Search

Familial Mediterranean fever (FMF) is an autoinflammatory disease which may cause endothelial dysfunction and arterial stiffness. In this study, we evaluated patients with FMF in terms of arterial stiffness indicators and investigated whether there was any difference according to colchicine response. This is a single-center, prospective, case-control study conducted on pediatric patients with FMF. Patients were categorized into 2 groups: patients on colchicine monotherapy (group 1) and patients who used anti-interleukin-1 (IL-1) plus colchicine (group 2). Patient age, mutations in the MEFV gene, overall duration of treatments, and general characteristics of symptoms were recorded. Laboratory values in an attack-free period were noted. Pulse wave velocity (PWV) was measured in all patients. Erythrocyte sedimentation rate and C-reactive protein, nocturnal hypertension, and PWV were higher in group 2. Arterial stiffness develops due to subclinical inflammation in patients with FMF. It is more pronounced in colchicine-resistant patients. [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 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]

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]

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]

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]

Introduction: Breast cancer is a significant health problem affecting the health of women globally. Breast self-examination is a procedure applied for the early detection of breast cancer. Given the barriers that women with visual impairments face to access health care and health education, there is a need to develop materials for breast self-examination training as a skills-based practice for this group. This study evaluated the effect of a training video with an audio description on the breast self-examination of women who were visually impaired. Methods: The universe of this quasi-experimental study comprised women who were visually impaired (N = 70) who were registered members of the Manisa Altinokta Blind Association in Turkey. The women who participated in the study volunteered and met the selection criteria (n = 60). They were divided into two groups by lot. The audio description group listened to a breast self-examination training video with an audio description (n = 30). The control group listened to the training video accompanied by typical sound, without audio description (n = 30). Before and after a training video, all women performed breast self-examination on a female mannequin torso. The skills of women in breast self-examination were evaluated using a checklist by a midwife who was non-researcher. Results: The skills differed significantly between the two groups after the video training (p < 0.05). The audio description group correctly performed most of the skills required for breast self-examination. None of the women in the groups were able to apply steps for such self-examination before the training. Discussion: A breast self-examination training video with audio description can improve the self-examination skills of women with visual impairments. Implications for Practitioners: Women with visual impairments benefit from watching a breast self-examination training video with an audio description before performing self-examinations. Training videos with audio descriptions should, therefore, be prepared for the health education of individuals who are visually impaired. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease emerged in 2019, spread in Turkey as all over the world rapidly. In this process, young people began to experience some mental problems due to the fear of contagion, as well as some changes in their lifestyles. Aims: In this study it is aimed to investigate anxiety and depression levels of medical school students and the factors associated with these mental problems. Method: The forms were sent over the internet to the officials responsible for medical education at universities in various regions of Turkey. A total of 2,778 medical faculty students were included in the study. Students were asked to fill out the sociodemographic data form, the Patient Health Questionnaire - 9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) Test. Results: Students' 67.3% were female and 31.7% were male. About 90.2% of the students in the PHQ-9 scale had depressive symptoms in the major depressive disorder (MDD) dimension, and 44.5% in the GAD-7 scale had moderate/severe anxiety symptoms. Gender, being a preclinical student, history of psychiatric treatment in the past, currently receiving psychiatric treatment, death of someone due to pandemic, economic and health situation, perception of mental health were found associated with MDD and Moderate/Severe Anxiety symptoms. Students with Anxiety and MDD reported significantly more anxiety about contamination and negative beliefs about precautions' sufficiency. Conclusions: It was determined that medical school students in our country showed anxiety and depression at a remarkable level during the pandemic. Examining the underlying causes of these high rates will be beneficial in terms of taking precautions during the long-term pandemic. In literature, there are a limited number of studies on this subject in our country, we believe that our study will be useful in future studies to determine the underlying causes of mental illnesses and what can be done to help students. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effect of motivational interviewing (MI) on adherence to treatment and quality of life in chronic hemodialysis patients. This study was conducted with a randomized controlled pretest, posttest, and follow-up design from March to July 2016 in the hemodialysis center. After the intervention (n = 30) and control groups (n = 30) completed a pretest, patients in the intervention group received four individual face-to face MI sessions per month. Then both groups participated in a posttest, 3 months after which a follow-up was conducted. A significant increase in adherence to treatment (according to both subjective and objective data) was observed in the experimental group compared to the control group. No significant difference was found between the two groups in their quality of life scores; however, within the experimental group, there was a significant increase in these scores between the posttest and the 3-month follow-up. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the relationship between dialysis adequacy and the incidence of symptoms in subjects treated with HD. This descriptive and cross-sectional study was conducted at two HD centers. The data were collected with the 'Descriptive Characteristics Form of the Participants' and the 'Dialysis Symptom Index (DSI)'. The study was reported according to the STROBE Declaration. The study was completed with 120 patients. The most common symptom reported was feeling tired or decreased energy and the least common was difficulty concentrating. No statistically significant relationship was found between DSI results and the Kt/V or urea reduction rate levels used to evaluate dialysis adequacy. Dialysis-related symptoms can also be seen in patients with adequate dialysis levels. It is therefore necessary to query the symptoms experienced by the patients at regular intervals. [ABSTRACT FROM AUTHOR]

