Günlük uygulamada yeni oral antikoagülanların karşılaştırmalı takip sonuçları

Okmeydanı Training and Research Hospital, Department of CardiologyIstanbul University Institute of Cardiology, Department of CardiologyObjectives: This study aims to examine the patients using dabigatran or rivoraxaban to compare their effectiveness and adverse events. Patients and methods: Our study includes a total of 174 patients (82 male, 92 female; mean age 70.7±8.8 years), using dabigatran (n=113) and rivoraksaban (n=61), who were admitted to our outpatient clinic consecutively between August 2013 and April 2014. Physical examination was performed, patient history, electrocardiogram and biochemical results were recorded. Bleeding and ischemic stroke risk scores (HAS-BLED and CHA2DS2-VASc scores) were calculated. Patients were followed for adverse events. Results: Patients were followed for an average of 12.9±2.4 months. The CHA2DS2-VASc scores were non-significant between the two groups (3.60±1.30 for dabigatran vs 3.90±1.22 for rivoraxaban, p>0.05). The patients using rivoraxaban had significantly higher HAS-BLED scores than the patients using dabigatran (2.01±0.95 vs 1.60±0.85, p=0.004). During the follow-up period, 12 of the patients had minor bleeding, two had gastrointestinal bleeding, two had intracranial hemorrhage and seven had ischemic stroke. Adverse events were non-significant between the rivoraxaban and dabigatran using patients (p>0.05 for each). Conclusion: Bleeding and ischemic stroke are rare adverse effects among all the patients. No significant difference was observed between both of the groups in terms of preventing ischemic stroke. Rivoraxaban can be a better option in the patients with high HAS-BLED score to avoid bleeding.Amaç: Bu çalışmada dabigatran veya rivoraksaban kullanan hastalar, bu ilaçların etkinlikleri ve yan etkilerini karşılaştırmak için araştırıldı. Hastalar ve yöntemler: Ağustos 2013 - Nisan 2014 tarihleri arasında ardışık olarak polikliniğimize başvuran ve halihazırda dabigatran (n=113) ve rivoraksaban (n=61) kullanan toplam 174 hasta (82 erkek, 92 kadın; ort. yaş 70.7±8.8 yıl) çalışmamıza dahil edildi. Hastaların fizik muayeneleri yapıldı, öyküleri, biyokimyasal değerleri ve elektrokardiyogramları kaydedildi. Kanama ve iskemik inme risk değerleri (HAS-BLED ve CHA2DS2-VASc) hesaplandı. Hastalar yan etkiler açısından takip edildi. Bulgular: Hastalar ortalama 12.9±2.4 ay takip edildi. İki grup arasında CHA2DS2-VASc skoru anlamlı değildi (dabigatran için 3.60±1.30’a karşın rivoraksaban için 3.90±1.22, p>0.05). Rivoraksaban kullanan hastaların HAS-BLED skorları dabigatran kullananlarınkinden anlamlı olarak yüksekti (2.01±0.95’e karşın 1.60±0.85, p=0.004). İzlem süresince hastaların 12’sinde minör kanama, ikisinde gastrointestinal kanama, ikisinde intrakraniyal kanama ve yedisinde iskemik inme meydana geldi. Dabigatran ve rivoraksaban kullanan hastalar arasında yan etkiler açısından anlamlı fark gözlenmedi (her biri için p>0.05). Sonuç: Kanama ve iskemik inme tüm hastalar arasında nadir yan etkilerdir. İskemik inmeden koruma açısından her iki grup arasında anlamlı farklılık gözlenmedi. Kanamayı önlemek için HAS-BLED skoru yüksek olan hastalarda rivoraksaban daha iyi bir seçenek olabili

Evaluation of CD109, PCP4 and SEMA3D genes for their association with Ovine Johne’s disease in Turkish sheep

