 2021) Muşdal, Bengi Derya; Kurt, MustafaElectromagnetic interactions between conventional earphones and the electroencephalography (EEG) electrodes used for analyzing brain waves give rise to efficiency problems in neurophysiological studies of auditory perception. Currently used speakers and headphones are electromagnetic devices based on strong magnets. In spite of intensive use of such systems, there has been no effective way to eliminate the electromagnetic artifacts produced by such audio transmitting devices to date. The ability for transferring audible sounds without the use of electromagnetic devices that can affect the EEG signal would open up many innovative possibilities in Audio Technologies. Audible sound transfer over long distances is possible by the photoacoustic effect. In such studies, the modulated optical signal can be converted into an audible signal arising from the absorption of the light energy of relevant molecules. In this study, we propose an earphone based on the photoacoustic effect, and calculated the dB SPL (Sound Pressure Level) values for a spherical cell filled with olive pomace. By the use of the method of Diebold and Westervelt, we theoretically calculated the sound pressure levels for our cell and determined a 60 dB SPL at a sound frequency of 1000 Hz for our preliminary earphone design.Öğe Exceptional Variant with Distant Cutaneous Metastasis as the First Clinical Sign in Gastric Signet-Ring Carcinoma(Springer, 2022) Bulut, Ezgi; Taştekin, Ebru; Topuz, Canberk; Özturk, Sevgi; Gökyer, AliObjective: Skin metastases from gastric cancer are rare and usually occur very late in the course of the disease. The most common metastatic sites liver, the peritoneal surfaces, and the non regional or distant lymph nodes. Case report: In this case we report the short-term survival of a 67-year-old man complined of multiple nodular lesions in various part of his skin. Histology showed a metastatic signet ring cell adenocarsinoma. Esophagogastroduodenoscopy was performed and a crater- like ulcer, about 3 cm in diameter, was observed on the anterior part of the stomach corpus distal. A biopsy specimen was obtained, and histopathological findings were consistent with gastric signet-ring cell carcinoma. XELOX chemotherapy regimen was initiated for the patient. Conclusion: Skin metastasis of gastric adenocarcinoma is a rare condition with a poor prognosis. It may be the first manifestation of a clinically silent visceral cancer or may represent a recurrence of an internal malignancy.Öğe Dental age and tooth development in children with molar-incisor hypomineralization: A case-control study(Elsevier Ltd, 2022) Sezer, Berkant; Çarıkçıoğlu, Burak; Kargül, BetülObjective: The aim of the study was to determine the dental age for the evaluation of tooth development in children with molar-incisor hypomineralization (MIH) by using the Willems method, Cameriere-European formula, and London Atlas. Design: Panoramic radiographs of 308 children between the ages of 6–13 diagnosed with MIH and the same number of sex- and age-matched children without MIH were evaluated by two different examiners using the Willems method, Cameriere-European formula, and London Atlas. The mean difference between chronological age and dental age in both groups was calculated for each sex and age. The mean absolute error was used to determine the accuracies of the Willems method, Cameriere-European formula, and London Atlas. Results: There was a statistically significant difference found only in Willems method in dental age estimation between the groups with and without MIH (P = 0.001). In the evaluation performed with Cameriere-European formula and London Atlas, which are more accurate methods for dental age estimation in both groups, no statistically significant difference was found in dental age estimation between the two groups (P = 0.322, P = 0.290, respectively). There was a statistically significant intense linear correlation for three methods in both groups (P < 0.001). Conclusions: MIH, which is a developmental enamel defect, does not affect dental age and tooth development since there was no significant difference between groups with and without MIH according to the evaluations made with accurate dental age estimation methods.