Background: The biased attitudes and behaviors of healthcare professionals towards individuals wi... more Background: The biased attitudes and behaviors of healthcare professionals towards individuals with obesity cause these individuals to not be able to benefit from health services adequately. Awareness of factors that limit the quality of treatment will improve obesity treatment outcomes. This study aimed to develop a tool for measuring the obesity bias of health students. Methods: 265 students who voluntarily participated in the study were asked to write 3 positive or negative definitions about individuals with obesity. These sentences were evaluated, the draft scale which consisted of 36 items was redesigned by the experts for the final edition. The scale was administered to 236 health sciences students. After correlation analysis of the items, 8 items were found to break the integrity of the Likert-type scale and reduced its reliability. And 1 item was neither positive nor negative. Results: The Cronbach's alpha coefficient of the scale was found as 0.847, which indicated that the developed scale was highly reliable. The one-dimension construct of the scale was validated by confirmatory factor analysis. Conclusion: This scale, which the researchers call "Obesity Bias Scale", has been found to be a reliable tool that can be used to detect obesity bias.
Small mesh size has been recognized as one of the factors responsible for recurrence after Lichte... more Small mesh size has been recognized as one of the factors responsible for recurrence after Lichtenstein hernia repair due to insufficient coverage or mesh shrinkage. The Lichtenstein Hernia Institute recommends a 7 × 15 cm mesh that can be trimmed up to 2 cm from the lateral side. We performed a systematic review to determine surgeons' mesh size preference for the Lichtenstein hernia repair and made a meta-analysis to determine the effect of mesh size, mesh type, and length of follow-up time on recurrence. Two medical databases, PubMed and ISI Web of Science, were systematically searched using the key word "Lichtenstein repair." All full text papers were selected. Publications mentioning mesh size were brought for further analysis. A mesh surface area of 90 cm(2) was accepted as the threshold for defining the mesh as small or large. Also, a subgroup analysis for recurrence pooled proportion according to the mesh size, mesh type, and follow-up period was done. In total, 514 papers were obtained. There were no prospective or retrospective clinical studies comparing mesh size and clinical outcome. A total of 141 papers were duplicated in both databases. As a result, 373 papers were obtained. The full text was available in over 95 % of papers. Only 41 (11.2 %) papers discussed mesh size. In 29 studies, a mesh larger than 90 cm(2) was used. The most frequently preferred commercial mesh size was 7.5 × 15 cm. No papers mentioned the size of the mesh after trimming. There was no information about the relationship between mesh size and patient BMI. The pooled proportion in recurrence for small meshes was 0.0019 (95 % confidence interval: 0.007-0.0036), favoring large meshes to decrease the chance of recurrence. Recurrence becomes more marked when follow-up period is longer than 1 year (p < 0.001). Heavy meshes also decreased recurrence (p = 0.015). This systematic review demonstrates that the size of the mesh used in Lichtenstein hernia repair is rarely discussed in clinical studies. Papers that discuss mesh size appear to reflect a trend to comply with the latest recommendations to use larger mesh. Standard heavy meshes decrease the recurrence in hernia repair. Even though there is no evidence, it seems that large meshes decrease recurrence rates.
Statement of problem. It is not clear whether newly introduced cordless displacement systems are ... more Statement of problem. It is not clear whether newly introduced cordless displacement systems are better able to manage gingiva than conventional systems. Purpose. The purpose of this in vivo study was to evaluate the gingival management ability of 4 different displacement methods with a standardized subgingival preparation finish line. Material and methods. The effects of 4 displacement techniques on gingival management and impression quality were evaluated by means of 6 evaluation criteria. A subgingival preparation finish line of between 1 and 2 mm was ensured, and the buccal aspects of 252 (n¼63) teeth were clinically assessed for ease of application, time spent, bleeding, remnants, and dilatation. The complete reproduction of the preparation finish line and the bubble and void formations on polyether impressions were also evaluated. The data were statistically analyzed with the c 2 test (a¼.05). The Bonferroni correction was used to control Type I error for the pairwise comparison groups (a¼.008). Results. Statistically significant differences were found for all criteria among the groups (P<.05). The nonimpregnated displacement cord group was the least effective group in terms of bleeding and impression quality (P<.008). The aluminum chloride impregnated cord group and the displacement paste with cap group were found to be comparable in terms of remnants, dilatation, and impression quality (P>.008). The retraction cap with paste group showed better results for ease of application, time spent, and bleeding than the aluminum chloride impregnated cord group (P<.008). Although the group with aluminum chloride impregnated cord, displacement paste, and cap showed better results for dilatation, it was time consuming and difficult (P<.008). Conclusions. Except for the nonimpregnated cord group, all of the groups were comparable and clinically useful, with perfect or acceptable impression qualities.
