The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

Background: Low bone mineral density (BMD) is one of the comorbidities that develop in people living with HIV (PLWHIV). Objective: This study was conducted to review the frequency and risk factors of reduced BMD according to age in HIV-infected patients in Turkey. Material and Method: This retrospective cohort study included HIV-infected patients aged 18-50. Bone density was analysed using dual-energy X-ray absorptiometry (DXA) according to the Z-score in three different regions including the lumbar, total-hip and femoral-neck. Results: The study included 224 PLWHIV with a mean age of 35.84-7.54, and 59.8% were ART naive. Of the patients, 40.6% had lower BMD than expected at least in one of the three examined regions including the lumbar, total hip and femoral neck. The low BMD ratios were found respectively as 11.6%, 11.6% and 28.6% in the femoral neck, total hip and lumbar regions. According to the logistic regression model, a high body mass index (p=0.003) and HIV-RNA level of ≥100.000IU/ml during the diagnosis in the ART-naive group (p=0.008) were associated with reduced bone demineralization. The low BMD frequency was high in the group that received ART for <24 months (p=0.001). Conclusion: Performing bone demineralization screening in the naive and young patient group, independently from ART status prior to making the diagnosis of HIV is important for organizing the bone health improvement methods. Keywords: HIV infection; bone density; antiretroviral therapy

ANXIETY AND DEPRESSION AMONG PEOPLE LIVING WITH HIV DURING THE COVID-19 PANDEMIC: A FACE-TO-FACE SURVEY FROM TURKEY

Background: During the COVID-19 pandemic, there have been some difficulties in the routine care of people living with HIV (PLWH). Subjects and methods: We aimed to evaluate the impact of COVID-19 on mental health of PLWH and their use of health services. This study was conducted using the face-to-face interview method in the outpatient clinic of a university hospital, between 01.09.2020 and 30.11.2020. Hospital Anxiety and Depression Scale and survey instrument designed by the researchers investigating socio-demographic data and access to health services were used. Results: The study included 217 patients, 91.7% (n=199) of whom were male. All of the patients were postponed their hospital appointments, 60.8% were concerned about not being able to contact their physician and 53% had concerned about being stigmatized if they went to the hospital. Of the participants, 27.6% had depression, 12.9% had anxiety and 8.3% had both depression and anxiety. Low income, job loss, and fear of being stigmatized were associated with depression and anxiety. Lower level of education, discontinuation of medications and lack of opportunity to work remotely were associated with depression, while history of psychiatric illness, worry about not being able to contact their physician and cessation of antiretroviral therapy were associated with higher anxiety levels. Conclusion: It is important to develop strategies ensuring the continuity of care for PWLH and identify and support those with a higher mental health impact

The Effect of Treatment on Weight Gain in Iron Deficiency Anemia and Its Association with Ghrelin and Hepcidin Levels

Aim: Although loss of appetite in iron deficiency anemia (IDA) and weight gain during treatment are common complaints, there are very few studies in adults. This study aimed to determine the levels of ghrelin, one of the appetite-related hormones, and hepcidin, one of the main regulators of iron metabolism, in IDA, and to examine the effects of treatment on weight gain and the levels of these hormones. Material and Methods: Eighty-seven adult patients with IDA and a control group of 50 healthy volunteers were included in the study. Anthropometric measurements and blood samples were obtained from the patient and control groups before treatment, and repeated after treatment in the IDA group. Results: No significant difference was found in terms of weight, body mass index (BMI), and waist-to-hip ratio between groups but there was a significant increase in weight and BMI, in the patient group after treatment (both

Comparison of various phenotypic methods in detection of extended-spectrum beta-lactamases

Genişlemiş spektrumlu beta-laktamaz (GSBL) enzimi bazı Gram negatif bakterilerde sefalosporinlere, geniş spektrumlu penisilinlere ve monobaktamlara karşı direnç sorununa neden olmaktadır. Tedavi başarısını arttırmak için bu enzimlerin varlığı çeşitli yöntemlerle araştırılmaktadır. Çalışmamızda Düzce Üniversitesi Araştırma ve Uygulama Hastanesi Klinik Mikrobiyoloji Laboratuvarında üretilen Escherichia coli ve Klebsiella suşlarında GSBL saptanmasında kullanılan fenotipik testlerin [disk difüzyon tarama testi (DDTT), çift disk sinerji testi (ÇDST), E-test] etkinliği karşılaştırılmıştır. Klebsiella spp. ve K.pneumoniae suşlarında, tarama testi ve E-test benzer sonuçlar vermiş iken ÇDST diğer testlerin saptayabildiği GSBL’lerin hepsini saptayamamıştır. Bu testin etkinliği, E-test ile karşılaştırıldığında Klebsiella spp. için p=0.002 ve K.pneumoniae için p=0.041 düzeyinde ve tarama testi ile karşılaştırıldığında Klebsiella spp. için p=0.001 ve K.pneumoniae için p=0.041 düzeyinde, anlamlı olarak düşük bulunmuştur. E.coli suşlarında ise farklı olarak; ÇDST ile E-test sonuçları benzer iken (p=0.187), tarama testi ÇDST’ne göre anlamlı derecede daha etkin bulunmuştur (p<0.05). Sonuç olarak, Gram negatif bakteri kaynaklı infeksiyonların tedavisinde antibiyotiklerin hastaya uygulanıp uygulanmaması konusunda karar verirken ÇDST’nin tek başına kullanılmaması gerektiği, DDTT yapılmasının çok önemli olduğu ve E-test ile doğrulanması gerektiği düşünülmüştür.Extended-spectrum beta-lactamase (ESBL) enzymes of some gram-negative bacteria cause resistance to cephalosporins, broad-spectrum penicillins and monobactams. The presence of these enzymes must be investigated by various methods for the success of the treatment. In this study, the effectiveness of various phenotypic methods for detection of extended-spectrum beta-lactamases [disk diffusion screening test (DDTT), double-disk synergy test (DDST), and E-test] in Escherichia coli and Klebsiella strains isolated in Clinical Microbiology Laboratory of Duzce University, Medical Faculty were compared. Similar results were obtained with screening test and E-test, whereas DDST was found insufficient in detecting ESBL&amp;#8217;s that were determined by other methods. The effectivity of this test was found significantly low, when compared with E-test, with results for Klebsiella spp. (p=0.002) and K.pneumoniae (p=0.041) and screening test, with results for the Klebsiella spp. (p=0.001) and K.pneumoniae (p=0.041). For E.coli strains, results obtained with DDST and E-test (p=0.187) were found similar but, screening test was significantly effective than DDST (p&lt;0.05). As a result, for the decision of the choice of antibiotics in the treatment of Gram-negative bacterial infections, DDST should not be used alone. Use of DDTT is very important and E-test should be used for verification

