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Evaluation of Clinical and Laboratory Findings in Patients with Brucellosis

Purpose: The purpose of this study is to evaluate the demographic data, laboratory and clinical findings and organ involvement of patients diagnosed with brucellosis. Materials and Methods: The patients were divided into groups according to sex (female/male) and age (≤40 years/>40 years and ≤30 years, 31-44 years, 45-59 years, and ≥60 years). Results: A total of 238 patients were assessed. Among those, 57.5% (n=137) were male, and the mean age was 43.8±15.0 years. Arthralgia (93.7%, n=223), myalgia (84.9%, n=202), and fatigue (84.5%, n=201) were the most common clinical symptoms. In female patients, myalgia (92.1% vs. 79.6%, p=0.008), fatigue (92.1% vs. 78.8%, p=0.005), headache (38.6% vs. 25.5%, p=0.031), and nausea (32.7% vs. 13.9%, p=0.001) were more common, whereas loss of appetite (43.5% vs. 59.9%, p=0.013) was less common. Weight loss (48.0% vs. 34.3%, p=0.034) and sacroiliitis (13.2% vs. 5.0%, p=0.029) were more common, whereas spondylodiscitis (2.0% vs. 9.3%, p=0.039) was less common in younger patients (≤40 years). Weight loss was more common in the ≤30 age group compared to the 31-44 age (55.8% vs. 32.8%, p=0.013) and 45-69 age groups (55.8% vs. 35.3%, p=0.019). Fever was less common in the ≤30 age group compared to the 45-59 age group (32.7% vs. 54.1%, p=0.015). Conclusion: In endemic areas, brucellosis should be considered in the differential diagnosis of patients with arthralgia, myalgia, fatigue, leukopenia or leukocytosis, and elevated ESR and CRP. Patients ≤40 years with brucellosis should be evaluated for sacroiliitis, and patients >40 years should be evaluated for spondylodiscitis complications.

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Hemşirelik Son Sınıf Öğrencilerinin Stres Algısı ile Sosyal Yeterlilik ve Sonuç Beklentisinin Değerlendirilmesi

Amaç: Bu çalışma hemşirelik son sınıf öğrencilerinin stres algıları ile sosyal yeterlilik ve sonuç beklentisi düzeylerini belirlemek ve stres algıları ile sosyal yeterlilik sonuç beklentisi düzeyi arasındaki ilişkiyi incelemek amacı ile yapılmıştır. Araçlar ve Yöntem: Tanımlayıcı-ilişki arayıcı tipte olan bu çalışma, bir devlet üniversitesinin Hemşirelik Fakültesi’nde yapılmıştır. Araştırmanın evrenini fakültede öğrenim gören hemşirelik son sınıf öğrencileri (N=288) oluşturmuştur. Çalışma araştırmaya katılmayı kabul eden 180 öğrenci ile tamamlanmıştır. Veri toplamada “Öğrenci Tanıtım Formu”, “Hemşirelik Öğrencileri İçin Algılanan Stres Ölçeği” ve “Sosyal Yeterlilik ve Sosyal Sonuç Beklentileri Ölçeği” kullanılmıştır. Verilerin değerlendirilmesinde non-parametrik testler kullanılmıştır. Bulgular: Öğrencilerin Algılanan Stres Ölçeğinden (HÖASÖ) aldıkları puan ile cinsiyet, sigara kullanımı, klinik yeterlilik ve kendini tanımlama arasında istatistiksel olarak anlamlı farklar bulunmuştur (p<0.05). Öğrencilerin sosyal güvencesinin olması, gelir düzeylerinin yüksek olması ve klinikte kendilerini yeterli olarak görmelerinin Sosyal Yeterlik ve Sosyal Sonuç Beklentileri (SYSSB) puanlarını arttırdığını ve bu farkın önemli olduğunu göstermiştir (p<0.05). HÖASÖ ve SYSSB Ölçekleri arasında negatif bir ilişki saptanmıştır (r=-0.163, p=0.05 ). Sonuç: Öğrencilerin klinik olarak kendilerini yeterli hissetmelerinin ve sakin yapıya sahip olmalarının stres düzeyini azalttığı, uygulamalarda kendilerini yeterli bulmalarının sosyal yeterlik ve sosyal sonuç düzeylerini yükselttiği bulunmuştur. Öğrencilerin uygulamalara başlamadan, yeterliliklerinin arttırılması, kendilerini klinik uygulamalarda yeterli hissetmelerini sağlayacak özellikle yeni ve teknoloji tabanlı eğitim tekniklerinin kullanılması önerilir.

