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Taha Toros Arşivi, Dosya Adı: İstanbul Genel Dokümanlarıİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

The role of vitamin D in the development of asthma.

TEZ8737Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2012.Kaynakça (s. 86-110) var.ix, 112 s. : rnk. res., tablo ; 29 cm.Objectives: Recently some studies have been published concerning about the role of vitamin D in asthma as in some other diseases. In this study, we aimed to evaluate the effect of serum vitamin D level and vitamin D deficiency on the development and clinical features of asthma. Material and Method: 88 stable and 24 exacerbated asthma patients and similar aged and gender 94 healthy adults as control group were evaluated in the study. Detailed demographic data and clinical features, pulmonary function tests results of all participants were recorded. Serum 25(OH)D3 has been analyzed with high pressure liquid chromotography technique. Serum vitamin D levels ?20 ng/ml has been accepted as vitamin D deficiency. Results: The group of patients with asthma, 86 (76.8 %) were female, mean age was 43.7 +- 14.2 years, while the healthy control group, 62 (66 %) were female, mean age was 45.1 +- 10.4 years. The mean serum vitamin D level in all asthmatic patients (n = 112) group was 25.19 +- 12.01 ng/ml while the control group's was 27.09 +- 12.9 ng/ml, respectively, and there was no significant difference between the two groups (p = 0.27). There was no significant difference between stable asthma group, exacerbated asthma group and the control group's mean serum vitamin D levels and vitamin D deficiency (respectively p=0.398, p=0.363). In contrast to the control group, serum vitamin D levels of all asthmatic females (23.89 +- 11.92 ng / ml) was significantly lower than males (29.52 +- 11.48 ng / ml) (p = 0.03). FEV1 (L) and FVC (L) levels were significantly lower in the vitamin D deficient group of both the asthmatic and the control group (respectively in patients p = 0.003, p = 0.01, in control group p = 0.04, p = 0.005). Also serum vitamin D level was significantly positively correlated with FEV1 (L) and FVC (L) levels in both groups (respectively in patients p = 0.004, p = 0.03, in control group p = 0.01, p = 0.04). In stable asthma group (n=88), mean serum vitamin D level of obese patients (22.8+-13.3 ng/ml) was significantly lower than non-obese patients (27.9+-11.2 ng/ml), the difference was significant (p=0.024). Again in the stable asthma group, body mass index and serum vitamin D levels were significantly negatively correlated (p=0.02) Conclusion: As a result of this study, the serum vitamin D levels and vitamin D deficiency were not different from control group, but significantly associated with female gender, poor lung function and obesity. In order to determine the effect of vitamin D on the development of asthma, further studies that contain both serum genetic analysis in addition to vitamin D level measurement are needed.Amac: Son yıllarda Vitamin D'nin ceşitli hastalıklarla ilişkisine ek olarak astım da rolu olabileceğini gosteren calışmalar yayınlanmıştır. Bu calışmada serum vitamin D duzeyinin ve vitamin D eksikliğinin astım gelişimi ve klinik ozellikleri uzerine olan etkisini araştırmayı amacladık. Gerec ve yontem: Bu calışmaya stabil astımlı 88 ve alevlenme doneminde olan 24 astımlı hasta ile benzer yaş, cinsiyet ozelliklerine sahip 94 sağlıklı yetişkin kontrol grubu olarak alınmıştır. Tum katılımcıların ayrıntılı demografik bilgileri ve klinik ozellikleri kaydedildikten sonra solunum fonksiyon testleri yapıldı. Serum 25(OH)vitaminD3 duzeyi yuksek basınclı sıvı kromotografi yontemiyle calışıldı. Serum 25(OH)D3 duzeyi ?20 ng/ml vitamin D eksikliği olarak kabul edildi. Bulgular: Astımlı hasta grubunun 86'sı (% 76,8) kadın olup yaş ortalaması 43,7+-14,2 yıl iken sağlıklı kontrol grubunun 62'si (% 66) kadın ve yaş ortalaması 45,1+-10,4 yıl idi. Serum vitamin D duzeyi ortalaması tum astımlı hasta (n=112) grubunda 25,19+-12,01 ng/ml iken kontrol grubunda 27,09+-12,9 ng/ml idi ve iki grup arasında anlamlı fark saptanmadı (p=0,27). Stabil astımlı hasta grubu, alevlenme donemindeki hasta ve kontrol grubu arasında serum ortalama vitamin D duzeyi ve vitamin D eksikliği yonunden anlamlı fark bulunmamıştır (p=0,398, p=0,363). Kontrol grubunun aksine tum astımlı hasta grubunda serum vitamin D duzeyi ortalaması kadınlarda (23,89+-11,92 ng/ml) erkeklerden (29,52+-11,48 ng/ml) anlamlı olarak duşuk bulunmuştur (p=0,03). Astımlı hasta ve sağlıklı kontrol grubunda vitamin D eksikliği olanlarda FEV1 (L) ve FVC (L) değeri vitamin D eksikliği olmayanların FEV1 (L) ve FVC (L) değerine gore anlamlı duzeyde duşuk bulunmuştur (sırasıyla astımlı hasta grubunda p=0,003, p=0,01, kontrol grubunda p=0,04, p=0,005) . Ayrıca her iki grupta da vitamin D duzeyi ile FEV1 ve FVC (L) değerleri arasında pozitif korelasyon saptanmıştır (sırasıyla astımlı hasta grubunda p=0,004, p=0,03, kontrol grubunda p=0,01, p=0,04). Stabil astımlı (n=88) hasta grubunda obez olanların serum ortalama vitamin D duzeyi (22,8+-13,3 ng/ml) obez olmayanlara gore (27,9+-11,2 ng/ml) anlamlı derecede duşuk bulunmuştur (p=0,024). Yine stabil astımlı hasta grubunda vucut kitle indeksi ile vitamin D duzeyi arasında anlamlı negatif korelasyon saptanmıştır (p=0,02). Sonuc: Bu calışma sonucunda serum vitamin D duzeyi ve eksikliğinin astımlı hastalarda kontrol grubundan farklı olmadığı ancak kadın cinsiyet, duşuk akciğer fonksiyonları ve obezite ile anlamlı duzeyde ilişkili olduğu saptanmıştır. Vitamin D'nin astım gelişimindeki etkisini ortaya koymada serum vitamin D duzeyi olcumunun genetik calışmalarla desteklendiği ileri calışmalara ihtiyac duyulmaktadır

