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Gynecological examination has an very place among to maintain women's health. Negative attitudes and anxiety about gynecological examination may affect coming to the examination. In this study, we aimed to determine the effect of online training and counseling on women's attitudes and anxiety toward the gynecological examination. We randomized 100 women participating in the study into experimental and control groups. We concluded that online training and counseling had a positive effect on the attitudes of women in the experimental group toward gynecological examination. Also we determined that online training and counseling reduced women's state anxiety toward gynecological examinations. In this study, we determined that online training and counseling positively improved women's attitudes toward gynecological examination. We also found that online training and counseling reduced women's state anxiety about gynecological examinations. In the literature, most of the studies on gynecological examination have a descriptive design. This study is important since it contributes to scientific knowledge in determining the attitudes and anxiety levels of women that may affect their status of undergoing gynecological examination. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to evaluate the relationship between toxoplasmosis and cryptogenic epilepsy (CE) by comparing the rate of Toxoplasma gondii seropositivity identified in CE patients with those without any neurological disorder. Methods: The study included 200 cryptogenic patients and 164 individuals without neurological disorders. T. gondii seropositivity was studied in individuals included in the study using the T. gondii-IgG ELISA kit. Results: The study found T. gondii IgG in 15.50% of CE patients and 28.66% of individuals without any neurological disorder. The difference between the two groups was determined to be statistically significant. Conclusion: Toxoplasmosis did not increase the risk of epilepsy in the region where this study was conducted. However, for a better understanding of the CE-T. gondii relationship, we believe that seroprevalence studies should be conducted in larger populations. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer (BC) is the most frequent cancer among women. Many BC patients suffer from sleep problems, which have a negative impact on their quality of life (QoL). Our study aims to investigate sleep problems in BC patients treated with active chemotherapy or in remission in comparison with a healthy control group (HCG), given the importance of sleep disorders and QoL. Materials and Methods: A multicenter, cross-sectional study was conducted. Four different surveys including sociodemographic characteristics questionnaire, Pittsburgh sleep quality index (PSQI), hospital anxiety and depression scale and The European Organisation for Research and Treatment of Cancer core quality of life questionnaire (QLQ-C30) were used to collect study parameters. Results: Of 164 participants, the mean age was 42.0±11.7 years. Overall PSQI median score for all participants was 6 points (range, 3-9 points). PSQI median value was higher in cancer patients compared to the control group, which were 6 points (range, 4-9 points), and 4 points (range, 3-7 points), respectively (p=0.004). The mean depression score was 5 points (range, 3-8 points) in BC patients, and 4 points (range, 2-6 points) in HCGs, respectively (p=0.025). Having BC diagnosis was an independent factor increasing the risk of bad sleep quality in compared to healthy controls (odds ratio: 2.568, 95% confidence interval: 1.169-5.645; p=0.019). Conclusion: There was a close association between poor sleep quality, depression and QoL scores in patients with BC. In patients with breast cancer, appropriate management of associated comorbidities will aid a better quality of life in these patients. [ABSTRACT FROM AUTHOR]

Children with disabilities and their families should receive education appropriate for the needs of children with disabilities in order for them to lead a more independent life. The aim of this study is to evaluate the effectiveness of the sexual health education given to the parents of children with disabilities aged 10–19. This study, which used an experimental design with a pre-test and post-test control group, was conducted with the parents of children with disabilities enrolled at the Kozlu Disabled Association in Kozlu, district of Zonguldak province. The sample of the study consisted of 47 parents who met the inclusion criteria. Parents were assigned to the experimental (n = 23) and control (n = 24) groups with the randomization method. The data of the study were collected using "Introductory Information Form", "Parental Self-Efficacy Scale" and "Knowledge Assessment Questionnaire". Sexual health education including 8 modules and lasting for 8 weeks was given to the parents in the experimental group once a week for 30–45 min. While the mean score of the Parental Self-Efficacy Scale of the experimental group was 55.50 ± 23.16 before the education, it increased to 97.17 ± 7.88 after the education, and a statistically significant relationship was found between the two measurements (p < 0.05). When the scores of the Knowledge Assessment Questionnaire of the experimental group were evaluated after the education, the sub-dimension scores of the Self-care Knowledge, Sexual Behavior Control Knowledge, Sexual Abuse Knowledge and Communication Knowledge were determined to be statistically significant (p < 0.05). It was concluded in the study that the sexual health education given to parents of children with disabilities was effective in increasing the level of parental self-efficacy and sexual health knowledge. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of exercises by mechanical hippotherapy devices on postural control, balance, mobility, and Quality of Life in patients with stroke. This was a randomized controlled clinical trial with a total of 30 which were randomly divided into two groups. The participants in the mechanical hippotherapy group (MHG) (n = 15) were given exercises with a mechanical hippotherapy device for 15 min in addition to intensive conventional treatments (45 min), while the control group (CG) (n = 15) received additional 15 min of postural control and balance exercises for five days per week for four consecutive weeks. The primary outcome was The Berg Balance Scale (BBS). Secondary outcomes were the Fugl–Meyer (FM) Rating Scale, Biodex Balance Measurement (BBM), Trunk Impairment Scale (TIS), the Timed Up and Go Test (TUG) and quality of Life Short Form (SF-36). In the MHG, FM-Lower extremity score (−6.4, p = 0.024), FM-Upper extremity score (−12.87, p = 0.013), TIS (−5.87, p = 0.04) and TUG (5.73, p = 0.027) improved statistically significant compared to CG. Exercises using mechanical hippotherapy devices could improve postural control, functional mobility and balance in patients with stroke. It may also improve the quality of life. NCT03528993 NCT03528993 It was concluded from our results that mechanical hippotherapy could be included in the treatment programs of stroke patients. [ABSTRACT FROM AUTHOR]

Objective: Helicobacter pylori (HP) is the most common bacterial infection in humans. Helicobacter pylori infection, which frequently increases with age, is seen in 30%-56.6% of children in Türkiye, although it varies by region. In this study, we aimed to determine the frequency of HP in children and adolescents who underwent upper gastrointestinal endoscopy and gastric biopsy in our region and to compare the changes over the years. Materials and Methods: Cases who underwent upper gastrointestinal endoscopy for various indications between 2007 and 2022 in our pediatric gastroenterology unit were included in the study. The clinical and endoscopic characteristics of 1737 cases whose histopathologic specimens were obtained, have been retrospectively analyzed from their records. The diagnosis of HP infection was based on the presence of HP on histopathologic examination of gastric biopsy specimens. Results: Of 1737 cases, 504 (29%) were HP positive. The HP positive case rates were 14.5%, 26.9%, and 33.6% in the 0-6, 7-12, and 13-18 age groups, respectively. H. pylori positivity was detected in 65.7% of patients with duodenal ulcers, and the relationship between duodenal ulcers and HP positivity was significant (P < .001). The average HP positivity rates were 44%, 28.6%, and 24.2% in 2007-2012 (group 1), 2013-2017 (group 2), and 2018-2022 (group 3). H. pylori positivity rates significantly decreased in years (P = .001/P = .056/P < .001). Conclusion: We found that the frequency of HP infection in children decreased in our region over the years. Helicobacter pylori positivity was higher in older than younger children. A decrease in HP frequency prevalence may be possible in parallel with awareness and socioeconomic development. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Latent tuberculosis infection (LTBI) screening is strongly recommended in the pre-transplant evaluation of solid organ transplant (SOT) recipients, although it remains inadequate in many transplant centers. We decided to investigate pre-transplant TB risk assessment, LTBI treatment, and registry rates in Türkiye. MATERIAL AND METHODS: Adult SOT recipients who underwent tuberculin skin test (TST) and/or interferon-gamma release test (IGRA) from 14 centers between 2015 and 2019 were included in the study. An induration of ≥5 mm on TST and/or probable/positive IGRA (QuantiFERON-TB) was considered positive for LTBI. Demographic features, LTBI screening and treatment, and pre-/post-transplant TB history were recorded from the electronic database of transplantation units across the country and pooled at a single center for a unified database. RESULTS: TST and/or IGRA were performed in 766 (33.8%) of 2266 screened patients most of whom were kidney transplant recipients (n = 485, 63.4%). LTBI screening test was positive in 359 (46.9%) patients, and isoniazid was given to 203 (56.5%) patients. Of the patients treated for LTBI, 112 (55.2%) were registered in the national registry, and 82 (73.2%) completed the treatment. Tuberculosis developed in 6 (1.06%) of 563 patients who were not offered LTBI treatment. CONCLUSION: We determined that overall, only one-third of SOT recipients in our country were evaluated in terms of TB risk, only 1 of the 2 SOT recipients with LTBI received treatment, and half were registered. Therefore, we want to emphasize the critical importance of pretransplant TB risk stratification and registration, guided by revised national guidelines. [ABSTRACT FROM AUTHOR]

