bluuebunny/crossref_metadata_2025 huggingface dataset:
Fen Bilimleri Öğretmenlerinin Mühendislik ve Tasarım Becerileri Alanında Karşılaştığı Sorunlar ve Çözüm Önerileri
Authors: BAKIRCI Hasan , KAPLAN Yusuf
Published: August 2021

Araştırmada Fen Bilimleri öğretmenlerinin 2018 Fen Bilimleri Dersi Öğretim Programı’nda yer alan Mühendislik ve Tasarım Becerileri alanı kapsamında görüşlerinin alınması, deneyimleri sırasında karşılaştıkları sorunların belirlenmesi ve bu sorunlara dair çözüm önerilerinin sunulması amaçlanmıştır. Araştırmada, nitel araştırma yöntemlerinden durum çalışması deseni kullanılmıştır. Araştırma, Fen Bilimleri dersini aktif olarak okutan 10 katılımcı ile yapılmıştır. Katılımcı seçiminde amaçsal örnekleme yöntemi kullanılmıştır. Araştırmada veri toplama aracı olarak yarı yapılandırılmış mülakat formu kullanılmış, veriler Covid-19 pandemisi önlemleri ışığında katılımcılarla uzaktan görüşme yapılarak toplanmıştır. Araştırmada veriler içerik analizi ve betimsel analize tabi tutularak sunulmuştur. Fen Bilimleri öğretmenlerinin 2018 yılından beri uygulamakta oldukları Mühendislik ve Tasarım Becerileri alanı hakkındaki görüşlerinin geçen zaman zarfında değiştiği görülmüştür.
Acute transverse myelitis after inactivated COVID-19 vaccine
Authors: Erdem Nazan Şimşek , Demirci Seden , Özel Tuğba , Mamadova Khalida , Karaali Kamil , Çelik Havva Tuğba , Uslu Ferda Ilgen , Özkaynak Sehür Sibel
Published: August 2021

Vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been rapidly developed to prevent coronavirus disease 2019 (COVID-19) pandemic. There is increasing safety concerns regarding COVID-19 vaccines. We report a 78-year old woman who was presented with tetraparesis, paresthesias of bilateral upper extremities, and urinary retention of one-day duration. Three weeks before these symptoms, she was vaccinated with CoronaVAC vaccine (Sinovac Life Sciences, China). Spine magnetic resonance imaging showed longitudinally extensive transverse myelitis (TM) from the C1 to the T3 spinal cord segment. An extensive diagnostic workup was performed to exclude other possible causes of TM. We suggest that longitudinally extensive TM may be associated with COVID-19 vaccination in this case. To the best of our knowledge, this is the first report of longitudinally extensive TM developing after CoronaVac vaccination. Clinicians should be aware of neurological symptoms after vaccination of COVID-19.
Covid-19 betegséget követő encephalitis
Authors: Varannai Lajos , Magyar Zsuzsa , Baranyai Beatrix , Ajzner Éva , Czurkó Marina
Published: August 2021

A Covid-19 betegség megjelenését követően rövid idő után világossá vált, hogy noha az elsősorban légúti tünetekkel jár, ezek mellett nagyon sok esetben egyéb szervek, szervrendszerek, így az idegrendszer károsodására utaló tünetek is megjelennek. Az első észlelés és közlés óta megjelent és naponta megjelenő nagy mennyiségű, a betegséggel, annak szövődményeivel foglalkozó közlemény között számos neurológiai komplikációkkal foglalkozó is megtalálható. Az adatok alapján viszonylag gyakori ideggyógyászati szövődménynek tartható az encephalitis kialakulása. Tünetei az esetek többségében a még zajló légúti kórfolyamattal egyidejűleg vagy a kialakult kritikus állapot során észlelhetők; többféle megjelenési formáját is közölték. Az általunk ismertetett esetben a központi idegrendszer érintettségét jelző tünetek több héttel a lezajlott Covid-19-pneumonia után, a beteg ebből a szempontból már gyógyult állapotában jelentek meg. A klinikum, a képalkotó, EEG- és liquorvizsgálatok eredményei alapján a tünetek hátterében encephalitis igazolódott. Az alkalmazott terápia mellett a klinikai szempontból rohamosan javuló folyamat hátterében az elvégzett vizsgálatok egyértelmű kórokot nem igazoltak. A korábban zajlott SARS-CoV-2-vírusinfekciót is figyelembe véve Covid-19 betegséget követő posztinfekciós központi idegrendszeri kórfolyamatot véleményeztünk, melyre vonatkozóan jelenleg csak elvétve található irodalmi adat.
Convective heat and mass transfer of chemically reacting fluids with activation energy with radiation and heat generation
Authors: YESODHA Poosappan , BHUVANESWARI Bhuvaneswari , SIVASANKARAN S. , SARAVANAN K.
Published: August 2021

TThis study is to investigate the effect of the chemical process by activation energy on heat transference and mass transference of a fluid by heat generation parameter (Hg) and radiation parameter (Rd). Attention has been given to the changes caused on the temperature by the flow in rotating frame by the heat generation parameter, Biot number, and radiation param-eter. The variation of velocity and concentration of fluid, which is chemically reacting, by the influence of the rotational parameter (β) has been incorporated. A numerical solution of the system through resulting equations has been undertaken. Effects of different flow parameters are presented by graphs and tables. Results show that activation energy increases when there is an increase in the concentration of the chemical species and that velocity decrease by the increase in porosity. With the rise of Prandtl number the temperature of the chemical sys-tem decreases. A numerical discussion on skin friction coefficients, Sherwood and Nusselt numbers has been done.
AFYONKARAHİSAR BÖLGESİNDE AİLESEL AKDENİZ ATEŞLİ ÇOCUKLARIN DEMOGRAFİK, KLİNİK, LABORATUVAR VE GENETİK ÖZELLİKLERİNİN DEĞERLENDİRİLMESİ
Authors: Elmas Ebru , Bükülmez Ayşegül , Elmas Muhsin , Demircin Gülay
Published: August 2021

