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1.
J Craniofac Surg ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38747579

RESUMO

OBJECTIVE: The aim of this study is to investigate whether there may be differences in the measurements of the orbital region between healthy children and children with attention deficit hyperactivity disorder (ADHD). METHODS: In this study, the orbital region measurements of 310 children, including 130 ADHD children and 180 healthy children aged 7 to 11 years, were analyzed. For this analysis, anterior view photographs of these individuals were used. For both sides, endocanthion (en), exocanthion (ex), and pupil (p) were determined in these photographs. A total of 5 distances (ex-ex, en-en, ex-en for the right side, ex-en for the left side and p-p) were analyzed using these points. RESULTS: In both sexes, no statistically significant difference was observed between the 2 groups in all 6 parameters analyzed. CONCLUSION: Although it was concluded that there was no difference in orbital measurements between healthy children and children with ADHD in this study, it was thought that a definite conclusion could not be reached because the cases examined belonged to a single center. Therefore, it is thought that multicenter studies in which more individuals are evaluated are needed.

2.
Med Princ Pract ; : 1-9, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38626747

RESUMO

OBJECTIVE: Prognostic models aid clinical practice with decision-making on treatment and hospitalization in exacerbation of chronic obstructive lung disease (ECOPD). Although there are many studies with prognostic models, diagnostic accuracy is variable within and between models. SUBJECTS AND METHODS: We compared the prognostic performance of the BAP65 score, DECAF score, PEARL score, and modified early warning score (MEWS) in hospitalized patients with ECOPD, to estimate ventilatory support need. RESULTS: This cross-sectional study consisted of 139 patients. Patients in need of noninvasive or invasive mechanical ventilation support are grouped as ventilatory support groups (n = 54). Comparison between receiver operating characteristic curves revealed that the DECAF score is significantly superior to the PEARL score (p = 0.04) in discriminating patients in need of ventilatory support. DECAF score with a cutoff value of 1 presented the highest sensitivity and BAP65 score with a cutoff value of 2 presented the highest specificity in predicting ventilatory support need. Multivariable analysis revealed that gender played a significant role in COPD exacerbation outcome, and arterial pCO2 and RDW measurements were also predictors of ventilatory support need. Within severity indexes, only the DECAF score was independently associated with the outcome. One-point increase in DECAF score created a 1.43 times higher risk of ventilatory support need. All severity indexes showed a correlation with age, comorbidity index, and dyspnea. BAP65 and DECAF scores also showed a correlation with length of stay. CONCLUSION: Objective and practical classifications are needed by clinicians to assess prognosis and initiate treatment accordingly. DECAF score is a strong candidate among severity indexes.

3.
Neuroendocrinology ; 113(10): 1051-1058, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37497936

RESUMO

INTRODUCTION: Olfaction and its relation to human health is an area of growing interest. Although olfaction disorders have been considered a part of Kallmann syndrome, the role of olfactory dysfunction on spermatogenesis has not been studied yet. We studied if olfactory bulbectomy (OBX) causes dysfunction in spermatogenesis as a result of Onuf's nucleus damage. METHODS: Twenty-eight male rats were divided into three groups: six as the control (G-1; n = 6), six as the only frontal burr hole applied animals SHAM (G-2; n = 6), and 16 as the study group (G-3; n = 16) in which OBX was performed. The animals were followed for 2 months. After the decapitation of the animals, olfactory bulb (OB) volumes (mm3), the neuron density of the Onuf's nucleus (n/mm3), and sperm density (n/mm3) were estimated stereologically and analyzed. RESULTS: OB volumes (mm3), degenerated neuron density of Onuf's nucleus (n/mm3), and sperm numbers of control, SHAM, and study groups were estimated as: 4 ± 0.5; 6 ± 2 and 103.245 ± 10.841 in G-1; 3.5 ± 0.7; 14 ± 4 and 96.891 ± 9.569 in G-2; and 1.3 ± 0.3; 91 ± 17 and 73.561 ± 6.324 in G-3. The statistical results of degenerated neuron density of Onuf's nucleus and sperm numbers between groups are p < 0.005 for G-1/G-2; p < 0.0005 for G-2/G-3; and p < 0.00001 for G-1/G-3. DISCUSSION: This study first time indicates that Onuf's nucleus degeneration secondary to OBX seems to be responsible for reduced sperm numbers.


