Would FRAX define the high fracture risk if the patients were evaluated the day before hip fracture?

Objective: The aim of this study was to evaluate the 10-year major osteoporotic and hip fracture risks in patients with a recent hip fracture. Material and Methods: The study population comprised 58 patients (32 male and 26 female, mean age 79.1 years) with a recent hip fracture. A bedside questionnaire including fracture risk assessment tool (FRAX®) variables and fall frequency was administered to the patients. The FRAX® 10-year major osteoporotic and hip fracture risks were calculated. Statistical analyses were performed to compare different age groups (60–69 years, 70–79 years, and ≥80 years). Results: The mean 10-year major osteoporotic and hip fracture risks were 13.9% and 78%, respectively. If the National Osteoporosis Foundation guidelines were taken into account according to major osteoporotic and hip fracture risks using FRAX® the day before the fracture, treatment would not be initiated in 75.8% and 18.9% of patients, respectively. There were significant differences between the age groups according to the 10-year major osteoporotic and hip fracture probability and fall frequency (p<0.001, p<0.001, and p=0.005, respectively). Conclusion: In our study group, the FRAX® 10-year major osteoporotic fracture probability had an underestimation in younger patients with a history of frequent falling and did not seem to improve the definition of high-risk patients. The 10-year probability of hip fracture by the FRAXObjective: The aim of this study was to evaluate the 10-year major osteoporotic and hip fracture risks in patients with a recent hip fracture. Material and Methods: The study population comprised 58 patients (32 male and 26 female, mean age 79.1 years) with a recent hip fracture. A bedside questionnaire including fracture risk assessment tool (FRAX®) variables and fall frequency was administered to the patients. The FRAX® 10-year major osteoporotic and hip fracture risks were calculated. Statistical analyses were performed to compare different age groups (60–69 years, 70–79 years, and ≥80 years). Results: The mean 10-year major osteoporotic and hip fracture risks were 13.9% and 78%, respectively. If the National Osteoporosis Foundation guidelines were taken into account according to major osteoporotic and hip fracture risks using FRAX® the day before the fracture, treatment would not be initiated in 75.8% and 18.9% of patients, respectively. There were significant differences between the age groups according to the 10-year major osteoporotic and hip fracture probability and fall frequency (p<0.001, p<0.001, and p=0.005, respectively). Conclusion: In our study group, the FRAX® 10-year major osteoporotic fracture probability had an underestimation in younger patients with a history of frequent falling and did not seem to improve the definition of high-risk patients. The 10-year probability of hip fracture by the FRAX® tool can classify populations at risk more effectively. tool can classify populations at risk more effectively. © 2015 by Turkish Society of Physical Medicine and Rehabilitation

Neotectonics and Geothermal potential of the East Anatolian Tectonic Block: A case study in Diyadin (Ağrı) geothermal field, NE Turkiye

The study area is Diyadin, which is situated 71 km ESE of Ağrı very close to the Turkish-Iranian State border. It is one of several type localities of promising geothermal fields in the Eastern Anatolia. The neotectonic regime and related structures are dominated by a strike-slip tectonic regime governed by a stress field in the Eastern Anatolia where the greatest principal stress (σ1) is operating in NNW direction (N22°W) while the least principal stress (σ3) is N68°E. This stress field state was proved once more by the tensor solution of the 12 June 2022 Akçift (Muradiye-Van) earthquake of Mw = 5.1. The strike-slip neotectonic regime started at the time of latest Pliocene-early Quaternary and then triggered the first occurrence of the fissure eruption along the NNW trending Kaletepe open fracture. This event was followed by the development of both the two-peaked Tendürek strato-shild volcano and the Diyadin geothermal field (DGF). The geothermal potential of the DGF is high and its most common manifestations are the active tectonic regime and related faults (extensional horse tail strucure), active volcanoes (Tendürek and Ağrı volcanoes), fumeroles, numerous hot water springs to artesian wells, widespread iron-rich alteration zones, actively growing fissure-ridge travertines and the probable presence of the unroofed hypabyssal felsic to intermediate intrusions of Quaternary age at the roots and their near environs of the isolated Quaternary volcanoes in the Eastern Anatolia. In addition, some significant similarities and contrasts are seen between the DGF and the IGF when they are compared

