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Painful skin lesions and squamous cell carcinoma predict overall mortality risk in organ transplant recipients: a cohort study
No full textBackgroundOrgan transplant recipients (OTRs) have a highly increased risk of cutaneous squamous cell carcinomas (SCCs). Sensation of pain in cutaneous tumours is a powerful patient-reported warning signal for invasive SCCs in OTRs.
ObjectivesTo investigate the impact of painful vs. painless skin lesions and SCC vs. other skin lesions on the overall mortality risk in OTRs.
MethodsWe followed 410 OTRs from 10 different centres across Europe and North America between 2008 and 2015. These patients had been enrolled in an earlier study to define clinically meaningful patient-reported warning signals predicting the presence of SCC, and had been included if they had a lesion requiring histological diagnosis. Cumulative incidences of overall mortality were calculated using Kaplan-Meier survival analysis, and risk factors were analysed with Cox proportional hazard analysis.
ResultsThere was an increased overall mortality risk in OTRs who reported painful vs. painless skin lesions, with a hazard ratio (HR) of 16 [95% confidence interval (CI) 097-27], adjusted for age, sex and other relevant factors. There was also an increased overall mortality risk in OTRs diagnosed with SCC compared with other skin lesions, with an adjusted HR of 17 (95% CI 10-28). Mortality due to internal malignancies and systemic infections appeared to prevail in OTRs with SCC.
ConclusionsWe suggest that OTRs have an increased overall mortality risk if they develop painful skin lesions or are diagnosed with cutaneous SCC
Are oxidative stress markers helpful for diagnosing the disease and determining its complexity or extent in patients with stable coronary artery disease?
No full textOBJECTIVE: The aim of this study was to investigate the relationship between oxidative/antioxidative stress markers and the diagnosis and complexity of coronary artery disease (CAD) in patients with stable CAD.
METHODS: A total of 145 patients were enrolled in the study. Based on coronary angiography results, the patients were categorized into 2 groups: those without CAD (Group 1) and those with CAD (Group 2). The patients in Group 2 were also categorized into low score and moderate/high score groups according to their SYNTAX score. The serum malondialdehyde (MDA) and total antioxidant capacity (TAOC) levels of Group 1 and Group 2 were compared. Finally, MDA and TAOC levels were compared between the moderate/high-risk and low-risk groups formed according to SYNTAX score.
RESULTS: There was a significant difference with respect to both serum TAOC and MDA levels between Group 1 and Group 2 (p=0.036 and p=0.029, respectively). The groups with a SYNTAX score 1-22 and with a SYNTAX score >22 were not significantly different with respect to serum TAOC or MDA level (p=0.582 and p=0.85, respectively).
CONCLUSION: The serum MDA level was significantly higher and the TAOC level was significantly lower in patients with stable CAD compared to those without; however, these molecule levels failed to predict disease complexity in patients with stable CAD
Prolongation of Corrected QT Interval Is a Strong Predictor of Arterial Stiffness in Maintenance Hemodialysis Patients: A Prospective Observational Study
No full textBackground: Rate of mortality due to cardiovascular diseases is high in Maintenance Hemodialysis (MHD) patients. Additionally, prolonged QT interval is reportedly associated with high-risk ventricular arrhythmia and sudden death. Vascular calcification may be related to QT dispersion interval in MHD patients because the extensive nature of the calcification process may involve the conducting system and myocardium.
Objectives: This study aimed to evaluate the relationship between QT interval and Pulse Wave Velocity (PWV) as a sign of arterial stiffness associated with atherosclerosis in MHD patients.
Patients and Methods: This prospective, observational study was conducted on 149 eligible MHD patients for 12 months. Patients using drugs known to affect QT interval were excluded. The patients were divided into four groups as follows: normal corrected QT (QTc) interval at the beginning and end of the study (n = 44, 29.5%), normal QTc interval at the beginning but prolonged QTc interval at the end of the study (n = 30, 20.1%), prolonged QTc interval at the beginning but normal QTc interval at the end of the study (n = 24, 16.1%), and prolonged QTc interval at the beginning and end of the study (n = 51, 34.2%). Demographic parameters, laboratory parameters, and PWV were assessed at the beginning and the 12th month of the study. Then, the data were analyzed using ANOVA or Pearson 2 test and P < 0.05 was considered to be statistically significant.
Results: The study groups were similar with respect to age and comorbidities, including diabetes mellitus, hypertension, and dyslipidemia. In addition, there were no significant differences among the groups regarding the initial PWV (P = 0.412); however, the ending PWV showed significant differences (P = 0.029). The results of multivariate analysis showed that PWV was independently associated with change in the maximum QTc (confidence interval: 0.039 -1.787, P = 0.031, beta= 0.178).
