Tampa Scale of Kinesiophobia for Heart Turkish Version Study: cross-cultural adaptation, exploratory factor analysis, and reliability

PURPOSE: Individuals with cardiac problems avoid physical activity and exercise because they expect to feel shortness of breath, dizziness, or chest pain. Assessing kinesiophobia related to heart problems is important in terms of cardiac rehabilitation. The Tampa Scale of Kinesiophobia Swedish Version for the Heart (TSK-SV Heart) is reliable and has been validated for cardiac diseases in the Swedish population. The aim of this study was to investigate the reliability, parallel-form validity, and exploratory factor analysis of the TSK for the Heart Turkish Version (TSK Heart Turkish Version) for evaluating kinesiophobia in patients with heart failure and pulmonary arterial hypertension. METHODS: This cross-sectional study involved translation, back translation, and cross-cultural adaptation (localization). Forty-three pulmonary arterial hypertension and 32 heart failure patients were evaluated using the TSK Heart Turkish Version. The 17-item scale, originally composed for the Swedish population, has four factors: perceived danger for heart problem, avoidance of exercise, fear of injury, and dysfunctional self. Cronbach’s alpha (internal consistency) and exploratory factor analysis were used to assess the questionnaire’s reliability. Results of the patients in the 6-minute walk test, International Physical Activity Questionnaire, and Nottingham Health Profile were analyzed by Pearson’s correlation analysis with the TSK Heart Turkish Version to indicate the convergent validity. RESULTS: Cronbach’s alpha for the TSK Heart Turkish Version was 0.75, indicating acceptable internal consistency. Although exploratory factor analysis showed a different subgroup distribution than the original questionnaire, the model was acceptable for the four-factor model hypothesis. Therefore, the questionnaire was rated as reliable. CONCLUSION: These results supported the reliability of the TSK Heart Turkish Version. Since the acceptable four-factor model fits the subgroups and measures of reliability are sufficiently high, the questionnaire seems reliable for pulmonary arterial hypertension and heart failure patients

Comparison of Audiological Findings in Patients with Vestibular Migraine and Migraine

Objective:The aim of this study was to investigate and compare the auditory findings in vestibular migraine (VM) and migraine patients without a history of vertigo.Methods:This study was conducted on 44 patients diagnosed with definite VM and 31 patients diagnosed with migraine who were followed and treated between January 2011 and February 2015. Also, 52 healthy subjects were included in this study as a control group. All participants underwent a detailed otorhinolaryngological examination followed by audiological evaluation, including pure tone audiometry, speech reception threshold, speech recognition score, and acoustic immitancemetry.Results:In the VM group, there were 16 patients (36.4%) with tinnitus, while in the other groups we did not observe any patients with tinnitus. The rate of tinnitus in the VM group was significantly higher in comparison to other groups (p<0.05). None of the groups had any patients with permanent or fluctuating sensorineural hearing loss.Conclusion:We conclude that patients with VM should be closely and longitudinally followed up for the early detection of other otological symptoms and possible occurrence of sensorineural hearing loss in the long term

Sağlıklı çocuklarda kan basıncı eğrilerinin belirlenmesi ve farklı eğri modellerinin karşılaştırılması

