Turkish version of the paindetect questionnaire in the assessment of neuropathic pain: A validity and reliability study

Objectives: The aim of this study was to develop a Turkish version of the painDETECT questionnaire (PD-Q) and assess its reliability and validity. Methods: Two hundred and forty patients who were diagnosed by expert pain physicians in daily clinical practice and classified as having either neuropathic, nociceptive, or mixed pain for at least 3 months were enrolled in this study. After the usual translation process, the Turkish version of the PD-Q was administered to each participant twice with an interval of 48 hours. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Douleur Neuropathique en 4 questions (DN4) and a pain visual analog scale were assessed along with the PD-Q. Chronbach's α was calculated to evaluate internal consistency of the PD-Q. Intraclass correlation coefficient was calculated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with LANSS and DN4. Discriminant statistics-sensitivity, specificity, Youden index, positive predictive value, negative predictive value-were also assessed. Results: A total of 240 patients with chronic pain, 80 patients in each neuropathic, nociceptive, and mixed pain group, were included in this study. Mean age of the patients was 54.1 years, and majority of the patients were female (52.9%). Chronbach's α of the Turkish version of the PD-Q was 0.81. The test-retest reliability of the Turkish version of the PD-Q was determined as 0.98 for the total score and ranged from 0.86 to 0.99 for individual items. The Turkish version of the PD-Q was possitively and significantly corralated with LANSS (r 0.89, P<0.001) and DN4 (r 0.82, P<0.001). When the two cutoff values in the original version were used, sensitivity was found 77.5% for a cutoff value ≤19, and specificity was 82.5%. Sensitivity and specificity were 90% and 67.5%, respectively, for the other cutoff value ≤12. Scores ≤12 represents a negative predictive value=87%, and scores 19≤ represents a positive predictive value=82%. When mixed pain patients were included in the neuropathic pain group, discriminant values were reduced as expected. Conclusions: The Turkish version of the PD-Q is a reliable and valid scale to be used to determine neuropathic component of chronic pain in Turkish patients. © 2013

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria

BackgroundMigraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.MethodsIn this multicenter study including 809 consecutive patients with a diagnosis of I/GE with or without headache, 163 patients who were diagnosed by an experienced headache expert as having a comorbid MwoA were reevaluated. Eligible patients were divided into three subgroups, namely, full diagnosis, zone I, and zone II according to their status of fulfilling the ICHD-3 criteria. A Classification and Regression Tree (CART) analysis was performed to bring out the meaningful predictors when evaluating patients with I/GEs for MwoA comorbidity, using the variables that were significant in the univariate analysis.ResultsLonger headache duration (&lt;4 h) followed by throbbing pain, higher visual analog scale (VAS) scores, increase of pain by physical activity, nausea/vomiting, and photophobia and/or phonophobia are the main distinguishing clinical characteristics of comorbid MwoA in patients with I/GE, for being classified in the full diagnosis group. Despite being not a part of the main ICHD-3 criteria, the presence of associated symptoms mainly osmophobia and also vertigo/dizziness had the distinguishing capability of being classified into zone subgroups. The most common epilepsy syndromes fulfilling full diagnosis criteria (n = 62) in the CART analysis were 48.39% Juvenile myoclonic epilepsy followed by 25.81% epilepsy with generalized tonic-clonic seizures alone.ConclusionLonger headache duration, throbbing pain, increase of pain by physical activity, photophobia and/or phonophobia, presence of vertigo/dizziness, osmophobia, and higher VAS scores are the main supportive associated factors when applying the ICHD-3 criteria for the comorbid MwoA diagnosis in patients with I/GEs. Evaluating these characteristics could be helpful to close the diagnostic gaps in everyday clinical practice and fasten the diagnostic process of comorbid MwoA in patients with I/GEs

