Genetic, haplotype and phylogenetic analysis of Ligula intestinalis by using mt-CO1 gene marker: ecological implications, climate change and eco-genetic diversity.

Ligula intestinalis is a cestode parasite that affects freshwater fish in different countries of the world. The current study aims to reveal the phylogenetic, genetic and haplotype diversity of mt-CO1 gene sequences sent to the NCBI database from different countries by using in-silico analysis. The 105 mt-CO1 (371 bp) gene sequences of L. intestinalis obtained from NCBI were used for bioinformatics analyses. Sequences were subjected to phylogenetic and haplotype analysis. As a result of the haplotype analysis of L. intestinalis, 38 haplotypes were obtained from 13 different countries. Hap24 constituted 44.76% of the obtained haplotype network. Changes in nucleotides between haplotypes occurred at 1-84 different points. China and Turkey have highest fixation index (Fst) values of 0.59761, while the lowest (-0.10526) was found between Russia and Turkey. This study provides a baseline for future studies on extensive scale on the epidemiology, ecological aspects, distribution pattern, transmission dynamics and population dispersion of L. intestinalis worldwide.

In-silico Analysis of Mt-CO1 Gene of Taenia Hydatigena Sheep Isolates.

Taenia hydatigena is a tapeworm that affects herbivores in different regions of the world. Cysticercus tenuicollis (larvae of T. hydatigena), is prevalent in ruminants and pigs. In the current study, phylogenetic analysis of the published mt-CO1 gene of C. tenuicollis sheep isolates was analyzed using in-silico method and vertical and horizontal transmission at the global level by using a meta-analysis approach. A total of 82 mt-CO1 nucleotide sequences (339 bp) of C. tenuicollis sheep isolates from the NCBI database (Italy -Sardinia-, Iran, Palestine, Iraq, Finland, India and China) were used to investigate haplotype and genetic relationships. Tajima's D (-2,2984) value was negative for the mt-CO1 sequences signifying the population expansion and/or purifying selection. The highly negative Fu's Fs (-60,528) values determined for the sequences reflecting the existence of uncommon haplotypes. The mt-CO1 of C. tenuicollis haplotype network had 47 haplotypes arranged within a star-like configuration with a main haplotype, which encompassed 25.6 % of the total isolates. In the mt-CO1 haplotype network analyzed, there were 80.5 % unique single haplotype and highest ratio was observed in C. tenuicollis from sheep originating from Iran, followed by Sardinia, Palestine and Finland. If the current condition continues, genetic differences in T. hydatigena will be able to rise, and possible new strains and/or genotypes that may influence the host adaptation and life cycle of the parasite may emerge.

ATHEROGENIC INDICES IN THE ASSESSMENT OF CARDIOVASCULAR DISEASE RISK IN CHILDREN WITH OBESITY AND SUBCLINICAL HYPOTHYROIDISM.

BACKGROUND: The frequency of subclinical hypothyroidism (SH) in patients with obesity is increased compared with the normal population. However, data on the risk of cardiovascular disease (CVD) in patients with SH are still scarce. Lipid parameters are strong predictors of early CVD. We aimed to investigate the role of lipid indices in predicting CVD risk compared to conventional lipid components. METHODS: A total of 220 euthyroid obese children (EU) and 90 obese children with SH were included in the study. All data were collected from hospital files. Lipid indices were evaluated. Atherogenic index of plasma (AIP), cardiac risk ratio (CRR) and atherogenic coefficient (AC) were calculated. AIP>0.24, CRR>5 ve AC>3 were considered as cardiovascular risk criteria. RESULTS: The presence of SH increased the risk of higher AIP and the risk of CRR, compared to euthyroid obese children. CONCLUSION: Subclinical hypothyroidism in obese children may cause dislipidemia carrying a high cardiovascular disease risk.

Preliminary Evidence for the Occurrence of ß-tubulin Isotype 3 Polymorphisms in Fasciola Hepatica Isolates in Cattle and Sheep in Turkey.

