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Explore 13,667 preprints on the Authorea Preprint Repository

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Lack of MECP2 gene transcription on the duplicated alleles of two MECP2 duplication f...
Yixi  Sun
Yali  Yang

Yixi Sun

and 7 more

April 05, 2021
Xq28 (involving MECP2) duplication syndrome is a severe neurodevelopmental disorder in males, most females are asymptomatic carriers, but there are phenotypic heterogeneities in the females. Skewed X-chromosome inactivation (XCI) seems to prevent duplicated region activation in asymptomatic females, but it remains controversial. Herein we reported two asymptomatic females (daughter and mother) with interstitial Xq28 duplication. HUMARA and RP2 assays showed that both had complete skewed XCI, the Xq28 duplicated chromosome was inactivated in the daughter, but surprisingly, it was activated in her mother. Interestingly, by combining RNA sequencing and whole-exome sequencing, we confirmed that XIST only expressed in the Xq28 duplication chromosomes of the two females, indicating that the Xq28 duplication chromosomes were inactive. Meanwhile, MECP2 and most XCI genes in the duplicated X-chromosomes were not transcriptionally expressed or upregulated, precluding major clinical phenotypes in the two females, especially the mother. We showed that XCI status detected by RNA sequencing was more relevant for establishing the clinical phenotype of MECP2 duplication females. It suggested there were other factors maintaining the XCI status in addition to DNA methylation, a possible additional inhibition mechanism occured at the transcriptional level in the unmethylated X-chromosome, counter balancing the MECP2 duplication’s detrimental phenotype effects
Ocular toxicity with TKI therapy in CML
Maria Eduarda Couto
Isabel Oliveira

Maria Eduarda Couto

and 3 more

April 05, 2021
Tyrosine kinase inhibitors are the standard treatment for Chronic Myeloid Leukemia. They have significantly improved the response rate and global survival in the long term for CML patients, but also added relevant and diverse toxicity. The authors report a clinical case of ocular toxicity connected to the TKIs.
Deceleration Area and Deceleration Capacity: Promising predictors of fetal acidaemia...
Shashikant Sholapurkar

Shashikant Sholapurkar

April 05, 2021
Letter to the Editor, BJOG Title:Deceleration Area and Deceleration Capacity: Promising predictors of fetal acidaemia in human labour? Visual versus computerised cardiotocographyRe: Georgieva A, Lear CA, Westgate JA, Kasai M, Miyagi E, Ikeda T, Gunn AJ, Bennet L. Deceleration area and capacity during labour-like umbilical cord occlusions identify evolving hypotension: a controlled study in fetal sheep. BJOG 2021; https://doi.org/10.1111/1471-0528.16638.Author: Mr. Shashikant L SHOLAPURKARMD, DNB, MRCOGDept of Obstetrics & Gynaecology,Royal United Hospital, Bath, BA1 3NG, UKEmail:s.sholapurkar@nhs.net; s.sholapurkar172@gmail.com; Tel: 07906620662Short Running Title: Deceleration area and capacity in labourWord count: 500Corresponding Author: Mr. Shashikant L SHOLAPURKARMD, DNB, MRCOGDept of Obstetrics & Gynaecology,Royal United Hospital, Bath, BA1 3NG, UKStatement of interest: The author has no conflict of interest or funding to declare.
A Scattering Problem for a Local Perturbation of an Open Periodic Waveguide
Andreas Kirsch

Andreas Kirsch

April 05, 2021
In this paper we consider the propagation of waves in an open waveguide in R^2 where the index of refraction is a local perturbation of a function which is periodic along the axis of the waveguide and equal to one outside a strip of finite width. Motivated by the limiting absorption principle (proven in an ealier paper by the author for the case of an open waveguide in the half space) we formulate a radiation condition which allows the existence of propagating modes and prove uniqueness, existence, and stability of a solution. In the last part we investigate the decay properties of the radiating part in the direction of periodicity and orthogonal to it.
Model analysis of forest thinning impacts on the water resources during hydrological...
Hiroki Momiyama
Tomo'omi Kumagai

