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Quality of Life in Multiple Sclerosis: Are Depressive Findings as Effective as Physical Disability?
No full textAmaç: Multipl Sklerozda (MS) yaşam kalitesinin bozulması tedavi uyumunu ve klinik takibi güçleştirir. Çalışmamızda hastaların yaşam kalitesine etki eden faktörlerden fiziksel nedenler ile psikolojik olarak en fazla gözlenen depresif bulgular arasında karşılaştırma yaparak, bu konunun önemini vurgulamayı amaçladık. Yöntemler: Mc Donalds kriterlerine göre relapsing-remitting tanısı almış 100 hasta çalışmaya dahil edildi. Sosyodemografik özellikleri, hastalık başlangıç yaşları, hastalık süreleri, özürlülük düzeyleri, Beck Depresyon Ölçeği, Yorgunluk Şiddet Ölçeği ve Kısa Form Yaşam Kalitesi Ölçeği skorları kaydedildi. Bulgular: 65’i kadın, 35’i erkek 100 hastanın yaş ortalaması 35,21 ± 8,86 (min-max:18-63) yıldı. Ortalama Krutzke Genişletilmiş Dizabilite Durum Skalası (EDSS) skorları 1,65 ± 1,47 (min-max:0-6,5) olarak kaydedildi. Beck Depresyon Ölçeği skorları kadınlarda erkeklere göre daha yüksek gözlendi (13,8 ± 11,02 vs 10,17 ± 6,15; p:0,036). Depresyonu olan hastaların depresyonu olmayanlara göre; yorgunluk şiddet ve yorgunluk etki ölçeği skor ortalamaları daha yüksekken, yaşam kalitesi ölçeği skorları daha düşük izlendi (p<0,001). Depresyon varlığının ve EDSS skorlarının yaşam kalitesi skorlarına etkisi incelendiğinde, yaşam kalitesi ölçeği ile EDSS skorları arasında istatistiksel açıdan anlamlı negatif yönlü orta şiddette bir ilişki gözlendi (r=-0,508; p<0,001). Yaşam kalitesi ile depresyon skorları arasında istatistiksel açıdan anlamlı negatif yönlü orta şiddette bir ilişki saptandı (r=-0,507; p<0,001). Sonuç: MS hastalarının fiziksel özürlülüğü nedeniyle ortaya çıkan yaşam kalitesi bozukluğu benzer şekilde depresif bulgular için de geçerlidir. Sonuçlarımız fiziksel özürlülük oluşmaması için gereken özenin (tedavi seçimi, yeni tedavi arayışları gibi) depresif bulgular için de gösterilmesi ve multipl skleroz hastasına multidisipliner yaklaşımın gerekliliğini bir kez daha ortaya koymuştur.Objective: Impairment of multiple sclerosis (MS) life make it difficult to comply with treatment and the clinical follow-up. In our study we emphasized the importance of this problem, compared with the most common depressive results the physical factors that affect the quality of life for patients. Methods: 100 patients were included in the study who were diagnosed with re-transmission in accordance with Mc Donalds criteria. Social demographic properties, age, duration of the disease, levels of disability, Beck Depression Scale, Fatigue Severity Scale and Life Scale Short Form Quality were recorded. Results: The mean age was 35,21 ± 8,86 (min-max:18-63) years for 100 patients, 65 females and 35 males. Approximately 1.65 ± 1.47 Expanded Disability Status Scale (EDSS) scores (min-max. 00-6.5) were recorded. In women the rate of Beck Depression was higher than in men (13.8 ± 11.02 vs 10.17 ± 6.15; p: 0.036). The mean measures of fatigue severity and tiredness were higher, but the scale of the quality of life was lower (p<0.001) according to patients with no depression. On the basis of a statistically significant negativemoderate relationship between the quality of life scale and EDSS scores (r = -0.508; p < 0.001) when depression and EDSS scores were evaluated. The negative correlation between quality of life and depression values was statistically significant (r=-0.507; p < 0.001). Conclusion: For depressive findings, the quality of life disorder caused by MS patients are equally valid. Once again, our results have shown the need to ensure that depressive observations are avoided (such as medication availability, the need for a new procedure) and that a multidisciplinary approach is needed for patients with multiple sclerosis
