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Objective: The aim of this study was to evaluate the adaptability of pediatric residents to the current seizure classification of the International League Against Epilepsy-2017 (ILAE-2017) using a modular education program (MEP). Materials and Methods: The MEP design consisted of 8 modules, including 5 modules for the current version of the ILAE-2017 seizure classification and 3 modules for the older ILAE-1981 version. The MEP was implemented with a group of pediatric residents, and it comprised 50 illustrative pediatric seizure videos along with an instruction manual kit that included a seizure determinator. Following a 3-month follow-up period, a posttest was conducted using 58 new videos in the MEP. Results: The overall success rates of the participants were similar both ILAE-2017 (41%) and ILAE-1981 (38.5%) seizure classifications in the post-MEP test. Regarding the ILAE-2017 modules, the participants demonstrated a higher proficiency in classifying focal nonmotor seizures (56.3%) compared to focal motor seizures (34.9%). However, when it came to generalized seizures, the participants had significantly lower accuracy rates for generalized nonmotor seizures (26%) compared to generalized motor seizures (46%) with the ILAE-2017 classification. The seizure types that were most commonly misclassified, with an error rate exceeding 50%, were automatisms and myoclonic seizures within the focal seizure modules and atypical absences in generalized seizure modules of ILAE-2017. Conclusion: The single-day MEP yielded modest results, with a success rate of 41% in terms of the initial adaptability of pediatric residents to the ILAE-2017 seizure classification. However, to ensure successful implementation of the ILAE-2017 classification in clinical practice, additional booster applications of the MEP are required. [ABSTRACT FROM AUTHOR]

Objective: The long- and short-term benefits of breastfeeding for mothers and infants are known, and the number of studies on this subject is increasing daily. This study aimed to reveal current research trends, hotspots, and future frontiers in research on breastfeeding in Turkey. Materials and Methods: The most productive institutions, influential authors, the journals with the most publications by the authors, core research teams, and keywords in Turkey in the field of breastfeeding were analyzed using bibliometric methods. Additionally, breastfeeding-related articles published in the Web of Science Core Collection between 1980 and 2022 were scanned. The collected data were analyzed with the R Bibliometrix package program and VOSviewer. Results: It was determined that research on breastfeeding has accelerated since 2004, and the number of citations has increased with the number of publications. The fields of most productive writers in the area were found as social pediatrics, and the most influential institutions were İstanbul University and Hacettepe University. It was determined that there was no specialization in research on breastfeeding among authors distributed based on their productivity. The results also revealed the most influential articles and journals. The word analysis revealed that the breastfeeding literature in Turkey is sensitive to current developments, whereas the current status of breastfeeding, the factors affecting breastfeeding, and the effects of breastfeeding are the top areas of research. It was observed that maternal attachment and coronavirus disease-2019 (COVID-19) pandemic-related issues have been studied more in recent years. Conclusion: This bibliometric analysis contributes to understanding the current status and development of breastfeeding research in Turkey. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The sleep quality and physical activity levels of patients with obstructive sleep apnea syndrome during the lockdown period have not yet been investigated. The aim of this study was to evaluate the sleep quality, physical activity level, and fear of movement in patients with obstructive sleep apnea syndrome and healthy individuals during the coronavirus disease 2019 pandemic. MATERIAL AND METHODS: Patients with obstructive sleep apnea syndrome (n = 33) and healthy individuals (n = 30) were included in the study. Physical activity levels, sleep quality, and fear of movement were evaluated. RESULTS: The total physical activity amount of patients with obstructive sleep apnea syndrome and healthy individuals was lower than the acceptable levels. The obstructive sleep apnea syndrome group had significantly lower leisure-time physical activity (P = .006) and higher sitting time (P = .008) than the healthy individuals. Patients with obstructive sleep apnea syndrome had significantly more sleep disturbances, daytime dysfunction, and daytime sleepiness than healthy people (P < .001). Fear of movement was negatively correlated with the amount of vigorous (r = -0.395, P = .023) and leisure activities (r = -0.557, P = .001) in the obstructive sleep apnea syndrome group. CONCLUSION: During the coronavirus disease 2019 pandemic, patients with obstructive sleep apnea syndrome and healthy individuals had lower physical activity levels. Physical activity counseling is an important strategy for increasing the physical activity of patients with obstructive sleep apnea syndrome and healthy individuals during and after the coronavirus disease 2019 pandemic. [ABSTRACT FROM AUTHOR]

Objective: Studies emphasize the importance of nutritional support in pancreatic cancer patients with malnutrition and suggest that immunonutrition products reduce postoperative morbidity compared to standard products. In this study, we evaluated the effect of standard nutritional support and immunonutrition on surgical site infection and postoperative length of hospital stay in patients undergoing pancr eatic oduod enect omy for malignancy. Methods: Patients who underwent pancr eatic oduod enect omy between 2018 and 2022 were divided into 3 groups: those who received no nutritional support, those who received standard nutritional support, and those who received immunonutrition. Patients' age, gender, body mass index, weight loss, Nutritional Risk Screening-2002 score, preoperative prealbumin and albumin values, whether they received nutritional support or not, the period of nutritional support use and whether standard nutritional support or immunonutrition was applied, postoperative surgical site infection development and length of hospital stay were evaluated. Results: The study included 114 patients, 66 of whom were male. The mean age of the patients was 63.8 ± 10.45 years, the mean body mass index was 26.53 ± 5.29 kg/m2, and the median Nutritional Risk Screening-2002 score was 4 (2-6). Weight loss was observed in 57% of the patients. Of the 65 patients with weight loss, 14 (21.5%) did not receive nutritional support. In total, 49 patients received immunonutrition. There were 31 patients in the no nutritional support group. When the groups were compared, the difference in the incidence of surgical site infection was significant (P = .030). However, there was no difference between the groups regarding length of hospital stay (P = .147). When the groups were compared among themselves, there was no difference in surgical site infection between the standard nutritional support or immunonutrition groups (P = .128). In those with weight loss, surgical site infection was highest in the no nutritional support group with 71.4%, while it was 23.3% and 23.8% in the immunonutrition and standard nutritional support groups, respectively (P = .004). Length of hospital stay was similar. In those without weight loss, there was no difference between the groups regarding surgical site infection and length of hospital stay (P = .057, P = .271, respectively). Conclusion: In malnourished or at risk of malnutrition patients undergoing pancr eatic oduod enect omy for periampullary site malignancy, nutritional support positively affects the development of surgical site infection, whereas specifically, immunonutrition does not reduce postoperative surgical site infection or length of hospital stay. [ABSTRACT FROM AUTHOR]

