Background/aim: Studies have shown an increased depression rate in patients with type 2 diabetes mellitus (T2DM) compared to the normal population. It is now acknowledged that patients suffer from distress rather than depression. Our aim was to validate the Turkish version of the Diabetes Distress Scale (DDS) and to show distress levels of the participants. Materials and methods: The scale was translated from English to Turkish by the authors and translated back to English. Between August 2015 and January 2016 all the patients who were referred to the T2DM Clinic of İstanbul Medeniyet University were screened, and eligible patients were recruited. For calculating internal consistency Cronbach's alpha coefficient was used. Results: A total of 205 patients [120 females (58.5%), 85 males (41.5%)] were included. Cronbach's alpha coefficient was 0.874, showing internal consistency. The Spearman Brown correlation coefficient was calculated between the first 9 and second 8 questions as 0.884. Thetotal variances were explained at a level of 66.2% with 4 factors. Sixty-three patients (30%) had a score of ≥3, indicating diabetic distress. Correlation analysis showed a significant correlation between total score and HbA1c levels (r = 0.152 and P = 0.038). Conclusion: The Turkish version of the DDS for type 2 diabetes is a reliable tool for assessment of distress levels.
Acute aortic dissection is a life-threatening disease. Approximately half of the aortic dissection observed in women under 45 years old has been reported to be related to pregnancy. Herein, we present a case of type A aortic dissection diagnosed in postpartum period. A 37-year-old woman admitted to the emergency department with the complaint of sudden onset of dyspnea. Arterial blood pressure was measured as 170/100 mmHg in left arm and 90/60 mmHg in right arm. With a prediagnosis of aortic dissection, thoracic and abdominal computed tomograpy was performed and type A aortic dissection extending form carotid artery to renal arterial level was detected. Operation of aortic dissection together with coronary arterial repairment and aortic valve replacement were successfully performed. Aortic dissection is not uncommon in pregnancy and furthermore it is potentially life-threatening for both mother and fetus. A high level of suspicion is required for prompt diagnosis and treatment in the peripartum period.
Diabetes is a major risk factor for cardiovascular disease. Despite recommendations and available therapeutic options, patients with diabetes do not always reach the recommended lipid levels. In this study, our aim was to compare the real world lipid profile of type 2 diabetes patients with guideline recommendations for dyslipidemia. Four hundred and sixty eight consecutive patients referred to Outpatient Diabetes Clinic of Istanbul Medeniyet University were recruited. Patient anthropometric measurements (height, weight, waist circumference), biochemical test results (LDL cholesterol (LDL-c), triglycerides, HDL cholesterol, HbA1c) and treatment modalities were recorded. Patients were stratified into cardiovascular risk categories according to the risk factors and their treatment dose was compared to the recommendations. Among 468 patients, 56 (12%) patients had coronary heart disease (CHD). Thirty-four percent of these patients were not on statin treatment (n=19) and their mean LDL-c level was 114±29 mg/dL (2.9±0.75 mmol/L). Nineteen percent of these patients were on high intensity statin treatment (atorvastatin 40-80 mg, rosuvastatin 20 mg). Only four patients with CHD had LDL-c levels <70 mg/dL (1.8 mmol/L). Four hundred and twelve patients had no CHD. In these patients, the mean LDL-c level was 132±38 mg/dL (3.4±0.9 mmol/L). Eighty (19%) patients had LDL-c level lower than 100 mg/dL (2.5 mmol/L). Overall 82% (n=384) of the cohort had not achieved treatment goal. In conclusion, a more pronounced approach for statin treatment is needed in diabetes patients for both primary and secondary prevention of cardiovascular diseases.
Introduction:Here, we aimed to analyze the risk factors of nasal methicillin-resistant Staphylococcus aureus (MRSA) carriage in a sample pool comprising university students and characterize MRSA isolates' antibiotic resistance profiles. Materials and Methods: A questionnaire was distributed to each participant and used as a data collection tool for obtaining demographic-and risk factor-related information. Each participant was also screened for S. aureus and MRSA nasal carriage. Associations between MRSA carriage and risk factors were evaluated with biostatistical methods. Bacterial isolates were isolated and identified with standard microbiological techniques. The antibiotic resistance phenotypes of the isolates were analyzed using the disk diffusion method in accordance with the European Committee on Antimicrobial Susceptibility Testing guidelines. Results: The nasal MRSA carriage rate detected in our population was 11.3%. Having a skin infection in the past year (p=0.039) and working in a healthcare system during the previous year (p=0.018) were found to be significant risk factors associated with the nasal MRSA carriage of students. The antibiotic susceptibility test on MRSA isolates demonstrated high resistance rates to rifampicin, erythromycin, and kanamycin. Conclusion: The high rate (11.3%) of nasal MRSA carriage among university students is concerning. Thus, activities that aim to enhance knowledge and awareness among university students and administrators should be implemented to prevent possible transmission and outbreak scenarios.Giriş: Burada, üniversite öğrencilerinden oluşan bir örnek havuzunda metisilin-dirençli Staphylococcus aureus (MRSA) taşıyıcılığı için risk faktörleri analiz edilmesi ve MRSA izolatlarının antibiyotik direnç profillerinin karakterizasyonu amaçlanmıştır. Gereç ve Yöntem: Risk faktörleri ve demografik bilgilerin elde edilmesi için tüm katılımcılara bir veri toplama aracı olarak anket dağıtılmıştır. Ayrıca, her katılımcı burunda S. aureus ve MRSA taşıyıcılığı için taranmıştır. MRSA taşıyıcılığı ve risk faktörleri arasındaki ilişkiler biyoistatistiksel yöntemlerle değerlendirilmiştir. Bakteriyel izolatların izolasyonunda ve tanımlanmasında standart mikrobiyolojik teknikler kullanılmıştır. İzolatların antibiyotik direnç fenotipleri disk difüzyon metodu ile European Committee on Antimicrobial Susceptibility Testing kriterlerine göre analiz edilmiştir. Bulgular: Popülasyonumuzda burunda MRSA taşıyıcılığı oranı %11,3 olarak belirlendi. "Geçen yılda bir deri enfeksiyonu geçirmiş olmak" (p=0,039) ve "geçmiş yıl içerisinde bir sağlık sisteminde çalışmış olmak" (p=0,018) öğrencilerde burunda MRSA taşıyıcılığı ile ilişkili anlamlı risk faktörleri olarak bulundu. MRSA izolatlarının antibiyotik duyarlılık testi rifampisin, eritromisin ve kanamisin için yüksek direnç oranları ile sonuçlandı. Sonuç: Üniversite öğrencilerindeki yüksek burunda MRSA taşıyıcılığı oranı (%11,3) endişe vericidir. Dolayısı ile, muhtemel yayılma ve salgın senaryolarının önlenmesi için üniversite öğrencilerinde ve yön...
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