Origin of SARS-CoV-2
No full textŞiddetli akut solunum sendromu ilişkili bir koronavirüsün [se- vere acute respiratory syndrome-related coronavirus (SARS-CoV-2)] etiyolojik etkeni olduğu koronavirüs hastalığı-19 [coronavirus disease- 19 (COVID-19)] pandemisi mevcut ve olası sonuçları açısından tüm dünyayı etkisi altına almıştır. SARS-CoV-2, 21. yüzyılın başından beri reseptör bağlanma ve proteoliz gibi kritik tür bariyerlerini aşarak sal- gınlara neden olabilen üçüncü koronavirüstür. Koronavirüslerin yük- sek sıklıkta mutasyon ve homolog RNA rekombinasyon kabiliyetleri, yeni viral genotiplerin oluşmasına, yeni çevrelere adaptasyon sağlama ve doku tropizmlerinin değişmesine imkân sağlayabilmektedir. İnsan SARS-CoV-2 ve yarasa koronavirüs sekansları arasındaki yüksek ben- zerlik nedeni ile SARS-CoV’nin doğadaki rezervuarının yarasalar ol- duğu kabul edilmektedir. Buna karşın, SARS-CoV-2’nin yarasalardan İnsana bulaşında rolü olan bir ara konağın varlığı ya da olası molekü- ler mekanizmalar henüz tanımlanmamıştır. Diğer yandan, özellikle SARSCoV-2’nin RaTG13’ten farklı olarak viral spike proteinini kod- layan genomda bir polibazik (furin) kesim alanı içeren insersiyon içer- mesi ve reseptör ACE2’ye bağlanma afinitesindeki artış dikkat çekici olarak yorumlanmaktadır. Dolayısıyla SARS-CoV-2'nin yarasadan in- sana bulaşma mekanizmaları henüz net olarak tanımlanmadığından, vi- rüsün kökeni hakkında bazı tartışmalar devam etmektedir. Bu çalışmada, SARS-CoV-2’nin orjinine ilişkin bilimsel verilerin değer- lendirilmesi amaçlanmıştır.The Coronavirus disease 19 (COVID-19) pandemic which is the etiological agent of severe acute respiratory syndrome- associated a coronavirus (SARS-CoV-2) has influenced the whole world with the current and possible results. SARS-CoV-2 is the third coronavirus causing outbreaks by overcome critical species barriers such as receptor binding and proteolysis since the beginning of the 21st century. Capabilities of coronaviruses high frequency mutation and ho- mologous RNA recombination can support that is formation of new viral genotypes, adapt to new environments, change tissue tropisms. It is considered that reservoir in natural of SARS-CoV-2 is bats because between sequence of human SARS-CoV-2 and bat coronavirus RaTG13 is similar at high level. However, existence of an intermedi- ate host that plays a role in the transmission of SARS-CoV-2. However from bats to human or possible molecular mechanisms have not been identified yet. On the other hand, it is interpreted as remarkable that unlike RaTG13, especially SARS-CoV-2 contains a polybasic (furin) cleavage site insertion in genome encoding viral spike protein and increased affinity of binding to receptor ACE2. Therefore, there is some of discussions continues about origin of the virus because mechanisms of bat-to-human transmission of SARS-CoV-2 has not been clearly identified yet. In this review, it is aimed to examination scientific data about the origin of SARS-CoV-2
Robotic Gynecologic Surgery: What it Means for Women
