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Öğe Emergence and co-infections of West Nile virus and Toscana virus in Eastern Thrace, Turkey(Wiley-Blackwell, 2014) Erdem, H.; Ergunay, K.; Yilmaz, A.; Naz, H.; Akata, F.; Inan, A. S.; Ulcay, A.The objective of this study was to identify the impact of West Nile virus (WNV) and Toscana virus (TOSV) in febrile diseases of unknown aetiology in Eastern Thrace, Turkey; this study was conducted during August-October 2012, and included 18 clinical cases and 296 blood donors for local serosurveillance. Antibodies were determined via commercial assays and further tested for specificity via neutralization assays (NA). Viral RNAs were sought via specific and/or generic primers. WNV infections were diagnosed in seven patients (38.8%), detected via RNA+IgM in four, RNA in one and IgM and low avidity IgG in two cases. The most common symptom was fever (>38 degrees C), followed by headache, malaise/fatigue, myalgia/arthralgia, muscle stiffness/lower back pain, anorexia, nausea/vomiting, diarrhoea, supraorbital/retrobulbar pain and abdominal pain. Neurological symptoms were noted in one individual. WNV strains in RNA-detectable patients were characterized as lineage 1. TOSV RNA or IgM were identified in two individuals with confirmed WNV infections and in one patient without evidence of WNV exposure. The clinical and laboratory findings in individuals with WNV/TOSV co-infection were comparable to those in WNV-induced disease. The TOSV strain in the patient with detectable viral RNA was characterized as genotype A. In local blood donors, seroreactivity for specific WNV and TOSV immunoglobulins was observed in 1.7% (5/296) and 14.4% (26/180), respectively. These findings indicate the emergence of WNV and TOSV-associated diseases in Eastern Thrace. WNV/TOSV co-infections were documented for the first time.Öğe THE IMPACT OF PHYSICAL AND PSYCHOLOGICAL COMORBID CONDITIONS ON THE QUALITY OF LIFE OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: A MULTI-CENTER, CROSS-SECTIONAL OBSERVATIONAL STUDY FROM TURKEY(Baywood Publ Co Inc, 2013) Sertoz, O. Onen; Aydemir, O.; Gulpek, D.; Elbi, H.; Ozenli, Y.; Yilmaz, A.; Ozan, E.Objective: Acute myocardial infarction (MI) has significant and detrimental effects on the lifestyles of the patients. It has been shown that quality of life (QoL) in patients with MI is impaired in every aspect. This study aims to evaluate the impact of depression and physical comorbidity on QoL in Turkish patients with acute first MI. Method: This multi-center cross-sectional study was carried out in 15 centers with 998 patients hospitalized for acute first MI. For detection of depression, Beck Depression Inventory (BDI) was used. For evaluation of QoL, World Health Organization Quality of Life Questionnaire (WHOQOL) was applied. Results: The mean age of the patients was 57.5 +/- 10.1 years and 79.2 % (n = 792) of the patients were men. Patients with comorbid depression (BDI >= 10) and comorbid medical conditions, and female patients had significantly lower scores in every domain of WHOQOL. In the regression analysis model, female gender, low education, comorbid medical conditions, especially comorbid hypertension, and BDI score were found to have a significant effect on the domains of WHOQOL. Conclusions: Female patients are more prone to impairment in quality of life after myocardial infarction. Both comorbid medical conditions and depression have a significant impact on the impairment of QoL in Turkish patients with acute MI. In order to improve the subjective wellbeing of post MI patients, both psychiatric and physical comorbidities must be detected and managed even in the short term.Öğe The relation between the interpedicular distance and the maximum pedicular screw length in lumbar one vertebra(Edizioni Minerva Medica, 2011) Copuroglu, C.; Ciftdemir, M.; Yilmaz, A.; Ozcan, M.; Kaya, M.; Yalniz, E.Aim. The aim of this paper was to demonstrate the relation between the distance of the midline of the corpus and the screw entry point on the pedicle and the maximum screw length that can be applied in the pediculocorporeal screw trajectory. Methods. The distance between two pedicular screw entry points and the distance between screw entry point and the anterior cortex of the vertebra corpus in the midline, on computed tomography (CT) sections and the same distances on cadaveric bony L1 specimens, were measured. Interpedicular distance was divided into two and the distance between the midline and the screw entry point was found. These measurements were compared and a constant ratio was observed. The pedicular screw