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Kilic H.,Ankara Ataturk Training and Research Hospital | Kokturk N.,Gazi University | Sari G.,Dr. Nafiz Korez Sincan Devlet Hastanesi | Cakr M.,Gazi University
International Journal of COPD | Year: 2015

Introduction: Little is known about whether there is any sex effect on chronic obstructive lung disease (COPD) exacerbations. This study is intended to describe the possible sex-associated differences in exacerbation profile in COPD patients. Methods: A total of 384 COPD patients who were hospitalized due to exacerbation were evaluated retrospectively for their demographics and previous and current exacerbation characteristics. Results: The study was conducted on 109 (28%) female patients and 275 (72%) male patients. The mean age was 68.30±10.46 years. Although females had better forced expiratory volume in 1 second and near-normal forced vital capacity, they had much impaired arterial blood gas levels (partial oxygen pressure [PO2] was 36.28 mmHg vs 57.93 mmHg; partial carbon dioxide pressure [PCO2] was 45.97 mmHg vs 42.49 mmHg; P=0.001), indicating severe exacerbation with respiratory failure. More females had two exacerbations and two hospitalizations, while more men had one exacerbation and one hospitalization. Low adherence to treatment and pulmonary embolism were more frequent in females. Females had longer time from the onset of symptoms till the admission and longer hospitalization duration than males. Comorbidities were less in number and different in women (P<0.05). Women were undertreated and using more oral corticosteroids. Conclusion: Current data showed that female COPD patients might be more prone to have severe exacerbations, a higher number of hospitalizations, and prolonged length of stay for hospitalization. They have a different comorbidity profile and might be undertreated for COPD. © 2015 Kilic et al. Source


Diabetes is an important disease affecting many people worldwide which causes significant morbidity. In the lower urinary tract (LUT), diabetes causes LUT dysfunction in humans by leading to neuropathic bladder. In addition, diabetes can lead to functional and anatomical abnormalities of the external urethral sphincter. Diabetes was suggested to cause these complications by affecting autonomic or peripheral nerves or both. Cells having similar characteristics with interstitial cells of Cajal that are present in the gastrointestinal system have also been described in the human urinary tract. Interstitial cells (ICs) in the urinary tract were suggested to function as pacemaker cells, stretch or chemical sensors that might trigger detrusor contractions which work with close relationship with the nerves. In the human urethra, ICs were suggested to control the frequency of tonic contractions of the urethral smooth muscle. Therefore, ICs seem be playing a very important role in LUT function in humans. The hypothesis in this paper suggests that diabetes might also adversely affect IC expression and IC function in the human LUT which might play a significant role in the development of diabetic LUT dysfunction. A search of the English literature was performed by using Medline/PubMed in order to search this hypothesis and no particular study was found in humans. The information and evidence obtained following the investigation of this hypothesis might uncover the possible underlying mechanism of decreased IC expression or function in addition to neuropathy in the development of diabetic LUT dysfunction. Currently, no specific medical drug treatment or preventive measure exists targeting the cellular components of the LUT (i.e. ICs and nerves) which are in fact responsible for a normally functioning LUT. If the expression and distribution of ICs are adversely affected in the LUT of patients with diabetes, specific drugs might be developed as targeted therapy stimulating IC function which could then be used to treat diabetic LUT dysfunction and benefit many diabetic patients worldwide. Moreover, having the knowledge of the IC expression and distribution status at the level of the LUT in patients with diabetes could be a possible prognostic factor for the clinicians indicating the risk of future LUT deterioration. Therefore, targeted therapy might also be used as to prevent the development of LUT dysfunction in this patient group. © 2011 Elsevier Ltd. Source


Akmese R.,Ankara Ataturk Training and Research Hospital | Kemal Us A.,Ankara University
Journal of Spinal Disorders and Techniques | Year: 2013

