Introduction: To determine the prevalence of involvement of symphysis pubis among male patients with ankylosing spondylitis (AS) and to analyze the relationship among this involvement, demographic data, clinical activity of the disease and radiological findings. Methods: Overall, 73 male patients diagnosed with AS who visited our clinic for follow-up were included in the study. In this retrospective study, clinical and radiological parameters were collected. In clinical evaluation, vertebral Visual Analog Scale (VAS) score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used. In AP pelvis radiography, symphysis pubis changes were rated as 0–4. Modified Stoke Ankylosing Spondylitis Spinal Score (M-SASSS) was calculated from the cervical and lumbar lateral radiography images. Results: Symphysis pubis involvement was radiologically observed in 45 patients (61.7%). The mean age (43.9 ± 12.6) of patients with symphysis pubis involvement was higher than the average (36.9 ± 9.0) of patients without involvement (p = 0.026). Average M-SASSS of patients with symphysis pubis involvement (15.9 ± 11.9) was higher than the average of patients without involvement (8.4 ± 7.4), and there was a significant positive correlation between symphysis pubis involvement and M-SASSS (p=0.002). BASDAI and BASMI averages of patients were not significant (p = 0.973 and p = 0.105, respectively). Conclusion: Symphysis pubis involvement is a common manifestation of AS and can be used to predict vertebral radiological involvement. Keywords: Ankylosing Spondylitis, Symphysis Pubis, Modified Stoke Ankylosing Spondylitis Spinal Score
{"title":"Comparison of radiological changes in symphysis pubis and disease activity parameters in male patients with ankylosing spondylitis","authors":"Arif Bi̇len, M. Resorlu, H. Reşorlu","doi":"10.22391/fppc.1038830","DOIUrl":"https://doi.org/10.22391/fppc.1038830","url":null,"abstract":"Introduction: To determine the prevalence of involvement of symphysis pubis among male patients with ankylosing spondylitis (AS) and to analyze the relationship among this involvement, demographic data, clinical activity of the disease and radiological findings.\u0000Methods: Overall, 73 male patients diagnosed with AS who visited our clinic for follow-up were included in the study. In this retrospective study, clinical and radiological parameters were collected. In clinical evaluation, vertebral Visual Analog Scale (VAS) score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used. In AP pelvis radiography, symphysis pubis changes were rated as 0–4. Modified Stoke Ankylosing Spondylitis Spinal Score (M-SASSS) was calculated from the cervical and lumbar lateral radiography images.\u0000Results: Symphysis pubis involvement was radiologically observed in 45 patients (61.7%). The mean age (43.9 ± 12.6) of patients with symphysis pubis involvement was higher than the average (36.9 ± 9.0) of patients without involvement (p = 0.026). Average M-SASSS of patients with symphysis pubis involvement (15.9 ± 11.9) was higher than the average of patients without involvement (8.4 ± 7.4), and there was a significant positive correlation between symphysis pubis involvement and M-SASSS (p=0.002). BASDAI and BASMI averages of patients were not significant (p = 0.973 and p = 0.105, respectively).\u0000Conclusion: Symphysis pubis involvement is a common manifestation of AS and can be used to predict vertebral radiological involvement.\u0000Keywords: Ankylosing Spondylitis, Symphysis Pubis, Modified Stoke Ankylosing Spondylitis Spinal Score","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43259439","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}
Introduction: A cancer diagnosis is often met with fear and distress in the patient and their family. Cancer also presents many psychosocial challenges for the patient and family caregiver. We aimed to investigate the relationships between health anxiety and intolerance of uncertainty regarding the quality of life in caregivers of cancer patients.Methods: A total of 83 cancer patients’ caregivers were included in the study. A sociodemographic information form, Health Anxiety Scale (HAS), Quality of Life Scale – Family Version (QoL-FV), and Intolerance of Uncertainty Scale (IUS-12), were given to participants to respond. Correlations between the study scale and sub-scale scores were evaluated. Two groups were formed as those with HAS scores greater than and less than the median. It was evaluated whether these groups differed in terms of IUS-12, QoL-FV-Total and QoL-FV subscale scores.Results: Median (IQR) scores of HAS, QoL-FV-Total and IUS-12 were 18.0 (10.0-25.0), 173.0 (145.0-206.0), and 29.0 (23.0-42.0), respectively. There was a significant positive correlation (r=0.469, p<0.001) between HAS scores and IUS-12 scores and a significant negative correlation (r=-0.328, p=0.002) between QoL-FV-Total scores. There was no significant correlation (r=-0.084, p=0.452) between QoL-FV-Total and IUS-12 scores. The IUS-12 score (median (IQR); 24.0 (20.0-27.0) vs 39.5 (31.5-45.0), p<0.001) was significantly lower and the QoL-FV-total score (median (IQR); 206.0 (157.5-263.5) vs 157.5 (142.25-176.0), p<0.001) and QoL-FV subscale scores were significantly higher in the HAS-low group than in the HAS-high group.Conclusions: Health anxiety may be one of the negative factors for quality of life in caregivers of cancer patients. More research is needed to explore the factors that predict and protect against health anxiety, which is thought to affect the quality of life of caregivers of cancer patients. Also, psychological intervention studies aiming at the relationship between health anxiety and the quality of life in caregivers of cancer patients are needed.Keywords: Caregivers, Uncertainty, Health Behavior, Anxiety, Quality of Life
