Relationship between subclinical hypothyroidism and serum homocysteine concentration in premenopausal women

Objective: In our study we aimed to examine serum homocysteinelevels of patients without thyroid dysfunctionswho have high serum anti thyroid peroxidase (anti-TPO)levels and patients with subclinical hypothyroidism whohave high serum thyroid stimulating hormone (TSH) andanti-TPO levels.Methods: One hundred and seven premenopause femaleoutpatients who referred to endocrine clinic of our hospitalwere included in our study. We generated 3 groups. Firstgroup (Control) consists of 53 (50%) patients between theages of 30-40 years. Second group (Euthyroid) consistsof 31 (29%) patients between the ages of 26-49. Thirdgroup (Subclinical Hypothyroidism) consists of 23 (21%)patients between the ages of 33-53 years. Serum totalcholesterol, triglycerides, high density lipoprotein (HDL)levels were measured by Olympus 2700 autoanalyzer.Serum TSH, free T4, anti-TPO and homocysteine levelswere measured by Siemens Immulite 2000 autoanalyzer.Results: In our study, total cholesterol, triglycerides, lowdensity lipoprotein (LDL) and very low density lipoprotein(VLDL) levels were not statistically significantly differentamong the groups. Although serum homocysteine levelsof the third group were higher than the other groups it wasnot statistically significantly different among the groups.Conclusion: Serum homocysteine and lipid levels of patientswith euthyroidism and subclinical hypothyroidismwho have positive anti-TPO levels may be inadequate inassessing the risk of cardiovascular diseases. J Clin ExpInvest 2013; 4 (3): 293-297Key words: Hypothyroidsm, homocysteine, premenopaus

Evaluation of patients receiving treatment at palliative care centers

Introduction: Palliative care centers (PC centers) provide multidisciplinary care for patients with multiple comorbid conditions. This study aimed to assess and compare patients’ diagnoses, length of hospital stays, and demographic data and coordination with home health care services.Methods: This is a descriptive, cross-sectional and retrospective study. Patients who were hospitalized in PC centers of secondary and tertiary care hospitals between 01.08.2018 and 01.08.2018 were retrospectively assessed. Patients’ demographic characteristics diagnoses of hospitalization, and length of hospital stays and centers where they received treatment were recorded. Results: Median age of 830 patients included in the study was 79 (24-102). Out of 830 patients, 48.9% were male and 51.1% were female. Mean length of hospital stay was 14 days and median length was 8.7 (0.6-112) days. The three most common comorbid diseases followed up were malignancy (21.8%), cerebrovascular disease (15.2%) and malaise-fatigue-senility (10.7%). The group with Alzheimer's disease was the oldest patient group. The group with nutritional deficiency-malnutrition was the patient group with the longest hospital stay (p=0.030). The number of patients who were hospitalized for cerebrovascular diseases was the highest in secondary care centers and the number of patients who were hospitalized for malignancy was the highest in tertiary care centers. Patients hospitalized in secondary PC center were older. The hospital stays were longer in tertiary PC center. Patients receiving treatment at a tertiary PC center had a significantly higher rate of mortality. The number of patients who were discharged was lower in the tertiary PC centers. Hospitalization to a secondary PC center through home care units was significantly higher. Conclusion: In this study, the rate and diagnoses of hospitalization and length of hospital stays were different in secondary and tertiary PC centers. Our study has made an assessment about palliative care centers at various levels of health care and can be considered as prior knowledge for other studies

Anxiety levels of healthcare personnel in different stages of COVID-19 pandemic: A nationwide study from Turkey

Aim: SARS CoV-2 transmission in healthcare personnel was first reported on January 20, 2020. The aim of this study was to evaluate the anxiety levels experienced by healthcare personnel in Turkey during the COVID-19 pandemic and the factors affecting these levels.Material and Methods: A survey investigating sociodemographic features and examining anxiety levels was conducted among approximately 1000 healthcare personnel who were expected to take active roles in the pandemic across Turkey. The survey was conducted in three stages: before the pandemic spread to Turkey, at the beginning of the pandemic and when the pandemic became prominent. A logistic regression analysis was performed to determine the factors affecting anxiety and predictors of anxiety levels.Results: In the first survey, always (odds ratio, 15.781; p<0.01) and often (odds ratio, 5.365; p<0.05) media use, in the second survey media use (p<0.05) and profession (odds ratio, 0.021; p<0.05) and in the third survey, marital status (odds ratio, 17.716; p<0.01) and gender (odds ratio, 4.431; p<0.05) were determined as the predictors of anxiety related to COVID-19.Discussion: As a result of this study, healthcare personnel groups were defined (women, nurses, married people) who need special intervention and support to provide spiritual comfort when working on the front line in the fight against COVID-19. Further comprehensive studies are needed of the extent of psychological support required by healthcare personnel and to whom and how this support should be provided