Assuntos
Síndrome de Kallmann , Masculino , Humanos , Animais , Ratos , Contagem de Espermatozoides , Olfato , Sêmen , Medula Espinal , Espermatozoides
4.
Women Health ; 63(8): 577-586, 2023 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-37599095

RESUMO

This study aimed to investigate lower urinary tract symptoms (LUTS) in Turkish adult women and to compare toileting behaviors in women with and without LUTS. This cross-sectional study was conducted in 815 women. The International Consultation on Incontinence Modular Questionnaire - Female LUTS and a toileting behaviors form, created by the authors, were used in evaluations. Nearly 50 % of the women had at least one LUTS, 45.8 % had storage symptoms, 7.4 % had voiding symptoms, and 20.2 % had incontinence symptoms. The rates of premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS than in women without LUTS (p < .05). The rate of squatting on the toilet while urinating was lower in women with LUTS than those without LUTS (p < .05). Various LUTS were common in adult women. Some toileting behaviors such as premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS compared to women without LUTS. Since the rate of unhealthy toilet behaviors is higher in women with LUTS, it is important to know unhealthy toilet behaviors in the management of LUTS and to organize training programs to prevent these behaviors and LUTS.


Assuntos
Sintomas do Trato Urinário Inferior , Feminino , Humanos , Adulto , Estudos Transversais , Encaminhamento e Consulta
5.
Int J Psychiatry Clin Pract ; : 1-7, 2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38014674

RESUMO

OBJECTIVE: A bidirectional relationship between family functioning and parenting styles and Attention Deficit and Hyperactivity Disorder (ADHD) is proposed. The aim of this study is to examine the effect of ADHD symptoms on parenting styles and the general functionality of the family as well as symptoms of depression and anxiety. METHODS: 73 children with ADHD (56%) and 56 controls (43%) (a total of 129 participants, 31% female, 69% male) with a mean age of 11.3 (7-17, n: 129) were included in the study, which was conducted in Gaziantep University Hospital Child Psychiatry Department in 2022. The participants completed psychometric scales. RESULTS: Parents of children with ADHD showed higher positive parenting scores than the control group (p < 0.05). Inconsistent discipline scores were substantially higher in the ADHD combined subtype (14.38 ± 5.2) than in the attention deficit dominant group (17.59 ± 3.96) In addition, a strong correlation was found between familial functionality scores and ADHD severity in the ADHD attention deficit dominant subtype (r:0.601; p:0.027) and as ADHD severity increased, family functionality decreased. CONCLUSIONS: This study shows that parents of children with ADHD have different parenting styles and ADHD affects the overall functionality of the family in the Turkish sample.

