Objektive: The aim of this study was to investigate whether there is a difference in terms of recurrence and progression rate before and after the pandemic in patients who applied for bladder cancer and / or were followed-up-treatment-operated in the urology clinic during the pandemic. Method: A total of 116 NMIBC patients with delayed cystoscopy and 90 control patients with timely cystoscopy were included in the study between June and July 2020. Demographic data of the patients were recorded. Recurrences and progression scores were calculated and grouped according to these scores. Cystoscopy delay time was calculated as the time from the planned cystoscopy time to the performed cystoscopy time. Recurrence and progression status of the patients were recorded and a comparison was made between the two groups. Results: The median age was 63.6 years (interquartile range [IQR] 35–85) in delayed cystoscopy group and 67.3 (25-87) in control group. In the delayed cystoscopy group, 29 (25%) patients had tumor recurrence on follow-up cystoscopy and 3 (10.34%) patients had tumor progression on subsequent TUR-BT. The mean cystoscopy delay time is 89.27±27.35 days. As a result of the chi-square analysis performed in the group with 10-17 recurrence points, a statistically significant relationship was found between the experimental and control groups (χ2=5.792; p=.016; p0.05). Conclusion: In this study, we reported that superficial bladder cancers with low recurrence score can wait 3-6 months but delaying 3-6 months in cases with a recurrence score of 10 or more increases the recurrence rate.
{"title":"Delayed Cystoscopic Follow-up of Non-muscle Invasive Bladder Cancer during the COVID-19 Pandemic may Increase Recurrence Rates but not Progression Rates","authors":"Yavuz Baştuğ, A. Çolakerol","doi":"10.46310/tjim.1345635","DOIUrl":"https://doi.org/10.46310/tjim.1345635","url":null,"abstract":"Objektive: The aim of this study was to investigate whether there is a difference in terms of recurrence and progression rate before and after the pandemic in patients who applied for bladder cancer and / or were followed-up-treatment-operated in the urology clinic during the pandemic. \u0000Method: A total of 116 NMIBC patients with delayed cystoscopy and 90 control patients with timely cystoscopy were included in the study between June and July 2020. Demographic data of the patients were recorded. Recurrences and progression scores were calculated and grouped according to these scores. Cystoscopy delay time was calculated as the time from the planned cystoscopy time to the performed cystoscopy time. Recurrence and progression status of the patients were recorded and a comparison was made between the two groups. \u0000Results: The median age was 63.6 years (interquartile range [IQR] 35–85) in delayed cystoscopy group and 67.3 (25-87) in control group. In the delayed cystoscopy group, 29 (25%) patients had tumor recurrence on follow-up cystoscopy and 3 (10.34%) patients had tumor progression on subsequent TUR-BT. The mean cystoscopy delay time is 89.27±27.35 days. As a result of the chi-square analysis performed in the group with 10-17 recurrence points, a statistically significant relationship was found between the experimental and control groups (χ2=5.792; p=.016; p0.05). \u0000Conclusion: In this study, we reported that superficial bladder cancers with low recurrence score can wait 3-6 months but delaying 3-6 months in cases with a recurrence score of 10 or more increases the recurrence rate.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"296 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76345670","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: Our objective was to assess the comprehensiveness of patient information websites from academic organizations regarding the most searched statements on the topic of "nocturia". Additionally, we aimed to analyze the frequency of these statements based on their classification as definition, etiology, diagnosis, or treatment. Methods: The website www.answerthepublic.com was used to retrieve outputs related with nocturia. After applying exclusion criteria, the outputs were searched within the American Urological Association (AUA) and European Association of Urology (EAU) patient information websites, and the comprehensiveness scores were evaluated. Results: The search engine retrieved 615 results, of which 67 queries were eligible for analysis. The most searched query was "nocturia definition" with 6,600 average clicks per month. The distribution of analyzed queries was 16.4% for definition, 46.3% for etiology, 11.9% for diagnosis, and 25.4% for treatment. The AUA and EAU websites had median comprehensiveness scores of 2.0 (IQR: 3.5) and 3.0 (IQR: 4.0), respectively, with no significant relation found (p-value: 0.438). A substantial proportion of searched items related to nocturia were not covered by the selected websites. Conclusions: Although the patient information websites provided by prominent academic organizations offer valuable information, there is a noticeable gap between the information they provide and the public's concerns regarding nocturia. Tools like www.answerthepublic.com may provide valuable insights into public concerns but have limitations.
