113 research outputs found
An Investigation on Residential Satisfaction in Mass Housing: A Case Study of Garanti Houses in Konya-Turkey
In due course, the changing culture, technological developments have continually presented new dimensions to shelter. All the quests and new solutions to housing have aimed to satisfy the users. Housing evaluation is a field that determines whether the housing fulfils the necessary conditions for the users' mental and physical health, whether the users would be content as individuals and as families, and whether the big housing investments would go down the drain. The mistakes in housing practices are constantly repeated. Housing evaluations have recently gained great importance in order to evade these inaccuracies. This study tackles user satisfaction in mass housing systems. The field of study is Garanti Houses, the largest mass housing in gated community-style in Konya. User satisfaction with inner and outdoor spaces is investigated and evaluated by means of user satisfaction questionnaires. Eventually, it is found out that the inhabitants of Garanti Houses are satisfied with the social facilities and the indoor and outdoor spaces of the housing complex, and with their locations at levels good and very good. It is believed that the findings to be obtained in this study will provide data for a participatory planning approach to the processes of planning of future mass housing projects
The clinical, cytogenetics and molecular characterization of inverted duplication/deletion of chromosome 8p in a boy with mental and motor retardation: Genotype-phenotype correlation in a case report
Background: Rearrangements that occur mainly through the non-allelic homologous recombination (NAHR) during maternal meiosis in short arms of chromosome 8 is relatively associated with various clinical spectrum.Aim: The objective of this study was to report cytogenetics and molecular characterization of a mental and motor retarded boy with short arm of chromosome 8 rearrangements [invdupdel(8p)] in this current case report. Subjects and methods: We report an 11-year-old boy with scoliosis, intellectual disability, mental-motor retardation and characteristic facial features. Agenesis of corpus callosum was detected with brain Magnetic Resonance Imaging (MRI) analysis. Derivative chromosome 8 structure was identified after conventional cytogenetics – karyotype analysis, Multiplex Ligation-Dependent Probe Amplification (MLPA) and Microarray-based Comparative Genomic Hybridization (aCGH) techniques. Genotype-phenotype correlation in the current proband case will be discussed.Results: Case was diagnosed as 46, XY, der (8), del (8) (p23.1) invdup (8) (p11.1-p23.1) by using advanced comparable techniques. Subtelomeric MLPA analysis showed deletion of FBXO25 gene which is located at 8p23.3 locus and FISH with subtelomeric probes for 8p shows also only deleted region. The microarray- CGH profilling showed 7,9 mb deletion for 8p23.1 and 31 mb duplication for 8p11.1 locuses.Conclusion: Results from the current case emphasized that the cases with clinical manifestations of such disorders extremely need to be examined by combined comparable genetics techniques such as; karyotyping, FISH, MLPA and chromosomal microarray for the accurate phenotype – genotype correlation.Keywords: Chromosomal rearrangement, Corpus callosum, Invdupdel(8p)Array-CGH, MLP
Effect of Educational Level on Oral Health in Peritoneal and Hemodialysis Patients
Background. In previous studies, the oral and dental health statuses were compared in hemodialysis (HD) and peritoneal dialysis (PD) patients without taking into account the effect of educational levels on oral health. Hence we aimed to make a comparison of these parameters based upon the subjects educational levels.
Patients and Methods. 76 PD (33 males, 43 females-mean age: 44 ± 12 years) and 100 HD (56 males, 44 females-mean age: 46 ± 14 years) patients were included. The number of decayed, missing and filled teeth were detected, DMFT index was calculated and plaque index (PI) values were assessed.
Results. Significantly higher numbers of filled teeth (P < .001) and lower PI values (P < .01) in the PD group were detected with higher educational levels, whereas no significance was detected in the HD group. Higher DMFT index values were assessed in the lower educated and high school levels in PD than HD patients (P < .05). Higher numbers of filled teeth (P < .05) were detected in the secondary school level in PD patients. This difference was even more significant in the high school level (P < .001).
