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Introduction The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results Of 17,351 patients 5871 (33.8%) were ≥65 years old. The mean age was 75.1 ± 7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2–11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients.

Objective: Covid-19 is a global epidemic that predominantly affects the respiratory system, in which about 20% of patients are severe and about 10-15% of mild cases become severe. The clinical and laboratory findings in the course of the disease are mild in the first week and may become more severe in the following days, also the possibility false negativity of the tomography in the first 24-48 hours, making it difficult to select patients in triage. Being able to detect cases that may have a serious course in the Covid-19 pandemic will help health systems to function without interruption. In our study, we tried to identify cases that may need intensive care in triage. Methods: Medical records and radiological findings of 368 patients with laboratory-confirmed Severe-Acute-Respiratory-Syndrome Coronavirus-2 infection who were hospitalized between March and June 2020 were reviewed. The patients were analyzed by dividing into two groups; group 1; critically ill patients with severe pneumonia who need intensive care during treatment. Approximately 8% of all patients are in this group. Group 2; non-critical patients who do not need intensive care followed in the clinic. Results: It was determined that the mean age of the patients in Group 1, the rate of being over 50 years old and the male gender ratio were higher than Group 2. Conclusion: Although there are low oxygen saturation, tachypnea and comorbid diseases in critically ill patients in triage, advanced age and male gender were found to be the most important risk factors for intensive care need.

INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a disease with high morbidity and mortality that adversely affects the activities of daily living. Disease progression in ALS is characterized by loss of function in bulbar, motor, and respiratory parameters. The revised amyotrophic lateral sclerosis functional rating scale (ALSFRS-R), which consists of 12 criteria, is used to determine disease effects on each of these functions. While each criterion is equally important when calculating the total ALSFRS-R score, the importance levels of the 12 criteria may vary in clinical practice. In this classical approach, the relationships among the parameters are not considered and the effects of bulbar, spinal, and respiratory dysfunctions on a patient’s activities of daily living may be different. METHODS: In this study, we aimed to evaluate ALS cases with the ALSFRS-R fuzzy method. Although each subheading in the ALSFRS-R had the same score, the disease score was determined by the fuzzy ALSFRS-R method, based on whether a subheading had priority in management of the disease. While creating the functional rating scale ALSFRS-R approach, fuzzy ALSFRS-R score values were obtained by creating fuzzy models for each main group and integrating the fuzzy model results of each main group into a separate model. RESULTS: In total, 50 patients with definite ALS according to the El Escorial criteria (33 men [66%] and 17 women [34%]; mean age, 58.49±10.01 years) were included in the study. When ALSFRS-R results and fuzzy ALSFRS-R results were compared, the prioritization order of 45 patients increased using the fuzzy ALSFRS-R score, while the prioritization order of five patients remained the same in both evaluations. CONCLUSION: The approach obtained by using fuzzy membership functions and decision rules, formed in accordance with expert opinion, was applied to the data of 50 patients from a large-scale hospital. In total, 90% of the patients had increased prioritization when using the fuzzy ALSFRS-R scoring method. Our results showed that the fuzzy approach provided more accurate information regarding a patient’s condition.

WOS: 000463053800027, Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter Study we analysed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in intensive care units (ICUs) of 15 hospitals (Eight terriary-care educational hospitals, six state hospitals and one private hospital) from 11 cities from six regions of Turkey The observations were made by infection control practitioners according to the World Health Organization - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene indications and compliance in 2015 and 2016 were 60071/78116-76,9% and 66551/83607-79,6% (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was in after body fluid exposure indication (88.2%-2015 and 91.4%-2016) while the lowest compliance was in before patient contact indication (61.3%-2015 and 65%-2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below 50 percentile rates in any of the 5 moments should increase efforts to enhance compliance in that indication.