AMAÇ: Ailesel Akdeniz Ateşi (AAA), tekrarlayan, çoğu kez ateş yüksekliğinin eşlik ettiği periton, sinovya, plevra ve nadiren de perikardın tutulduğu ve kendi kendine iyileşen akut inflamasyon atakları ile ortaya çıkan otozomal resesif geçişli bir hastalıktır. Bu çalışmada Afyonkarahisar Sağlık Bilimleri Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları polikliniğinde izlenen AAA’li çocukların demografik, klinik ve laboratuvar bulgularını değerlendirmek, genotip dağılımlarını ve genotip-fenotip ilişkilerini incelemek, bölgesel farklılık olup olmadığına bakmak, bu konuda bölgedeki hekimleri bilgilendirerek AAA’li hastaların daha kolay ve geç kalmadan tanımlanmasını sağlamak ve bölgede AAA’ne bağlı morbidite ve mortaliteyi azaltmak amaçlanmıştır.GEREÇ VE YÖNTEM: Bu çalışmaya kliniğimize başvuran, Ailesel Akdeniz Ateşi tanısı alan 100 hasta alındı. Hastaların retrospektif olarak demografik, klinik, laboratuvar ve genetik bulguları incelendi ve genotip-fenotip ilişkisi araştırıldı.BULGULAR: Hastaların kız/erkek oranı 1.5/1 olarak bulundu. Hastaların çalışmaya alındıkları sıradaki yaş ortalaması 10.74±4.06 yıl idi. Hastaların %33’ünde anne-babaları arasında akrabalık vardı. En sık görülen klinik bulgular ateş (%88), karın ağrısı (%84), eklem ağrısı (%77), myalji (%45), baş ağrısı (%42), artrit (%36), göğüs ağrısı (%33) olarak saptandı. En sık saptanan mutasyon homozigot M694V mutasyonu olup bunu sırasıyla heterozigot M694V, birleşik heterozigot M694V/M680I, birleşik heterozigot M694V/M694I, birleşik heterozigot M694V/V726A, homozigot V726A, homozigot M680I, heterozigot E148Q, birleşik heterozigot M694V/E148Q mutasyonları izledi. SONUÇ: AAA heterojen bir hastalık grubu olup, hastalığın şiddeti ve seyri değişkenlik gösterebilmektedir. Sonuçlarımız genel olarak ülkemizde ve yurt dışında yapılan çalışmalarla benzerlik göstermektedir. Tanısı ön planda klinik olarak konulan ancak şüpheli durumlarda genetik olarak desteklenmesi gereken bu hastalık konusunda hekimlerin geliştirilmiş eğitim programları ile bilinçlendirilmesi gerekmektedir.
PAROKSİSMAL ATRİAL FİBRİLASYONU OLAN HASTALARDA PULMONER VEN İZOLASYONUNUN YAŞAM KALİTESİNE ETKİSİ
Authors: Yontar Gözde , Yontar Osman Can
Published: August 2021

AMAÇ: Kardiyak aritmilerde depresif duygudurum gibi ruhsal semptomlar sık görülür. Hastalarda aniden başlayan çarpıntı atakları, anksiyete bozukluğuna neden olabilir veya temelde var olan anksiyete bozukluğunu tetikleyebilir. Paroksismal atrial fibrilasyonun (PAF) küratif tedavisi henüz kateter ablasyonu ya da tek başına medikal tedavi ile sağlanamasa da, bu tedavilerin hastaların yaşam kalitesine olumlu katkıları çalışmalara konu edilmiştir. Çalışmamızda radyofrekans ablasyon yönteminin hastaların yaşam kalitesine etkisini ve bu etkinin sosyodemografik özellikler ilişkisini araştırdık.GEREÇ VE YÖNTEM: Samsun Eğitim ve Araştırma Hastanesinde PAF tanısıyla takip edilen ve ablasyon planlanan 50 hasta çalışmaya dahil edildi. Kontrol grubu olarak da medikal tedaviyle takibe karar verilen 50 hasta alındı. Tüm hastalara işlemden önce ve ablasyon yapılanlara 1 ay sonrasında Dünya Sağlık Örgütü yaşam kalitesi ölçeğinin 26 maddelik kısa formu ile değerlendirme yapılarak yaşam kalitesi araştırıldı.BULGULAR: Gruplar demografik ve medikal olarak birbirinden farksızdı. Çalışma grubu ile kontrol grubu arasında fiziksel sağlık alanında, psikolojik sağlık alanında, çevre ve sosyal ilişkiler alanlarında alınan puanlar arasında fark gözlenmezken, ablasyon sonrasında gruplar arasında aynı parametrelerde farklılık anlamlı olarak belirlendi. İstatistiksel analiz ablasyon sonrasında psikometrik bulgularda anlamlı bir derece iyileşme olduğunu gösterdi. Yaşam kalitesindeki değişimin, kişinin eğitim durumundan, medeni hâlinden ve cinsiyetinden bağımsız olduğu da gösterilmiştir.SONUÇ: Çalışmamızda pulmoner ven antral izolasyon yöntemi ile tedavi uygulanmasının hastanın yaşam kalitesini önemli düzeyde iyileştirdiğini ve bu iyileşmenin hastanın eğitim düzeyi, cinsiyet ve medeni durum gibi özellikler ile ilişkili olmadığını gösterdik. Elde ettiğimiz bulgular, paroksismal atrial fibrilasyon hastalarında şu an öncelikli tedavi olarak önerilen radyofrekans ablasyonun tam kür sağlanmasa da atakları azaltarak ya da atak süresini kısaltması nedeniyle hastanın günlük hayatına olan psikolojik ve fiziksel etkileri de azalttığını göstermektedir.
AFLATOKSİNLERİN ANNE VE ÇOCUK SAĞLIĞINA ETKİLERİ
Authors: Demirer Büşra , Özdemir Mehmet
Published: August 2021

