Validity and reliability of the assessment tool for Asthma (ATA) questionnaire: the ATA study

OBJECTIVES: A multicenter trial was designed to validate the “Assessment Tools for Asthma (ATA)” questionnaire, a newly developed questionnaire, which evaluates both asthma control and risk factors associated with asthma control with a single instrument. MATERIALS AND METHODS: This cross-sectional study involved 810 cases from 14 clinics in 9 Turkish cities. The ATA questionnaire and Asthma Control Test (ACT) were administered. The Visual Analog Scale (VAS) was used to evaluate the control status of 100 randomized cases. ATA is an eight-item physician-administered questionnaire. It comprises the following two sections-ATA1, assesses symptomatic control criteria, and the remaining section, queries the flre-up of asthma, control of comorbidities, treatment adherence, and inhaler technique. RESULTS: The mean scores for ATA1, ATA total, VAS, and ACT were 24.7±14.8, 53.8±19, 7.1±3, and 18.8±5.5, respectively. According to the ATA questionnaire, among all patients, 34.3% had controlled, 18.8% had partly controlled, and 46.9% had uncontrolled asthma. Furthermore, 16.6% patients had flre-ups between visits, 96.4% patients had uncontrolled comorbidity, 17% patients had irregular asthma treatment, and only 8.4% patients used the incorrect inhaler technique. The ATA questionnaire showed internal consistency (Cronbach’s alpha coeffiient=0.683). ACT, ATA1, and two specialists’ evaluations using VAS correlated strongly with the ATA total scores (Spearman correlation coeffiient (r) values: 0.776, 0.783, and 0.909, respectively; p-values: p<0.001, p<0.001, and p<0.001, respectively). According to Receiver Operating Characteristic analysis, the cut-off value of ATA was 50 (sensitivity=84.4%, specifiity=82.40%). CONCLUSION: The validated ATA questionnaire may be a practical tool for physicians in asthma management

Public Health Rep

12983486PMCnul

Heavy metal accumulation in some plants in the yesilirmak river near the antimony mining area tokat, Northern Turkey

The levels of Sb, Cd, Pb, Zn and Cu in Phalaris arundinacea, Junculus inflexus, Polygonum percicarìa, Carex riparia and Spirogyra sp.in the Yesilirmak River near the antimony mining area from June 2004 to November 2004 were determined. Antimony, cadmium, lead, zinc and copper uptake are not efficient for these 5 species when the availability of the elements in the water or sedimet are low or interme- diate. The present results suggest that Phalaris arundinacea, Junculus inflexus, Polygonum percicarìa, Carex riparia and Spirogyra sp. can not use as a bioindicator for Sb, Pb, Cd, Cu and Zn accumulation. These 5 heavy metals level remained below at which toxic effect would be likely to occur in potential concern about macroinvertebrate and fish

Ağrılı Total Oftalmoparezi ile Seyreden İndirekt Karotikokavernöz Fistül Olgusu I

84 year old woman applied to our clinic with the complaints of right eye ptosis and pain. Her neurological examination revealed ptosis and limitation of movement in all directions in the right eye. Direct and indirect light reflex of the right eye was positive. Visual acuity of the case was normal. Dilatation in the superior ophthalmic vein and signal increase in cavernous sinus were observed in cranial magnetic resonance angiography (MRA) imaging of three-dimensional (3D) time-of- flight (TOF) slab sequence. Indirect carotid cavernous fistula (CCF) draining to superior ophthalmic vein and right inferior petrosal sinus fed by multiple meningeal branch of bilateral external carotid artery was detected at the level of cavernous sinus in the right in digital subtraction angiography (DSA). Total occlusion in fistula was achieved through transvenous cavernous sinus and inferior petrosal vein coil embolization method.Özet 84 yaşında kadın hasta iki haftadır sağ göz kapağında düşme ve ağrı şikayeti ile başvurdu. Nörolojik muayenesinde sağ gözde her yöne hareketlerinin kısıtlılık ve pitoz saptandı. Sağ gözde direkt ve indirekt ışık refleksi pozitifti. Olgunun görme keskinliği tam olarak değerlendirildi. Kraniyal magnetik rezonans anjiografi tetkikinde 3 D TOF slab sekansında ,superior oftalmik vende dilatasyon ve kavernöz sinüste sinyal artışı izlendi. Serebral anjiografide (DSA) sağda kavernöz sinüs düzeyinde bilateral eksternal karotid arterin multipl meningeal dalından beslenen sağ inferior petrosal sinüse ve superior oftalmik vene direne olan indirekt KKF saptandı. Transvenöz yolla kavernöz sinüs ve inferior petrosal ven koil embolizasyon yöntemi ile fistülde total oklüzyon sağlandı . Tedavi sonrası dördüncü haftada hastanın sağ göz ağrısı tamamen geçti, pitoz ve göz hareketlerindeki kısıtlılık tama yakın düzeldi