Effect of gradually expanding flow passages on flow boiling of micro pin fin heat sinks

In this paper, effect of gradually expanding flow passages on saturated flow boiling characteristics of micro pin fin heat sinks is experimentally investigated. In this regard, a comparative analysis is performed based on three different heat sinks having straight parallel channels, uniformly distributed micro pin fins, and decreasing number of micro pin fins in flow direction. For these three geometries, visualization supported experiments are conducted, approximately, at the mass flux of 212 kg m(-2) s(-1), inlet temperature of 75 +/- 1 degrees C and effective heat fluxes of 132 - 272 kW m(-2). Working fluid was deionized water. It is concluded that gradually expanding flow passages towards the outlet significantly improves the two-phase heat transfer coefficient up to nearly 501% and 365% compared to straight parallel channels and uniformly distributed micro pin fins, respectively. The structure having decreasing number of micro pin fins obviously suppresses flow boiling instabilities, and also presents lower pressure drop (lower up to 1.45 times) than uniformly distributed micro pin fins. Gradually enlarging flow passages provide escape-ways in the highly saturated region; thus, accelerate the flow and shorten the waiting period of vapor on heat transfer surface. Important conclusions are obtained regarding flow mechanism via flow images. (C) 2022 Elsevier Ltd. All rights reserved

The 30-day mortality predictor role of c-reactive protein/albumin ratio in critically ill COPD patients

INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that develops due to inflammation in the airways. The aim of this study is to demonstrate the effectiveness of c-reactive protein/albumin ratio (CAR) as a 30-day mortality indicator in COPD patients admitted to ICU. MATERIAL AND METHODS: A total of 235 COPD patients with available data between January 2018 and December 2018 were included in this retrospective cohort study. Demographics, APACHE II, Charlson comorbidity index (CCI), SOFA score, CAR and outcomes were evaluated. RESULTS: 87 (37%) of the cases were female and 148 (63%) were male. Their ages ranged from 26 to 95 years, with an average of 70.9± 11.4. The non-survivors had significantly higher APACHE II, CCI, SOFA score, procalcitonin, creatinine, mechanical ventilation (MV) time, WBC, CRP and CAR compared to the survivors (p˂0.05). Albumin and prealbumin were significantly lower (p˂0.05) in non-survivors. In the univariate model; age, sepsis, inotropic support, APACHE II score, CCI, SOFA, procalcitonin, creatinine, MV time, WBC, CRP, albumin, prealbumin and CAR were observed to be significantly effective (p˂0.05) in predicting 30-day mortality. In the multivariate reduced model; inotropic support, SOFA, WBC and prealbumin value exhibited significant independent (p&lt;0.05) effectiveness in predicting 30-day mortality. Albumin, CRP, CAR, APACHE II, SOFA and CCI value were observed to be significant in predicting mortality (p=0.000). CONCLUSIONS: In the study, the predictive power of APACHE II score, CCI, SOFA score, albumin and prealbumin values alone was found to be significantly higher than that of the CAR

Evaluation of patients receiving treatment at palliative care centers

Introduction: Palliative care centers (PC centers) provide multidisciplinary care for patients with multiple comorbid conditions. This study aimed to assess and compare patients’ diagnoses, length of hospital stays, and demographic data and coordination with home health care services.Methods: This is a descriptive, cross-sectional and retrospective study. Patients who were hospitalized in PC centers of secondary and tertiary care hospitals between 01.08.2018 and 01.08.2018 were retrospectively assessed. Patients’ demographic characteristics diagnoses of hospitalization, and length of hospital stays and centers where they received treatment were recorded. Results: Median age of 830 patients included in the study was 79 (24-102). Out of 830 patients, 48.9% were male and 51.1% were female. Mean length of hospital stay was 14 days and median length was 8.7 (0.6-112) days. The three most common comorbid diseases followed up were malignancy (21.8%), cerebrovascular disease (15.2%) and malaise-fatigue-senility (10.7%). The group with Alzheimer's disease was the oldest patient group. The group with nutritional deficiency-malnutrition was the patient group with the longest hospital stay (p=0.030). The number of patients who were hospitalized for cerebrovascular diseases was the highest in secondary care centers and the number of patients who were hospitalized for malignancy was the highest in tertiary care centers. Patients hospitalized in secondary PC center were older. The hospital stays were longer in tertiary PC center. Patients receiving treatment at a tertiary PC center had a significantly higher rate of mortality. The number of patients who were discharged was lower in the tertiary PC centers. Hospitalization to a secondary PC center through home care units was significantly higher. Conclusion: In this study, the rate and diagnoses of hospitalization and length of hospital stays were different in secondary and tertiary PC centers. Our study has made an assessment about palliative care centers at various levels of health care and can be considered as prior knowledge for other studies