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Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society.

AMAÇ: Yeni Korona virus (COVID-19) salgının ortaya çıkışı, her yaştan bireyler olmak üzere cerrahi hemşirelerinin mental sağlığını oldukça etkilemiştir. Bu çalışma COVID-19 salgını sırasında Türk cerrahi hemşirelerinin öz bildirimlerine dayalı olarak mental sağlık ve uyku kalitelerini araştırmayı amaçlamıştır.GEREÇ VE YÖNTEM: Çalışma verileri, 10 Mayıs - 10 Haziran 2020 tarihleri arasında 453 cerrahi hemşiresinin katılımıyla web tabanlı çevrimiçi kartopu yöntemiyle toplanmıştır. Verilerin toplanmasında Hemşire Bilgi Formu, Yaygın Anksiyete Bozukluğu-7 (GAD-7) ölçeği, CES-Depresyon Ölçeği (CES-D) ve Pittsburg Uyku Kalitesi İndeksi (PSQI) ile kullanılmıştır.BULGULAR: Cerrahi hemşirelerin %77,3’ünün COVID-19’lu hastaya bakım verdiği ve %2’sinin COVID-19 hastalığını geçirdikleri saptanmıştır. Cerrahi hemşirelerin %76,2’si pandemi sürecinden olumsuz etkilendiğini ve %56,2’si kendisine virüs bulaşmasından korktuğunu ifade etmiştir. Cerrahi hemşirelerinin, CES-D puan ortalaması 27,8±12,5, GAD-7 puan ortalaması 8,7±5,1 ve PSQI puan ortalamasının 10,4±3,5 olduğu belirlenmiştir. PSQI ile CES-D ve GAD-7 düzeyleri arasında pozitif yönde ve orta büyüklükte bir ilişki olduğu bulunmuştur (sırasıyla; r=0,558; r=0,554; p, OBJECTIVE: The outbreak of new coronavirus disease (COVID-19) has affected the mental well-being of individuals of all ages, especially surgical nurses. This study aimed to explore the association between self-reported mental health and subjective sleep quality of the Turkish surgical nurses during the COVID-19 pandemic.MATERIAL AND METHODS: Data were collected from N = 453 surgical nurses using online snowball sampling through social media between May 10 and June 10, 2020, during the COVID-19 pandemic. The data were collected using the Nurse Information Form, the Generalized Anxiety Disorder-7 Scale (GAD-7), and the Center for Epidemiologic Studies Depression Scale (CES-D), and The Pittsburgh Sleep Quality Index (PSQI).RESULTS: While 77.3% of them were determined to provide care to patients with COVID-19, and 2.0% of them had a positive COVID-19 test. A total of 76.2% of surgical nurses were stated to be negatively affected by the pandemic process and 56.2% of them were scared of infecting someone else with the virus. Surgical nurses had a mean GAD-7score of 8.7±5.1, a mean CES-D score of 27.8±12.5, and a mean PSQI score of 10.4±3.5. A positive and moderate level of relationship was found between PSQI and CES-D and GAD-7 levels (r=0.558; r=0.554; p

Amaç: Bu çalışmada 65 yaş üstü hastalarda RIRS'ın etkinlik ve güvenliğini değerlendirmeyi amaçladık.Materyal ve Metod: Kliniğimizde RIRC yapılan 65 yaş üstü 107 hasta retrospektif değerlendirildi. Hastalar hem komplikasyon olup olmasına göre (Grup:1 Komplikasyon yok, Grup 2: Komplikasyon var ) hem de yaşa göre iki gruba (Grup 1:65-74 yaş, Grup 2: 75 yaş ve üzeri) ayrıldı. Taşsızlık oranı, komplikasyon oranı, taş özellikleri, hastanede kalış süreleri açısından gruplar birbirleriyle karşılaştırıldı. Bulgular: Yaşa göre gruplara ayrıldığında grup (65-74 yaş) grup 2 (75 yaş ve üzeri ) arasında American Society of Anesthesiogists skoru, taş boyutu, taş sayısı ve taşın hounsfield ünitesi açısından fark gözlenmedi. Diğer yandan grup 2'nin hastanede kalış süresi ve komplikasyon oranının grup 1'e göre daha fazla olduğu gözlendi. (sırasıyla p değeri 0,01 ve 0,02) Hastalar komplikasyon görülme durumuna göre iki gruba ayrıldı. Grup1 (komplikasyon olmayan) ve grup 2 (komplikasyon olan) arasında ASA skoru, taşın hounsfield ünitesi ve taşsızlık oranında anlamlı fark saptanmadı. (sırasıyla p değeri: 0.127, 0.915, 0.379 )Sonuç: Yaşlı nüfusun dünyada giderek artmasıyla böbrek taşı olan daha çok yaşlı hasta tedavi için başvuracaktır. Bu nedenle çalışmamız sonucunda olduğu gibi RIRS yaşlı hastalarda böbrek taşı tedavisinde etkinlik ve güvenlik açısından yaygın şekilde kullanılabilir., Background: In this study, we aimed to investigate the efficacy and safety of RIRS in patients over 65 years of age.Materials and Methods: 107 patients over 65 who underwent RIRC in our clinic were evaluated retrospectively. The patients were divided into two groups, according to whether there were complications (Group: No complications, Group 2: There are complications) and according to age (Group 1: 65-74 years, Group 2: 75 years and above). The groups were compared with each other regarding stone-free rate, complication rate, stone characteristics, and hospital stay.Results: When divided into groups according to age, no difference was observed between group 1 (65-74 years old) and group 2 (75 years and older) in terms of American Society of Anesthesiogists score, stone size, number of stones, and Hounsfield unit of the stone. On the other hand, it was observed that the hospital stay and complication rate of group 2 were higher than group 1. (p-value 0.01 and 0.02, respectively). The patients were divided into two groups according to whether there were complications. There was no significant difference in ASA score, Hounsfield unit of stone, and stone-free rate between group 1 (without complications) and group 2 (with complications). (p-value respectively: 0.127, 0.915, 0.379 )Conclusion: With the increasing elderly population in the world, more elderly patients with kidney stones will apply for treatment. Therefore, as in our study, RIRS can be widely used in treating kidney stones in elderly patients in terms of efficacy and safety.

The main objective of this study was to provide an overview of the current practice for transverse mandibular and maxillary discrepancies in the Netherlands using a web-based survey. Orthodontists (ORTHO) and Oral and Maxillofacial Surgeons (OMFS) in the Netherlands were invited to the web-based survey via their professional association. Three cases were presented which could be treated non-surgically and surgically. Participants were asked what treatment they preferred: no treatment, orthodontic treatment with optional extractions or surgically assisted orthodontic treatment. The web-based survey ended with questions on various technical aspects and any experienced complication. Invitation was sent to all 303 members of professional association for ORTHO and to all 379 members of professional association for OMFS. Overall response number was 276 (response rate of 40.5%), including 127 incomplete responses. Generally, ORTHO prefer orthodontic treatment with optional extractions and OMFS lean towards surgically assisted orthodontic treatment. Mandibular Midline Distraction appears to be less preferred, possibly due to lack of clinical experience or knowledge by both professions despite being proven clinical stable surgical technique with stable long-term outcomes. There seems to be consensus on technical aspects by both professions, however, there are various thoughts on duration of consolidation period. Complications are mostly minor and manageable.

