Flatfoot (pes planus) is described as a reduction or absence of the medial longitudinal arch (MLA) of the foot, with or without additional deformities of the foot and ankle. It is a very common orthopedic manifestation in infants and children and usually resolves by adolescence. Flat foot is usually flexible and painless with no functional compromise so that described as physiologic. In some rare cases flatfoot can become painful or rigid and may be a sign of pathology such as vertical talus or tarsal coalition. Although it is very common, there is no standard definition and no universally accepted classification system for pediatric flatfoot. Furthermore there are no large, prospective studies comparing the natural history of flatfoot in response to various treatments during the developmental period. Current literature suggests that it is safe and appropriate to simply observe an asymptomatic child with flatfoot. Painful flexible flatfoot may benefit from orthopedic intervention such as physical therapy, orthosis or sometimes a surgical procedure.Keywords: Pes planus, flatfoot, infant, child, foot arch, surgery
{"title":"Pediatrik Pes Planus (düztabanlık)","authors":"Nazan Kaymaz, Burak Kaymaz","doi":"10.22391/fppc.1065797","DOIUrl":"https://doi.org/10.22391/fppc.1065797","url":null,"abstract":"Flatfoot (pes planus) is described as a reduction or absence of the medial longitudinal arch (MLA) of the foot, with or without additional deformities of the foot and ankle. It is a very common orthopedic manifestation in infants and children and usually resolves by adolescence. Flat foot is usually flexible and painless with no functional compromise so that described as physiologic. In some rare cases flatfoot can become painful or rigid and may be a sign of pathology such as vertical talus or tarsal coalition. Although it is very common, there is no standard definition and no universally accepted classification system for pediatric flatfoot. Furthermore there are no large, prospective studies comparing the natural history of flatfoot in response to various treatments during the developmental period. Current literature suggests that it is safe and appropriate to simply observe an asymptomatic child with flatfoot. Painful flexible flatfoot may benefit from orthopedic intervention such as physical therapy, orthosis or sometimes a surgical procedure.Keywords: Pes planus, flatfoot, infant, child, foot arch, surgery","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":"48834497","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}
Giriş: Bu çalışma, ilaç alerjisi olan hastalarda otoantikor sıklığını incelemeyi amaçlamaktadır. İlaç alerjisi üzerine gözlemsel araştırmalar, otoimmünite patofizyolojisi hakkında yeni hipotezlerin oluşturulmasına katkıda bulunabilir.Yöntem: Eğitim ve Araştırma Hastanesi veri tabanına 31 Aralık 2018 sonuna kadar kayıt olan ve ilaç alerjisi tanısı konan hastaların verileri geriye dönük olarak değerlendirildi. Genel olarak, ICD 10'a göre “ilaçlara alerji durumu” tanısı konan ve en az bir otoantikor sonucu olan 617 adet yetişkin hasta çalışmaya dahil edildi.Bulgular: Araştırmada en az bir otoantikora sahip olma sıklığı % 0 ile % 92,1 arasında değişti. En sık saptanan otoantikor romatoid faktör (RF) idi (n = 241; % 92,1). İkinci en sık rastlanan oto antikorun anti-doku transglütaminaz IgA (Anti-tTG-IgA) (n = 22; % 68,2) olduğu görüldü. Anti-tiroglobulin (Anti-TG), anti-tiroid peroksidaz (anti-TPO) ve anti-çift sarmallı DNA (Anti-dsDNA) sıklıkları sırasıyla % 65,2 (n = 155), % 59,7 (n = 159) ve % 43,6 (n = 55) olarak saptandı.Sonuç: Birçok ilaç, otoimmün hastalıkları için ilerleme olmaksızın otoantikor gelişimini tetikleyebilir. İlaçlara alerjisi olan hastalarda otoantikorlardan şüphelenilmesi gereklidir. İlaç alerjisi üzerine yapılan gözlemsel araştırmalar, otoimmünitenin patofizyolojisi hakkında yeni hipotezlerin oluşturulmasına katkı sağlayacaktır. Bu alanda yapılacak çok sayıda çalışma, riskli ilaçların yaygın kullanımını daha objektif bir şekilde tartışmamızı sağlayabilir. Çalışmamızın ilaç reaksiyonu ile otoimmün hastalıklar arasındaki ilişkiye ışık tutacağını düşünüyoruz.Anahtar kelimeler: Otoantikorlar, otoimmünite, ilaç alerjisi, ilaç aşırı duyarlılığı
