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1.
Sci Rep ; 11(1): 14387, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-34257381

RESUMO

This study aims to evaluate the monitoring and predictive value of web-based symptoms (fever, cough, dyspnea) searches for COVID-19 spread. Daily search interests from Turkey, Italy, Spain, France, and the United Kingdom were obtained from Google Trends (GT) between January 1, 2020, and August 31, 2020. In addition to conventional correlational models, we studied the time-varying correlation between GT search and new case reports; we used dynamic conditional correlation (DCC) and sliding windows correlation models. We found time-varying correlations between pulmonary symptoms on GT and new cases to be significant. The DCC model proved more powerful than the sliding windows correlation model. This model also provided better at time-varying correlations (r ≥ 0.90) during the first wave of the pandemic. We used a root means square error (RMSE) approach to attain symptom-specific shift days and showed that pulmonary symptom searches on GT should be shifted separately. Web-based search interest for pulmonary symptoms of COVID-19 is a reliable predictor of later reported cases for the first wave of the COVID-19 pandemic. Illness-specific symptom search interest on GT can be used to alert the healthcare system to prepare and allocate resources needed ahead of time.


Assuntos
COVID-19/diagnóstico , Ferramenta de Busca/estatística & dados numéricos , Correlação de Dados , França , Humanos , Itália , Espanha , Turquia , Reino Unido
2.
Tuberk Toraks ; 69(2): 196-206, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34256510

RESUMO

Introduction: Evaluation of parameters that will predict prognosis in COVID19 disease ensures correct determination of treatment strategy. In this study, it was aimed to determine the clinical, radiological and laboratory parameters affecting mortality and to evaluate the risk factors. Materials and Methods: Patients hospitalized with the diagnosis of COVID-19 in September 2020 were included in the study. Clinical features, laboratory parameters, and radiological findings at admission were recorded. The relationship of these parameters with 30-day mortality was evaluated. Statistical analysis was performed with SPSS for Windows 16.0 Package Program. Result: Three hundred and sixty patients (female/male, n= 228/132) hospitalized in the specified period were included in the study. 30-day mortality rate was 14.4% in all patients. In multiple logistic regression analysis, age, presence of heart failure, admission oxygen saturation, body temperature higher than 38.2 and high ferritin levels were evaluated as independent risk factors for 30-day mortality. Conclusions: The relationship between clinical and laboratory markers and mortality is very important for the correct orientation of healthcare services and the correct determination of treatment strategy during the COVID-19 pandemic.


Assuntos
COVID-19/mortalidade , Pacientes Internados , Pandemias , SARS-CoV-2 , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida/tendências , Turquia/epidemiologia
3.
Tuberk Toraks ; 69(2): 207-216, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34256511

RESUMO

Introduction: Healthcare workers (HCWs) are at the forefront of the fight against coronavirus. The purpose of this study was to evaluate COVID-19 phobia levels of HCWs of a pandemic hospital and explore associated factors. Materials and Methods: This was a descriptive cross-sectional study conducted on HCWs employed in a pandemic hospital. A total of 365 HCWs (95 physicians, 187 nurses and 83 assistant healthcare staffs) were included in the study. In order to evaluate COVID-19 phobia, coronavirus-19 phobia scale (C19P-S) was administrated. Chronophobia levels of frontline and nonfrontline HCWs were compared. Additionally, the effect of working in different departments, profession and associated factors on COVID-19 phobia was evaluated. Result: Overall, 172 HCWs completed the C19P-S and agreed to participate in the study. Mean total CP19P-S score of the HCWs included in the study was 50.1 ± 17.3. Of the study population, 59.3% participants were frontline HCWs and 40.7% were non-frontline HCWs. When frontline HCWs and nonfrontline HCWs were compared in terms of total C19P-S and subscales scores (psychological, psycho-somatic, economic, social), no statistically significant differences were found (p= 0.914, p= 0.687, p= 0.766, p= 0.347, p= 0.794, respectively).When the HCWs were divided into three groups according to departments (clinics, intensive care unit (ICU), emergency department) where they worked regardless of whether they cared for patients with COVID-19, HCWs employed in the ICUs had the highest scores regarding total C19P-S and subscales scores (p= 0.002, p= 0.001, p= 0.001, p= 0.012, p= 0.002,respectively) . Profession based comparison revealed no significant difference between the groups regarding total C19P-S score (p= 0.117). Conclusions: It is essential to make a comprehensive evaluation regarding the effects of pandemics on HCWs, not only for controlling the COVID-19 pandemic but also to protect the mental health of HCWs. Critical care professions appear to need particular attention among HCWs. The C19P-S, which assesses coronaphobia levels with psychological, psycho-somatic, economic, and social aspects could be a convenient screening tool for evaluating COVID-19 phobia levels in HWCs.


