Chronicles of Precision Medical Researchers

AMINO ACID LEVELS IN PATIENTS WITH FIBROMYALGIA SYNDROME

2024-08-06T17:13:57+03:00

GİRİİŞ

Fibromiyalji sendromu (FMS), yaygın kas-iskelet ağrısı, yorgunluk, uyku bozuklukları ve bilişsel semptomlarla karakterize kronik bir ağrı sendromudur ve hastaların uzun vadeli sağlık hizmeti aramasına neden olur. Kadınlarda daha yaygın olsa da, hastalığın kesin etiyopatogenezi net değildir ve mevcut biyomedikal ve psikososyal tedaviler birçok hasta için yetersizdir. Bu çalışma, FMS'li hastaların amino asit profil seviyelerini inceleyerek FMS'nin tanısında ve tedavisinde potansiyel olarak kullanılabilecek amino asitleri belirlemeyi amaçlamaktadır.

MALZEMELER VE YÖNTEMLER

Çalışmaya Fiziksel Tıp ve Rehabilitasyon Kliniğine başvuran 90 katılımcı (FMS tanısı almış kadın hastalar: n=45, yaş ortalaması= 42.80 ± 11.78 yıl; sağlıklı kontroller: n=45, yaş ortalaması= 39.60 ± 12.35 yıl) dahil edildi. Tüm katılımcılardan kan örnekleri alındı ve plazma aminoasit profilleri 8045 LC-MS/MS cihazı kullanılarak ölçüldü. Aminoasit profil parametrelerinin multivariate analizi yapıldı.

SONUÇLAR

Alanin, arginin, aspartik asit, sitrülin, glutamin, glutamik asit, glisin, histidin, lösin, izolösin, alloizolösin, fenilalanin, prolin, serin, tirozin, valin, alfa aminopimelik asit, hidroksi prolin, serotonin, 5-hidroksitriptamin, taurin, glutamin ve glutamik asidin ortalama plazma düzeyleri FMS hasta grubunda anlamlı olarak daha düşüktü (p <0,001). Buna karşılık, triptofan, sistin, anserin, argino süksinik asit ve gama amino bütirik asit düzeyleri FMS'li hastalarda anlamlı olarak daha yüksekti (p <0,001).

SONUÇLAR

FMS'li hastaların ve bunlara karşılık gelen sağlıklı kontrollerin amino asit profillerinde belirgin farklılıklar vardı. Bu bulgular, amino asitlerin FMS'nin patofizyolojisini aydınlatmada ve prognozunda, tedavisinde ve takibinde potansiyel biyobelirteçler olarak rolünü göstermektedir.

Developmental hip dysplasia screening results in a children hospital in Konya: A large cohort study

2024-09-05T22:13:06+03:00

Aim: Developmental hip dysplasia (DHD) is the most common congenital hip pathology in babies. The aim of this study is to evaluate the incidence of DHD in Konya region using the ultrasonography(USG) and to emphasize the importance of early detection of DHD.

Material and method: The study was a retrospective study which was designed between June 2016 and March 2022 in Konya region. Hip ultrasonography was used for detection of DHD according to Graf method. Babies who were referred to the pediatric outpatient clinic of our hospital by their family physicians for hip ultrasonography or who applied to the outpatient clinic for any reason and were asked to have hip USG to screen for DHD were included in the study.

Results: A total of 2074 infants who met the inclusion criteria were included in the study. The mean duration of the first hip USG was 8.4 (4-18) weeks. In 1946 infants, the hip USG result was found to be bilateral type 1. We found the incidence of DHD to be 1.35% in our series.

Conclusion: In our study, the incidence in our series was similar to other studies in which ultrasonography technique was used. In addition, the incidence of 1.35% we found is the same with the study conducted in Konya in 1992 and shows that the incidence for Konya has not changed in the last 20 years. Prospective multicenter studies should be organized to obtain a clearer picture of the incidence of DHD at the national level.

Factors Affecting Mothers' Preference for University Hospitals for Their Sick Children

2024-08-14T20:34:24+03:00

Aim: This study aimed to identify the reasons why mothers of patients who visited the pediatric clinics and polyclinics of a university hospital chose the university hospital and to examine the factors influencing this decision.

Materials and Methods: A survey prepared by the researchers was applied to the mothers accompanying the patients between April 1 and May 31, 2015 to determine demographic information and the reason for preferring the university hospital.

Findings: Data from the surveys applied to 385 mothers between the ages of 17-59 (mean age=32.7 ± 6.9 years) were analyzed. 188 (48.8%) of the patients were girls and the mean age of all patients was=6.7 ± 4.9 years. The most important factor in choosing a university hospital was the high number of experienced specialist physicians who have made a career, and the lowest factor was the high number of radiological tests.

