İstanbul Atlas University Institutional Repository
Not a member yet
783 research outputs found
Sort by
Diastazis rekti abdominisli kadınlarda süpervize ve süpervize olmayan tele-egzersiz programının inter-rekti mesafesi, karın kası enduransı ve denge üzerinde etkisinin karşılaştırılması
Full text linkBu çalışma, diastazis rekti abdominisi bulunan kadınlarda süpervize edilen ve edilmeyen tele- egzersiz programlarının inter-rekti mesafesi, abdominal enduransı, denge, beden imajı ve depresyon üzerindeki etkilerini karşılaştırmayı amaçlamaktadır. Çalışmaya, postpartum 8 hafta ile 36 ay arasında olan 39 kadın dahil edilmiştir. Katılımcılar, Süpervize Tele-Egzersiz Grubu (n=20) ve Süpervize Olmayan Tele-Egzersiz Grubu (n=19) olarak randomize şekilde iki gruba ayrılmıştır. Her iki gruba da değerlendirmeler, inter-rekti mesafesi ölçümü, abdominal enduransı testi, denge değerlendirmesi, Çok Yönlü Beden-Benlik İlişkileri Ölçeği, Pelvik Taban Distress Envanteri ve Edinburgh Doğum Sonrası Depresyon Ölçeği parametreleri kullanılarak gerçekleştirilmiştir. Süpervize tele-egzersiz grubuna, fizyoterapist tarafından yönlendirilen videolardaki egzersizi yaparken video çekmeleri istenmiş ve hatalarının düzeltildiği bir tele-egzersiz programı uygulanırken; süpervize olmayan tele-egzersiz grubu, sadece video talimatlarına göre egzersizlerini kendi başına gerçekleştirmiştir. Her iki grup da altı hafta süresince, motor kontrol temelli, aşamalı egzersizler içeren bir programı uygulamıştır. Egzersizler ilk üç hafta 10 sağ ve 10 sol tekrar, son üç hafta ise 15 sağ ve 15 sol tekrar şeklinde uygulanmıştır. Çalışma; abdominal ve pelvik taban kaslarının aktivasyonu, denge ve endurans egzersizleri ile ilerlemeyi sağlamayı hedeflemiştir Sonuçlar, süpervize tele-egzersiz grupta inter-rekti mesafesi (umblikus ve 2.5 cm üstünde), abdominal enduransı, gözler açık denge testi ve PTDE- 20 toplam puanında anlamlı iyileşmeler olduğunu göstermiştir (p .05).Bu bulgular, süpervize tele-egzersiz programlarının süpervize olmayan tele-egzersiz programına göre diastazis rekti abdominis tedavisinde daha etkili bir yöntem olduğunu göstermektedir. Ancak, bu sonuçların daha geniş örneklem gruplarıyla doğrulanması gerekmektedir.This study aims to compare the effects of supervised and unsupervised tele-exercise programs on inter-recti distance, abdominal muscle endurance, balance, body image and depression in women with diastasis recti abdominis. The study included 39 women between 8 weeks and 36 months postpartum. Participants were randomly divided into two groups as Supervised Tele-Exercise Group (n=20) and Non-Supervised Tele-Exercise Group (n=19). Both groups were evaluated using inter-recti distance measurement, abdominal muscle endurance test, balance assessment, Multidimensional Body-Self Relationship Scale, Pelvic Floor Distress Inventory and Edinburgh Postpartum Depression Scale. The supervised tele-exercise group was asked to take videos of themselves doing the exercises in the videos directed by the physiotherapist and a tele-exercise program was applied in which their mistakes were corrected, while the unsupervised tele-exercise group performed the exercises on their own according to the video instructions only. Both groups followed a program of motor control-based, progressive exercises for six weeks. The exercises were performed as 10 right and 10 left repetitions for the first three weeks and 15 right and 15 left repetitions for the last three weeks. The results showed significant improvements in the inter-recti distance (above umbilicus and 2.5 cm), abdominal muscle endurance, eyes-open balance test and PTDE-20 total score in the supervised tele-exercise group (p .05).These findings suggest that supervised tele-exercise programs are a more effective method in the treatment of diastasis recti abdominis than unsupervised tele-exercise programs. However, these results need to be confirmed with larger sample groups
Investigation of symptom-specific functional connectivity patterns in Parkinson's disease
