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Serbetcioglu, Gonca Coban/0000-0002-3285-5519, WOS:000523502502065, [No Abstract Available]

Background Frailty is a condition of elderly characterized by increased vulnerability to stressful events with high risk of adverse outcomes. The purpose of this study was to evaluate the association between frailty and adverse outcomes including death and hospitalization due to heart failure in elderly patients. Methods We included patients aged ? 65 years with the diagnosis of heart failure. The clinical and laboratory data, echocardiography and ECGs were recorded. Additionally, the frailty scores of the patients were evaluated according to Canadian Study of Health and Aging. All the patients were divided as frail or non-frail. The groups were compared for their characteristics and the occurrence of clinical outcomes. Results We included 86 eligible patients. The median follow-up time was four months. The mean age was 75 ± 6.5 years. Of these 86 patients, 17 (19.7%) patients encountered an event (death and/or hospitalization). Nine patients (10.4%) died during follow-up. Thirty patients (34.9%) were considered frail. Among the demographic, clinical and laboratory data, only total protein and albumin levels were found to be lower in frail patients (total protein level: 6.8 ± 0.6 g/dL in non-frails, 6.5 ± 0.9 g/dL in frails, P = 0.05; albumin level: 3.8 ± 0.4 g/dL in non-frails, 3.4 ± 0.6 g/dL in frails, P = 0.001). In multivariate analysis, frailty was found to be strongly associated with clinical outcomes in short term. Conclusions Being frail in an elderly heart failure patient is associated with death and/or hospitalization due to heart failure in short term. Therefore, frailty score should be evaluated for all elderly heart failure patients as a prognostic marker. © 2018 JGC All rights reserved.

Background: A wide range of HLA-DR alleles have been associated with sarcoidosis either in terms of disease phenotype or extra pulmonary involvement, however the effect on non-resolution in different ethnic groups is not fully understood. Te aim of this study was to investigate whether disease characterics and HLA-DRB1 alleles may early reflect non resolution in sarcoidosis. Methods: 91 patients who were diagnosed in Cukurova University Faculty of Medicine Department of Chest Diseases between 1993-2012 and were followed up until June 2017 were included in the study. All patients underwent HLA analysis by the Sequence Specifc Oligonucleotide Prob (SSOP) method. Fifteen of them were excluded from the study group due to lost of follow-up (n=6) and not yet passed 5 years since diagnosis (n=9). Complete resolution at 5th year was defned according to the predefned standard criteria (ACCESS). Results: Te resolution rate was 51.3%. Te HLA-DRB1*14 allele was signifcantly higher in patients without resolution (11.8 vs 1.3%)(p=0.006). According to multivariate logistic regression analysis the independent risk factors of non resolution were female gender (OR: 12.6; 95%CI: 2.1-74.9, p=0.005), HLA DRB1*14 allele (OR:51.9; 95%CI: 3.6-735.8, p=0.000), baseline TLCO

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PubMedID: 28817141 This study was conducted to evaluate the effects of platelet-rich fibrin (PRF) on palatal wound healing after free gingival graft (FGG) harvesting. A total of 125 patients were randomized after FGG: PRF with butyl-cyanoacrylate (BC) adhesive (PRF group; n = 42), BC adhesive alone (BC group; n = 42), and sterile wet gauze compression (WG group; n = 41). Bleeding, pain, epithelialization, feeding habits, and sensation scores were recorded for different time points. Statistically significant differences were found for all parameters in favor of the PRF group (P = .0001). PRF may provide significant benefits for wound healing parameters and patients' postoperative course after palatal graft harvesting. © 2017 by Quintessence Publishing Co Inc.

