Bezmiâlem Vakif Üniversitesi

Orthostatic hypotension (OH) is common in older people. We examined the influence of self-reported occupational-related physical activity (PA) and leisure-time physical exercise (PE) on orthostatic response in a sample of older people over a 2 year period. Supine and orthostatic systolic blood pressure (sBP), diastolic blood pressure (dBP), and mean blood pressure (mBP) were assessed in response to Active Stand (AS) test in 205 older subjects (> 60 years old) at baseline and 2-year follow-up. OH was found in 24 subjects (11.71%) at baseline and 20 subjects (9.76%) after 2 years, with a significant degree of variability in the occurrence of OH after 2 years. Twenty-two subjects who had OH at baseline were free of it after 2 years, two subjects had persistent OH at baseline and after 2 years. After 2 years, adults with occupational PA showed no significant decrease of blood pressure in response to AS test, while lack of undertaking an occupation-related PA was significantly related with a greater decrease in sBP and mBP in response to AS testing in the 1st min. Occupation-related PA and leisure-time-related PE were related to an increase in the response of BP on AS in change between baseline and after 2 years. High between-subjects variance in OH over 2 years was noted. Occupations that involved continuous physical activity and leisure-time physical exercise in middle age were both protective for BP decline on orthostatic stress test within 2 years.

This study aimed to investigate the effect of Pilates-based exercise training applied with hybrid telerehabilitation on Cobb angle, respiratory function, respiratory muscle strength, and functional capacity in patients with adolescent idiopathic scoliosis (AIS). This is an evaluator-blinded, randomized, controlled trial. For the study, 32 patients were randomly allocated into two groups: a hybrid telerehabilitation group (training group), provided with modified Pilates-based exercises with synchronous sessions; and a home-based group (control group), doing the same exercises in their home. The Pilates-based exercise program consists of stretching and strengthening exercises combined with postural corrections and breathing exercises modified according to the curve type and localization of the patients, done every day of the week for 12 weeks. Analyses were made based on the comparison between the angle of trunk rotation, Cobb angle, spirometry, maximal inspiratory (MIP) and expiratory pressures (MEP), and incremental shuttle walk tests done at the beginning and end of the study. The training group showed statistically significant improvements in Cobb angle, PEF%, MIP, and MEP values compared with the control group (p < 0.05). Conclusion: Pilates-based exercises applied with the hybrid telerehabilitation method can improve Cobb angle and respiratory muscle strength in patients with AIS. The hybrid telerehabilitation method can be used as an alternative to home-based programs, especially in locations and times where there may be limited access to supervised training. Also, the nature of the disease that requires long-term follow-up is another factor where hybrid telerehabilitation may be an advantage. Trial registration: ClinicalTrials.gov ID: NCT05761236. What is Known: • Exercise training is one of the main approaches to treating scoliosis. What is New: • Application of exercises via telerehabilitation method may contribute more to the improvement of scoliosis-related parameters than home-based programs. • Telerehabilitation may be a preferable alternative exercise method in scoliosis, considering the advantages of accessibility and long-term follow-up.

A novel simple and cost effective HPLC technique was presented for the quantification of selexipag (SLP) in human plasma sample and the technique's applicability to a pharmacokinetic investigation. Chromatographic separation was achieved with C18 (5 µm × 4.6 mm × 150 mm) column, at 30 °C with isocratic elution, mobile phase composed of solution A (acetonitrile), and solution B (0.5% formic acid) (65:35 v/v) at flow rate 1.2 mL min ⁻¹ . The linearity range is 10–150 ng mL ⁻¹ . As sample preparation step human plasma was precipitated with acetonitrile and the detection was provided at 300 nm. The retention time is 8.20 ± 0.02 min. LOD is found to be 3.3 ng mL ⁻¹ for drug. The method was applied to the analysis of SLP in human plasma with good recovery as 97.83%. Validation of the studied methods was carried out according to EMA guideline. The new method applied on a prototype pharmacokinetic study by administration of 800 μg SLP to a healthy volunteer and parameters like AUC 0–24 , AUC 0–∞ , C max , t max , and t 1/2 were assessed.

Background The research on ChatGPT-generated nursing care planning texts is critical for enhancing nursing education through innovative and accessible learning methods, improving reliability and quality. Purpose The aim of the study was to examine the quality, authenticity, and reliability of the nursing care planning texts produced using ChatGPT. Methods The study sample comprised 40 texts generated by ChatGPT selected nursing diagnoses that were included in NANDA 2021-2023. The texts were evaluated by using a descriptive criteria form and the DISCERN tool to evaluate health information. Results DISCERN total average score of the texts was 45.93 ± 4.72. All texts had a moderate level of reliability and 97.5% of them provided moderate quality subscale score of information. A statistically significant relationship was found among the number of accessible references, reliability ( r = 0.408), and quality subscale score ( r = 0.379) of the texts ( P < .05). Conclusion ChatGPT-generated texts exhibited moderate reliability, quality of nursing care information, and overall quality despite low similarity rates.