Giriş ve Amaç: Hipertansiyon, dünyada çok önemli bir sağlık sorunudur. Çocuklarda erişkin yaşamdaki kardiyovasküler hastalıklar için önemli bir risk faktörüdür, çocukluk döneminde de aterosklerozis ve organ hasarlarına neden olur. Bu çalışmada 2-18 yaş grubu sağlıklı çocukların kan basıncı normal değer eğrilerinin farklı modellerle belirlenmesi ve modellerin performansının değerlendirilmesi amaçlanmıştır. Yöntem: Kesitsel bir çalışma yapılmış ve olasılıklı örnekleme yöntemi uygulanmıştır. Toplam örnek büyüklüğü 3456 çocuk olarak hesaplanmıştır. Sosyoekonomik durumu farklı üç bölgede 10 okul (kreş, anaokulu, ilköğretim, lise) seçilmiş (n=5417) ve öğrencilerin %92'sine (n=4984) ulaşılmıştır. Çocukların ağırlık, boy, kilo ve kan basınçları standardizasyon eğitimleri yapılarak uygun yöntemlerle ölçülmüştür. Kan basıncı eğrilerinin tahminlenmesi için R programı, version 3.0.2 (2013-09-25) kullanılarak polinomiyal regresyon modeli ile kan basıncı eğri modelleri tahminlenmiştir. Bulgular: Sistolik ve diyastolik kan basıncı ölçüm ortalamaları her iki cinste de yaş ile birlikte artış göstermektedir. Her iki cinsiyet için yaş-10, boy Z skor ve ağırlık Z skoru değişkenlerinin dördüncü dereceden modele dahil edildiği polinomiyal regresyon analizleri gerçekleştirildi. Yaş ve boya ait değişkenlerin kan basıncını etkilediği modellerin anlamlı olduğu saptandı. Erkek çocukların tahminlenen hem sistolik hem de diastolik kan basıncı için değerlerinin kız çocukların tahmin değerlerinden biraz yüksek olduğu görüldü. Sonuç: Bu çalışmanın çocuk ve ergen kan basıncı tahminleri Avrupa ve Amerika'da geliştirilen eğri tahminlerinden daha düşük değerlerde olduğu saptanmıştır. Belirli aralıklarla daha geniş coğrafi temsiliyeti olan örneklerle Türk çocuklarına ait kan basıncı normal değerleri belirlenmeli, farklı istatistik yöntem ve modellerle sonuçlar değerlendirilmelidir.Aim: Hypertension is one of the most important public health problem in worldwide. Hypertension in childhood and adolescence is a significant risk factor for cardiovascular disease in the adult life and it also causes early development of atherosclerosis and end-organ damage in childhood. The aim of this study is to determine the systolic and diastolic BP percentiles using different models aged 2 to18 years in Turkish children and to evaluate the performances of the models. Methods: A cross-sectional study was performed and the probability sampling method was applied. The total sampling size was 3456 children. Of the total 5,417 children at 10 selected schools (nursery, pre-elementary school, primary school, and high school), 4,984 (the reached rate 92%) were evaluated. Weight, height and systolic and diastolic blood pressure of these children were measured by suitable methods. The estimations of systolic and diastolic blood pressure percentiles in children using polynomial regression and quantile regression models were done. Data were analyzed by R program, version 3.0.2 (2013-09-25) and version 2.15. Results: The mean values of systolic and diastolic blood pressure increased with age and hight at both genders. For both genders, polynomial regression analyzes were performed in which the age-10, height Z score, and weight Z score variables were included in the fourth-degree regression model. It was found that age and height variables affected blood pressure and models were statistically significant. It was observed that the estimated values of systolic and diastolic blood pressures for boys were slightly higher than the predicted values for girls. Conclusion: The blood pressure normal values of Turkish children should be determined with samples of wider geographical representation and at certain intervals. Different statistical methods and models should be used to evaluate the results

The determination of the effect of passive smoking on lower respiratory tract infections in children aged 2-12 years by urinary cotinine and eosinophil cationic protein levels