I In nt tr ro od du uc ct ti io on n: : Levothyroxine (LT4) therapy has been used for the treatme... more I In nt tr ro od du uc ct ti io on n: : Levothyroxine (LT4) therapy has been used for the treatment of euthyroid nodular goiter, but there are controversial results about its usefulness. We aimed to evaluate the possible role of benign nodules' cytological characteristics in response to LT4 therapy. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : In total, 93 patients with 128 nodules were included in the study; 74 of the nodules were treated with LT4 (group 1), and 54 of them had no medication (group 2). The subgroups consisted of adenomatous nodules, colloid nodules and cystic nodules. R Re es su ul lt ts s: : In group 1, mean thyroid volume and mean nodule volume were reduced significantly (p = 0.002 and p = 0.022, respectively) with low-normal level thyrotropin (TSH) suppression (between 0.3 mIU/ml and 1.0 mIU/ml), while there were no significant changes in group 2. When we evaluated changes of the initial and last nodule volumes in cytological subgroups, only colloid nodules in group 1 had significant reduction (p = 0.040) and the others had no significant changes. By omitting the colloid nodules, when the other nodules were revaluated, there were no significant changes in either group. C Co on nc cl lu us si io on ns s: : On the basis of these results, obtained from a large sample of Anatolian patients, it is possible that LT4 therapy leads to significant reductions of both thyroid volume and nodule size in colloid nodules, but not in other kinds of benign nodules.
The American Journal of the Medical Sciences, 2014
Purpose: Studies to date have not investigated whether body mass index (BMI) affects the sensitiv... more Purpose: Studies to date have not investigated whether body mass index (BMI) affects the sensitivity and specificity of magnetic resonance cholangiopancreatography (MRCP). The purpose of this study was to investigate the effect of BMI and also concomitant pancreatitis, cholecystitis and cholelithiasis on the sensitivity and specificity of MRCP. Materials and Methods: Between January 2004 and December 2011, 185 patients were included in the study and divided into 3 groups according to BMI as normal, overweight or obese. Both MRCP and endoscopic retrograde cholangiopancreatography (ERCP) were performed in all patients. ERCP was accepted as the "gold standard." The accuracy, sensitivity and specificity values of the 3 groups were calculated to determine any effects on the results of the MRCP. Results: Before separating into groups according to BMI, the statistical results for MRCP in the detection of stone disease were as follows: specificity 74.3%, sensitivity 81.7% and accuracy 79%. After dividing the patients into 3 groups according to BMI, the specificity of stone detection with MRCP in the normal-weight group was 93.8% but decreased to 65.5% in the overweight group and to 72% in the obese group. The sensitivity of stone detection with MRCP in the normalweight group was 85.2% but decreased to 75% in the overweight group and increased to 88.9% in the obese group. The accuracy was 88.3% in the normal-weight group but decreased to 71.6% in the overweight group and to 81.9% in the obese group. Conclusion: Our study showed that MRCP performance was decreased in the overweight and obese groups.
