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Open and arthroscopic excision of the distal clavicle for osteoarthritis of the acromioclavicular joint--results over 5 years
(TMMOB Makina Mühendisleri Odası, 2022) Saylık, Murat
Objective: Initially performed as open surgery, arthroscopic applications of distal clavicle excision (DCE) have gained prevalence in recent years. Literature reviews about the long-term results give no clear indication that one method is superior to the other. This study aims to compare the follow-up results of patients treated with arthroscopic and open DCE for more than five years and to detect the superiority of each method. Material and Method: The study involved 328 patients treated with DCE between February 2008 and April 2017. One hundred and fourteen patients (66 male and 48 female; 81 arthroscopic and 33 open surgery), who had their records available and under went no other surgery than DCE, were included in the study. The Disability of the Arm, Shoulder, and Hand (DASH) score and Visual Analogue Scale (VAS) were used to assess post-DCE shoulder functions and pain, respectively. Within the study's scope, surgery duration, excision extent, complications (frozen shoulder, hematoma, surgical site infection, and instability), and revisions were compared. Results: In the >5-year follow-up process, no statistically significant difference was observed between pre-DCE DASH and VAS values or between post-DCE DASH and VAS values of the two groups, one involving 32 patients who underwent open surgery and the other involving 82 patients treated with arthroscopic surgery. However, there was a statistically significant difference between the pre- and post-DCE DASH and VAS scores of both groups, and it was observed that both surgical methods were effective. No statistically significant difference was observed between the two groups regarding the surgery duration. Arthroscopic DCE was measured to be 4.70 mm on average, while the average measure for open surgery was 5.53 mm, which indicated a statistically significant difference between the two groups. However, no significant association was observed between the excision extent and the DASH and VAS scores. Furthermore, no significant difference was observed between complication and revision rates. Conclusion: In the >5-year follow-up of patients who underwent arthroscopic or open DCE due to their acromioclavicular joint osteoarthritis, which could not be treated with conservative treatment, no statistically significant difference was observed in the two groups' post-DCE DASH scores, VAS scores, complication rates, and revision rates. There was, however, a statistically significant difference between both groups' pre- and post-DCE VAS and DASH scores, and both methods were effective.
Investigation of the effect of computer-aided animations on conceptual understanding through metaphors: an example of artificial intelligence
(ICETOL, 2022-06) Aydın, Sevim; Duman, Emel; Bertiz, Yasemin; Birişçi, Salih; 385249
In this research, Information Technology and Software (IT) course the differences between the conceptual understanding of fifth grade students regarding the concept of artificial intelligence before and after computer-aided animation monitoring were tried to be determined through metaphors. In the 2021-2022 academic year, 39 teachers working in the field of Information Technologies and 101 fifth-grade students studying at a secondary school in the Nilufer District of Bursa participated in the study. The purposeful sampling method was used to select the sample of the study. At the first stage of the study, the “Information Technology and Software Course Concept Teaching Questionnaire” prepared by the researchers was applied to the teachers online in order to identify the concepts that had difficulty in teaching within the scope of the BTY course. As a result of the survey dec, many concepts that are difficult to teach have been revealed, and among them, the concept of “artificial intelligence” has been included in the study due to its current and open to development. In the second stage of the study, in order to determine the metaphorical perceptions of students about the concept of artificial intelligence, students were asked to “Artificial intelligence is like ... because …”. In the light of the themes obtained from the metaphor results, computer-aided animation was developed by the researchers, which takes the concept of artificial intelligence as a subject. After the animation was shown to the students, the metaphor study was repeated and the change in the students' understanding of the concept of artificial intelligence was tried to determine. As a result of the study, although the conceptual categories related to artificial intelligence had similar characteristics in general, it was found that the justifications in the conceptual perceptions after animation were more meaningful
Game-based teaching in teacher education: a systematic review
(ICETOL, 2022-06) Aydın, Sevim; Bertiz, Yasemin; Parlak Yılmaz, Nuray; 385249
Today, technological tools have entered almost all fields and have been used extensively. Games have inevitably been affected by this process and games have become played in virtual environments with digital tools. Today, people of all ages interact with games and children can spend long hours playing games without getting bored, and the results of the research have paved the way for the use of games in education. The research, it is aimed to systematically deal with the studies on game-based teaching used in teacher education. The distribution of these studies by years, the distribution of their methods, data collection tools, data analysis methods, keywords, citations and country distribution of citations were revealed. Advanced search modules ERIC, EBSCO, Web of Science and TR Index are used. Keywords in the search are “game-based teaching” or “digital game-based learning”. Among the research articles, articles used as teaching methods and educational studies in higher education were taken. In this context, the PRISMA statement was used in research and report creation. The obtained data and results were analyzed by discussing with other findings obtained from the literature.
