Evaluation of ear, nose and throat involvement in pemphigus vulgaris in comparison with pemphigus severity scoring systems: a cross-sectional study

Pemphigus vulgaris (PV) frequently affects the mucous membranes of the ear, nose, and throat (ENT). Since ENT examination is not a routinely performed procedure, the exact involvement of PV remains unrecognized. The available severity scoring systems (Pemphigus Disease Area Index (PDAI) and Autoimmune Bullous Skin Disorder Intensity Score (ABSIS)) for PV do not include a full ENT examination. This study was designed to evaluate the real extent of PV in ENT areas and to find out the specific scores which indicate the need for ENT examination. The patients were evaluated for ENT manifestations by endoscopic examination whether or not they exhibited symptoms. PDAI, ABSIS, and ENT scores were calculated, and the results were compared for correlation and significance. The mucosal involvement was more severe when scored by ENT examination than when assessed by PDAI or ABSIS. The ENT score was significantly associated with symptoms and endoscopic findings, especially when PDAI ≥15 and/or ABSIS ≥17. ENT endoscopic examination could result in more accurate grading in PV. In particular, performing such an examination should be considered in patients, especially when PDAI ≥15 and/or ABSIS ≥17, regardless of ENT symptoms. </p

Nutritional practices in medical intensive care units: Multicenter, one-day point prevalence study

Background/Aim: Nutritional planning is an important aspect of Intensive Care Unit (ICU) care. The present study aimed to evaluate the nutritional practices adopted in medical ICUs in Turkiye and to investigate their compliance with current international guidelines. Methods: This multicenter, cross-sectional study was performed on a predetermined study date. Centers were required to fill three groups of questionnaires: One on ICU characteristics and facilities, one on patients included, and one on outcomes of patients. Forms on patients had questions on demographics and their nutritional status. Results: A total of 12 sites participated and 132 patients were recorded in the study and 109 patients were included in analyses. The median age was 72 [57–83] years and 55 (50%) of them was female. The median APACHE II score was 23 [18–29], median SOFA score was 6 [4–9] and median BMI was 25.32 [21.22–29.38]. More than 50% of patients were fed enterally; for most, it was started within the first 24 hours of admission. On the study day, the median energy intake of the patients during the last 24 hours was 21.62 [15.9–27.3] kcal/kg and the median amount of protein intake was 1.02 [0.7–1.3] g/kg, representing 83.1% and 78.9% of the targets, respectively. A total of 64 (58.7%) patients were alive on the 28th day of the study, of them 23 (21.1% of all patients) were still in the ICU. Conclusion: Nutrition therapy in medical ICUs was initiated early after ICU admission, the enteral route was preferred and target calories were calculated using weight-based formulas. These results suggest that multi-dimensional planning of critical care management of patients by intensivists may provide better nutritional care for the critically ill. © 2023 Société francophone nutrition clinique et métabolisme (SFNCM