Hiroki Momiyama

and 2 more

April 05, 2021
In Japan, there has recently been an increasing call for forest thinning to conserve water resources from forested mountain catchments in terms of runoff during prolonged drought periods of the year. How their water balance and the resultant runoff are altered by forest thinning is examined using a combination of 8-year hydrological observations, 100-year meteorological data generator output, and a semi-process-based rainfall-runoff model. The rainfall-runoff model is developed based on TOPMODEL assuming that forest thinning has an impact on runoff primarily through an alteration in canopy interception. The main novelty in this analysis is that the availability of the generated 100-year meteorological data allows the investigations of the forest thinning impacts on mountain catchment water resources under the most severer drought conditions. The model is validated against runoff observations conducted at a forested mountain catchment in the Kanto region of Japan for the period 2010--2017. It is demonstrated that the model reproduces temporal variations in runoff and evapotranspiration at inter- and intra-annual time scales, resulting in well reproducing the observed flow duration curves. On the basis of projected flow duration curves for the 100-year, despite the large increase in an annual total runoff with ordinary intensifying thinning, low flow rates, i.e., water resources from the catchment in the drought period in the year, in both normal and drought years were impacted by the forest thinning to a lesser extent. Higher catchment water retention capacity appreciably enhanced the forest thinning effect on increasing available water resources.
Quantification of the influence of different Mini Disk Infiltrometer (MDI) suction se...
Nathaniel Revell
Craig Lashford

Nathaniel Revell

and 3 more

April 05, 2021
Defining the infiltration characteristics of an area is beneficial for understanding soil compaction, determining soil health, and measuring the rate of surface water infiltration, which is needed for hydrological modelling. Single and double ring infiltrometers (SRI, DRI) are commonly used to determine infiltration characteristics in the field, however these are frequently impractical due to the required water volume, the weight and the intrusiveness of measurement, hindering the ease of replication. The Mini Disk Infiltrometer (MDI) offers a lightweight, portable and non-intrusive method of measuring infiltration, however no previous research has explained the influence of changing the tension settings on the collected infiltration data. To address this gap, this novel study tested the relationship between infiltration data collected using all tension settings of the Mini Disk Infiltrometer (MDI), against infiltration data collected using a 100mm Single Ring Infiltrometer (SRI). Three soil textures (sand, silt and clay) were collected from different geographical areas of the UK and deposited within the experimental facility designed for this study. Controlled infiltration measurements were taken with both the MDI and the SRI for each soil type, to further define the impact of MDI tension settings on derived infiltration, in comparison to the SRI. For the first time, the results show that the MDI tension setting of 0cm most closely replicated the findings of the SRI across all soils, which was supported through applying the Nash and Sutcliffe Efficiency (NSE) analysis. The accuracy with which the MDI replicated the infiltration of the SRI reduced as tension increased. Consequently, the previously assumed ideal tension setting of 2 cm, as defined by the MDI handbook and used in previous research, does not offer an accurate representation of derived infiltration.
Predictable and host-species specific humanization of the gut microbiota in captive p...
Jennifer Houtz
Jon Sanders

Jennifer Houtz

and 3 more

April 05, 2021
Humans and non-human primates (NHPs) harbor complex gut microbial communities that affect phenotypes and fitness. The gut microbiotas of wild NHPs reflect their hosts’ phylogenetic histories and are compositionally distinct from those of humans, but in captivity the endogenous gut microbial lineages of NHPs can be lost or replaced by lineages found in humans. Despite its potential contributions to gastrointestinal dysfunction, this humanization of the gut microbiota has not been investigated systematically across captive NHP species. Here we show through comparisons of well-sampled wild and captive populations of apes and monkeys that the fraction of the gut microbiota humanized by captivity varies significantly between NHP species but is remarkably reproducible between captive populations of the same NHP species. Conspecific captive populations displayed significantly greater than expected overlap in the sets of bacterial 16S rRNA gene variants that were differentially abundant between captivity and the wild. This overlap was evident even between captive populations residing on different continents but was never observed between heterospecific captive populations. In addition, we developed an approach incorporating human gut microbiota data to rank NHPs’ gut microbial clades based on the propensity of their lineages to be lost or replaced by lineages found in humans in captivity. Relatively few microbial genera displayed reproducible degrees of humanization in different captive host species, but most microbial genera were reproducibly humanized or retained from the wild in conspecific pairs of captive populations. These results demonstrate that the gut microbiotas of captive NHPs display predictable, host-species specific responses to captivity.
Effects of Music Intervention during Cesarean Section on the Level of the Mother’s An...
Jule Eriç Horasanlı
NUR DEMIRBAS