Does scapular elevation occur with glenohumeral flexion and abduction? a study through open magnetic resonance imaging and autopsy

Objectives: This study aims to reveal whether there is an elevation in scapula during flexion and abduction of the glenohumeral joint. Patients and methods: In the first stage of our study 32 subjects were randomly divided into two groups. The mobility of the scapular notch was examined using open magnetic resonance imaging (MRI) assay when the glenohumeral joint was in flexion in the first group (5 males, 10 females; mean age 21.1 years; range 18 to 24 years) and in abduction in the second group (8 males, 9 females; mean age 22.1 years; range 18 to 27 years) and the motion range was found to be between 0 and 150 degrees. In the second stage of our study, the mobilities of the scapular notch was examined on autopsy during passive humeral mobility. Results: According to the open MRI results, there was no elevation or depression during the passive flexion and abduction of the glenohumeral joint. While the scapular notch migrated slightly to the medial side during abduction of the glenohumeral joint, it did not move during flexion. Also in an autopsy study, we observed that scapula did not move in vertical direction during the glenohumeral abduction and flexion mobilities. Conclusion: There is no vertical mobility in the scapula during glenohumeral flexion and abduction. Also, there is no medial mobility during flexion except during abduction

A Case of Community Acquired Pneumonia Related Cavitary Lesion Due to Methicillin-Resistant Staphylococcus Aureus

Toplumda gelişen pnömoni, tüm dünyada yaygın ve ciddi bir hastalıktır. En sık etkenler Streptococcus pneumoniae ve Mycoplasma pneumoniae'dir. Toplum kökenli metisilin dirençli Staphylococcus aureus (TK-MRSA), sağlık bakımı risk faktörü olmayan, sağlıklı kişilerde pnömoni etkeni olarak karşımıza çıkar. TK-MRSA'nın neden olduğu kaviter pnömoni yüksek mortalite ve morbiditeye sahiptir. Bu nedenle erken tanı ve tedavi çok önemlidir. Bu yazıda, kaviter lezyonla ilişkili MRSA'ya bağlı toplumda gelişen pnömoni olgusunun sunulması amaçlanmıştırCommunity acquired pneumonia is a common and serious illness worldwide. The most common causative agents are Streptococcus pneumoniae and Mycoplasma pneumoniae. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) emerges as agent of pneumonia in healthy people without health care risk factor. Cavitary pneumonia which is caused by CA-MRSA, has high mortality and morbidity. Therefore, early diagnosis and treatment are crucial. In this paper, we aimed to present a case of community-acquired pneumonia related cavitary lesion due to MRS