Conclusions: The results suggested inclusion of QTc interval prolongation, as a predictor of cardiovascular disease, either alone or in combination with PWV in such high-risk patients
Comparison of Dentofacial and Periodontal Effects of Rapid and Semi-rapid Maxillary Expansion
No full textObjective: The purpose of this study was to compare the skeletal, dentoalveolar and periodontal effects that occurred after rapid maxillary expansion (RME) and semirapid maxillary expansion (SRME) with an acrylic splint bonded expansion appliance and also to compare the degree of root resorption in the supporting teeth during expansion.
Materials and Methods: The sample of the study included 19 patients having maxillary constriction requiring bilateral upper premolar extraction. The semi-rapid group consisted of 10 patients and the rapid group consisted of 9 patients. Lateral and posteroanterior (PA) cephalometric radiographs were taken at the beginning of the treatment, at the end of expansion and after 3 months of retention period. Eleven patients underwent low-dose computed tomography (CT) at the beginning of treatment and at the end of retention period, after giving informed consent. The evaluation of root resorption was made using a scanning electron microscope from the extracted teeth.
Results: Both lateral and PA radiographs showed similar changes between the groups. Posterior nasal cavity width, palatal maxillary width, the distance between palatinal roots and the distance between incisor roots showed significant increase in the CT measurements. Buccal bone thickness decreased and palatal bone thickness increased in all molar and premolar teeth examined. Root resorption was seen in both groups, but no significant differences were observed between the groups.
Conclusion: Some differences were seen in short-time effects between SRME and RME but these differences were temporary and disappeared at the end of the retention period. The qualitative evaluation of the roots showed that the location and degree of the root resorption were similar between the groups
Achalasia as a complication of bulimia nervosa: A case report
No full textObjective: Oesophageal achalasia is a medical condition characterised by oesophageal aperistalsis, an increased resting pressure with partial or incomplete relaxation of the lower oesophageal sphincter. Bulimia nervosa (BN) is an eating disorder manifested by binge eating attacks followed by recurrent inappropriate compensatory behaviours, such as self-induced vomiting and excessive exercise. Dysphagia, regurgitation, vomiting, retrosternal pain, heartburn, weight loss, avoidance of eating, consumption of large amount of liquids and aberrant eating behaviours are symptoms of both achalasia and BN. Owing to these common signs and symptoms, oesophageal achalasia can be misdiagnosed as an eating disorder. In addition, oesophageal achalasia can occur as a complication of BN. It is often difficult to distinguish organic and psychological vomiting or comorbidity because of overlapping of the symptoms.
Case report: We report the case of a patient who developed oesophageal achalasia following severe, repetitive vomiting as a complication of BN.
Conclusion: We want to raise awareness regarding the development of a medical illness in the presence of a psychiatric disorder. Importantly, physicians should have a fundamental knowledge of these two diseases regarding their clinical patterns to differentially diagnose one or both disorders as quickly as possible
Approaches to Female Congenital Genital Tract Anomalies and Complications
No full textObjective: Female congenital genital tract anomalies may appear with quite confusing and deceptive complications. This study aims to evaluate the difficulties in diagnosis and treatment of female congenital genital tract anomalies that frequently present with complications.
Summary: During a 10-year period, we evaluated 20 female patients with congenital genital tract anomalies aged between 3 days and 16 years. All patients were retrospectively analyzed in terms of the results of diagnostic studies, surgical intervention, and treatment.
Methods: Ultrasonography and magnetic resonance imaging revealed hydromucocolpos or hematocolpometra, imperforate hymen, distal vaginal atresia, didelphys uterus, an obstructed right hemivagina, uterovaginal atresia, a unicornuate uterus with a noncommunicating rudimentary horn, a vesicovaginal fistula, a utero-rectal fistula, intraabdominal collection, and a vaginal calculus.
Results: Two patients had Mayer-Rokitansky-Kuster-Hauser syndrome and 6 patients had obstructed hemivagina and ipsilateral renal anomaly syndrome. Definitive surgical interventions were hymenotomy, vaginal pull-through, vaginovaginostomy, and vesico-vaginal fistula repair using a transvesical approach. In conclusion, female congenital genital tract anomalies may appear with a wide range of complications.