entry point was accepted as the point just lateral to the inferior articular process at the mid level of the transverse process. Results. When these measurements were compared, a constant ratio was observed. The ratio between the distance of the midline of the vertebra and the screw entry point and the distance between the screw entry point and the midline anterior cortex of the vertebral body, was 2.5 cm. When the distance between the midline of the vertebra and the screw entry point during the operation or by measuring half of the interpedicular distance on plane roentgenograms, is measured, the maximum length of the pedicular screw can be estimated. Conclusion. In this study, we described an easy method of determining the maximum pedicular screw length by measuring the distance between the midline level of the vertebra corpus (spinous process level) and pedicle screw entry point on coronal section.Öğe What can anthropometric measurements tell us about obstructive sleep apnoea?(Via Medica, 2017) Yilmaz, A.; Akcaalan, M.Background: Clinical detection of anatomic narrowing of the upper airway may facilitate early recognition of obstructive sleep apnoea (OSA). The aim of this study was to investigate whether anthropometric measurement can be used to predict OSA. Materials and methods: One hundred forty-seven subject were included from those patients who were referred to our sleep laboratory with suspected sleep apnoea. All patients were divided two groups with respect to the apnoea-hypopnoea index (AHI). The first group was diagnosed as OSA, AHI greater than 5. The second group was not diagnosed with OSA, AHI less than 5 (non-OSA control). Anthropometric measurements such as lower face height (LFH), interincisial distance, nose height, anterior neck height (ANH), lateral neck height, posterior neck height (PNH), ramus mandible height, corpus mandible height (CML), bigonial distance (BGD), neck width, and neck depth were assessed. Results: Patients with OSA had higher body mass index (BMI) and larger LFH, ANH, thyromental distance, CML, BGD, and neck circumference than those without OSA (p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p < 0.0001, p = 0.023, p < 0.0001, respectively). There was no difference between the two groups in terms of other parameters. Conclusions: In this study, it was determined that BMI, lower face height, neck height, mandible length, bigonial width, thyromental distance and neck circumference are in significant relationship with sleep disordered breathing. Thus, these measurements may be used in clinical practice for prediction of OSA.Öğe When the sourcil width is larger than the femoral neck, it can be a predictor for an upcoming hip fracture(Edizioni Minerva Medica, 2011) Copuroglu, C.; Yilmaz, A.; Ozcan, M.; Ciftdemir, M.; Unver, K. V.; Kaya, M.; Copuroglu, E.Aim. Response of the bone to pressure depends on the strength of the pressure applied. If the load, transferred from the sourcil to the femoral head, is heavy and if the femoral neck is large, development of load carrying structures will be greater. We aimed to evaluate the relationship between the width of the sourcil and the width of the femoral neck and their relation with the fracture type of the hip in correlation with the neck-shaft angle. Methods. This is a retrospective case series study (N.=320) including the instutional data between January 2007 through April 2010. The medial and lateral side of the sourcil was pointed on the AP X-ray, and the distance between these two points was measured. On the same AP X-rays, the radius at the thinnest width of the femoral neck was measured in millimetres. The width of the sourcil and the width of the femoral neck in normal hips were compared with the measurements of the fractured hips. Neck-shaft angles of all the hips were also measured. Results. The width of the sourcil is mostly equal to the width of the femoral neck in normal hips. The width of the sourcil was greater than the width of the femoral neck in hip-fractured patients. This shows that, if the sourcil is bigger than the femoral neck, the femoral neck cannot carry as much load as the sourcil and fractures may happen. If the neck-shaft angle is smaller than normal hips, we observed that collum femoris is broken and if the neck-shaft angle is bigger than normal hips, then intertrochanteric femur fracture occurs. Conclusion. When the sourcil width is larger than the femoral neck width, it can be a predictor for an upcoming hip fracture. Varus in the neck-shaft angle is a predictor for femoral neck fracture and valgus is a predictor for intertrochanteric fracture.
