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Objective: Exenatide (twice daily) has been used as a glucagon-like peptide-1 receptor agonist in patients with diabetes with inadequate glycemic control for over a decade. In this paper, we aimed to investigate the long-term glycemic control and change in body weight in patients treated with exenatide. Methods: A total of 287 patients who were treated with exenatide twice daily between 2012 and 2022 were included in this retrospective study. The changes in glycated hemoglobin (HbA1c) levels and body weight were assessed over time after exenatide administration. The administered insulin dosage and metabolic parameters were documented. The baseline data were compared over a period of 3 months to 3 years. Results: The study included 101 (36%) males and 186 (64%) females, with an average age of 56.4 ± 10.7 years. The baseline HbA1c level was 8.0 ± 1.8%, and the body mass index was 38.8 ± 5.9 kg/m². The HbA1c level had decreased by 1.29% from the baseline at 3 months (P < .001), which continued up to 3 years (−0.63%, P = .010). During the 3-year period, body weight continued to decrease significantly (−12.1, P < .001). Glucose levels were significantly reduced, but the lipid levels and glomerular filtration rate after exenatide treatment were similar. Notably, exenatide administration resulted in a decrease in insulin dosage for patients treated with insulin. Conclusion: Exenatide therapy produced continued improvements in glycemic control and progressive weight loss for 3 years in patients with diabetes in a real-life setting. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: The COVID-19 pandemic is progressing rapidly, sending the world into a great panic. Healthcare professionals have responded by embarking on a concerted search for therapies to cure and prevent COVID-19. Recently, interferon (IFN) has emerged as a potential therapy as it is associated with reducing lung inflammation and suppressing viral replication. This research paper assessed the efficacy of high-dose nebulized IFN α 2b in severe COVID-19 pneumonia. METHODS: This is a retrospective study. It commenced on April 9 and ended on June 17, 2020. Researchers selected participants from hospitalized patients aged 18 years and above who were diagnosed with severe COVID-19 pneumonia. Other inclusion criteria were bilateral pneumonia on lung or chest X-ray scan and severe respiratory distress. SMART-COP, which is a risk stratification scoring tool, and radiologic severity index (RSI) were used to assess pneumonia severity. Patients in the treatment cohort received nebulized IFN α 2b at a dose of 10 million IU every 12 hours for 5 days, in addition to standard treatment. Patients in the control cohort received standard treatment only. RESULTS: Seventy-three patients met the inclusion criteria; 37 were included in the treatment cohort and 36 in the control cohort. Mechanical ventilation was needed in 14 of 36 (38.9%) patients in the control cohort, compared with 6 of 37 (27.4%) patients in the treatment cohort (HR 5.62 [95% CI 1.81-17.48]; P = .003). For pneumonia severity, there was a hazard ratio (HR) of 3.72 [95% CI 1.74-7.98]; P = ·.01. After 5 days of treatment, chest X-rays indicated significant beneficial changes in the treatment group (HR 2.24 [CI 1.05-4.79]; P = .036). Multivariate analysis revealed that pneumonia severity and RSI remained higher in the control group. The HR was 3.44 [95% CI 1.49-7.94]; P = .004 and 2.26 [95% CI 0.99-5.16]; P = .05, respectively. There was an increase in liver aminotransferases in 5 (14%) participants in the control cohort and 3 (8%) participants in the treatment cohort. CONCLUSION: High-dose nebulized IFN α 2b has potential efficacy in mitigating severe COVID-19 pneumonia. This study established that administering high-dose nebulized IFN α 2b significantly reduces pneumonia severity in COVID-19 patients. We also found a strong relationship between using nebulized IFN α 2b and reduced need for mechanical ventilation among patients with severe COVID-19 pneumonia. However, a well-designed control trial is needed to confirm the drug's efficacy in reducing the COVID-19 pneumonia severity. [ABSTRACT FROM AUTHOR]

Objective: The objective is to study to what extent the development of retinopathy of prematurity (ROP) is associated with assisted conception (AC) and in vitro fertilization (IVF) in a tertiary referral hospital. Materials and Methods: This study is a retrospective observational cohort study. Very-low-birth weight (VLBW) infants with gestational age (GA) <32 weeks or birth weight <1500 g were admitted to the neonatal unit of a tertiary care hospital between January 1, 2011, and December 31, 2021. The study determined the degree of ROP developed according to the type of fertilization used for conception. Main outcome measures were ROP prevalence in pregnancies obtained after IVF/intracytoplasmic sperm injection (ICSI) in the period from January 1, 2011, to December 31, 2021, in a tertiary hospital. Results: Of the 408 infants included in the study sample, 105 (25.7%) were born following AC and 12.4% of these developed ROP. In our sample, the practice of IVF was not associated with an increase in the incidence of VLBW infants (R² = 0.12; P = .29). Conclusion: Conception achieved via AC or IVF is not significantly associated with ROP in any degree of severity. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to compare the surgical outcomes of open appendectomy (OA) and laparoscopic appendectomy (LA) for pediatric acute appendicitis in order to guide its future management. Materials and Methods: We conducted a retrospective study including all children under the age of 14 years, who underwent appendectomy for acute appendicitis, during a period of 6 years (2013-2018). We divided our patients in two groups based on the surgical modality: the laparoscopic and open group. P values of less than .05 were considered statistically significant. Results: A total of 690 appendectomies were identified: 151 (22%) were performed laparoscopically and 539 (78%) via laparotomy. The demographic data were comparable between the 2 groups. There was no statistical difference regarding the age, sex. However the frequency of obese patients was higher in laparoscopic approach (P < .001).The mean operative time was significantly longer in the Laparoscopic group (77 ± 39, 6 minutes) compared with Open group (57 ± 27 minutes) (P < .001). Prophylactic drain placement was significantly more common in the open appendectomy group (P = .034). Patients undergoing laparoscopic appendectomy experienced a quicker recovery to apyrexia, reduced use of postoperative analgesics, and postoperative antibiotic compared to those undergoing open appendectomy (P < .05). The mean length of hospital stay was respectively 4 ± 1 day in LA group and 4 ± 2 days in the OA group. No significant difference was observed. The results showed no significant difference between the 2 groups regarding the incidence of wound infection, intra abdominal abscess, intestinal obstruction and umbilical hernia (P > .05).There was no death in this study. Conclusion: Laparoscopic appendectomy is safe and feasible for the management of appendicitis without significant influence on the complications rate. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The Turkish Global Youth Tobacco Survey (GYTS) 2017 revealed that 17.9% of students aged 13-15 used tobacco products and 7.7% smoked cigarettes. Given the high prevalence of smoking, it is important to evaluate the factors associated with quit attempts among adolescents. This study aimed to identify the factors associated with Turkish adolescents' attempts to quit smoking using Structural Equation Model (SEM) analyses. MATERIAL AND METHODS: This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, schoolbased study carried out below 18-year-olds. The study population (n = 18 985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9735 students remained for the analysis. The outcome was an attempt to quit smoking within the past year. Structural Equation Model (SEM) was used for data analysis. The model had good fit (CFI = 0.917, TLI = 0.900, RMSEA = 0.032). RESULTS: Of the 9735 students, 66.4% were male. In the past 12 months, 56.3% (95%CI: 55.3%-57.3%) of smokers attempted to quit. Exposure to anti-tobacco policies (β = 0.114. P < .001) had positive direct effects, whereas sociodemographic factors (β = -0.086. P < .001), nicotine dependency (β = -0.037. P = .008) and exposure to second-hand smoke (β = -0.051. P < .001) had negative direct effects on quit attempts. CONCLUSION: More than half of the smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to secondhand smoke decreased cessation attempts. Anti-tobacco policies such as sale restrictions and warnings of the dangers of tobacco products should be given high priority and enforced fully since they are the strongest predictors of quit attempts. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AIM: This study aims to retrospectively evaluate the incidence and stage of oral mucositis in patients undergoing hematopoietic stem cell transplantation. METHODS: A total of 102 patient records of patients hospitalized between 2014 and 2019 in the adult hematopoietic stem cell transplantation clinic of a tertiary university hospital in Turkey were evaluated. Data were collected through a retrospective evaluation of patient records. Records made according to the WHO Oral Toxicity Scale included in the patient records during hospitalization in the adult hematopoietic stem cell transplantation clinic were evaluated. Oral mucositis data from recordings were analyzed at baseline, and on days 5, 10, 15, and 30). RESULTS: 96.1% (n = 98) of 102 patients developed oral mucositis; only 10.7% had Grade 3, and 2.7% had Grade 4. Oral mucositis development time was 8.28 ± 0.32 days, and recovery time was 14.25 ± 0.78 days. It was determined that smoking, diagnosis, transplantation type, and preparatory regimen affected the oral mucositis healing process. CONCLUSION: While the incidence of oral mucositis in patients undergoing hematopoietic stem cell transplantation in our study was similar to be similar with the reported findings in the literature, the proportions of Grade 3 and 4 oral mucositis were lower in our study. [ABSTRACT FROM AUTHOR]