{"title":"Do the platforms where professional health organizations inform the public answer all the needed questions?","authors":"Burhan Coşkun, N. Koca","doi":"10.46310/tjim.1329810","DOIUrl":"https://doi.org/10.46310/tjim.1329810","url":null,"abstract":"Objective: \u0000Our objective was to assess the comprehensiveness of patient information websites from academic organizations regarding the most searched statements on the topic of \"nocturia\". Additionally, we aimed to analyze the frequency of these statements based on their classification as definition, etiology, diagnosis, or treatment. \u0000Methods: \u0000The website www.answerthepublic.com was used to retrieve outputs related with nocturia. After applying exclusion criteria, the outputs were searched within the American Urological Association (AUA) and European Association of Urology (EAU) patient information websites, and the comprehensiveness scores were evaluated. \u0000Results: \u0000The search engine retrieved 615 results, of which 67 queries were eligible for analysis. The most searched query was \"nocturia definition\" with 6,600 average clicks per month. The distribution of analyzed queries was 16.4% for definition, 46.3% for etiology, 11.9% for diagnosis, and 25.4% for treatment. The AUA and EAU websites had median comprehensiveness scores of 2.0 (IQR: 3.5) and 3.0 (IQR: 4.0), respectively, with no significant relation found (p-value: 0.438). A substantial proportion of searched items related to nocturia were not covered by the selected websites. \u0000Conclusions: \u0000Although the patient information websites provided by prominent academic organizations offer valuable information, there is a noticeable gap between the information they provide and the public's concerns regarding nocturia. Tools like www.answerthepublic.com may provide valuable insights into public concerns but have limitations.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74650278","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}
Talha Mahmood, Amit Meda, Stuti Trivedi, F. Anami̇ka, S. Garg, Rohit Jai̇n
The COVID-19 epidemic had an enormous effect on the health of millions of individuals worldwide and the global economy. A shortage of doctors, nurses, personal protective equipment, and medicines was seen globally. The pandemic drew attention to limitations in the healthcare sector of the United States of America. The massive rise in the daily number of cases, more usage of ICU facilities and all the treatment modalities, and increased overtime compensation for the staff negatively impacted the hospital’s finances. This also affected the mental and physical health of all the healthcare workers. Through additional funding from federal relief legislation and the relaxation of many regulatory requirements, the federal, state, and local governments took significant steps to address the need for prevention and treatment services that arose from COVID-19 and the disruptions in healthcare delivery and finances resulting from the pandemic. Congress enacted the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, on March 27th, 2020. This measure appropriated $2.2 trillion to offer immediate and direct economic assistance to Americans affected by the COVID-19 outbreak.