{"title":"İlaç alerjisi olan hastalarda otoantikor sıklığı","authors":"Zeynep Altın, Papatya BAYRAK DEĞİRMENCİ","doi":"10.22391/fppc.1134893","DOIUrl":"https://doi.org/10.22391/fppc.1134893","url":null,"abstract":"Giriş: Bu çalışma, ilaç alerjisi olan hastalarda otoantikor sıklığını incelemeyi amaçlamaktadır. İlaç alerjisi üzerine gözlemsel araştırmalar, otoimmünite patofizyolojisi hakkında yeni hipotezlerin oluşturulmasına katkıda bulunabilir.Yöntem: Eğitim ve Araştırma Hastanesi veri tabanına 31 Aralık 2018 sonuna kadar kayıt olan ve ilaç alerjisi tanısı konan hastaların verileri geriye dönük olarak değerlendirildi. Genel olarak, ICD 10'a göre “ilaçlara alerji durumu” tanısı konan ve en az bir otoantikor sonucu olan 617 adet yetişkin hasta çalışmaya dahil edildi.Bulgular: Araştırmada en az bir otoantikora sahip olma sıklığı % 0 ile % 92,1 arasında değişti. En sık saptanan otoantikor romatoid faktör (RF) idi (n = 241; % 92,1). İkinci en sık rastlanan oto antikorun anti-doku transglütaminaz IgA (Anti-tTG-IgA) (n = 22; % 68,2) olduğu görüldü. Anti-tiroglobulin (Anti-TG), anti-tiroid peroksidaz (anti-TPO) ve anti-çift sarmallı DNA (Anti-dsDNA) sıklıkları sırasıyla % 65,2 (n = 155), % 59,7 (n = 159) ve % 43,6 (n = 55) olarak saptandı.Sonuç: Birçok ilaç, otoimmün hastalıkları için ilerleme olmaksızın otoantikor gelişimini tetikleyebilir. İlaçlara alerjisi olan hastalarda otoantikorlardan şüphelenilmesi gereklidir. İlaç alerjisi üzerine yapılan gözlemsel araştırmalar, otoimmünitenin patofizyolojisi hakkında yeni hipotezlerin oluşturulmasına katkı sağlayacaktır. Bu alanda yapılacak çok sayıda çalışma, riskli ilaçların yaygın kullanımını daha objektif bir şekilde tartışmamızı sağlayabilir. Çalışmamızın ilaç reaksiyonu ile otoimmün hastalıklar arasındaki ilişkiye ışık tutacağını düşünüyoruz.Anahtar kelimeler: Otoantikorlar, otoimmünite, ilaç alerjisi, ilaç aşırı duyarlılığı","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45408111","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: This study aims to evaluate the relationship between herniated disc-related low back pain and depression, sleep, and quality of life.Methods: A control group consisting of 28 patients with herniated disc-related pain and 28 healthy volunteers were included in the study. Beck Depression Inventory (BDI) and Quality of Life Index (SF-36) are applied to all groups. Pain severity was evaluated with the Visual Analogue Scale (VAS). Sleep parameters were analyzed with an actigraphy device.Results: Depression and quality of life scores differed between the two groups, and they were observed as significantly higher in the group with herniated disc. Moreover, there was a positive correlation between pain severity and depression. On the other hand, there was a negative correlation between pain intensity and sleep efficiency. Subjects with low back pain had worse sleep quality and lower sleep efficiency (mean 71.7%) than the control group. The logistic regression analysis found a significant relationship between depression and VAS pain variables (p=0.030; 95% CI: 0.021-0.823).Conclusions: Our study's results reveal a relationship between pain and depression in herniated disc patients. Moreover, it was concluded that the deteriorated sleep quality due to low back pain also increased the severity of depression. This relationship related to the unpleasant consequences of chronic pain should be taken into account when planning the medical treatment and follow-up of patients with herniated disc, and also when explaining their expectations from surgical treatment.Keywords: Herniated disc, pain, sleep, depression, actigraphy.
