Functional evaluation of patients with mastectomy lymphedema

Objectives: In this study, we aimed to investigate the availability of the Timed Up and Go (TUG) test in daily practice instead of the Tampa Scale for Kinesiophobia (TSK) test for the evaluation of fear of movement and to assess the functionality of the upper extremity in postmastectomy lymphedema patients. Patients and methods: Between March 2018 and July 2018, a total of 30 female patients (mean age 53.8±12.3 years; range, 35 to 80 years) with postmastectomy lymphedema were included in this study. The severity of lymphedema of the patients was measured circumferentially at 5-cm intervals. All patients were evaluated for upper extremity functionality using the Timed Functional Arm and Shoulder Test, hand grip strength using a hand dynamometer, and pinch strength using a pinchmeter. The TSK test was used for the evaluation of fear of movement and TUG test was used for the evaluation of functional status of lower extremity. Results: There was a significant difference in functionality between the affected and unaffected side of upper extremity (p<0.05). According to the TSK results, all patients described themselves as kinesiophobic, and advanced fear of movement was found in 66.67% of the patients. However, according to the TUG scores, lower extremity functionality of all patients was normal. Conclusion: Our study results showed that, independently of the severity of lymphedema, fear of movement was seen in every patient and functionality of upper extremity decreased on the affected side. On the other hand, the TUG test may not be useful to asses fear of movement in daily practice regarding to functional scores of these patients.No sponso

DETERMINATION OF PROFITABILITY PERFORMANCES OF INDUSTRIAL SECTORS BY MEANS OF TOPSIS METHOD: APPLICATION OF TURKEY

Stock exchanges are accepted the most important instruments for the regional economies. The main reason for this is that stock exchanges provide capital to spread to the base and, also, enable the resource need of the investment platforms, whose functionality is registered, to be able to be satisfied. Stock exchanges are formed due to forming supplydemand balance on a certain asset and to managing the commercial activities. In this study the profitability performance exhibited by 39 industrial sectors that are being processed in Stock Exchange Istanbul (BİST), i n Turkey, in r espect w ith t he first h alf of the year 2 014, was examined on the sectorial basis in the framework of the criteria determined, compared to the same period of the last year. Handling the Variation of Net Sale Incomes, compared to the same period of the previous year; FAVÖK (profit, before the interest, tax, depreciation) Variation; Variation of the Essential Activity Profit; Variation of Net Profit, compared to the same period of the previous year; 2004/06 Equity Profitability, Variation Value of Equity Profitability in the periods of 2013/06-and 2014//06 as the criteria used in the study, they were analyzed by the method of TOPSIS, among the methods of multi criteria decision making. As a result, it was seen that the main metal industry showed the best performance in terms of profitabilit

DETERMINATION OF PROFITABILITY PERFORMANCES OF INDUSTRIAL SECTORS BY MEANS OF TOPSIS METHOD: APPLICATION OF TURKEY

Stock exchanges are accepted the most important instruments for the regional economies. The main reason for this is that stock exchanges provide capital to spread to the base and, also, enable the resource need of the investment platforms, whose functionality is registered, to be able to be satisfied. Stock exchanges are formed due to forming supplydemand balance on a certain asset and to managing the commercial activities. In this study the profitability performance exhibited by 39 industrial sectors that are being processed in Stock Exchange Istanbul (BİST), i n Turkey, in r espect w ith t he first h alf of the year 2 014, was examined on the sectorial basis in the framework of the criteria determined, compared to the same period of the last year. Handling the Variation of Net Sale Incomes, compared to the same period of the previous year; FAVÖK (profit, before the interest, tax, depreciation) Variation; Variation of the Essential Activity Profit; Variation of Net Profit, compared to the same period of the previous year; 2004/06 Equity Profitability, Variation Value of Equity Profitability in the periods of 2013/06-and 2014//06 as the criteria used in the study, they were analyzed by the method of TOPSIS, among the methods of multi criteria decision making. As a result, it was seen that the main metal industry showed the best performance in terms of profitabilit

Evaluation of Kinesiophobia, Pain and Functional Status in Adhesive Capsulitis and Rotator Cuff Syndrome

