Quality of life in adult patients with acne vulgaris before and after treatment

Objectives: To investigate effect of acne treatment on quality of life in patients with acne vulgaris.Materials and methods: The study was prospective and conducted in a university hospital, enrolling the previously untreated patients with acne vulgaris. Before treatment, dermatology life quality index (DLQI) was applied to all participants of both study and control group. After 3rd and 6th months of treatment administration, DLQI tool was applied to patients in the study group, and scores were compared.Results: The acne severity of patients in the study group was 17 (27.9%), 34 (55.7%) and 10 (16.4%) for mild, moderate and severe form, respectively. Mean scoring for DLQI in the study group and the control group was 8.74±5.07 and 2.21±2.44, respectively (p=0.0005). In the study, significant difference were observed in life quality scores between severe acne and mild acne patients, and between severe acne and moderate acne patients (p=0.003 and p=0.011, respectively), but not between mild and moderate acne patients (p=0.937). Effect of gender in acne vulgaris on quality of life was not significantly different (p=0.336). At stage of treatment at the end of 3rd and 6th month, improvements on quality of life was observed significant for overall and all classification of acne severity (mild, moderate and severe; p<0.001, p<0.001 and p<0.001, respectively).Conclusions: We concluded that acne vulgaris was one of the major skin diseases inversely affecting quality of life in patients and we observed that quality of life improved with treatment in patients

Serum levels of TNF-α and osteoprotegerin and bone mineral density in patients with Behçet’s Disease

Objectives: Osteoporosis is commonly developed due tonatural course of Behçet’s disease (BD) and therapeuticagents. It was aimed to investigate levels of osteoprotegerinand TNF-α (tumor necrosis factor), and bone mineral density(BMD) and correlation between them in BD.Materials and methods: The study included two groupsas the study and the control group. Serum levels of TNF-α,osteoprotegerin, osteocalcine, erythrocyte sedimentation rate(ESR), C-reactive protein (CRP), and urinary creatinine anddeoxypyridinoline along with BMD level were evaluated andcompared. Correlation between TNF-α and osteoprotegerinlevel was investigated.Results: The study enrolled 41 BD patients and 36 agedmatchedcontrol subjects. Mean age was 42.26±11.64 and41.66±70.99, in the study and control groups, respectively.There was no significant difference in body mass index(BMI) of subjects between groups (p>0.05). Level of TNF-α(p<0.001), deoxypyridinoline (p<0.001) and osteocalcine(p=0.041) was significantly higher in the study group comparedto the control group. Osteoprotegerin was lower inBD patients, but the difference was not significant (p>0.05).Urinary deoxypyridinoline/ urinary creatinine ratio in patientswith BD was significantly higher than those in control group(p=0.030). Patients had significantly lower BMD comparfedto the control group, except L2-L4 vertebral area (p<0.001,p<0.001, p=0.035, p<0.001, p=0.012, p<0.001, p<0.001 andp=0.111, respectively). No correlation was found betweenTNF-α and osteoprotegerin.Conclusions: The present study indicated that TNF-α andBMD was negatively correlated with each other and TNF-αhad an effect on osteoporotic process in patients with BD.Osteoprotegerin level was not decreased, and not correlatedwith TNF-α.Key words: Behçet’s disease, osteoprotegerin, TNF-α, osteocalcin

Ocena zaburzeń przewodzenia przedsionkowego i czynności mechanicznej lewego przedsionka u chorych z subklinicznymi zaburzeniami czynności tarczycy