{"title":"Bel fıtığına bağlı bel ağrısının uyku, yaşam kalitesi ve depresyon belirtileri üzerine olan etkileri","authors":"Ümit Ali Malçok","doi":"10.22391/fppc.960875","DOIUrl":"https://doi.org/10.22391/fppc.960875","url":null,"abstract":"Introduction: This study aims to evaluate the relationship between herniated disc-related low back pain and depression, sleep, and quality of life.Methods: A control group consisting of 28 patients with herniated disc-related pain and 28 healthy volunteers were included in the study. Beck Depression Inventory (BDI) and Quality of Life Index (SF-36) are applied to all groups. Pain severity was evaluated with the Visual Analogue Scale (VAS). Sleep parameters were analyzed with an actigraphy device.Results: Depression and quality of life scores differed between the two groups, and they were observed as significantly higher in the group with herniated disc. Moreover, there was a positive correlation between pain severity and depression. On the other hand, there was a negative correlation between pain intensity and sleep efficiency. Subjects with low back pain had worse sleep quality and lower sleep efficiency (mean 71.7%) than the control group. The logistic regression analysis found a significant relationship between depression and VAS pain variables (p=0.030; 95% CI: 0.021-0.823).Conclusions: Our study's results reveal a relationship between pain and depression in herniated disc patients. Moreover, it was concluded that the deteriorated sleep quality due to low back pain also increased the severity of depression. This relationship related to the unpleasant consequences of chronic pain should be taken into account when planning the medical treatment and follow-up of patients with herniated disc, and also when explaining their expectations from surgical treatment.Keywords: Herniated disc, pain, sleep, depression, actigraphy.","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43884374","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 aim of this study is to evaluate the demographic, clinical and laboratory characteristics and treatment results of pediatric patients followed up with the diagnosis of brucellosis in our clinic.Methods: Patients who were followed up with the diagnosis of brucellosis in Kayseri Training and Research Hospital, Pediatric Infectious Diseases Clinic between October 2016 and December 2018 were retrospectively analyzed.Results: A total of 37 patients, 26 (70.3%) male, were included in the study. The mean age of the patients whose ages ranged from 1 to 17 years was 9.3±4.3 years. Unpasteurized milk and/or dairy products were consumed in 86.5% of the patients and 48.6% had a family history of brucellosis. Joint pain (75.7%) was the most common presenting complaint. In the laboratory evaluation, 8.1% of the patients had leukopenia, 2.7% had thrombocytopenia and 21.4% had ALT elevation. Doxycycline plus rifampicin (43.2%) was the most commonly preferred treatment regimen. Addition of aminoglycoside to initial therapy in hospitalized patients was statistically higher than in outpatients (81.2% vs. 23.8%) (p=0.001). During the follow-up, relapse developed in a total of 4 (10.8%) patients, 3 of whom were outpatients. There was no statistical relationship between the initial treatment regimen and relapse (p=0.418).Conclusion: In conclusion, brucellosis should be kept in mind in terms of differential diagnosis in patients who present with joint pain in our country and who have cytopenia and/or isolated aminotransferase elevation in their investigations.Keywords: Child, Brucellosis, Relapse
{"title":"Çocukluk çağında bruselloz: 37 olgunun retrospektif değerlendirilmesi ve literatürün gözden geçirilmesi","authors":"Taylan Çelik, Emre Kaan","doi":"10.22391/fppc.1035377","DOIUrl":"https://doi.org/10.22391/fppc.1035377","url":null,"abstract":"Introduction: The aim of this study is to evaluate the demographic, clinical and laboratory characteristics and treatment results of pediatric patients followed up with the diagnosis of brucellosis in our clinic.Methods: Patients who were followed up with the diagnosis of brucellosis in Kayseri Training and Research Hospital, Pediatric Infectious Diseases Clinic between October 2016 and December 2018 were retrospectively analyzed.Results: A total of 37 patients, 26 (70.3%) male, were included in the study. The mean age of the patients whose ages ranged from 1 to 17 years was 9.3±4.3 years. Unpasteurized milk and/or dairy products were consumed in 86.5% of the patients and 48.6% had a family history of brucellosis. Joint pain (75.7%) was the most common presenting complaint. In the laboratory evaluation, 8.1% of the patients had leukopenia, 2.7% had thrombocytopenia and 21.4% had ALT elevation. Doxycycline plus rifampicin (43.2%) was the most commonly preferred treatment regimen. Addition of aminoglycoside to initial therapy in hospitalized patients was statistically higher than in outpatients (81.2% vs. 23.8%) (p=0.001). During the follow-up, relapse developed in a total of 4 (10.8%) patients, 3 of whom were outpatients. There was no statistical relationship between the initial treatment regimen and relapse (p=0.418).Conclusion: In conclusion, brucellosis should be kept in mind in terms of differential diagnosis in patients who present with joint pain in our country and who have cytopenia and/or isolated aminotransferase elevation in their investigations.Keywords: Child, Brucellosis, Relapse","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46795221","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}