International Conference of the American-Thoracic-Society (ATS) -- MAY 15-20, 2015 -- Denver, CO WOS: 000377582804210 … Amer Thorac Soc

International Conference of the American-Thoracic-Society (ATS) -- MAY 15-20, 2015 -- Denver, CO WOS: 000377582800388 … Amer Thorac Soc

Aim: Realizing migraine comorbidities is particularly important for physiopathology, treatment, and progress of the disease. In the present study, we aimed to assess the comorbid conditions in patients with migraine. Method: This retrospective study was conducted by the Turkish Headache Database Study Group, at 23 headache centers. Diagnosis of migraine was established by a physician based on the International Classification of Headache Disorders-II criteria. Comorbidities of migraine were determined based on the patients' self reports. Results: A total of 3478 cases, which have been diagnosed with migraine were evaluated. (mean age 43.5±11.2, 81.8% female). Comorbidity was detected in 55.7% (n:1937) of overall cases. Psychiatric diseases have been reported to be the most prevalent comorbidity in these patients (31.5%, p?0.0001). Cardiovascular diseases (16.5%), and hypertension (16.3%) have been found to be more prevalent in migraine with aura. Prevalence of neurological comorbidity, also, was higher in migraine with aura. Epilepsy (1.5%) and vertigo (4.6%) were detected in migraine with aura cases. Difficulty in falling asleep was found in 35.4% of the cases (p?0.0001). Prevalence of non-headache pain was found to be 2.9% (p>0.0001).?0.0001). Patients with comorbidities were more sensitive to migraine triggers and accompanied symptoms were more severe (p?0.0001). Conclusion: Comorbidity of migraine is the important component of complex nature of the disease. The present study is important in terms of being the first multicenter study exposing migraine comorbidities and their reflections in clinical practice.

PubMedID: 25078644 Background: Several HLA-DR alleles have been described as a potential risk factor for sarcoidosis between distinct ethnic groups however the relationship between HLA-DR alleles and extra-pulmonary sarcoidosis (EPS) is still scarce. Objectives: The aim of this prospective study is to investigate the relationship between extra-pulmonary involvement and HLA-DR genetic analysis in Turkish patients with sarcoidosis.Methods: In this study, we HLA-typed sarcoidosis patients with and without extra-pulmonary involvement, and compared with healthy control subjects.The presence of EPS was evaluated with previously defined standard criteria (ACCESS) and only patients with definite and probable involvement were accepted as positive. Sequence Specific Oligonucletide Probes method was used for typing of HLA-DRB1 alleles from DNA samples in both groups. Results: The frequency of HLA DRB1*15 allele was more frequent in patients with sarcoidosis than controls (% 20.4 vs % 9.6)(pcorr=0.017). According to multivariate analysis (MVA), the presence of HLA DRB1*15 was indicated as an independent risk factor for sarcoidosis (OR:2.37; 95% CI: 1.31-4.30, p=0.004). Extra-pulmonary involvement was present in 39 patients (42.9 %).When the patients with and without extra-pulmonary involvement compared, HLADRB1*11 allele was significantly higher in patients without extra-pulmonary sarcoidosis which may be concluded as a protective allele for systemic involvement (%30.8 vs. %15.4)(p

Objective: Objective: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction applied with gonadotrophins. In this study, we aimed to determine the incidence and risk factors of OHSS for cases taken into IVF- ICSI/ET cycle and subjected to controlled ovarian hyperstimulation in our clinic. Material and Methods: IVF-ICSI/ET cycles subjected to controlled ovarian hyperstimulation in the Assisted Reproductive Treatment Center of Qukurova University were evaluated. Patients developing OHSS and patients not developing OHSS were set as two different groups. Patients' files were reviewed and their demographic features, examination data, laboratory findings, ultrasonography (USG) characteristics and treatment protocols were compared. Results: Number of cycles for the groups developing OHSS and not developing OHSS were 69 and 1373 respectively. Incidences of moderate and intense OHSS were determined to be 4% and 0.2% respectively. OHSS was more frequent in patients having high basal LH values, LH/FSH ratios and hCG day estradiol (E2) values. HCG day mature follicle numbers, aspired preovulatory follicle numbers, aspired small follicle numbers and collected oocyte numbers were higher in the OHSS developing group (p=0.0001). Risk of OHSS in patients with polycystic ovary syndrome (PCOS) was 7.6 times higher (95% CI 4.3-13.5) than the others. The comparison made between the antagonist protocol and long luteal agonist protocol showed that there was no statistically significant dif-ference between the two groups in terms of OHSS development (p=0.069). Conclusion: Multivariate analysis revealed that, pregnancy, >3000 pg/ml E2 values, >2 LH/FSH ratio and presence of PCOS were found to be an independent risk factors for OHSS. Treatment of the high risk cases should be individual. During the treatment process of these patients, follicular development should be closely monitored using ultra-sonography and E2 follow-up. Copyright © 2013 by Türkiye Klinikleri.

