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2.
Domest Anim Endocrinol ; 88: 106855, 2024 May 09.
Article in English | MEDLINE | ID: mdl-38805775

ABSTRACT

Freemartinism is the most common congenital anomaly among sexual disorders in dairy cows. This syndrome typically occurs in different-sex twin pregnancies and causes vascular anastomoses to form with the placenta in the early stages of fetal development. The study aims to determine the effectiveness of Anti-müllerian hormone (AMH) levels in calves and heifers of different age groups for diagnostic factors and to investigate the potential consequences of different hormone levels in different age groups on some liver biochemical parameters. The study involved 50 cattle from diverse age categories, divided into the freemartin group (FM Group, n=25) and the control group (C Group, n=25). Both FM and control groups were further divided into early-age (3-5 months), middle-aged (5-9 months), and older-aged groups (9-12 months). Serum AMH levels, along with total protein, albumin, and total cholesterol levels, were measured. While no statistically significant difference in AMH levels was observed in the early-age group (P:0.53), significant differences were determined in the middle (P:0.015) and older-age groups (P:0.01), where the FM group exhibited significantly decreased AMH levels compared to the control group. The evaluation of liver biochemistry revealed a statistically significant difference in total protein levels between the FM and control groups in the older age group (P:0.033). Consequently, it is reasonable to suggest that AMH levels may serve as a valid parameter for diagnosing freemartin syndrome in calves aged older than five months. Conversely, particularly in young calves, no significant differences in liver functionality were observed between freemartin-affected and healthy calves.

3.
Nurse Educ Pract ; 78: 103993, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38788617

ABSTRACT

BACKGROUND: The rising gamification in educational contexts has been driven by its potential to increase student motivation, engagement, interest and learning outcomes. Thanks to these effects, gamification has gained popularity in health education. Due to the increase in studies on gamification in health education in recent years, this study has been carried out to present the studies in the relevant literature to researchers. AIM: This study presents a quantitative mapping of gamification in health education through a bibliometric analysis of its publications. METHODS: In this study, a total of 475 articles were analyzed by searching "health education*" and "gamif*" and similar terms from Web of Science and Scopus databases. R bibliometric package program was used for the analysis. 1971 authors contributed to the studies, which were spread between 2012 and 2024. The number of studies on gamification in the field of health education has grown in recent years. In particular, it was seen that 2018 can be seen as the breaking point and the highest number of publications was in 2023, with 101 publications. RESULTS: The descriptive results showed that Zhang, X. was the most productive author, Nurse Education Today and BMC Medical Education were the most productive journals and the United States was the most productive country. It is concluded that terms such as gamification, medical education, game-based learning, education, serious games, simulation and e-learning are the most frequently used words in gamification studies in the field of health education. It has been observed that the concept of gamification is trending, especially in 2018-2023, with a frequency of 150 uses. CONCLUSIONS: This study is expected to guide researchers in terms of key points for future research on gamification in health education contexts. It is expected that the knowledge provided by this study will enable researchers to be involved in this field and/or focus their research more effectively.

4.
Turk J Pediatr ; 66(2): 180-190, 2024 May 23.
Article in English | MEDLINE | ID: mdl-38814299

ABSTRACT

BACKGROUND: Given the strong genetic background of familial Mediterranean fever (FMF), the frequently reported co-existing diseases in children with FMF should also be investigated in other family members. Therefore, we aimed to examine the medical conditions of first-degree relatives (FDRs) of our pediatric patients with FMF in the present study. METHODS: Chronic diseases of FDRs of pediatric 449 FMF, 147 juvenile idiopathic arthritis (JIA) patients and 93 healthy controls (HC) were questioned during their routine clinical visits for 9 consecutive months. RESULTS: A total of 1975 FDRs of 449 FMF, 690 FDRs of 147 JIA patients, and 406 FDRs of 93 HC were included into the study. The most common medical conditions were non-atopic asthma (n=71, 3.6%), type 2 DM (n=14, 2%), and tonsillectomy history (n=12, 2.95%) in the FMF, JIA, and HC groups, respectively. Atopic diseases (FMF vs. JIA: p=0.013; FMF vs. HC: p=0.014), rheumatic diseases (FMF vs. JIA: p=0.030; FMF vs. HC: p=0.017), and surgical histories (FMF vs. JIA: p<0.01; FMF vs. HC: p=0.026), including adenoidectomy, tonsillectomy, and appendectomy, were significantly more common in the FMF group than in other groups. CONCLUSIONS: Our novel findings may contribute to understanding the hereditary burden of co-existing diseases in children with FMF and encourage further studies involving genetic screenings.