Full text linkParkinson's disease (PD) is a complex neurodegenerative disease, characterized by pronounced heterogeneity in symptoms. This study investigates the functional connectivity (FC) patterns associated with distinct symptom clusters, aiming to elucidate the heterogeneity in PD and uncover the neural mechanisms underlying its motor and cognitive symptoms. Resting-state functional MRI (rs-fMRI) data from 55 non-demented PD patients and 24 healthy controls (HC) were used to perform seed-to-seed FC analyses. A clustering algorithm was applied to the cognitive and motor scores of all PD patients to generate relatively homogeneous symptomatic subgroups. PD patients exhibited a general decrease in FC within a network comprising the sensorimotor network (SMN) and the visual network (VN) regions. Symptom-based clustering revealed three relatively homogeneous subgroups, exhibiting a gradient pattern: patients with greater motor deficits showed significant disconnection within the SMN, whereas patients with greater visuospatial deficits exhibited reduced FC in an extended subnetwork, with pronounced disconnections between the VN and SMN areas. Our study demonstrated a notable disconnection between the SMN and VN, indicating impaired visual-motor integration in PD. Stronger disconnection within the SMN was associated with greater motor dysfunction, and stronger visual-sensorimotor disconnections were associated with greater visuospatial deficits. These findings suggest that at least two separate routes of functional disconnection may be responsible for the inhomogeneous symptom distribution in PD
Kinesiophobia in Women with Stress and Mixed Urinary Incontinence: Associations with Severity and Quality of Life Using a Novel Scale
Full text linkObjective: This prospective study explored the connections between kinesiophobia traditionally defined as an irrational fear of movement due to expected pain or harm in chronic conditions, but in this study defined as the avoidance of movement due to fear of urinary incontinence, the severity of urinary incontinence (UI), the severity of urinary incontinence, and UI-related quality of life (QoL) among women with stress urinary incontinence (SUI) or mixed urinary incontinence (MUI), utilizing a newly developed UI-specific kinesiophobia scale. Methods: Between August and November 2024, 55 women aged 18-65 with SUI and MUI were recruited from a urology outpatient clinic. Participants completed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Incontinence Quality of Life Questionnaire (I-QOL), and a novel three-item UI-specific kinesiophobia scale. Pearson correlation analysis assessed relationships between kinesiophobia, UI severity, and QoL. Results: Kinesiophobia showed a moderate positive correlation with UI severity (r = 0.548, p < 0.001) and a moderate negative correlation with QoL (r = -0.447, p = 0.001). Mean scores were 13.82 +/- 4.57 for ICIQ-SF, 59.55 +/- 20.60 for I-QOL, and 14.09 +/- 8.27 for kinesiophobia. Conclusion: UI severity significantly influences kinesiophobia, which in turn diminishes QoL in women with SUI and MUI. The UI-specific kinesiophobia scale offers a concise tool to measure movement-related fears, emphasizing the importance of holistic interventions, such as pelvic floor therapy and psychological support, to address both physical and emotional challenges in UI management
A nano-design of image masking and steganography structure based on quantum technology
No full textSecure image storage and transmission require sound encryption methods that resist key exposure while maintaining high image quality. Various encryption approaches have been developed to protect image content and its transmission from unauthorized access. One such method is image masking, where a special mask is generated to conceal information within the original image. Instead of hiding the image visually, the mask creates an intermediate layer that obfuscates the encryption key, eliminating the need to transmit it directly. However, implementing such masking techniques efficiently at the hardware level poses particular challenges. Traditional Complementary Metal-Oxide-Semiconductor (CMOS)-based Very-Large-Scale-Integration (VLSI) systems face scalability issues, excessive heat, and high-power consumption. To overcome these challenges, this study utilizes a nano-scale image masking architecture based on Quantum-dot Cellular Automata (QCA), offering reduced area, lower power dissipation, and faster processing. The core operations utilize a three-input XOR gate, designed as a single-layer QCA structure without rotated cells. While QCA-based approaches improve hardware efficiency, most existing implementations focus only on grayscale images, leaving a gap in colorful image encryption. To address this, the work presents a QCA-based encryption and masking architecture for colored