AIM: This research aimed to assess the financial literacy levels of healthcare professionals working at a Provincial Health Directorate and examine their relationships with various financial domains. METHODS: The study utilized a cross-sectional online survey. The financial literacy scale was employed to assess the financial knowledge and compentencies of healthcare professionals, providing a structured evaluation of their understandig across various financial domains. Statistical analyses, including correlation analysis, independent samples t-test, and one-way ANOVA, were performed using SPSS-25 and R programs. RESULTS: A total of 240 participants took part, comprising 52.1% males and 47.9% females, aged between 20 and 65 years. Younger healthcare professionals (p=.017) and males (p=.001) demonstrated higher financial literacy levels. Significant correlations were found between financial literacy and domains such as investment instruments, debt and risk management, and personal finance management. Weak but positive relationships were observed between financial literacy and digital assets, indicating emerging trends in digital finance awareness. For instance, males exhibited higher proficiency in investment instruments and debt management, while younger professionals displayed higher knowledge in investment areas. CONCLUSION: The findings underscore the importance of targeted financial education for healthcare professionals, highlighting the need for sector-specific training programs. Enhanced financial literacy is essential for improving financial decision-making, ultimately benefiting both personal financial well-being and professional performance in the healthcare sector. [ABSTRACT FROM AUTHOR]

AIM: Computer vision syndrome has been an issue of concern among students who use digital devices continuously. This study aimed to determine the prevalence and level of knowledge on computer vision syndrome and its relationship with associated factors among undergraduate students in a public university in Malaysia. METHODS: This study was conducted between 26 May and 23 June 2022 at National University of Malaysia. A cross-sectional study among 208 undergraduate students from a public university was conducted. A self-reported questionnaire via Google Form was used to capture the data among the undergraduates. The prevalence and associated factors of computer vision syndrome were each evaluated using the validated Computer Vision Syndrome Questionnaire and Computer Vision Syndrome Survey Form 3 questionnaires, respectively, while knowledge of computer vision syndrome was assessed using a validated questionnaire from a previous study. All the data were analyzed using the Statistical Package for Social Sciences version 26.0 software (IBM Corp.; Armonk, NY, USA). RESULTS: The prevalence of computer vision syndrome among undergraduates was 63.0% (n = 131), with 91.9% having poor knowledge of computer vision syndrome. Significant associations toward computer vision syndrome were found among undergraduates who have refractive errors/wearing glass (69.3%), screen edge at or above horizontal eye level (79.4%), uncomfortable sitting postures (79.4%) and close eye--screen distance (82.0%). In-depth analysis showed that having refractive errors/wearing glasses (aOR: 1.93; CI: 1.05, 3.57), uncomfortable sitting postures (aOR: 2.01; CI: 1.08, 3.74), and close eye--screen distance (aOR: 2.81; CI: 1.31, 6.05) had odd chance to develop computer vision syndrome. CONCLUSION: The study's findings denoted that digital device users should have more knowledge of computer vision syndrome and practice the preventable measures, such as proper viewing distance and angle, upright sitting postures, appropriate screen and surrounding illuminance, as well as regular eye check-ups. [ABSTRACT FROM AUTHOR]

Background: The optimal surgical technique for managing external ear melanoma and its corresponding prognosis remain areas lacking comprehensive data. In this retrospective study were patients treated with a cartilage-sparing excision of melanoma of the external ear. The primary objectives are to evaluate local control rates, overall survival, and disease-specific survival. Methods: After conducting a structured review encompassing surgical methodologies and survival rates, a clinical retrospective analysis was undertaken involving patients treated from 2011 to 2022. The treatment approach across all cases involved cartilage-sparing resection followed by wound closure utilizing primary closure or split/full-thickness skin grafting for reconstruction. Statistical analysis was conducted employing the Kaplan–Meier survival analysis. Results: Superficial spreading melanoma represents the predominant histological subtype observed. In all cases, patients underwent cartilagesparing resection of the tumor. Among them, 9 patients underwent simultaneous sentinel lymph node biopsy during resection, all of which yielded negative results. Subsequent to treatment, 1 patient experienced local recurrence after 9 months, while another presented with locoregional recurrence in a lymph node after 15 months. No instances of distant metastasis were recorded within the patient cohort. The local control rate was 92.86%, the overall survival 100% and the disease-specific survival 100%. The average follow-up was 41 months. Conclusion: The outcomes regarding local control rate, overall survival, and disease-specific survival underscore the efficacy of cartilage-sparing resection as a viable treatment modality, particularly for early-stage melanoma cases. These results not only highlight the significance of achieving tumor-free margins but also emphasize the importance of attaining aesthetically satisfactory outcomes. Consequently, cartilage-sparing resection emerges as an acceptable therapeutic approach for managing melanoma of the external ear, offering promising prospects for patients in terms of both medical and cosmetic considerations [ABSTRACT FROM AUTHOR]