Subject(s)
Arthritis, Juvenile , Familial Mediterranean Fever , Humans , Familial Mediterranean Fever/genetics , Familial Mediterranean Fever/epidemiology , Female , Male , Child , Child, Preschool , Arthritis, Juvenile/genetics , Arthritis, Juvenile/epidemiology , Adolescent , Turkey/epidemiology , Case-Control Studies , Family , Adult , Asthma/genetics , Asthma/epidemiology
5.
Eur J Pediatr ; 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38619568

ABSTRACT

While most countries provide safe and effective influenza vaccines for at-risk groups, influenza vaccine coverage among children with rheumatic diseases remains uncertain. This study investigated influenza vaccination rates in children with juvenile idiopathic arthritis (JIA) during the 2019-2020 season and assessed the knowledge and attitudes of caregivers of children with JIA regarding influenza vaccination. The secondary aims were to identify barriers to vaccination and explore strategies to improve vaccination rates. A multi-centre, cross-sectional anonymous survey was conducted in 7 countries during the 2019-2020 influenza season to assess the uptake history of influenza vaccination. Among 287 participants, only 87 (30%) children with JIA received the influenza vaccine during the 2019-2020 season. Children who were more likely to be vaccinated were those with systemic juvenile idiopathic arthritis (sJIA), a history of previous vaccination and those aware of the vaccination recommendations. Conversely, children who previously experienced adverse vaccine-related events reported the lowest uptake. The primary reason for non-vaccination was lack of awareness about the necessity of influenza vaccination.  Conclusion: Despite variations among countries, the uptake of influenza vaccines remains low in children with JIA. Improving awareness among families about the importance of influenza vaccination may increase vaccination rates in children with rheumatic diseases. What is Known: • Rheumatic children are at increased risk for influenza infection due to immunosuppressive therapy and immune dysregulation. • Influenza vaccine is formally recommended to children with rheumatic diseases. What is New: • This multicentre study showed that influenza vaccine uptake rates remain suboptimal among children with Juvenile Idiopathic Arthritis despite formal recommendations. • Factors like previous experience with vaccination and information provided by medical professionals via different ways play essential roles in increasing vaccination rates and can contribute to improved health outcomes for these vulnerable children.

6.
Semin Arthritis Rheum ; 66: 152454, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38678817

ABSTRACT

INTRODUCTION: Vascular events account for a considerable burden of morbidity and mortality in Behçet syndrome (BS). Thrombosis occurs in 1.8-21 % pediatric BS patients, even if the real prevalence is still largely unknown. OBJECTIVES: To report clinical features and outcomes of pediatric BS patients with thrombosis and to compare the demographic and clinical characteristics of BS patients with and without thrombosis. METHODS: Retrospective data collection of BS patients with thrombosis (T+) included in the EUROFEVER registry. BS patients without thrombosis (T-), belonging to the same rheumatology units, were matched in a 2:1 ratio. RESULTS: 37 T+ were compared to 74 T- patients. At onset, ICBD criteria fulfillment was higher in the T- group (p = 0.015). Caucasian patients were more often T-, Turkish patients were more frequent in T+ group (p = 0.002). At onset, pustulosis was most frequently observed in the T- (p < 0.001) as well as gastrointestinal symptoms (p < 0.001) and ocular involvement (p = 0.022). Neurological symptoms were more often described in T+ (p = 0.034). As for T+, thrombosis was reported at BS presentation in 8/37 (21.6 %). For the T + e patients who developed thrombosis later, oral aphthosis (p = 0.003), genital aphthosis (p = 0.014) were more frequently observed at BS onset, while pustulosis (p = 0.005) and fever (p = 0.043) coexisted with thrombosis. Thrombosis was mainly venous (26/37,70.3 %), involving the cerebral sinuses (21/37, 56.8 %). After thrombosis, 35/37 (94.6 %) T+ patients received an immunomodulatory treatment compared with 16/29 (55.2 %) pre-thrombosis. A recurrence was reported in 6/31(19.4 %). CONCLUSION: Thrombosis was reported at BS presentation in one fifth of cases. Pustolosis and fever were more frequently concomitant to thrombosis. Sinus veins were the most frequent site.