Öğe Screening autonomic functions in patients with restless legs syndrome: A case-control study in a tertiary care hospital(Elsevier B.V., 2022) Başaran, Şehnaz; Akıncı, ErhanPurpose: The clinical importance of autonomic involvement in patients with restless legs syndrome (RLS) remains unclear. To our knowledge, no study has explored the relationship between autonomic dysfunction and disease-related variables in patients with RLS. Therefore, this study aimed 1) to determine the presence of autonomic symptoms in drug-naïve patients with RLS in comparison with healthy controls using Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) questionnaire and 2) to evaluate the possible associations of autonomic dysfunction with clinical factors in RLS. Methods: A total of 70 drug-naïve patients with RLS and 85 healthy volunteers were enrolled. The SCOPA-AUT questionnaire and Epworth Sleepiness Scale (ESS) scores were used to determine autonomic functions and sleep propensity, respectively. Moreover, the International Restless Legs Syndrome Study Group rating scale was used to evaluate disease severity in the patient group. Results: Compared with the control group, the RLS group had significantly higher subscale scores (gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual [women]) and total scores of the SCOPA-AUT questionnaire (p < 0.05). In the patient group, there was a significant correlation between the total scores and subscale scores (gastrointestinal, cardiovascular, and thermoregulatory subscales) of the SCOPA-AUT questionnaire and disease severity. Moreover, ESS was positively correlated with the total scores and subscale scores (urinary, cardiovascular, and pupillomotor) of the SCOPA-AUT questionnaire. Conclusion: Disease severity and daytime sleepiness may be related to autonomic dysfunction in RLS. Further studies focusing on autonomic functions in RLS are required to improve management strategies and clinical outcomes.Öğe CT angiography prior to DIEP flap breast reconstruction: a randomized controlled trial(Elsevier Ltd., 2022) Çolakoğlu, Salih; Tebockhorst, Seth; Freedman, Jonathan; Douglass, Sara; Sıddıkoğlu, Duygu; Chong, Tae W.; Mathes, David W.Background: CT angiogram (CTA) has become the preferred method for the planning of abdominal-based microsurgical breast reconstruction to gather information about location, number, caliber and trajectory of the abdominal perforators and to decrease overall flap dissection and operating room time. However, the high-level evidence to support its utility has been limited to nonrandomized retrospective and prospective studies. Methods: Patients undergoing deep inferior epigastric artery perforator (DIEP) flap breast reconstruction were prospectively randomized to preoperative CTA and no imaging groups. Patient demographics, operative times, selected row and number of perforators for flap harvest, agreement in perforator selection between radiologist and surgeon, and clinical outcomes data were collected. Two-way ANOVA, Fisher's exact and Student's t-tests were used for statistical analysis. Results: Overall, 37 patients with 63 flaps were included in this study. Seventeen patients had CT scan prior to surgery. Mean age was 50.5 ± 9.6 years. Flap dissection time was significantly shorter in the CT group (150.8 ± 17.8 vs 184.7 ± 25.1 min and p< 0.001). Although overall odds ratio (OR) time was also shorter in the CT group, this only reached a statistical significance in bilateral surgeries (575.9 ± 70.1 vs 641.9 ± 79.6 min and p = 0.038). Hemiabdomen side, selected DIEP row, and the number of dissected perforators did not affect the overall dissection time. Complication rates were similar between the two groups. Conclusion: This prospective, randomized study demonstrates that preoperative CTA analysis of perforators decreases flap harvest and overall OR time with equivalent postoperative outcomes.