Most studies on nursing students' awareness and knowledge of child abuse and neglect (CAN) report insufficient knowledge. However, there are limited studies evaluating the effectiveness of educational interventions. This study aimed to examine the effect of the Child Abuse and Neglect Awareness Program (CANAP) on nursing students on their CAN knowledge and awareness levels. A randomized controlled study was conducted between 21 May and 29 June 29, with 75 students, 40 in the experimental group and 35 in the control group, studying nursing at a foundation university in Turkey. While CANAP was applied to the participants in the experimental group, no intervention was applied to those in the control group. The data were collected in three stages (before the intervention, immediately after the intervention and 1 month after the intervention) using the Personal Information Form, Diagnosis Scale of the Risks and Symptoms of Child Abuse and Neglect (DSRSCAN) and Child Abuse and Neglect Awareness Scale (CANA‐S). Data were analysed using Chi‐square and Fisher exact tests, independent samples t test and repeated measures analysis of variance (ANOVA) test. The groups were homogeneous regarding the students' sociodemographic characteristics (p > 0.05). In the study, the mean DSRSCAN and CANA‐S scores of the groups were similar in the pre‐test before CANAP but increased significantly in the post‐test and re‐test (p < 0.05). All CANA‐S re‐test sub‐dimension mean scores of the experimental group were significantly higher than the control group (p < 0.05). The mean scores of the experimental group in the DSRSCAN physical symptoms of abuse on the child, characteristics of parents prone to abuse and neglect, characteristics of children at risk of abuse and neglect and familial characteristics in child abuse and neglect sub‐dimensions were significantly higher than the control group (p < 0.05). CANAP effectively increases nursing students' CAN knowledge and awareness levels. It was observed that the experimental group students maintained their increased knowledge and awareness 1 month after the intervention. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the relationship between pancreatin-derived medications and the treatability of gastrointestinal complaints after cholecystectomy. Patients and Methods: The relationship between postoperative symptomatic status and the use of proton pump inhibitors (PPIs) and pancreatin-derivated medications in patients admitted to our hepatobiliary surgery service who underwent cholecystectomy was retrospectively analyzed. IBM SPSS Statistics 23 (IBM SPSS,Turkey) was used for statistical analysis. Descriptive statistical methods (mean, standard deviation, median, frequency, ratio, minimum, maximum) were used to evaluate the study data. Pearson Chi-Square Test and Fisher's Exact test were used to compare qualitative data. Significance was evaluated at the p<0.05 level. Results: Proton pump inhibitors and pancreatin-derivatives were prescribed to all patients in the postoperative period. Although, the rate of postoperative asymptomatic course was higher in all patients, the rate of postoperative symptoms was found to be higher in patients who received PPI and pancreatin therapy (p=0.001, p=0.022; p<0.01). Conclusions: Although, the high rate of asymptomatic postoperative course in all patients indicates that cholecystectomy alone is curative, some symptoms may persist in the postoperative period and it was found to be more frequent in patients who used PPI and pancreatin-derived medications in the postoperative period. [ABSTRACT FROM AUTHOR]

Background: Nurses have a key role in the recognition, reporting, and channelization of child abuse and neglect. Nurses should have sufficient knowledge about the presentation of child abuse and neglect. They also need to understand their role in reporting any instance where they detect cases of abuse and neglect. Purpose: The aim of this study is to determine the effect of a structured Child Neglect and Abuse Educational Program (CNaA‐EP) on the level of knowledge and awareness of nursing students about child neglect and abuse. Methods: This study conducted with nursing students used a pretest−post‐test quasi‐experimental design. The third‐year nursing students were divided into two groups: experimental (n = 25) and control groups (n = 30). The intervention group received CNaA‐EP. In both groups, pretests were performed using the "Child Abuse and Neglect Awareness Scale," and "Child Abuse and Neglect Knowledge Test" The posttest was conducted 1 week after the 14‐week CNaA‐EP course was completed. Numbers, percentages, chi‐square test, t‐test, Kolmogorov–Smirnov test, Fisher's exact test were conducted using SPSS 22.00 software. Results: The education group's scores of child abuse/neglect awareness (t = −2.768 p < 0.05) and child abuse/neglect knowledge (t = −12.416 p < 0.01) were significantly higher than those of the control group. After the education program, a significant difference was found between the education and control groups on the core measures. Conclusion: A child neglect and abuse education program was an effective method of educating nursing students on knowledge and awareness of child abuse and neglect. For this reason, education programs should be planned and implemented to increase awareness about abuse and neglect problems that threaten children's health and development. [ABSTRACT FROM AUTHOR]

Objective: The novel coronavirus caused a disease that mainly affected the respiratory system. The effect of severe acute respiratory syndrome coronavirus 2 on the hypot halam ic–pi tuita ry–ad renal axis is unknown. This study assesses the prognostic accuracy of serum cortisol levels and prediction tools in predicting mortality rates in patients with coronavirus disease 2019 (COVID-19). Methods: We prospectively analyzed 106 inpatients (53 COVID-19 positive, 53 non-COVID-19; mean 59.9 ± 17.3 years; 38 males and 68 females) with serum cortisol and adrenocorticotropic hormone levels compared with prognostic scores. Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores determined the disease’s severity. The predictive value of serum cortisol, APACHE, and SOFA on mortality was assessed using receiver operating characteristic curve analysis and the area under the curve (AUC). Results: No significant age or sex differences were found between groups. Serum cortisol levels were similar. The APACHE-II scores in the COVID-19 group were higher than in the other group, while SOFA scores showed no significant difference. The AUC for the APACHE-II score in predicting mortality was 0.765 (95% CI 0.672-0.842), with an optimal cutoff (>9) demonstrating 62.5% sensitivity and 86.7% specificity for overall participants. No correlation was found between serum cortisol levels and prediction tools such as APACHE-II and SOFA. Conclusion: The measurement of serum cortisol did not provide additional prognostic information beyond that established by the APACH-II score. This study highlights the significance of assessing novel prognostic tools for predicting outcomes in hospitalized patients with COVID-19. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of lullabies and classical music on preterm neonates' cerebral oxygenation, vital signs, and comfort during orogastric (OG) tube feeding. Methods: This was a parallel-group pretest-posttest randomized controlled study. The research was conducted between December 2020 and May 2022. The sample consisted of 51 preterm neonates hospitalized in the neonatal intensive care unit (NICU) of Selçuk University Faculty of Medicine Hospital in Konya, Türkiye. Participants were randomized into three groups (17 preterm infants in each group). The first group listened to lullabies sung by their mothers and the second group listened to classical music during OG tube feeding. The control group received routine care with no music. Data were collected using a Neonatal Identification Information Form, Physiological Parameters and rSO2 Monitoring Form, and the Newborn Comfort Behavior Scale (Comfort-Neo). The study was registered on the ClinicalTrials database (NCT05333575). Results: The lullaby group had stable peak heart rates and oxygen saturation levels (p =.002). Both lullaby and classical music groups had significantly higher cerebral oxygenation levels than the control group. The classical music group had the highest cerebral oxygenation level (p =.001). Both lullaby and classical music groups had significantly higher mean Comfort-Neo scores than the control group. The classical music group had the highest mean Comfort-Neo score (p =.040). Conclusion: Preterm neonates who listen to lullabies and classical music are likely to have higher cerebral oxygen and comfort levels. Listening to lullabies helps stabilize vital signs. These results suggest that healthcare professionals should encourage parents to get their preterm neonates to listen to lullabies and classical music. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

Uric acid (UA) to albumin ratio (UAR) is an emerging marker to predict coronary artery disease (CAD)-related events. There is limited data on the relationship between UAR and the severity of the disease in chronic CAD patients. We aimed to evaluate UAR as an indicator for CAD severity using the Syntax score (SS). We retrospectively enrolled 558 patients with stable angina pectoris and underwent coronary angiography (CAG). Patients were divided into 2 groups, according to CAD severity: low SS (≤22) and intermediate-high SS (>22) groups. UA levels were higher and albumin levels were lower in the intermediate-high SS score group (P <.001). UAR levels were significantly higher in the intermediate-high SS group (P <.001). Also, there was a significant correlation between UAR levels and SS (r =.55, 95% confidence interval (CI):.49–.60, P <.001). In multivariable analysis, UAR >1.34 (Odds ratio, 3.8 [2.3–6.2]; P <.001) was an independent predictor of intermediate-high SS while albumin and UA levels were not. In conclusion, UAR predicted disease burden in chronic CAD patients. It may prove useful as a simple and readily available marker to select patients for further evaluation. [ABSTRACT FROM AUTHOR]