Subject(s)
Behcet Syndrome , Registries , Thrombosis , Humans , Behcet Syndrome/complications , Behcet Syndrome/epidemiology , Male , Female , Child , Adolescent , Retrospective Studies , Thrombosis/etiology , Thrombosis/epidemiology , Europe/epidemiology , Prevalence
7.
Turk Neurosurg ; 34(3): 435-440, 2024.
Article in English | MEDLINE | ID: mdl-38650558

ABSTRACT

AIM: To investigate the effectiveness of local halofuginone application for spinal epidural fibrosis (EF) after lumbar laminectomy in rats. MATERIAL AND METHODS: Forty rats were equally divided into four groups (Groups I-IV; 10 rats in each group), and lumbar laminectomy was performed under general anesthesia. After laminectomy, Group I received saline (NaCl 0.9%) locally (control), Group II received spongostan, Group III received 0.5 mL of halofuginone-impregnated spongostan, and Group IV received 0.5 mL of halofuginone. Spongostan was used to prolong the exposure period of halofuginone. All rats were sacrificed after four weeks and evaluated according to histopathological criteria. A p-value of < 0.05 was considered statistically significant. RESULTS: Fibrosis was significantly lower in Group IV than in Group I (p < 0.05). There was no significant difference in fibrosis between Group II/III and Group I. It was observed that spongostan increased fibrosis. CONCLUSION: Halofuginone helps prevent EF after spinal surgery. However, further clinical and experimental studies are needed to assess its safety in humans.


Subject(s)
Epidural Space , Fibrosis , Laminectomy , Piperidines , Quinazolinones , Animals , Fibrosis/drug therapy , Rats , Piperidines/administration & dosage , Laminectomy/adverse effects , Quinazolinones/administration & dosage , Quinazolinones/therapeutic use , Epidural Space/pathology , Male , Postoperative Complications/drug therapy , Lumbar Vertebrae/surgery , Disease Models, Animal , Rats, Sprague-Dawley
8.
Turk Arch Pediatr ; 59(2): 121-130, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38454219

ABSTRACT

In this era of rapidly advancing technology, artificial intelligence (AI) has emerged as a transformative force, even being called the Fourth Industrial Revolution, along with gene editing and robotics. While it has undoubtedly become an increasingly important part of our daily lives, it must be recognized that it is not an additional tool, but rather a complex concept that poses a variety of challenges. AI, with considerable potential, has found its place in both medical care and clinical research. Within the vast field of pediatrics, it stands out as a particularly promising advancement. As pediatricians, we are indeed witnessing the impactful integration of AI-based applications into our daily clinical practice and research efforts. These tools are being used for simple to more complex tasks such as diagnosing clinically challenging conditions, predicting disease outcomes, creating treatment plans, educating both patients and healthcare professionals, and generating accurate medical records or scientific papers. In conclusion, the multifaceted applications of AI in pediatrics will increase efficiency and improve the quality of healthcare and research. However, there are certain risks and threats accompanying this advancement including the biases that may contribute to health disparities and, inaccuracies. Therefore, it is crucial to recognize and address the technical, ethical, and legal challenges as well as explore the benefits in both clinical and research fields.

9.
Polymers (Basel) ; 16(6)2024 Mar 16.
Article in English | MEDLINE | ID: mdl-38543433

ABSTRACT

Enhancing interfacial interactions in fiber-reinforced polymer composites (FRPCs) is crucial for improving their mechanical properties. This can be achieved through the incorporation of nanomaterials or chemically functional agents into FRPCs. This study reports the tailoring of the fiber-matrix interface in FRPCs using non-functionalized graphene nanoplatelets (GNPs) in combination with a waterborne, highly branched, multi-functional polyurethane dispersion (HBPUD). A unique ultrasonic spray deposition technique was utilized to deposit aqueous mixtures of GNP/HBPUDs onto the surfaces of carbon fiber fabrics, which were used to prepare epoxy-prepreg sheets and corresponding FRPC laminates. The influence of the polyurethane (PU) and GNP content and their ratio at the fiber-matrix interface on the tensile properties of resulting high-performance composites was systematically investigated using stress-strain analysis of the produced FRPC plates and SEM analysis of their fractured surfaces. A synergistic stiffening and toughening effect was observed when as low as 20 to 30 mg of GNPs was deposited per square meter of each side of the carbon fiber fabrics in the presence of the multi-functional PU layer. This resulted in a significant improvement in the tensile strength from 908 to 1022 MPa, while maintaining or slightly improving the initial Young's modulus from approximately 63 to 66 MPa.

