Repositorio de la Asociación Española de Neuropsiquiatría
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Başa Çıkma: Bütüncül Bir Gözden Geçirme
No full textÖz
Psikolojik ve fizyolojik sağlığın önemli temellerinden biri değişimler ve zorlu yaşantılarla uyumlu bir şekilde başa çıkabilmektir. Başa çıkma, oldukça köklü bir geçmişe sahip olan ve günümüzde de çok fazla araştırmaya konu olan bir çalışma alanıdır. Öyle ki başa çıkmayı gerektiren yaşantılar ciddi yaşamsal zorluklardan günlük hayat streslerine kadar uzanmaktadır. Bununla birlikte epidemiyoloji, kişilik psikolojisi, bilişsel ve sosyal psikoloji ile tıp gibi çeşitli sağlık ve davranış bilimi disiplinleri de stres ve başa çıkma anlayışına katkıda bulunmuştur. Bu doğrultuda başa çıkma için pek çok farklı yaklaşım, model ya da ilişkili teoriler kapsamında açıklamalar getirilmeye çalışılmıştır. Her ne büyük ilerlemeler kaydedilmiş olsa da kullanılan kavramlar, sınıflama ve ölçme araçlarının farklılıkları, yapılan çalışmaları karşılaştırmayı güçleştirmekte bu nedenle araştırmaların da birbiri üzerine eklenemediği de göze çarpmaktadır. Bu makalenin amacı, başa çıkma alanına dair yaklaşımları, modelleri ve başa çıkma davranışlarına dair oluşturulmuş sınıflamaları bütüncül ve sistemli bir şekilde incelemektir. Bu bağlamda konu ile ilgili incelemeler yapmak isteyen araştırmacılar ve psikolojik danışmanlar başta olmak üzere, alanda çalışan sağlık uzmanları için var olan karmaşaları azaltabilmek ve bütüncül bir bakış açısı yaratabilmek hedeflenmiştir. Son olarak araştırmacılar için bazı öneriler de sunulmuştur
Su kayıp yönetimi için temel hesaplama araçlarının geliştirilmesi ve temel su kayıp bileşenlerinin analizi
No full textÖz: Su kayıp yönetimi, çeşitli yöntem ve süreçleri içermekte ve bu yöntemlerin kullanılması ile sürdürülebilir kentsel suyönetiminin sağlanması mümkün olmaktadır. Su ve enerji verimliliği ve sürdürülebilir su kayıp yönetiminde en uygunhesaplama araçlarının kullanılması ve uluslararası literatüre göre analiz yapılması önemlidir. Bu çalışmada, su kayıpyönetiminin sistematik, planlı ve sürdürülebilir bir şekilde yapılmasına esas teşkil eden temel su kayıp analizleri içinhassas ve doğru analiz imkanı sunan hesaplama araçlarının geliştirilmesi amaçlanmıştır. Bunun için web tabanlı çalışan,birbiri ile bütünleşik olan “su dengesi”, “minimum gece debisi” ve “altyapı kaçak indeksi” hesaplama araçları geliştirilmişve pilot veri seti için uygulama gerçekleştirilmiştir. Bu hesaplama araçlarının, İdarelerde, sızıntıların yönetilmesinde, sukayıp yönetim performanslarının izlenmesinde, sistem verimliliğinin sağlanmasında, sızıntı hesaplarının daha sistematikve hassas bir şekilde yapılmasında, su kayıp yönetimi hesaplamalarının uluslararası standartlara göre yapılmasında önemlikatkılar sunacağı düşünülmektedir.Öz: Water loss management includes various methods and processes, and it is possible to ensure sustainable urban water management to use these methods. However, it is important to use the most appropriate tools and to analyze according to international literature in water and energy efficiency and sustainable water loss management. In this study, it is aimed to perform basic water loss analysis, which is the basis for systematic, planned and sustainable water loss management, and to develop analysis tools that provide more precise and accurate analysis. For this purpose, web-based, integrated "water balance", "minimum night flow" and "infrastructure leakage index" calculation tools have been developed and an application has been made for the pilot data set. It is thought that these calculation tools will provide significant contributions in the management of spills, monitoring water loss management performances, ensuring system efficiency, making leakage calculations more systematically and precisely, and making water loss management calculations in accordance with international standards
Prognostic value of glucose fluctuation in patients undergoing thrombolysis or thrombectomy due to acute ischemic stroke