Ferit Kaya, A. Oğuzöncül, Ramazan Gürgöze, Medine Kaya
Giriş: Meslek hastalıkları günümüzde giderek önemini arttırmaktadır. Bu çalışmanın amacı hastane öncesi sağlık hizmeti çalışanlarının, meslek hastalıkları ile ilgili karşılaşabilecekleri risk faktörlerine yönelik bilgi düzeylerini ve etkileyen faktörleri belirlemektir.Yöntem: Bu araştırma kesitsel tipte bir çalışmadır. Çalışmanın evrenini Elazığ ili hastane öncesi acil sağlık hizmetlerinde çalışan 504 personel oluşturmuştur. Örneklem grubu seçilmemiş olup evrenin tamamına ulaşılması planlanmıştır. Anket 25 sorudan oluşmaktadır. Gönüllülük esasına dayalı olarak yüz yüze görüşme yöntemi ile anket uygulanmıştır. Anketlere katılım oranı %84,6 olarak gerçekleşmiştir. Elde edilen veriler istatistik paket programa kaydedilmiştir. İstatistiksel analiz için X² ve Fisher’s Exact test kullanılmıştır.Bulgular: Katılımcıların yaş ortalaması 30,61±9,83’ idi. Çalışanların %59,6’sı kadın, %40,9’u paramedik ve %55,4’ü ilçe istasyonların da çalışmaktaydı. Mesleği isteyerek seçenlerin oranı %90,2’di. Çalışanların %93,0’ı mesleklerinin kas iskelet sistemi hastalıkları için risk oluşturduğunu düşünüyordu. Çalışanların %69,6’sı için şiddete maruz kalma riski stres oluşturan ana faktördü.Sonuç: Katılımcıların çoğunluğu mesleği isteyerek seçmiştir. Mesleki risk faktörü olarak en sık ergonomik faktörler görülmektedir. Nöbet süresinin uzun olması doktorlar arasında, nöbet arkadaşının uyumsuz olmasını ise acil tıp teknisyenleri (ATT) arasında yüksek oranda stres kaynağıdır. Sağlık çalışanlarına yönelik meslek hastalıkları konusunda eğitimlerin sıklaştırılması, HBV bulaşı gibi sık bilinen enfeksiyonlar dışında diğer biyolojik risk faktörlerine ve kimyasal risk faktörlerine karşıda duyarlılığın arttırılması yanında şiddete karşı önlemlerin arttırılması önerilmektedir.Anahtar kelimeler: Meslek hastalıkları, sağlık çalışanları, risk faktörleri, acil servis, ergonomi
入门：如今，就业疾病正在增加。这项研究的目的是确定可以在住院前向卫生工作者、专业疾病提供的信息水平和因素。方法：本研究为部分研究。Çalışmanın evrenini Elazığili hastaneöncesi acil sağlık hizmetrindeçalı。尚未选择模型组，并且已到达整个宇宙。这篇文章大约有25个问题。采用面对面访谈的方法，在随机性的基础上进行问卷调查。民意调查的参与率为84.6%。收集的数据存储在统计包程序中。为了进行统计分析，使用了X²和Fisher精确检验。例如：参与者的平均年龄为30.61±9.83'。59.6%的工人是妇女，40.9%是妇女，55.4%在该县。90.2%的人选择找工作。93.0%的工人认为肌肉骨骼系统有患病风险。Çalışanların%69,6的ıiçinşiddete maruz kalma riski stres oluşturan ana faktördü。Sonuç：Katılımcılarınçoğunluğu mesleği isteyerek seçmiştir。最常见的人体工程学因素被视为职业风险因素。医生之间的长期死亡率是急诊医学工程师（ATT）之间的高压力率。关键是要增加对其他生物风险因素和化学风险因素的暴力，除了频繁的HBV相关感染，培训被减少为与工作相关的疾病。卫生工作者、风险因素、急救服务、工效学
{"title":"Hastane öncesi acil sağlık çalışanlarının meslek hastalığı risk faktörleri ile ilgili bilgi düzeyleri ve etkileyen faktörler","authors":"Ferit Kaya, A. Oğuzöncül, Ramazan Gürgöze, Medine Kaya","doi":"10.22391/fppc.1114859","DOIUrl":"https://doi.org/10.22391/fppc.1114859","url":null,"abstract":"Giriş: Meslek hastalıkları günümüzde giderek önemini arttırmaktadır. Bu çalışmanın amacı hastane öncesi sağlık hizmeti çalışanlarının, meslek hastalıkları ile ilgili karşılaşabilecekleri risk faktörlerine yönelik bilgi düzeylerini ve etkileyen faktörleri belirlemektir.Yöntem: Bu araştırma kesitsel tipte bir çalışmadır. Çalışmanın evrenini Elazığ ili hastane öncesi acil sağlık hizmetlerinde çalışan 504 personel oluşturmuştur. Örneklem grubu seçilmemiş olup evrenin tamamına ulaşılması planlanmıştır. Anket 25 sorudan oluşmaktadır. Gönüllülük esasına dayalı olarak yüz yüze görüşme yöntemi ile anket uygulanmıştır. Anketlere katılım oranı %84,6 olarak gerçekleşmiştir. Elde edilen veriler istatistik paket programa kaydedilmiştir. İstatistiksel analiz için X² ve Fisher’s Exact test kullanılmıştır.Bulgular: Katılımcıların yaş ortalaması 30,61±9,83’ idi. Çalışanların %59,6’sı kadın, %40,9’u paramedik ve %55,4’ü ilçe istasyonların da çalışmaktaydı. Mesleği isteyerek seçenlerin oranı %90,2’di. Çalışanların %93,0’ı mesleklerinin kas iskelet sistemi hastalıkları için risk oluşturduğunu düşünüyordu. Çalışanların %69,6’sı için şiddete maruz kalma riski stres oluşturan ana faktördü.Sonuç: Katılımcıların çoğunluğu mesleği isteyerek seçmiştir. Mesleki risk faktörü olarak en sık ergonomik faktörler görülmektedir. Nöbet süresinin uzun olması doktorlar arasında, nöbet arkadaşının uyumsuz olmasını ise acil tıp teknisyenleri (ATT) arasında yüksek oranda stres kaynağıdır. Sağlık çalışanlarına yönelik meslek hastalıkları konusunda eğitimlerin sıklaştırılması, HBV bulaşı gibi sık bilinen enfeksiyonlar dışında diğer biyolojik risk faktörlerine ve kimyasal risk faktörlerine karşıda duyarlılığın arttırılması yanında şiddete karşı önlemlerin arttırılması önerilmektedir.Anahtar kelimeler: Meslek hastalıkları, sağlık çalışanları, risk faktörleri, acil servis, ergonomi","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47938545","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 most common injury resulting from blunt chest trauma is a rib fracture (25%) which is usually visible on radiographs. However, radiographs sometimes cannot show fractures, especially those in cartilage, unless they're densely calcified. The