{"title":"Impact of the COVID-19 Pandemic on the US healthcare system","authors":"Talha Mahmood, Amit Meda, Stuti Trivedi, F. Anami̇ka, S. Garg, Rohit Jai̇n","doi":"10.46310/tjim.1285390","DOIUrl":"https://doi.org/10.46310/tjim.1285390","url":null,"abstract":"The COVID-19 epidemic had an enormous effect on the health of millions of individuals worldwide and the global economy. A shortage of doctors, nurses, personal protective equipment, and medicines was seen globally. The pandemic drew attention to limitations in the healthcare sector of the United States of America. The massive rise in the daily number of cases, more usage of ICU facilities and all the treatment modalities, and increased overtime compensation for the staff negatively impacted the hospital’s finances. This also affected the mental and physical health of all the healthcare workers. Through additional funding from federal relief legislation and the relaxation of many regulatory requirements, the federal, state, and local governments took significant steps to address the need for prevention and treatment services that arose from COVID-19 and the disruptions in healthcare delivery and finances resulting from the pandemic. Congress enacted the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, on March 27th, 2020. This measure appropriated $2.2 trillion to offer immediate and direct economic assistance to Americans affected by the COVID-19 outbreak.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73049284","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}
Background Hyperleukocytosis is a high-mortality emergency that must be diagnosed and treated promptly. The treatment options are low-dose cytosine arabinoside, hydroxyurea, steroids and leukapheresis. The risks and benefits of leukapheresis and leukapheresis with cytoreductive drugs in hyperleukocytosis are unclear. Therefore, we aimed to evaluate the efficacy of leukapheresis and the effect of adding cytoreductive drugs to leukapheresis in reducing leukocyte count and mortality in our patients. Material and Methods Thirty-four adult patients with acute leukaemia who underwent leukapheresis were included in this retrospective study. Results The median age was 66.5 years old, and 88.2% of the patients were acute myeloid leukaemia. The total number of leukapheresis was 69 cycles, and the median number of the procedure was 2. The most common symptoms were associated with the pulmonary system (67.6%). The median follow-up was 17.5 days. The mean reduction of leukocyte count was 69,112/mm3, and the efficacy of leukapheresis was 40.9%. The decrease in leukocyte and platelet counts was statistically significant when compared before and after leukapheresis. The mortality rate was 76.5% during hospitalization. While 24 patients received concomitant cytoreductive drugs with leukapheresis, ten did not. There was no statistically significant difference between these groups regarding reducing leukocyte count, efficiency of leukapheresis and mortality (p values 0.857, 0.562 and 0.553). Conclusions In our study, we showed the efficacy of leukapheresis in hyperleukocytosis but failed to show any difference in leukocyte reduction or mortality with additional cytoreductive drugs. Leukapheresis with concomitant cytoreduction does not abolish or increase mortality.
{"title":"Evaluation of leukapheresis and leukapheresis with additional cytoreduction in acute leukemia with hyperleukocytosis","authors":"Tuğcan ALP KIRKIZLAR, A. Demir","doi":"10.46310/tjim.1270432","DOIUrl":"https://doi.org/10.46310/tjim.1270432","url":null,"abstract":"Background Hyperleukocytosis is a high-mortality emergency that must be diagnosed and treated promptly. The treatment options are low-dose cytosine arabinoside, hydroxyurea, steroids and leukapheresis. The risks and benefits of leukapheresis and leukapheresis with cytoreductive drugs in hyperleukocytosis are unclear. Therefore, we aimed to evaluate the efficacy of leukapheresis and the effect of adding cytoreductive drugs to leukapheresis in reducing leukocyte count and mortality in our patients. \u0000Material and Methods Thirty-four adult patients with acute leukaemia who underwent leukapheresis were included in this retrospective study. \u0000Results The median age was 66.5 years old, and 88.2% of the patients were acute myeloid leukaemia. The total number of leukapheresis was 69 cycles, and the median number of the procedure was 2. The most common symptoms were associated with the pulmonary system (67.6%). The median follow-up was 17.5 