Search

Background To perform reliability and validity study of the Functional Index for Hand Osteoarthritis (FIHOA) in the Turkish language. Methods FIHOA was translated into Turkish following the principles of cross-cultural adaptation. Our translation was firstly tested in 40 patients with hand osteoarthritis. Adapted FIHOA questionnaire was then administrated to 100 hand OA patients successively with Modified Health Assessment Questionnaire (mHAQ), Numerical Rating Scale (NRS), and Short Form-36 (SF-36). Patients filled out the FIHOA questionnaire one more time after five days for test-retest assessment. Patients were divided into two groups as symptomatic or asymptomatic, with a NRS score of 5 or above defining symptomatic OA. Internal consistency was assessed by Cronbach's alpha and intraclass correlation coefficient (ICC) of test-retest reliability. Spearman correlation analysis was used to determine the correlation and validity between data. External construct validity was assessed using the correlation between FIHOA, mHAQ, hand pain NRS, and negative correlation with SF-36 subgroups. Results According to the total score, Cronbach-alpha was found as 0.90, while ICC was determined as 0.98 for test-retest reliability. When the correlations between the FIHOA questionnaire, mHAQ, and NRS questionnaires were examined, significant correlations were determined, and negative correlations between FIHOA and SF-36 subgroups were observed. Conclusion Turkish FIHOA is a reliable and valid method for assessing functionality in Turkish patients with hand osteoarthritis.

BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) can develop left ventricular (LV) systolic dysfunction and geometric changes due to several reasons. We investigated subclinical LV systolic dysfunction and structural features in patients with COPD, and its correlation with the severity of airway obstruction, identified by GOLD classification. METHODS We studied 52 patients with COPD and 29 age and sex-matched controls, without any cardiac disease. In addition to conventional echocardiographic evaluation speckle tracking echocardiography (STE) based strain imaging were performed to analyze sub-clinical LV systolic dysfunction. Also LV volumes were measured by using three dimensional real time echocardiography (3DRTE). All patients underwent spirometry. RESULTS Conventional echocardiographic parameters (LV wall thickness and diameters, LV EF) and LV volume measurements were similar between the groups. LV global longitudinal peak systolic strain (-14.76 ± 2.69% to -20.27 ± 1.41%, p

Post-earthquake observations have outlined the poor seismic performance of substandard reinforced concrete (RC) beam-column joints in existing buildings. They often exhibit significant cracking even under moderate intensity earthquakes, compromising the seismic performance of the entire building. This makes the quantification of their residual capacity and the definition of reliable repairability thresholds critical. Different approaches are available in the literature to establish the repairability of RC joints. However, a simple crack width-based criterion is required for practitioners during in-situ inspections. This study deals with the definition of crack width-based fragility curves relying on numerical analyses. Those are carried out by using the validated finite element (FE) models, being capable of reproducing the initiation and development of cracks in RC joints. To this end, the uncertainties in material properties, influencing the seismic performance of structural components, are accounted for different joints. In particular, experimentally validated FE models are evolved to stochastic level by generating random variables of material properties with the stratified sampling scheme. Fragility curves representing a certain level of probability of exceeding the defined crack width at the joint back, joint core, and beam-to-joint interface are developed. An application of the proposed methodology for in-situ inspections is also presented, and the results of in-situ measurements of residual crack width from real buildings damaged by recent earthquakes are used for the validation.

Aim To compare the muscle strength of muscle groups in axial spondyloarthritis (axSpA) patients with the muscle powers of healthy volunteers and to examine the relationship of muscle strengths with disease activity, functionality, and disability. Method One hundred males (50 axSpA, 50 healthy) were included in the study. Bath Disease Activity Index (BASDAI), Functional Index (BASFI), and Health Assessment Questionnaire-Disability Index (HAQ-DI) scores were recorded. The maximum (max) and mean cervical flexion, extension, lateral flexion (CF, CE, CLF), truncal flexion, extension (TF, TE), root joint flexion, extension, abduction, internal and external rotation (SF, SE, SAB, SIR and SER for the shoulder; HF, HE, HAB, HIR and HER for the hip) muscle strengths of the patients in both groups were measured by a handheld dynamometer. Total muscle strength (CT, TT, ST, HT) was found according to the sum of the max and mean values for each region. Results All muscle strengths were lower in the axSpA group compared to the healthy volunteers. The symptom duration was found to have a weak-moderate negative correlation with CT, TT, ST, HT and all individual muscle strengths except for the TE, CF, HIR, and HER. BASDAI and HAQ-DI had weak-moderate negative correlations with HIR and HER. BASFI had a weak-moderate negative correlation with cervical measurements, TE, TF, SF, SER, SIR, and hip measurements. Conclusion All muscle strengths were lower in patients compared to healthy volunteers. Strengthening specific muscle groups for the desired goal can be a reasonable strategy. The study is prospectively registered and available at www.clinicaltrials.gov (NCT04435860).

Drawing on a comprehensive panel data of 137 low income and developing countries, this study queries the macro-economic drivers of Public Private Partnership (PPP) in these countries. PPP is mainly used as a method to address infrastructure needs of nation states which cannot allocate their financial resources towards infrastructure investments and/or cannot secure finance through other instruments. Previous studies in the field remain partial as they included a limited number of macro-economic factors and a smaller number of countries. Our findings suggest that general government balance, population size, money supply and the share of investments in GDP are significant determinants of PPP activity.

[No abstarct]

Purpose: The aim of this study was to compare the reliability of scoring methods in determining critical geriatric patients in the emergency department. Materials and Methods: This prospective study included patients aged over 65 who presented to the emergency department between 15 October 2014 and 15 November 2014. APACHE II (Acute Physiology and Chronic Health Evaluation II), REMS (Rapid Emergency Medicine Score), HOTEL (Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence), VIEWS (Vital PAC Early Warning Score) and VIEWS-L (Vital PAC Early Warning Score with Lactate Level) were evaluated. Results: Of the 244 patients included in the study, the mean age of survivors was 75.69 ± 6.96 years, and the mean age of the mortal cases was 80.47 ± 6.63 years, 139 (57%) women. It was found that 30 (12.3%) of the patients included in the study died. The risk scores of the patients hospitalized in the intensive care unit were higher than those who were discharged or hospitalized. All risk scores in the mortality group were found to be significantly higher than the other patient groups. Conclusion: The study showed that risk scoring systems can be used safely in the evaluation of geriatric patients in the emergency department, to predict mortality and to select critically ill patients.