No full textAKYUZ, AYGUL/0000-0001-7477-9932WOS:000613115500012Objective: The aim of this study is to improve the understanding of the experiences of women undergoing robotic-assisted gynecologic surgery. Methods: A qualitative descriptive phenomenologic approach was used. We conducted phone interviews with women who had undergone a gynecologic procedure via robotic-assisted surgery in a gynecology clinic of a university hospital (n=19). Semi-structured interviews were conducted with women, and data were analyzed using Colaizzi's methods. Results: Two major themes were identified. These two themes concerned: (1) Ambivalent Feelings on Robotic Surgery, and (2) Robotic Surgery was a Piece of Cake. Conclusions: Because of the newness of this procedure, the women in this study indicated that they had concerns and lacked information about robotic-assisted gynecologic surgery but that their decision was influenced by the confidence they had in their physicians. The women indicated that they had confidence in the robotic technique and recovered quickly physically
Study on the relationship between low back pain and emotional state, sleep and quality of life in postmenopausal women
No full textPubMed: 32804115WOS:000595519300013OBJECTIVE: The aim of this study was to investigate the incidence of low back pain in the postmenopausal period and the relationship between low back pain and emotional state, sleep and quality of life. METHODS: This cross-sectional study was conducted with 368 postmenopausal women between 40 and 65 years old. The frequency and severity of low back pain were recorded for all participants, as well as depressive symptoms and anxiety, quality of life and sleep quality. RESULTS: 90.2% of the participants reported low back pain. As low back pain severity increased, it was found that depression, anxiety levels, NHP and PSQI total scores increased as well (p = 0.0001). Significant positive correlations were found between pain intensity and outcome measures, except for sleep duration and habitual sleep efficiency (p < 0.01). CONCLUSION: A great majority of women experience postmenopausal low back pain, which causes significant problems that negatively affect their quality of life, emotional state and sleep quality
Urodynamic Study Findings Prior to Myelomeningocele Repair in Neonates
No full textPubMed: 33531935WOS:000639444900009Introduction: Myelomeningocele (MMC) is the most common cause of neurogenic bladder dysfunction in children. Neurogenic bladder dysfunction is developed before birth due to autonomous nervous system affected prenatally in patients with MMC. The aim of this study was to share urodynamic study findings before MMC repair and to discuss the correlation with neurological evaluation. Materials and Methods: We prospectively studied 37 patients who underwent surgery for MMC repair in our institution in the first 20 h of their lives between 2013 and 2016. All patients were evaluated by a neurosurgeon, neonatologist, and pediatric surgeon. Urodynamic study was performed in first 18 h of life before MMC repair in all patients. Lesion level, occurrence of hydrocephalus, neurological functions, spinal deformities, and urodynamic study results were analyzed. Results: The study included 18 female and 19 male patients. Overactive detrusor was detected in 22 patients, and hypoactive detrusor was detected in 5 patients. Overactive sphincter muscle was detected in 32 patients, and hypoactive sphincter was detected in 2 patients. Detrusor-sphincter dyssynergia was present in 34 patients. Conclusion: Detailed analysis of urodynamic study findings in larger patient groups may be important to understand the physiopathology of prenatal damage in patients with MMC
Comparison between Chest CT and X-ray Under 15 Years Old: Has Technological Progress Lead to Higher Radiation Exposure?
