1983 research outputs found
Sort by
Reliability and Validity of the Turkish Version of Patient and Observer Scar Assessment Scale in Patients with Burnso
No full textObjective: To evaluation reliability and validity of the Turkish version of Patient and Observer Scar Assessment Scale (POSAS) in patients with burns.
Methods: This is a methodologically study. Data were collected using POSAS, survey form and plexiglas. Patient Scar Assessment Scale (PSAS) was completed by patients (n=53) and Observer Scar Assessment Scale (OSAS) was completed by two observers separately. The test-retest was measured applying the scales in 25 patients after two weeks. Data were analyzed by Kruskal-Wallis and Mann-Whitney U test. Content validity was determined using Kaiser-Meyer-Olkin, Barlett's test and structure validity was performed by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA); reliability was evaluated using internal consistency, Cronbach's alpha and intraclass correlation coefficient (ICC).
Results: Factor weights were in appropriate range according to EFA, 6 items single factor structure of the original scale was valid and had high consistency index according to CFA, ICC between the 7th item and the total points was proportional, inner consistency was highly reliable (PSAS alpha=0.992, OSAS alpha=0.993), consistency between the observers was high (alpha=0.952, r=0.909). It was determined OSAS scores increased as the burn degree increased (p<0.05).
Conclusion: POSAS was determined to be a valid and reliable scale in patients with burns in the Turkish society
Congenital insensitivity to pain: How should anesthesia be managed?
No full textCongenital insensitivity to pain syndrome is a rare, sensorial and autonomic neuropathy characterized by unexplained fever, insensitivity to pain and anhidrosis. Patients may require anesthesia even for minor surgical procedures due to mental retardation and trauma arising from self-mutilating behavior.
A child diagnosed with congenital insensitivity to pain syndrome was scheduled for gastric endoscopy under sedation due to suspected ingestion of a household cleaning disinfectant. Deep sedation was achieved, and spontaneous respiration was maintained. We did not encounter any complications.
There is limited data regarding the safe anesthesia management in these patients because of the rarity of the disease. Therefore, we think that more clinical experience, case reports and studies are needed to establish the appropriate anesthesia management
A Comparison of Er:YAG Laser with Photon-Initiated Photoacoustic Streaming, Nd:YAG Laser, and Conventional Irrigation on the Eradication of Root Dentinal Tubule Infection by Enterococcus faecalis Biofilms: A Scanning Electron Microscopy Study
No full textThis study evaluated the antimicrobial efficacy of Er:YAG laser activation with photon-initiated photoacoustic streaming (PIPS), Nd:YAG laser disinfection, and conventional irrigation on Enterococcus faecalis biofilms using scanning electron microscopy (SEM). Biofilms were grown on 110 root halves and divided into the following: Groups 1 and 2 (saline and 1% NaOCl with apical position of PIPS, resp.), Groups 3 and 4 (saline and 1% NaOCl with coronal position of PIPS, resp.), Groups 5 and 6 (Nd: YAG laser after saline and 1% NaOCl irrigation, resp.) and Groups 7, 8, and 9 (conventional irrigation with 1% NaOCl, 6% NaOCl, and saline, resp.). SEM images of the apical, middle, and coronal levels were examined using a scoring system. Score differences between Groups 1 and 2 were insignificant at all levels in the remaining biofilm. Group 4 had significantly greater bacterial elimination than Group 3 at all levels. Differences in Nd: YAG laser irradiation between Groups 5 and 6 were insignificant. Groups 7 and 8 were insignificantly different, except at the middle level. Saline group had a higher percentage of biofilms than the others. In this study, PIPS activation with NaOCl eliminates more E. faecalis biofilms in all root canals regardless of the position of the fiber tip
A comparison of rat degloving injury models
No full textObjective: Two different rat models for degloving injury were described in the literature. Our aim in this study is to compare these rat models to determine which one is more reliable and reproducible.