As the use of digital tools and the Internet becomes widespread and easier, the age of use is also decreasing. The decrease in the age of use makes opportunities as well as risks an important factor in digital environments. Children who are not aware of the risks in these environments may be exposed to various risks, especially as the age of Internet usage decreases. Parents are primarily responsible for protecting their children from risks in these environments. Parents can protect their children if they use digital media consciously and safely. In this context, the aim of this study is to investigate the parent’s conscious and safe use of the Internet across Turkey. In accordance with this purpose, the study was designed as a survey study and the data of the study were collected from 9581 parents from 26 provinces with the Conscious and Safe Use of the Internet questionnaire developed by the researchers in the study. Descriptive statistics (%, f, X ̅, SS), t-test for independent samples, one-way analysis of variance (ANOVA), and correlation were used in the analysis of the data. As a result of the analysis of the data, it was determined that the parents’ use of the Internet on weekdays and weekends was similar, but this situation differed in children. It has also been determined that the leading situations that worry parents in digital environments are the harmful and illegal content and excessive time spent in these harmful and illegal environments.

Introduction The reliability of the information on the Internet, which people use as an easy and practical solution about diseases, is essential for public health. Our aim in this study is to evaluate the quality and readability of websites related to myofascial pain syndrome. Methods On April 4, 2020, websites were searched on the Google search engine using the term “myofascial pain syndrome”. The typologies, quality, readability, and content parameters of the sites were analyzed. Websites were divided into eight categories according to typology. To evaluate the quality, we evaluated the websites according to the JAMA scoring system or a HONcode certificate existence. Flesch-Kincaid grade and the Simple Measure of Gobbledygook was used to evaluate readability. Content analysis was performed for etiology, symptoms, diagnosis, and treatment. Results 56 of the 151 websites evaluated were classified as high-quality websites. It was determined that the quality scores of scientific publications and professional websites were high. Comparing the readability parameters of the websites in terms of quality, there was no significant difference between high-quality websites and low-quality websites (p = 0.391 and 0.746 respectively). The content was focused on etiology on scientific websites, while on commercial and professional websites, the content was focused on treatment. Conclusion High-quality websites did not offer an advantage in readability parameters. These results show that online information about MPS should be questioned and more extensive studies are required.

Objective: Internet usage for obtaining health-related information is widely popular among patients. However, there are still concerns about the reliability and comprehensibility of online information. The purpose of this study is to investigate the reliability and readability of osteoporosis-related websites. Materials and methods: On April 2, 2020, we searched the term “osteoporosis” on Google (https://www.google.com). We evaluated the first 200 uniform resource locators (URLs) in the query results regarding typology, the Journal of the American Medical Association (JAMA) scores, Health on the Net Foundation Code of conduct (HONcode) certification, Flesch–Kincaid Grade (FKG), and Simple Measure of Gobbledygook (SMOG) scores. The JAMA scoring system and HONcode stamp were used for assessing the reliability, whereas FKG and SMOG scores were used to assess the readability of online information. Results: Of the 151 analyzed websites, 57 (37.7%) were classified as highly reliable, and 19 (12.6%) were assigned with HONcode certification. The average FKG scores (8.81 ± 2.21) and SMOG scores (7.63 ± 1.81) were below the recommended grade, which is considered as easily readable. High reliable information was found to have higher readability scores, thereby representing the difficulty of readability. We observed a weak correlation between the increased reliability of information and decreased readability. Conclusion: Osteoporosis-related content on the internet generally has low reliability. High-reliable information is available online in scientific published materials, health portals, and news. Although the readability of the overall material is acceptable, the high-reliable websites still require high literacy and comprehension skills. Arch Endocrinol Metab. 2021;65(1):85-92

Objective: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality worldwide and statins are frequently prescribed in the treatment of CAD to help lower blood cholesterol levels. Since the main enzyme involved in the metabolism of statins is CYP3A4, we aimed to investigate the effect of CYP3A4 * 1B genotypes on plasma lipid profile in Turkish cardiovascular disease subjects with and without obesity taking statin. Materials and Methods: The study group consisted of 85 cardiovascular disease patients who were prescribed statins and had routine biochemical analysis data. Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) assay was performed for genotyping of CYP3A4 *1B (rs2740574) polymorphism. Results: Genotype distribution of CYP3A4 *1B polymorphism was found for homozygous wild (AA) and homozygous polymorphic (GG) genotypes as 94.1% and 5.9%, respectively. We did not detect patients with heterozygous genotype in our study group. We found that the mean LDL-c, TG and TC levels were higher in patients with CYP3A4 *1B GG compared to the AA genotype. The frequency of CYP3A4 *1B GG genotype frequency (9.5%) was detected higher in the obese patients compared to the non-obese patients (7.7%) (χ2=0.037, p=0.85). Conclusions: Our results demonstrate that CYP3A4 *1B homozygous polymorphic genotype distribution tends to be higher in obese patients compared to non-obese patients with cardiovascular disease which may point to *1B allele having a slight effect on serum lipids during statin therapy. Additional studies with higher samples are needed for evaluating the role of CYP3A4 *1B on lipids in patients under statin therapy.

This study aimed to detect patients’ characteristics who suffered severe and critical COVID-19 pneumonia admitted to the post-acute COVID-19 rehabilitation clinic in Ankara City Hospital, Physical Medicine and Rehabilitation Hospital and to share our experiences and outcomes of rehabilitation programmes applied. This study was designed as a single-centre, retrospective, observational study. Severe and critical COVID-19 patients, admitted to the post-acute COVID-19 rehabilitation clinic, were included in patient-based rehabilitation programmes, targeting neuromuscular and respiratory recovery. Functional status, oxygen (O2) requirement and daily living activities were assessed before and after rehabilitation. Eighty-five patients, of which 74% were male, were analysed, with the mean age of 58.27 ± 11.13 and mean body mass index of 25.29 ± 4.81 kg/m2. The most prevalent comorbidities were hypertension (49.4%) and diabetes mellitus (34.1%). Of the 85 patients, 84 received antiviral drugs, 81 low-molecular-weight heparin, 71 corticosteroids, 11 anakinra, 4 tocilizumab, 16 intravenous immunoglobulin and 6 plasmapheresis. 78.8% of the patients were admitted to the intensive care unit, with a mean length of stay of 19.41 ± 18.99 days, while those who needed O2 support with mechanic ventilation was 36.1%. Neurological complications, including Guillain–Barre syndrome, critical illness-related myopathy/neuropathy, cerebrovascular disease and steroid myopathy, were observed in 39 patients. On initial functional statuses, 55.3% were bedridden, 22.4% in wheelchair level and 20% mobilised with O2 support. After rehabilitation, these ratios were 2.4%, 4.7% and 8.2%, respectively. During admission, 71 (83.5%) patients required O2 support, but decreased to 7 (8.2%) post-rehabilitation. Barthel Index improved statistically from 44.82 ± 27.31 to 88.47 ± 17.56. Patient-based modulated rehabilitation programmes are highly effective in severe and critical COVID-19 complications, providing satisfactory well-being in daily living activities.