Öğe Hyaluronic acid (HA)-Gd(III) and HA-Fe(III) microgels as MRI contrast enhancing agents(Elsevier Ltd, 2022) Şahiner, Nurettin; Umut, Evrim; Sağbaş Suner, Selin; Şahiner, Mehtap; Culha, Mustafa; Ayyala, Ramesh S.Hyaluronic acid (HA) was crosslinked with Gd(III) and Fe(III) ions rendering physically crosslinked HA-metal(III) microgels as magnetic resonance imaging (MRI) enhancing contrast agents. These HA-Gd(III) and HA-Fe(III) microgels are injectable with size range, 50–5000 nm in water. The same isoelectric point, pH 1.2 ± 0.1, was measured for both microgels. HA-Gd(III) and HA-Fe(III) microgels are hemo-compatible biomaterials and can be safely used in intravascular applications up to 1000 μg/mL concentration. Furthermore, no significant toxicity was attained as 95 ± 8 and 81 ± 2% cell viability on L929 fibroblast cells at 100 μg/mL of HA-Gd(III) and HA-Fe(III) microgels were measured. Moreover, HA-Gd(III) microgels were found to afford significant contrast improvement capability in MRI with proton relaxivity, r1 = 2.11 mM−1 s−1, comparable with the values reported for Gd(III) labeled functionalized HA gel systems and commercial Gd based contrast agents.Öğe Linear and non-linear dynamics of the epidemics: System identification based parametric prediction models for the pandemic outbreaks(ISA - Instrumentation, Systems, and Automation Society, 2022) Tutsoy, Önder; Polat, AdemCoronavirus disease 2019 (COVID-19) has endured constituting formidable economic, social, educational, and phycological challenges for the societies. Moreover, during pandemic outbreaks, the hospitals are overwhelmed with patients requiring more intensive care units and intubation equipment. Therein, to cope with these urgent healthcare demands, the state authorities seek ways to develop policies based on the estimated future casualties. These policies are mainly non-pharmacological policies including the restrictions, curfews, closures, and lockdowns. In this paper, we construct three model structures of the SpInItIbD-N (suspicious Sp, infected In, intensive care It, intubated Ib, and dead D together with the non-pharmacological policies N) holding two key targets. The first one is to predict the future COVID-19 casualties including the intensive care and intubated ones, which directly determine the need for urgent healthcare facilities, and the second one is to analyse the linear and non-linear dynamics of the COVID-19 pandemic under the non-pharmacological policies. In this respect, we have modified the non-pharmacological policies and incorporated them within the models whose parameters are learned from the available data. The trained models with the data released by the Turkish Health Ministry confirmed that the linear SpInItIbD-N model yields more accurate results under the imposed non-pharmacological policies. It is important to note that the non-pharmacological policies have a damping effect on the pandemic casualties and this can dominate the non-linear dynamics. Herein, a model without pharmacological or non-pharmacological policies might have more dominant non-linear dynamics. In addition, the paper considers two machine learning approaches to optimize the unknown parameters of the constructed models. The results show that the recursive neural network has superior performance for learning nonlinear dynamics. However, the batch least squares outperforms in the presence of linear dynamics and stochastic data. The estimated future pandemic casualties with the linear SpInItIbD-N model confirm that the suspicious, infected, and dead casualties converge to zero from 200000, 1400, 200 casualties, respectively. The convergences occur in 120 days under the current conditions.Öğe Assessment of genetic damage induced by gadolinium-based radiocontrast agents(Elsevier GmbH, 2022) Çobanoğlu, HayalBackground: Today, although gadolinium based contrast agents have been frequently used in the field of medicine, there is limited data available whether gadolinium based agents affect the genome. Aim: The present study aimed to investigate the genotoxic and cytotoxic potentials of gadoteric acid and gadoversetamide used as gadolinium-based contrast agents for magnetic resonance (MR) imaging. Material and methods: The cytokinesis-block micronucleus assay was applied to human peripheral blood lymphocytes to assess the genotoxicity