Conclusions: There is a potential to do significant harm, if the patient's anatomic problems are not understood using detailed imaging. Revealing the anatomy completely and defining the complications that have already developed are critical to tailor the optimal treatment strategies and surgical approaches
Problematic Internet Usage: Personality Traits, Gender, Age and Effect of Dispositional Hope Level
No full textPurpose: The aim of this study is to examine the effect of personality traits, gender, age and effects of dispositional hope level in problematic internet usage of university students. Research Methods: This paper is an example of a descriptive study, which presents the relationship between problematic internet usage of university students considering personality traits, gender, age and dispositional hope level. The study group consists of 376 students from different universities. Research data was collected by using the Problematic Internet Usage Scale, The Big Five Inventory, and the Dispositional Hope Scale. In the analysis of data, parametric tests were used. Findings: It has been observed that as neuroticism increases, excessive usage also increases; as conscientiousness increases, excessive usage of the internet decreases. As openness, extraversion and neuroticism increase, the effects of negative results of internet usage increase; as conscientiousness increases, the effects of negative results of internet usage decrease. At the same time, it can be said that as hope levels increase, the negative effects of internet usage decrease. All of these results can be interpreted as variables, except being an extravert does not have a practical value. Implications for Research and Practice: Based on the results, it was suggested that evaluation of results related to the studies made with high school students and adults will contribute to the field. In future studies, relationships between different usage fields of internet and problematic internet usage can be examined. The results would be helpful for prevention and intervention programs. (C) 2017 Ani Publishing Ltd. All rights reserve
Posttraumatic Stress Symptoms and Related Variables in Families of Children with Disabilities
No full textThe purpose of this study was to examine the effects and relationships of variables related to the children with disabilities and their parents as well as the diagnosis process and informing parents after the diagnosis and variables which might be related to the traumatic stress levels of the parents of children with disabilities on parents' traumatic stress levels. This study which was conducted as relational research included a total of 347 parents of children with disabilities. Data collection forms included personal information form, Traumatic Stress Symptom Scale, and Multidimensional Scale of Perceived Social Support. The results showed that traumatic stress levels of parents of children with physical impairments were higher than other parents, there was a significant relationship between the time passed after the diagnosis and parents' traumatic stress levels; there was significant relationship between the parents' age and parents's traumatic stress levels; parents' traumatic stress levels didn't differ in terms of gender; traumatic stress levels of single parents were higher than married parents
Are oxidative stress markers helpful for diagnosing the disease and determining its complexity or extent in patients with stable coronary artery disease?
No full textObjective: The aim of this study was to investigate the relationship between oxidative/antioxidative stress markers and the diagnosis and complexity of coronary artery disease (CAD) in patients with stable CAD.
Methods: A total of 145 patients were enrolled in the study. Based on coronary angiography results, the patients were categorized into 2 groups: those without CAD (Group 1) and those with CAD (Group 2). The patients in Group 2 were also categorized into low score and moderate/high score groups according to their SYNTAX score. The serum malondialdehyde (MDA) and total antioxidant capacity (TAOC) levels of Group 1 and Group 2 were compared. Finally, MDA and TAOC levels were compared between the moderate/high-risk and low-risk groups formed according to SYNTAX score.
Results: There was a significant difference with respect to both serum TAOC and MDA levels between Group 1 and Group 2 (p=0.036 and p=0.029, respectively). The groups with a SYNTAX score 1-22 and with a SYNTAX score >22 were not significantly different with respect to serum TAOC or MDA level (p=0.582 and p=0.85, respectively).
Conclusion: The serum MDA level was significantly higher and the TAOC level was significantly lower in patients with stable CAD compared to those without; however, these molecule levels failed to predict disease complexity in patients with stable CAD
Kültürel değerlere göre karanlık lider algısının çalışan iş performansı etkisi üzerine bir araştırma
No full textBu çalışmanın temel amacı, iş motivasyonu, bireysel kültürel değer boyutlarından olan kolektivizm, güç mesafesi ve algılanan karanlık lider davranışlarının iş performansı üzerindeki etkilerini oluşturan bir model çerçevesinde araştırılmasıdır. Ankara’da faaliyet gösteren büyük ve orta ölçekli işletmelerde çalışan 245 kişiden elde edilen veriler ile oluşturulan örneklem üzerinden bir araştırma yapılmıştır. Araştırmada elde edilen veriler SPSS programı kullanılarak yapılmıştır. Elde edilen bulgular incelendiğinde, çalışanların iş performansı üzerinde karanlık lider algısının etkisi olduğu istatistiksel olarak kanıtlanmıştır. Kolektivizmin güç mesafesiyle, içsel ve dışsal motivasyon boyutlarının da birbiriyle ilişkisi olduğu gözlemlenmiştir. Karanlık lider davranışları ile iş motivasyonu arasındaki ilişki incelendiğinde ise analiz sonuçlarına göre anlamlı bir ilişki kurulamamıştır.
The main purpose of this study is to examine the impacts of work motivation, collectivisim, power distance and perceived abusive supervision actions on employee job performance. Research is done with data collected from 245 person who works at large and middle size companies in Ankara. Quantitative reserach is made by SPSS Program. When the findings are examined, it is statistically proven that the abusive supervision perception affect workers’ job performance positively. Findings also show that collectivisim and power distance is related to intrinsic and extrinsic motivation. There is no evidence found that abusive supervision actions are related to work motivation and cultural values