days. The mean reduction of leukocyte count was 69,112/mm3, and the efficacy of leukapheresis was 40.9%. The decrease in leukocyte and platelet counts was statistically significant when compared before and after leukapheresis. The mortality rate was 76.5% during hospitalization. While 24 patients received concomitant cytoreductive drugs with leukapheresis, ten did not. There was no statistically significant difference between these groups regarding reducing leukocyte count, efficiency of leukapheresis and mortality (p values 0.857, 0.562 and 0.553). \u0000Conclusions In our study, we showed the efficacy of leukapheresis in hyperleukocytosis but failed to show any difference in leukocyte reduction or mortality with additional cytoreductive drugs. Leukapheresis with concomitant cytoreduction does not abolish or increase mortality.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83381227","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 The efficacy of early rehabilitation in patients in the intensive care unit is apparent. However, it is still unclear in COVID-19 patients. Also, the effects of diaphragm kinesiotaping on outcomes and muscle thickness were not shown previously. Thus, we aimed to investigate the efficacy of rehabilitation and diaphragm kinesiotaping in patients with severe COVID-19 pneumonia by evaluating with the ultrasonography of the diaphragm. Methods Patients with severe COVID-19 pneumonia in intensive care unit requiring high flow oxygen therapy included in the study. Patients with severe COVID-19 pneumonia in intensive care unit requiring high flow oxygen therapy were divided into three groups: Group 1 (n = 22) rehabilitation, group 2 (n = 26) rehabilitation and diaphragm kinesiotaping, Group 3 (n = 24) control group-only standard intensive care unit care. Ultrasonographic measurements of diaphragm thickness and thickening fraction were recorded repeatedly. Results The demographic characteristics, mortality, and length of stay were not different between groups. However, invasive mechanic ventilation requirement and the decrease in diaphragm thickness and thickening fraction values were significantly lower in the diaphragm kinesiotaping group. Baseline diaphragm thickness and thickening fraction values were found to impact invasive mechanic ventilation requirement. Cut-off values for these parameters are 2.85 mm and 37.95%, respectively. Conclusion Baseline diaphragm thickness can be used to predict noninvasive ventilation failure. By the way, the patients who are more likely to develop respiratory failure should receive inspiratory muscle training exercises combined with general rehabilitation principles. Also, diaphragm kinesiotaping should be included in the rehabilitation protocol.
{"title":"The Effects of Early Rehabilitation and Diaphragm Kinesiotaping on Diaphragm Muscle Thickness in Patients with Severe COVID-19 Pneumonia in the Intensive Care Unit","authors":"S. Akseli̇m, T. Dandinoglu, S. Topal, G. Calıskan","doi":"10.46310/tjim.1279770","DOIUrl":"https://doi.org/10.46310/tjim.1279770","url":null,"abstract":"Objective The efficacy of early rehabilitation in patients in the intensive care unit is apparent. However, it is still unclear in COVID-19 patients. Also, the effects of diaphragm kinesiotaping on outcomes and muscle thickness were not shown previously. Thus, we aimed to investigate the efficacy of rehabilitation and diaphragm kinesiotaping in patients with severe COVID-19 pneumonia by evaluating with the ultrasonography of the diaphragm. \u0000Methods Patients with severe COVID-19 pneumonia in intensive care unit requiring high flow oxygen therapy included in the study. Patients with severe COVID-19 pneumonia in intensive care unit requiring high flow oxygen therapy were divided into three groups: Group 1 (n = 22) rehabilitation, group 2 (n = 26) rehabilitation and diaphragm kinesiotaping, Group 3 (n = 24) control group-only standard intensive care unit care. Ultrasonographic measurements of diaphragm thickness and thickening fraction were recorded repeatedly. \u0000Results The demographic characteristics, mortality, and length of stay were not different between groups. However, invasive mechanic ventilation requirement and the decrease in diaphragm thickness and thickening fraction values were significantly lower in the diaphragm kinesiotaping group. Baseline diaphragm thickness and thickening fraction values were found to impact invasive mechanic ventilation requirement. Cut-off values for these parameters are 2.85 mm and 37.95%, respectively. \u0000Conclusion Baseline diaphragm thickness can be used to predict noninvasive ventilation failure. By the way, the patients who are more likely to develop respiratory failure should receive inspiratory muscle training exercises combined with general rehabilitation principles. Also, diaphragm kinesiotaping should be included in the rehabilitation protocol.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80962889","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}
