Neurološki simptomi koji su česti u pacijenata s COVID-19: retrospektivna opservacijska studija

In December 2019, a novel coronavirus outbreak spread rapidly all over the world. The virus is known to be neuroinvasive, but much is still unknown. In this study, we aimed to present the main neurologic symptoms in patients who were diagnosed with coronavirus disease 2019 (COVID-19). The study was conducted retrospectively by phoning 156 patients in Turkey diagnosed with COVID-19 through real-time polymerase chain reaction; only 100 patients could be reached. Data about their demographics, initial symptoms, neurological symptoms, and sleeping habits were collected. During the disease process, 66% had at least one neurological symptom, 55% had central nervous system symptoms, 42% had peripheral nervous system symptoms, and 64% had sleep disturbances and myalgia. Impaired consciousness, smell and taste impairments, and sleep disturbances were significantly higher in patients with positive chest computed tomography imaging (p < 0.05). Neurological symptoms were observed in COVID-19, as in other coronaviruses. Headache in particular was the most common symptom in our population. In patients with respiratory system findings, the detection of certain neurological symptoms such as smell-taste impairments, impaired consciousness, and sleep disorders were more common. We concluded that COVID-19 patients should be approached in a more holistic way, taking the nervous system into account.U prosincu 2019. nova epidemija koronavirusa brzo se proširila cijelim svijetom. Poznato je da je virus neuroinvazivan, ali je pun nepoznanica. U ovoj studiji imali smo za cilj predstaviti glavne neurološke simptome kod pacijenata kojima je dijagnosticirana koronavirusna bolest 2019. (COVID-19). Studija je provedena retrospektivno telefoniranjem 156 pacijenata u Turskoj kojima je dijagnosticiran COVID-19 putem lančane reakcije polimeraze u stvarnom vremenu; moglo se doći do samo 100 bolesnika. Prikupljeni su podaci o njihovim demografskim podacima, početnim simptomima, neurološkim simptomima i navikama spavanja. U procesu bolesti, 66% je imalo barem jedan neurološki simptom, 55% je imalo simptome središnjeg živčanog sustava, 42% imalo je simptome perifernog živčanog sustava, a 64% imalo je poremećaje spavanja i mijalgiju. Poremećaji svijesti, mirisa i okusa te poremećaji spavanja bili su značajno veći u bolesnika s pozitivnim slikanjem računalne tomografije u prsima (p <0,05). Neurološki simptomi primijećeni su u COVID-19, kao što su ostali koronavirusi. Posebno je glavobolja najčešći simptom u našoj populaciji. U bolesnika s nalazima dišnog sustava češće je otkrivanje određenih neuroloških simptoma kao što su smetnje okusa mirisa, oslabljena svijest i spavanje. Zaključili smo da s pacijentima s COVID-19 treba postupati na cjelovitiji način, uzimajući u obzir živčani sustav

Effects of serum leptin and resistin levels on cancer cachexia in patients with advanced-stage non-small cell lung cancer

Intr oducti on: Cancer cachexia is one of the most frequent effects of malignancy, is often associated with poor prognosis, and may account for up to 20% of cancer deaths. The aim of our study was to evaluate the relationship of cancer cachexia and serum levels of resistin and leptin in patients with advanced non-small cell lung cancer. Met hods: A total of 67 chemotherapy-naïve patients with advanced-stage non-small cell cancer and a control group containing 20 healthy individuals without a known chronic disease were enrolled in this study. All individuals in the control group were age and sex matched. Demographic, anthropometric, laboratory data and serum levels of adipokines were measured for 2 groups. Progression-free survival and overall survival were estimated using the Kaplan-Meier method. Survival among various factors was calculated using the log-rank test. Res ults : Patients presented significantly higher serum resistin (P =.0001) and lower serum leptin levels (P =.025) than the control group. Lower serum levels of leptin were correlated with overall survival (P =.011). Concl usi ons : Serum leptin and resistin levels play key role as proinflammatory cytokines in lung cancer and cancer cachexia; however, their use as diagnostic or prognostic markers is not possible yet, and further large-scale studies are required to confirm our findings. © The Author(s) 2017

