Objectives: The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients’ swallowing-related quality of life (QoL), and patients’ stroke-specific QoL. Patients and methods: This multi-center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1±12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient’s swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). Results: The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients’ swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p=0.007) were being an employed caregiver (B=17.48, p=0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=-0.37, p=0.04) scores. Conclusion: Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver’s relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments.

Background/Objectives: A limited number of previous studies have reported high rates of end-stage renal disease (ESRD) in adults with IgA vasculitis nephritis (IgAVN). Despite the high prevalence of the disease and the high rates of ESRD reported in the literature, no specific guidelines for adult patients have been established and there is no consensus on the management of the disease. This study aimed to prospectively investigate adults with IgAVN from a broad perspective. Methods: This investigation was designed as a prospective observational study and was conducted between 01.02.2022 and 01.10.2024. A total of 49 newly diagnosed adult (>18 years) patients with IgAVN were regularly followed up. At the end of the study, the renal remission rates, factors influencing remission, treatment data, treatment-related adverse events, and disease outcomes were determined. Results: The median follow-up time was 22 (IQR: 11–24) months. A total of 42 patients (87%) received immunosuppressive treatment in addition to the initial glucocorticoid treatment. Azathioprine (AZA) was the preferred (41%) first steroid-sparing agent. ESRD occurred in only one patient (2%), while a total of ten patients (20%) had an unfavorable outcome. The rate of nephrotic-range proteinuria (NRP) was significantly higher in the patients who did not achieve renal remission at the end of the 12-month follow-up period (9,7% vs. 60%; p = 0.02) and NRP was an independent risk factor for unfavorable outcomes [OR: 17.18; 95% CI: 1.31–224.95; p = 0.03]. A total of 16% of the patients developed an infection that required hospitalization during follow-up; these patients had a higher rate of IgAVN-associated acute kidney injury (62.5% vs. 22%; p = 0.02) and were significantly older (mean: 46 ± 15.3 vs. 65 ± 13.3; p = 0.002). One patient died of sepsis at 4 months and another died of a myocardial infarction at 32 months. Conclusions: These results suggest that adults with IgVAN do not have a high rate of ESRD if they receive effective immunosuppressive therapy. However, immunosuppressive therapy is associated with an increased risk of infection, particularly in the elderly. The presence of NRP is associated with lower long-term remission rates and has a predictive value for unfavorable outcomes.

Aile hekimliği tıp disiplinin özelliklerini, ilkelerini ve temel değerlerini detaylarıyla bulabileceğiniz bölümlerin yanında, klinik uygulamalarda izlenecek yollar ve kılavuzların eşlik ettiği güncel bilgileri sizlerle paylaşmayı hedefledik. Aile hekimliğinin, yaş, cinsiyet, hastalık ayırt etmeksizin sunduğu sağlık bakımına ek olarak koruyucu sağlık hizmetlerinin prekonsepsiyonel dönemden bireyin ölümü sonrasındaki aile bireylerinin durumuna kadar geniş konu yelpazesinin varlığı bu kitabın kapsamlı ve güncel olması yönünde bize yol haritası olmuştur. Aile hekimliğinin, kendi eğitim içeriği, araştırmaları, kanıta dayalı ve klinik uygulamaları olan akademik ve bilimsel bir disiplin ve birinci basamağa odaklı bir klinik uzmanlık modeli ile konuların bilimsel ve pragmatik düzenlemesi yapılarak akışı sağlanmış, bilgilerin sistematik anlatımı kitap içerisinde planlanmıştır.

Background: We evaluated the clinical characteristics, follow-up, and treatment outcomes of peroneal neuropathy, which is frequently observed in agricultural workers who work in a squatting position. Methods: The study included 21 patients diagnosed with peroneal neuropathy who had worked in a squatting position and presented to the orthopedics and traumatology outpatient clinic. After diagnosis, the patients underwent 20 sessions of standard physiotherapy and used an ankle-foot orthosis (AFO). Electromyography (EMG) was used to assess the tibialis anterior, extensor digitorum brevis, peroneus longus, and gastrocnemius muscles and peripheral nerve conduction velocities before treatment and at the first and third months. Results: Of the patients, 12 (57.1%) were male and 9 (42.9%) were female. All patients had unilateral (13 right, 8 left) foot-drop. Pre-treatment EMG showed decreased proximal compound muscle action potential (CMAP) in 13 patients (61.9%). The physiotherapy program and AFO use increased nerve conduction (p<0.05). At the third month after treatment, three patients (14.3%) had low CMAP in the peroneus longus muscle, showing fibrillation and positive sharp wave patterns. Surgical treatment was recommended for these patients. Conclusion: Peroneal nerve injury, which may cause foot drop, occurs in agricultural workers who work seated for long periods. Three-month clinical follow-up, medical treatment, physiotherapy, and AFO use resulted in recovery in patients with a foot drop. Surgery may be required in non-recovering patients.