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

Symptom prevalence and risk factors for asthma at the rural area of Denizli

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

Shoulder glenohumeral elevation estimation based on upper arm orientation

Due to copyright restrictions, the access to the full text of this article is only available via subscription.In this paper, the shoulder glenohumeral displacement during the movement of the upper arm is studied. Four modeling approaches were examined and compared to estimate the humeral head elevation (vertical displacement) and translation (horizontal displacement). A biomechanics-inspired method was used firstly to model the glenohumeral displacement in which a least squares method was implemented for parameter identification. Then, three Gaussian process regression models were used in which the following variable sets were employed: i) shoulder adduction/abduction angle, ii) combination of shoulder adduction/abduction and flexion/extension angles, iii) overall upper arm orientation in the form of quaternions. In order to test the respective performances of these four models, we collected motion capture data and compared the models' representative capabilities. As a result, Gaussian process regression that considered the overall upper arm orientation outperformed the other modeling approaches; however, it should be noted that the other methods also provided accuracy levels that may be sufficient depending on task requirements.New Energy and Industrial Technology Development Organization ; Japan Society for the Promotion of Science ; Cabinet Office, Government of Japan ; Council for Science, Technology and Innovation ; TÜBİTAK ; Japan Agency for Medical Research and Development

Effect of serum interleukin-1 receptor antagonist level on survival of patients with non-small cell lung cancer

Due to poor prognosis in advanced non-small cell lung cancer (NSCLC), new effective markers are required in the monitoring of the disease. The present study aimed to investigate the association between the serum IL-1 receptor antagonist (IL-1Ra) level, overall survival (OS), and treatment response in NSCLC, and to evaluate the usefulness of the serum IL-1Ra level as a prognostic marker for NSCLC. Eighty patients (72 men and 8 women) and 40 healthy volunteers (13 men and 27 women) were included in the present study. The median progression-free survival was 16 weeks for patients with high serum IL-1Ra levels, and 35 weeks for patients with low serum IL-1Ra levels (P=0.027). The median OS was 38 weeks in patients with a high serum IL-1Ra level, and 62 weeks in patients with a low serum IL-1Ra level (P=0.065). The results of the present study have demonstrated that there was a significant correlation between IL-1Ra levels and NSCLC progression and survival, although the correlation between IL-1Ra levels and the response to treatment was not statistically significant. Therefore, the pre-treatment IL-1Ra level has been identified as a putative prognostic factor for NSCLC