Joint modeling of survival and longitudinal data: Carrico index data example

Aim: When the respiratory system is unable to adequately absorb oxygen or excrete carbon dioxide, acute respiratory failure (ARF) develops. A current area of study is the survival analysis of patients with acute hypercapnic respiratory failure (AHRF) in the field of pulmonary diseases. In the follow-up period, several biochemical markers are repeatedly measured, such as respiration rate and Carrico Index; however, baseline or averaged values are mostly related to treatment failure. Although this approach is not inaccurate, it causes information loss, which leads to biased estimates. This prospective cohort study primarily looked at the relationship between changes in Carrico Index and failure of treatment in AHRF patients. Methods: We included 86 patients from Ankara University School of Medicine Pulmonary Diseases Department. The association between the trajectory of the Carrico Index and failure in AHRF patients was examined using a joint modeling approach for longitudinal and survival data. Results: Results showed that averaged Carrico Index change was inversely and significantly associated with failure (HR: 0.97, 95% CI: -0.05 to 1.97). With hazard ratios of 1.43 and 1.4, chronic health evaluation II (Apache II), and COPD Assesment test (CAT) were positively correlated with failure risk. Conclusions: The present study demonstrate that applying the risk predictors' trajectory through an appropriate statistical method improved accuracy and avoid biased results

Cold effect in median nerve conductions in clinical carpal tunnel syndrome with normal nerve conduction studies

WOS: 000460844400018PubMed: 30538080Clinical diagnosis of carpal tunnel syndrome (CTS) is confirmed by nerve conduction studies (NCS). In some cases, NCS may be normal. We aimed to demonstrate changes of distal motor latency (DML) and nerve conduction velocity (NCV) pathology of demyelination in entrapment neuropathy with cold application in case of clinical CTS with normal NCS. This prospective, cross-sectional, randomise, case-control involved 15 patients (25 hands) with clinically definite unilateral or bilateral CTS and normal nerve conduction studies (NCS), and 11 controls (22 hands). Ice pack was applied to median nerve trasse at wirst with monitoring skin temperature. NCS of median nerve were examinated again. Increases of DML, decrease of velocity of median nerve were observed in two groups after post-cooling. The change in NCV was greater than the change in DML. Cold effect was evident in DML and NCV in the patient group. This could be sign of the demyelination pathology. We think that cold application is influential to determine electrophysiologic abnormalities in clinic CTS with normal NCS. (C) 2018 Elsevier Ltd. All rights reserved

Ağrılı diyabetik periferal nöropatide dolu bardak testi ile ağrı şiddetinin belirlenmesi