6.
Tuberk Toraks ; 71(4): 325-334, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38152003

RESUMO

Introduction: In a resource-constrained situation, a clinical risk stratification system can assist in identifying individuals who are at higher risk and should be tested for COVID-19. This study aims to find a predictive scoring model to estimate the COVID-19 diagnosis." Materials: Patients who applied to the emergency pandemic clinic between April 2020 and March 2021 were enrolled in this retrospective study. At admission, demographic characteristics, symptoms, comorbid diseases, chest computed tomography (CT), and laboratory findings were all recorded. Development and validation datasets were created. The scoring system was performed using the coefficients of the odds ratios obtained from the multivariable logistic regression analysis." Result: Among 1187 patients admitted to the hospital, the median age was 58 years old (22-96), and 52.7% were male. In a multivariable analysis, typical radiological findings (OR= 8.47, CI= 5.48-13.10, p< 0.001) and dyspnea (OR= 2.85, CI= 1.71-4.74, p< 0.001) were found to be the two important risk actors for COVID-19 diagnosis, followed by myalgia (OR= 1.80, CI= 1.08- 2.99, p= 0.023), cough (OR= 1.65, CI= 1.16-2.26, p= 0.006) and fatigue symptoms (OR= 1.57, CI= 1.06-2.30, p= 0.023). In our scoring system, dyspnea was scored as 2 points, cough as 1 point, fatigue as 1 point, myalgia as 1 point, and typical radiological findings were scored as 5 points. This scoring system had a sensitivity of 71% and a specificity of 76.3% for a cut-off value of >2, with a total score of 10 (p< 0.001). Conclusions: The predictive scoring system could accurately predict the diagnosis of COVID-19 infection, which gave clinicians a theoretical basis for devising immediate treatment options. An evaluation of the predictive efficacy of the scoring system necessitates a multi-center investigation.


Assuntos
COVID-19 , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , COVID-19/diagnóstico , COVID-19/epidemiologia , Estudos Retrospectivos , Teste para COVID-19 , Mialgia , Dispneia/diagnóstico , Dispneia/etiologia , Tosse/diagnóstico , Tosse/epidemiologia , Tosse/etiologia
7.
Turk J Med Sci ; 53(5): 1330-1338, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38813030

RESUMO

Background/aim: Chronic subdural hematoma is the most frequently operated on intracranial hemorrhage worldwide. Although surgical results are satisfactory, recurrence remains an important problem. In this study, it was aimed to evaluate patients who underwent craniotomy with limited membranectomy (CwLM) in terms of recurrence rate and other complications. Materials and methods: Electronic records of 291 consecutive patients who were operated on at our clinic (Atatürk University Yakutiye Research Hospital) between 2015 and 2020 were retrospectively reviewed. Their radiological images at the time of admission, clinical status, any early postoperative complications, and clinical status at the 6-month follow-up were all evaluated. Results: According to the results of the study, postoperative mortality and morbidity of patients who underwent CwLM were similar to those with minimally invasive methods, and it reduced recurrence, especially in laminar and separated subtypes. Conclusion: It is our belief that CwLM will be an appropriate treatment approach in suitable patients (radiologically detected) in chronic subdural hematoma, where recurrence is an important problem.


Assuntos
Craniotomia , Hematoma Subdural Crônico , Humanos , Hematoma Subdural Crônico/cirurgia , Hematoma Subdural Crônico/diagnóstico por imagem , Craniotomia/métodos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Adulto , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia , Recidiva , Idoso de 80 Anos ou mais
8.
Intern Med J ; 52(9): 1495-1504, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35257465

RESUMO

BACKGROUND: Laboratory biomarkers to estimate the severity of coronavirus disease 2019 (COVID-19) are crucial during the pandemic since resource allocation must be carefully planned. AIMS: To evaluate the effects of basal serum total immunoglobulin E (IgE) levels and changes in inflammatory parameters on the clinical progression of patients hospitalised with COVID-19. METHODS: Patients hospitalised with confirmed COVID-19 were included in the study. Laboratory data and total IgE levels were measured on admission. Lymphocyte, eosinophil, ferritin, d-dimer and C-reactive protein parameters were recorded at baseline and on the 3rd and 14th days of hospitalisation. RESULTS: The study enrolled 202 patients, of which 102 (50.5%) were males. The average age was 50.17 ± 19.68 years. Of the COVID-19 patients, 41 (20.3%) showed clinical progression. Serum total IgE concentrations were markedly higher (172.90 (0-2124) vs 38.70 (0-912); P < 0.001) and serum eosinophil levels were significantly lower (0.015 (0-1.200) vs 0.040 (0-1.360); P = 0.002) in clinically worsened COVID-19 patients when compared with stable patients. The optimal cut-off for predicting clinical worsening was 105.2 ng/L, with 61% sensitivity, 82% specificity, 46.3% positive predictive value and 89.2% negative predictive value (area under the curve = 0.729). Multivariable analysis to define risk factors for disease progression identified higher total IgE and C-reactive protein levels as independent predictors. CONCLUSIONS: Our single-centre pilot study determined that total IgE levels may be a negative prognostic factor for clinical progression in patients hospitalised due to COVID-19 infection. Future studies are required to determine the impact of individuals' underlying immune predispositions on outcomes of COVID-19 infections.