Background: Hypertrophy of inferior turbinate (IT) may arise from soft tissue and/or bony enlargement and is most related to inflammatory rhinitis. We aimed to study and compare the histopathological changes in the IT mucosa, submucosa, and bone in chronic rhinosinusitis with (CRSwNP) and without nasal polyps (CRSsNP). Methods: The specimens of the IT in patients who underwent endoscopic sinus surgery and inferior turbinoplasty (ITplasty) were included and studied under the microscope in the high-power field. The changes in the mucosa, submucosa, and bone were studied, graded accordingly, and compared between the 2 groups. Results: In the mucosa, there was no significant difference in the polymorphonuclear neutrophils (PMN) and lymphocytic counts; however, the eosinophilic count in the mucosa was significantly higher in CRSwNP (P = .001). There was no significant difference in basement membrane thickness or subepithelial oedema. However, the lymphocyte count was higher in CRSsNP (P = .003), and the eosinophilic count was higher in CRSwNP (P = .001). The bone did not show inflammation. The significant osteitic changes in the bone were periosteal thickening with osteoblastic activity (P = .016). Conclusion: The mucosa and submucosa had a significant change in CRSwNP related to the eosinophilic infiltrates. In the submucosa, the lymphocyte count was significantly higher in CRSsNP. The osteitic changes seen were limited to periosteal thickening with minimal osteoblastic activity in both groups, but were significantly higher in CRSsNP. Hence, we can resect only the effected mucosa and spare bone during ITplasty in cases of CRSwNP, and IT bone may be partly resected in CRSsNP patients [ABSTRACT FROM AUTHOR]

OBJECTIVE: Tobacco use is an important risk factor for more than 20 types of cancer, especially cardiovascular and respiratory diseases, and many other health problems. Cigarettes are one of the most commonly used tobacco products in the world, and they can cause both physical and mental addiction. Adolescence is known to be the highest-risk period in terms of addiction among all age groups. As a result, smoke-free campus practices have become even more important in universities. This study investigates the prevalence of smoking among Pamukkale Medical School students and their views and behaviors regarding smoke-free campus practices. MATERIAL AND METHODS: This cross-sectional study was conducted with 548 medical students at Pamukkale Universıty Faculty of Medicine during the academic year 2021-2022, between April 1-29, 2022. A face-to-face interview was conducted. Students' smoking status and their views about a smoke-free campus were assessed. In the questionnaire, the independent variables were socio-demographic characteristics, duration of staying in a smoke-free environment, smoking status in the place of residence, areas where smoking is most common, Fagerström nicotine dependence level, knowledge about smoke-free campus applications and campuses with the smokefree application. The Statistical Package for the Social Sciences version 21.0 package program was used to analyze the data. Descriptive statistics are presented with numbers and percentages for categorical variables, while the arithmetic mean and standard deviation are used for continuous variables. The chi-square test was used to compare categorical variables, and the Kolmogorov-Smirnov analysis was used to test the compatibility of data to normal distribution. RESULTS: The student smoking rate increased significantly as the number of semesters increased (P = .021). The smoking rate of male students was higher than that of female students (P = .001). The smoking rate of students living with their family or relatives was lower (P = .020). Smokers (14.7%) were more likely to have heard about the introduction of smoke-free zones on campus than nonsmokers (11%) (P = .280). 81.4% of students affirmed the statement, "The number of smoke-free rooms should be increased," and 84.3% responded, "I support the existence of smoke-free spaces." Nonsmoking students (90.8%) are more likely to agree that smoke-free spaces should be increased than those who smoke (57.7%) (P < .001). Among the students, 17.6% of nonsmokers and 37.8% of smokers find the information about smoke-free spaces sufficient (P < .001). The rate of those who consider smoke-free space inspections to be sufficient is lower for nonsmoking students than for nonsmokers (P = .017). Nonsmokers (89.5%) support the existence of smoke-free spaces to a higher degree than smokers (71.2%) (P < .001). CONCLUSION: One-third of Pamukkale University Faculty of Medicine students smoke, and smoking rates are higher among men and those who do not live with family or relatives. All participants strongly support the existence of smoke-free zones (84.3%), while a proportion of tobacco users (31.4%) support the implementation of a smoke-free campus. Student opinions of the smoke-free zones and the smoke-free campus application are more positive among nonsmokers than smokers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The total annual count of reported tuberculosis (TB) cases continues to decline throughout Turkey. Recognizing the regions with high and low burdens and revealing the factors affecting TB notification rates may play a role in guiding national control programs. This study aimed to analyze the spatial distribution of TB notification rates from 2005 to 2018 and evaluate the factors contributing to TB rates. MATERIAL AND METHODS: In this ecological study, we used freely available open data from the Internet. We employed global and local spatial autocorrelation analysis to identify the spatial distribution and the clusters with low and high burdens. We conducted an ordinary least square regression model, spatial lag model, and spatial error model. The best-fitting model was selected via model parameters. RESULTS: Throughout the study period, the provinces in West Marmara Region (Edirne, Kırklareli, Tekirdağ, Çanakkale) were consistently in a high-burden cluster. In univariate ordinary least square regression, population density, the proportion of contacts screened for TB, the proportion of TB contacts who received prophylaxis, TB dispensary count, mean particulate matter 10 levels, and gross domestic product were found to be positively associated with TB notification rate. The best-fitting multivariate spatial lag model revealed that the proportion of contacts screened for TB (ß, z-value: 0.89, 2.21) positively affected TB notification rate. CONCLUSION: The high TB burden in West Marmara Region should warn policymakers to maintain a focused approach to controlling TB in this area. This study showed the importance of contact tracing efforts to prevent the underdetection of TB cases. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to evaluate the effect of cold sand pack on vascular complications and pain in patients who undergoing percutaneous coronary intervention. METHODS: This randomized controlled interventional trial was conducted in a hospital between November 30, 2021 and April 3, 2022. The patients were randomly assigned to CSP and NSP. A 5 kg sand pack was applied on the femoral area of the patients in the CSP group at an average temperature of 18.9°C for the first 20 minutes. A 5 kg sand pack was applied at an average temperature of 24.1°C after the procedure on the femoral region of the patients in the NSP group. RESULTS: After percutaneous coronary intervention, less bleeding developed in the CSP group at hours 2, 3, and 12 when compared to the NSP group, and the ecchymosis diameters measured at hours 1, 2, 3, 4, 5, 6, 12, and 24 were higher than those of the NSP patients (p<0.05). It was detected that the pain score of the NSP group was higher at hours 1, 2, 3, 4, 5, 6, 12, and 24 on the femoral region when compared to the CSP group. CONCLUSION: It was detected that the cold sand pack applied for the first 20 minutes prevented bleeding and reduced ecchymosis diameter and pain intensity. [ABSTRACT FROM AUTHOR]