Jule Eriç Horasanlı

and 1 more

April 05, 2021
Background: Anxiety is commonly experienced during the delivery process and has been shown to have adverse effects on maternal and infant health outcomes. Music interventions tend to mitigate the effects of anxiety in a variety of populations, are low-cost and easily accessible, and have high acceptability. The aim of this study is to evaluate the effectiveness of music intervention on expectant mothers’ vital signs and anxiety levels during cesarean section. Methods: This study is a single-center, controlled, randomized study. The women in the intervention group listened to music via earpieces during the operation. The control group received standard treatment without music. Cesarean section was performed under regional anesthesia. The State-Trait Anxiety Inventory (STAI) was administered to the patients before and after the operation. Results: There was no significant difference between the pre- and postoperative systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, or O2 saturation parameters of the music group and the control group (p>0.05). The pre-operative STAI anxiety score was similar in the music (45.58±4.60) and control (43.82±4.33) groups (p=0.183). After the operation, the anxiety score of the music group (35.88±5.39) was found to be statistically significantly lower than the anxiety score of the control group (42.14±3.75) (p<0.001). Conclusion: This study supports the hypothesis that slow, rhythmic Sufi music during cesarean section can reduce patients’ anxiety. It is possible to distract the patient from negative thoughts and reduce stress. The results show that patients who listened to music during surgery had significantly lower anxiety levels than patients who did not listen to music.
Is There any Effect of lycopene’s preventing peritoneal adhesion formation in rats: A...
Ahmet Bilgi
Mustafa Cosan Terek

Ahmet Bilgi

and 6 more

April 05, 2021
Objective Purpose of the study; to demonstrate the effects of lycopene on the prevention of intraabdominal adhesions in rats with biochemical, histological and macroscopic parameters. Material methods Twenty eight rats were divided into four groups consisting of 7 rats each. Group 1 [only adhesion], Group 2 [adhesion+corn oil], Group 3 [adhesion+ 5 mg/kg lycopene], Group 4 [ adhesion+20 mg / kg lycopene]. Macroscopic adhesion score, histopathological examination, Vascular endothelial growth factor (VEGF) H-score, malondialdehyde, total anioxidant capacity and VEGF values were measured in the groups. Results There were significantly higher extend [P < 0.05], severity [P < 0.05], degree [P < 0.05] and total adhesion [P < 0.05] scores in the control group and corn-oil group than in the low lycopene group and high lycopene group. VEGF H-scores were significantly lower in lycopene-given groups, regardless of dose. When low lycopene group and high lycopene group were compared in terms of anti VEGF H-score, no significant difference was observed. Malondialdehyde levels were statistically significantly lower in the control group and high lycopene group [p<0.05]. Conclusion Biochemical parameters, histopathological examination, and adhesion scoring revealed that lycopene significantly reduced adhesion formation.
Resource availability is much more important than resource heterogeneity in determini...
Yuan LIU
Wenchao Qi

Yuan LIU

and 7 more

April 05, 2021
Resource availability and heterogeneity are recognized as two essential environmental aspects to determine species diversity and community abundance. However, how resource availability and heterogeneity determine species diversity and community abundance in highly heterogeneous and most fragile karst landscapes is largely unknown. We examined the effects of resource availability and heterogeneity on plant community composition and quantified their relative contribution by variation partitioning. Then, a structural equation model (SEM) was used to further disentangle the multiple direct and indirect effects of resource availability on plant community composition. Species diversity was significantly influenced by the resource availability in shrubland and woodland but not by the heterogeneity in woodland. Abundance was significantly affected by both resource availability and heterogeneity, whereas variation partitioning results showed that resource availability explained the majority of the variance in abundance, and the contribution of resource heterogeneity was marginal. These results indicated that resource availability plays a more important role in determining karst plant community composition than resource heterogeneity. Our SEMs further found that the multiple direct and indirect processes of resource availability in determining karst species diversity and abundance were different in different vegetation types. Resource availability and heterogeneity both played a certain role in determining karst plant community composition, while the importance of resource availability far exceeded resource heterogeneity. We propose that steering community restoration and reconstruction should be highly dependent on resource availability, and multiple direct and indirect pathways of resource availability for structuring karst plant communities need to be taken into account.
Factors influencing rehabilitation outcomes in prelingually deafened late implanted c...
Riyuan Liu
Qian WANG

