Caner Öksüz, Fatih Çubuk, M. Hasbek, Seyit Ali Buyuktuna
Introduction: The incidence of Candidemia, which is a significant cause of morbidity and mortality, is increasing. Patients with a diagnosis of malignancy, who use immunosuppressants, and who require follow-up in the intensive care unit are at high risk for Candidemia. The incidence and resistance patterns of Candida species may vary depending on population, geographical location, and previous antifungal exposure. It was aimed to identify Candida spp. isolated from blood culture samples of patients diagnosed with malignancy for the species level, and to determine their antifungal drug susceptibility, in this study. Materials and Methods: In this study, the results of the samples with growth in blood cultures between January 2016 and July-2022 were examined retrospectively. The patients with a diagnosis of Candida spp. fungal growth in at least one blood culture set during hospitalization and the patients with a diagnosis of malignancy defined as candidemia and treated with antifungal were included in the study. Results: Candida albicans growth was detected in 43.5% (10) of the blood cultures included in the study. Non-albicans species were isolated in a total of 13 blood cultures (56.5%): 30.4% (7) C. parapsilosis; 17.4% (4) C. glabrata; 4.3% (1) C. tropicalis; 4.3% (1) C. krusei. Very low resistance rates were determined against many antifungals such as Amphotericin B (0%), Micafungin (0%), Fluconazole (10%), Posaconazole (0%), Voriconazole (0%), and Anidulafungin (25%) for C. albicans isolates in our study. On the other hand, higher levels of resistance were observed for almost all antifungals for non-albicans species, the incidence of which has increased in recent years. Discussion and Suggestions: The epidemiology of Candida infections has been changing in recent years. Although C. albicans is still the main reason for invasive Candidiasis in many clinical environments, a significant number of patients are now infected with non-albicans Candida species. Candida species may show differential susceptibility to commonly used antifungal agents. The susceptibility of Candida species to commonly used antifungal agents varies. As in our study, we believe that following the epidemiological data and antifungal susceptibility patterns of medical centers will allow effective empirical treatment and improve Candidemia prognosis.
{"title":"Patients with the Diagnosis of Malignancy Followed Up with Candidemia in a Tertiary University Hospital: Analysis of Species and Resistance","authors":"Caner Öksüz, Fatih Çubuk, M. Hasbek, Seyit Ali Buyuktuna","doi":"10.7197/cmj.1200716","DOIUrl":"https://doi.org/10.7197/cmj.1200716","url":null,"abstract":"Introduction: The incidence of Candidemia, which is a significant cause of morbidity and mortality, is increasing. Patients with a diagnosis of malignancy, who use immunosuppressants, and who require follow-up in the intensive care unit are at high risk for Candidemia. The incidence and resistance patterns of Candida species may vary depending on population, geographical location, and previous antifungal exposure. It was aimed to identify Candida spp. isolated from blood culture samples of patients diagnosed with malignancy for the species level, and to determine their antifungal drug susceptibility, in this study. \u0000Materials and Methods: In this study, the results of the samples with growth in blood cultures between January 2016 and July-2022 were examined retrospectively. The patients with a diagnosis of Candida spp. fungal growth in at least one blood culture set during hospitalization and the patients with a diagnosis of malignancy defined as candidemia and treated with antifungal were included in the study. \u0000Results: Candida albicans growth was detected in 43.5% (10) of the blood cultures included in the study. Non-albicans species were isolated in a total of 13 blood cultures (56.5%): 30.4% (7) C. parapsilosis; 17.4% (4) C. glabrata; 4.3% (1) C. tropicalis; 4.3% (1) C. krusei. Very low resistance rates were determined against many antifungals such as Amphotericin B (0%), Micafungin (0%), Fluconazole (10%), Posaconazole (0%), Voriconazole (0%), and Anidulafungin (25%) for C. albicans isolates in our study. On the other hand, higher levels of resistance were observed for almost all antifungals for non-albicans species, the incidence of which has increased in recent years. \u0000Discussion and Suggestions: The epidemiology of Candida infections has been changing in recent years. Although C. albicans is still the main reason for invasive Candidiasis in many clinical environments, a significant number of patients are now infected with non-albicans Candida species. Candida species may show differential susceptibility to commonly used antifungal agents. The susceptibility of Candida species to commonly used antifungal agents varies. As in our study, we believe that following the epidemiological data and antifungal susceptibility patterns of medical centers will allow effective empirical treatment and improve Candidemia prognosis.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87368999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Taştemur, Ayşegül Öztürk, Asım Sabancioğullari, I. Salk, H. Teti̇ker, A. Altun, V. Sabancıoğulları
