Evaluation of the Quality of Life in Chronic and Transplanted Liver Patients

Kronik karaciğer hastalığı yasam kalitesini olumsuz etkileyen sağlık problemlerinden biridir. Ülkemizde kronik karaciğer hastalığı ve karaciğer nakli yapılmış hastaların yasam kalitelerine ait veri yoktur. Bu tezin konusunu oluşturan çalışmanın amacı; kronik viral hepatit, siroz ve karaciğer nakli hastalarında yasam kalitesini değerlendirmektir. Araştırma kapsamına Antalya ilindeki Akdeniz Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji Anabilim Dalı Polikliniğinde takip edilen kronik hepatit B ya da kronik hepatit C tanılı 30 hasta, klinik olarak siroz tanısı olan 30 hasta ile aynı hastanede Organ Nakli Merkezi Polikliniğinde takip edilen karaciğer nakli yapılmış 30 hasta olmak üzere toplam 90 hasta alındı. Veri toplama araçları olarak sosyodemografik veri formu ve SF 36 Yasam Kalitesi Ölçeği kullanıldı. Sirozlu hastalarda hastalık şiddetini belirlemek için Child-Pugh skorlaması kullanıldı. Verilerin istatistiksel olarak değerlendirilmesinde ki-kare testi, Kruskal Wallis, Mann Whitney U testi ve T-testi kullanıldı. Siroz ve kronik hepatit hastalarının yasam kaliteleri karaciğer nakli yapılmış olan hastaların yasam kalitelerinden daha düşük bulundu. Siroz ve kronik hepatit hastalarının yasam kaliteleri arasında rol fonksiyon fiziksel ve zindelik alt boyutları anlamlı olarak farklı bulundu. Bu iki boyutta da kronik hepatit hastalarının puanları daha yüksekti. Siroz şiddetinin artmasıyla SF 36 yasam kalitesi puanlarının değişmediği görüldü. Kronik hepatit ve siroz tanısı olan hastalarda, erkek hastaların yasam kalitesi kadın hastalara göre daha yüksek, karaciğer nakli yapılmış olan hastalarda cinsiyetler arasında bir farklılık olmadığı bulundu. Sonuç olarak organ nakilli kronik karaciğer hastalarında yasam kalitesi daha yüksektir. Kronik hepatit ve sirozlu kadın hastalarda daha düşük olan yasam kalitesi nakil sonrası erkeklerle benzerdir. Dolayısıyla organ bağışı konusundaki çalışmaların daha da artırılması gereklidir. Ayrıca kadın hastalara daha fazla sosyal ve psikolojik rehberlik sağlanması önerilebilir. Hepatitten siroza hastalık şiddeti artarken yasam kalitesi anlamlı farklılık göstermemektedir. Viral hepatitli hastalarda hastalıkları ile ilgili danışmanlık ve rehberlik hizmetlerinin verilmesi bu hastalarda yasam kalitelerini iyileştirebilir.Chronic liver disease is one of the health problems that negatively affect quality of life. In our country, we do not have any data regarding quality of life of the patients that have chronic liver disease and that had liver transplantation. The aim of the study, which constitutes the subject of this thesis, is to evaluate the quality of life of the patients with chronic viral hepatitis, cirrhosis and patients of liver transplantation. Thirty patients that are being followed with the diagnosis of chronic hepatitis B or chronic hepatitis C and 30 patients that were clinically diagnosed as cirrhosis at Akdeniz University Faculty of Medicine, Department of Gastroentrology in Antalya, and 30 patients that had liver transplantation and are being followed at the Organ Transplantation Centre Polyclinic of the same hospital, a total of 90 patients are enrolled into this study. Sociodemographic data form and SF 36 Quality of Life Scale have been used as means of data gathering. For the evaluation of disease severity in patients with cirrhosis, scoring of Child Pugh Test has been used. Chi- Square, Kruskal Wallis, test of Mann Whitney U, and T-test have been used for the statistical assessment of the data. The quality of life of cirrhosis and chronic hepatitis patients has been found lower than that of liver transplantation patients. Between quality of life of cirrhosis and hepatitis patients, sub-dimensions of role function physical and physical fitness have been found significantly different. Points of chronic hepatitis patients have been high in both of these sub-dimensions. It has been observed that with the increase of cirrhosis severity, points of SF 36 Quality of Life have not been changed. It has been found out that male patients of chronic hepatitis and cirrhosis have a higher quality of life than female patients of these illnesses, while there is no difference between the sexes of liver transplantation patients. In conclusion, quality of life of organ transplanted chronic liver patients is higher. Quality of life, which is lower in female patients with chronic hepatitis and cirrhosis than males, is similar in both sexes with transplanted patients. Hence, the studies on the organ donation should be augmented. Also, it can be suggested that more social and psychological counseling is provided for female patients. The quality of life of viral hepatitis patients can be improved if consultancy and counseling services are given regarding their illnesses