Riyuan Liu

and 6 more

April 04, 2021
Objectives: Our study aimed to identify potential factors that influence rehabilitation outcomes in late-implanted adolescents and adults with prelingual deafness and attempted to develop a reliable nomogram. Design: This retrospective study included 120 subjects less than 30 years of age who had received cochlear implantation at a single medical center. The Categories of Auditory Performance (CAP) scale was used to evaluate the rehabilitation outcomes. A nomogram was constructed using the R and EmpowerStats software. Results: Univariate analysis indicated higher rates of auditory performance improvement in younger aged subjects. Residual hearing and regular and longer implant use were more common among subjects showing auditory performance improvement. Multivariate analysis identified residual hearing (Hazard Ratio, 6.11; 95% Confidence Interval, 1.83-20.41; P<0.01), age at implantation (Hazard Ratio, 0.31; 95% Confidence Interval, 0.14-0.83; P=0.02) and regular CI use (Hazard Ratio, 7.79; 95% Confidence Interval, 2.50-24.20; P<0.01) as independent predictors for auditory performance improvement. The nomogram’s predictive performance was satisfactory as verified by the calibration curve and Receiver operating characteristic (ROC) curve. Conclusions: We demonstrated that residual hearing, younger age, and regular CI use were associated with auditory performance improvement in this cochlear implant user population. Our nomogram model demonstrated satisfactory predictive performance for this population.
Existence and Uniqueness of Weak Solution for chemotaxis model coupled with heat equa...
Ali slimani
Amar Guesmia

Ali slimani

and 1 more

April 04, 2021
Keller-Segel chemotaxis model is described by a system of nonlinear PDE : a convection diffusion equation for the cell density coupled with a reaction-diffusion equation for chemoattractant concentration. In this work, we study the phenomenon of Keller Segel model coupled with a heat equation, because The heat has an effect the density of the cells as well as the signal of chemical concentration, since the heat is a factor affecting the spread and attraction of cells as well in relation to the signal of chemical concentration, The main objectives of this work is the study of the global existence and uniqueness and boundedness of the weak solution for the problem defined in (8) for this we use the technical of Galerkin method.
TRENDS OF COMMUNITY-BASED INTERVENTIONS ON SUSTAINABLE WATERSHED DEVELOPMENT IN THE E...
Meseret Addissie
Gashaw Molla

Meseret Addissie

and 1 more

April 04, 2021
Soil erosion is the driver of food insecurity and environmental degradation affecting the lives of smallholder farmers. To tackle soil and water degradation government-led large-scale soil and water management programs have been introduced at a watershed scale. The long-term viability of those practices in the Gumara watershed remains a major challenge. The objective of the study was to better understand the general approaches used to implement and design watershed management practices so that soil and nutrient transport to downstream water bodies could be managed. Sub watersheds from the large Gumara watershed were identified for detailed study based on erosion hotspots using the SWAT model. These sub-watersheds represent communities organized for conservation works in the absence of food assistance programs. The data were collected from four focus groups of fifty participants each, field observation, and desk-level meetings with experts. A structured questionnaire was used to get relevant information to the participating farmers. According to the findings, each of the selected watersheds used similar approaches to implement conservation activities. The community withdrew from conservation efforts, even on their farm fields, since the success rate was below the expectation. At this spot realizing the long-term benefits of watershed development activities stayed challenging. The smallholder farmer, on the other hand, clearly relies on rain-fed agriculture and hopes to see immediate results to feed his family. In conclusion, government-led development programs have not been evaluated, technically supported, lack trusted in the community and hence development efforts were put in jeopardy.
Plant communities and potential native phytoremediator species in petroleum hydrocarb...
Sarah Al_Ateeqi
Layla Al-Musawi