10.
Pediatr Cardiol ; 45(5): 1007-1014, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38546846

ABSTRACT

Early detection of cardiac involvement in Juvenile Dermatomyositis (JDM) is difficult due to the absence of clinical signs and symptoms, with systolic dysfunction often emerging in late stages and associated with a poor prognosis. This study aimed to employ two-dimensional speckle-tracking echocardiography (STE) for subclinical assessment of left ventricular (LV) systolic failure in JDM and explore potential associations between impaired LV systolic function (LV-GLS) and disease activity. A prospective study enrolled 20 healthy volunteers and 26 JDM patients (< 18 years old) without cardiac symptoms. Clinical data were collected from medical records, and echocardiograms were conducted by a pediatric cardiologist. Our study cohort demonstrated similar age to controls (13.5 ± .6 vs. 13.8 ± 4.7; p = 0.465). Median illness duration at echocardiography was 5 (1.5-17.5) years, and conventional echocardiography indicated normal LV ejection fraction (> 55%) in all participants. However, STE revealed lowered LV GLS in JDM patients (- 22.2 ± 4.1% vs. - 26.5 ± 5.3% p = 0.022). Pulse steroid users displayed lower GLS average values compared to non-users (ß = 4.99, 95% CI 1.34-8.64, p = 0.009). Negative correlations existed between LV-GLS and age at diagnosis (r = - 0.499; p = 0.011), diastolic parameters (E/E' ratio) and age at diagnosis (r = - 0.469; p = 0.018), as well as RV global strain and age at diagnosis (r = - 0.443; p = 0.024). Employing STE in JDM patients facilitated the identification of preclinical cardiac dysfunction. Given JDM patients' younger age, early myocardial damage detection through STE may impact treatment decisions and long-term cardiovascular prognosis.


Subject(s)
Dermatomyositis , Echocardiography , Ventricular Dysfunction, Left , Humans , Dermatomyositis/complications , Dermatomyositis/diagnostic imaging , Dermatomyositis/physiopathology , Male , Female , Adolescent , Prospective Studies , Echocardiography/methods , Child , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Left/physiopathology , Case-Control Studies , Stroke Volume , Systole
11.
Cytotherapy ; 26(6): 556-566, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38483359

ABSTRACT

BACKGROUND AIMS: Few human induced pluripotent stem cell (hiPSC) lines are Good Manufacturing Practice (GMP)-compliant, limiting the clinical use of hiPSC-derived products. Here, we addressed this by establishing and validating an in-house platform to produce GMP-compliant hiPSCs that would be appropriate for producing both allogeneic and autologous hiPSC-derived products. METHODS: Our standard research protocol for hiPSCs production was adapted and translated into a GMP-compliant platform. In addition to the generation of GMP-compliant hiPSC, the platform entails the methodology for donor recruitment, consent and screening, donor material procurement, hiPSCs manufacture, in-process control, specific QC test validation, QC testing, product release, hiPSCs storage and stability testing. For platform validation, one test run and three production runs were performed. Highest-quality lines were selected to establish master cell banks (MCBs). RESULTS: Two MCBs were successfully released under GMP conditions. They demonstrated safety (sterility, negative mycoplasma, endotoxins <5.0 EU/mL and negative adventitious agents), cell identity (>75% of cells expressing markers of undifferentiated state, identical STR profile, normal karyotype in >20 metaphases), purity (negative residual vectors and no plasmid integration in the genome) and potency (expression of at least two of the three markers for each of the three germ layers). In addition, directed differentiation to somitoids (skeletal muscle precursors) and six potential clinical products from all three germ layers was achieved: pancreatic islets (endoderm), kidney organoids and cardiomyocytes (mesoderm), and keratinocytes, GABAergic interneurons and inner-ear organoids (ectoderm). CONCLUSIONS: We successfully developed and validated a platform for generating GMP-compliant hiPSC lines. The two MCBs released were shown to differentiate into clinical products relevant for our own and other regenerative medicine interests.


Subject(s)
Cell Differentiation , Induced Pluripotent Stem Cells , Humans , Induced Pluripotent Stem Cells/cytology , Cell Culture Techniques/methods , Cell Line
12.
Am Heart J ; 271: 112-122, 2024 May.
Article in English | MEDLINE | ID: mdl-38395293