Background: Primary repair of the anterior cruciate ligament (ACL) has some potential advantages over the reconstruction technique, which include but are not limited to better knee sensation due to preservation of the natural ACL tissue in patients compared with tendon graft. Proprioception is impaired after ACL injuries and the sense of the joint position is lost. Purpose/Hypothesis: The purpose of this study was to compare arthroscopic ACL primary repair and ACL reconstruction techniques clinically and functionally and analyze the differences in proprioception. It was hypothesized that primary repair would restore knee joint proprioception more successfully because the original tissue of the ACL is preserved. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 63 patients (34 underwent reconstruction and 29 underwent primary repair between 2017 and 2020) and 33 healthy controls, as well as the healthy knees of the operated groups, were evaluated between 24 and 48 months (mean, 29 months) postoperatively. Patients with proximal femoral avulsion tears and stump quality suitable for repair underwent primary repair, and those with tears outside these criteria underwent reconstruction using hamstring tendon autograft. Proprioception was evaluated using the active joint position sensation method during weightbearing, with a digital inclinometer used to measure differences between the target and achieved flexion angles of 15°, 30°, and 60°. Results: At 15° of knee flexion, the deviation angles for the healthy knee of the reconstruction and primary repair groups were significantly smaller than those of the control group (P <.001), but there was no statistically significant difference between the groups in terms of deviation angle at 30° and 60° of flexion. The deviation angle of the operated knees was statistically significantly larger in the reconstruction group than in the primary repair group at all angles. The deviation angles at 15°, 30°, and 60° were 2.83°, 2.66°, and 2.66° in the reconstruction group and 1.00°, 1.00°, and 1.33° in the primary repair group, respectively (P <.001). There was no statistically significant difference between the reconstruction and primary repair groups in terms of clinical scores. Conclusion: Primary ACL repair can preserve proprioception in a well-selected patient group. In short-term follow-up, primary repair of the ACL in patients with proximal femoral avulsion tears and stump quality suitable for repair appears to be proprioceptively protective. Future studies are needed to clarify the long-term consequences of primary repair on proprioception in a larger population. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare high-flow nasal cannula oxygen therapy (nc-HFOT) and non-invasive nasal cannula ventilation (nc-NIV) in terms of intubation requirements. Materials and Methods: The study was conducted retrospectively on cases followed up in the pediatric intensive care unit (PICU) between October 2019 and December 2021. Results: Of all cases, 43 (55.8%) were male, and the median age was 16 months. The median PRISM-3 score for all cases was 2.5 (range: 0-3). Among the cases 45 cases (58.4%) received nc-HFOT treatment, and 32 cases (41.6%) received nc-NIV treatment. The median duration of respiratory support for all cases was 2 days, and 14 cases (18.2%) needed intubation. The median PICU stay day for all cases was 7 days, and the median hospital stay day was 11 days. The median age, PICU, and hospital stay days of the nc-NIV group were significantly higher (P < .05). In the logistic regression analysis, the probability of requiring intubation in cases initially nc-NIV was performed was found to be 4.95 times higher than those using nc-HFOT (OR: 4.95, 95% CI: 1.3-18.8, P = 0.01). Additionally, cases with underlying chronic diseases were found to have a 5.9 times increased likelihood of requiring intubation compared to those without (OR: 5.9, 95% CI: 1.41-24.5, P = .01). Five cases (6.5%) were lost during intensive care stay. Conclusion: The application of nc-NIV increases intubation by 4.95 times compared to the application of nc-HFOT. The intubation rate in cases with underlying chronic diseases is also 5.9 times higher than those without. [ABSTRACT FROM AUTHOR]

Objective: The increase in the prevalence of obesity, nonalcoholic fatty liver disease (NAFLD), and related comorbidities in children creates a social and financial burden. In our study, we aimed to evaluate liver findings together with anthropometric and laboratory data with twodimensional shear wave elastography (2D-SWE), one of the SWE types, which is a noninvasive method for assessing tissue stiffness in children with obesity, and to obtain quantitative data that can be used in early diagnosis and follow-up. Materials and Methods: In our single-center, observational cross-sectional study, liver gray scale findings, 2D-SWE findings, anthropometric measurements, and laboratory values of 48 children with obesity and 50 healthy children aged between 5 and 18 years, both between groups and in prepubertal and pubertal subgroups, are compared. Results: A significant difference was found in the liver stiffness indicator kilopascal (kPA) values and between aspartate aminotransferase values in the prepubertal period and alanine aminotransferase values in the pubertal period (P < .001). No significant difference was found between insulin, HOMA-IR, waist circumference, waist/height ratio, and kPA. Conclusion: Two-dimensional shear wave elastography can be easily applied in the pediatric population as a practical, noninvasive, reproducible, and highly compatible technique. In this regard, 2D-SWE may be useful in the early diagnosis and follow-up of hepatosteatosis and fibrosis in children with obesity and NAFLD-risky cases. [ABSTRACT FROM AUTHOR]

Objective: The number of admissions for severe diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes (T1D) increased during the coronavirus disease 2019 pandemic. We aimed to investigate whether there has been a change in this situation in recent years. Materials and Methods: All children with T1D who were diagnosed in our tertiary hospital between 2019 and 2023 were included. Plasma insulin, C-peptide, hemoglobin A1c (HbA1c), and antibodies against thyroid peroxidase, thyroglobulin, insulin, islet cell, glutamic acid decarboxylase, tissue transglutaminase IgA, and endomysium IgA were measured. Results: The frequency of moderate–severe acidosis at admission, which increased after pandemic period compared to the pre-pandemic period, returns to its previous levels over time but still shows a statistical difference compared to the pre-pandemic period (P = .012). Age, blood gas pH and HCO3 level, C-peptide, HbA1c, and length of stay of children at the time of admission were compared year by year (years 2019-2023). No statistical differences were observed (P = .509, P = .181, P = .069, P = .469, P = .346, P = .946), respectively. A significant difference was observed in venous glucose (P < .001) and insulin (P = .001) according to years. Also, no significant difference was found about the degree of acidosis according to age (P = .334). Conclusion: Although the frequency of DKA in children with newly-diagnosed T1D increased in the first years of the pandemic, it has been decreasing over the years toward pre-pandemic levels. The frequency of DKA is still higher than the pre-pandemic period. [ABSTRACT FROM AUTHOR]

Objective: To determine oncology nurses' practices about the diagnosis, prevention, and management of delirium. Background: Delirium can occur at any stage of the disease process of patients with cancer, or it can develop when the first diagnosis is learned. Study Design and Methods: A cross-sectional design was used. The study was conducted between May 10 and July 16, 2021 in Turkey with 181 nurses who worked in the oncology units of public and private hospitals and were reached by using the snowball sampling method. Data were statically analysed. Results: Of the nurses, 48.6% have a bachelor's degree and the average working years in oncology is 6.61 ± 5.47, 38.1% had been making routine delirium assessments, and only 5.5% of these nurses had prior experience using a screening tool. Also, 38.1% of the nurses had difficulty diagnosing delirium, with the patient group they had difficulty diagnosing most often being patients with dementia, hypoactive delirium, and those who were sedated, respectively. The rate of nurses who worked with a patient with delirium in the last month was 31.5%, and 40.3% could not determine the type of delirium. While the nurses' definition of hyperactive delirium findings was high, their definition of hypoactive delirium findings such as lethargy (48.8%), decreased psychomotor activity (47.7%) and withdrawal (56.1%) was low. In the study, it was found that being male, having an undergraduate degree in nursing, having professional work experience, having a lower patient-to-nurse ratio, using a screening tool, having experience working with patients diagnosed with delirium, and having positive views on delirium treatment had a significant impact on nurses' routine follow-up of delirium (p<0.05). In addition, it was determined that those who had experience working with patients diagnosed with delirium had less difficulty diagnosing delirium (p<0.05). Also, 82.4% of the nurses stated that they first applied pharmacological treatment after the diagnosis of delirium and that they most frequently used haloperidol (35%), benzodiazepine (29.8%) and dexmedetomidine (22.8%). Although nurses were self-confident about the management of delirium, they thought that it was difficult to prevent and treat delirium in patients with cancer. Conclusions: Although approximately one-third of the nurses had cared for patients diagnosed with delirium in the last month, the rate of using a measurement tool for routine delirium screening and diagnosis was low. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the tear and conjunctival secretions of laboratory-confirmed coronavirus disease-2019 (COVID-19) patients. Methods: A total of 152 consecutive COVID-19 patients, confirmed by real-time polymerase chain reaction (RT-PCR) test in nasopharyngeal swabs, were included. The conjunctival swabs were taken from both eyes by the same ophthalmologist in the first 24-36 hours after positive test results for COVID-19 in the nasopharyngeal swabs were detected. Results: Of the 152 patients, 96 (63.15%) were male and 56 (36.85%) were female. The mean age was 39.36±13.15 years. Sixteen (10.5%) patients had symptoms or findings such as tearing, stinging, redness, pain, and burning in their eyes. RT-PCR tests for SARS-CoV-2 RNA in conjunctival swabs were positive in 13 (8.55%) of 152 COVID-19 patients. Conclusion: This study showed that SARS-CoV-2 may be found in the conjunctival swabs of laboratory-confirmed COVID-19 patients, and ocular secretions may be a possible route for virus transmission. [ABSTRACT FROM AUTHOR]