Retroperitoneal bronchogenic cyst originating from diaphragmatic crura

Bronchogenic cyst is a benign lesion which is commonly seen in the posterior mediastinum. Diaphragmatic origin in retroperitoneum is an unusual location for a bronchogenic cyst. Cross-sectional imaging modalities describe the origin and content of the cyst evidently. Magnetic resonance (MR) images of a 42-year-old male patient who attended ER with back pain revealed a huge retroperitoneal complicated bronchogenic cyst arising from the diaphragm and surrounding the abdominal aorta anteriorly. Bronchogenic cysts in the retroperitoneum rarely originate from the diaphragm and should be kept in mind in the differential diagnoses of abdominal cystic lesions. MR imaging (MRI) is superior to other imaging techniques such as computerized tomography (CT) in detecting the origin and content of these cystic lesions. © 2014, Association of Surgeons of India

A hemophagocytic lymphohistiocytosis case with newly defined UNC13D (C.175G>C; p.Ala59Pro) mutation and a rare complication

Hemophagocytic lymphohistiocytosis (HLH) represents a severe hyperinflammatory condition with cardinal symptoms of prolonged fever, cytopenias, hepatosplenomegaly, and hemophagocytosis by activated, morphologically benign macrophages with impaired function of natural killer cells and cytotoxic T lymphocytes. A 2-month-old girl, who was admitted with fever, was diagnosed with HLH and her genetic examination revealed a newly defined mutation in the UNC13D (c.175G>C; p.Ala59Pro) gene. She was treated with dexamethasone, etoposide, and intrathecal methotrexate. During the second week of treatment, after three doses of etoposide, it was noticed that there was a necrotic plaque lesion on the soft palate. Pathologic examination of debrided material in PAS and Grocott staining revealed lots of septated hyphae, which was consistent with aspergillosis infection. Etoposide was stopped and amphotericin B treatment was given for six weeks. HLH 2004 protocol was completed to eight weeks with cyclosporine A orally. There was no patient with invasive aspergillosis infection as severe as causing palate and nasal septum perforation during HLH therapy. In immuncompromised patients, fungal infections may cause nasal septum perforation and treatment could be achieved by antifungal therapy and debridement of necrotic tissue. © 2015 Turkish Society of Hematology. All rights reserved

EFFECTIVENESS OF SUPERVISED RESISTIVE EXERCISE AND HOME-BASED EXERCISE TRAINING ON LOWER LIMB MUSCLE STRENGTH IN PATIENTS WITH KNEE OSTEOARTHRITIS: A LONG-TERM COMPARATIVE STUDY

World Congress of the Osteoarthritis-Research-Society-International (OARSI) on Osteoarthritis -- MAR 31-APR 03, 2016 -- Amsterdam, NETHERLANDSWOS: 000373538800849Twenty-six patients with knee OA (Kellgren & Lawrence grade 2 or 3), aged 53,86 ± 5,33 years participated in this study. All of the patients were informed about OA risk factors, pathogenesis, prognosis, modification of daily living activities during a 2-hour long patient education lecture. Participants were then assigned at random to one of two groups as home-based strength training group (HEG) (n ¼ 13) and resistive exercise training group (REG) (n ¼ 13). Both exercise programs include the same or similar exercises and aimed at increasing lower limb strength (hip, knee and ankle muscles). All subjects performed three months exercise training. The subjects in the HEG were given strength exercise training and instructed to perform the exercise program three times a week for three months at home. And also, they received one session monthly supervised exercise training for progression. Progression in exercise training obtained with elastic bant. The REG received a supervised program three times a week for three months at indoor resistive exercise station. Patients in both groups performed 10 minutes warm-up period and cool-down period. The strength of quadriceps femoris, hamstrings, hip abductors, hip adductors, and gastrocnemius muscles assessed by using handheld dynamometry by the same investigator. Muscle strength of participants was assessed at baseline, 12 weeks and 24 weeks (follow-up).Osteoarthritis Research Society Internationa

Muhasebe Bilgi Sistemi ve Karar Destek Sistemleri İlişkisinin Yönetsel Karar Alma Faaliyetlerine Etkisi