Hepatitis-associated aplastic anemia (HAA) is a form of acquired aplastic anemia (AA) in which bone marrow failure develops after an acute attack of hepatitis. Bone marrow failure leading to AA is generally severe in cases of HAA and fatal if left untreated. This retrospective multicenter study investigated clinical and laboratory characteristics, possible causes, treatment, and outcome of HAA in children. Twenty patients from 8 centers were included in the study. Aspartate aminotransferase and alanine aminotransferase were 10×ULN in 16 patients. Acute liver failure developed in 5 (29%) patients. Pancytopenia was simultaneously present in 6 of 20 (30%) patients. Eleven of the 20 patients (55%) were alive, in remission and transfusion free. Those who were alive either had undergone hematopoietic stem cell transplantation and/or immunosuppressive treatment, except 1 patient who had received no treatment. Patients with the diagnosis of acute hepatitis should be evaluated and followed up carefully for presence of cytopenia, so that definitive treatment of AA can be initiated in a timely and appropriate manner when needed. Copyright r 2021 Wolters Kluwer Health, Inc. 34669357

This study aimed to biochemically and histopathologically investigate the effect of sunitinib on oxidative testicular damage induced by ischemia/reperfusion in rats.Experimental animals were divided into three groups of six rats each: testicular torsion-detorsion (TTD), sunitinib+testicular torsion-detorsion (STD), and sham control (SC). Sunitinib (25mg/kg) was administered orally to the STD group by gavage. Normal saline (0.9% NaCl) was administered orally to the TTD and control groups as the solvent. One hour after administration of sunitinib and 0.9% NaCl, all animal groups were done torsion-detorsion. Then, all the rats were killed by high-dose anesthesia, and their testicles were removed. Biochemical and histopathological examinations were performed on the removed testicular tissues.Malondialdehyde; it was observed that the results in the STD group were close to those of the SC group and statistically significant lower compared to the TTD group (p=0.001). The glutathione values were statistically significantly higher in the STD group compared to the TTD group (p0.001). Nuclear factor kappa B values, revealing a statistically significant difference between the TTD and STD groups (p0.001). The TNF-α levels were measured and indicating that the results of the STD group were statistically significantly lower than those of the TTD group (p0.001). Histopathologically, animal tissues given sunitinib were observed to resemble normal tissues.Sunitinib was shown to prevent histopathological changes in testicular tissue against ischemia/reperfusion damage.

Introduction The purpose of this study was to identify the relation of daily prosthesis usage time (DPUT) of individuals with amputation with quality of life (QoL) questionnaires. Methods The research was carried out on 125 individuals with amputation. Prosthetic-related parameters were searched, as well as demographic data. A generic (Nottingham Health Profile [NHP]) questionnaire and a questionnaire specific to individuals with amputation (Trinity Amputation and Prosthesis Experience Scales [TAPES]) QoL measurements were used. Results Ninety-one males and 28 females with a mean age of 42.4 ± 14.7 years participated in the study. The average DPUT was 11.1 ± 4.4 hrs/d. Study results showed that there was significant correlation between both of the QoL questionnaires (NHP and TAPES) and DPUT. High correlation was determined between DPUT and NHP total score and NHP-Pain, and very high correlation was found between DPUT and NHP-Physical Activity subscale. A moderate negative correlation was found between DPUT and NHP-Energy Level, NHP-Emotional Reaction, NHP-Social Isolation, and NHP-Sleep. A moderate negative correlation was found between DPUT and TAPES-Activity Restriction. A high correlation was found between DPUT and residual limb pain, prosthetic satisfaction, time interval after amputation, and number of prosthetic fittings. A moderate correlation was found between DPUT and walking aids, whereas a poor relationship was shown between phantom pain and DPUT. Conclusions This study showed that "the average DPUT"may be used in terms of short assessment of QoL of individuals with amputation. The outcomes of this study pointed out that especially prosthetic-related parameters affected the QoL in individuals with amputation. In problems resulting from routine assessment and questionnaires having so many items, a single-item question, "the average DPUT,"may be used effectively in a shorter period and is helpful for organizing a rehabilitation program. Clinical Relevance A single-item question, "The average daily prosthesis usage time (DPUT),"be used effectively in a shorter assessment of quality of life of individuals with amputation and is helpful for organizing a rehabilitation program. © Lippincott Williams & Wilkins.

Background: Depression occupies an important place in medical students’ psychiatric disorders, with a prevalence of approximately 20-40%. We aim to examine factors that might affect depression in medical students and investigate the relationship between occupational anxiety and depression severity.Methods: Eighty-eight medical students who were diagnosed with major depressive disorder were included in the study. A Sociodemographic Data Form, the Occupational Anxiety Questionnaire for Medical Students, Beck Depression Inventory, and Beck Anxiety Inventory were used.Results: A statistically significant relationship was found between academic success, living with family, Occupational Anxiety Questionnaire for Medical Students, and Beck Depression Inventory scores. The mean value of the occupational anxiety of the students was 35.87±9.82. The most anxious options for students in the Occupational Anxiety Questionnaire for Medical Students were the inability to prepare for and pass the Central Medical Specialty Exam.Conclusions: It is necessary to focus on factors that may affect the severity of depression, which affect both the social and professional lives of medical students who are physician candidates. The issues about occupational anxiety should be considered when planning medical school education and postgraduate working conditions.

While data on the efficacy and safety of continuous glucose monitoring (CGM) exist across a broad age spectrum, it is limited in very young children with type 1 diabetes (T1D). We aimed to assess real-world data in this high-risk population, focusing on glycemic variability and metrics beyond HbA1c. A 12-month multi-national, prospective, observational, registry-based cohort study in children with T1D aged 1-7 years compared glucose control using real-time CGM and using fingerstick blood glucose monitoring (BGM) alone. The prespecified primary endpoint was a difference in coefficient of variation (CV) between the CGM users and BGM-only cohort. Among 227 individuals using insulin pumps (42% female, age 5.3 years), 175 were CGM and 52 were BGM-only users. The median (IQR) CV was 39.1% (36.6-41.9) among CGM and 46.8% (42.3-51.2) among BGM-only users (P