The anterior horn cells control all voluntary movement. Motor activity, respiratory, speech, and swallowing functions are dependent upon signals from the anterior horn cells. Diseases that damage the anterior horn cells, therefore, have a profound impact. Symptoms of anterior horn cell loss (weakness, falling, choking) lead patients to seek medical attention. In this article, anterior horn diseases were reviewed, diagnostic criteria and management were discussed in detail. [Archives Medical Review Journal 2016; 25(3.000): 269-303]

Cerebrovascular diseases which called as stroke causes severe mortality and morbidity. Stoke is the third cause of death and first cause of the sequela among in its disorder group. Stroke with a 80-85% has the most frequency and the most cause of death in among the neurological disorders. Besides its lethal effects, sequela of stroke also cause physiological problems on individuals, families and social groups, it also brings some economic problems. [Archives Medical Review Journal 2010; 19(2.000): 85-140]

Cerebellar Ataxia can be defined as the loss of balance and coordination due to various causes emerging in the cerebellum or related pathways. Ataxias can be classified as congenital, hereditary, sporadic and non-hereditary (infections, toxins, drugs and systemic reasons etc). In this study, features of clinical and genetical findings of hereditary ataxia were reviewed. [Archives Medical Review Journal 2009; 18(3.000): 171-226]

Certain difficulties in daily life activities appear and quality of life (QoL) begins to deteriorate with old age. This study aimed at determining QoL and activities of daily living (ADL) of elderly people in rural areas of Eskişehir, and at identifying applicable factors in this regard. Cross-sectional study managed to reach 1301 (81.3%) of elderly people. Face-to-face interviews and the WHOQOL-BREF QoL scale and questionnaire were applied to evaluate daily life activities, as well as instrumental activities all of which contained sociodemographic features. WHOQOL-BREF life quality scale comprised of four domains with grades between 0 and 20. Those who received help from others in the execution of these activities were labelled as "dependent", those who received partial aid during the execution of these activities were labelled as "partially dependent", and those who did not receive any help in their daily activities were labelled as "independent" individuals. Average age of 1301 people contacted was 71.52+/-5.18 (ranging 65-91 years); 675 of them were women (51.9%), 626 were men (48.1%). Three hundred and eighty-seven of these elderly people (29.7%) had no medically diagnosed illnesses, whereas 18 of them (1.4%) were bedridden. With older age, with the exception of social and environmental areas, life quality got even worse in women, widows, illiterates, bedridden and those with medically diagnosed diseases. As women were more dependent on issues such as housework, shopping, traveling, transporting and bathing, men were more dependent on areas such as meal preparation. No distinction between men and women were identified in areas such as dressing, toilet use, urine and bowel continence and eating. As a conclusion, in cases where medically diagnosed diseases were present, quality of life in women that were dependent somehow in daily activities was worse. It was concluded that medicosocial services for the elderly would be prioritized and studies on chronic diseases would be re-evaluated.

WOS: 000386954300001, PubMed: 27809934, Background: The aim of this study was to assess health-related quality of life (HRQOL) among chronic hepatitis B (CHB) patients in Turkey and to study related factors. Methods: This multicenter study was carried out between January 01 and April 15, 2015 in Turkey in 57 centers. Adults were enrolled and studied in three groups. Group 1: Inactive HBsAg carriers, Group 2: CHB patients receiving antiviral therapy, Group 3: CHB patients who were neither receiving antiviral therapy nor were inactive HBsAg carriers. Study data was collected by face-to-face interviews using a standardized questionnaire, Short Form-36 (SF-36) and Hepatitis B Quality of Life (HBQOL). Values equivalent to p < 0.05 in analyses were accepted as statistically significant. Results: Four thousand two hundred fifty-seven patients with CHB were included in the study. Two thousand five hundred fifty-nine (60.1 %) of the patients were males. Groups 1, 2 and 3, consisted of 1529 (35.9 %), 1721 (40.4 %) and 1007 (23.7 %) patients, respectively. The highest value of HRQOL was found in inactive HBsAg carriers. We found that total HBQOL score increased when antiviral treatment was used. However, HRQOL of CHB patients varied according to their socio-demographic properties. Regarding total HBQOL score, a higher significant level of HRQOL was determined in inactive HBV patients when matched controls with the associated factors were provided. Conclusions: The HRQOL score of CHB patients was higher than expected and it can be worsen when the disease becomes active. Use of an antiviral therapy can contribute to increasing HRQOL of patients.