Background The study aimed to evaluate the role of homocysteine (HCY) in modulating various stroke parameters. The primary objective was to study the correlation of HCY levels with carotid intima-media thickness (IMT) in stroke patients and investigate if HCY levels had any predictive value for the National Institutes of Health Stroke Scale (NIHSS) score. Material and Methods Seventy-eight patients of magnetic resonance imaging or computed tomography scans-confirmed acute ischaemic stroke were recruited for this study, and the NIHSS score was evaluated upon admission. Fasting blood samples were tested for serum HCY, fasting blood glucose (FBG) and lipid profile. Ultrasonography of the neck ascertained IMT of common carotid artery (CCA) and internal carotid artery (ICA). Results The mean age of male and female subjects was 57.88±13.97 and 59.16±13.62 years, respectively. 71.93% of stroke patients were hyperhomocysteinemic (HHcyc), and 24.36% were hyperlipidemic. Patients with NIHSS ≥5 had higher LDL cholesterol than those with NIHSS
{"title":"Implications of homocysteine levels and carotid intima-media thickness in Indıan stroke patients","authors":"V. Jai̇n, P. Rana, Kshitij Arun Bhoge, M. Rojekar","doi":"10.46310/tjim.1248356","DOIUrl":"https://doi.org/10.46310/tjim.1248356","url":null,"abstract":"Background The study aimed to evaluate the role of homocysteine (HCY) in modulating various stroke parameters. The primary objective was to study the correlation of HCY levels with carotid intima-media thickness (IMT) in stroke patients and investigate if HCY levels had any predictive value for the National Institutes of Health Stroke Scale (NIHSS) score. \u0000Material and Methods Seventy-eight patients of magnetic resonance imaging or computed tomography scans-confirmed acute ischaemic stroke were recruited for this study, and the NIHSS score was evaluated upon admission. Fasting blood samples were tested for serum HCY, fasting blood glucose (FBG) and lipid profile. Ultrasonography of the neck ascertained IMT of common carotid artery (CCA) and internal carotid artery (ICA). \u0000Results The mean age of male and female subjects was 57.88±13.97 and 59.16±13.62 years, respectively. 71.93% of stroke patients were hyperhomocysteinemic (HHcyc), and 24.36% were hyperlipidemic. Patients with NIHSS ≥5 had higher LDL cholesterol than those with NIHSS","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90207656","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}
Background Plasma atherogenic index (PAI) is a novel index investigated in recent years related to cardiovascular disease and atherosclerosis. The role of PAI is not clear in non-alcoholic fatty liver disease (NAFLD). This study aimed to examine the role of PAI in patients with NAFLD and its relationship with metabolic components. Material and Methods This study was designed as a retrospective study, and the patients' files admitted to the Internal Medicine unit were retrospectively scanned. Within the scope of the study, demographic and laboratory data of the groups with and without NAFLD were compared. Results A total of 234 patients were evaluated, 159 of which were NAFLD (age: 39.52 ± 10.38 years) and 75 controls (age: 38.07 ± 12.11 years) (p = 0.374). PAI level was statistically significantly higher in the NAFLD group compared to the control group (p = 0.006). In the whole group correlation analysis, PAI level and body mass index (p < 0.001, r = 0.363), waist circumference (p < 0.001, r = 0.366), systolic blood pressure (p < 0.001, r = 0.333), diastolic blood pressure (p = 0.001, r = 0.210), ALT (p < 0.001, r = 0.312), AST (p = 0.005, r = 0.182), fasting plasma glucose (p = 0.017, r = 0.157) and insulin resistance (p < 0.001, r = 0.302) values were positively correlated. Conclusions PAI level was higher in patients with NAFLD; this index was associated with other metabolic components, especially insulin resistance. This indicates that the PAI level may be associated with clinical progression in the pathogenesis and course of the disease.