Aflatoksinler Aspergillus türevleri tarafından üretilen sekonder metabolitlerdir. İnsanların aflatoksin maruziyeti genel olarak aflatoksin ile kontamine olmuş besinlerin tüketiminden kaynaklanmaktadır. Aflatoksinlerin; belirlenmiş miktarların üzerinde alınmasının insan sağlığı üzerine olumsuz etkilerinin olduğu birçok çalışma ile gösterilmiştir. Bu olumsuz etkiler vücutta birçok farklı patolojik durumun gelişiminde etkili olabilmektedir ancak etki mekanizmaları bireyin metabolik durumuna, alınan türe ve doza bağlı olarak değişmektedir. Yetişkin bireylerde aflatoksin maruziyetinin etkilerine yönelik yapılmış birçok çalışma bulunurken maternal aflatoksin maruziyetinin anne ve çocuk üzerindeki etkilerine yönelik yapılmış çalışmalar oldukça sınırlıdır. Yapılan insan ve hayvan çalışmaları sonucu genel olarak maternal aflatoksin maruziyetinin; gebelikte maternal anemi, mikro besin ögesi eksiklikleri, proinflamatuar sitokinlerin artması ve oksidatif stresin artması gibi maternal komplikasyonlarının bulunduğu bildirilmektedir. Maternal artmış proinflamatuar durumun ise ileride birçok kronik hastalığın oluşması ile ilişkili olduğu bildirilmektedir. Gebelik dönemindeki maternal aflatoksin maruziyetinin aynı zamanda fetüs ve yenidoğan üzerinde de olumsuz etkileri bulunmaktadır. Vücutta güvenilir seviyelerin üzerindeki aflatoksin maruziyetinin, plasental yetmezliğe sebep olduğu, fetal büyüme ve gelişmeyi olumsuz etkilediği, yenidoğan sarılığına sebep olabileceği bildirilmektedir. Aflatoksinin intrauterin büyüme ve gelişmeyi olumsuz etkileme mekanizmalarının arasında; enteropatiye sebep olması, immün sistemi baskılaması ve insülin benzeri büyüme faktörü salınımını azaltması gösterilmekle birlikte ayrıca annenin aflatoksin maruziyetinin erken çocukluk dönemi bodurluğu ile ilişkili olabileceği bildirilmektedir. Ancak yapılmış çalışmaların büyük kısmının hayvan çalışmaları ve in vitro çalışma olması, ileriye dönük epidemiyolojik insan çalışmaların sınırlı olması sebebi ile maternal aflatoksin maruziyetinin anne ve çocuk sağlığına etkileri henüz tam olarak bilinememektedir. Özellikle gelişmekte olan ülkelerdeki yaygın maruziyet göz önüne alındığında, olumsuz gebelik sonuçlarında aflatoksinin rolü için daha güçlü kanıtlar sağlamak oldukça önemlidir. Bu derleme yazının amacı maternal aflatoksin maruziyetinin anne ve çocuk sağlığına etkilerinin güncel bilgiler eşliğinde tartışılmasıdır.
DAHİLİ VE CERRAHİ KLİNİKLERDE YATAN HASTALARIN YAKINLARININ BAKIM YÜKLERİ İLE YAŞAM KALİTELERİ ARASINDAKİ İLİŞKİ
Authors: Akbulut Kıymet , Çevik Kıvan
Published: August 2021

AMAÇ: Araştırma, dahiliye ve cerrahi kliniklerinde yatarak tedavi gören hastaların yakınlarının bakım yükleri ile yaşam kaliteleri arasındaki ilişkiyi incelemek amacıyla planlandı.GEREÇ VE YÖNTEM: Bu araştırma Manisa ilindeki bir devlet hastanesinin dahili ve cerrahi kliniklerinde 14 Ocak - 6 Nisan 2019 tarihleri arasında yatan 300 hastanın yakını ile yapılan tanımlayıcı ilişki arayıcı tipte bir araştırmadır. Veriler, Refakatçi Tanıtım Formu, Hasta Tanıtım Formu, Cheltenham’ın Hasta Sınıflama Ölçeği, SF-36 Yaşam Kalitesi Ölçeği ve Bakım Verme Yükü Ölçeği kullanılarak elde edildi. Araştırmadan elde edilen veriler SPSS (Statistical Package For Social Science) 15.0 programında sayı, yüzde, aritmetik ortalama, standart sapma gibi tanımlayıcı istatistik yöntemleri ve Kruskal Wallis testi, Spearman Korelasyon Analizi kullanılarak değerlendirildi.BULGULAR: Bakım verenlerin yaş ortalamasının 46,87±15,22 yıl, %74,7’sinin kadın ve %78,7’sinin evli olduğu belirlendi. Bakım verenlerin bakım verme yükü ölçeği toplam puan ortalaması 15,82±12,86’dır. SF-36 yaşam kalitesi ölçekleri puan ortalamaları dağılımı incelendiğinde; fiziksel sağlık durumu alt boyutu için 62,44±24,89, mental sağlık durumu alt boyutu için 56,95±22,42, genel yaşam kalitesi alt boyutu için 59,69±22,62 puan olduğu saptandı. Bakım verme yükü ile fiziksel sağlık durumu, mental sağlık durumu ve genel yaşam kalitesi arasında negatif ve zayıf ilişki bulundu (sırasıyla, rs: -0,327; rs: -0,264; rs: -0,315).SONUÇ: Bakım verenlerin bakım verme yükü ile genel yaşam kalitesi, fiziksel ve mental sağlık durumu arasında negatif yönde, zayıf ilişki olduğu; bakım verme yükünün artması durumunda, genel yaşam kalitesi ve alt boyutlarında azalma olduğu saptandı.
BÖBREK NAKLİ VERİCİLERİNDE RENAL BİLGİSAYARLI TOMOGRAFİ ANJİYOGRAFİ TEKNİĞİ VE RADYASYON DOZU
Authors: Atlı Eray , Kılınçer Abidin , Uyanık Sadık , Öğüşlü Umut , Çevik Halime
Published: August 2021

AMAÇ: Bu çalışmada amaç, böbrek nakli vericilerinin renal bilgisayarlı tomografi anjiyografi (RBTA) tetkiklerinin radyasyon dozunu saptamaktadır.GEREÇ VE YÖNTEM: Etik kurul onayı retrospektif olarak alınan bu çalışmaya 3. basamak hastanede Temmuz 2017 ve Aralık 2019 tarihleri arasında çekilen RBTA tetkikleri dahil edildi. Görüntü arşivleme iletişim sisteminden, BT tetkiklerinin hacimsel BT doz indeksi (Volume CT dose index, CTDIvol) ve tarama alanı boyunca alınan doz (dose length product, DLP) değerleri hasta doz raporlarından kaydedildi. Etkin doz (ED) ve tarama uzunluğu (TU) hesaplandı.BULGULAR: RBTA çekilmiş 142 hastanın % 54 (n=76)'ü erkek, % 46 (n=66)'sı kadındı. RBTA'sı elde edilen hastaların ortalama yaşı 43,8±12,5'dir. RBTA tetkiklerinin ikinci çeyrek (ortanca) toplam tarama alanı boyunca alınan doz (DLP) ve ED değerleri sırasıyla 835 mGy.cm ve 12,5 mSv'dir. Kontrastsız, arteryel, venöz ve geç faz çekimlerin ortalama TU değerleri sırasıyla 31,4±3, 21,9±3, 32,1±4,5 ve 22,7±4,7 cm'dir.SONUÇ: Çalışmamızda RBTA tetkiklerinin radyasyon dozu parametreleri literatüre göre daha düşüktür.
COMPARISON OF THE TREATMENT COSTS BETWEEN OPEN SURGERY AND ULTRASONOGRAPHY - GUIDED HYDROSTATIC REDUCTION OF INTUSSUSCEPTION IN PEDIATRIC CASES
Authors: Özkaraca Boyacı Evrim , Tuncer Ahmet Ali , Baskın Embleton Didem , Bayraktaroğlu Altınay , Özer Gökaslan Çiğdem , Çetinkurşun Salih
Published: August 2021