Methods: We surgically induced degloving injury on tails and left hindlimbs of Wistar albino rats (n = 8), and sutured the avulsed tissues back in their original positions after a waiting period. We observed the changes in the avulsed flaps every other day for 10 days. At the end of follow-up period we evaluated the lesions in avulsed flaps by macroscopic measurement of necrosis and histological ulcer scoring using the National Pressure Ulcer Advisory Panel (NPUAP) Scale.
Results: The average length of necrosis in avulsed tail flaps was 28.42 +/- 3.04 mm, whereas there was no necrosis in avulsed hindlimb flaps (p < 0.05). The average ulcer score of the lesions in tail and left hindlimb were 3.42 +/- 0.78, and 1.28 +/- 0.48, respectively (p < 0.05). Despite the lack of visible necrosis TUNEL staining revealed an increased amount of apoptotic cells in avulsed hindlimb flaps. Literature review revealed a significant variability in previous studies in terms of the amount of necrosis observed in tail degloving injury model.
Conclusion: Tail degloving injury model proved to be a more reliable animal model for degloving injuries. However, standardization of the magnitude of degloving force is required to decrease the variability of necrosis observed in the literature. (C) 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V
Treatment of Class II, Division 2 Malocclusion with Miniscrew Supported En-Masse Retraction: Is Deepbite Really an Obstacle for Extraction Treatment?
No full textA 17-year-old female patient, whose chief complaint was her unpleasing smile, had skeletal and dental class II malocclusion, hypodivergent facial type with a severely increased overbite. Among the treatment options, upper-first-premolar extractions followed by miniscrew-supported en-masse retraction was the treatment of choice. After the initial levelling and alignment, miniscrews with 1.5- to 1.4-mm diameter and 7-mm lenght, were installed between the roots of the second premolars and the first molars, bilaterally. En-masse retraction was achieved on a 0.016x0.022-inch stainless steel archwire with 7-mm long power hooks placed distal to the lateral incisors, and with nickel-titanium (NiTi) closed coil springs exerting 250-gr of force per side. At the end of the treatment, deepbite, incisor inclinations and interincisal angle were corrected, and Class II molar relationship with good intercuspation was achieved. Upper 2-2, lower 3-3 retainers were bonded for retention. As a result, deepbite and Class II canine relationship was successfully corrected with simultaneous incisor intrusion and retraction using miniscrew-supported en-masse retraction
Reversible cycloplegia caused by duloxetine: a case report
No full textA Duloxetine is a balanced and potent dual reuptake inhibitor of serotonin and norepinephrine (SNRI) that has previously been shown to be effective in the treatment of major depressive disorder (MDD), generalized anxiety disorder, and diabetic peripheral neuropathic pain (DPNP). Cycloplegia is paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation. Here, we present a reversible cycloplegia case caused by duloxetine use. The patient was a 24 years-old woman with MDD diagnosis. Patient had somatic symptoms like fatigue, myalgia, and headache, besides her depressive symptoms for the last two months. Escitalopram and sertraline were used for her MDD before and she had to quit both owing to side effects such as nausea and drowsiness. Duloxetine 30mg/day treatment was started in our outpatient clinic. In her first follow-up exam, she reported light sensitivity and increased visual impairment. The visual impairment led dizziness and an increase in headache. She was consulted to ophthalmology unit of our hospital and cycloplegia was detected in her eye examination. Duloxetine was stopped in the ninth day of treatment but cycloplegia negatively affected the patient's daily life for almost 4 weeks and impaired her functionality. Because of the paralysis of the ciliary muscle, the curvature of the lens can no longer be adjusted to focus on nearby objects. Eye pain, changes in vision and swelling or redness in or around the eye are mentioned as possible visual side effects in the medication of duloxetine. The ocular and visual side effects from a patient's systemic medication can range from mild to severe. These side effects may or may not be serious enough to warrant discontinuing treatment. Cycloplegia seems as a rare adverse effect in antidepressant treatment and may take a long time to wash out. Recognition of ocular and visual side effects is important to prevent and minimize serious complications. In such visual disturbances, eye examination of the patient should be performed and the responsible drug should be discontinued as early as possible
Thiol/Disulphide Homeostasis in Men with Heroin Addiction
No full textObjective: Heroin addicts have increased oxidative stress which can disturb thiol/disulfide (SH/SS) homeostasis, causing disulfide formation. No study has determined the serum thiol amount and blood disulfide amount in heroin addicts. The aim of the study was to investigate dynamic SH/SS homeostasis in heroin addicts.