EASL International Liver Congress -- APR 13-17, 2016 -- -- Barcelona, SPAIN, WOS: 000398711700582, …, EASL

Mitochondria are unique organells which their own DNA in cells. Human mitochondrial DNA is circular, double-stranded molecule and small. Because all mitochondria are contributed by the ovum during the formation of the zygote, the mitochondrial genom is transmitted by maternal inheritance. Multisystem disorders such as deafness, cardiomyopathy, miyopathy can be seen in mitochondrial diseases. [Archives Medical Review Journal 2003; 12(0.100): 14-31]

[Cukurova Med J 2015; 40(1.000): 0-0]

Prenatal diagnosis is the process of determining the health or disease status of the fetus or embryo before birth. The purpose is early detection of diseases and early intervention when required. Prenatal genetic tests comprise of cytogenetic (chromosome assessment) and molecular (DNA mutation analysis) tests. Prenatal testing enables the early diagnosis of many diseases in risky pregnancies. Furthermore, in the event of a disease, diagnosing prenatally will facilitate the planning of necessary precautions and treatments, both before and after birth. Upon prenatal diagnosis of some diseases, termination of the pregnancy could be possible according to the family's wishes and within the legal frameworks., Prenatal (Doğum öncesi) tanı; fetus veya embriyodaki hastalıkların doğum öncesi dönemde tespit edilmesi işlemidir. Amaç; hastalıkların olabildiğince erken dönemde saptanması ve sonuca göre gerekli işlemlerin yapılmasıdır1. Prenatal genetik testler; sitogenetik testleri (kromozom düzeyinde değerlendirme) ve moleküler testleri (DNA düzeyinde mutasyon analizi) içermektedir. Prenatal tanı ile özellikle risk taşıyan gebeliklerde bebeğe henüz anne karnındayken tanı konulması mümkün olmaktadır. Prenatal tanı aynı zamanda hastalığın varsa doğum öncesi tedavisine ve doğum sonrası gerekli önlemlerin alınmasına, tedavi planlanmasına olanak vermektedir. Bu yöntemler ile tanısı konulan bazı hastalıklar için yasal çerçeveler dahilinde ailenin isteği doğrultusunda gebeliklerin sonlandırılması da mümkün olabilmektedir.

Mitochondria are energy source of cells. They have external and internal membranes, cristas and matrix. External membranes consist of specialized transport proteins. They have monoamine oxidase and citokrome-c reductase which both play role in KREBS cycle as catalyst and many enzymes which are necessary for phospholipid and phosphoric acid synthesis. Enzymes of electron transport chain and oxidative phosphorylation are located in the internal membranes. Also, here, there are transport systems for specific substances, such as ATP, ADP, P1, pyruvate, succinate, malate, citrate, and -ketoglutarate . Matrix; having gel-like consistency, contains a large number of enzymes., Mitokondriler hücrelerin enerji kaynağıdır. Mitokondrilerde iç ve dış membran bulunur. Dış membran özelleşmiş transport proteinlerden oluşur KREBS çemberinde katalizör rolü oynayan monoamine oksidaz, sitokrom-c reduktaz enzimleri yanısıra fosfolipid ve fosforik asit sentezi için gerekli birçok enzime sahiptir. İç membran, Elektron transport zinciri enzimleri ve oksidatif fosforilasyona ait enzimler burada yerleşmiştir. Ayrıca ATP,ADP ve P1, piruvat, süksinat, malat, sitrat ve -ketoglutarat gibi özel maddeler için taşıma sistemine sahiptirler Matriks; jel kıvamında olup içinde erimiş birçok enzim bulunur.