OBJECTIVE: In the treatment of childhood intussusception, in addition to the commonly adopted open surgery, different treatment methods are used in selected cases. One of these treatment is ultrasonography (USG)-guided hydrostatic reduction with normal saline. In this study, the treatment cost of open surgery and USG-guided hydrostatic reduction was compared.MATERIAL AND METHODS: The medical records of 48 cases treated in our clinic after the diagnosis of intussusception between January 2011 and June 2017 were reviewed retrospectively. The age, gender, length of hospital stay, treatment modality, and the cost of the treatment of the cases were evaluated.RESULTS: Of the 48 cases, 31 were male and 17 were female, with a mean age of 48 months. Open surgery was performed in 30 cases, and USG-guided hydrostatic reduction with normal saline was performed in 18 cases. The mean length of hospital stay and the cost of treatment were 5.13 days and 1,094.60 TL, respectively for the open surgery cases, and 2.6 days and 841.30 TL for those that underwent USG-guided hydrostatic reduction. When the two treatment methods were compared, a statistically significant difference was found in terms of the cost of treatment (p < 0.05) and the duration of hospitalization (p < 0.01).CONCLUSIONS: USG-guided hydrostatic reduction with normal saline is known as a simple, effective, and reliable method with a low complication rate. In this study, it was determined that the cost of treatment was low; thus, it is also an economical treatment option. Therefore, it should be considered as the first treatment modality in all cases of childhood intussusception presenting without bad general condition or signs of peritonitis
John Zizioulas’ concept of the person: a critical appraisal
Authors: Prasolov Valeriy I. , Grigoriev Sergey M. , Martynenko Elena V. , Shindryaeva Natalya N. , Skutelnik Oleg A.
Published: August 2021

Much of John Zizioulas’ treatment of the human being as a person revolves around four crucial concepts: being, otherness, ontology, and freedom. Our critical appraisal of Zizioulas’ concept of human personhood emphasizes the importance of creative tension between (ontological) freedom and contingency as understood within the frame of reference of the human being’s intrinsic contingency as a finite, created being. According to this concept, the other (another distinct embodied personhood) is neither an object nor competition but rather a gift for one’s self who reminds me of one’s limitedness, dependence, and deep relatedness. Thus, the other helps the human self realize his/her potential in a mutual sharing of love. We examine Zizioulas’ critical stance to the modern notion that ‘otherness is necessary for freedom to exist’ against the background of his treatment of ‘otherness’ and ‘nature,’ as well as ‘otherness’ and ‘new being,’ ‘Logos,’ and ‘new nature.’ Finally, we lay out Zizioulas’ mature ontology of human personhood as a profound albeit mystical account of what it means to be human in our fragmented age.
CAN THE PEDAGOGICAL PRACTICE OF THE PRE-SERVICE TEACHERS REMOVE THE SOCIAL PREJUDICE TOWARDS THE PUPILS WITH SPECIAL NEEDS? A COMPARATIVE ANALYSIS ON THE ATTITUDE TOWARDS BEHAVIORAL MANAGEMENT IN PRIMARY SCHOOL
Authors: Bochiș Laura , Florescu Maria Cristina , Indrieș Mihaela
Published: August 2021

The aim of the study is to highlight the attitude of the students (N=72) from Pedagogy of Primary and Preschool Education Program (pre-service teacher), from first and third years of study, related to how they want, as future teachers, to develop pupils’ learning skills in the inclusive classroom by adopting certain behavioral management of pupils with special needs. The working tool used is the Behavior and Instructional Management Scale, developed by Martin and Sass (2010). The comparative analysis of the results obtained according to the year of study captures the existence of statistically significant differences in the aspect of the management of the behavior in the classroom, both in traditional and inclusive classes, during the lessons, with higher averages for the pre-service teachers of 3rd year. Also, pre-service teachers from the 3rd year of study have a higher level of expectations for implementing the rules in school activities with pupils with special needs, compared to the pre-service teachers of the 1st year, which draws attention to the importance of pedagogical practical stage in primary school.
EXPERIENCES AND SUPPORT NEEDS OF CHILDREN WITH BROTHER OR SISTER WITH DISABILITY
Authors: Tammemäe Tiiu , Lilleoja Lii , Valma Mari-Liis
Published: August 2021

There are many children with special needs whose siblings play an important role in their lives for a longer time than other family members. Longer life expectancy and the deepening of disabilities bring along a higher need of being taken care of. When the parents grow older it is often the siblings who become the caretakers. Meyer & Vadasy (2007) found that if siblings of children with SEN get proper support and information while growing up, the well-being of siblings with special needs also increases. Relationship with a sibling with special needs influences development of adaptability and self-esteem, this influence can be positive or negative (Burke, 2008). The parents of the children with SEN have many ways to receive information or help from the family – doctors, therapists, consultants, teachers, books, etc. The siblings in their turn usually get their information from the parents. (Conway & Meyer, 2008) Family members of different ages need different information. Therefore, there should be research on what kind of experiences do the siblings of the disabled child need, how their needs and well-being are guaranteed, and what kind of support they need. The aim of this study is to describe the experiences of brothers and sisters with siblings with special needs, try to understand their need for support, and find out the need for support groups and camps.
KÜLÖNLEGES BÁNÁSMÓD, 2021. 7. (2.)
Authors: Különleges Bánásmód
Published: August 2021