present study aimed to investigate the role of ultrasonography (US) in detecting rib fractures with minor blunt chest trauma and comparing its success with posteroanterior (PA) chest radiography.Methods: Patients with minor blunt chest trauma who had previously undergone US and radiography to assess suspected rib fractures, between June 2017– March 2019, were included. Radiography was obtained in the PA projection. US was performed by a radiologist who identified fractures by the disruption of the anterior margin of the rib on the US. The incidence and location of the fractures detected by US and radiography were then compared.Results: Totally 126 patients were included in the study. Ninety-eight patients (78%) were admitted to the hospital for the first time, and 28 patients (22%) for the second time (they previously admitted to the other hospitals and were evaluated as ‘normal’ by radiography). A total of 108 fractures ( in 79 patients (63%) ) were detected based on radiography and US examination, while 47 patients (37%) had no diagnostic evidence of fracture. All fractures were correctly detected by ultrasonography (100%), whereas radiography revealed 16 fractures (14.81%). A statistically significant difference in diagnostic capability was found between patients diagnosed by radiography and US (p=0.001).Conclusion: Ultrasonographic imaging is significantly superior to radiography in terms of accuracy in diagnosing rib fractures. Ultrasound was found to be significantly superior to radiography regardless of trauma site, localization, and location. Even though some rib areas are inaccessible on ultrasonographic evaluation, rapid evaluation of the most affected areas is most effective with ultrasonography when it comes to minor energy chest trauma. For this reason, the US increases the accuracy of diagnosis in minor chest traumas and rib fractures and decreases the repetitive referral of patients to health institutions by reducing the missed diagnosis.Keywords: Rib fractures, thoracic injuries, trauma, ultrasonography, radiography
{"title":"Minör göğüs travmasında radyografinin kaburga kırıklarını tanımada yeterliliği: Sonografi ve radyografinin etkinlik kıyaslaması","authors":"Emre Yurdakul, Servet Kahveci̇","doi":"10.22391/fppc.1033620","DOIUrl":"https://doi.org/10.22391/fppc.1033620","url":null,"abstract":"Introduction: The most common injury resulting from blunt chest trauma is a rib fracture (25%) which is usually visible on radiographs. However, radiographs sometimes cannot show fractures, especially those in cartilage, unless they're densely calcified. The present study aimed to investigate the role of ultrasonography (US) in detecting rib fractures with minor blunt chest trauma and comparing its success with posteroanterior (PA) chest radiography.Methods: Patients with minor blunt chest trauma who had previously undergone US and radiography to assess suspected rib fractures, between June 2017– March 2019, were included. Radiography was obtained in the PA projection. US was performed by a radiologist who identified fractures by the disruption of the anterior margin of the rib on the US. The incidence and location of the fractures detected by US and radiography were then compared.Results: Totally 126 patients were included in the study. Ninety-eight patients (78%) were admitted to the hospital for the first time, and 28 patients (22%) for the second time (they previously admitted to the other hospitals and were evaluated as ‘normal’ by radiography). A total of 108 fractures ( in 79 patients (63%) ) were detected based on radiography and US examination, while 47 patients (37%) had no diagnostic evidence of fracture. All fractures were correctly detected by ultrasonography (100%), whereas radiography revealed 16 fractures (14.81%). A statistically significant difference in diagnostic capability was found between patients diagnosed by radiography and US (p=0.001).Conclusion: Ultrasonographic imaging is significantly superior to radiography in terms of accuracy in diagnosing rib fractures. Ultrasound was found to be significantly superior to radiography regardless of trauma site, localization, and location. Even though some rib areas are inaccessible on ultrasonographic evaluation, rapid evaluation of the most affected areas is most effective with ultrasonography when it comes to minor energy chest trauma. For this reason, the US increases the accuracy of diagnosis in minor chest traumas and rib fractures and decreases the repetitive referral of patients to health institutions by reducing the missed diagnosis.Keywords: Rib fractures, thoracic injuries, trauma, ultrasonography, radiography","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47146675","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}
Hatice Betül Altınışık, Uğur Altınışık, Mehmet Aşık