Assuntos
COVID-19/psicologia , Pessoal de Saúde/psicologia , Hospitais/estatística & dados numéricos , Pandemias , Transtornos Fóbicos/epidemiologia , Adulto , COVID-19/complicações , COVID-19/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Saúde Mental , Transtornos Fóbicos/etiologia , SARS-CoV-2 , Turquia/epidemiologia
4.
Tuberk Toraks ; 69(2): 217-226, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34256512

RESUMO

Introduction: Coronavirus disease 2019 (COVID-19) has a 1-2% fatality rate, where no specific treatment has yet been defined. Although corticosteroids are recommended for selected COVID-19 patients without acute respiratory distress syndrome (ARDS) and septic shock, there is no consensus regarding patient subgroups, dose, and duration. In this study, it was aimed to examine the contribution of corticosteroid treatment to the management of COVID-19 pneumonia without ARDS, septic shock both in acute and recovery setting. Materials and Methods: The study population was divided into two as those who used corticosteroids during the recovery phase (who did not develop sufficient radiological or clinical improvement) and those who did so during the activation phase (non-ARDS/septic shock condition, clinical, laboratory or radiological progression). Result: We identified 47 patients, 26 of which were males, and mean age was 60.5 ± 16.5 years. Seventeen patients were found to receive corticosteroids during the recovery phase and the rest (n= 30) during the activation period. After corticosteroid therapy, we found reduction of increased pre-treatment levels of D-dimer, ferritin, fibrinogen, CRP, increment of decreased pre-treatment lymphocyte count and saturation. Complete symptomatic improvement was detected in 6.9% and 17.6% of the patients in the activation phase and recovery phase, respectively. Complete radiological improvement was found in 11.5% and 35.3% of the patients in the activation phase and recovery phase, respectively. While corticosteroid treatment was initiated on day 4.2 ± 2.6 and continued for a mean of 5.9 ± 2.8 days in the activation group, it was started on day 8.1 ± 11.3 and administered for 7.8 ± 3.8 days in the recovery group. In both groups, methylprednisolone was given at a median dose of 40 mg/day. Conclusions: Short-term low-dose corticosteroid therapy may improve clinical, radiological, laboratory outcomes in the management of COVID-19 pneumonia during the activation period without ARDS and non-septic shock and during recovery period with no satisfactory response. Further randomized controlled studies will be useful in demonstrating its efficacy.


Assuntos
Corticosteroides/administração & dosagem , COVID-19/tratamento farmacológico , Pandemias , SARS-CoV-2 , COVID-19/diagnóstico , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Turquia/epidemiologia
5.
Tuberk Toraks ; 69(2): 242-246, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34256515

RESUMO

COVID-19, caused by severe acute respiratory syndrome coronavirus-2, typically presents with respiratory symptoms and fever, but still a variety of clinical presentations have been reported. In this study, it was aimed to report a case of COVID-19 with an atypical presentation and an atypical course. As well, the recovery phase was complicated with GBS and consequently cytomegalovirus infection. It should be kept in mind that patients with COVID-19 severe disease need to be followed for neurological and other complications which may arise during the course of critical illness.


Assuntos
COVID-19/diagnóstico , Síndrome de Guillain-Barré/diagnóstico , SARS-CoV-2 , Idoso , COVID-19/epidemiologia , Diagnóstico Diferencial , Síndrome de Guillain-Barré/virologia , Humanos , Masculino , Pandemias , Turquia/epidemiologia
6.
Tuberk Toraks ; 69(2): 269-278, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34256519

RESUMO

COVID-19 emerged in Wuhan, China in late December 2019, and WHO declared it a pandemic on March 11, 2020. The disease has a wide spectrum ranging from asymptomatic or mild disease to ARDS and death. There have been over 83.9 million cases with 1.8 million deaths worldwide. COVIDassociated coagulopathy appears to be an entity responsible for deaths. Thromboprophylaxis is recommended in patients with COVID-19 to prevent arterial and venous thromboembolism. Low molecular weight heparin such as enoxaparin is often recommended. However, there is still no consensus regarding the treatment dose and duration. The purpose of this review was to observe the pathogenesis of thromboembolic events in COVID-19, current thromboprophylaxis regimens, treatment dosage and duration with guidelines of international scientific institutions.