Conclusion. We assume that PD patients, who were found to be in a higher educational level, are more caring for their oral health as compared to HD patients
Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications
BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients.
OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs.
DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification.
PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries.
MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes.
RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure.
CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome
Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study
BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223
Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries
BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p
Respiratory syncytial virus infections in neonates and infants
Respiratory syncytial virus is one of the major causes of respiratory tract infections during infancy with high rates of hospitalization and mortality during the first years of life. It is the most common cause of acute bronchiolitis and viral pneumonia in children below two years of age and second the most common cause of postneonatal infant mortality all around the world following malaria. In addition, the virus has been causally linked to recurrent wheezing and associated with pediatric asthma. The respiratory syncytial virus infections tend to be severe in high risk patients such as patients below six months of age, with prematurity, congenital heart diseases, neuromuscular diseases and immune deficiencies. No specific treatment is available for respiratory syncytial virus infections to date. Severe cases require supportive therapy, mainly oxygen supplementation and hydration, and less frequently, ventilatory support. Because there is no vaccine to prevent respiratory syncytial virus infections or clinically effective treatment to administer to children with respiratory syncytial virus infection, immunoprophylaxis with palivizumab is currently the only method for reducing morbidity associated with severe respiratory syncytial virus in high-risk infants
Respiratory syncytial virüs infections in neonates and infants
Respiratory syncytial virus is one of the major causes of respiratory tract infections during infancy with high rates of hospitalization and mortality during the first years of life. It is the most common cause of acute bronchiolitis and viral pneumonia in children below two years of age and second the most common cause of postneonatal infant mortality all around the world following malaria. In addition, the virus has been causally linked to recurrent wheezing and associated with pediatric asthma. The respiratory syncytial virus infections tend to be severe in high risk patients such as patients below six months of age, with prematurity, congenital heart diseases, neuromuscular diseases and immune deficiencies. No specific treatment is available for respiratory syncytial virus infections to date. Severe cases require supportive therapy, mainly oxygen supplementation and hydration, and less frequently, ventilatory support. Because there is no vaccine to prevent respiratory syncytial virus infections or clinically effective treatment to administer to children with respiratory syncytial virus infection, immunoprophylaxis with palivizumab is currently the only method for reducing morbidity associated with severe respiratory syncytial virus in high-risk infants
Serebral palsi̇li̇ çocuklarda denge egzersi̇zleri̇ni̇n fonksi̇yonel kapasi̇te üzeri̇ne etki̇si̇
Giriş: Serebral Palsi (SP), aktivite kısıtlılıkları, duyu, algı, kognisyon, iletişim ve davranışları etkileyen bir gelişim bozukluğudur. Ayrıca kas iskelet sistemindeki bozukluklar ve günlük yaşam aktivitelerindeki kısıtlamalar çocukların fonksiyonel kapasitelerin etkilemektedir. Erişkin dönemde yetersiz ambulasyon düzeyi de çocukların fonksiyonel kapasitelerini olumsuz etkileyerek kardiyopulmoner hastalık gelişme riskini arttırabilmektedir. Bu çalışmanın amacı SP’li çocukların rehabilitasyon programlarına ek olarak uygulanan denge egzersizlerinin fonksiyonel kapasite üzerindeki etkisini araştırmaktır.
Gereç-Yöntem: Çalışma kapsamında dahil edilme kriterlerine uyan ve çalışmaya katılmaya aileleri tarafından onay verilen 6-12 yaş arasında 44 SP’li çocuk değerlendirildi. Çocukların demografik bilgileri, klinik durumları, özgeçmiş ve soygeçmiş bilgileri kaydedildi. Denge değerlendirmesi Berg Denge Ölçeği (BDÖ); fonksiyonel kapasite değerlendirmesi On Metre Yürüme Testi ile yapıldı. Çocuklar denge egzersizlerinin dahil edildiği rehabilitasyon programına alındı. Altı hafta sonra değerlendirmeler tekrarlandı. Veri analizinde SPSS 16.0 paket istatistik programı kullanıldı. Analizler %95 güven aralığında, p<0.05 anlamlılık düzeyinde değerlendirildi.