Osteosarcopenia: Clinical Perspective

Osteosarkopeni yaşlanma ile ilişkili iki kronik kas iskelet sistemi sorunu olan osteoporoz ve sarkopeninin birlikteliğini tanımlayan bir geriatrik sendromdur. Bu sendrom düşmelere ve kırıklara, morbidite, mortalite ve yeti yitiminde artışa ve yaşam kalitesinde azalmaya yol açabilir. Osteosarkopenin etiyopatogenezi multifaktöriyeldir; mekanik, biyokimyasal, genetik ve yaşam tarzı ile ilişkili faktörler ortaya çıkmasında önemli rollere sahiptir. Prevalansı %5 ile %37 arasında bildirilmiştir. Prevalanstaki bu değişkenlik, muhtemelen çalışma popülasyonlarındaki heterojeniteye veya farklı tanı kriterlerin kullanılmasına bağlıdır. Osteosarkopeni tanısı detaylı klinik değerlendirme (örneğin; tarama ve risk hesaplama araçları, kavrama kuvveti ölçümü, fiziksel performans testleri), laboratuvar testleri ve görüntüleme yöntemleri ile konulabilir. Osteoporoz tanısına yönelik olarak kemik mineral yoğunluğunu ölçmek için en sık kullanılan dual enerjili X-ışını absorbsiyometri yöntemidir. Sarkopenide meydana gelen iskelet kas kütlesindeki kaybı saptamak amacıyla kullanılan görüntüleme teknikleri ise dual enerjili X-ışını absorbsiyometri, bilgisayarlı tomografi, ultrasonografi ve manyetik rezonans görüntülemedir. Osteosarkopeninin tedavi seçenekleri arasında egzersiz, besin takviyeleri (protein, D vitamini, kalsiyum ve kreatin), yaşam tarzı değişiklikleri ve farmakolojik tedaviler yer almaktadır. Osteosarkopeni gelişiminin altında yatan mekanizmalar daha iyi anlaşıldıkça hem kası hem de kemiği hedef alan terapötik ajanların geliştirilmesi, yeni bir araştırma alanı haline gelmiştir. Bu derlemede, konuyla ilgili güncel literatür ışığında, osteosarkopenin epidemiyolojisi, patogenezi, tanı ve tedavisi özetlenmiştir.Osteosarcopenia is a geriatric syndrome characterised by the co-existence of osteoporosis and sarcopenia, two chronic musculoskeletal conditions associated with ageing. This syndrome may lead to falls and fractures, increased morbidity, mortality and disability, and reduced quality of life. the etiopathogenesis of osteosarcopenia is multifactorial; mechanical, biochemical, genetic and lifestyle factors all play important roles. Its prevalence has been reported between 5% and 37%. the varied prevalence is likely due to the heterogeneous populations or non-unified diagnostic criteria for this syndrome. Osteosarcopenia can be diagnosed by detailed clinical assessment (e.g. screening and risk calculation tools, grip strength, physical performance tests), laboratory tests and imaging methods. Dual-energy X-ray absorptiometry is the most common method used in measuring bone mineral density for the diagnosis of osteoporosis. the imaging techniques used to detect loss of skeletal muscle mass in sarcopenia are dual-energy X-ray absorptiometry, computed tomography, ultrasonography and magnetic resonance imaging. Treatment options for osteosarcopenia include exercise, nutritional supplements (protein, vitamin D, calcium and creatine), life style modifications and pharmacological therapy. With increasing understanding of the underlying mechanisms of osteosarcopenia, the development of therapeutic agents targeting both muscle and bone has become a new area of investigation. This review summarises the epidemiology, pathophysiology, diagnosis and treatment of osteosarcopenia in the light of the relevant literature