STUDY DESIGN: A retrospective study. OBJECTIVE: The objectives of this study were to show the advantages of an alternative segmental spinal instrumentation technique, termed subtransverse process wiring, and compare it with a sublaminar wiring technique in the treatment of idiopathic thoracic scoliosis. SUMMARY OF BACKGROUND DATA: High rates of neurological complications and the need for high experience limit the use of the sublaminar wiring technique, although it is an effective segmental spinal instrumentation technique in the treatment of scoliosis. This is the first study to correlate sublaminar wiring and subtransverse process wiring techniques clinically. METHODS: In a retrospective study, 64 patients with idiopathic thoracic scoliosis were chosen randomly. Nineteen patients were treated with subtransverse process wires (group A), and 45 patients were treated with sublaminar wires (group B). RESULTS: The mean follow-up period was 50.9 months (25 to 90 mo) in group A and 57.9 months (26 to 108 mo) in group B. The average deformity correction was 26.5 degrees (52.9%) in group A and 28.9 degrees (54.1%) in group B. The average correction loss was 2.9 degrees (17.2%) in group A and 6.4 degrees (27%) in group B. None of the patients developed neurological complications in group A. In group B, 5 (11.1%) intraoperative dural tears, 4 (8.9%) neurological deficits, and 8 (14.4%) transient dysesthesia syndromes were seen. The average operation time was 3.6 hours (3 to 4 h) in group A and 4.9 hours (3.75 to 8 h) in group B. The average replacement of blood (erythrocyte suspension) was 2.9 U (2 to 5 U) in group A and 3.1 U (2 to 6 U) in group B. CONCLUSIONS: Sublaminar wiring is a time-consuming technique with high risks of neurological complications, whereas subtransverse process wiring is an easy and neurologically safe method, which maintains effective deformity correction and stability of the correction. Copyright © 2012 by Lippincott Williams & Wilkins. Source


Batmaz S.,Psychiatry Clinic | Kaymak S.U.,Ankara Ataturk Training and Research Hospital | Ozalp E.,Ankara Oncology Training and Research Hospital | Turkcapar M.H.,Hasan Kalyoncu University
Comprehensive Psychiatry | Year: 2013

Background There is very limited data about the cognitive structure of bipolar depression when compared to unipolar depression. The aim of the study was to look into the differences between unipolar and bipolar depressed patients regarding their cognitive structure in view of Beck's cognitive theory. Methods In this study, 70 bipolar patients during a depressive episode, 189 unipolar depressed patients and 120 healthy subjects were recruited. The participants were interviewed by using a structured clinical diagnostic scale. To evaluate the cognitive structure differences, the Automatic Thoughts Questionnaire (ATQ) and the Dysfunctional Attitude Scale (DAS) were used. Results We found that on the mean ATQ total score, the unipolar depressed patients scored significantly higher (92.9 ± 22.7) than both the bipolar depressed patients (73.2 ± 24.7) and the healthy subjects (47.1 ± 19.6), even after controlling for all confounding factors, e.g. gender, marital status, depressive symptom severity (F = 157.872, p < 0.001). The bipolar depressed patients also scored significantly higher on the mean ATQ total score than the healthy controls. On the mean DAS total score, and on the mean score of its subscale of need for approval, the bipolar depressed patients scored (152.8 ± 21.2 and 48.2 ± 7.4, respectively) significantly higher than both the unipolar depressed patients (160.9 ± 29.0 and 51.9 ± 9.7, respectively) and the healthy subjects (127.9 ± 32.8 and 40.2 ± 12.2, respectively), even after controlling for any confounding factor (F = 45.803 [p < 0.001] and F = 43.206 [p < 0.001], respectively). On the mean score of the perfectionistic attitude subscale of the DAS, the depressed groups scored significantly higher than the healthy subjects, but they did not seem to separate from each other (F = 41.599, p < 0.001). Conclusions These results may help enhance the understanding of the potentially unique psychotherapeutic targets and the underlying cognitive theory of bipolar depression. © 2013 Elsevier Inc. All rights reserved. Source


Kocaoz S.,Nigde University | Eroglu K.,Hacettepe University | Sivaslioglu A.A.,Ankara Ataturk Training and Research Hospital
Gynecologic and Obstetric Investigation | Year: 2013

Objective: The aim of this study was to determine the role of pelvic floor muscle exercises (PFME) in the prevention of stress urinary incontinence (SUI) during pregnancy and the postpartum period. Methods: A total of 102 women was included in the study. Data, collected through forms, included characteristics of the women, follow-up data during the pregnancy and postpartum period and a three-day urinary diary. Both groups were evaluated in terms of SUI at the 14th-20th, 28th and 32nd weeks of gestation and at 12 weeks postpartum. Results: As shown by the pad test, SUI developed in 5.8, 17.3 and 1.9% of the subjects in the intervention group at the 28th and 32nd gestational week and the 12th postpartum week, respectively. The relevant ratios in the control group were 30, 48 and 18%, respectively. A statistically significant difference was found between the intervention and control groups in terms of SUI development at the 28th and 32nd weeks of gestation and the 12th postpartum week (p < 0.05). Conclusion: PFME are effective for prevention of SUI development during pregnancy and in the postpartum period. Health care providers are therefore recommended to provide education and counseling to pregnant women about SUI prevention. Copyright © 2012 S. Karger AG, Basel. Source

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