images. The method encrypts an image using a random key to generate a cipher image, which is then XORed with the original image to produce a mask. This process, applied independently to each RGB channel, produces three cipher-mask pairs, embedding steganographic property by concealing key information within the image. The keys are generated using a true random number generator (TRNG) based on cross-coupled loops and crossoriented structures, ensuring high entropy. The design was modeled in QCADesigner 2.0.3, with the encryption/decryption algorithms implemented in Python. Experimental results demonstrated a meaningful reduction in cell count and consumed area compared to the prior designs. Image quality and security analysis confirmed visual fidelity and improved robustness
Translation and Validation of the TOR-BSST Into Turkish for Stroke Patients
No full textPurposeThe most common cause of death in Turkey is attributed to vascular diseases, including stroke. Dysphagia stands out as one of the prevalent and life-threatening complications that often follow a stroke. Within the Turkish context, the availability of validated bedside screening tests for assessing dysphagia remains limited. The primary objective of this study was to undertake the translation of the TOR-BSST into Turkish and subsequently validate this newly translated Turkish version.MethodOnce the translation of the TOR-BSST into Turkish was accomplished, 60 stroke patients were consecutively enroled in the validation process. The enroled patients were evaluated using the TOR-BSST-TR, administered by a speech and language pathologist (SLP) trained in TOR-BSST screener training. On the screening day, each patient underwent a videofluoroscopic swallowing study (VFSS), administered by another SLP blinded to the patient's medical information and TOR-BSST-TR results. The VFSS images were recorded for independent analysis by the second SLP who conducted the VFSS, and a third SLP, also blinded to the TOR-BSST-TR findings, using the Penetration Aspiration Scale (PAS) to measure airway invasion severity, and Dysphagia Severity Rating Scale (DSRS) to measure overall dysphagia severity. The reliability of the gold standard VFSS ratings was assessed using the intra-class correlation coefficient (ICC). The accuracy of the new TOR-BSST-TR was assessed using sensitivity, specificity, predictive values and likelihood ratios.ResultsOf all the 60 patients, 35 (58.3%) failed the TOR-BSST-TR, and 33 (55%) were identified with some degree of dysphagia from VFSS imaging scores. The overall inter-rater reliability (in ICC, 95% CI) for the gold standard ratings were as follows: PAS semi-solids (0.98, 0.95-0.99), PAS liquids (0.75, 0.58-0.85) and overall DSRS (0.70, 0.32-0.85). Based on the total screening score of the TOR-BSST-TR, the sensitivity, specificity, positive and negative predictive values along with positive likelihood ratio were as follows: 93.9%, 85.2%, 90.5%, 90.4% and 6.34, respectively.ConclusionThe TOR-BSST was successfully translated into Turkish, and the resulting TOR-BSST-TR demonstrated high accuracy in the acute stroke phase using videofluoroscopy as the gold standard. Specifically, the new TOR-BSST-TR screening tool yielded excellent sensitivity, specificity and predictive values in this patient population. The clinical implementation of this validated screening tool has the potential to enhance early detection of dysphagia, thereby triggering early management and ultimately improving patient outcomes and reducing the burden of complications from vascular diseases, such as stroke. Further research and widespread adoption of the TOR-BSST-TR could contribute to more standardized and effective dysphagia assessment protocols in clinical practice.WHAT THIS PAPER ADDSWhat is already known on the subject Dysphagia, prevalent in over half of stroke survivors, poses severe complications, including aspiration pneumonia. While Turkey faces high stroke mortality, limited validated dysphagia screening tools exist. Recent cultural adaptation studies focus on tools like The Barnes-Jewish Hospital Stroke Dysphagia Screen, The Gugging Swallowing Screen Test and The Mann Assessment of Swallowing Ability. The Toronto Bedside Swallow Screening Test (TOR-BSST), a water-swallowing test for stroke patients, demonstrates accuracy. Adapting it to Turkish is crucial for effective bedside screening and managing dysphagia, offering significant benefits.