Assuntos
Anticoagulantes/administração & dosagem , COVID-19/complicações , Gerenciamento Clínico , Pandemias , SARS-CoV-2 , Tromboembolia Venosa/prevenção & controle , COVID-19/epidemiologia , Humanos , Turquia/epidemiologia , Tromboembolia Venosa/etiologia
7.
J Coll Physicians Surg Pak ; 31(7): 93-98, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34271803

RESUMO

OBJECTIVE: To investigate the symptoms and laboratory results of children hospitalised with the diagnosis of COVID-19, aiming to reveal the characteristics of symptomatic cases. STUDY DESIGN: A descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Kastamonu Training and Research Hospital, Kastamonu, Turkey from March to December 2020. METHODOLOGY: Seventy-nine children, hospitalised with the diagnosis of COVID-19, were included in the study and were divided into two groups as symptomatic and asymptomatic. The demographic data, laboratory results and clinics of the patients of the two groups were compared. RESULTS: The mean age of participants was 10.43 ± 5.91 (0-17) years, and 57% (n=45) of them were girls. Five patients in the symptomatic group had comorbidities (2 allergic asthma,  cerebral palsy, type-1 diabetes mellitus and anorexia nervosa). The most common symptom was fever (36.7%, n=29). It was noteworthy that everyone with an NLR >3.13 (high-NLR) was symptomatic. Significantly more patients in the high-NLR group were symptomatic compared with the low-NLR group (p=0.005). On the other hand, symptomatic children had significantly higher levels of C-reactive protein (2.8 (IQR: 1.2-10.0) mg/L vs. 1.4 (IQR: 0.4-2.0) mg/L, p=0.011); and procalcitonin (0.05 (IQR: 0.02-0.10) ng/mL vs. 0.01 (IQR: 0.00-0.03) ng/mL, p<0.001) than those without symptoms. One of the children with cerebral palsy died from pneumonia during the study. CONCLUSION: C-reactive protein, procalcitonin and NLR levels were found to be significantly higher in symptomatic children. NLR can be suggested as a potential marker associated with disease severity in COVID-19 patients, which needs to be supported by other studies. Key Words: COVID-19, Children, Neutrophil / lymphocyte ratio, C-reactive protein, Procalcitonin.


Assuntos
COVID-19 , Pediatria , Adolescente , COVID-19/sangue , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Linfócitos/metabolismo , Masculino , Neutrófilos/metabolismo , Estudos Retrospectivos , SARS-CoV-2 , Turquia/epidemiologia
8.
Environ Monit Assess ; 193(8): 489, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34251512

RESUMO

Water, which is a basic need for humans and the natural world, is a limited resource. It is a cyclical element and not a freely traded commodity. The right to access to water is acknowledged as a basic right because of the importance of water for human life, and for this reason, water is a topic in many human rights texts. The restricted availability of this global resource, which must be sustainable to maintain life, has increased its importance for countries and made its fair and just management necessary. Putting the proper methods into practice is a lot harder than it appears, however, because theories and practices did not sit well together from different perspectives and different ones were developed worldwide. These approaches vary according to countries' access to water, amount of water usage, level of development, and economic situation. Because of these variables, a number of international studies have been carried out to eliminate the strain on water resources. The focus of these studies is on the definition of water resources and the rights and principles of usage and ownership of water. This study views water as a commercial commodity, and its subject is the pricing strategies for water and the underlying legal basis of the acknowledgement of water resources in Turkey as a public asset.