{"title":"The relationships between health anxiety and intolerance of uncertainty with quality of life in caregivers of cancer patients","authors":"P. Eraslan, A. Ilhan","doi":"10.22391/fppc.1172873","DOIUrl":"https://doi.org/10.22391/fppc.1172873","url":null,"abstract":"Introduction: A cancer diagnosis is often met with fear and distress in the patient and their family. Cancer also presents many psychosocial challenges for the patient and family caregiver. We aimed to investigate the relationships between health anxiety and intolerance of uncertainty regarding the quality of life in caregivers of cancer patients.Methods: A total of 83 cancer patients’ caregivers were included in the study. A sociodemographic information form, Health Anxiety Scale (HAS), Quality of Life Scale – Family Version (QoL-FV), and Intolerance of Uncertainty Scale (IUS-12), were given to participants to respond. Correlations between the study scale and sub-scale scores were evaluated. Two groups were formed as those with HAS scores greater than and less than the median. It was evaluated whether these groups differed in terms of IUS-12, QoL-FV-Total and QoL-FV subscale scores.Results: Median (IQR) scores of HAS, QoL-FV-Total and IUS-12 were 18.0 (10.0-25.0), 173.0 (145.0-206.0), and 29.0 (23.0-42.0), respectively. There was a significant positive correlation (r=0.469, p<0.001) between HAS scores and IUS-12 scores and a significant negative correlation (r=-0.328, p=0.002) between QoL-FV-Total scores. There was no significant correlation (r=-0.084, p=0.452) between QoL-FV-Total and IUS-12 scores. The IUS-12 score (median (IQR); 24.0 (20.0-27.0) vs 39.5 (31.5-45.0), p<0.001) was significantly lower and the QoL-FV-total score (median (IQR); 206.0 (157.5-263.5) vs 157.5 (142.25-176.0), p<0.001) and QoL-FV subscale scores were significantly higher in the HAS-low group than in the HAS-high group.Conclusions: Health anxiety may be one of the negative factors for quality of life in caregivers of cancer patients. More research is needed to explore the factors that predict and protect against health anxiety, which is thought to affect the quality of life of caregivers of cancer patients. Also, psychological intervention studies aiming at the relationship between health anxiety and the quality of life in caregivers of cancer patients are needed.Keywords: Caregivers, Uncertainty, Health Behavior, Anxiety, Quality of Life","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46654946","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. T. Atayoğlu, M. Tokaç, Sibel Doğan, A. Güner, Erdoğan Kocayi̇ği̇t, Muharrem Güner
Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional & Complementary Medicine (T&CM).Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T&CM methods, their views on integration of T&CM into family medicine, and the impact of these practices on patient care.Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T&CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T&CM training, and 66.4% reported inquiring about T&CM in their patient consultations. Over half of the physicians (56.79%) believed that T&CM methods should be used in preventive medicine. The most widely recognized T&CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T&CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.Keywords: Family physician, complementary medicine, integrative medicine, traditional medicine
{"title":"Traditional and complementary medicine perspectives of family physicians in Istanbul","authors":"A. T. Atayoğlu, M. Tokaç, Sibel Doğan, A. Güner, Erdoğan Kocayi̇ği̇t, Muharrem Güner","doi":"10.22391/fppc.1192917","DOIUrl":"https://doi.org/10.22391/fppc.1192917","url":null,"abstract":"Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional & Complementary Medicine (T&CM).Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T&CM methods, their views on integration of T&CM into family medicine, and the impact of these practices on patient care.Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T&CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T&CM training, and 66.4% reported inquiring about T&CM in their patient consultations. Over half of the physicians (56.79%) believed that T&CM methods should be used in preventive medicine. The most widely recognized T&CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T&CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.Keywords: Family physician, complementary medicine, integrative medicine, traditional medicine","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43097334","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}