This study translated TOR-BSST into Turkish, aiming to evaluate its validity and reliability in acute stroke patients, addressing a critical need in the Turkish stroke population. What this paper adds to the existing knowledge This study addresses the pressing issue of dysphagia, a life-threatening complication following strokes in Turkey, where validated bedside screening tests are limited. The research translates and validates the TOR-BSST into Turkish, involving 60 stroke patients. The TOR-BSST-TR form, administered by trained speech-language pathologists, demonstrated high sensitivity (93.9%) and good specificity (85.2%) in comparison to videofluoroscopy, the gold standard. Inter-rater reliability was satisfactory, showcasing the tool's effectiveness in identifying dysphagia. The study contributes valuable insights into dysphagia assessment, offering a reliable and culturally adapted screening tool for stroke patients in Turkey. What are the potential or actual clinical implications of this work? The clinical implications of this study are significant for stroke patients in Turkey facing dysphagia. The successful translation and validation of the TOR-BSST into Turkish offer healthcare professionals a culturally adapted and reliable bedside screening tool. This tool demonstrates high sensitivity and good specificity in identifying dysphagia, providing a valuable resource for early detection and effective management. The study's findings imply that the TOR-BSST-TR can be a practical and accurate instrument for clinicians, aiding in timely intervention, reducing complications and improving patient outcomes. Incorporating this tool into routine clinical practice may enhance dysphagia screening, leading to better patient care and quality of life.WHAT THIS PAPER ADDSWhat is already known on the subject Dysphagia, prevalent in over half of stroke survivors, poses severe complications, including aspiration pneumonia. While Turkey faces high stroke mortality, limited validated dysphagia screening tools exist. Recent cultural adaptation studies focus on tools like The Barnes-Jewish Hospital Stroke Dysphagia Screen, The Gugging Swallowing Screen Test and The Mann Assessment of Swallowing Ability. The Toronto Bedside Swallow Screening Test (TOR-BSST), a water-swallowing test for stroke patients, demonstrates accuracy. Adapting it to Turkish is crucial for effective bedside screening and managing dysphagia, offering significant benefits. This study translated TOR-BSST into Turkish, aiming to evaluate its validity and reliability in acute stroke patients, addressing a critical need in the Turkish stroke population. What this paper adds to the existing knowledge This study addresses the pressing issue of dysphagia, a life-threatening complication following strokes in Turkey, where validated bedside screening tests are limited. The research translates and validates the TOR-BSST into Turkish, involving 60 stroke patients. The TOR-BSST-TR form, administered by trained speech-language pathologists, demonstrated high sensitivity (93.9%) and good specificity (85.2%) in comparison to videofluoroscopy, the gold standard. Inter-rater reliability was satisfactory, showcasing the tool's effectiveness in identifying dysphagia. The study contributes valuable insights into dysphagia assessment, offering a reliable and culturally adapted screening tool for stroke patients in Turkey. What are the potential or actual clinical implications of this work? The clinical implications of this study are significant for stroke patients in Turkey facing dysphagia.
The successful translation and validation of the TOR-BSST into Turkish offer healthcare professionals a culturally adapted and reliable bedside screening tool. This tool demonstrates high sensitivity and good specificity in identifying dysphagia, providing a valuable resource for early detection and effective management. The study's findings imply that the TOR-BSST-TR can be a practical and accurate instrument for clinicians, aiding in timely intervention, reducing complications and improving patient outcomes. Incorporating this tool into routine clinical practice may enhance dysphagia screening, leading to better patient care and quality of life.WHAT THIS PAPER ADDSWhat is already known on the subject Dysphagia, prevalent in over half of stroke survivors, poses severe complications, including aspiration pneumonia. While Turkey faces high stroke mortality, limited validated dysphagia screening tools exist. Recent cultural adaptation studies focus on tools like The Barnes-Jewish Hospital Stroke Dysphagia Screen, The Gugging Swallowing Screen Test and The Mann Assessment of Swallowing Ability. The Toronto Bedside Swallow Screening Test (TOR-BSST), a water-swallowing test for stroke patients, demonstrates accuracy. Adapting