Eurasian Journal of Medicine最新文献

Objective: Sarcopenia, the gradual decline in skeletal muscle mass (SMM), strength, and functionality, has negative health consequences such as premature death and disability. It is prevalent in chronic lung disease (CLD). Timely recognition of sarcopenia is required for focused therapy. This study sought to analyze the rate of sarcopenia in patients with CLD and to assess the diagnostic accuracy of the sarcopenia screening tests: the SARC-F, SARC-CalF, and Ishii tests. Materials and Methods: This study comprised individuals diagnosed with CLD and referred for pulmonary rehabilitation. Sarcopenia was evaluated based on the European Working Group on Sarcopenia in Older People criteria (EWGSOP and EWGSOP2), utilizing handgrip strength, SMM index, and gait speed. The diagnostic accuracy of screening tests (SARC-F, SARC-CalF, and Ishii) was assessed by sensitivity, specificity, and the area under the curve (AUC) in the Receiver Ooperating Ccharacteristics. Results: A total of 227 patients, with a mean age of 59.00 ± 13.98 years, of whom 50.7% had chronic obstructive pulmonary disease (COPD), were included. The rate of probable sarcopenia was 41.2%, confirmed sarcopenia 2.5%, and severe sarcopenia 0.5%. The Ishii test exhibited the highest sensitivity (71.59%) and specificity (90.48%) for probable sarcopenia (AUC: 0.810); it also showed 100% sensitivity and substantial specificity (78.57%, AUC: 0.893) for confirmed sarcopenia. Conclusion: Sarcopenia is highly prevalent in CLD patients, underscoring the need for routine screening. Among the screening tools, the Ishii test exhibited the highest diagnostic accuracy, making it a valuable tool for early detection. Routine assessment and targeted interventions for sarcopenia could improve functional outcomes in CLD patients.

Background: Major bleeding is a common and severe complication associated with vitamin K antagonist use. Rapid reversal of anticoagulation is crucial in cases of acute bleeding. Prothrombin complex concentrates (PCC) have emerged as an effective option. This study examines the efficacy of 4-factor PCC (4F-PCC) alone and in combination with vitamin K for International Normalized Ratio (INR) control in patients with life-threatening bleeding due to warfarin. Methods: This retrospective cross-sectional study included 50 patients who presented with bleeding and coagulopathy to the Ondokuz Mayıs University Health Practice and Research Center Adult Emergency Department between January 1, 2022, and January 1, 2023. Patients were divided into 2 groups based on vitamin K administration within 24 hours: group 1 received only 4F-PCC, while group 2 received both 4F-PCC and vitamin K. Results: The median age of patients was 72 years, 56% were male. The most common indication for warfarin use was heart valve disease (54%). Gastrointestinal hemorrhage was the leading cause of bleeding (44%). Mortality was 26%, with all deaths occurring within 72 hours of admission. Group 2 had significantly lower INR levels at 24th-hour than group 1 (P=.048). No significant differences were found in INR levels between the 1st and 24th hours within either group (P > .05). Conclusion: The study demonstrates that the combination of 4F-PCC and vitamin K is more effective in controlling INR than 4F-PCC alone, though it does not significantly impact rebound INR increases. Further prospective, multicenter studies are needed to confirm these findings and explore long-term outcomes.

Background: Tea ranks among the most popular beverages globally. In this study, we assessed the short-term changes in ocular biometric and specular microscopic parameters in healthy subjects following the consumption of different types of tea. Methods: A total of 144 subjects were randomly assigned to 3 groups (black, green, and white tea groups) in this study. Ocular parameters, including axial length (AL), aqueous depth (AD), lens thickness (LT), and central corneal thickness (CCT), were measured using optic biometry. Endothelial cell density (ECD), coefficient of variation (CV), number of hexagonal cells (A6A), and average cell area (AVG) were evaluated using non-contact specular microscopy before, as well as 1 hour and 4 hours after, consuming a cup of tea (containing 60 mg of caffeine per 100 mL). Results: The average age of the subjects was 32.9 ± 5.9 years. A significant increase in AD values was observed specifically at the 1st hour following the consumption of black, green, or white tea in healthy subjects. Additionally, black and white tea significantly reduced LT in the 1st hour of the study. The differences in AL and CCT values, as well as in specular microscopy parameters, were not significant among all participants after consuming different types of tea. Conclusion: Black, green, and white tea induce a significant increase in AD, particularly observed 1 hour after oral intake. Furthermore, a reduction in LT parameters was observed in the black and white tea groups, respectively.

Alzheimer's disease (AD) remains a formidable challenge, impacting individuals, families, caregivers, and soci- ety. Despite being identified over a century ago, effective drug treatments for AD remain elusive, with numerous clinical trials failing to produce meaningful results. The pathological hallmarks of AD, including the accumulation of beta-amyloid plaques and tau protein tangles, are well-established contributors to cogni- tive decline. However, recent research has raised questions about the efficacy of therapies targeting these abnormalities. Emerging evidence suggests that AD should not be viewed purely as a brain-centered disease but as a systemic condition involving complex interactions between the brain and peripheral organs. While the mechanisms linking peripheral processes and AD pathology remain unclear, studies indicate that these systems may contribute to or be affected by the disease. Recognizing AD as a heterogeneous disorder with systemic implications opens new opportunities for therapeutic innovation. Multimodal therapies targeting both central and peripheral aspects of AD pathology-such as amyloid-beta deposition, neuroinflammation, and systemic dysfunction-hold promise for slowing disease progression. This review aims to critically assess the current understanding of AD pathology, with a particular focus on the peripheral system's involvement and its interplay with the brain. Additionally, it will explore novel therapeutic strategies and emphasize the importance of interdisciplinary collaboration to advance our knowledge and develop effective treatments.