PubMedID: 23534040 Purpose: To investigate the level of dental fear and anxiety of children who have cleft lip and palate (CLP). Materials and Methods: The study was performed at Cukurova University, Faculty of Dentistry. A total of 32 7- to 12-yearold children, 17 of them with CLP (8 girls and 9 boys) and 15 of them without CLP (7 girls and 8 boys) participated in the study. The children were evaluated by using the Facial Image Scale (FIS) and Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) methods. The anxiety state of the children was assessed twice using FIS: first in the dental hospital waiting room (FIS-WR) and after, while sitting in the dental chair (FIS-DC). CFSS-DS was administered to all participants in order to assess the dental anxiety while they were sitting in the dental chair. Results: According to the FIS results, there was no difference between CLP and control group in the waiting room (P = 0.682). However, the CLP group showed lower scores than the control group while they were sitting in the dental chair (P = 0.030). The FIS scores of the CLP group were significantly higher in the waiting room than while sitting in the dental chair (P = 0.007). In the control group, there was no significant difference between FIS-WR and FIS-DC values (P = 0.664). The total CFSS-DS scores of children with CLP were lower than those of the control group, but these differences were not statistically significant (P < 0.05). Conclusion: Children with CLP showed more anxiety in the FIS-WR than in the FIS-DC, but they showed lower scores than the control group in the FIS-DC. The positive previous experience of meetings with dentists of the CLP children could explain these results. Positive previous experiences with dentists and a short time in the waiting room could be key elements in the care of CLP children.

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Objective: The aim of this study was to assess the prevalence of sexual dysfunction and to assess the related risk factors that might influence sexual dysfunction in infertile women. Material and Methods: Two-hundred volunteer infertile women who visited the infertility outpatient clinic of the Department of Obstetrics and Gynecology at Çukurova University were given the Index of Female Sexual Function (IFSF) and Beck Depression Inventory (BDI). IFSF score=30 was considered sexual dysfunction. The relationship between IFSF score and age, marriage age, level of education, occupational status, monthly income, way of partner selection, feelings towards husband, and depression was analyzed. Results: The prevalence of sexual dysfunction in infertile women was 35.5% (n=71) and the mean IFSF score was 31.6±4.5. There was a statistically significant correlation between the frequency of sexual dysfunction and level of education, occupational status, monthly income, feelings towards husband, male infertility, and depression. A negative correlation was found between the IFSF score and the BDI score (r=-0,44, p=0,001). In addition, level of education, occupational status, monthly income, and feelings towards husband significantly correlated to the IFSF score, desire, orgasm, and arousal sensation. No significant relationship was found between the frequency of sexual dysfunction and age, residency, being a parent, presence of chronic disease, way of partner selection, marriage age, and smoking history. Conclusion: Infertile women have a higher risk for sexual dysfunction than fertile women do. The prevalence of sexual dysfunction is lower in infertile women who are well educated, are employed, and have a high monthly income. © 2013 by Türkiye Klinikleri.