Assuntos
Monitoramento Ambiental , Água , Direitos Humanos , Humanos , Propriedade , Turquia
9.
Artigo em Inglês | MEDLINE | ID: mdl-34242155

RESUMO

Cells of strains P66T, V1 and W15Feb18 are Gram-stain-negative short rods and motile by one polar flagellum. Strain P66T was isolated from rainbow trout (Oncorhynchus mykiss) cultivated at a fish farm in Turkey. Strain V1 was isolated from sand of an intertidal shore on the Galicia coast in Spain and strain W15Feb18 was isolated from water collected at the Woluwe River in Belgium. Based on 16S rRNA sequence similarity values, the strains were grouped under the genus Pseudomonas and the Pseudomonas putida phylogenetic group of species. The DNA G+C content ranged from 58.5 to 58.9 mol%. The strains were characterized phenotypically by the API 20NE and Biolog GEN III tests, and chemotaxonomically by their whole-cell MALDI-TOF MS protein profiles and fatty acid contents. The absence of the hydrolysis of gelatin and the assimilation of arabinose, mannose and mannitol differentiated these strains from the closest species, Pseudomonas alkylphenolica. The major fatty acid components were C16:0 (29.91-31.68 %) and summed feature 3 (36.44-37.55 %). Multilocus sequence analysis with four and 83 housekeeping gene sequences and a core proteome analysis showed that these strains formed a phylogenetic cluster in the P. putida group of species. Genome comparisons by the average nucleotide identity based on blast and the Genome-to-Genome Distance Calculator demonstrated that the three strains belonged to the same genomic species and were distant from any known species, with similarity values lower than the thresholds established for species in the genus Pseudomonas. These data permitted us to conclude that strains P66T, V1 and W15Feb18 belong to a novel species in the genus Pseudomonas, for which the name Pseudomonas arcuscaelestis sp. nov. is proposed. The type strain is P66T (=CECT 30176T=CCUG 74872T). The other strains have been deposited in the CECT with the corresponding collection numbers: V1 (=CECT 30356) and W15Feb18 (=CECT 30355).


Assuntos
Oncorhynchus mykiss/microbiologia , Filogenia , Pseudomonas/classificação , Rios/microbiologia , Microbiologia da Água , Animais , Técnicas de Tipagem Bacteriana , Composição de Bases , Bélgica , DNA Bacteriano/genética , Ácidos Graxos/química , Genes Bacterianos , Tipagem de Sequências Multilocus , Hibridização de Ácido Nucleico , Pseudomonas/isolamento & purificação , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Espanha , Turquia
10.
An Acad Bras Cienc ; 93(3): e20200252, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231757

RESUMO

Vuralia turcica (Fabaceae; Papilionoideae) is a critically endangered endemic plant species in Turkey. This plant grows naturally in saline environments, although the photosynthesis and physiological functions of many plants are affected by salt stress. Molecular control mechanisms and identification of genes involved in these mechanisms constitute the critical field of study in plant science. Trehalose-6-phosphate synthase (TPS) is one of the essential enzyme genes involved in trehalose biosynthesis, which is protective against salt stress. Also, the vacuolar Na+/H+ antiporter gene (NHX) is known to be useful in salt tolerance. In this study, the TPS and NHX-like genes in V. turcica were partially sequenced using degenerate primers for the first time and submitted to the NCBI database (accession numbers MK120983 and MH757417, respectively). Also, the expression levels of the genes encoding TPS and NHX were investigated. The results indicate that the increase in both the level of applied salt and cadmium is coupled with the increase in the expression level of NHX and TPS genes. However, salt exposure significantly affected the expression level of the NHX gene. The findings suggest that the NHX gene might play a crucial role in the salt tolerance ability of V. turcica.


Assuntos
Cádmio , Fabaceae , Cádmio/toxicidade , Fabaceae/metabolismo , Regulação da Expressão Gênica de Plantas , Glucosiltransferases , Filogenia , Proteínas de Plantas/genética , Plantas Geneticamente Modificadas/metabolismo , Trocadores de Sódio-Hidrogênio/genética , Trocadores de Sódio-Hidrogênio/metabolismo , Turquia
11.
Braz J Biol ; 82: e249745, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231666