ABSTRACT

BACKGROUND: To date, there has been no independent core lab angiographic analysis of patients with COVID-19 and STEMI. The study characterized the angiographic parameters of patients with COVID-19 and STEMI. METHODS: Angiograms of patients with COVID-19 and STEMI from the North American COVID-19 Myocardial Infarction (NACMI) Registry were sent to a Core Laboratory in Vancouver, Canada. Culprit lesion(s), Thrombolysis In Myocardial Infarction (TIMI) flow, Thrombus Grade Burden (TGB), and percutaneous coronary intervention (PCI) outcome were assessed. RESULTS: From 234 patients, 74% had one culprit lesion, 14% had multiple culprits and 12% had no culprit identified. Multivessel thrombotic disease and multivessel CAD were found in 27% and 53% of patients, respectively. Stent thrombosis accounted for 12% of the presentations and occurred in 55% of patients with previous coronary stents. Of the 182 who underwent PCI, 60 (33%) had unsuccessful PCI due to post-PCI TIMI flow <3 (43/60), residual high thrombus burden (41/60) and/or thrombus related complications (27/60). In-hospital mortality for successful, partially successful, and unsuccessful PCI was 14%, 13%, and 27%, respectively. Unsuccessful PCI was associated with increased risk of in-hospital mortality (risk ratio [RR] 1.96; 95% CI: 1.05-3.66, P = .03); in the adjusted model this estimate was attenuated (RR: 1.24; 95% CI: 0.65-2.34, P = .51). CONCLUSION: In patients with COVID-19 and STEMI, thrombus burden was pervasive with notable rates of multivessel thrombotic disease and stent thrombosis. Post-PCI, persistent thrombus and sub-optimal TIMI 3 flow rates led to one-third of the PCI's being unsuccessful, which decreased over time but remained an important predictor of in-hospital mortality.


Subject(s)
COVID-19 , Coronary Angiography , Percutaneous Coronary Intervention , Registries , ST Elevation Myocardial Infarction , Humans , ST Elevation Myocardial Infarction/therapy , ST Elevation Myocardial Infarction/diagnostic imaging , COVID-19/complications , COVID-19/therapy , Male , Female , Percutaneous Coronary Intervention/methods , Percutaneous Coronary Intervention/statistics & numerical data , Middle Aged , Aged , Hospital Mortality , SARS-CoV-2 , Coronary Thrombosis/diagnostic imaging , Canada/epidemiology
13.
Burns ; 50(4): 966-979, 2024 May.
Article in English | MEDLINE | ID: mdl-38331663

ABSTRACT

AIM: This study was conducted to determine the segmentation, classification, object detection, and accuracy of skin burn images using artificial intelligence and a mobile application. With this study, individuals were able to determine the degree of burns and see how to intervene through the mobile application. METHODS: This research was conducted between 26.10.2021-01.09.2023. In this study, the dataset was handled in two stages. In the first stage, the open-access dataset was taken from https://universe.roboflow.com/, and the burn images dataset was created. In the second stage, in order to determine the accuracy of the developed system and artificial intelligence model, the patients admitted to the hospital were identified with our own design Burn Wound Detection Android application. RESULTS: In our study, YOLO V7 architecture was used for segmentation, classification, and object detection. There are 21018 data in this study, and 80% of them are used as training data, and 20% of them are used as test data. The YOLO V7 model achieved a success rate of 75.12% on the test data. The Burn Wound Detection Android mobile application that we developed in the study was used to accurately detect images of individuals. CONCLUSION: In this study, skin burn images were segmented, classified, object detected, and a mobile application was developed using artificial intelligence. First aid is crucial in burn cases, and it is an important development for public health that people living in the periphery can quickly determine the degree of burn through the mobile application and provide first aid according to the instructions of the mobile application.


Subject(s)
Artificial Intelligence , Burns , Mobile Applications , Burns/classification , Burns/diagnostic imaging , Burns/pathology , Humans , Photography/methods
14.
Res Vet Sci ; 169: 105179, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38335894

ABSTRACT

Ovariohysterectomy (OVH) is a widely used surgical procedure in small animal practice. In developing countries, injectable anesthetics such as ketamine and xylazine are commonly used in veterinary medicine. Pharmacological agents with analgesic activity, such as ketamine and meloxicam, are not sufficiently effective in reducing visceral pain. Therefore, this study aimed to investigate the visceral analgesia and anti-inflammatory effectiveness of maropitant compared with those of meloxicam during and after OVH in bitches. In this study, thirty-six bitches were randomly divided into the maropitant, meloxicam, and control groups. The heart rate (HR), peripheral oxygen saturation, and respiratory rate were monitored during the procedure. Pain scores were assessed using the University of Melbourne pain scale (UMPS). Rescue analgesia was not necessary for any bitch at any time point. Blood samples were collected before anesthesia induction and 24 h after the operation to determine C-reactive protein (CRP) levels. No significant difference was observed in HR between the control and meloxicam groups when the right ovary was removed, and the HR of the maropitant group was significantly (p < 0.05) lower than that of the control group. The pain scores of the maropitant group were significantly (p < 0.05) lower than those of the other groups. However, no significant differences were observed in CRP levels between the groups. In conclusion, compared to meloxicam, maropitant provided more effective visceral analgesia in bitches undergoing OVH, although no significant difference was found in its anti-inflammatory effect.


