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Introduction: There is a misperception in society that individuals with visual impairment are asexual and cannot marry, have children, or take care of children. In addition, individuals with visual impairment face difficulties in many aspects of life due to accessibility issues. Although it is expected that visually impaired individuals experience difficulties when having children, very few studies have focused on understanding the challenges women with visual impairment face in the process of having children. The aim of this study was to identify the challenges faced by mothers with visual impairment from preconception through the postpartum period in Turkey., Methods: Semistructured interviews were conducted with a purposive sample of 17 mothers with visual impairment. Participants were from 28 to 38 years of age, and their youngest children were 2 years old or younger. Participants were asked about their experiences with the decision to have children, pregnancy, birth, and postpartum. Content analysis was used to analyze and present the data., Results: Participants had 1 to 3 children and a mean age of 32.4 years. Eleven themes were identified within 4 periods: preconception, pregnancy, birth, and postpartum. Themes related to the experience of the preconceptional period included concern about the decision to have a child and the social pressure on the decision to have a child. Themes related to the experience of pregnancy included inaccessible pregnancy tests, emotional reactions to pregnancy, dissatisfaction with health care providers, and unmet expectations. Themes related to labor and birth included mixed feelings about labor dissatisfaction with health care providers and unmet expectations. Themes related to the postpartum period included personal care, infant care, reaction of the social network, and unmet expectations., Discussion: The mothers with visual impairment faced many challenges in the process of becoming a parent. Mothers expressed the need for accessible health services from institutions and health professionals., (© 2024 The Author(s). Journal of Midwifery & Women's Health published by Wiley Periodicals LLC on behalf of American College of Nurse Midwives (ACNM).)

Aim: This study aims to examine the nursing diagnosis skills of students who took the case-based online nursing processes course during the COVID-19 pandemic., Methods: The study followed a descriptive and cross-sectional design. The participants were first-year students (n = 148) enrolled in the nursing principles course in the spring semester of the 2020-2021 academic year in the nursing department of a university. The course on nursing processes was delivered online due to the COVID-19 pandemic. At the end of the course, students who volunteered to participate in the study developed nursing diagnoses for the cases assigned to them. The data were collected from the students using two forms and were evaluated using a form developed by the researchers. The data were analyzed with numeric and percentage calculations., Findings: Although 56.8% of the students stated that they had difficulty making nursing diagnoses, 56.8% of them thought online education was not useful. The most commonly made diagnoses by the students who participated in the study included hyperthermia (66.2%), ineffective breathing pattern (54.7%), risk of falling (39.9%), fatigue (34.5%), and anxiety (33.8%). It was also found that students were able to identify objective data more easily as diagnosis criteria, whereas they were not able to identify abstract concepts., Conclusions: It was seen that the students who participated in the study had low levels of nursing diagnoses. Based on the findings, it is recommended that different teaching methods be employed in the online nursing processes course, and these methods be evaluated in terms of their effects on students' learning outcomes., Implications for Nursing Practices: The online nursing process course should be made more efficient. First-year nursing students are not yet ready to identify nursing diagnoses in terms of knowledge and skills., (© 2023 NANDA International, Inc.)

Background: Studies show that reducing the length of hospital stay (LOS) for surgical patients leads to cost savings. We hypothesize that LOS has a nonlinear relationship to cost of care and reduction may not have a meaningful impact on it. We have attempted to define the relationship of LOS to cost of care. We utilized the itemized bill, generated in real time, for hospital services., Materials: Adult patients admitted under General, Neuro, and Orthopedic surgery over a 3-month period, with an LOS between 4 and 14 days, were the study population. Itemized bill details were analyzed. Charges in Pakistani rupees were converted to US dollar. Ethical exemption for study was obtained., Results: Of the 853 patients, 38% were admitted to General Surgery, 27% to Neurosurgery, and 35% to Orthopedics. A total of 64% of the patients had an LOS between 4 and 6 days; 36% had an LOS between 7 and 14 days. Operated and conservatively managed constituted 82% and 18%, respectively. Mean total charge for operated patients was higher $3387 versus $1347 for non-operated ones. LOS was seen to have a nonlinear relationship to in-hospital cost of care. The bulk of cost was centered on the day of surgery. This was consistent across all services. The last day of stay contributed 2.4%-3.2% of total charge., Conclusions: For surgical patients, the cost implications rapidly taper in the postoperative period. The contribution of the last day of stay cost to total cost is small. For meaningful cost containment, focus needs to be on the immediate perioperative period., (© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)

Aim: This study aimed to identify the effects of a web-based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self-efficacy and the labour process in primigravida women., Methods: The study was conducted in a single-blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A-B, the Childbirth Self-efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education., Results: Fear of birth was lower, and the birth self-efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery., Conclusion: Health Belief Model-based web-based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self-efficacy and positively affect the birth process in primigravida women., (© 2023 The Authors. International Journal of Nursing Practice published by John Wiley & Sons Australia, Ltd.)

Aim: The aim of this study is to determine the effects of milking and suction methods on maintaining drain patency following cardiac surgery in paediatric patients., Methods: This was a randomized controlled trial. The patients were assigned to three groups (suction method, milking method, and control group) between July 2018 and December 2019., Results: The most frequent medical diagnoses were tetralogy of Fallot (34.4%, n = 31) and ventricular septal defect (14.4%, n = 13). Heart rate may increase unless a method was chosen to maintain drain patency (F: 4.450, p = 0.003); suction (F: 0.528 p = 0.781) and milking (F: 2.281 p = 0.070) methods did not significantly increase the heart rate. The use of a manipulation method for maintaining drain patency maintained stability of the blood pressure values and did not affect haemodynamic stability, oxygen saturation, and body temperature. There was no statistically significant difference within and among the groups (p > 0.05) in relation to the volume of bleeding between admission until the sixth hour, although there was greater bleeding with the milking method (2.67 ± 15.30 ml) and less bleeding (-5.00 ± 23.30) with the suction method., Conclusion: The milking and suction methods used to maintain drain patency can be employed and will assist with maintaining the stability of the patient within the first critical 6 h. Further studies need to be conducted in order to clarify that the recommendations can be generalized to all children with congenital heart disease., (© 2022 John Wiley & Sons Australia, Ltd.)

Purpose: This systematic review and meta-analysis aimed to synthesize the outcomes of theory-based nursing interventions for coronary heart disease management., Design and Methods: Web of Science, Scopus, Science Direct, and PubMed databases were electronically searched from January 2013 to August 2021. The Preferred Reporting Item for Systematic Reviews and Meta-analyses statement guidelines was followed for this meta-analysis. Randomized controlled trials on patients with coronary heart disease, using a theory-based nursing intervention were eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p-values, and fixed or random-effect models (PROSPERO registration number X)., Findings: A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta-analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD = 8.7) years. This meta-analysis found theory-based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life., Conclusions: The evidence from this meta-analysis reveals that theory-based nursing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well-designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory-based nursing interventions on patient outcomes in the CHD population., Clinical Relevance: Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta-analysis provides insights into the implementation of theory-based nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory-based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes., (© 2022 Sigma Theta Tau International.)