Különleges Bánásmód, 2021. 7. (2.) - teljes szám
Role of sperm apoptosis and oxidative stress in male infertility: A narrative review
Authors: Asadi Asadollah , Ghahremani Rozita , Abdolmaleki Arash , Rajaei Farzad
Published: August 2021

Activation of caspase, externalization of phosphatidyl serine, change in the mitochondrial membrane potential, and DNA fragmentation are apoptosis markers found in human ejaculated spermatozoa. Also, reactive oxygen species (ROS) play a vital role in the different types of male infertility. In this review, data sources including Google Scholar, Scopus, PubMed, and Science Direct were searched for publications with no particular time restriction to get a holistic and comprehensive view of the research. Apoptosis regulates the male germ cells, correct function and development from the early embryonic stages of gonadal differentiation to fertilization. In addition to maintaining a reasonable ratio between the Sertoli and germ cells, apoptosis is one of the well-known quality control mechanisms in the testis. Also, high ROS levels cause a heightened and dysregulated apoptotic response. Apoptosis is one of the well-known mechanisms of quality control in the testis. Nevertheless, increased apoptosis may have adverse effects on sperm production. Recent studies have shown that ROS and the consequent oxidative stress play a crucial role in apoptosis. This review aims to assimilate and summarize recent findings on the apoptosis in male reproduction and fertility. Also, this review discusses the update on the role of ROS in normal sperm function to guide future research in this area.
Key words: Fertility, Spermatogonia, Apoptosis, Reproduction, DNA fragmentation, DNA integrity, ROS.
Assessment of apoptosis and appearance of hepatocyte growth factor in placenta at different gestational ages: A cross-sectional study
Authors: Kreicberga Ilze , Junga Anna , Pilmane Māra
Published: August 2021

Background: Fetal growth is determined by the interaction between mother and fetus using the placental interface throughout the pregnancy.
Objective: To research apoptosis and appearance of hepatocyte growth factor (HGF) in placentas of different gestational ages and to describe the anthropometrical and clinical indices of mothers and newborns.
Materials and Methods: The study material was obtained from 53 human immunodeficiency virus negative pregnant women of legal age without systemic diseases. The staining of placental apoptotic cells was processed by a standard in situ cell death detection kit. The detection of HGF was provided by the ImmunoCruz goat ABC Staining System protocol sc-2023. Relative distribution of positive structures was evaluated using the semiquantitative counting method.
Results: The mean rank value of the amount of HGF-containing cells (cytotrophoblasts, syncytiotrophoblasts, extravillous trophoblasts, Höfbauer cells, and cells of extraembryonic mesoderm) was 1.61 ± 0.94. Apoptotic cells (cytotrophoblasts, syncytiotrophoblasts, extravillous trophoblasts, and cells of extraembryonic mesoderm) were found in all placental samples of various gestational ages (term 13.00 ± 13.05 and preterm 27.00 ± 18.25); in general, their amount decreased with advancing gestational age of the placenta (p < 0.01).
Conclusion: Weight of a placenta directly depends on the gestational age and correlates with the main fetal anthropometrical parameters (weight, length, and head and chest circumferences). The decrease in HGF-containing and apoptotic cells with advancing gestation depends on the adaptation potential of the placenta, proving the other ways of cellular disposition.
Key words: Pregnancy, Placenta, Gestational age, Apoptosis, Immunohistochemistry.
Improved hormonal and oxidative changes by Royal Jelly in the rat model of PCOS: An experimental study
Authors: Khazaei Fatemeh , Ghanbari Elham , Khazaei Mozafar
Published: August 2021

Background: Polycystic ovarian syndrome (PCOS) is an endocrine and complex metabolic disorder, associated with anovulation, changes in sex hormone, biochemical factors, and ovarian tissue. Royal Jelly (RJ) has antioxidant and anti-inflammatory properties.
Objective: To examine the therapeutic effect of RJ on PCOS-related hormonal and biochemical changes in a rat model of PCOS.
Materials and Methods: In this experimental study, 42 female Wistar rats (weighing 180–200 gr, aged 10–12 wk) were divided into six groups (n = 7/each): control; PCOS; RJ 100 mg/kg; RJ 200 mg/kg; PCOS + RJ 100 mg/kg; and PCOS + RJ 200 mg/kg. After 21 days, the animals were weighed and dissected. The serums were used for nitric oxide (NO) and ferric-reducing antioxidant power (FRAP) assay and estradiol and progesterone measurements. The ovaries were assessed for histological changes.
Results: PCOS increased estradiol and NO levels, and decreased progesterone and FRAP levels. In PCOS + RJ groups, the progesterone (p = 0.01) and FRAP levels (p ≤ 0.001) increased and the estradiol and NO (p ≤ 0.001) levels decreased significantly. Moreover, the number of mature follicles (p = 0.01) and corpus luteum increased (p ≤ 0.001), and ovarian and uterus weight deceased significantly (p ≤ 0.001).
Conclusion: RJ improved estradiol, progesterone, FRAP, and NO levels, and ovarian structure in the rat model of PCOS.
Key words: Royal Jelly, Polycystic ovary syndrome, Ovary, Sex hormone.
Endometrial and follicular development following stair-step and traditional protocols in women with polycystic ovary syndrome: An RCT
Authors: Shahgheibi Sholeh , Seyedoshohadaei Fariba , Khezri Danial , Ghasemi Solmaz
Published: August 2021

Background: Various strategies have been proposed for polycystic ovary syndrome (PCOS) treatment.
Objective: To investigate and compare the number and size of ovarian follicles, endometrial thickness, and ovulation rate by traditional protocol (TP) and stair-step protocol (SSP).
Materials and Methods: Sixty infertile PCOS women were allocated into two groups (SSP = 30 and control TP = 30) between May and October 2019 in the Besat Hospital, Sanandaj, Iran. In the SSP group, the infertile women were treated with 50 mg/daily clomiphene citrate (CC) for five days, while the nonresponsive women were prescribed 100 mg daily CC for five days in the same cycle. The maximum dose (150 mg) was administered until ovulation occurred. In the control group, in non-ovulatory cases, the dose was increased in the next cycle. Ultrasound was used to detect ovulation.
Results: Endometrial thickness changes with various doses of CC were significantly different in the TP. The comparison of both protocols showed a significant difference in endometrial thickness only at 50 mg CC. The number of follicles in the left ovary was significantly different in both protocols at 150-mg CC. The size of ovarian follicles in the left ovary was significantly different between the two protocols at 100-mg CC. The ovulation rate was significantly different in the SSP at 100- and 150-mg doses of CC. Moreover, 86% of ovulation occurred at 100-mg CC in the SSP, while this rate was 73% in the TP.
Conclusion: The most appropriate dose for ovulation in patients with PCOS is 100 mg CC.
Key words: Polycystic ovary syndrome, Clomiphene, Infertility, Ovulation induction.
The effect of Phoenix dactylifera pollen on the expression of NRF2, SOD2, CAT, and GPX4 genes, and sperm parameters of fertile and infertile men: A controlled clinical trial
Authors: Fallahi Soghra , Rajaei Minoo , Javad Hesam Mohammad , Koolivand Mohsen , Malekzadeh Kianoosh
Published: August 2021