No full textBackground Hyperglycemia during acute ischemic stroke is associated with worse outcomes, and this glucose altitude may persist in the initial days. In this study, we investigate the effect of glucose fluctuations in the first 4 days in patients diagnosed with acute ischemic stroke and who underwent ivr-tPA +/- interventional thrombectomy or only interventional thrombectomy on stroke prognosis. Study was designed bicentered retrospective case series. Patients older than 18 years were included and those suitable for acute treatment, treatment indications, contraindications, and treatment management of hyperglycemia were selected according to the 2018 American Stroke Association guidelines. The effect of fasting glucose values of patients in the first 4 days on admission and 24th hour NIHSS scores, duration of hospitalization, disability, mortality, and prognosis were analyzed. We aimed to demostred the effect of the first 4-day glucose values measured in patients treated in a stroke center on clinical prospect. Results One hundred and seventy-six patients were included in the study. Group 1 included 30 (17%) patients with severe clinical condition (NIHSS at admission >= 16), and Group 2 comprised 146 (83%) patients with moderate and mild clinical condition (NIHSS at admission = 200 mg/dl was 43.5% on day 1 (p > 0.05), 57.1% on day 2, 68.4% on day 3, and 76.5% on day 4 (p < 0.05). Conclusions The glucose level of patients in severe clinical condition peaked on the second day and that 4 days of resilient severe hyperglycemia is a negative risk factor for sequela and mortality
Factors affecting the accuracy of18f-fdg pet/ct in detecting additional tumor foci in breast cancer
No full textOBJECTIVE To evaluate the effectiveness of18F-FDG PET/CT for detecting additional tumor foci in breast cancer. MATERIAL-METHOD The data were reviewed retrospectively of 232 women who underwent18F-FDG PET/CT examination prior to breast cancer surgery between January 2013 and December 2018. RESULTS Additional tumor foci were suspected in 95 cases on18F-FDG PET/ CT, which were confirmed by histopathological analysis in 81 cases. The sen-sitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of18F-FDG PET/CT in detection of additional tumor foci were 77.7%, 79.48%, 66.3%, 87.32%, and 79.23%, respectively. The false negative and false positive rates were 22.22% and 20.51%, respectively. In univariate analysis, only the patient’s age was positively associated with accuracy of 18 F-FDG PET/CT in detecting additional tumor foci. The accuracy was lower in women aged ?50 years, with a substantial increase in false positive findings in women in that age group. CONCLUSIONS18F-FDG PET/CT alone cannot replace conventional diagnostic procedures for evaluating additional tumor foci in breast cancer, as a substantial increase in false positive findings is recorded with this method in women aged ?50 years old. © Athens Medical Society
The effectiveness of olmesartan on inflammation at cardiopulmonary bypass
No full textAim: Systemic inflammatory response syndrome may develop after coronary artery bypass graft surgery that performed by cardiopulmonary bypass technique. It is known that olmesartan, an angiotensin II receptor blocker, has anti-inflammatory effects. The antiinflammatory efficacy of olmesartan treatment was investigated in patients undergoing cardiopulmonary bypass.Materials and Methods: The study included 50 patients (14 female, 36 male) between 30-80 years of age were underwent CABG surgery. Patients were randomly assigned to control (Group C) and olmesartan (Group O) gruoups. Group O were treated with a single dose of 10 mg per day; 5 days preoperatively and 35 days postoperatively, 30 mg at the operation day. Samples were taken before the induction of anesthesia (T1), 5 minutes before cross clamping (T2), 5 minutes after cross clamping (T3), after protamine infusion (T4), postoperative day 3 (T5) and postoperative day 35 (T6) for total serum levels of IL-6, IL-10 and IL-18; for h-CRP levels preoperative (T1) and postoperative day 35 (T2).Results: Statistically significant decrease of CRP levels were observed on the postoperative 35th day in Group O (p0.05). Statistically significant decrease of IL-6 levels were observed in the Group O after protamine infusion (T4) and postoperative 3rd day (T5) (p 0.05).There was a statistically significant increase at 5 min. after the cross declamping time (T3) for IL-10 levels (p0.05).Conclusion: Although the anti-inflammatory efficacy of olmesartan has been proven, it can be accomplished by combining it with drugs that have anti-inflammatory effects like statins or dose increasing
Management of irreducible giant rectal prolapse: A case report and literature review