Seven novel pyrazole derivatives (4a-g) and four novel starting compounds incorporating substituted pyridine moieties were synthesized successfully. Cell viability assay for the tested compounds was performed, and the inhibitory concentrationlogarithmic 50 (LogIC 50 ) values of the compounds were calculated after a 24-h treatment. Four of the examined compounds (3d, 3g, 4f, and 4g) showed comparable cytotoxic activity against CaCo-2 compared to the standard drug docetaxel at 0.1 and 1 μM concentrations. Although the LogIC 50  of docetaxel was -0.678 μM for CaCo-2 cells at 24 h, the LogIC 50 values of compounds were -0.794, -0.567, -0.657, and -0.498 μM, respectively. Five of the compounds (2d, 2g, 3d, 3g, and 4e) showed comparable cytotoxic activity against MCF-7 at 0.1 μM concentration compared to docetaxel (p < 0.05). Docking studies revealed the compounds have a good affinity to the active site of the human topoisomerase II β enzyme. The antioxidant capacities of all compounds were determined using both 1,1-diphenyl-2-picrylhydrazyl and metal chelation methods. Although the compounds did not show significant antioxidant activity, relatively effective are compounds 3c, 3d, and 3g, which are hydrazine derivatives with approximately 50% antioxidant activity of standard antioxidants at concentrations of 62.5 and 125 μg/ml., (© 2022 Wiley Periodicals LLC.)

Introduction: Numerous efforts in natural product drug development are reported for the treatment of Coronavirus. Based on the literature, among these natural plants Artemisia annua L. shows some promise for the treatment of SARS-CoV-2., Objective: The main objective of our study was to determine artemisinin content by liquid chromatography electrospray ionisation tandem mass spectrometry (LC-ESI-MS/MS), to investigate the in vitro biological activity of artemisinin from the A. annua plants grown in Turkey with various extracted methods, to elaborate in silico activity against SARS-CoV-2 using molecular modelling., Methodology: Twenty-one different extractions were applied. Direct and sequential extractions studies were compared with ultrasonic assisted maceration, Soxhlet, and ultra-rapid determined artemisinin active molecules by LC-ESI-MS/MS methods. The inhibition of spike protein and main protease (3CL) enzyme activity of SARS-CoV-2 virus was assessed by time resolved fluorescence energy transfer (TR-FRET) assay., Results: Artemisinin content in the range 0.062-0.066%. Artemisinin showed significant inhibition of 3CL protease activity but not Spike/ACE-2 binding. The 50% effective concentration (EC 50 ) of artemisinin against SARS-CoV-2 Spike pseudovirus was found greater than 50 μM (EC 45 ) in HEK293T cell line whereas the cell viability was 94% of the control (P < 0.01). The immunosuppressive effects of artemisinin on TNF-α production on both pseudovirus and lipopolysaccharide (LPS)-induced THP-1 cells were found significant in a dose dependent manner., Conclusion: Further studies of these extracts for COVID-19 treatment will shed light to seek alternative treatment options. Moreover, these natural extracts can be used as an additional treatment option with medicines, as well as prophylactic use can be very beneficial for patients., (© 2021 John Wiley & Sons, Ltd.)

The use of phytochemicals is gaining interest for the treatment of metabolic syndromes over the synthetic formulation of drugs. Senna is evolving as one of the important plants which have been vastly studied for its beneficial effects. Various parts of Senna species including the root, stem, leaves, and flower are found rich in numerous phytochemicals. In vitro , in vivo , and clinical experiments established that extracts from Senna plants have diverse beneficial effects by acting as a strong antioxidant and antimicrobial agent. In this review, Senna genus is comprehensively discussed in terms of its botanical characteristics, traditional use, geographic presence, and phytochemical profile. The bioactive compound richness contributes to the biological activity of Senna plant extracts. The review emphasizes on the in vivo and in vitro antioxidant and anti-infectious properties of the Senna plant. Preclinical studies confirmed the beneficial effects of the Senna plant extracts and its bioactive components in regard to the health-promoting activities. The safety, side effects, and therapeutic limitations of the Senna plant are also discussed in this review. Additional research is necessary to utilize the phenolic compounds towards its use as an alternative to pharmacological treatments and even as an ingredient in functional foods., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Mohammed M. Alshehri et al.)

Diabetes is a metabolic disease with multifactorial causes which requires lifelong drug therapy as well as lifestyle changes. There is now growing scientific evidence to support the effectiveness of the use of herbal supplements in the prevention and control of diabetes. Curcumin is one of the most studied bioactive components of traditional medicine, but its physicochemical characteristics are represented by low solubility, poor absorption, and low efficacy. Nanotechnology-based pharmaceutical formulations can help overcome the problems of reduced bioavailability of curcumin and increase its antidiabetic effects. The objectives of this review were to review the effects of nanocurcumin on DM and to search for databases such as PubMed/MEDLINE and ScienceDirect. The results showed that the antidiabetic activity of nanocurcumin is due to complex pharmacological mechanisms by reducing the characteristic hyperglycemia of DM. In light of these results, nanocurcumin may be considered as potential agent in the pharmacotherapeutic management of patients with diabetes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cristina Quispe et al.)

Aim: The aim of this study was to develop a self-assessment scale for nurses' ethical behaviours for protecting patients' rights and to determine its reliability and validity., Methods: This was a methodological study. This study was conducted in public, private and university hospitals in Turkey between August 2018 and May 2019. The sample group consisted of 450 nurses. The item pool was formed with 44 items. After five experts' assessment for content validity, the draft scale was formed with 37 items with a 5-point Likert-type scale. The item-total score correlation and exploratory factor analysis were used., Results: The scale included 28 items and five subscales (respect for right to information and decision making, providing fair care, providing benefit-not harming, respect for patient values and choices, attention to privacy). Cronbach's alpha was 0.84 for the whole scale., Conclusion: Validity and reliability have been demonstrated for a newly developed scale to measure nurses' ethical behaviours to protect patients' rights., (© 2021 John Wiley & Sons Australia, Ltd.)