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The Role of Disease Activity as a Determinant of Central Sensitivity and Body Awareness in Fibromyalgia Patients: A Cross-Sectional Study

Purpose: The present study aimed to identify the influence of disease activity on central sensitization (CS) and body awareness in fibromyalgia syndrome (FMS) patients. Materials and Methods: Forty-five patients with FMS (mean age: 45.9 (6.9) years, median disease duration: 3 (2-6) years) were participated this cross-sectional study. Disease activity was assessed using the Fibromyalgia Impact Questionnaire (FIQ) and higher score was considered high disease activity. The Central Sensitization Inventory (CSI) was performed for central sensitivity. Body awareness levels were evaluated with the Body Awareness Questionnaire (BAQ). Visual Analogue Scale (VAS) was used to identify pain severity. Simple linear regression analyses were used to determine which independent variables could explain disease activity. Results: The mean FIQ and BAQ were 53.4 and 90 points, respectively. The median VAS and CSI were 8 cm and 52 point, respectively. The CS is positive in 82.2% of all patients. FIQ was moderately correlated with the VAS score (r=0.445, R2=0.198, p=0.002) and is highly correlated with CSI (r=0.539, R2=0.291, p<0.001). There was no significant correlation between FIQ and BAQ (p=0.791). The results of the simple linear regression analysis presented that VAS explained 19.8% of the the disease activity. FIQ (r=0.445, p=0.002) significantly predicted pain severity. Additionally, The CSI explained 29.1% of the disease activity and FIQ (r=0.539, p<0.001) significantly predicted CS. Conclusion: High disease activity negatively impacts CS and body awareness in FMS patients. Clinicians should consider a multimodal biopsychosocial perspective in addition to routine treatments in the management of patients with high disease activity.

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The Psychological Impact of War on Immigrants: Public Health Strategies for Support

Armed conflict has significant psychological effects on migrants exposed to it. They often face mental health challenges such as depression, anxiety, and post-traumatic stress disorder (PTSD), which are worsened by factors like social isolation, discrimination, and language barriers. Prolonged violence and military activities further increase the risk of these psychological issues. This study aims to explore the psychological impact of war on migrants and identify effective strategies for providing mental health support. It focuses on how trauma, discrimination, and social factors contribute to conditions like depression, anxiety, and PTSD among migrant populations. A review of existing literature was conducted to assess the prevalence of mental health issues, such as depression and anxiety, among war refugees. The relationship between war trauma, discrimination, and other contributing factors like economic hardship and social isolation was analyzed to better understand the broader psychological consequences. Exposure to war trauma and discrimination significantly heightens anxiety and the likelihood of developing PTSD, which can severely affect an individual’s long-term functioning. The review highlights the need for targeted interventions to support migrants' mental health, especially in the face of social and economic challenges. Social support has been shown to reduce the negative psychological effects of war. Factors such as cultural adaptation, religious beliefs, and financial stability are also crucial for improving migrants' mental well-being. Further research is needed to develop effective interventions and policies that address the mental health needs of migrants in conflict-affected areas.