血浆动脉粥样硬化指数(PAI)是近年来研究的与心血管疾病和动脉粥样硬化相关的新指标。PAI在非酒精性脂肪性肝病(NAFLD)中的作用尚不清楚。本研究旨在探讨PAI在NAFLD患者中的作用及其与代谢成分的关系。材料与方法本研究采用回顾性研究设计，对内科收治的患者档案进行回顾性扫描。在研究范围内，比较了有和没有NAFLD组的人口统计学和实验室数据。结果共评估234例患者，其中NAFLD 159例(年龄:39.52±10.38岁)，对照组75例(年龄:38.07±12.11岁)(p = 0.374)。NAFLD组PAI水平明显高于对照组(p = 0.006)。在全组相关分析中，PAI水平与体重指数(p < 0.001, r = 0.363)、腰围(p < 0.001, r = 0.366)、收缩压(p < 0.001, r = 0.333)、舒张压(p = 0.001, r = 0.210)、ALT (p < 0.001, r = 0.312)、AST (p = 0.005, r = 0.182)、空腹血糖(p = 0.017, r = 0.157)、胰岛素抵抗(p < 0.001, r = 0.302)呈正相关。结论NAFLD患者PAI水平较高;该指标与其他代谢成分有关，尤其是胰岛素抵抗。这表明PAI水平可能与该病的发病机制和病程的临床进展有关。
{"title":"The role of plasma atherogenic index in patients with NAFLD","authors":"A. Kırık, H. Şen","doi":"10.46310/tjim.1256322","DOIUrl":"https://doi.org/10.46310/tjim.1256322","url":null,"abstract":"Background Plasma atherogenic index (PAI) is a novel index investigated in recent years related to cardiovascular disease and atherosclerosis. The role of PAI is not clear in non-alcoholic fatty liver disease (NAFLD). This study aimed to examine the role of PAI in patients with NAFLD and its relationship with metabolic components. \u0000Material and Methods This study was designed as a retrospective study, and the patients' files admitted to the Internal Medicine unit were retrospectively scanned. Within the scope of the study, demographic and laboratory data of the groups with and without NAFLD were compared. \u0000Results A total of 234 patients were evaluated, 159 of which were NAFLD (age: 39.52 ± 10.38 years) and 75 controls (age: 38.07 ± 12.11 years) (p = 0.374). PAI level was statistically significantly higher in the NAFLD group compared to the control group (p = 0.006). In the whole group correlation analysis, PAI level and body mass index (p < 0.001, r = 0.363), waist circumference (p < 0.001, r = 0.366), systolic blood pressure (p < 0.001, r = 0.333), diastolic blood pressure (p = 0.001, r = 0.210), ALT (p < 0.001, r = 0.312), AST (p = 0.005, r = 0.182), fasting plasma glucose (p = 0.017, r = 0.157) and insulin resistance (p < 0.001, r = 0.302) values were positively correlated. \u0000Conclusions PAI level was higher in patients with NAFLD; this index was associated with other metabolic components, especially insulin resistance. This indicates that the PAI level may be associated with clinical progression in the pathogenesis and course of the disease.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84783143","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}
Pınar Atagün Güney, I. Irmak, Ayse Nigar Halis, Ertan Saribas
Background Osteoporosis is a well-recognized and curable complication of lung transplantation. This study aimed to determine the degree of bone mineral density before transplantation and to evaluate the risk factors associated with osteoporosis in lung transplant patients. Material and Methods The bone mineral density of 72 patients who underwent lung transplantation with the diagnosis of end-stage lung diseases between December 2016 and April 2021 was evaluated in the pre-transplant period. Results 58 of 72 patients who underwent lung transplantation were included in the study. The age range of the cases was 14-64 (mean 48) years, and 14 (23.7%) were female. The presence of osteoporosis in the study population was 49.2% (n: 29), and osteopenia was 40.7% (n: 24). Osteoporosis was significantly more common in patients with younger age and lower body mass index (p = 0.024 and p = 0.009, respectively). And most down forced expiratory volüme 1 values were in patients with osteoporosis (p < 0.001 and p = 0.008, respectively). Steroid usage (OR: 0.06, 95% CI: 0.01-0.36, p = 0.002) in T score (femur neck) and 1.25 dihydroxy vitamin D (OR: 1.15, 95% CI: 1.03-1.28, p = 0.012) in T score (lumbal spine) were found to be independent predictors of osteoporosis according to multivariate analyzes. Conclusions A significant proportion of patients with end-stage lung disease undergoing lung transplantation have osteoporosis and osteopenia. Interestingly, the candidates were similarly affected despite the variety of underlying conditions. Since osteoporosis is treatable, strict follow-up and treatment management are recommended before referral for transplant candidates.