measured as micronucleus (MN), nucleoplasmic bridge (NPBs) and nuclear bud (NBUDs) frequencies. Furthermore, cytokinesis-block proliferation index (CBPI) was calculated to determine cytostasis. Lymphocytes were treated with gadoteric acid at concentrations of 1.0, 2.5, 5.0, and 25 mM and with gadoversetamide at concentrations of 0.25, 1.0, 2.5, and 5.0 mM for 48 h. Results: Gadoteric acid did not cause significant increase in MN, NBPs and NBUDs frequencies and CBPI values at any concentration. Gadoversetamide induced significantly increase MN formation at concentration of 2.5 mM, NBP formation at concentrations of 1.0 and 2.5 mM, and NBUD formation at concentrations of 0.25, 1.0 and 2.5 mM. Additionally, gadoversetamide exposure resulted in statistically significant decrease in CBPI values compared to the control at concentrations of 2.5 and 5.0 mM. In addition, CBPI levels in response to concentrations of gadoversetamide was negatively and significantly associated with concentration. Conclusion: These findings show that gadoteric acid does not have genotoxic or cytotoxic potential, while gadoversetamide might have both genotoxic and cytotoxic potential on human peripheral blood lymphocytes. As a comparison, gadoversetamide was found more genotoxic and cytotoxic.Öğe Electronic Spectra of C60Films Using Screened Range Separated Hybrid Functionals(American Chemical Society, 2021) Chakravarty, Chandrima; Aksu, Hüseyin; Maiti, Buddhadev; Dunietz, Barry D.We study computationally the electronic spectra of C60thin films using the recently developed density functional theory (DFT) framework combining a screened range separated hybrid (SRSH) functional with a polarizable continuum model (PCM). The SRSH-PCM approach achieves excellent correspondence between the frontier orbital’s energy levels and the ionization potential and electron affinity of the molecular systemat the condensed phaseand consequently leads to high quality electronic excitation energies when used in time-dependent DFT calculations. Our calculated excited states reproduce the experimentally main reported spectral peaks at the 3.6-4.6 eV energy range and when addressing excitonic effects also reproduce the red-shifted spectral feature. Notably, we analyze the low-lying peak at 2.7 eV and associate it to an excitonic state.Öğe The Impact of Stone Density on Operative Complications of Retrograde Intrarenal Surgery: A Multicenter Study with Propensity Score Matching Analysis(Mary Ann Liebert Inc., 2022) Başatac, Cem; Özman, Oktay; Akgül, Hacı Murat; Özyaman, Onur; Çınar, Önder; Can, Günay; Sancak, Eyüp BurakBackground: The aim of the study was to evaluate the impact of stone density on operative complication rates in retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 473 consecutive patients undergoing RIRS for the treatment of upper tract urinary stones were included. To adjust for baseline confounders, one-to-one propensity score matching was performed. After matching, the patients were divided into two groups according to stone density (low density [LD] group, ≤970 Hounsfield unit [HU]; high density [HD] group, >970 HU). The patients' demographics, stone-related features, stone-free rates, and intraoperative and postoperative complication rates were compared between the groups. The primary objective was to evaluate whether the intraoperative and postoperative complication rates were higher in patients whose stone density was greater than 970 HU. Results: After propensity score matching, 170 of 210 LD and 170 of 263 HD patients undergoing RIRS were included. The baseline characteristics did not differ significantly between the groups. There were no significant differences between LD and HD patients with respect to intraoperative (5.9% and 8.8%, respectively; P = .29), postoperative (10.6% and 15.3%, respectively; P = .14), and overall complication rates (15.2% and 21.1%, respectively; P = .16). Stone-free status was achieved in 143 patients (84.1%) in the LD group and 148 patients (87%) in the HD group; the difference was not statistically significant (P = .27). Conclusion: Our results show that RIRS is a safe and effective minimally invasive procedure for the treatment of upper urinary tract stones, even in HD stones.