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Alcohol use disorder and emotional abuse: the mediating role of early maladaptive schemas
No full textWOS: 000466903900002Objective: Studies have shown a relationship between the development of alcohol use disorder (AUD) and the existence of childhood traumas (CT). In this study, in order to gain a better understanding of the association between CT and AUD, the relationship between CT and AUD was analyzed. Further, it was investigated whether Early Maladaptive Schemas (EMS) play a mediating role in the relationship between emotional abuse (EA) and AUD. Methods: The participants were consecutively admitted male alcohol-dependent inpatients (n=220) and healthy controls (n=108). The participants were investigated with the Childhood Trauma Questionnaire (CTQ-28), Young Schema Questionnaire-Short Form (YSQ-SF) and Michigan Alcoholism Screening Test (MAST). Mediation analyses were conducted in order to evaluate the mediating effect of EMS between the relationship of AUD and CT. Results: The difference between CT total score and the EA score between the control group and the AUD group were statistically significant. An analysis of different types of traumas in the correlation with AUD revealed EA as the main predictor of AUD both directly and through its mediating effect with the EMS. In addition, it was determined that in the relationship between EA and AUD, EMS such as Enmeshment, Emotional Inhibition, Dependence and Insufficient Self-Control had mediating effect. Discussion: CT, especially EA are quite common in male inpatients with AUD and the negative effects of EA may play an important role in the development of AUD by causing EMS. Our findings imply that those with EA history in childhood may be particularly vulnerable to the development of AUD in adulthood. Therefore, in the prevention of the development and in the treatment of AUD, it may be useful to take into consideration EA experiences, to screen EMS that may mediate such relationship through scales and to conduct interventions in this regard
The analysis of surface saccharide profiles through fluorescein-labelled lectins in a rat pancreatic tissue with established metabolic syndrome model
No full textWOS: 000461427300013Glycans, which are generally referred as oligosaccharides and polysaccharides, are structures that are present on all cellular surfaces with proteins and lipids being attached to their basic chain structures. Many studies in the field of glycobiology have identified the various and complicated biological roles of these glycans which make them perfect molecules to use in labelling and selecting body cells specifically. This study aims at analyzing the modifications in saccharide units of glycans on a cell membrane surfaces of the pancreatic tissue of rats to which normal and metabolic syndrome (MetS) are established. To this end, a MetS model was created through a high fructose diet in Spraque Dawley breed of rats and the pancreatic tissue sections of the group with MetS and control group animals were evaluated comparatively. The targeted saccharide units were examined with Fluorescent Microscope by using two different Fluorescein (FITC) labelled lectins, namely Maackia amurensis-1 lectin [FITC-(MAL-I)] and the Wheat Germ Agglutinin (FITC-WGA). It was observed that FITC-MAL-1-labelled Gal beta 4GlcNAc units did not change much due to high-fructose diet. On the other hand, more GlcNAc, Neu5Ac and beta-GlcNAc units which are labelled with FITC-WGA lectin increase in numbers in pancreatic sections of high fructose diet, compared to control group. Thus, a rapid and specific labelling method, which can identify surface saccharide sequences specifically, was developed. The method can be used in early diagnosis and/or treatment for metabolic diseases
Should we use hypobaric bupivacaine in spinal anesthesia for ERAS patients undergoing total hip arthroplasty [ERAS protokolüile total kalça protezi yapilan hastalarda hipobarik bupivakain ile spinal anestezi uygulamali miyiz?]