Aim: The aim of our research was to investigate retrospectively the relationship between the symptoms and general characteristics, initial laboratory values and treatments in patients who had COVID-19 and who applied to the chest diseases outpatient clinic for control after 1 month., Method: Three hundred fifteen patients who were diagnosed with COVID-19 and applied to the chest diseases outpatient clinic between May 2020 and August 2020 for control in the 1st month were included in the study. Patient information was collected from the hospital information system and the e-pulse system., Results: Females accounted for 50.2% of our patients and their mean age was 47.9 ± 14.8 (19-88) years. About 14.3% (n: 45) of the individuals were 65 years of age and older, 20.6% (n: 65) of our patients were smoking and 70.2% (n: 221) of our patients were treated at home. A total of 133 patients had at least one comorbid disease. The patients most frequently reported cough, dyspnoea, weakness, myalgia and diarrhoea. The most common symptoms were cough, dyspnoea, weakness and myalgia in the 1st month. Initial D-dimer, initial CRP and the values of platelet, D dimer and CRP in the 1st month were detected to be higher in patients with persistent symptoms when the laboratory values of patients whose symptoms continue after 1 month were examined. It was determined that the symptoms had persisted in patients who had been hospitalised, had dual therapy, had comorbid diseases and had more common pathologies in their pulmonary imaging., Conclusion: Symptoms may persist for a long time in hospitalised patients, in patients with COVID-19-related pneumonia and concomitant chronic diseases and in patients with high D-dimer and high CRP at the time of admission. Patients are informed that their symptoms may last for a long time, unnecessary hospital admissions can be avoided., (© 2021 John Wiley & Sons Ltd.)

Aim: In patients with COVID-19, no validated efficient treatment has been reported. Herein, we examine the effect of treatment with teicoplanin in hospitalised patients with COVID-19., Methods: This retrospective study included 115 hospitalised patients in one medical centre. Fifty-four patients with laboratory-confirmed COVID-19 who received teicoplanin plus standard care were included in the Teicoplanin arm of this study, whereas 61 patients who were treated with standard care (SC) according to the Turkish Health Organization guidelines were included in the control arm. Patients' baseline characteristics, clinical presentation, treatment and outcomes were compared between the two groups., Results: In this non-randomised control study, all baseline characteristics were comparable between the two arms and there were no significant differences in the presenting symptoms, comorbidities and clinical outcomes between the two groups. However, the mortality rate was significantly lower in the teicoplanin group than in the control group (1.9% vs 14.8%; P < .05). In addition, no adverse reactions were found in the teicoplanin arm., Conclusions: Teicoplanin administration is associated significantly with lower mortality in hospitalised patients with COVID-19 in our study. Further clinical investigations is required to verify the role of teicoplanin in COVID-19 patients., (© 2021 John Wiley & Sons Ltd.)

Aims: This study aimed to investigate the clinical and chest computed tomography (CT) features associated with clinical parameters for coronavirus disease (COVID-19) in the capital of Turkey, Ankara., Materials and Methods: Epidemiological, clinical features, laboratory findings and radiological characteristics of 1563 hospitalised patients with COVID-19 in Ankara were collected, reviewed and analysed in this study. The risk factors associated with disease severity were investigated., Results: Non-severe (1214; 77.7%) and severe cases (349; 22.3%) were enrolled in the study. Compared with the non-severe group, the severe group were significantly older and had more comorbidities (ie, hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease). Smoking was more common in the severe group. Severe patients had higher respiratory rates and higher incidences of cough and dyspnoea compared with non-severe patients. Compared with the non-severe patients, the severe patients had increased C-reactive protein (CRP), procalcitonin, neutrophil to lymphocyte ratio (NLR) and CRP/albumin ratio and decreased albumin. The occurrence rates of consolidation, subpleural sparing, crazy-paving pattern, cavity, halo sign, reversed halo sign, air bronchogram, pleural thickening, micronodule, subpleural curvilinear line and multilobar and bilateral involvement in the CT finding of the severe patients were significantly higher than those of the non-severe patients., Conclusions: Many factors are related to the severity of COVID-19, which can help clinicians judge the severity of the patient and evaluate the prognosis. This cohort study revealed that male sex, age (≥55 years), patients with any comorbidities, especially those with cardiovascular disease, dyspnoea, increased CRP, D-dimer and NLR, and decreased lymphocyte count and CT findings of consolidation and multilobar involvement were predictors of severe COVID-19., (© 2021 John Wiley & Sons Ltd.)

Aims: The differential diagnosis of Fever of Unknown Origin (FUO) is still a major clinical challenge despite the advances in diagnostic procedures. In this multicentre study, we aimed to reveal FUO aetiology and factors influencing the final diagnosis of FUO in Turkey., Methods: A total of 214 patients with FUO between the years 2015 and 2019 from 13 tertiary training and research hospitals were retrospectively evaluated., Results: The etiologic distribution of FUO was infections (44.9%), malignancies (15.42%), autoimmune/inflammatory (11.68%) diseases, miscellaneous diseases (8.41%) and undiagnosed cases (19.62%). Brucellosis (10.25%), extrapulmonary tuberculosis (6.54%) and infective endocarditis (6.54%) were the most frequent three infective causes. Solid malignancies (7.1%) and lymphoma (5.6%), adult-onset still's disease (6.07%) and thyroiditis (5.14%) were other frequent diseases. The aetiological spectrum did not differ in elderly people (P < .05). Infections were less frequent in Western (34.62%) compared with Eastern regions of Turkey (60.71%) (P < .001, OR: 0.31, 95% Cl: 0.19 to 0.60). The ratio of undiagnosed aetiology was significantly higher in elderly people (p: 0.046, OR: 2.34, 95% Cl: 1.00 to 5.48) and significantly lower in Western Turkey (P: .004, OR: 3.07, 95% Cl: 1.39 to 6.71)., Conclusions: Brucellosis, extrapulmonary tuberculosis and infective endocarditis remain to be the most frequent infective causes of FUO in Turkey. Solid tumours and lymphomas, AOSD and thyroiditis are the other common diseases. The aetiological spectrum did not differ in elderly people, on the other hand, infections were more common in Eastern Turkey. A considerable amount of aetiology remained undiagnosed despite the state-of-the-art technology in healthcare services., (© 2021 John Wiley & Sons Ltd.)

Aim: H. pylori is a bacterial pathogen in the human stomach which infects about 50% of the world population. Untreated infection can lead to various diseases leading to cancer. Some of the H. pylori strains are asymptomatic, but some of them cause more severe diseases. Standard treatment protocol used for the treatment of H. pylori infection is triple therapy, which includes omeprazole as a proton pump inhibitor (PPI) and two antibiotics usually consist of amoxicillin and clarithromycin or metronidazole. In the recent years, because of the increase in the rate of antibiotic resistance, the eradication rate has decreased., Materials and Methods: We evaluated 140 patients who applied to a university hospital gastroenterology department and underwent biopsy during endoscopy. In these patients, we analysed floroquinolone and clarithromycin resistance using the GenoType® HelicoDR (Hain Life Science, Germany). We also used the real-time method for clarithromycin resistance., Results: We found the number and rate of floroquinolone resistance as 20 (25.6%) and clarithromycine resistance as 31 (39.7%). With the real-time PCR method, we detected clarithromycine resistance in 26 (33.3%) patients. These results were not statistically significant. Discussion and Conclusion . Our results show similarity to the other studies held in our country. There should be more studies for the policy of eradication through our country., Competing Interests: There are no conflicts of interest regarding this article., (Copyright © 2020 Zehra Kipritci et al.)