Evaluation of the Quality of Life in Chronic and Transplanted Liver Patients

Kronik karaciğer hastalığı yasam kalitesini olumsuz etkileyen sağlık problemlerinden biridir. Ülkemizde kronik karaciğer hastalığı ve karaciğer nakli yapılmış hastaların yasam kalitelerine ait veri yoktur. Bu tezin konusunu oluşturan çalışmanın amacı; kronik viral hepatit, siroz ve karaciğer nakli hastalarında yasam kalitesini değerlendirmektir. Araştırma kapsamına Antalya ilindeki Akdeniz Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji Anabilim Dalı Polikliniğinde takip edilen kronik hepatit B ya da kronik hepatit C tanılı 30 hasta, klinik olarak siroz tanısı olan 30 hasta ile aynı hastanede Organ Nakli Merkezi Polikliniğinde takip edilen karaciğer nakli yapılmış 30 hasta olmak üzere toplam 90 hasta alındı. Veri toplama araçları olarak sosyodemografik veri formu ve SF 36 Yasam Kalitesi Ölçeği kullanıldı. Sirozlu hastalarda hastalık şiddetini belirlemek için Child-Pugh skorlaması kullanıldı. Verilerin istatistiksel olarak değerlendirilmesinde ki-kare testi, Kruskal Wallis, Mann Whitney U testi ve T-testi kullanıldı. Siroz ve kronik hepatit hastalarının yasam kaliteleri karaciğer nakli yapılmış olan hastaların yasam kalitelerinden daha düşük bulundu. Siroz ve kronik hepatit hastalarının yasam kaliteleri arasında rol fonksiyon fiziksel ve zindelik alt boyutları anlamlı olarak farklı bulundu. Bu iki boyutta da kronik hepatit hastalarının puanları daha yüksekti. Siroz şiddetinin artmasıyla SF 36 yasam kalitesi puanlarının değişmediği görüldü. Kronik hepatit ve siroz tanısı olan hastalarda, erkek hastaların yasam kalitesi kadın hastalara göre daha yüksek, karaciğer nakli yapılmış olan hastalarda cinsiyetler arasında bir farklılık olmadığı bulundu. Sonuç olarak organ nakilli kronik karaciğer hastalarında yasam kalitesi daha yüksektir. Kronik hepatit ve sirozlu kadın hastalarda daha düşük olan yasam kalitesi nakil sonrası erkeklerle benzerdir. Dolayısıyla organ bağışı konusundaki çalışmaların daha da artırılması gereklidir. Ayrıca kadın hastalara daha fazla sosyal ve psikolojik rehberlik sağlanması önerilebilir. Hepatitten siroza hastalık şiddeti artarken yasam kalitesi anlamlı farklılık göstermemektedir. Viral hepatitli hastalarda hastalıkları ile ilgili danışmanlık ve rehberlik hizmetlerinin verilmesi bu hastalarda yasam kalitelerini iyileştirebilir.Chronic liver disease is one of the health problems that negatively affect quality of life. In our country, we do not have any data regarding quality of life of the patients that have chronic liver disease and that had liver transplantation. The aim of the study, which constitutes the subject of this thesis, is to evaluate the quality of life of the patients with chronic viral hepatitis, cirrhosis and patients of liver transplantation. Thirty patients that are being followed with the diagnosis of chronic hepatitis B or chronic hepatitis C and 30 patients that were clinically diagnosed as cirrhosis at Akdeniz University Faculty of Medicine, Department of Gastroentrology in Antalya, and 30 patients that had liver transplantation and are being followed at the Organ Transplantation Centre Polyclinic of the same hospital, a total of 90 patients are enrolled into this study. Sociodemographic data form and SF 36 Quality of Life Scale have been used as means of data gathering. For the evaluation of disease severity in patients with cirrhosis, scoring of Child Pugh Test has been used. Chi- Square, Kruskal Wallis, test of Mann Whitney U, and T-test have been used for the statistical assessment of the data. The quality of life of cirrhosis and chronic hepatitis patients has been found lower than that of liver transplantation patients. Between quality of life of cirrhosis and hepatitis patients, sub-dimensions of role function physical and physical fitness have been found significantly different. Points of chronic hepatitis patients have been high in both of these sub-dimensions. It has been observed that with the increase of cirrhosis severity, points of SF 36 Quality of Life have not been changed. It has been found out that male patients of chronic hepatitis and cirrhosis have a higher quality of life than female patients of these illnesses, while there is no difference between the sexes of liver transplantation patients. In conclusion, quality of life of organ transplanted chronic liver patients is higher. Quality of life, which is lower in female patients with chronic hepatitis and cirrhosis than males, is similar in both sexes with transplanted patients. Hence, the studies on the organ donation should be augmented. Also, it can be suggested that more social and psychological counseling is provided for female patients. The quality of life of viral hepatitis patients can be improved if consultancy and counseling services are given regarding their illnesses