Rescue surgical embolectomy in acute massive pulmonary embolism presenting with supraventricular tachycardia

Acute massive pulmonary embolism (PE) has a high mortality rate despite the advances in the diagnosis and therapy. Patients with PE need rapid diagnosis, risk stratification and an appropriate management for reducing mortality and morbidity. Patients with massive PE could be admitted to the emergency room presenting with not only dyspnea but also with predominant supraventricular tachycardia (SVT). In such case, heart rate control with drugs may be more difficult, and may lead to hemodynamic instability, in addition to the overloaded right heart depends on PE. A rapid computed tomography pulmonary angiography is demanded to confirm PE. Transthoracic echocardiography may play an important role for risk stratification of patients with PE, in order to show dilated right chambers, paradoxical movement of interventricular septum, and increased pulmonary arterial pressures presenting with the overloaded right heart. Although lifesaving treatment, thrombolytics has potential bleeding risk, especially intracranial hemorrhagia. Rescue surgical pulmonary embolectomy may be a life-saving altenative therapy in patients with massive PE who have not responded to thrombolysis. Hereby, we report a case with acute massive PE presenting with SVT, rescued via surgical embolectomy. © 2017 by Türkiye Klinikleri

Meme küçültme cerrahisinin solunum fonksiyon testleri üzerine etkisi

Introduction: Bilateral breast reduction surgery is the surgical treatment of bilateral breast hypertrophy. This is one of the most common breast surgery requested by women, and performed by plastic surgeons. The reasons that patients want this surgery are to re-size sagging breasts aesthetically, and to get rid of somatic symptoms such as shoulder, chest, back, and neck pain. We believe that the objective positive effects of breast reduction surgery exist beside aesthetic. In our study, our aim is to elicit positive effects of surgery on lungs, if there are, by making pulmonary function test and carbon monoxide diffusion test before surgery and after 6 months of surgery. Materials and Methods: Thirty patients agreed to participate in the study. Study is completed with 19 patients. Pulmonary function test and carbon monoxide diffusion test were made to all patients in preoperative and 6 months of postoperative period. Lung roentgenogram of all patients was performed and height, weight, body mass index were measured. Saturation level was measured. Results: There was a meaningful increase in FEV1 and FVC values in the postoperative period in comparison with pulmonary function test performed in preoperative period. DLCO in postoperative period decreased meaningfully as compared to the preoperative period. Conclusion: Breast reduction surgery seems to have positive effects on pulmonary function test values and relaxes patients clinically. Patients with big breasts should be evaluated from this perspective if they apply chest diseases clinic with shortness of breath. © 2017, Ankara University. All rights reserved

Impaired Hemorheology in Exacerbations of COPD

Background. Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation. Cardiovascular-related comorbidities are established to contribute to morbidity and mortality especially during exacerbations. The aim of the current study was to determine alterations in hemorheology (erythrocyte aggregation, deformability) in newly diagnosed COPD patients and their response to medical treatment and to compare with values of COPD patients with exacerbations. Materials and Methods. The study comprised 13 COPD patients, 12 controls, and 16 COPD patients with exacerbations. The severity of COPD was determined according to Global Initiative for Chronic Obstructive Lung Disease guidelines. Red blood cell (RBC) deformability and aggregation were measured by an ektacytometer. Results. RBC deformability of COPD patients with exacerbations was decreased compared to the other groups. Erythrocyte aggregation and plasma fibrinogen of COPD patients determined during exacerbations were higher than control. Conclusion. Decreased RBC deformability and increased aggregation associated with exacerbations of COPD may serve as unfavorable mechanisms to worsen oxygenation and thus clinical symptoms of the patient. Treatment modalities that modify rheological parameters might be beneficial. © 2017 Erhan Ugurlu et al

The relationship between attitude toward physical activity and weight gain in children and young adolescence