Objective: In this study, the aim was to investigate the incidence of intestinal parasites in children, demographic features related to parasite positivity, life style features and accompanying symptoms. Materials and Methods: Fecal samples from 342 children (49.1% girls, 50.9% boys) attending with different symptoms were investigated with native, lugol, trichrome, acid fast, sedimentation and cellophane anal band methods for parasite diagnosis. Results: All cases, 29% were preschool age of 1-5 years, 45.6% were 6-10 years and 25.4% were 11-18 years old. The incidence of intestinal parasites was 51.2% with the most commonly observed parasites identified as Cryptosporidium spp. (41.1%), Blastocystis spp. (40.6%), and Enterobius vermicularis (21.1%). Settlement area was determined to be a lifestyle feature significant for parasite positivity (p

Bu çalışmada; cerrahi kliniğine getirilen buzağılarda tespit edilen cerrahi hastalıkların genel olarak bir değerlendirilmesi yapıldı. Çalışma materyalini yaşları 1 gün ile 7 ay arasında değişen farklı ırk ve cinsiyette toplam 350 adet buzağı oluşturdu.Hastalar ırklara göre değerlendirildiğinde Simmental 179 adet (%51.14), Montofon 151 adet (%43.14), yerli 8 adet (%2.29), Holstein 6 adet (%1.71), Şarole 4 adet (%1.14) ve diğer ırk buzağılar 2 adet (%0.58) olarak tespit edildi. Vakaların 227’sini (%64.86) erkek, 123’ünü (%35.14) ise dişi buzağılar oluşturdu.Toplam 350 vaka cerrahi hastalıklar yönünden değerlendirildiğinde göbek bölgesi lezyonuna sahip buzağılar (omfalitis, omfaloflebitis, omfaloarteritis, hernia umbilikalis, göbek apsesi, urakus fistülü, evantratio umbilikalis) 100 adet (%28.57), artritis 80 adet (%22.86), kırık olguları 54 adet (%15.43), iskelet sistemi (kemik, bağ, kas, tendo) doku travması 33 adet (%9.43), kongenital intestinal anomali 32 adet (%9.14), arqure-bouleture 16 adet (%4.57), angular deformite 7 adet (%2), idrar yolu problemi 7 adet (%2), luksasyon 5 adet (%1.43), parapleji 4 adet (%1.14), bursitis 3 adet (%0.86), prolapsus rekti 2 adet (%0.57), kist dermoid 2 adet (%0.57), palatoşizis 2 adet (%0.57) ve diğer hastalıklar 3 adet (%0.86) olarak tespit edildi.Sonuç olarak hastalıklar yönünden bir değerlendirme yapıldığında sırasıyla göbek bölgesi lezyonları, artrit, kırık olguları, iskelet sistemi (kemik, bağ, kas, tendo) doku travmaları, intestinal anomali ve arqure-bouleture olguları buzağılarda en çok görülen hastalıklar olarak belirlendi., In this study; a general evaluation of surgical diseases detected in calves brought to the surgery clinic was made. A total of 350 calves of different breed, gender and aged between 1 day and 7 months, formed the study material. The cases according to breeds were evaluated Simmental 179 (51.14%), Montofon 151 (43.14%), Domestic breeds 8 (2.29%), Holstein 6 (1.71%), Charole 4 (1.14%) and other calves 2 ( 0.58%). Of the cases that came to the clinic, 227 (64.86%) male and 123 (35.14%) female calves were constituted. When a total of 350 cases were evaluated in terms of surgical diseases, calves with umbilical lesions (omphalitis, omphalophlebitis, omphaloarteritis, hernia umbilicalis, umbilical abscess, uracus fistula, evantratio umbilicalis) 100 (28.57%), arthritis 80 (22.86%), fracture cases 54 (15.43%), skeletal system (bone, ligament, muscle, tendo) tissue trauma 33 (9.43%), congenital intestinal anomaly 32 (9.14%), arqure-bouleture 16 (4.57%), angular deformity 7 ( 2%), urinary tract problems 7 (2%), luxation 5 (1.43%), paraplegia 4 (1.14%), bursitis 3 (0.86%), prolapse recti 2 (0.57%), cyst dermoid 2 (0.57%) palatoschisis, 2 (0.57%) and 3 other diseases (0.86%).As a result, when an evaluation was made in terms of diseases, umbilical region lesions, arthritis, fracture cases, skeletal system (bone, ligament, muscle, tendo) tissue trauma, intestinal anomaly and arqure bouleture cases were determined as the most common diseases in calves.

Rationale: obstructive sleep apnea (OSA) may contribute to poor outcomes in adults with Coronavirus Disease 2019 (COVID-19). Objective: to determine the effect of OSA on clinical outcomes in patients with COVID-19. Methods: the current prospective observational study was conducted in three hospitals in Istanbul, Turkey from March 10 to June 22, 2020. The participants were categorized as modified high-risk (mHR), or low-risk (mLR)-OSA according to a modified version of the Berlin questionnaire. Snoring patterns (intensity and/or frequency), breathing pauses and morning/daytime sleepiness, without taking obesity and hypertension into account, were used in the regression models. Results: the primary outcome was clinical improvement defined as a decline of 2 categories from admission on a 7-category ordinal scale. Secondary outcomes included worsening (increase of 1 category), need for hospitalization, supplemental oxygen and intensive care. In total, 320 eligible patients were enrolled. According to the modified scoring, 70 (21.9%) had mHR-OSA. Among 242 patients requiring hospitalization, clinical improvement within 2 weeks occurred in 75.4 % of the mHR-OSA group compared to 88.4 % of the modified low-risk (mLR-OSA) group (P = 0.014). In multivariate regression analyses, mHR-OSA (adjusted OR 0.42; 95% CI 0.19-0.92) predicted the delayed clinical improvement. In the entire study population (n=320), mHR-OSA was associated with clinical worsening and need for supplemental oxygen. Snoring patterns, especially louder snoring, were significantly predicted delayed clinical improvement, worsening, need for hospitalization, supplemental oxygen, and intensive care. Conclusions: adults with mHR-OSA in our Covid-19 cohort had poorer clinical outcomes than those with mLR OSA independent of age, sex and comorbidities., NA

Introduction: We hypothesized that latent MTrPs might decrease gluteus medius muscle strength in healthy individuals. This study aimed to investigate the relationship between latent MTrPs and gluteus medius muscle strength in a group of healthy adults.Methods: Forty-eight healthy men were included in the study. Trigger point examination for the gluteus medius was performed bilaterally. Subjects with one or more trigger points on the dominant side and those without any trigger point were assigned to two groups. Muscle strength for the gluteus medius was assessed with a manual muscle tester using the "break test" technique on both sides. For statistical analysis, the independent sample t-test was used to compare the intergroup differences.Results: The latent MTrP group demonstrated lower abduction muscle strength in the dominant gluteus medius. Moreover, the latent MTrP group showed higher abduction muscle strength in the non -dominant gluteus medius (p < 0.05). Intergroup comparison revealed that gluteus medius abduction muscle strength on the dominant side was higher in the non-latent MTrP group (p < 0.05).Conclusion: Latent MTrP may cause joint movement limitation, overload by affecting motor activation patterns and reciprocal inhibition mechanisms. Outcomes of the current study revealed that gluteus medius abduction strength values below 9.7 kg could be associated with latent MTrP with high sensi-tivity and low specificity. It is imperative to note that the latent MTrP of gluteus medius muscle, which has a critical role in the lumbopelvic junction, should not be ignored in clinical practice, and treatment should be applied when detected. (c) 2021 Elsevier Ltd. All rights reserved.

