Background : Diabetes Mellitus (DM) is the most common endocrine disease worldwide. One of the most important chronic complications of this disease is the development of diabetic foot. The management ...of diabetic foot wounds is quite important with respect to public health.
Aims : To determine the effect of Vacuum Assisted Closure (VAC) therapy on the quality of life in the treatment of diabetic foot ulcers and compare it with standart wound care.
Methods : Between May 2007 to December 2008, 67 consecutive patients with diabetic foot ulcers were randomly assigned to VAC therapy (Group1, n: 30) or standart wound care (Group 2, n: 37). The SF-36 questionnaire was administered the day before and in the month following wound healing. Global analyses of the 8 domains and 2 comprehensive indexes of SF-36, Physical Component Summary (PCS) and Mental Component Summary (MCS) were performed. Clinical measures included standard antidiabetic treatment, daily wound care including antiseptic bath, debridement, toe removal for gangrene when necessary, and wound care with conventional methods or VAC. Healing time was calculated as the time from hospital admission to the time of re-epithelization.
Results : There were no differences in the mean age, ulcer size and pulse status of the patients in both groups. Healing time in the VAC group was significantly reduced (p < 0.05). All 8 domains of SF-36 and MCS and PCS scores improved remarkably after VAC therapy.
Conclusion : Vacuum Assited Closure therapy was found to be effective in the treatment of chronic diabetic ulcers. The improvement of quality of life demonstrates a clear-cut indication in this particular group of patients.
Tensile data from literature are reanalyzed to determine ductility potential in magnesium alloys, which has yielded a linear relationship between maximum elongation and yield strength. Ductility ...potential line is significantly higher than those in the literature. Moreover, grain size, chemical composition, temper do not affect the yield strength-maximum elongation relationship.
Hyperemesis gravidarum is known as a complex disease with interaction of biological, psychological and sociocultural factors. Our study was an attempt to understand the psychological effects on ...hyperemesis gravidarum by using an objective scale.
Thirty-four pregnant women with hyperemesis gravidarum who were hospitalized in the Obstetrics and Gynecology Department of Dr. Lutfi Kirdar Kartal Education and Research Hospital in Istanbul, Turkey comprised the patient group and asymptomatic pregnant women who came for routine antenatal visits to our clinic were enrolled in this study as the control group between March 1, 2007 and October 15, 2008. Women in both groups filled in the Symptom Check List (SCL-90-R) questionnaire. The data collected from both groups were analyzed by using the Student's t-test (SPSS 13.00). Frequencies of high SCL scores between groups were analyzed by chi-square tests.
The patients with hyperemesis gravidarum had higher distress scores than those in the control group. The mean value of global severity index (GSI) was 1.03 in the patient group and 0.64 in the control group. The difference was statistically significant (p < 0.005). The most significant difference between the two groups was in somatization subscales (p < 0.0001).
Hyperemesis gravidarum is a complex disorder with psychological aspects. Considering this fact can help us deal with the disorder.
Summary
Objective: To determine the efficacy of intravenous (i.v.) paracetamol for decreasing pain associated with fractional curettage.
Materials and methods: This double‐blind, randomised, ...placebo‐controlled trial included 70 women who underwent fractional curettage. Patients were randomly assigned to receive i.v. infusion of either 1000 mg paracetamol (n = 36) or 0.9% normal saline as placebo (n = 34) prior to the procedure. The main outcome measure was the intensity of pain assessed by a 10‐cm visual analogue scale. Pain scoring was performed at t1 = prior to the procedure, t2 = during the procedure and t3 = 30 min after the procedure. Statistical analysis was performed using the Student’s t‐test, chi‐squared and Pearson’s correlation analysis.
Results: The pain scores at t2 and t3 were significantly higher than the score at t1 in both groups. There was no statistically significant difference between the pain scores at t1, t2 and t3 among the two groups. Menopausal status had no effect on the pain scores and on the treatment outcome. The pain scores prior to the procedure were significantly higher in women with a history of endometrial curettage when compared with women who have no history.
Conclusions: Fractional curettage is associated with mild pain. We were unable to detect a significant difference in pain scores in patients undergoing fractional curettage when comparing the use of i.v. paracetamol with placebo. History of prior endometrial curettage seems to be a predictor of the basal pain scores at admission although it does not affect the pain intensity related to the procedure.