Introduction: In intensive care units (ICU), patients remain bedridden for a long time. In addition, severe infections are frequently seen in ICUs. Both prolonged immobilization and serious infections are associated with bone tissue loss. The Wnt pathway has recently been focused on evaluating bone tissue loss. The Wnt pathway participates in both infections and the formation of bone tissue. Wnt pathway inhibitors sclerostin and Dickkopf-1 (DKK-1) inhibit bone formation and increase osteoclastic activity. In this study, we aimed to examine bone turnover by the Wnt inhibitors sclerostin and DKK-1 and their possible associations with inflammation in SIRS patients.Methods: We included 30 patients diagnosed with systemic inflammatory response syndrome (SIRS) in the study group and 16 in the control group. Serum sclerostin, DKK-1, white blood cell (WBC), and C-Reactive Protein (CRP) levels on the day of SIRS diagnosis (basal), the 7th, 14th, and 21stdays were evaluated in the study group, and the results were compared with the control group.Results: When the control group was compared with the basal SIRS, there was a significant elevation in both sclerostin (p=0.003) and DKK-1 (p=0.001). Statistical analysis showed significant decreases in sclerostin levels between basal and the 7th, 14th, and 21st days (p=0.033, p=0.003, p=0.002, respectively). Similarly, significant decreases in DKK-1 levels between basal and the 7th and 21st days (p=0.015, p=0.001, respectively) and an insignificant decrease on the 14th day (p=0.191) was observed. Sclerostin was positively and significantly correlated with WBC and CRP in basal and 7th-day measurements and WBC in 7th and 14th days. DKK-1 is positively and significantly correlated with WBC in basal and 7th-daymeasurements, while DKK-1 negatively correlates with CRP in basal-7th-day measurements.Conclusion: In this study, it was shown for the first time that the Wnt antagonists sclerostin and DKK-1 values are high in SIRS patients in ICU. Both biomarker levels decreased in parallel with the treatment. However, it could not be associated with disease severity and inflammatory marker levels. We believe that monitoring the change of Wnt antagonists will be useful in demonstrating bone turnover in patients with SIRS.Keywords: Dickkopf-1, Intensive care unit, Sclerostin, Systemic inflammatory response syndrome, Wnt signaling pathway, Bone turnover
{"title":"SIRS tanılı hastalarda enflamasyon ve kemik döngüsü arasındaki ilişkinin sklerostin ve Dickkopf-1 (DKK-1) düzeyleri ile değerlendirilmesi","authors":"Hatice Betül Altınışık, Uğur Altınışık, Mehmet Aşık","doi":"10.22391/fppc.1102573","DOIUrl":"https://doi.org/10.22391/fppc.1102573","url":null,"abstract":"Introduction: In intensive care units (ICU), patients remain bedridden for a long time. In addition, severe infections are frequently seen in ICUs. Both prolonged immobilization and serious infections are associated with bone tissue loss. The Wnt pathway has recently been focused on evaluating bone tissue loss. The Wnt pathway participates in both infections and the formation of bone tissue. Wnt pathway inhibitors sclerostin and Dickkopf-1 (DKK-1) inhibit bone formation and increase osteoclastic activity. In this study, we aimed to examine bone turnover by the Wnt inhibitors sclerostin and DKK-1 and their possible associations with inflammation in SIRS patients.Methods: We included 30 patients diagnosed with systemic inflammatory response syndrome (SIRS) in the study group and 16 in the control group. Serum sclerostin, DKK-1, white blood cell (WBC), and C-Reactive Protein (CRP) levels on the day of SIRS diagnosis (basal), the 7th, 14th, and 21stdays were evaluated in the study group, and the results were compared with the control group.Results: When the control group was compared with the basal SIRS, there was a significant elevation in both sclerostin (p=0.003) and DKK-1 (p=0.001). Statistical analysis showed significant decreases in sclerostin levels between basal and the 7th, 14th, and 21st days (p=0.033, p=0.003, p=0.002, respectively). Similarly, significant decreases in DKK-1 levels between basal and the 7th and 21st days (p=0.015, p=0.001, respectively) and an insignificant decrease on the 14th day (p=0.191) was observed. Sclerostin was positively and significantly correlated with WBC and CRP in basal and 7th-day measurements and WBC in 7th and 14th days. DKK-1 is positively and significantly correlated with WBC in basal and 7th-daymeasurements, while DKK-1 negatively correlates with CRP in basal-7th-day measurements.Conclusion: In this study, it was shown for the first time that the Wnt antagonists sclerostin and DKK-1 values are high in SIRS patients in ICU. Both biomarker levels decreased in parallel with the treatment. However, it could not be associated with disease severity and inflammatory marker levels. We believe that monitoring the change of Wnt antagonists will be useful in demonstrating bone turnover in patients with SIRS.Keywords: Dickkopf-1, Intensive care unit, Sclerostin, Systemic inflammatory response syndrome, Wnt signaling pathway, Bone turnover ","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41565660","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: Inflammatory bowel diseases (IBD) form a group of inflammatory diseases occurring in genetically-susceptible people, which are characterized by chronic progression and whose cause is not fully known. The aim of this study is to determine the incidence of IBD in our region and examine the clinical characteristics, sociodemographic features, and treatment results of IBD patients.Methods: Our study retrospectively investigates 211 patients over 18 years of age who were monitored for an IBD diagnosis between January 2, 2013, and December 