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Pulmonary Physiotherapy in Kidney Recipients: Evaluation of Effects on Functional Capacity 肾受体肺物理治疗:对功能能力影响的评估
Pub Date : 2023-10-15 DOI: 10.58322/stmj.v2i4.35
Zuhal Zeydan, Makbule Ergin
Introduction: Renal replacement therapy (RRT), including dialysis and kidney transplantation (KT), is employed for treating patients with end-stage renal disease (ESRD). Among RRT options, KT offers the highest quality of life (QoL) and overall survival. However, pulmonary complications following KT remain significant contributors to morbidity, mortality, and potential graft failure. The primary objective of this study is to assess the impact of respiratory and strengthening exercises on respiration, body composition, physical performance, and QoL of the patients following KT. Materials and Methods: Preoperative assessments included forced expiratory volume in one second (FEV1), 6-minute walking test (6MWT) scores, body composition measurements, hand grip strength, and QoL scores using the Short Form 36 Scale (SF-36) for the patients undergoing their first KT at Antalya Medical Park Hospital. Participants were randomly assigned to two groups. The experimental group (EG) received respiratory exercises until discharge, followed by combined respiratory, upper, and lower extremity strengthening exercises three days a week for two weeks post-discharge, while the control group (CG) received standard care. Measurements were repeated at the end of the third postoperative week, and the changes from the initial measurements were statistically compared between the groups. Results: Demographic characteristics were comparable between the groups. The SF-36 physical function sub-parameter demonstrated a significant increase in the experimental group, while it decreased in the control group. Pain sub-parameter scores and grip strengths of the SF-36 QoL scale did not exhibit statistically significant changes in either group. Conclusion: Implementing early respiratory physiotherapy and strengthening program over three weeks following KT improved QoL and physical function significantly.
& # x0D;肾替代疗法(RRT),包括透析和肾移植(KT),用于治疗终末期肾病(ESRD)患者。在RRT选项中,KT提供最高的生活质量(QoL)和总生存期。然而,KT后的肺部并发症仍然是导致发病率、死亡率和潜在移植物失败的重要因素。本研究的主要目的是评估呼吸和强化运动对KT后患者呼吸、身体成分、身体表现和生活质量的影响。材料和方法:术前评估包括一秒钟用力呼气量(FEV1)、6分钟步行测试(6MWT)评分、身体成分测量、手部握力和使用SF-36短表格量表(SF-36)对在安塔利亚医学公园医院接受首次KT的患者的生活质量评分。参与者被随机分为两组。实验组(EG)在出院前进行呼吸运动,出院后每周3天进行呼吸、上、下肢联合强化运动,持续2周。对照组(CG)接受标准护理。在术后第三周结束时重复测量,并对组间初始测量的变化进行统计学比较。结果:两组人口统计学特征具有可比性。SF-36生理功能子参数实验组明显升高,对照组明显降低。SF-36生活质量量表的疼痛子参数得分和握力在两组间均无统计学意义的变化。结论:在KT术后3周内实施早期呼吸物理治疗和强化方案,可显著改善患者的生活质量和身体功能。
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 Introduction: Renal replacement therapy (RRT), including dialysis and kidney transplantation (KT), is employed for treating patients with end-stage renal disease (ESRD). Among RRT options, KT offers the highest quality of life (QoL) and overall survival. However, pulmonary complications following KT remain significant contributors to morbidity, mortality, and potential graft failure. The primary objective of this study is to assess the impact of respiratory and strengthening exercises on respiration, body composition, physical performance, and QoL of the patients following KT. Materials and Methods: Preoperative assessments included forced expiratory volume in one second (FEV1), 6-minute walking test (6MWT) scores, body composition measurements, hand grip strength, and QoL scores using the Short Form 36 Scale (SF-36) for the patients undergoing their first KT at Antalya Medical Park Hospital. Participants were randomly assigned to two groups. The experimental group (EG) received respiratory exercises until discharge, followed by combined respiratory, upper, and lower extremity strengthening exercises three days a week for two weeks post-discharge, while the control group (CG) received standard care. Measurements were repeated at the end of the third postoperative week, and the changes from the initial measurements were statistically compared between the groups. Results: Demographic characteristics were comparable between the groups. The SF-36 physical function sub-parameter demonstrated a significant increase in the experimental group, while it decreased in the control group. Pain sub-parameter scores and grip strengths of the SF-36 QoL scale did not exhibit statistically significant changes in either group. Conclusion: Implementing early respiratory physiotherapy and strengthening program over three weeks following KT improved QoL and physical function significantly.