Fatma Demir Yenigurbuz, Elif Söbü, Berkin BERK AKBEYAZ
Introduction: Obesity is an increasing health problem in the whole world, and it has an important inflammatory component related to the insulin resistance (IR), hypertension, atherosclerosis and some cancers. This study aims to evaluate the inflammatory hematological parameters in childhood obesity.Methods: Sixty-four obese and 50 normal weight cases were included in the study. The physical examination features and laboratory data of the patients were evaluated retrospectively from the patient’s files. Laboratory tests, hematological parameters, gender were compared between the groups. Correlations between Homeostasis model evaluation for insulin resistance (HOMA-IR) and other laboratory parameters in the obese group were examined.Results: The leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values of the obese group were found to be statistically higher than the control group (p: 0.006, p:0.015, p:0.014, p:0.001, p<0.001). There was no statistically significant difference between the two groups for Neutrophile/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR) and Platelet/Lymphocyte ratio (PLR) (p:0.642, p:0.989, 0.982). Also, there was no statistically significant correlation between Homa IR and age, BMI, Neutrophil, Lymphocyte, Monocyte, Thrombocyte, Neutrophil/Lymphocyte, Monocyte/Lymphocyte and Thrombocyte/Lymphocyte values.Conclusion: The current study showed that there was no significant difference between obese and controls in terms of NLR, PLR, and MLR values. However, the leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values were statistically higher in obese group than controls. Nevertheless, these findings can point relation between obesity and inflammation.Keywords: obesity, children, inflammation, hematological parameters
{"title":"The comparison of inflammatory hematological parameters in obese and non-obese children","authors":"Fatma Demir Yenigurbuz, Elif Söbü, Berkin BERK AKBEYAZ","doi":"10.22391/fppc.1197997","DOIUrl":"https://doi.org/10.22391/fppc.1197997","url":null,"abstract":"Introduction: Obesity is an increasing health problem in the whole world, and it has an important inflammatory component related to the insulin resistance (IR), hypertension, atherosclerosis and some cancers. This study aims to evaluate the inflammatory hematological parameters in childhood obesity.Methods: Sixty-four obese and 50 normal weight cases were included in the study. The physical examination features and laboratory data of the patients were evaluated retrospectively from the patient’s files. Laboratory tests, hematological parameters, gender were compared between the groups. Correlations between Homeostasis model evaluation for insulin resistance (HOMA-IR) and other laboratory parameters in the obese group were examined.Results: The leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values of the obese group were found to be statistically higher than the control group (p: 0.006, p:0.015, p:0.014, p:0.001, p<0.001). There was no statistically significant difference between the two groups for Neutrophile/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR) and Platelet/Lymphocyte ratio (PLR) (p:0.642, p:0.989, 0.982). Also, there was no statistically significant correlation between Homa IR and age, BMI, Neutrophil, Lymphocyte, Monocyte, Thrombocyte, Neutrophil/Lymphocyte, Monocyte/Lymphocyte and Thrombocyte/Lymphocyte values.Conclusion: The current study showed that there was no significant difference between obese and controls in terms of NLR, PLR, and MLR values. However, the leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values were statistically higher in obese group than controls. Nevertheless, these findings can point relation between obesity and inflammation.Keywords: obesity, children, inflammation, hematological parameters","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45101479","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}
Introduction: Thyroid fine-needle aspiration biopsy (TFNAB), which is basically planned according to the ultrasonographic features is of clinical importance; since it helps early diagnosis of malignancy, facilitates the selection of patients who will undergo thyroid surgery and prevents unnecessary surgical procedures. In our study, we aimed to evaluate the adequacy of TFNAB as well as the retrospective investigation of the link between the estimated malignancy risk and the descriptive features, radiologic findings and biopsy cytology of patients who underwent ultrasonography guided TFNAB.Methods: In this study, the ultrasonographic characteristics of 659 thyroid nodules belonging to 523 patients who underwent TFNAB between 2018 and 2021 were evaluated. The correlation between the risk of malignancy