RESUMO

Today, most of the world's population faces water scarcity, while global warming, urbanization, industrialization and population increases continue to increase the severity of the pressure on water resources. Management of water resources plays a key role in the sustainability of agricultural production. The water footprint (WF) is different in comparison to other water statistics because it takes direct and indirect water consumption into account, and helps in the management of water resources. Within this context, the WF of Van province, which is Turkey's most easterly located arid region, was calculated from 2004 to 2019. The study area covers lake Van, which is Turkey's largest lake, and the Van basin with an area of 23.334 km2 and a population of 1.136.757 (2019). In the calculations, crop (WFcrop), livestock (WFlivestock), and domestic and industrial water footprints (WFdomestic+industrial) were evaluated separately, and blue and green water footprints (WFblue and WFgreen) were analyzed in detail. According to the results, the average WF of Van province was found to be 8.73 billion m3 year-1. Throughout the province, 87.6% of the WF is composed of WFcrop, 4.9% is WFlivestock and 7.5% is WFdomestic+industrial. Of the WFcrop, 62.5% depends on WFblue, i.e., freshwater. Most of the WFlivestock consisted of dairy cattle (49%) and sheep (38%). The average WFdomestic+industrial for 2004 to 2019 was 0.64 billion m3 year-1. The average per capita water footprint of Van province was found to be 889.9 m3 year-1 capita-1. In addition, the province is classified as severe water scarcity (257%). This study is one of the first province-based calculations of WF in Turkey and is the first study to bring a different aspect to published literature by including residual soil moisture from the winter months. As a result of this study, the WFblue of the WFcrop is above the worldwide average and should be reduced by changing the crop pattern or synchronizing the planting and harvest dates of the crops to a period that benefits from precipitation. In addition, this study is expected to contribute to new studies for calculating the provincial scale WF and will have positive effects on agricultural planning, water allocation and the sustainability of water resources.


Assuntos
Insegurança Hídrica , Água , Agricultura , Animais , Bovinos , Ovinos , Turquia , Recursos Hídricos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34205391

RESUMO

Drowning is a public-health threat and a leading cause of injury-related death. In Turkey, drowning results in 900 fatalities annually, and the rate is rising. As data on rescue-related drowning are scarce, this retrospective study explores the epidemiology of fatal drowning among rescuers in Turkey. As there are no routinely collected death registry data on drowning in Turkey, data were sourced from media reports of incidents between 2015 and 2019. Rescuer fatalities were analysed by age, sex, activity prior to rescue, location, incident day of week and season, and place of death. Statistical analyses comprised X2 tests of significance (p < 0.05) and calculation of relative risk (95% confidence interval) using fatality rates. In total, 237 bystander rescuers drowned (90% male; 35% 15-24 years). In 33% of cases, the primary drowning victim (PDV) was successfully rescued, while in 46% of cases the rescue resulted in multiple drowning fatalities (mean = 2.29; range 1-5 rescuers). Rescues were more likely to be successful in saving the PDV if undertaken at the beach/sea (X2 = 29.147; p < 0.001), while swimming (X2 = 12.504; p = 0.001), or during summer (X2 = 8.223; p = 0.029). Risk of bystander rescue-related fatal drowning was twice as high on weekdays compared to on weekends (RR = 2.04; 95%CI: 1.56-2.67). While bystanders play an important role in reducing drowning, undertaking a rescue is not without risk and can lead to multiple drowning incidents. Training in rescue and resuscitation skills (especially the prioritization of non-contact rescues) coupled with increasing awareness of drowning risk, are risk-reduction strategies which should be explored in Turkey.


Assuntos
Afogamento , Feminino , Humanos , Masculino , Trabalho de Resgate , Ressuscitação , Estudos Retrospectivos , Turquia/epidemiologia
13.
Future Microbiol ; 16: 697-702, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34223786

RESUMO

Aim: COVID-19, caused by SARS-CoV-2, started in December 2019 and has spread across the world. Materials & methods: We analyzed real-time PCR results of 10,000 samples from 2 April to 30 May 2020 in three neighbor cities located in the East of Turkey. The final study population was 7853 cases, after excluding screening tests. Results: Real-time PCR was performed to detect the SARS-CoV-2-specific RNA-dependent-RNA-polymerase gene fragment. The number of total positive samples out of 7853 were 487; however, the number of nonrepeating positive patient was 373 (4.8%). Cough and fever were the most common symptoms in positive cases. Conclusion: Epidemiologic studies should be performed about the prevalence of SARS-CoV-2 infection to better understand the effect of the virus across the world.


