Said Bodur

Fibrinolytic markers and neurologic outcome in traumatic brain injury

AIMS To determine the usefulness of fibrinolytic markers as early prognostic indicators in patients with isolated head trauma. MATERIALS AND METHODS Sixty-two consecutive patients (26 women and 36 men; mean age 61 years, range 2-76 years) with isolated head trauma seen within the first three hours of the trauma were included in the study. The Glasgow Coma score (GCS), platelet counts (Plt), prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, fibrin degradation products (FDP) and D-dimer levels were measured. Head computerized tomography (CT) findings were categorized as brain edema, linear fracture, depressed fracture, contusion and bleeding. Plt counts, PT, PTT, fibrinogen, FDP, D-dimer levels and CT findings were compared with both GCS and mortality in the first week. Statistical significance was accepted at P <or=0.05. RESULTS A marked negative relationship was found between GCS and PT, PTT, FDP and D-dimer levels (P < 0.001). Plt levels did not correlate with GCS. Mortality was most strongly related to GCS, PT, FDP and D-dimer levels (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). We found no relationship between mortality and CT findings, nor was there any significant relationship between Plt, PTT and fibrinogen levels. CONCLUSION GCS and fibrinolytic markers measured within the first three hours were useful in determining the prognosis of patients with isolated head trauma.

Effects of sildenafil and vardenafil on erectile dysfunction and health-related quality of life in haemodialysis patients: a prospective randomized crossover study

BACKGROUND Erectile dysfunction (ED) is prevalent in end-stage renal disease (ESRD) and has been associated with impaired health-related quality of life (HRQoL). HRQoL, in turn, is related to morbidity and mortality in ESRD patients. Previous studies have shown improved HRQoL with ED treatment using sildenafil and vardenafil. However, no study has examined the effects of sildenafil or vardenafil on HRQoL in impotent ESRD patients. Furthermore, vardenafil has never been tested and its safety profile has not been determined in ESRD patients. The aim of this randomized crossover study was to compare the effects of sildenafil and vardenafil on measures of HRQoL and on ED scores as well as to determine the safety profile of vardenafil in ESRD patients. METHODS In 32 haemodialysis patients with impotence, ED and HRQoL were evaluated by the International Index of Erectile Function (IIEF-5) and the 36-item Short-Form Health (SF-36) surveys, respectively. Patients were randomized into sildenafil and vardenafil groups. After a 4-week treatment and 2-week washout periods, crossover was performed and an additional 4-week treatment was administered. IIEF-5 and SF-36 surveys were given before and after each treatment period. Adverse effects were evaluated by interview. Friedman tests and Bonferroni-adjusted Wilcoxon signed-rank tests were used to compare groups and for post hoc analysis, respectively. RESULTS IIEF-5 and SF-36 scores were significantly improved by both sildenafil and vardenafil compared to pretreatment values. There were no differences between sildenafil and vardenafil with respect to the studied parameters. Adverse effect profiles were also similar. No patient dropped out because of side effects. CONCLUSIONS Sildenafil and vardenafil caused similar improvements in ED and HRQoL in haemodialysis patients. Vardenafil was well tolerated in our patient population.

Evaluation of application of multiple needle pricks on the pathergy reaction

Background  The pathergy reaction (PR) to a needle prick is a well‐known feature of Behçets disease (BD). Although PR is accepted as a major criterion in this disease, there is a lack of a standardized method to measure PR. The aim of this study was to evaluate the effect on the positive rate of PR of the application of numerous (one to six) needle pricks.

KARAMAN İL MERKEZİNDE YAŞAYAN YAŞLILARIN BAĞIMLILIK DÜZEYLERİ, DEMOGRAFİK VE MEDİKAL ÖZELLİKLERİNİN İNCELENMESİ

Calisma Karaman’da yasayan 65 yas ve uzeri yaslilarin gunluk yasam aktivitelerinde bagimlilik duzeylerini ve bagimliligi etkileyen risk etmenlerini saptamak amaciyla yapildi. Bu tanimlayici arastirma 2003 yili Nisan ayinda Karaman 3 Nolu Saglik Ocagi bolgesinde gerceklestirildi. Yaslilarin bagimlilik duzeylerini saptamak amaciyla Katz Bagimlilik Olcegi ve arastiricilar tarafindan gelistirilen sosyo-demografik bilgi formu kullanildi. Anket ve olcek tek tek ev ziyareti yapilarak yuz yuze gorusme teknigiyle uygulandi. Arastirma kapsamina alinan yaslilarin yas ortalamasi 70.46±5.51 (65-95) idi. Ulasilabilen 277 yaslinin 52’sinde (%18.8) bagimlilik tespit edildi. Bagimlilikta ilk siralari banyo yapma, giyinme ve idrar kontrolu almaktaydi. Kadinlarin idrar kontrolunde bagimliligi erkeklere gore daha yuksek orandaydi. Temel gunluk yasam aktivitelerinde bagimlilik icin risk etmenleri 75 yas ve uzerinde bulunma, kronik hastalik varligi ve ogrenim gormeme olarak tespit edildi. Sonuc olarak, yasli sagligi hizmetlerinin planlama ve yurutumunun yaslilarin beste birinin bagimli oldugu gerceginin ve bagimliligin risk etmenlerinin dikkate alinarak yapilmasinin uygun olacagi kanaatine varildi.