31, 2019, by the gastroenterology department of Canakkale Onsekiz Mart University’s Faculty of Medicine. The mean age, female-male ratio, smoking habits, disease severity, and localization sites were identified for included patients. Local and systemic complications of administered treatment types and reasons for surgical treatment were also assessed in patients.Results: Of the 211 patients with IBD diagnoses, 158 (74.9%) had Ulcerative Colitis (UC) and 53 (25.1%) had a diagnosis of Crohn’s disease (CD). The mean age at the time of diagnosis was 43.97±16.22 years for UC patients and 42.30±14.73 years for CD cases. The involvement sites for UC were distal colitis for 58.4% of patients, left colon for 24.1% of patients, pancolitis for 16.5% of patients, and backwash ileitis for 7% of patients. According to the treatment results, 152 (72.0%) patients took 5-aminosalicylate (5-ASA) alone, 48 (22.8%) took thiopurine, and 20 (9.5%) took anti-TNF.Conclusion: Knowing the demographic, clinical, and laboratory features of these diseases, which are frequently seen in our region, can support the early identification of probable complications that may occur and the selection of appropriate approaches during diagnosis, treatment, and follow-up monitoring of these diseases.Keywords: Inflammatory Bowel Diseases, Ulcerative Colitis, Crohn’s Disease, Severity of Illness Index, Abdominal Pain, Diarrhea
{"title":"İnflamatuvar barsak hastalığı olan hastalarda klinik özellikler, tedavi seçenekleri ve komplikasyonların değerlendirilmesi","authors":"Mücahit Ugar, Fatih Kamiş, Yavuz Beyazit","doi":"10.22391/fppc.1088562","DOIUrl":"https://doi.org/10.22391/fppc.1088562","url":null,"abstract":"Introduction: Inflammatory bowel diseases (IBD) form a group of inflammatory diseases occurring in genetically-susceptible people, which are characterized by chronic progression and whose cause is not fully known. The aim of this study is to determine the incidence of IBD in our region and examine the clinical characteristics, sociodemographic features, and treatment results of IBD patients.Methods: Our study retrospectively investigates 211 patients over 18 years of age who were monitored for an IBD diagnosis between January 2, 2013, and December 31, 2019, by the gastroenterology department of Canakkale Onsekiz Mart University’s Faculty of Medicine. The mean age, female-male ratio, smoking habits, disease severity, and localization sites were identified for included patients. Local and systemic complications of administered treatment types and reasons for surgical treatment were also assessed in patients.Results: Of the 211 patients with IBD diagnoses, 158 (74.9%) had Ulcerative Colitis (UC) and 53 (25.1%) had a diagnosis of Crohn’s disease (CD). The mean age at the time of diagnosis was 43.97±16.22 years for UC patients and 42.30±14.73 years for CD cases. The involvement sites for UC were distal colitis for 58.4% of patients, left colon for 24.1% of patients, pancolitis for 16.5% of patients, and backwash ileitis for 7% of patients. According to the treatment results, 152 (72.0%) patients took 5-aminosalicylate (5-ASA) alone, 48 (22.8%) took thiopurine, and 20 (9.5%) took anti-TNF.Conclusion: Knowing the demographic, clinical, and laboratory features of these diseases, which are frequently seen in our region, can support the early identification of probable complications that may occur and the selection of appropriate approaches during diagnosis, treatment, and follow-up monitoring of these diseases.Keywords: Inflammatory Bowel Diseases, Ulcerative Colitis, Crohn’s Disease, Severity of Illness Index, Abdominal Pain, Diarrhea","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43308365","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 aim of the study was to examine the 30-day total SARS-CoV-2 antibody positivity in patients across a clinical spectrum ranging from asymptomatic to pneumonia.Methods: This prospective cohort study consisted of 51 consecutive patients who were RT-PCR positive and diagnosed COVID-19 pneumonia (Group 1) and 58 consecutive patients who were also RT-PCR positive but were asymptomatic or had mild symptoms (Group 2). On the 30th day from the date of symptom onset, the patients were called for examination and blood samples were taken for the detection of SARS-CoV-2 antibodies.Results: Patients with pneumonia, fever, muscle pain, and loss of taste and smell had significantly higher rates of antibody positivity (p= 0.001, 0.003, 0.030, and 0.018, respectively). Antibody positivity was found to be significantly higher in patients with at least one symptom on admission compared to asymptomatic patients (p = 0.001). While the antibody positivity rate was 96.1% in Group 1 (patients with pneumonia), it was 50% in Group 2 (patients without pneumonia), and 77.7% in patients with at least one symptom on admission compared to 33.3% in asymptomatic patients (p=0.001).Conclusions: Patients with COVID-19 pneumonia have significantly higher disease-specific total antibody positivity rates than patients without pneumonia. Considering the 50% antibody positivity in patients who had COVID-19 infection who were asymptomatic or had symptoms other than pneumonia, the issue of COVID-19 re-infection and immunity is much more important than it appears.