{"title":"Bone Mineral Density in Lung Transplant Recipients: Experience of A Referral Lung Transplantation Center","authors":"Pınar Atagün Güney, I. Irmak, Ayse Nigar Halis, Ertan Saribas","doi":"10.46310/tjim.1206443","DOIUrl":"https://doi.org/10.46310/tjim.1206443","url":null,"abstract":"Background Osteoporosis is a well-recognized and curable complication of lung transplantation. This study aimed to determine the degree of bone mineral density before transplantation and to evaluate the risk factors associated with osteoporosis in lung transplant patients. \u0000Material and Methods The bone mineral density of 72 patients who underwent lung transplantation with the diagnosis of end-stage lung diseases between December 2016 and April 2021 was evaluated in the pre-transplant period. \u0000Results 58 of 72 patients who underwent lung transplantation were included in the study. The age range of the cases was 14-64 (mean 48) years, and 14 (23.7%) were female. The presence of osteoporosis in the study population was 49.2% (n: 29), and osteopenia was 40.7% (n: 24). Osteoporosis was significantly more common in patients with younger age and lower body mass index (p = 0.024 and p = 0.009, respectively). And most down forced expiratory volüme 1 values were in patients with osteoporosis (p < 0.001 and p = 0.008, respectively). Steroid usage (OR: 0.06, 95% CI: 0.01-0.36, p = 0.002) in T score (femur neck) and 1.25 dihydroxy vitamin D (OR: 1.15, 95% CI: 1.03-1.28, p = 0.012) in T score (lumbal spine) were found to be independent predictors of osteoporosis according to multivariate analyzes. \u0000Conclusions A significant proportion of patients with end-stage lung disease undergoing lung transplantation have osteoporosis and osteopenia. Interestingly, the candidates were similarly affected despite the variety of underlying conditions. Since osteoporosis is treatable, strict follow-up and treatment management are recommended before referral for transplant candidates.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80628403","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}
Background Irritable bowel syndrome is a very common condition in the elderly, and it can also be extremely disabling being able to go to undermine the patient's independence. We wanted to conduct a study on the Territory to test a recently approved molecule for treating a variant with constipation-predominant irritable bowel syndrome, testing the treatment in a cohort of elderly subjects and comparing the results with those of other existing therapies. Here we exposed the results of our experience. Material and Methods We conducted an open-label study in the general medicine setting, enrolling patients who appeared eligible for drug treatment with the study drug during the medical examination. So we examined 20 elderly patients. Half of the patients were treated with linaclotide 290 mcg, the other 50% with macrogol 27.6 g (25%) and psyllium 2 sachets/day (25%), continuing the treatment up to 12 weeks. Results There was a reduction of bloating in 70% of the Linaclotide group and 80% of the macrogol and psyllium group, an improvement/reduction of tenesmus in 100% of patients in the three groups, with a change in the quality of stool occurring with Bristol Stool Scale assessment. 60% of patients failed to complete therapy in 3 months. Conclusions Linaclotide is an innovative drug increasingly gaining space in the pharmacopoeia in the possession of doctors for treating intestinal disorders on a functional basis. The limited experience has shown little tolerance of Linaclotide compared to treatments for longer in force, especially in the elderly.
{"title":"Treatment of Bowel Syndrome with Constipation: An Experience with The Agonist of Guanylate Cyclase Receptor in Advanced Age Patients","authors":"V. M. Magro","doi":"10.46310/tjim.1230072","DOIUrl":"https://doi.org/10.46310/tjim.1230072","url":null,"abstract":"Background Irritable bowel syndrome is a very common condition in the elderly, and it can also be extremely disabling being able to go to undermine the patient's independence. We wanted to conduct a study on the Territory to test a recently approved molecule for treating a variant with constipation-predominant irritable bowel syndrome, testing the treatment in a cohort of elderly subjects and comparing the results with those of other existing therapies. Here we exposed the results of our experience. \u0000Material and Methods We conducted an open-label study in the general medicine setting, enrolling patients who appeared eligible for drug treatment with the study drug during the medical examination. So we examined 20 elderly patients. Half of the patients were treated with linaclotide 290 mcg, the other 50% with macrogol 27.6 g (25%) and psyllium 2 sachets/day (25%), continuing the treatment up to 12 weeks. \u0000Results There was a reduction of bloating in 70% of the Linaclotide group and 80% of the macrogol and psyllium group, an improvement/reduction of tenesmus in 100% of patients in the three groups, with a change in the quality of stool occurring with Bristol Stool Scale assessment. 