Asthma and vitamin D

WOS: 000449650901585

Massive Pulmonary Thromboembolism In A Sarcoidosis Patient: Case Report

Although sarcoidosis is not a well known risk factor of pulmonary thromboembolism, recent investigations shows increased risk of pulmonary thromboembolism in these patients with the lack of any other risk factor. In this case report, massive pulmonary embolism was presented in a forty seven years old female patient who is followed up under metilprednisolon therapy due to sarcoidosis for five months. This patient was underlined because of that sarcoidosis may be a potential risk factor of pulmonary thromboembolism and must be kept in mind at the patients with sarcoidosis and acute deletoration. Keywords: [Cukurova Med J 2011; 36(1.000): 37-40

Safety and pulmonary function impact of surgical mask usage in stable COPD patients during the COVID-19 pandemic

There are hesitations about the use of surgical face masks, which are the main tools in protection from the COVID-19 pandemic, one of the biggest disasters of our age, in chronic airway diseases. The purpose of the study was to examine how stable patients with chronic obstructive pulmonary disease (COPD) responded to short-term surgical mask use in terms of in-mask air quality, oxygen saturation, and pulmonary function. Forty-one patients with stable COPD, by clinical presentation and pulmonary function tests (PFTs), were included in a quasi-experimental study. Stable COPD patients' PFTs, in-mask air quality, and pollution measures were collected before and after wearing surgical masks for two hours at rest. The findings of simultaneous tests of peripheral-blood-oxygen saturation were also recorded. The mean age of participants was 67.1 years and 87.8% were male. The pre- and post-mask PFTs parameters for GOLD (A+B) group were FEV1 (ml), FEV1 (%), FVC (ml), FVC (%), FEV1/FVC (%) and DLCO (%) (p=0.067, p=0. 065, p=0.062, p=0.083, p=0.083, p=0.269, p=0.956, respectively), whereas in GOLD (C+D) group (p=0.340, p=0.538, p=0.728, p=0.044, p=0.105, p=0.054, respectively). In post-mask measurements, the respiratory function was not impaired in GOLD-2022 (A-B-C-D) COPD subgroups. Oxygen and carbon-monoxide concentrations in exhaled air and oxygen saturation decreased after surgical mask use. The difference was statistically significant, but the difference was unimportant in terms of clinical implications. Surgical masks don't appear to have a negative effect on pulmonary function and clinical parameters in stable COPD. This study may help provide evidence-based data to overcome hesitations in use of surgical masks in chronic airway diseases. [Med-Science 2023; 12(3.000): 865-71

Postoperative Mortality after Hip Fracture Surgery: A 3 Years Follow Up.

To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period.The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded. At 36 months after surgery, evaluation was made using a structured telephone interview and a detailed examination of the hospital medical records, especially the documents written during anesthesia by the anesthesiologists and the documents written at the time of follow-up visits by the orthopaedic surgeons. A total of 124 cases were analyzed and 4 patients were excluded due to exclusion criteria. The collected data included demographics, type of fracture, co-morbidities, American Society of Anesthesiologists (ASA) scores, anesthesia techniques, operation type (intramedullary nailing or arthroplasty; cemented-noncemented), peroperative complications, refracture during the follow-up period, survival period and mortality causes.The total 120 patients evaluated comprised 74 females(61.7%) and 46 males(38.3%) with a mean age of 76.9±12.8 years (range 23-95 years). The ASA scores were ASA I (0.8%), ASA II (21.7%), ASA III (53.3%) and ASA IV (24.2%). Mortality was seen in 44 patients (36.7%) and 76 patients (63.3%) survived during the 36-month follow-up period. Of the surviving patients, 59.1% were female and 40.9% were male.The survival period ranged between 1-1190 days. The cumulative mortality rate in the first, second and third years were 29.17%, 33.33% and 36.67% respectively. The factors associated with mortality were determined as increasing age, high ASA score, coronary artery disease, congestive heart failure, Alzheimer's disease, Parkinson's disease, malignancycementation and peroperative complications such as hypotension (p<0.05). Mortality was highest in the first month after fracture.The results of this study showed higher mortality rates in patients with high ASA scores due to associated co-morbidities such as congestive heart failure, malignancy and Alzheimer's disease or Parkinson's disease. The use of cemented prosthesis was also seen to significantly increase mortality whereas no effect was seen from the anesthesia technique used. Treatment of these patients with a multidiciplinary approach in an orthogeriatric ward is essential. There is a need for further studies concerning cemented vs. uncemented implant use and identification of the best anesthesia technique to decrease mortality rates in these patients