Objective:Kinesiophobia, which is defined as the fear of moving due to the fear of re-injury, impairing the quality of life of the patients, causes various degrees of disability and participation problems, adversely affects the treatment, and may cause the pain to become chronic and may predispose to depression. Severe pain and limitation of movement in a short time are common in muscle, joint and ligament pathologies of the shoulder, which is one of the most common problems of the upper extremity. We aimed to conduct this study in patients with a diagnosis of rotator cuff and adhesive capsulitis, anticipating that the presence and degree of kinesiophobia should be considered when planning treatment for shoulder diseases.Method:A total of 80 patients, aged 30-75 years, who had shoulder pain complaints for at least 1 month and applied to the outpatient clinic for rehabilitation, diagnosed with rotator cuff syndrome (n=40) and adhesive capsulitis (n=40) were included in the study. Pain degree of the patients, active joint range measurement of the painful shoulder, anxiety and depression, degree of disability and presence of kinesiophobia; it was evaluated with the numerical rating scale (NRS), the arm, shoulder and hand problems questionnaire (DASH), the hospital anxiety depression scale (HAD), and the Tampa kinesiophobia scale. The patients voluntary consent for the study and approval of University of Health Sciences Turkey, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital Ethics Committe with protocol number 2019-421 was obtained on 12.09.2019.Results:NRS with movement, at rest and sleep, HAD and TAMPA measurements of the cases did not show any statistically significant difference according to the groups (p>0.05). The DASH score of the cases in the adhesive capsulitis group was found to be statistically significantly higher than that of the cases in the rotator cuff syndrome group (p<0.05). In both groups, a moderate kinesiophobia score was determined according to the Tampa kinesiophobia scale. However, there was no statistically significant difference between the groups.Conclusion:In this study, kinesiophobia was detected in both patients with rotator cuff syndrome and adhesive capsulitis. It is emphasized that in addition to pain, functional status and psychological factors, the presence of kinesiophobia should be considered in the evaluation, treatment planning and follow-up of patients

Determination of Primary Surface Water Pollution Indicators by Multivariate Statistical Techniques in an Industrialized Basin

This study aimed to investigate the point and diffuse pollution sources of high total phosphorus (TP) pollution detected in the dry and wet seasons of the industrialized and urbanized Saz-Cayirova Basin through field observation and multivariate statistical techniques. In this context, nineteen water quality parameters were analyzed in surface water samples collected monthly between June 2020 and July 2021 from nineteen different sites along the Saz-Cayirova stream. Firstly, two reference sites representing a better surface water status were determined and assessed the water quality on the stream tributaries affecting the wastewater treatment plant in the two Organized Industrial Zones (OIZ). Secondly, hierarchical cluster analysis (HCA) and principal component analysis (PCA) were performed to evaluate the complex water quality dataset and reveal the latent sources of TP pollution. The results showed that the tributaries in the pressure of OIZ discharges were highly enriched in COD, TOC, NO3-N, NH3-N, and TP concentrations compared to the reference level. Compared with reference sites, the concentrations of the four heavy metals examined were at a plausible level. Besides, the pollution sources of TP were industrial processes wastewater such as dyeing, washing, phosphating, domestic wastewater from OIZ, urban diffuse waters with organic character, and continuous discharges of undefined sources. The seasonal variation of TP values is observed relatively low, indicating that the stream network is greatly affected by point source pollution. Our observation and analysis imply that the treatment technologies adopted by the OIZ wastewaters plant is sufficient to treat heavy metals. However, measures need to be formulated to remove TP and organic pollution from the secondary production process. © 2022, Avestia Publishing. All rights reserved

The Effect of Early Rehabilitation on COVID-19: A Prospective, Observational Study

Objective:The aim of this study was to investigate the effect of early pulmonary rehabilitation (PR) on the course of the disease, respiratory functions, physical activity, fatigue, and discharge time in Coronavirus disease-2019 (COVID-19) patients in the intensive care unit (ICU) setting.Method:A total of 31 patients (20 females, 11 males) with COVID-19 confirmed by real-time polymerase chain reaction who were admitted to the ICU were included. Demographic, clinical, and laboratory data of the patients were recorded. Physical activity, dyspnea, and fatigue of all patients were evaluated before and after PR program. All patients were evaluated on the day of PR in the ICU, the day of discharge from ICU to the ward, and on the day of discharge from hospital. Functional status was evaluated using the functional disability questionnaire (FDQ), the ambulation status using the functional ambulation classification (FAC), dyspnea using the modified Borg scale (MBS), and fatigue using the fatigue severity scale.Results:The mean length of ICU and hospital stay was 17.93±11.54 days and 18.29±8.41 days, respectively. The mean number of sessions was 8.87±7.66. The mean time from hospitalization to recovery was 13.00±9.62 days. Median FDQ and MBS scores were significantly higher during the ICU stay than the ward stay and at the time of discharge (p<0.05). Median FAC scores were significantly higher at the time of discharge than the ward and ICU scores (p<0.05). There was a positive and statistically significant correlation between the FDQ scores during the ward stay and C-reactive protein (CRP) values during the ICU stay (r=0.382, p=0.034) and CRP values during the ward stay (r=0.379, p=0.035). There was a negative and statistically significant correlation between the FDQ scores at the time of discharge and ferritin levels during the ICU stay (r=-0.421, p=0.018). A positive and statistically significant correlation was observed between MBS scores at the time of discharge and CRP values during the ward stay (p=0.418, p=0.019).Conclusion:Our study suggests that PR is an effective and safe approach with improved physical and functional results and COVID-19 survivors should undergo a PR program in an individualized manner using a multidisciplinary approach to improve short- and long-term outcomes