Subject(s)
Analgesia , Dog Diseases , Ketamine , Quinuclidines , Female , Dogs , Animals , Meloxicam/therapeutic use , Pain Management/veterinary , Ovariectomy/adverse effects , Ovariectomy/veterinary , Pain, Postoperative/drug therapy , Pain, Postoperative/prevention & control , Pain, Postoperative/veterinary , Hysterectomy/veterinary , Analgesia/veterinary , Anti-Inflammatory Agents/therapeutic use
15.
Clin Exp Rheumatol ; 42(1): 194-201, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37497697

ABSTRACT

OBJECTIVES: Biological drugs are one of the most effective treatment methods for systemic juvenile idiopathic arthritis (SJIA) and can significantly prevent morbidity and mortality. This study aimed to evaluate the efficacy and safety of biologics in patients with SJIA and provide real-life data that might help improve the outcomes. METHODS: TURSIS was a retrospective multicentre study carried out in patients with SJIA for whom a biological treatment had been initiated between 1st March 2013 and 30th December 2018. Data include patients' characteristics, laboratory-clinical results, outcomes, and safety-related variables. The 24-month follow-up data of the patients and the efficacy and safety of biological drugs were evaluated. RESULTS: 147 patients were enrolled. The clinical course of the disease was as follows; it was monocyclic in 38.1%, polycyclic in 49%, and persistent in 12.9% of patients. First-choice biologics were interleukin (IL)-1 blockers in the majority of patients (56.5%), followed by the anti-IL-6 (25.2%) and anti-TNF-alpha drugs (18.4%). Anakinra was the most preferred biologic agent in patients with macrophage activation syndrome (MAS), and tocilizumab was used more frequently in patients with persistent type (p=0.000 and p=0.003). The most frequent switch rate was seen in patients receiving anakinra (n=40/68, 58.8%), and it was most frequently switched to canakinumab (n=32/40, 80%). Better physician's global assessment scores were achieved in patients treated with anakinra in Month 3, compared to other treatments (p=0.04). CONCLUSIONS: The results of our study support the efficacy of biological drugs in particular anti-IL-1 and anti-IL-6 drugs, in the treatment of SJIA. These treatments resulted in improvement in activity of disease and provide a considerable decrease in the frequency of MAS.


Subject(s)
Arthritis, Juvenile , Biological Products , Macrophage Activation Syndrome , Humans , Arthritis, Juvenile/diagnosis , Arthritis, Juvenile/drug therapy , Interleukin 1 Receptor Antagonist Protein/adverse effects , Turkey , Tumor Necrosis Factor Inhibitors/therapeutic use , Interleukin-1 , Biological Products/adverse effects , Macrophage Activation Syndrome/chemically induced
16.
Clin Rheumatol ; 43(1): 399-406, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37646858

ABSTRACT

BACKGROUND/OBJECTIVES: The aim of the study is to assess the effect of juvenile idiopathic arthritis (JIA) and biologic disease-modifying anti-rheumatic drugs (bDMARDs) on ovarian reserve in children. MATERIALS AND METHODS: A cross-sectional study was performed from March 2021 to March 2022 and included 81 patients with JIA and 49 healthy children. Serum anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol levels were analyzed using electrochemiluminescence methods. RESULTS: The mean of current age (13.5 ± 3.2 vs. 14.4 ± 2.4 years), height standard deviation score (SDS) (- 0.35 ± 1.18 vs. - 0.44 ± 0.94), body mass index SDS (0.12 ± 1.33 vs. 0.25 ± 1.28), and the median weight SDS (- 0.13 (- 2.27-3.23) vs. - 0.52 (- 3.4-3.3)) were similar in JIA patients and controls (p > 0.05). Patients with JIA were divided into two groups according to their treatment regimens: treated with methotrexate (MTX) (biologic naive) (n = 32) and treated with MTX plus bDMARDs (n = 49). No significant differences were detected between the 3 groups regarding menarche age, menstrual cycle length, and flow duration (for all p > 0.05). The median serum concentration of AMH was 2.94 (1.12-7.88) ng/ml in the control group, 3.02 (0.36-8.54) ng/ml in the biologic naïve group, and 3.01 (0.99-8.26) ng/ml in the MTX plus bDMARD group. There were no significant differences between 3 groups according to serum AMH, FSH, LH, and estradiol levels (p > 0.05). CONCLUSION: Biologic DMARDs are reassuring in terms of ovarian reserve in girls with JIA and demonstrate that AMH is unaffected by treatment. Prospective studies with larger sample sizes are needed to confirm our findings and to evaluate the impact on the future fertility of patients. Key Points • Although biologic disease-modifying anti-rheumatic drugs (bDMARDs) are being game-changing treatment options in juvenile idiopathic arthritis, their effect on fertility and ovarian reserve is one of the most discussed issues. • In addition to treatment used, autoimmune diseases might also have a negative effect on fertility. • In this cross-sectional study, we found that anti-Mullerian hormone level of patients who were on bDMARDs, patients who were on methotrexate, and healthy controls were similar. • Our results suggest that bDMARDs are reassuring in terms of ovarian reserve in girls with JIA and demonstrate that AMH is unaffected by treatment.