and demographic data, thyroid hormone levels, and ultrasonographic characteristics of nodules was examined. The diagnostic accuracy performances of European thyroid imaging reporting and data system (EU-TIRADS) classification prepared by the European Thyroid Association (ETA), the risk classification systems recommended by the American Thyroid Association (ATA) and the Society of Endocrinology and Metabolism of Turkey (TEMD) were compared with The Bethesda System for Reporting Thyroid Cytopathology (Bethesda). The adequacy of biopsy was also evaluated. The data which is obtained from the study was statistically analyzed by means of SPSS 20.0 (Statistical Package for the Social Sciences; SPSS Inc. Chicago, IL, USA) program.Results: In this study, the biopsies of 41 (6.2%) among 659 thyroid nodules appeared to be malignant. A statistically significant correlation was detected between malignancy and hypoechogenicity (p=0.011), microcalcification (p=0.005), irregular margins (p=0.028), and accompanying pathological lymph node (p=0.002). Compared to the surgical pathology results, the accuracy that was closest to that of Bethesda System (AUC: 0.778) (Area Under Curve) was found in EU-TIRADS (AUC:0.715). In the biopsies performed in our own endocrinology clinic (43.7% of the total biopsies), the ratio of non-diagnostic results was found to be 8.3%, whereas it was 29.1% in the biopsies performed in other clinics (56.3% of the total biopsies).Conclusion: It should always be kept in mind that, in the cytologic evaluation, the ultrasonographic nodule pattern recommended by the guidelines is very important in the management of patients, because cytology may show false negative and false positive results as well as unclear or non-diagnostic pathological findings. However, clinicians should also understand that classification systems may have strengths and weaknesses. Our study also emphasizes the importance of how experienced a clinic performing biopsy is as well as the role of cytopathologist in obtaining diagnostic results in biopsy.Keywords: Thyroid nodule, neoplasia, ultrasonography, biopsy fine-needle
简介:甲状腺细针穿刺活检(TFNAB)，基本根据超声表现进行规划，具有临床意义;因为它有助于恶性肿瘤的早期诊断，有利于选择接受甲状腺手术的患者，并防止不必要的外科手术。在我们的研究中，我们旨在评估TFNAB的充足性，并回顾性调查估计的恶性风险与超声引导下接受TFNAB的患者的描述性特征、放射学表现和活检细胞学之间的联系。方法:对2018 - 2021年523例TFNAB患者659个甲状腺结节的超声特征进行评价。恶性肿瘤的风险与人口统计数据、甲状腺激素水平和结节的超声特征之间的相关性进行了检查。比较欧洲甲状腺协会(ETA)编制的欧洲甲状腺影像报告和数据系统(EU-TIRADS)分类、美国甲状腺协会(ATA)和土耳其内分泌与代谢学会(TEMD)推荐的风险分类系统与Bethesda甲状腺细胞病理学报告系统(Bethesda)的诊断准确性。活检的充分性也进行了评估。本研究所得数据采用SPSS 20.0 (Statistical Package for The Social Sciences;SPSS。芝加哥，伊利诺伊州，美国)计划。结果:659例甲状腺结节中有41例(6.2%)为恶性结节。恶性肿瘤与低回声(p=0.011)、微钙化(p=0.005)、边缘不规则(p=0.028)、伴发病理性淋巴结(p=0.002)有统计学意义的相关性。与手术病理结果相比，EU-TIRADS的准确度最接近Bethesda系统(AUC: 0.778)(曲线下面积)(AUC:0.715)。在本院内分泌科门诊的活检中，非诊断性结果的比例为8.3%(占总活检的43.7%)，而在其他门诊的活检中，非诊断性结果的比例为29.1%(占总活检的56.3%)。结论:在细胞学检查中，由于细胞学检查可能出现假阴性、假阳性以及病理表现不明确或无法诊断，因此指南所推荐的超声结节图对患者的处理非常重要。然而，临床医生也应该明白，分类系统可能有优点和缺点。我们的研究还强调了临床活检经验的重要性，以及细胞病理学家在活检中获得诊断结果的作用。关键词:甲状腺结节，肿瘤，超声检查，细针活检
{"title":"The sonographic pattern of nodule and thyroid fine needle aspiration cytology in the evaluation of thyroid malignancy risk","authors":"Berkay Kuscu, M. Eroğlu","doi":"10.22391/fppc.1173267","DOIUrl":"https://doi.org/10.22391/fppc.1173267","url":null,"abstract":"Introduction: Thyroid fine-needle aspiration biopsy (TFNAB), which is basically planned according to the ultrasonographic features is of clinical importance; since it helps early diagnosis of malignancy, facilitates the selection of patients who will undergo thyroid surgery and prevents unnecessary surgical procedures. In our study, we aimed to evaluate the adequacy of TFNAB as well as the retrospective investigation of the link between the estimated malignancy risk and the descriptive features, radiologic findings and biopsy cytology of patients who underwent ultrasonography guided TFNAB.Methods: In this study, the ultrasonographic characteristics of 659 thyroid nodules belonging to 523 patients who underwent TFNAB between 2018 and 2021 were evaluated. The correlation between the risk of malignancy and demographic data, thyroid hormone levels, and ultrasonographic characteristics of nodules was examined. The diagnostic accuracy performances of European thyroid imaging reporting and data system (EU-TIRADS) classification prepared by the European Thyroid Association (ETA), the risk classification systems recommended by the American Thyroid Association (ATA) and the Society of Endocrinology and Metabolism of Turkey (TEMD) were compared with The Bethesda System for Reporting Thyroid Cytopathology (Bethesda). The adequacy of biopsy was also evaluated. The data which is obtained from the study was statistically analyzed by means of SPSS 20.0 (Statistical Package for the Social Sciences; SPSS Inc. Chicago, IL, USA) program.Results: In this study, the biopsies of 41 (6.2%) among 659 thyroid nodules appeared to be malignant. A statistically significant correlation was detected between malignancy and hypoechogenicity (p=0.011), microcalcification (p=0.005), irregular margins (p=0.028), and accompanying