Introduction: Changes of thyroid hormones levels may lead to effects, not only in ventricular function, but also atrial function. The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical coupling and P wave dispersion in patients with subclinical thyroid disorders. Material and methods: Eighty patients with subclinical thyroid disorders and forty controls were included. A diagnosis of subclinical thyroid disorders were reached with increased or decreased serum TSH and normal free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay were measured by tissue Doppler imaging (TDI). Results: All groups had similar demographic findings. LA mechanical functions significantly impaired in subclinical thyroid disorders than control group. Intra- and Interatrial delay, were measured significantly higher in patients with subclinical thyroid disorders than control group. PA lateral and interatrial delay were positively correlated with TSH (r = 0.507, p = 0.006 and r = 0.455, p = 0.015, respectively) in subclinical hypothyroid patients. There was negative correlation between TSH and interatrial delay (r = &#8211;0.492, p = 0.006) in subclinical hyperthyroid patients. Linear multivariate regression analysis demonstrated that, TSH was the only an independent factor of interatrial delay in patients with subclinica tlhyroid disorders. Conclusions: This study showed that impaired LA mechanical and electromechanical function in subclinical thyroid disorders. TSH was an independent determinant of interatrial delay. Prolonged atrial electromechanical coupling time and impaired mechanical atrial functions may be related to the increased incidence of arrhythmias.Wstęp: Zmiany stężeń hormonów tarczycy mogą wpływać nie tylko na czynność komór serca, ale również na czynność przedsionków. Niniejsze badanie przeprowadzono w celu oceny czynności mechanicznej lewego przedsionka (LA), sprzężenia elektromechanicznego i dyspersji załamka P u chorych z subklinicznymi zaburzeniami czynności tarczycy. Materiał i metody: Do badania włączono 80 chorych z subklinicznymi zaburzeniami czynności tarczycy i 40 osób stanowiących grupę kontrolną. Zaburzenia czynności tarczycy rozpoznawano na podstawie obniżonego lub podwyższonego stężenia TSH w surowicy i prawidłowego stężenia wolnej T4 (fT4). Zmierzono objętości LA, posługując się dwupłaszczyznową metodą area-lenght (pole&#8211; wymiar podłużny). Obliczono również objętości i frakcje aktywnego i biernego opróżniania LA. Do pomiaru opóźnienia przewodnictwa wewnątrzi międzyprzedsionkowego zastosowano technikę doplera tkankowego. Wyniki: Grupy nie różniły się pod względem charakterystyki demograficznej. W grupie z zaburzeniami czynności tarczycy mechaniczna funkcja przedsionków była istotnie upośledzona w porównaniu z osobami z grupy kontrolnej. Opóźnienie przewodnictwa wewnątrzi międzyprzedsionkowego stwierdzano istotnie częściej u osób z zaburzeniami czynności tarczycy. Stwierdzono dodatnią korelację miedzy opóźnieniem elektromechanicznym (PA lateral) i opóźnieniem przewodzenia międzyprzedsionkowego a TSH (odpowiednio r = 0,507; p = 0,006 i r = 0,455; p = 0,015) u osób z subkliniczną niedoczynnością tarczycy. Z kolei u osób z subkliniczną nadczynnością tarczycy zaobserwowano ujemną korelację między TSH i opóźnieniem przewodzenia międzyprzedsionkowego (r = &#8211;0,492; p = 0,006). W wieloczynnikowej analizie regresji liniowej wykazano, że stężenie TSH było jedynym parametrem niezależnie związanym z opóźnieniem przewodzenia międzyprzedsionkowego u chorych z subklinicznymi zaburzeniami czynności tarczycy. Wnioski: W niniejszym badaniu wykazano upośledzoną czynność mechaniczną i elektromechaniczną LA u chorych z subklinicznymi zaburzeniami czynności tarczycy. Stężenie TSH było niezależnym czynnikiem determinującym opóźnienie przewodzenia międzyprzedsionkowego. Wydłużenie czasu sprzężenia elektromechanicznego i upośledzenie mechanicznej czynności przedsionków mogą się wiązać ze zwiększoną zapadalnością na zaburzenia rytmu

Acil servislerde geriatrik hastalara yaklaşım

Geriatrik hastalar acil servisler için özel bir topluluğu temsil etmektedir. Yaşlı insanlar genellikle gençlere göre daha sık ve ağır durumda acil servislere başvurmaktadır. Geriatrik popülasyondaki hızlı artışa bağlı olarak acil servislerin bu hastaların bakımını karşılayacak destekleri geliştirmesi önem kazanmaktadır. Bu yazımızda acil servis çalışanlarına acil servislere başvuran geriatrik yaş grubundaki hastalara yaklaşımda önem arz eden ve dikkat edilmesi gereken noktaları bir bütün halinde sunmayı amaçladık. Acil hekimlerinin geriatrik hastalar ile ilgili düşünceleri; eğitimleri sırasında geriatrik sorunlar üzerine yetersiz zaman harcanması ve geriatri konusunda acil tıp araştırmalarının yetersiz olmasıdır. Sonuç olarak, yaşlı istismarı, düşme, depresyon, alkolizm ve malnütrisyon gibi önemli konuların ortaya çıkarılmasında acil servis hekimleri anahtar rol oynayabilir. Acil servis çalışanları için geriatrik acil durumları tanımaya yönelik eğitim modellerinin ve protokollerin oluşturulmasının acil servislerde geriatrik hastalara bakımın kalitesini artıracağını düşünmekteyiz. (JAEM 2013; 12: 93-7)Geriatric patients represent a special group for emergency services. Geriatric patients usually apply to emergency services in more frequent and more severe situations than younger patients. Due to the rapid rise in the geriatric population, development of reinforcements in order to supply care for these patients becomes a more urgent issue for emergency services. In this paper, we aimed to present points which are important considerations in the management of geriatric group patients admitted to emergency room for emergency service workers, as a whole. It has been shown in many studies that there has been inadequate information and education for emergency physi- cians and nurses in identifying geriatric emergency situations. The majority of emergency physicians feel that inadequate time is spent on geriatric issues in residency, and that research in geriatric emergency medicine is inadequate. As a result, emergency physicians may play a key role in detecting important issues such as elder abuse, falling down, depression, alcoholism and malnutrition. We think that the creation of educational models and protocols for the recognition of geriatric emergency situations for emergency service workers will improve the quality of care given to geriatric patients in emergency services. (JAEM 2013; 12: 93-7

