Gait speed predictors and gait-speed cut-off score to discriminate asthma control status and physical activity in patients with asthma

Introduction: As a “vital sign” of health and functional capacity, gait speed is commonly used. However, there is insufficient evidence for possible determinants of gait speed in patients with asthma. The primary objective of the present study was to determine predictors of gait speed in patients with asthma. The second objective was to determine the cut-off point for the 4-minute Gait Speed (4MGS) to better discriminate asthma control status and physical activity in asthma. Material and methods: Fifty-seven patients with asthma were included in this cross-sectional study. Demographic and clinic characteristics, pulmonary function, asthma control status (ACT, Asthma Control Test), dyspnea, gait speed (4MGS), physical activity [International Physical Activity Questionnaire-Short Form (IPAQ-SF)] and activities of daily living were evaluated. Stepwise multiple linear regression analysis was used to investigate the possible predictors of gait speed. Receiver operating characteristic (ROC) curve analysis was used to determine whether usual gait speed had a discriminative value. Results: The stepwise multiple regression analysis revealed that the ACT score and the IPAQ-SF score were significant and independent predictors of the 4MGS in patients with asthma explaining 40% of the variance in 4MGS (p < 0.001). The ROC curve showed a cut-off point of 1.06 m/s for the 4MGS for poorly controlled asthma and physical inactivity (p < 0.05). Conclusions: Our findings indicate that asthma control status and physical activity can be independent predictors of gait speed in patients with asthma. In addition, gait speed may be discriminative to determine poorly controlled asthma and physical inactivity in patients with asthma. © 2022 PTChP

Cognitive and motor performances in dual task in patients with chronic obstructive pulmonary disease: a comparative study

Background Patients with chronic obstructive pulmonary disease (COPD) may display a motor and/or cognitive disadvantage during dual tasking. However, studies investigating dual task are quite limited in patients with COPD. Aims To compare cognitive and motor performances (i.e., muscle force production and functional balance/mobility together with a cognitive task) in dual task between patients with COPD and healthy controls. Methods Thirty-five clinically stable patients with COPD and 27 age- and sex-matched healthy controls participated in this cross-sectional controlled study. The muscle force production (knee extension muscle strength assessed with an isokinetic strength dynamometer) and functional balance/mobility (Timed Up and Go (TUG) test) were performed with and without a cognitive task. Dual-task interference (DTI) was assessed. Additionally, the rate of correct responses per second (RCR) was calculated to evaluate cognitive performance. Results The decrease in RCR(muscle force production)values was greater in the COPD group compared with the control group (p= 0.045). Similarly, the cognitive DTI in muscle force production test was higher in the control group than in the COPD group (p 0.05). Conclusion The study results indicate that in individuals with COPD, cognitive performance deteriorations are more pronounced than motor performance defects during dual tasking. Further studies are needed to investigate the effects of dual task taking into account this disadvantage in patients with COPD rather than focusing solely on motor performance

Optimal Cut-Off Points of 4-meter Gait Speed to Discriminate Functional Exercise Capacity and Health Status in Older patients with Chronic Obstructive Pulmonary Disease

Background: Gait speed, a vital sign of health and functional capacity, is commonly used to measure mobility. Although studies have assessed gait speed in older adults and individuals with chronic obstructive pulmonary disease (COPD) separately, few have evaluated gait speed in older adults with COPD. Therefore, the primary objective of our study was to determine the threshold point for the 4-meter gait speed test (4MGS) to better discriminate between functional exercise capacity and health status in older patients with COPD. The second objective was to determine possible predictors of gait speed. Methods: In this cross-sectional study, we assessed participants’ pulmonary function, dyspnea, health status (COPD Assessment Test [CAT]), gait speed (4MGS), functional exercise capacity (6-minute walk test [6MWT]), and physical activity. Results: For-ty-five older patients with COPD participated in this study. The predicted 6MWT and CAT scores were independent and significant determinants of the 4MGS score, explaining 54% of the vari-ance (p<0.001). We identified gait speeds of 0.96 m/s and 1.04 m/s as thresholds to predict abnormal functional exercise capacity (sensitivity 85% and specificity 56%) and impaired health status (sensitivity 90% and specificity 69%), respectively (p<0.05). Conclusion: Our findings demonstrated that gait speed can discriminate between abnormal functional exercise capacity and impaired health status in older patients with COPD. Moreover, functional exercise capacity and health status are predictors of gait speed. © 2022 by The Korean Geriatrics Society