Background: To reveal whether the quality perceptions service expectations of patients and their relatives who come to health institutions for examination and treatment differ according to their demographic structures. Methods: The data collection tool used was the Patient Satisfaction Survey. The sample of the study consisted of 428 patients aged 21 and over 21 years who applied to Atatürk University Faculty of Dentistry for dental examinations between April 1, 2022 and July 31, 2022. The descriptive scanning method, one of the quantitative research methods, was used in the study. Survey analyzes were evaluated using scientific statistical analysis techniques described in the literature, and IBM Statistical Package for the Social Sciences (IBM SPSS Corp.; Armonk, NY, USA) Statistics 20 software was used. Results: Since the normal distribution condition was not met in normality tests, nonparametric tests were performed. Nonparametric tests revealed that patients' perceptions of quality and expectations did not differ according to gender, education, or marital status. On the other hand, patients' perceptions of quality and expectations differed according to age, profession, and monthly income. Conclusion: As a result of the statistical evaluation of the survey results, it was revealed that the quality perception and patient expectations in health institutions and organizations vary according to the demographic structures of the patients such as gender, age, education level, and monthly income.

Hydatid disease is a zoonotic infection caused by the larval stage of the Echinococcus granulosus worm, commonly found in developing countries. The lungs represent the second most commonly affected organ in both children and adults. The disease is more common in children than in adults, and the growth of hydatid cysts is more rapid in children than in adults. Diagnosing uncomplicated cases of hydatid cysts is generally straightforward clinically and radiologically. However, difficulties may arise in diagnosing complicated cysts. Surgery is the definitive treatment for pulmonary hydatid cysts. The surgical approach is contingent upon a number of factors, including the dimensions of the cyst, the integrity of its structure, whether it is solitary or multiple, unilateral or bilateral, and the extent of lung parenchyma destruction. In contrast to the liver, surgical treatment is promptly planned upon the diagnosis of a pulmonary hydatid cyst. The most effective surgical method is cystotomy and capitonnage while maintaining the integrity of the lung parenchyma to the greatest extent possible. Albendazole is the preferred medical treatment, but it is not recommended for intact cysts during the preoperative period due to its potential to weaken the cyst wall and cause rupture. Albendazole is administered to prevent postoperative recurrence and for treatment in cases where surgery is not feasible.

Conduction blocks complicating ST(ST-segment)-elevation myocardial infarction are associated with increased morbidity and mortality. Research indicates that anterior and inferior wall myocardial infarction were the most encountered causes of blocks but with conflicting results. However, patterns of conduction blocks have not been widely established in our population. The aim was to study the various patterns of conduction blocks following ST-elevation myocardial infarction and their prognostic implications. Prospectively, 70 patients, aged > 18 years, diagnosed with ST segment elevation myocardial infarction were included in the study. Post intensive care unit admission, all patients were observed for conduction blocks using a standard 12-lead electrocardiogram and repeated the same every 48 h throughout the hospitalization stay. Statistical analysis was performed using software R version 3.6.0. Out of 70 patients, 70% were males. Mean age was 60.7 ± 13.4 years. The proportion of blocks was first-degree heart block (28.6%), Mobitz II heart block (20%), complete heart block (17.1%), Mobitz I heart block (11.4%), right bundle branch block (10%), left bundle branch block (10%), left anterior hemiblock (1.4%), and trifascicular block (1.4%). No significant diference was found between males and females with respect to various conduction heart blocks (P > .05). Mortality was observed only in patients with complete heart block (11.4%) and first-degree heart block (2.8%; P = .003). Statistically, no significant diference was observed between various conduction blocks with respect to cardiac enzymes, random blood sugar, and lipid levels (P > .05). High mortality rate has been found in the patients with complete heart block indicating that severity of conduction block is a predictor of poor outcome in the ST-elevation myocardial infarction patients.

The use of intravenous lipid emulsion (ILE) is thought to reverse the acute neurological and cardiac toxicities generated by local anesthetic and non-anesthetic drugs. The aim of this review is to provide an updated overview of ILE therapy in the management of the toxic efects of medications on humans. Indications, mechanisms of action, monitoring, dosing, lipid formulations, adverse efects, and contraindications related to ILE are highlighted. Although ILE therapy was initially utilized for local anesthetic toxicity, its use has been extended to patients with overdoses or poisoning induced by various non-local anesthetic drugs. It has been proposed that intravenous lipid droplets generate a discrete lipophilic phase in the bloodstream into which liposoluble drugs preferentially partition. This partitioning efect, known as the lipid sink phenomenon, is thought to decrease the quantity of drug content in tissues in vital organs. At the same time, other studies have also described several molecular mechanisms that may contribute to ILE efcacy. Potential adverse efects of ILE have also been identified, such as pulmonary toxicity, hypertriglyceridemia, acute pancreatitis, interference with laboratory measurements, fat overload syndrome, worsening of systemic absorption of toxin, and hepatic dysfunction. Intravenous lipid emulsion therapy is gaining wider acceptance in critical care units and emergency rooms as a possible treatment modality for liposoluble drug toxicity. Currently, recommendations on ILE administration in clinical toxicology are mainly based on published case reports and animal studies. Thus, further clinical studies are required to increase knowledge about ILE therapy.