Assuntos
COVID-19 , Adulto , Idoso , Biomarcadores , Proteína C-Reativa , Feminino , Humanos , Imunoglobulina E , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Prognóstico , Estudos Retrospectivos , SARS-CoV-2
9.
J Craniofac Surg ; 33(1): 322-324, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34267125

RESUMO

ABSTRACT: It was aimed to examine the orbital region in children with autism spectrum disorder and comparison with the healthy controls in the present study. A total of 195 children and adolescents (101 of them were in the autism group, 94 of them were in healthy group) were evaluated. Anterior view photographs were taken, and endocanthion (en), exocanthion (ex), and pupil were determined bilaterally on the photographs. Outer canthal (ex-ex), intercanthal (ex-en), inner canthal (en-en) and interpupillary distances were measured and intercanthal index [(en-en / ex-ex) × 100] was calculated. There was a statistically significant difference between the groups for males for all parameters, while a statistically significant difference was not observed for females. All orbital region distances were higher in male autistic children. Although minor physical anomalies in children and adolescents with autism have been reported before, anthropometric measurements in individuals with autism may differ between genders. Further studies are needed to investigate the differences between genders in autism spectrum disorder.


Assuntos
Transtorno do Espectro Autista , Adolescente , Antropometria , Criança , Face/anatomia & histologia , Feminino , Nível de Saúde , Humanos , Masculino , Pupila
10.
Women Health ; 62(4): 293-301, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35414348

RESUMO

This study compared the pelvic floor dysfunction (PFD) symptoms and knowledge levels in obese and non-obese women. The study included 40 obese and 41 non-obese women. The presence of PFD and the severity of its symptoms were questioned with the Pelvic Floor Distress Inventory-20 (PFDI-20) (its sub-scales: Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Colorectal-Anal Distress Inventory-8 (CRADI-8), Urinary Distress Inventory-6 (UDI-6)). Participants' PFD knowledge levels were evaluated with the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and the Anal Incontinence Knowledge Questionnaire (AIKQ). The rates of urinary incontinence (UI) and pelvic organ prolapse (POP) symptoms were higher in the obese group compared to the control group (p = .001). The POPDI-6, CRADI-8, UDI-6, and PFDI-20 scores were higher in the obese group compared to the control group (p < .001). Moreover, the knowledge level related to treatment methods for PFD was lower in the obese women compared to the non-obese women (p < .05). PFD symptom incidence and severity were higher and knowledge levels related to PFD were lower in the obese women compared to the non-obese women. Informative teaching programs on this issue would be beneficial as part of preventive health services.


Assuntos
Distúrbios do Assoalho Pélvico , Prolapso de Órgão Pélvico , Feminino , Humanos , Obesidade/complicações , Diafragma da Pelve , Distúrbios do Assoalho Pélvico/complicações , Qualidade de Vida , Inquéritos e Questionários
11.
Psychol Health Med ; 27(5): 1117-1130, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-33486992

RESUMO

All healthcare workers (HCWs) encounter stress during in their working lives, and are constantly exposed to adverse conditions. The present study evaluates the relationship between burnout syndrome, anxiety levels and insomnia severity among healthcare workers, who mostly work in shifts. The Maslach Burnout Inventory, the Insomnia Severity Index and the Beck Anxiety Inventory were used to measure burnout, insomnia severity and anxiety status, respectively. This cross sectional study included a total of 1,011 HCWs and 679 (67.2%) of the study respondents were women. The respondents were aged 20-72, with a mean age of 35.67 ± 8.61 years. Fifty-eight percent (n = 589) of the participants were rotating shift workers. Working on-call led to a significant difference in all burnout parameters (for each, <0.001). Age and on-call duty were seen to lead to a significant difference in the severity of insomnia (p = 0.028, p < 0.001, respectively). The total ISI score was found to be statistically significant positively correlated with the MBI subscales and the total BAI score (for each, <0.001). An increased awareness of the impact of sleep deprivation, burnout and anxiety among HCWs and meaningful interventions promoting change within the healthcare system are needed.