Purpose: To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes., Design: An assessor-blinded prospective randomized controlled trial., Methods: Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention-matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT-F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL)., Findings: VAS scores were significantly lower in the RG and MG at week 12 (p < .05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p < .05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p > .05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p < .05)., Conclusions: Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue., Clinical Relevance: Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP., (© 2020 Sigma Theta Tau International.)

The aim of this study is to evaluate the association between seven important H . pylori virulence factors and antibiotic resistance in patients with gastritis. H . pylori strains isolated from 33 patients with gastritis were examined. Antimicrobial susceptibilities were tested by GenoType® HelicoDR (Hain Life Science, Germany) test kit and RT-PCR. The virulence-factors were determined using conventional PCR. 39% of patients were resistant for clarithromycin and 27% of patients were resistant for fluoroquinolone. 15% of patients were resistant to both clarithromycin and fluoroquinolone. The H . pylori vacA m1/s2 genotype was the most frequent allelic combination. Patients were possessed the vacA s1 , m1 (6.1%); s1 , m2 (6.1%); s2 , m1 (15.1%); and s2 , m2 (3.0%) genotypes. 94% of patients with gastritis were positive for H . pylori napA gene. Also, there were no dupA gene-positive gastritis patients. There was no significant correlation between the vacA , cagA , oipA , hpaA , babA , napA , dupA , ureA , ureB virulence genes, clarithromycin, and fluoroquinolone resistance. Herein, we report that the relationship between the H . pylori napA gene and gastritis. Although we found a correlation between H . pylori virulence factor and clinical outcome, there is a need for further studies to enlighten the relation between H . pylori virulence genes and antibiotic resistance., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2020 Sinem Oktem-Okullu et al.)

This work has been prepared to find out changes in the biochemicals with DNA damage, micronucleus, and apoptosis to lipopolysaccharides (LPS) alone or vitamin E (VE) and sodium selenite (SS) in rats' blood tissue. Rats were divided into eight groups according to the treatment into control vitamin E (VE) treatment group (200 mg/kg bw), sodium selenite (SS) treatment (0.35 mg/kg bw) group, VE + SS treatment group (200 + 0.35 mg/kg bw), LPS treatment group (10 mg/kg bw), LPS + VE (10 + 200 mg/kg bw), LPS + SS treatment (10 + 0.35 mg/kg bw), and LPS + SS+VE treatment (10 + 0.35 + 200 mg/kg bw) group for 6 hr. LPS increased malondialdehyde (MDA) level and decreased antioxidant enzymes' activities in rat erythrocytes and leukocytes. DNA damage of leukocytes with comet assay and RAPD-PCR was detected in LPS treatment group. The levels of micronucleus and apoptosis percentage were increased significantly at the end of 6 hr. VE and/or SS protected the LPS-induced erythrocytes and leukocytes against damage as they have caused amelioration of rats by altering the results. As a result, the co-administration of VE and/or SS against LPS-induced damage provides protection. VE and/or SS in patients and animal models with sepsis must be taken in the diet because they are protective against the cellular degradation caused by oxidative damage. PRACTICAL APPLICATIONS: LPS obtained from E. coli is used more frequently in experimental sepsis studies. When LPS is administered to experimental animals, interstitial pneumonia, adult respiratory fatal syndrome, acute tubular necrosis, and fatal effects such as coagulopathy and hypoglycemia may be seen in these animals. The co-treatment of VE and SS may be more effective than using them alone against LPS., (© 2019 Wiley Periodicals, Inc.)

Objective: Studies that demonstrate an association between rheumatoid arthritis (RA) and dysbiotic oral microbiomes are often confounded by the presence of extensive periodontitis in these individuals. This study was undertaken to investigate the role of RA in modulating the periodontal microbiome by comparing periodontally healthy individuals with RA to those without RA., Methods: Subgingival plaque was collected from periodontally healthy individuals (22 with RA and 19 without RA), and the 16S gene was sequenced on an Illumina MiSeq platform. Bacterial biodiversity and co-occurrence patterns were examined using the QIIME and PhyloToAST pipelines., Results: The subgingival microbiomes differed significantly between patients with RA and controls based on both community membership and the abundance of lineages, with 41.9% of the community differing in abundance and 19% in membership. In contrast to the sparse and predominantly congeneric co-occurrence networks seen in controls, RA patients revealed a highly connected grid containing a large intergeneric hub anchored by known periodontal pathogens. Predictive metagenomic analysis (PICRUSt) demonstrated that arachidonic acid and ester lipid metabolism pathways might partly explain the robustness of this clustering. As expected from a periodontally healthy cohort, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were not significantly different between groups; however, Cryptobacterium curtum, another organism capable of producing large amounts of citrulline, emerged as a robust discriminant of the microbiome in individuals with RA., Conclusion: Our data demonstrate that the oral microbiome in RA is enriched for inflammophilic and citrulline-producing organisms, which may play a role in the production of autoantigenic citrullinated peptides in RA., (© 2018, American College of Rheumatology.)

In the present study, one-step purification of angiotensin-converting enzyme (ACE, peptidyldipeptidase A, EC 3.4.15.1), responsible for regulation of blood pressure, was achieved using affinity chromatography from human plasma. The enzyme was purified 12,860-fold with a specific activtiy of 5080 EU/mg protein. Optimum temperature and pH were determined for the enzyme as 35-40°C and pH 7.4-7.5, respectively. The purity of ACE was determined by SDS-PAGE and the enzyme showed two bands at 60 and 70 kDa on the gel. The native molecular weight of ACE was found to be 260 kDa by gel filtration chromatography, demonstrating that the enzyme has a heterodimeric structure. Natural fatty acids of Nigella sativa (Ranunculaceae) were isolated by means of column chromatography. The structures of these compounds were determined using NMR and GC-MS. The results showed that high concentrations of linoleic, oleic and palmitic acids were isolated from the plant. The effect of six fractions (Fr 1-6) on ACE activity was examined. Fraction 3 increased the ACE activity while the other fractions decreased the enzyme activity. The concentrations of the fractions inhibiting the half-maximum activity of the enzyme were calculated as 1.597 mg/mL for Fr 1, 0.053 mg/mL for Fr 2, 0.527 mg/mL for Fr 4, 0.044 mg/mL for Fr 5 and 0.136 mg/mL for Fr 6 using a Lineweaver-Burk graph., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Both insulin-like growth factor-binding protein 7 (IGFBP7) and telomere length (TL) are associated with proliferation and senescence of human breast cancer. This study assessed the clinical significance of both TL and IGFBP7 methylation status in breast cancer tissues compared with adjacent normal tissues. We also investigated whether IGFBP7 methylation status could be affecting TL., Methods: Telomere length was measured by quantitative PCR to compare tumors with their adjacent normal tissues. The IGFBP7 promoter methylation status was evaluated by methylation-specific PCR and its expression levels were determined by western blotting., Results: Telomeres were shorter in tumor tissues compared to controls (P<.0001). The mean TL was higher in breast cancer with invasive ductal carcinoma (IDC; n=72; P=.014) compared with other histological type (n=29), and TL in IDC with HER2 negative (n=53; P=.017) was higher than TL in IDC with HER2 positive (n=19). However, telomeres were shortened in advanced stages and growing tumors. IGFBP7 methylation was observed in 90% of tumor tissues and 59% of controls (P=.0002). Its frequency was significantly higher in IDC compared with invasive mixed carcinoma (IMC; P=.002) and it was not correlated either with protein expression or the other clinicopathological parameters., Conclusion: These results suggest that IGFBP7 promoter methylation and shorter TL in tumor compared with adjacent tissues may be predictive biomarkers for breast cancer. Telomere maintenance may be indicative of IDC and IDC with HER2 (-) of breast cancer. Further studies with larger number of cases are necessary to verify this association., (© 2016 Wiley Periodicals, Inc.)