Assuntos
COVID-19/diagnóstico , COVID-19/epidemiologia , Adolescente , Adulto , Idoso , COVID-19/fisiopatologia , COVID-19/virologia , Teste para COVID-19 , Criança , Pré-Escolar , Tosse/epidemiologia , Tosse/virologia , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Turquia/epidemiologia , Adulto Jovem
14.
J Coll Physicians Surg Pak ; 30(7): 770-774, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271774

RESUMO

OBJECTIVE: To determine the results of high-risk geriatric patients treated with percutaneous cholecystostomy (PC) for acute cholecystitis (AC). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Interventional Radiology, Recep Tayyip Erdogan University Hospital, Rize, Turkey, from April 2015 to October 2020. METHODOLOGY: Seventy-four patients, who underwent PC with a diagnosis of AC, were divided into three groups according to their ages: 65-74 years as group I, 75-84 years as group II, and ≥85 years as group III. Groups were compared in terms of American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), technical success, clinical success, complications, need for cholecystectomy, duration of hospital stay, 30 and 90 days mortality, catheter removal time, and recurrent cholecystitis after catheter insertion. RESULTS: Technical success was 100% in all groups. Clinical success decreased with age. There was a positive correlation between the patients' ASA score and age (p <0.001). The duration of hospital stay increased with age (p = 0.049). ASA score was found to be an independent risk factor in predicting overall survival (HR: 4.748; 95% CI: 1.030-21.895; p = 0.046). The mean catheter removal time was the longest in group III, and there was a significant difference between the groups (p <0.001). A significant positive correlation was found between catheter removal time and CCI (p <0.001). There was no statistically significant difference between groups in terms of complications and recurrent cholecystitis.  Conclusion: PC can be considered as definitive treatment in advanced elderly patients and interval therapy in early old age. Key Words: Acute cholecystitis, Elderly, Percutaneous cholecystostomy.


Assuntos
Colecistite Aguda , Colecistite , Colecistostomia , Idoso , Colecistectomia , Colecistite Aguda/cirurgia , Humanos , Estudos Retrospectivos , Resultado do Tratamento , Turquia
15.
J Coll Physicians Surg Pak ; 30(7): 775-779, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271775

RESUMO

OBJECTIVE: To determine the association of alpha-1 antitrypsin deficiency (AATD) in patients diagnosed with primary spontaneous pneumothorax (PSP), the presence of the SERPINA 1 gene, and the phenotype in patients with low enzyme values. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Kayseri City Training and Research Hospital, Turkey, from October 2019 to October 2020. METHODOLOGY: A total of 42 patients with PSP and 42 healthy volunteers were included in the study. The antitrypsin (AAT) level of all participants was measured by the ELISA method. Presence of SERPINA 1 gene was determined in all the participants and its phenotype variants. RESULTS: In this study, AAT level was statistically and significantly lower in the patient group than the control group (p = 0.018). The presence of the SERPINA 1 gene was studied in 13 (31%) patients with AATD and 7 (16.7%) healthy volunteers. Six patients had PI M1V variant (37.5%), five patients had PI M1A variant (31.3%), four patients had PI M4 variant (25%), and one patient had an indeterminate variant (6.2%). Four healthy volunteers had PI M1V variant (66.7%), and two healthy volunteers had PI M4 variant (33.3%). CONCLUSION: AAT level was found to be lower in the patient group compared to the control group. In addition, the effect of SERPINA 1 gene on PSP development was found to be benign. AATD is an effective factor in the development of PSP. Key Words: Primary spontaneous pneumothorax, Alpha 1 antitrypsin deficiency, Genotype variants, SERPINA 1 gene.


Assuntos
Pneumotórax , Doença Pulmonar Obstrutiva Crônica , Deficiência de alfa 1-Antitripsina , Estudos Transversais , Predisposição Genética para Doença , Humanos , Fenótipo , Pneumotórax/genética , Turquia , alfa 1-Antitripsina/genética , Deficiência de alfa 1-Antitripsina/complicações , Deficiência de alfa 1-Antitripsina/genética
16.
J Coll Physicians Surg Pak ; 30(7): 798-804, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271779

RESUMO

OBJECTIVE:  To determine the relationship between resected specimen length and tumor location, the number of LN harvested (LNh), and the positive LN ratio (LNR) in colon cancer. STUDY DESIGN: A descriptive study. Place & Duration of Study: Department of General Surgery, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, between January 2009 and December 2019. METHODOLOGY: Colon specimens resected for colon cancer were evaluated retrospectively, in terms of tumor location, type of surgery, resected colon length, LNh and the number of metastatic LN, based on hospital records. Chi-square test, Kruskal-Wallis along with Dunn-Bonferroni post hoc tests were applied. The lymph node ratio (LNR) (= ratio of LN+  to LNh), the number of lymph nodes per unit distance (LNh/cm), the ratio of LNR to length of specimen (LNR/cm) were evaluated. RESULTS: The rate of ≥12 LNh in 644 colon cancer patients was 81.4%. The length of colon specimen and the number of harvested lymph nodes (LNh) were higher in patients, who underwent subtotal colectomy (StC), compared to patients who underwent right and left hemicolectomy (RhC and LhC, p<0.001). Inadequate LNh was more common in LhC patients (p<0.001). The ratio of the number of LNh to the length of the resected specimen (LNh/cm) was higher in RhC and LhC patients than StC patients (p<0.001). LNR and LNR/cm were higher in LhC patients, though mean specimen length was shorter in LhC patients (p<0.05). The number of LNh had a direct proportion with the resected specimen length; however, the LNh/cm and LNR/cm ratios decreased in >50 cm length specimen patients (p<0.001). CONCLUSION: Central LN dissection and vascular high ligation, according to tumor site are more efficient than the length of the resected specimen for an adequate LN dissection in colon cancers. Key Words: Colon cancer, Harvested lymph node,  Specimen length, Adequate dissection.