Erişkin akne vulgaris hastalarında tedavi öncesi ve sonrası hayat kalitesi

To investigate effect of acne treatment on quality of life in patients with acne vulgaris. Materials and methods: The study was prospective and conducted in a university hospital, enrolling the previously untreated patients with acne vulgaris. Before treatment, dermatology life quality index (DLQI) was applied to all participants of both study and control group. After 3rd and 6th months of treatment administration, DLQI tool was applied to patients in the study group, and scores were compared. Results: The acne severity of patients in the study group was 17 (27.9%), 34 (55.7%) and 10 (16.4%) for mild, moderate and severe form, respectively. Mean scoring for DLQI in the study group and the control group was 8.745.07 and 2.212.44, respectively (p0.0005). In the study, significant difference were observed in life quality scores between severe acne and mild acne patients, and between severe acne and moderate acne patients (p0.003 and p0.011, respectively), but not between mild and moderate acne patients (p0.937). Effect of gender in acne vulgaris on quality of life was not significantly different (p0.336). At stage of treatment at the end of 3rd and 6th month, improvements on quality of life was observed significant for overall and all classification of acne severity (mild, moderate and severe; p0.001, p0.001 and p0.001, respectively). Conclusions: We concluded that acne vulgaris was one of the major skin diseases inversely affecting quality of life in patients and we observed that quality of life improved with treatment in patients.Akne vulgaris hastalarında akne tedavisinin hayat kalitesi üzerine etkisinin incelenmesi amaçlanmıştır. Gereç ve yöntem: çalışma prospektif olarak tasarlandı. Daha öncesinde akne tedavisi almayan hastalar alındı ve çalışma bir üniversite hastanesinde yürütüldü. çalışma grubu ve kontrol grubu oluşturuldu. Tedavi öncesi hastalara ve kontrol grubuna Dermatolojik Yaşam Kalitesi İndeksi (DYKI) ölçeği uygulandı. Tedavi sonrası 3. ve 6. aylarda DYKI tekrar uygulandı. Tüm Skorlar karşılaştırıldı. Bulgular: çalışma grubunda bulunan akne olgularından 17 (%27,9) hasta hafif, 34 hasta orta (%55,7) ve 10 hasta (%16,4) ileri derece akne grubunda idi. çalışma grubu ve kontrol grubunun ortalama DYKI skoru sırası ile 8,74±5,07 ve 2,21±2,44 idi (p0,0005). çalışma grubunda ileri derece akne ile orta derece akne; ileri derece akne ile hafif dereceli akne arasında yaşam kalitesi skoru arasında anlamlı fark izlendi (p0,003, p0,011 sırası ile), fakat hafif ve orta derece akne arasında fark izlenmedi (p0,036). Cinsiyetin akne vulgarisin hastalarında yaşam kalitesi üzerine etkisi izlenmedi (p0,336). Tedavinin 3. ve 6. aylarında çalışma grubunda yaşam kalitesi tüm olgu ve her bir akne derecesi (hafif, orta ve ileri derece) için tekrar değerlendirildi (sırası ile; p<0,001, p<0,001, p<0,001 ve p<0,001). Sonuç: Sonuç olarak, çalışmamızda akne vulgarisin yaşam kalitesini ciddi anlamda etkileyen bir majör deri hastalıklarından biri olduğu, fakat tedavi ile yaşam kalitesinin düzeldiği sonucuna ulaştık