Objectives : It is usually accepted that some of the treatments affect not only the survival time... more Objectives : It is usually accepted that some of the treatments affect not only the survival times but as well the quality of life of patients. The aim of study is to reach more reliable conclusions by using the metaanalysis method on published studies which deal with the effects of antihypertansive theraphies on the quality of life of patients. Material and Methods : Meta-analysis is used to combine the results of different experiments or studies examining the same question. Meta-analysis is a systematic reviewing strategy for adressing research question that is especially useful when results from several studies disagree with regard to magnitude or direction of the effect, when sample sizes are small to detect an effect and label it statistically significant, or when a large trial is too costly and time consuming to perform. The effect size, d, is the difference between the means in standard score form ,i.e., the ratio of the difference between the means to the standard deviation. Results : When quality of life is considered meta-analysis results showed, except sexual function, positive effect sizes for sleep, general well-being and psychomotor scores (ave(d)=-0.03; ave (d)=0.11; ave (d)=0.135; ave (d)=0.40 Standard Deviations, respectively). When the effect of drug grups on the recovery of patients are studied ave (d) is found to be 0.17 for ACEI (p>0.05) and 0.20 SD (p>0.05) for BETA. When the effect of ACEI drug group on psychomotor scores of patients is considered, Meta-analysis results yielded a mean effect size of 0.50 SD (p<0.01). The mean effect size was 0.40 SD for BETA drug group (p<0.01). The effect of BETA drug group on sexual function scores was the smallest effect (ave (d)=-0.103 ; p>0.05). Conclusions : Among all of the applied metaanalysis, none of the drug groups showed negative effects. Meta-analysis results when quality of life is considered showed, except sexual function positive effect sizes for sleep, general well-being and psychomotor scores (ave (d)=-0.03; ave (d)=0.11; ave (d)=0.135; ave (d)=0.40 Standard Deviation, respectively). Different drug groups have different effect sizes on the dimensions of quality of life of patients. Therefore, as well as this study, all other studies in this field meta-analysis which use , will help researchers to choose the best strategy on deciding the type of the drug.
In this study, we investigated possible independent predictive factors for survival, other than M... more In this study, we investigated possible independent predictive factors for survival, other than MELD score, in patients with cirrhosis. We reviewed the serum sodium, cholesterol, albumin, and platelet levels of 99 patients with cirrhosis and investigated the possible correlation of these parameters with survival period. We found that 77% and 81% of patients with cirrhosis were hypocholesterolemic and hypoalbuminemic, respectively. We noted that the survival time of 6 months in patients with serum sodium levels <125 mM at the time of admission to the study was 27% less than that in patients with sodium levels >130 mM. Patients with cirrhosis and serum sodium levels >130 mM survived for more than 1 year (95% CI). MELD scores of patients with serum sodium levels >130, between 125 and 129, and <125 mM were 15.8 to 19.9, 19.7 to 23.6, and 23.3 to 27.2, respectively (95% CI). In conclusion, we suggest that although all of these parameters are correlated with survival in patients with cirrhosis, the serum sodium level is the most accurate prognostic factor and a valid tool for predicting survival when considered in combination with the MELD score.
Objective Thyrotoxic hypokalaemic periodic paralysis (THPP) is an uncommon condition with interm... more Objective Thyrotoxic hypokalaemic periodic paralysis (THPP) is an uncommon condition with intermittent episodes of muscle weakness and occasionally severe paralysis. THPP is a common complication of hyperthyroidism in Asian populations, and has also been reported in other ethnic groups including Caucasians. This study aimed to conduct an analysis of THPP in a Turkish population, and is to our knowledge the first analysis of a homogeneous Caucasian group.Subjects Forty cases with THPP were identified in the Turkish population. Three out of the 40 were new cases and were assigned as index cases. Two cases were not included in the analysis because of lack of data.Results THPP was diagnosed in 10 cases during the first attack and was observed to have a significant shorter complete recovery time statistically in this group (P < 0·01). The majority of cases were hypokalaemic, while there were two normokalaemic cases. Classification of the cases according to their potassium (K) levels revealed that the group with K levels < 2·5 mEq/l had a statistically longer amelioration time than the group with K levels ≥ 2·5 mEq/l. When the cases were classified according to intravenous or oral application of K, the mean amelioration time was 6·8 ± 3·6 h for the intravenous group and 13·1 ± 7·6 for the oral group. Mean complete recovery times of the groups were 29·4 ± 16·2 h and 52·8 ± 18·0 h, respectively. The intravenous group had a shorter amelioration time and complete recovery time, and both were statistically significant (P < 0·05 for each).Conclusions THPP may be seen among Caucasians. Diagnosing THPP during the first attack might decrease the recovery time. The level of hypokalaemia seems to affect the recovery time and initial low K levels may lead to more deterioration in a patient's health compared with mild or near-normal levels. Intravenous, rather than oral, application of K may be advantageous for shortening both the amelioration and complete recovery times.