OBJECTIVES: Coronavirus Disease-2019 (COVID-19) pandemic has a massive impact on human health, causing sudden lifestyle changes. As it affects health, determining the lifestyles of university students related to smoking has gained importance. This study provides evidence of change in smoking behavior among university students in Türkiye during the ongoing COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional survey study was conducted via an electronic questionnaire approximately 2020-2021 among university students in Türkiye. The study comprised a structured questionnaire that inquired about demographic information; and the Fagerström Test for Nicotine Dependence. The questionnaire was distributed randomly to university students; it required 6 min to complete. RESULTS: A total of 749 respondents were included in the study, aged between 19 and 35 years (54.8% females). Of 749 participants, 571 health science students (medicine, pharmacy, dentistry, etc.) completed the survey. The pre-pandemic and COVID-19 pandemic mean nicotine dependence scores were 3.03 and 2.97, respectively. A difference was seen pre-pandemic (p= 0.002) and during pandemic (p= 0.005) for those studying in health and other departments. Students who had middle socio-economical status had significantly higher nicotine dependence scores pre-COVID-19, compared to during the pandemic (p= 0.027). Compared to pre and during the pandemic, the mean score of dependence was significantly lower in students, whose parents were non-smokers during the pandemic. CONCLUSION: In this study, we have provided the first data on the Turkish university student’s nicotine dependence changes during the COVID-19 lockdown. The nicotine dependence level may change based on various factors including behavioral changes. Crucial times such as pandemics can affect individuals, thus, smoking addiction can increase. Behavioral support for quitting smoking such as digital platforms, internet, and television programs should also assist to support smokers quitting successfully during this supreme time.

Objective: The role of norepinephrine (NE) on growth, adhesion and invasion of methicillin-resistant Staphylococcus aureus (MRSA) ATTC 43300 was examined in human osteoblast (HOB) cells. The effects of NE and/or MRSA on the viability and cell death pathways of HOB cells were also investigated. Furthermore, the alterations of bacterial response to oxidative stress (H2O2) were analyzed in the presence/absence of NE. Materials and Methods: Bacterial growth was detected spectrophotometrically. The colony counting method was examined for adhesion-invasion. The alteration of HOB cell viability was determined by methyl thiazolyl diphenyl-tetrazolium bromide (MTT) assay. The death pathways of HOB cells were examined microscopically using acridine orange-ethidium bromide dual staining and dichlorofluorescein-diacetate (DCF-DA) dye. The bacterial response to H2O2 was investigated by agar dilution.Results: The growth of bacterium was not affected in the presence of NE. Bacterial adhesion was decreased by NE (p

Objective: Vaccines were considered as one of the most important public health measures during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to quantify and compare restorative dental practices of geriatric patients during pre-pandemic, pre-vaccination, and post-vaccination periods. Materials and Methods: Dental records of patients aged older than 65 who presented to Bursa Oral and Dental Health Training and Research Hospital were included in the study. Restorative dental practices during the three periods: pre-pandemic period (01.01.2019−10.03.2020), pre-vaccination period (11.03.2020−13.02.2021) and post-vaccination period (14.02.2021−01.09.2021) were reviewed according to the patient’s age (young-old, middle-old and old-old), sex, tooth number (anterior and posterior), restoration type (occlusal, proximal, or cervical) and the type of restoration material (amalgam or composite). Results: Anterior restorations accounted for more than half (53%) of all restorations in the pre-COVID-19 pandemic period and 46.5% and 55.4% of restorations in the pre- and post-vaccination periods, respectively. The distribution of posterior amalgam restorations in the pre-pandemic period (31.5%) was higher than the pandemic period; in contrast, the composite restorations were higher during the pandemic pre-vaccination (73.9%) and post-vaccination (76.3%) periods (p

Objective: In breast cancer radiotherapy (RT) application has an important role in the control and survival of the disease. In this study, it was aimed to evaluate the brachial plexus, carotid artery and thyroid doses in breast cancer patients who underwent RT.Methods: Fifteen left breast cancer patients who underwent radical mastectomy were selected for our study. Three different radiotherapy plans were prepared with field-in-field (Field in Field (FinF)), static intensity modulated radiotherapy (S-IMRT) and dynamic intensity modulated radiotherapy (D-IMRT) techniques. Plans were evaluated in terms of planned target volume (PTV) doses, conformity index (CI) and homogeneity index (HI). Brachial plexus, left carotid artery and thyroid doses were compared as critical organs.Results: The mean doses received by PTV were similar for the three techniques. Dort, V20, V30 (Gy) dose values of the thyroid were significantly decreased in the S-IMRT technique compared to the FinF and D-IMRT techniques (p, Amaç: Meme kanserinde radyoterapi (RT) uygulaması hastalığın kontrolünde ve sağkalımında önemli bir yere sahiptir. Genel sağkalım sürelerinin artmasına bağlı olarak meme kanseri tedavisinde görülen yan etkilerin önemi artmıştır. Bu çalışmada RT uygulanan meme kanseri olgularda, brakial pleksus, karotis arter ve tiroid dozlarının değerlendirilmesi amaçlandı.Yöntem: Çalışmamızda radikal mastektomi yapılmış 15 sol meme kanseri hastaya, alan içinde alan (Field in Field (FinF)), statik yoğunluk ayarlı radyoterapi (S-YART) ve dinamik yoğunluk ayarlı radyoterapi (D-YART) teknikleri ile üç farklı radyoterapi planları hazırlandı. Planlar planlanan hedef hacim (Planned Target Volume-(PTV)) dozları, konformite indeksi (CI) ve homojenite indeksi (HI) açısından değerlendirildi. Kritik organlar olarak brakial pleksus, sol karotis arter ve tiroid dozları karşılaştırıldı.Bulgular: PTV’ nin aldığı ortalama dozlar üç teknik içinde benzer bulundu. Tiroidin Dort, V20, V30 (Gy) doz değerleri S-YART tekniğinde, FinF ve D-YART tekniklerine göre anlamlı olarak azaldı (p

© Author(s).Objective: Vitamin D deficiency is a common health problem around the world. This study aimed to evaluate the nationwide prevalence of vitamin D status in tertiary care hospitals in Turkey. Methods: Retrospectively, the data on vitamin D levels from 33 tertiary care hospitals’ clinical biochemistry laboratories around Turkey between January and December were collected. Results: In total, 706 434 serum samples from adult subjects (female/male: 469 028/237 406; 66.4%/33.6%) were included. While vitamin D levels were sufficient in 20.3% (n = 14 222), they were insufficient in 21.9% (n = 154 360) and deficient in 57.8% (n = 408 882). We observed the highest rates of deficiency in those aged between 18 and 29 years (62.9%, n = 70 235) and lowest rates between 60 and 69 years (52.3%, n = 61 121) and between 70 and 79 years (52.3%, n = 32 397). Hypervitaminosis D was detected in 5.5% of adult subjects; highest rates of hypervitaminosis D were observed in those who were over 80 years (6.6%) and 70-79 years (6.5%) and the lowest in 18-29 years (2.8%). Discussion: In this cohort, over half of the subjects admitted to the tertiary care hospitals in Turkey had vitamin D deficiency and required vitamin D supplementation. The elderly population had the lowest prevalence of vitamin D insufficiency and the highest prevalence of hypervitaminosis D.