PubMedID: 23444753 Objective: To evaluate the impact of gestational age on clinical laboratory findings and maternal-perinatal outcomes in patients with HELLP syndrome. Method: A retrospective review of 74 patients with HELLP syndrome between January 2007 and October 2010 was performed. Data were stratified into two groups by gestational age at the onset of disease: group 1 (< 34 weeks) and group 2 (? 34 weeks). Clinical signs and symptoms, laboratory findings, and maternal and perinatal outcomes were evaluated. Results: No differences were observed between the two groups in the clinical and laboratory characteristics according to onset of HELLP syndrome except for gravidity, parity, and delivery interval. Maternal complications did not differ between the groups. The perinatal mortality rate was 22.9% in total and it was 43.2% in group 1. Conclusions: The time of onset of the HELLP syndrome mainly affects neonatal outcomes. To assess the effect on maternal morbidity more studies are needed.

PubMedID: 22069238 Purpose: To explore the optimal b value in diffusion-weighted (DW)-MRI for differentiation of benign and malignant gynecological lesions. Materials and Methods: Consecutive 58 patients (66 lesions) with pathologically confirmed diagnosis of gynecological disease were included in the study. Routine pelvic MRI sequences were used for defining the lesions and reviewed independently for benignity/ malignity. Single-shot echoplanar imaging (SH-EPI) DW-MRI with eight b values and nine apparent diffusion coefficient (ADC) maps were obtained. The lesions were analyzed qualitatively on DW-MRI for benignity/malignity on a five-point-scale and quantitatively by measurement of apparent diffusion coefficient (ADC) values. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of ADC values for differentiating between benign and malignant lesions. Pathology results were the reference standard. Results: Differentiation between benign and malignant gynecological lesions using visual scoring was found to be successful with b values of 600, 800, or 1000 s/mm 2. The mean ADC values of malignant lesions were significantly lower than those of benign lesions for all b value (P < 0.005). The ADCs with b = 0 and 600, 0 and 1000 s/mm 2, 0, 600, 800 and 1000 s/mm 2, and all b values were more effective for distinguishing malignant from benign gynecological lesions (Az = 0.851, 0.847, 0.848, 0.849, respectively). Using ADC with b = 0, 600, 800, and 1000 s/mm 2, a threshold value of 1.20 × 10 -3 mm 2/s permitted this distinction with a sensitivity of 83%, a specificity of 81%. Conclusion: DW-MRI is an important method, and the optimal b values are between 600 and 1000 s/mm 2 for differentiation between benign and malignant gynecological lesions. Copyright © 2011 Wiley-Liss, Inc.

PubMedID: 23138993 BACKGROUND In this study, we aimed to determine the effects of trauma severity on cardiac involvement through evaluating the trauma severity score together with diagnostic tests in multiple trauma patients. A trauma score was determined using various trauma severity scales. METHODS After obtaining the approval of the ethics committee of the faculty, this prospective study was performed through evaluating 100 multiple trauma patients, aged over 15 years, who applied to our Emergency Department (ED). After determining the trauma severity score using instruments such as the Injury Severity Score (ISS), Glasgow Coma Scale (GCS), and Revised Trauma Score (RTS), the cardiac condition was evaluated using biochemical and radiological diagnostic tests. RESULTS During the study period, 100 patients were evaluated (78 male, 22 female; mean age: 33.2±15.4; range 15 to 70 years). It was determined that 92 (92%) were blunt trauma cases, and 77 (77%) of them were due to traffic accidents. The majority of cases showed electrocardiogram (ECG) abnormalities (63%) and sinus tachycardia (36%). Abnormal echocardiogram (ECHO) findings, mostly accompanied by ventricular defects (n=24), were determined in 31 of the cases. Nineteen cases with high trauma severity score resulted in death, and 14 of all deaths were secondary to traffic accidents. Trauma scores were found to show a significant difference between the two groups. CONCLUSION The ISS trauma scale was determined to be the most effective in terms of indicating heart involvement in patients with multiple traumas. Close follow-up and cardiac monitoring should be applied to patients with high trauma severity scores considering possible cardiac rhythm changes and hemodynamic disturbances due to cardiac involvement.