The aim of this study was to evaluate the effect of climate and altitude differences on the volume of paranasal sinuses and on the frequency of anatomic variations by comparing the paranasal sinus computerized tomography (PNSCT) of patients who were born and living in a cold, dry climate at high altitude with those of patients who were born and living on the coast at sea level in a temperate climate. We also aimed to determine differences relating to gender. Axial and coronal CT sections were used for volume measurements in the paranasal sinuses. For measurements, the widest view of the sinuses was used. The findings of this study have shown that age groups and genders compared measurements between the two cities. When the age groups are examined, there is no significant difference between the regions between 0-20 years of age (p> 0.05), whereas 21-40,41-60,61 and above individuals have a significant difference between the frontal and sphenoid sinuses (p 0.05). Besides, when the diameter of the paranasal sinuses between regions is examined; It was found that individuals in Adana were longer than Sivas (p
{"title":"The relationship between anatomical variations and paranasal sinus volumes with climate and altitude","authors":"Y. Taştemur, Ayşegül Öztürk, Asım Sabancioğullari, I. Salk, H. Teti̇ker, A. Altun, V. Sabancıoğulları","doi":"10.7197/cmj.1225307","DOIUrl":"https://doi.org/10.7197/cmj.1225307","url":null,"abstract":"The aim of this study was to evaluate the effect of climate and altitude differences on the volume of paranasal sinuses and on the frequency of anatomic variations by comparing the paranasal sinus computerized tomography (PNSCT) of patients who were born and living in a cold, dry climate at high altitude with those of patients who were born and living on the coast at sea level in a temperate climate. We also aimed to determine differences relating to gender. Axial and coronal CT sections were used for volume measurements in the paranasal sinuses. For measurements, the widest view of the sinuses was used. The findings of this study have shown that age groups and genders compared measurements between the two cities. When the age groups are examined, there is no significant difference between the regions between 0-20 years of age (p> 0.05), whereas 21-40,41-60,61 and above individuals have a significant difference between the frontal and sphenoid sinuses (p 0.05). Besides, when the diameter of the paranasal sinuses between regions is examined; It was found that individuals in Adana were longer than Sivas (p","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84737111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Acıbucu, Suat Sen, İbrahim Erdem, Ceren Susan, Şekure Demet Küçük
Introduction: Early detection of dysglycemia is critical for avoiding the development of type 2 diabetes mellitus (T2D). The risk of developing type 2 diabetes is assessed using fasting plasma glucose (FPG) and 2-hour plasma glucose (PG) after a 75 gr oral glucose tolerance test (OGTT). Intermediate steps taken during an OGTT may reveal additional details about a person's diabetes risk in the future. Our goal was to assess the risk of developing diabetes in patients with high one hour plasma glucose level in an 75 gr OGTT. Method: Patients were admitted to an 75gr OGTT. During the 75gr OGTT, patients with FPG below 100 mg/dl and 2-hour PG below 140 mg/dl but first hour PG above 200 mg/dl were included in this study. We evaluated whether the patients diagnosed with T2D by hospital data, E-Nabız (an online public healthcare data system) and via direct contact with patients. ADA criteria was used for T2D diagnose. Results: We have included 73 patients which were 31 male and 42 female in our study. The youngest patient was 23 and the oldest one was 74. The median age was 51. We have found that the mean FPG in OGTT was 92.55±5.12mg/dl, 1-hour PG was 215.42±17.94mg/dl and 2- hour PG was 112.01±22.92mg/dl. Patients were followed minimum of 20 months and maximum of 65 months. The median was 37 months. During the follow up 30 patiens (%41.1) have developed T2D in 28.17±14.25 months. There were no direct correlation between age and sex with developing T2D. We found no correlation between 1-hour PG levels and T2D developing time in patients who developed T2D ( r:0.118, p=0.536). There were no evidence of correlation between T2D developing time and age (p:0.980 r:0.005). There was no difference between patients with and without T2D in terms of age, FPG, 1-hour PG, 2-hour PG and follow-up time. Conclusion: Despite the limitations of our study, we think that checking the PG level in the first hour during OGTT will be useful in early detection of individuals at risk for diabetes and preventing diabetes.