pathological lymph node (p=0.002). Compared to the surgical pathology results, the accuracy that was closest to that of Bethesda System (AUC: 0.778) (Area Under Curve) was found in EU-TIRADS (AUC:0.715). In the biopsies performed in our own endocrinology clinic (43.7% of the total biopsies), the ratio of non-diagnostic results was found to be 8.3%, whereas it was 29.1% in the biopsies performed in other clinics (56.3% of the total biopsies).Conclusion: It should always be kept in mind that, in the cytologic evaluation, the ultrasonographic nodule pattern recommended by the guidelines is very important in the management of patients, because cytology may show false negative and false positive results as well as unclear or non-diagnostic pathological findings. However, clinicians should also understand that classification systems may have strengths and weaknesses. Our study also emphasizes the importance of how experienced a clinic performing biopsy is as well as the role of cytopathologist in obtaining diagnostic results in biopsy.Keywords: Thyroid nodule, neoplasia, ultrasonography, biopsy fine-needle","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47180117","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}
Introduction: Oculogyric crisis (OGC) is a dystonic reaction characterized as conjugate and typically upward deviation of the eyes lasting from seconds to hours which is seen as an uncommon neurologic manifestation. Metoclopramide is a prokinetic agent that is frequently prescribed in the treatment of nausea, vomiting prophylaxis, and vomiting. One of the side effects after metoclopramide treatment is acute dystonic reactions.Case Presentation: We report a case of metoclopramide-induced OGC despite the anticholinergic treatment in patient diagnosed with schizophrenia.Conclusions: Metoclopramide-induced OGC and other acute dystonic reactions may be more frequent than expected. Therefore, clinicians should monitor patients closely during treatment with metoclopramide and necessary precautions should be taken for these reactions.Keywords: Metoclopramide, oculogyric crisis, side effect, schizophrenia
{"title":"A case of metoclopramide-induced oculogyric crisis in a schizophrenic patient under anticholinergic therapy","authors":"H. Ertekin, Begüm Aygen Gümüş","doi":"10.22391/fppc.1031963","DOIUrl":"https://doi.org/10.22391/fppc.1031963","url":null,"abstract":"Introduction: Oculogyric crisis (OGC) is a dystonic reaction characterized as conjugate and typically upward deviation of the eyes lasting from seconds to hours which is seen as an uncommon neurologic manifestation. Metoclopramide is a prokinetic agent that is frequently prescribed in the treatment of nausea, vomiting prophylaxis, and vomiting. One of the side effects after metoclopramide treatment is acute dystonic reactions.Case Presentation: We report a case of metoclopramide-induced OGC despite the anticholinergic treatment in patient diagnosed with schizophrenia.Conclusions: Metoclopramide-induced OGC and other acute dystonic reactions may be more frequent than expected. Therefore, clinicians should monitor patients closely during treatment with metoclopramide and necessary precautions should be taken for these reactions.Keywords: Metoclopramide, oculogyric crisis, side effect, schizophrenia","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46291089","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}
Introduction: The current study aimed to examine the relationship between 25 hydroxyvitamin D [25(OH)D] levels and demographic, clinical and laboratory parameters and response to treatment in patients living in a Central Anatolian city of Turkey and diagnosed with osteomalacia.Methods: A total of 533 patients who live in the continental climate, older than 18 years old, and have 25(OH)D levels lower than 30 ng/ml were enrolled prospectively. Patients' age, body mass index (BMI), type of clothing, season in which they were diagnosed, type of treatment and duration were recorded. At the time of diagnosis, the patients were evaluated with clinical and laboratory parameters at 1st, 2nd, and 4th months.Results: Mean serum 25(OH)D level was 7.59±4.41 ng/mL at the time of diagnosis. 25(OH)D level was 24.42±14.77 ng/ml after treatment, with severe deficiency (<10 ng/mL) in 74% of patients, deficiency (<20 ng/mL) in 24.2%, insufficiency in 1.3% (20-29.99 ng/mL). 74.4% of the women had a closed clothing style. Vitamin D levels during diagnosis and at the end of treatment did not differ according to the BMI and the diagnosis period (p> 0.05). However, as BMI increased, the response given to the treatment decreased.Conclusions: The current study showed that vitamin D deficiency is common in study population. The current findings demonstrate that treatment and follow-up should be continued until achieving normal serum 25(OH)D levels, taking into account geographic and ethnical structures to bring vitamin D levels to adequate levels.Keywords: 25-hydroxytamin D; Osteomalacia; vitamin D deficiency
