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Stem Cell-Based Disease Modeling and Cell Treatments.
Most adolescents will experience discomfort during menstruation. Due to normalization of dysmenorrhea, there is delay to diagnosis and treatment. Non-steroidal anti-inflammatories are a first line treatment. Adolescents can safely be offered menstrual suppression with combined hormonal contraception, and progestin-only options. When the above are ineffective, gonadotropin releasing hormone agonists with add back treatment can be considered. Transabdominal ultrasound is indicated when first line treatments do not improve symptoms. Endometriosis should be considered in adolescents who experience ongoing pain despite medical treatment. If laparoscopy is performed and endometriosis visualized, it should be treated with either excision or ablation. Women with endometriosis should be counselled on menstrual suppression until fertility is desired. Management of chronic pain requires the involvement of a multi-disciplinary team.This article reviews the current understanding and management of abnormal uterine bleeding (AUB) in adolescents. It is hoped that this review will provide readers with an approach to the evaluation and treatment of mild to severe uterine bleeding. AUB is a common problem which has significantly adverse effects on an affected adolescent’s quality of life. The most common underlying condition in AUB in adolescence is anovulation. During the evaluation, pregnancy, trauma and sexually transmitted diseases must be ruled out, regardless of history. It should be kept in mind that AUB during this period may be the first sign of underlying bleeding disorders. Although observation is sufficient in the mild form of AUB, at the other end of the spectrum life-threatening bleeding may necessitate the use of high doses of combined oral contraceptives, intravenous estrogen and/or interventional procedures.AIM We aimed to reveal the incidence and predictive role of insulin resistance and distorted oral glucose tolerance test in non-diabetic patients with Bell's Palsy (BP). MATERIALS AND METHODS Eighty-six patients with BP and 28 control subjects; all with normal blood glucose levels and no history of diabetes, were enrolled in the study. We investigated insulin resistance (IR) in all subjects, in terms of HOMA-IR greater than 2.7. Sixty-two of the patients also underwent an Oral Glucose Tolerance Test (OGTT). RESULTS The mean HOMA-IR value was significantly increased in patients, compared to the control group (3.2 vs 1.6; p less then 0.01). IR was detected more in BP patients than in controls (p less then 0.05). The patients with higher HOMA-IR values had more severe facial dysfunction at the initial presentation and complete recovery time took longer than the patients with normal HOMA-IR value (75 days vs 42 days; p less then 0.05). Following a 2h-OGTT, impaired glucose tolerance and newly diagnosed DM was found in 60% of the patients. Recovery time was significantly longer in prediabetics and newly diagnosed diabetic patients than in patients with normal glycemia (68 days, 52 days and 32 days, respectivel194-196y; p less then 0.01). CONCLUSION There is a strong linkage between HOMA-IR value and BP prognosis so HOMA-IR value may have a significant role of predicting BP prognosis at presentation.OBJECTIVE The aim of this study was to evaluate the clinical outcomes and identify the predictors of mortality in peritoneal dialysis patients. METHODS Medical records of all incident peritoneal dialysis (PD) patients followed up between January 2011 and May 2019 were reviewed retrospectively. All patients were followed up until death, renal transplantation, transfer to hemodialysis or the end of the study. RESULTS A total of 242 patients were included in the study. The incidence of peritonitis was 0.18 (range 0 - 14.9) episodes per patient year. Death occurred in 28% (n68) of cases. Age, diabetes mellitus, malignancy and refractory heart failure were independent risk factors for all-cause mortality according to multivariate analysis. The presence of comorbid disease and diabetes mellitus and patients aged > 65 years were associated with increased risk of mortality and decreased patient survival. Peritonitis history was associated with increased risk of mortality. Between peritonitis and peritonitis-free group, there was no significant difference in Kaplan-Meier curves in terms of patient survival Conclusion This is the first study to define 9-year mortality predictors in PD patients in our center. Although peritonitis is the most feared complication of PD, our study showed that peritonitis did not reduce patient survival.BACKGROUND/AIM This study aimed to investigate the correlation between the Glasgow-Blatchford score, shock index, and Forrest classification in patients with peptic ulcer bleeding. MATERIALS AND METHODS A total of 955 patients with peptic ulcer bleeding were assessed using the Glasgow-Blatchford score and shock index, as well as the Forrest classification based on gastroscopic results. The correlation between the Glasgow-Blatchford score and shock index was determined using scatter plot analysis, and the correlation between the Glasgow-Blatchford score or shock index and Forrest classification was determined using Spearman?s analysis. RESULTS Both the Glasgow-Blatchford score and shock index showed highest values in patients with Forrest class IIa. The Glasgow-Blatchford score was significantly higher than patients with Forrest class Ib/IIc/III (P less then 0.05), and the shock index was significantly higher than patients with Forrest class Ib/IIb/III (P less then 0.05). A positive correlation was observed between the Glasgow-Blatchford score and shock index, with r=0.427 (P less then 0.001). A negative correlation was observed between the Glasgow-Blatchford score and Forrest classification, with r=-0.111 (P less then 0.01), and between the shock index and Forrest classification, with r=-0.138 (P less then 0.01). CONCLUSIONS A moderate correlation was observed between the Glasgow-Blatchford score and shock