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Identifying a cut-off point for Timed Up and Go Test and 30-second Chair Stand Test in dual-task condition: Effects of cognitive status

Original Article

Identifying a cut-off point for Timed Up and Go Test and 30-second Chair Stand Test in dual-task condition: Effects of cognitive status

Cevher Savcun Demirci, Meral Sertel, Elif Sakizli Erdal, Sabiha Bezgin

   

Abstract
A decline in mental function is a common problem associated with aging. The most commonly used tests for evaluating functional mobility, fall risk, and lower limb strength of older adults in the clinic are ‘Timed Up and Go Test’ and ‘30-second Chair Stand Test’. This study was planned to determine the cut-off point of these tests in cognitive declines. A total of 204 older adults aged 65 years and over participated in this study. To examine the cut-off points of tests for single and dual-tasks, count off by twos was added as a cognitive task. The cut-off points of tests without and with an additional task were determined as 10.54, 12.21 second, 10.5, and 8.5 stands respectively. These results are important to reveal the effects of mental declines should be taken into account when interpreting the results of clinical functional mobility assessments in older adults.

Key words: Elderly, timed up and go test, 30-second chair stand test, roc analysis, multi-tasking behavior.

Med-Science. 2021; 10(2): 272-7

 
Medicine Science Vol:10 Issue:2 Year:2021 PP:272–669

The effects of propofol-ketamine combination on QTc interval in patients with coronary artery disease

Original Article

The effects of propofol-ketamine combination on QTc interval in patients with coronary artery disease

Erdinc Koca, Feray Akgul Erdil, Huseyin Ilksen Toprak, Nurcin Gulhas Ozcan Ersoy, Mahmut Durmus

   

Abstract
The purpose of this study was to evaluate the effects of propofol-ketamine combination on QTc, T wave (Tp-e) interval, hemodynamics during the induction of anesthesia in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG). Patients were prospectively randomized, in a double blinded manner, to either the propofol group (Group P, n=41) or the propofol-ketamine combination group (Group PK, n=45). In both groups the drugs were infused at an IV dose of 2 mg/kg administered over 30 seconds. After that, 5µg/kg fentanyl and 0.1mg/kg vecuronium were administered and tracheal intubation was performed. ECG recordings were performed prior to induction of anesthesia (baseline, T1), 2 min after the beginning of study drugs (T2), 3 min after vecuronium (immediately before intubation, T3), and 30 s (T4), 1 min (T5) and 5 min (T6) after intubation. Eighty-six patients were evaluated in the study. The baseline QTc interval values were similar between the groups, In Group P, QTc interval increased significantly for T3-T6 in all periods according to baseline value. Also in Group P, QTc interval increased significantly in T4, T5, T6 according to T3. In group PK, QTc interval increased significantly in T3-T6 according to baseline value. Group PK increased significantly in T5 and T6 compared to T3. In both groups a statistically significant change was not found in Tp-e intervals of all periods. Following induction with propofol-ketamine combination, QTc interval did not increase, but it prolonged postintubation QTc interval just like propofol. Assuming that increased repolarization transmural dispersion (TDR) is a reliable indicator of risk of torsade de pointes (TdP), and lack of any change in Tp-e interval, in the presence of depressed hemodynamic response to intubation, we think that this combination can be safely used for the induction of anesthesia in patients with CAD undergoing CABG.

Key words: Propofol; ketamine; QT interval; Tp-e interval

Med-Science. 2021; 10(2): 278-82

 

Can the perfusion index predict spinal anesthesia-induced hypotension in geriatric patients?

Original Article

Can the perfusion index predict spinal anesthesia-induced hypotension in geriatric patients?

