95, p less then 0.001).  https://www.selleckchem.com/products/trastuzumab-emtansine-t-dm1-.html  A positive, significant correlation was found in concurrent validity. According to the results of factor analysis, the scale had two-dimensional structure. CONCLUSION Turkish version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale is a valid and reliable instrument to assess perceived self-efficacy level of patient with chronic disease.BACKGROUND/AIM Adipokines play an important role in the regulation of metabolism. In critical illness, these alter serum levels and suspected to worsen clinical outcomes. But the effect of the route of nutrition on adipokines is not known. The purpose of this study was to evaluate the association between the route of nutrition and adipokine levels in critically ill patients. MATERIALS AND METHODS This prospective study was performed in an intensive care unit (ICU). Patients admitted to the ICU for least 72 h and receiving either enteral nutrition (EN) via tube feeding or parenteral nutrition (PN) were enrolled. Serum was obtained at baseline, 24 h, and 72 h for concentrations of leptin, adiponectin, resistin, glucagon-like peptide 1 (GLP-1), insulin-like growth factors-1 (IGF-1), and ghrelin. RESULTS A total of 26 patients were included in the study. Thirteen patients received EN and 13 patients received PN. In PN group, leptin level significantly increased (p=0.037), adiponectin and ghrelin significantly decreased during follow-up (p=0.037, p=0.008, respectively). There was no significant change between all adipokines in the EN group and resistin, IGF-1 and GLP-1in the PN group during follow-up. Resistin levels were markedly lower in the EN group at both 24 h (p=0.015) and 72 h (p=0.006) while GLP-1 levels were higher in the EN group at baseline, 24 h, and 72 h (p=0.018, p=0.005, and p=0.003, respectively). There were no differences in leptin, adiponectin, IGF-1, and ghrelin levels over time. CONCLUSION The delivery of EN in critical illness was associated with decreased resistin levels and increased GLP-1 levels. Thus, the route of nutrition may impact the clinical outcome in critical illness due to adipokines.BACKGROUND/AIM FloTrac/Vigileo is a non-calibrated arterial pressure waveform analysis for cardiac index (CI) monitoring. The aim of our study was to compare the CI measured by the 4th generation of FloTrac with PiCCO in septic shock patients. MATERIALS AND METHODS We simultaneously measured the CI using FloTrac (CIv) and compared it with the CI derived from transpulmonary thermodilution (CItd) as well as the pulse contour-derived CI using PiCCO (CIp). RESULTS Thirty-one septic shock patients were included. The CIv correlated with CItd (r = 0.62, p less then 0.0001). The Bland-Altman analysis showed a bias of 0.14, and the limits of agreement were -1.62 to 1.91 L/min/m2, with a percentage error of 47.4%. However, the concordance rate between CIv and CItd was 93.6%. The comparison of CIv with CIp (n=352 paired measurements), revealed a bias of -0.16, and the limits of agreement were -1.45 to 1.79 L/min/m2, with a percentage error of 44.8%. The overall correlation coefficient between CIv and CIp was 0.63 (p less then 0.0001), and the concordance rate was 85.4%. CONCLUSION The 4th generation of FloTrac has not acceptable agreement to assess CI; however it has the ability to tracked changes of CI, when compared with the transpulmonary thermodilution method by PiCCO.BACKGROUND/AIM Synthetic cannabinoids (SC) are full agonists of both cannabinoid receptors. Conventional magnetic resonance imaging (MRI) findings of SC users are mainly defined as diffusion restriction and T2/FLAIR hyperintensity. Diffusion tensor imaging (DTI) studies examining SC users have shown contradictory results. The aim of this study was to define white matter changes of SC users using DTI. MATERIALS AND METHODS The study included 22 patients with a history of using SC for 5-37 months, and 22 healthy, age and gender-matched control subjects. A total of 41 diffusion gradient directions were used in the acquisition of diffusion imaging data. FA and Apparent Diffusion Coefficients (ADC) values were obtained. ROIs were placed on white matter areas of normal appearance. RESULTS In the SC users, significantly lower FA values were determined in the left temporal lobe (216.2±58.9 vs. 263±27.4; p=0.002) and right hippocampus (224.5±61.5 vs. 255±24.3; p=0.040). The ADC values of the hippocampus and temporal lobe were significantly higher than those of the control group on both the left and right sides. CONCLUSION SC use causes white matter micro-structural changes especially in the hippocampus, and temporal lobes. DTI is a useful tool to reveal white matter changes in SC addicts, earlier than conventional MRI.A fracture that does not unite in nine months is defined as non-union. Non-union is common in fragmented fractures and large bone defects where vascularization is impaired. The distal third of the tibia, the scaphoid bone or the talus fractures are furthermore prone to non-union. Open fractures and spinal fusion cases also need special monitoring for healing. Bone tissue regeneration can be attained by autografts, allografts, xenografts and synthetic materials, however their limited availability and the increased surgical time as well as the donor site morbidity of autograft use, and lower probability of success, increased costs and disease transmission and immunological reaction probability of allografts oblige us to find better solutions and new grafts to overcome the cons. A proper biomaterial for regeneration should be osteoinductive, osteoconductive, biocompatible and mechanically suitable. Cytokine therapy, where growth factors are introduced either exogenously or triggered endogenously, is one of the commonly used method in bone tissue engineering. Transforming growth factor ß (TGFß) superfamily, which can be divided structurally into two groups as bone morphogenetic proteins (BMPs), growth differentiation factors (GDFs) and TGFß, Activin, Nodal branch, Mullerian hormone, are known to be produced by osteoblasts and other bone cells and present already in bone matrix abundantly, to take roles in bone homeostasis. BMP family as the biggest subfamily of TGFß superfamily is also reported to be the most effective growth factors in bone and development, which makes them one of the most popular cytokines used in bone regeneration. Complications depending on the excess use of growth factors, and pleiotropic functions of BMPs are however the main reasons of why they should be approached with care. In this review, the Smad dependent signaling pathways of TGFß and BMP families and their relations and the applications in pre-clinical and clinical studies will be briefly summarized.