Objective: Persistent postural-perceptual dizziness (PPPD) is a chronic functional disorder where treatment should be tailored to the individual needs. While customized therapy with a physiotherapist has evidence-based benefits, it comes at a cost and the facility may not be available to some, especially in rural areas. An alternative option is a home-based treatment called MEND (Move, Eye, Neck stretching, and Deep breathing exercises) therapy. This study aimed to assess the efficacy of MEND therapy in PPPD compared to the hospital-based vestibular rehabilitation therapy (VRT). Methods: 59 PPPD patients completed the randomized-controlled study comparing MEND therapy (intervention) and hospital-based VRT (control). EuroQOL Group quality of life questionnaire (EQ-5D), Dizziness Handicap Inventory (DHI), and 21-question Depression, Anxiety, and Stress Scale (DASS-21) were monitored at baseline, 4 weeks, and 12 weeks. Results: At the end of the study, 100% patients on MEND therapy found it beneficial compared to 79.3% in the control group. The MEND therapy provided significant improvements in the physical (P = .007), functional (P = .0006), emotional (P = .0003), and total DHI (P = .0003) with a medium to large effect size. The control group showed significant improvement only in the functional elements of DHI (P = .04), and total DHI (P = .04) with a small to medium effect size. Conclusion: The MEND therapy is an effective option that incorporates all elements of therapy for PPPD. [ABSTRACT FROM AUTHOR]

Objective: Oticon Medical cochlear implant (CI) systems were evaluated for noise reduction effectiveness using voice track (VT) and adaptive directional microphones to determine the optimum CI fitting parameters, especially in noisy environments. Methods: Ten CI users (3 females, mean age 28.22; 7 males, mean age 36.71) participated in the study. Speech recognition in noise was evaluated in different test conditions with 2-syllable word lists in stationary speech-shaped noise. Five different test conditions were determined for each participant using a combination of software-based VT and directional microphone technology. In the first condition, the omnidirectional microphone (M) was selected and VT was turned off. The fully directional M and strong VT combination were activated in the second condition. In the third condition, the omnidirectional M and strong VT were set. In the fourth condition, automatic adaptive directional M and medium VT were used. Finally, omnidirectional M and medium VT were selected. Results: Speech comprehension scores obtained in a quiet environment were significantly better than those of the other 4 conditions in a noisy environment (P < .01). In addition, the best noise comprehension score (44%) was obtained in the fourth condition, although this was not statistically significant (P < .05). Conclusion: The VT technology was more effective in understanding speech in noise when used in the medium setting and with an automatic adaptive directional microphone. [ABSTRACT FROM AUTHOR]

Objective: This prospective study aimed to evaluate the benefit of barbed reposition pharyngoplasty in the management of patients presenting with isolated unilevel palatal snoring, regardless of the presence of obstructive sleep apnea (OSA). Methods: Barbed reposition pharyngoplasty was performed in 16 patients with confirmed unilevel palatal snoring observed during drug-induced sleep endoscopy. Patient-reported snoring questionnaires were taken before surgery and at 2 weeks, 6 weeks, and 6 months after surgery. Additionally, postoperative data, including pain scores, duration of hospitalization, and complication types and rates, were reported. Results: The mean snoring intensity dropped significantly from 8.1 ± 2.0 preoperatively to 3.5 ± 2.1 after 6 months (P < .001). The mean preoperative and postoperative snoring severity were 7.0 ± 1.5 and 3.1 ± 1.7, respectively (P < .001). The mean snoring score decreased from 8.5 ± 1.5 to 3.6 ± 2.0 (P < .001). The Epworth Sleepiness Scale scores decreased from 6.7 ± 4.2 to 4.9 ± 5.0, but this reduction did not reach significance (P = .087). Mean pain scores reached a peak at 6.4 ± 1.8 on day 4. The average hospitalization period was 1.06 ± 0.25. Thread extrusion occurred in 5 patients (31.3%) with no clear effect on the outcome measures. Conclusion: Barbed reposition pharyngoplasty is an effective surgical treatment option for patients with unilevel palatal snoring, and indications for palatal surgery should not be limited to OSA. Future studies assessing objective outcome measures and longer follow-up periods are needed to validate our findings. [ABSTRACT FROM AUTHOR]

AIM: Research self-efficacy helps predict the individual interest and confidence in conducting research. The study was conducted to identify the research self-efficacy among nurses working in a group of tertiary hospitals and their research-related behavior. METHOD: The study design was descriptive cross-sectional and conducted among nurses at Hamad Medical Corporation, Qatar Convenient sampling was done and 500 is the sample size. Data were collected through an online survey during 2 months in 2019 by using a validated "Nursing Research Self-Efficacy Scale" questionnaire. The scale includes 38 items under five domains, and the response was collected on a Likert scale from 1 to 5. The authors of the scale suggested excellent reliability score for the subscales, ranging from .94 to .97 and the existence of subscales was supported by exploratory and confirmatory factor analysis. RESULTS: A completed survey was collected from 780 nurses. The mean self-efficacy score was 2.92 ± 0.97. The mean score for the subscale of obtaining science-based knowledge resources was the highest (3.24 ± 1.03) and the lowest for critically read and evaluate qualitative research literature (2.63 ± 1.12). Nurses with higher educational qualifications and those who enrolled in any educational program further to their nursing education have statistically significantly high research self-efficacy. CONCLUSION: The overall research self-efficacy of working nurses is moderate. However, nurses' confidence in the ability to perform critiquing research and understand the concept and methodology in research is minimal. Introduction of nurse-tailored research training, which covers fundamental aspects of research to an advanced level, will help make them more confident in research. [ABSTRACT FROM AUTHOR]