Hayatının birçok safhasında gerekli olan “karar alma” neticesinde ortaya çıkan her karar için, istenen sonuçların elde edilmesi, sürecin doğru bir şekilde gerçekleşmesine bağlıdır. Bu süreçte, karar alıcılar içinpek çok farklıyöntem tercih edilebilir: sezgilerle hareket edilebilir ya da çeşitli matematiksel yöntemler kullanılabilir. Gerek problemlerin çözümünde ve gerekse de kararların etkinliğinde yadsınamayacak ve çağın gerektirdiği unsurlar; bilgisayar teknolojileri, bilgi vebilgi sistemleridir. Bu nedenle, ihtiyaç duyulan bilgilere hızlıve zamanında erişim ile kararların kalitesini arttırmada, son yıllarda bilgi sistemlerinin kullanımıoldukça yaygınlaşmıştır. Bu çalışmamızda, söz konusu gelişmeler bağlamında yönetimin ve işletmede karar alıcıkonumunda olan yöneticinin performansınıetkileyecek fonksiyonlar ve organizasyon işlemleri için gereken bilgiyi zamanında sağlayacak önemli bir bilgi sistemi olan Muhasebe Bilgi Sistemi MBS üzerinde durulmuştur. Yönetim kademelerince alınan kararların çeşitliliği biliniyorken bu süreçte MBS’nin tek başına yeterli olamayabileceği de açıktır. Bu bağlamda, söz konusu sistemin yönetim kademelerine destek verebilmesi için bir diğer sistem olan Karar Destek Sistemleri KDS ’nden bağımsız olmayacaktır. Bu veriler ışığında, çalışmamızda, MBS ve KDS ilişkisinden ne tür yönetsel kararların alınmasında faydalanıldığıve bu ilişkinin karar alma faaliyetlerine etkisi araştırılmaya çalışılmıştır. Bu doğrultuda bir uygulama örneği de çalışmaya dahil edilmiştir. İnşaattan, alışverişmerkezlerine kadar birçok alanda faaliyet gösteren bir holdingte sermaye, alacak yönetimi, vb. konuların kontrolüne verilen önem gereği, gerek günlük nakit girişve çıkışının, bütçe hazırlamada oluşan giderlerin, gerek satış, üretim ve pazarlama bölümlerinin gelirlerinin, kapasiteleri, vb. konulara ilişkin verilerin yönetimine ilişkin bilgi sistemlerinin katkısıortaya konmaya çalışılmıştır. Bu bağlamda holdingte diğer bilgi sistemlerinden personel, üretim, pazarlama, dağıtım, muhasebe sisteme gelen veriler, işlenmekte, istatistiksel modeller ve karar destek sistemleri Örn: Uzman Sistemler yardımıile raporlara dönüştürülmektedir. İşlenmişveriler muhasebe bilgi sistemine aktarılarak karar sürecine dahil edilmektedir. Alınan kararların verimliliği yine analitik modellemeler yardımıile değerlendirilerek sisteme geri bildirim verilmektedir. Bölüm yöneticilerine ve üst yönetime ilgili raporlar sunulmaktadır. Geri bildirimler sonucunda aksaklıklar için alternatif planlar hazırlanmakta ve uygulanmaktadır. Aynızamanda kurumsal değişim ve gelişmeler şirkette artan ölçülerde bilgi sistemlerine olan yatırımlarıarttırmaktadır. Yönetim Bilgi Sistemleri’nden proaktif Karar Destek Sistemleri’ne, OLAP, internet ve Web yaygın destek araçlarına ihtiyaç duyulmaktadır ki bu sistemlerden işletme fonksiyonlarına ve karar süreçlerine bilgi sağlanmaktadır

Ölümünün üçüncü yılında Yılmaz Güney'in ardından

Taha Toros Arşivi, Dosya No: 162-Yılmaz Güneyİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033)Çok güzel gülen adamÖlümsüzlüğe ulaştıGüzel duygularİş arkadaşına saygıFilmlerine sahip çıkalımOnurlu bir yaşa

Effect on perception of bronchoconstriction of moderate-dose fluticason plus salmeterol in elderly asthmatics