Background: Patients can often access the internet and social media for health information but it is not clear how much they trust and use the information retrieved. Objective: To investigate the social media and internet use rates and preferences of orthopaedic patients, to reveal to what extent they self‐treat, and to probe the affecting factors. Methods: Two thousand fifty‐eight patients admitted to an orthopaedic polyclinic were asked to fill out a survey (voluntarily) consisting of 15 items, to collect demographic data, preference for platforms and sources used, trusted sources, and the extent to which information obtained was used for self‐care. Results: The most preferred and most trusted sources of information were Google and other search engines, and physicians' personal websites (p < 0.001). Discussion: Variables such as age, gender, educational level and occupation affect the research preferences. Reliance on social media decreases with increasing educational levels (p < 0.001). Conclusion: Health information and knowledge services should work with health professionals to improve aspects of health literacy among orthopaedic patients. [ABSTRACT FROM AUTHOR]

Objective Acute bronchiolitis (AB) is one of the most common respiratory diseases in early childhood and is still an important health problem worldwide. The systemic immune-inflammatory index (SII) is thought to have potential to be a new-generation inflammatory biomarker. We sought to investigate the value of SII for severity assessment in children with AB. Methods A total of 74 AB patients were included in a prospective observational study. Patients were classified into 3 AB groups according to this classification: mild (1-5 points), moderate (6-10 points), and severe (11-12 points). Complete blood count, C-reactive protein, and procalcitonin tests were carried out. Modified Tal score was evaluated to determine severity. The performance of parameters to predict the severity of AB was assessed using the receiver operating characteristic (ROC). Results Whereas neutrophil count (P =.037), neutrophil-to-lymphocyte ratio (P =.030), and SII (P =.030) values increased significantly with disease severity, red cell distribution width (P =.048) values were higher in the moderate AB group. The SII was found to have the highest area under the curve in the comparison of the mild-moderate groups combination and the high group on ROC analysis (P =.009). Conclusion The SII values of pediatric patients hospitalized with the diagnosis of AB were significantly higher in the high-severity group. The SII may offer additional severity stratification in children with AB. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to compare the effects of online functional exercises and posture exercises on lower limb functions, posture, and physical activity in office workers working at home and in office alternately during the COVID-19 pandemic. Design: Forty individuals were included in the study and were randomized into two groups: group I (functional exercise group, 20 participants) and group II (posture exercise group, 20 participants). The exercises programs were performed online for 2 days/in a week/ 8 wk. Lower limb functions, posture, and physical activity were evaluated before and after the exercise program. Result: Significant improvement was obtained in lower limb functions (muscular endurance, balance, and functional capacity), posture, and physical activity in group I, while significant improvement was obtained in balance and functional capacity in group II after treatment. The change in scores of lower limb functions, posture, and physical activity after treatment was statistically superior in group I compared with group II ( P < 0.05). Conclusions: It was found that both online exercise programs provided effective results in office workers working at home and in office alternately due to the COVID-19 pandemic, but the functional exercise program had superior effects on lower limb functions, posture, and physical activity compared with the posture exercise program [ABSTRACT FROM AUTHOR]

OBJECTIVE: We compared the survival outcomes of surgery within multimodality treatment regimens with the outcomes of definitive chemoradiation treatments in patients diagnosed with clinical (c) IIIB/N2 non-small cell lung cancer (NSCLC). We investigated whether surgery within multimodality treatment provides a survival advantage at this stage. MATERIAL AND METHODS: Data from 79 patients with cIIIB/N2 between 2009 and 2016 were analyzed retrospectively. While the surgery was performed after neoadjuvant therapy in 51 cases (IIIB/Surgery Group), definitive chemotherapy ± radiotherapy was applied in 28 cases (IIIB/Definitive Group). RESULTS: In cIIIB/N2 cases, the 5-year overall survival (OS) was 27.4%, with a median OS of 24.6 months. The 5-year OS of the IIIB/ Surgery Group was 27.3% (median survival 22.5 months), while it was 28.6% (median survival 29.1 months) in the IIIB/Definitive Group (P = .387, HR = 0.798, 95% CI, 0.485-1.313). Although there was a survival advantage in the group with a pathological complete response (PCR) after surgery (n = 14) compared to the group that did not (n = 37), the observed difference was not statistically significant. (5-year OS; 42.9% vs. 18.5%, P = .104). Additionally, there was no statistically significant difference between the survival of PCR patients and the IIIB/Definitive Group in terms of OS (P = .488). CONCLUSION: Surgery performed within multimodality treatment regimens in selected cIIIB/N2 cases did not provide a survival advantage over definitive chemoradiation treatments. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Coronavirus disease 2019 (COVID-19) can cause hypoxic respiratory failure; long-term oxygen therapy (LTOT) duration is unknown. MATERIAL AND METHODS: The aim was to investigate which patients would need LTOT after COVID-19 pneumonia. This single-center, prospective study was conducted at the Ankara University Faculty of Medicine, Department of Chest Diseases, between May 2021 and December 2021. The 70 patients hospitalized for COVID-19 pneumonia and discharged with LTOT due to hypoxemic respiratory failure were included. Patients were divided into 2 groups as group I (LTOT requirement <3 months) and group II (LTOT requirement continued =3 months). RESULTS: The mean age was 64.4 ± 13.5 years, and 44 (62.9%) of them were male. The most frequently encountered comorbidities were cardiovascular disease (57.1%) and lung disease (22.9%). While PaO2 levels increased in both groups during the follow-up period, this increment was significantly higher in group I (PaO2: 66.6 ± 9.9 mm Hg, P < .001). The factors affecting the LTOT requirement were evaluated using binary logistic regression. On multivariate analyses of lymphocytes, ferritin, C-reactive protein, PaO2, SaO2, subpleural reticulation, and number of lobes affected (=3 lobes), the SaO2 level and presence of subpleural reticulation were significantly different between the 2 groups [odds ratio (OR) (95% CI): 0.853 (0.749-0.971), P = .016] and [OR (95% CI): 0.171 (0.042-0.733), P = .017], respectively. CONCLUSION: A significant proportion of patients who develop respiratory failure due to COVID-19 recover within the first 3 months. Factors determining the LTOT requirement for more than 3 months were SaO2 and the presence of subpleural reticulation. [ABSTRACT FROM AUTHOR]

Purpose: The present study was conducted to determine the effect of odor stimulation with breast milk (BM) applied to premature newborns before and during enteral feeding on feeding cues, transition time to oral feeding and abdominal perfusion. Design: This study was a parallel group pretest-post test randomised controlled trial (RCT). Methods: The study was conducted in the neonatal intensive care unit (NICU) in Türkiye. Study data were collected from 32 premature newborns between October 2020 and December 2021. Newborns were randomly assigned to either intervention (n = 16) or control (n = 16) groups. Odor stimulation with BM was applied to newborns in the intervention group (IG) before and during enteral feeding for 3 days. Data were collected with the Newborn Information Form, Abdominal Perfusion Follow-up Form, and Feeding Cues Follow-up Form. Yates corrected and Fisher chi-squared test, Mann-Whitney U test, Cohen Kappa statistics, Permanova analysis, and Wilcoxon test were used in the analysis. The study was registered in ClinicalTrials.gov (NCT04843293). Results: The frequency of feeding cues in newborns who were exposed to the odor of BM, was higher than in the control group (CG) (p <.05). The transition times to oral feeding were similar in newborns in the IG and CG (p >.05). Abdominal perfusion level of newborns in the IG was higher than the CG (p <.05), and the level of abdominal perfusion showed a significant difference in terms of group*time interaction (p <.05). Conclusion: Our findings suggest that odor stimulation with BM will be beneficial in improving the digestive functions of premature newborns. [ABSTRACT FROM AUTHOR]

Ethyl chloride (EC) spray is a vapocoolant which is used in interventional procedures as a topical local anesthetic. The aim of the present study was to investigate whether or not EC spray can facilitate radial coronary angiography. The study was conducted on a study group EC of 106 (age: 58.1 ± 12.4) patients and a control group (placebo) of 104 (age: 59.1 ± 10.8) patients. Visual analogue scale scores (VAS), radial cannulation failure (RCF), the rates of clinical and anatomical radial artery spasm (RAS), pain lasting >2 day and >1 week, and radial artery occlusion (RAO) at first week and first month were evaluated in both groups. VAS scores, the rates of RCF, clinical and anatomical RAS and pain lasting >1 week were found significantly lower in the study group than the control group (p <.001, p =.024, p =.009, p =.028 and p =.042, respectively). But the rates of RAO were similar in both groups. Topical spray including EC, which has low-cost and rapid efficacy, may be preferred in transradial coronary angiography as it reduces the risk of RCF and RAS, and increases patient comfort with its analgesic effect, without significant side-effects. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are a special population in which hospitalizations are more recommended due to physiological changes mimicking pathologies and medico-legal concerns. Objectives: We aimed to assess the obstetric outcomes of expectant mothers who were admitted to the obstetrics emergency outpatient clinic and declined the hospitalization advised by doctors. Additionally, we examined the appropriateness of physicians' recommendations. Design: We have retrospectively evaluated the patients admitted to the 'Obstetric Emergency Outpatient Clinic' and refused hospitalization between 1 January 2019 and 31 December 2019. Methods: Cases were classified into three groups based on the trimester, considering the substantial variation between complaints and complications in each trimester. The complaints of pregnant women were categorized as psychosocial causes, obstetric complications, maternal systemic complaints, and suspicion of labor. We evaluated the compatibility of the hospitalization decision with the pregnancy outcome of patients. Results: A total of 958 pregnant women were included in the study. Leading causes for admissions were obstetric complications, maternal systemic complaints, and suspicion of labor in first, second, and third trimesters, respectively. Psychosocial causes were mostly observed in the second trimester. Readmission to the hospital within a week was highest in the third trimester group. According to pregnancy outcomes, 12.5% (94/753) of our recommendations were appropriate in all trimesters. Conclusion: Obstetricians seem overcautious in managing obstetric patients and willing to offer hospitalization more often than the actual requirements. [ABSTRACT FROM AUTHOR]