Background: Oxidative stress is caused by the imbalance occurring between the creation and clearance of the reactive oxygen species (ROS), which is responsible for 30–40% of male infertility. The positive impact of phoenix dactylifera pollen (Date palm pollen, DPP) on the improvement of sperm parameters has been well documented in animal models.
Objective: For evaluating the effect(s) of DPP on sperm parameters, ROS levels, expression of antioxidant genes, and activity of antioxidant enzymes of infertile men.
Materials and Methods: In this controlled clinical trial, a total of 60 male case with infertility and 20 normospermic fertile men were recruited. Before and after the treatment with DPP, the case were administered 400 mg/kg of gelatinous capsules daily for 30 consecutive days and semen samples were taken. Quantitative real-time polymerase chain reaction was applied for the evaluation of the mRNA expression levels of Nuclear factor erythroid 2-related factor 2(NRF2), superoxide dismutase (SOD2), glutathione peroxidase 4(GPX4), and catalase (CAT) genes.
Results: The mRNA expression levels of NRF2, SOD2, GPX4, and CAT (p < 0.05 for all) and significantly increased after treatment with DPP. The increased expressions of all antioxidant genes and enzymes significantly correlated with improvement in semen parameters including count (p = 0.01), motility (p = 0.05), and morphology (p = 0.01) of sperm. A significant correlation between the alteration of SOD2 gene expression and SOD activity, GPX4 and GPX, and CAT were also observed (p = 0.05).
Conclusion: DPP can increase the expressions of NRF2, GPX4, SOD2, and CAT genes and also improve the semen quality in infertile men.
Key words: DPP, Male infertility, SOD2, NRF2, GPX4, CAT, ROS, Spermatozoa.
Early oocyte triggering followed by in vitro maturation is a good approach in women with resistance ovary syndrome: A case-series
Authors: Eftekhar Maryam , Mohammadi Banafsheh , Tabibnejad Nasim , Hossein Razi Mohammad
Published: August 2021

Background: Some women represent the inability to respond to endogenous and exogenous gonadotropins during in vitro fertilization/intracytoplasmic sperm injection cycles leading to the follicular developmental arrest. The women with resistant ovaries could benefit from in vitro maturation.
Case: This case-series presents pregnancies resulting from initially scheduled conventional in vitro fertilization which led to arrested cycles because of resistant ovary syndrome. The protocol was changed to early oocyte triggering for 15 women due to the small follicles ≤ 12 mm in diameter on day 15 after stimulation with high doses of exogenous gonadotrophins instead of cycle cancellation. Germinal vesicle and metaphase I oocytes that were retrieved from follicles were matured in vitro and inseminated by intracytoplasmic sperm injection. Twenty formed embryos were transferred on day 3 after oocyte retrieval. This resulted in a 30.76% chemical pregnancy out of which no abortion occurred. Therefore, we reported a 30.76% singleton ongoing pregnancy.
Conclusion: It seems that early oocyte triggering followed by in vitro maturation may be considered as a good modality in women experiencing follicular resistance to gonadotropins. These cycles can be rescued from cancellation with satisfactory clinical outcomes.
Key words: Arrested stimulation cycle, Early oocyte triggering, In vitro maturation, Clinical outcome.
Low-dose bitter leaf improves sperm quality disrupted in immunosuppressed Wistar rats: An experimental study
Authors: Akbaribazm Mohsen , Khazaei Mozafar
Published: August 2021

This is a Letter to the Editor. Please download the PDF or view the article HTML.
Erratum to “Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: An RCT” [Int J Reprod BioMed 2019; 17: 671-676]
Authors: Eftekhar Maryam , Hoseini Masrooreh , Saeed Lida
Published: August 2021

This article is an Erratum to “Progesterone-primed ovarian stimulation in polycystic ovarian syndrome: An RCT” [Int J Reprod BioMed 2019; 17: 671–676]. Please download the PDF or view the article HTML.
Accelerated versus Standard Corneal Cross-linking for Progressive Keratoconus in Syria
Authors: M Salman Abdelrahman , R Darwish Taym , H Haddad Yusra , H Shabaan Rafea , Z Askar Mohammad
Published: August 2021

Purpose: To compare the outcomes of accelerated versus standard corneal cross-linking for the treatment of progressive keratoconus.
Methods: In this retrospective comparative study, 63 eyes of 40 patients with progressive keratoconus were divided into two groups; 27 eyes in group one were treated with an accelerated protocol (10 mW/cm2, 9 min) and 36 eyes in group two were treated with the standard method (3 mW/cm2, 30 min). Visual acuity, refraction, corneal topography, corneal tomography, and anterior and posterior corneal higher-order aberrations (HOAs) were assessed preoperatively and 18–30 months postoperatively.
Results: The LogMAR uncorrected and corrected distance visual acuity values were improved in both groups postoperatively. However, the improvement was significantly higher in group one (P < 0.05, all). The flattening in the anterior keratometry readings, flat K, steep K, and average K were significantly higher in group two (P < 0.001, all). The maximum anterior keratometry (AKf) values significantly decreased in both groups, whereas the maximum posterior keratometry (AKb) values increased. The reduction in the minimum corneal thickness (ThKmin) was significantly greater (36.49um) in group two, compared to 10.85um in group one. There was a significant increase in the posterior average keratometry, and a significant decrease in the posterior astigmatism, along 3 mm meridian in S-CXL (P = 0.03, P = 0.008, respectively), while the corresponding values showed no statistical significance in group one (P > 0.05). The anterior corneal trefoil was significantly reduced in group one (P = 0.002), whereas anterior total HOAs and coma were significantly improved in group two (P < 0.0014, all). The posterior corneal spherical aberration decreased significantly in group one (P = 0.02), while group two revealed significant reduction in the posterior trefoil values (P = 0.011). The change in the anterior maximum keratometry was significantly and positively correlated to the preoperative maximum keratometry in group two (P = 0.53, P = 0.003).
Conclusion: An accelerated cross-linking protocol using 10 mW/cm2 for 9 min showed more visual improvement and less pachymetric reduction when compared to the standard protocol, however, anterior corneal flattening, posterior corneal steepening, and the change in the posterior astigmatism were significantly higher in the standard protocol; while corneal HOAs were improved in both protocols.
Potential Effect of Human Platelet Lysate on in vitro Expansion of Human Corneal Endothelial Cells Compared with Y-27632 ROCK Inhibitor
Authors: Amir Mishan Mohammad , Balagholi Sahar , Chamani Tahereh , Feizi Sepehr , Soheili Zahra-Soheila , Rezaei Kanavi Mozhgan
Published: August 2021