Objective: Differential diagnosis and prognosis of low-risk follicular cell-derived thyroid neoplasms have been conflicting. We aimed to evaluate immunohistochemical features and prognosis of tumors in "well-differentiated tumor of uncertain malignant potential" and "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" categories. Methods: Fifty-two low-risk thyroid tumors which were classified as well-differentiated tumor of uncertain malignant potential (n = 23) and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (n = 29) with a follow-up of at least 60 months were included. Galectin-3, HBME-1, CK19, and CD56 expressions were evaluated. The control group included benign nodules (n = 53), conventional papillary thyroid carcinomas (n = 37), and encapsulated follicular variant papillary thyroid carcinomas (n = 60). Results: During a median 84 months follow-up period, none of the patients experienced a recurrence of tumor. Expression of HBME-1 in low-risk tumors was significantly frequent than benign and infrequent than malignant tumors (P = .001 and P < .001, respectively). The frequency of galectin-3 positivity was similar between low-risk and malignant tumors (P = .805) and significantly higher in low-risk tumors when compared to benign nodules (P < .001). Expression of CK19 in low-risk tumors was significantly frequent than benign nodules and infrequent than malignant tumors (P = .01 and P = .001, respectively). The expression profile of CD56 was similar in benign nodules and low-risk tumors (P = .361). Total loss of CD56 in tumor was the most specific marker of malignancy (100%). Positive staining of HMBE-1 was the most sensitive marker (89.7%) for predicting malignancy. Conclusion: Low-risk thyroid tumors had immunohistochemical features overlapping with both benign and malignant thyroid tumors and had a benign course of disease during a long follow-up period. [ABSTRACT FROM AUTHOR]

Objective: Bisphenol A (BPA) is an endocrine disruptor that interferes with estrogen (E2) levels, while Foeniculum vulgare L. (FV), a plant with phytoestrogen compounds and medicinal properties, has been suggested as a potential remedy against endocrine disruptors. This study aimed to evaluate the effect of FV extract on changes in estrogen levels, total antioxidant capacity (TAC), nitric oxide (NO), and ovarian structure in rats induced by BPA. Methods: The study used 30 female rats that were divided into different treatment groups, including a control group, a BPA group, and 3 BPA-FV-treated groups with varying doses of FV (250, 500, and 1000 mg/kg). Blood samples were taken from the rats to measure estrogen, TAC, and NO levels, while their ovaries were analyzed. Results: The results showed that BPA exposure caused a reduction in E2, TAC, and the number of ovarian follicles while increasing NO levels. However, treatment with FV extract resulted in increased E2 and TAC levels and the number of ovarian follicles while reducing NO levels. Conclusion: FV extract could be used as a natural supplement to mitigate the harmful effects of BPA. [ABSTRACT FROM AUTHOR]

Objective: The purpose of our study was to devise a new brain Magnetic Resonance Imaging (MRI) scoring system based on the Loes and modified Loes scores in phenylketonuria (PKU) patients. Materials and Methods: The brain MRI scans of patients with late diagnosed PKU were evaluated retrospectively. Patients’ age at diagnosis, age at which diet started, age at MRI, and, blood phenylalanine (Phe) levels at the time point closest to the MRI were recorded. Results: Eleven patients aged from 3 to 28 years were included in the study. The median MRI involvement score was 17 (interquartile range = 3). The most involved white matter areas were the parietooccipital areas. There was a significant (P = .046) correlation between the blood Phe level at the timepoint closest to the imaging and the MRI involvement score. Conclusion: Our study provides insights into the MRI findings and scoring system in PKU patients. We have developed a scoring system based on the widely used Loes and modified Loes scoring systems that can be implemented in clinical practice. Also, our study contributes to the long-forgotten and largely abandoned area-imaging findings in late diagnosed and untreated PKU patients and set the stage for the future research in this field. [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: 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]

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: 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]

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]

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: 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]

Objective: Pneumatization of paranasal sinuses varies greatly between patients, and certain pneumatization variants have been associated with specific clinical conditions. The present research aimed to evaluate the presence of coexistence smaller maxillary and frontal sinus volume and narrow internal nasal valve angle and whether this association is significant. Methods: Sixty patients aged above 18 years old who underwent surgery for caudal septal deviation at the ear nose throat department of a tertiary care hospital between 2018 and 2021 were included in this retrospective cross-sectional study. The internal nasal valve angle was measured from reformatted coronal computed tomography scans. The maxillary sinus volume and frontal sinus volume were calculated using a workstation. The maxillary sinus and frontal sinus volumes were classified as narrow side and wide side according to the internal nasal valve angle measurements. The narrow- and wide-side maxillary sinus and frontal sinus volumes were compared within each other. Results: There was a statistically significant difference between the maxillary sinus volumes of the narrow internal nasal valve angle side and wide internal nasal valve angle side (mean ± SD: 14.47 ± 5.45 and 15.21 ± 5.31 mL, respectively, P = .014). There was a statistically significant difference between the frontal sinus volumes of the narrow internal nasal valve angle side and wide internal nasal valve angle side (median: 2.85 and 3.08 mL, respectively, P < .001). Conclusion: The maxillary sinus and frontal sinus volumes ipsilateral to the narrow internal nasal valve angle sides were significantly decreased. This coexistence may be significant. Further studies are needed to explain the significance of this association. [ABSTRACT FROM AUTHOR]