PHEinAction® is a theory‐based nurse‐led patient engagement intervention developed among an Italian older adult population with various chronic diseases to facilitate cognitive, emotional, and behavioral processes in promoting individuals' active roles. This study aims to adapt and evaluate the effectiveness of PHEinAction® on diabetes self‐management (DSM) among Turkish type 2 diabetes mellitus patients. First, the generic content of the intervention was customized for diabetes management and adapted for the Turkish population, including back‐forward translation and expert panel evaluation; then, a randomized controlled trial was conducted with 51 adult diabetes patients randomly assigned to intervention or the control group receiving the usual care. The intervention consisted of two in‐person sessions of 4‐week intervals, a telephone consultation, and home‐based written exercises, which involved personalized care activities addressing individuals' engagement levels and covering the cognitive, emotional, and behavioral aspects. The scores for treatment adherence, self‐efficacy, and patient engagement had significantly improved with a large size effect in the intervention group at the fourth‐week follow‐up compared with the control group. Findings suggest that the nurse‐led personalized patient engagement program could effectively promote DSM. [ABSTRACT FROM AUTHOR]

Background: Individuals with spastic cerebral palsy are more predisposed to parafunctional oral activities and oral motor problems because of spasticity. Objectives: The aim of the study was to evaluate the relationship between the gross motor function classification system score (GMFCS), age, bruxism, parafunctional oral habits and oral motor problems in children with cerebral palsy. Methods: This cross‐sectional study included 63 children with spastic cerebral palsy, aged 3–18 years, with developmental disabilities. The relationship between parentally reported bruxism, parafunctional oral activity rates, oral motor problems, and GMFCS was analysed. Results: The prevalence of bruxism was 52.4%, and the rate decreased as age increased. There was a greater likelihood of bruxism in individuals with tongue thrust (OR [95% CI] = 8.15 [1.4–47.3]) and swallowing problems (OR [95% CI] = 5.78 [1.3–24.68]). Conclusion: In children with spastic cerebral palsy, bruxism and the rate of parafunctional oral habits were high, thus affecting oral motor activities. A relationship was found between oral motor problems and increased GMFCS levels, but no relationship was found between bruxism and GMFCS levels. Children with spastic cerebral palsy who display tongue thrust or swallowing problems have an increased likelihood of presenting with bruxism. The study found that the prevalence of bruxism was 52.4% among 63 children with spastic cerebral palsy, ranging in age from 3 to 18 years, and the incidence of bruxism decreased as age increased. Individuals with tongue thrust (OR [95% CI] = 8.15 [1.4–47.3]) and swallowing problems (OR [95% CI] = 5.78 [1.3–24.68]) had a significantly higher likelihood of experiencing bruxism. In children with spastic cerebral palsy, both bruxism and the frequency of parafunctional oral habits were notably high, thereby influencing oral motor activities. [ABSTRACT FROM AUTHOR]

Objective: To compare the results of perinatal outcomes between Syrian refugees and Turkish women between 2016 and 2020. Methods: The birth results of 17,997 participants (Syrian refugees: 3579 and Turkish women: 14,418) who delivered in the Labor Department of our hospital between January 2016 and December 2020 were retrospectively analyzed. Results: Maternal age was younger (24.73 ± 6.08 vs. 27.4 ± 5.91 years, p < 0.001) and adolescent pregnancy rate was higher (19.4% vs. 5.6%, p < 0.001) in Syrian refuges than in Turkish women. Bishop scores on admission (4.6 ± 1.6 vs. 4.4 ± 1.1, p < 0.001), birth weight (3088.19 ± 575.32 g vs. 3109.76 ± 540.89 g, p = 0.044), low birth weight (11.3% vs. 9.7%, p = 0.004), and the rate of primary cesarean deliveries (10.1% vs. 15.8%, p < 0.001) were also statistically different. Additionally, the rates of anemia (65.9% vs. 29.2%, p < 0.001), preeclampsia (1.4% vs. 2.7%, p < 0.001), stillbirth (1.3% vs. 0.6%, p < 0.001), preterm premature rupture of membranes (2.7% vs. 1.9%, p = 0.002), and obstetric complications were different between the groups. Conclusions: This study showed that inadequate antenatal care, communication and language barrier problems in Syrian refugees caused some adverse perinatal outcomes. All birth data of Syrian refugees must be disclosed by the Ministry of Health to confirm the accuracy of our data. Significance: What is already known on this subject? Syrian refugees did not receive adequate antenatal care, and some adverse perinatal outcomes were observed more frequently due to communication and language barrier problems. What does this study add? This study showed that more planned-programmed antenatal care-follow-up services should be provided, communication and language problems should be minimized, refugees should benefit more from health services, and effective-appropriate contraception methods should be provided to reduce negative perinatal outcomes. [ABSTRACT FROM AUTHOR]

Introduction: In the adjuvant treatment of low-risk stage III colon cancer treated surgically, 3 months of CAPOX followed by 3 months of capecitabine is not a common clinical practice. Since there are no data on this practice in the literature, we have no idea how often it is used. However, it should be noted that this application is used in some centers due to the cumulative neurotoxicity of oxaliplatin but there are insufficient data in the literature on its efficacy. Methods: The data of patients with colon cancer treated surgically who were followed up in 12 different oncology centers in Turkey between November 2004 and June 2022 were analyzed retrospectively. Results: The study included 194 patients. The treatment arms were as follows: 3 months of CAPOX followed by 3 months of capecitabine = arm A and CAPOX/FOLFOX (6 months) = arm B. There were 78 patients (40.2%) in arm A and 116 patients (59.8%) in arm B. The median age and sex distribution were similar between the treatment arms. The median follow-up period of all patients was 34.4 months (95% confidence interval, 29.1–39.7). When arm A was compared with arm B, 3-year disease-free survival (DFS) was 75.3% versus 88.4% and 5-year DFS was 75.3% versus 82.8%, respectively. There were similar DFS outcomes between the treatment arms (p = 0.09). Rates of any grade of neuropathy were numerically lower in arm A, but the difference between the treatment arms was not statistically significant (51.3% vs. 56.9%; p = 0.44). The frequency of neutropenia was similar between the treatment arms. Conclusion: In this study, the efficacy and safety of the 3 months of CAPOX followed by 3 months of capecitabine chemotherapy regimen in the adjuvant treatment of low-risk stage III colon cancer treated surgically were proven. This result may also support the discontinuation of oxaliplatin at 3 months while continuing fluoropyrimidines, which is a common clinical practice but lacks sufficient data. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the efficacy, complication, and mortality of patients who were supported by venovenous (VV) extracorporeal membrane oxygenation (ECMO) and venoarterial (VA) ECMO for pediatric acute respiratory distress syndrome (PARDS). Materials and Methods: This study is a single-center, retrospective cohort study between 2014 and 2022. We evaluated to indication of ECMO support, ECMO type, patients’ demographic features, complications, and children’s outcomes supported by ECMO for PARDS. Results: Twenty-two patients with PARDS, 12 (54%) with VV, and 10 (46%) with VA ECMO were selected. The median number of days to be intubated before ECMO cannulation was 5 (0-16) days. The distribution of intubated days before the patients underwent ECMO was as follows: 0-1 days, 7 (31.8%) patients; 2-3 days, 2 (9.1%) patients; 4-7 days, 7 (31.8%) patients; 8-14 days, 5 (22.8%) patients; >14 days, 1 (4.5%) patient. The median ECMO cannulation day after admission to the pediatric intensive care unit was 3 (range, 1-9) days in the VV ECMO patient group, whereas it was 8 (range, 0-19) days in the VA ECMO group (P = .02). Considering hospital survival, 4 (45%) patients who underwent double-lumen VV ECMO, 1 (33%) patient who underwent VV ECMO, and 3 (30%) patients who supported by VAECMO survived. There was no difference between the groups in terms of hospital discharge rates. Conclusion: The highest survival rate was found in the VV ECMO patient group established with double-lumen cannulas, similar to the literature. There was no difference in mortality between the groups whose intubation time before ECMO was 14 days or less. [ABSTRACT FROM AUTHOR]