PubMedID: 21303759 Objective: To establish and compare the frequency of intrauterine congenital heart defects in high-risk and low-risk pregnancies for congenital heart diseases. Methods: Records of 3782 patients who underwent fetal echocardiography at the Pediatric Cardiology Unit were reviewed for reasons of refer- ral and results of echocardiography retrospectively. The categorical variables between the groups were analyzed using a Chi-square test. Results: Structural heart defects were found in 213 (5.6%) fetuses in both high and low risk groups. Most common defects were ventricular septal defect (36.2%) and atrioventricular septal defect (14.1%). Frequency of congenital heart diseases was 7.8% (169 fetuses) in high-risk group: 4.1% were complex, 2.3% significant and 1.4% were minor. In low-risk group, the frequency was 2.7% (44 fetuses): 0.6% were complex, 0.8% significant and 1.3% were minor. In this group, rates of congenital defects were high regarding particular reasons: intrauterine fetal death in previous pregnancy (6.3%), abnormal first or second trimester screening tests (4.3%), and multiple gestations (3.4%). The sensitivity and specificity of fetal echocardiography according to transthoracic echocardiography were found to be 86% and 99%, respectively. Conclusion: Congenital heart diseases rate, as expected, was found to be higher in high-risk group. However, regarding intrauterine fetal death in previous pregnancy, abnormal first or second trimester screening tests and multiple gestation, no statistically significant difference was observed between low-risk and high-risk groups. Therefore, we suggest the routine use of fetal echocardiography in cases we have mentioned above if the staff and equipment of the pediatric cardiology clinic are eligible. © 2011 by AVES Yayi{dotless}nci{dotless}li{dotless}k Ltd.

PubMedID: 21443557 Aim: The purpose of this randomized controlled clinical trial was to evaluate the effectiveness of a new treatment approach, which consists of coronally advanced flap (CAF) procedure combined with orthodontic button application (CAF+B) for the treatment of multiple recession-type defects in patients with aesthetic demands. Materials and methods: Forty-one healthy subjects presenting at least three adjacent Miller Class I or II multiple gingival recessions were treated with a CAF technique. Twenty-one patients were randomly assigned to the test group, and the other 20 patients were assigned to the control group. On the test group, orthodontic buttons were used for the stabilization of advanced flaps. Clinical and patient centered parameters were measured at baseline, 7 days and 6 months after the surgery. Results: A total of 155 recessions were treated. Complete root coverage from baseline to 6 months post-surgery was 61% for the control group and 84% for the test group. There was no difference on visual analog scale-pain measurements among the treatment groups. Patient satisfaction with aesthetics was very high in CAF+B group when compared with CAF group. Conclusion: Six months results showed that the CAF+B approach was effective for the treatment of multiple gingival recessions in patients with aesthetic demands. © 2011 John Wiley & Sons A/S.

This study aimed to evaluate the usefulness and safety of a new method for taking a placental biopsy.The procedures were performed using the traditional single needle technique (group 1) or the new method (group 2). In group 2, the piston was fixed in a simple metallic clip and the negative pressure was maintained in a continuous manner which was controlled with a three-way stopcock.Multiple uterine insertion was necessary in 14 cases (32.6%) in group 1 and five (11.9%) in group 2 (p0.05). The amount of chorionic tissue obtained was significantly higher in group 2 (19.1 +/- 15.0 mg vs. 33.9 +/- 17.4 mg p0.05). The abortion rates did not differ in either group.While using this technique, the operator is capable of performing the procedure without any assistance and of applying constant negative pressure only in the placenta. The advantageous outcomes are probably related to the size as well as the incessant fashion of the vacuum force.