Background: The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods: The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results: The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion: There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk. [ABSTRACT FROM AUTHOR]

This descriptive, cross-sectional study investigated problems experienced by patients after undergoing a thyroidectomy. The study included 60 firsttime, post-thyroidectomy patients diagnosed with benign thyroid disease from a university hospital's general surgery clinic in Ankara, Turkey. The data were collected in two stages: interviews with patients on the first day following surgery and postoperative follow-up telephone interviews in each of the first 4 weeks following surgery. The follow-ups revealed that patients principally experienced varying degrees of pain and difficulties in connection with work and recreation, communication, body image, and movement, for up to 4 weeks after surgery. These results showed that patients were particularly prone to problems on the first day and during the first week of the postoperative period; therefore, patients should be provided with follow-up telephone interviews to facilitate easier recovery and to help them overcome any problems experienced during the postoperative period. [ABSTRACT FROM AUTHOR]

Objectives: This study examines the impact of women's human rights education on improving the gender perceptions (GPs) of social work students. Methods: Experimental group consists of third-year social work students participated in the "Human Rights Education Program for Women (HREP)" within the scope of social work principles and methods II course given in Ankara University, Department of Social Work, whereas control group consists of the same class students who did not participate in the program. Gender Perception Scale was employed as an outcome measure tool in the study in which 65 students participated. The research in question is a quasi-experimental study, where pretest–posttest model is used. The HREP was performed on the students in a total of 12 sessions and each session lasted about 120 min. Results: The research study revealed GP levels of the social work students participated in the HREP were improved. Conclusions: HREP is effective in educating women on human rights; hence, this program should be used to educate female students at universities and create awareness on human rights. [ABSTRACT FROM AUTHOR]

Sleep problems may have negative effects on work–life balance, overall health, and safety. We aimed to investigate the association between sleep disorders and absenteeism and delay to work (being late or tardy) among the working adult population. The study was conducted by using data from a large survey of working adults who participated in the Turkish Adult Population Epidemiology of Sleep Study (TAPES) managed by Turkish Sleep Medicine Society (TSMS). Secondary analyses was employed to examine absenteeism and delay to work and their associations with sleep problems, including sleepiness by Epworth Sleepiness Scale (ESS), parasomnias, sleep apnea (by Berlin Questionnaire), sleep quality (by Pittsburgh Sleep Quality Index), and restless leg. History of any absenteeism and delay to work was observed in 276 (18%) and 443 (29%) out of 1,533 working adults, respectively. In the multivariate analyses, absenteeism was associated with younger age, female gender and poor sleep quality, while delay to work was associated with younger age, poor sleep quality, parasomnia, and sleepiness. In the presence of absenteeism and delay to work, sleep disorders including sleepiness, poor sleep quality, and parasomnia should be considered. Such evaluation may improve worker well-being and provide some additional benefits in terms of increasing productivity and lowering work-related costs. [ABSTRACT FROM AUTHOR]