Objectives There is no consensus on canakinumab treatment tapering and discontinuation strategies in colchicine-resistant FMF patients. In this study, we aimed to establish a treatment management and discontinuation protocol in paediatric FMF patients treated with canakinumab. Methods Fifty-eight FMF patients treated with canakinumab were included. Since 2020, we have applied a protocol based on our experience whereby canakinumab is administered monthly in the first 6 months, followed by bimonthly for 6 months, and a final period of every 3 months (for 6 months). The patients were divided into two groups: 2012–2019 (group A) and 2020–2022 (group B). Results In group A (n  = 33), the median duration of canakinumab treatment was 2.5 years [interquartile range (IQR) 1.9–3.7]. A total of 25 of 33 patients discontinued canakinumab after a median of 2.1 years (IQR 1.8–3.4). In two patients, canakinumab was restarted because of relapse. In group B (n  = 25), canakinumab was discontinued in 18 patients at the end of 18 months. After a median follow-up of 0.8 years (IQR 0.6–1.1), two patients had a relapse and canakinumab treatment was reinitiated. The remaining 16 patients still have clinically inactive disease and are receiving only colchicine. When we compared the characteristics between groups A and B, there were no significant differences regarding demographics, clinical features, and outcomes. Conclusion This is the largest study in the literature suggesting a protocol for discontinuing canakinumab in paediatric FMF patients. It was possible to discontinue canakinumab successfully in more than half of the patients in 18 months. Thus we suggest that this protocol can be used in paediatric FMF patients. [ABSTRACT FROM AUTHOR]

Objective There is an ongoing debate about the best and comfortable way to administer surfactant. We hypothesized that uninterrupted respiratory support and continuous PEEP implementation while instilling surfactant via endotracheal tube (ETT) with side port will result in higher regional cerebral tissue oxygenation (rcSO2) and the alterations in cerebral hemodynamics will be minimal. Study Design Preterm infants who required intubation in the delivery room and/or in the first 24 hours of life with gestational age <32 were enrolled. Patients were intubated either via conventional ETT or ETT with side port (Vygon) with appropriate sizes. Following neonatal intensive care unit admission a near-infrared spectroscopy (NIRS) probe was placed on the forehead and each infant was started to be monitored with NIRS. In conventional ETT group, patients separated from the ventilator while surfactant was instilled. In ETT with side port group, respiratory support was not interrupted during instillation. Heart rate, oxygen saturation, rcSO 2 , cerebral fractional tissue oxygen extraction (cFTOE), and blood pressures were recorded. Results A total of 46 infants were analyzed. Surfactant was instilled with conventional ETT in 23 and ETT with side port in 23 infants. Birth weights (1,037 ± 238 vs. 1,152 ± 277 g) and gestational ages (28 ± 2.3 vs. 29 ± 1.6 weeks) did not differ between groups. During instillation of surfactant, rcSO2 levels [61.5 (49–90) vs. 70 (48–85)] and cFTOE levels 0.28 (0.10–0.44) vs. 0.23 (0.03–0.44)] were similar (p = 0.58 and 0.82, respectively). Conclusion Interruption of respiratory support during surfactant instillation did not significantly alter the cerebral tissue oxygenation. These results did not support our hypothesis and should be confirmed with further studies. Key Points Monitoring intracerebral oxygenation changes during surfactant administration with NIRS is feasible. The surfactant administration method does not significantly alter the cerebral oxygenation. Surfactant administration itself rather than the method caused a transient drop in cerebral NIRS readings. [ABSTRACT FROM AUTHOR]

Objective: There are limited studies regarding endocrine complications in Turkish adult thalassemic patients. Data regarding newly emerging endocrine complications in the long-term monitoring of adult patients with beta-thalassemia are also quite limited. Methods: The study was a single-center cohort study involving 103 adult patients with betathalassemia. Results: The most frequent endocrine disorder was vitamin D insufficiency (69%), whereas the most common endocrine complications were hypogonadism (56%) and osteoporosis (37%) in thalassemic patients. Three or more endocrine disorders were present in 42% of the patients. Patients with hypogonadism had higher ferritin levels (P = .014), lower hemoglobin concentrations (P = .028), and increased myocardial iron deposition (P = .002) compared to those without hypogonadism. There was also a link between 5-year calculated mean ferritin levels and fasting plasma glucose (r = 0.29, P = .004) and 75 g oral glucose tolerance test second-hour glucose levels (r = 0.46, P = .001). Osteoporosis was more common in patients with hypogonadism (51% vs. 21%, P = .003) and diabetes (75% vs. 35%, P = .027). The remaining endocrine problems, on the other hand, were not linked to thalassemia-related characteristics or each other. In 3 and 5 years of follow-up, 16% and 12% of patients developed a new endocrine-metabolic complication, respectively, with osteoporosis and prediabetes/diabetes being the most common. Conclusion: A significant proportion of adult thalassemic patients have multiple endocrine-metabolic complications. All patients with thalassemia major, regardless of their ferritin levels, should be evaluated for the occurrence of endocrine complications. Endocrinologists should be especially vigilant during long-term follow-up for the development of glucose metabolism disorders and osteoporosis in adult thalassemic patients. [ABSTRACT FROM AUTHOR]

Purpose: The study was conducted to determine the effect of mother's voice and music sound on pain and physiological parameters during aspiration procedure in children with mechanical ventilation support in the pediatric intensive care unit. Design and Methods: This study was a randomized controlled type experimental study. According to the power analysis result of the sample of the study, 84 children who were treated in the pediatric intensive care unit of two university hospitals in Istanbul were formed. Introductory Information Form, Ramsey Sedation Scale, Physiological Parameter Form and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were used to collect data. Results: When the pain results of the children were evaluated, the mean FLACC Pain Scale value of the children in the control group was found to be significantly higher than children in the mother's voice and music voice group (p < 0.05). It was determined that the lowest FLACC Pain Scale value was in the mother's voice group (p < 0.05). When the physical parameter results were evaluated, it was determined that the physiological measurement values of the children in the experimental group were positively affected (p < 0.05), there was a significant difference between the control group (p < 0.05) and the most effective result was in the mother's voice group (p < 0.05). Practice Implications: Allowing children to listen mother's voice and music during aspiration procedure reduces pain of the children, positively affects their physical parameter values and enhances quality of nursing care. The results of this study create a scientific basis for nursing practices in the clinical settings and contribute to the clinical practices by shedding a light on future evidence‐based studies. [ABSTRACT FROM AUTHOR]

Aim and Objective: The aim of this cross‐sectional study was to determine the point prevalence and associated risk factors of medical device‐related pressure injuries (MDRPI) in intensive care patients in Turkey. Background: MDRPI remain a clinical problem that has garnered the attention of healthcare professionals. Design: This study used a cross‐sectional design and was conducted over a single day in all intensive care units. Method: Data were collected through face‐to‐face interviews, observation, skin examination and detailed diagnosis of MDRPI development and influencing factors. Presence of pressure injuries on the skin in the areas where the patient's medical device was placed was defined. The study was reported according to the STROBE declaration. Results: MDRPI developed in 65 out of 200 patients included in the study (32.5%). The most frequent locations were on the face (71%). The MDRPIs were commonly associated with nasogastric tube (29.2%), endotracheal tube (18.5%) and CPAP mask (15.4%). A significant proportion of these injuries were mucosal (53.8%, n = 35). The majority of the skin pressure injuries were classified as Stage II (18.5%, n = 12). The risk increased 14 times in patients who were hospitalised for 9–16 days and 13 times in those who received mechanical ventilator support. Conclusion: The study findings suggest that MDRPI developed in approximately one of three patients hospitalised in the intensive care unit, and the length of hospital stay and mechanical ventilator support were important determining risk factors. The high prevalence of MDRPI may indicate inadequate nursing care quality. Therefore, it is recommended that nurses be aware of risk factors and evaluate the suitability and safety of medical devices. Patient or Public Contribution: No patient or public contribution was involved in this study. [ABSTRACT FROM AUTHOR]