Introduction Rheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies. Methods A multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry. Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups. Results The study included a total of 565 patients. The mean age was 53.7 +/- 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05). Conclusions The groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment. Turkish Medicine and Medical Devices Agency ; Ankara Numune Egitim ve Arastirma Hastanesi

It is assumed that in candidates for TNF-alpha inhibitor (TNFi) treatment, tuberculin skin test (TST) may be unreliable, since BCG vaccination causes false positive and drugs cause false negative results, favoring the use of Quantiferon or T-spot assays. However, these tests may not be readily available in all parts of the world. We aimed to determine the reliability of TST with respect to BCG vaccination and drugs in candidates for TNFi treatment, and how isoniazid is tolerated, assuming that the use of TST would result in increased isoniazid use. We included 1031 adult patients who were prescribed a TNFi for the first time. We analysed the association of BCG and drugs with TST and Quantiferon results, the determinants of a positive TST, and evaluated the tolerability of isoniazid. BCG vaccination and male sex were associated with positive TST (OR 3.56, 95% CI 1.98-6.41 and OR 2.54, 95% CI 1.75-3.68, respectively), while prednisolone and azathioprine were associated with negative TST (OR 0.63, 95% CI 0.43-0.91 and OR 0.40, 95% CI 0.11-0.76). Isoniazid was prescribed to 684 (66.3%) patients and had to be discontinued in 12.2% of these before 9 months, most commonly due to hepatotoxicity (44%). One patient developed tuberculosis despite isoniazid use. BCG vaccination may be associated with false positive TST, despite a long time since vaccination in candidates for TNFi treatment. Prednisolone and azathioprine use were associated with negative TST. Despite the high frequency of isoniazid use associated with using TST instead of QTF, isoniazid was generally well tolerated.

In this study; the diagnosis, treatment method and results of calves brought to Sivas Cumhuriyet University Veterinary Faculty Surgery Clinic with a complaint of umbilical lesion between 2017-2020 were evaluated retrospectively. The material of the study consisted of 100 calves (28.57%) of different breeds, ages and genders, with umbilical lesions from 350 calves brought to the surgery clinic between 2017 and 2020 due to various complaints. 64 (64%) of the calves with umbilical lesions were male and 36 (36%) were female. Umbilical lesions are evaluated according to breeds Simmental breed calves 55 (55%), Brown-Swiss 38 (38%), Holstein 2 (2%), Charolaise 2 (2%), Domestic 2 (2%) and Angus 1 (1%). The distribution of umbilical lesions according to the cases was diagnosed as 35 (35%) omphalophlebitis, 25 (25%) hernia umbilicalis, 17 (17%) omphalitis, 9 (9%) omphalophlebitis with omphaloarteritis, 6 (6%) omphaloarteritis, 4 umbilical abscesses (4%), 2 uracus fistulas (2%) and 2 evantratio umbilicalis were determined. In omphalitis (omphalophlebitis, omphaloarteritis) cases, umbilical cord thickening was measured as 0.5-3 cm in 64 cases and 4 cm in 3 cases. Open herniorrhaphy was performed in 19 cases with an average diameter of 2.8 cm, and hernioplasty in 6 cases with a diameter of 8.25 cm. As a result; it was concluded that the animals can survive for a long time with early diagnosis and early surgical treatment of umbilical lesions that cause significant economic losses in newborn calves., Bu çalışmada; 2017-2020 yılları arası Sivas Cumhuriyet Üniversitesi Veteriner Fakültesi Cerrahi Kliniğine göbek lezyonu şikâyeti ile getirilen buzağıların tanı, uygulanan tedavi şekli ve sonuçları retrospektif olarak değerlendirildi. Çalışmanın materyalini çeşitli şikayetlere bağlı olarak getirilen toplam 350 adet buzağıdan göbek bölgesi lezyonu tespit edilen farklı ırk, yaş ve cinsiyette 100 adet (%28.57) buzağı oluşturdu. Göbek lezyonlu buzağıların 64’nü (%64) erkek, 36’sını (%36) dişiler oluşturdu. Göbek bölgesi lezyonu tespit edilen buzağılar ırklara göre değerlendirildiğinde Simmental ırkı 55 (%55), Montofon ırkı 38 (%38), Holstein ırkı 2 (%2), Şarole ırkı 2 adet (%2), Yerli ırk 2 (%2) ve Angus ırkı 1 adet (%1) olarak tespit edildi. Göbek lezyonlu buzağıların olgulara göre dağılımlarını sırasıyla 35 adet (%35) omfaloflebitis, 25 adet (%25) hernia umbilikalis, 17 adet (%17) omfalitis, 9 adet (%9) omfaloflebitis+omfaloarteritis, 6 adet (%6) omfaloarteritis, 4 adet (%4) göbek apsesi, 2 adet (%2) urakus fistülü ve 2 adet (%2) evantratio umbilikalisin oluşturduğu belirlendi. Omfalitis (omfaloflebitis, omfaloarteritis) olgularında göbek kordonu kalınlaşmaları 64 olguda 0.5-3 cm, 3 olguda ise 4 cm olarak ölçüldü. Fıtık defekt genişliği ortalama 2.8 cm çapında olan 19 olguya açık herniyorafi, 8.25 cm çapında olan 6 olguya ise herniyoplasti yapıldı. Sonuç olarak; yeni doğan buzağılarda önemli ekonomik kayıplara neden olan göbek lezyonlarının erken tanı ve erken cerrahi sağaltım yöntemleri ile ekonomik kayıpların önüne geçilebileceği kanısına varılmıştır.