Objective: Due to insufficient data on the metabolic consequences of long-term whey protein consumption, in this trial, we aimed to examine the effects of whey protein, as fortified bread, on glycemic status, lipid profile, and blood pressure in overweight/obese women with type 2 diabetes mellitus. Methods: In a 12-week double-blind placebo-controlled randomized clinical trial, 48 overweight/obese women with type 2 diabetes mellitus were randomly allocated into either whey protein (bread fortified by 20 g whey protein concentrate) or placebo (unfortified bread) group. At pre- and postintervention phase, physical activity, blood pressure, serum levels of glucose, insulin, glycosylated hemoglobin A1C, lipid profile, and dietary intakes were assessed. The homeostatic model assessment for insulin resistance was used for the estimation of insulin resistance. Results: Totally 35 patients completed the trial. At the endpoint, there were no significant between-group differences for the assessed glycemic parameters (P > .05), except glycosylated hemoglobin A1C, which was higher in the whey protein group after adjusting for the confounders and baseline values (P < .05). Fasting blood glucose was significantly increased in whey protein group (P < .05). There was a significant increase in HOMA-IR and serum level of insulin in both whey protein and placebo groups (P < .05). There were no significant within- or between-group changes in the lipid profile and blood pressure of the patients (P > .05). Conclusion: Three-month consumption of the whey protein concentrate fortified bread has no effects on lipid profile and blood pressure. It may cause some undesirable changes in some glycemic indices among overweight/obese women with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objective: The coronavirus disease 2019 pandemic affected the healthcare systems worldwide. In this study, we aimed to examine the impact of the coronavirus disease 2019 pandemic on injury-related visits. Materials and Methods: We conducted a retrospective analysis of 7648 injury-related pediatric emergency department visits between March 11 and June 30, 2018, 2019, and 2020, and compared the total number of visits, triage levels, distributions of injury mechanisms, and admission rates during the pandemic in 2020 to the same period in 2018 and 2019. Results: In the first 4 months of the pandemic, there was a 69.5% drop in all pediatric emergency department visits compared to the previous 2 years. Despite this decrease, the proportion of injury-related pediatric emergency department visits increased from 14% to 20.9% in 2020 (P < .001). There was a 3.8% increase in the frequencies of patients with high triage acuity levels (T1, T2, and T3) and a 3.8% decrease in patients with low triage acuity levels (P < .001). The domestic injury rate increased from 40% to 60% during the pandemic period (P < .001). Hospitalization rates increased from 6% to 11.5% and admission to intensive care units increased from 0.9% to 3.3%. The differences were statistically significant (P < .001). Visits due to burn increased from 2.7% to 5.2% (P < .001), poisoning from 3.4% to 5.5% (P < .001), bicycle accidents from 3.3% to 6.8% (P < .001), while injuries due to motor vehicle accidents decreased from 2.6% to 1.3% (P = .004) and sports injuries decreased from 8% to 2.1% (P < .001). Conclusion: This study revealed that despite the significant decrease in total pediatric emergency department visits, percentages of injury-related visits increased during the pandemic. [ABSTRACT FROM AUTHOR]

Objective: Atrial septal defect is a congenital heart disease usually diagnosed in childhood. This study aimed to evaluate the mid-term follow-up results of patients who underwent transcatheter closure of atrial septal defect by comparing the devices and methods used in the procedure and investigating the complications of this procedure in children. Materials and Methods: This study evaluated 232 patient files retrospectively. Of the 232 patients, 24 were excluded from the study due to missing files or data. Also, patients with multi-fenestrated atrial septal defect and aneurismatic septal tissue were excluded from the study. The following data were evaluated: follow-up time, patient complaints, symptoms, transthoracic echocardiography, and transesophageal echocardiography findings (if performed), the size of the defect as measured by balloon-sizing, the size of the device used in the procedure, and major and minor complications. Results: The study included 208 children who were diagnosed with atrial septal defect. The mean age of the patients was 88.0 ± 56.5 months. Of the patients, 170 (81.7%) had no complaints. The success rate of the procedure was found to be 95.7%. While device embolization was the most common major complication, arrhythmia was the most common minor complication. The complication rate was statistically different according to the device type used in the procedure. Conclusion: Transcatheter closure of atrial septal defect is a safe method for atrial septal defect closure in pediatric patients. The study found that defect diameters measured by different methods were not correlated with each other. The procedure complication rates differed according to device type. [ABSTRACT FROM AUTHOR]

Objective: Essential tremor is the most common movement disorder diagnosed during adolescence. However, there are insufficient data about its prevalence among adolescents. This study aims to determine the prevalence of potential essential tremor cases in Turkish adolescents. Materials and Methods: This cross-sectional study was carried out in Istanbul, Turkey. A total of 5 high schools were visited. In the first step, the authors provided 5559 students (aged 14-18) with clinical information about tremors and essential tremors in their classrooms. After that, a 12-item questionnaire filled by adolescents and parental consent forms were collected. The response rate was 78% (n = 4330). According to the questionnaire answers, adolescents who complained of experiencing tremors in any part of their body were clinically evaluated in the second step of the study. Lastly, a neurological examination to classify essential tremors based on the Washington Heights Inwood Genetic Study of Essential Tremor (1998) diagnostic criteria was conducted by a specialist. Results: The prevalence of tremor in the respondents aged 14-18 (median = 15) years was 1.2 % (n = 52/4330), and the prevalence of essential tremor was 0.41% (n = 18/4330). Male to female ratio for essential tremor was 5 : 1 (male = 15 and female = 1). Essential tremor cases were sub-classified as following: 10 (55.5%) definite essential tremor, 3 (16.6%) probable essential tremor, and 5 (27.7%) possible essential tremor. Conclusion: The data support the claim that essential tremor is a prevalent movement disorder in Turkish adolescents. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Altered cardiac repolarization is an important mechanism in the development of malignant cardiac arrhythmia and in the occurrence of sudden cardiac death. It is known that the risk of cardiac arrhythmia and sudden death is increased in patients with chronic obstructive pulmonary disease. Evaluating the measurements of repolarization in the electrocardiogram may provide useful information to determine potential risks for lethal arrhythmias in the patients with chronic obstructive pulmonary disease. In the present study, we investigated the possible relationships between repolarization parameters in the electrocardio and demographic, clinical, and biochemical findings in patients with chronic obstructive pulmonary disease. MATERIAL AND METHODS: In the present study, 35 patients with Global Initiative for Chronic Obstructive Lung Disease A-B constituted group 1 and 35 patients with Global Initiative for Chronic Obstructive Lung Disease C-D constituted group 2. Cardiac repolarization and dispersion (QTc interval and QT dispersion) were measured on 12-lead electrocardiogram. QTc interval, QT dispersion, TP-e, and Tp-e/QTc were evaluated in order to determine the patients at risk of sudden cardiac death. QTc interval >440 ms in men and >460 ms in women was considered as prolonged QTc interval. RESULTS: QTc and QTd values were found to be statistically significantly prolonged in the group of GOLD C-D compared to the group of GOLD A-B (P < .001). QTc value showed negative correlation with the ratio of forced expiratory volume in 1 second to forced vital capacity and partial pressure of oxygen (P = .030, r = -0.260; P = .006, r = -0.332, respectively). No significant difference was in Tp-e and Tp-e/QTc between the groups (P = .73, P = .12, respectively). CONCLUSION: QTc and QTd are non-invasive markers reflecting arrhythmogenicity, and our findings were found to be related to prolonged QTc and QTd in patients with chronic obstructive pulmonary disease. Prolongation in the dispersion of repolarization and altered cardiac repolarization in the population with chronic obstructive pulmonary disease may be related to hypoxemia and airway obstruction. Alterations in the cardiac repolarization may put these patients at high risk for malignant ventricular arrhythmia and sudden cardiac death. [ABSTRACT FROM AUTHOR]