{"title":"Evaluation of the response given to the vitamin D treatment in patients with osteomalacia","authors":"S. Genc, F. Kilicli","doi":"10.22391/fppc.1127577","DOIUrl":"https://doi.org/10.22391/fppc.1127577","url":null,"abstract":"Introduction: The current study aimed to examine the relationship between 25 hydroxyvitamin D [25(OH)D] levels and demographic, clinical and laboratory parameters and response to treatment in patients living in a Central Anatolian city of Turkey and diagnosed with osteomalacia.Methods: A total of 533 patients who live in the continental climate, older than 18 years old, and have 25(OH)D levels lower than 30 ng/ml were enrolled prospectively. Patients' age, body mass index (BMI), type of clothing, season in which they were diagnosed, type of treatment and duration were recorded. At the time of diagnosis, the patients were evaluated with clinical and laboratory parameters at 1st, 2nd, and 4th months.Results: Mean serum 25(OH)D level was 7.59±4.41 ng/mL at the time of diagnosis. 25(OH)D level was 24.42±14.77 ng/ml after treatment, with severe deficiency (<10 ng/mL) in 74% of patients, deficiency (<20 ng/mL) in 24.2%, insufficiency in 1.3% (20-29.99 ng/mL). 74.4% of the women had a closed clothing style. Vitamin D levels during diagnosis and at the end of treatment did not differ according to the BMI and the diagnosis period (p> 0.05). However, as BMI increased, the response given to the treatment decreased.Conclusions: The current study showed that vitamin D deficiency is common in study population. The current findings demonstrate that treatment and follow-up should be continued until achieving normal serum 25(OH)D levels, taking into account geographic and ethnical structures to bring vitamin D levels to adequate levels.Keywords: 25-hydroxytamin D; Osteomalacia; vitamin D deficiency","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46544256","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}
Cundullah Cavli, E. Önalan, B. Yakar, E. Dönder, İlay Buran, Ebru Önalan
Introduction: Meteorin-like (Metrnl), also known as subfatin is a newly discovered adipokine of adipocyte origin that may play a role in obesity and insulin resistance. The current study aimed to investigate the association between subfatin and biochemical values, demographic characteristics, and insulin resistance in obese patients and healthy controls.Methods: This cross-sectional study included 59 obese patients with sex and age-matched group of 41 healthy controls. An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of Subfatin (Metrnl), and the correlations of Metrnl level with anthropometric parameters, HOMA index, and biochemical measurements were assessed.Results: The levels of BMI (p<0.001), insulin (p=0.002), and HOMA-IR score (p<0.001) were significantly higher in obese patients than controls. The serum levels of Subfatin were found to be lower in obese patients (1.85 [1.35–5.51] ng/ml) compared to the healthy controls (21.82 [12.61–27.76] ng/ml) (p<0.001). Subfatin had a significantly negative relationship with age (r =-0.250, p=0.012), weight (r =-0.373, p=0.001), BMI (r =-0.492, p=0.001), HbA1c (r =-0.209, p=0.037), LDL (r =-0.264, p=0.008), HOMA-IR (r =-0.223, p=0.026), and glucose (r =-0.376, p<0.001). There was a significantly positive correlation between subfatin and height (r=0.321, p=0.001).Conclusion: These results show that levels of subfatin were decreased in obese patients. There is a relationship between circulating amounts of subfatin hormone and age, weight, height, LDL-cholesterol, glucose, hbA1c, and HOMA-IR. Subfatin might be a new biomarker of obesity and insulin resistance.Keywords: Meteorin-like/subfatin, adiposity, insulin resistance, adipokines, biomarkers, diabetes mellitus type 2
{"title":"Low serum levels of meteorin-like/subfatin is related to obesity and insulin resistance","authors":"Cundullah Cavli, E. Önalan, B. Yakar, E. Dönder, İlay Buran, Ebru Önalan","doi":"10.22391/fppc.1130758","DOIUrl":"https://doi.org/10.22391/fppc.1130758","url":null,"abstract":"Introduction: Meteorin-like (Metrnl), also known as subfatin is a newly discovered adipokine of adipocyte origin that may play a role in obesity and insulin resistance. The current study aimed to investigate the association between subfatin and biochemical values, demographic characteristics, and insulin resistance in obese patients and healthy controls.Methods: This cross-sectional study included 59 obese patients with sex and age-matched group of 41 healthy controls. An enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of Subfatin (Metrnl), and the correlations of Metrnl level with anthropometric parameters, HOMA index, and biochemical measurements were assessed.Results: The levels of BMI (p<0.001), insulin (p=0.002), and HOMA-IR score (p<0.001) were significantly higher in obese patients than controls. The serum levels of Subfatin were found to be lower in obese patients (1.85 [1.35–5.51] ng/ml) compared to the healthy controls (21.82 [12.61–27.76] ng/ml) (p<0.001). Subfatin had a significantly negative relationship with age (r =-0.250, p=0.012), weight (r =-0.373, p=0.001), BMI (r =-0.492, p=0.001), HbA1c (r =-0.209, p=0.037), LDL (r =-0.264, p=0.008), HOMA-IR (r =-0.223, p=0.026), and glucose (r =-0.376, p<0.001). There was a significantly positive correlation between subfatin and height (r=0.321, p=0.001).Conclusion: These results show that levels of subfatin were decreased in obese patients. There is a relationship between circulating amounts of subfatin hormone and age, weight, height, LDL-cholesterol, glucose, hbA1c, and HOMA-IR. Subfatin might be a new biomarker of obesity and insulin resistance.Keywords: Meteorin-like/subfatin, adiposity, insulin resistance, adipokines, biomarkers, diabetes mellitus type 2","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49001387","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}
N. Şen, M. Tezcan, Gizem Dogan gokce, N. Zorlutuna Kaymak, S. Acer, Ayşe ALGA BATIREL
Introduction: COVID-19 disease caused by the SARS-Cov-2 virus is characterized by clinical spectra of varying severity. Coagulopathy and inflammation are the most important factors associated with COVID-19 severity. The use of a biomarker of inflammation and coagulation factors has not yet been clarified. The present study aimed to examine the role of CRP/Albumin, an inflammation marker, in predicting the course of COVID-19 disease.Methods: The Demographic, laboratory, and prognosis of 457 patients who were hospitalized during the COVID-19 pandemic service between April and May 2020 were analyzed retrospectively. The relationship between the patients' CRP/Albumin ratio and disease severity, length of hospital stays, and prognosis were analyzed.Results: The rate of hospitalization in the intensive care unit was 10.5% (n=48), mechanical ventilation was 8.1% (n=37), and death was 1.3% (n=6). The CRP/albumin ratio was statistically higher in those with lung infiltration (p=0.005), those who were taken to the intensive care unit (p<0.001), and those who needed mechanical ventilation (p<0.001). A positive significant correlation was found between the length of hospital stay and the CRP/albumin ratio(r=0.412, p < 0.001).Conclusion: The CRP/Albumin ratio is thought to be an auxiliary marker for doctors in the early transfer of patients to the intensive care unit, the early detection of those in need of MV, and the determination of lung infiltration.Keywords: COVID-19, CRP/albumin ratio, prognosis
由SARS-Cov-2病毒引起的COVID-19疾病具有不同严重程度的临床谱特征。凝血功能障碍和炎症是与COVID-19严重程度相关的最重要因素。炎症和凝血因子的生物标志物的使用尚未明确。本研究旨在探讨炎症标志物CRP/白蛋白在预测COVID-19病程中的作用。方法:回顾性分析2020年4 - 5月收治的457例COVID-19大流行期间住院患者的人口学、实验室和预后。分析患者CRP/Albumin比值与病情严重程度、住院时间及预后的关系。结果:重症监护病房住院率为10.5% (n=48)，机械通气率为8.1% (n=37)，死亡率为1.3% (n=6)。CRP/白蛋白比值在肺浸润组(p=0.005)、重症监护组(p<0.001)和需要机械通气组(p<0.001)中均有统计学意义。住院时间与CRP/白蛋白比值呈正相关(r=0.412, p < 0.001)。结论:CRP/Albumin比值可作为医生早期将患者转入重症监护病房、早期发现需要MV者、判断肺浸润的辅助指标。关键词:COVID-19, CRP/白蛋白比值，预后
{"title":"The effect of CRP/albumin ratio on prognosis of hospitalized patients due to COVID-19","authors":"N. Şen, M. Tezcan, Gizem Dogan gokce, N. Zorlutuna Kaymak, S. Acer, Ayşe ALGA BATIREL","doi":"10.22391/fppc.1132063","DOIUrl":"https://doi.org/10.22391/fppc.1132063","url":null,"abstract":"Introduction: COVID-19 disease caused by the SARS-Cov-2 virus is characterized by clinical spectra of varying severity. Coagulopathy and inflammation are the most important factors associated with COVID-19 severity. The use of a biomarker of inflammation and coagulation factors has not yet been clarified. The present study aimed to examine the role of CRP/Albumin, an inflammation marker, in predicting the course of COVID-19 disease.Methods: The Demographic, laboratory, and prognosis of 457 patients who were hospitalized during the COVID-19 pandemic service between April and May 2020 were analyzed retrospectively. The relationship between the patients' CRP/Albumin ratio and disease severity, length of hospital stays, and prognosis were analyzed.Results: The rate of hospitalization in the intensive care unit was 10.5% (n=48), mechanical ventilation was 8.1% (n=37), and death was 1.3% (n=6). The CRP/albumin ratio was statistically higher in those with lung infiltration (p=0.005), those who were taken to the intensive care unit (p<0.001), and those who needed mechanical ventilation (p<0.001). A positive significant correlation was found between the length of hospital stay and the CRP/albumin ratio(r=0.412, p < 0.001).Conclusion: The CRP/Albumin ratio is thought to be an auxiliary marker for doctors in the early transfer of patients to the intensive care unit, the early detection of those in need of MV, and the determination of lung infiltration.Keywords: COVID-19, CRP/albumin ratio, prognosis","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42304862","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}
Orhan Ayan, A. Yılmaz, A. Dündar, Vasfiye DEMİR PERVANE, Mahir Kuyumcu