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引用次数: 0
Predictive Factors for Detection of Clinically Significant Cancer in Repeat Prostate Biopsy 重复前列腺活检中检测临床显著癌的预测因素
Pub Date : 2023-10-15 DOI: 10.58322/stmj.v2i4.33
UĞUR ÖZTÜRK, Mustafa Aydın, Lokman İrkılata, Mustafa Kemal Atilla, Muhammet Şahin
Amaç: İki prostat büyümesiyle oluşan ikinci böbrek hücrelerinde klinik olarak anlamlı kanserin saptanmasını öngören prediktif faz belirlemeyi amaçladık. Yöntemler:Kliniğimizde 2016-2022 yılları arasında prostat spesifik antijen (PSA) yüksekliği nedeniyle prostat biyopsisi yapılmış ve patolojide kansere rastlanmamıştır; ancak atipik küçük asiner proliferasyon (ASAP) tespiti ve/veya PSA yüksekliğinin devam etmesi nedeniyle ikinci biyopsi yapılan hastalar çalışmaya dahil edildi. 103 hastanın verileri retrospektif olarak değerlendirildi. İlk biyopsi 12 kadran rutin protokolünde yapıldı. İkinci biyopsi ASAP olan hastalara 3 ay içinde, PSA yüksekliği devam eden hastalara ise 6 ay sonra yapıldı. Patolojik evrelemede Gleason skorlama sistemi kullanıldı. Gleason skoru 7 ve üzerinde olanlar klinik olarak anlamlı kanser olarak kabul edildi. İlk biyopsiden 6 ay sonra ölçülen PSA değerlerine göre; ikinci PSA değeri %20'nin üzerinde olan veya olmayan hastalar; yaşlarına göre 65 yaş altı ve yaş sınırı olmayanlar olarak gruplandırıldılar. İstatistiksel analizde Fisher'in kesin testi kullanıldı, 0,05'in altındaki ap değeri anlamlı kabul edildi. Bulgular: Çalışmaya 103 hasta dahil edildi. İkinci bağırsakta ise 13 (%12,6) hastada kanser tespit edildi. 5'i (%4,8) aktif klinik kriterlerini karşılayan klinik olarak küçük kanserlerdi; Bunların sekizinde (%7,8) Gleason skoru 7 ve üzerindeydi. İlk kliniklerde ASAP yapılanlarla yapılanyanlar arasında ikinci yardımlarda kanser veya klinik olarak anlamlı kanser saptanması açısından fark yoktu (p= 0,982). PSA'sı %20'den fazla artanlarda klinik olarak anlamlı kanser oranı %15,4 iken, artmayanlarda bu oran %3,1 idi (p= 0,024). Klinik olarak anlamlı kanser oranı 65 yaş ve üzerinde %14,2 iken, 65 yaş altı grupta bu oran %1,9 idi (p=0,019). Sonuç: PSA nedeniyle prostat kanseri yapılan ve iyi huylu olduğu tespit edilen, PSA değeri %20'nin üzerinde olan ve/veya 65 yaş üstü hastalığa göre klinik olarak anlamlı kanser tespit oranı daha yüksekti. ısırdım. Bu yıkanabilir ikinci bakteriler için zaman saklanmamalıdır.
目的我们旨在确定在两次前列腺增生形成的第二个肾细胞中发现具有临床意义的癌症的预测阶段。方法:将2016年至2022年间因前列腺特异性抗原(PSA)升高而在本诊所接受前列腺活检,且病理检查未发现癌症的患者纳入研究;但将因检测到非典型小尖头增生(ASAP)和/或PSA持续升高而接受第二次活检的患者纳入研究。研究对103名患者的数据进行了回顾性分析。第一次活检按照 12 象限常规方案进行。ASAP患者的第二次活检在3个月内进行,PSA持续升高患者的第二次活检在6个月后进行。病理分期采用格里森评分系统。Gleason 评分 7 分及以上被认为是有临床意义的癌症。根据首次活检后 6 个月的 PSA 值,将第二次 PSA 值超过 20% 或未超过 20% 的患者分为 65 岁以下患者和无年龄限制患者。统计分析采用费雪精确检验,ap值低于0.05为显著:研究共纳入 103 名患者。13例(12.6%)患者的第二肠发现癌症。其中 5 例(4.8%)为符合活动性临床标准的临床小癌;8 例(7.8%)的格里森评分为 7 分或更高。就第二次就诊时发现癌症或有临床意义的癌症而言,首次就诊时接受 ASAP 的患者与未接受 ASAP 的患者之间没有差异(P= 0.982)。在 PSA 增高超过 20% 的人群中,有临床意义的癌症发生率为 15.4%,而在未增高的人群中,有临床意义的癌症发生率为 3.1%(P= 0.024)。在 65 岁及以上年龄组中,有临床意义的癌症发生率为 14.2%,而在 65 岁以下年龄组中,有临床意义的癌症发生率为 1.9%(P=0.019):与 PSA 值高于 20% 和/或年龄超过 65 岁的患者相比,因 PSA 而接受前列腺癌检查并发现良性前列腺癌的患者中,有临床意义的癌症检出率更高。 这种可清洗的第二种细菌不应存放太久。
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 Yöntemler:Kliniğimizde 2016-2022 yılları arasında prostat spesifik antijen (PSA) yüksekliği nedeniyle prostat biyopsisi yapılmış ve patolojide kansere rastlanmamıştır; ancak atipik küçük asiner proliferasyon (ASAP) tespiti ve/veya PSA yüksekliğinin devam etmesi nedeniyle ikinci biyopsi yapılan hastalar çalışmaya dahil edildi. 103 hastanın verileri retrospektif olarak değerlendirildi. İlk biyopsi 12 kadran rutin protokolünde yapıldı. İkinci biyopsi ASAP olan hastalara 3 ay içinde, PSA yüksekliği devam eden hastalara ise 6 ay sonra yapıldı. Patolojik evrelemede Gleason skorlama sistemi kullanıldı. Gleason skoru 7 ve üzerinde olanlar klinik olarak anlamlı kanser olarak kabul edildi. İlk biyopsiden 6 ay sonra ölçülen PSA değerlerine göre; ikinci PSA değeri %20'nin üzerinde olan veya olmayan hastalar; yaşlarına göre 65 yaş altı ve yaş sınırı olmayanlar olarak gruplandırıldılar. İstatistiksel analizde Fisher'in kesin testi kullanıldı, 0,05'in altındaki ap değeri anlamlı kabul edildi.
