Objectives: This study aims to evaluate demographic and clinical characteristics of the emergency department (ED) cases with a diagnosis of temporomandibular joint (TMJ) dislocation alongside the patient management of these cases.Materials and Methods: Our single-center and retrospective study was conducted at the ED of Eskisehir Osmangazi Health, Practice and Research Hospital in 10 years and 10 months (01.01.2010-30.10.2020). All 18 years and older patients diagnosed with TMJ dislocation at the ED during the studied period were included in the study. The information on demographics, dislocation type and mechanism, medical history of repeated dislocation, imaging, application of reduction, reduction outcome, and necessity of sedo-analgesia were obtained from the patients’ records. The lack of data required for analysis in the records was taken as an exclusion criterion.Results: When the file records were examined 113 cases were diagnosed with TMJ dislocation in ED. 66 cases were primary admissions and 47 cases were recurrent admissions of these cases. Primary applications are evaluated; the mean age was 42.74±20.83 and 69.7%(n=46) were women. The joint dislocation was present in 56.1%(n=37) bilaterally. 98.5%(n=65) of them were non-traumatic. When all the cases were evaluated, it was determined that 91.2%(n=103) did not perform radiological imaging. During reduction, it was observed that sedo-analgesia was applied in 13.3%(n=15) cases. It was observed that 98.2%(n=111) of the reduction applications resulted successfully. No complication records of the cases were found.Conclusion: Management of TMJ dislocation is important for patient comfort and joint function. Emergency physicians successfully manage acute TMJ dislocation, which they rarely encounter.
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Objectives: To compare the reverse transcription-polymerase chain reaction (RT-PCR) test results and chest computerized tomography (CT) findings in pediatric patients with a pre-diagnosis of COVID-19.Materials and Methods: The thorax CT examinations and RT-PCR test results were retrospectively evaluated in 177 children. According to the test results, the patients were divided into two groups as ‘COVID-19-positive’ and ‘COVID-19-negative’.Results: In the COVID-19-positive group, 65.71% of the patients with a family history of COVID-19 (p<0.01). In the same group, 50.00% of patients with normal CT findings were older than 16 years (p<0.01), and singlelobe involvement was more common (54.54%, p<0.01). The most observed CT finding was consolidation with ground-glass opacities (GGO) in both groups. Fibrotic bands (51.46%, p<0.01), reticular pattern (34.95%, p<0.01), atelectasis (9.71%, p<0.01), mosaic perfusion (26.21%, p<0.01), and pleural effusion (19.42%, p<0.01) were mostly seen in the COVID-19-negative group. In patients with underlying diseases, the sensitivity values were calculated as 0.441 for CT and 0.863 for the RT-PCR test.Conclusion: In patients with a family history of COVID-19, the chest CT showed focal GGO with or without consolidation as the most common finding. If CT findings diffuse and severe, the patient most likely does not have COVID-19. The RT-PCR test results are more reliable than CT in children with underlying diseases.
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Methemoglobinemi, kanda aşırı methemoglobin bulunması durumudur. Methemoglobinemi, siyanozun ayırıcı tanıları arasında düşünülmesi gereken, nadir görülen fakat klinik olarak önemli bir durumdur, teşhisi hızlı ve nispeten kolay bir prosedürdür. Acil hastaların tedavisinde; yüksek akım O2 (HFO2) mevcut hemoglobinin doygunluğunu sağlamak için önemlidir. Metilen mavisi, ilaçların indüklediği semptomatik methemoglobinemi (göğüs ağrısı, nefes darlığı veya konfüzyon gibi hipoksi bulguları) veya MetHb düzeyleri>%20 olan asemptomatik hastalarda ilk seçenek tedavidir. 19 yaş kadın hasta acil servisimize suisid amaçlı 2,5 gram dapson alımı sonrası başvurduğu başka bir merkezden kan gazında ölçülen methomoglobinemi seviyesi %34 ölçülmesi üzerine getirildi. Yüksek akım oksijen tedavisine yanıt vermeyen hastaya hiperbarik oksijen tedavisi 90 dakika süreyle yapıldı. Bu vaka sunumunda, standart metilen mavisi tedavisine yanıt vermeyen hipoksik ve siyanozlu methemoglobinemi hastası anlatmak istedik.
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Obezite, çağımızın sağlık sorunlarının en önemlilerindendir. Günümüzde, tüm dünyada obezite prevalansı artmakta olup bu durum sadece yetişkin bireyleri değil, çocukları ve gençleri de etkilemektedir. Obezite, kalpdamar hastalıkları, hipertansiyon, diyabet, bazı kanser türleri, solunum sistemi hastalıkları, kas-iskelet sistemi hastalıkları gibi pek çok sağlık probleminin oluşmasına zemin hazırlamaktadır. Bununla birlikte, gerek obeziteye neden olan davranışsal faktörler gerekse obezitenin vücutta yarattığı değişiklikler ağız ve diş sağlığını da tehdit edebilmektedir. Literatürde obezitenin diş çürüğü, periodontal hastalık ve tükürük üzerindeki etkisinin araştırıldığı çok sayıda çalışma yer almaktadır. Bu derlemenin amacı, çeşitli alanlardaki sağlık personelinin obezitenin yol açabileceği ağız ve diş sağlığı problemleri açısından farkındalıklarını artırmaktır.