Ahmet Yuksek, Gamze Talih

 
   

Abstract
Spinal anesthesia patients have a risk of hypotension as a result of decreased vascular tonus and venous pooling. Especially elderly patients may not tolerate this condition. Therefore, it is important to predict hypotension in elderly patients and to take precautions. In our study, the ability of the basal perfusion index (PI) to predict the incidence of hypotension in geriatric patients was tested. 80 patients over 65 years of age who were operated under spinal anesthesia were included in this study. Preoperative PI values, preoperative and after anesthesia systolic arterial pressure values were compared. High PI measurements of the patients can be interpreted as an indication that systolic blood pressure measurements will be low after spinal anesthesia (r = -0.155 p = 0.041). However, it was concluded that PI value is not a useful test for routine use in predicting hypotension. Although PI may be affected by fluid status, vascular tone or sympathetic activities of patients, with preoperative use of PI, A correlation between PI and systolic blood pressure may be guiding in perioperative follow-up. In fact, complications can be reduced by considering the signs of PI.

Key words: Spinal anesthesia, hypotension, perfusion index.

Med-Science. 2021; 10(2): 283-6

 

 

Effects of the elixhauser comorbidity index on the time of discharge and 30-day mortality rate in geriatric and non-geriatric patients undergoing partial hip prosthesis arthroplasty

Original Article

Effects of the elixhauser comorbidity index on the time of discharge and 30-day mortality rate in geriatric and non-geriatric patients undergoing partial hip prosthesis arthroplasty

Ozkan Gorgulu, Sadullah Turhan

 
   

Abstract
In this study, we aimed to analyse the non-routine discharge period of the ECI and its predicted effect on the 30-day mortality rate in geriatric and non-geriatric patients admitted for partial hip replacement. 215 patients who underwent elective partial hip arthroplasty under spinal anaesthesia in our tertiary hospital were included in the study. This was a single-centre retrospective descriptive study. Data were collected by reviewing the electronic patient data system and patient files. The patients were divided into two groups as non-geriatric (18-64-year-old, n=125) and geriatric (≥65-year-old, n=90). The impact of the Elixhauser Comorbidity Index (ECI) on postoperative mortality rates and the discharge time from the hospital was analysed by comparing the age groups. The ECI percentage values (80.86 ± 3.99) of recovered patients were higher than patients discharged as exitus (71.5 ± 7.74) (p 0.05). When ECI≤77.8%, it predicts mortality with 77.8% sensitivity and 85.92% specificity. The Elixhauser Comorbidity index could not predict the time of discharge due to complications developed after transfer of patients to the postoperative intensive care unit. There was no significant correlation between ECI and discharge time in non-geriatric and geriatric patients.

Key words: Anaesthesia, comorbidity, geriatrics; non-geriatric, hip prosthesis, mortality

Med-Science. 2021; 10(2): 287-92

 

 

Investigating CFTR gene variations in patient groups with positive newborn screening test results and preliminary clinical diagnosis of cystic fibrosis in the eastern anatolia region of Turkey

Original Article

Investigating CFTR gene variations in patient groups with positive newborn screening test results and preliminary clinical diagnosis of cystic fibrosis in the eastern anatolia region of Turkey

Ayberk Turkyilmaz, Oguzhan Yarali

   

Abstract
Cystic fibrosis (CF, OMIM: #219700), caused by biallelic pathogenic variations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, is the most common monogenic disease. The present study aimed to investigate CFTR gene variations in patients with a positive screening test result for CF and those with a clinical suspicion of CF. Overall, 443 patients (190 females/253 males) were retrospectively included. Of these, a positive neonatal screening test result for CF was reported in 124 patients (58 females/66 males) and a preliminary clinical diagnosis of CF based on recurrent lung infection and/or delayed weight gain was reported in 327 patients (134 females/193 males). All patients were evaluated based on clinical findings, sweat test (ST) results, and CFTR gene sequence analysis results. In the group of 116 patients having a positive neonatal screening test result for CF, heterozygous variations were observed in 21 (18%) patients, compound heterozygous variations in 9 (8%) patients, and homozygous variations in 5 (4%) patients. In the group of 327 patients with a clinical suspicion of CF, heterozygous variations were observed in 52 (16%) patients, compound heterozygous variations in 26 (8%) patients, and homozygous variations in 11 (3%) patients. When the two groups were cumulatively evaluated, the most common mutant alleles were Pro1013Leu (10.4%), Tyr515* (9.6%), and Phe508del (4.8%). In the total study sample of 443 patients, 51 different variants were detected. To the best of our knowledge, this is the first comprehensive study that demonstrated CFTR gene variation distribution in the Eastern Anatolia Region of Turkey. In this study, mutation distribution was highly heterogeneous, and we believe that investigation of the entire CFTR gene is necessary and would improve the diagnostic rates for CF in the Turkish population.