There are so many studies that suggest the changes in lipid profiles and lipoprotein (a) [Lp(a)] ... more There are so many studies that suggest the changes in lipid profiles and lipoprotein (a) [Lp(a)] are associated with early atherosclerosis in rheumatoid arthritis (RA). But there are some opposite studies also. Because of marked ethnicity differences in the distribution of Lp(a), we aimed to investigate the associations of Lp(a) levels and lipid changes in Turkish RA patients. There were 30 women and 20 men, a total of 50 patients with RA (mean age 47.6±13.2 years), included and 21 healthy women and 14 healthy men (mean age 45.7±14.5 years) were recruited as a control (C) group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) levels were analysed for each group. Analysis of six different studies was performed. In the RA and C groups, mean serum Lp(a) levels were 39.7±64.4 and 10.5±13.4 mg/dl, respectively (P=0.001). Mean TC levels were 189.2±142.5 and 174.0±29.3 mg/dl (P=0.294), mean TG levels were 121.4±65.4 and 106.5±80.0 mg/dl (P=0.030), mean HDL-C levels were 44.5±10.0 and 47.7±4.8 mg/dl (P=0.014) and mean LDL-C levels were 94.3±35.3 and 102.0±24.6 mg/dl (P=0.98), respectively. Analysis of the six studies showed Lp(a) level was higher and HDL level was lower in RA patients than in healthy controls. Patients with RA may have altered lipid profiles from one country to another one. Especially in Turkey, higher serum Lp(a), lower HDL-C and higher TG levels may be found in RA patients instead of some findings of other countries showing different results. Ethnicity may be a reason for these findings.
POSTERS However, the available information regarding its incidence and predictive factors is scar... more POSTERS However, the available information regarding its incidence and predictive factors is scarce. Aims: To assess frequency, clinical and microbiological findings and the existence of predictive factors of infection episodes during MARS therapy. Methods: Eighty-three patients received MARS therapy between January 2002 and September 2006. Clinical features (age, sex, indication of MARS therapy, concomitant immunosuppressive therapy or steroid use, previous recent infection, renal impairment), as well as characteristics of MARS procedure (number of sessions, use of antibiotic prophylaxis) and in hospital mortality were analyzed. Infection during MARS was defined as the appearance of culture proven infection or unequivocal clinical findings of infection from the first MARS session until 7 days after the last session. Results: The indication for MARS treatment was acute-on-chronic liver failure (ACLF) in 31 patients (37.3%), refractory pruritus in 16 cases (19.3%), fulminant hepatic failure in 19 patients (22.9%), post-liver transplantation distinction in 12 (14.4%) and other reasons in 5 cases (6%). Sixty-seven patients (80%) received antibiotic prophylaxis during MARS sessions. Seventeen patients (20.5%) had infection, only one of them without antibiotic prophylaxis. Four (23%) patients developed bacteraemia, 5 (29.4%) respiratory infections, 3 (17.5%) urinary tract infections, 1 (5.9%) spontaneous bacterial peritonitis and 4 (23%) had other locations. Although gram positive isolates were most frequently found (29.4%), gram negative (1 1.8%), anaerobic (5.9%) and fungal isolates (17.4%) were
Background: The biased attitudes and behaviors of healthcare professionals towards individuals wi... more Background: The biased attitudes and behaviors of healthcare professionals towards individuals with obesity cause these individuals to not be able to benefit from health services adequately. Awareness of factors that limit the quality of treatment will improve obesity treatment outcomes. This study aimed to develop a tool for measuring the obesity bias of health students. Methods: 265 students who voluntarily participated in the study were asked to write 3 positive or negative definitions about individuals with obesity. These sentences were evaluated, the draft scale which consisted of 36 items was redesigned by the experts for the final edition. The scale was administered to 236 health sciences students. After correlation analysis of the items, 8 items were found to break the integrity of the Likert-type scale and reduced its reliability. And 1 item was neither positive nor negative. Results: The Cronbach's alpha coefficient of the scale was found as 0.847, which indicated that the developed scale was highly reliable. The one-dimension construct of the scale was validated by confirmatory factor analysis. Conclusion: This scale, which the researchers call "Obesity Bias Scale", has been found to be a reliable tool that can be used to detect obesity bias.