index in patients with peptic ulcer bleeding, and the correlation between Forrest classification and Glasgow-Blatchford score or shock index was relatively low.BACKGROUND/AIM Gastrointestinal (GI) cancers are among the most common cancers in the world. Many risk factors may increase the chance of developing GI cancers. In recent years, a number of epidemiological studies have reported evidence of carcinogenic effects of opium in humans. This study aimed to investigate the relationship between opium use and GI cancer. MATERIALS AND METHODS This case-control study was performed on 95 patients with GI cancer and 190 healthy individuals (matched for age, sex, place of residence, and smoking) in Rafsanjan, Iran, in 2018. Diet information, as well as history of smoking, the use of hookah, opium, and its derivatives was collected using a checklist in interview sessions. Conditional logistic regression was performed to investigate the proposed relationship and to estimate odds ratios (OR). RESULTS After adjusting the confounding variables, the use of opium was significantly associated with an increased risk of GI cancer development (OR = 5.95, 95% CI 2.4-14.9). Also, a dose-response association was found between the cumulative use of opium and the risk of GI cancers. Consumption of fruit and vegetables reduced the risk of developing GI cancers in opium users (OR = 4.9 and 4.7, respectively). CONCLUSION Opium, in the form used among drug users in this area, can lead to an increased risk of GI cancers. Fruit and vegetables have a protective and modifying effect on the risk of GI cancer development caused by opium consumption.BACKGROUND/AIM To adapt the Sunnybrook Facial Grading System (SFGS) into Turkish and to perform the validation and reliability studies of the Turkish version. MATERIALS AND METHODS The original English version of the SFGS was translated to Turkish by performing linguistic validity study based on international standards. Six physicians were involved as the evaluators. Evaluations were performed independently twice using the video recordings of 65 facial palsy patients. Synchronously, House-Brackman Facial Grading System (HBFGS) was filled out to display concurrent validity. The intraclass correlation coefficient (ICC) and Cronbach?s alpha was used for the examination of the inter-rater and intra-rater reliability. As another indication of reliability, the generalizability was also examined. RESULTS ICC for the inter-rater reliability for resting symmetry, symmetry of voluntary movement, synkinesis and the composite score, which are four components of SFGS, were determined, respectively, as 0.822; 0.956; 0.606 and 0.957 for the first evaluation, 0.805; 0.965; 0.584 and 0.965 for the second evaluation. For the intra-rater reliability ICC were determined, as 0.842; 0.956; 0.794 and 0.937, Cronbach?s alpha coefficients were determined as 0.809; 0.956; 0,792 and 0.948, respectively. The generalizability coefficient was found as G=0.772. For the concurrent validity, a strong correlation was found between the SFGS and HBFGS scores. CONCLUSION The present study adapted the SFGS into Turkish, and demonstrated the adapted scale to be valid and reliable. The Turkish version can be used for evaluation of the facial palsies, the follow-up of treatment efficiency and standardization in reporting outcomes with the international literature.BACKGROUND/AIM To compare the clinical use, image quality and viewing angle of a commonly used contact wide angle viewing (WAV) system (Advanced Visual Instruments Panoramic Imaging Systems, NY, USA) with a commonly used non-contact WAV system (Leica RUV800, Leica Microsystems, Switzerland). MATERIALS AND METHODS Images of 42 consecutively operated eyes were obtained with both systems at the same surgical stages, and were compared for image quality using the Imatest Master 4.5.13 (Imatest LLC, Boulder, USA) software. The viewing angles of the images were calculated using the optic disc sizes measured from the OCT and infrared fundus images. The 68 degree AVI lens was compared with the 90-diopter (D) Leica RUV800 lens, while the 130 degree AVI lens was compared with the 132-D Leica RUV800 lens. The surgical assistants were asked to grade the difficulty of holding the lens in place from 1 to 10, 1 being easiest and 10 being the most difficult. RESULTS The contact system provided wider viewing angles with higher quality compared to the non-contact system both under fluid and air media. The difference was clinically significant in eyes with impaired corneal clarity, very high myopia, or small pupil. The difficulty of holding the lens in place ranged from 4 to 7, and decreased gradually with practice. CONCLUSIONS Both WAV systems provided high image quality and adequate viewing angles in most cases. However, the contact system appeared to be provide a superior image quality and/or a wider viewing angle in more challenging situations. The difficulty of holding the contact lens in place was found to be moderate.WUSCHEL-RELATED HOMEOBOX (WOX) transcription factors play critical roles in cell fate determination during plant development. As the founding member of the WOX family, WUSCHEL (WUS) is characterized for its role in maintaining stem cell in meristem. In this study, we investigated the function of Populus tomentosa WUSCHELa (PtoWUSa) in adventitious roots (ARs) in poplar. Expression profile analysis showed that PtoWUSa was not only expressed in shoot apical meristem and stem, but also expressed in ARs. Ectopic expression of PtoWUSa in Arabidopsis resulted in shortened primary root, as well as agravitropism and multiple branches. Overexpression of PtoWUSa in poplar increased the number of ARs but decreased their length. Moreover, the AR tip and lateral root tip became larger and swollen. In addition, the expression of auxin transporter genes PIN-FORMED were downregulated in ARs of transgenic plant. Taken together, these results suggest that PtoWUSa could be involved in AR development in poplar through regulating the polar auxin transport in ARs.
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