Assuntos
Neoplasias do Colo , Excisão de Linfonodo , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Humanos , Linfonodos/patologia , Linfonodos/cirurgia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Turquia
17.
J Coll Physicians Surg Pak ; 30(7): 805-810, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271780

RESUMO

OBJECTIVE: To investigate the association between the ratio of negative/positive lymph nodes (RNP) and other clinic pathological parameters. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY:  Faculty of Medicine, Cumhuriyet University, Sivas, Turkey, from February 2008 to December 2019. METHODOLOGY: Consecutive 119 patients with gastric adenocarcinoma, who underwent gastrectomy and D2 lymph node dissection, were included. RNP, other clinicopathological parameters such as tumour grade, type and lymphovascular invasion (LVI) were analysed, as their prognostic impact was investigated. RESULTS: RNP was an independent prognostic factor for overall survival (p = 0.003) and was significantly associated with poor survival (p <0.001). Advanced pathologic T and N stage, presence of perineural invasion (PNI), presence of LVI, high tumour grade, and diffuse-type as per Louren's classification, and the number of the negative lymph nodes were also significantly associated with poor survival (all p <0.05). Although pathologic N stage (p <0.01), PNI (p <0.01), LVI (p <0.01), tumour type as per Louren's classification (p <0.01), tumour grade (p <0.01) and the number of negative lymph nodes (p <0.01) were significantly associated with overall survival in univariate analyses; only gender (p = 0.025), gastrectomy type (p = 0.037), PNI (p = 0.028), tumour type (p = 0.006), and number of  negative lymph nodes (p = 0.003) were meaningfully associated with survival in a multivariate analysis. CONCLUSION: The ratio of negative/positive lymph nodes can be used as an independent prognostic marker in patients with gastric cancer, who undergo curative resection, as an alternative prognostic marker to the pathologic N stage. Key Words: Stomach neoplasms, Lymph node ratio, Prognosis, Gastrectomy, Lymph nodes.


Assuntos
Adenocarcinoma , Neoplasias Gástricas , Adenocarcinoma/cirurgia , Gastrectomia , Humanos , Excisão de Linfonodo , Razão entre Linfonodos , Linfonodos/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida , Turquia/epidemiologia
18.
J Coll Physicians Surg Pak ; 30(7): 811-816, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271781

RESUMO

OBJECTIVE: To investigate the genetic causes of colorectal cancers (CRCs); and to determine the genotype-phenotype correlation. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Genetics, Diskapi Yildirim Beyazit Training and Research, Hospital, Ankara, Turkey, between January 2018 and January 2020. METHODOLOGY: 59 cancer susceptibility genes of 41 patients, included in the study and diagnosed with CRC, were examined using next generation sequencing (NGS) technique. Statistical analysis of the possible relationships among the mutation carrier status of the patients and the parameters of gender, age at diagnosis, and family cancer history, were performed. RESULTS: The mean age at diagnosis of all CRC patients was 48.7 years (range 28-74). Mutations in MLH1, MSH6, CHEK2, PMS2 and MUTYH genes were detected in 10 patients (24.4%). The mean age at diagnosis of CRC was 46.2 years in those who carried the mutation, while it was 49.5 years in those without. Carriers and non-mutation carriers, when compared in terms of age at diagnosis, gender, family cancer history, no significant difference was observed. CONCLUSION: Genes that may cause susceptibility to cancer may play a role in the etiopathogenesis of the CRC. NGS-based multigene panels allow these genes to be detected in the patient and to identify an inherited cancer syndrome. Key Words: Colorectal cancer, Lynch syndrome, Hereditary cancer, Gene, Next generation sequencing.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose , Síndromes Neoplásicas Hereditárias , Adulto , Idoso , Neoplasias Colorretais Hereditárias sem Polipose/genética , Predisposição Genética para Doença , Mutação em Linhagem Germinativa , Humanos , Pessoa de Meia-Idade , Turquia
19.
J Coll Physicians Surg Pak ; 30(7): 825-828, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271784

