Haluk Mergen

Acute phase reactants in patients with coronary slow flow phenomenon.

OBJECTIVE In this study, we sought to investigate the serum levels of high sensitivity C-reactive protein (Hs-CRP), N-terminal pro-brain natriuretic peptide (NT proBNP), erythrocyte sedimentation rate, leukocyte, thyroid hormone and fibrinogen levels in patients with coronary slow flow phenomenon (CSFP). METHODS A total of 82 patients with angiographically proven normal coronary arteries and slow coronary flow in all three coronary vessels (45 males and 37 females, mean age 59±11 years) and 34 patients with normal coronary arteries and normal coronary flow (19 males and 15 females, mean age 56±10 years) with similar risk profiles were included in this cross-sectional observational study. Coronary flow rates of all patients and control subjects were documented by Thrombolysis In Myocardial Infarction (TIMI) frame count, serum level of Hs-CRP, NT proBNP, sedimentation, leukocyte, free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and fibrinogen levels were measured. Statistical analysis was performed using t test for independent samples, Chi-square test and Pearson correlation analysis. RESULTS Hs-CRP (0.88±0.86 vs 0.36±0.35 mg/L, p=0.001) and NT proBNP (117.83±163.2 vs 47.33±30.6 ng/ml, p=0.01) were found to be significantly higher in patients with coronary slow flow compared with normal control group. There were no significant differences regarding thyroid hormones, fibrinogen, sedimentation rate and leukocyte count between two groups. The mean TIMI frame counts were positively correlated (r=0.454, p=0.001 and r=0.554, p=0.001, respectively) with plasma Hs-CRP levels and NT-proBNP levels. CONCLUSION Hs-CRP and NT proBNP are significantly higher in patients with coronary slow flow compared with normal control group. Their increased levels are positively correlated with TIMI frame count.

Contemporary Home Care Service and Family Medicine in Turkey

Home care service is providing health care to the patient in his or her dwelling when care in the hospital is no longer required. Home care services provide not only medical services but also the social services that the human needs. Studies concerning home care services bear great importance. In this review, the authors aim to guide new studies by stating the legal and scientific point reached at the moment in Turkey.

Factors associated with depression among Turkish faculty of education freshmen by Beck depression Inventory–II-Turkish

Aims: To a ssess the prevalence of depression among the fi rst-year university students. Methods: 237 freshmen contributed anonymously to the study on a voluntary basis and an informed consent was obtained. Beck Depression Inventory-II Turkish (BDI-II-T) was applied. SPSS 11.0 statistical program was used. Results: Overall depression prevalence was 8.4 %. 54.9 % of subjects were females. 3 factors were found: factor 1 (depressive) with 11.2 %, factor 2 (cognitive) with 9.7 % and factor 3 (somatic-aff ective) with 8.8 % of total variance. Mild depression was found in 5.9 %, moderate in 1.7 % and severe depression in 0.8 % of subjects. Conclusion: BDI-II-T was found to be useful for the detection of depression among freshmen in terms of academic failure and future health.

Assessing adolescents admitting to adolescent counseling & health center with Beck Depression Scale and CES Depression Scale

152 2016

Obesity concomitant with eventration of the diaphragm: A case report

Introduction: Eventration of the diaphragm is a disorder in which all or part of the diaphragmatic muscle is replaced by fibroelastic tissue. The incidence of evantration is uncertain, although one paper reports that this entity is detected in 1 per 1400 chest radiographies. This article reports a case of right-sided eventration of diaphragm in 70 years old obese woman who was admitted to our institution with complaints of recurrent cough and sweating. Case report: A 70 year-old obese woman was admitted to Izmir Tepecik Education and Research Hospital Family Medicine Obesity Polyclinic with complaints of recurrent cough and sweating symptoms for the last few months. Reduction in lungs sounds on the right side and dullness were detected by the physical examination. X-ray chest in posteroanterior (PA) and lateral view exhibited elevation of the right diaphragm. During hospitalization patient was treated with Valsartan (320 mg) + Hydrochlorotiazide (12,5 mg) combination for hypertension; atorvastatine 40 mg for hyperlipidemia; asetylsistein for productive cough and alginic acid as an antacid. She had had a 1800 kilocalories diet without salt. Upper respiratory tract symptoms were regressed and blood pressure was at the normal range. She was hospitalized for 15 days for diagnosis and weight reduction as well. Thus; the patient was discharged from the institution with the information about diaphragm eventration and obesity, and advised of their symptoms, warnings and guarding herself against trauma, and referred to Chest Diseases polyclinic. Conclusion: Respiratory symptoms such as recurrent cough and upper respiratory infections are the most common complaints in the patients’ visits to family medicine practitioners. Although eventration of the diaphragm is rarely seen and usually is asymptomatic; it should be kept in mind as a reason of recurrent cough especially in obese patients who have vertebral pathologies or history of surgery. Кey words: Chronic disease management, nutrition and metabolism