Subject(s)
Antirheumatic Agents , Arthritis, Juvenile , Biological Products , Ovarian Reserve , Female , Child , Humans , Arthritis, Juvenile/drug therapy , Methotrexate/pharmacology , Cross-Sectional Studies , Anti-Mullerian Hormone , Prospective Studies , Luteinizing Hormone , Follicle Stimulating Hormone , Antirheumatic Agents/therapeutic use , Antirheumatic Agents/pharmacology , Estradiol/pharmacology
17.
ACS Omega ; 8(49): 47173-47186, 2023 Dec 12.
Article in English | MEDLINE | ID: mdl-38107921

ABSTRACT

One-component epoxy resins (OCERs) are proposed to overcome the energy inefficiency and processing difficulties of conventional two-component epoxy resins by employing latent curing agents, specifically thermal latent curing agents (TLCs). Despite recent progress, the need for TLCs with a simple preparation method for different curing agents, epoxy resins, and process conditions remains. Here, tailorable TLCs were prepared by forming complexes between imidazole (Im) and amphiphilic polyoxazoline copolymers with tunable structures and properties by a solvent evaporation method. The obtained TLCs were manually mixed with DGEBA to prepare OCERs. The miscibility of the complexes with DGEBA was studied, considering the functionalities of copolymers. The curing behaviors of TLCs were compared using dynamic Differential Scanning Calorimetry (DSC) studies considering the side chain and composition of the copolymers, copolymer:Im ratio, and concentration of Im in DGEBA. The curing behavior of the promising OCERs was studied by isothermal DSC studies to investigate their stability at different temperatures and curing rate at elevated temperatures revealing the stability of these OCERs.

18.
Turk J Med Sci ; 53(4): 979-989, 2023 Aug.
Article in English | MEDLINE | ID: mdl-38031949

ABSTRACT

BACKGROUND: The aim of our study was to evaluate the long-term impacts of Kawasaki disease on our patients regarding coronary involvement demographic characteristics, treatment regimens, and clinical course. METHODS: Our study included 104 patients diagnosed and hospitalized with Kawasaki disease in our center, from January 2004 to January 2019. In our study, patients were divided into three groups according to coronary artery involvement. Patients in group 1 had no echocardiographic findings, while the ones in group 2 had coronary artery dilatation and ones in group 3 had coronary artery aneurysm (CAA). RESULTS: Among 104 patients, the median age was 9.15 (3.0-22.0) years, and 61 of the patients were male while 43 of the patients were female. With a wide range of 1.50-16.50 years of follow-up time, the median diagnosis age of our patients was 31 months (3.0-164.0). Fever duration (median day 10 (5-21), p = 0.025) was statistically significantly higher in group 3. Blood C-reactive protein (CRP) levels, white blood cell (WBC) counts, and neutrophil counts were significantly higher in group 3. There was a statistically significant difference between patients in group 3 and group 2 in which the lowest strain deformation values were in the patients of group 3. In contrast to group 1, the time for initiation of IVIG therapy is significantly prolonged both in group 2 (median: 9.5 days, p = 0.028) and group 3 (median: 10 days, p = 0.036). DISCUSSION: In our study, serum CRP levels, WBC count, and neutrophil count were higher in patients with coronary artery abnormalities, in agreement with the previous studies. In the light of our results, we consider that the most important determining factor for the development of coronary artery aneurysm is the time of intravenous immunoglobulin (IVIG) administration.