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A Comparison of the Measuring Instruments to Assess Quality of Life in Patients with Fibromyalgia Syndrome

Amaç: Kompleks ve çok boyutlu bir klinik sendrom olan fibromiyalji sendromu (FMS), birçok somatik ve psikolojik yakınmalara neden olduğu için yaşam kalitesini bozmaktadır. Çalışmanın amacı, FMS tanısı almış kişilerin, yaşam kalitesini en kısa sürede ve en verimli şekilde değerlendiren ölçeği belirlemektir. Yanı sıra SF-12, SF-8 ve SF-6D formlarının güvenilirliği ve geçerliliğinin de incelenmesi amaçlandı.Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon AD'de tanı almış, çalışmaya katılmayı kabul etmiş ve formları tam doldurmuş olan 59 FMS hastası değerlendirildi. Hastaların yaşam kalitesi SF-36, WHOQOL-BREF, QuickDASH, SF-12, SF-8 ve SF-6D ölçekleri ile incelendi. Bulgular: Elde edilen veriler doğrultusunda ölçeklerin iç tutarlılığı ve ölçek puanlarının tekrarlama derecesi yüksek bulundu. SF-36 ölçek puanları ile diğer üç kısa formdan (SF) elde edilen puanlar arasındaki ilişki incelendiğinde, SF-12 ve SF-6D ölçekleri geçerlilik bakımından SF-8'den üstün bulundu. Tartışma ve Sonuç: Geçerlilik için yapılan bütün hesaplamalar değerlendirildiğinde, FMS'de SF12 ve SF-6D ölçekleri yaşam kalitesini ölçmede SF-36 yerine kullanabilir. SF-8'in ise bütün alt boyutlarda SF-12 ve SF-6D kadar etkili olmaması ve mental sağlık alt boyutunun bulunmaması nedenleriyle FMS'de yaşam kalitesini ölçmek amacıyla kullanımı önerilmemektedir.Aim: Fibromyalgia syndrome (FMS), a complex and multidimensional clinical syndrome, disrupts quality of life, causing many somatic and psychological problems. In this study we aimed to determine which measuring instrument should be chosen for the fastest and most efficient assessment of life quality in patients diagnosed with FMS. The reliability and validity of the SF12, SF-8, and SF-6D were also assessed concurrently.Materials and Methods: Fifty-nine patients diagnosed with FMS at Department of Physical Medicine and Rehabilitation, Medical Faculty of Duzce University, who consented to participate in the study and filled out the forms fully were evaluated. Life quality of the patients was investigated by using the instruments SF-36, WHOQOL-BREF, QuickDASH, SF-12, SF-8, and SF-6D.Results: The internal consistency and repeatability of these scales were found to be high in light of the obtained data. When the relation between the SF-36 scores and the scores obtained from the other three short forms (SF) was investigated, the SF-12 and SF-6D scales were found superior to the SF-8 in terms of validity.Discussion and Conclusion: In light of the entire data resulted from our assessment of validity, we suggest that the SF-12 and SF-6D might be preferred over the SF-36 in measuring life quality in patients with FMS. Because its lower efficiency than the SF-12 and SF-6D in all subdimensions and its lack of a mental health-related sub-dimension, the SF-8 is not an appropriate tool for this purpose in FMS

A New SEYHAN's Approach in Case of Heterogeneity of Regression Slopes in ANCOVA

Ankarali, Handan Camdeviren/0000-0002-3613-0523; ankarali, seyit/0000-0003-3752-0846WOS: 000432000500006PubMed: 27757767In this study, when the assumptions of linearity and homogeneity of regression slopes of conventional ANCOVA are not met, a new approach named as SEYHAN has been suggested to use conventional ANCOVA instead of robust or nonlinear ANCOVA. The proposed SEYHAN's approach involves transformation of continuous covariate into categorical structure when the relationship between covariate and dependent variable is nonlinear and the regression slopes are not homogenous. A simulated data set was used to explain SEYHAN's approach. In this approach, we performed conventional ANCOVA in each subgroup which is constituted according to knot values and analysis of variance with two-factor model after MARS method was used for categorization of covariate. The first model is a simpler model than the second model that includes interaction term. Since the model with interaction effect has more subjects, the power of test also increases and the existing significant difference is revealed better. We can say that linearity and homogeneity of regression slopes are not problem for data analysis by conventional linear ANCOVA model by helping this approach. It can be used fast and efficiently for the presence of one or more covariates