17-20 yaş grubundaki güreşçilerde ve sedanterlerdeki iskelet osteoblastik aktivite dağılımlarının karşılaştırılması

In this study, the difference in the ratios of bone invasion in wrestlers and sedantery persons has been investigated by using 99m Tc _ MDP scintigraph. By this aim, twenty elite level wrestlers were selected from the activity show wrestling clups in Konya city, whit at least five years in practice and they were 17-20 years old; this group wasconsidered as an experimental group. Ten sedantary persons whith same range of age who never exercised any form of sports were considered as a control group . totally 30 subjects were involved in this study.By using of 99m Tc – MDP scintigraph in both group, for all persons static images were taken in the palm of the hands, head and neck, thoracic cage and in the lumbar, pelvic and both kness and feet regions and in the anterior and posterior regions of bi-lateral shoulders.According to the result of the guantitative analysis of both wrestlers and sedantery persons, the ratios of the radioactive invasion were calculated in the palm of the hands, anterior and posterior regions of the sholdres, anterior and posterior  regions of the pelvic articulations of knees and feed regions and in the shafts of the humerus, tibia and femur.Obtaining data of both groups were statistically analyzed and compared whith Mann Whitney U- test. Result showed that radioactive invasion in the shafts of humeral, radial, and femoral bones in wrestlers was significantly higherthan in controls(p<0,05). İn the other regions no significant differences between group has been found(p>0,05).In case of wrestlers, it was seen that stres over the skaletal system had an excersive effect on the upper limbs namely the shafts of humerus and radius in both sides. However, in the lower limb a same effect was seen in the shafts of bi-lateral femurs and in the knees joint regions. In these regions, it was fount thatin bone scintigraph, increment in the osteoblasttic activity causes secondary increment in the radioactive invasion.According to the physiological changes in bone formation, with more confidence, the streess effect over the skeletal system can be visually and quantitatively evaluated.Bu çalışmayla güreşçilerde ve sedanterlerde 99m Tc- MDP sintigrafisi uygulanarak kemik tutulum oranlarındaki farklılık araştırılmaya çalışıldı. Bu amaçla Konya ilinde güreş sporunda faaliyet gösteren kulüplerden en az beş yıl güreş yapmış 17-20 yaşları arasında elit düzeydeki 20 güreşçi deney grubu, hiç spor yapmamış aynı yaş grubunda 10 sedanter kontrol grubu olmak üzere toplam 30 kişi çalışma kapsamına alınmıştır.Her iki gruba da 99m Tc-MDP sintigrafisi uygulanarak çalışmada tüm kişilerin elin anterior, baş, boyun, göğüs kafesi, pelvis, diz ve ayak bölgeleri ile omuzun anterio’u ve posterior’u, lumbal ve pelvisin statik görüntüleri alındı. Kopütürde kantitatif analiz sonucu güreşçi ve sedanterlerin elinin anterior’u ve posterior’u, omuzun  anterior’u ve posterior’u, pelvisin anterior’u ve posterior’u, diz ve ayak bölgesi eklemleri, humerus,tibiave femur şaftında radyo aktif tutulum (RAT) oranları hesaplandı. Elde edilen değerler, güreşçi ve sedanterlerin ortalamaları eşleştirilmiş gruplar arası Man Whitney U testi ile istatistiksel değerlendirilmeye alınmıştır. Güreşçilerde her iki humerus, radius ve femur kemik şaftlarında artmış radyoaktif tutulumları (p<0i05) bulunmuştur. Diğer bölgelerde pelvis, omuz ve ayak bölgelerinde her iki grup radyoaktif dağılımları arasında anlamlı fark bulunamamıştır (p>0,05).Sonuç olarak güreşçilerde iskelet sistemi üzerinde yüklenmenin üst ekstremitede en fazla her iki humerus ve radius şaftlarında görülmüştür. Alt ekstremitede ise her iki femur şaftı ve diz eklem bölgesinde görülmüştür. Bu bölgelerde kemik sintigrafisinde osteoblastik aktivite artışına sekonder artmış radyoaktif tutulumlar mevcuttur.Bu sonuçlar güreşçilerde aktivite sonucu kuvvete en fazla maruz kalınan bölgelerin üst eksremitede humerus ve radius olduğu, alt eksremitede ise her iki femur ve diz eklemi olduğu görülmektedir. İskelet sisteminde yüklenmeye bağlı oluşan fizyolojik değişiklikleri en doğru güvenilir olarak vizvel  ve kantitatif olarak değerlendirilmesi mümkündür.&nbsp

Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention

Background: Concomitant thyroid and heart disease are frequently encountered in clinical practice. There are many studies evaluating thyroid function in acute and critical conditions. Information on thyroid dysfunction in ST-segment elevation myocardial infarction (STEMI) is limited; its correlation with short and long-term outcome is not fully known.Methods: Four hundred and fifty seven patients diagnosed with STEMI in our emergency department were included in the study. Patients were divided into two groups: patients with normal thyroid function (euthyroid) and patients with thyroid dysfunction. STEMI was diagnosed with 12 derivation surface electrocardiogram. Thyroid hormone levels (TSH, free T3 and free T4) were measured. Patients with other acute coronary syndromes and endocrine pathologies except diabetes mellitus were excluded. Two patient groups were compared in terms of in-hospital and long-term outcome.Results: Out of 457, 72 (15%) patients with thyroid dysfunction were detected. The other patients were euthyroid and constituted the control group. In-hospital cardiogenic shock (15% vs. 3% in the control group; p < 0.01) and death (7% vs. 1% in the control group; p < 0.01) were more frequently observed in the thyroid dysfunction group. In the subgroup analysis, it was observed that patients with sick euthyroid syndrome have the poorest outcome. Other markers for poor outcome were anemia and renal failure.Conclusions: Thyroid dysfunction, particularly sick euthyroid syndrome, was found to be related to in-hospital and long term mortality in patients with STEMI undergoing primary percutaneous intervention

ADMA (Asymmetric Dimethylarginine) level in dipper and nondipper hypertensive patients