In this study, the prevalence of Cyclospora cayetanensis and Cryptosporidium spp. were researched in children with parasitological investigations requested for a variety of reasons, regardless of immune status. The stool samples of 1057 pediatric patients with parasitological evaluation requested for a variety of reasons within two years were investigated under a microscopy using native-lugol, sedimentation and modified Kinyouns acid-fast stain methods. The mean age of the 1057 pediatric patients participating in the research were 8.07±4.32 years, 11.4% were identified to have coccidian parasites (Cyclospora cayetanensis and Cryptosporidium spp.). Evaluation according to age group found the majority of children positive for Cryptosporidium spp. were in the 6-12 year interval. These parasites were observed more frequently in the spring and summer seasons compared to other seasons. There was a significant correlation between parasite positivity and spring and summer seasons (p [Med-Science 2021; 10(2.000): 338-45]

PURPOSE OF REVIEW: The purpose of this review is to evaluate the risk of intraoperative aerosol viral transmission and the impact of updated COVID-19 guidelines on minimally invasive surgery (MIS) in Austria. RECENT FINDINGS: The current literature does not support the risk of intraoperative viral transmission nor does it suggest a harm of minimally invasive procedures in the context of the COVID-19 pandemic. However, medical societies mostly adopted a precautionary approach with a focus on protective measures. Austrian surgeons considered MIS safe during the pandemic and Austria managed to keep the initial outbreak in control. Yet, MIS programs were still affected due to the postponements of elective procedures and switches to other methods by some surgeons. SUMMARY: The postponement and cancellation of MIS caused complexities in health-care delivery in Austria, whilst the evidence to substantiate this precautionary approach is missing. It must be noted, both the guidelines and our review are limited by the scarcity of evidence. In further consequence, regional factors should be considered while taking precautions. Specific studies on the severe acute respiratory syndrome coronavirus type 2 transmission risk during MIS are urgently needed.

Günümüzde işletmeler rakiplerinden farklılaşmak için daha fazla çaba harcamaya başlamıştır. İşletmelerin rakiplerinden farklı olabilmesi ve kimliklerini yansıtabilmeleri; markalar aracılığıyla gerçekleşmektedir. Amaca yönelik pazarlama ve sponsorluk faaliyetleri; markayı rakiplerinden farklılaştırmakta, markaya ilişkin olumlu çağrışımlar yaratabilmekte, hedef kitlenin zihninde yüksek kaliteli ürünlerle yer etmesini sağlamakta ve tüketiciyle duygusal bağ kurarak markaya olan bağlılığı arttırmakta etkili olan pazarlama araçlarıdır. Bu çalışmanın amacı, amaca yönelik pazarlama ve sponsorluk faaliyetleriyle desteklenen marka değerinin tüketicilerin satın alma niyetleri üzerindeki etkisini belirlemektir. Çalışmanın amacı doğrultusunda; Kütahya Dumlupınar Üniversitesi İktisadi ve İdari Bilimler Fakültesinde yüz yüze anket yöntemiyle 339 öğrenciden toplanan verilerle yapılan regresyon analizi sonucunda; amaca yönelik pazarlama ve sponsorluk faaliyetlerinde bulunan işletmelerin marka değerine ilişkin tüketici algılarının satın alma niyetine etkisi açıklanmıştır. Sponsorluk uygulamalarının amaca yönelik pazarlamaya göre, marka değeri üzerinde daha etkili olduğu belirlenmiştir. İlaveten, işletmelerin amaca yönelik pazarlama faaliyetlerinin kısa süreli satışları ve markanın tercih edilmesini arttırma da başarılı olduğu tespit edilmiştir.

This study presents an investigation of the seismic performance of a historical masonry minaret which was built in the 12th century in Bayburt. The minaret was built as masonry with regional stones and handmade bricks. The most important feature of the minaret is its longitudinally conical geometry. An experimental investigation was made to obtain the mechanical properties of the regional stone used in the historical minaret. A three-dimensional Finite Element Model of the historical minaret was created in SAP2000. Three earthquake ground motions such as Erzincan, Kocaeli-Duzce, and Van-Ercis were used to investigate the seismic performance of the historical minaret. The results show that Erzincan, Kocaeli-Duzce and Van-Ercis earthquakes may cause some damages in the same zone of the minaret body since the tensile stresses occurred due to the earthquakes exceed the limit tensile stress of the masonry brick. The use of the data obtained from the experimental investigation of the Bayburt yellow stone in the analysis is important for the reliability of the results.

The purpose of this study was to develop a mobile learning acceptance model for pre-service teachers and to examine the relationships among technology acceptance factors. The literature on mobile learning acceptance lacks studies on pre-service teachers and studies that include concrete mobile learning scenarios. To overcome these problems, we have developed and implemented a mobile-technology-enabled information technology course. The data collection and analysis were conducted in two separate studies. First, we developed a mobile learning acceptance scale and applied confirmatory factor analysis with 408 participants. The final instrument included 28 items measuring eight technology acceptance factors, namely behavioral intention, attitude towards use, perceived usefulness, perceived ease of use, social influence, facilitating conditions, self-efficacy, and anxiety. After this, we collected a new set of data from 316 participants to examine the relationships among the factors using structural equation modeling. In both studies, we investigated the respective models’ invariance across gender and discipline groups, and both models fulfilled invariance requirements. The results indicated that perceived ease of use and social influence have direct effects on behavioral intention, whereas self-efficacy has an indirect effect. Depending on the group, the explained variance of behavioral intention ranged between 18.1% and 60.6%.

Objective:The purpose of this study is to determine the effect of latent strabismus on stereoacuity.Methods:Stereoacuities of normal individuals, ranging in age from 18 to 35 years, were measured using the TNO or Titmus tests. The study population was divided into 2 groups regarding the achievement of the accepted excellent stereoacuity threshold of 30 arcseconds (group A) or not (group B). The relationship between latent deviation angles and stereoacuity levels were evaluated.Results:Latent deviation angles ranged from 0 to 35 prism diopters (PD). Both TNO (r=0.380 p=0.002) and Titmus (r=0.306 p=0.015) stereothresholds tended to increase as the latent deviation angles increased. Group A included 27 participants who had either exophoria (18) or orthophoria (9), and the mean deviation angle of this group was 3.07±3.26 PD. Group B included 36 participants, 28 of whom had exophoria, three had esophoria, and the remaining five had orthophoria. The mean angle of deviation in group B was 6.50±6.92 PD. This value was statistically higher than the mean deviation angle in group A (p=0.012). Though none of the esophoric participants achieved excellent stereoacuity, the distribution of the deviation types did not cause any difference between the groups (p=0.077). The mean age of group A was found to be higher than that of group B (p=0.006).Conclusion:Latent deviation can mask true stereosensitivity potentials of subjects to some extent during the stereotesting procedure.