No full textIntroduction and importance: Rectal prolapse is defined as herniation of mucosa or full-thickness of the rectal wall through the anal canal. It has a negative impact on the quality of life and therefore, it should be treated as soon as diagnosis is confirmed. Definitive treatment is surgical and it depends on the clinical characteristics of the patients. We aimed to present the one of the largest rectal prolapse case in the literature. Case presentation: A 32-years-old male patient with a history of severe constipation was admitted to our institution with a giant rectal prolapse. The prolapsed segment was incarcerated, and a semi-emergent procedure was performed though a mid-line laparotomy. The sigmoid colon was redundant and therefore sigmoid colon and the upper two thirds of rectum were resected and end to end anastomosis was performed. The patient was discharged postoperative day 7 without any complication. Clinical discussion: Rectal prolapse has a negative impact on quality of life and should be operated as soon as the diagnosis is reached. The surgical strategy depends on the compliance of the patient as well as the experience of the surgical team. Conclusion: Clinicians should know that chronic constipation together with other factors may result in rectal prolapse which may become disproportionately large in size
ACUTE KIDNEY INJURY IN HOSPITALIZED COVID-19 PATIENTS: A MULTICENTRE STUDY BY TURKISH SOCIETY OF NEPHROLOGY
No full text58th Congress of the European-Renal-Association (ERA)-European-Dialysis-and-Transplant-Association (EDTA) -- JUN 05-08, 2021 -- ELECTR NETWORK[Abstract Not Available]European Renal Assoc,European Dialysis & Transplant Asso
Changes in hepatocellular carcinoma aggressiveness characteristics with an increase in tumor diameter
No full textBackground: Hepatocellular carcinoma prognosis depends on both liver and tumor determinants, especially on maximum tumor diameter, multifocality, and presence of portal vein thrombosis, despite apparently complete tumor removal by resection or liver transplantation. Aims: To examine parameters of hepatocellular carcinoma aggressiveness as tumor size increases. Methods: A large hepatocellular carcinoma database was examined for trends in serum alpha-fetoprotein and the percentage of patients with macroscopic portal vein thrombosis or tumor multifocality. Results: A total of 13,016 hepatocellular carcinoma patients were identified having full tumor and survival data. Of these, 76.56% were male and 23.44% were female, with a median age of 64.4 years. We found that as the maximum tumor diameter increased, there was a significant trend for increased alpha-fetoprotein levels (P<0.001) and an increased percentage of patients with either portal vein thrombosis or tumor multifocality, each P<0.0001. Furthermore, the increases of both alpha-fetoprotein and portal vein thrombosis were proportionately greater than the related maximum tumor diameter increases. These trends of increased alpha-fetoprotein, portal vein thrombosis, and multifocality with increasing maximum tumor diameter had non-linear patterns. Within alpha-fetoprotein and multifocality trends, there were identifiable sub-trends associated with specific maximum tumor diameter ranges. Conclusions: The greater fold-increases in alpha-fetoprotein and portal vein thrombosis compared with increases in maximum tumor diameter imply that hepatocellular carcinoma characteristics may change with increasing size to a more aggressive phenotype, suggesting that follow-up tumor sampling might be useful, in addition to baseline tumor sampling, for optimal therapeutic choices to be made.NIH [CA 82723]The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported in part by NIH grant CA 82723 (B.I.C)
The relation of infectious and inflammatory markers with placental atherosclerosis in preeclampsia
No full textAim: The aim of this study was to compare CRP, TNF-α, CMV, Chlamydia pneumonia IgG and IgM levels between preeclamptic and uneventful pregnant womens, to explain the effects of infectious trigger on the placental pathology of preeclampsia. Materials and Methods: All cases of preeclamptic pregnants detected at or referred to Inonu Univrsty Faculty of Medicine Gynaecology and Obstetric Department between July 2006 and July 2007 were prospectively collected. The study group was a group of 40 women who are preeclamptic. The study also included 40 control subjects who were matched for age, gestational age and body mass index. Results: In the preeclamptic group the level of CRP was significantly higher [28 (1.9– 196); vs. 6.2 (1.2–23) (mg/L) (p0.999 and p=0.385). Plasma H.pylori IgA levels were higher in the study group with the value of [ 14 (35%) vs. 5 (12.5%) (p=0.035)].Conclusion: In the present study, serum CRP, TNF-α and H.pylori IgA levels were significantly higher than normal pregnant women