{"title":"First Hour Plasma Glucose in 75 gr Oral Glucose Tolerance Test And Risk Of Developing Diabetes Mellitus","authors":"F. Acıbucu, Suat Sen, İbrahim Erdem, Ceren Susan, Şekure Demet Küçük","doi":"10.7197/cmj.1170079","DOIUrl":"https://doi.org/10.7197/cmj.1170079","url":null,"abstract":"Introduction: Early detection of dysglycemia is critical for avoiding the development of type 2 diabetes mellitus (T2D). The risk of developing type 2 diabetes is assessed using fasting plasma glucose (FPG) and 2-hour plasma glucose (PG) after a 75 gr oral glucose tolerance test (OGTT). Intermediate steps taken during an OGTT may reveal additional details about a person's diabetes risk in the future. Our goal was to assess the risk of developing diabetes in patients with high one hour plasma glucose level in an 75 gr OGTT. \u0000Method: Patients were admitted to an 75gr OGTT. During the 75gr OGTT, patients with FPG below 100 mg/dl and 2-hour PG below 140 mg/dl but first hour PG above 200 mg/dl were included in this study. We evaluated whether the patients diagnosed with T2D by hospital data, E-Nabız (an online public healthcare data system) and via direct contact with patients. ADA criteria was used for T2D diagnose. \u0000Results: We have included 73 patients which were 31 male and 42 female in our study. The youngest patient was 23 and the oldest one was 74. The median age was 51. We have found that the mean FPG in OGTT was 92.55±5.12mg/dl, 1-hour PG was 215.42±17.94mg/dl and 2- hour PG was 112.01±22.92mg/dl. Patients were followed minimum of 20 months and maximum of 65 months. The median was 37 months. During the follow up 30 patiens (%41.1) have developed T2D in 28.17±14.25 months. There were no direct correlation between age and sex with developing T2D. We found no correlation between 1-hour PG levels and T2D developing time in patients who developed T2D ( r:0.118, p=0.536). There were no evidence of correlation between T2D developing time and age (p:0.980 r:0.005). There was no difference between patients with and without T2D in terms of age, FPG, 1-hour PG, 2-hour PG and follow-up time. \u0000Conclusion: Despite the limitations of our study, we think that checking the PG level in the first hour during OGTT will be useful in early detection of individuals at risk for diabetes and preventing diabetes.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78809035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Şahin, N. Çabuk Çelik, I. Yalcin, B. Karakaş, B. Karataş
ABSTRACT We present a case of coronary artery thrombosis due to Behçet's disease. A 49-year-old female patient, diagnosed with Behçet's disease and followed up by us, applied to the emergency department with sudden onset of pressure-type chest pain, and was evaluated as acute myocardial infarction due to elevated cardiac enzymes and ST segment elevation in the anterior leads on electrocardiography (ECG). Coronary angiography revealed near-total thrombosis in the lumen of the left anterior descending artery (LAD) and in the circumflex (CX) artery,it was intervened with anticoagulant therapy. The patient's cardiac risk was found to be low and differential diagnosis was made in terms of myocardial infarction. Thereupon, the causes of hypercoagulability were investigated in the patient who was consulted to us, and acute phase reactants were found to be high. This was related to the coronary artery involvement of Behçet's disease and in addition to the treatment containing antiaggregant, statin, angiotensin receptor blocker, intravenous (IV) high-dose methylprednisolone and cyclophosphamide-mesna treatment was given for immunosuppressive purposes. It should not be forgotten that there may be vascular involvement due to Behçet's disease and coronary arteries may also be affected.
{"title":"A CASE REPORT OF BEHÇET'S DISEASE WITH CORONARY ARTERY INVOLVEMENT","authors":"A. Şahin, N. Çabuk Çelik, I. Yalcin, B. Karakaş, B. Karataş","doi":"10.7197/cmj.1063869","DOIUrl":"https://doi.org/10.7197/cmj.1063869","url":null,"abstract":"ABSTRACT \u0000We present a case of coronary artery thrombosis due to Behçet's disease. A 49-year-old female patient, diagnosed with Behçet's disease and followed up by us, applied to the emergency department with sudden onset of pressure-type chest pain, and was evaluated as acute myocardial infarction due to elevated cardiac enzymes and ST segment elevation in the anterior leads on electrocardiography (ECG). Coronary angiography revealed near-total thrombosis in the lumen of the left anterior descending artery (LAD) and in the circumflex (CX) artery,it was intervened with anticoagulant therapy. The patient's cardiac risk was found to be low and differential diagnosis was made in terms of myocardial infarction. Thereupon, the causes of hypercoagulability were investigated in the patient who was consulted to us, and acute phase reactants were found to be high. This was related to the coronary artery involvement of Behçet's disease and in addition to the treatment containing antiaggregant, statin, angiotensin receptor blocker, intravenous (IV) high-dose methylprednisolone and cyclophosphamide-mesna treatment was given for immunosuppressive purposes. It should not be forgotten that there may be vascular involvement due to Behçet's disease and coronary arteries may also be affected.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81301207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: In this study, it was aimed to update the chronology of the pandemic and to examine the effect of important administrative and political decisions, primarily the curfew, on the number of cases and deaths. Materials and Methods: In this descriptive study, about COVID-19 important developments in Turkey and the world with were given in chronological order. The effect of curfews on the daily number of cases and deaths was calculated. Compliance of data to normal distribution in SPSS-21 (IBM SPSS Corp; Armonk, NY, USA) was evaluated by Kolmogorov-Smirnov test. Mann-Whitney U test was used for data whose normal distribution did not match. Ethical permission was obtained with the decision number 2021-02 / 24, dated 10.02.2021. Results: There was a gradual relaxation in the tight measures, especially in May, June, July and August. As the number of cases increased again after September, the same measures were gradually introduced again. While the effects of curfews are ineffective on the daily number of cases, they have an effect on the daily number of deaths. The low number of deaths and significant differences in the days when the curfews were effective show that the people in this group comply with the curfews. Conclusions: Humanity and all states must be prepared for new and more destructive epidemics. For a more effective result, curfews, which will be meticulously followed by all societies and implemented in the form of complete closure, will quickly stop the spread of the epidemic.