Small mesh size has been recognized as one of the factors responsible for recurrence after Lichte... more Small mesh size has been recognized as one of the factors responsible for recurrence after Lichtenstein hernia repair due to insufficient coverage or mesh shrinkage. The Lichtenstein Hernia Institute recommends a 7 × 15 cm mesh that can be trimmed up to 2 cm from the lateral side. We performed a systematic review to determine surgeons&#39; mesh size preference for the Lichtenstein hernia repair and made a meta-analysis to determine the effect of mesh size, mesh type, and length of follow-up time on recurrence. Two medical databases, PubMed and ISI Web of Science, were systematically searched using the key word &quot;Lichtenstein repair.&quot; All full text papers were selected. Publications mentioning mesh size were brought for further analysis. A mesh surface area of 90 cm(2) was accepted as the threshold for defining the mesh as small or large. Also, a subgroup analysis for recurrence pooled proportion according to the mesh size, mesh type, and follow-up period was done. In total, 514 papers were obtained. There were no prospective or retrospective clinical studies comparing mesh size and clinical outcome. A total of 141 papers were duplicated in both databases. As a result, 373 papers were obtained. The full text was available in over 95 % of papers. Only 41 (11.2 %) papers discussed mesh size. In 29 studies, a mesh larger than 90 cm(2) was used. The most frequently preferred commercial mesh size was 7.5 × 15 cm. No papers mentioned the size of the mesh after trimming. There was no information about the relationship between mesh size and patient BMI. The pooled proportion in recurrence for small meshes was 0.0019 (95 % confidence interval: 0.007-0.0036), favoring large meshes to decrease the chance of recurrence. Recurrence becomes more marked when follow-up period is longer than 1 year (p &lt; 0.001). Heavy meshes also decreased recurrence (p = 0.015). This systematic review demonstrates that the size of the mesh used in Lichtenstein hernia repair is rarely discussed in clinical studies. Papers that discuss mesh size appear to reflect a trend to comply with the latest recommendations to use larger mesh. Standard heavy meshes decrease the recurrence in hernia repair. Even though there is no evidence, it seems that large meshes decrease recurrence rates.