Assuntos
Esgotamento Profissional , COVID-19 , Distúrbios do Início e da Manutenção do Sono , Adulto , Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento Psicológico , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Masculino , Distúrbios do Início e da Manutenção do Sono/epidemiologia
12.
Surg Technol Int ; 412022 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-36017960

RESUMO

BACKGROUND: Laparoscopic surgery for colorectal cancer is mostly performed in university hospitals or experienced centers. This study aimed at determining the learning curve of laparoscopic surgery for colorectal cancer at a new regional state hospital. PATIENTS AND METHODS: Clinico-pathological data of 106 consecutive patients who underwent laparoscopic surgery for colorectal cancer at a new regional state hospital between August 2018 and September 2021 were prospectively recorded and analyzed. All surgeries were performed by a single inexperienced surgeon without supervision. The primary outcome of the study was the operative time, which was used for a Cumulative Sum (CUSUM) analysis of the learning curve. The secondary outcomes included a comparison of preoperative, intraoperative, and postoperative outcomes during the learning curve period. RESULTS: According to the CUSUM analysis, the learning curve consisted of three unique phases: phase 1 [the initial learning period (cases 1-53)], phase 2 [the consolidation period (cases 54-68)], and phase 3 [the experienced period (cases 69-106)]. Of the intraoperative outcomes, operative time and estimated blood loss were significantly reduced from phase 1 to phase 3 (p<0.001). Of the postoperative outcomes, time to pass stool (p<0.05), time to oral feeding (p=0.001), drain removal time (p<0.001), and length of hospital stay (p=0.042) were shorter in phase 3 compared to phases 1 and 2. Of the histopathological results, the specimen length and the number of harvested lymph nodes increased with experience (p=0.001). CONCLUSIONS: The present results suggest that a surgeon at a new regional state hospital must experience 53-68 cases to achieve competence in laparoscopic colorectal cancer surgery.

13.
Nord J Psychiatry ; 76(2): 150-157, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34232109

RESUMO

AIM: The aim of the current study is to compare serum B12, folate, and ferritin levels and peripheral inflammatory indicators between children with Autism Spectrum Disorders (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and healthy controls (HC) and to evaluate the correlation of those with symptoms. MATERIALS AND METHODS: A total of 203 children were evaluated (ASD = 72; ADHD = 61; HC = 70). Diagnoses of ASD and ADHD were ascertained according to Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL). Control group was chosen among the healthy children who applied to general pediatrics outpatient clinic. Gilliam Autism Rating Scale-2 is used to assess autistic symptoms and Atilla Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale is used for ADHD symptoms. RESULTS: Neutrophil levels (p = 0.014) and neutrophil/lymphocyte ratio (NLR) (p = 0.016) were higher in the ADHD and ASD groups compared to HC. Neutrophil values explained 70.1% of the variance across groups while NLR explained a further 29.9% of the variance. NLR significantly correlated with social interaction problems in ASD (r = 0.26, p = 0.04). There were no significant differences between groups in terms of vitamin B12, folate and ferritin levels. CONCLUSION: Our results may support involvement of inflammation in the underlying pathophysiology of neurodevelopmental disorders. However, these parameters should be analyzed in a wider population to clarify the effect on the etiology and symptomatology of neurodevelopmental disorders.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Biomarcadores/sangue , Criança , Ferritinas/sangue , Ácido Fólico/sangue , Humanos , Vitamina B 12/sangue
14.
Int Ophthalmol ; 42(4): 1347-1354, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35083600