Using web 3.0 in education: a systematic review
(ISRES Publishing, 2022-12) Aydın, Sevim; Duman, Emel; Baltacı, Şehnaz; 385249; Hebebci, Mustafa Tevfik; Yılmaz, Oğuz
The internet, which has become an indispensable part of our lives, is rapidly developing and changing with each passing day. In parallel with the development of the Internet, the expected development in the Web is also observed. The first web technologies that entered our lives along with the emergence of the Internet consist of simple, plain, read-only content and are called Web 1.0 (Parsa, 2009; Dominic, Francis & Pilomenraj, 2014). In Web 1.0 technologies, there are websites where the flow of information is unidirectional, the content is limited and created by a content provider, and users can only access the provided subject (Park, 2013; Thomas & Li, 2008). Due to the limited use of Web 1.0, Odabaşı et al. (2012) named Web 1.0 users as content-dependent passive readers.
Prognostic value of the leuko-glycemic index in coronary chronic total occlusion patients
(Prusa Medikal Yayıncılık, 2023) Peker, Tezcan; Özbek, Mehmet; Boyraz, Bedrettin; Aslan, Selen Filiz; Demir, Muhammed; Aslan, Burhan; 313898
Objectives: Inflammation parameters are related to the prevalence and mortality of coronary artery disease (CAD). We aimed to evaluate the prognostic value of the leuko-glycemic index (LGI) and determine mortality in patients with chronic coronary total occlusion (CTO). Methods: A total of 546 patients were evaluated in the study. All-cause death was the primary endpoint. The leuko-glycemic index was calculated from the blood samples at admission and patients were divided into 3 groups according to their LGI levels. Kaplan-Meier survival curves were performed and logistic regression analyses was used for all multivariable analysis. Results: The mean age of the study population was 63.1 ± 11.1 years and 70.3% were male. Median follow-up time 58.2 ± 22.4 months. The mortality rate was 33.6% in the high LGI group and significantly higher compared to the other group. In multivariable analysis, LGI (OR: 1.05, 95% CI: 1,0-1.2; p = 0.02) and age (OR: 1.07, 95% CI: 1.04-1.11; p = 0.001) were found as predictors of all-cause death. Conclusions: The study revealed that high LGI is associated with all-cause death in CTO patients and LGI was a predictor of all-cause death.
Short-term prognostic value of the culprit-SYNTAX score in patients with acute myocardial infarction
(MDPI, 2023) Peker, Tezcan; Boyraz, Bedrettin; 313898
Background: The SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) score is a scoring system that helps to decide on surgery or percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI), and studies are showing the prognostic value of this scoring system in both MI and coronary artery disease patients undergoing PCI. In acute coronary syndrome (ACS) patients, the infarct-related artery and the complexity of the lesions are also important in terms of mortality and morbidity. Our study aimed to determine the prognostic value of the culprit vessel’s SYNTAX score (cul-SS) in patients presenting with MI. Methods: In our study, 1284 patients presenting with MI were analyzed retrospectively. The SYNTAX scores and cul-SS of the patients were calculated. In-hospital and 30-day deaths and major complications were accepted as primary outcomes. The SYNTAX scores and cul-SS were compared in terms of predicting primary outcomes. Conclusions: Major complications were observed in 36 (2.8%) patients, death in 42 (3.3%) patients, and stent thrombosis in 24 (1.9%) patients. The area under the curves for SYNTAX and cul-SS for predicting primary outcomes is 0.64 and 0.68 (p = 0.026), respectively. Cul-SS was as successful as the SYNTAX score in predicting stent thrombosis and was superior in predicting short-term death and major complications.