Background: Metabolic or non-metabolic many bone diseases can be distinguished in sickle cell anemia. Patients with sickle cell anemia have a high risk of osteopenia and osteoporosis. The aim of this study is to reveal bone mineral density abnormalities and related factors in patients with sickle cell anemia. Methods: A total of 70 patients with sickle cell anemia were retrospectively included in our study. Complete blood count (CBC) parameters, serum creatinine, lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, uric acid, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, C reactive protein (CRP) and calculated bone mineral densitometry measurements by Dual-Energy X-ray Absorptiometry (DEXA) were assessed and recorded to the statistics program. We diagnosed osteopenia and osteoporosis according to World Health Organization (WHO) criteria. To determine the status of avascular necrosis and bone fracture, we examined x-ray and magnetic resonance imaging reports and epicrisis reports of patients from the records. Results: The average age was 30.01 ± 8.64 years. Eighteen (26.5%) of the 68 patients whose Z-score was evaluated by DEXA had bone mass below the expected age-related range according to the Z score, while 50 (73.5%) had bone mass within the expected age-related range. Of the patients whose T score was evaluated by DEXA, 46.8% were normal (n=29), 45.1% were osteopenic (n=28) and 8.1% were osteoporotic (n=5). Conclusion: Patients with sickle cell anemia are at increased risk for osteoporosis, osteopenia, and osteomalacia. Bone health should be emphasized in these patients.

Objective: Hypoglycemia is a common acute complication of type 1 diabetes (T1D), which may cause seizure, loss of consciousness, and temporary motor or sensory impairment. Glucagon administration is an effective way of treating severe hypoglycemia, especially in a free-living setting. Nonetheless, families have difficulties in managing severe hypoglycemia due to their anxiety and challenges with current glucagon administration techniques. The aim of the current study was to explore the associations between parental fear of hypoglycemia (FoH) and their general anxiety level, and in particular, their attitudes towards and thoughts on glucagon administration. Methods: Parents of children with T1D completed questionnaires assessing background and clinical information, FoH, generalized anxiety disorder (GAD) and parental anxiety for glucagon administration (PAGA). Results: sixty-eight parents participated. Positive correlations were found between parental GAD-7 score and both FoH and the number of night-time blood glucose measurements and there was a negative correlation with the child's age. Parents mean self-evaluation score of their competence in glucagon administration was 6 (standard deviation +/- 2.9) on a scale of 0 to 10. Unsurprisingly, this score was negatively correlated with the PAGA scores. There was no significant difference between children using continuous glucose monitoring system and self-monitoring of blood glucose in terms of parental FoH, anxiety and misconceptions about glucagon administration. Conclusion: the results showed that parents of children with T1D had anxiety and fear connected with hypoglycemia and glucagon administration. Structured and practical training should be implemented to increase parents' self-confidence including annual refresher training for home glucagon administration., NA

Adenoid hypertrophy (AH) has been identified as a cause of otitis media with effusion (OME), which is the most common cause of childhood hearing loss. Indeed, there may be other upper airway-related predisposing factors such as, location of the adenoid, accompanying tonsillar hypertrophy (TH) and nasal septal deviation (NSD) for the development of OME. In this study, we aimed to evaluate the associations between the upper airway physicals and OME with auditory functions.Eighty-six ears of 43 children, aged 3-11 years were included in this prospective clinical study. Findings of otolaryngologic examinations were noted. Data of pure tone audiometry (PTA), traditional tympanometry (TT) and wideband tympanometry (WBT) parameters were collected. Cluster analysis was performed to the following variables: age, sex; the adenoid choana percentage (ACP), the presences of adenoid around torus tubarius (AATT), TH, NSD and OME; peak pressure (PP) values on TT, resonance frequencies (RF) on WBT, ambient pressure absorbance ratios (APAR) and PTA hearing thresholds.Two groups of ears revealed by clustering; cluster-1 (n = 46) and cluster-2 (n = 40), at the similarity level of 0.662. The presences of AH, AATT, OME and the medians of ACP, PP, RF, WBT APARs at all frequencies except 5656 Hz and 8000 Hz, all PTA thresholds were significantly different between two clusters (p0.05). The lower WBT APARs and higher PTA thresholds were associated with higher levels of ACP and higher frequencies of the presence of AATT and OME in cluster-1.There are associations between AH, AATT and OME together with decline in hearing and SEA. Whereas, TH and NSD are not related to the formation of clusters and they are insignificant factors.

This study was conducted to determine the anxiety status of women with chronic diseases during the coronavirus disease pandemic. This descriptive study was conducted in February-August 2021 within the internal medicine outpatient clinic of a training and research hospital located in the Southeastern Anatolia Region of Turkey. Individual Descriptive Questionnaire and Spielberger State-Trait Anxiety Inventory forms were used to collect data. The mean state anxiety score of the participants was 46.40±10.46, and the mean trait anxiety score was 49.56±9.33. The trait anxiety mean scores of the participants who have a good relationship with the family and whose health status was not affected during the pandemic was found to lower statistically significant (p, Bu araştırma, koronavirüs hastalığı pandemi sürecinde kronik hastalığı olan kadınların kaygı durumlarını belirlemek amacıyla yapıldı. Tanımlayıcı tipteki bu çalışma, Türkiye’nin güneydoğusunda bulunan bir eğitim ve araştırma hastanesinin dahiliye polikliniğinde, Şubat-Ağustos 2021 tarihleri arasında yapıldı. Verilerin toplanmasında Birey Tanıtıcı Anketi ve Spielberger Durumluk- Sürekli Kaygı Ölçeği formları kullanıldı. Katılımcıların durumluluk kaygı puan ortalaması 46.40±10.46 ve sürekli kaygı puan ortalaması 49.56±9.33’tür. Pandemi sürecinde aile ile ilişkisi iyi olan ve sağlık durumu etkilenmeyen katılımcıların sürekli kaygı puan ortalamaları istatistiksel olarak anlamlı derecede düşük bulundu (p