PubMedID: 20420278 Objectives: To evaluate the effect of genetic amniocentesis on the preterm delivery rate in women with uterine myoma. Methods: The volume of each fibroid and the relation to the placenta, myometrium and uterine corpus were recorded. Amniocentesis was performed by an experienced operator, if indicated. Results: During the study 14,579 pregnant women were examined and 234 had complications of uterine myomas (1.61%). Forty-three women delivered prematurely (19.46%). The results revealed that multifocal fibroids in relation to the myometrium, uterine myoma subjacent to the placenta, total myoma volume greater than 150 cm3 are statistically significant independent risk factors for preterm delivery, while amniocentesis was not found to be an independent risk factor for preterm delivery. Conclusions: Although having uterine myoma is a fairly known cause of preterm delivery, second trimester genetic amniocentesis does not seem to have any additional adverse effect on the preterm delivery rate in women with uterine myomas.

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PubMedID: 21077522 Objective: This study aimed to evaluate the usefulness and safety of a new method for taking a placental biopsy. Methods: The procedures were performed using the traditional single needle technique (group 1) or the new method (group 2). In group 2, the piston was fixed in a simple metallic clip and the negative pressure was maintained in a continuous manner which was controlled with a three-way stopcock. Results: Multiple uterine insertion was necessary in 14 cases (32.6%) in group 1 and five (11.9%) in group 2 (p < 0.05). The amount of chorionic tissue obtained was significantly higher in group 2 (19.1 ± 15.0 mg vs 33.9 ± 17.4 mg p < 0.05). The abortion rates did not differ in either group. Conclusion: While using this technique, the operator is capable of performing the procedure without any assistance and of applying constant negative pressure only in the placenta. The advantageous outcomes are probably related to the size as well as the incessant fashion of the vacuum force.

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Objective: When the studies are reviewed about domestic violence against partner and child, there are a few studies which include psychiatric sample, especially children. The aim of this study is to compare the two methods to domestic violence against child (DVAC) and domestic violence against partner (DVAP) in the pediatric psychiatric sample. Methods: In this study, DVAC and DVAP were investigated with two different methods. The first was self-report questionnaire. The second was to ask similar questions during face to face intervention, Participants were 510 mothers who had 4-12 years old child and who applied child and adolescent psychiatry department. Findings: Both DVAC and DVAP were determined higher rates in the first method. Additionally, correlation between two methods was very little. DVAC rates increased in the children who had DVAP history in their family. Conclusion: This study results were not similar to literature knowledge that 'DV should be examined as short and close and questions during face to face intervention'; according to our results the rate of this suggested method was effective at a level of only half-of the another method. This traditional method might be true, but it couldn't forget that this rate might bring Iower results than the reality. When there is a doubt about the presence of DV in family, different methods should be use, and each family member should be examined separately.

PubMedID: 19711826 Aim: The aim of this study was to evaluate the trends in acute adult poisoning data during ten years in university emergency department and determine the factors of hazardous outcome such as severe clinical status, prolonged hospital stay and mortality. Material and methods: Medical records of 4569 poisoned patients admitted to Emergency Department (ED) of Qukurova University, School of Medicine in Adana. Results: The mean age of 2988 females (65.4 % of the patients) was 24.5±10.1 years, whilst the mean age of 1581 male patients (34.6 %) was 29.5±13.2 years (p=0.001). Of the poisonings 80.0 % were suicidal; 69.4 % of the women and 30.6 % of the men committed suicide. The most common types of poisonings were ingestion of drugs (58.4 %), organophosphates (23.9 %) corrosives (3.4%), mushrooms (1.7 %), methanol (2.4 %), carbon monoxide (2.1 %) and unknown (8.1 %). Of the total 96.0 % were discharged from emergency department, 1.4 % transferred to IC and 2.6 % died. Conclusions: Young people and women are high-risk groups for acute poisoning and drug poisoning was found to be the most common type of poisoning. The poisoning by psychoactive drugs is increasinging in the recent years and organophosphates poisoning seems to be still a serious problem in such an agricultural area. How-ever, while the ratios of prolonged hospitalization and mortality are decreasing, suicidal poisoning is seriously increasing (Tab. 4, Fig. 2, Ref. 34). Full Text (Free, PDF) www.bmj.sk.