Nonpalpable BI-RADS 4 breast lesions: sonographic findings and pathology correlation

PURPOSEWe aimed to evaluate ultrasonography (US) findings for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions using BI-RADS US lexicon and determine the positive and negative predictive values (PPV and NPV) of US with respect to biopsy results.METHODSSonograms of 186 BI-RADS 4 nonpalpable breast lesions with a known diagnosis were reviewed retrospectively. The morphologic features of all lesions were described using BI-RADS lexicon and the lesions were subcategorized into 4A, 4B, and 4C on the basis of the physician’s level of suspicion. Lesion descriptors and biopsy results were correlated. Pathologic results were compared with US features. PPVs of BI-RADS subcategories 4A, 4B, and 4C were calculated.RESULTSOf 186 lesions, 38.7% were malignant and 61.2% were benign. PPVs according to subcategories 4A, 4B, and 4C were 19.5%, 41.5%, and 74.3%, respectively. Microlobulated, indistinct, and angular margins, posterior acoustic features, and echo pattern were nonspecific signs for nonpalpable BI-RADS 4 lesions. Typical signs of malignancy were irregular shape (PPV, 66%), spiculated margin (PPV, 80%) and nonparallel orientation (PPV, 58.9%). Typical signs of benign lesions were oval shape (NPV, 77.1%), circumscribed margin (NPV, 67.5%), parallel orientation (NPV, 70%), and abrupt interface (NPV, 67.6%).CONCLUSIONBI-RADS criteria are not sufficient for discriminating between malignant and benign lesions, and biopsy is required. Subcategories 4A, 4B, and 4C are useful in predicting the likelihood of malignancy. However, objective and clear subclassification rules are needed

Toksični učinci patulina na timus mužjaka štakora u razvoju

Patulin is a mycotoxin produced by several Penicillium, Aspergillus, and Byssachlamys species growing on food products. In this study, we investigated the effects of patulin on the thymus of growing male rats aged fi ve to six weeks. The rats were receiving it orally at a dose of 0.1 mg kg-1 bw a day for either 60 or 90 days. At the end of the experiment, the thymus was examined for histopathology by light microscopy and for epidermal growth factor (EGF) and its receptor (EGFR) by immunolocalisation. For morphometry we used the Bs200prop program to analyse images obtained with the Olympus BX51 light microscope. Cell ultrastructure was studied by electron microscopy. In rats treated with patulin, the thymus showed haemorrhage, plasma cell hyperplasia, a dilation and fi brosis in the cortex, enlarged interstitial tissue between the thymic lobules, enlarged fat tissue, thinning of the cortex, and blurring of the cortico-medullary demarcation. Electron microscopy showed signs of cell destruction, abnormalities of the nucleus and organelles, and loss of mitochondrial cristae. However, no differences were observed in thymus EGF and EGFR immunoreactivity between treated and control rats.Patulin je mikotoksin koji proizvode plijesni sojeva Penicillium, Aspergillus i Byssachlamys na različitim prehrambenim proizvodima kao podlozi. Učinke patulina istražili smo na timusu mužjaka štakora u razvoju (dobi 5 do 6 tjedana). Mikotoksin je životinjama davan per os u dnevnoj dozi 0,1 mg kg-1 tj. t. 60 odnosno 90 dana. Na kraju pokusa štakori su žrtvovani, timus je podvrgnut histološkim analizama s pomoću svjetlosne mikroskopije, a imunocitokemijskim je metodama istražena stanična lokalizacija epidermalnog faktora rasta (EGF) i njegova receptora (EGFR). Morfometrijska analiza provedena je s pomoću računalnog programa Bs200prop povezanog u sustav sa svjetlosnim mikroskopom Olympus BX51. Elektronskomikroskopski je istražena ultrastruktura stanica timusa. Utvrđeno je da patulin izaziva krvaranja u timusu, hiperplaziju plazma-stanica, dilataciju i fi brozu u kortikalnoj regiji timusa, širenje intersticijskog tkiva između režnjeva timusa, povećanje masnih stanica, smanjenje debljine kore timusa te nestanak kortiko-medularne demarkacije. Elektronskomikroskopski u tkivu timusa štakora tretiranih patulinom uočeni su znakovi raspadanja stanica, abnormalnosti jezgre i organela te gubitak mitohondrijskih krista. Unatoč navedenomu, na presjecima tkiva kontrolnih štakora i štakora tretiranih patulinom nismo utvrdili razlike u imunoreaktivnosti EGF i EGFR, što bi trebalo dodatno istražiti osjetljivijim molekularnim metodama