Key words: CFTR, newborn screening, immunoreactive trypsinogen, sweat test

Med-Science. 2021; 10(2): 293-8

 

 

The effect of platelet-rich plasma on chronic pain in osteoarthritic knees

Original Article

The effect of platelet-rich plasma on chronic pain in osteoarthritic knees

Mehmet Boz, Abdullah Alper Sahin

 
   

Abstract
Platelet-rich plasma (PRP) is an autologous blood product with widespread use in recent years to increase regeneration in many joints and tissues. Knee osteoarthritis is a degenerative process increasing with age and causing chronic pain. Therefore, the aim of the study was to investigate the short-term effectiveness of intra-articular PRP injection, used to provide cartilage regeneration, on chronic pain in osteoarthritic knees. 60 patients with stage 1-4 knee osteoarthritis according to the Kellgren-Lawrence grading scale (K-L) were included in the study. Three doses of PRP were injected into the knee joint once every three weeks. All three initial measurements were made before injection. Chronic pain of the patients was evaluated using visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) scales on Day 1, Week 3, Week 6, Week 12, and Month 6. 6 months of follow-ups for all 60 patients were completed. Mean baseline values were measured as follows: VAS 8.63 ± 1.0, and KOOS Pain 22.11 ± 13.7, KOOS Sympt 24.80 ± 18.3, KOOS Function 24.90 ± 15.7, KOOS Sport 13.00 ± 11, 6, KOOS QoL 16.16 ± 10.2. Mean values measured during the last follow-up were as follows: VAS 2.30 ± 1.0, and KOOS Pain 81.20 ± 11.7, KOOS Sympt 81.78 ± 12.5, KOOS Function 78.08 ± 10.9, KOOS Sport 73.58 ± 11.7, KOOS QoL 68.91 ± 10.7 values. Significant improvements were observed in VAS and KOOS values after injection compared to the baseline values (p = 0.001 for all). Treatment of knee osteoarthritis (OA) with PRP injection is safe in terms of adverse reactions. PRP seems to be effective in managing pain and improving quality of life in all osteoarthritis stages, especially in patients with K-Lgrade 1-2 knee OA.

Key words: Gonarthrosis, platelet-rich plasma (PRP), kellgren-lawrence grading scale, the knee injury and osteoarthritis outcome score (KOOS), injection

Med-Science. 2021; 10(2): 299-303

 

 

The relationship between monocyte HDL-C ratio and reduced left ventricular systolic function in patients among acute myocarditis

Original Article

The relationship between monocyte HDL-C ratio and reduced left ventricular systolic function in patients among acute myocarditis

Ozge Cakmak Karaaslan, Firdevs Ayesenur Ekizler, Cem Coteli, Sefa Unal, Ahmet Akdi, Murat Oguz Ozilhan, Orhan Maden

   

Abstract
Myocarditis contributes to the global burden of cardiovascular disease mainly through sudden death and chronic cardiomyopathy in young age groups. Monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) has developed as a new inflammation biomarker. In this study has investigated that relationship between admission MHR levels and the reduced left ventricular systolic functions after acute myocarditis. The study included a total of 156 consecutive cases wanted by their doctors to undergo cardiovascular magnetic resonance imaging for “acute myocarditis” as the clinical diagnosis between 2009 and 2017 at our hospital. Study participants were split into two groups; group I patients (patients with LVEF

Key words: Inflammation, monocyte HDL ratio, myocarditis

Med-Science. 2021; 10(2): 304-9

 

 

Clinical significance of preoperative neutrophil to lymphocyte ratio in organ-confined urothelial bladder cancer

Original Article

Clinical significance of preoperative neutrophil to lymphocyte ratio in organ-confined urothelial bladder cancer