Kablosuz Vücut Algılayıcı Ağları Ve Uzaktan Hasta Takip Sistemi

TÜBİTAK EEEAG Proje01.07.2017Bu projede, kalp yetmezligi, yüksek tansiyon, diyabet ve kronik obstrüktif akciger hastalıgı(KOAH ) gibi kronik hastalıklara sahip hastaların uzaktan izlenmesi için günümüz bilgi vemobil iletisim teknolojilerini kullanan bir teletıp sisteminin gerçeklestirilmesi amaçlanmıstır.Çalısmanın baslangıcını 2010 yılında dünya saglık örgütü (WHO) nun tele-tıp alanındagereksinim duydugu arastırmalar ve aynı yıllarda Eric TOPOL un yaptıgı bir dizi konferans vekitap yayınları olusturmustur. Ancak son yıllarda bu alanda yapılan yayınlar, konferanslar veendüstriyel girisimler öyle artmıstır ki; yaptıgımız çalısmanın öneminden çok endüstriyelyeterliligimizin ve akademik girisimlerimizin gölgelenmemesi endisesi ile projetamamlanmıstır.Proje içeriginde Bluetooth ve Zigbee gibi alternatif teknolojilerde karsılasılan güç tüketimi vegirisim problemlerinin üstesinden gelebilecek IEEE 802.15.6 radyosu yazılım ve donanımıylabirlikte gerçeklestirilmistir. Söz konusu standart 2.36 ile 2.4 GHz arasında 600 kHz likkanallarda sadece saglık verilerinin aktarılabilecegi haberlesme kanallarını öngörmektedir.IEEE 802.15.6 standardının öngördügü haberlesmeyi gerçeklestirecek radyo ve uygulamalarıdestekleyecek yazılımın mevcut olmamasından dolayı projenin önemli bir is yükünü buçalısmalar olusturmustur. Projeyle birlikte uygulamaların gerektirdigi cihazlar arası otomatikhaberlesme, ag kurulumu ve servis tanıma gibi makinadan makinaya haberlesme protokolüde gerçeklestirilmistir. Projenin hedefledigi kablo esdegeri güvenilirlik ve düsük güçlü radyoihtiyacı önemli ölçüde karsılanmıstır.Projenin diger iki temel bileseni insan vücudundan saglık verisini toplayacak algılayıcılar vehasta ile saglık personeli arasında iletisimi saglayıp, saglık personeline yardımcı olacak karardestek sistemi yazılımıdır. Algılayıcılar olarak EKG, Solunum, SPO2, tansiyon, vücut ısısı,agırlık ve ivme ölçüm sensörleri gelistirilmistir. Karar destek yazılımı iki ana bölümdenolusmaktadır. Bunlardan birincisi ölçülen verilerden alarmların üretilmesidir. Burada daha çokEKG verisinden alarm üretilmesine yogunlasılmıstır. Ikincisi ise, EKG aritmilerininsınıflandırılması ile olusturulan karar destek yazılımıdır.This project involves development of a telemedicine system utilizing today's information andmobile communication technologies for remote monitoring of patients with chronic diseasessuch as diabetes, asthma, heart attacks and high blood pressure. Initialization of this study isbased on the publications of Eric TOPOL and The World Health Organization about theimportance of telemedicine and remote patient monitoring in 2010.An important part of the project involves to develop software and hardware for the emergingstandards IEEE 802.15.6, since the power consumptions and interference problems ofZigBee and Bluetooth technologies, which are main rivals for the health industry, are foundunsuitable for a business model of remote patient monitoring. IEEE 802.15.6 offers acommunication highway for health data in 2.36 to 2.4 GHz with 600 kHz of its channels.However there was no hardware and software to implement such a communication andsupport applications required for health industry based on IEEE 802.15.6 standards. So, animportant part of the project is dedicated to implement the required hardware including radioand software. The software also realizes machine to machine communication to implementdevice to device communication to collect health data, as a fashion of machine-to-machinecommunication. The aim of the project, which is obtain a cable equivalent reliablecommunication for health data, has been mostly achieved.Other two essential part of the projects are sensor devices to measure the health data anddecision making system from the measurements. The circuits for ECG, respiration, SPO2,blood-pressure, body temperature and acceleration sensors are developed in a way that theirperformances equivalent to devices used in an intensive care unit. And, a software forgenerating alarms and classification of the disease during the remote monitoring of patientsis developed in order to assist health personnel. The obtained accuracies are published inseveral conferences.Keywords: eHealth, telemedicine, tele-monitoring, IEEE 802.15.6, BAN, M2M, ECG,respiration, SPO2, blood-pessure

The prevalence of nutritional anemia in pregnancy in an east Anatolian province, Turkey

<p>Abstract</p> <p>Background</p> <p>Anemia is considered a severe public health problem by World Health Organization when anemia prevalence is equal to or greater than 40% in the population. The purpose of this study was to determine the anemia prevalence with the associated factors in pregnant women and to determine the serum iron, folate and B12 vitamin status in anaemic pregnants in Malatya province.</p> <p>Methods</p> <p>This is a cross-sectional survey. A multi-sage stratified probability-proportional-to-size cluster sampling methodology was used. A total of 823 pregnant women from sixty clusters were studied. Women were administered a questionnaire related with the subject and blood samples were drawn. Total blood count was performed within four hours and serum iron, folate and B12 vitamin were studied after storing sera at -20 C for six months.</p> <p>Results</p> <p>Anemia prevalence was 27.1% (Hb < 11.0 gr/dl). Having four or more living children (OR = 2.2), being at the third trimester (OR = 2.3) and having a low family income (OR = 1.6) were determined as the independent predictors of anemia in pregnancy. Anemia was also associated with soil eating (PICA) in the univariate analysis (p < 0.05). Of anaemic women, 50.0% had a transferrin saturation less than 10% indicating iron deficiency, 34.5% were deficient in B12 vitamin and 71.7% were deficient in folate. Most of the anemias were normocytic-normochromic (56.5%) indicating mixed anemia.</p> <p>Conclusions</p> <p>In Malatya, for pregnant women anemia was a moderate public health problem. Coexisting of iron, folate and B vitamin deficiencies was observed among anaemics. To continue anemia control strategies with reasonable care and diligence was recommended.</p

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

Valproik asit ve karbamazepin kullanan epileptik çocuklarda serum nitrit ve nitrat düzeyleri

In the electroweak phase transition there arises the problem of baryon numberwashout by sphaleron transitions, which can be avoided if the phase transitionis strongly enough first order. The minimal supersymmetric standard model hasjust two Higgs doublets H1 and H2, while the next to minimal model, NMSSM, hasan additional singlet, N, this latter giving rise to the helpful feature thatthe Higgs potential contains a tree level trilinear field term. We use thetunneling criterion for the existence of a first order electroweak phasechange. A quantitative statistical analysis indicates that with parameters ofthe NMSSM satisfying the experimental constraints a strong first order phasechange occurs in about 50% of cases