Objectives: The aim of this study was to test the utility and validity of the full cup test (FCT) to assess the severity of pain in subjects with painful diabetic peripheral neuropathy (PDPN). Methods: Subjects with diabetic PDPN were enrolled for this prospective, cross-sectional study. Other causes of PDPN and subjects with cognitive impairment were excluded. The diagnosis of neuropathic pain was made using the results of a physical examination and the Douleur Neuropathique 4 questionnaire. Pain severity was assessed with a FCT and a visual analog scale (VAS) administered before and after treatment. The correlation of FCT with VAS was evaluated to examine validity. Results: A total of 43 (33 female, 10 male) subjects were included. The mean age was 61.9±8.25 years and the mean disease duration was 13.02±7.6 years. Type I diabetes mellitus (DM) was present in 2 (4.7%) subjects and Type II DM in 41 (95.3%) subjects. The mean glycated hemoglobin level was 8.9±1.9 mmol/mol. When the mean VAS and FCT scores were analyzed, the results were 6.7±2.05 and 66.35±23.2, respectively, pretreatment and 4.6±2.2 and 41.36±23.5 posttreatment, which were both statistically significant (p<0.001, p<0.001). The mean control period was 23.4 days (min–max: 15-30 days). The VAS and FCT scores in pretreatment and posttreatment demonstrated a high positive correlation (rs =0.86, p<0.001; rs =0.843, p<0.001). Conclusion: The FCT can be useful to detect pain severity in PDPN.Amaç: Dolu bardak testinin (DBT) ağrılı diyabetik periferal nöropati (ADPN)’de kullanımını ve geçerliliğini test etmek. Gereç ve Yöntem: Bu kesitsel ve prospektif çalışmaya ADPN olan olgular alındı. Çalışma popülasyonunda periferal nöropati yapacak diğer nedenler ve kognitif yetmezlik dışlandı. Periferik nöropati tanısı muayene ve Douleur Neuropathique 4 (DN4) anketi kullanılarak gösterildi. Ağrı şiddeti tedavi öncesi ve sonrasında DBT ve Vizüel Analog Skala (VAS) ile değerlendirildi. Geçerlilik için DBT’nin VAS ile korelasyonuna bakıldı. Bulgular: Çalışmaya 43 (33 kadın, 10 erkek) olgu alındı. Ortalama yaş 61.9±8.25, ortalama hastalık süresi 13.02±7.6 yıldı. Tip I DM 2 (%4.7) olguda, Tip II DM 41 (%95.3) olguda mevcuttu. HbA1c düzeyi ortalama 8.9±1.9 mmol/mol’du. Ağrı şiddetinin değerlendirilmesinde kullanılan VAS ve DBT tedavi öncesi ve sonrası karşılaştırıldığında ortalama skorlar tedavi öncesinde 6.7±2.05, 66.35±23.2, tedavi sonrasında ise 4.6±2.2, 41.36±23.5 bulundu. Sonuçlar istatistiksel olarak anlamlıydı (p<0.001, p<0.001). Olgularda ortalama kontrol süresi 23.4 (minimum–maksimum: 15–30) gün oldu. Ağrı şiddet ölçeği DBT, tedavi öncesi ve sonrasında VAS ile yüksek korele bulundu (rs =0.86, p<0.001; rs =0.843, p<0.001). Sonuç: Dolu bardak testi ADPN’de ağrı şiddetini belirlemede kullanışlı olabilir

Optical coherence tomography neurodegenerative findings in patients with bipolar disorder

Buyuktortop Gokcinar, Nesrin/0000-0001-7795-5188WOS:000535250900001PubMed: 32452640Introduction Neuroimaging studies of patients with bipolar disorder (BD) have recently revealed neurodegenerative changes in the central nervous system. Optical coherence tomography (OCT) imaging of the retina, as an extension of brain, may be a biomarker in understanding the neurobiology of the disease. To assess OCT as a tool to detect neurodegeneration in BD we compared the retinal changes between patients with BD and healthy individuals. Methods We performed complete ophthalmological examinations and took OCT images for 70 eyes of 70 patients with BD, and for age and sex-matched individual controls. We compared retinal nerve fiber layers (RNFLs) and total retinal (TR) thickness in the peripapillary areas; and ganglion cell complexes (GCCs) and TR thickness in the maculas between the groups. Results The mean age of the patients was 40.41 +/- 13.22 years and that of the controls 40.20 +/- 13.03 years. The men/women ratios were 37/33 in both groups. BD was significantly associated with a decrease in the average peripapillary RNFL, with the average peripapillary TR, and with the average GCC thickness (P = .033, P = .008, and P = .009, respectively). The peripapillary RNFL and TR thinnings were prominent in the superior (P = .039, P = .033, respectively) and inferior quadrants (P = .031, P = .018, respectively). The BD effects on GCC thinning was prominent in the superior half (P = .001) and in the nasal sectors (except in the inner superonasal sector; all P < .05). BD was associated with a decrease in macular TR thickness only at the inner superior sector (P = .014). Disease duration was inversely correlated with the peripapillary RNFL, TR, and macular GCC thicknesses (P < .05). Discussion Our findings support the neurodegeneration hypothesis in the etiopathogenesis of BD. OCT, a non-invasive neuro-imaging method, may be useful for BD diagnosis and follow-ups.Kirikkale University Scientific Research Projects Coordination UnitKirikkale University [2018/087]Kirikkale University Scientific Research Projects Coordination Unit, Grant/Award Number: 2018/08