Objective: to determine homocysteine, vitamin B12, and folate levels in patients with Parkinson's disease and to investigate the effect of entacapone use on homocysteine levels. Materials and methods: the records of patients who were followed up in our outpatient clinic between 2009 and 2010 were reviewed retrospectively. The demographic, clinical characteristics, and laboratory findings of the patients were recorded. The control group consisted of healthy subjects with similar demographic characteristics. The patients were divided into two groups according to the treatment they received. Results: the control group consisted of 22 healthy subjects (group 1), group 2 comprised 22 patients [entacapone (+)], and group 3 constitued 50 patients [entacapone (-)]. The homocysteine levels of the control group were significantly lower than the entacapone (-) and entacapone (+) groups. The vitamin B12 level of the control group was significantly higher than in the entacapone (-) group. The folate levels of the control group were significantly higher than those of the entacapone (-) group. There was no significant difference between the entacapone (-) and entacapone (+) groups in terms of homocysteine, vitamin B12, and folate levels. Conclusion: levodopa treatment affects homocysteine levels in patients with Parkinson's disease. The effect of levodopa + entacapone on plasma homocysteine levels should be evaluated together with basal vitamin B12 and folate levels and genetic features. / Amaç: parkinson hastalarında homosistein, vitamin B12 ve folat düzeylerinin belirlenmesi ve entakapon kullanımının homosistein düzeylerine etkisinin araştırılması amaçlanmıştır. Gereç ve yöntem: hareket bozuklukları polikliniğimizde 2009-2010 tarihleri arasında takipli olan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik, klinik özellikleri ve laboratuvar bulguları kayıt edildi. Benzer demografik özelliklere sahip laboratuvar değerleri incelenmiş olan sağlıklı kişiler kontrol grubunu oluşturdu. Hastalar aldıkları tedaviye göre 2 gruba ayrılarak değerlendirme yapıldı. Bulgular: grup 1: Yirmi iki sağlıklı kişiden (kontrol grubu), grup 2: Yirmi iki hastadan [entakapon (+)], grup 3: Elli hastadan [entakapon (-)] oluşmaktadır. Kontrol grubunun homosistein düzeyi entakapon (-) ve entakapon (+) gruba göre anlamlı derecede düşük saptandı. Kontrol grubunun vitamin B12 düzeyi entakapon (-) grupa göre anlamlı olarak yüksek saptandı. Kontrol grubunun folat düzeyi entakapon (-) gruba göre anlamlı olarak yüksek saptandı. Entakapon (-) ve entakapon (+) gruplar arasında homosistein, vitamin B12 ve folat düzeyleri açısından anlamlı fark saptanmadı. Sonuç: Parkinson hastalarında levodopa tedavisi homosistein düzeyini etkilemektedir. Levodopa + entakapon kullanımının plazma homosistein düzeylerine etkisinin plazmanın bazal vitamin B12 ve folat düzeyleri ve genetik özelliklerle birlikte değerlendirilmesi gerektiği düşünülmüştür., NA

Background: Evaluation of the fallopian tubes are important for infertile patients. The two most important diagnostic procedures used to evaluate tubal patency are hysterosalpingography and laparoscopy. Objectives: To asses the hysterosalpingography and laparoscopy results of patients diagnosed with infertility and investigate the diagnostic value of hysterosalpingography in patients with tubal factor infertility. Methods: The hysterosalpingography and laparoscopy results of 208 patients who presented to the Obstetrics and Gyne- cology Clinic at Dicle University, Faculty of Medicine between January 2014- January 2018 were retrospectively evaluated. Hysterosalpingography and laparoscopy results were compared with regard to the investigation of the presence of tubal obstruction and of the pelvic structures that could cause tubal obstruction. The specificity, sensitivity, positive, and negative predictive values of hysterosalpingography were computed. Results: The number of patients evaluated was 208. The ratio of primary infertile patients was 57.2% and 42.8% was secondary infertile. Hysterosalpingography was found to have a specificity of 64.6%, the sensitivity of 81.3%, the positive predictive value of 56.4%, and a negative predictive value of 86% in the determination of tubal obstruction. Conclusion: Patients with suspected tubal infertility can primarily be examined using hysterosalpingography in considera- tion of the invasive nature and the higher complication rate of laparoscopy. Keywords: Infertility; hysterosalpingography; laparoscopy; tubal factor.

OBJECTIVE: To determine the perinatal mortality rate in patients with HELLP syndrome in our clinic and to investigate the factors affecting perinatal mortality. It also makes recommendations to reduce perinatal mortality and contributes to the literature. STUDY DESIGN: Three-hundred-and-eighty-three patients were retrospectively evaluated in this cohort study. The patients' demographic, clinical data, laboratory results, gestational week at delivery, method of delivery, neonatal birth weight, fetal gender, 1- and 5-minute APGAR scores, place of delivery, maternal morbidity, mortality rates, and perinatal mortality rates were recorded. The relationship of these factors with perinatal mortality was investigated. RESULTS: The rate of perinatal mortality was determined as 6%. Patients with HELLP syndrome who experienced perinatal mortality showed significantly lower birth weight, gestational age at delivery, and 1- and 5-minute APGAR score values (p

Objective: The objective of this study was to evaluate and compare knowledge, attitude, and practice patterns between pulmonologists and allergists for adult asthma in Turkey. Methods: Questionnaire-based data were gathered from 236 pulmonologists and 62 allergists, who had been members of the Turkish Thoracic Society and Turkish National Society of Allergy and Clinical Immunology in January-March 2021. Univariate and multivariate statistics were used to determine the factors associated with primary reliever preferences. Results: Of the 298 physicians, 39% encountered at least five asthma patients daily. Spirometer was used frequently by both the allergists (82.3%) and pulmonologists (77.5%) for asthma diagnosis. Budesonide was the most preferred inhaler corticosteroid. Formoterol/budesonide was the most preferred ICS/LABA combination, followed by beclomethasone/formoterol and fluticasone/salmeterol for asthma treatment. For mild asthmatics, formoterol/ICS was the most preferred (72.6%) reliever among allergists, whereas salbutamol was the most preferred (66.1%) among pulmonologists (p < 0.001). Age and workplace were associated with salbutamol preference of doctors for mild asthmatics. Age, specialty, and patient examination time were significantly associated with salbutamol preference for severe asthmatics. Conclusions: The use of diagnostic tools, such as a spirometer, for asthma diagnosis was compatible with the guidelines. While recent updates of the guidelines indicate that salbutamol should not be used solely in mild asthmatics due to its harmful effects in long-term use, it still was the most preferred drug by pulmonologists. Postgraduate education programs are needed to improve compliance with the guidelines.

Introduction: Trapezius myalgia (TM) is the chronic pain of trapezius muscle, one of the most common reasons for shoulder pain seen in a common population. The aim of our study is to determine the effects of an existence of preoperative TM to the postoperative pain in the patients, who underwent a laparoscopic cholecystectomy. Methods: After receiving an ethical committee approval, we have included 60 ASA 1-2 patients who underwent a laparoscopic cholecystectomy surgery in the general surgery operating room in University of Health Sciences Turkey, İstanbul Training and Research Hospital between January and June 2015. The patients who were classified as ASA 3-4, had head and neck surgery or trauma, operations which had started as the laparoscopic procedures but then had to be performed as an open surgery, patients who had rheumatological and neurological diseases, tendinitis that affects the shoulder joints, and patients who had to have the emergency surgeries were excluded in this study. Patients were divided into two groups, one with (TM+) and who were not having (TM), when evaluated preoperatively. Each group had analgesia by a patient-controlled device. Using Numeral Rating scale demographical data, shoulder and umbilical pain levels were evaluated, and postoperative analgesic needs and doses were recorded in the case files. Results: Five patients who were excluded; n=26 in TM+ group and n=29 in TM group were taken. There was no significant demographic difference found between two groups. No statistically significant difference was found between TM+ and TM- groups (p>0.05). While no statistically significant difference was established in the tramadol doses between two groups, a total of ten patients out of 26 TM+ had shoulder pain, and additional analgesic need was found statistically increased in TM+ group (p