{"title":"Process According To Date In The World and Turkey During Covid 19 Pandemic and Effects of Measures TakenTo Daily Covid-19 Statistics in Turkey","authors":"M. Özdemir, Irem Akova","doi":"10.7197/cmj.936049","DOIUrl":"https://doi.org/10.7197/cmj.936049","url":null,"abstract":"Objective: In this study, it was aimed to update the chronology of the pandemic and to examine the effect of important administrative and political decisions, primarily the curfew, on the number of cases and deaths. \u0000Materials and Methods: In this descriptive study, about COVID-19 important developments in Turkey and the world with were given in chronological order. The effect of curfews on the daily number of cases and deaths was calculated. Compliance of data to normal distribution in SPSS-21 (IBM SPSS Corp; Armonk, NY, USA) was evaluated by Kolmogorov-Smirnov test. Mann-Whitney U test was used for data whose normal distribution did not match. Ethical permission was obtained with the decision number 2021-02 / 24, dated 10.02.2021. \u0000Results: There was a gradual relaxation in the tight measures, especially in May, June, July and August. As the number of cases increased again after September, the same measures were gradually introduced again. While the effects of curfews are ineffective on the daily number of cases, they have an effect on the daily number of deaths. The low number of deaths and significant differences in the days when the curfews were effective show that the people in this group comply with the curfews. \u0000Conclusions: Humanity and all states must be prepared for new and more destructive epidemics. For a more effective result, curfews, which will be meticulously followed by all societies and implemented in the form of complete closure, will quickly stop the spread of the epidemic.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"61 11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77567490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mercan Taştemur, G. Arık, Hilal Heybeli̇, H. Selvi Öztorun, K. Silay, I. Ateş, Denizcan Hastürk, Busra Betul Cagir, R. Tuna Doğrul, Atacan Aras, E. Özenç
Background: COVID 19 continues to affect the whole world with its different presentations and unenlightened aspects.Older patients are the group most at risk. Low hemoglobin levels contribute to hypoxia during COVID 19 infection and increase the risk of complications, especially in risky groups. In this study, we aimed to investigate the prevalence of anemia and its effect on mortality in geriatric COVID 19 patients. Materials and Methods: Data of 251 patients over the age of 65 who were followed up in the Internal Medicine services allocated for COVID 19 of our hospital between August and October 2020, were included in the study. Anemia was defined as a hemoglobin level of 13 mg/dl in men and below 12 mg/dl in women at the time of admission. Demographic and laboratory data of the patients and hemoglobin levels were compared. Results: The mean age of 251 COVID-19 patients included in the study was 75.6±7.6 years. 45.8% (n:115) of the patients were female and 54.2% (n:136). While 51.8% of the patients had anemia, the presence of anemia was found to be 67.9% in patients who died due to COVID 19. According to multivariate logistic regression analysis, advanced age (OR=1.082; 95% CI=1.03-1.137; p=0.002), presence of anemia (OR=1.969; 95% CI=1.113-4.246; p=0.034),hypertension (OR =5.763; 95% CI=1.713-19.389; p=0.005), dementia (OR=3.614; 95% CI=1.128-11.578; p=0.031) were determined as independent risk factors predicting mortality in patients with COVID-19. Conclusion: Advance age, presence of anemia, hypertension and dementia has been found as İndependant risk factors for mortality in COVID 19 infection in our study. In elderly Covid 19 patients hemoglobin levels at admission may be helpful in predicting mortality.