Perioperative hypoglossal nerve palsy is a rare postoperative complication. We present a case of transient unilateral hypoglossal nerve palsy after vocal cord polypectomy. The cause of the hypoglossal nerve palsy in our patient was assumed to be a complication of oropharyngeal manipulation during orotracheal intubation for general anesthesia., Perioperatif hipoglossal sinir felci operasyon sonrası ender komplikasyonlardan biridir. Biz vokal kord polipektomisi sonrası ortaya çıkan geçici unilateral hipoglossal sinir felci olan bir olgu sunuyoruz. Olgumuzdaki hipoglossal sinir felci, orotrekeal entübasyon sırasında orofaringeal girişimin bir komplikasyonu olarak kabul edildi.

To study strength-duration properties of motor and sensory axons to evaluate whether there is a change in current through the persistent sodium (Na+) channels of sensory and motor axons in peripheral nerves of epileptic patients before and after valproic acid (VPA) and carbamazepine (CBZ) treatment due to the presence of similar channels in the CNS and peripheral nervous system (PNS).This study, conducted in Baskent University Faculty of Medicine, Adana, Turkey from January 2011 to February 2012, involved 10 patients with partial epilepsy, 10 patients with primary generalized epilepsy who were not currently prescribed anticonvulsant therapy, and 10 control subjects. Using an electromyography machine, stimulus intensity was performed to produce the target (40% of maximum) compound muscle action potentials and compound sensory action potentials. The currents required for different stimulus durations, 0.05, 0.1, 0.2, 0.3, 0.5, and 1 ms, were produced. Stimulus-response curves were then constructed, and the strength-duration time constants were estimated using Weiss`s formula.The rheobase of motor and sensory fibres was lower in the control group than the values of patients before and after CBZ and VPA therapy.In the PNS of epileptic patients, CBZ and VPA therapy results in decreased axonal excitability. This method may be used in investigating the underlying pathology of peripheral nerve diseases in vivo.

PubMedID: 25033069 Context: Gordon Holmes syndrome (GHS) is characterized by cerebellar ataxia/atrophy and normosmic hypogonadotropic hypogonadism (nHH). The underlying pathophysiology of this combined neurodegeneration and nHH remains unknown.Objective: We aimed to provide insight into the disease mechanism in GHS.Methods: We studied a cohort of 6 multiplex families with GHS through autozygosity mapping and whole-exome sequencing.Results: We identified 6 patients from 3 independent families carrying loss-of-function mutations in PNPLA6, which encodes neuropathy target esterase (NTE), a lysophospholipase that maintains intracellular phospholipid homeostasis by converting lysophosphatidylcholine to glycerophosphocholine. Wild-type PNPLA6, but not PNPLA6 bearing these mutations, rescued a well-established Drosophila neurodegenerative phenotype caused by the absence of sws, the fly ortholog of mammalian PNPLA6. Inhibition of NTE activity in the LßT2 gonadotropecell line diminished LH response to GnRH by reducing GnRH-stimulated LH exocytosis, without affecting GnRH receptor signaling or LHß synthesis.Conclusion: These results suggest that NTE-dependent alteration of phospholipid homeostasis in GHS causes both neurodegeneration and impaired LH release from pituitary gonadotropes, leading to nHH. Copyright © 2014 by the Endocrine Society. National Science Foundation: IOS1121691

Marfan sendromu iskelet, oküler, kardiyovasküler, akciğer, deri ve dura anormalliklerine yol açan otozomal dominant geçişli multisistem bir hastalıktır. Bu makalede Ailesel Marfan Sendromu tanısı alan ve takip periyodunda inme gelişen bir olgu sunulmuştur. . Marfan syndrome is an autosomal-dominant disorder of connective tissue with musculoskeletal, ocular, lung, the skin and cardiovascular manifestations. We present a case of ischemic stroke who is diagnosed with Marfan Syndrome.