Engin Kolukcu, Velid Unsal, Latif Mustafa Ozbek, Osman Demir

   

Abstract
We aimed to investigate the relationship between the preoperative neutrophil to lymphocyte ratio (NLR) and the postoperative tumor stage and grade in patients with organ-confined urothelial bladder cancer. We examined 308 patients who underwent transurethral resection in our clinic. Our study only included patients whose pathology results were organ-confined urothelial bladder cancer. The patients were classified according to tumor stage (Ta, T1, and T2) and tumor grade (Grade 1 and 2, indicating a low-grade; Grade 3, referring to a high-grade). Then each group was compared within itself based on the NLR evaluated before the surgery. A total of 279 cases (90.6%) were male. The mean age, tumor size, neutrophil and lymphocyte counts of the patients were 69.33±10.92 years, 2.99±2.35 cm, 5.36±1.99 K/uL, and 2.23±0.78 K/uL, respectively. Inflammation parameters regarding the cancer stage were as follows: NLR was 2.08, 2.36, and 3.07, for Ta, T1, and T2 tumors respectively. The relationship between T1 and T2 tumors and Ta and T2 tumors was significant (p

Key words: Lymphocyte, neutrophil, bladder, cancer

Med-Science. 2021; 10(2): 310-6

 

 

Should enterobiasis be considered during the examination of sexually abused children?

Original Article

Should enterobiasis be considered during the examination of sexually abused children?

Serbulent Kilic, Muharrem Bostanci

 
   

Abstract
The medical rape examination has some difficulties and sometimes genital findings can be confusing for the examiner. In this study, the sexually abused children with anal rape were focused on. Perianal reddening due to itching is important. It is known that one of the parasitic diseases that cause anal pruritus is enterobiasis. A person infected with Enterobius vermicularis can occasionally scratch his/her perianal region and make a reddening in the anal region mimicking sexual abuse. The present study aimed to determine the rate of reddening in the anal region due to enterobiasis. 24 sexually abused children and 24 healthy participants were recruited in this study to determine the seen ratio of enterobiasis in sexually abused children by using the transparent tape method. Three of 24 sexually abused children were found infected. No infection was seen in any control group member. The seen ratio of enterobiasis was not significantly associated with sexual abuse history (P=0,234). No difference was not seen in the two groups in terms of enterobiasis. The rate of enterobiasis in sexually abused children was 12.5% in the current trial, a finding that should encourage the practitioners to consider the possibility of enterobiasis infection during the examination of the genitalia.

Key words: Forensic medicine, anal pruritus, Enterobius vermicularis, injury, sexually abused children, trauma

Med-Science. 2021; 10(2): 317-20

 

 

Nursing students’ perspectives on the quality of nursing care in-home health care

Original Article

Nursing students' perspectives on the quality of nursing care in-home health care

Elif Donmez, Ilknur Dolu, Ahu Kurklu

 
   

Abstract
This study was aimed to evaluate the perspective of senior nursing students on nursing care in the home healthcare settings based on their experience within the context of public health nursing courses. A qualitative research design. Interviews were conducted with 13 senior nursing students by a using semi-structured interview guide between 22 December 2017 and 15 January 2018. Thematic analysis was used for analyzing the qualitative data. Thematic analysis deduced three themes; (i) security, (ii) personal traits, and (iii) working environment. Our findings addressing problems in-home healthcare settings should be considered to improve the quality of nursing care in-home healthcare settings. This qualitative study revealed how senior nursing students perceived the role of home healthcare nurses based on their theoretical knowledge and experience acquired during the practical training that allowed them to have a chance to observe nurses in their natural working environment. There is very little information about home healthcare nursing services with a knowledgeable and unbiased perspective. Therefore, the findings of this study establish an unbiased basis of information home healthcare nursing services provided by senior nursing students who will soon begin working as a nurse. The findings of this study underscore should be considered by academicians, nurses, other healthcare professionals practicing in this field, and decision-makers.

Key words: home care, caregiving, public health nursing, teamwork

Med-Science. 2021; 10(2): 321-7