The role of advanced glycation end-product levels measured by skin autofluorescence in the development of mitral annular calcification
(MDPI, 2023) Boyraz, Bedrettin; Peker, Tezcan; 313898
As a person ages, mitral annular calcification develops in the mitral annulus with increasing frequency. Lipid deposition, inflammation, and aging-related degeneration have been cited as potential causes of this pathophysiology, though there is currently no conclusive evidence to support this. AGEs accumulate in tissues due to the glycation of proteins and lipids, increasing the release of proinflammatory cytokines secondary to oxidative stress through the AGE receptor. The AGE levels increase in diabetic microvascular complications and degenerative aortic valve disease. Our study was planned prospectively as a case–control study involving 94 MAC-positive patients and 94 MAC-negative patients. The demographics, echocardiographic data and AGE levels of the patients were measured and recorded using the skin autofluorescence method. AGE levels were significantly higher in the MAC-positive patient group (3.2 vs. 2.7; p < 0.001). The AGE levels were observed as an independent predictor of MAC development in a regression analysis (OR: 8.05, 95% CI: 3.74–17.33, p < 0.001). In a ROC-curve analysis, the AUC was 0.79 (95% CI: 0.72–0.85). At a cut-off value of 2.7, 79.7% sensitivity and 69.1% specificity were observed. AGE levels can be used to cheaply, easily and non-invasively identify patients at risk of developing MAC.
Bilateral locked posterior shoulder dislocation overlooked for 15 months treated with the modified McLaughlin procedure: A case report
(Bayçınar Tıbbi Yayıncılık, 2023) Saylık, Murat; Gökkuş, Kemal
Neglected bilateral posterior shoulder dislocation is a rare injury caused primarily by an epileptic seizure. The injury is usually associated with a reverse Hill-Sachs lesion in the anteromedial aspect of the humeral head. The modified McLaughlin technique may avoid instability and osteoarthritis when 20 to 40% of the articular surface is affected by reverse Hill-Sachs. In this article, we present the clinical results of a case overlooked in the literature for the longest time, i.e., for 15 months. A 46-year-old male patient was receiving treatment for epilepsy for five years. There was no fall or trauma in the four seizures he had during this time. The last seizure was 15 months ago. When the patient presented to our clinic, both shoulders were symmetrically deformed, the anterior shoulder contour disappeared (empty socket sign), and there was a loss of upper contour. The computed tomography (CT) scan revealed a posteriorly locked dislocation with a reverse Hill-Sachs lesion in 32% of the left shoulder and 36% of the right shoulder. We applied the modified McLaughlin procedure to the dominant right shoulder and, two months later, we used it to the left shoulder (with a graft taken from the anterior superior iliac spine). At one-year of follow-up, both shoulders were moderately functional: forward elevation left 70° and right 50°, abduction left 40° and right 60°, and internal rotation: the back of the hand could touch the fifth lumbar vertebra. Meanwhile, the patient did not suffer from recurrent dislocation. The pre- and postoperative Constant-Murley Scores for the right and left shoulder were 30/52 and 11/48, respectively. Although the operational outcomes using the modified McLaughlin technique were not ideal, with no recurrence, the patient seemed to be satisfied with this outcome. In conclusion, in neglected locked shoulder fracture-dislocations, the modified McLaughlin technique is a method that can respond to the pathophysiology by eliminating reverse Hill–Sachs lesion.
Interventional therapy of acute coronary syndromes in very old patient population and results of 2 years follow‑up
(Springer, 2023) Boyraz, Bedrettin; Peker, Tezcan; Akgümüş, Alkame; Balun, Ahmet; 313898
Background Research on cardiovascular treatment options and prognosis in very old age groups of patients is warranted. In our study, we evaluated and followed up on clinical conditions on admission and comorbidities of patients older than 80 years who were admitted to our hospital with acute myocardial infarction and shared our findings. Results A total of 144 patients were included in the study, with a mean age of 84.56 ± 5.01 years. No complications resulting in death or requiring surgery were observed in the patients. All-cause mortality was found to be related to heart failure, chronic pulmonary disease shock, and C-reactive protein levels. Cardiovascular mortality was correlated to heart failure, shock on admission, and C-reactive protein levels. No significant difference in mortality was observed between Non-ST elevated myocardial infarction and ST-elevation myocardial infarction. Conclusions Percutaneous coronary intervention is a safe treatment option with low complication and mortality rates in very old patients with acute coronary syndromes.
The effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study
(Lippincott Williams & Wilkins, 2023) Akgümüş, Alkame; Balun, Ahmet; Peker, Tezcan; Boyraz, Bedrettin; 313898
Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 (P = .003), SDNN index was 66 ± 20 versus 56 ± 12 (P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 (P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 (P = .001), HF was 450 ± 270 versus 225 ± 130 (P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 (P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.
The Relationship between Resistant Hypertension and Advanced Glycation End-Product Levels Measured Using the Skin Autofluorescence Method: A Case–Control Study
(MDPI, 2023-10) Peker, Tezcan; Boyraz, Bedrettin; 313898
Resistant hypertension is hypertension that cannot be controlled despite the use of three antihypertensive drugs, one of which is a diuretic. Resistant hypertension often coexists with advanced age, obesity, smoking, and diabetes. Advanced glycation end products (AGEs) are substances that are generated as a result of the glycation of proteins, lipids, and nucleic acids due to conditions such as hyperlipidemia, oxidative stress, and hyperglycemia. There are studies showing the relationships between AGE levels and aortic stiffness, hypertension, and microvascular and macrovascular complications in diabetes. In our study, we examined the relationship between resistant hypertension and AGE levels. Our study was planned as a case–control study, and 88 patients with resistant hypertension were included in the focus group, while 88 patients with controlled hypertension were included in the control group. The AGE levels of the patients were measured using the skin autofluorescence method. AGE levels were found to be significantly higher in patients with resistant hypertension than those recorded in the control group. A significant increase in AGE levels was also observed in patients with resistant hypertension and without diabetes compared with the control group. The levels of AGEs, which can be measured cheaply, noninvasively, and quickly with the skin autofluorescence method, may provide benefits in identifying these patients with resistant hypertension.
The effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position: a quasi-experimental study
(Wiley, 2024-02) Yiğit Avcı, Şenay; Yılmaz, Dilek; 397256
Aims: The aim of this study was to research the effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position. Methods: This study was a non-randomized and non-controlled, quasiexperimental repeated measures study. The study was conducted with 50 intensive care patients aged 18 and over in a general surgery intensive care unit in Turkey. With each patient in the supine position, the bed head was raised to an angle of 0°, 20°, 30°, and 45° without a pillow, and the hemodynamic parameters of central venous pressure, systolic and diastolic blood pressure, heart rate, breathing rate, and peripheral oxygen saturation were recorded after 0 and 10 min. Results: It was found that the mean central venous pressure value measured at min 0 and 10 was higher when the intensive care patients' bed head angle was raised to 45° than when the bed head was at an angle of 0° or 20° (p < .05). It was found that the patients' other hemodynamic parameters were not affected by different bed head angles. Conclusions: It was concluded as a result of this research that in intensive care patients in the supine position, only central venous pressure was affected by bed head angle, and that central venous pressure measurement can be reliably made at a bed head angle of 30°.
Increasing Cases of Retroperitoneal Fibrosis After Covid-19: Case Report, Did She Die Retroperitoneal Fibrosis or Cancer?
(Emergency Medicine Physicians Assoc Turkey, 2024-03) Deniz, Gulnihal; Cakir, Murteza; Bilgin Akyagci, Serpil
This case report details the unfortunate journey of a 59-year-old breast cancer survivor who developed secondary Retroperitoneal Fibrosis (RPF) in 2022. Despite diligent treatment efforts, her condition took a devastating turn when, in June 2023, she was diagnosed not only with persistent RPF but also with advanced liver, omental, and duodenal cancer. Tragically, her condition deteriorated rapidly, leading to her passing on day 41 following her presentation. This case underscores the challenges of diagnosing and treating RPF. It highlights the importance of considering cancer development in advanced RPF cases that do not respond to treatment, often leaving limited options for effective intervention.