No full textObjectives: PA chest X-ray is the first choice for evaluation of the lung pathologies in children. The use of computedtomography (CT) has been increasing due to defensive medicine approaches and diagnostic advantages such as multiplanar imaging. The most important situation in childhood imaging is avoiding high radiation exposure, which is thedisadvantage of CT. In this study, diagnostic coherence between chest X-ray and CT and the necessity of chest CT wereevaluated.Methods: 644 patients under 15 years old who had admitted to emergency room and underwent chest CT betweenJanuary 2017 and January 2019 were enrolled in this retrospective study. 348 of 644 patients had just chest CT withoutchest X-ray. All pathologies in chest CT and chest X-ray were examined by two radiologist (F.E.U, B.O). Lung pathologieswere classified as radiologically. Statistical Package for the Social Sciences (SPSS, version 21 for windows) was used forthe statistical analysis. The coherence between chest X-ray and CT was evaluated with Cohen’s kappa test. P<0.05 wasconsidered.Results: Chest CT was performed only in 0.9% of under 15 years old patients who had chest X-ray between January 2017 and January 2019. Normal radiological findings were found in 288 of 348 patients (83%) who had only CTscanning. There were coherence for all radiological findings (atelectasis, consolidation, ground glass opacity, nodularinfiltration, pneumothorax, pleural effusion, bone fracture, mass and cavitary lesions) in between two methods. In 8patients who had both chest CT and X-ray, cavitary lesion was not detected in chest X-ray (Kappa: 0.490, p=0.002).Conclusion: Patients had mostly normal findings when they were examined by just CT before not underwent chest X-ray.There was a coherence between two examinations in all lung pathologies. Radiation exposure significantly decreaseswhen the patients examined firstly with PA chest X-ray. There are problems such as positioning and inspirium sufficiencyin chest X-ray in children, but it is usually enough for evaluating lung pathologies, as seen in our study. We think that it isappropriate to perform chest X-ray firstly in stable patients. Further, we think that it is also appropriate to perform chest Ctwhen clinical findings was not regress or for excluding additional pathologies
Bilateral Optic Neuropathy in a Patient with Imatinib Usage
No full textA 59-year-old woman presented with a painless vision loss in her left eye for five days. The nasal side of the right optic nerve head was mildly oedematous and hyperaemic, and the left optic nerve head was oedematous and hyperaemic. She was diagnosed as bilateral optic neuropathy. Imatinib was stopped, intravenous metilprednisolone was given for a week. The vision and fundus findings recovered in a few days. After 2 months imatinib was restarted, there was no ocular side effects until now. Imatinib is an important drug in the treatment of chronic myeloid leukemia, but bilateral optic neuropathy, which is a serious ocular side effect, may be seen related to imatinib mesylate usage
Determination of the anxiety and the needs of family members of critical care patients in emergency departments
No full text2-s2.0-85101256231Aims: It is very important to find ways to meet the needs of patients' family members and to control their anxiety. This study aims to identify the needs and anxiety levels of family members of critically-ill adult patients in emergency departments (ED). Methods: This descriptive study was conducted in the adult ED of a training and research hospital in Turkey. In order to collect data, we conducted face-to-face interviews with family members of critically-ill patients. The “Critical Care Family Needs Inventory-Emergency Department” (CCFNI-ED) and the “Spielberger State Trait Anxiety Inventory-State Scale” (STAI-S) were also used to identify the needs and the anxiety levels of the family members. Results: The average age of the participants was 40.81±13.32 years. Of the participants (n=172), 61.6% (n=106) were female. CCFNI-ED results showed that eight of the ten needs expressed by family members were related to communication. Overall anxiety level of the family members was 49.67%. Additionally, a statistically significant correlation was found between being female and STAI-S scores (t=2.41, p=0.01). 18.6% of family members expressed that their needs were unmet, while 29.1% of the participants stated that their needs were met. Conclusions: This study found no significant correlations between the scores obtained from STAI-S and CCFNI-ED. However, a statistically significant correlation was found between being female and STAI-S scores of relatives. Health professionals should take the higher anxiety levels of female family members into consideration, and they should pay attention to the needs of patients' relatives in order to manage their anxiety. © 2020 the University of Health Sciences Turkey, Gülhane Faculty of Medicine / Gülhane Medical Journal published by Galenos Publishing House. All Rights Reserved
GIANT THROMBUS IN A STROKE PATIENT WITH BIOLOGICAL MITRAL VALVE REPLACEMENT
No full textWOS:000587365203357[No Abstract Available]0267