YÖK Tez No: 266773Giriş: ADMA, nitrik oksit sentezinin endojen bir inhibitörü olup aynı zamanda endotel disfonksiyonunun bir göstergesidir. HT, hiperkolesterolemi, DM, periferik arter hastalığı ve KKY' de arttığı birçok çalışmada gösterilmiştir. Ayrıca, non-dipper HT paternine sahip hastalarda yapılan çalışmalarda endotel disfonksiyonun dolayısıyla hedef organ hasarının dipper HT paterni olan hastalardan daha fazla olduğu gösterilmiştir. Ancak bu çalışmalarda endotel fonksiyonun değerlendirilmesinde ADMA dışındaki diğer endojen belirteçler kullanılmıştır. Biz ise çalışmamızda bu iki grup arasında endotel fonksiyonu değişikliklerini ADMA seviyelerine bakarak karşılaştırdık.Materyal-Metod: Bu çalışmaya 6 ay içerisinde Düzce Üniversitesi Tıp Fakültesi Kardiyoloji polikliniğine başvuran ve daha önceden esansiyel HT tanısı konulup medikal tedavi ile takip edilen 87 hasta dahil edildi. Hastalar ambulatuar kan basıncı ölçümü yapılarak dippers ve non-dippers olmak üzere iki gruba ayrıldı. Hastaların VKİ, SKB ve DKB, trigliserid, total kolesterol, LDL kolesterol, HDL kolesterol ve ADMA ölçümleri yapıldı.Bulgular: Grupların yaş, VKİ ve lipid değerleri arasında istatistiksel olarak fark yoktu (p>0.05). Dipper grubunda bakılan ADMA seviyeleri 1.29±0.17 µmol/L, non-dipper grubunda ise 1.27±0.13 µmol/L idi. Dipper ve non-dipper grupları arasında ADMA açısından anlamlı farlılık yoktu (p=0.575).Sonuç: ADMA seviyeleri HT hastalarında bozulmuş endotel fonksiyonuna bağlı olarak yüksek olarak bulunur. Kan basıncının non-dipper paterninde endotel disfonksiyonu dipper paterni olanlara göre daha fazladır. Bizim çalışmamızda iki patern arasında ADMA seviyelerinde farklılık bulunamamıştır. Bu konuda daha büyük çapta çalışmalara ihtiyaç olduğu kanaatindeyiz.Introduction: ADMA is an endogenous inhibitor of nitric oxide synthesis and also is an indicator of endothelial dysfunction. Increased ADMA levels has been shown in many studies in patients with hypertension, hypercholesterolemia, diabetes mellitus, peripheral arterial disease, and congestive heart failure. Patients who has nondipper blood pressure pattern has been shown to exhibit more endothelial dysfunction than patients who has dipper blood pressure pattern. However , other endogenous markers, but not ADMA, are used to assess endothelial function in these studies. In our study, we used ADMA levels to campare differences in endothelial function between each groups.Material-method: This study includes 87 patients who admitted to Düzce University, Cardiology outpatient clinic within 6 months and previously has been diagnosed with essential HT and followed with medical therapy. Patients were divided into two groups as non-dippers and dippers, using ambulatory blood pressure measurement. Patients' BMI, SBP and DBP, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol and ADMA levels were measured.Findings: Age, BMI and lipid values did not differ significantly between groups (p>0,05). Mean ADMA level of dipper group was 1.29±0.13, and that of non-dipper group wass 1.27±0.13µmol/L. ADMA levels did not differ significantly between the non-dipper and dipper groups (p=0.575).Conclusion: ADMA levels was found to be higher in hypertensive patients due to endothelial dysfunction. Endothelial dysfunction was more frequent in patients who had nondipper blood pressure pattern than patients who had dipper blood pressure pattern. In our study, ADMA levels did not differ significantly between two patterns. additional large-scale studies on this topic are warranted

A case of primary hyperparathyroidism secondary to ectopic parathyroid adenoma located in thymus

Primer hiperparatiroidizmin (HPT) en sık görülen sebebi soliter paratiroid adenomudur. Paratiroid adenomları nadiren mediastende lokalize olabilir. Bu lezyonlar genellikle servikal insizyonla eksize edilemeyecek lokalizasyondadır ve torasik yaklaşım gerekir. Bu makalede çok ender rastlanan, mediastinal yerleşimli, primer HPT'ye neden olan paratiroid adenomlu olguyu sunuyoruz. Ektopik paratiroid dokusunun tanımlanmasında en etkili görüntüleme yöntemi teknesyum-99m sestamibi sintigrafisidir. Paratiroid adenomunun preoperatif dönemde, özellikle sintigrafik yöntemle lokalizasyonunun belirlenmesi cerrahi girişimin etkinliğini arttıracağı gibi postoperatif nüks ve morbiditeyi de azaltacaktır.The most common etiologic factor of primary hyperparathyroidism is solitary parathyroid adenoma. Parathyroid adenomas may rarely locate in the mediastinum. These lesions are usually at such a localization that cannot be excised through a cervical incision and require a thoracic approach. We present a case of mediastinally located parathyroid adenoma resulting in primary hyperparathyroidism. Technetium-99m sestamibi scintigraphy is the most superior imaging technique in detecting the ectopic parathyroid tissue. Preoperative determination of the localization of the parathyroid adenoma, particularly with scintigraphy will improve the effectiveness of the surgical approach and reduce the postoperative recurrence and morbidity as well