Statement of problem. It is not clear whether newly introduced cordless displacement systems are ... more Statement of problem. It is not clear whether newly introduced cordless displacement systems are better able to manage gingiva than conventional systems. Purpose. The purpose of this in vivo study was to evaluate the gingival management ability of 4 different displacement methods with a standardized subgingival preparation finish line. Material and methods. The effects of 4 displacement techniques on gingival management and impression quality were evaluated by means of 6 evaluation criteria. A subgingival preparation finish line of between 1 and 2 mm was ensured, and the buccal aspects of 252 (n¼63) teeth were clinically assessed for ease of application, time spent, bleeding, remnants, and dilatation. The complete reproduction of the preparation finish line and the bubble and void formations on polyether impressions were also evaluated. The data were statistically analyzed with the c 2 test (a¼.05). The Bonferroni correction was used to control Type I error for the pairwise comparison groups (a¼.008). Results. Statistically significant differences were found for all criteria among the groups (P<.05). The nonimpregnated displacement cord group was the least effective group in terms of bleeding and impression quality (P<.008). The aluminum chloride impregnated cord group and the displacement paste with cap group were found to be comparable in terms of remnants, dilatation, and impression quality (P>.008). The retraction cap with paste group showed better results for ease of application, time spent, and bleeding than the aluminum chloride impregnated cord group (P<.008). Although the group with aluminum chloride impregnated cord, displacement paste, and cap showed better results for dilatation, it was time consuming and difficult (P<.008). Conclusions. Except for the nonimpregnated cord group, all of the groups were comparable and clinically useful, with perfect or acceptable impression qualities.
I In nt tr ro od du uc ct ti io on n: : Levothyroxine (LT4) therapy has been used for the treatme... more I In nt tr ro od du uc ct ti io on n: : Levothyroxine (LT4) therapy has been used for the treatment of euthyroid nodular goiter, but there are controversial results about its usefulness. We aimed to evaluate the possible role of benign nodules' cytological characteristics in response to LT4 therapy. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : In total, 93 patients with 128 nodules were included in the study; 74 of the nodules were treated with LT4 (group 1), and 54 of them had no medication (group 2). The subgroups consisted of adenomatous nodules, colloid nodules and cystic nodules. R Re es su ul lt ts s: : In group 1, mean thyroid volume and mean nodule volume were reduced significantly (p = 0.002 and p = 0.022, respectively) with low-normal level thyrotropin (TSH) suppression (between 0.3 mIU/ml and 1.0 mIU/ml), while there were no significant changes in group 2. When we evaluated changes of the initial and last nodule volumes in cytological subgroups, only colloid nodules in group 1 had significant reduction (p = 0.040) and the others had no significant changes. By omitting the colloid nodules, when the other nodules were revaluated, there were no significant changes in either group. C Co on nc cl lu us si io on ns s: : On the basis of these results, obtained from a large sample of Anatolian patients, it is possible that LT4 therapy leads to significant reductions of both thyroid volume and nodule size in colloid nodules, but not in other kinds of benign nodules.
The American Journal of the Medical Sciences, 2014
Purpose: Studies to date have not investigated whether body mass index (BMI) affects the sensitiv... more Purpose: Studies to date have not investigated whether body mass index (BMI) affects the sensitivity and specificity of magnetic resonance cholangiopancreatography (MRCP). The purpose of this study was to investigate the effect of BMI and also concomitant pancreatitis, cholecystitis and cholelithiasis on the sensitivity and specificity of MRCP. Materials and Methods: Between January 2004 and December 2011, 185 patients were included in the study and divided into 3 groups according to BMI as normal, overweight or obese. Both MRCP and endoscopic retrograde cholangiopancreatography (ERCP) were performed in all patients. ERCP was accepted as the "gold standard." The accuracy, sensitivity and specificity values of the 3 groups were calculated to determine any effects on the results of the MRCP. Results: Before separating into groups according to BMI, the statistical results for MRCP in the detection of stone disease were as follows: specificity 74.3%, sensitivity 81.7% and accuracy 79%. After dividing the patients into 3 groups according to BMI, the specificity of stone detection with MRCP in the normal-weight group was 93.8% but decreased to 65.5% in the overweight group and to 72% in the obese group. The sensitivity of stone detection with MRCP in the normalweight group was 85.2% but decreased to 75% in the overweight group and increased to 88.9% in the obese group. The accuracy was 88.3% in the normal-weight group but decreased to 71.6% in the overweight group and to 81.9% in the obese group. Conclusion: Our study showed that MRCP performance was decreased in the overweight and obese groups.