Involvement of γδ T cells is implicated in the pathogenesis of Behcet's disease (BD) as a bridge between innate and adaptive responses. IL-17 and IL-22 have also been shown to participate in the BD pathogenesis in addition to IFN-γ. Mainly CD4+ T cells are investigated previously for the production of these inflammatory cytokines. In this study, the role of γδ T cells in cytokine-related mechanisms was evaluated in BD in comparison to CD4+ T cells. Surface expression of markers for functional states of both CD4+ and γδ T cells were compared in ex vivo samples collected from patients with BD and healthy controls (HC). Sixteen active BD (a-BD), 9 inactive BD (i-BD) patients and 25 HC were investigated. The expression of CD161, CCR6 as markers for IL-17 producing cells were analyzed on γδ and CD4+ T cells. IFN-γ, IL-17A, IL-22, as well as CD107a (LAMP1) and CD16 (FcγRIII) were evaluated in both cell subtypes after in vitro stimulation. Only IFN-γ production was increased in γδ T cells of a-BD patients. There was no difference in increase of CD107a or decrease of CD16 surface expression on γδ T cells upon stimulation between the groups. Ex vivo IL-17A and both IL-17A/IFN-γ production and expression of CD161, CCR6 by CD4+ T cells were increased in a-BD. Along with CD4+ T cells, γδ T cells have complementary roles in cytokine production in BD. Higher IFN-γ production of γδ T cells suggests the role of an environmental triggers in BD pathogenesis, whereas IL-17 related activity is mainly provided by CD4+ T cells.

The gut commensal Anaerobutyricum soehngenii is an anaerobe that can produce both propionate and butyrate, metabolites that have been shown to have a positive effect on gut and overall health. Murine and human dose finding studies have shown that oral intake of A. soehngenii has a positive influence on peripheral insulin resistance, thereby reducing the risk of type 2 diabetes. A recent human intervention provided support for the mode of action of A. soehngenii as it affected gene expression in the duodenum, stimulated the secretion of GLP-1 and improved insulin sensitivity. For these reasons A. soehngenii has been proposed as a food ingredient. Before introducing this bacterium to the food chain, however, it must be established that oral intake of live A. soehngenii bacteria does not pose any health risk. As part of the safety analysis of A. soehngenii strain CH106, we performed genotoxicity assays to determine its mutagenic potential (bacterial reverse mutation and in vitro mammalian cell micronucleus tests) and a 90-day subchronic toxicity study in rats to determine overall toxicity potential. The results of both genotoxicity studies were negative, showing no genotoxic effects. For the 90-day subchronic toxicity study, no adverse events were registered that could be attributed to the feeding with A. soehngenii strain CH106. Even at the highest dose, which exceeds the expected daily human intake more than 100-fold, no adverse events were observed. These result support the conclusion that the use of A. soehngenii strain CH106 as a food ingredient is safe.

Lower limb amputation causes difficulties in mobility together with motor and sensory loss. Challenging situations such as concurrent tasks cause gait parameters to deteriorate. Understanding the effect of concurrent tasks on gait is important for the rehabilitation of amputees.Are the effects of concurrent cognitive and motor tasks on gait parameters at fixed speed different in individuals with transtibial amputation, or transfemoral amputation compared to healthy individuals?The gait parameters were evaluated of 20 individuals with transtibial amputation, 13 individuals with transfemoral amputation and 20 healthy individuals while walking on a motorized treadmill under single task (ST), cognitive dual task (CDT) and motor dual task (MDT) conditions. The self-selected comfortable velocity, which was determined in the single-task gait, was used in all three walking tests.ST, CDT and MDT gait parameters of individuals with transtibial amputation, transfemoral amputation and healthy individuals were significantly different (p 0.01). Covariance of step length variability increased in amputees when walking under MDT (p 0.05). The dual task cost (DTC) for all the gait parameters was similar in all three groups (p 0.05). The motor DTC of covariance of step length was greater than cognitive DTC (p 0.05).Individuals with lower limb amputation have the capacity to walk with cognitive and motor tasks without changing velocity on the treadmill, but concurrent motor tasks cause an increase in gait variability. The results of this study suggest that there is an increase in gait variability especially with motor tasks, which may cause a higher risk of falling. Trial number: NCT04392466 (clinicaltrials.gov).

Purpose To compare hemodynamic effects of two different modes of ventilation (volume-controlled and pressure-controlled volume guaranteed) in patients undergoing laparoscopic gynecology surgeries with exaggerated Trendelenburg position. Methods Thirty patients undergoing laparoscopic gynecology operations were ventilated using either volume-controlled (Group VC) or pressure-controlled volume guaranteed mode (Group PCVG) (n = 15 for both groups). Hemodynamic variables were measured using Pressure Recording Analytical Method by radial artery cannulation in addition to peak and mean airway pressures and expired tidal volume. Results The only remarkable finding was a more stable cardiac index in Group PCVG, where other hemodynamic parameters were similar. Expired tidal volume increased in Group VC while peak airway pressure was lower in Group PCVG. Conclusion PCV-VG causes less hemodynamic perturbations as measured by Pressure Recording Analytical Method (PRAM) and allows better intraoperative hemodynamic control in exaggerated Trendelenburg position in laparoscopic surgery.

Dapagliflozin (DAPA), sodium-glucose cotransporter 2 (SGLT2) inhibitor, is an insulin-independent antidiabetic drug used to control hyperglycaemia by promoting glucose excretion from the kidney. Its adverse effects include orthostatic hypotension, dehydration and urinary tract and genital infections caused by glycosuria. DAPA is subjected to constant additional monitoring, as drugrelated adverse reactions are frequently updated in line with the results of case studies, clinical trials and in vivo studies. Some antidiabetic drugs have shown potential harmful effects on the male reproductive system; however, the effects of DAPA have not been sufficiently studied in this capacity. Aiming to fill this gap in the literature, the present work investigates the toxic effects of DAPA on the male reproductive system.Diabetes was induced using streptozotocin (STZ) in adult male Sprague-Dawley (SD) rats. DAPA (10 mg/kg) was administered by gavage to the diabetic rats over 28 days, after which the animals were sacrificed. The biochemical, morphological and histological examinations were performed on testicle, sperm and plasma samples.As a result of this study, we observed reproductive system damage in the form of induction of apoptosis in the seminiferous tubules, changes in testis and sperm parameters and oxidative damage, alongside the development of diabetes in test animals. With the exception of sperm morphological damage, the changes observed in diabetic animals treated with DAPA were similar to those of the control group. Improvements were observed in histological, hormonal and proliferative parameters in the DAPA group compared to the DC group.Even if DAPA is found to have antioxidant effects, it may raise abnormal sperm counts through a mechanism completely independent of these effects and thus may not have a significant toxic effect on the male reproductive system.