Objective: Currently, concerning the evaluation of psoriatic arthritis (PsA), there is no agreement on a standardized composite index for disease activity that includes all relevant domains. The present study sought to assess the rates of remission (REM)/low disease activity (LDA) and disease states [minimal disease activity (MDA), very low disease activity (VLDA)] as defined by diverse activity scales (DAPSA, DAS28-ESR) in an attempt to display discrepancies across these assessment tools for peripheral PsA. Methods: The study involved 758 patients (496 females, 262 males; mean age 47,1 years) with peripheral PsA who were registered to the Turkish League Against Rheumatism (TLAR) Network. The patients were assessed using the DAS28-ESR, DAPSA, MDA, and VLDA. The overall yield of each scale was assessed in identifying REM and LDA. The presence or absence of swollen joints was separately analysed. Results: The median disease duration was 4 years (range 0-44 years). According to DAPSA and DAS28-ESR, REM was achieved in 6.9% and 19.5% of the patients, respectively. The rates of MDA and VLDA were 16% and 2.9%, respectively. Despite the absence of swollen joints, a significant portion of patients were not considered to be in REM (296 (39.1%) patients with DAS28-ESR, 364 (48%) with DAPSA, and 394 (52%) with VLDA). Conclusion: Patients with peripheral PsA may be assigned to diverse disease activity levels when assessed with the DAS28-ESR, DAPSA, MDA and VLDA, which would inevitably have clinical implications. In patients with PsA a holistic approach seems to be necessary which includes other domains apart from joint involvement, such as skin involvement, enthesitis, spinal involvement, and patient-reported outcomes. © 2021 Société française de rhumatologie

Inclusive business, which is a concept that is attracting increasing attention, aims to provide goods, services or livelihoods in a scalable way by enabling people living at the bottom of the economic pyramid to take part in the value chain of the company's core business. This study aims to investigate private sector’s level of engagement in inclusive business, the changes put forward in the supply chains of the companies which implemented these models and the relationship between inclusiveness and business model innovation. According to the results of the survey research, there is still a lack of interest and/or awareness regarding inclusive business among Turkish companies, particularly in terms of including the low income producers in the supply chain as suppliers. On the other hand, the research also shows that there is a strong relationship between supply chain innovativeness and inclusiveness, as well as company’s future intentions to engage in inclusive business. Considering these findings, this study argues that developing the innovativeness capabilities of companies not only in terms of their products and services, but also their business models has the potential to increase companies’ adoption of inclusive business. Giderek daha fazla ilgi çeken bir kavram olan kapsayıcı işletmeler, ekonomik piramidin en alt katmanında yer alan bireylerin, şirketin ana iş kolunun değer zincirinde görev alması yoluyla, onlara ölçeklenebilir bir şekilde mal, hizmet veya geçim kaynağı sağlamayı amaçlamaktadır. Bu çalışma, özel sektörün kapsayıcı işlere katılım düzeyini, bu modelleri uygulayan şirketlerin tedarik zincirlerinde ortaya konan değişiklikleri ve kapsayıcılık ile iş modeli inovasyonu arasındaki ilişkiyi incelemeyi amaçlamaktadır.Anket araştırmasının sonuçlarına göre, özellikle düşük gelirli üreticilerin tedarik zincirine dahil edilmesi açısından, Türk şirketleri arasında kapsayıcı faaliyetler konusunda halen ilgi ve/veya farkındalık eksikliği söz konusudur. Öte yandan, araştırma aynı zamanda tedarik zinciri yenilikçiliği ile kapsayıcılık ve şirketin kapsayıcı bir işe girme konusundaki gelecek niyetleri arasında güçlü bir ilişki olduğunu göstermektedir. Bu bulgular göz önüne alındığında bu çalışma, şirketlerin ürün ve hizmet yenilikçiliğinin yanı sıra iş modelli yenilikçiliği becerilerini de geliştirmelerinin kapsayıcı iş modellerini benimseme düzeylerini artırma potansiyeline sahip olduğunu öne sürmektedir.

Background: Every working woman has the right to continue to live as a healthy individual. The working environment has important effects on the general health status and reproductive health of women. If menopause period of women is not taken into consideration and if appropriate arrangements are not made at workplaces, their work performance and productivity decrease. It is important to have detailed knowledge about factors creating risk for health in order to develop effective policies and programs directed towards preventing them. Objective: This study was performed to determine the perceived effects of menopause on work life and attitudes of an institution towards menopausal women. Methods: The study population included 419 women aged 45-55 years and working at a university. Out of 419 women, 291 could be contacted. Data were collected with a questionnaire composed of questions about descriptive characteristics, effects of menopause on work life, and support from and attitudes of the institution about menopause. Data collected to reveal menopausal women’s experiences at work were analyzed with statistical methods frequency, percentages, and mean. Results: The mean age at which menopause started was 47 years and 89.7% of the women experienced menopausal complaints. Conclusions: Physical conditions at work and stressors were found to increase menopausal complaints and had a negative effect on work performance.

Background and Study Aim. The purpose of this study was to examine the effect of metabolic stress created by 6-week football training applied in the pre-season period on circulation and hematological parameters of well-trained male football players. Material and Methods. Fourteen male football players who competed in the U19 category of a football team in Turkish Football Super League participated in the study voluntarily. In the study, players’ systolic - diastolic blood pressures and resting heart rates were measured and their blood samples were taken before and after the 6-week training period. Laboratory analysis was made to determine counts and concentration percentage of erythrocyte, leukocyte, and platelet sub-parameters. Wilcoxon Signed-Rank test was performed to determine the difference between pre and post measurements. Results. Our findings indicated that baseline mean values of lymphocyte, mean cell hemoglobin, and mean corpuscular hemoglobin concentration were significantly higher than posttest mean values. The mean of diastolic blood pressure and resting heart rate measured before the preseason training camp were lower than their posttest mean values (p > .05). Conclusion. It is thought that the decrease in the mean values of diastolic blood pressure and resting heart rate caused by the effect of regular training during the preseason training period, while the increase in the mean values of mean cell haemoglobin and mean corpuscular haemoglobin concentration caused by the increased oxygen demand of the metabolism during the training period.

Objectives This study aims to evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in carpal tunnel syndrome (CTS) compared to the wrist splint treatment. Patients and methods Between April 2016 and March 2017, a total of 189 patients (22 males, 167 females, mean age 48.8±9.5 years, range, 24 to 70 years) with mild-to-moderate CTS were included in this double-blind, prospective, randomized, placebo-controlled study. The patients were divided into four treatment groups using stratified randomization: splint group (Group 1, n=47), splint+ESWT (Group 2, n=47), ESWT (Group 3, n=45), and splint+placebo ESWT (Group 4, n=50). All patients were evaluated at baseline, and one and three months. Pain using the Visual Analog Scale (VAS), finger pinch strength, Boston Carpal Tunnel Questionnaire (BCTQ), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), and electrophysiological examination were assessed. Results A total of 168 patients completed the study. There was no significant difference among the four groups in terms of age, sex, comorbid diseases, symptom duration, VAS-pain, BCTQ, and LANSS scores (p>0.05). Pain and functionality significantly improved in all groups (p

This paper addresses the establishment of the Red Crescent, an equivalent of the Red Cross, in the Ottoman Empire in 1868 through the founding of 'the Society of Care and Aid for Wounded and Disabled Soldiers' (Mecrȗhȋnve Marzȃ-yi Askeriyeye İmdad ve Muavenet Cemiyeti). Following initial slow development, the Society was revitalized in April 1877 in preparation for war with Russia. Importantly, the 1877-1878 Ottoman-Russian conflict was the first major war conducted by signatories of the 1864 First Geneva Convention, which made provisions for the treatment of wounded and sick soldiers and protection for those providing care. Although both the Ottoman Empire and Russia were signatories, major issues remained to be resolved in practice and the heat of conflict. One of the unresolved issues was international and Russian recognition of a red crescent on a white background as a sign of neutrality, in addition to a red cross. An interim agreement was signed between the two sides with international support. Full international approval of the red crescent symbol took much longer and was only confirmed at the ninth Red Cross Conference in Washington in 1912, 35 years later. Today, the red crescent represents all majority Muslim countries' aid institutions.