Fasciolosis caused by Fasciola hepatica is a common parasitic disease of livestock especially sheep and cattle. In this study molecular characterization of ß-tubulin isotype 3 gene in Fasciola hepatica isolates from cattle and sheep in Turkey was carried out. For this purpose a total of 80 adult Fasciola hepatica isolates were collected from 20 sheep and 20 cattle in Kayseri and Erzurum provinces. PCR-RFLP was performed on ß-tubulin isotype 3 gene and MboII revealed two fragments of approximately 350 bp and 390 bp, whereas HphI enzyme yielded 210, 340 and 540 bp bands, HindII yielded 380 and 450 bp bands in all samples. A total of 80 isolates were tested by SSCP and all of them presented the same band profiles. Six samples (4 sheep and 2 cattle) were randomly selected and DNA sequence of a 935 bp coding fragment of ß-tubulin isotype 3 was performed. Sheep samples were more polymorphic than the cattle. This ß-tubulin isotype 3 gene polymorphism of F.hepatica isolates from sheep and cattle of two distinct geographical areas of Turkey have been investigated for the first time.

Validation of the integrative model of adjustment to chronic conditions: Applicability to adult-onset epilepsy.

Adapting to life with adult-onset epilepsy is a challenge and there is a need for better interventions to support people, who have difficulty with psychosocial adjustment to the condition. The integrative model of adjustment to chronic conditions was developed for type 2 diabetes. This study aimed to demonstrate the applicability of the model to adult-onset epilepsy and thus make an original contribution to the development of relevant interventions. Qualitative data from a previous phenomenological study on the experience of adult-onset epilepsy were mapped onto the integrative model of adjustment to chronic conditions using framework analysis. Ten of the original 39 datasets were selected. All 10 datasets were from females diagnosed with epilepsy within 5 years before participation in the original study. The results demonstrated applicability of the integrative model of adjustment to chronic conditions after minor revisions to the model. These findings support further development of the integrative model of adjustment to chronic conditions for use as a clinical intervention for people with adult-onset epilepsy.

The treatment of intertrochanteric fractures comparison of PFN and hemiarthroplasty 3-year mortality study.

Intertrochanteric fractures in elderly patients can increase mortality due to complications and negative functional results. The aim of this study is to retrospectively compare the follow-up and mortality rates among patients given a proximal femoral nail (PFN), the current routine treatment for these types of fractures, with those given hemiarthroplasty.The study retrospectively investigated 202 patients over the age of 60 who completed at least 3 years of follow-up after hemiarthroplasty or PFN for intertrochanteric fractures between 2007 and 2012. While 132 patients underwent cemented hemiarthroplasty, 70 had PFN.The monitoring duration for those with PFN surgery was 31.25±1.3 months while the duration of follow-up for those with hemiarthroplasty surgery was 20.0±1.2 months. At the end of 3 years of monitoring of the 202 patients, 99 were deceased. There was a statistically significant difference found in terms of patient life expectancy between those with PFN and those with hemiarthroplasty; Cox regression analysis identified that the mortality rate of those with hemiarthroplasty was 5.1 times greater.As a result, patients undergoing hemiarthroplasty should be carefully chosen and if possible, PFN should be preferred.

Evaluation of epithelial chimerism after bone marrow mesenchymal stromal cell infusion in intestinal transplant patients.

Intestinal transplantation is the most effective treatment for patients with short bowel syndrome and small bowel insufficiencies. We evaluated epithelial chimerism after infusion of autologous bone marrow mesenchymal stromal cells (BMSCs) in patients undergoing cadaveric donor isolated intestinal transplantation (I-ITx). BMSCs were isolated from patients' bone marrow via iliac puncture and expanded in vitro prior to infusion. Two out of the 3 patients were infused with autologous BMSCs, and small intestine tissue biopsies collected post-operatively were analyzed for epithelial chimerism using XY fluorescent in situ hybridization and short tandem repeat polymerase chain reaction. We observed epithelial chimeric effect in conditions both with and without BMSC infusion. Although our results suggest a higher epithelial chimerism effect with autologous BMSC infusion in I-ITx, the measurements in multiple biopsies at different time points that demonstrate the reproducibility of this finding and its stability or changes in the level over time would be beneficial. These approaches may have potential implications for improved graft survival, lower immunosuppressant doses, superior engraftment of the transplanted tissue, and higher success rates in I-ITx.