Bulgular: Değerlendirilen çocukların 17’si kız 27’si erkekti (yaş ortalaması: 9,56±1,74 yıl). Rehabilitasyon öncesi sonrası BDÖ skorları karşılaştırıldığında istatistiksel olarak anlamlı fark bulundu (p<0,05). Ayrıca rehabilitasyon sonrası on metre yürüme test sonuçları rehabilitasyon öncesi sonuçlarla karşılaştırıldığında istatistiksel olarak anlamlı artış saptandı (p<0,05). Rehabilitasyon sonrası BDÖ ve yürüme hızlarının artış yüzdeleri arasında pozitif yönlü, orta şiddette, istatistiksel olarak anlamlı korelasyon bulundu (r: 0,425; p<0,05).
Sonuç: Çalışmamızın sonuçlarına göre rehabilitasyon programı sonrasında SP’li çocukların BDÖ skorlarının ve on metre yürüme testine göre yürüme hızlarının arttığı görüldü. Ayrıca program sonrası dengedeki iyileşme ve fonksiyonel kapasitedeki gelişme yüzdelerin birbiri ile ilişkili olduğu saptandı. SP’li çocuklarda uygulanan rehabilitasyon programlarına eklenen denge egzersizleri, ambulasyona olan olumlu etkileri ile fonksiyonel kapasitelerinin gelişmesine yardımcı olabilir. Bu nedenle programlara denge egzersizlerinin eklenmesi ve tedavide çocukların fonksiyonel kapasitelerinin gelişimine yönelik uygulamalara yer verilmesi pediatrik ve erişkin dönem kardiyopulmoner hastalık riskinin azaltılması açısından önem taşımaktadır.Introduction: Cerebral Palsy (CP) is a developmental disorder that affects activity limitations, sensation, perception, cognition, communication and behavior. In addition, disorders in the musculoskeletal system and restrictions in activities of daily living affect the functional capacities of children. Insufficient ambulation level in adulthood may also negatively affect children's functional capacities and increase the risk of developing cardiopulmonary disease. The aim of this study is to investigate the effect of balance exercises applied in addition to rehabilitation programs of children with CP on functional capacity.
Material-Method: Within the scope of the study, 44 children with CP between the ages of 6 and 12 who met the inclusion criteria and were approved by their families to participate in the study were evaluated. Demographic information, clinical status, and family history of the children were recorded. Balance assessment was done with Berg Balance Scale (BBS); functional capacity assessment was done with the Ten Meter Walk Test. Children were included in a rehabilitation program that included balance exercises. Evaluations were repeated six weeks later. SPSS 16.0 package statistics program was used for data analysis. The analyzes were evaluated at the 95% confidence interval, at the p<0.05 significance level.
Results: Of the children evaluated, 17 were girls and 27 were boys (mean age: 9.56±1.74 years). When the BBS scores before and after rehabilitation were compared, a statistically significant difference was found (p<0.05). In addition, when the ten-meter walking test results after rehabilitation were compared with the results before rehabilitation, a statistically significant increase was found (p<0.05). A positive, moderate, statistically significant correlation was found between the percentages of increase in BBS and walking speed after rehabilitation (r: 0.425; p<0.05).
Conclusion: According to the results of our study, it was observed that the BBS scores of the children with CP and their walking speed according to the Ten Meter Walk Test increased after the rehabilitation program. In addition, it was determined that the percentages of improvement in balance and functional capacity were correlated with each other after the program. Balance exercises added to rehabilitation programs in children with CP can help improve their functional capacities with their positive effects on ambulation. For this reason, it is important to add balance exercises to the programs and to include applications for the development of children's functional capacities in the treatment, in terms of reducing the risk of pediatric and adult cardiopulmonary diseases
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