Aim: Our aim was to examine the effect of CYP2C9 and VKORC1 polymorphisms on warfarin dose requirements in Turkish patients. Materials & methods: 24 warfarin prescribed patients were included and analyzed for eight VKORC1 and 6 CYP2C9 polymorphisms in the study. Results: Patients with CYP2C9 *1/*1 and VKORC1 -1639 GG and GA genotypes required higher warfarin doses in comparison to wild type VKORC1 genotype. Patients with CYP2C9 *1/*3 and VKORC1 -1639 GG genotypes simultaneously, required the lowest dose of warfarin (4.64 mg/day). Patients with CYP2C9 *1/*1 and VKORC1 9041 AA genotype were found to require higher warfarin doses. Conclusion: Our results provide additional evidence to support the hypothesis that CYP2C9 *2, *3, VKORC1 9041 G > A polymorphisms explain considerable proportion of inter-individual variability in warfarin dose requirement.

Background and Study Aim. ln this academic research, it was aimed to compare the physical activity and skinfold thickness of the students living in the city center and rural areas. Material and Methods. 89 students attending the 6th grade level, whose total age is 12 years old, residing in the city center and rural areas of Çanakkale participated in the study. Students were examined with SenseWear armband bmi, total energy consumption, daily step count, met, active energy consumption, physical activity time, reach time and sleep times. Body mass index was determined with Holtain Skinfold Caliper. For the analysis of the dataset, the Independent Sample t test was utilized to examine the difference between the students' physical activity levels and skin fold thickness. Then, the relevance between physical activity level and skinfold thickness was examined for pearson correlation. Significance value p

Objectives This study aims to evaluate physical activity, sleep, depression, quality of life, and musculoskeletal problems pre- and postoperatively in morbidly obese patients who underwent bariatric surgery and analyze the factors that are strongly associated with physical activity. Patients and methods This prospective study conducted between January 2016 and May 2017 included 27 patients (4 males, 23 females; mean age 37.1±10.4 years; range, 18 to 52 years) who underwent bariatric surgery and 20 healthy controls (3 males, 17 females; mean age 32.0±5.7 years; range, 26 to 46 years). All patients were evaluated by using the short form of International Physical Activity Questionnaire (IPAQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and short form 36 (SF-36). Patients were evaluated for regional musculoskeletal pain including back, waist, hip, knee, ankle, heel, and metatarsal pain using Visual Analog Scale. Presence of pes planus was recorded. The examinations and tests performed in the preoperative period were repeated at postoperative six months and the results were compared with the control group. Results The body mass index was 46.2±5.2 kg/m2 preoperatively and 33.8±5.0 kg/m2 postoperatively (p

Objectives: Bile duct injuries and fistulas due to bile leakage are observed at certain rates in laparoscopic cholecystectomy. In complicated cases, in patients with cholelithiasis cystic duct edema, the cystic canal may be enlarged to the extent that it cannot be closed with a clip in a standard operation. In this study we evaluated the eficiency of stapler closure of cystic canal. Methods: In this retrospective study the cases who had laparoscopic cholecystectomy and cystic canal was closed with stapler between August 2016 and December 2018 were reviewed. Patients' hospital stay and complications were noted. Results: Thirty-three patients who were electively operated and cystic canal closure was performed with vascular staples because of a wide cystic canal during the operation were included in this study. Low bile drainage was observed in only one case and this patient had spontaneous regression with conservative follow-up. Mean duration of hospital stay was 3.7 days. Patients were followed up from 2 months to 28 months postoperatively.Conclusions: Endo-vasculer stapler can be used safely during laparoscopic cholecystectomy with a history of stones in the main bile duct. In this group of patients, it is advisable to make preparations in this direction before the operation.

Sheet metal forming has an important place in the automotive industry today. Design of the dies to be used in shaping and product design is very important parameter to produce with as little scrap as possible using the sheet metal in the most efficient way. It is inevitable that the die and product design, which is made without predicting the amount of scrap for the product to be produced, will cause high waste rate. In the design of both the product and the die, besides the functionality of the product, the effective use amount of the semifinished-product, the amount of waste and scrap should also be taken into account and costed. These approaches significantly reduce the amount of scrap and help to use sheet metal more efficiently and increase the gain. In this study, the locations in the current manufacturing situation and pitch amounts of the high capacity parts produced in the enterprise in the 3.5-month period were examined. As a result of these examinations, the parts that have low sheet metal usage efficiencies are distinguished. For these parts, researches have been made on the position and pitch suggestions proposed in the literature. Part location and pitches have been re-modeled to increase efficiency by reducing the amount of scrap in the computer environment. Thus, examples of more efficient use of semi-finished sheet metal were created and the earnings were calculated.

SMED, Single Minute Exchange of Dies (Tekli Dakikalarda Kalıp Değişimi), üretim süreci boyunca oluşan kalıp değişiminden kaynaklanan kayıpları minimize etmek için kullanılan önemli bir yöntemdir. Özellikle otomotiv sektöründe saniyeler bile önemli iken dikkatsiz tasarlanan kalıplar ve bu yanlış tasarımın bir sonucu olarak uzun süren kalıp değişim süreleri üretimi ciddi anlamda olumsuz etkilemektedir ve verimliliği düşürmektedir. Mümkün olan en kısa sürede, en kaliteli ürünü üretmek günümüzün önemli gereksinimlerindendir. Bu kapsamda SMED yöntemi bu çalışmanın temel kaynağı olarak kullanılmıştır. Bu çalışmada, işletmede kullanılan manuel pres hattında üretilen 6 farklı ürün için kullanılan kalıplar referans alınmıştır. Bu 6 ürün manuel üretimin %85’ini oluşturan ürünlerdir. Ürünler maksimum 5 farklı manuel pres kullanılarak üretilmektedir. Bu preslerde ürünlerin kalıp değişim süreleri 3,5 aylık bir gözlem sonucu belirlenmiştir. Bu süreler detaylı bir şekilde incelenerek, kalıp tasarımından veya kullanılan bağlama ekipmanlarından kaynaklı olduğu tespit edilmiştir. Kalıplar üzerinde yapılabilecek iyileştirmeler ve kullanılan ekipmanlarda yapılacak yenilikler veya iyileştirmeler belirlenmiştir. Gerekli iyileştirmeler yapıldığı zaman oluşacak kazanç hesaplanarak SMED yaklaşımının sac imalat sektörüne etkisi hakkında kantitatif sonuçlar verilmiştir.

