Effect of Physical Performance Levels of Elderly Living in Urban and Rural Areas on Social Participation, Social Functioning, and Quality of Life: A Cross-sectional Study from the Mediterranean Region of Turkey.

BACKGROUND: Social interaction is a very important subject for the elderly, especially in the context of active aging. AIM: This study aims to investigate the effect of physical performance levels of the elderly living in rural and urban areas on social participation, social functioning, and quality of life. METHODS: A total of 418 volunteer elderly aged 65 and over, living in rural (42.3%) and urban (57.7%) areas, participated in this study. The Mini-Mental State Examination, Short Physical Performance Battery, the World Health Organization Quality of Life Scale for Older Adults, Social Functioning Scale, and the Community Integration Questionnaire were applied to participants. RESULTS: The scores of social functioning (P = 0.027) and the social network subscale of social participation (P = 0.001) were significantly higher among participants living in urban areas compared to those living in rural areas. Physical performance was positively correlated with social participation (r = 0.404) and social functioning (r = 0.324) at a moderate level (P = 0.000), and with quality of life at a low level (r = 0.158) (P = 0.001). Social participation was positively correlated with social functioning at a high level (r = 0.572) and with quality of life at a moderate level (r = 0.300) (P = 0.000). Social functioning was positively correlated with quality of life at a low level (r = 0.234) (P < 0.01). CONCLUSION: To increase social participation, social functioning, and quality of life among the elderly, it is necessary to keep physical performance levels higher. In addition, in the planning of social participation, it is crucial to take into account where the elderly live in.

A novel and useful predictive indicator of prognosis in ST-segment elevation myocardial infarction, the prognostic nutritional index.

BACKGROUND AND AIM: The prognostic impact of poor nutritional status and cardiac cachexia in myocardial infarction is not clearly understood. Recent studies have implied a prognostic value of the prognostic nutritional index (PNI) in colorectal surgeries and postoperative septic complications. The present study aimed to evaluate the prognostic value of PNI in ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: We evaluated the in-hospital and long-term (3 years) prognostic impact of PNI on 1823 patients with STEMI undergoing primary percutaneous coronary intervention. Patients with lower PNI had significantly higher in-hospital and long-term mortality and major adverse cardiac events. After adjustment for all confounders, the in-hospital mortality rates were 7.9 times higher at the lower PNI level (95% CI: 5.0-15.8) than those at the higher PNI level. The long-term mortality rates were also 6.4 times higher at the lower PNI level (95% CI: 4.4-12.4) than those at the higher PNI level. CONCLUSION: The present study demonstrated that the PNI, calculated based on the serum albumin level and lymphocyte count, is an independent prognostic factor for mortality in patients with STEMI.

Primary intraorbital hydatid cyst: an unusual location, case report and review of the literature.

Retrobulbar hydatid cysts are extremely rare while non-orbital forms constitute a still frequently encountered disease in underdeveloped countries. This report concerns a patient with a primary hydatid cyst in the orbit. A 22-year-old female patient was admitted to our hospital with proptosis of her right eye, conjunctival edema, hyperemia and headache. The family and patient's own past history were significant for continuous contact with sheep. The neurological examination revealed a retrobulbar mass and limited ocular motility in lateral direction on the right side. The papilledema was found in ophthalmoscopic examination and loss of vision was fixed. The eyeball was non-reductible and non-pulsatile. A frontoparietal craniotomy and orbitotomy was performed and then the mass was removed totally. This case was accepted as a primary infection because of no findings and previous history of liver or lung cysts. In the treatment of orbital hydatid cysts; early diagnosis, surgical excision and then systemic use of albendazole are suggested. Although cyst rupture is rather common, it sometimes results in severe anaphylactic reaction anaphylaxis, incomplete removal or secondary implantation. To avoid of a cyst rupture, intraoperative aspiration is recommended.

Coexistence of life threatening chemotherapy related leukoencephalopathy, saggital sinus thrombosis and multiple organ failure in a child with acute lymphoblastic leukemia: an unusual case with clinical recovery.

A nine-year old girl with T cell acute lymphoblastic leukemia (ALL) had acute severe neurologic complications at the end of the remission-induction chemotherapy course. Thirty-six hours following triple intrathecal (IT) therapy and intravenous (IV) administration of L-asparaginase (L-asp), tetraplegia developed and she became unconscious. She had bouts of hypertension and persistent tachycardia unresponsive to digitalis therapy. Magnetic resonance imaging (MRI) showed multiple brain white matter hyperintensities and filling defects in the saggital sinus, suggesting thrombosis. Over the 40 days, in addition to her neurologic compromise she also had transient diabetes mellitus, severe hyperlipidemia, hypoproteinemia and edema, liver and heart failure and staphylococcus aureus sepsis with prolonged bone marrow depression. Despite, coexistence of all these chemotherapy related complications, her neurologic functions and multiple organ failure improved gradually. After a 70 days' period of interruption, chemotherapy was resumed and continued without any further complications. Although, the etiology of her extensive sensitivity to some drugs remains unclear, we believe that it is important to document these unusual events in this child.

MRI in neuro-Behçet's disease.

Our purpose was to characterise specific MRI findings and to determine their value in neuro-Behçet's disease. We examined 17 patients (14 men, 3 women) with neuro-Behçet's disease using T1- and T2-weighted spin-echo images and contrast-enhanced images at 0.5 T. There were 13 patients (76.5%) who had single or multiple lesions. Most of these were in the basal ganglia, brain stem or deep white matter region, giving high signal on T2-weighted images and isointense or low signal on T1-weighted images. In 3 cases (17.6%) there was linear high signal along the posterior limb of the internal capsule on T2-weighted images. This was considered as a potential differentiating feature of neuro-Behçet's disease. Contrast-enhancement was seen in 17 lesions in 7 patients.

MRI of brucella polyneuritis in a child.

MRI of a rare case of polyneuritis following brucellosis is presented. An 8-year-old boy with a history of brucellosis showed marked enlargement of the origin of the left fifth cranial nerve and contrast enhancement of the fifth cranial nerves and the Gasserian ganglion in Meckel's caves. A well-defined low-signal cystic mass showing peripheral contrast enhancement lay anteromedial to the left seventh and eighth cranial nerves. The seventh and eighth nerves showed marked enhancement. The prechiasmatic portion of the right optic nerve showed fusiform enlargement with marked contrast enhancement of the nerve and right optic tract. MRI immediately after treatment showed no enhancement of the cranial nerves. Enlargement of the origin of the left fifth cranial nerve persisted, but there was no enlargement of the optic nerve. The mass near the left seventh and eighth cranial nerves was still present with no obvious morphological change, but no longer showed peripheral enhancement.

Persistent müllerian duct syndrome: report of a case with bilateral cryptorchidism.

We report on persistent müllerian duct structures (vagina, uterus, fallopian tubes) in a phenotypically normal white, infertile man with bilateral cryptorchidism. The presence of müllerian structures has been shown during a laparotomy performed because of an accident. The clinical and radio-sonographic findings are presented.