Purpose: This study aimed to examine the effects of aromatherapy massage on neuropathic pain severity and quality of life (QoL) in patients suffering from painful diabetic neuropathy., Design and Methods: This open-label randomized controlled clinical study was conducted in a university hospital endocrine outpatient clinic in Turkey. The study sample consisted of 46 patients, randomly allocated to an intervention group (n = 21) and a control group (n = 25). The intervention group received aromatherapy massage three times per week for a period of 4 weeks. The control group received only routine care. Data were collected from patients using the Douleur Neuropathique questionnaire, the visual analog scale, and the Neuropathic Pain Impact on Quality of Life questionnaire., Findings: Neuropathic pain scores significantly decreased in the intervention group compared with the control group in the fourth week of the study. Similarly, QoL scores significantly improved in the intervention group in the fourth week of the study., Conclusions: Aromatherapy massage is a simple and effective nonpharmacological nursing intervention that can be used to manage neuropathic pain and improve QoL in patients with painful neuropathy., Clinical Relevance: Aromatherapy massage is a well-tolerated, feasible, and safe nonpharmacological method that can be readily integrated into clinical settings by nursing staff. The essential oils rosemary, geranium, lavender, eucalyptus, and chamomile can be safely used by nurses in the clinical setting, if applicable. However, training and experience of nurses in aromatherapy massage is critical to achieving positive results., (© 2017 Sigma Theta Tau International.)

Purpose: The purpose of this study was to determine sexuality assessment knowledge, attitude, and skill of student nurses before and after sexuality training., Methods: This study was conducted experimentally in a model with a pretest to posttest control group., Findings: In the measurements made after training, it was observed that mean scores of Sexuality Assessment Information Test, Sexual Attitude and Beliefs Scale, and Sexuality Assessment Skills Check List in the experimental group were significantly higher than mean scores of students in the control group (p < .05)., Conclusion: It was determined that sexuality assessment skills training has a positive effect on the knowledge, attitude, and behavior of nursing students., Practice Implications: Sexuality assessment skills training can provide nurses with a guide for discussing the topic of sexual health with their patients., (© 2015 NANDA International, Inc.)

Objectives. Exposure to ambient metals and air pollutants in urban environments has been associated with impaired lung health and inflammation in the lungs. Fractional exhaled nitric oxide (FeNO) is a reliable marker of airway inflammation. In this study, we aimed to compare the FeNO levels of three schools that have different distances from iron and steel industry zone for assessing the effects of heavy metals and air pollution on their respiratory health. Methods. Pulmonary function test and FeNO measurements were evaluated in 387 adolescents in three schools which have different distance from plant. Results. FeNO levels were significantly higher in School I ( n = 142; 18.89 ± 12.3 ppb) and School II ( n = 131; 17.68 ± 7.7 ppb) than School III ( n = 114; 4.28 ± 3.9 ppb). Increased FeNO concentration was related to the distance of iron and steel industry zone in young adults. Conclusion. The FeNO concentrations in school children were inversely proportional to the distance from the steel mill. There are needed some studies that can evaluate the safe distance and legislation must consider these findings., Competing Interests: The authors declared no conflict of interests.

β-Thalassemia is the most common hereditary disorder characterized by reduced production of β-globin chains of hemoglobin A (HbA). In recent years, hydroxyurea (HU) has shown promising therapeutic benefits in patients with β-thalassemia by fetal hemoglobin augmentation. We have analyzed effects of hydroxyurea treatment on oxidative stress in β-thalassemia patients by assessing activities of paraoxonase (PON) and arylesterase along with malondialdehyde (MDA) and total reactive oxygen species (ROS) concentrations. Blood samples from 159 individuals including 56 HU-treated and 58 untreated β-thalassemia patients and 45 healthy controls were analyzed. PON activity was found to be highest in healthy individuals (177.76 ± 4.44 U/mL) as compared to treated (52.67 ± 3.65 U/mL) and untreated (55.11 ± 3.26 U/mL) patients. A similar trend was observed in the case of arylesterase activity in normal, β-thalassemia-treated, and untreated (210.0 ± 11.25 U/mL, 163.03 ± 9.04 U/mL, 139.77 ± 10.10 U/mL) subjects. Serum MDA concentrations (2.59 ± 0.09 nmol/mL, 2.45 ± 0.08 nmol/mL, and 1.15 ± 0.05 nmol/mL) and total ROS concentrations (3.73 ± 0.20 nmol/mL, 3.54 ± 0.23 nmol/mL, and 2.45 ± 0.14 nmol/mL) were significantly elevated in both groups (untreated and treated) as compared to healthy individuals (P < .01). Oxidative stress was found to be markedly elevated in β-thalassemia patients as compared to healthy controls. Insignificant differences were, however, observed in mean concentrations of PON1 paraoxonase and arylesterase activities, serum MDA concentration and total ROS concentrations between HU-treated and untreated patients. We propose that HU therapy alone seems to be ineffective in managing oxidative stress and is likely to offer a better clinical outcome when supplemented with efficient iron chelation therapy and antioxidants., (© 2015, The American College of Clinical Pharmacology.)

Introduction. Biliary atresia is a surgical cause of prolonged jaundice, which needs to be diagnosed with cholangiography that has traditionally been performed via laparotomy. Laparoscopic assistance has lately been introduced to avoid unnecessary laparotomy. We aim to evaluate the benefits of the laparoscopy-assisted cholangiography and compare it to the traditional procedure via laparotomy. Patients and Method. The medical records of the cases who had undergone cholangiography for prolonged jaundice between 2007 and 2014 were analyzed. The patients were grouped according to cholangiography technique (laparotomy/laparoscopy). The laparoscopy and laparotomy groups with patent bile ducts were focused and compared in terms of operation duration, postoperative initiation time of enteral feeding, and full enteral feeding achievement time. Results. Sixty-one infants with prolonged jaundice were evaluated between 2007 and 2014. Among the patients with patent bile ducts, operation duration, postoperative enteral feeding initiation time, and the time to achieve full enteral feeding were shorter in laparoscopy group. Conclusion. Laparoscopic cholangiography is safe and less time-consuming compared to laparotomy, with less postoperative burden. As early age of operation is a very important prognostic factor, laparoscopic evaluation should be an early option in work-up of the infants with prolonged jaundice with direct hyperbilirubinemia, for diagnosis/exclusion of biliary atresia.