Giriş: Son zamanlarda D vitamini eksikliğinin kemik metabolizma hastalıkları dışında, alzheimer, parkinson, multiple sklerozis, diyabet, kardiyovasküler hastalıklar gibi pek çok hastalığın oluşmasında rolü olabileceğini destekleyen çalışmalar artmaktadır. Biz de çalışmamızda D vitamini düzeyinin, kardiyovasküler erken risk belirteçleri olarak kabul edilen serum endocan ve ADMA düzeyleri arasındaki ilişkiyi araştırmayı amaçladık.Materyal- Metod: Çalışmada Vitamin D düzeyi 30 ng/ml olan 35 kişiden (grup2) oluşan iki grup oluşturuldu. Grupların VKİ, serum vitamin D, Endocan, ADMA, PTH, TSH, Glikoz, HOMA-IR, HDL kolesterol, LDL kolesterol, Trigliserit, düzeyleri karşılaştırıldı.Bulgular: Çalışmaya dahil edilen toplam 77 hastanın sonuçları karşılaştırıldı. Her iki grubun yaş, cinsiyet ve BMI değerleri karşılaştırıldığında anlamlı fark olmadığı saptandı (sırasıyla p:0.67, p:0.69, p:0.052). Grup 1 de serum ADMA düzeyi 104.5 ± 44 μmol/L olarak, grup 2’de 90.42 ± 29 μmol/L tespit edildi (p:0.31). Endocan düzeyi ise grup 1’de 549.5 ± 245 ng/L ve grup 2’de 465.99 ± 207 ng/L tespit edildi (p:0.12). Vitamin D düzeyi ile endocan düzeyi arasında anlamlı negatif korelâsyon saptandı (r:-0.26 p:0.02). Serum endocan ve ADMA arasında da anlamlı bir korelâsyon izlenmedi (r:0.19, p:0.1). Gruplar arası PTH, ALT, ALP, HDL kolesterol ve Trigliserit düzeylerinde istatistiksel olarak anlamlı fark tespit edilirken diğer parametrelerde anlamlı olarak fark tespit edilemedi.Sonuç: Kardiyovasküler riski değerlendirmek üzere endotel disfonksiyonu göstergelerinden serum endocan ve ADMA düzeylerini incelediğimiz çalışmada vitamin D düşüklüğü olan hastalarda anlamlı bir değişim saptamadık. Bu parametreler üzerinden yalnızca vitamin D düşüklüğünün endotel disfonksiyonu üzerine bir etki saptayamadığımızı söyleyebiliriz. Ancak çalışma sınırlı sayıda gönüllü ile yapıldığından daha kesin sonuçlara ulaşmak için daha büyük çalışmalara ihtiyaç olduğunu düşünüyoruz.

Objectives This study aims to evaluate the coexistence of metabolic syndrome (MetS) and fibromyalgia syndrome (FMS) and determine the effects of this coexistence on neuroendocrine levels and clinical features of FMS. Patients and methods One-hundred female FMS patients (mean age 40.1±7.8 years; range, 24 to 58 years) and 38 healthy females (mean age 40.4±5.8 years; range, 30 to 55 years) were included in this cross-sectional study. MetS was identified by using the criteria from the Adult Treatment Panel III. Widespread pain index, symptom severity score and number of tender points were determined. Visual analog scale, Fibromyalgia Impact Questionnaire, Fatigue Severity Scale, Beck Depression Inventory, and pain pressure threshold were used as the outcome measures. The severity of FMS was assessed with total myalgic score (TMS) and control point score. Results Twenty-four (24%) of the 100 FMS patients and three (7.9%) of the 38 control patients fulfilled the MetS criteria (p=0.047). The coexistence of FMS and MetS was associated with higher symptom severity score (p=0.004), widespread pain index (p=0.001), number of tender points (p=0.039), and lower total myalgic score (p=0.029) values. There was a significant association between the occurrence of FMS and MetS (odds ratio=3.76; 95% confidence interval: 1.04-13.4; p=0.043). Conclusion We found that patients with FMS had a nearly four times higher risk for MetS and the coexisting MetS may increase the severity of FMS. In clinical practice, when evaluating a patient with FMS, metabolic characteristics should also be evaluated.

Objectives: This study aims to evaluate the effectivity of Familial Mediterranean Fever Quality of Life (FMF-QoL) Scale for the measurement of QoL in patients with FMF and to perform correlations between related clinical variables in Turkish patients. Patients and methods: This multicenter prospective study performed between December 2017 and November 2018 included 974 FMF patients (334 males, 640 females; median age: 35; range, 26 to 45 years). Sociodemographic characteristics and clinical features were recorded. All participants were asked to complete the FMF-QoL Scale, Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Health Assessment Questionnaire (HAQ), and Functional Assessment of Chronic Illness Therapy (FACIT) Scale. Results: The median FMF-QoL Scale score was 26. Higher FMF-QoL Scale scores were shown to be related to female sex, illiteracy or primary education, monthly low-income (US$20 years), a higher number of attacks per month (>1/month), and severe disease. FMF-QoL Scale scores were correlated negatively with subscales of SF-36, and positively with HADS-anxiety and HADS-depression scores, HAQ and FACIT. Conclusion: Female sex, smoking, lower educational status, more severe disease, fatigue, and functional impairment were associated with poor QoL. FMF-QoL Scale was noted as a valid and simple patient-reported outcome instrument and correlated with the SF-36 scale.

Objective: To investigate the correlation of DUS and pulmonary function tests (PFTs), and investigate the effects of respiratory exercises on the above parameters. Methods: For the treatment group (n=20), neurological rehabilitation and respiratory exercise program, and for the control group (n=21), only a neurological rehabilitation program was implemented for 30 sessions. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), endinspiration diaphragm thickness (IDT), end-expiratory diaphragm thickness (EDT), and diaphragm thickening ratio (DTR) were measured pre- and post-treatment. Results: IDTs and EDTs as well as DTRs of affected side (p < .001, .001, and .03, respectively) and intact side (p < .001, .001, and .02, respectively) were found to improve post-treatment than before treatment in the treatment group. Similarly, FVC, FEV1, and FEV1/FVC, were better post-treatment than before treatment in the treatment group. Moreover, the affected side IDT was positively correlated with FVC and FEV1 before treatment (r = .38, p = .03 and r = .35, p = .02) and posttreatment (r = .46, p = .02 and r = .39, p = .03). The affected side DTR was positively correlated with FVC and FEV1 before treatment (r = .44, p = .01 and r = .40, p = .02) and post–treatment (r = .32, p = .03 and r = .40, p = .04). Conclusion: DUS can be used for the evaluation of respiratory problems in stroke patients. Moreover, breathing exercises improve these parameters in stroke patients, and they can be followed up by DUS.