OBJECTIVE This study aimed to increase awareness by determining the risk of obstructive sleep apnea syndrome in individuals aged 18 years and above. METHODS The study is a descriptive and cross-sectional study. A total of 633 individuals aged 18 years and above participated in the study. The data were collected online from individuals in the form of describing the demographic characteristics of individuals and with the Berlin survey. The IBM SPSS statistics 26.0 program was used in the analysis of the data. RESULTS In this study, 38.9% of individuals were found to be at high risk for obstructive sleep apnea syndrome. A significant relationship was found between the risk of obstructive sleep apnea syndrome and gender, age, body mass index, education level, chronic obstructive pulmonary disease, diabetes, hypertension, presence of cardiovascular diseases, and smoking (p<0.05). CONCLUSION The results of this study showed that male gender, increasing age, obesity, presence of chronic disease, and smoking increase the risk of obstructive sleep apnea syndrome. Defining the risk of obstructive sleep apnea syndrome, especially in risky groups, will be effective in planning health care, increasing the effectiveness of treatment, and improving the quality of life. It is recommended to include this diagnosis in health care protocols and to expand its use in order to plan and repeat trainings that will emphasize its importance.

The aim of the study was to evaluate the real-world clinical outcomes of atezolizumab and bevacizumab (Atez/Bev) as the initial therapy for advanced hepatocellular carcinoma (HCC). We retrospectively analyzed 65 patients treated with Atez/Bev for advanced HCC from 22 institutions in Turkey between September 2020 and March 2023. Responses were evaluated by RECIST v1.1 criteria. The median progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan–Meier method. Cox regression model was employed to conduct multivariate analyses. The median age was 65 (range, 22–89) years, and 83.1% of the patients were male. A total of 1.5% achieved a complete response, 35.4% had a partial response, 36.9% had stable disease, and 26.2% had progressive disease. The disease control rate was 73.8% and associated with alpha-fetoprotein levels at diagnosis and concomitant antibiotic use. The incidence rates of any grade and grade ≥ 3 adverse events were 29.2% and 10.7%, respectively. At a median follow-up of 11.3 (3.4–33.3) months, the median PFS and OS were 5.1 (95% CI: 3–7.3) and 18.1 (95% CI: 6.2–29.9) months, respectively. In univariate analyses, ECOG-PS ≥ 1 (relative to 0), Child-Pugh class B (relative to A), neutrophil-to-lymphocyte ratio (NLR) > 2.9 (relative to ≤ 2.9), and concomitant antibiotic use significantly increased the overall risk of mortality. Multivariate analysis revealed that ECOG-PS ≥ 1 (HR: 2.69, P = .02), NLR > 2.9 (HR: 2.94, P = .017), and concomitant antibiotic use (HR: 4.18, P = .003) were independent predictors of OS. Atez/Bev is an effective and safe first-line therapy for advanced-stage HCC in a real-world setting. The survival benefit was especially promising in patients with a ECOG-PS score of 0, Child-Pugh class A, lower NLR, and patients who were not exposed to antibiotics during the treatment.

Neonatal sepsis and meningitis are worrisome infectious diseases that can lead to serious consequences. Sepsis is defined as systemic signs of infection and isolation of a pathogen from the bloodstream [1]. An infant with signs of infection without culture confirmation from blood or other sterile sites is considered to have clinical sepsis. Meningitis usually accompanies bacteremia and shares a common cause and pathogenesis. Patients may have complications such as neuromotor and learning disabilities, seizure disorders, visual problems, hearing loss (HL), and impaired cognitive function. Here, the sequelae of neonatal sepsis and meningitis, emphasizing auditory problems, will be discussed.