it to Turkish is crucial for effective bedside screening and managing dysphagia, offering significant benefits. This study translated TOR-BSST into Turkish, aiming to evaluate its validity and reliability in acute stroke patients, addressing a critical need in the Turkish stroke population. What this paper adds to the existing knowledge This study addresses the pressing issue of dysphagia, a life-threatening complication following strokes in Turkey, where validated bedside screening tests are limited. The research translates and validates the TOR-BSST into Turkish, involving 60 stroke patients. The TOR-BSST-TR form, administered by trained speech-language pathologists, demonstrated high sensitivity (93.9%) and good specificity (85.2%) in comparison to videofluoroscopy, the gold standard. Inter-rater reliability was satisfactory, showcasing the tool's effectiveness in identifying dysphagia. The study contributes valuable insights into dysphagia assessment, offering a reliable and culturally adapted screening tool for stroke patients in Turkey. What are the potential or actual clinical implications of this work? The clinical implications of this study are significant for stroke patients in Turkey facing dysphagia. The successful translation and validation of the TOR-BSST into Turkish offer healthcare professionals a culturally adapted and reliable bedside screening tool. This tool demonstrates high sensitivity and good specificity in identifying dysphagia, providing a valuable resource for early detection and effective management. The study's findings imply that the TOR-BSST-TR can be a practical and accurate instrument for clinicians, aiding in timely intervention, reducing complications and improving patient outcomes. Incorporating this tool into routine clinical practice may enhance dysphagia screening, leading to better patient care and quality of life
Böbrek transplantasyonu yapılan çocuklarda kognitif fonksiyonlar, el becerisi, kavrama kuvveti, reaksiyon zamanı ve dengenin değerlendirilmesi
No full textÇalışmamızın amacı; kronik dönem böbrek transplantasyonu olan çocuklarda sağlıklı akranlarına kıyasla kognitif fonksiyonların, el becerisinin, el kavrama kuvvetinin, reaksiyon zamanının ve dengenin etkilenip etkilenmediğini belirlemektir. İstinye Üniversitesi Hastanesi Bahçeşehir Liv Hospital'da takip edilen 30 hasta böbrek transplantasyon grubu, 30 sağlıklı çocuk ise kontrol grubu olmak üzere iki gruba ayrıldı. Tüm katılımcıların kognitif fonksiyonları Stroop Testi ile, kaba motor el becerisi Tahta Kutu ve Blok Testi ile, ince motor el becerisi 9 Delikli Peg Testi ile, el kavrama kuvveti (Handgrip Strength Test - HGST) ile reaksiyon zamanının değerlendirilmesi Light-Trainer (LTv2, Türkiye) Cihazı ile, denge Pediatrik Denge Ölçeği ile değerlendirildi. Tüm değerlendirmeler sonucunda böbrek transplantasyon grubu ve kontrol grubunun demografik özellikleri benzer bulundu (p>0.05). Kognitif fonksiyonlar, el motor beceri ve el reaksiyon zamanı parametrelerinde önemli farklılıklar gözlenmiştir. Kognitif değerlendirmede Stroop Testi'nde "Siyah/Beyaz Okuma"(p0.05). Light Trainer cihazı ile yapılan reaksiyon zamanı ölçümlerinde ise dominant ve non-dominant elin "en hızlı" (p0.05). Significant differences were observed in cognitive functions, hand motor skills, and hand reaction time parameters. In cognitive assessment, the Stroop Test showed significantly higher times in the transplantation group for "Black/White Reading" (p0.05). In reaction time measurements performed with the Light Trainer device, statistically significant differences were found between the two groups in the "fastest" (p<0.001), "slowest" (p=0.005), and "average" (p=0.018) reaction times of the dominant and non-dominant hands (p<0.05). No significant difference was observed between the groups in balance assessment (p=0.276). Our results show a multidimensional impairment in executive functions, attention, motor coordination, and time-based motor performance in children who have undergone kidney transplantation. These cognitive and motor impairments may lead to various difficulties in daily life, academic success, and social participation. Therefore, it is necessary to integrate neurodevelopmental assessments into the post-transplant clinical follow-up process and to create individualized rehabilitation programs specific to children. Physiotherapy and rehabilitation interventions targeting attention, processing speed, motor coordination, and postural control should be planned at an early stage, and holistic intervention models that include integration into the school environment should be adopted
Association of nutritional status indices with clinical outcomes in acute pancreatitis