Objective: The evaluation of the morphometric features of the Achilles tendon with magnetic resonance imaging is an essential aspect of musculoskeletal imaging, with significant implications for the diagnosis and management of Achilles tendon injuries. The aim of this study is to investigate the morphology of the Achilles tendon in normal and healthy individuals and establish a standard value using specific measurement techniques. Methods: The sagittal images were used to compute the free Achilles tendon length between the most distal portion of the soleus muscle fibers and the proximalsuperior calcaneal insertion of the Achilles tendon. On the axial images, the most distal portion of the soleus muscle fibers was identified, and the free Achilles tendon length was measured between this location and the Achilles tendon's most distal calcaneal insertion. In the axial section, the thickest portion of the unrestricted portion of the Achilles tendon in the anteroposterior plane was measured. The distance between the point at which the Achilles tendon attained its maximum thickness and its proximal insertion into the calcaneus was measured. Results: The thickest portion of the unconstrained portion of the Achilles tendon, known as the APM distance, was measured to be 5 ± 0.2 mm in the anteroposterior plane. The MKPM distance, which is the distance from the point where the Achilles tendon reaches its maximal thickness to the proximal insertion of the calcaneus, was measured to be 18.4 ± 4.7 mm. Conclusion: Future research should aim to expand our understanding of the factors influencing Achilles tendon morphology and their impact on tendon health and injury risk. Such knowledge can inform the development of personalized strategies for the prevention, diagnosis, and treatment of Achilles tendon disorders. [ABSTRACT FROM AUTHOR]

Post-cholecystectomy bile duct injury treatment is always challenging for the surgeon. In order to perform endoscopic treatments, it is necessary to pass through the stricture site with a guide wire. The Rendezvous technique and single-operator cholangioscopy are used for this purpose. Magnetic compression anastomosis is a novel minimally invasive treatment for biliobiliary or bilioenteric anastomosis in a situation where the guide wire cannot be passed. However, there are only a few case reports regarding magnetic compression anastomosis usage in human, especially in biliary stricture after cholecystectomy. This case showed that the magnetic compression anastomosis is an alternative nonsurgical method for reconnecting the internal biliary pathway after a failed conventional method. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the knowledge, attitude, and anxiety levels of healthcare workers in Turkey and South Africa and to determine the possible factors associated with anxiety. Methods: A cross-sectional study with 864 healthcare workers in Turkey and South Africa was conducted during May 1-October 30, 2020. The questionnaire included sociodemographic, individual, work-related, and about coronavirus disease 2019 questions. Anxiety was measured with the Beck Anxiety Inventory. Results: A total of 864 people answered the questionnaire, 527 from South Africa and 337 from Turkey. Healthcare workers in both countries have mild anxiety levels, and the median value of the Beck Anxiety Scale score was significantly higher in the participants from South Africa (10) than the participants in Turkey (8) (P = .004). Compared to Turkey, the risk of moderate/severe anxiety was 1.56 times higher in South Africa. Female gender, duties out of work definition, difficulties of chronic illness management, difficulties in accessing the treatment of mental health problem, living with a person who is older than 65 or has a comorbidity, and personal protective equipment support were found to be associated with moderate/severe anxiety (P < .05). Conclusion: In order to reduce the mental health impact on healthcare workers, pandemic readiness plans must take into account working hours and workload, adequate personal protective equipment supply, and measures to provide psychological support to healthcare workers, especially those with pre-existing mental health illnesses. [ABSTRACT FROM AUTHOR]

Uterine prolapse represents the herniation of the uterus into or beyond the vagina as a result of failure of the sustaining ligaments and of the fascia that supports it. When it coexists with prolapse of the vaginal walls, involving the bladder it is called uterine prolapse associated with cystocele and when it coexists with prolapse of the rectum is called uterine prolapse associated with enterocele. The prevalence of the pelvic organ prolapse is uncertain, previous studies showing a prevalence between 2.9% and 41% of women. The following case is that of a 63-year-old patient who required a multidisciplinary approach given the complexity of the case, the comorbidities associated with the pathology and the patient’s personal pathological history [ABSTRACT FROM AUTHOR]

The authors here reviewed the neurosurgical treatment and neuromodulation techniques used for writer’s cramps. The basic aim of this review is to shed a light on the current and previous research done for treating writer’s cramp. Surgical treatments and deep brain stimulation has been examined in many trials, with positive results. However, sample sizes in the studies were not large, and higher sample sizes in future studies may help researchers better understand how these treatments work in writer’s cramps. Furthermore, procedures are frequently required to alleviate writer’s cramps incapacitating effects. Although research has shown that many neurorehabilitation and neuromodulation procedures are effective, most of the studies that evaluated these types of techniques had small sample sizes, limiting their widespread adoption. It is important to remember that these therapies necessitate a personalized approach. There is a requirement for multiple trials with the incorporation of various techniques to determine one treatment method that is most reliable and safe for a patient. Surgical treatments for treating writer’s cramps such as magnetic resonance-guided targeted ultrasonic thalamotomy, is good for patients suffering from extreme disabling effects, but it comes with the expense of severe side effects. Recent research on neuromodulation, behavioral methods, and sensorimotor training in the treatment of writer’s cramps has yielded encouraging results with few adverse effects, but more research is needed before these interventions can be adopted in practice. [ABSTRACT FROM AUTHOR]