Background: Immunoglobulin A nephropathy (IgAN) is a common primary glomerulonephropathy. There is evidence that mesangial C3 deposition plays a role in the development of the disease. The aim of this study was to examine the effect of C3 deposition on the prognosis of IgAN patients. Method: The study included 1135 patients with biopsy-confirmed IgAN from the database of the Turkish Nephrology Association Glomerular Diseases Working Group (TSN-GOLD). Patients were excluded from the study if they were aged < 18 or > 75 years or if C3 staining had not been performed in the immunofluorescent analysis. C3 deposition was defined as an immunofluorescence intensity of C3 ≥ 2 + within the mesangium. The primary endpoints were the development of end-stage renal disease, a 30% decrease in glomerular filtration rate compared to the basal value or an elevation in proteinuria to a nephrotic level (3.5 gr/day). Results: Mesangial C3 deposition was observed in 603 (53.1%) patients. No statistically significant difference was found at baseline between the groups with and without mesangial C3 deposition, as for age, sex, BMI, proteinuria level, or the presence of hypertension. In the follow-up period with a mean duration of 78 months, no significant difference was found between the two groups regarding the primary endpoints (p = 0.43). A significant correlation between C3 deposition and segmental glomerulosclerosis (S1) according to the Oxford MEST-C classification was found (p = 0.001). Conclusion: Although a correlation was observed between mesangial C3 deposition and the S1 MEST-C classification, mesangial C3 deposition was not a prognostic factor in IgAN.

Cryptochromes (CRYs) are essential components of the circadian clock, playing a pivotal role as transcriptional repressors. Despite their significance, the precise mechanisms underlying CRYs' involvement in the circadian clock remain incompletely understood. In this study, we identified a rare CRY2 variant, p.Ser420Phe, from the 1000 Genomes Project and Ensembl database that is located in the functionally important coiled-coil-like helix (CC−helix) region. Functional characterization of this variant at the cellular level revealed that p.Ser420Phe CRY2 had reduced repression activity on CLOCK:BMAL1−driven transcription due to its reduced affinity to the core clock protein PER2 and defective translocation into the nucleus. Intriguingly, the CRY2 variant exhibited an unexpected resistance to degradation via the canonical proteasomal pathway, primarily due to the loss of interactions with E3 ligases (FBXL3 and FBXL21), which suggests Ser-420 of CRY2 is required for the interaction with E3 ligases. Further studies revealed that wild type and CRY2 variant are degraded by the lysosomal-mediated degradation pathway, a mechanism not previously associated with CRY2. Surprisingly, our complementation study with Cry1 −/− Cry2 −/− double knockout mouse embryonic fibroblast cells indicated that CRY2 variant caused 7 hours shorter circadian period length in contrast to the observed prolonged period length in CRY2 −/− cell lines. In summary, this study reveals a hitherto unknown degradation pathway for CRY2, shedding new light on the regulation of circadian rhythm period length.

This study aims to demonstrate a new surgical technique that can be applied in patients with cephalic malposition and patients with alar retraction. In this technique, a cartilage incision is made between the upper 2/3 and lower 1/3 close to the caudal edge and parallel to the cephalic edge of the lateral crus. Following this incision, the cephalic lateral crus and middle crus are meticulously dissected away from the underlying vestibular skin. The prepared flap is transposed over the intact caudal part of the lateral crus and secured in position. The average age of the patients included in the study was 24 years. The mean follow-up period was nine months, ranging from 6 to 12 months. No complications were observed following the application of the technique. Satisfactory outcomes were achieved postoperatively. Lateral overlay sliding transposition as a novel surgical technique has been demonstrated in patients presenting with cephalic malposition, mild to moderate alar retraction, and alar irregularity. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Cucurbitacins have high economic value as they are a major source of food and have pharmacological properties. Cucurbitacin I (CuI) is a plant‐derived natural tetracyclic triterpenoid compound that shows an anticancer effect via inhibiting the JAK2‐STAT3 signaling pathway. The actin cytoskeleton is the most abundant protein in cells and regulates critical events through reorganization in cells. In this study, it is aimed at determining the direct effect of CuI on actin dynamics. The fluorescence profile of G‐actin in the presence of CuI (1–200 nM) shifted to a higher temperature, suggesting that G‐actin binds CuI and that G‐actin–CuI is more thermally stable than the ligand‐free form. CuI dose‐dependently inhibited the polymerization of F‐actin in vitro and disrupted actin filaments in endothelial cells. Docking and MD simulations suggested that CuI binds to the binding site formed by residues I136, I175, D154, and A138 that are at the interface of monomers in F‐actin. The migration ability of cells treated with CuI for 24 h was significantly lower than the control group ( p < .001). This study reveals the molecular mechanisms of CuI in the regulation of actin dynamics by binding G‐actin. More importantly, this study indicates a novel role of CuI as an actin‐targeting drug by binding directly to G‐actin and may contribute to the mode of action of CuI on anticancer activities.