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Relationship between Preoperative Pulmonary Function Test Parameters and Postoperative Pulmonary Complications in Laparoscopic Obesity Surgery

Purpose: The value of preoperative spirometry in laparoscopic obesity surgery is a subject of debate. The aim of our study is to investigate the relationship between preoperative pulmonary function tests (PFT) and postoperative pulmonary complications. Materials and Methods: The study included 73 patients who were evaluated in the pulmonology department before bariatric surgery at a training and research hospital in Izmir, Turkey. Demographic data, pulmonary function, and postoperative complications were retrospectively analyzed. Results: Seventeen patients (23.3%) had abnormal preoperative PFT results, while postoperative complications occurred in 7 patients (9.6%). Age, gender, surgery duration, and abnormal pulmonary function patterns were found to be significant factors in the development of complications (p=0.026, 0.047, 0.004, and 0.024, respectively). In multivariate analysis, surgery duration was identified as statistically significant in relation to complications (p=0.009). Conclusion: These findings suggest that patients with abnormalities in preoperative PFT may have an increased risk of postoperative complications. In this context, preoperative PFT assessment in bariatric surgery could influence surgical and postoperative monitoring decisions, especially for patients at higher risk of complications.

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Konuşma ve Dil Bozukluğu Olan Çocuk ve Ergenlerde Sosyodemografik Prenatal ve Postnatal Özellikler

Amaç: Bu çalışmada, konuşma ve dil bozukluğu olan çocuk ve ergenlerle sağlıklı bireylerin sosyodemografik, prenatal ve postnatal özellikleri karşılaştırılarak, konuşma ve dil bozuklukları için risk faktörlerinin belirlenmesi amaçlanmaktadır. Araçlar ve Yöntem: Çalışmada 01.01.2023-31.12.2023 tarihleri arasında tarafımıza başvuran, konuşma ve dil bozukluğu tanısı konulan 3-17 yaş arası olgular ile sağlıklı kontrollerden oluşan 1299 kişilik örneklem üzerinde gerçekleştirilmiştir. Olgu grubunda 76, kontrol grubunda 43 çocuk ve ergen çalışmaya dahil edilme kriterlerini karşılamış ve bu katılımcıların sosyodemografik, prenatal ve postnatal özelliklerini içeren veriler analiz edilmiştir. Bulgular: Sosyodemografik veriler açısından iki grup arasında anlamlı fark bulunmadı. Prenatal faktörlerden gebelikte demir takviyesi kullanımı olgu grubunda anlamlı derecede yüksek bulundu (p=0.02). Postnatal faktörlerden ise sadece okul öncesi eğitim alma sıklığı kontrol grubunda anlamlı derecede yüksek bulundu (p=0.012). Sonuç: Dil ve konuşma gelişimi, biyolojik ve çevresel faktörlerden etkilenen ve anne karnında başlayıp hayatın ilk yıllarda hızla devam eden bir süreçtir. Bu gelişimi olumsuz etkileyen faktörlerin erken tespiti ve önlem alınması büyük önem taşımaktadır. Çalışmamız, okul öncesi eğitimin bu gelişim için önemli olduğunu göstermektedir.

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Relationship between RT-PCR Threshold Cycle Values and Thorax CT Severity Score in COVID-19 Patients

Purpose: In this study, we aimed to investigate the relationship between RT-PCR Cycles Threshold (Ct) values, which provide information about the viral load, and CT severity score (CTSS), which is used to demonstrate lung involvement. Materials and Methods: Between January 1, 2021 and November 30, 2021, a total of 162 patients with lung auscultation findings and/or suspicious findings on posteroanterior chest radiography, along with a positive RT-PCR test, were included in the study. Viral loads, lung involvement, and mortality rates of the cases were analyzed based on the units in which they were hospitalized. Additionally, we investigated the correlation between comorbid diseases associated with COVID-19, CTSS (CT severity score), RT-PCR Ct viral load values, and age. Results: The CTSS showed a positive and significant correlation with age (p=0.017). Statistical analysis revealed no significant correlation between viral load and thoracic involvement (p=0.663). Conclusion: According to the present study, no significant correlation was found between RT-PCR Ct values, which play a crucial role in the diagnosis of COVID-19, and thoracic CT involvement. However, the prevalence of lung involvement and the mortality rate of the cases increased with age. Additionally, a significant correlation was observed between the CT severity score (CT-SS) and age. These findings pave the way for future in-depth research in this field, fostering a better understanding of the subject matter.