60% of patients failed to complete therapy in 3 months. \u0000Conclusions Linaclotide is an innovative drug increasingly gaining space in the pharmacopoeia in the possession of doctors for treating intestinal disorders on a functional basis. The limited experience has shown little tolerance of Linaclotide compared to treatments for longer in force, especially in the elderly.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"208 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77736943","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}
B. N. Coşkun, N. Lermi, Cihan Semet, H. E. Dalkılıç, Yavuz Pehlivan, H. Akalın
The aetiology may be complex in patients presenting with fever and rash. The differential diagnosis may include coronavirus disease 2019 (COVID-19) infection, an adverse effect of the COVID-19 vaccine, infection, and vasculitis. We reported a patient who presented with fever and vasculitic rash, which we hypothesized was an adverse vaccine effect. A 35-year-old male patient presented to the emergency department reporting headache, fever, rash, weakness, and myalgia. The first dose of the mRNA vaccine, COVID-19, had been administered five days before his presentation. A nasopharyngeal severe acute respiratory syndrome coronavirus two-challenge test was negative. Antinuclear antibody, antineutrophil cytoplasmic antibody, rheumatoid factor, and cryoglobulin were negative. No hypocomplementemia was detected. Skin biopsy was predominantly lymphocytic, with a vasculitic reaction with a few neutrophils. The Rickettsia conorii immunoglobulin M test examined using enzyme-linked immunosorbent assay (ELISA) was positive. COVID-19 should be excluded in patients with fever, rash, and headache. Symptoms that occur after vaccination may indicate adverse reactions. Even though we are in the pandemic phase, rickettsiosis should not be forgotten. Key Points • COVID-19 is suspected first in the patient who applied to the emergency department with the complaints of fever and maculopapular rash during the pandemic era. • Although the COVID-19 vaccine is widely used, possible side effects of the vaccine may raise doubts among physicians and patients. • The preliminary diagnosis of a patient with a vasculitic rash who complains of fever and myalgia should be thought to be Rickettsiosis.
{"title":"A young patient presents with a fever and rash: Is this an adverse effect of the mRNA vaccine, vasculitis, or rickettsiosis?","authors":"B. N. Coşkun, N. Lermi, Cihan Semet, H. E. Dalkılıç, Yavuz Pehlivan, H. Akalın","doi":"10.46310/tjim.1274327","DOIUrl":"https://doi.org/10.46310/tjim.1274327","url":null,"abstract":"The aetiology may be complex in patients presenting with fever and rash. The differential diagnosis may include coronavirus disease 2019 (COVID-19) infection, an adverse effect of the COVID-19 vaccine, infection, and vasculitis. We reported a patient who presented with fever and vasculitic rash, which we hypothesized was an adverse vaccine effect. A 35-year-old male patient presented to the emergency department reporting headache, fever, rash, weakness, and myalgia. The first dose of the mRNA vaccine, COVID-19, had been administered five days before his presentation. A nasopharyngeal severe acute respiratory syndrome coronavirus two-challenge test was negative. Antinuclear antibody, antineutrophil cytoplasmic antibody, rheumatoid factor, and cryoglobulin were negative. No hypocomplementemia was detected. Skin biopsy was predominantly lymphocytic, with a vasculitic reaction with a few neutrophils. The Rickettsia conorii immunoglobulin M test examined using enzyme-linked immunosorbent assay (ELISA) was positive. COVID-19 should be excluded in patients with fever, rash, and headache. Symptoms that occur after vaccination may indicate adverse reactions. Even though we are in the pandemic phase, rickettsiosis should not be forgotten. \u0000 \u0000Key Points \u0000• COVID-19 is suspected first in the patient who applied to the emergency department with the complaints of fever and maculopapular rash during the pandemic era. \u0000• Although the COVID-19 vaccine is widely used, possible side effects of the vaccine may raise doubts among physicians and patients. \u0000• The preliminary diagnosis of a patient with a vasculitic rash who complains of fever and myalgia should be thought to be Rickettsiosis.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86160327","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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