Airborne pollen grains of Manisa

Manisa ilinin atmosferik polenleri, iki yıllık periyotta (1990-1991) Durham cihazı kullanılarak çalışılmıştır. İki yıllık sürede 55 taksona ait toplam 8858 adet polen tespit edilmiştir. Bunların 5148'i 1990, 3710'u ise 1991 yılında tanımlanmıştır. Toplam polen miktarının % 78.60'ı odunsu, % 20.17'si otsu ve % 1.23'ü ise tanımlanamamıştır. Çalışılan bölgede, sırası ile Pinus spp., Gramineae, Cupressaceae I Taxaceae, Olea spp., Quercus spp., Platanus spp., Morus spp., Casuarina spp., Plantago spp. ve Chenopodiaceae I Amaranthaceae taksonlarma ait polenler yoğun olarak bulunmuştur. Çalışma süresince en fazla polene Mart ile Mayıs arasında rastlanmıştır.The airborne pollen grains of Manisa have been studied for two years (1990-1991) with a Durham sampler. During these two years, a total of 8858 pollen grains belonging to 55 taxa have been identified and recorded with some unidentified ones. of them, 5148 were identified in 1990 and 3710 in 1991. of the total pollen grains, 78.60 % were arboreal, 20.17 % non-arboreal and 1.23 % unidentified. Pinus spp., Gramineae, Cupressaceae I Taxaceae, Olea spp., Quercus spp., Platanus spp., Morus spp., Casuarina spp., Plantago spp. and Chenopodiaceae I Amaranthaceae released the greatest amounts of pollen grains in the region investigated. During the study period, the pollen concentration reached its highest level between March and May

Patient saffety and Patient satisfaction.

İstanbul Bilim Üniversitesi, Sağlık Hizmetleri Meslek Yüksekokulu.Hasta güvenliği, sağlık hizmetlerinden kaynaklanan hatalar,bu hataların yarattığı sorunların önlenmesi, raporlanması, değerlendirilmesi ve ortadan kaldırılması veya azaltılmasına yönelik alınan önlemlerin tamamı şeklinde tanımlanmaktadır. The Institute of Medicine (IOM) hasta güvenliğini “hastalara zararın önlenmesi” olarak tanımlamış ve kalitenin elde edilmesinde ayırt edilmez bir olgu olarak görmüştür.Patient safety, error resulting from health care, prevention of problems and the problems caused by these errors, reportin, evaluation and describes the way in all the measures taken fort he elimination or reduction in the middle. The Institute of Medicine (IOM) patient safety “preventing harm to patients” and was seen as a phenomenon can not be distinguished in achieving quality

SEVERE GENERALIZED MORPHEA: A DEVASTATING EVENTUALITY IN THE ELDERLY

WOS: 000276780900009Morphea is a localized form of scleroderma characterized by sclerotic skin plaques. It is an uncommon fibrotic reaction limited to the skin and adjacent structures which is unaccompanied by visceral involvement. Although its cause is unknown; genetic, infectious and autoimmune mechanisms have been suggested in morphea. It is more common among children and young women. Topical corticosteroids, systemic corticosteroids methotrexate, penicillamin and topical tacrolimus 0.1% are used in treatment. UVA1 (340-450 nm) phototherapy may also be helpful. In this report we present a 72 year old man with severe generalized morphea. Besides dwelling on its etiopathogenesis, we are also touching upon the impact of the disease on this geriatric patient's functional and psychosocial capabilities

SEVERE GENERALIZED MORPHEA: A DEVASTATING EVENTUALITY IN THE ELDERLY

WOS: 000276780900009Morphea is a localized form of scleroderma characterized by sclerotic skin plaques. It is an uncommon fibrotic reaction limited to the skin and adjacent structures which is unaccompanied by visceral involvement. Although its cause is unknown; genetic, infectious and autoimmune mechanisms have been suggested in morphea. It is more common among children and young women. Topical corticosteroids, systemic corticosteroids methotrexate, penicillamin and topical tacrolimus 0.1% are used in treatment. UVA1 (340-450 nm) phototherapy may also be helpful. In this report we present a 72 year old man with severe generalized morphea. Besides dwelling on its etiopathogenesis, we are also touching upon the impact of the disease on this geriatric patient's functional and psychosocial capabilities