Differential diagnosis is important for clinical management of cases with thyroid diseases. We aimed to find the most useful diagnostic panel including immunohistochemistry markers and BRAF 600E mutation for papillary thyroid carcinoma. The study included 99 papillary thyroid carcinoma, 95 benign thyroid disease and 6 well differentiated tumour of uncertain malignant potential cases. Three groups were compared for immunohistochemistry marker expressions (CK19, Gal-3, HBME-1, p63, CD56). Diagnostic contribution of BRAF V600E mutation and its relationship with the immunohistochemistry and prognostic parameters were evaluated. CK19, Gal-3, HBME-1 and p63 positivity and loss of CD56 expression were significantly higher in papillary thyroid carcinoma than in benign thyroid disease. Gal-3 was the most useful marker to differentiate both papillary thyroid carcinoma and well-differentiated tumour of uncertain malignant potential cases from benign thyroid disease. CK19&HBME-1 and CK19&-Gal-3 dual panels had the highest sensitivities and high specificities for distinguishing papillary thyroid carcinoma from benign thyroid disease. Moreover, CK19&Gal-3 dual panel had the highest sensitivity and specificity to distinguish well-differentiated tumour of uncertain malignant potential from benign thyroid disease. In addition, CK19&Gal-3&HBME-1 was the most sensitive triple panel in differentiating both papillary thyroid carcinoma and well-differentiated tumour of uncertain malignant potential cases from benign thyroid disease. When combined with immunohistochemistry markers, the BRAF V600E reduced sensitivities and increased specificities towards malignancy, and it was not associated with prognostic parameters except for histological subtypes. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) is still a challenge for children. About 15 to 45% of the HIV positive pregnant women can transmit the virus to their children during pregnancy, delivery and/or breastfeeding. The risk of transmission can be decreased my several measures. Aims: To identify factors associated with HIV infection in children born to HIV-infected mothers. Study Design: A multi-center retrospective cohort study. Methods: A ten-year retrospective cohort study in five dedicated HIV centers was conducted. The 325 women in our cohort were between the ages of 18 and 45. During the study period, 44 (13.5%) of these women gave birth and 51 babies were born. Of the 51 infants, 7 (13.7%) were HIV/AIDS positive. Results: Among the factors studied, breastfeeding, having a HIV-positive sibling and being on antiretroviral treatment during pregnancy and detectable HIV-RNA during delivery were found statistically significant. A multivariable logistic regression analysis showed that being on antiretroviral treatment during pregnancy is the most important predictor of mother-to-child transmission. Conclusion: Mother-to-child transmission appears to be an important route of HIV transmission in Turkey. Lack of antiretroviral treatment during pregnancy appears to be a key factor in transmission. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study reports the results of stereotactic radiosurgery and fractionated stereotactic radiosurgery treatment for brain metastasis in non-small cell lung cancer patients treated with modern systemic treatment methods (immunotherapy, targeted agents, and current chemotherapy agents). MATERIAL AND METHODS: This study retrospectively analyzed patients diagnosed with non-small cell lung cancer and brain metastases who underwent stereotactic radio surge ry/fr actio nated stereotactic radiosurgery in the Radiation Oncology Clinic of Ankara Bilkent City Hospital between February 21, 2019, and August 15, 2022. The study's primary endpoint was accepted as the lesions' response status after stereotactic radio surge ry/fr actio nated stereotactic radiosurgery. The secondary endpoint was accepted as the patients' intracranial progression-free survival and overall survival. RESULTS: This study included 85 patients treated for 174 lesions. Their median follow-up was 6.6 (range: 1-42) months. Their median intracranial progression-free survival after radiotherapy was 5.3 (range: 1-33) months, and their median overall survival was 6.6 (range: 1-42) months. Concurrent immunotherapy was administered to 10 (11%) patients and targeted therapy to 8 (9%). Magnetic resonance imaging indicated that 14 (6%) patients had a complete response, 62 (35.6%) had a partial response, 10 (5.7%) had stable disease, and 23 (13.2%) had progressive disease. The complete response rate was significantly higher in patients receiving targeted therapy (P < .001; odds ratio = 0.0025, 95% CI = 0.006-0.109). Intracranial recurrence was observed in 28 (32.9%) patients after stereotactic radio surge ry/fr actio nated stereotactic radiosurgery: 7 (8.2%) were inside the radiotherapy field, 13 (15.3%) were outside the radiotherapy field, and 8 (9.4%) overlapped the radiotherapy field. Intracranial progression-free survival was higher in patients receiving concomitant immunotherapy (P = .028; hazard ratio = 0.107, 95% CI = 0.015-0.783). However, overall survival was higher in patients receiving targeted therapy (P = .035; hazard ratio = 0.217, 95% CI = 0.053-0.897). CONCLUSION: Using current systemic agents with radiotherapy for brain metastasis significantly affected post-radiotherapy intracranial progression-free survival. [ABSTRACT FROM AUTHOR]

Aim: Tooth discoloration is a common clinical finding which is considered primarily as an aesthetic problem. Black stain (BS) is a specific type of extrinsic tooth discoloration mostly seen in children, but also in adults and it is not dependent on gender. The present study aimed to investigate the relationships between the presence of BS and dental caries incidence, dental plaque scores and to examine the colonization of Streptococcus mutans, Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. in dental plaque samples with or without BS. The socioeconomic status of the family, the oral hygiene and dietary habits of the children, and the medical and dental history of the children were also compared between the two groups. Materials and Methods: A total of 1000 children aged 3-12 years were evaluated to take part in this study. From this group, those children with BS (n=44) were selected as the study group. With the same number as the study group, and with a same age and gender profile, 44 children without BS were selected as a control group. Dental examinations including the presence of BS, dental caries incidence and dental plaque scores were performed by the same investigator. Structured questionnaires were completed by the parents. The levels of S. mutans, Lactobacillus spp., Actinomyces spp. and Capnocytophaga spp. were determined from dental plaque samples. All data were analyzed by SPPS 25.0 using Student's t-test, the Mann-Whitney U, Fisher's exact and the chi-squared tests. Results: BS was detected in 4.4% of the patients in the present study. DMFT and DMFS scores were significantly lower in those children with BS than in those without BS (p=0.001 and p=0.010). However, no statistically significant difference was found between dmft and dmfs scores and the presence of BS (p>0.05). Lower numbers of S. mutans and Lactobacillus spp. and greater numbers of Actinomyces spp. and Capnocytophaga spp. were found in those children with BS. There was no statistically significant relationship between S. mutans and Actinomyces spp. and the presence of BS (p>0.05). Colonizations of Lactobacillus spp. were statistically significantly lower, while colonizations of Capnocytophaga spp. were significantly higher in the BS group than in the control group (p<0.05). Conclusion: It could be suggested that the different microbial composition of BS might be associated with lower caries experiences in affected subjects. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the effects of a nurse navigation program on the capability for self‐care, quality of life, risk of anxiety and depression, and severity of the physical symptoms of postpartum mothers. Methods: This prospective, parallel‐group, randomized controlled study included 64 primiparous pregnant women (32 women each in the intervention and control groups) at ≥36 gestational weeks admitted to the pregnancy outpatient clinic of a public hospital in Turkey. The intervention group received navigation program‐based nursing care comprising three home visits, four phone calls, and five text messages aside from the standard hospital care during delivery and the postpartum period. Meanwhile, the control group received only the standard hospital care during delivery and the postpartum period. Data were collected using a sociodemographic data form, the Self‐Care Power Scale, the Maternal Postpartum Quality of Life Instrument (MPQoL‐I), the Postpartum Specific Anxiety Scale (PSAS), the Edinburgh Postnatal Depression Scale (EPDS), and the Postpartum Physical Symptom Severity Scale. Results: Mean scores for the capability for self‐care and quality of life were higher, while those for the risk of depression and anxiety were lower for the intervention group than the control group (p <.05). Conclusions: Navigation program‐based care provided to primiparous mothers improved maternal health. [ABSTRACT FROM AUTHOR]

Background: Transient hypothyroxinemia of prematurity (THOP) is defined as a low level of circulating thyroxine (T4), despite low or normal thyroid-stimulating hormone (TSH) levels. Aims: We aimed to evaluate the incidence of THOP, the clinical and laboratory findings of preterm infants with this condition and the levothyroxine (L-T4) treatment. Methods: Preterm infants (n = 181) delivered at 24–34 weeks of gestation were evaluated by their thyroid function tests that were performed between the 10th and 20th days of postnatal life and interpreted according to the gestational age (GA) references. Clinical and laboratory characteristics of the patients with THOP and normal thyroid function tests were compared. Patients with THOP and treated with L-T4 were compared with the ones who were not regarding laboratory, and clinical characteristics. Results: Incidence of hypothyroxinemia of prematurity was 45.8% (n = 83). Euthyroidism, primary hypothyroidism, and subclinical hypothyroidism were diagnosed in 47.5% (n = 86), 5% (n = 9) and 1.7% (n = 3) of the patients, respectively. Mean birth weight (BW) and GA were significantly lower in the hypothyroxinemia group than in the euthyroid group (p < 0.001). L-T4 was started in 43% (n = 36) of the patients with THOP. Treatment initiation rate was 44.4% (n = 16) in 24–27 wk, 41.6% (n = 15) in 28–30 wk, and 13.8% (n = 5) in 31–34 wk. As the GA increased, the incidence of THOP and the rate of treatment initiation decreased (p < 0.001). The lowest free thyroxine (FT4) cut-off value was 0.72 ng/dl in the treated group. In addition, incidences of vancomycin + amikacin, caffeine, dopamine treatments, RDS, IVH, BPD, central catheter, FFP transfusion, and ventilator support were higher in the treated group (P < 0.05). Conclusion: This study revealed that prevalence of THOP increased as the GA and BW decreased. As the GA decreased, THOP patients requiring L-T4 treatment increased. Additionally, association with comorbid diseases increased the requirement of treatment. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we aimed to evaluate the development of 0-6 year old children with Denver II and to examine the factors affecting the results. Materials and Methods: The population of the descriptive and retrospective, in which the surveillance data were analyzed, consisted of 391 children who applied to healthy life center of district health directorate. SPSS 22.0 package program was used to analyze the data. The data was examined by using ANOVA, Kruskal- Wallis, Fisher's exact test and Pearson chi-square, p<0.05 was considered as statistically significant. Results: 49.9% of the participants in our study were girl, average age was 3.0±1.4 year and 100% was between 0-6 age. As a result of the study, 241 (61.6%) out of 391 children identified with DDST II have been found to be normal, 53 (13.6%) of them suspicious and 97 (24.8%) children are found to be abnormal. A statistically significant difference was found between the decrease in the education level of the parents, the fact that the mother was a housewife and the child's gender was male and the probability of abnormal DDST II results (p<0.05). Conclusion: In the study, it was determined that almost one fourth of the children showed abnormal development. It has been found that the education level of the mother and father, the mother's profession and the child's gender are effective in the development of the child. [ABSTRACT FROM AUTHOR]