Amaç: Orta-doz Flutikazon ve salmeterol tedavisinin bronkokonstriksiyonun algılanmasına etkisinin yaşlı ve genç astımlılarda değerlendirilmesi. Metot: Yirmidokuz yaşlı astımlı ($geq$60 yaş) ve 21 genç astımlı (<60 yaş) hasta çalışmaya katıldı. Yaşlı astımlılar semptom sürelerine göre iki gruba ayrıldı (geç başlangıçlı astım <5 yıl; erken başlangıçlı astım $geq$5 yıl). Orta persistan astımlı 50 hasta bir yıl boyunca günde iki defa 250 ug flutikazon propionat ve 50ug salmeterol tedavisi aldı. Her hastaya başlangıçta ve bir yıl sonra histamin ile bronş provokasyon testi yapıldı. Nefes darlığı modifiye Borg skalası ile değerlendirildi. Birinci saniye zorlu vital kapasite'de (FEVİ) %20'lik bir düşmenin olduğu Borg skoru Algılama skoru 20 (AS20) olarak saptandı.Sonuçlar: Geç başlangıçlı yaşlı astımlılarda başlangıç ortalama AS20 değerleri (1.21 ± 0.18) ile tedavi sonrası ortalama AS20 değerleri (1.32 ± 0.22) arasında anlamlı fark yoktu (p=0.7). Erken başlangıçlı yaşlı astımlılarda başlangıç ortalama AS20 değerleri ile (1.45 ± 0.14) tedavi sonrası ortalama AS20 değerleri (1.11 ± 0.30) arasında anlamlı fark yoktu (p=0.2). Genç astımlılarda başlangıç ortalama AS20 değerleri (2.27 ±0.25) ile tedavi sonrası ortalama AS20 değerleri (2.07 ± 0.29) arasında anlamlı fark yoktu (p=0.3). Yaşlı astımlılarda başlangıç ortalama AS20 değerleri (1.31 ± 0.12; 2.27 ± 0.25 p=0.001) ve tedavi sonrası ortalama AS20 değerleri (1.23 0.18; 2.07 ± 0.29 p=0.01) genç astımlılardan düşüktü. Yorum:Çahşma orta doz flutikazon ve salmeterol tedavisinin yaşlı ve genç astımlılarda bronkokonstriksiyonun algılanmasını değiştirmediğini düşündürmektedir.Ancak yaşlı astımlıların başlangıçtaki ve bir yıl sonraki algılamaları genç astımlılardan daha düşük bulunmuştur.We evaluate the effect of moderate-dose fluticasone plus salmeterol on perception of bronchoconstriction in elderly and in young asthmatics. Twenty-one young asthmatics (aged &lt;60yrs) and 29 elderly asthmatics ($geq$60 yrs ) were studied. The elderly asthmatics were separated into two groups according to the duration of symptoms (late-onset asthma &lt;5 year, early-onset asthma $geq$5 year). 50 patients with moderate asthma were assigned to a 1yr treatment with 250 ug of fluticason propionate plus 50ug salmetorol, twice daily.At entry and after 1 yr , histamine challenge test was performed for each patient. Dyspnea was assessed by modified Borg scale. The Borg score in FEVi reduction by 20% was determined as perception score 20 (PS20). Results: There was no significant difference between mean PS20 values at entry (1.21 &plusmn; 0.18) and after the first year(1.32 &plusmn; 0.22) for late onset elderly asthmatics (p=0.7). There was no significant difference between mean PS20 values at entry (1.45 &plusmn; 0.14) and after the first year (1.11 &plusmn; 0.30) for early onset elderly asthmatics (p=0.2). There was no difference between mean PS20 values at entry (2.27 &plusmn; 0.25) and after the first year (2.07 &plusmn; 0.29) for young asthmatics (p=0.3). The mean PS20 value of elderly asthmatics at entry (1.31 &plusmn; 0.12, 2.27 &plusmn; 0.25 p=0001) and after the first year (1.23 &plusmn; 0.18, 2.07 &plusmn; 0.29 p=0.01) was lower than young asthmatics. Conclusion: Our study suggested that the treatment of moderate-dose fluticasone plus salmeterol did not change perception of bronchoconstriction in elderly asthmatics. Perception of elderly asthmatics at entry and after 1 yr was lower than young asthmatics