Assessment the effect of diabetes education on self-care behaviors and glycemic control in the Turkey Nursing Diabetes Education Evaluating Project (TURNUDEP): a multi-center study

Background: Diabetes education in Turkey is provided by diabetes nurse educators in almost all healthcare organizations. However, the education is not standardized in terms of learning content, duration, and methods. This multi-center study was performed to assess the self-care behaviors and glycemic control following education provided to the patients with type 2 diabetes mellitus by diabetes nurse educators. Methods: This was a descriptive and cross-sectional study and included 1535 patients admitted to 28 public hospitals for the treatment of type 2 diabetes mellitus. The education was assessed by using a Patient Identification Form and Self-care Scale. Results: The proportion of individuals who received diabetes education within the last year was 78.5%, with 46.7% of them having received it once. Of the patients, 84.8% reported that they received diabetes education individually. It was found that the proportion of individuals who received education about oral antidiabetics (78.5%) and glucose testing at home (78.5%) was higher than the proportion of individuals who received education about exercise (58.8%) and foot care (61.6%). The status of diabetes education, education intervals, and the correlation of the education method with self-care and glycemic control was evaluated. Self-care and glycemic control levels were better among the patients who received diabetes education thrice or more and in patients who received education both individually and in a group (p < 0.05). Conclusions: Approximately three-quarters of individuals with type 2 diabetes mellitus received education by diabetes nurse educators in Turkey. Diabetes education is positively correlated with self-care and glycemic control levels among patients with type 2 diabetes mellitus. Efforts for generalization and standardized education for all diabetes patients are necessary. © 2022, The Author(s)

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Basın işletmelerinde mali denetim

Basın işletmelerinoe iç denetim ile bağımsız dış denetimin ve işletme içi kontrol sisteminin incelenmesi çalışmanın esasını oluşturmaktadır. Bu nedenle bir gazetenin bilanço ve gelir tablosu hesaplarının denetimi, basın işletmeleri yönünden dikkate alınması gereken hususlar irdelenerek detaylı biçimde incelenmiştir.Üç bölümden oluşan çalışmanın birinci bölümünde basın işletmelerinin çeşitleri, özellikleri, işletme fonksiyonları, hukuki yapıları ve mali sorunlarıyla ilgili genel açıklamalar yapılmıştır. İkinci bölümde denetim kavramı ve türleri ile denetim teknikleri, denetim standartları, işletme içi kontrol sistemi ve denetim raporlarına ilişkin bilgiler yer almaktadır.Üçüncü bölüm, bağımsız dış denetimin işlevlerini, bir gazetenin bilanço ve gelir tablosunda yer alan varlık, sermaye, borç, gelir ve gider hesaplarının bakiyelerinin incelenmesini kapsamaktadır.Türkiye'de basın işletmelerinde yapılan bağımsız dış denetimin yatırımcılar, alıcılar, kredi verenler, diğer çıkar grupları kısaca mali bilgileri kullananlar yönünden oynadığı rolün önemi detaylı şekilde açıklanmıştır. Ayrıca basın işletmelerinin, hataları önlemek amacıyla iç kontrol sistemlerini hızla geliştirdiği belirtilmiştir. Etkili bir iç kontrol sisteminin işletmede çalışanlar ve bölümler arasında tatmin edici bir işbölümü sağladığı ve bağımsız denetim çalışmalarının kapsamını belirleyen unsur olduğu vurgulanmıştır.The aim of this study is to analyze the internal and independent external auditing for media organizations as well as their internal control systems. The balance sheet and the income statement accounts of a newspaper prepared for use in auditing is analyzed in detail to determine the important points that should be taken into account.This study is composed of three sections. The first section gives general information about types and features of media organizations as well as their functions, legal structures and financial problems.In the second section basic concepts and types of auditing have been explained. This section was also prepared with an emphasis on auditing standards, auditing techniques, internal control systems and auditing reports. The third section is concerned with the functions of independent auditing and tests of important asset, owners' equity, liability, revenue and expense account balances of a newspaper.The important role of independent auditing in Turkish Press Industry for external financial information users such as investors, customers, creditors and other interest groups is explained in detail. It is also mentioned that Turkish media organizations are recently developing their internal control systems to prevent errors and irregularities. The efficient internal control is a satisfactory division of work among employees, departments and groups of employees in a firm and determines the extent of auditing procedures to be applied by the independent auditors