IntroductionThe purpose of this study was to investigate the association between attitudes toward physical activity and weight gain among children and young adolescents with an additional focus on the impact of gender on these attitudes.MethodsEmploying a descriptive survey method, data were systematically gathered via purposive sampling from 11 specific cities in Türkiye, ensuring representation from all seven regions. A total of 3,138 students, aged between 9 and 14 years, participated in this study, with a distribution of 46% girls and 54% boys. To assess the attitudes of children and young adolescents toward physical activity, the Youth Physical Activity Attitude Scale was utilized. Height and body weight measurements were taken to determine the body mass index of participants. SPSS 26.0 software facilitated the statistical analyses, including Pearson correlation analysis to explore relationships between variables. Multivariate Analysis of Variance was employed to evaluate the impact of age, BMI, and gender on attitudes toward physical activity.ResultsParticipants classified as normal weight exhibited a more positive attitude towards physical activity compared to their obese and overweight counterparts. Moreover, a significant gender difference emerged, with boys demonstrating significantly higher positive attitudes toward physical activity than girls. However, no significant difference was observed in negative attitudes based on gender. The study also revealed that an escalation in negative attitudes towards physical activity correlated with students being categorized as underweight, overweight, or obese, as opposed to having a normal weight status. Additionally, a statistically significant divergence in both positive and negative attitudes towards physical activity was found based on age. Specifically, the results indicated that students aged 9 and 14 exhibited lower levels of positive attitude when contrasted with their counterparts of different age groups. Conversely, in the domain of negative attitudes, students at the age of 9 scored higher than their peers in other age categories.DiscussionAttitudes towards physical activity can serve as a convenient indicator and guide for assessing the effectiveness of various practices or interventions aimed at promoting physical activity, with recognition of the significant gender difference in positive attitudes among children and young adolescents

Denizli ili kırsal alanda astım semptom prevalansı ve risk faktörleri

Amaç: Standart bir yöntem (ECRHS anketi) kullanılarak Denizli ili kırsal alanında 18 yaş üstü erişkinlerde astım semptom prevalansını ve astım için risk oluşturabilecek faktörleri değerlendirmek. Gereç ve Yöntem: Temmuz 2009-Eylül 2009 tarihleri arasında, Bekilli İlçesi, Süller Beldesi ve Bükrüce Köyü'nde kesitsel nitelikte bir çalışma yüz yüze anket kullanılarak yürütüldü. Katılımcılara solunum fonksiyon testleri uygulandı. Bulgular: Çalışma grubu 764 kadın (% 56,9) ve 579 erkekten (% 43,1) oluşmakta idi. Yaş ortalamaları 52,45±16,13 yıl (18-89 yıl) idi. Denizli ili kırsal alanında, şimdiki astım prevalansı, astım benzeri semptom prevalansı, ve allerjik rinit prevalansı sırasıyla %5,9, %34,0 ve %2,5 olarak tespit edildi. Son bir yıl içinde astım benzeri semptomlardan; hışıltı (wheezing), bu hışıltı ile eş zamanlı nefes darlığı, soğuk algınlığı olmadığı halde hışıltı, nefes darlığı ile uyanma, öksürük nöbeti ile uyanma prevalansları sırasıyla %12,7, %10,3, %9,7, %20,5, ve %19,9 olarak rapor edildi. Kadın cinsiyet, evde hamamböceği olması, ailesel atopi öyküsü ve allerjik rinit astım ve astım benzeri semptomlar için risk faktörü olarak saptandı. Sonuç: Astım sadece kentsel alanda değil kırsal alanda da sıklıkla karşımıza çıkan önemli bir hastalıktır. Kırsal alanda astım ve astım benzeri semptomlar için risk faktörleri kentsel alana göre kimi farklılıklar gösterebilmektedir. Kent/kır farklılıklarının belirlenebilmesi için kırsal alanda daha çok araştırmanın yapılmasına gerek olduğunu düşünüyoruz.Aim: The aim of this study was to determine the prevalence of asthma sypmtoms and evaluate the risk factors for asthma among adults older than 18 years-old living at the rural area of Denizli by using a standart method (ECRHS quesionnaire). Methods: Between July 2009 and September 2009, a cross-sectional study was conducted by a questionnaire applied person to person at Bekilli, Süller towns and Bükrüce village. Pulmonary function tests were performed to participants. Results: Study group consisted of 764 women (56,9%) and 579 men (43,1%). Mean age was 52,45±16,13 years (18-89 years). The prevalences of current asthma, asthma like symptoms, and allergic rhinitis were found 5,9%, 34,0% and 2,5%, respectively at the rural area of Denizli. The prevalances of asthma like symptoms in last year such as; wheezing, wheezing with breathlessness, wheezing without cold, woken up with shortness of breath and woken up with coughing were reported 12,7%, 10,3%, 9,7%, 20,5%, and 19,9% respectively. Female gender, presence of cockroach at house, history of family atopy and allergic rhinitis were detected as risk factors for asthma and asthma like symptoms. Conclusion: Asthma is an important disease that may occur not only in cities but also at country sides. In rural areas risk factors for asthma and asthma-like symptoms compared to urban areas may show some differences. İn rural areas, more studies should be conducted to determine urban/rural differences