No full textObjective: Enhanced Recovery After Surgery (ERAS) is a standardized perioperative care within a programme aims to reduce postoperative morbidity and length of hospital stay. The aim of this study was to evaluate which technique (hyperbaric or hypobaric spinal anesthesia) should we use in geriatric patients undergoing total hip arthroplasty according to ERAS. Material and Methods: 104 patients’ records (52 of them hypobaric spinal, 52 of them had been applied hyperbaric spinal anesthesia), American Society of Anesthesiologists (ASA) I-III, undergoing total hip arthroplasty between June 2017-December 2017 was elected for study. Haemodynamic values, postoperative complications, hospital length of stay, readmission or reoperation after surgery, intensive care unit (ICU) length of stay, mortality, 30-day readmission two months’ mortality rates, duration of surgery, gender, age, ASA and additional co-morbidities were recorded from the patients’ files. Results: 38 males and 66 females were involved in the study, and their mean age was 76.24 years. The hospital length of stay, readmission or reoperation after surgery, ICU length of stay, duration of surgery were statistically significant differences between the groups. There were no statistically significant differences between the groups in 30-day readmission and mortality rates. When compared the blood pressures before and after the spinal block there were statistically significant differences between the groups. Conclusion: The aim of ERAS in the arthroplasty is to reduce the hospitalization time without increasing complications and readmission. We conclude that hypobaric solutions are suitable for ERAS protocol in total hip arthroplasty, but more studies should be done for evaluate effect of hypobaric spinal anesthesia related with ERAS protocol. © 2019 by Türkiye Klinikleri
Az elektroencefalográfia hasznossága syncope esetén [The yield of electroencephalography in syncope]
No full textPubMed ID: 30957465Background and purpose: Syncope is defined as a brief transient loss of consciousness due to cerebral hypoperfusion. Although the diagnosis of syncope is based on a thorough history and examination, electroencaphalography (EEG) is also an important investigational tool in the differential diagnosis in this group of patients. In this study we aimed to identify the diagnostic value of EEG in patients with syncope. Methods: We retrospectively examined EEG recordings of 288 patients with the diagnosis of syncope referred to the Cankiri State Hospital EEG laboratory, from January 2014 to January 2016. The EEG findings were classified into 6 groups as normal, epileptiform discharges (spike and sharp waves), generalized background slowing, focal slowing, hemispherical asymmetries, and low amplitude EEG tracing. The EEGs were separated according to gender and age. Results: Total of 288 patients were included in this study, 148 were females (51.4%) and 140 (48.6%) were males. Among all the EEG reports, 203 (70.5%) were normal, 8 of them (2.8%) showed generalized background slowing and 7 (2.4%) demonstrated focal slow waves. Epileptiform discharges occured among 13 patients (4.5%). Hemispherical asymmetries were detected in 10 patients (3.5%) and low amplitude EEG tracing in 47 patients (16.3%). There was no significant difference between age groups in EEG findings (p=0.3). Also no significant difference was detected in EEG results by gender (p=0.2). Conclusion: Although the diagnosis of syncope, epilepsy and non-epileptic seizures is clinical diagnosis, EEG still remains additional method.Background and purpose: A syncope definíció szerint agyi hipoperfúzió miatt bekövetkez? rövid, átmeneti eszméletvesztés. Habár a syncope diagnózisa a kórtörténet adatain és az alapos kivizsgáláson alapul, az elektroencefalográfia (EEG) fontos eszköz a differenciáldiagnózisban. A tanulmány célja az volt, hogy megállapítsuk, milyen diagnosztikai értéke van az EEG-nek syncope esetén. Methods: Retrospektív módon elemeztük 288, syncope diagnózissal 2014. január és 2016. január között a Cankiri Állami Kórház EEG-laborjába utalt beteg EEG-felvételét. Az EEG-felvételeket hat csoportba soroltuk: normál, epileptiform jel (csúcsok és éles hullámok), generalizált háttérlassulás, fokális lassulás, féltekei aszimmetriák, alacsony amplitúdójú szakaszok. Az EEG-ket nem és életkor alapján is csoportosítottuk. Results: Összesen 288 beteg vett részt a vizsgálatban, 148 n? (51,4%) és 140 (48,6%) férfi. Az EEG-felvételek közül 203 (70,5%) volt normális, nyolc (2,8%) mutatott generalizált háttérlassulást, hét (2,4%) fokális lassú hullámokat. Epileptiform jel 13 betegnél (4,5%) jelentkezett. Féltekei aszimmetria 10 betegnél (3,5%) volt megfigyelhet?, alacsony amplitúdójú szakaszok 47 betegnél (16,3%) jelentkeztek. Nem volt szignifikáns különbség a korcsoportok EEG-eredményei között (p = 0,3). Nem volt szignifikáns különbség az EEG-eredményekben nemek szerint sem (p = 0,2). Conclusion: Habár a syncope, az epilepszia és a nem epileptikus rohamok diagnózisa a klinikai megfigyeléseken alapul, a diagnózis felállításának továbbra is hasznos segít?je az EEG
Bronchoscopic Treatment of Benign Endoluminal Lung Tumors
No full textWOS: 000460867000001PubMed ID: 30937111Background and Aim. Endobronchial benign tumors are a rarely seen clinical entity but may cause significant symptoms. Endobronchial treatment has the potential for relieving symptoms while saving the patient from invasive surgical procedures. No trials have been published that present and compare the various endobronchial treatment modalities for endobronchial benign tumors. The aim of the present study is to define safety and efficacy of endobronchial treatment in patients with benign endobronchial tumors from the point of complications and success rate. Methods. This study is a retrospective cohort study from a review of medical charts. Eligibility criteria included diagnosis of a benign endobronchial tumor. Our institution's bronchoscopy and pathology database was searched for specific benign tumors, and the results were further detailed based on the endobronchial location. Results. Forty-four patients with pathologically confirmed benign endobronchial tumors were included. Tumor regression was achieved in all patients with diode laser and argon plasma coagulation in combination with or without cryotherapy and without any major complication. There were no significant differences between the use of either diode laser or of argon plasma coagulation as a modality with immediate effect from the occurrence of residual tissue that needed cryotherapy (P>0.05). There were no major complications. Eight patients had minor complications including minor bleeding (6 patients) and hypertension (2 patients) that were controlled medically. Thirty-one patients (70%) had very good response, and 13 patients (30%) had good response as defined in literature before. Conclusion. Diode laser and argon plasma coagulation in combination with or without cryotherapy are safe and effective methods for endobronchial treatment of benign endobronchial tumors