Objectives : It is usually accepted that some of the treatments affect not only the survival time... more Objectives : It is usually accepted that some of the treatments affect not only the survival times but as well the quality of life of patients. The aim of study is to reach more reliable conclusions by using the metaanalysis method on published studies which deal with the effects of antihypertansive theraphies on the quality of life of patients. Material and Methods : Meta-analysis is used to combine the results of different experiments or studies examining the same question. Meta-analysis is a systematic reviewing strategy for adressing research question that is especially useful when results from several studies disagree with regard to magnitude or direction of the effect, when sample sizes are small to detect an effect and label it statistically significant, or when a large trial is too costly and time consuming to perform. The effect size, d, is the difference between the means in standard score form ,i.e., the ratio of the difference between the means to the standard deviation. Results : When quality of life is considered meta-analysis results showed, except sexual function, positive effect sizes for sleep, general well-being and psychomotor scores (ave(d)=-0.03; ave (d)=0.11; ave (d)=0.135; ave (d)=0.40 Standard Deviations, respectively). When the effect of drug grups on the recovery of patients are studied ave (d) is found to be 0.17 for ACEI (p>0.05) and 0.20 SD (p>0.05) for BETA. When the effect of ACEI drug group on psychomotor scores of patients is considered, Meta-analysis results yielded a mean effect size of 0.50 SD (p<0.01). The mean effect size was 0.40 SD for BETA drug group (p<0.01). The effect of BETA drug group on sexual function scores was the smallest effect (ave (d)=-0.103 ; p>0.05). Conclusions : Among all of the applied metaanalysis, none of the drug groups showed negative effects. Meta-analysis results when quality of life is considered showed, except sexual function positive effect sizes for sleep, general well-being and psychomotor scores (ave (d)=-0.03; ave (d)=0.11; ave (d)=0.135; ave (d)=0.40 Standard Deviation, respectively). Different drug groups have different effect sizes on the dimensions of quality of life of patients. Therefore, as well as this study, all other studies in this field meta-analysis which use , will help researchers to choose the best strategy on deciding the type of the drug.
In this study, we investigated possible independent predictive factors for survival, other than M... more In this study, we investigated possible independent predictive factors for survival, other than MELD score, in patients with cirrhosis. We reviewed the serum sodium, cholesterol, albumin, and platelet levels of 99 patients with cirrhosis and investigated the possible correlation of these parameters with survival period. We found that 77% and 81% of patients with cirrhosis were hypocholesterolemic and hypoalbuminemic, respectively. We noted that the survival time of 6 months in patients with serum sodium levels <125 mM at the time of admission to the study was 27% less than that in patients with sodium levels >130 mM. Patients with cirrhosis and serum sodium levels >130 mM survived for more than 1 year (95% CI). MELD scores of patients with serum sodium levels >130, between 125 and 129, and <125 mM were 15.8 to 19.9, 19.7 to 23.6, and 23.3 to 27.2, respectively (95% CI). In conclusion, we suggest that although all of these parameters are correlated with survival in patients with cirrhosis, the serum sodium level is the most accurate prognostic factor and a valid tool for predicting survival when considered in combination with the MELD score.
Objective Thyrotoxic hypokalaemic periodic paralysis (THPP) is an uncommon condition with interm... more Objective Thyrotoxic hypokalaemic periodic paralysis (THPP) is an uncommon condition with intermittent episodes of muscle weakness and occasionally severe paralysis. THPP is a common complication of hyperthyroidism in Asian populations, and has also been reported in other ethnic groups including Caucasians. This study aimed to conduct an analysis of THPP in a Turkish population, and is to our knowledge the first analysis of a homogeneous Caucasian group.Subjects Forty cases with THPP were identified in the Turkish population. Three out of the 40 were new cases and were assigned as index cases. Two cases were not included in the analysis because of lack of data.Results THPP was diagnosed in 10 cases during the first attack and was observed to have a significant shorter complete recovery time statistically in this group (P < 0·01). The majority of cases were hypokalaemic, while there were two normokalaemic cases. Classification of the cases according to their potassium (K) levels revealed that the group with K levels < 2·5 mEq/l had a statistically longer amelioration time than the group with K levels ≥ 2·5 mEq/l. When the cases were classified according to intravenous or oral application of K, the mean amelioration time was 6·8 ± 3·6 h for the intravenous group and 13·1 ± 7·6 for the oral group. Mean complete recovery times of the groups were 29·4 ± 16·2 h and 52·8 ± 18·0 h, respectively. The intravenous group had a shorter amelioration time and complete recovery time, and both were statistically significant (P < 0·05 for each).Conclusions THPP may be seen among Caucasians. Diagnosing THPP during the first attack might decrease the recovery time. The level of hypokalaemia seems to affect the recovery time and initial low K levels may lead to more deterioration in a patient's health compared with mild or near-normal levels. Intravenous, rather than oral, application of K may be advantageous for shortening both the amelioration and complete recovery times.