{"title":"The Relationship Between Anemia and Mortality in Elderly COVID 19 Patients","authors":"Mercan Taştemur, G. Arık, Hilal Heybeli̇, H. Selvi Öztorun, K. Silay, I. Ateş, Denizcan Hastürk, Busra Betul Cagir, R. Tuna Doğrul, Atacan Aras, E. Özenç","doi":"10.7197/cmj.1168081","DOIUrl":"https://doi.org/10.7197/cmj.1168081","url":null,"abstract":"Background: COVID 19 continues to affect the whole world with its different presentations and unenlightened aspects.Older patients are the group most at risk. Low hemoglobin levels contribute to hypoxia during COVID 19 infection and increase the risk of complications, especially in risky groups. In this study, we aimed to investigate the prevalence of anemia and its effect on mortality in geriatric COVID 19 patients. \u0000Materials and Methods: Data of 251 patients over the age of 65 who were followed up in the Internal Medicine services allocated for COVID 19 of our hospital between August and October 2020, were included in the study. Anemia was defined as a hemoglobin level of 13 mg/dl in men and below 12 mg/dl in women at the time of admission. Demographic and laboratory data of the patients and hemoglobin levels were compared. \u0000Results: The mean age of 251 COVID-19 patients included in the study was 75.6±7.6 years. 45.8% (n:115) of the patients were female and 54.2% (n:136). While 51.8% of the patients had anemia, the presence of anemia was found to be 67.9% in patients who died due to COVID 19. According to multivariate logistic regression analysis, advanced age (OR=1.082; 95% CI=1.03-1.137; p=0.002), presence of anemia (OR=1.969; 95% CI=1.113-4.246; p=0.034),hypertension (OR =5.763; 95% CI=1.713-19.389; p=0.005), dementia (OR=3.614; 95% CI=1.128-11.578; p=0.031) were determined as independent risk factors predicting mortality in patients with COVID-19. \u0000Conclusion: Advance age, presence of anemia, hypertension and dementia has been found as İndependant risk factors for mortality in COVID 19 infection in our study. In elderly Covid 19 patients hemoglobin levels at admission may be helpful in predicting mortality.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"238 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77696315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asbest, akciğer kanserine neden olduğu iyi bilinen bir mineraldir. Asbest ve akciğer kanseri arasındaki nedensel ilişki 1930'larda düşünülmüş ve 1955'te kanıtlanmıştır. 1960'lı yıllarda işçilerde mezotelyoma ve akciğer kanseri gibi durumların saptanmasıyla asbest kullanımı kısıtlanmaya ve yasaklanmaya başlamıştır. 20. yüzyılın ilk çeyreğinden sonra asbest, Dünya Sağlık Örgütü ve Uluslararası Kanser Araştırma Merkezi tarafından "Kanserojen Maddeler" listesinde 1A Grubu kanserojen olarak belirlenmiştir. Dünyada asbest işletmelerinin çoğu, asbestin insan sağlığına olumsuz etkileri nedeniyle doksanlı yılların sonundan itibaren faaliyetlerini durdurmuştur. Bugün tüm dünyada asbestin işletilmesi ve ticareti yasaklanmıştır. Gözle görülmeyen lifsi bir toz olan asbest, solunduğunda akciğerde birikir. Pürüzlü ve çengelli yapısı nedeniyle akciğerde doku hasarına neden olur. Epidemiyolojik çalışmalar, asbeste maruz kalmanın akciğer kanseri, mezotelyoma, gırtlak ve yumurtalık kanseri ve asbestoz gibi ölümcül sonuçlara yol açabilecek hastalıkların nedeni olduğunu kesin olarak ortaya koymuştur. Asbest temas noktaları çevresel temas ve mesleki (endüstriyel) maruziyettir ve asbest maruziyeti Türkiye'de önemli bir halk sağlığı sorunudur. Mezotelyoma, akciğer kanseri, asbestoz gibi ciddi akciğer hastalıklarını önlemek için asbest temizliği yetkili kişilerce yapılmalı ve doğal ortamlar rehabilite edilmelidir. Ayrıca kırsal alanlarda asbestin zararları konusunda toplumu bilinçlendirmeye yönelik eğitim faaliyetlerinin planlanması ve uygulanması gerekmektedir.