Restless leg syndrome (RLS) is an abnormal sensation disorder. Defining the syndrome is difficult. It is transmitted autosomal dominant genetically, is especially prevalent in the lower limbs, and is seen in both genders. In the differential diagnosis of RLS, nocturnal leg cramps, akathisia, peripheral neuropathy, entrapment neuropathy, and vascular disease (for example, deep vein thrombosis) should be considered. A 52-year-old woman was admitted to our clinic with signs of paresthesia, she had abnormal sensation disorder in both legs and the right arm, which she had difficulty defining. She had applied to another center with the same complaints and had been evaluated as entrapment neuropathy, carpal tunnel syndrome, and/or peripheral neuropathy. Her electromyographic examination carried out by us was normal. The history, neurological examination findings, and results of standard laboratory analyses provided a diagnosis of idiopathic RLS. After the diagnosis of RLS in the proband, we questioned other family members. Her large family had 63 members, 35 males, and 28 females. Of 63 members, 17 also had an RLS diagnosis.

Myasthenia gravis is a rare autoimmune disorder in which antibodies form against acetylcholine nicotinic postsynaptic receptors at the myoneural junction. Psoriasis vulgaris is a chronic, recurring, and an inflammatory skin disease. Myasthenia gravis and psoriasis are both autoimmune diseases and correlated with specific human histocompatibility antigens. In this report, a 53-year-old woman who has myasthenia gravis accompanied with psoriasis vulgaris is presented. To conclude, this association is extremely rare and the pathogenetic etiology was thought to depend on a generalized immunological disturbance.

The aim of this study was to determine the frequency of tinea pedis and manuum (dermatophyte infections of the hands and feet) in adults in rural areas of Turkey, the risk factors and self-administered treatment options. A total of 2,574 people living in a rural area were enrolled in the study. Participants were asked demographic data, hygienic habits in a questionnaire. KOH preparations and culture were performed from suspicious lesions. Medical and alternative therapy methods and former dermatophytosis diagnosis history were taken from the respondents with suspicious lesions. Microbiological samples were taken from 285 (11.1%) participants. Culture was positive in 109 (4.2%) of those. The most common agent was Trichophyton rubrum. The predisposing factors were found as age older than 40, male gender and obesity. Forty-nine (44.9%) of patients had taken a medical therapy, 56 (51.4%) had performed non-medical methods (cologne, Lawsonia inermis-Henna and softener creams). Patient's education about the treatment compliance is important.

Lyme disease (borreliosis) is a systemic illness resulting from infection with the spirochete Borrelia burgdorferi. It is transmitted to humans by the bites of infected ticks belonging to several species of the genus Ixodes. After the bacteria enter the body via the dermis, most patients develop the early, localised form of Lyme disease, which is characterised by erythema migrans and influenza-like symptoms. This disease may also affect the heart, nervous system and joints. The neurological findings of this disease may include peripheral and central nervous system signs. A 21-year-old woman attended a family medicine outpatient clinic complaining of unexplained pain and muscle power loss in her lower extremities. The problem had started in her right leg 3 months earlier and worsened in the last week. She had a neurology consultation and was hospitalised. Her neurological examination revealed bilateral facial paralysis and sensory impairment. Immunoglobulin M antibody to B. burgdorferi was positive on Western blotting in both serum and cerebrospinal fluid. The patient was diagnosed with subacute neuroborreliosis and treated.

Friedreich's ataxia (FRDA), the most common subtype of early onset hereditary ataxia, is an autosomal recessive neurodegenerative disorder caused by unstable GAA expansions. Two-dimensional, pulse, and pulse tissue Doppler echocardiographic examinations were performed on 21 patients with GAA expansion. There was no association between left ventricle ejection fraction, tissue Doppler systolic s wave, and left ventricle diastolic functions examined by pulse and tissue Doppler. The septum thickness of patients with Friedreich's ataxia was significantly increased when compared with that of the control group and wall thickness was found to be associated with GAA repeats. In patients with FRDA, despite a correlation between genetic abnormality with left ventricular early and late diastolic parameters, global diastolic functions were preserved when examined by tissue Doppler.