Impacts of coil treatment on anxiety and depression in emphysema

Chronic obstructive pulmonary disease (COPD) is a widespread, preventable, and treatable disease. Emphysema is one of the primary components of COPD and manifests itself via decrease in elastic recoil, hyperinflation, and increase in air trapping. Various lung-volume-reduction treatments have come up in recent years for late-stage emphysema patients. Mental disorders and especially anxiety and depression are among the frequently encountered comorbid cases observed in COPD. The aim of our study was to examine the impact of coil treatment applied for late-stage COPD-emphysema diagnosed patients on the accompanying anxiety and depressive symptoms. A total of 21 patients diagnosed with emphysema that meet the suitability criteria for coil treatment were included in the study. The accompanying anxiety and depressive symptoms of the patients were assessed via beck anxiety inventory (BAI) and beck depression inventories (BDI-I) prior to the procedure and one month later. All patients were male with an age average of 66.5 ± 5.5 (57-76). Among patients without a psychiatric diagnosis, BAI scores before and after coil treatment were determined, respectively, as 12.1 ± 6.3 (4-26) and 11.2 ± 9.3 (0-28), whereas BDI-I scores before and after coil treatment were determined, respectively, as 13.5 ± 10.4 (1-31) and 8.8 ± 10.6 (0-34), with a statistically significant difference between them. Also among patients with a psychiatric diagnosis, both anxiety and depressive symptoms decreased after coil treatment, and this reduction was found more significant for anxiety. Coil treatment as a current and novel treatment method for COPD-emphysema diagnosed patients with or without psychiatric comorbidity has a positive impact on anxiety and depressive symptoms. © 2020 Tugce Toker Ugurlu and Erhan Ugurlu

Shift work and women

Background: Shift workers face many physical, mental and social problems due to the disruption in the synchronization of their circadian rhythms, unusual working hours, exemption from social life as well as the negative impacts of such work. The purpose of the present study was to assess the different impacts of shift work on sleep, mental and social status among female textile workers in Denizli, Turkey. Methods: The study was carried out in 2012 at two different textile factories in Denizli-Turkey. A total of 799 workers took part in the study: 661 were shift workers and 138 were non-shift workers. Daytime sleepiness and quality of sleep were evaluated respectively via the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Polysomnographic examinations and psychiatric interviews were conducted on seven shift workers and 11 non-shift workers who exhibited daytime sleepiness. Results: The prevalence of daytime sleepiness was 20% and the rate of poor sleep quality was 61.5% among non-shift workers, while the rates were 15.4% and 83.5%, respectively among shift workers. It was observed that working shifts does not have an impact on daytime sleepiness, but is related to a 4.92-fold risk of poor sleep quality. In addition, risk of daytime sleepiness was 3.41 times higher in the presence of a mentally/physically disabled person in the family, 3.36 times higher if the person has an extra job, 3.15 times higher if the person suffered/suffers from a previous/ current psychiatric disorder, and 1.17 times higher if the daily house work load of the individual is high. Conclusions: Working shifts disturbs sleep quality independent of many factors known to effect sleep. A history of previous or present psychiatric disorders increases the risk of daytime sleepiness. © 2020, Mediafarm Group. All rights reserved