Objectives: Adequate hydration is essential for the maintenance of physiological functions. Older adults may not be able to maintain adequate hydration, which is often not recognized. Our aim was to investigate the prevalence, risk factors and clinical implications of dehydration in older adults. Methods: This cross-sectional study included 964 older adults in one geriatric outpatient clinic in Turkey. Dehydration was defined as a calculated [1,86 × (Na+K)+1,15×glucose+urea +14] plasma osmolarity of ≥ 295 mOsm/L. Clinical characteristics and measures of comprehensive geriatric assessments of patients with dehydration and normohydration were compared. Predictors of dehydration were assessed using logistic regression analysis. Results: Mean age was 79.9 ± 7.7 years, (71.7% female). The prevalence of dehydration was 31%. Female patients, diabetes mellitus (DM), chronic renal failure (CKD), a higher risk of falling (based on Timed Up and Go test), probable sarcopenia, dependence based on basic and instrumental daily living activities (BADL and IADL) were more common in the dehydrated group (p < 0.05). After adjusting for age and gender, dependency on BADL and IADL, the risk of falling were still higher in the dehydrated group (p < 0.05). There were significant relationships between dehydration and risk of falling (OR 1.38, 95% CI 1.00-1.90; p < 0.05), after adjustment for age, gender, DM, CKD. Conclusion: Dehydration is common among older adults and is associated with a dependency, probable sarcopenia, and an increased risk of falling. Screening for dehydration and taking preventive measures may be beneficial in avoiding the negative consequences associated with dehydration.

TW68, cryptochromes stabilizer, regulates fasting blood glucose levels in diabetic ob/ob and high fat-diet-induced obese mice, Biochemical Pharmacology (2023), doi: https://doi. Abstract Cryptochromes (CRYs), transcriptional repressors of the circadian clock in mammals, inhibit cAMP production when glucagon activates G-protein coupled receptors. Therefore, molecules that modulate CRYs have the potential to regulate gluconeogenesis. In this study, we discovered a new molecule called TW68 that interacts with the primary pockets of mammalian CRY1/2, leading to reduced ubiquitination levels and increased stability. In cell-based circadian rhythm assays using U2OS:Bmal1-dLuc cells, TW68 extended the period length of the circadian rhythm. Additionally, TW68 decreased the transcriptional levels of two genes, Phosphoenolpyruvate carboxykinase 1 (PCK1) and Glucose-6-phosphatase (G6PC), which play crucial roles in glucose biosynthesis during glucagon-induced gluconeogenesis in HepG2 cells. Oral administration of TW68 in mice showed good tolerance, a good pharmacokinetic profile, and remarkable bioavailability. Finally, when administered to fasting diabetic animals from ob/ob and HFD-fed obese mice, TW68 reduced blood glucose levels by enhancing CRY stabilization and subsequently decreasing the transcriptional levels of Pck1 and G6pc. These findings collectively demonstrate the antidiabetic efficacy of TW68 in vivo, suggesting its therapeutic potential for controlling fasting glucose levels in the treatment of type 2 diabetes mellitus.

Purpose Conservative treatment is the first step in the management of coccydynia. However, surgical treatment is required in cases where conservative treatment fails. The aim of this study was to compare the effect of traumatic and atraumatic etiologies on functional outcomes in patients who underwent coccygectomy for chronic coccydynia. Methods Ninety-seven patients who underwent partial coccygectomy between October 2010 and December 2018 for the diagnosis of chronic coccygodynia were evaluated retrospectively. The patients were divided into two groups according to etiologies as atraumatic (group AT) and traumatic (group T). Concomitant disorders of the patients were recorded as psychiatric and musculoskeletal diseases. Visual Analog Scale (VAS) for low back pain, the Oswestry Disability Index (ODI) scale, Short Form-36 Physical Component Summary and Short Form-36 Mental Component Summary were used to evaluate the clinical outcomes pre- and postoperative at the last follow-up. Results The mean follow-up time was 67.3 ± 13.9 (range; 44–115) months. Group AT and group T included 48 (mean age 37.1 ± 11.3 and 36 (75%) female) and 49 patients (mean age 36 ± 11 and 35 (71.4%) female), respectively. The groups were statistically similar in terms of age (p = 0.614), gender (p = 0.691), body mass index (p = 0.885), tobacco usage (p = 0.603) and duration of pain (p = 0.073). However, the rate of musculoskeletal and total concomitant disorders was higher in the Group AT than in Group T (p < 0.05). The average preoperative SF-36 MCS and SF-36 PCS scores improved at the last follow-up from 43.3 ± 6.2 and 35.6 ± 4.9 to 72 ± 14.1 and 58.3 ± 10.9, respectively. The preoperative VAS and ODI decreased from 8 ± 1.4 and 39.8 ± 8.5 to 2.6 ± 1.8 and 13.4 ± 8.9 at the last follow-up, respectively. Conclusion Successful results were obtained with surgical treatment in chronic coccygodynia. In addition, functional outcomes in patients with traumatic etiology are better than in atraumatic ones. Levels of evidence Level III; Retrospective Comparative Study.