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Evaluation of the Relationship Between Systemic Immune-Inflammatory Index and Morning Blood Pressure Surge in Newly Diagnosed Essential Hypertension Patients

Purpose: This study aims to explore the relationship between the Systemic Immune-Inflammatory Index (SII) and Morning Blood Pressure Surge (MBPS) in patients with newly diagnosed essential hypertension. Materials and Methods: A cross-sectional study was conducted between April and June 2024, involving 405 participants, 217 controls, and 188 hypertensive patients, recruited from a cardiology outpatient clinic. Participants' blood pressure was monitored using Ambulatory Blood Pressure Monitoring (ABPM), and inflammatory markers, including SII, were assessed. SII was calculated by multiplying platelet count by neutrophil count and dividing by lymphocyte count. Statistical analysis included ROC curve analysis to evaluate SII's predictive value for MBPS. Results: Hypertensive patients exhibited significantly higher 24-hour, daytime, and nighttime systolic and diastolic blood pressure values compared to controls (all p<0.001). MBPS and SII were also significantly elevated in the hypertensive group (both p=0.003). ROC analysis demonstrated that SII had an AUC of 0.645 (p=0.001) with a sensitivity of 56.4% and specificity of 67% at a cut-off value of 577.38 for predicting MBPS greater than 27.3 mmHg. Elevated neutrophil and platelet counts were associated with higher blood pressure levels and cardiovascular risk. Conclusion: The study identified a significant association between SII and MBPS in hypertensive patients, suggesting that systemic inflammation may play a role in the regulation of blood pressure and the pathogenesis of hypertension. SII could serve as a valuable biomarker for predicting MBPS and associated cardiovascular risks, facilitating earlier and more targeted interventions.

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Obez Çocuk ve Ergenlerde Subklinik Hipotiroidi Sıklığı ve İlgili Parametrelerin İncelenmesi

Amaç: Subklinik hipotiroidizm (SH), obez çocuk ve ergenlerde sık görülen bir tiroid hormon bozukluğudur. Bu çalışmada, obez çocuk ve ergenlerde subklinik hipotiroidi sıklığını belirlemek, TSH düzeyi ile antropometrik ve metabolik parametreler arasındaki ilişkinin araştırılması planlanmıştır. Araçlar ve Yöntem: Çalışmaya yaşları 10-18 yaş aralığından değişen 100 obez grup, 70 kontrol grubu olmak üzere toplam 170 olgu alındı. Tüm olguların dosya kayıtlarından; cinsiyet, antropometrik ölçümleri (vücut ağırlığı, boy, beden kitle indeksleri) ve standart deviasyon skorları (SDS), tiroid fonksiyon testleri (TSH, sT4, sT3), insülin, açlık kan şekeri, total kolesterol (TK), yüksek dansiteli lipoprotein, kolesterol (HDL-K), trigliserid ve düşük dansitelilipoprotein kolesterol (LDL-K), HOMA-IR düzeyleri elde edildi. Bulgular: Obez gruptaki 100 hastanın 7’sinde (% 7) SH saptandı. Obez grubun VA ve BKİ-SDS değerleri kontrol grubuna göre anlamlı derecede yüksek saptandı. (p=<0.01,<0.01, sırasıyla). Obez grupta sT4 düzeyi kontrol grubuna göre anlamlı düşük (p=0.04 ), HOMA-IR ve AST düzeyi de anlamlı olarak yüksek bulundu (p=<0.01, <0.01, sırasıyla). Serum TSH düzeyi ile HOMA-IR düzeyi arasında pozitif yönde düşük derecede korelasyon saptandı (r=0.15, p=0.049). Sonuç: Obez çocuk ve ergenlerde SH normal popülasyona göre daha sık görülür, ancak çoğu olguda TSH 10 UI/ml’nın altında ve tedaviye ihtiyaç duyulmamaktadır. Obez çocuklarda Hashimato tiroiditi olmaksızın tiroid otoantikor pozitifliği görülebilir. TSH düzeyi ile insülin direnci arasında düşük derecede de olsa pozitif bir ilişki olduğundan, obez çocuklarda SH saptanması insülin direnci olasılığı konusunda klinisyen için uyarıcı olmalıdır.

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