"It shouldn't be something that's evil, it should be talked about": a phenomenological approach to epilepsy and stigma.

OBJECTIVE: The concepts of felt and enacted stigma (Scambler and Hopkins, 1986(1)) are well established in epilepsy research. However, more recent research tends to focus on either those doing the stigmatising or utilises quantitative methodologies, exploring daily occurrences of stigma for those with epilepsy. The current study aims to explore the concept of felt stigma in today's society, arguing that a return to a phenomenological approach would allow people with epilepsy to discuss issues of importance to them, seeing them as the experts on this concept (Byrne, 2001(17)). METHODS: Fifty-two people with epilepsy were recruited via an advertisement on the Epilepsy Action website, thirty of whom took part in a follow-up interview. The interviews were analysed following Lemon and Taylor's (1997)(22) phenomenological approach. RESULTS: Three themes emerged, surrounding issues of embarrassment of having the condition, non-disclosure of the diagnosis and misconceptions of the condition. These findings support previous research which argues that people with epilepsy perceive a stigma due to feeling different from the rest of society, meaning that they conceal their condition as a way of managing such stigma and thus need to renegotiate their social identity. Additionally, the moderating role of education in increasing knowledge of epilepsy, with a view to reducing felt stigma, was evident. CONCLUSIONS: The findings indicated a need to promote epilepsy awareness programmes as a means of increasing public knowledge of epilepsy, with the aim of reducing felt stigma.

The experience of discontinuing antiepileptic drug treatment: an exploratory investigation.

OBJECTIVE: Between 60% and 70% of people with epilepsy become seizure free and may choose to withdraw from antiepileptic medication. Numerous studies discuss possible factors which may influence seizure recurrence following discontinuation. However, few studies attempt to explore the decision-making process from the perspective of the patient. It is believed this is the first study to explore patients' experience of discontinuing medication following a seizure-free period of 2 years. METHOD: Semi-structured interviews were conducted with twelve people with epilepsy who had attempted withdrawal from their medication. All twelve of the participants lived in the North-East of England. A phenomenological approach was taken in order to gain an in depth understanding of their withdrawal decisions. RESULTS: Five themes emerged from the interviews. Principally, the timing of when to withdraw was a key concern, as well as the uncertainty of seizure recurrence, issues with medication and the embarrassment of being diagnosed with epilepsy. Those who unsuccessfully withdrew from medication discussed their acceptance of the condition. Mixed feelings regarding satisfaction with G.P. support were also reported. CONCLUSIONS: Incorporating the themes into the Theory of Planned Behaviour [Ajzen I. In: Marks DF, editor. The health psychology reader. London: Sage; 1985] provides a model of the withdrawal decision-making process based on the experiences of those who have made the decision. There is a paucity of research investigating the withdrawal decision, therefore the findings from this study should be used for the production of appropriate and relevant information regarding the key issues which have been raised regarding withdrawal decisions and support those making the decision.

Isokinetic measurement of trunk muscle strength in women with chronic low-back pain.

OBJECTIVES: To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined. DESIGN: A controlled, prospective study of trunk muscle strengths of patients with chronic low-back pain and the short-term impact of exercise on strength. The study group consisted of 25 female patients who had been experiencing low-back pain for at least 3 mo, and the control group included 20 age-matched women without known low-back trouble. The Davenport Index was used to calculate the body mass indexes of all subjects. The Oswestry Disability Questionnaire was used to assess pain in the study group. Full flexion and extension ranges of motion were measured, then isokinetic measurements of trunk muscles were performed at 60-, 120-, and 180-degrees/sec velocities. Isometric measurements were also recorded for both flexors and extensors at a 60-degree angle. RESULTS: Increased body mass index and decreased trunk muscle strength were found to be directly associated with chronic low-back pain (P < 0.05). After a 15-day standard trunk strengthening exercise program in the patient group, trunk muscle strength was found to be increased (P < 0.05). CONCLUSIONS: Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.

Correlates for end-stage renal disease patients.