There are so many studies that suggest the changes in lipid profiles and lipoprotein (a) [Lp(a)] ... more There are so many studies that suggest the changes in lipid profiles and lipoprotein (a) [Lp(a)] are associated with early atherosclerosis in rheumatoid arthritis (RA). But there are some opposite studies also. Because of marked ethnicity differences in the distribution of Lp(a), we aimed to investigate the associations of Lp(a) levels and lipid changes in Turkish RA patients. There were 30 women and 20 men, a total of 50 patients with RA (mean age 47.6±13.2 years), included and 21 healthy women and 14 healthy men (mean age 45.7±14.5 years) were recruited as a control (C) group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) levels were analysed for each group. Analysis of six different studies was performed. In the RA and C groups, mean serum Lp(a) levels were 39.7±64.4 and 10.5±13.4 mg/dl, respectively (P=0.001). Mean TC levels were 189.2±142.5 and 174.0±29.3 mg/dl (P=0.294), mean TG levels were 121.4±65.4 and 106.5±80.0 mg/dl (P=0.030), mean HDL-C levels were 44.5±10.0 and 47.7±4.8 mg/dl (P=0.014) and mean LDL-C levels were 94.3±35.3 and 102.0±24.6 mg/dl (P=0.98), respectively. Analysis of the six studies showed Lp(a) level was higher and HDL level was lower in RA patients than in healthy controls. Patients with RA may have altered lipid profiles from one country to another one. Especially in Turkey, higher serum Lp(a), lower HDL-C and higher TG levels may be found in RA patients instead of some findings of other countries showing different results. Ethnicity may be a reason for these findings.
POSTERS However, the available information regarding its incidence and predictive factors is scar... more POSTERS However, the available information regarding its incidence and predictive factors is scarce. Aims: To assess frequency, clinical and microbiological findings and the existence of predictive factors of infection episodes during MARS therapy. Methods: Eighty-three patients received MARS therapy between January 2002 and September 2006. Clinical features (age, sex, indication of MARS therapy, concomitant immunosuppressive therapy or steroid use, previous recent infection, renal impairment), as well as characteristics of MARS procedure (number of sessions, use of antibiotic prophylaxis) and in hospital mortality were analyzed. Infection during MARS was defined as the appearance of culture proven infection or unequivocal clinical findings of infection from the first MARS session until 7 days after the last session. Results: The indication for MARS treatment was acute-on-chronic liver failure (ACLF) in 31 patients (37.3%), refractory pruritus in 16 cases (19.3%), fulminant hepatic failure in 19 patients (22.9%), post-liver transplantation distinction in 12 (14.4%) and other reasons in 5 cases (6%). Sixty-seven patients (80%) received antibiotic prophylaxis during MARS sessions. Seventeen patients (20.5%) had infection, only one of them without antibiotic prophylaxis. Four (23%) patients developed bacteraemia, 5 (29.4%) respiratory infections, 3 (17.5%) urinary tract infections, 1 (5.9%) spontaneous bacterial peritonitis and 4 (23%) had other locations. Although gram positive isolates were most frequently found (29.4%), gram negative (1 1.8%), anaerobic (5.9%) and fungal isolates (17.4%) were
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