Intravenous Immunoglobulin Treatment for Recurrent Optic Neuritis
No full textWOS: 000468130500002PubMed ID: 30911229Introduction: Recurrent optic neuritis neuritis (rON) is an autoimmune inflammatory condition of unknown cause. Intravenous immunoglobulin (IVIg) treatment is used for many autoimmune disorders; however we do not have any information about its effect in rON, other than case reports. We aimed to evaluate our patients with rON who were treated with IVIg. Methods: Data from all our patients with rON with or without anti aquaporin4 (AQP4) seropositivity, seen between April 2011 and October 2015, who received IVIg treatment were retrospectively evaluated. Results: Nine patients (all female) with rON had received IVIg. These patients were aged between 34 and 65 years, and had started receiving monthly IVIg from 6 to 58 months after onset of disease. In three out of nine rON patients serum AQP4 antibody were positive. Under current treatments the patients had continued to have attacks, therefore monthly IVIg was given in addition to the existing immunosuppressant drug. The follow up duration was between 6 to 31 months. Three patients, each suffered one relapse under IVIg treatment. Mean number of relapses in the year prior to treatment was 1.4 +/- 0.72, whereas it was 0.3 +/- 0.5 during the year after IVIg therapy. During follow-up with IVIg administration only one patient had fever and no other adverse events were reported. Conclusion: Monthly IVIg is well-tolerated and safe and it seems to be effective in rON as an add on treatment. However, since our study is a retrospective case series, future randomized controlled trials with IVIg are needed
Analysis of the genetic component of systemic sclerosis in Iranian and Turkish populations through a genome-wide association study
No full textWOS: 000459631600018PubMed ID: 30247649Objectives. SSc is an autoimmune disease characterized by alteration of the immune response, vasculopathy and fibrosis. Most genetic studies on SSc have been performed in European-ancestry populations. The aim of this study was to analyse the genetic component of SSc in Middle Eastern patients from Iran and Turkey through a genome-wide association study. Methods. This study analysed data from a total of 834 patients diagnosed with SSc and 1455 healthy controls from Iran and Turkey. DNA was genotyped using high-throughput genotyping platforms. The data generated were imputed using the Michigan Imputation Server, and the Haplotype Reference Consortium as a reference panel. A meta-analysis combining both case-control sets was conducted by the inverse variance method. Results. The highest peak of association belonged to the HLA region in both the Iranian and Turkish populations. Strong and independent associations between the classical alleles HLA-DRB1*11:04 [P = 2.10 x 10(-24), odds ratio (OR) = 3.14] and DPB1*13:01 (P = 5.37 x 10(-14), OR = 5.75) and SSc were observed in the Iranian population. HLA-DRB1*11:04 (P = 4.90 x 10(-11), OR = 2.93) was the only independent signal associated in the Turkish cohort. An omnibus test yielded HLA-DRB1 58 and HLA-DPB1 76 as relevant amino acid positions for this disease. Concerning the meta-analysis, we also identified two associations close to the genome-wide significance level outside the HLA region, corresponding to IRF5-TNPO3 rs17424921-C (P = 1.34 x 10(-7), OR = 1.68) and NFKB1 rs4648133-C (P = 3.11 x 10(-7), OR = 1.47). Conclusion. We identified significant associations in the HLA region and suggestive associations in IRF5-TNPO3 and NFKB1 loci in Iranian and Turkish patients affected by SSc through a genome-wide association study and an extensive HLA analysis.Spanish Ministry of Economy and Competitiveness [SAF2015-66761-P]; Cooperative Research Thematic Network (RETICS) program, from the Instituto de Salud Carlos III (ISCIII, Health Ministry, Madrid, Spain) [RD16/0012/0004]This work was supported by the Spanish Ministry of Economy and Competitiveness [SAF2015-66761-P to J.M. and SAF2015-66761-P to D.G.S.] and The Cooperative Research Thematic Network (RETICS) program, from the Instituto de Salud Carlos III (ISCIII, Health Ministry, Madrid, Spain) [RD16/0012/0004]
Reliability and Validity of Rowland Universal Dementia Assessment Scale in Turkish Population
No full textWOS: 000456414900004PubMed ID: 30328357Background: The aim is to validate Turkish version Rowland Universal Dementia Assessment Scale (RUDAS). Methods: One hundred forty patients (>65 years) were included. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition -V was used in all patients. Rowland Universal Dementia Assessment Scale was applied for 2 days. Results were compared with Mini-Mental State Examination; reliability, validity, and statistical values were determined. Results: Time validity was verified. Mini-mental state examination was correlated 45.3% in control and 73% in dementia group. Factor weights varied between 0.44 and 0.81; factor construct was verified as 6-item scoring. When 25 was cutoff point, sensitivity was 92.86% and specificity was 92.86%. Content validity index was found to be 100% by 7 specialists. Cronbach alpha (0.692) and test-retest reliability (intraclass correlation = 0.987) were determined. Conclusion: Rowland Universal Dementia Assessment Scale (Turkish) is validated and verified as reliable. Test could be applied for 5 minutes approximately; results are not affected by educational status, immigrant status, and language used; however, age and gender have significant effect on results
Can Rotational Thromboelastometry be a New Predictive Tool for Retinal Vein Occlusion Development?