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PubMedID: 18081859 The aim of this study was to evaluate the immediate post-operative pain, wound healing and clinical results after the application of an enamel matrix protein derivative (EMD) alone or combined with a low-level laser therapy (LLLT) for the treatment of deep intra-bony defects. This study was an intra-individual longitudinal test of 12 months' duration conducted using a blinded, split-mouth, placebo-controlled and randomized design. In 22 periodontitis patients, one intra-bony defect was randomly treated with EMD+LLLT, while EMD alone was applied to the contra-lateral defect site. LLLT was used both intra- and post-operatively. Clinical measurements were performed by a blinded periodontist at the time of surgery, in the first week and in the first, second, sixth and 12th month. Visual analogue scale (VAS) scores were recorded for pain assesment. The results have shown that the treatment of intra-bony defects with EMD alone or EMD+LLLT leads to probing depth reduction and attachment-level gain. In addition, EMD+LLLT had resulted in less gingival recession (p

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PubMedID: 17479639 Diagnosis of neonatal sepsis may be difficult because clinical presentations are often nonspecific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. In this study, we aimed to investigate the role of procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6, IL-8 and tumor necrosis factor-alpha (TNF-?) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis. Twenty-six neonates with blood-culture positivity and clinical sepsis, hospitalized for clinical suspicion of neonatal sepsis in neonatal intensive care units of Balcal? Hospital, Çukurova University and Adana State Hospital between May 2000 and January 2001 (Group I) and 29 healthy neonates followed at the neonatal units and outpatient clinics of these hospitals (Group II) in the same period were studied. Among the septic neonates, 13 had early-onset (Group Ia) and 13 had late-onset (Group Ib) neonatal sepsis, while 14 of the healthy neonates had perinatal risk factors (Group IIa) and 15 of them had no risk factors (Group IIb). The demographic and clinical characteristics of the septic and healthy neonates were recorded, blood samples for determining serum PCT, CRP, IL-6, IL-8 and TNF-? were collected from the healthy and the septic neonates before starting treatment, and these investigations were repeated on the 3rd and 7th days of treatment. In this study, it was found that: (a) pre-treatment mean serum PCT, CRP, IL-6, IL-8 and TNF-? levels were significantly higher in the septic neonates than in the healthy ones, (b) compared with the pre-treatment values, serum PCT, IL-6 and TNF-? had progressively decreased on the 3rd and 7th days of the treatment in the 17 recovered patients, though they progressively increased in nine patients who died during treatment, (c) the area under the receiver operating characteristic (ROC) curve (AUC) for PCT, TNF-?, IL-6, CRP, and IL-8 were 1.00, 1.00, 0.97, 0.90 and 0.68, respectively. For the cut-off value of PCT ?0.34 ng/ml, the test was found to have a sensitivity of 100%, specificity of 96.5%, positive predictive value of 96.2%, negative predictive value of 100% and diagnostic efficacy of 98.3% for bacterial sepsis in neonates. For the cut-off value of TNF-? ?7.5 pg/ml, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficacy were found to be 100%, 96.6%, 96.2%, 96.5% and 98.3%, respectively. It was detected that sensitivity, specificity and diagnostic efficacy values were lower for IL-6, CRP and IL-8. We conclude that PCT and TNF-? are the best markers in the diagnosis of neonatal sepsis, and these markers are also valuable in following the effectiveness of treatment and determining the prognosis of the disease.