Full text linkBackground/Objectives: Acute pancreatitis (AP) is an inflammatory condition marked by pancreatic tissue damage due to the activation of digestive enzymes in the pancreas, triggered by various factors. Nutritional status is considered an essential factor in the management and progression of AP. The Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) score are used to assess nutritional status and may have prognostic value in AP. This study aimed to investigate whether PNI and CONUT scores at admission are associated with clinical outcomes in patients with AP. Methods: A retrospective analysis was conducted on 261 acute pancreatitis patients admitted between 2016 and 2021. Statistical analyses included normality assessment (Shapiro-Wilk), group comparisons (Student's t-test, Mann-Whitney U, chi-square/Fisher's exact test), correlation analyses (Pearson/Spearman), logistic regression for predictors of complications, and ROC curve analysis for cut-off determination. Results: Patients were categorized into two groups: those with (n = 132) and those without complications (n = 129). No significant difference was observed in PNI scores between the two groups (p > 0.05). However, CONUT scores were significantly higher in patients with complications (p = 0.012). In cases with necrosis, PNI scores were substantially lower (p = 0.036), whereas CONUT scores were significantly higher (p = 0.006). A significant inverse correlation was found between PNI and CONUT scores (r = -0.584, p = 1.5, with a sensitivity of 67.4% and a specificity of 47.3%. Conclusion: This study demonstrates that while PNI scores did not significantly differ between AP patients with and without complications, lower PNI and higher CONUT scores were significantly associated with the presence of pancreatic necrosis. Moreover, the CONUT score was significantly higher in patients who developed complications, suggesting its potential utility as a prognostic tool. These findings highlight the importance of early assessment of nutritional status in the clinical management of AP. The CONUT score, in particular, may help identify patients at risk for worse outcomes and guide timely nutritional interventions to improve prognosis
Evaluation of the accuracy of ChatGPT-4 and Gemini's responses to the World Dental Federation's frequently asked questions on oral health
Full text linkBackgroundThe field of artificial intelligence (AI) has experienced considerable growth in recent years, with the advent of technologies that are transforming a range of industries, including healthcare and dentistry. Large language models (LLMs) and natural language processing (NLP) are pivotal to this transformation. This study aimed to assess the efficacy of AI-supported chatbots in responding to questions frequently asked by patients to their doctors regarding oral health.MethodsFrequently asked questions in the oral health section of the World Dental Federation FDI website were asked about Google-Gemini Trends and ChatGPT-4 chatbots on July 9, 2024. Responses from ChatGPT and Gemini, as well as those from the FDI webpage, were recorded. The accuracy of the responses given by ChatGPT-4 and Gemini to the four specified questions, the detection of similarities and differences, and the comprehensive examination of ChatGPT-4 and Gemini's capabilities were analyzed and reported by the researchers. Furthermore, the content of the texts was evaluated in terms of their similarity with respect to the following criteria: "Main Idea," "Quality Analysis," "Common Ideas," and "Inconsistent Ideas."ResultsIt was observed that both ChatGPT-4 and Gemini exhibited performance comparable to that of the FDI responses in terms of completeness and clarity. Compared with Gemini, ChatGPT-4 provided responses that were more similar to the FDI responses in terms of relevance. Furthermore, ChatGPT-4 provided responses that were more accurate than those of Gemini in terms of the "Accuracy" criterion.ConclusionsThis study demonstrated that, according to the assessment conducted by FDI, the ChatGPT-4 and Gemini applications contain contemporary and comprehensible information in response to general inquiries concerning oral health. These applications are regarded as a prevalent and dependable source of information for individuals seeking to access such data
Koroner arter bypass greft cerrahisi geçiren hastalarda preoperatif ve postoperatif kardiyak rehabilitasyonun etkilerinin incelenmesi