{"title":"Association of Asbestos Exposure with Lung Cancer","authors":"İ. Şentürk","doi":"10.7197/cmj.1177293","DOIUrl":"https://doi.org/10.7197/cmj.1177293","url":null,"abstract":"Asbest, akciğer kanserine neden olduğu iyi bilinen bir mineraldir. Asbest ve akciğer kanseri arasındaki nedensel ilişki 1930'larda düşünülmüş ve 1955'te kanıtlanmıştır. 1960'lı yıllarda işçilerde mezotelyoma ve akciğer kanseri gibi durumların saptanmasıyla asbest kullanımı kısıtlanmaya ve yasaklanmaya başlamıştır. 20. yüzyılın ilk çeyreğinden sonra asbest, Dünya Sağlık Örgütü ve Uluslararası Kanser Araştırma Merkezi tarafından \"Kanserojen Maddeler\" listesinde 1A Grubu kanserojen olarak belirlenmiştir. Dünyada asbest işletmelerinin çoğu, asbestin insan sağlığına olumsuz etkileri nedeniyle doksanlı yılların sonundan itibaren faaliyetlerini durdurmuştur. Bugün tüm dünyada asbestin işletilmesi ve ticareti yasaklanmıştır. \u0000Gözle görülmeyen lifsi bir toz olan asbest, solunduğunda akciğerde birikir. Pürüzlü ve çengelli yapısı nedeniyle akciğerde doku hasarına neden olur. Epidemiyolojik çalışmalar, asbeste maruz kalmanın akciğer kanseri, mezotelyoma, gırtlak ve yumurtalık kanseri ve asbestoz gibi ölümcül sonuçlara yol açabilecek hastalıkların nedeni olduğunu kesin olarak ortaya koymuştur. Asbest temas noktaları çevresel temas ve mesleki (endüstriyel) maruziyettir ve asbest maruziyeti Türkiye'de önemli bir halk sağlığı sorunudur. Mezotelyoma, akciğer kanseri, asbestoz gibi ciddi akciğer hastalıklarını önlemek için asbest temizliği yetkili kişilerce yapılmalı ve doğal ortamlar rehabilite edilmelidir. Ayrıca kırsal alanlarda asbestin zararları konusunda toplumu bilinçlendirmeye yönelik eğitim faaliyetlerinin planlanması ve uygulanması gerekmektedir.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79735436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amaç: Polikistik over sendromu (PKOS), kronik anovülasyon, adet düzensizlikleri ve hiperandrojenizm ile karakterize heterojen bir hastalıktır. Bu çalışmada revize edilmiş Rotterdam tanı kriterlerine göre PKOS alt gruplarının metabolik özelliklerini karşılaştırmayı amaçladık. Materyal ve Metod: PKOS'lu 95 kadın çalışmaya dahil edildi ve dört gruba ayrıldı. Grup 1; biyokimyasal hiperandrojenemi ve/veya hiperandrojenizm ile oligomenore ve/veya anovülasyon, grup 2; polikistik over ile biyokimyasal hiperandrojenemi ve/veya hiperandrojenizm, grup 3; polikistik over ile oligomenore ve/veya anovulasyon ve grup 4; polikistik over ile biyokimyasal hiperandrojenemi ve/veya hiperandrojenizm ile oligomenore ve/veya anovulasyon. Çalışmaya alınan tüm hastaların vücut kitle indeksleri (kg/m2) ve bel-kalça oranları hesaplandı. 12 saatlik açlıktan sonra açlık glukozu, lipid düzeyleri, böbrek ve karaciğer fonksiyon testleri ölçüldü. Glukoz ve insülin yanıtlarını değerlendirmek için oral glukoz tolerans testi (OGTT) yapıldı. Adet döngüsünün foliküler fazında hormon seviyeleri ölçüldü. Adrenal ve over hiperandrojenemisini değerlendirmek için adrenokortikotropik hormon (ACTH) (0,5 mg Synacthen IM) ve gonadotropin salgılatıcı hormon agonisti (buserelin) testleri yapıldı. PKO morfolojisini tanımlamak için tüm çalışma hastalara ultrasonografi yapıldı. Bulgular: Klasik PKOS fenotipinin sıklığı, klasik olmayan PKOS fenotipinden daha yüksekti (sırasıyla %74,7 ve %25,2). Vücut kitle indeksleri, bel-kalça oranları tüm gruplarda benzerdi. Serum trigliserit düzeyleri grup 2'de diğer gruplara göre anlamlı olarak düşük bulundu (p< 0.01). Pik insülin ve AUC insülin seviyeleri grup 2'de anlamlı olarak düşüktü (p< 0.05). Bozulmuş açlık glukozu ve bozulmuş glukoz toleransı prevalansı tüm gruplarda benzerdi. Serbest testosteron ve androstenedion düzeyleri grup 3'te grup 4'e göre anlamlı olarak düşüktü. Sonuç: Hiperandrojenizmi olmayan PKOS'lu hastaların (OA+PCO; grup 3) metabolik bozuklukları beklenenin aksine klasik PKOS gruplarına benzerdi. Menstrüel disfonksiyonu olmayan PKOS'lu hastalarda (HA+PCO; grup 2) saptanan metabolik bozuklukların lipid düzeyleri ve insülin direnci açısından daha ılımlı olduğu saptandı. Bu bulgular yeni gelişen HA+PKO ve OA+PKO gruplarının geniş PKOS spektrumunun bir parçası olduğunu ve PKO morfolojisinin PKOS tanı kriterlerinden biri olduğunu desteklemektedir.