Sarah Al_Ateeqi

and 4 more

April 04, 2021
This paper reported the recovery of desert plant communities after twenty years of oil-derived hydrocarbon contamination in desert habitats of Kuwait, caused by the First Gulf War (1990 – 1991). The hypothesis that certain native desert plant species can tolerate weathered oil-polluted soils with oil breakdown products (i.e., polycyclic aromatic hydrocarbons ( PAHs)) and have the potential to function as bioindicators and phytoremediator species for oil-polluted soil was tested. A field survey of 200 quadrat sampling plots at seven hydrocarbon-contaminated and unpolluted desert areas in Kuwait was performed that recorded 42 plant species, with Haloxylon salicornicum, Cyperus conglomeratus and Rhanterium epapposum as the most dominant species. Analysis of plant tissues indicated plant uptake and accumulation of some PAHs. H. salicornicum was used as a representative species in a controlled field study that included growth of plants in hydrocarbon-polluted and unpolluted soils in two separate desert areas under similar growth conditions. Results showed a significant decrease in plant biomass in oil-contaminated soil compared to those from the uncontaminated site. However, the plants appeared green and healthy in both sites, and showed no overt stress. The results suggest that some desert plant communities exhibit signs of recovery after severe oil pollution, and that H. salicornicum may serve as a phytoremediator of oil-contaminated desert soils. Our results also demonstrated that some desert plant communities could be cultivated in oil fields to reduce hydrocarbon contamination and provide guide to other ecosystem services through improving soil quality and biodiversity.
Exploring Spatio-temporal change in global land cover using categorical intensity ana...
M Lamchin
Thomas  Bilintoh

M Lamchin

and 4 more

April 04, 2021
Global land degradation and urbanization are rapidly progressing during the 21st century. Herein, we assessed Spatio-temporal changes in global land cover using categorical intensity analyses from 1992 to 2018 to evaluate global land degradation and urbanization. Specifically, we evaluated the decrease, increase, and expansion processes and observed temporal differences. These evaluations were performed on a global scale across continents and climates at a category level for six-term intervals. Intensity analysis is a means of characterizing differences between sets at multiple time points using mathematics. In this study, inputs were gridded land cover from 1992, 1997, 2002, 2007, 2012, 2015, and 2018 and for six land categories: “Cropland,” “Forest,” “Shrubland,” “Built,” “Bare areas,” and “Other” The analysis of change for the 26 years shows that the cropland area increased globally by 786,656 km2 between 1992 and 2018. The areas occupied by forests continuously decreased by 936,960 km2, especially in South America which experienced the highest decline. Urban areas increased by 436,084 km2, with the highest increase observed in temperate regions. This paper concludes that for the last 26 years, land has been converted and degraded attributable to urbanization in temperate regions. Additionally, in South America and tropical regions, the expansion of cropland is the biggest contributor to the decline in “Forests” and “Shrubland”. The largest component of change was observed for the “Built” category. while, “Forest” and “Cropland” experienced significant losses and gains in the first, second, and third intervals.
Pediatric Pulmonology Year in Review 2020: Physiology
Angela Delecaris
Samantha Averill,

Angela Delecaris

and 4 more

April 04, 2021
Pulmonary physiology is a core element of pediatric pulmonology care and research. This article reviews some of the notable publications in physiology that were published in Pediatric Pulmonology in 2020.
Outcomes to measure the effects of pharmacological interventions for pain management...
Annie Tan
Alyce Wilson