The effect of haptonomy and virtual reality on anxiety, prenatal attachment and acceptance of pregnancy in the unplanned pregnant women: Imagining the baby
No full textAmaç:Bu araştırmada, haptonomi ve sanal gerçeklik uygulamasının plansız gebeliklerdeki anksiyete, bağlanma ve gebeliğin kabulüne etkisini belirlemek amaçlanmıştır. Materyal ve Metot: Randomize kontrollü yürütülen bu araştırmanın örneklemini, Haziran 2020-Nisan 2021 tarihleri arasında Elazığ Fethi Sekin Şehir Hastanesi Kadın Doğum Polikliniklerine başvuran 217 gebe(haptonomi:73, sanal gerçeklik:72 ve kontrol:72) oluşturdu. Her iki deney grubu için 7-10 günlük aralar ile 24-32. gebelik haftasındaki gebelerle dört görüşme yapıldı. Haptonomi grubundaki gebelerden haptonomi felsefesiyle karınlarına dokunarak bebeklerini hayal etmeleri istendi. Sanal gerçeklik grubunda ise gebenin kendi bebeğine ait ultrason görüntüsü alındı ve gelişirilen yazılım sistemi sayesinde gebenin sanal gerçeklik gözlüğü aracılığı ile bebeğini görmesi ve hayal etmesi sağlandı. Kontrol grubuna herhangi bir girişim uygulanmadı. Veriler, Gebe Tanıtım Formu, LPGBÖ, PBE, GAÖ-R2 ve PKDÖ- Gebeliğin Kabulü Alt Boyutu ile toplandı. Verilerin analizinde tanımlayıcı istatistikler, pearson ki-kare testi, one-way anova testi ve LSD post-hoc analizi kullanıldı. Bulgular: Deney gruplarındaki gebelerde kontrol grubuna oranla gebelikle ilişkili anksiyete düzeyi daha düşük, gebeliğin kabul düzeyinin ise daha yüksek olduğu saptandı (p=0.000). Haptonomi ve sanal gerçeklik uygulama gruplarında kontrol grubuna göre prenatal bağlanma düzeyinin daha düşük olduğu görüldü(p=0.000). Özellikle haptonomi grubundaki prenatal bağlanma düzeyinin sanal gerçeklik uygulama grubuna oranla daha yüksek olduğu saptandı(p=0.000). Sonuç:Plansız gebeliklerde haptonomi ve sanal gerçeklik uygulaması ile bebeği hayal etme gebelikle ilişkili anksiyete düzeyini azaltan, bağlanma ile gebeliğin kabul düzeyini artıran tekniklerdir. Özellikle haptonomi uygulaması prenatal bağlanmada daha yüksek etki göstermiştir.Aim:This study was aimed to determine the effect of haptonomy and virtual reality application on anxiety,attachment and acceptance of pregnancy in unplanned pregnancies. Material and Methods:The sample of this randomized controlled study consisted of 217 pregnant women (haptonomy:73, virtual reality:72 and control:72) who applied to the Elazig Fethi Sekin City Hospital Gynecology Polyclinics between June 2020 and April 2021.24-32 gestation age with 7-10 day intervals for both experimental groups. Four interviews were conducted with pregnant women at the gestational week.The haptonomy group were asked to imagine their babies by touching their bellies with the philosophy of haptonomy.In the virtual reality group, ultrasound images of the pregnant woman's own baby were taken,and thanks to the developed software system, the pregnant woman was allowed to see and imagine her baby through virtual reality glasses.No intervention was applied to the control group.The data were collected with the Pregnancy Identification Form, LMUP, PAI, PRAQ-R2,and PSEQ-Conception of Pregnancy Sub-Dimension.It was analyzed by descriptive statistics, pearson chi-square test, one-way anova test and LSD post-hoc analysis were used in the analysis of the data. Results:It was determined that the pregnancy-related anxiety level was lower and the acceptance level of pregnancy was higher the haptonomy and virtual reality groups than the control group(p=0.000).It was determined that the post-test prenatal attachment level was lower in the control group than the haptonomy and virtual reality groups(p=0.000).Especially, it was found that the prenatal attachment level in the haptonomy group was higher than the virtual reality group(p=0.000). Conclusion:Unplanned pregnancies, imagining the baby with haptonomy and virtual reality are techniques that reduce pregnancy-related anxiety and increase the acceptance level of pregnancy with attachment. Especially haptonomy showed a higher effect on prenatal attachment