Purpose: Corneal endothelial cell (CEC) therapy can be used as a promising therapeutic option for patients with various corneal endothelial dysfunctions. In this study, we compared the proliferative effect of human platelet lysate (HPL), as a xeno-free medium supplement, with Y-27632 Rho/rho-associated protein kinase (ROCK) inhibitor, as a wellknown proliferative and adhesive agent for CECs, and fetal bovine serum (FBS) as the control, in the culture medium of human corneal endothelial cells (HCECs).
Methods: We isolated HCECs from human donors and treated the cells as three different treatment groups including 20% HPL only, 10 μM Y-27632 ROCK inhibitor, combination of 20% HPL and 10 μM Y-27632 ROCK inhibitor, and 20% FBS as the control group. ELISA cell proliferation assay and cell counting was performed on the treated cells. Finally, HCECs were characterized by morphology and immunocytochemistry (ICC).
Results: There was no significant proliferative effect of HPL on cell proliferation compared with the cells treated with Y-27632 ROCK inhibitor or the combination of HPL and Y-27632 ROCK inhibitor, but all the respected treatments had significant inducible effect on cell proliferation as compared with FBS-treated cells. The cells grown in all three treatment groups exhibited CEC morphology. Also, there was a higher expression of Na+/K+-ATPase and ZO-1, as CEC characteristic markers, in the culture of HCECs treated with HPL as compared with FBS.
Conclusion: HPL offers a xeno−free and affordable medium supplement for CEC expansion that can be used in clinical applications.
Scleral Buckling for Primary Retinal Detachment: Outcomes of Scleral Tunnels versus Scleral Sutures
Authors: R. Starr Matthew , H. Ryan Edwin , Obeid Anthony , Ryan Claire , Gao Xinxiao , L. Madhava Malika , M. Maloney Sean , Z. Adika Adam , V. Peddada Krishi , Sioufi Kareem , G. Patel Luv , J. Ammar Michael , J. Forbes Nora , Capone Jr. Antonio , G. Emerson Geoffrey , P. Joseph Daniel , Eliott Dean , D. Regillo Carl , Hsu Jason , P. Gupta Omesh , Yonekawa Yoshihiro
Published: August 2021

Purpose: There are primarily two techniques for affixing the scleral buckle (SB) to the sclera in the repair of rhegmatogenous retinal detachment (RRD): scleral tunnels or scleral sutures.
Methods: This retrospective study examined all patients with primary RRD who were treated with primary SB or SB combined with vitrectomy from January 1, 2015 through December 31, 2015 across six sites. Two cohorts were examined: SB affixed using scleral sutures versus scleral tunnels. Pre- and postoperative variables were evaluated including visual acuity, anatomic success, and postoperative strabismus.
Results: The mean preoperative logMAR VA for the belt loop cohort was 1.05 ± 1.06 (Snellen 20/224) and for the scleral suture cohort was 1.03 ± 1.04 (Snellen 20/214, p = 0.846). The respective mean postoperative logMAR VAs were 0.45 ± 0.55 (Snellen 20/56) and 0.46 ± 0.59 (Snellen 20/58, p = 0.574). The single surgery success rate for the tunnel cohort was 87.3% versus 88.6% for the suture cohort (p = 0.601). Three patients (1.0%) in the scleral tunnel cohort developed postoperative strabismus, but only one patient (0.1%) in the suture cohort (p = 0.04, multivariate p = 0.76). All cases of strabismus occurred in eyes that underwent SB combined with PPV (p = 0.02). There were no differences in vision, anatomic success, or strabismus between scleral tunnels versus scleral sutures in eyes that underwent primary SB.
Conclusion: Scleral tunnels and scleral sutures had similar postoperative outcomes. Combined PPV/SB in eyes with scleral tunnels might be a risk for strabismus post retinal detachment surgery.
Manual Segmentation of 12 Layers of the Retina and Choroid through SD-OCT in Intermediate AMD: Repeatability and Reproducibility
Authors: Camacho Pedro , Dutra-Medeiros Marco , Salgueiro Luís , Sadio Sílvia , C. Rosa Paulo
Published: August 2021

Purpose: To evaluate the repeatability and reproducibility of the segmentation of 12 layers of the retina and the choroid, performed manually by SD-OCT, along the horizontal meridian at three different temporal moments, and to evaluate its concordance with the same measurements performed by two other operators in intermediate AMD.
Methods: A cross-sectional study of 40 eyes from 40 subjects with intermediate AMD was conducted. The segmentation was performed manually, using SD-OCT. The 169 measurements per eye were repeated at three time points to study the intra-operator variability. The same process was repeated a single time by two different trained operators for the inter-operator variability.
Results: Forty participants (28 women and 12 men) were enrolled in this study, with an average age of 76.4 ± 8.2 (range, 55–92 years). Overall, the maximum values of the various structures were found in the 3 mm of the macula. Intra-operator variability: the highest ICC values turned out to be discovered in thicker locations. Inter-operator variability: except correlation values of 0.826 (0.727; 0.898) obtained in the OPL (T2.5) and 0.634 (0.469; 0.771) obtained in the IPL (N2), all other correlation values were >0.92, in most cases approaching higher values like 0.98.
Conclusion: The measurements of several layers of the retina and the choroid achieved at 13 locations presented a good repeatability and reproducibility. Manual quantification is still an alternative for the weaknesses of automatic segmentation. Locations of greatest concordance should be those used for the clinical control and monitoring.
Ocular Manifestations of the Sturge–Weber Syndrome
Authors: Hassanpour Kiana , Nourinia Ramin , Gerami Ebrahim , Mahmoudi Ghavam , Esfandiari Hamed
Published: August 2021