Mobbing is a type of violence which occurs in workplaces and is classified under the community violence subgroup of interpersonal violence. The aim of this study is to examine health care workers who work in primary health care in the city of Mugla and to determine whether there is a relationship between sociodemographic characteristics, work conditions, and their level of mobbing. A cross-sectional analysis has been conducted in which 130 primary health care workers were selected. Of the 130, 119 health workers participated, yielding a response rate of 91.5%; 83.2% of health workers are female, 42.9% are midwives, 27.7% are nurses, and 14.3% are doctors. In all, 31.1% of health workers have faced with “mobbing” in the last 1 year, and the frequency of experiencing “mobbing” of those 48.6% of them is 1 to 3 times per year. A total of 70.3% of those who apply “mobbing” are senior health workers, and 91.9% are female. The frequency of encountering with “mobbing” was found significantly in married health workers, in those 16 years and above according to examined total working time, in those who have psychosocial reactions, and in those who have counterproductive behaviors. It has been discovered that primary health care workers have high prevalence of “mobbing” exposure. To avoid “mobbing” at workplace, authorities and responsibilities of all employees have to be clearly determined. [ABSTRACT FROM AUTHOR]

Coronary artery ectasia (CAE) is associated with coronary artery disease (CAD). The underlying pathophysiology of CAE is not fully understood. α1-antitrypsin (A1AT) plays a role in the tissue protease system, and AAT-1 deficiency (A1ATD) has been shown to be related to CAD. We compared A1AT serum levels in patients with and without CAE to determine the association between A1AT levels and the extent of ectasia using the Markis score. We included 50 patients (38 males) with isolated CAE and 46 patients (28 males) with normal coronary arteries after coronary angiography. The levels of A1AT were measured by nephelometry. The median A1AT levels were lower in patients with isolated CAE than in the control group (1.27 ng/mL [range: 1.07-1.37 ng/mL] vs 1.43 ng/mL [range: 1.27-1.59 ng/mL]; P < .001). According to the Markis classification, the extent of CAE was not correlated with A1AT levels (P = .41). Our results demonstrate an inverse relationship between serum A1AT levels and CAE. α1-antitrypsin is fundamental for the stability and integrity of the arterial wall. Lack of elastase inhibition in cases of A1ATD may contribute to ectasia formation by facilitating proteolysis and weakening the arterial wall. [ABSTRACT FROM AUTHOR]

Bilirubin may have important antiatherosclerotic effects. Prediabetes (PD), the intermediate stage before diabetes mellitus, is associated with increased cardiovascular morbidity and mortality. We evaluated the relationship between serum bilirubin levels and carotid intima–media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with PD. We enrolled 170 consecutive patients with PD. The patients underwent ultrasonography to evaluate cIMT. The patients were divided into groups according to cIMT values (<0.9 vs ≥0.9 mm). The patients with cIMT ≥ 0.9 mm had significantly higher diastolic blood pressure, neutrophil–lymphocyte ratio (NLR), and glycated hemoglobin values compared with patients having cIMT < 0.9 mm, whereas total and direct bilirubin values were significantly lower in this group. Multivariate regression analyses revealed NLR and total bilirubin as the independent predictors of subclinical atherosclerosis. The present study demonstrated that NLR and lower total bilirubin levels were independent predictors of subclinical atherosclerosis in patients with PD. Simple measures such as NRL and total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with PD. [ABSTRACT FROM AUTHOR]

We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of thrombus burden in patients with acute myocardial infarction. Patients (n = 229; male 72.9%; mean age 63 ± 13.4 years) who were admitted with ST-segment elevation myocardial infarction (STEMI) were enrolled. Patients were divided into 2 groups. Group 1 was defined as low thrombus burden and group 2 was defined as high thrombus burden. Patients with high thrombus burden had higher total bilirubin levels (14.4 [4.3-22.9] vs 7.7 [2.4-20.3] µmol/L, P ≤ .001), (0.84 [0.25-1.34] vs 0.45 [0.14-1.19] mg/dL P ≤ .001) and direct bilirubin levels (3.1 [2.1-8.4] vs 1.7 [0.5-6.5] µmol/L, P ≤ .001), (0.18 [0.03-0.49] vs 0.10 [0.03-0.38] mg/dL, P ≤ .001). At multivariate analysis, total bilirubin (odds ratio: 1.05, 95% confidence interval: 1.03-1.08, P ≤ .001) was the independent predictor of high thrombus burden. In conclusion, total bilirubin level is independently associated with high thrombus burden in patients with STEMI. [ABSTRACT FROM AUTHOR]