Conclusion: The study highlights the complexity of hospital selection, driven by personal, institutional and societal factors, providing valuable insights for improving healthcare services and policy planning. The findings highlight the need for healthcare providers to prioritize patient-centered improvements, manage expectations and strategically consider geographical and financial aspects when developing services or establishing new facilities.

Effect Of Fluid Biochemistry On Bleomycin Pleuredesia In Non-Mesothelioma Malign Pleural Effusions

2024-09-24T19:46:40+03:00

Objective: Malignant pleural effusions (MPE) often signal terminal-stage malignancy, with limited survival and quality of life prospects. This study aimed to evaluate whether fluid biochemistry influences recurrence after bleomycin pleurodesis in patients diagnosed with MPE through VATS pleural biopsy and fluid cytology.

Method: A total of 23 patients diagnosed with MPE due to primary lung carcinoma or pleural metastasis, and treated with bleomycin pleurodesis at our institution, were included. All diagnoses were confirmed via VATS pleural biopsy.

Results: The mean age of patients with recurrence was 52.5 years. Their mean pleural fluid values were: LDH 569.75 U/L, pH 7.5, protein 4.53 g/dL, glucose 81 mg/dL, and albumin 3.13 g/dL. The average drainage time was 10.5 days. Recurrence occurred in 20% of men and 12.5% of women, with a 20% recurrence rate on the right side and 12.5% on the left. Recurrence in pulmonary adenocarcinoma patients was 33.3%, while the overall recurrence after bleomycin pleurodesis was 17.4%. General anesthesia had a higher recurrence rate (25%) compared to local anesthesia (9.1%).

Conclusion: Recurrent pleural effusion in MPE presents a clinical challenge. VATS is a crucial tool in diagnosing and managing MPE. Bleomycin is readily available for pleurodesis in our country, but the treatment should be personalized to balance quality of life and hospitalization time. International guidelines offer valuable insights but need to be adapted to individual cases.

Keywords: Malignant pleural effusions, video-assisted thoracoscopic surgery, quality of life, adenocarcinoma, pleurodesis

The Role of Procalcitonin in Differentiating Between Gram-Negative and Gram-Positive Sepsis

2024-10-22T23:17:57+03:00

Introduction: Detecting the agent group in sepsis patients with culture positivity is crucial in determining our treatment scheme. We aimed to evaluate the diagnostic accuracy of procalcitonin (PCT) levels in distinguishing between different pathogen groups in sepsis patients with proven bacteremia.

Materials & Methods: Records of patients hospitalized in ICU were retrospectively investigated over 28 were retrospectively investigated confirmed microbiologically to have a positive blood culture result. The patients were evaluated in two groups regarding gram-negative (GN) and gram-positive bacteria based on the findings of blood culture and Gram staining. Age, gender, APACHE II score, hospital stay, mortality, and laboratory parameters were compared in both groups. Of 894 patients followed up in ICU during 28 months, 56 sepsis patients confirmed microbiologically to have blood culture positivity were included.

Results: While GN bacteria grew in the blood cultures of 26 (46.4%) patients, 30 (53.6%) patients were found to have GP bacteria. The level of PCT was significantly higher in the GN group, compared to that of the GP group (p=0.003). There were no significant differences in CRP values and APACHE II scores between the GN and GP groups (p=0.147 and p=0.633, respectively). Additionally, no statistically significant difference was determined between the GN and GP groups regarding the mortality rate (p=0.712). Leukocyte, neutrophil, lymphocyte, platelet, and albumin values of both groups were also similar.

Conclusionː PCT was found to be a useful marker in predicting the pathogen groups in early treatment management of patients diagnosed with sepsis.

The Effect Of Sonographic Head Circumference On Delivery Mode And Perineal Laceration

2024-10-21T21:08:28+03:00

Aim:The present study aimed to determine the role of head circumference for delivery mode and perineal laceration both in primiparous and multiparous patients and compare this role with estimated fetal weight.

Material and Methods:A total of 866 patients, who delivered in our clinic were divided into two groups: vaginal delivery (n=604) and cesarean section (n=262). Demographic characteristics, sonographic head circumference, estimated fetal weight, birth week and weight, presence of severe perineal laceration, gender, neoatal head circumference, Apgar scores were compared between groups.

Results:The median head circumference was 339 (302-384) milimeter in vaginal delivery and 347 (314-384) milimeter in cesarean section (p<0.001). Sonographic head circumference was positively correlated with estimated fetal weight (r=0.561,p<0.001), birth weight (r=0.446,p<0.001) and neonatal head circumference (r=0.396,p<0.001). Head circumference >35.4 predicted cesarean section with 36.3% sensitivity and 84.8% specificity (AUC=0.637,p<0.001) and >35.2 predicted perineal laceration with 78.6% sensitivity and 85.4% specificity (AUC=0.853,p<0.001). Head circumference was superior for cesarean section as compared to estimated fetal weight (p=0.003) whereas no difference was found for perineal laceration (p=0.64).Head circumference >34.9 predicted cesarean section with 60% sensitivity and 73.8% specificity (AUC=0.692,p<0.001) in primiparous while >35.4 predicted cesarean section with 34.3% sensitivity and 84.5% specificity in multiparous women (AUC=0.624,p<0.001).