In this study 112 end-stage renal disease patients on hemodialysis were analyzed for their state of well-being, cognition, ambulatory capacity, and dexterity. The Nottingham Health Profile, the locomotion and dexterity sections of the Office of Population Censuses and Surveys disability scale, the modified Mini Mental State examination and a weighted index of comorbidity were used for assessment. The study revealed that good cognition, good mood, young age, and milder comorbid conditions were positively linked with good functional levels of locomotion and dexterity. The test instruments used in the investigation were considered simple to use and were effective in revealing relationships between the above-mentioned parameters.

Assessment of spasticity using isokinetic dynamometry in patients with spinal cord injury.

OBJECTIVES: To determine the value of isokinetic dynamometric measurement of passive resistance in quantifying spasticity. SETTING: Turkey. METHODS: Thirty-three spastic spinal cord-injured patients and 14 age-matched normal individuals were studied. Five consecutive flexion-extensions of the knee, abduction-adductions of the hip, and dorsal-plantar flexions of the ankle were performed at specific velocities (15, 30, 60, 90 and 120 degrees /s) using a computerized isokinetic dynamometer set at the continuous passive motion mode. We recorded maximum torque and the sum of torque amplitudes for five repetitions of each type of joint motion at all velocities. RESULTS: Maximum torque values and the sum of torque amplitudes were both significantly higher in spastic patients than in controls, and there was a positive correlation between torque values and Ashworth scores. There was no significant linear increase in torque values associated with increasing velocity for any of the motions in either controls or patients. CONCLUSION: Isokinetic dynamometric measurement of passive resistance appeared to be a valuable tool for assessing and quantifying spasticity, as well as other types of hypertonus.

Diurnal variation of antidiuretic hormone and urinary output in spinal cord injury.

INTRODUCTION: Healthy individuals have a nocturnal decrease in urine output due to increased plasma antidiuretic hormone levels at night. This does not occur in spinal cord injury and most patients experience nocturnal polyuria, which triggers dysreflexic crises secondary to urinary bladder overdistension, and interferes with patients' sleep due to the need for extra catheterization. OBJECTIVE: To evaluate the diurnal variation in ADH level, urinary output, and plasma and urine osmolality in SCI patients with regard to their level of injury and in comparison with age- and sex-matched healthy individuals. MATERIALS AND METHODS: Sixteen ASIA-A spinal cord-injured patients, eight with paraplegia, eight with tetraplegia, and eight healthy individuals, were evaluated for urinary output, urine and serum osmolality, and antidiuretic hormone levels during day and night hours. RESULTS: Absence of diurnal variation in urinary output and antidiuretic hormone secretion was detected in both paraplegic and tetraplegic patients, while antidiuretic hormone levels rose significantly at night in the control group. CONCLUSION: Antidiuretic hormone levels should be monitored both day and night in spinal cord injury patients, with severe nocturnal polyuria. Treatment with desaminocystein-D-arginine vasopressin can be attempted when conservative measures fail to control nocturnal polyuria, especially in patients who are on an intermittent catheterization program.

Double spinal cord injury in a patient with ankylosing spondylitis.

Ankylosing spondylitis patients are more prone to spinal fractures and these fractures commonly result in mobile nonunion. We report a patient with a 30-year history of ankylosing spondylitis who sustained double spinal cord injuries following minor trauma. The first injury occurred at the lumbar level due to pseudoarthrosis of an old fracture, and the second at the thoracic level following cardiopulmonary arrest and an episode of hypotension. The possible mechanisms of the injuries are discussed and maintaining normal blood pressure in these patients is emphasized.

Bone mineral density in ankylosing spondylitis.

Vertebral osteoporosis is a well-recognized feature of ankylosing spondylitis (AS) and also the vertebral compression fractures due to osteoporosis are a common but frequently unrecognized complication of AS. Both may contribute to the pathogenesis of spinal deformity and back pain. The aim of this study was to measure vertebral and femoral neck bone mass in patients with AS by dual photon absorptiometry, to determine the prevalence of compression fractures and to examine the relationship between bone density and disease severity. We found that the bone mass was diminished in the lumbar spine in moderate AS versus mild forms but the patients with advanced disease had the highest BMD values. Examination of spinal radiographs revealed compression and biconcave fractures in 9 (40.9%) cases. Neither the duration of the disease and the degree of sacroiliitis, nor the disease activity assessed by laboratory and clinical parameters was found to significantly affect the results.