SYNTAX score II (SS II) uses 2 anatomical and 6 clinical variables for the prediction of mortality after coronary artery bypass graft and percutaneous coronary intervention. The aim of this study was to investigate the relationship between glycated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial glucose (PPG), and SYNTAX Score (SS) and SS II in patients with type 2 diabetes mellitus and coronary artery disease (CAD). We enrolled 215 consecutive diabetic patients with stable angina pectoris who underwent coronary angiography. The SS II was calculated using a nomogram that was based on the findings of a previous study. There was a moderate correlation between HbA1c and SS (r = .396, P < .001), but there was a good correlation between HbA1c and SS II (r = .535, P < .001). There was also a weak correlation between FBG (r = .270, P = .001), PPG (r = .177, P = .027), and SS, but there was a weak–moderate correlation between FBG (r = .341, P < .001), PPG (r = .256, P = .001), and SS II. A better correlation has been detected between HbA1c and SS II compared to the correlation between HbA1c and SS. [ABSTRACT FROM AUTHOR]

We assessed the prognostic value of the platelet to lymphocyte ratio (PLR) on in-hospital and long-term major adverse cardiovascular events (MACEs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) in a large prospective study. Patients (n = 1938) admitted with acute STEMI within 12 hours of symptom onset and who underwent pPCI between January 2010 and January 2015 were followed up for 31.6 ± 16.2 months. During the in-hospital and long-term follow-up period, MACE, the prevalence of stent thrombosis, nonfatal myocardial infarction, and mortality were higher in the third PLR tertile group. A PLR in the third tertile had 2.4-fold increased risk of in-hospital MACE and 2.8-fold risk of long-term MACE. The PLR was significantly and positively correlated with peak creatine kinase MB (CK-MB) levels (r = 0.562, P < .001) and Gensini score (r = 0.408, P < .001). Kaplan-Meier analysis of long-term MACE-free survival revealed a higher occurrence of MACE in the third PLR tertile group compared to the other tertiles. In conclusion, the PLR may be a marker of inflammatory and prothrombotic status and predicted in-hospital and long-term MACE in a population with STEMI. [ABSTRACT FROM AUTHOR]

Background Healthy term newborns commonly undergo painful procedures during routine follow-up visits. Non-pharmacological strategies have currently become more important than pharmacological analgesic agents in neonatal pain management. Acupuncture is a new non-pharmacological method for preventing pain in newborns. Objective We aimed to investigate the effect of laser acupuncture (LA) at the Yintang point before heel lancing as a non-pharmacological intervention for procedural pain management in infants. Methods Forty-two term newborns, who were undergoing heel lancing between postnatal days 3 to 8 as part of routine neonatal screening, were randomly assigned to the LA group or the oral sucrose group. In the LA group, 2 min before the heel lancing, 0.3 J of energy was applied to the Yintang point using a Laser PREMIO-30 unit for 30 s. In the sucrose group, each infant received 0.5 mL of 24% sucrose orally via syringe 2 min before the heel lancing. Each baby's behaviour was scored using the Neonatal Infant Pain Scale (NIPS), assessed blinded to group. Results There were no significant differences between the LA and oral sucrose groups with respect to means for gestational week of age at birth, birth weight, actual weight, or Apgar score. Mean procedure time was significantly shorter in the LA group; however, mean crying time was longer and NIPS score was lower compared to the oral sucrose group. Conclusions Our results indicate that 0.3 J of LA at the Yintang point before heel lancing is less effective than oral sucrose for reducing the discomfort of this procedure. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. Design: An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Results: We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6-93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79-0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73-0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54-0.60, p 0.0001). Conclusions: Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance. [ABSTRACT FROM AUTHOR]