Klingsor Syndrome has been defined as a self-mutilative behaviour to genital organs, which is rare but can be accompanied by serious complications, and is often accompanied by psychotic symptoms. In the literature, risk factors of Klingsor syndrome are found as having commanding type auditory hallucinations, religious delusions, personality disorders, history of suicidal attempt, thoughts of guilt related to sexual conflicts, depressive features, and severe childhood deprivation. In this paper, our aim is presenting the clozapine response of a patient with schizophrenia, who had recurrent suicidal attempts, and performed genital self mutilation due to commanding type hallucinations. In this patient with severe self-mutilative behavior, and a history of multiple suicidal attempts, it was observed that parasuicidal thoughts regressed, self-mutilative behavior, and thoughts did not recur during the 28-week follow-up period. Recognition of risky patients, and taking precautions for this, treatment of psychotic symptoms and performing anatomical repair in terms of surgery are important for prognosis of these type of cases. [ABSTRACT FROM AUTHOR]

Objective: Ventricular extrasystole is one of the most common rhythm disorders in children, and almost all of them are characterized by normal cardiac functions without structural cardiac abnormalities. The aim of this study was to assess the clinical course of ventricular extrasystole in children who did not have cardiac structural abnormalities. Materials and Methods: This retrospective study analyzed 24-hour rhythm Holter recordings performed in our clinic in children. Patients diagnosed with isolated ventricular extrasystole in Holter records and without structural heart disease on echocardiography were included in the evaluation. Results: A total of 20 160 Holter results were evaluated in the study, and 226 patients (male; 66%) met the criteria. The mean follow-up time was 8.7 ± 3.2 years. While 81.8% of the patients were asymptomatic, the most common symptom was palpitation and 5 patients had syncope. Of the patients, 72 (31.8%) received medical therapy. Beta-blockers were the most often prescribed medication. Cardiomyopathy did not develop in any of the patients during the followup period. A partial reduction in the frequency of ventricular extrasystole was observed in 42% of the patients, while complete recovery was observed in 22%. Conclusion: Ventricular extrasystole in children generally has a good prognosis; most of them are asymptomatic, and the rates of spontaneous regression over time are quite high, regardless of the origin. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most common nutrient deficiency in the world. Epidemiological data indicate that iron deficiency is more prevalent in infants, in preschool-children, and in adolescents. Etiologies of iron deficiency in children include inadequate dietary iron intake, which is the most common cause, as well as increased iron requirements, bleeding, and intestinal iron absorption disorders. Iron deficiency can lead to symptoms related to anemia, may interfere with neurodevelopment and may cause skin, hair, nail, and gastrointestinal problems. This review focuses on the causes, signs, symptoms, diagnosis and management of iron deficiency in infancy, childhood, and adolescence. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the role that serum vitamin D concentration plays in the number of eosinophils in peripheral blood in adults with allergic asthma. MATERIAL AND METHODS: A total of 142 patients were categorized based on different cutoff points for eosinophils: =200, =300, =400, and =500 cells/mL. The vitamin D concentration was stratified into <20 and =20 ng/mL. The association between vitamin D (independent variable) and eosinophils (dependent variable) was explored using multivariate analysis. RESULTS: The average number of eosinophils in the included patients was 418 cells/mL, and 33.8% of the included patients had vitamin D concentrations =20 ng/mL. Asthmatic patients with vitamin D< 20 ng/mL had a higher mean concentration of eosinophils than did asthmatic patients with vitamin D =20 ng/mL (464 ± 377.7 eosinophils/mL vs. 327.8 ± 247.2 eosinophils/mL, P = .025). We also observed that vitamin D was inversely correlated with eosinophil count (rho = 0.244, P = .003). In the multivariate analysis, vitamin D <20 ng/mL showed a significant inverse association with each cutoff value for eosinophilia (odds ratio >1). CONCLUSION: Vitamin D concentrations <20 ng/mL are associated with a significant increase in the number of eosinophils in blood. Studies that analyze the use of vitamin D supplements as complementary therapy for the treatment of asthma are needed. [ABSTRACT FROM AUTHOR]

Objective: Visceral adipose tissue performs an important role in the development of atherosclerotic cardiovascular disease. Expressing its close association with epicardial adipose tissue simplifies the understanding of visceral adipose tissue in terms of atherosclerotic cardiovascular disease risk and facilitates the implementation of necessary lifestyle changes. In this study, we aimed to explore the relationship between epicardial adipose tissue and visceral adipose tissue proxies such as visceral fat rating, visceral adiposity index, and lipid accumulation product index as well as anthropometrics and lipid profile. Methods: This cross-sectional study involved 244 participants (131 female, 113 males), aged 18-83 years without established atherosclerotic cardiovascular disease and diabetes mellitus. Epicardial adipose tissue was measured by transthoracic echocardiography. Visceral fat rating, total body fat percentage, and mass were assessed by a bioimpedance analyzer. Mathematical formulas calculated the visceral adiposity index and lipid accumulation product index. Demographic, clinical, and biochemical information of the participants was provided from the hospital's data system. Homeostasis model assessment of insulin resistance -insulin resistance was calculated using fasting insulin and glucose. Results: Epicardial adipose tissue was significantly correlated with the visceral fat rating, visceral adiposity index, lipid accumulation product index, age, body weight, body mass index, waist circumference, waist-to-height ratio, waist-to-hip ratio, total body fat percentage and mass, systolic blood pressure, diastolic blood pressure, fasting glucose, hemoglobin A1c, insulin, homeostasis model assessment of insulin resistance, total cholesterol, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol, and cigarette smoking. Multivariate regression analyses revealed that age (β = 0.036, P = .001), visceral fat rating (β = 0.221, P < .001), systolic blood pressure (β = 0.033, P < .001), diastolic blood pressure (β = -0.048, P < .001), and cigarette smoking (β = 0.042, P < .001) were independent variables related to epicardial adipose tissue. Conclusion: Epicardial adipose tissue is associated with cardiovascular disease risk factors and indices of visceral adiposity in people without established atherosclerotic cardiovascular disease and diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objective: A healthy diet is a major component of lifestyle management for maintaining optimum health. Dietary carbohydrates may induce inflammation and oxidative stress. We aimed to assess the relationship between adherence to a low-carbohydrate diet pattern with oxidative stress status and a panel of blood biomarkers of inflammation in healthy young women. Methods: In this study, 171 healthy young women participated. We estimated the low-carbohydrate diet scores using a food frequency questionnaire. The total antioxidant capacity and free radical scavenging activity and malondialdehyde of serum and urine were quantified using the ferric reducing/antioxidant power, a, a-dip henyl -ß-pi crylh ydraz yl, and formation of thiobarbituric acid reactive substances methods. Several routine hematological parameters were measured including white blood cells, neutrophil counts, and mean platelet volume. Neutrophil:lymphocyte ratio and platelet:lymphocyte ratio were derived from these measures. Results: A higher low-carbohydrate diet score indicates a lower intake of carbohydrates and fiber and a higher intake of protein and fat. A greater adherence to a low-carbohydrate diet pattern was related to a lower level of hematological inflammatory indices including neutrophil count and neutrophil:lymphocyte ratio. Multivariable-adjusted odds ratios (95% CIs) demonstrated that a higher adherence to low-carbohydrate diet (third vs. first tertile) was associated with significantly higher levels of urinary a, a-dip henyl -ß-pi crylh ydraz yl (adjusted odds ratio = 1.10; 95% CI: 1.02-1.20), as well as serum ferric reducing/antioxidant power (adjusted odds ratio = 1.05; 95% CI: 1.01-1.011) and a, a-dip henyl -ß-pi crylh ydraz yl (adjusted odds ratio = 1.21; 95% CI: 1.11-1.33). Conclusions: A greater compliance with a low-carbohydrate-style diet was related to lower levels of inflammatory biomarker and oxidative stress in healthy young women. [ABSTRACT FROM AUTHOR]