Evaluation Of Enzymatic Hydrolysis Reaction Of Sunflower Acid Oil

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2002Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2002Deterjan, sabun, kozmetik, tekstil ve boya endüstrisinde geniş bir kullanım alanına sahip olan yağ asitlerinin üretimi, günümüzde kimyasal katalizörler varlığında yüksek sıcaklık ve basınç altında yürütülen sürekli ters akım hidroliz prosesi ile yapılmaktadır. Bu yöntemin çok fazla enerji gerektiren bir proses olması ve termal bozunma sonucu ürün kalitesinin bozulmasından dolayı, yeni arayışlara girilmiş, enzimatik yağ hidrolizinin yağ asitleri üretiminde önemli bir potansiyel oluşturabileceği düşünülerek bu konudaki çalışmalara hız verilmiştir. Bu çalışmada, günümüzde düşük kaliteli sabunların üretiminde ham madde olarak kullanılan, yemeklik yağ üretimi yan ürünü olan ayçiçek asidik yağının Lipase PS Amano mikrobiyal lipazı varlığındaki enzimatik hidroliz reaksiyonu incelenmiştir. Çeşitli enzim miktarı, sıcaklık, enzim/yağ oranı, su ve tampon çözelti içeriğinde yürütülen reaksiyonlarla hidroliz reaksiyonunun optimum koşullarının belirlenmesine çalışılmıştır. Ayçiçek asidik yağının Lipase PS Amano mikrobiyal lipazı katalizörlüğünde gerçekleştirilen hidroliz reaksiyonu için optimum enzim /yağ oranının 0.05 olduğu gözlenmiştir. Bu enzim/yağ oranında optimum sıcaklık 45°C ve optimum su miktarı nötral gliseridlerin %80i olarak belirlenmiştir. 45°Cde, 0.05 enzim/yağ oranında, nötral gliseridlerin %80i kadar farklı pHlardaki tampon çözeltiler ile yürütülen hidroliz reaksiyonlarında ise Lipase PS Amano için optimum pHın 7 olduğu görülmüştür.The production of fatty acids which has wide applications in detergent, soap, cosmetics, textile and paint industries, is realised with the continuous reverse flow hydrolysis under the presence of chemical catalysts, at high temperature and pressure. Since this method is high energy demanding process and thermal denaturation of products becasue of thermal dissociation, new research studies are started and with the consideration of enzymatic hydrolysis will be important potential in the production of fatty acids these studies are accelerated. In this study, enzymatic hydrolysis reaction with the presence of Lipase PS “Amano” microbial lipase for sunflower acid oil which is one of the acid oils mainly that are used as a raw material in low quality soap production, which is by product of edible oil production was examined. With the various amounts of enzyme, temperature, enzyme/acid oil ratio, water and buffer solution contents the reactions were carried out and the optimum conditions were tried to be determined. For the hydrolysis reaction of sunflower acid oil with the presence of Lipase PS “Amano” microbial lipase catalyst the optimum enzyme/acid oil ratio was determined as 0.05. At this enzyme/fatty acid ratio the optiumum temperature was observed as 45°C and the optimum water amount as 80% of neutral glycerids. At the conditions of 45°C and 0.05 enzyme/acid oil ratio, water amount 80% of neutral glycerids various reactions were carried out with differernt buffer solutions and for Lipase PS “Amano” the optimum pH was determined as 7. With the optimum reaction conditions which are determined for sunflower acid oil a hydrolysis reaction for corn acid oil was carried out and it was decided that Lipase PS ”Amano” has a substrat selectivity for sunflower acid oil.Yüksek LisansM.Sc

EPİLEPSİ FARE MODELLERİNDE KETOJENİK DİYET ARALIKLI AÇLIK VE YÜKSEK YAĞLI DİYETİN DAVRANIŞ VE BDNF ÜZERİNE ETKİSİNİN DEĞERLENDİRİLMESİ

Dirençli epilepsi tedavisinde ketojenik diyet etkinliği bilinen bir tedavi yöntemidir. Keton cisimlerin serumda artışı, kan beyin bariyerini geçerek santral sinir sistemine kolay iletişimi ile tedavi edici özelliği oluşmaktadır. Ancak keton cisimlerin santral sinir sistemine ulaşımı ile birlikte oluşan antiepileptik durumun moleküler mekanizmaları tam olarak bilinmemektedir. Ketojenik diyetin epilepsi üzerine etkisinden yola çıkarak normal diyete karşın yüksek yağlı diyet, aralıklı açlık ve santral sinir sistemindeki etkisi BDNF düzeyleri ölçülerek değerlendirilecektir.8 haftalık erkek farelere PTZ enjeksiyonu ile epilepsi modeli oluşturulacaktır. Fareler dört ayrı beslenme grubuna ayrılarak ketojenik diyet, aralıklı açlık, yüksek yağlı diyet ve standart diyet uygulanacaktır. Diyet uygulaması 3 ay boyuca devam edecek ve sürecin sonunda serumdan BDNF düzeyi analiz edilecek ve davranış testleri uygulanacaktır.BDNF farklı diyet uygulamalarında farklı etkileri olan; nöbet oluşumunda ve tedavisinde etkili bir moleküldür. Bu çalışma farklı diyet uygulamalarının BDNF ve davranış üzerine etkisini anlamayı amaçlar.</p