Subject(s)
Coronary Aneurysm , Coronary Artery Disease , Mucocutaneous Lymph Node Syndrome , Humans , Child , Male , Female , Infant , Child, Preschool , Immunoglobulins, Intravenous/therapeutic use , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/epidemiology , Retrospective Studies , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/epidemiology , Coronary Aneurysm/etiology , Coronary Artery Disease/epidemiology
19.
Heliyon ; 9(10): e20920, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37916076

ABSTRACT

Monitoring locomotor demands in team sports becomes popular in professional and recreational daily activities. Precise measurements are main of importance in training routine. The aim of this study is three-fold: (i) analyze the validity of Polar M400 Global Positioning System (GPS) watches for measuring distances covered in team sports simulation cycle; (ii) testing inter-unit reliability of two devices attached during testing; and (iii) testing inter-session reliability for the same simulation cycle. Methods: Twenty-one team athletes (age: 24.5 ± 5.2 years; body mass: 71.8 ± 5.7 kg; height: 176.5 ± 4.3 cm) were tested in the team sport simulation cycle (TSSC). Two Polar M400 sport watches were used by each player on their wrists at the same time. The data obtained from Polar M400 were compared to the reference fixed distance of the TSSC to determine the watch validity. Inter-session reliability was also tested using the two watches in two different sessions. Results: No significant differences between the reference value and the watches (F = 1.086; p = 0.368; ηp2 ≤0.042) were found. The %CV (0.03-0.05%) and SEM (0.05-0.09) values found for all considered groups confirmed good levels of reliability of the Polar M400 to measure total distance. Conclusions: The Polar M400 is a valid and reliable watch for measuring the distances covered by team sport athletes. Both coaches and athletes can monitor the distances covered with accuracy and precision, through the use of the Polar M400 sport watch.

20.
JAMA Netw Open ; 6(11): e2343402, 2023 Nov 01.
Article in English | MEDLINE | ID: mdl-37971742

ABSTRACT

Importance: The clinical characteristics and prognosis of patients with ST-segment elevation myocardial infarction (STEMI) with nonobstructive coronaries (MINOCA) are largely unknown. Objective: To assess differences in 5-year mortality in patients presenting with STEMI due to MINOCA and MINOCA mimickers as compared with obstructive disease. Design, Setting, and Participants: A retrospective analysis of a prospective registry-based cohort study of consecutive STEMI activations at 3 regional Midwest STEMI programs. STEMI without a culprit artery and elevated troponin levels were categorized as MINOCA (absence of coronary artery stenosis >50% and confirmed or suspected coronary artery plaque disruption, epicardial coronary spasm, or coronary embolism/thrombosis) or MINOCA mimickers (takotsubo cardiomyopathy, myocarditis, or nonischemic cardiomyopathy). Data were analyzed from March 2003 to December 2020. Main Outcomes and Measures: Adjusted Cox regression analysis was used to assess 5-year mortality risk in STEMI presenting with MINOCA and MINOCA mimickers in comparison with obstructive disease. Results: Among 8560 consecutive patients with STEMI, mean (SD) age was 62 (14) years, 30% were female (2609 participants), and 94% were non-Hispanic White (4358 participants). The cohort included 8151 patients with STEMI due to obstructive disease (95.2%), 120 patients with MINOCA (1.4%), and 289 patients with MINOCA mimickers (3.8%). Patients were followed up for a median (IQR) of 7.1 (3.6-10.7) years. Patients with MINOCA and MINOCA mimickers were less likely to be discharged with cardiac medications compared with obstructive disease. At 5-year follow-up, mortality in STEMI presenting with obstructive disease (1228 participants [16%]) was similar to MINOCA (20 participants [18%]; χ21 = 1.1; log-rank P = .29) and MINOCA mimickers (52 participants [18%]; χ21 = 2.3; log-rank P = .13). In adjusted Cox regression analysis compared with obstructive disease, the 5-year mortality hazard risk was 1.93 times higher in MINOCA (95% CI, 1.06-3.53) and similar in MINOCA mimickers (HR, 1.08; 95% CI, 0.79-1.49). Conclusions and Relevance: In this large multicenter cohort study of consecutive clinical patients with STEMI, presenting with MINOCA was associated with a higher risk of mortality than obstructive disease; the risk of mortality was similar in patients with MINOCA mimickers and obstructive disease. Further investigation is necessary to understand the pathophysiologic mechanisms involved in this high-risk STEMI population.


Subject(s)
Myocardial Infarction , ST Elevation Myocardial Infarction , Humans , Female , Middle Aged , Male , ST Elevation Myocardial Infarction/epidemiology , Myocardial Infarction/epidemiology , MINOCA , Retrospective Studies , Cohort Studies , Coronary Vessels , Coronary Angiography
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