KNX is a widely used organization in the world that standardizes the open system communication protocol for smart home and building automation. KNX controls integrated functions such as heating, cooling, ventilation, lighting systems, audio and video services, security, and energy management in all types of residential, commercial, and industrial building structures. KNX power supply is designed to ensure the continuous operation of these automation systems by considering the number of devices connected to the system. According to the KNX standards, in devices that are compliant with these standards, the main current and communication signals required for the operation of the devices use the same line. Conventional power supplies cannot cope with these standards and therefore special power supplies are required. In this study, a high-frequency (100 kHz) and high-efficiency (minimum 85%) flyback converter-based power supply with 155-265 VAC input and 30 V 640 mA output values in accordance with KNX standards has been designed and implemented. [ABSTRACT FROM AUTHOR]

The electric meters used to measure the amount of electricity consumption measure both active and reactive power consumption in the distribution line with current transformers. As in every analog measurement process, in every analog measurement, existing of undesired components such as noises, interferences and harmonics are caused mistakes. In order to remove this undesirable information included in the measurement from the measurement results, digital filters are used in applications because of their performance and their easily replaceable features. In this study, we aimed to remove unwanted components such as noise and interference from the measurement signal. The subject of a commercial project is to design a digital filter in MATLAB® environment, which allows filtering the measurements of reactive power consumption in power distribution lines with less than 1% error. To ensure whether designed filter satisfies for mentioned criteria or not, we used the Gaussian model as a noise model because Gauss noise is spreaded whole frequency spectrum. While the power signal modeled in the design is a sine wave of IPP = 2 A 50 Hz, Gaussian noise with different variances and mean values is used in modeling the unwanted components. [ABSTRACT FROM AUTHOR]

Introduction: Somatoform and psychosomatic disorders have long been associated with cardiovascular disease. We examined in a 16-year population the full range of mental, biomedical, and biophysical, temporal hyper-morbidity associated with cardiovascular system diseases. The analysis introduces a novel approach to big-data representation in terms of presenting across dependent groupings the frequency that diagnoses are made within individuals for the full range of independent diagnoses. Methods: The study employed a 16-year population sample of, the diagnoses of 768 460 individuals (54% female), to examine the full range of international classification of disease diagnoses associated with cardiovascular disease employing odds ratios and proportions to compare within and between groups and temporal differences for the full range of international classification of disease diagnoses for each sex. Results: Overall and temporal differences were observed across age within both the main classes and the full range of international classification of disease diagnoses for each sex. Comparing the groups with and without cardiovascular disease, the diagnosis frequency ratios of biomedical and biophysical morbidity associated with mental disorders preceding cardiovascular disease at younger ages were greater than the ratio of biomedical and biophysical morbidity without mental disorders preceding cardiovascular disease. Conclusions: The integration into psychiatric and general education and practice of the consideration of a psychosomatic or somatoform diagnosis, especially in relation to circulatory diseases, also requires examination of the full range of associated biomedical and biophysical diagnoses, as well as the history of the temporal order of biomedical and biophysical disease manifestation within the presenting individual that references population norms. [ABSTRACT FROM AUTHOR]

Background: Nano-biomaterials have transformed traditional medicine and are now considered an essential part of modern medicine. The present systemic review aimed to highlight the scope of silver nanoparticles in periodontal and peri-implant wound healing with special emphasis on its antibacterial effects in the management of periodontal and peri-implant infection in in vitro and in vivo animal studies. Methods: A computer search of electronic databases, mainly PubMed, was conducted with a combination of keywords. The investigation was limited to studies discussing the effects of silver or silver nanoparticles in periodontal regeneration and perio donta l/per i-imp lant healing and/or disease. Results: The search resulted in 1566 articles of potential interest. Twenty-one articles were included in the systematic review for analysis. Although with considerable methodological limitations, the in vitro and in vivo animal studies noted high antibacterial properties of silver nanoparticles without any toxic effects on the cellular structure. In vitro and in vivo small-animal studies have demonstrated the safety and antimicrobial efficacy of AgNPs in periodontal and peri-implant wound healing. However, the therapeutic potential of AgNPs in clinical situations has not been explored. Conclusion: There is a need to establish animal models that are closer in soft and hard tissue response to humans to verify the safety and efficacy of silver nanoparticles. Owing to the potential risk of antimicrobial resistance with the contemporary antibiotics, unconventional therapeutic regiments, like silver nanoparticles, that are safe and have high antimicrobial efficacy should be tried as an adjunct in the management of periodontal and peri-implant therapy. [ABSTRACT FROM AUTHOR]