Annie Tan

and 7 more

April 04, 2021
Background: Pharmacological pain management options can relieve women’s pain during labour and birth. Trials of these interventions have used a wide variety of outcomes, complicating meaningful comparisons of their effects. Consensus about key outcomes would facilitate the development of a core outcome set to assess the effectiveness of labour pain management. Objective: To identify all outcomes used in studies of pharmacological pain management interventions during labour and birth. Design: A review of systematic reviews and their included randomised controlled trials was undertaken. Search Strategy: Cochrane CENTRAL was searched to identify all Cochrane systematic reviews describing pharmacological pain management options for labour and birth. Search terms included “pain management”, “labour” and variants, with no limits on year of publication or language. Selection Criteria: Cochrane reviews and randomised controlled trials contained within these reviews were included, provided they compared a pharmacological intervention with other pain management options, placebo or no treatment. Data Collection and Analysis: All outcomes reported by reviews or trials were extracted and tabulated, with frequencies of individual outcomes reported. Main Results: Nine Cochrane reviews and 227 unique trials were included. In total, 148 unique outcomes were identified and categorised into maternal, fetal, neonatal, child, health service, provider’s perspective, or economic outcome domains. Conclusions: Outcomes of pharmacological pain management interventions during labour and birth vary widely between trials. The standardisation of trial outcomes would permit more meaningful comparison between studies. Funding: No external funding was provided. Keywords: Labour and birth; pain management; pharmacological interventions; systematic review
Does chronotherapy for essential hypertension matter by class? A systematic review an...
Hongyu Kuang
Yunlin Chen

Hongyu Kuang

and 1 more

April 04, 2021
Objectives The study was performed to evaluate the efficacy and safety of chronotherapy of hypertension with different medications monotherapy or a combination compared with traditional regimens Methods Three databases including PubMed, EMBASE and the Cochrane Library were searched, from the inception of each database to 10 April 2020. The Review Manager 5.4 was adopted for meta-analyses and subgroup analyses. The blood pressure delta (Δ) was used as mean of differences (MD) with 95% confidence intervals (CIs), and the estimated effect for events estimates the 95% CIs for frequency of events. The adults with essential hypertension were treated with chronotherapy and traditional regimens. Results Twenty-eight RCTs, recruiting 1865 patients in bedtime/evening dosing and 1867 in awakening/morning dosing, were enrolled in this quantitative review. Meta-analysis showed no significant differences for overall drug-related AEs (RR=0.81, P=0.17; I2=41%), but an obvious reduction of risk for overall withdrawals (RR=0.52, P=0.005; I2=0.0%) with bedtime dosing. No statistically significant differences were noted for clinic BP and diurnal BP, but 24-hour (48-hour) BP, nocturnal BP, morning BP, and non-dippers (%) showed obvious reductions, statistically. By class, there existed different efficacy between 2 administrations, with great decrease in nocturnal BP control and changes in circadian rhythm with RAAS blockers monotherapy, but an all-day control of BP for CCBs and diuretics. With regard to a combination, no significant differences in BP management were detected and the data about beta-receptor blockers were limited. Conclusions The safety and efficacy of chronotherapy in antihypertensive drugs might be based on the classes.
The radical and requisite openness of viable systems - implications for healthcare st...
Felice Borghmans

Felice Borghmans

April 04, 2021
This paper begs an ontological question about the nature of health and challenges some underpinning assumptions in western healthcare. In its analysis, the structure of health, in its various statuses, is framed as a complex adaptive system made up of dynamically interacting subsystems that include the physiological, psychological, spiritual, social, cultural, and more, realms. Furthermore, openness in complex systems such as health, is necessary for the exchange of energy, information, and resources. Yet, within healthcare much effort is invested in constraining systems’ behaviours, whether they be systems of knowledge, states of health, models of care, and more. This paper draws on the complexity sciences and Levinasian philosophy to explicate the essential role of system openness in individual and population health, and the viability of healthcare systems. It highlights holism to be ‘not whole-ism’, and system openness to be, not just a reality, but a critical feature of viability. Hence requisite openness is advocated as essential to efficacious and ethical healthcare practice and strategy, and vital for good quality health.
COMPARISON OF PATIENTS WITH ACUTE ISCHEMIC STROKE WITH AND WITHOUT COVID-19
Dilek YILMAZ OKUYAN
Meltem KARACAN GÖLEN