Introduction: Hypertension is a global public health problem that is the leading cause of preventable death in the world and a disease which can cause many morbidities and mortality if not controlled or treated effectively. In many studies, it has been determined that anxiety and body mass index(BMI) are among the factors affecting hypertension. However, different results have been obtained in many studies in terms of the relationship between anxiety and hypertension. This study was carried out with the aim to evaluate the effect of body mass index and anxiety on blood pressure and the factors affecting blood pressure in patients who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine.Methods: 403 patients aged between 18- 65 years, who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine between 01.04.2018 and 01.07.2018, were included in this cross-sectional study. The population of the study was the province where the study was carried out, and the sample size was calculated with a power of 80%. The patients' body mass index and anxiety scores from Beck anxiety scale were calculated and measurements of arterial blood pressure were performed. The relationship between BMI, Beck anxiety scores and blood pressure of patients were investigated.Results: Of the participants, 50.1% were male, 49.9% were female and the average age was 34.11 in years. Of the patients, the mean BMI as 25.52 kg/m², the mean anxiety score as 7.40 and the arterial blood pressures as 117.80/75.54 mmHg were measured. It was found that arterial blood pressure raised significantly as the BMI group increased. While the relationship between the severity of anxiety and systolic blood pressure was significant, its relationship with diastolic blood pressure was not significant. There was a positive correlation between BMI, anxiety score and systolic and diastolic blood pressure.Conclusions: According to the results of this study, it was found that the increase in BMI and Beck anxiety scores may be related with increase in arterial blood pressure. This result showed that common health problems in primary care such as anxiety, obesity and hypertension may be associated with each other, and it can be effectively fought against hypertension and its complications with the perspective of family medicine and biopsychosocial approach.Keywords: Anxiety, Hypertension, Blood Pressure, Obesity, Body Mass Index
{"title":"Aile hekimliği polikliniğine başvuran hastalarda vücut kitle indeksi ve anksiyete durumunun kan basıncı üzerine etkisi","authors":"Orhan Ayan, A. Yılmaz, A. Dündar, Vasfiye DEMİR PERVANE, Mahir Kuyumcu","doi":"10.22391/fppc.1039824","DOIUrl":"https://doi.org/10.22391/fppc.1039824","url":null,"abstract":"Introduction: Hypertension is a global public health problem that is the leading cause of preventable death in the world and a disease which can cause many morbidities and mortality if not controlled or treated effectively. In many studies, it has been determined that anxiety and body mass index(BMI) are among the factors affecting hypertension. However, different results have been obtained in many studies in terms of the relationship between anxiety and hypertension. This study was carried out with the aim to evaluate the effect of body mass index and anxiety on blood pressure and the factors affecting blood pressure in patients who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine.Methods: 403 patients aged between 18- 65 years, who applied to outpatient clinic of family medicine at Dicle University Faculty of Medicine between 01.04.2018 and 01.07.2018, were included in this cross-sectional study. The population of the study was the province where the study was carried out, and the sample size was calculated with a power of 80%. The patients' body mass index and anxiety scores from Beck anxiety scale were calculated and measurements of arterial blood pressure were performed. The relationship between BMI, Beck anxiety scores and blood pressure of patients were investigated.Results: Of the participants, 50.1% were male, 49.9% were female and the average age was 34.11 in years. Of the patients, the mean BMI as 25.52 kg/m², the mean anxiety score as 7.40 and the arterial blood pressures as 117.80/75.54 mmHg were measured. It was found that arterial blood pressure raised significantly as the BMI group increased. While the relationship between the severity of anxiety and systolic blood pressure was significant, its relationship with diastolic blood pressure was not significant. There was a positive correlation between BMI, anxiety score and systolic and diastolic blood pressure.Conclusions: According to the results of this study, it was found that the increase in BMI and Beck anxiety scores may be related with increase in arterial blood pressure. This result showed that common health problems in primary care such as anxiety, obesity and hypertension may be associated with each other, and it can be effectively fought against hypertension and its complications with the perspective of family medicine and biopsychosocial approach.Keywords: Anxiety, Hypertension, Blood Pressure, Obesity, Body Mass Index","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47350426","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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