We aimed to investigate the effects of melatonin and resveratrol on diabetes-related papillary muscle dysfunction and structural heart disorders. The protective effect of resveratrol and melatonin ...supplementation on cardiac functions was investigated in a diabetic elderly female rat model. 16-month-old rats (n=48) were allocated into 8 groups. Group1: Control, Group2: Resveratrol Control, Group3: Melatonin Control, Group4: Resveratrol and Melatonin Control, Group5: Diabetes, Group6: Diabetes Resveratrol, Group7: Diabetes Melatonin, Group8: Diabetes Resveratrol and Melatonin. Streptozotocin was injected intraperitoneally to the rats for experimental diabetes induction. Thereafter, resveratrol (intraperitoneal) and melatonin (subcutaneous) were administered for 4 weeks. Resveratrol and melatonin had a protective effect on the contractile parameters and structural properties of the papillary muscle, which was impaired by diabetes. it has been presented that diabetes impairs the contractile function of the papillary muscle for each stimulus frequency tested and the responses obtained as a result of Ca+2 uptake and release mechanisms from the Sarcoplasmic reticulum, and it has been observed that these effects are improved with resveratrol and melatonin injection. The decrease in myocardial papillary muscle strength in the diabetic elderly female rat can be reversed with the combination of resveratrol, melatonin and resveratrol+melatonin. Melatonin+resveratrol supplementation is no different from melatonin and/or resveratrol supplementation. Resveratrol and melatonin supplementation may have a protective effect on cardiac functions in a diabetic elderly female rat model.
The aim of this study was to assess the preference of pregnant women for mode of delivery in an uncomplicated pregnancy and reasons of their choice, also to determine if maternal characteristics were ...predictors of maternal preference. Pregnant women applying to the antenatal clinic for a routine control visit were recruited. After verbal consents, a questionnaire was administered to 1,588 pregnant women. Of the women questioned, 84.1% opted for vaginal delivery whereas only 15.9% opted for an elective caesarean delivery. The main reasons for vaginal delivery preference were; earlier healing and earlier hospital discharge, being a more physiological way of delivery and previous vaginal delivery history. The most common reasons for choosing caesarean delivery were; fear of vaginal delivery, tubal ligation demand and to avoid labour pain. Educational status, occupation and gestational age were not found to be influencing factors but age, parity and monthly income were found to be influencing factors for maternal preference.
Superficial venous insufficiency is a common problem associated with varicose veins which, if untreated, may progress to venous ulceration. Endovenous laser ablation (EVLA) is a new, minimally ...invasive method for management of superficial venous insufficiency and varicose veins. The aim of this study was to demonstrate the effectiveness of 980 nm EVLA for treatment of symptomatic saphenous venous insufficiency and to present its early outcomes.
Thirty-eight great saphenous veins and 5 small saphenous veins in 40 patients with saphenofemoral reflux were treated with 980 nm diode endovenous laser equipment. The diameter and length of the vein treated, total laser energy and energy density (Joules/cm) delivered were recorded. To determine the severity of the venous disease Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were used. Patients were followed up for 6 months after the procedure. Complications were recorded prospectively.
Forty-three saphenous veins in 40 patients were treated. The mean age of the patients was 39.9 (range 21-72) years. The mean diameter and length of the veins were 4.9 mm (range, 3.5 to 8.5 mm) and 30.2 cm (range, 16 to 50 cm), respectively. At 6 months follow-up, total occlusion rate was 95.4% (41/43), and recanalization rate was 4.6%. Significant decrease was observed for VCSS and VAS scores after the procedure. No major complication was detected.
EVLA treatment for superficial venous insufficiency is safe and can be carried out under local anaesthesia in an outpatient setting with good patient satisfaction and low complication rates.
Behcet's Disease (BD) is a rare disease, of unknown origin that generally causes an inflammation in the subcutaneous tissue, eyes and brain vessels, and related with the immune system, predominantly ...seen in male patients and the mean age at onset is mainly in the third decade. The aim of the study was to present our experiences with the cases of arterial pseudoaneurysms that we treated conservatively without surgical or radiological intervention. Eleven patients with Behcet's disease who developed arterial pseudoaneuryms and responsed to the medical treatment are included in the study. The operation requirement, the complication rates, and factors that influence morbidity and mortality are evaluated. The mean age of the patients was 29,5 (18-35) years. Nine of the patients were male and 2 were female. The mean period of hospitalization was 18 (11-34) days. Six patients redeveloped aneurysm during their follow-up. Three of these patients were treated with surgery. Five patients had no complication during an average of 20 months of follow-up period. Arterial pseudoaneurysm is a rare complication of Behcet's disease. Despite the good response to conservative treatment at the beginning period, the patients should be closely followed up and redevelopment of the aneurysm should be kept in mind.
Previous research on dog-human companionship shows that there are multiple dimensions characterizing the relationship between dogs and their owners. The purpose of this research is to identify key ...consumer behavior-based segments and show how such dimensions of dog-human companionship vary across these segments. A two-stage research design was employed utilizing 75 in-depth interviews, and a resultant survey of 745 US dog owners. Cluster analysis using shopping-related variables produced three distinct segments of dog owners. Results show that how people shop for their dogs is systematically related to the nature of their relationships with their dogs. These results add to the literature on dog-related consumer behavior and provide practitioners with a more detailed perspective on targeting dog owners. PUBLICATION ABSTRACT
PDF