Dilek YILMAZ OKUYAN

and 1 more

April 04, 2021
Objectives: Information on the incidence of acute ischemic stroke (AIS), which is an important cause of morbidity and mortality, its association with COVID-19, and its course in infected patients in this pandemic period is limited. In this study, it was aimed to compare the demographic, clinical and stroke characteristics, and the laboratory, prognosis and mortality findings of patients with AIS with and without COVID-19. Methods: This study included 43 patients with a positive nasopharyngeal PCR test who were followed up for AIS, and 70 patients without COVID-19 who were followed up for AIS during the same period. Results: Poor prognosis and mortality were found to be significantly higher in the AIS group with COVID-19 compared with the non-COVID-19 AIS group. In the AIS group with COVID-19, a higher rate of intensive care unit (ICU) need (40% vs. 5%), higher intubation rate (35% vs. 3%) and longer hospital stay (12.9 ± 10.8 vs. 6.6 ± 4.0 days) were observed. In the laboratory examinations, C-reactive protein, ferritin, D-dimer, troponin, and lactate dehydrogenase levels were found to be significantly higher in patients with AIS who were positive for COVID-19. An increase in D-dimer, ferritin and thrombocytopenia were found to be associated with mortality in the COVID-19 positive AIS group. Conclusion: Patients with AIS and COVID-19 had a higher rate of ICU need, higher intubation rate, longer hospital stay, higher mortality, and poorer prognosis than those without COVID-19. High levels of ferritin, D-dimer and fibrin degradation products were associated with a poor prognosis. Keywords: COVID-19, stroke, prognosis, mortality
Comparison of the N-Terminal pro-Brain Natriuretic Peptide Levels, Neutrophil-to-Lymp...
Özgür Altınbaş
İbrahim Halil Ertaş

Özgür Altınbaş

and 6 more

April 04, 2021
Backround: The ongoing pandemic of Coronavirus Disease 2019 (COVID-19) infection has declared as a global emergency. Although the most people had mild illness due to the infection, some patients were seriously affected associated with complications especially including respiratory and cardiovascular systems. In despite of the respiratory system involvement is in the foreground, cardiovascular complications result in worse clinical outcomes. The purpose of this study is to compare the levels of the N-terminal pro-brain natriuretic peptide, neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratios -which are accepted as a marker of negative outcomes in cardiovascular diseases- of the patients with COVID-19 and healthy subjects and reveal the increased risk of cardiovascular disease in patients with COVID-19. Methods: This prospective study was designed in a single center and included 33 patients with COVID-19 (Group 1) and 33 healthy subjects consisted of health care professionals (Group 2). N-terminal pro-brain natriuretic peptide levels, neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratios were compared between the groups. Results: N-terminal pro-brain natriuretic peptide levels, neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were statistically significantly higher in the patients with COVID-19 (p<0,0001) and lymphocyte-to-monocyte ratio was statistically significantly lower in the same group (p<0,0001). Conclusion: Cardiovascular manifestations result in worse outcomes in patients with COVID-19 although the disease primarily affects the respiratory system. Early detection of this clinical situation and taking precautions have vital importance in the progress of the disease. NT-proBNP levels, neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratios are inexpensive, easy, fast and reproducible parameters that can be used in determination of probabl cardiovascular events that may develop during COVID-19 and enables early optimal treatment strategies for patients.
Correlation of Complete Blood Count Parameters and Ferritin Levels at the Time of Dia...
Rafiye Çiftçiler
Ali Erdinc Ciftciler

