Istanbul University

About: Istanbul University is a(n) education organization based out in Istanbul, Turkey. It is known for research contribution in the topic(s): Population & Cancer. The organization has 19050 authors who have published 38464 publication(s) receiving 727640 citation(s). The organization is also known as: İstanbul Üniversitesi & University of Istanbul.

Diagnosis and management of dementia with Lewy bodies: Third report of the DLB Consortium

Abstract: The dementia with Lewy bodies (DLB) Consortium has revised criteria for the clinical and pathologic diagnosis of DLB incorporating new information about the core clinical features and suggesting improved methods to assess them. REM sleep behavior disorder, severe neuroleptic sensitivity, and reduced striatal dopamine transporter activity on functional neuroimaging are given greater diagnostic weighting as features suggestive of a DLB diagnosis. The 1-year rule distinguishing between DLB and Parkinson disease with dementia may be difficult to apply in clinical settings and in such cases the term most appropriate to each individual patient should be used. Generic terms such as Lewy body (LB) disease are often helpful. The authors propose a new scheme for the pathologic assessment of LBs and Lewy neurites (LN) using alpha-synuclein immunohistochemistry and semiquantitative grading of lesion density, with the pattern of regional involvement being more important than total LB count. The new criteria take into account both Lewy-related and Alzheimer disease (AD)-type pathology to allocate a probability that these are associated with the clinical DLB syndrome. Finally, the authors suggest patient management guidelines including the need for accurate diagnosis, a target symptom approach, and use of appropriate outcome measures. There is limited evidence about specific interventions but available data suggest only a partial response of motor symptoms to levodopa: severe sensitivity to typical and atypical antipsychotics in ∼50%, and improvements in attention, visual hallucinations, and sleep disorders with cholinesterase inhibitors.

Sarcopenia: Revised European consensus on definition and diagnosis

Abstract: Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.

Minimal information for studies of extracellular vesicles 2018 (MISEV2018) : a position statement of the International Society for Extracellular Vesicles and update of the MISEV2014 guidelines

Abstract: The last decade has seen a sharp increase in the number of scientific publications describing physiological and pathological functions of extracellular vesicles (EVs), a collective term covering various subtypes of cell-released, membranous structures, called exosomes, microvesicles, microparticles, ectosomes, oncosomes, apoptotic bodies, and many other names. However, specific issues arise when working with these entities, whose size and amount often make them difficult to obtain as relatively pure preparations, and to characterize properly. The International Society for Extracellular Vesicles (ISEV) proposed Minimal Information for Studies of Extracellular Vesicles (“MISEV”) guidelines for the field in 2014. We now update these “MISEV2014” guidelines based on evolution of the collective knowledge in the last four years. An important point to consider is that ascribing a specific function to EVs in general, or to subtypes of EVs, requires reporting of specific information beyond mere description of function in a crude, potentially contaminated, and heterogeneous preparation. For example, claims that exosomes are endowed with exquisite and specific activities remain difficult to support experimentally, given our still limited knowledge of their specific molecular machineries of biogenesis and release, as compared with other biophysically similar EVs. The MISEV2018 guidelines include tables and outlines of suggested protocols and steps to follow to document specific EV-associated functional activities. Finally, a checklist is provided with summaries of key points.

Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.

Abstract: Objective The Systemic Lupus International Collaborating Clinics (SLICC) group revised and validated the American College of Rheumatology (ACR) systemic lupus erythematosus (SLE) classification criteria in order to improve clinical relevance, meet stringent methodology requirements, and incorporate new knowledge regarding the immunology of SLE. Methods The classification criteria were derived from a set of 702 expert-rated patient scenarios. Recursive partitioning was used to derive an initial rule that was simplified and refined based on SLICC physician consensus. The SLICC group validated the classification criteria in a new validation sample of 690 new expert-rated patient scenarios. Results Seventeen criteria were identified. In the derivation set, the SLICC classification criteria resulted in fewer misclassifications compared with the current ACR classification criteria (49 versus 70; P = 0.0082) and had greater sensitivity (94% versus 86%; P < 0.0001) and equal specificity (92% versus 93%; P = 0.39). In the validation set, the SLICC classification criteria resulted in fewer misclassifications compared with the current ACR classification criteria (62 versus 74; P = 0.24) and had greater sensitivity (97% versus 83%; P < 0.0001) but lower specificity (84% versus 96%; P < 0.0001). Conclusion The new SLICC classification criteria performed well in a large set of patient scenarios rated by experts. According to the SLICC rule for the classification of SLE, the patient must satisfy at least 4 criteria, including at least one clinical criterion and one immunologic criterion OR the patient must have biopsy-proven lupus nephritis in the presence of antinuclear antibodies or antidouble-stranded DNA antibodies. (Less)