Öğe Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey(Oxford University Press, 2021) Özturk, Savaş; Turgutalp, Kenan; Arıcı, Mustafa; Odabaş, Ali Rıza; Altıparmak, Mehmet Rıza; Aydın, Zeki; Bakırdöğen, SerkanBackground. Chronic kidney disease (CKD) and immunosuppression, such as in renal transplantation (RT), stand as one of the established potential risk factors for severe coronavirus disease 2019 (COVID-19). Case morbidity and mortality rates for any type of infection have always been much higher in CKD, haemodialysis (HD) and RT patients than in the general population. A large study comparing COVID-19 outcome in moderate to advanced CKD (Stages 3-5), HD and RT patients with a control group of patients is still lacking. Methods. We conducted a multicentre, retrospective, observational study, involving hospitalized adult patients with COVID-19 from 47 centres in Turkey. Patients with CKD Stages 3-5, chronic HD and RT were compared with patients who had COVID-19 but no kidney disease. Demographics, comorbidities, medications, laboratory tests, COVID-19 treatments and outcome [in-hospital mortality and combined in-hospital outcome mortality or admission to the intensive care unit (ICU)] were compared. Results. A total of 1210 patients were included [median age, 61 (quartile 1-quartile 3 48-71) years, female 551 (45.5%)] composed of four groups: Control (n = 450), HD (n = 390), RT (n = 81) and CKD (n = 289). The ICU admission rate was 266/ 1210 (22.0%). A total of 172/1210 (14.2%) patients died. The ICU admission and in-hospital mortality rates in the CKD group [114/289 (39.4%); 95% confidence interval (CI) 33.9-45.2; and 82/289 (28.4%); 95% CI 23.9-34.5)] were significantly higher than the other groups: HD = 99/390 (25.4%; 95% CI 21.3-29.9; P<0.001) and 63/390 (16.2%; 95% CI 13.0-20.4; P<0.001); RT = 17/81 (21.0%; 95% CI 13.2-30.8; P = 0.002) and 9/81 (11.1%; 95% CI 5.7-19.5; P = 0.001); and control = 36/450 (8.0%; 95% CI 5.8-10.8; P<0.001) and 18/450 (4%; 95% CI 2.5-6.2; P<0.001). Adjusted mortality and adjusted combined outcomes in CKD group and HD groups were significantly higher than the control group [hazard ratio (HR) (95% CI) CKD: 2.88 (1.52- 5.44); P = 0.001; 2.44 (1.35-4.40); P = 0.003; HD: 2.32 (1.21- 4.46); P = 0.011; 2.25 (1.23-4.12); P = 0.008), respectively], but these were not significantly different in the RT from in the control group [HR (95% CI) 1.89 (0.76-4.72); P = 0.169; 1.87 (0.81-4.28); P = 0.138, respectively]. Conclusions. Hospitalized COVID-19 patients with CKDs, including Stages 3-5 CKD, HD and RT, have significantly higher mortality than patients without kidney disease. Stages 3-5 CKD patients have an in-hospital mortality rate as much as HD patients, which may be in part because of similar age and comorbidity burden. We were unable to assess if RT patients were or were not at increased risk for in-hospital mortality because of the relatively small sample size of the RT patients in this study.Öğe Mitochondria and aging in older individuals: an analysis of DNA methylation age metrics, leukocyte telomere length, and mitochondrial DNA copy number in the VA normative aging study (vol 12, pg 2070, 2019)(Impact Journals Llc, 2020) Dolcini, Jacopo; Wu, Haotian; Nwanaji-Enwerem, Jamaji C.; Kioumourtzoglou, Marianthi-Anna; Cayir, Akin; Sanchez-Guerra, Marco; Vokonas, Pantel[Anstract Not Available]Öğe An investigation on endoparasites of Rana ridibunda complex (s. I.) with dermal parasite (metacercariae) in Dalaman (Turkey)(Triveni Enterprises, 2007) Unal, Guler; Saygi, Gulendame; Ayaz, Dincer; Tok, Cemal VarolIn this study, endoparasites of the Rana ridibunda specimens collected from Dalaman area, southwestern Turkey were investigated. In the intestine of 17 specimens of R. ridibunda, five different parasites, represented by three species of the trematoda (Diplodiscus sp, Pleurogenoides sp, Plagiorchis sp) and two genera of round worms (Cosmocerca sp; Foleyella sp) were recognized. The trematoda and one of the round worms were found in the rectal region whereas the other round worm species are observed in the abdominal cavity.