RESUMO

PURPOSE: To evaluate arterial stiffness using the pulse wave velocity (PWV) and augmentation index (AI) in central retinal vein occlusion (CRVO) patients. METHODS: Forty-two CRVO patients (i.e., CRVO group) and 54 healthy controls (i.e., control group) were included in this comparative and cross-sectional study. The PWV, AI and augmentation pressure were measured with a noninvasive, oscillometric method. RESULTS: The mean PWV, AI and augmentation pressure values were significantly higher in CRVO patients than in controls (p = 0.024, p < 0.001 and p = 0.001, respectively). The mean augmentation pressure, AI and PWV measurements were not statistically significant between CRVO patients with and without hypertension (p = 0.856 and p < 0.526, p = 0.432, respectively). Age, presence of hypertension, AI and PWV were found to be as independent risk factors of CRVO development (OR = 2.21, 95% CI [1.44, 3.38] and OR = 2.40, 95% CI [1.50, 3.86], OR = 3.2, 95% CI [1.70, 5.60] and OR = 5.70, 95% CI [2.00, 18.50], respectively). CONCLUSION: The AI and PWV values were significantly higher in CRVO patients than in controls. These results indicate that similar abnormalities in the arterial wall structure may play an important role in the pathogenesis of the CRVO and cardiovascular diseases. In addition, our findings show that each patient with RVO should be examined in terms of systemic vascular pathologies.


Assuntos
Hipertensão , Oclusão da Veia Retiniana , Rigidez Vascular , Pressão Sanguínea , Estudos Transversais , Humanos , Hipertensão/complicações , Análise de Onda de Pulso , Oclusão da Veia Retiniana/complicações , Oclusão da Veia Retiniana/diagnóstico
15.
Tuberk Toraks ; 70(4): 324-333, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36537089

RESUMO

Introduction: Noninvasive ventilation (NIV) for acute hypercapnic respiratory failure (AHRF) is an established treatment modality. Current evidence does not conclude any superiority between fixed pressure support (PS) and average volume-assured pressure support (AVAPS) modes. However, given the ability of rapid PaCO2 decline in AVAPS mode, we hypothesized that COPD patients with AHRF who did not show the desired reduction in PaCO2 with fixed-level PS-NIV might benefit from the AVAPS mode. Materials and Methods: Patients admitted to the non-ICU pulmonary ward with acute exacerbation of COPD (AECOPD) and AHRF were included consecutively in this observational study. Patients with hypercapnic respiratory failure due to obesity-hypoventilation, neurological diseases, or chest wall deformities were excluded. All patients started NIV treatment with fixed pressure support (PS) and patients who did not reach clinical and laboratory stability under PS-NIV treatment were switched to the average volume-assured pressure support (AVAPS) mode of NIV. Result: Thirty-five COPD patients with hypercapnic respiratory failure were included. Under PS-NIV treatment, 14 (40%) patients showed a 17.9 (-0.0-29.2) percent change in terms of PaCO2, meaning no improvement or worsening. Therefore, these patients were treated with AVAPS mode. Arterial PaCO2 and pH levels significantly improved after AVAPS-NIV administration. AVAPS-NIV treatment created a significantly better PaCO2 change rate than using PS-NIV [-11.4 (-22.0 - -0.5) vs 8.2 (-5.3-19.5), p= 0.02]. Independent predictors of AVAPS mode requirement were higher Charlson Comorbidity Index [OR= 1.74 (95% CI= 1.02-2.97)] and higher PaCO2 upon admission [OR= 1.18 (95% CI= 1.03-1.35)]. Thirteen (92.8%) patients reaching significant clinical stability with AVAPS-NIV were able to return to fixed-level PS-NIV and maintain acceptable PaCO2 levels. Conclusions: Our study demonstrated that patients can benefit from AVAPSNIV despite insufficient response to fixed-level PS-NIV.