Tethyan evolution of Turkey: A plate tectonic approach

Abstract: The Tethyan evolution of Turkey may be divided into two main phases, namely a Palaeo-Tethyan and a Neo-Tethyan, although they partly overlap in time. The Palaeo-Tethyan evolution was governed by the main south-dipping (present geographic orientation) subduction zone of Palaeo-Tethys beneath northern Turkey during the Permo-Liassic interval. During the Permian the entire present area of Turkey constituted a part of the northern margin of Gondwana-Land. A marginal basin opened above the subduction zone and disrupted this margin during the early Triassic. In this paper it is called the Karakaya marginal sea, which was already closed by earliest Jurassic times because early Jurassic sediments unconformably overlie its deformed lithologies. The present eastern Mediterranean and its easterly continuation into the Bitlis and Zagros oceans began opening mainly during the Carnian—Norian interval. This opening marked the birth of Neo-Tethys behind the Cimmerian continent which, at that time, started to separate from northern Gondwana-Land. During the early Jurassic the Cimmerian continent internally disintegrated behind the Palaeo-Tethyan arc constituting its northern margin and gave birth to the northern branch of Neo-Tethys. The northern branch of Neo-Tethys included the Intra-Pontide, Izmir—Ankara, and the Inner Tauride oceans. With the closure of Palaeo-Tethys during the medial Jurassic only two oceanic areas were left in Turkey: the multi-armed northern and the relatively simpler southern branches of Neo-Tethys. The northern branch separated the Anatolide—Tauride platform with its long appendage, the Bitlis—Poturge fragment from Eurasia, whereas the southern one separated them from the main body of Gondwana-Land. The Intra-Pontide and the Izmir—Ankara oceans isolated a small Sakarya continent within the northern branch, which may represent an easterly continuation of the Paikon Ridge of the Vardar Zone in Macedonia. The Anatolide-Tauride platform itself constituted the easterly continuation of the Apulian platform that had remained attached to Africa through Sicily. The Neo-Tethyan oceans reached their maximum size during the early Cretaceous in Turkey and their contraction began during the early late Cretaceous. Both oceans were eliminated mainly by north-dipping subduction, beneath the Eurasian, Sakaryan, and the Anatolide- Tauride margins. Subduction beneath the Eurasian margin formed a marginal basin, the present Black Sea and its westerly prolongation into the Srednogorie province of the Balkanides, during the medial to late Cretaceous. This resulted in the isolation of a Rhodope—Pontide fragment (essentially an island arc) south of the southern margin of Eurasia. Late Cretaceous is also a time of widespread ophiolite obduction in Turkey, when the Bozkir ophiolite nappe was obducted onto the northern margin of the Anatolide—Tauride platform. Two other ophiolite nappes were emplaced onto the Bitlis—Poturge fragment and onto the northern margin of the Arabian platform respectively. This last event occurred as a result of the collision of the Bitlis—Poturge fragment with Arabia. Shortly after this collision during the Campanian—Maastrichtian, a subduction zone began consuming the floor of the Inner Tauride ocean just to the north of the Bitlis—Poturge fragment producing the arc lithologies of the Yuksekova complex. During the Maastrichtian—Middle Eocene interval a marginal basin complex, the Maden and the Cungus basins began opening above this subduction zone, disrupting the ophiolite-laden Bitlis—Poturge fragment. The Anatolide-Tauride platform collided with the Pontide arc system (Rhodope—Pontide fragment plus the Sakarya continent that collided with the former during the latest Cretaceous along the Intra Pontide suture) during the early to late Eocene interval. This collision resulted in the large-scale south-vergent internal imbrication of the platform that produced the far travelled nappe systems of the Taurides, and buried beneath these, the metamorphic axis of Anatolia, the Anatolides. The Maden basin closed during the early late Eocene by north-dipping subduction, synthetic to the Inner-Tauride subduction zone that had switched from south-dipping subduction beneath the Bitlis—Poturge fragment to north dipping subduction beneath the Anatolide—Tauride platform during the later Palaeocene. Finally, the terminal collision of Arabia with Eurasia in eastern Turkey eliminated the Cungus basin as well and created the present tectonic regime of Turkey by pushing a considerable piece of it eastwards along the two newly-generated transform faults, namely those of North and East Anatolia. Much of the present eastern Anatolia is underlain by an extensive melange prism that accumulated during the late Cretaceous—late Eocene interval north and east of the Bitlis—Poturge fragment.