Optical coherence tomography neurodegenerative findings in patients with bipolar disorder

Buyuktortop Gokcinar, Nesrin/0000-0001-7795-5188WOS: 000535250900001PubMed: 32452640Introduction Neuroimaging studies of patients with bipolar disorder (BD) have recently revealed neurodegenerative changes in the central nervous system. Optical coherence tomography (OCT) imaging of the retina, as an extension of brain, may be a biomarker in understanding the neurobiology of the disease. To assess OCT as a tool to detect neurodegeneration in BD we compared the retinal changes between patients with BD and healthy individuals. Methods We performed complete ophthalmological examinations and took OCT images for 70 eyes of 70 patients with BD, and for age and sex-matched individual controls. We compared retinal nerve fiber layers (RNFLs) and total retinal (TR) thickness in the peripapillary areas; and ganglion cell complexes (GCCs) and TR thickness in the maculas between the groups. Results The mean age of the patients was 40.41 +/- 13.22 years and that of the controls 40.20 +/- 13.03 years. The men/women ratios were 37/33 in both groups. BD was significantly associated with a decrease in the average peripapillary RNFL, with the average peripapillary TR, and with the average GCC thickness (P = .033, P = .008, and P = .009, respectively). The peripapillary RNFL and TR thinnings were prominent in the superior (P = .039, P = .033, respectively) and inferior quadrants (P = .031, P = .018, respectively). The BD effects on GCC thinning was prominent in the superior half (P = .001) and in the nasal sectors (except in the inner superonasal sector; all P < .05). BD was associated with a decrease in macular TR thickness only at the inner superior sector (P = .014). Disease duration was inversely correlated with the peripapillary RNFL, TR, and macular GCC thicknesses (P < .05). Discussion Our findings support the neurodegeneration hypothesis in the etiopathogenesis of BD. OCT, a non-invasive neuro-imaging method, may be useful for BD diagnosis and follow-ups.Kirikkale University Scientific Research Projects Coordination UnitKirikkale University [2018/087]Kirikkale University Scientific Research Projects Coordination Unit, Grant/Award Number: 2018/08

The efficacy of cognitive behavioral group therapy in women with obesity antidepressant treatment

Objective: We aimed to investigate the effects of a structured cognitive behavioral group therapy (CBGT) on weight loss, depression, anxiety, body image and self-esteem levels in women with obesity treatment and to show that cognitive behavioral therapy may also be effective in the treatment of obese women receiving antidepressant medication in our study. Methods: Fourteen sessions of CBGT were administered to 28 obese female patients who met inclusion criteria. Measurement and clinical scale application were made before and after the therapy. Six months after the therapy, the patients were asked about their weight by phone call. Sociodemographic Information Form, body mass index (BMI) monitoring, DSM-IV based Structured Clinical Interview, State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Short Form-36 (SF-36), and Symptom Check List-90 (SCL-90) were applied to the cases. Results: A statistically significant decrease in patients' weight and body mass index were found after 14 sessions of therapy (p<0,001). Statistically significant difference were found about the BDI (p=0,009), TAI (p=0,020), SCL-90 (p=0,001), SF-36 physical function (p=0.035), SF-36 general health (p=0.004), SF-36 social function (p=0.034) scores between the beginning and the end of the therapy. There was no statistically significant difference between the measurements of BMIs at the end of therapy and at the end of therapy. Conclusion: We can say that the method we applied with the findings obtained works. According to this, CBGT is a suitable treatment method for obese people in controlling BMI, providing psychological well-being and improving quality of life