Search

The purpose of this study is to assess the relationship between chemotherapy toxicity and frailty as determined using the Edmonton Frail Scale (EFS).Older adults (≥ 65 years old) newly diagnosed with cancer were evaluated for frailty with EFS prior to chemotherapy. Participants evaluated on 17 points were grouped as "No Frailty" (0-4), "Apparently Vulnerable" (5-6), "Mild Frailty" (7-8), "Moderate Frailty" (9-10), and "Severe Frailty" (11 or more). Before the second and third chemotherapy cycles, patients were reassessed for toxicity.Of the 44 participants, 12 (27.4%) were rated as "frail" (EFS score ≥ 7). The median Charlson Age-Comorbidity Index score was 3 (IQR: 1), and the median EFS score was 5 (IQR: 3). There was no significant difference between the "frail" and "robust" groups in terms of the toxicity. There was no correlation between age, gender, chemotherapy intent, chemotherapy dosing, ECOG performance score, or other parameters with grade 3 or higher toxicity development.The Edmonton Frail Scale is not successful in predicting the toxicity risk of chemotherapy. However, it may be used as a tool to determine the need for comprehensive geriatric assessment and it may lead to increased alertness to adverse events during treatment of frail patients.

Introduction: Individuals with hearing loss have reduced hearing sensitivity and may not adequately process the temporal cues in acoustic signals. Cognitive skills that decrease with aging and hearing loss contribute negatively on the ability to understand speech. Hence, they may experience communication problems in noisy environments. The aim of the study was to investigate the effect of sloping high-frequency hearing loss on speech perception in noise and to examine the impact of temporal and cognitive processing in young and middle-age adults. Methods: Speech in noise (SIN), temporal processing, and cognitive tests were conducted to hearing loss and normal hearing individuals aged 18–59 years. The measurements included the matrix sentence test, binaural temporal fine structure sensitivity (TFS) test, Visual Aural Digit Span (VADS), and Auditory Verbal Learning Test (AVLT). Twenty participants with normal hearing were recruited in the control group, whereas 20 participants with hearing loss at high frequencies were composed of the study group. Results: Hierarchical regression analysis for SIN was performed by entering 3 separate blocks of independent variables. We entered age and hearing loss into the first block, which explained a significant amount of variability in SIN (R2 = 0.72, p < 0.001). Block 2 was comprised of scores from TFS sensitivity test, and this independent variable characterized temporal processing (R2 change = 0.002, p < 0.001). Block 3 was consisted of scores from VADS test and AVLT; these variables characterized cognitive processing and accounted for a good portion of SIN variance (R2 change = 0.04, p < 0.001). The age, hearing loss, and VADS contributed independently in the presence of all independent variables. Conclusion: The final model accounted for 76.2% of the variance in SIN. The results suggested that sloping hearing loss, aging, and cognitive decline affected auditory performance, and the poor performance starts from an early age. Additionally, the findings indicated that a more comprehensive approach might be recommended to evaluate the listening skills and identify communication problems.

Amac : Bu calismada ic hastaliklari kliniginde yatarak tedavi goren ve eritrosit sedimantasyon hizi 100 mm/saati gecen hastalarda gorulen hastaliklarve oranlari arastirildi. Hastalar ve yontemler : Haziran 2014 ile Haziran 2015 tarihleri arasinda ic hastaliklari kliniginde yatarak tedavi goren eritrosit sedimantasyon hizi(ESH) 100 mm/saati gecen toplam 152 hasta (78 erkek, 74 kadin; ort. yas 65.4 yil) calismaya dahil edildi. Hastalarin dosyalari yas, cinsiyet ve etyolojileriacisindan geriye donuk olarak incelendi. Bulgular : Hastalarin ortalama ESH’si 121.44 mm/saat (erkeklerde ortalama: 119.243 mm/saat, kadinlarda ortalama: 120.527 mm/saat) idi. Artmis eritrositsedimantasyon hizinin hastalik gruplarina gore dagilimi incelendiginde en yuksek oran hematolojik ve onkolojik hastaliklarda (%44.7), en dusuk oranise gastroenterolojik hastaliklarda (%2.6) tespit edildi. En yuksek ESH degeri 163 mm/saat idi. Hastaya multipl miyelom tanisi konuldu. Sonuc : Eritrosit sedimantasyon hizi cesitli hastaliklarin tani ve takibinde basit, ucuz ve yaygin kullanilabilir bir yontem olarak halen guncelliginikorumaktadir.