RESUMO

OBJECTIVE: To describe the outcome of modified transabdominal laparoscopic preperitoneal (TAPP) hernioplasty repair with plug-patch of polypropylene mesh. STUDY DESIGN:  A descriptive study. PLACE AND DURATION OF STUDY: Alanya Alaaddin Keykubat University Training and Research Hospital, Alanya, Turkey from December 2017 to December 2019. METHODOLOGY: Patients aged 18-70 years, who underwent TAPP hernioplasty at this clinic between December 2017 and 2019 were evaluated retrospectively. Those with a defect diameter of 3 cm and above, which were measured intraoperatively, were considered as large inguinal hernias. A modified TAPP procedure that includes the plug-patch technique, using polyester mesh, similar to that of open inguinal hernia repair, was performed on these patients. Complications and recurrences frequency was noted. RESULTS: This modified TAPP procedure was applied to 35 patients (24 men, 11 women). The defect size was 3-4 cm in 24 patients, and 4 cm in 11 patients. None of the patients developed chronic pain. Five patients had a feeling of fullness in the inguinal region where the repair was performed, and their complaints subsided at the first month of follow-up. Seroma developed in 2 patients, but resolved spontaneously. During the follow-up period, no chronic complications or recurrences were observed. CONCLUSION: This technique is simple and does not create a serious cost burden on TAPP technique. Furthermore, it can be applied routinely with the advantages of low pain, rapid recovery and acceptable complication rates as well as the reduction of pseudo-recurrence rates. Key Words: Hernia, Laparoscopic repair, Plug-patch technique, Modified TAPP, Mesh.


Assuntos
Hérnia Inguinal , Laparoscopia , Feminino , Hérnia Inguinal/cirurgia , Herniorrafia , Humanos , Masculino , Polipropilenos , Recidiva , Estudos Retrospectivos , Telas Cirúrgicas , Resultado do Tratamento , Turquia
20.
J Coll Physicians Surg Pak ; 31(7): 99-103, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34271804

RESUMO

OBJECTIVE: To analyse whether prealbumin could be a new biomarker for predicting mortality in severe COVID-19 patients. STUDY DESIGN: An observation study. PLACE AND DURATION OF STUDY: Intensive care units (ICU) of Sakarya University Training and Research Hospital, Sakarya, Turkey, from October 2020 to December 2020. METHODOLOGY: The data of 149 patients, who were admitted to the ICU were collected and analysed retrospectively. Routine blood samples were collected from all patients at the time of admission to the ICU; and 102 patients with the mortal course and 47 patients with the non-mortal course were included in the study. The data obtained from these patients were analyzed in the biostatistics programme.  Results: The median age of all patients was 68 years; while 94 of them were males (63.1%) and 55 of them were females (36.9%). Median levels of potassium (K) (p=0.04), uric acid (p=0.001), C-reactive protein (CRP) (p=0.004), and procalcitonin (PCT) (p<0.001) were significantly higher and median level of prealbumin (p=0.002) was significantly lower in the deceased group. The cut-off level of prealbumin for mortality was found as 0.085 g/L (p=0.002). Further analysis revealed that the risk of mortality was found as 2.193 times more in patients with prealbumin levels of <0.085 g/L (Odds Ratio (OR): 2.193, 95% CI: 1.084-4.434). CONCLUSION: As a result of this study, it was found that patients with lower levels of prealbumin at the time of admission to the ICU have a higher risk for mortality. It was showed that prealbumin can be a useful biomarker for predicting mortality in patients with severe COVID-19. Key Words: Prealbumin, COVID-19, Mortality, Prognostic biomarkers, Severe disease.


Assuntos
COVID-19 , Pré-Albumina , Idoso , Biomarcadores , Proteína C-Reativa/análise , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pré-Albumina/análise , Prognóstico , Estudos Retrospectivos , SARS-CoV-2 , Turquia/epidemiologia
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