Johne’s disease is a chronic, contagious, zoonotic disease that affects numerous species including livestock and sometimes humans. The disease is globally distributed in sheep populations and caused by Mycobacterium avium Subsp. paratuberculosis (MAP). A previous genome-wide association study identified single nucleotide polymorphism (SNP) markers associated with OJD serostatus in CD109, PCP4, and SEMA3D genes. Our aim was to evaluate the same markers for association with OJD seroprevalence in Turkish sheep in a retrospective matched case-control study. The serological status for OJD in 1801 sheep was determined for four native and four composite breeds from three research flocks. One hundred eleven matched case-control pairs were constructed according to breed type and age from 1750 comingled ewes reared in the same environment. A Single Nucleotide Primer Extension (SNuPE) assay was designed to genotype PCP4-Intron 1, PCP4-3’UTR, SEMA3D, CD109-intron 2 and CD109-intron 8 markers and a McNemar’s test was performed on the matched pairs. An association with these five markers was not detected with the OJD serostatus in Turkish sheep (power of detection, 0.95; odds ratio \u3e3; McNemar’s p \u3c.05). Thus, a wider search may be needed to identify any major underlying genetic risk factors for OJD in Turkish sheep

IMPORTANCE OF ROENTGEN TUBE ANGLES IN CINEFLUOROSCOPIC INVESTIGATION OF MECHANICAL PROSTHESES

Aim. We planned a cinefluoroscopy (CF) study to mark the ideal opening and closing tube angles for mitral and aortic positioned mechanical valves. Our hypothesis was that if we find an intensity zone where the valves were optimally seen, then starting the CF examination from that tube position would shorten the examination durationMaterial and methods. Between January 2010 and August 2011, 192 consecutive patients (mean age 51,86±12,80 years; 101 women and 91 male) with mitral (n=135; monoleaflet: 37; bileaflet: 98) and aortic (n=87; monoleaflet:19; bileaflet: 68) and tricuspid (n=3; all bileaflet) prostheses were enrolled into the study. Cinefluoroscopy was performed with Philips Radiologic System. For each type and location of mechanical prostheses optimal opening-closing angles obtained and marked on x-y axis graphic. Furthermore, we investigated whether there is an intensity zone quadrant.Results. Among patients with prosthetic bileaflet mitral valve in supine position optimal images were obtained: 34 (58,6%) patients were in RAO-Cranial, 12 (20,7%) were in left anterior oblique (LAO) cranial, 7 (12,1%) were in RAO caudal and 5 (8,6%) were in LAO caudal angles. Among patients with prosthetic bileaflet aortic valves in supine position shown: 27 (50%) patients were in LAO-cranial, 10 (18,5%) were in RAO- cranial, 9 (16,7%) were in LAO-caudal and 8 (14,8%) patients were in RAO-caudal angles.Conclusion. According to our results it seems logical to start mitral position CF assessment by RAO-Cranial angles quadrant and for aortic position by LAO-Cranial angles quadrant to decrease time and lower radiation exposure

Türkiye’de lisans eğitimi veren fizyoterapi ve rehabilitasyon okullarındaki son sınıf öğrencilerinin mesleki farkındalık düzeylerinin değerlendirilmesi