Vazoaktif intestinal peptid salgilayan tumorler (VIPomalar), en nadir gorulen tumor tiplerinden biridir. Bu yazida yorgunluk, halsizlik, sulanmis ishal ve dehidratasyon sikayetleri ile basvuran ve daha sonra bunun pankreas VIPoma'ya ikincil metastatik hastalik oldugu anlasilan 79 yasindaki bir kadin hasta sunuldu. Hekimlerin yaslilarda uzun sureli sulanmis ishalde serum vazoaktif intestinal peptid duzeylerini kontrol etmeleri onerilmektedir.

Methylphenidate is the first-choice medication for the Pervasive Developmental Disorders (PDDs), and comorbid Attention Deficit Hyperactivity Disorder (ADHD). But this approach generally results with poor outcomes, and increased adverse effects. It is aimed to investigate the comparison of cases who diagnosed with PDDs and Mild Mental Retardation (MR) and cases with pure ADHD in terms of the clinical response to MPH. Also we aimed to investigate the relations between CES-1 polymorphism gene and the clinical response to MPH.For clarifying this we searched for three polymorphisms (Arg199/His, Ser75/Asn, and Ile49/Val) in carboxylesterase-1 gene (CES-1) in the saliva of patients diagnosed with PDD+ADHD. Also, we assessed the clinical response to MPH by dimensional approach using the Attention Deficit Hyperactivity Disorder Rating Scale IV and Clinical Global Impression-Improvement scale.PDD+ADHD groups had significantly higher Arg199/His polymorphism, and clinically responded poorer with symptoms sometimes even worsening to the MPH treatment compared with "pure" ADHD and ADHD+MR groups.This is the first study that an association between Arg199/His polymorphism in CES1 and altered treatment response to MPH in patients with PDD that presents with symptoms of ADHD.

The aim of this study was to investigate the factors associated with the development of atrial fibrillation (AF) and to examine the impact of these factors for long-term outcome after cardiac resynchronization therapy (CRT).The effect of CRT on the development of new AF is under debate.Clinical assessment, 12-lead electrocardiogram, echocardiography with speckle tracking strain imaging, and device interrogation before implantation and every 6 months thereafter were performed regularly over a 5-year follow-up. The primary endpoint was new-onset AF. Pre-specified outcome events were transplantation, assist device implantation, and death.During follow-up, AF occurred in 29 of 106 patients. Parameters of left atrial (LA) mechanics including mitral annular (A') velocity, left atrial volume index (LAVI), LA ejection fraction, active emptying fraction, LA mean systolic strain (Ss) and late diastolic strain (Sa) improved at 6 months only in patients who remained free of AF. The change in LA Ss and Sa from baseline to 6 months after CRT had the highest accuracy to predict new-onset AF (area under the curve [AUC] = 0.793, 0.815, respectively, p 0.0001 for both vs. left ventricular [LV] reverse remodeling AUC = 0.531; p 0.01 for both). In addition, the change in LA Ss and Sa predicted outcome events independently from new-onset AF and LV volume response.LA functional improvement is essential for AF-free survival after CRT and is an independent predictor of AF-free survival. The improvement in LA Ss and Sa as a means of LA mechanical reserve also predicts long-term event-free survival after CRT independently from LV volume response and new-onset AF.