Assuntos
Ventilação não Invasiva , Doença Pulmonar Obstrutiva Crônica , Insuficiência Respiratória , Humanos , Respiração com Pressão Positiva , Respiração Artificial , Insuficiência Respiratória/terapia , Doença Pulmonar Obstrutiva Crônica/terapia , Hipoventilação , Hipercapnia
16.
Reumatologia ; 60(3): 220-223, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35875715

RESUMO

Introduction: In this study, we aimed to determine the frequency of MEFV mutations in Behçet's disease (BD) and to investigate the relationship between clinical findings of the disease and the MEFV mutations. Material and methods: A total of 66 participants (30 BD patients, 36 healthy subjects) were included in this study. The MEFV gene was analyzed by using DNA sequence analysis. Results: The distribution of MEFV mutations was not significantly different between the patients and the control group (p = 0.373). However, individuals with R202Q mutation had a risk of OR 4 times (95% CI: 1.1-14.5) higher than those without the mutation (p = 0.035). The rate of vascular involvement was statistically significantly higher in patients with the mutation than in patients without the mutation (p = 0.005). Conclusions: MEFV mutation was associated with vascular involvement in patients with BD. This is also the first study to indicate that the R202Q mutation may have a role in BD. However large series from different regions are required to compare these results.

17.
Am J Emerg Med ; 46: 515-519, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33172746

RESUMO

BACKGROUND: Posterior-anterior chest x-ray (PA-CXR) is among the most commonly used imaging methods in the diagnosis both in the emergency departments (ED) and the other clinics. The aim of the present study was to evaluate the diagnostic reliability of PA-CXRs sent via a smartphone. METHODS: This study was conducted as an inter-observer study. PA-CXRs were photographed with a smartphone and they were sent to two separate participants (emergency medicine specialists one with 4 years experience and another with 3) via the WhatsApp application. And the participants evaluated to these images on their mobile phone. RESULTS: A poor concordance was determined in a ratio of 3/8 and good concordance was detected in a ratio of 3/8 between the two participants (p < 0.05). It was observed that only the mediastinum assessments could be an alternative to the gold standard (p < 0.01). CONCLUSION: We may conclude that the assessments done via a smartphone (photographing and sharing) may not be reliable.


Assuntos
Medicina de Emergência , Fotografação , Radiografia Torácica , Smartphone , Adulto , Idoso , Osso e Ossos/diagnóstico por imagem , Feminino , Coração/diagnóstico por imagem , Humanos , Pulmão/diagnóstico por imagem , Masculino , Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Variações Dependentes do Observador , Médicos , Pleura/diagnóstico por imagem , Reprodutibilidade dos Testes , Telerradiologia
18.
J Oncol Pharm Pract ; 27(7): 1665-1673, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33040673

RESUMO

INTRODUCTION: Erlotinib is an effective treatment option for EGFR-mutant non-small cell lung cancer. It is important to predict patients who will respond better to erlotinib. We designed this study to investigate the effect of renal insufficiency (RI) on erlotinib treatment outcomes. METHODS: All patients receiving erlotinib were stratified into 3 groups. Group 1 consisted of non-RI subjects with classical epidermal growth factor receptor (EGFR) mutations, Group 2 consisted of those with RI (Estimated glomerular filtration rate <60 mL/min) and classical EGFR mutations, and Group 3 consisted of those with non-classical EGFR mutations. RESULTS: 82 patients were included in the study. Median progression-free survival (PFS) in patients with classical mutation was approximately 6 months shorter in those with RI, although not statistically significant. Median overall survival (OS) in Group 1, 2 and 3 was 34.1 months, 35.2 months, and 15 months, respectively and although not statistically significant, median OS was 20 months shorter in Group 3. Univariate and multivariate cox-regression analysis revealed shorter PFS and OS in males and those with ECOG ≥2 while PFS and OS were longer in those with recurrent lung tumors and generating rash during erlotinib treatment. There was no difference between RI and non-RI patients in terms of adverse events except for fatigue and appetite loss. CONCLUSIONS: This research showed OS in patients with and without RI was comparable. Although not statistically significant, PFS in patients with classical mutation was approximately 6 months shorter in those with RI patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Insuficiência Renal , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Receptores ErbB/genética , Cloridrato de Erlotinib/efeitos adversos , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Masculino , Mutação , Recidiva Local de Neoplasia , Inibidores de Proteínas Quinases/efeitos adversos , Quinazolinas , Insuficiência Renal/genética
19.
Int J Psychiatry Clin Pract ; 25(3): 325-330, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34097567