Objective: Macrolides are often accepted as safe antibiotics due to their low allergenicity. However, studies on macrolides, particularly studies evaluating cross-reactivity in macrolides, are highly rare in children. This study aimed to evaluate the clinical manifestations, confirmation rate, and frequency of cross-reactivity in children admitted with suspicious clarithromycin or azithromycin allergy. Materials and Methods: A total of 61 children suspected of macrolide antibiotic allergy (clarithromycin, n = 39 and azithromycin, n = 22) were evaluated. Allergy work-up including drug provocation tests were performed in all patients to confirm drug allergy. Results: Macrolide allergy was confirmed in 9.8% (n = 6) of patients (azithromycin, 18.2% [n = 4] and clarithromycin, 5.1% [n = 2]). There was no significant difference between the confirmation rate of clarithromycin and azithromycin (P = .117). Cross-reaction with clarithromycin was confirmed in 2 (33.3%) patients with azithromycin allergy. Conclusion: Drug skin tests are not capable of confirming or ruling out macrolide allergy, and oral provocation tests are essential for a definitive diagnosis. Cross-reactivity, albeit rare, can occur between clarithromycin and azithromycin, which are the most frequently used macrolides in children. [ABSTRACT FROM AUTHOR]

Objective: The Impact of Weight on Quality of Life--Kids is a self-reported weight-related quality of life measure that has been validated for children and adolescents aged between 11 and 19. Impact of Weight on Quality of Life--Kids does not have a Turkish version. The aim of this study was to explore the reliability and validity of the Impact of Weight on Quality of Life--Kids in Turkish. Materials and Methods: The Impact of Weight on Quality of Life--Kids was translated into Turkish using Mapi Research Institute's suggested international translation technique. The psychometric evaluation included test--retest reliability, internal consistency, discriminant validity, concurrent validity, exploratory factor analysis, and confirmatory factor analysis. Results: For the total score, the internal consistency of the scale (Cronbach's alpha coefficient) was 0.93. The item-total score correlation coefficients ranged from 0.178 to 0.785. The testretest coefficients were found to be 0.94 for the total score and the subscales ranged from 0.66 to 0.89 after 2 weeks. Discriminant validity analysis demonstrated that the instrument differentiated well between the obese and non-obese samples. Five variables were discovered via factor analysis that explained 66.9% of the total variation. The chi-square/degree of freedom ratio value was 3.535, the comparative fit index value was 0.834, and the value of root mean square error of approximation was 0.10, as determined by confirmatory factor analysis. Conclusion: Our results demonstrated the adequate reliability and validity of the Impact of Weight on Quality of Life--Kids, suggesting that this scale is a useful tool for screening Turkish children and adolescents for weight-related quality of life. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to share our experience about clinical findings, natural course, and treatment response rates of a large cohort of patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. Materials and Methods: Medical records of patients who were diagnosed with PFAPA syndrome between January 2010 and May 2021 at Istanbul University-Cerrahpasa Cerrahpasa Medical Faculty pediatric rheumatology department were reviewed retrospectively. Results: A total of 607 patients (females: 277, males: 330) with PFAPA syndrome were included. The median duration of episodes was 3 (1-15; interquartile range (IQR) 3-5) days, and the median interval between episodes was 20 days (5-120; IQR 15-30). The median age at the last attack and median disease duration were 66 (24-168; IQR 48-84) months and 40 (4-132; IQR 27.5-60) months, respectively. Fever (100%) was the most common clinical finding, followed by pharyngitis/exudative tonsillitis in 594 (97.9%), aphthous stomatitis in 308 (50.7%), cervical lymphadenopathy in 278 (45.8%), abdominal pain in 249 (41%), and arthralgia in 228 (37.6%) of the patients. Among the clinical findings, there was no statistical difference according to gender, except for cervical lymphadenitis being higher in males (P < .001). Of the patients who were given steroids during attacks, 94.6% were responsive. Colchicine was effective in 93 (63.7%) patients. The disease episodes ceased in 313 (95.4%) of patients who had tonsillectomy/adenoidectomy. Conclusions: Clinicians should be alert for additional symptoms such as abdominal pain, arthralgia, and headache apart from the cardinal signs. Although tonsillectomy is highly effective, its use is controversial. Colchicine may be a good alternative for prophylaxis. [ABSTRACT FROM AUTHOR]

Aims: In clinical practice, birth weight reference percentiles for singletons are used to evaluate twin births. The utilization of singleton reference percentiles for twins is not appropriate as they experience different growth trajectories. However, Turkey still lacks such references. Our aim was to create gestational age-specific birth weight references for female and male Turkish twins. Materials and Methods: This is a hospital-based, multi-centered, retrospective study. In total, 2544 live-born twins between 2010 and 2019 were included in the study. Gestational age, birth weight, mode of delivery, gender, birth order, chorionicity, maternal age, pregnancy resulting from assisted reproduction techniques, APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score at 5 minutes, admission to the neonatal intensive care unit (NICU), length of stay in NICU, and death during the NICU stay were recorded. Results: Smoothed reference curves for birth weight by gestational age and separate tables for female and male twin neonates for the 3rd, 10th, 50th, 90th, and 97th percentiles from 26 to 39 weeks of gestational age were constructed. Overall neonatal and infant mortality rates during NICU stay in our twin cohort were 12/1000 and 16/1000, respectively. Conclusion: Twin-specific birth weight nomograms could be helpful as a reference for clinicians to identify high-risk neonates and fetuses who need specialized care. However, further studies with larger series are urgently needed for validation and use of these nomograms in clinical practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Aspirin desensitization is recommended for patients with nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity, in whom asthma is uncontrolled despite medical treatment, and/or frequent endoscopic sinus surgery (ESS) is required due to nasal polyps. There are few studies in the literature on long-term follow-up of patients undergoing regular aspirin treatment after desensitization. This study aims to evaluate the effect of regular aspirin treatment on respiratory function, symptom control, quality of life, and the number of nasal surgeries required during a period of 12 years. MATERIAL AND METHODS: A total of 18 patients were included in the study in 2006; 11 patients were excluded and 7 patients regularly taking aspirin for 12 years were evaluated. Oral aspirin desensitization was performed at 4-6 weeks following the ESS. Patients receiving 300 mg/day aspirin were followed up in control visits every 3 months. Nasal and respiratory system examinations and pulmonary function test were performed, and all patients responded to the SF-36 Quality of Life scale during each visit. RESULTS: There was no change in respiratory function parameters following the12-year aspirin treatment. There was no statistically significant improvement in the quality of life; however, the need for ESS due to the recurrence of nasal polyps decreased significantly (P = .000). At the 12-year follow-up, all symptom scores improved, but improvement in the postnasal drip score was statistically significant (P = .046). CONCLUSION: Long-term regular treatment with aspirin at a dose of 300 mg/day in patients with N-ERD improved symptom scores, and alleviated the need for ESS due to nasal polyp recurrence. [ABSTRACT FROM AUTHOR]