Objective: Primary osteoporosis is a rare and essential problem in childhood that can cause severe skeletal deformities. We aimed to reveal the spectrum of primary osteoporosis and assess the effectiveness and safety of bisphosphonates in increasing bone mineral density and reducing fractures. Materials and Methods: Patients with primary osteoporosis who received at least one course of pamidronate or zoledronic acid were included in the study. Patients were divided into 2 groups, osteogenesis imperfecta and non-osteogenesis imperfecta subjects. We evaluated bone densitometer parameters, activation scores, pain status, deformity status, and the number of fractures per year in all patients. Results: Of the 31 patients, 21 with osteogenesis imperfect, 3 patients with spondyloocular syndromes, 2 with Bruck Syndrome, and 5 with idiopathic juvenile osteoporosis were included. A total of 21 patients had received pamidronate treatment, while only 4 received zoledronic acid, and 6 of them switched from pamidronate to zoledronic acid. At the end of the treatment, the mean bone mineral density height-adjusted Z-score increased from −3.39 ± 1.30 to −0.95 ± 1.34. The number of fractures per year decreased from 2.28 ± 2.67 to 0.29 ± 0.69. The activation score increased from 2.81 ± 1.47 to 3.16 ± 1.48. The pain decreased significantly. There was no difference in bone mineral density increase in patients treated with pamidronate or zoledronic acid. Conclusion: Those with osteogenesis imperfecta were diagnosed at an earlier age with severe deformity and fractures. Pamidronate and zoledronic acid increased bone mineral density in all types of primary osteoporosis. [ABSTRACT FROM AUTHOR]

Objective: Brain tumors in childhood carry a high risk for endocrine disorders due to the direct effects of the tumor and/or surgery and radiotherapy. Somatotropes are vulnerable to pressure and radiotherapy; therefore, growth hormone deficiency is one of the most frequent abnormalities. This study aimed to evaluate endocrine disorders and recombinant growth hormone treatment outcomes in brain tumor survivors. Materials and Methods: In this study, 65 (27 female) patients were classified into 3 groups as craniopharyngioma (n = 29), medulloblastoma (n = 17), and others (n = 19). “Others” group included astrocytoma, ependymoma, germinoma, pineoblastoma, and meningioma patients. Anthropometric data and endocrine parameters of patients and their growth outcome with/without recombinant growth hormone therapy were collected from medical records, retrospectively. Results: Mean age at the first endocrinological evaluation was 8.7 ± 3.6 years (range: 1.0- 17.1 years). Height, weight, and body mass index standard deviation score, mean ± standard deviation (median) values were −1.7 ± 1.7 (−1.5), −0.8 ± 1.9 (−0.8), and 0.2 ± 1.5 (0.4), respectively. Hypothyroidism (central 86.9%, primary 13.1%) was detected during follow-up in 81.5% of patients. Primary hypothyroidism in medulloblastoma (29.4%) was significantly higher compared to other groups (P = .002). The frequency of hypogonadotropic hypogonadism, central adrenal insufficiency, and diabetes insipidus was significantly high in the craniopharyngioma cases. Conclusion: In our study, endocrine disorders other than growth hormone deficiency were also frequently observed. In craniopharyngioma cases, the response to recombinant growth hormone therapy was satisfactory. However, there was no improvement in height prognosis during recombinant growth hormone therapy in medulloblastoma patients. A multidisciplinary approach to the care of these patients, referral for endocrine complications, and guidelines on when recombinant growth hormone therapy is required. [ABSTRACT FROM AUTHOR]

Objective: Nasal polyposis is a chronic inflammatory disease of the paranasal sinuses, for which the physiopathology is not fully understood. The aim of this study was to evaluate whether or not there was a change in the Lund--Mackay scores of computed tomography scans repeated preoperatively in patients with nasal polyposis. Methods: The study included 34 patients diagnosed with nasal polyposis between January 2016 and July 2023 with an indication for endoscopic sinus surgery. Computed tomography (CT) scan slices at 3 mm intervals in axial and coronal planes of all the patients were examined. Nasal polyposis was evaluated with the Lund--Mackay CT score. Separate scores for the right and left side of the nose were calculated, as was the total score. Results: As a result of the preoperative CT examinations, the mean time between the 2 CT scans was found to be 22.3 months. No statistically significant difference was determined in the Lund--Mackay CT scores of the first and second CT scans. Conclusion: Based on the absence of difference in the preoperative CT scores of the patients with nasal polyposis, taking a second CT close to the time of surgery can be said to be unnecessary. [ABSTRACT FROM AUTHOR]

The article discusses the increasing use of Musculoskeletal Ultrasound (MSKUS) in the field of rheumatology. Rheumatologists are showing a growing interest in MSKUS, and it has become a valuable tool in diagnosing and monitoring conditions such as rheumatoid arthritis and psoriatic arthritis. Training programs on MSKUS skills are being offered by various rheumatology associations and societies. The article also highlights the use of ultrasound beyond joints and tendons, such as in the diagnosis of lung diseases and crystal deposition diseases. The authors emphasize the importance of MSKUS in improving diagnostic accuracy and patient care. [Extracted from the article]

An introduction is presented in which the editor discusses various reports within the issue on topics including research papers related to Neutrophil/Lymphocyte Ratio in COPD, Chronic Thromboembolic Pulmonary Hypertension and Respiratory Disability.

AIM: The aim of this study was to describe the research output of African's nurses in the field of palliative care from January 1, 2012 to December 31, 2021. METHODS: A scoping review was conducted. The key words Africa and nursing in combination with palliative care, end of life, terminal care, hospice, and supportive care were used to search the databases Cumulative Index to Nursing and Allied Health Literature, PsychINFO, PubMed, Scopus, and Web of Science. Only studies authored by a nurse with an African affiliation focusing on issues related to advanced cancer were included. The data were captured onto an extraction sheet and analyzed by means of descriptive statistics and content analyses. RESULTS: Of the 522 articles identified, only 16 met the inclusion criteria. The work originated from eight African countries was primarily qualitative and focused on the family and caregivers. Pain was the only symptom investigated. CONCLUSIONS: Studies focusing on symptoms, psychosocial, spiritual, end of life care as well as studies testing nursing interventions are urgently needed. Interregional research could also assist with building the current evidence. [ABSTRACT FROM AUTHOR]