This study was conducted to examine the effect of a healthy nails program on nail-biting in Turkish schoolchildren. This quasi-experimental study was of pretest–posttest control group design. A total of 50 students of a primary school formed the intervention group, while 53 students from the same school formed the control group. Data were collected with a demographic form, a nail-biting follow-up form, and photographs of the fingernails. It was found that 68.9% of students were biting seven or more of their nails; 46.6% had damaged nail beds. In the intervention group, the rate of the children who were not biting their nails (baseline = 0%, 4th week = 56.0%, 8th week = 64.0%) increased significantly compared to the control group (baseline = 0%, 4th week = 15.1%, 8th week = 18.9%). Outcomes indicate the efficacy of the healthy nails program in reducing the nail-biting problem in schoolchildren. [ABSTRACT FROM PUBLISHER]

The article presents a study to identify the intermediate-term results of medial meniscal tears repaired with single or double vertical sutures meniscal tissue is essential for load transmission, shock absorption, joint stability, and joint lubrication of the knee. The results indicated that single or double vertical sutures using the inside-out technique provide a high rate of healing in longitudinal medial meniscal tears.

Eradication of Helicobacter pylori, which is associated with diverse gastroduodenal pathologies of varying severity, is sometimes challenging. We conducted a prospective study to determine the effect of tonsillectomy on the eradication of H pylori from the gastrointestinal tract. Our study population was made up of 46 patients-32 females and 14 males, aged 14 to 58 years (mean: 28.84 ± 9.65)-who had chronic tonsillitis and concomitant dyspepsia. An initial gastrointestinal endoscopy was performed to obtain specimens for histology and a rapid urease test. These gastroscopies revealed that 32 patients were H pylori-positive (69.6%) and 14 were H pylori-negative (30.4%); these groups were designated A and B, respectively. The 32 H pylori-positive patients were divided into three subgroups based on the sequence in which they underwent drug therapy and tonsillectomy. All 3 subgroups received the same 14-day combination-drug regimen for eradication of gastric H pylori. The patients in group A1 (n = 12) underwent tonsillectomy prior to receiving drug treatment; 2 months after the cessation of drug therapy, they underwent a second gastroscopy. The patients in group A2 (n = 10) received drug treatment first followed by tonsillectomy; 2 months later, they underwent their second gastroscopy. The patients in group A3 (n = 10) received drug treatment first, then they underwent a second gastroscopy, and then they were taken for tonsillectomy. The success or failure of H pylori eradication was determined by the second gastroscopy. Also, analyses were performed after tonsillectomy to look for H pylori infection in tonsillar specimens. Eradication of gastric H pylori was achieved in 9 of the 12 group A1 patients (75.0%), 8 of the 10 group A2 patients (80.0%), and 7 of the 10 group A3 patients (70.0%); there were no statistically significant differences among the three groups. Likewise, there were no significant differences between any subgroups or combination of subgroups in terms of tonsillar positivity. As far as we know, this is the first study to investigate the effect of tonsillectomy on the outcome of H pylori eradication treatment. In light of our findings, we may speculate that tonsillar tissue does not seem to be a reservoir for H pylori infection. Although tonsillectomy had no significant effect on gastric H pylori eradication in our study, our results might have been skewed by the relatively small size of our sample. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the prevalence, characteristics, triggers, and consequences of skin picking (SP) in a sample of Turkish university students, with an emphasis on gender differences. A total of 245 students from two universities in Turkey were assessed by using the Skin Picking Inventory. In total, 87.8% of the students reported engaging in SP, and 2.04% of the students had pathological SP. There was no statistically significant difference between female and male students regarding the frequency of SP and the estimated daily SP time. The SP episodes began earlier in men than in women. Women were found to pick their chins, whereas men were found to pick their legs more frequently. SP is prevalent among Turkish students. Triggers, characteristics, and consequences of SP in Turkish students are similar to the results reported in studies conducted on different cultures. Large-scale studies are needed to further investigate gender differences in SP. [ABSTRACT FROM PUBLISHER]