Evaluation of the Quality of Life in Chronic and Transplanted Liver Patients

Kronik karaciğer hastalığı yasam kalitesini olumsuz etkileyen sağlık problemlerinden biridir. Ülkemizde kronik karaciğer hastalığı ve karaciğer nakli yapılmış hastaların yasam kalitelerine ait veri yoktur. Bu tezin konusunu oluşturan çalışmanın amacı; kronik viral hepatit, siroz ve karaciğer nakli hastalarında yasam kalitesini değerlendirmektir. Araştırma kapsamına Antalya ilindeki Akdeniz Üniversitesi Tıp Fakültesi Hastanesi Gastroenteroloji Anabilim Dalı Polikliniğinde takip edilen kronik hepatit B ya da kronik hepatit C tanılı 30 hasta, klinik olarak siroz tanısı olan 30 hasta ile aynı hastanede Organ Nakli Merkezi Polikliniğinde takip edilen karaciğer nakli yapılmış 30 hasta olmak üzere toplam 90 hasta alındı. Veri toplama araçları olarak sosyodemografik veri formu ve SF 36 Yasam Kalitesi Ölçeği kullanıldı. Sirozlu hastalarda hastalık şiddetini belirlemek için Child-Pugh skorlaması kullanıldı. Verilerin istatistiksel olarak değerlendirilmesinde ki-kare testi, Kruskal Wallis, Mann Whitney U testi ve T-testi kullanıldı. Siroz ve kronik hepatit hastalarının yasam kaliteleri karaciğer nakli yapılmış olan hastaların yasam kalitelerinden daha düşük bulundu. Siroz ve kronik hepatit hastalarının yasam kaliteleri arasında rol fonksiyon fiziksel ve zindelik alt boyutları anlamlı olarak farklı bulundu. Bu iki boyutta da kronik hepatit hastalarının puanları daha yüksekti. Siroz şiddetinin artmasıyla SF 36 yasam kalitesi puanlarının değişmediği görüldü. Kronik hepatit ve siroz tanısı olan hastalarda, erkek hastaların yasam kalitesi kadın hastalara göre daha yüksek, karaciğer nakli yapılmış olan hastalarda cinsiyetler arasında bir farklılık olmadığı bulundu. Sonuç olarak organ nakilli kronik karaciğer hastalarında yasam kalitesi daha yüksektir. Kronik hepatit ve sirozlu kadın hastalarda daha düşük olan yasam kalitesi nakil sonrası erkeklerle benzerdir. Dolayısıyla organ bağışı konusundaki çalışmaların daha da artırılması gereklidir. Ayrıca kadın hastalara daha fazla sosyal ve psikolojik rehberlik sağlanması önerilebilir. Hepatitten siroza hastalık şiddeti artarken yasam kalitesi anlamlı farklılık göstermemektedir. Viral hepatitli hastalarda hastalıkları ile ilgili danışmanlık ve rehberlik hizmetlerinin verilmesi bu hastalarda yasam kalitelerini iyileştirebilir.Chronic liver disease is one of the health problems that negatively affect quality of life. In our country, we do not have any data regarding quality of life of the patients that have chronic liver disease and that had liver transplantation. The aim of the study, which constitutes the subject of this thesis, is to evaluate the quality of life of the patients with chronic viral hepatitis, cirrhosis and patients of liver transplantation. Thirty patients that are being followed with the diagnosis of chronic hepatitis B or chronic hepatitis C and 30 patients that were clinically diagnosed as cirrhosis at Akdeniz University Faculty of Medicine, Department of Gastroentrology in Antalya, and 30 patients that had liver transplantation and are being followed at the Organ Transplantation Centre Polyclinic of the same hospital, a total of 90 patients are enrolled into this study. Sociodemographic data form and SF 36 Quality of Life Scale have been used as means of data gathering. For the evaluation of disease severity in patients with cirrhosis, scoring of Child Pugh Test has been used. Chi- Square, Kruskal Wallis, test of Mann Whitney U, and T-test have been used for the statistical assessment of the data. The quality of life of cirrhosis and chronic hepatitis patients has been found lower than that of liver transplantation patients. Between quality of life of cirrhosis and hepatitis patients, sub-dimensions of role function physical and physical fitness have been found significantly different. Points of chronic hepatitis patients have been high in both of these sub-dimensions. It has been observed that with the increase of cirrhosis severity, points of SF 36 Quality of Life have not been changed. It has been found out that male patients of chronic hepatitis and cirrhosis have a higher quality of life than female patients of these illnesses, while there is no difference between the sexes of liver transplantation patients. In conclusion, quality of life of organ transplanted chronic liver patients is higher. Quality of life, which is lower in female patients with chronic hepatitis and cirrhosis than males, is similar in both sexes with transplanted patients. Hence, the studies on the organ donation should be augmented. Also, it can be suggested that more social and psychological counseling is provided for female patients. The quality of life of viral hepatitis patients can be improved if consultancy and counseling services are given regarding their illnesses