Objective: To assess the effectiveness of a reduced duration (12hours) of magnesium sulfate (MgSO4) administration for eclampsia., Methods: In a prospective randomized study, women with eclampsia (prepartum, intrapartum, or postpartum) attending Jawaharlal Nehru Medical College, Aligarh, India, between January 2012 and September 2013 were enrolled. The inclusion criteria were blood pressure of at least 140/90mm Hg after 20weeks, proteinuria (dipstick value≥+1), and seizures not attributed to other causes. Participants were assigned to control and study groups according to the time of enrollment (6-month blocks). All patients received a MgSO4 loading dose (4g, intravenously), followed by maintenance doses (1g/hour) for 12hours (study group) and 24hours (control group). The primary outcome was recurrent convulsions after completion of MgSO4 therapy. Patients with treatment failure were excluded from analyses., Results: Analyses included 132 patients in the study group and 72 patients in the control group. No convulsions recurred in either group after the completion of treatment., Conclusion: For women with eclampsia, 12hours of magnesium sulfate could effectively prevent recurrent convulsions., (Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Management of ovarian dysfunctions requires accurate estimation of ovarian reserve (OR). Therefore, reproductive hormones and antral follicle count (AFC) are assessed to indicate OR. Serum anti-Mullerian hormone (AMH) is a unique biomarker that has a critical role in folliculogenesis as well as steroidogenesis within ovaries. Secretion from preantral and early antral follicles renders AMH as the earliest marker to show OR decline. In this review we discuss the dynamics of circulating AMH that remarkably vary with sex and age. As it emerges as a marker of gonadal development and reproductive disorders, here we summarize the role of AMH in female reproductive physiology and provide evidence of higher accuracy in predicting ovarian response to stimulation. Further, we attempt to compile potential clinical applications in children and adults. We propose that AMH evaluation has a potential role in effectively monitoring chemotherapy and pelvic radiation induced ovarian toxicity. Furthermore, AMH guided ovarian stimulation can lead to individualization of therapeutic strategies for infertility treatment. However future research on AMH levels within follicular fluid may pave the way to establish it as a marker of "quality" besides "quantity" of the growing follicles.

Tracheobronchial amyloidosis is a rare presentation and accounts for about 1% of benign tumors in this area. The diagnosis of disease is delayed due to nonspecific pulmonary symptoms. Therapeutic approaches are required to control progressive pulmonary symptoms for most of the patients. Herein, we report a case of a 68-year-old man admitted with progressive dyspnea to our institution for further evaluation and management. He was initially diagnosed with and underwent management for bronchial asthma for two years but had persistent symptoms despite optimal medical therapy. Pulmonary computed tomography scan revealed severe endotracheal stenosis. Bronchoscopy was performed and showed endotracheal mass obstructing 70% of the distal trachea and mimicking a neoplastic lesion. The mass was successfully resected by mechanical resection, argon plasma coagulation (APC), and Nd-YAG laser during rigid bronchoscopy. Biopsy materials showed deposits of amorphous material by hematoxylin and eosin staining and these deposits were selectively stained with Congo Red. Although this is a rare clinical condition, this case indicated that carrying out a bronchoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma is very important.

Background: Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy., Objective: To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities., Methods: Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales., Results: Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer., Conclusion: Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer., Practice Implications: Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills., (© 2014 John Wiley & Sons Ltd.)

Objective: To examine the effects of perineal massage during active labor on the frequency of episiotomy and perineal tearing., Methods: A randomized controlled study was conducted at a center in Sivas, Turkey, between January 1, 2010, and May 31, 2011. Healthy pregnant women presenting for their first or second delivery at 37-42 weeks of pregnancy were enrolled during the first stage of labor. Participants were randomly assigned (1:1) to the massage group (10-minute perineal massage with glycerol four times during the first stage and once during the second stage of labor) or control group (routine care). The frequency of episiotomy and perineal tearing were compared between the groups. Participants and investigators were not masked to group assignment., Results: Both groups contained 142 participants. Episiotomy was performed among 44 (31.0%) women in the massage group and 99 (69.7%) in the control group (P = 0.001). Lacerations were recorded among 13 (4.2%) women in the massage group and 6 (4.2%) in the control group (P = 0.096)., Conclusion: Application of perineal massage during active labor decreased the frequency of episiotomy procedures. ClinicalTrials.gov:NCT02201615., (Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

This was a cross-sectional study to analyse the relationship between menopausal symptoms and sexual dysfunction among 229 married Turkish women in the 40-65 age group. The study was carried out at a menopause clinic of a state hospital between 1 October and 31 December 2010. Data were collected with Personal Characteristics Form, Menopause Rating Scale (MRS) and the Arizona Sexual Experience Scale (ASEX). The average age of the women was 52.33 (SD = 4.80) years. The average MRS total score was 20.13(SD = 9.20). The ASEX mean score was 19.97 (SD = 5.44). It was determined that there is a positive meaningful relationship between ASEX mean score, MRS total mean score and the sub-score of women. From the results obtained from this study, it can be said that women have differing levels of menopausal symptoms, and as the severity of menopausal symptoms increases, there is an increase in sexual dysfunction., (© 2014 Wiley Publishing Asia Pty Ltd.)

Pyrethroids are broad-spectrum insecticides. Permethrin intoxication due to topical application has not been documented in humans. We report a 20-month-old infant who had used 5% permethrin lotion topically for scabies treatment. Approximately 60 mL (20 mL/day) was used and after the third application he developed agitation, nausea, vomiting, respiratory distress, tachycardia, and metabolic acidosis. His clinical symptoms and metabolic acidosis normalized within 20 hours. His follow-up was unremarkable. Toxicity of permethrin is rare, and although permethrin is a widely and safely used topical agent in the treatment of scabies and lice, inappropriate use may rarely cause toxicity. Moreover, in cases of unexplained metabolic acidosis, topically applied medications should be carefully investigated., (© 2014 Wiley Periodicals, Inc.)