Rafiye Çiftçiler

and 2 more

April 04, 2021
Background and Aim:The novel coronavirus (SARS-CoV-2) that causes novel coronavirus pneumonia (COVID-19) is the third fatal coronavirus. The prognosis of disease varies depending on patient’s specialties. The aim of this study was to evaluate the correlation of CBC parameters and ferritin levels at the time of diagnosis with the prognosis of patients hospitalized due to COVID 19. Materials and Methods: In this retrospective study, 1320 patients hospitalized at the Aksaray University Training and Research Hospital between July 2020 and December 2020 were evaluated. Results: All of the patients were hospitalized because of symptoms associated with COVID 19. There were 688 males and 632 females with a median age of 70 (19-98) at the time of hospitalization with COVID 19 symptoms. The median follow-up time was 7 (range, 1-57) days in hospital for all patients. Median age was significantly higher in patients who do not respond to treatment and have mortality (p<0.001). Most of the patients with mortality were males (p=0.001). There was a statistically significant difference in the parameters other than monocyte and basophil among the hemogram parameters checked at the time of presentation. Neutrophil / lymphocyte ratio was significantly higher in patients with mortality (p<0.001). Conclusion: In conclusion, this study indicates that by using the most simple and routine hematological tests at the time of COVID-19 diagnosis, it may be possible to predict a patient’s prognosis. This will help patients receive early clinical care, reducing patient mortality and aiding in the control and prevention of the outbreak.
The effect of optical dilatation before retrograde intrarenal surgery on success and...
Eyup Burak  Sancak
Cem Basatac

Eyup Burak Sancak

and 6 more

April 04, 2021
Aims: The guidelines propose optical dilatation before retrograde intrarenal surgery (RIRS), but there are no evidence-based studies concerning the impact of optical dilatation with semirigid ureteroscopy (sURS) in the literature. The aim of this study was to evaluate the effect of optical dilatation through sURS prior to the procedure on the success and complications of RIRS. Methods: In a multicentre retrospective study, 422 patients were included in the study. The patients were divided into two groups according to whether sURS was to be performed. Patients’ demographics, stone parameters and operative outcomes were compared. Surgical success was defined as no or up to 3-mm residual stone fragments without the need for additional procedures. The independent predictors for surgical success were determined with a multivariable logistic regression model. Results: Of the 422 patients, 133 (31.5%) were in the sURS group and 289 (68.5%) were in the non-sURS group. Operation time in the sURS group was significantly long (p<0.0001). A ureteral access sheath (UAS) could not be placed in four (3.0%) patients in the sURS group, nor in 25 (8.7%) patients in the non-sURS group (p=0.03). Compared with the non-sURS group, the intraoperative complication rate was low in the sURS group (14 (4.8%) vs 1 (0.8%), p=0.04). The surgical success rate was higher in the sURS group (p=0.002). Nevertheless, sURS had no independent effect on surgical success. We have found two independent predictors for surgical success rate: stone number (p<0.0001, OR:2.28) and failed UAS placement (p=0.035, OR:3.49) Conclusion: Optical dilatation with sURS before RIRS increases surgical success by raising the rate of UAS placement and reducing the rate of intraoperative complications. We suggest that this method can be routinely applied in the group of patients who have not been passively dilated with a JJ stent
THE EFFICACY OF GREATER OCCIPITAL NERVE BLOCK IN PATIENTS WITH CHRONIC MIGRAINE
Meltem KARACAN GÖLEN
Dilek YILMAZ OKUYAN

Meltem KARACAN GÖLEN

and 1 more

April 04, 2021
Background and Purpose: In chronic migraines(CM), the rate of benefiting from medical treatment is relatively low, and it is known that patients use analgesics extensively. Greater occipital nerve (GON) block, have been started to be used in chronic migraine patients who were refractory to treatment. In this study, we aimed to evaluate the headache attack frequency, analgesic use, VAS (Visual Analog Scale) and MIDAS (Migraine Disability Assessment Scale) scores in the 3-month follow-up of patients we had performed a GON block in our clinic for chronic migraine refractory to medical treatment. Methods: A total of 120 CM patients were included in the study. The number of analgesics used, the number of days with pain, and the VAS and MIDAS scores were recorded before the GON block and at one and three months of treatment. Results: There was a statistically significant (p<0.001*) reduction in the number of days with pain, analgesic use, and the VAS and MIDAS scores in the first and third months compared to the pre-treatment baseline values in patients who had undergone a GON block. No significant differences between the first and third months. Conclusions: After the GON block, we noted a significant reduction of headaches and improved quality of life in patients who had been experiencing severe headaches despite medical treatment. The GON block has an exceptionally high benefit rate, might be considered as a treatment option before migraines gain chronicity, patients are not exposed to an excessive medical burden and increased treatment costs. Keywords: Headache; Chronic migraine; Greater occipital nerve block.
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