Prognostic nutritional index (PNI), consisting of inflammatory-nutritional parameters, has been investigated in terms of outcomes and renal function in patients with coronary artery disease. The objective of this study is to assess the predictive power of the PNI in predicting the risk for developing contrast-associated acute kidney injury (CA-AKI), an important complication following coronary angiography in patients with non-ST-elevation myocardial infarction (NSTEMI). The study population (336 patients with the diagnosis of NSTEMI) was divided into two groups: patients with CA-AKI and patients without CA-AKI. The mean age of the whole population was 62.0 ± 12.7 (21–95) years. CA-AKI was detected in 68 (20%) patients. Prognostic nutritional index values were significantly (P <.001) lower in the CA-AKI (+) group. Low PNI values (cutoff < 48.5%) were independent predictors of CA-AKI with Odds ratio (OR):.913, 95% confidence interval (CI):.866–.962, P :.001, with a sensitivity 70.6% and specificity 69.4%. Prognostic nutritional index seems to be an easily assessable and promising scoring system that can be used in clinical practice for predicting the risk of developing CA-AKI. [ABSTRACT FROM AUTHOR]

Objective: Governments have enforced restrictions to prevent the spread of coronavirus disease 2019, which has affected lifestyle and psychosocial well-being. The aim of this study is to examine the psychosocial dimensions of children with type 1 diabetes mellitus and lifestyle changes in the face of the pandemic. Materials and Methods: Sixty school-aged children with type 1 diabetes mellitus were included to evaluate socioeconomic status, lifestyle changes, and psychological state after a 3-month school closure, using a questionnaire as well as scales in children and mothers [Depression-Anx iety-Stress Scale (short-form), Revised Child Anxiety-Depression Scale (parent-version), The Perceived Stress Scale in Children] via a Google® Form. The effect of pre-pandemic glycemic control on lifestyle and factors affecting HbA1c change were also investigated. Results: The percentage of mothers having scale scores above the cutoff in terms of stress, anxiety, and depression were 18.3%, 23.3%, and 33.3%, respectively. Mother's and children's anxiety, depression, and stress scores were positively correlated. Employed mothers had higher depression scores. Paternal unemployment increased the anxiety of the mothers. Seventy-eight percent (n = 46) of the mothers thought that diabetes in their children increased the risk of coronavirus disease 2019 infection, and children of these mothers had higher depression, anxiety, and stress scores(P = .01, P < .01, P < .01). The majority of participants were adversely affected by coronavirus disease 2019 in terms of daily routines and dietary compliance. Patients with poor-controlled type 1 diabetes mellitus deteriorated more in terms of diet compliance (P = .01). Conclusion: Coronavirus disease 2019 affects the psychosocial dimensions in the family of children with type 1 diabetes mellitus. The psychosocial impact is reflected within the family and may affect diabetic control. Thus, it should be handled within the context of family. The provision of proper information and guidance to parents may be crucial to alleviate the psychosocial burden on the family during the pandemic. [ABSTRACT FROM AUTHOR]

Objective: Hereditary multiple osteochondromas is an autosomal dominant disorder caused by heterozygous pathogenic variants in EXT1 or EXT2. We aimed to evaluate the clinical and molecular findings of a Turkish cohort with hereditary multiple osteochondroma. Materials and Methods: Thirty-two patients aged 1.3-49.6 years from 22 families were enrolled. Genetic analyses were made by EXT1 and/or EXT2 sequencing and chromosomal microarray analyses. Results: We found 17 intragenic pathogenic variants in EXT1 (13/17) and EXT2 (4/17), 12 of which are novel. Four probands had EXT1 deletions, including 2 patients with partial EXT1 microdeletions involving exons 2-11 and 5-11, and 2 patients with whole-gene deletions. In 21 variants, the frequency of truncating and missense variants was 76.1% and 23.8%, respectively. Two families had no detectable variants in EXT1 and EXT2. All patients had multiple osteochondromas at the long bones, mainly at the tibia, forearm, femur, and humerus. Bowing deformity of the forearms (9/32) and the lower extremities (2/32), and scoliosis (6/32) were observed. The clinical severity was not different between patients with EXT1 or EXT2 variants. One patient with an EXT2 variant and another with an EXT1 microdeletion had the most severe phenotype with class III disease. Four patients with no EXT1 or EXT2 variants had milder phenotypes. Intrafamilial variability in disease severity was not observed. Conclusion: We report a hereditary multiple osteochondroma cohort with clinical and molecular data including 12 novel intragenic variants in EXT1 or EXT2, and 4 microdeletions involving EXT1. Taken together, our data expand the existing knowledge of the phenotype-genotype spectrum in hereditary multiple osteochondroma. [ABSTRACT FROM AUTHOR]

Objective: Although vaccines are considered safe for most people, patients with some chronic diseases have been very hesitant to get vaccinated, especially at the initial stages of vaccination. We conducted a survey among patients with epilepsy (PWE) who are currently experiencing hesitations, aiming to investigate the vaccination rates against Coronavirus disease-2019 (COVID-19) and the side effects emerged in vaccinated patients. Methods: Two hundred nineteen PWE were questioned during a routine outpatient follow-up through previously prepared questionnaires that contained questions about patients' demographic features, information about the vaccination status, and its adverse effects. Results: We included 219 PWE in the study of which 112 (51.1%) were female and 107 (48.8%) were male. One hundred eighty patients (82.1%) had been vaccinated at least once, 75% of the patients preferred two doses of BNT162b2 mRNA COVID-19 vaccine, 9.4% of the patients preferred two doses of Sinovac's inactivated vaccine, 6.1% of the patients preferred three doses of Sinovac, and 9.4% of the patients preferred Sinovac and BNT162b2 vaccines. Seventy-seven (42.7%) patients reported that they experienced side effects after vaccination whereas ten patients (5.5%) reported worsening of their seizures after vaccination; one person stated that she/he was hospitalized in the intensive care unit due to status epilepticus. Conclusion: Generally, the tolerance of COVID-19 vaccines has progressed with mild side effects in most cases, which is consistent with previous studies in the general population, similarly no serious and previously unreported side effects were found in our study. Our study showed that COVID-19 vaccines are well-tolerated and safe for seizures in PWE. [ABSTRACT FROM AUTHOR]

Objective: Surgical excisional biopsy is accepted as the standard of care approach in the diagnosis of lymphomas. Financial issues related to the increased cost and the invasive nature of the procedure forced physicians to use some alternative diagnostic methods. Percutaneous core needle biopsy, which gained a reputation for the diagnosis of lymphomas with the advent of improved pathological, immunohistochemical, and molecular analysis, made it possible to have an accurate diagnosis with limited tissue samples. In this retrospective study, we aimed to compare the diagnostic yield of surgical excisional biopsy and core needle biopsy. Materials and Methods: This study included 131 patients who were diagnosed with lymphoma with a nodal biopsy which was acquired via surgical excisional biopsy or core needle biopsy between 2014 and 2020 in our center. Around 68 patients underwent surgical excisional biopsy and the remaining 63 underwent core needle biopsy. Samples that allowed to the identification of the exact tumor type and/or subtype were accepted as fully diagnostic. Sufficient amount of tissue that the pathologist could have any suspicious findings considering malignant lymphoma was classified as partial diagnostic group. Inadequate samples were the ones who were not enough to report any final diagnosis. Results: The patients who underwent a core needle biopsy were significantly older than the patients who underwent to surgical excisional biopsy (56.8 vs. 47.6, P = .003). Despite the full diagnostic ability of surgical excisional biopsy outperformed core needle biopsy (95.2 % vs. 83.8 %, P = .035), in 92.6% of the patients whose tissue samples were obtained via core needle biopsy were accepted to have a sufficient diagnosis to initiate the treatment and not required a second biopsy, which was comparable with the ones achieved by surgical excisional biopsy (92.6% vs. 95.2%, P = .720). Conclusion: According to the results obtained in our study, we may conclude that core needle biopsy is a viable and comparable alternative to surgical excisional biopsy, offering a less invasive and less-expansive approach. [ABSTRACT FROM AUTHOR]