Multi-inflammatory index as a novel predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting
(Polish Cardiac Soc, 2024-05) Yüksel, Ahmet; Velioğlu, Yusuf; Atasoy, Mustafa Selçuk; Müdüroğlu, Ayhan; Deşer, Serkan Burç; Gürbüz, Orçun; Aldemir, Mustafa; Çetintaş, Demir; Kılıç, Ali Önder; Badem, Serdar
Background: To our knowledge, a possible predictive relationship of the multi-inflammatory index (MII) with new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (CABG) has not yet been studied in the literature. Aims: We aimed to investigate whether the MII is a novel group of hematological markers for predicting postoperative new-onset AF in patients undergoing off-pump CABG. Methods: A total of 427 patients undergoing isolated off-pump CABG between October 2021 and December 2023 were enrolled in this retrospective observational cohort study and allocated to two groups: the AF group (n = 108) and the non-AF group (n = 319). The groups were compared in terms of baseline clinical patient characteristics, laboratory parameters, and operative and postoperative data. Results: The median values of age, length of hospital stay, platelet and neutrophil count, C-reactive protein level, systemic immune-inflammation index, MII-1, MII-2, and MII-3 were significantly greater in the AF group compared to the non-AF group in univariate analyses. In multiple explanatory variable logistic regression analysis, MII-1, MII-2, and MII-3 were determined to be significant hematological variables, and thereby these indices were considered the independent predictors of postoperative new-onset AF. Receiver operating characteristic curve analyses showed that to predict postoperative new-onset AF, MII-1 of 22.47 constituted the cut-off value with 62.0% sensitivity and 57.0% specificity, MII-2 of 141.77 constituted the cut-off value with 43.5% sensitivity and 76.8% specificity, and MII-3 of 5669 constituted the cut-off value with 63.8% sensitivity and 58.3% specificity. Conclusion: This study demonstrated for the first time that all MIIs predicted new-onset AF after off-pump CABG.
Problems and solution suggestions related to logistics processes in cross-border e-commerce: evaluations towards e-export in Bursa province
(Süleyman Demirel University, 2024-08) Sönmezay, Mine; Yıldırır Keser, Hilal; 409821
Rapidly growing e-commerce, due to globalization and the impact of the Covid-19 epidemic, has significantly increased global demand, and cross-border e-commerce has become a frequently mentioned concept. Cross-border e-commerce, which also triggers the development of international trade, has begun to influence the economic policies of countries, especially with its e-export dimension. The most important factor behind the development and success of cross-border e-commerce can be expressed as being its logistics services. E-commerce processes achieve success with the effectiveness of these services. However, as in many countries, problems may occur in logistics processes in Türkiye, which may prevent cross-border e-commerce companies from using their potential. In this context, in the study, firstly, the concepts of e-commerce and cross-border e-commerce are discussed and the concept of e-export is clarified. Then, logistics services in cross-border e-commerce are explained. Finally, a qualitative research is conducted to reveal the logistics problems encountered in cross-border e-commerce, and the findings of in-depth interviews with companies engaged in e-export in Bursa are evaluated.
Fixation of superolateral platysma flap to the mastoid fascia: a novel isolated neck lift technique
(Springer, 2024-09) Okumuş, Ayhan; 293876
Background This study aimed to evaluate the utility of a novel neck lift technique based on fixation of superolateral platysma flap to the mastoid fascia in terms of postoperative aesthetic outcome and patient satisfaction within an 18-month follow-up period. Methods A total of 145 female patients who underwent isolated neck lift operation with the superolateral platysma flap technique were included. Global Aesthetic Improvement Scale (GAIS) scores (by the investigator) and the patient reported outcomes were recorded in terms of improvement in the cervicofacial angle, jowls, platysmal bands and malpositioned cervical fats, at 6 and 18 months, postoperatively. The complications were recorded at early postoperative period and at 1, 6 and 18 months, postoperatively. Results The median duration of follow-up was 18 months (range, 6–48 months). GAIS scores at 18th months, revealed exceptional improvement in the cervicofacial angle (82.8%), the jowls (93.1%), platysmal bands (93.1%) and malpositioned cervical fat (97.2%). Majority of patients were very satisfied with the treatment in terms of the aesthetic improvement. Complications involved the minor ecchymosis (17.2%) and minor skin circulatory problem (11.7%) in the early postoperative period, suture exposure (12.4%) in the postoperative 1st month, and cervical band reformation in the 6th (0.7%) and 18th (1.4%) months. Conclusion In conclusion, lateral displacement and fixation of superolateral platysma flap to the mastoid fascia seems to be a useful neck lift technique for correction of platysma- and skin-derived aging sings with minor and manageable complications, immediate return to everyday activities and a high patient satisfaction.