Confirmation of the placement of the nasogastric tube is essential to ensure safe feeding without the risk of aspiration, pneumonia, and pneumothorax that may occur due to incorrect placement of the nasogastric tube. The risk of incorrect placement of the nasogastric tube may increase in the high-risk patient group, especially with some factors such as decreased consciousness, weak gag reflex, intubation, mechanical ventilation, and sedation. In addition to the problems that may occur during the initial placement of the nasogastric tube, displacement of the nasogastric tube may occur during the enteral feeding process. For this reason, tube placement should be checked regularly in order to minimize the complications of enteral nutrition. Although there are some advantages and limitations of the methods used to determine the location of the nasogastric tube, it is seen that there is no standard practice on this subject in clinics. The aim of this review is to summarize the commonly used methods for the initial placement of the nasogastric tube and the confirmation of the tube position during the feeding process and to summarize the advantages and limitations of these methods. [ABSTRACT FROM AUTHOR]

Objective: This study was done to investigate the causal links between malocclusion, tongue tone, and jaw structure and the initiation of apneic/hypopneic events during sleep. Structural causes of strain on the lips and downstream tongue collapse were tested using physical models. Methods: Distinct models were used to break down the sequence of apneic events. First, the establishment of the lips as a resting closure mechanism of the mouth was tested. Next, a tongue tone model was used to determine the force required to prevent collapse into the pharynx. Finally, a pharyngeal model was used to evaluate differential negative pressure zones during collapse. Results: The lips may be the primary closure structure of the mouth due to mechanical advantage. The least radial strain placed on the lips permitted better mouth closure. There is a threshold that is required to maintain oral position of the tongue without collapse and resultant buildup of pharyngeal negative pressure. Conclusions: Apneic/hypopneic events can be simplified to 3 steps: (1) failure of mouth closure due to strain upon the lips, (2) release of tongue restraint by oral compression or intrinsic tongue tone causes collapse, and (3) partial or complete tongue collapse into the pharynx causes a distal negative pressure surge. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to assess a possible association between allergic rhinitis and asthma and surgical management of chronic rhinosinusitis. Methods: A retrospective study was carried out to review the clinical charts of adult patients who underwent functional endoscopic sinus surgery as a surgical treatment for chronic rhinosinusitis. Data regarding clinical symptoms, endoscopic findings, and radiological findings were considered. Results: The studied population included 74 patients. An average Lund-Mackay score of 10.59 ± 5.427 was identified with no statistically significant difference between the presence or absence of allergic rhinitis or asthma. There was a statistically significant association between the presence of sneezing attacks, nasal itching, and hyposmia before surgery and the presence of asthma previously diagnosed. There is no statistically significant difference between the Lund-Mackay score before the surgery or the presence of nasal polyposis, asthma, or allergic rhinitis. Overall, we verified a reduced prevalence of symptoms after functional endoscopic sinus surgery with no difference between the groups with and without allergic rhinitis or asthma. Conclusions: There was a statistically significant association between the presence of sneezing attacks, nasal itching, and hyposmia before surgery and the presence of asthma previously diagnosed. We did not find a statistical difference between the degree of regression of nasal polyposis in the sub-samples of patients with allergic rhinitis or asthma. Our findings are also in line with the literature which shows that symptoms improved significantly in both asthmatics and non-asthmatics postoperatively. [ABSTRACT FROM AUTHOR]

Objective: Laryngopharyngeal reflux is a frequent medical condition affecting about 1/3 of the general population. Also, laryngopharyngeal reflux may involve the ocular surface. Dry eye disease is also a common disorder affecting any age. Dry eye disease is a multifactorial disease sustained by different causes. Methods: We reviewed the most recent evidence about the relationship between laryngopharyngeal reflux and eye. Results: There is documentation that pepsin may be detectable in the tears of laryngopharyngeal reflux patients. Notably, pepsin is produced only in the stomach, so it is a biomarker of gastric reflux. There is also the demonstration that patients with dry eye disease may have frequent laryngopharyngeal reflux comorbidity, and dry eye disease severity is associated with high odds of laryngopharyngeal reflux comorbidity. In addition, a preliminary trial suggested that treating also laryngopharyngeal reflux in dry eye disease patients with gastric reflux could be a promising strategy. As a result, it is conceivable to imagine that eye reflux could be a new nosologic entity. It seems reasonable to recommend that the management of laryngopharyngeal reflux patients should include the investigation of possible ocular comorbidity. Conclusions: Laryngopharyngeal reflux and dry eye disease are 2 common diseases that not rarely can be associated together. Thus, careful attention to these disorders should be paid to in clinical practice by otolaryngologists visiting patients with laryngopharyngeal reflux. [ABSTRACT FROM AUTHOR]

The ocular inflammatory process may be associated with autoimmune inflammatory joint damage and can be better recovered by B-mode ultrasound, being little explored in the absent eye evaluation. This study aimed to conduct a systematic review using the Patients or Problem, Intervention, Control or Comparison, Outcomes strategy: uveitis; ultrasound, arthritis, and diagnosis. Clinical trials, meta-analysis, and randomized controlled trials that specifically address the scope of this study will be evaluated. For the search in the database, a choice of controlled vocabulary will be used with the MEDLINE MeSH platform (Medical Subject Headings). The articles must be dated from the year 2010 until the year 2020. To charting methods will be used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Flow Diagram and risk of bias: the Cochrane risk of bias tool. Grade of recommendation assessment: Grading of Recommendations Assessment, Development, and Evaluation Group guidelines. Of 2909 studies, only 13 studies were included, which evaluated the use of B-mode ultrasound to assess anterior and intermediate uveitis and complications, and 5 cases showed an association of vitreitis. B-mode ultrasound can be an important benefit of complementing clinical evaluation in patients with the uveal inflammatory process associated with several autoimmune arthropathies, but more studies with better-elaborated methodology design will be necessary. [ABSTRACT FROM AUTHOR]