No full textWOS: 000464751200004PubMed ID: 30512971Purpose: To evaluate clotting dynamics by a new tool called rotational tromboelastometry (ROTEM) in retinal vein occlusion.Materials and methods: Thirty-six patients who were diagnosed with retinal vein occlusion and 43 age and sex matched healthy controls were included in this study. Diabetes and use of anticoagulant therapy were exclusion criteria. All study participants underwent detailed ophthalmologic and systemic medical examination, including blood pressure measurement, hemoglobin-hematocrit levels, platelet count, coagulation parameters including prothrombin time, activated partial thromboplastin time, fibrinogen levels, and D-dimer levels. Peripheral blood samples were collected and analyzed with ROTEM Coagulation Analyzer (Tem International, Munich, Germany).Results: The RVO patients and controls did not differ with respect to age, sex, hemoglobin, hematocrit, platelet numbers, prothrombin time, activated partial thromboplastin time, fibrinogen levels, D-dimer levels, and glucose levels. When extrinsic thromboelastometry results were analyzed, RVO patients showed a significantly decreased clotting time (76.515.0 vs. 95.0 +/- 21s, respectively; p =0.01) and clot formation time (83.3 +/- 22 vs. 99.7 +/- 24s; p =0.01) as compared with healthy controls. Other ROTEM parameters did now show any difference between two groups.Conclusion: Patients with retinal vein occlusion showed faster clotting time and shorter clotting formation time as compared with healthy controls. ROTEM detects the altered clotting dynamics and may be a useful tool to elucidate the disease pathophysiology. Further studies are needed to investigate if it can be used as a screening test for individuals who are under risk to develop RVO or as a first step test to evaluate hypercoagulable state in RVO
An international perspective on hospitalized patients with viral community-acquired pneumonia
No full textWOS: 000457638600021PubMed ID: 30401576Background: Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP. Methods: Secondary analysis of GLIMP, an international, multicenter, point-prevalence study of hospitalized adults with CAP. Testing frequency, prevalence of viral CAP and treatment with oseltamivir were assessed among patients who underwent a viral swab. Univariate and multivariate analysis was used to evaluate risk factors. Results: 553 (14.9%) patients with CAP underwent nasal swab. Viral CAP was diagnosed in 157 (28.4%) patients. Influenza virus was isolated in 80.9% of cases. Testing frequency and viral CAP prevalence were inhomogeneous across the participating centers. Obesity (OR 1.59, 95%CI: 1.01-2.48; p = 0.043) and need for invasive mechanical ventilation (OR 1.62, 95%CI: 1.02-2.56; p = 0.040) were independently associated with viral CAP. Prevalence of empirical treatment with oseltamivir was 5.1%. Conclusion: In an international scenario, testing frequency for viruses in CAP is very low. The most common cause of viral CAP is Influenza virus. Obesity and need for invasive ventilation represent independent risk factors for viral CAP. Adherence to recommendations for treatment with oseltamivir is poor.Asociacion Latinoamericana de Torax; European Respiratory Society; World Federation of Societies of Intensive and Critical Care Medicine; American College of Chest PhysiciansOther investigators: Lorena Noriega; Ezequiel Alvarado; Mohamed Aman; Lucia Labra. We would like also to thank the Asociacion Latinoamericana de Torax, European Respiratory Society, World Federation of Societies of Intensive and Critical Care Medicine, and American College of Chest Physicians for their support of this project