Amaç. Topluma dayalı bu olgu-kontrol çalısmasının amacı, çocuklarda idrarda kotinin ve eozinofil katyonik protein düzeyleri belirlenerek, alt solunum yolu enfeksiyonu olusumunda pasif sigara içiciliginin etkisini saptamaktır. Yöntem. Arastırmanın örnek büyüklügü, arastırmanın gücü %80, etkenle karsılasma prevalansı %50, olgu/kontrol=1/1, OR=2.0 ve güven aralıgı %95 olarak alındıgında olgu ve kontrol grubunun her biri için en az 148 çocuk olarak bulunmustur. Arastırmaya en az örnek büyüklügünü karsılayacak sekilde 150 olgu ve 150 kontrol alınmıstır. Ekim 2003 - Mart 2004 tarihleri arasında yapılan çalısmada olgular Narlıdere Bölgesi'ndeki üç saglık ocagının kayıtlarından alınmıs alt solunum yolu tanısı almıs 2-12 yas grubundaki çocuklardır. Kontroller aynı saglık ocakları bölgesinden olgularla yas, cins ve aynı sokakta oturuyor olması açısından eslestirmesi yapılmıs, saglıklı çocuklardır. Çalısmaya alınan olguların ve kontrollerin evlerine tanı sonrası ilk üç günde gidilerek önceden olusturulan anketle gerekli bilgiler ve idrar örnegi toplanmıstır. _x0001_drarda kotinin düzeylerine radioimmunoassay, eosinofil katyonik protein düzeylerine flouroenzymeimmunoassay yöntemleriyle bakılmıstır. Veri çözümlemeleri SPSS 11.0 programı kullanılarak McNemar Ki-kare, ve bagımlı grupta t-testi ve pearson korelasyon analizi ile degerlendirilmistir. P 0.05 degeri istatistiksel olarak anlamlı kabul edilmistir. Bulgular. Bildirime göre pasif içicilik prevalansı alt solunum yolu enfeksiyonu olan olgu grubunda %71.3, saglıklı kontrol grubunda %72.0 bulunmustur. _x0001_drar kotinin/kreatinin oranı 30 ng/mg kesim degerine göre, olgu grubunda içicilik prevalansı %87.3, kontrol grubunda %84.7 bulunmustur (p=0.618). Kesim degeri 60 ng/mg olarak alındıgında pasif sigara içiciliginin alt solunum yolu enfeksiyonunun 4.7 kat arttırdıgı saptanmıstır (p grubuna göre daha yüksektir (p=0.018). Alt solunum yolu enfeksiyonu olan çocuklarda idrarda kotinin ve eozinofil katyonik protein degerleri arasında olumlu birliktelik bulunmaktadır (p=0.034). Sonuç. Pasif sigara içiciligi karsılasılan dumanın yogunluguna baglı olarak çocuklarda alt solunum yolu enfeksiyonu sıklıgını arttırmaktadır. Alt solunum yolu enfeksiyonu pasif sigara ile birlikte hava yolu yangısına yol açarak reaktif hava yolu hastalıkları için risk olusturmaktadır. Anahtar kelimeler: alt solunum yolu enfeksiyonu, eozinofil katyonik protein, kotinin, pasif sigara içiciligi Aim. The aim of this community-based and case-control study was to determine the effect of passive smoking on lower respiratory tract infections in children by urinary cotinine and eosinophil cationic protein values. Methods. The minimum sample size of the study was determined as 148 children in case and control groups at 95% confidence interval, 80% power, case/control considered equal, odds ratio=2.0, and possible exposure prevalence 50%æ 150 children with lower respiratory tract infection and 150 healthy children were included in the study. The children aged 2 to 12 years with lower respiratory tract diseases in the study carried out between October 2003 and March 2004 were selected from the records of three health centres in Narlidere district. The children in control groups were healthy children who were paired with the cases obtained from the same health centres according to age, gender and street of the residing area. The residences of children diagnosed with LRTI and, also healthy children were visited within first 3 days of diagnosis, and a specialy designed questionnaire was used to obtain information, and urine samples were collected. The urine cotinine and eosinophil cationic protein levels were measured by radioimmunoassay and fluoro enzyme immunoassay methods respectively. Data were analyzed on SPSS 11.0 programme, and were assessed by McNemar Chi-square, paired t-test and pearson corelation test. P was accepted statistically significant. Results. The prevalence of parental self-reported, indoor smoking was 71.3% in children with lower respiratory tract infection and 72.0% in healthy children. According to the value of urinary cotinine/creatinine for 30 ng/mg, the prevalence of passive smoking was 87.3% in case group and 84.7% in control group (p=0.618). When the cut-off level of urinary cotinin/creatinine was accepted as 60 ng/mg, it was found that passive smoking increased lower respiratory tract infection 4.7 times (p cationic protein values were significantly higher in the case group compared with the healthy children group (p=0.018). A positive association was determined between urinary cotinine and eosinophil cationic protein values in children with lower respiratory tract infection (p=0.034). Conclusion. Dose-dependent exposure to environmental tobacco smoke increases the prevalence of lower respiratory tract infection in children. Lower respiratory tract infections together with passive smoking may be a risk factor for bronchial hyperresponsiveness by airway inflammation. Keywords. lower respiratory tract infection, eosinophil cationic protein cotinine, passive smokin