Objective: Trigeminal autonomic headaches are the primary headache group that occurs with autonomic stimulation of the cranial nerves. The most common type of this group is cluster headache (CH). This study aimed to report the clinical features and pain characteristics of patients with CH. Materials and Methods: Patients of the outpatient headache center between 2010 and 2020 were retrospectively analyzed. Inclusion criteria were diagnosis of CH and a minimum of 1-year follow-up. Records were reviewed using the International Headache Classification-3β. The sociodemographic characteristics of patients, types of pain, pain characteristics, and treatments that were used were documented. Clinical features were compared with sociodemographic characteristics and factors that could affect the pain features. Results: The mean age of 32 patients (25 male and 7 female) was 41.8 (23-68) years, and the mean age at disease onset was 31.7 (15-65) years. Lacrimation followed by conjunctival injection were the most common autonomic findings. According to gender, no statistical significance was found between pain character (p=0.166), painful side (p=0.572), month of onset (p=0.562), accompanying autonomic findings (p=0.495), pain duration (p=0.650), pain occurrence time during the day (p=0.394), and localization (Retroorbital/orbital, p=0.602; temporal, p=0.650; and forehead p=0.394). Nine patients had migraine-like features (MLF). The pain duration of patients with MLF was found to be 1.14±0.6 months and this period was longer than the results of other patients. No statistically significant difference was found between pain characteristics. Conclusion: The delay in diagnosis due to MLF that may accompany shows the importance of increasing awareness in the definition of CH.

Aim:This study was carried out to determine the effect of obstetric characteristics of pregnant women who had relatives diagnosed with SARS-COV2 (COVID-19) on depression, anxiety and stress levels. Material and Methods:This descriptive study was conducted between 17 April 2020 and 30 May 2020 with 450 pregnant women in the Obstetrician Clinic of a private hospital in Istanbul. The study data were collected face-to-face with the Introductory Information Form, State-Trait Anxiety Index (STAI), and the Depression Anxiety Stress Scale (DASS-21). Results:All pregnant women were aware of COVID-19 pandemic (100.0%), and 40.0% of them had a relative diagnosed with COVID-19. A total of 64.4% of those with no relatives diagnosed with COVID-19 had depression, 80.4% had anxiety and 81.5% had stress. A total of 100.0% of those who had relatives diagnosed with COVID-19 had depression, anxiety, and stress (DASS). Conclusions:It was found that DASS-21 scores were high in all pregnant women who had relatives diagnosed with COVID-19. Presence of chronic diseases and parity count were decisive in depression and anxiety levels in pregnant women who had relatives diagnosed with COVID-19, unlike those who did not. Clinical evaluations should be made carefully with this situation in mind..

Aim:The aim of this study was to determine the status of intern nurses to protect and maintain patient privacy and affecting factors. Methods:The study planned as cross-sectional study and conducted between December 2017 and February 2018 at a nursing faculty in Turkey. In the collection of data, 252 intern nurses were reached. The data of the study were gathered by questionnaire method using “Individual Identification Form,” Intern Nursing Students’ Information Form Related to Privacy,” and “Patient Privacy Scale”. In statistical analysis, frequency, mean and standard deviation, Kruskal–Wallis and Mann–Whitney U-test were used. Results: Of the intern nurses, 82.5% were female and their ages were in the range of 21-24 years. The mean score of the Patient Privacy Scale of them was 4.56 ± 0.40. In the subscales, “physical privacy” displayed the highest mean score (4.67 ± 0.47), while “gender-related privacy” was the lowest (4.41 ± 0.51). In addition, it was found that there was a statistically significant relationship between the variables of Patient Privacy Scale total score, gender, hospitalization experience, having knowledge about privacy, believing privacy was always necessary and meeting the privacy needs of their patients variables (P < .05). Conclusion: It was determined that the intern nurses’ approaches to protect and maintain patient privacy were found to be positive. It should be observed whether this is reflected in care during clinical practice.

Objective:This study aimed to determine the factors affecting the mortality of patients in critical condition with coronavirus disease-2019 (COVID-19) in the intensive care unit (ICU).Materials and Methods:We included a total of 445 patients who are admitted in the ICU due to COVID-19. Patients were divided into two groups-those who survived and those who died during the ICU follow-up-and their demographic, clinical and laboratory characteristics were compared. Factors affecting mortality were also determined.Results:Older age, high Kidney Disease: Improving Global Outcome (KDIGO) stage and Sequential Organ Failure Assessment (SOFA) scores at first admission to the ICU, high neutrophil/lymphocyte ratio, high D-dimer levels, low bicarbonate (HCO3) values and high lactate dehydrogenase (LDH) and creatinine levels were determined as independent risk factors for mortality in patients in critical condition with COVID-19 admitted in the ICU. Particularly, a substantial relationship was observed between the KDIGO stage and mortality during the ICU admission.Conclusion:Age, KDIGO stage and SOFA scores at first admission, neutrophil/lymphocyte ratio and D-dimer, HCO3, LDH and creatinine levels were independent risk factors for mortality in patients in critical condition with COVID-19 admitted in the ICU.

Background: It Fear that individuals experience is effective on health promoting behaviors. Thus, it is believed that the fear of Covid-19 experienced by nurses who are primarily responsible for patient care in the pandemic process, affects health promoting and protective health behaviors. The study was conducted to determine the impact of nurses’ fear of the coronavirus on health promoting and protective health behaviors. Materials and Methods: The descriptive study was carried out with nurses working in a university hospital. The sample comprised 301 nurses. In collection of the data the introductory information form, fear of the coronavirus scale and health promoting and protective health behaviors scale were used. In the analysis of the data, descriptive statistics (number, percentage, mean), independent groups t test, analysis of variance, Mann-Whitney U test, Kruskal Wallis analysis and correlation analysis were performed. Results: The nurses obtained 25.20±5.49 points from the fear of the coronavirus scale and 85.29±8.63 points from the health promoting and protective health behaviors scale on average. A moderately signifi-cant correlation existed between the score averages of the fear of the coronavirus scale and health pro-moting and protective health behaviors scale in a positive direction.Conclusions: As a consequence, it was seen that the nurses’ score averages of the fear of the coronavirus scale and health promoting and protective health behaviors scale were not up to the mark. In addition, considering that a moderate correlation exists between the fear of the coronavirus and health promoting and protective health behaviors; it can be recommended to conduct interventions to reduce the fear of the coronavirus. Key Words: Fear of the coronavirus, Health promoting and protective health behaviors, Nurse, Amaç: Bireylerin yaşadıkları korku, sağlığı geliştirici davranışlar üzerinde etkilidir. Bu nedenle pandemi sürecinde hasta bakımından birinci derecede sorumlu olan hemşirelerin yaşadığı Covid-19 korkusunun sağlığı geliştirici ve koruyucu sağlık davranışlarını etkilediği düşünülmektedir. Çalışma, hemşirelerin koronavirüs korkusunun sağlığı geliştirici ve koruyucu davranışlara etkisini belirlemek amacıyla yapılmıştır.Materyal ve Metod: Tanımlayıcı tipte bir çalışma bir üniversite hastanesinde gerçekleştirilmiştir. Örneklemi 301 hemşire oluşturmuştur. Verilerin toplanmasında Tanıtıcı Bilgi Formu, Koronavirüs Korkusu Ölçeği ve Sağlığı Koruyucu ve Geliştirici Davranışlar Ölçeği kullanılmıştır. Verilerin analizinde tanımlayıcı istatistikler (sayı, yüzde, ortalama), bağımsız gruplarda t testi, Varyans analizi, Mann-Whitney U testi, Kruskal Wallis analizi ve Korelasyon analizi yapılmıştır.Bulgular: Hemşirelerin koronavirüs (Covid-19) korkusu ölçeği puan ortalaması 25.20 ± 5.49, sağlığı geliştirici ve koruyucu davranışlar ölçeği puan ortalaması ise 85.29 ± 8.63 olarak saptanmıştır. Hemşirelerin koronavirüs (Covid-19) korkusu ölçeği puan ortalaması ve sağlığı geliştirici ve koruyucu davranışlar ölçeği puan ortalaması arasında orta düzeyde, pozitif yönde, anlamlı bir ilişki saptanmıştır.Sonuç: Sonuç olarak hemşirelerin koronavirüs korkusu ölçeği ile sağlığı geliştirici ve koruyucu sağlık dav-ranışları ölçeği puan ortalamalarının yeterli düzeyde olmadığı görüldü. Ayrıca koronavirüs korkusu ile sağlığı geliştirici ve koruyucu sağlık davranışları arasında orta düzeyde bir ilişki olduğu düşünüldüğünde; koronavirüs korkusunu azaltmak için müdahalelerde bulunulması önerilebilir.Anahtar kelimeler: Koronavirüs korkusu, Sağlığı geliştirici ve koruyucu davranışlar, Hemşireler