{"title":"COVID-19 hastalarının semptomlarına ve pnömoni varlığına göre antikor tepkileri","authors":"Ramazan Korkusuz, Faruk Karandere","doi":"10.22391/fppc.1049314","DOIUrl":"https://doi.org/10.22391/fppc.1049314","url":null,"abstract":"Introduction: The aim of the study was to examine the 30-day total SARS-CoV-2 antibody positivity in patients across a clinical spectrum ranging from asymptomatic to pneumonia.Methods: This prospective cohort study consisted of 51 consecutive patients who were RT-PCR positive and diagnosed COVID-19 pneumonia (Group 1) and 58 consecutive patients who were also RT-PCR positive but were asymptomatic or had mild symptoms (Group 2). On the 30th day from the date of symptom onset, the patients were called for examination and blood samples were taken for the detection of SARS-CoV-2 antibodies.Results: Patients with pneumonia, fever, muscle pain, and loss of taste and smell had significantly higher rates of antibody positivity (p= 0.001, 0.003, 0.030, and 0.018, respectively). Antibody positivity was found to be significantly higher in patients with at least one symptom on admission compared to asymptomatic patients (p = 0.001). While the antibody positivity rate was 96.1% in Group 1 (patients with pneumonia), it was 50% in Group 2 (patients without pneumonia), and 77.7% in patients with at least one symptom on admission compared to 33.3% in asymptomatic patients (p=0.001).Conclusions: Patients with COVID-19 pneumonia have significantly higher disease-specific total antibody positivity rates than patients without pneumonia. Considering the 50% antibody positivity in patients who had COVID-19 infection who were asymptomatic or had symptoms other than pneumonia, the issue of COVID-19 re-infection and immunity is much more important than it appears. ","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43421918","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}
Giriş: Osteoid Osteoma (OO) belirgin bir nidus ve onu çevreleyen sklerotik reaktif zon ile karakterize küçük selim bir kemik tümörüdür. Genellikle uzun kemiklerde yerleşmekle birlikte nadiren patellada da görülebilmektedir.Vaka Sunumu: Sekiz yaşında kız çocuğu ön diz ağrısı şikayetiyle polikliniğimize başvurdu. Hastanın ağrı şikayetleri yaklaşık bir yıldır mevcuttu. Hastada Patellar Osteoid Osteoma tespit edildi. Lezyon kürete edildi ve cerrahi sonrası ilk gün hastanın ağrıları tamamen geçti.Sonuç: Her ne kadar Patellar OO nadir gözükse de çocuk ve genç erişkinlerdeki uzun süreli diz ağrısının ayırıcı tanısında düşünülmesi gerekir.Anahtar Kelimeler: Osteoid Osteoma, patella, diz ağrısı, küretaj, gecikmiş tanı, kemik neoplazmı
{"title":"Bir çocukta ön diz ağrısının nadir bir nedeni: Patellar Osteoid Osteoma ve literatürün gözden geçirilmesi","authors":"Nazan Kaymaz, Burak Kaymaz","doi":"10.22391/fppc.1065332","DOIUrl":"https://doi.org/10.22391/fppc.1065332","url":null,"abstract":"Giriş: Osteoid Osteoma (OO) belirgin bir nidus ve onu çevreleyen sklerotik reaktif zon ile karakterize küçük selim bir kemik tümörüdür. Genellikle uzun kemiklerde yerleşmekle birlikte nadiren patellada da görülebilmektedir.Vaka Sunumu: Sekiz yaşında kız çocuğu ön diz ağrısı şikayetiyle polikliniğimize başvurdu. Hastanın ağrı şikayetleri yaklaşık bir yıldır mevcuttu. Hastada Patellar Osteoid Osteoma tespit edildi. Lezyon kürete edildi ve cerrahi sonrası ilk gün hastanın ağrıları tamamen geçti.Sonuç: Her ne kadar Patellar OO nadir gözükse de çocuk ve genç erişkinlerdeki uzun süreli diz ağrısının ayırıcı tanısında düşünülmesi gerekir.Anahtar Kelimeler: Osteoid Osteoma, patella, diz ağrısı, küretaj, gecikmiş tanı, kemik neoplazmı","PeriodicalId":31541,"journal":{"name":"Family Practice and Palliative Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45087979","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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