The role of ergonomics training and posture exercises in surgeons’ musculoskeletal system disorders
(Turkish Surgical Assoc, 2024-09) Külekçioğlu, Sevinç; Dilektaşlı, Evren; 249947
Objective: The surgeon needs to understand the risks involved in performing surgery with ergonomic errors. Although there are many barriers to ergonomic effectiveness, success begins with the surgeon’s awareness, recognition of existing obstacles, and education. The main purpose of the study is to evaluate the effect of ergonomic training and posture exercises on the surgeon’s pain, physical workload, psychological state, and quality of life to prevent musculoskeletal system disorders and extend career life. Material and Methods: Surgeons who had completed at least one year in their profession, worked an average of 40 hours a week, had musculoskeletal pain in at least one area, and volunteered to participate in the study, regardless of gender and age, were included in the study. Researchers carried out the ergonomics training and exercise program individually by giving face-to-face training. Surgeons were asked to complete the physical workload questionnaire (PWQ), Beck depression index (BDI), and short form health survey (SF-36) before and one month after the study. Changes in visual analogue scale (VAS) and activities of daily living were recorded. Results: Surgeons who received ergonomic training and exercise programs showed significant improvements in pain, physical workload, depression, and quality of life measurements. Conclusion: To prevent fatigue and pain resulting from the accumulation of ergonomic flaws, surgeons should be trained and guided on proper posture and endurance, and encouraged to maintain a comfortable and natural posture.
Exploring Cognitive Enhancements and Default Mode Network Connectivity in Relapsing-Remitting Multiple Sclerosis: Insights from a Prospective Study Investigating the MIND Diet
(Sage, 2024-09) Demirel, Mert; Daşgın, Hacer; Acar, Nazire Pınar; Özçelik-Eroğlu, Elçin; Atabilen, Büşra; Ertuğrul, Aygün; Akdevelioğlu, Yasemin; Oğuz, Kader Karlı; Tuncer, Meryem Aslı; 396621
The potential therapeutic impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on relapsing-remitting multiple sclerosis (RRMS) remains an underexplored area. Objectives/Aims: This study aims to evaluate the influence of the MIND diet on RRMS by examining neurological, cognitive, and functional magnetic resonance imaging (fMRI) parameters. Methods: Seventeen early-stage RRMS patients (aged 20-40, disease duration < 10 years, Beck Depression Inventory Score < 17) underwent MRI at baseline and following a 9-month adherence to the MIND diet. They were matched with 10 healthy controls. Diet adherence was assessed using the MIND Diet scale score. MRI encompassed structural and resting-state fMRI (RS-fMRI) sequences. Neurological evaluation (Expanded Disability Status Scale [EDSS], Timed 25-Foot Walk [T25W], 9-Hole Peg Test [9HPT]), and cognitive assessments (Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Test [AVLT], phonemic and semantic fluency, forward and backward digit span tests [FDST, BDST]) were conducted. Functional connectivity was assessed using seed-based correlation (SBC) and global correlation by general linear model (GLM), focusing on Default Mode Network (DMN), Central Executive Network (CEN), Dorsal Attention Network (DAN), Salience Network (SN), Visual Network (VN), and Sensorimotor Network (SMN). Results: Patients exhibited high adherence to the diet throughout the 9-month period. Significant improvements were observed in dominant hand 9-HPT (p=0.023) and AVLT parameters (p<0.001), except delayed recall (p=0.982), following the intervention. Increased connectivity within the whole brain was noted in the left frontal orbital cortex of the 9th-month group compared to healthy controls (p=0.000005). Moreover, RRMS patients in the 9th-month group displayed enhanced functional connectivity in the bilateral caudate, bilateral pallidum, and right putamen within the DMN compared to baseline (p=0.000034). Conclusion: The findings of this study suggest potential cognitive benefits of the MIND diet, as evidenced by improvements in AVLT scores. Furthermore, the observed alterations in Default Mode Network (DMN) connectivity in RRMS patients following the dietary intervention indicate a promising avenue for further investigation into cognitive deficit management in this population