 Bulgular: Çalışmaya 103 hasta dahil edildi. İkinci bağırsakta ise 13 (%12,6) hastada kanser tespit edildi. 5'i (%4,8) aktif klinik kriterlerini karşılayan klinik olarak küçük kanserlerdi; Bunların sekizinde (%7,8) Gleason skoru 7 ve üzerindeydi. İlk kliniklerde ASAP yapılanlarla yapılanyanlar arasında ikinci yardımlarda kanser veya klinik olarak anlamlı kanser saptanması açısından fark yoktu (p= 0,982). PSA'sı %20'den fazla artanlarda klinik olarak anlamlı kanser oranı %15,4 iken, artmayanlarda bu oran %3,1 idi (p= 0,024). Klinik olarak anlamlı kanser oranı 65 yaş ve üzerinde %14,2 iken, 65 yaş altı grupta bu oran %1,9 idi (p=0,019).
 Sonuç: PSA nedeniyle prostat kanseri yapılan ve iyi huylu olduğu tespit edilen, PSA değeri %20'nin üzerinde olan ve/veya 65 yaş üstü hastalığa göre klinik olarak anlamlı kanser tespit oranı daha yüksekti. ısırdım. Bu yıkanabilir ikinci bakteriler için zaman saklanmamalıdır.","PeriodicalId":471403,"journal":{"name":"Somalia Turkiye Medical Journal (STMJ)","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761298","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}
引用次数: 0
Post-cardiac catheterization infective endocarditis with flail mitral valve leaflets: an interesting and rare case 心导管插入术后感染性心内膜炎伴连枷状二尖瓣小叶:一个有趣而罕见的病例
Pub Date : 2023-10-15 DOI: 10.58322/stmj.v2i4.34
None Mohamud mire waberi, Mohamed Omar Hassan, Abdijalil Abdullahi Ali, Said Abdirahman ahmed, Ishak Ahmed Abdi
Infectious endocarditis (IE) occurs after the colonization of the cardiac endocardium by virulent microorganisms, usually bacteria. Infective endocarditis causes significant morbidity and mortality, even in this era of antibiotics. Here we present a 52-year-old male patient with hypertension and ischemic heart disease who presented with shivering, fever, and confusion for two days, fourteen days after PCI. On further assessment, transesophageal echocardiography was done due to the patient’s fulfillment of 3 minor and 1 major of Duke's criteria. Flail posterior mitral valve leaflet of 1.1x0.60cm vegetation, and severe eccentric mitral regurgitation were observed in the transesophageal echocardiography. Post PCI infective endocarditis is rare and missed diagnosis so it should be haven high suspension for those present with signs and symptoms compatible with infective endocarditis. Keywords: PCI, infective endocarditis, vegetation, echocardiography, PCI, mitral regurgitation
感染性心内膜炎(IE)发生在心内膜被毒性微生物(通常是细菌)定植后。感染性心内膜炎引起显著的发病率和死亡率,即使在这个时代的抗生素。在此,我们报告一位52岁男性高血压合并缺血性心脏病患者,在PCI术后14天内出现颤抖、发热和精神错乱2天。在进一步的评估中,由于患者满足Duke标准中的3个次要标准和1个主要标准,我们进行了经食管超声心动图检查。经食管超声心动图观察到连枷状二尖瓣后叶1.1x0.60cm植被,二尖瓣严重偏心反流。 PCI术后感染性心内膜炎罕见且漏诊,故对体征和症状符合感染性心内膜炎的患者应高度重视。 关键词:PCI,感染性心内膜炎,植被,超声心动图,PCI,二尖瓣反流
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 Post PCI infective endocarditis is rare and missed diagnosis so it should be haven high suspension for those present with signs and symptoms compatible with infective endocarditis.
 Keywords: PCI, infective endocarditis, vegetation, echocardiography, PCI, mitral regurgitation
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引用次数: 0
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Somalia Turkiye Medical Journal (STMJ)
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