Sturge–Weber syndrome (SWS) or encephalotrigeminal angiomatosis is a non-inherited congenital disorder characterized by neurologic, skin, and ocular abnormalities. A somatic activating mutation (R183Q) in the GNAQ gene during early embryogenesis has been recently recognized as the etiology of vascular abnormalities in SWS. Approximately, half of the patients with SWS manifest ocular involvement including glaucoma as the most common ocular abnormality followed by choroidal hemangioma (CH). The underlying pathophysiology of glaucoma in SWS has not been completely understood yet. Early onset glaucoma comprising 60% of SWS glaucoma have lower success rates after medical and surgical treatments compared with primary congenital glaucoma. Primary angle surgery is associated with modest success in the early onset SWS glaucoma while the success rate significantly decreases in late onset glaucoma. Filtration surgery is associated with a higher risk of intraoperative and postoperative choroidal effusion and suprachoroidal hemorrhage. CH is reported in 40–50% of SWS patients. The goal of treatment in patients with CH is to induce involution of the hemangioma, with reduction of subretinal and intraretinal fluid and minimal damage to the neurosensory retina. The decision for treating diffuse CHs highly depends on the patient’s visual acuity, the need for glaucoma surgery, the presence of subretinal fluid (SRF), its chronicity, and the potential for visual recovery.
Fundus Autofluorescence and Clinical Applications
Authors: Pole Cameron , Ameri Hossein
Published: August 2021

Fundus autofluorescence (FAF) has allowed in vivo mapping of retinal metabolic derangements and structural changes not possible with conventional color imaging. Incident light is absorbed by molecules in the fundus, which are excited and in turn emit photons of specific wavelengths that are captured and processed by a sensor to create a metabolic map of the fundus. Studies on the growing number of FAF platforms has shown each may be suited to certain clinical scenarios. Scanning laser ophthalmoscopes, fundus cameras, and modifications of these each have benefits and drawbacks that must be considered before and after imaging to properly interpret the images. Emerging clinical evidence has demonstrated the usefulness of FAF in diagnosis and management of an increasing number of chorioretinal conditions, such as agerelated macular degeneration, central serous chorioretinopathy, retinal drug toxicities, and inherited retinal degenerations such as retinitis pigmentosa and Stargardt disease. This article reviews commercial imaging platforms, imaging techniques, and clinical applications of FAF.
Ankylosing Spondylitis
Authors: Ebrahimiadib Nazanin , Berijani Sahar , Ghahari Mohammadreza , Golsoorat Pahlaviani Fatemeh
Published: August 2021

The seronegative spondyloarthropathies are a group of autoimmune inflammatory diseases lacking rheumatoid factor or antinuclear antibody in their serum. They include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis, spondylitis associated with Crohn’s disease and ulcerative colitis, and undifferentiated spondyloarthropathies. Inflammation mostly affects the axial joints, entheses, and extra-articular structures such as uveal tract, gastrointestinal tract, mucocutaneous tissue, and heart. Uveitis is the most common extra-articular manifestation. Spondyloarthropathies, especially AS, have a strong association with the presence of Human Leukocyte Antigen (HLA)-B27 gene. AS happens earlier in HLA-B27 patients and men are more prone to the disease. Uveitis, typically unilateral nongranulomatous acute anterior uveitis, occurs in up to 50% of the patients with AS. HLA-B27 positivity correlates with more frequent flare-ups. Conjunctivitis and scleritis are rare ocular manifestations of AS. To establish the diagnosis of AS, at least one clinical and one radiologic parameter are required for definitive diagnosis. Magnetic resonance imaging (MRI) or bone scan can help early detection of the axial skeleton inflammation. The course of eye and joint involvement are not correlated. Short-term treatment with topical corticosteroids and cycloplegic agents control the uveitis attack. In resistant cases, local or systemic therapy with corticosteroids are recommended. NSAIDs, disease-modifying anti-rheumatic drugs (DMARDs), methotrexate, azathioprine, anti-IL-17A monoclonal antibodies, and TNF- α antagonists are effective treatments for ocular and systemic manifestations of AS. If not treated adequately, uveitis may become recalcitrant and extend posteriorly. Functional impairment due to joint destruction can also occur as a result of undertreatment.
Macular Optical Coherence Tomography Imaging in Glaucoma
Authors: Kamalipour Alireza , Moghimi Sasan
Published: August 2021

The advent of spectral-domain optical coherence tomography has played a transformative role in posterior segment imaging of the eye. Traditionally, images of the optic nerve head and the peripapillary area have been used to evaluate the structural changes associated with glaucoma. Recently, there is growing evidence in the literature supporting the use of macular spectral-domain optical coherence tomography as a complementary tool for clinical evaluation and research purposes in glaucoma.
Crystals on the Iris: Russell Bodies in Fuchs Uveitis
Authors: Interlandi Emanuela , Pellegrini Francesco , Mandarà Erika , Pavesio Carlos
Published: August 2021

This is a Photo Essay and does not have an abstract. Please download the PDF or view the article HTML.
The Use of Tutoplast as an Adjunct in Scleral Buckle Procedure in Patients with Extremely Thin Sclera
Authors: R. Starr Matthew , J. Bakri Sophie
Published: August 2021

Extremely thin sclera often necessitates abortion of scleral buckle procedures. In patients in whom a scleral buckle is desired, previous techniques have included the use of cyanoacrylate glue and continuing with surgery or placing donor tissue over the areas of thin sclera, but this can delay surgery. This was a retrospective review of three patients with thin sclera encountered during scleral buckling procedures. All patients had Tutoplast Pericardial Graft placed over the areas of thin sclera which allowed the scleral buckle to be sutured onto the Tutoplast rather than the thin sclera. Tutoplast Pericardial Graft is a useful adjunct in scleral buckle procedures with extremely thin sclera, and a scleral buckle can be safely placed over it and lead to successful retinal reattachment.