Methods: Serum SH/SS statuses of 31 heroin addicts and 31 healthy controls were compared to determine the changes in SH/SS homeostasis in heroin addicts. Blood serum native thiol and total thiol (ToSH) levels were measured and the disulfide bond amount was calculated as the half value of the difference between native thiol and ToSH levels. For comparison t-test was used.
Results: SH and ToSH levels were significantly lower (p<0.001 for both) in heroin addicts than in the healthy group whereas disulfide levels were significantly higher (p<0.001). Heroin addicts had significantly higher SS/ToSH and SS/SH ratios and significantly lower SH/ToSH ratios than healthy individuals.
Conclusion: The results showed that SH and ToSH levels were decreased in heroin addicts and SH/SS homeostasis was also disturbed with a shift to the disulfide bond formation side. Results of this study could contribute to the knowledge about pathogenesis of heroin addiction and also to its management. We suggest that replacement of the thiol gap and reduction of excess SS might have positive effects in treatment results
PREVALENCE AND RELATED FACTORS OF LIMITED HEALTH LITERACY IN PATIENTS WITH CHRONIC MUSCULOSKELETAL DISEASES
No full textPurpose: Not knowing the dimensions of inadequate health literacy is an important public health issue not just for healthcare professionals but all population. It is, therefore, necessary to ensure that politicians see this as an investment and to encourage service to productive resources. It is important to be aware of limited health literacy to develop new and different strategies. The aim of this study was to determine the prevalence of limited health literacy and to examine the relationship between health readiness and socio-demographic characteristics in patients with chronic musculoskeletal disorders.
Methods: A total of 423 patients who have different chronic musculoskeletal disorders were recruited into the study. The level of health literacy was measured using Rapid Estimate of Adult Literacy in Medicine and Newest Vital Sign instruments. The cognitive level of participants was estimated using Mini-Mental Status Examination Test.
Results: Approximately 17.3 percent of participants assessed using Rapid Estimate of Adult Literacy in Medicine had limited health literacy. More than 27.2 percent of participants evaluated using the Newest Vital Sign had limited literacy and lower numeracy skills.
Conclusion: Limited health literacy and numeracy skills are common in patients who have different chronic musculoskeletal disorders. It is associated with older age, lower level of education, and lower cognitive level. Healthcare literacy can be improved with various strategies in health services, and more successful outcomes can be obtained in treatment
The effect of structured education to patients receiving oral agents for cancer treatment on medication adherence and self-efficacy
No full textObjective: This study was conducted to examine the effect of structured education on medication adherence and self-efficacy through the use of the MASCC Oral Agent Teaching Tool (MOATT) for patients receiving oral agents for cancer treatment. Methods: This quasi-experimental study has been conducted at two hospitals; 41 patients were included in the study. Data were obtained using a questionnaire, medication adherence self-efficacy scale (MASES), memorial symptom assessment scale, and a follow-up form (diary). Patients were educated through the use of the MOATT at a scheduled time; drug-specific information was provided along with a treatment scheme and follow-up diary. Phone interviews were completed 1 and 2 weeks after the educational session. At the next treatment cycle, the patients completed the same questionnaires. Results: Majority of the patients were receiving capecitabine (90.2%; n = 37) as an oral agent for breast (51.2%; n = 21) and stomach cancer (24.6%; n = 10) treatment. About 90.2% of patients (n = 37) stated that they did not forget to take their medication and experienced medication-related side effects (78%; n = 32). The total score of MASES was increased after the education (66.39 vs. 71.04, P < 0.05). Conclusions: It was shown that individual education with the MOATT and follow-up for patients receiving oral agents for cancer treatment increased patient medication adherence self-efficacy
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