20th Congress of the European-College-of-Neuropsychopharmacology -- OCT 13-17, 2007 -- Vienna, AUSTRIA WOS: 000251231901216 … European Coll Neuropsychopharmacol

WOS: 000245874800002 PubMed ID: 17479639 Diagnosis of neonatal sepsis may be difficult because clinical presentations are often nonspecific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. In this study, we aimed to investigate the role of procalcitonin (PCT), C-reactive protein (CRP), interleukin (IL)-6, IL-8 and tumor necrosis factor-alpha (TNF-alpha) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis. Twenty-six neonates with blood-culture positivity and clinical sepsis, hospitalized for clinical suspicion of neonatal sepsis in neonatal intensive care units of Balcali Hospital, Cukurova University and Adana State Hospital between May 2000 and January 2001 (Group I) and 29 healthy neonates followed at the neonatal units and outpatient clinics of these hospitals (Group II) in the same period were studied. Among the septic neonates, 13 had early-onset (Group Ia) and 13 had late-onset (Group Ib) neonatal sepsis, while 14 of the healthy neonates had perinatal risk factors (Group IIa) and 15 of them had no risk factors (Group IIb). The demographic and clinical characteristics of the septic and healthy neonates were recorded, blood samples for determining serum PCT, CRP, IL-6, IL-8 and TNF-alpha were collected from the healthy and the septic neonates before starting treatment, and these investigations were repeated on the 3(rd) and 7(th) days of treatment. In this study, it was found that: (a) pre-treatment mean serum PCT, CRP, IL-6, IL-8 and TNF-alpha levels were significantly higher in the septic neonates than in the healthy ones, (b) compared with the pre-treatment values, serum PCT, IL-6 and TNF-alpha had progressively decreased on the 3rd and 7th days of the treatment in the 17 recovered patients, though they progressively increased in nine patients who died during treatment, (c) the area under the receiver operating characteristic (ROC) curve (AUC) for PCT, TNF-alpha, IL-6, CRP, and IL-8 were 1.00, 1.00, 0.97, 0.90 and 0.68, respectively. For the cut-off value of PCT >= 0.34 ng/ml, the test was found to have a sensitivity of 100%, specificity of 96.5%, positive predictive value of 96.2%, negative predictive value of 100% and diagnostic efficacy of 98.3% for bacterial sepsis in neonates. For the cut-off value of TNF-alpha >= 7.5 pg/ml, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic efficacy were found to be 100%, 96.6%, 96.2%, 96.5% and 98.3%, respectively. it was detected that sensitivity, specificity and diagnostic efficacy values were lower for IL-6, CRP and IL-8. We conclude that PCT and TNF-alpha are the best markers in the diagnosis of neonatal sepsis, and these markers are also valuable in following the effectiveness of treatment and determining the prognosis of the disease.

PubMedID: 17153645 Purpose: The aim of this study was to examine the validity and reliability of the Com-DAS (combined dental anxiety scale) as an indicator for children's perceived dental anxiety and to investigate the effect of age, gender and socio-economic factors on dental anxiety. Materials and Methods: A total of 258 children aged between 8 and 12 years, who had not visited a dentist before, were randomly selected from three different socio-economic status groups. A new scale was developed by combining the C-DAS (Corah's dental anxiety scale) and FIS (facial imaging scale), and named Com-DAS. Original C-DAS was used for validation. Results: There was a high correlation between C-DAS and Com-DAS (r = 0.69). The lowest correlation was in 8-year-old children (r = 0.46), however the mean difference between the scales in this age group was not statistically significant (p > 0.05). The Com-DAS scores showed no statistical difference according to gender, whereas there was a significant difference according to age and socio-economic status (p = 0.001 in both cases). Conclusion: The Com-DAS used in this study may be of use in those communities where the children and their families have limited literacy skills and their understanding of modern dental procedures may be influenced by non-qualified dental practice. © quintessenz.

Case management of adult patients with acute poisoning in a university-based emergency department to determine the factors that affect duration of hospital stay was assessed. In this survey, data were obtained for the period between January 1, 1997 and December 31, 2002 at the emergency department (ED). Case analyses of 2229 patients older than 14 years of age were reviewed. Of all patients, 725 (32.5%) were male, 801 (35.9%) were younger than 20, and 540 (24.2%) were older than 30 years. Mean ages of patients were 29.3±13.2 for the males and 23.8±9.6 for the females (P