Secondary Cough Headache Responding to Topiramate

WOS: 000316655800016Cough headache is a type of headache lasting one minute to 30 minutes and arising from activities, such as cough and Valsalva maneuver, which increase intra-abdominal pressure. It is seen in adults aged forty years and older. It is bilateral, intense and stabbing type of headache. Herein, we report the case of a 65-year-old patient presented with severe headache which was aggravated with defecation, lifting a heavy object and going up and downstairs. Her neurologic examination was normal. Magnetic resonance imaging revealed Arnold-Chiari malformation type 1. Surgical operation was planned, but she denied surgical operation. Indomethacin was not administered due to intractable dyspeptic complaints. Topiramate was administered to lower intracranial pressure. Her headache symptom considerably disappeared. Topiramate was stopped after 6 months, but her headache recurred. Hereupon, topiramate was re-administered. Headache symptom was quite relieved. We concluded that, topiramate could be medical alternative for secondary headaches, such as cough headache in case of Arnold-Chiari malformation type 1. (Archives of Neuropsychiatry 2013; 50: 82-83

Siklik mastaljili hastaların tedavisinde vitex agnus castus preperatının meloksikam ve plasebo i?le karşılaştırılması

Background: Mastalgia is classified as cyclic and non-cyclic. Cyclical one constitutes approximately 60-70% of mastalgia. It is seen between 2 to 3 decades of age, and it usually responds to treatment. Objectives: To compare efficacy of vitex agnus castus (VAC) preparation with meloxicam and placebo in treatment of mastalgia. Methods: The study was designed as prospective and placebo-controlled clinical trial. Three groups were constituted. Before grouping, prolactin level was tested for every patient. The group1 enrolled the patients with cyclical mastalgia and high level prolactin. VAC was administered to patients from study group1. The second group enrolled the patients with cyclical mastalgia along with normal prolactin level, and to which meloxicam was given. Third group was placebo group, and placebo was applied. Before treatment, VAS (Visual analogue scale) scoring was applied to every patient. Prolactin level was tested for patients from group 1. After 3 months of study, VAS scoring was applied to every patient, but only prolactin levels were re- evaluated in patients from group1. Results: 95 patients were analyzed; enrolling women aged 19 to 54 years. Intensity of mastalgia diminished in VAC group 1, 2 more than in placebo group (p<0.0001). In addition to VAS scoring, prolactin level in group 1 after treatment was significantly reduced, comparing with before treatment (p<0.0001). In conclusion, we found that VAC preparation was effective in the treatment of mastalgia and hyperprolactinemia, with good tolerability. © 2011 Düzce Medical Journal

Investigation of the Relationship of Job Satisfaction and Depression Level among Medical Faculty Research Assistants

Amaç: Bu çalışmada, Düzce Üniversitesi Tıp Fakültesindeki araştırma görevlilerinde, iş doyumu düzeyi ile depresyon derecesi, kişisel ve çevresel faktörler arasındaki ilişkilerin değerlendirilmesi amaçlanmıştır. Yöntem: Bu tanımlayıcı ve kesitsel çalışmaya, 70i (%60) erkek, 47si (%40) kadın 26-34 yaş aralığında 117 araştırma görevlisi katıldı. Yüz yüze görüşme yöntemiyle yapılan yarı yapılandırılmış anket formunda açık uçlu sorular ile iki veya daha fazla seçenekli sorular yer almaktaydı. Anket formu demografik özellikler, antidepresan ilaç kullanımı, kronik hastalık durumu, çalışma koşulları, alışkanlıklar ve boş zaman uğraşısı ile ilgili sorular içermekteydi. Araştırmada yarı yapılandırılmış anket formuna Beck Depresyon Envanteri, Minnesota İş Doyum Ölçeği de eklenmiştir. Bulgular: Çalışmamızda Uzmanlık eğitiminin zorluğu, insan fizyolojisini zorlayan iş yükü, yoğun çalışma temposu, hekim kimliğine saygının önceki dönemlere nazaran azalması ve tabiî ki ücretteki yetersizlik gibi nedenlerle asistan hekimlerin çoğu (n74 kişi; %63,2) imkânı olduğu takdirde farklı bir fakülte (farklı bir meslek dalı) tercihi yapabileceklerini belirtmiştir. Çalışma ortamındaki fiziki yetersizlikler, yardımcı personel azlığı, nöbet sayılarının fazlalığı, nöbette kalan asistan sayısında yetersizlik ve en önemlisi nöbet sonrası izinden mahrumiyet asistanların genel, iç ve dışsal iş doyumlarında azalmaya neden olmaktadır. Sonuç: Araştırma görevlilerinin imkânı olduğu takdirde mevcut bölümünden daha az iş yükünün ve risk faktörünün olduğu alanları tercih etme düşüncesinde olduğu belirlenmiştir. Farklı uzmanlık dallarındaki hekimlerin içsel, dışsal ve genel iş doyum puan ortalamaları arasında anlamlı bir fark bulunamamıştır.Aim: The purpose of this study was to examine the relationships between job satisfaction level and depression degree, personal and environmental factors among assistants of Düzce University Medical Faculty. Methods: 117 physicians including 70 males (%60) and 47 females (%40), participated in this descriptive and cross-sectional survey. A questionnaire was applied by face-to-face interview, which consisted of open-ended questions and questions with two or multiple-choices. Questions were asked about demographic attributes, usage of anti-depressant medications, having chronic illnesses, working conditions, habits, and spare time activities. Beck Depression Scale and Minnesota Job Satisfaction Scale were added to the semi-structured questionnaire form. Results: Most of the assistant doctors joined this research (n74; 63.2%) implied that if they had a chance, they would prefer another faculty because of difficulty of doctorate education, heavy job responsibilities threatening human physiology, high intensity of working tempo, decreasing respect on doctor identity, and of course low salary. Inadequacy of physical conditions in working area, scarcity of supportive staff, high numbers of night duties, inadequacy of night duty assistant doctors and the most important factor that is deprivation from allowance after night duty cause reduction of internal and external work satisfaction. Conclusion: It was pointed out that many assistants have the idea to prefer another department that has less labor and less risk factor if they had the opportunity. There was no significant diversity between internal, external and general job satisfaction scores of doctors from different specialties