Background. Iron deficiency is the prevalent complication of inflammatory bowel disease (IBD). Herein, we investigated the effect of intravenous iron treatment on quality of life (QoL) in nonanemic and iron deficient IBD patients. Methods. Eighty-five IBD patients were recruited for this study. The patients were intravenously administered 500 mg iron sucrose in the first week of the study. Hematologic parameters and QoL were evaluated before to iron treatment and during the 12th week of treatment. The Inflammatory Bowel Disease Questionnaire (IBDQ) and the Short Form-36 (SF-36) Health Survey were used to assess QoL. Results. Prior to intravenous iron administration, the IBDQ, SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were 152.3 ± 30.6, 46.7 ± 7.3, and 45.7 ± 9.8, respectively. In the 12th week of iron administration, those scores were 162.3 ± 25.5 (P < 0.001), 49.3 ± 6.4 (P < 0.001), and 47.6 ± 8.9 (P = 0.024), respectively, which were all significantly different from the scores prior to iron administration. The mean changes in the IBDQ scores for ulcerative colitis and Crohn's disease were 8.7% and 3.0% (P = 0.029), were 6.4% and 4.7% (P = 0.562) for the SF-36 PCS, and were 4.6% and 3.2% (P = 0.482) for the SF-36 MCS, respectively. Conclusion. Intravenous iron treatment may improve QoL in nonanemic, but iron deficient, IBD patients.

The aim of this study was to evaluate the protective effects of Pycnogenol® (Pyc), a complex plant extract from the bark of French maritime pine, on oxidative stress parameters (superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities and total glutathione (GSH) and malondialdehyde (MDA) levels), an inflammatory cytokine (tumor necrosis factor alpha (TNF-α) level) and also DNA damage in Wistar albino rats. Rats were treated with 100 mg/kg intraperitonally Pyc following the induction of sepsis by cecal ligation and puncture. The decreases in MDA levels and increases in GSH levels, and SOD and GPx activities were observed in the livers and kidneys of Pyc-treated septic rats. Plasma TNF-α level was found to be decreased in the Pyc-treated septic rats. In the lymphocytes, kidney, and liver tissue cells of the sepsis-induced rats, Pyc treatment significantly decreased the DNA damage and oxidative base damage using standard alkaline assay and formamidopyrimidine DNA glycosylase-modified comet assay, respectively. In conclusion, Pyc treatment might have a role in the prevention of sepsis-induced oxidative damage not only by decreasing DNA damage but also increasing the antioxidant status and DNA repair capacity in rats., (Copyright © 2014 John Wiley & Sons, Ltd.)

Background: Robotic telemanipulation systems have emerged as facilitating tools that enhance minimally invasive cardiac surgery.The purpose of this study was to evaluate graft patency by a combination of invasive and non-invasive coronary angiography methods in robotic-assisted coronary artery surgery(CABG) for optimal quality control., Methods: Between April 2004 and February 2012, patients who had robotic-assisted CABG were called to have cardiac catheterization or multislice computed tomographic angiography to evaluate graft patency., Results: One hundred patients out of a total 250 cases were followed for graft patency for a mean period of 60.3 ± 23.8 (range 12-94) months. Mean operative time and left internal mammary artery harvest time was 165.96 ± 19.5 and 41.74 ± 5.9 (range 30-55) min. Postoperative graft patency rate was 94% and freedom from target vessel re-interventions was 98%., Conclusion: Robotic-assisted CABG can be accomplished with low morbidity, mortality and re-intervention rates. It is a safe procedure in selected patients and produces excellent mid-term graft patency., (Copyright © 2013 John Wiley & Sons, Ltd.)

Soft rough sets which are a hybrid model combining rough sets with soft sets are defined by using soft rough approximation operators. Soft rough sets can be seen as a generalized rough set model based on soft sets. The present paper aims to combine the covering soft set with rough set, which gives rise to the new kind of soft rough sets. Based on the covering soft sets, we establish soft covering approximation space and soft covering rough approximation operators and present their basic properties. We show that a new type of the soft covering upper approximation operator is smaller than soft upper approximation operator. Also we present an example in medicine which aims to find the patients with high prostate cancer risk. Our data are 78 patients from Selçuk University Meram Medicine Faculty.

Brain tumors are rarely diagnosed during pregnancy. Accelerated growth of intracranial meningiomas during pregnancy sometimes requires urgent surgical intervention. We describe a 41-year-old pregnant woman with severe neurological decompensation requiring immediate neurosurgery. Cesarean section resulted in maternal death. Meningioma diagnosed during a viable pregnancy should be managed according to the severity of maternal neurological symptoms and gestational age of pregnancy. Early intervention for intracranial tumors during pregnancy may save maternal and fetal lives.

Background: The aim of this study is to investigate whether methylenetetrahydrofolate reductase (MTHFR) C677T mutation is associated with the development of hyperlipoproteinemia and obesity in coronary heart disease (CHD)., Methods: This study was carried out in 82 diabetic and 112 nondiabetic patients with CHD and in 138 CHD-free healthy controls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and agarose gel electrophoresis techniques were used to determine the MTHFR C677T., Results: Distributions of MTHFR genotypes (C677T dbSNP: rs1801133) were similar in our study groups (P > 0.05). There was no statistical association between biochemical parameters and genotype distribution in nondiabetic CHD patients, while diabetic CC genotype carriers have elevated levels of body mass index (BMI) independently from lipid profiles (P = 0.002). In diabetic CHD patients, while evaluating the clinical parameters according to gender, it was found that gender had an impact on BMI (P = 0.013). Due to this gender effect, a multivariate analysis was conducted on the diabetic CHD patient group. The multivariate logistic regression analysis confirmed that the MTHFR-CC genotype was associated with elevated BMI levels in diabetic CHD patients (odds ratio [OR] = 5.42, P = 0.003)., Conclusion: The results of the present study demonstrated that possessing T allele of MTHFR C677T mutation indicates a protective association on BMI independently from other risk factors., (© 2013 Wiley Periodicals, Inc.)

