PubMed İndeksli Yayınlar
http://hdl.handle.net/20.500.12575/69425
2024-03-28T14:10:34ZImpact of echocardiography on one-month and one-year mortality of intertrochanteric fracture patients
http://hdl.handle.net/20.500.12575/72798
Impact of echocardiography on one-month and one-year mortality of intertrochanteric fracture patients
Kalem, Mahmut
Objective: The aim of this study was to analyze the effects of preoperative echocardiography on patient survival, timing of surgery in length of hospital stay in patients who will undergo hip nailing for an intertrochanteric fracture.
Methods: The clinical records of the patients who were admitted to a tertiary university hospital with an intertrochanteric femur fracture were retrospectively analyzed. The age, gender, American Society of Anesthesiologists (ASA) score, days to surgery, total hospital stay, cardiac drug prescription/modification, cardiac intervention and presence of an echocardiography assessment including detailed findings were reviewed. Mortality data were accessed from the national civil registration system.
Results: 181 (110 women and 71 men; mean age 81 (44-98)) cases were studied whom 65 underwent pre-operative echocardiography. Time to surgery and total hospital stay was 2 days longer at transthoracic echocardiography (TTE) group (p < 0.001). At one month control group survival rate was 93.1% on contrary it was 75.4% at TTE group. One-year survival rates were 77.3% and 55.1% respectively. Likewise mean expected survival time was 21.6 ± 1.03 months for control group and 15.12 ± 1.64 months for TTE group (p < 0.001). Only increased left ventricular end diastolic diameter (LVEDD) was showed to be associated with increasing one-year mortality with a hazard ratio of 10.78 (2.572-45.19) at multivariate model.
Conclusion: Cardiac findings and requisite for preoperative TTE and increased LVEDD is a strong predictor for mortality. TTE significantly lengthens the time to surgery. Also LVEDD measurement can be easily performed in the bedside which we believe would save time and reduce mortality.
Level of evidence: Level III Diagnostic study.
2018-01-01T00:00:00ZNatural Products for the Prevention and Treatment of Chronic Inflammatory Diseases: Integrating Traditional Medicine into Modern Chronic Diseases Care
http://hdl.handle.net/20.500.12575/72632
Natural Products for the Prevention and Treatment of Chronic Inflammatory Diseases: Integrating Traditional Medicine into Modern Chronic Diseases Care
Kismali, Gorkem
2018-01-01T00:00:00ZAnalyzing differential item functioning of the Nottingham Health Profile by Mixed Rasch Model
http://hdl.handle.net/20.500.12575/72631
Analyzing differential item functioning of the Nottingham Health Profile by Mixed Rasch Model
Elhan, Atilla Halil
Objectives: This study aims to evaluate whether items in the Turkish version of the Nottingham Health Profile (NHP) function differently according to age, sex, and duration of pain using the Mixed Rasch Model (MRM).
Patients and methods: The NHP data of patients with low back pain from a previous study was analyzed. To analyze differential item functioning (DIF) within the items of the NHP, the MRM was used. Age, sex, and duration of pain were considered factors which could cause DIF. The most powerful factor to define latent classes derived from the MRM was estimated using the Rasch tree method.
Results: The two-class mixture version of the nominal response model was identified as the best fitting model for the physical mobility, sleep, and social isolation sections. For the physical mobility dimension, some items showed DIF by age and for the social isolation dimension some items showed DIF by sex. For the sleep dimension, latent classes were unable to be explained by age, sex, and duration of pain. Items in other dimensions of the NHP were DIF-free and no items showed DIF according to age, sex, and duration of pain.
Conclusion: The results of this study may shed light on explaining the different response behavior of patients on the items of the NHP. Age and sex were found to be variables affecting item responses of NHP. Contrary to expectations, duration of pain did not cause DIF for any item. From the perspective of DIF, it can be concluded that NHP scale is a robust scale in terms of validity.
2018-01-01T00:00:00ZTemperature Effects Explain Continental Scale Distribution of Cyanobacterial Toxins
http://hdl.handle.net/20.500.12575/72630
Temperature Effects Explain Continental Scale Distribution of Cyanobacterial Toxins
Demir, Nilsun
Insight into how environmental change determines the production and distribution of cyanobacterial toxins is necessary for risk assessment. Management guidelines currently focus on hepatotoxins (microcystins). Increasing attention is given to other classes, such as neurotoxins (e.g., anatoxin-a) and cytotoxins (e.g., cylindrospermopsin) due to their potency. Most studies examine the relationship between individual toxin variants and environmental factors, such as nutrients, temperature and light. In summer 2015, we collected samples across Europe to investigate the effect of nutrient and temperature gradients on the variability of toxin production at a continental scale. Direct and indirect effects of temperature were the main drivers of the spatial distribution in the toxins produced by the cyanobacterial community, the toxin concentrations and toxin quota. Generalized linear models showed that a Toxin Diversity Index (TDI) increased with latitude, while it decreased with water stability. Increases in TDI were explained through a significant increase in toxin variants such as MC-YR, anatoxin and cylindrospermopsin, accompanied by a decreasing presence of MC-LR. While global warming continues, the direct and indirect effects of increased lake temperatures will drive changes in the distribution of cyanobacterial toxins in Europe, potentially promoting selection of a few highly toxic species or strains.
2018-01-01T00:00:00Z