Mesleki farkındalık, o mesleğin yeterlilikleri, meslekle ilgili yasa ve yönetmelikler, görev vesorumluluklarla ilgili önbilgi sahibi olmayı gerektirir. Bireysel istek her zaman insanların mesleğinitam olarak belirleyememektedir. Literatürde, ülkemizdeki fizyoterapi ve rehabilitasyon okullarındakison sınıf öğrencilerinin mesleki farkındalık düzeyi kapsamlı bir şekilde değerlendirilmemiştir.Çalışmanın amacı, bu okullardaki son sınıf öğrencilerinin mesleki farkındalık düzeylerinideğerlendirmek ve bölümü istekleri doğrultusunda tercih eden öğrencilerle, bölümü istemedentercih eden öğrencilerin mesleki farkındalık düzeylerini karşılaştırmaktı.Yöntem: Bu çalışma için, Türkiye’deki 10 üniversite örneklem olarak seçildi. Katılımcılara meslekifarkındalıkla ilgili 10 sorudan oluşan bir anket uygulandı. Tanımlayıcı istatistikler hesaplandı.Öğrencilerin mesleki farkındalık düzeylerinin karşılaştırılmasında Ki-kare testi kullanıldı.Sonuçlar: Çalışmamıza 850 fizyoterapi ve rehabilitasyon bölümü son sınıf öğrencisi katıldı.Soruların % 71,19’una doğru cevap verildi. Katılımcıların % 77,29’unun bölümü isteyerek tercihettiği belirlendi. Bölümü isteyerek tercih edenler ile istemediği halde tercih edenler arasındamesleki farkındalık açısından fark bulunmadı (p>0,05).Tartışma: Bu çalışmada son sınıf fizyoterapi ve rehabilitasyon bölümü öğrencilerinin çoğundamesleki farkındalığın iyi düzeyde olduğu görüldü. Ancak bazı okullardaki mesleki farkındalık düzeyiorta seviyedeydi. Bu okullarda mesleki farkındalık düzeylerinin artırılması için seminerler vesöyleşiler gibi faaliyetlerin yapılmasının faydalı olacağını düşünüyoruz

Atypical Chest X-Ray Calcification in an Idiopathic Constrictive Pericarditis Case

Constrictive pericarditis is an uncommon cause of heart failure. It is a clinical entity caused by thickening, fibrosis, and/or calcification of the pericardium. We present a 50-year-old female patient who was admitted to our institution with a 6-month history of progressive dyspnea on exertion, abdominal swelling, and lower extremity edema. Her chest X-ray revealed an oblique linear calcification in the cardiac silhouette. Transthoracic echocardiography revealed biatrial enlargement. Left ventricular size and systolic function were normal. Cardiac computed tomography revealed the pericardial thickening (>5 mm) and heavy calcification in left atrioventricular groove. Simultaneous right and left heart catheterization showed elevation and equalization of right-sided and left-sided diastolic filling pressures, with characteristic dip, and plateau. Pericardiectomy was performed which revealed a thick, fibrous, calcified, and densely adherent pericardium constricting the heart. The postoperative period was uneventful and was in NYHA functional class I after 3 months

An assessment of professional awareness of senior undergraduate students in physiotherapy and rehabilitation schools in Turkey[Türkiye'de lisans eğitimi veren fizyoterapi ve rehabilitasyon okullarindaki son sinif öğrencilerinin mesleki farkindalik düzeylerinin değerlendirilmesi]

Purpose: Professional awareness requires knowledge of the competencies of the profession, occupational laws and regulations, duties and responsibilities. Individual demand cannot always determine the profession of people. In the literature, level of professional awareness of senior students in physiotherapy and rehabilitation schools in Turkey has not been extensively assessed. The aim of the study was to evaluate level of professional awareness of senior grade students, and to compare professional awareness between the students who prefer the department on their willingness and the students who prefer the department unwillingly. Methods: For this study, 10 universities were selected to be as samples in Turkey. A 10-item survey was applied to the participants about professional awareness. The descriptive statistics were given. Chi-Square test was used to compare the students' professional awareness levels. Results: The 850 senior students from physiotherapy and rehabilitation participated in the study. The 71.19% of the questions were answered correctly. It was detected that 77.29% of the participants preferred due to their wish. There was no difference in terms of professional awareness among those who preferred the department whether based on their wish and not (p>0.05). Conclusion: In this study, it was seen that most of the last year physiotherapy and rehabilitation students had good professional awareness. However, level of professional awareness in some schools was moderate. We thought that it would be beneficial to accomplish activities such as seminars and interviews for increasing the levels of professional awareness in these schools. © 2019 Turkish Physiotherapy Association. All rights reserved