Clinical and laboratory evaluation of children with congenital hyperinsulinism: A single center experience

Objectives: To evaluate and present the data regarding clinical, laboratory, radiological and the results of molecular genetic analysis of patients with hyperinsulinemic hypoglycemia in our clinics. Methods: A total of 9 patients with CHI followed at Istanbul Medipol University. Data related to gender, age at presentation, birth weight, gestational age, consanguinity, glucose and insulin levels at diagnosis, treatment modalities, response to treatment, the results of genetic analysis and radiological evaluation were gathered from the files. Results: The oldest age at presentation was 6 months. K-ATP channel mutation was detected in 55% (n: 5). Diazoxide unresponsiveness was seen in 55% (n: 5). Octreotide was effective in 3 of them. F-18-DOPA PET performed in 4 diazoxide unresponsive patients revealed focal lesion in 3 of them. Spontaneous remission rate was 66% (n:6). All the patients with normal genetic result achieved spontaneous remission. Spontaneous remission was even noted in diazoxide unresponsive patients and in patients with focal lesion on F-18-DOPA PET. Conclusions: Clinical presentation of patients with congenital hypereinsulinism is heterogeneous. Spontaneous remission rate is quite high even in patients with severe clinical presentation. It is important to develop methods that can predict which patients will have spontaneous remission. Reporting the clinical and laboratory data of each patient is important and will help to guide the management of patients with hyperinsulinemic hypoglycemia

Thyroid function tests and affecting factors in twins and triplets

WOS: 000445204104201

Laryngeal web associated with chromosome 22q11 deletion in a preterm infant

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Staphylococcal scalded skin syndrome in a preterm infant

WOS: 000418094200002A male infant was delivered by cesarean section at 26 weeks and 3 days gestational age and weighed 1020 grams. Apgar scores were 7 and 8 at 1st and 5th minutes, respectively. The baby was hospitalized for prematurity, and given one dose of surfactant therapy on the first day of life. Empirical ampicillin and gentamicin therapy was started on the first day of life and continued for ten days. He also received high-flow oxygen through nasal cannula. The patient had neither clinical nor culture-proven sepsis attacks. On the 25th day of his life, the patient developed diffuse blanching erythema which started around the nose followed by appearance of bullous lesions on the extremities, neck and upper back regions (Figure 1)

Bronchoscopic findings in children with congenital heart disease

WOS: 000451979401455Introduction: The aim of this study was evaluation of broncoscopic findings in children with congenital heart disease(CHD). Method: Bronchoscopy was performed in 37 patients with CHD who were followed between October 2012–December 2014 in our hospital. The data obtained from these patients were evaluated retrospectively. Results: Twenty-one of the patients were males and 16 were females, median ages 12.5 mo (1-36m). Twenty-seven patients (72.9 %) were operated for congenital heart disease. Twelve of the patients had pulmonary hypertension. Bronchoscopy was performed because of extubation failure, atelectasis, recurrent or persistant pneumonia, stridor and persistant cough; 17,7,7,4 and 2, respectively. Laryngomalacia, tracheomalacia, bronchomalacia, tracheal stenosis, airway branch anomalies, granulation tissue formation and pulsatile airway pressure was determined in flexible bronchoscopy, 13,12,8,4,17,7 and 10, respectively. Twenty-seven of the patients were followed with mechanical ventilation(MV). MV duration before and after bronchoscopy was median 30 and 12 days, respectively. Tracheostomy was performed in 15 cases. After bronchoscopy five of these patients were removed from tracheostomy. Eleven out of the patients had positive culture in bronkoalveolar lavage. Patients were discharged with room air, tracheostomy with room air, only with supplemental oxygen, tracheostomy with supplemental oxygen; 19(51.3%), 6(16.2%), 1(2.7%),1(2.7%), respectively. One patient was following intubated with ventilatory support. Nine patients died. Conclusions: Airway anomalies were more frequently encountered in patients with congenital heart disease

Urgent surgical management of congenital intracranial hemangiopericytoma in a preterm neonate

Hemangiopericytoma is a rare mesenchymal tumor originating from capillary pericytes, known as Zimmermann pericytes. The adult form is not uncommon and generally malignant but tumor is found rarely in children. Here we describe an intracranial hemangiopericytoma in a preterm newborn whose had the tumor resected successfully shortly after birth