Conclusion:Considering large head circumference was more strongly associated with cesarean delivery and perineal lacerations than estimated fetal weight, we suggest that measuring head circumference would be an appropriate approach for determining delivery mode and complications.

Comparison of Volumetric Arc Therapy (VMAT) and Helical Intensity Modulated Radiotherapy (Hel-IMRT) in Lung Cancer Radiotherapy

2024-10-28T00:30:12+03:00

Definitive radiotherapy (RT) is the mainstay of treatment for locally advanced lung cancer (LALC). There are different RT techniques for LALC. In this study, Volumetric Arc Therapy (VMAT) and Helical Intensity Modulated RT (Hel-IMRT) were compared dosimetrically. For the study, 15 patients who received definitive RT with the diagnosis of LALC between 01.01.2022 and 01.04.2022 in the Radiation Oncology Clinic of Ankara City Hospital were evaluated retrospectively and dosimetrically. Simulation Computed Tomography (CT) images were obtained using the GE Discovery. Two plans were achieved for each patient: a Hel-IMRT plan with the Tomotherapy® H™ treatment planning system (TPS), and a VMAT plan with the Eclipse™ TPS. The value of D 95% (95% of the target volume takes 95% of the prescribed dose) of PTV was intended to receive 5700cGy and above. Additionally, dose limitations have been complied with in critical organs by current guidelines. Using patient electronic system data and patient file information; disease stage, lateralization (right-left), location according to the carina (upper-lower), hot spot doses, gradient index (GI) and homogeneity index (HI), conformity index (CI), heart mean dose, esophageal mean and maximum dose (0.03cc), spinal cord max dose (0.03cc) were noted. The SPSS Package Program version 23.0 was used for data analysis. Non-parametric Wilcoxon-Signed Rank test was used for dependent two-group analysis. The statistical significance limit was £ 0.05. The value of D 95% was significantly higher in the Hel-YART technique than in VMAT (p=0.001). In terms of CI (p=0.001), more optimal values were found with the VMAT technique. There was no significant difference between HI (p=0.069) and GI (p=0.069) two techniques. In critical organs data; the spinal cord maximum dose was significantly lower in the Hel-YART technique (p=0.011). In the VMAT technique, lung V20 (p=0.002), lungV5 (p=0.01), mean lung dose (p=0.01) and mean heart dose (p=0.012) were significantly lower than Hel-YART.

There was no significant difference between the two techniques in terms of esophageal mean, esophageal maximum, and hot spot doses. There are different points where the two different techniques are superior. In the choice of treatment technique, patient-based choices are appropriate per the patient, disease, life expectancy, and clinical practice.

Evaluation of Biochemical, Inflammatory, and Hematological Parameters in COVID-19 Patients

2024-10-30T19:21:36+03:00

Aim: This study aims to evaluate the effects of demographic
factors such as age and gender on routine laboratory parameters
in COVID-19 patients. COVID-19 disease can exhibit a wide range of
clinical findings, from mild symptoms to critical multiorgan failure.
In this context, the role of biochemical markers in predicting the
prognosis of the disease is very important.
Material and Method: In the study, biochemical parameters
evaluating liver, kidney and heart functions and inflammation
markers were analyzed in COVID-19 patients depending on age
and gender.
Results: Uric acid, Blood urea nitrogen (BUN), Lactate
dehydrogenase (LDH), Potassium, C-reactive protein (CRP), CRP/
Lymphocyte ratio (CLR), Neutrophil/Lymphocyte ratio (NLR),
D-Dimer, Monocyte count (MONO), Fibrinogen, Hematocrit (HCT),
White blood cells (WBC), Neutrophil count (NEU) and Platelet
distribution width (PDW) parameters were positively correlated
with age. In addition, De Ritis ratio (AST/ALT), sodium, Gromerular
filtration rate (EFGR), Red blood cells (RBC), Hemoglobin (HBG) and
Eosinophil count (EOS) were negatively correlated with age. In
addition, thrombosis-related markers such as thrombocytopenia
and hypercoagulation increased with age.
Conclusion: Our study reveals that inflammatory markers and
organ function deteriorations become evident with age in
COVID-19 patients. It can be concluded that elderly patients
should be closely monitored and that parameters that show
very significant correlation in the findings section can be used as
markers to evaluate the prognosis of the disease in this group.