Objective: Early repolarization pattern (ERP) on electrocardiogram is more common among young athletes than in the general population, and has been considered a benign finding. However, ERP has been associated with increased risk of sudden cardiac death. The objectives of this study were to evaluate ERP in teenage athletes; investigate associations between ERP and echocardiographic findings of the left ventricle (LV); and to describe the impact of different sports disciplines on ERP. Methods: ERP was assessed in male teenage athletes from sports institutions for 5 different types of sport--basketball, swimming, football, wrestling, and tennis. All had been training for at least 3 hours per week for over at least 2 years. ERP was defined as J-point elevation ≥ 1 mV in 2 contiguous and/or lateral leads. A conventional echocardiography was performed in all athletes. Results: ERP was evaluated in 159 athletes with a mean age of 14 (range 10-18 years). It was more common in those training with combined exercise. There was no association between ERP and echocardiographic findings of left ventricular remodeling and geometric pattern. Conclusion: ERP is a frequent finding among teenage athletes. However, frequency varies by sports type, being more common in those training with combined exercise. It is not associated with structural echocardiographic alterations and is primarily seen as an electrophysiological change. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Endocrinology & Metabolism is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: Millions of people suffer from sleep disturbances. In addition, the coronavirus disease 2019 (COVID-19) pandemic created several new challenges--particularly for frontline healthcare workers (HCWs). This study assessed the sleep quality (SQ) among HCWs. MATERIAL AND METHODS: A cross-sectional study was conducted using an English-language online survey. The participants were invited via a web link sent using social network platforms. It included sociodemographic- and profession-related characteristics. COVID-19-associated risks were assessed (e.g., being on the front line, doing swabs, satisfaction about protective equipment, and management protocols). Assessment of SQ was done using the Pittsburgh Sleep Quality Index (PSQI) and various medical errors were recorded. RESULTS: A total of 217 HCWs completed the survey with mean (±standard deviation) age of 35.8 (±7.3) years; 56.2% were male, 18.43% had comorbidities, and 61.75% experienced sleep difficulties before the COVID-19 crisis. This work reports a 78.8% prevalence of poor SQ, with the mean (standard deviation) global PSQI score of 9.36 (±4.4). HCWs with poor sleep experienced more positive comorbid profile (23.64% versus 6.52%, p=0.01). Working on the front lines of COVID-19 was associated with poor sleep (69.59% versus 47.83%, p=0.006). Among the participants, 77.42% performed medical errors, particularly not checking for drug allergies (17.97%), dispensing medication with incomplete instructions (20.74%), providing incorrect doses or overdosing (14.75%), incorrectly explaining the use of medication (9.22%), and prescribing a drug to the wrong patient (10.14%). CONCLUSION: This nationwide survey reported high prevalence of poor SQ among HCWs during the COVID-19 pandemic. Being an HCW on the front lines of COVID-19 and doing swabs with a positive comorbidity was associated with poor sleep. [ABSTRACT FROM AUTHOR]

Objective: Irritant contact dermatitis and Allergic contact dermatitis are two distinct forms of contact dermatitis. Allergic contact dermatitis is a Type 4 (delayed-type) hypersensitivity reaction that occurs during subsequent contact with an allergen to a previously sensitized person. The number of allergens that cause allergic contact dermatitis is increasing day by day. Although it is not the gold standard for the detection of these allergens, skin patch testing is a very helpful method. This study aimed to determine the most common contact allergens in the pediatric age group. Material and Methods: All patients with the diagnosis of contact dermatitis who underwent a skin patch test (TRUE TEST) in the department of Pediatric Allergy and Immunology between March 2017- February 2018 were enrolled in this study. The patch test was evaluated 72 hours later by the same physician and interpreted as recommended by the American Academy of Dermatology. In addition to the patient files, demographic and clinical characteristics, localization of lesions, and itch score according to visual analog scale were recorded. Results: A total of 80 children enrolled in the study; 45 (56.3%) were girls and 35 (43.7%) were boys. The mean age of the children was 7.37±3.84 years and 57.5% of the patients who underwent skin patch testing had a positive response to at least one or more allergens. The most common allergens were Nickel sulfate, CI + Me-Isothiazolinone, Thiuram Mix, Formaldehyde, and P-tert-butylphenol formaldehyde resin (14.8%, 10%, 6.3%). There was no difference in terms of age, sex, duration of complaints, and pruritus score according to nickel sensitization. Conclusion: In the presence of chronic dermatitis in children, allergic contact dermatitis should be considered in the differential diagnosis. The culprit allergen should be determined. Also, the most common contact allergen is Nickel Sulphate in the world and the increased sensitization to other allergens is due to the increased contact of children with cosmetics and different contact allergens. [ABSTRACT FROM AUTHOR]

Objective: Nasal airway obstruction caused by inferior turbinate hypertrophy is the most troublesome symptom for patients with allergic rhinitis. The aim of this study was to determine any correlation between different nasal obstruction measurements in children with allergic rhinitis. Material and Methods: Nasal airway obstruction was assessed with Sonoelastography, Turkish version of the Nose Obstruction Symptom Evaluation scale, Rhinoconjunctivitis Total Symptom Score and visual analog scale methods in children with allergic rhinitis and the results were compared with a healthy control group. Results: Evaluation was made of a total of 68 patients (40 boys and 28 girls [male: female ratio, 1.42]) with a mean age of 13.35±3.35 (range, 7-18) years. The Rhinoconjunctivitis Total Symptom Score, visual analog scale, and Turkish version of the Nose Obstruction Symptom Evaluation scale scores were significantly higher in the AR group than in the control group (p=0.001, p=0.001, p=0.001, respectively). The sonoelastography scores were significantly higher in the AR group than in the control group (p=0.001). Although a positive significant correlation was determined between Rhinoconjunctivitis Total Symptom Score, visual analog scale, and Turkish version of the Nose Obstruction Symptom Evaluation scale scores in terms of AR severity, no relationship was found with the sonoelastography scores (p=0.022, p=0.009, p=0.001, and p=0.0751, respectively). Conclusion: The Turkish version of the Nose Obstruction Symptom Evaluation scale and sonoelastography can be used to evaluate nasal obstruction due to inferior turbinate hypertrophy in children with allergic rhinitis. [ABSTRACT FROM AUTHOR]