The Role of Advanced Glycation End Products in Saphenous Vein Graft Failure
(Karger, 2024-10) Akgümüş, Alkame; Boyraz, Bedrettin; Balun, Ahmet; 313898
Objective: We aimed to investigate the relationship between advanced glycation end product (AGE) levels in patients with saphenous vein graft (SVG) failure and in patients without SVG failure. Subjects and Methods: In our study, 55 patients with a history of previous coronary artery bypass grafting (CABG) surgery, who subsequently underwent coronary angiography for any reason and were found to have either SVG occlusion or significant lesions, were included as study patients. Additionally, 55 patients who have had CABG surgery without SVG failure for at least 1 year served as the control group. AGE values of the patients were measured using the skin autofluorescence method. Results: In our study results, we observed a significant difference in AGE levels between the two groups of patients with similar demographic characteristics (SVG failure groups AGE 3.2 [2.8–3.6] vs. control groups AGE 2.4 [2.1–2.7] p < 0.001). In the receiver operating characteristic curve analysis, we determined the ability of AGE levels to detect SVG failure with an area under the curve of 0.869. We found that in patients with AGE >3, it could detect SVG failure with a sensitivity of 70.9% and a specificity of 87.3%. Conclusions: Our results demonstrate that AGE levels can predict SVG failure risk inexpensively, easily, and quickly.
Investigation of pepsin levels in bronchial lavage in patients with interstitial lung disease and chronic cough
(Elsevier, 2024-11) Ala Çitlak, Fatma Selen; Köksal, Nurhan; Avci, Bahattin; Tibel Tuna, Nazmiye; Güllü, Yusuf Taha; 156045
Aim: Pepsin is an enzyme that helps digest protein secreted only from the gastric chief cell in an inactive state. Pepsin is a good marker for acidic gastroesophageal reflux (GER). Its presence in sputum or saliva is considered pathologic. In GER, cough is stimulated by broncho-esophageal neurogenic reflex and aspiration of gastric contents into the airways. GER is the most common cause of cough. Gastric acid reflux is also thought to play a role in Interstitial Lung Disease (ILD) etiology. In many studies, pepsin and bile acid levels in bronchial lavage were high in patients with interstitial lung disease and chronic cough. In our study, we aimed to evaluate pepsin levels in bronchial lavage in patients with ILD and chronic cough and to investigate the relationship between symptoms and reflux treatment. Methods: Between January 2021 and February 2022, 212 patients who underwent bronchoscopy in our tertiary clinic were evaluated. These patients were divided into three groups: 52 patients with interstitial lung disease, 81 patients with chronic cough, and 79 patients who underwent bronchoscopy with a pre-diagnosis of lung cancer as the control group. Bronchial lavage obtained by bronchoscopy was analyzed for pepsin levels. Results: Shortness of breath and cough were the most common symptoms in all three groups. Pepsin levels were 16.71 ± 8.6 ng/ml in the chronic cough group, 15.6 ± 8.9 ng/ml in the ILD group, and 10.58 ± 5.4 ng/ml in the lung cancer (control) group. Pepsin levels in the ILD and chronic cough group were statistically significantly higher than in the lung cancer group (p:0.00). There was no statistical difference between the ILD group and the chronic cough group regarding pepsin levels. It was found that pepsin levels were lower in the three groups who received anti-reflux treatment. There was no difference in pepsin levels between ILD subgroups. Conclusion: Pepsin levels in bronchial lavage were higher in the ILD and chronic cough groups. This suggests that reflux may be involved in the etiology of chronic cough and ILD. Low pepsin values in patients receiving antireflux therapy have shown that occult reflux may occur. In our study, the high level of pepsin in bronchial lavage, especially in the chronic cough and ILD group, may be instructive in the etiology and treatment planning of the disease.

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