Full text linkKoroner Arter Bypass Greft Cerrahisi Geçiren Hastalarda Preoperatif ve Postoperatif Kardiyak Rehabilitasyonun Etkilerinin İncelenmesi. Yüksek Lisans Tezi, İstanbul Atlas Üniversitesi Lisansüstü Eğitim Enstitüsü, Fizyoterapi ve Rehabilitasyon Anabilim Dalı, İstanbul. Bu çalışma, koroner arter bypass greft (KABG) cerrahisi geçiren hastalarda preoperatif ve postoperatif dönemde uygulanan kardiyak rehabilitasyon programının etkilerini, yalnız postoperatif dönemde uygulanan kardiyak rehabilitasyon programının etkileri ile karşılaştırmayı amaçlamaktadır. Randomize kontrollü tasarımla yürütülen bu araştırmada kontrol grubundaki katılımcılara (n=15), hastaların cerrahi sonrası yoğun bakımdan çıkıp servise yatışı yapıldığında vital bulguları stabil ise postoperatif 1.gün itibariyle başlayan ve taburculuğa kadar devam eden, en az 5 gün; ortalama 1 haftalık bir süreç olan postoperatif dönemde postoperatif kardiyak rehabilitasyon programı uygulanmıştır. Deney grubundaki katılımcılara (n=15) hastaların cerrahi servise yatışlarının yapılmasını takiben ilk gün itibariyle başlayıp cerrahi işleme kadar geçen sürede; en az 5 gün; ortalama 1 haftalık bir süreç olan preoperatif dönemde preoperatif kardiyak rehabilitasyon programı ve ek olarak kontrol grubuna verilen postoperatif kardiyak rehabilitasyon programı uygulanmıştır. Çalışmaya dahil edilen tüm katılımcıların demografik ve klinik bilgileri, solunum fonksiyonları, tepe öksürük akımları (TÖA), fonksiyonel kapasiteleri, mobiliteleri, periferik kas kuvvetleri, ağrı seviyeleri, hareket korkuları ve yaşam kaliteleri sırasıyla "Demografik ve Klinik Değerlendirme Formu", solunum fonksiyon testi, PEF metre cihazı, 6 dakika yürüme testi (6DYT), 30 saniye otur kalk testi (30snOKT), dijital el tipi dinamometre, Vizüel Analog Skala (VAS), Tampa Kinezyofobi Ölçeği Kalp Versiyonu (TKÖ-K) ve SF-36 Yaşam Kalitesi Ölçeği ile değerlendirilmiştir. Tüm değerlendirmeler preoperatif dönem başlangıç, preoperatif dönem bitiş, postoperatif dönem başlangıç ve postoperatif dönem bitiş olmak üzere 4 tekrarlı şekilde gerçekleştirilmiştir. Her iki grupta da cerrahi sonrası FEV₁, FVC, PEF ve TÖA parametrelerinde anlamlı artış gözlenmiş; ancak bu değişkenler için zaman x grup etkileşimi anlamlı bulunmamıştır (p>0,05). Deney grubunda, kontrol grubuna kıyasla 6DYTmesafesi, 30snOKT skoru, quadriseps ve biseps kas kuvveti, VAS ağrı skoru, TKÖ puanı ve SF-36 fiziksel fonksiyon alt boyutlarında zaman x grup etkileşimi anlamlı olarak daha yüksekti (p0.05). In contrast, statistically significant time x group interactions were identified in the experimental group in favor of greater improvements in 6MWT distance, 30sSTS score, quadriceps and biceps muscle strength, VAS pain scores, TSK scores, and the physical function subscale of SF-36 (p<0.05). These findings indicate that preoperative cardiac rehabilitation not only mitigates the negative effects of surgery but also contributes to the improvement of physical and psychological well-being. Therefore, integration of preoperative rehabilitation into routine clinical practice is recommended for patients scheduled to undergo CABG surgery
To polish or not to polish? An evaluation of the accuracy in measuring depth of cure calculated by microhardness ratio
Full text linkAim This study aimed to evaluate the influence of surface polishing on the reliability of microhardness ratio-based assessment of depth of cure in resin-based composites. Materials and methods A total of 60 composite discs (n = 10 per group) were prepared using six different resin-based composite materials. The tested materials included two conventional sculptable composites (Tetric Prime and Neo Spectra ST HV), one conventional flowable composite (Tetric EvoFlow), one bulk-fill sculptable composite (Tetric PowerFill), and two bulk-fill flowable composites (Tetric PowerFlow and SDR Plus), all prepared according to the respective manufacturers' instructions. Prior to microhardness measurements, the bottom-to-top surface microhardness ratios were assessed using three distinct approaches: 1)unpolished bottom/unpolished top, 2) unpolished bottom/polished top, 3) polished bottom/polished top. Vickers Microhardness Numbers (VHN) were determined under a load of approximately 50 g applied for 15 s. The threshold value for acceptable depth of cure was set at 80%. Results Statistical analysis revealed significant differences in the depth of cure measurements of resin-based materials when evaluated using the unpolished bottom/polished top, polished bottom/top, and unpolished bottom/top approaches (p < 0.001). Among these, the lowest degree of conversion was consistently observed in the configuration where the bottom surface remained unpolished while the top surface was polished. Notably, SDR was the only material that surpassed the 80% threshold across all three evaluation methods. Conclusion The unpolished bottom/polished top configuration resulted in the lowest conversion rates, primarily due to the increase in microhardness values caused by polishing the top surface. Whether or not surface finishing is applied has a substantial impact on the mechanical performance, and should therefore be thoughtfully considered when interpreting the effectiveness of polymerization