Ischemic injury, which occurs as a result of sympathetic hyperactivity, plays an important role in heart failure. Melatonin is thought to have antiatherogenic, antioxidant, and vasodilatory effects. In this study, we investigated whether melatonin protects against ischemic heart failure (HF). In Wistar albino rats, HF was induced by left anterior descending (LAD) coronary artery ligation and rats were treated with either vehicle or melatonin (10 mg/kg) for 4 weeks. At the end of this period, echocardiographic measurements were recorded and the rats were decapitated to obtain plasma and cardiac tissue samples. Lactate dehydrogenase, creatine kinase, aspartate aminotransferase, alanine aminotransferase, and lysosomal enzymes (β-D-glucuronidase, β-galactosidase, β-D-N-acetyl-glucosaminidase, acid phosphatase, and cathepsin-D) were studied in plasma samples, while malondialdehyde and glutathione levels and Na+, K+-ATPase, caspase-3 and myeloperoxidase activities were determined in the cardiac samples. Sarco/endoplasmic reticulum calcium ATPase (SERCA) and caveolin-3 levels in cardiac tissues were evaluated using Western blot analyses. Furthermore, caveolin-3 levels were also determined by histological analyses. In the vehicle-treated HF group, cardiotoxicity resulted in decreased cardiac Na+, K+-ATPase and SERCA activities, GSH contents and caveolin-3 levels, while plasma LDH, CK, and lysosomal enzyme activities and cardiac MDA and Myeloperoxidase (MPO) activities were found to be increased. On the other hand, melatonin treatment reversed all the functional and biochemical changes. The present results demonstrate that Mel ameliorates ischemic heart failure in rats. These observations highlight that melatonin is a promising supplement for improving defense mechanisms in the heart against oxidative stress caused by heart failure., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The regeneration of functional, clinically viable, tissues from acellular ex vivo tissues has been problematic largely due to poor nutrient transport conditions that limit cell migration and integration. Compounding these issues are subcellular pore sizes that necessarily requires extracellular matrix (ECM) remodeling in order for cells to migrate and regenerate the tissue. The aim of the present work was to create a directed growth environment that allows cells to fully populate an ex vivo-derived vascular scaffold and maintain viability over extended periods. Three different culture conditions using single (one nutrient source) or dual perfusion bioreactor systems (two nutrients sources) were designed to assess the effect of pressure and nutrient gradients under either low (50/30 mmHg) or high (120/80) relative pressure conditions. Human myofibroblasts were seeded to the ablumenal periphery of an ex vivo-derived vascular scaffold using a collagen/hydrogel cell delivery system. After 30 days culture, total cell density was consistent between groups; however, significant variation was noted in cell distribution and construct mechanics as a result of differing perfusion conditions. The most aggressive transport gradient was developed by the single perfusion low-pressure circuits and resulted in a higher proportion of cells migrating across the scaffold toward the vessel lumen (nutrient source). These investigations illustrate the influence of directed nutrient gradients where precisely controlled perfusion conditions significantly affects cell migration, distribution and function, resulting in pronounced effects on construct mechanics during early remodeling events., (Copyright © 2013 Wiley Periodicals, Inc.)

This study aimed to determine the general self efficacy levels of students studying for undergraduate degree in nursing and to examine the relationship between skills development and self efficacy. The research was conducted in a descriptive way. The sample consisted of 100 students. Data were collected via the use of a student introduction form, Self-Efficacy Scale (SES) and an intramuscular (i.m.) injection procedure checklist; the forms were filled in by 100% of the nursing students. The mean general self-efficacy score of the students in the study was high. the self-efficacy levels of our students were high, and no correlation was observed between personal characteristics and self-efficacy; therefore, education in injection technique had the same influence on all students' self-efficacy., (© 2013 Wiley Publishing Asia Pty Ltd.)

PHACE syndrome is characterized by posterior fossa malformations (P), large facial hemangiomas (H), arterial anomalies (A), cardiac anomalies or coarctation of aorta (C), and eye anomalies (E) and has striking female predominance. Endocrine abnormalities have recently been described in these patients, involving the thyroid and pituitary glands. We report the case of a 2-year-old girl with the clinical features of PHACE with absence of bilateral internal carotid arteries and isolated growth hormone deficiency., (© 2011 Wiley Periodicals, Inc.)

Objective: To compare the efficacy of fosfomycin trometamol, cefuroxime axetil, and amoxicillin clavulanate antibiotics, and to assess the difference in patient compliance, in the treatment of urinary tract infections during pregnancy., Methods: Between September 2007 and May 2008, 90 out of 324 pregnant women with complaints of lower urinary tract infection, who were followed at the outpatient clinic or referred to the emergency department of Vakif Gureba Education and Research Hospital, were enrolled in a prospective study. Patients were randomized into 3 equal groups for treatment with single-dose fosfomycin trometamol, or 5-day courses of amoxicillin clavulanate or cefuroxime axetil. After follow-up, study data were obtained for 28, 27, and 29 patients, respectively., Results: The treatment groups did not differ significantly in terms of demographics, clinical success rate, microbiological cure rate, or adverse effects. Significantly higher drug compliance was observed in the fosfomycin trometamol group than in the other 2 groups (P<0.05)., Conclusion: Treatment with a single dose of fosfomycin trometamol was as effective for UTI as the standard course of treatment with amoxicillin clavulanate or cefuroxime axetil. Fosfomycin trometamol may be a preferable treatment for UTI because of its simpler use and better rates of compliance., (Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: To evaluate the frequency of dysplasia and other cervical conditions in a population at normal risk, and compare demographic characteristics of the women with normal and abnormal results., Methods: Characteristics such as gravidity, parity, age at marriage, and smoking status were obtained from a questionnaire completed from January 2004 through July 2005 at Denizli State Hospital, Denizli, Turkey, by the 19639 participants before they were screened. The results were analyzed., Results: The dysplasias detected in 107 smears (0.54%) included ASCUS (0.31%), LSIL (0.15%), and HSIL (0.07%); there were also 1 case of AGUS and 1 of squamous cell carcinoma. Age, age at marriage, number of pregnancies, number of deliveries, and smoking habit were similar for participants with and without dysplasia (P>0.05). Bacterial vaginosis was seen in 1633 smears (8.3%), candidiasis in 1346 (6.9%), Actinomyces sp. in 648 (3.3%), and Trichomonas vaginalis in 143 (0.7%)., Conclusion: Cytologic abnormalities in a cervical smear can point to precancerous or cancerous processes or to other conditions. The prevalence of dysplasia was lower for our participants than in Western populations, which could be explained by a conservative lifestyle and a lower prevalence of HPV in Turkey., (Copyright (c) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Background. Intraabdominal lesions such as mesenteric cysts are uncommon disorders. Most are discovered incidentally during routine abdominal examinations. Methods. We report a patient with a mesenteric cyst masquerading as tuberculous peritonitis and ascites. Conclusion. Mesenteric cysts generally do not show typical clinical findings. They may also present with peritoneal tuberculosis findings such as low albumin gradient ascites with high ascitic adenosine deaminase levels. Surgery is used to remove a wide variety of mesenteric cysts. A correct diagnosis can be made by the combined use of radiographic and sonographic examinations in conjunction with the clinical signs.

Background. Uterine perforation and transvesical migration of an intrauterine device are rare complications. Case. A 28-year-old woman who had an intrauterine device was admitted to our outpatient clinic with complaints of amenorrhea lasting 5 weeks and pelvic pain lasting a year. Transvaginal ultrasonography revealed embedding of the intrauterine device in the bladder. The misplaced device was removed by laparotomy. Conclusion. The followup of intrauterine device localization with transvaginal ultrasonography is essential for early detection of possible serious complications.

Background: Peripheral arterial disease (PAD) is associated with increased mortality. Lower extremity (LE) revascularization improves symptoms, but less is known about long-term survival benefits of LE arterial revascularization., Methods: Two hundred and eighty-three patients with an ankle brachial index (ABI) or=65 years (HR 2.42 [95% CI 1.52-3.85], P < 0.001), history of coronary artery disease (HR 1.67 [95% CI 1.13-2.46], P = 0.010), chronic kidney disease (HR 1.75 [95% CI 1.15-2.67], P = 0.010), and an ABI