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Objectives: Healthy lifestyle behaviors refer to “maintaining a healthy state of mind and developing healthy activity behaviors.” The aim of this study was to investigate the relationship between healthy lifestyle behaviors and body composition in university students. Materials and Methods: The population for this cross-sectional study consisted of students from the Nutrition and Dietetics Department. Demographic data were collected, and the “Health Promoting Lifestyle Profile II” (HPLP-II) was administered. Results: The mean HPLP-II score of the students was 130.15 ± 15.07. The physical activity score of the students was normal according to body mass index (BMI), and it was significantly higher than that of those who were underweight and overweight. According to BMI, the nutrition scores of normal students were statistically significantly higher than those who were underweight. The physical activity scores of the students who were obese according to their body fat percentage were statistically significantly lower than those of those who were athletes, fitness, or average. According to their waist circumference, the health responsibility and physical activity scores of the overweight students were statistically significantly lower than those of those who were normal. Conclusion: In this study, it was shown that students who have healthier and fitter bodies pay greater attention to their nutrition, take part in more physical activity, and have higher levels of health responsibility.
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Amaç: Adölesan idiopatik skolyoz’un (AIS) cerrahi tedavisinde standart yaklaşımı posterior enstrümentasyon ve füzyon (PEF) oluşturur. Tedaviye alternatif, füzyonsuz cerrahi yöntem olan vertebra cisim gerdirme (VBT) ise giderek daha sık kullanılmaktadır. Bu çalışmayla, PEF ve VBT yöntemleri ile ameliyat edilmiş AIS hastalarının düzelme miktarları ve yaşam kalitelerinin karşılaştırılması amaçlanmıştır. Materyal ve Metot: Eşleşmiş kohortlar, 2 yıl takipli 40⁰-70⁰ eğriliği olan AIS hastaları incelenerek elde edildi. Lomber eğriliğin cerrahiye dahil edildiği hastalar çalışmadan çıkartıldı. Hastaların demografik verileri, perioperatif ve takip radyografik ölçümleri ve hasta tarafından bildirilen SRS-22 skorları karşılaştırıldı. Bulgular: Çalışmaya, 16 PEF ve 18 VBT hastası (30K, 4E) dahil edildi. Kohortun ortalama yaşı 13,4 (10-17) yıl ve takip süresi 25,7 (24–32) aydı. Grupların preoperatif üst torasik, ana torasik (MT) ve torakolomber (TL) skolyoz açıları benzerdi. PEF grubunda MT eğrilikte cerrahi düzelme oranı daha fazla (%84–%53, p<0,001) iken, 2. yılda toplam düzelme oranları gruplarda benzerdi (%80–%76, p=0,616). 2. yılda PEF ve VBT gruplarında kendi imaj/görüşünde ve ara toplamda anlamlı iyileşme olduğu saptandı (p<0,001–p=0,037 ve p<0,001–p=0,016). PEF grubunda, fonksiyon/ aktivite alt başlığındaki skorlar 6. ayda ve 2. yılda (p=0,027) ve ağrı, ara-toplam skorları 2. yılda, VBT grubuna göre düşüktü (p=0,020, p=0,036). Sonuç: PEF ve VBT cerrahisi takibinde MT ve TL eğriliklerde 2. yılda benzer oranda düzelme görülmektedir. SRS22 skorlarında iki cerrahi ile benzer iyileşme elde edilirken, VBT’de bu iyileşme dinamik olarak seyretmektedir. İki grup arasında fonksiyon/aktivite, ara-toplam ve ağrı skorlarının VBT grubunda erken dönem ve takipte füzyona kıyasla daha iyi olması, daha uzun takipli geniş hasta serilerinde incelenmelidir.
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Abstract Objectives: The aim of this study is to investigate the parameters that may contribute to the prediction of inhospital mortality in patients who were admitted to the emergency department with non-variceal upper gastrointestinal system (GI) bleeding and underwent endoscopy. Materials and Methods: Patients with non-variceal upper GI bleeding who were admitted to the emergency department of our hospital between March 2019 and June 2021 were evaluated retrospectively. Surviving and deceased patients were compared. To predict mortality independently, logistic regression analysis was performed with parameters that were significant. Results: It was shown that there was a relationship between low albumin and T score, older age, high LDH and higher white blood cell count, and mortality. In the ROC analysis, where the diagnostic accuracy of these five factors in predicting mortality was evaluated, the area under the curve was calculated as 0.84. Conclusion: The evaluation of albumin, age, T score, white blood cell and LDH together may be helpful in predicting the in-hospital mortality of patients with non-variceal upper GI bleeding.
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Objectives: In this study, we aimed to investigate complementary and alternative medicine (CAM) use and its relationship with adherence to long-term medical therapy in Type 2 Diabetes Mellitus (T2DM). Materials and Methods: The research was designed as a descriptive study. 100 (a hundred) patients who were using oral antidiabetic for at least one year were included in the study. A questionnaire to determine sociodemographic characteristics and CAM use and a six-item Turkish Modified Morisky Scale for the measure of medication adherence were applied to the participants. Results: 55% of patients (n=55) used at least one CAM practice. The most commonly used practice was herbal medicine [80% (n = 44)]. The main reasons for using CAM were to relieve complaints and support their conventional treatment, and 85.5% (n=47) of patients did not consult their physicians about the use of these practices. There was no statistically significant relationship between CAM use and medication adherence. Conclusion: The fact that patients do not consult a doctor while using CAM shows that we need to be careful about toxicities and dose insufficiency due to drug-herb interactions. Physicians should effectively investigate the use of these therapies in addition to the drug history of their patients. Therefore, all physicians should have at least basic knowledge of CAM and learn how to access evidence-based information about these practices.
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Geriatric patients tend to have multiple diseases and a high burden of medication. Primary care centers are more accessible for the elderly to meet their examination and prescription needs compared to hospitals. In rural places, the convenience of primary care centers is far more important. Therefore, family physicians may be the only doctors in rural places to correct and/or supply proper medications as well as detecting ongoing problems of the elderly. In this article, three geriatric patients who visited their family physician in a rural town, Bala, were evaluated in terms of potentially inappropriate drug use.
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