Objective: Sarcoidosis is a systemic inflammatory disease. Fibromyalgia is a chronic disease that is characterized by widespread musculoskeletal pain, muscle tenderness, fatigue, sleep disturbances, and depression. Fatigue is an integral part of the clinical picture of sarcoidosis. Fatigue and pain are the frequent symptoms in fibromyalgia patients as well as patients with sarcoidosis. This study seeks to determine the prevalence of fibromyalgia, pain, depression, and quality of life in patients with sarcoidosis. Methods: Between January 2015 and June 2015, 39 sarcoidosis patients were included. Patients were evaluated using the Fatigue Severity Scale, fibromyalgia impact questionnaire, Beck’s Depression Inventory, and visual analog scale. The groups with and without fibromyalgia were compared with each other. Results: Fibromyalgia prevalence in sarcoidosis patients is determined to be 43.6% (17/39). Evaluation parameters such as Fatigue Severity Scale, fibromyalgia impact questionnaire, and Beck’s Depression Inventory are statistically significant in fibromyalgia group. Conclusion: The main reason of pain, fatigue, and depression in sarcoidosis patients might be fibromyalgia. If fibromyalgia is considered and diagnosed in the presence of these symptoms, this can help us manage our patients more successfully. [ABSTRACT FROM AUTHOR]

To provide guiding principles to deliver high-quality treatment with implantable bone conducting hearing devices and to guarantee the best possible outcomes for each patient in Belgium. A consensus meeting was convened on March 26, 2019, including surgeons and audiologists from different bone conducting hearing devices hospitals and fitting centers in Belgium, and an independent moderator. First, different care models for treatment with bone conducting hearing devices, currently applied in Belgium, were identified and discussed. It was agreed that bone conducting hearing devices surgery and fitting should be provided by clinicians with adequate training and experience and that bone conducting hearing devices care should be centralized as much as possible. Preferably sound processor fitting is carried out within the bone conducting hearing devices hospital or at a specialized fitting center outside the hospital. In any case, a close interdisciplinary collaboration between both the bone conducting hearing devices surgeon and the bone conducting hearing devices audiologist was considered critical to ensure good patient outcomes (e.g., to facilitate appropriate treatment in the event of complications). Second, general guidelines were debated and agreed upon to improve the quality of care for the different phases of the patient journey (referral, assessment, treatment, and follow-up). Providing a standard of care means that every person, regardless of the type or degree of hearing loss, the region in which they reside and the healthcare professional they see, has access to a standardized assessment and treatment process, resulting in the most efficient hearing solution for his or her indication. This consensus statement was a first step towards a more standardized approach for treatments with bone conducting hearing devices in Belgium. [ABSTRACT FROM AUTHOR]

To analyze and assess the safety and efficacy of dupilumab as an adjuvant treatment for chronic rhinosinusitis with nasal polyposis. Two authors independently searched 6 databases from inception until May 2021. We included and analyzed studies comparing dupilumab-treated (dupilumab) and placebo-treated (control) groups. The risk of bias was evaluated using the Cochrane Risk of Bias tool. Three studies, including 784 participants, were included. The dupilumab group showed significantly improved laboratory markers in serum and nasal secretions compared to the control group except for serum eosinophils. In addition, dupilumab showed higher efficacy for olfactory symptoms, disease-related symptoms (nasal congestion, sinusitis symptom severity, nasal polyp score), and radiologic findings (computed tomography score). However, there were no significant differences in treatment-related morbidities between the 2 groups. According to a meta-analysis of studies reporting laboratory and clinical results, dupilumab is a safe and effective treatment for patients suffering from chronic rhinosinusitis with nasal polyps. [ABSTRACT FROM AUTHOR]

Objective: An appreciation of the prevalence, correlates, and risk factors of suicidal thoughts and behaviors in Turkey may provide valuable knowledge for understanding the intersocietal variation of suicidal phenomena. In this report, we systematically reviewed the prevalence, correlates, and risk factors for suicidal thoughts and behaviors in Turkey. Methods: Relevant publications were identified by a literature search using Google Scholar, PubMed, PsycInfo, Scopus, and Web of Science. Results: Seventy-two studies were included. This review found evidence that variables such as poor problem-solving skills, coping strategies, hopelessness, childhood trauma, adverse life experiences, loneliness, lack of social support, family-related factors, anger, low self-esteem, attachment, substance use, and depression were associated with suicidal ideation and attempts. Despite this, reviewed studies showed incongruity in whether variables such as alexithymia, sleep quality, and obsessive symptoms were related to suicidal ideation and attempts. In addition, variables such as education, female gender, and reasons for living were only found to be associated with suicidal ideation. Conclusion: All the studies included in this review were from Turkey; therefore, the generalizability of the findings to other cultures or geographical contexts might be limited. This review did not include gray literature and studies on suicide death. The risk and correlated factors identified in this review can be included in comprehensive suicide screening and assessment administered by clinicians in Turkey. [ABSTRACT FROM AUTHOR]