Factors affecting exhaled carbon monoxide levels in coffeehouses in the Western Black Sea region of Turkey

KARA, ISMAIL HAMDI/0000-0003-2022-1882; KARA, ISMAIL HAMDI/0000-0003-2022-1882; Kandis, Hayati/0000-0001-9151-6050WOS: 000288949000001PubMed: 20858650The aim of this study was to evaluate indoor air quality and factors affecting expired carbon monoxide (CO) levels in a coffeehouse environment. This cross-sectional study was conducted at 16 randomly selected coffeehouses in Duzce, Turkey, during November 2007 to March 2008. A total of 547 people, average age 46.72 +/- 17.03 (19-82) years, participated. The selected coffeehouses were divided into four groups: (1) smoking, (2) nonsmoking, (3) old-style and (iv) new-style coffeehouses. Prior to entering the coffeehouse, exhaled CO levels in smokers (mean 21.17 +/- 6.73 parts per million [ppm]) were significantly higher than those for nonsmokers (6.51 +/- 4.56 ppm; p < 0.001). Measurements taken after 2 hours in the coffeehouse also showed significantly higher CO concentrations for smokers (22.72 +/- 5.31 ppm), compared to nonsmokers (6.51 +/- 4.56 ppm; p < 0.001). It was determined that CO levels inside coffee shops were above the WHO guidelines. Exhaled CO levels in nonsmokers are influenced by the ambient CO levels as a result of the use of cigarettes in coffeehouses in addition to the structure of coffeehouses

Nevus lipomatosus cutaneous superficialis: Case report

Nevüs lipomatöz superfisiyalis (NLS) üst dermiste ektopic adipositle karakterize seyrek bir deri malformasyonudur. Özellikle lezyonlar gövdenin alt kısmında ve kalçada lokalize olurlar. Zosteri form ve lineer özelliktedir. Buradaki olgu birinci basamakta nadir görülen bir hastalık olması nedeniyle rapor edildi. Vakamızda, 42 yaşında kadın hasta beş yıldır sırt bölgesinde sayıları giderek artan ağrısız ve kaşıntısız kabarık lezyonlarla polikliniğimize başvurdu. Hastanın muayenesinde; sağ skapular bölge alt kısmında zosteri form yerleşim gösteren çok sayıda papülo-nodüller saptandı. Histopatolojik inceleme sonucunda hastamıza NLS tanısı konuldu. NLS’li hastalarda başlıca tedavi seçeneği, benign lezyon olması nedeni ile kozmetik amaçlı yapılan cerrahi eksizyondur. Bu hastada da hastanın lezyonları eksize edildi.Nevus lipomatosus cutaneous superficialis (NLS) is a rare skin malformation characterized by ectopic adipocyte in upper dermis. It is composed of multiple nodular and papular lesions localized especially on lower part of trunk and gluteal region. These lesions have linear and zoster form pattern. In our case, 42 years-old woman admitted to our clinic, presenting with non-painful and non-itchy bulky lesion gradually increased on her upper back region since 5 years. On her examination, multiple nodulo-papular lesions with zoster form pattern localized on lower margin of right scapular region were detected. It was diagnosed as NLS, depending on histopathological investigation. Treatment for NLS is cosmetically surgical excision, and the patient&#8217;s lesion was excised, because it is benign lesion