LIMPRINT study - the Turkish experience

Background: Lymphedema and chronic oedema is a major healthcare problem in both developed and non-developed countries The LIMPRINT study is an international health service based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods: 1051 patients from 8 centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools which assess the demographic and clinical properties as well as disability and QoL. Results: Most of the Turkish patients were recruited from specialist lymphedema services and were found to be female, housewives and having secondary lymphedema due to cancer treatment. The duration of lymphedema was commonly less than 5 years and most of them had ISL Grade 2 lymphedema. Cellulitis, infection and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to Lymphedema centres nevertheless access seemed difficult due to distance and cost. Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis and treatment in Turkey that utilise this informative data

Clinical diagnosis and management in traumatic brain injury

Travmatik beyin yaralanması (TBY) yüksek sıklık oranı, genç yetişkinleri daha çok etkilemesi ve hayatta kalanlarda ileri fonksiyonel kısıtlanmaların görülmesi nedeniyle önemli bir sosyal sağlık problemidir. Bu derlemede, travmatik beyin yaralanmasının epidemiyolojisi, pediatrik ve yaşlı popülasyonlar arası beyin yaralanması farklılıkları vurgulanmıştır. Travmatik beyin yaralanmasının sınıflandırması yapılmış; aynı zamanda sekonder beyin yaralanmasının altta yatan fizyolojik ve kimyasal mekanizmaları, yaralanmaları azaltmak için uygulanan stratejiler ve çalışmalar gözden geçirilmiştir. Kazanılmış beyin yaralanması sonrası sonucu etkileyen değişkenler ve hasta popülasyonları için en uygun değerlendirme ölçütleri tartışılmıştır. Bu derleme ayrıca, yeni görüntüleme yöntemleri ve bunların travmatik beyin yaralanmalı hastalardaki potansiyel klinik uygulamaları üzerine odaklanmıştır.Traumatic brain injury represents a significant public health problem. The importance of this problem derives from high incidence rates, young previously healthy adults comprising a large proportion of those injured and the possibility of persistent functional limitations in survivors. In this article, brain injury epidemiology is summarized, and differences of brain injury between pediatric and elderly persons are emphasized. Traumatic brain injury has been classified by various variables. Underlying physiologic and chemical mechanisms for secondary brain injury regarding strategies and research to minimize this injury are reviewed. Variables that affect outcome after acquired brain injury are described, and the outcome tools most appropriate for the patient populations are discussed. In addition, this article focuses on new neuro-imaging techniques and their potential clinical applications in patients with traumatic brain injury

Optimization of loop-mediated isothermal amplification (LAMP) reaction mixture for biosensor applications

Genetically Modified (GM) foods are becoming the future of agriculture on surviving global natural disasters and climate change by their enhanced production efficiency and improved functional properties. On the other hand, their adverse health and environmental effects, ample evidence on transgene leakage of Genetically Modified Organisms (GMOs) to crops have raised questions on their benefits and risks. Consequently, low-cost, reliable, rapid, and practical detection of GMOs have been important. GMO-detection platforms should be capable of stably storing detection reagents for long-delivery distances with varying ambient temperatures. In this study, we developed an event-specific, closed tube colorimetric GMO detection method based on Loop-Mediated Isothermal Amplification (LAMP) technique which can be integrated into GMO-detection platforms. The entire detection process optimized to 30 min and isothermally at 65 °C. The durability of the LAMP mixture in the test tubes showed that the LAMP reaction mixture, in which Bst polymerase and DNA sample was later included, yielded DNA amplicons for 3 days at room temperature, and for 6 days at 4 °C. • Simple, stable, and cheap storage method of LAMP reaction mixture for GMO-detection technologies. • GMO-detection platforms can stably store detection reagents for long-delivery distances with varying ambient temperatures. • Any DNA sample can be used in the field or resource-limited setting by untrained personnel