RESUMO

OBJECTIVE: Attention deficit/hyperactivity disorder (ADHD) is associated with impairment in social, academic and job-related functioning in both children and adults. The purpose of this study is to investigate the susceptibility to cardiovascular risk factors in children with ADHD diagnosis through common carotid artery intima-media thickness (cIMT) measurement, to compare cIMT in ADHD and control groups and to evaluate the association between cIMT and ADHD symptom severity. METHODS: The mean cIMT of 42 children with ADHD, ADHD symptom scales and a semi-structured psychiatric interview, and 42 age and sex matched healthy controls were measured with B-mode Doppler neck ultrasonography. RESULTS: The median cIMT was significantly higher for the ADHD group compared to the healthy controls. There was a statistically significant, negative, moderate correlation between cIMT and Conners ADHD index score, hyperactivity score, oppositional score and the presence of ODD comorbidity. CONCLUSIONS: In this study, we found significantly higher cIMT in children with ADHD when compared to healthy controls. Considering that increased cIMT is a sign of atherosclerosis and it can be used as a marker of cardiovascular risk factors, our finding may indicate that children with ADHD are at increased risk for cardiovascular diseases.KeypointscIMT was significantly higher in children with ADHD when compared to healthy controls.Higher cIMT in children with ADHD may indicate that children with ADHD are at increased risk for cardiovascular diseases.cIMT measurement may be studied as a potential tool for risk assessment before a child with ADHD is started on psychostimulant medications.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Doenças Cardiovasculares , Artéria Carótida Primitiva , Espessura Intima-Media Carotídea , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Biomarcadores , Doenças Cardiovasculares/epidemiologia , Artéria Carótida Primitiva/diagnóstico por imagem , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Medição de Risco
20.
Tuberk Toraks ; 69(1): 49-58, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33853305

RESUMO

INTRODUCTION: Tobacco-free college campuses refer to colleges and universities that have implemented policies prohibiting the use of tobacco products at all indoor and outdoor campus locations. We aimed to evaluate university students' smoking behaviors and their attitudes towards "Tobacco-Free Campus Policy". MATERIALS AND METHODS: A total of 10,383 university students were included in this cross-sectional study. The questionnaire was sent via web-based student information system. Demographical variables, the frequency of tobacco use, the addiction levels of the smoker students, and their perspective on the Tobacco-Free Campus Policy were evaluated. RESULT: The study population consisted of 5461 (52.6%) males and their mean age was 22.1 ± 3.9 years. Among the students, 3992 (38.4%) were current smokers and the age of first smoking was 16.5 ± 2.78 years. According to FTND scores, 15.1% of participants have high dependence, and 7.5% of them have very high dependence. There was a significant difference among participants who finds unacceptable "Tobacco-Free Campus Policy" in terms of gender (70.7% males vs. 29.3% females, p<0.001) and smoking habit (7% never smoker, 4.1% ex-smoker, 88.9% current smoker, p<0.001). CONCLUSIONS: The Tobacco-Free Campus Policy is important to fight against the tobacco industry in order to protect the right to health of all tobacco users and those who do not use it and should be considered as a goal to be achieved in order to live in a healthy environment.


Assuntos
Política Antifumo , Fumantes/psicologia , Prevenção do Hábito de Fumar/métodos , Fumar/psicologia , Estudantes/psicologia , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
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