{"title":"POLİKİSTİK OVER SENDROMU'NUN ALT GRUPLARINDA METABOLİK ÖZELLİKLER","authors":"Mukaddes Yilmaz, F. Keleştemur","doi":"10.7197/cmj.1216549","DOIUrl":"https://doi.org/10.7197/cmj.1216549","url":null,"abstract":"Amaç: Polikistik over sendromu (PKOS), kronik anovülasyon, adet düzensizlikleri ve hiperandrojenizm ile karakterize heterojen bir hastalıktır. Bu çalışmada revize edilmiş Rotterdam tanı kriterlerine göre PKOS alt gruplarının metabolik özelliklerini karşılaştırmayı amaçladık. \u0000Materyal ve Metod: PKOS'lu 95 kadın çalışmaya dahil edildi ve dört gruba ayrıldı. Grup 1; biyokimyasal hiperandrojenemi ve/veya hiperandrojenizm ile oligomenore ve/veya anovülasyon, grup 2; polikistik over ile biyokimyasal hiperandrojenemi ve/veya hiperandrojenizm, grup 3; polikistik over ile oligomenore ve/veya anovulasyon ve grup 4; polikistik over ile biyokimyasal hiperandrojenemi ve/veya hiperandrojenizm ile oligomenore ve/veya anovulasyon. Çalışmaya alınan tüm hastaların vücut kitle indeksleri (kg/m2) ve bel-kalça oranları hesaplandı. 12 saatlik açlıktan sonra açlık glukozu, lipid düzeyleri, böbrek ve karaciğer fonksiyon testleri ölçüldü. Glukoz ve insülin yanıtlarını değerlendirmek için oral glukoz tolerans testi (OGTT) yapıldı. Adet döngüsünün foliküler fazında hormon seviyeleri ölçüldü. Adrenal ve over hiperandrojenemisini değerlendirmek için adrenokortikotropik hormon (ACTH) (0,5 mg Synacthen IM) ve gonadotropin salgılatıcı hormon agonisti (buserelin) testleri yapıldı. PKO morfolojisini tanımlamak için tüm çalışma hastalara ultrasonografi yapıldı. \u0000Bulgular: Klasik PKOS fenotipinin sıklığı, klasik olmayan PKOS fenotipinden daha yüksekti (sırasıyla %74,7 ve %25,2). Vücut kitle indeksleri, bel-kalça oranları tüm gruplarda benzerdi. Serum trigliserit düzeyleri grup 2'de diğer gruplara göre anlamlı olarak düşük bulundu (p< 0.01). Pik insülin ve AUC insülin seviyeleri grup 2'de anlamlı olarak düşüktü (p< 0.05). Bozulmuş açlık glukozu ve bozulmuş glukoz toleransı prevalansı tüm gruplarda benzerdi. Serbest testosteron ve androstenedion düzeyleri grup 3'te grup 4'e göre anlamlı olarak düşüktü. \u0000Sonuç: Hiperandrojenizmi olmayan PKOS'lu hastaların (OA+PCO; grup 3) metabolik bozuklukları beklenenin aksine klasik PKOS gruplarına benzerdi. Menstrüel disfonksiyonu olmayan PKOS'lu hastalarda (HA+PCO; grup 2) saptanan metabolik bozuklukların lipid düzeyleri ve insülin direnci açısından daha ılımlı olduğu saptandı. Bu bulgular yeni gelişen HA+PKO ve OA+PKO gruplarının geniş PKOS spektrumunun bir parçası olduğunu ve PKO morfolojisinin PKOS tanı kriterlerinden biri olduğunu desteklemektedir.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78108591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Aydın, Fatih Doğanay, M. Erdoğan, H. Doğan, Attila Beştemir, Alpay Tuncar
Background: Early recognition and treatment of patients with acute pancreatitis (AP) is important to improve prognosis and increase survival. Many scoring systems have been developed to assess the prognosis and disease severity in AP. The aim of this study was to compare the effectiveness of the Charlson Comorbidity Index (CCI), Bedside Index for Severity in AP (BISAP), and Acute Physiology and Chronic Health Evaluation (APACHE II) scores in predicting 30-day mortality and the development of severe AP (SAP) in patients with mild AP (MAP). Materials and Methods: This single-center, retrospective, and observational study was conducted with adult patients classified as MAP within 48 hours of arrival at the emergency department. Areas under the receiver operating characteristic curve (AUC) were calculated for each score to evaluate the effectiveness of the scores in predicting the development of SAP and 30-day mortality. Results: A total of 1419 patients with MAP were included in the study between January 01, 2018 and April 01, 2022. In MAP patients, SAP development rate was 14.4%, and the 30-day mortality rate was 1.8%. The accuracy of CCI (AUC=0.797±0.015) in predicting the development of SAP was significantly higher than BISAP (AUC =0.736±0.019, p