Objective: The frequency of using the internet and social media increases in childhood, which leads to a decrease in physical activity. We aimed to investigate the effects of such technological applications on the internet and food addiction in obese and nonobese children. Materials and Methods: A total of 180 obese and 180 nonobese children were included in this study. Turkish version of the Parent-Child Internet Addiction Scale and Dimensional Yale Food Addiction Scale Version 2.0 for Children were applied. Results: The frequency of internet addiction in the sample was 1.7%. The mean internet addiction scores of males were found to be significantly higher than females (34.9 ± 20.6, 26 ± 17.2; P < .001). Children, who used the internet for information and homework had significantly lower internet addiction scores and food addiction scores, respectively (P = .002, P = .009). Watching movies, TV series, or sports events (P < .001, P = .009); following food recipes, campaigns, or advertisements (P = .04, P < .001); and eating snacks in front of the screen (P < .001, P < .001) were found to cause higher internet addiction scores and food addiction scores. It was observed that body mass index showed a positive and significant correlation with internet addiction scores and food addiction scores. Conclusions: Internet addiction and social media applications were found to be significantly related. Considering the relationship between body mass index and addiction, the effect of internet usage style and internet addiction and food addiction on obesity is striking. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the prognostic factors in a single-center pediatric cohort with autoimmune encephalitis. Materials and Methods: The study group consisted of 23 pediatric autoimmune encephalitis patients (seropositive autoimmune encephalitis: 15, seronegative autoimmune encephalitis: 8). Five group prognostic parameters were evaluated: clinical manifestations, electroenc ephalography features, magnetic resonance imaging characteristics, biomarkers, and treatment modalities. Three scoring models were applied: the Antibody Prevalence in Epilepsy and Response to Immunotherapy in Epilepsy for predicting autoimmune-related epilepsy in the whole cohort and the anti-N-methyl-d-aspartate receptor Encephalitis 1-Year Functional Status score for overall outcome in patients with anti-N-methyl-d-aspartate receptor encephalitis. Results: The initial clinical spectrum of the disease was similar in the seronegative and seropositive groups. Almost half of the patients (48%) recovered without any complications with first-line immunotherapy. The patients with movement disorders in the acute phase of the disease needed more likely second-line immunotherapy (P = .039). The presence of status epilepticus at admission was significantly associated with adverse outcomes and the development of autoimmune-related epilepsy (P = .019). Autoimmune-related epilepsy was defined in an equal proportion of patients (91.5%) with 2 immune epilepsy scores (Antibody Prevalence in Epilepsy and Response to Immunotherapy in Epilepsy). The N-methyl-d-aspartate receptor Encephalitis 1-Year Functional Status score and the modified Rankin score assessed for the first-year prognosis were strongly correlated among the patients with anti-N-methyl-d-aspartate receptor encephalitis (P = .03, Spearmen's rho = 0.751). Conclusions: The presence of status epilepticus was the most important prognostic factor in the patients with the adverse outcome. The studied scoring models (Anti-N-methyl-d-aspartate receptor Encephalitis 1-Year Functional Status, Antibody Prevalence in Epilepsy, and Response to Immunotherapy in Epilepsy) have also been proven to be applicable to the pediatric age group for predicting overall outcome and autoimmune-related epilepsy. [ABSTRACT FROM AUTHOR]

Objective: Hospitalization and the possibility of surgery are known as the main causes of anxiety in children, and anxiety is a natural physiological process in individuals that allows them to adapt and deal with a diversity of adverse conditions. The purpose of this research aimed to compare 2 methods of distraction including puzzle-solving and music on anxiety before pediatric surgery. Materials and Methods: This study is clinical trial research. First, 90 children 6 to 10 years old were randomly assigned to the intervention and control groups. In group A, the visual puzzlesolving items were presented, in group B, music with related pictures via a tablet was presented in the waiting room for surgery, and in group C, only standard care for each patient was presented. Anxiety before surgery was measured with a Children's Fear Scale questionnaire before moving the patient to the operating room, then 30 minutes before surgery in the pre-surgery waiting room, and the third stage immediately after transfer to the operating room before induction of anesthesia. Data were analyzed by one-way analysis of variance, chi-square test, and Tukey test using Statistical Package for the Social Sciences software version 21.0. Results: The results of this research showed that the levels of anxiety significantly improved in the intervention groups compared to the control group after the intervention (P < .001). Conclusion: Music and puzzle-solving as complementary therapy can improve the levels of anxiety in children before surgery. Therefore, this technique can be recommended to be used along with modern medicine in children. [ABSTRACT FROM AUTHOR]

Chronic inflammatory conditions including allergic, autoimmune, metabolic, and neuropsychiatric disorders are constantly increasing and leading to a high burden, especially in more industrialized countries. The prevalence is still on the rise in developing countries. The start of the steep increase in asthma, atopic dermatitis, and allergic rhinitis dates to the 1960s, whereas a second wave with an increase in eosinophilic gastrointestinal disease, food allergy, and drug hypersensitivity started after the 2000s. These diseases also started to appear more with neuropsychiatric and autoimmune conditions during the last few decades. Many theories have been proposed to explain this outbreak. The hygiene hypothesis was consolidated by "old friends" and biodiversity, although some gaps remained unresolved. The introduction of the epithelial barrier hypothesis gave us a new perspective to explain the effects of industrialization without environment control and health concerns creeping into our daily lives. The present review touches on the possible explanations of why epithelial barrier hypothesis covers all previous ones, which are not contradictory but mostly complementary. [ABSTRACT FROM AUTHOR]

The use of renewable energy sources (RESs) can ensure both lower cost of energy and improvement in voltage levels in the grid. Likewise, batteries can help achieve technical improvement and cost reduction. However, the full benefits of integrating RESs and batteries into the grid can only be realized by a suitable energy management system (EMS). In this work, a predictive EMS is developed to optimally operate a microgrid (MG) with photovoltaics and batteries while satisfying voltage constraints in the distribution grid. First, mathematical models of the MG components are obtained. Then, proper load flow method is selected for the network structure. Using component models and the load flow method, a day-ahead EMS is posed as an optimization problem. Since the power flow calculations are nonlinear, the optimization problem is constructed as a nonlinear program. Simulation studies are performed to analyze the sensitivity of the cost of operation and power loss in the grid, with respect to different system parameters. It is confirmed that the purchase price of electricity and the amount of photovoltaic panels were the most effective factors on the daily energy cost. [ABSTRACT FROM AUTHOR]

Due to the increasing energy demand and the climate crisis in the world, the importance of alternative energy generation techniques, which are clean and cheap, is increasing. Since renewable energy sources are clean and sustainable, their integration into the grids at transmission or distribution levels as distributed generation sources provides significant benefits both economically and environmentally. Rooftop solar panels are also an application of small-power renewable distributed generation technologies. In this study, the economic and environmental analysis of the rooftop photovoltaic system designed to increase the green energy usage rate and reduce the greenhouse gases released to the environment has been made. Considering the electricity consumption data and roof area of an office building of a factory located in the north of Turkey, solar radiation data obtained from three different sources such as the General Directorate of Meteorology, National Aeronautics and Space Administration, and Photovoltaic Geographical Information System were used during the analyses carried out in the Hybrid Optimization Models for Energy Resources program. By providing an annual average of 160 000 kWh (11%) clean energy generation, the annual release of pollutants such as 101.353 kg of carbon dioxide, 0.439 kg of sulfur dioxide, and 0.215 kg of nitrogen oxide to the environment has been prevented. [ABSTRACT FROM AUTHOR]