{"title":"Comparison of CCI, BISAP and APACHE II Scoring Systems to Predict Severe Disease in Patients with Mild Acute Pancreatitis: A Retrospective Observational Study","authors":"H. Aydın, Fatih Doğanay, M. Erdoğan, H. Doğan, Attila Beştemir, Alpay Tuncar","doi":"10.7197/cmj.1216327","DOIUrl":"https://doi.org/10.7197/cmj.1216327","url":null,"abstract":"Background: Early recognition and treatment of patients with acute pancreatitis (AP) is important to improve prognosis and increase survival. Many scoring systems have been developed to assess the prognosis and disease severity in AP. The aim of this study was to compare the effectiveness of the Charlson Comorbidity Index (CCI), Bedside Index for Severity in AP (BISAP), and Acute Physiology and Chronic Health Evaluation (APACHE II) scores in predicting 30-day mortality and the development of severe AP (SAP) in patients with mild AP (MAP). \u0000Materials and Methods: This single-center, retrospective, and observational study was conducted with adult patients classified as MAP within 48 hours of arrival at the emergency department. Areas under the receiver operating characteristic curve (AUC) were calculated for each score to evaluate the effectiveness of the scores in predicting the development of SAP and 30-day mortality. \u0000Results: A total of 1419 patients with MAP were included in the study between January 01, 2018 and April 01, 2022. In MAP patients, SAP development rate was 14.4%, and the 30-day mortality rate was 1.8%. The accuracy of CCI (AUC=0.797±0.015) in predicting the development of SAP was significantly higher than BISAP (AUC =0.736±0.019, p","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78710342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: The aim of this study was to find out the association between the Fibroblast Growth Factor-23 (FGF-23), Insulin-Like Growth Factor-1 (IGF-1), androgens, insulin resistance (IR), and bone mineral density (BMD) in patients with PCOS (Polycyctic Ovary Syndrome) and healthy controls is presented. Materials and Methods: The FGF-23, IGF-1, and Homeostatic Model Assessment for Insulin Resistance were evaluated in 47 patients with PCOS and 26 healthy females, and BMD was evaluated only in the PCOS group. Then these parameters were compared between groups, according to the presence of IR and hyperandrogenemia. Results: The mean FGF-23 was 137.55± 75.42 and 414.81 ± 53.02 (pg/ml), and mean IGF-1 was 28.41 ± 99.69 and 244.26 ± 58.99 (ng/ml) in patients with PCOS and healthy controls, respectively. In PCOS group, the FGF-23 was more significantly decreased in those with IR and amenorrheic. DEXA scores were found to be similar in PCOS group in terms of hyperandrogenemia and IR. Conclusions: Our results revealed that FGF-23 levels decreased in patients with PCOS, which was particularly significant in patients with IR. According to our findings; the low level of FGF-23 in the PCOS group with IR suggests that this marker may also be associated with the complications of PCOS, but to clarify this hypothesis, this marker needs to be investigated.
{"title":"The Relationship between Fibroblast Growth Factor-23, Insulin-Like Growth Factor-1, Bone Mineral Density, Insulin Resistance, and Hyperandrogenemia in Polycystic Ovary Syndrome","authors":"E. Çiftel, S. Çiftel, F. Kilicli","doi":"10.7197/cmj.1215068","DOIUrl":"https://doi.org/10.7197/cmj.1215068","url":null,"abstract":"Aims: The aim of this study was to find out the association between the Fibroblast Growth Factor-23 (FGF-23), Insulin-Like Growth Factor-1 (IGF-1), androgens, insulin resistance (IR), and bone mineral density (BMD) in patients with PCOS (Polycyctic Ovary Syndrome) and healthy controls is presented. \u0000Materials and Methods: The FGF-23, IGF-1, and Homeostatic Model Assessment for Insulin Resistance were evaluated in 47 patients with PCOS and 26 healthy females, and BMD was evaluated only in the PCOS group. Then these parameters were compared between groups, according to the presence of IR and hyperandrogenemia. \u0000Results: The mean FGF-23 was 137.55± 75.42 and 414.81 ± 53.02 (pg/ml), and mean IGF-1 was 28.41 ± 99.69 and 244.26 ± 58.99 (ng/ml) in patients with PCOS and healthy controls, respectively. In PCOS group, the FGF-23 was more significantly decreased in those with IR and amenorrheic. DEXA scores were found to be similar in PCOS group in terms of hyperandrogenemia and IR. \u0000Conclusions: Our results revealed that FGF-23 levels decreased in patients with PCOS, which was particularly significant in patients with IR. According to our findings; the low level of FGF-23 in the PCOS group with IR suggests that this marker may also be associated with the complications of PCOS, but to clarify this hypothesis, this marker needs to be investigated.","PeriodicalId":10750,"journal":{"name":"Cumhuriyet medical journal","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80030178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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