Background: The aim of this study is to retrospectively evaluate the prevalence and localization of the accessory mental foramen in the Southeastern Anatolian population using Cone-Beam Computed Tomography.Materials and Methods: In this retrospective study, cone beam computed tomography images of 629 patients who applied to Dicle University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery between 2015 and 2020 for various reasons were retrospectively evaluated and 61 accessory mental foramen fixations were made. the reported case; Age, gender and localization were evaluated. The mean distance between the mental foramen and the accessory mental foramen was also calculated, and all measurements were then statistically analyzed.Results: As a result of the analysis, 629 patients were evaluated. AMF was detected in 61 of them. While 28 of them were male patients, 33 of them were determined in female patients. While unilateral accessory mental foramen was detected in 56 patients, it was detected bilaterally in 5 patients. After the comparison made by gender, the mean value was found to be 1.931 for men, while this value was found to be 1.91 for women. As a result of the statistical analysis, no significant difference was found between them.Conclusions: As a result of the evaluations, we think that gender and age have no effect on the distance between the mental foramen and the accessory mental foramen. Larger studies with larger samples are required for more precise results., Amaç: Bu çalışmanın amacı aksesuar mental foramenin Güneydoğu Anadolu popülasyonundaki prevalansının ve lokalizasyonunun Konik Işınlı Bilgisayarlı Tomografi ile retrospektif olarak değer-lendirilmesidir.Materyal ve Metod: Bu retrospektif çalışmada, 2015-2020 yılları arasında Dicle Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Çene Cerrahisi Anabilim Dalı’na çeşitli nedenlerle başvuran 629 hastaya ait konik ışınlı bilgisayarlı tomografi görüntüleri retrospektif olarak değerlendirildi ve 61 aksesuar mental foramen tespit edilen vaka; yaş, cinsiyet ve lokalizasyon açısından değerlendirildi. Mental foramen ve aksesuar mental foramen arasındaki ortalama mesafesi de hesaplandı ve tüm ölçümler istatistiksel olarak analiz edildi.Bulgular: Yapılan analizler sonucunda 629 hasta değerlendirildi. Bunlardan 61 tanesinde aksesuar mental foramen tespit edildi. Bunlardan 28 tanesi erkek hasta iken 33 tanesi kadın hastada belirlendi. 56 hastada unilateral aksesuar mental foramen tespit edilirken 5 hastada bilateral olarak tespit edildi. Cinsiyete göre yapılan karşılaştırma sonrasında erkeklerde ortalama değer 1,931 elde edilirken kadınlarda 1,91 olarak tespit edilmiştir. Yapılan istatistiksel analizler sonucunda aralarında anlamlı bir fark elde edilememiştir.Sonuç: Yapılan değerlendirmeler sonucunda, cinsiyetin ve yaşın mental foramen ile aksesuar mental foramen arasında bulunan mesafeye etkisinin olmadığını düşünmekteyiz. Daha kesin sonuçlar için daha fazla örneklem ile daha geniş çalışmalar yapılması gerekmektedir.

A new Schiff base compound and its derivative, 3-cyclopropyl-4-(4-nitrofuran-1-yl)methyleneamino-4,5-dihydro-1[Formula: see text]-1,2,4-triazol-5-one (3-CNM) and 1-acetly-3-cyclopropyl-4-(4-nitrofuran-1-yl)methyleneamino-4,5-dihydro-1[Formula: see text]-1,2,4-triazol-5-one (1-ACNM), were synthesized. The structures of compounds were characterized by [Formula: see text]C-NMR, 1H-NMR and FT-IR spectroscopy techniques. The antioxidant capacities of the molecules were investigated by different methods (metal chelation, DPPH and reducing power). Some quantum chemical calculations are performed on the B3LYP, B3PW91, MPW1PW91 functionals with the 6-311++G(d,p) level basis set of the density functional theory (DFT). Using the optimized structures of Schiff bases, the frontier molecular orbital, the theoretical spectroscopic and the nonlinear optic (NLO) analysis, the molecular electrostatic potential (MEP) surface, the thermodynamic parameters, the dipole moment, the molecular geometric properties and the total energy were calculated. The calculation results showed that the 3-CNM compound can be used as a suitable and good nonlinear optical compound. In addition, electronegative and electropositive atoms were determined from the MEP surface map. The difference between ([Formula: see text]) the highest occupied molecular orbitals (HOMO) and the lowest unoccupied molecular orbitals (LUMO) energies was calculated as 3.3[Formula: see text]eV and 3.4[Formula: see text]eV for 3-CNM and 1-ACNM, respectively, and these values express the chemical stability of the molecule and the orbital interactions. This work is important because it includes the synthesis of two new molecules and theoretical calculations that support their experimental properties. It can also provide significant benefits in terms of synthesis of similar Schiff base compounds and their calculated electronic, geometric and thermodynamic properties.

B lenfosit yüzeyinde bulunan CD19 molekülü olgun B hücrelerinde CD21, CD81, CD225 ile birlikte CD19 kompleksini oluşturur ve antijen uyarısı ile birlikte B lenfosit aktivasyonunu düzenler. CD19 molekülünü kodlayan gende oluşacak mutasyonlar, CD19 protein ekspresyonunu etkilemekte ve primer immün yetmezlik (PIY) tablosu ortaya çıkmaktadır. Bu çalışmada CD19 eksikliği tanısıyla izlediğimiz hastamızın 3 aylık bebeğinin, RFLP yöntemiyle aynı gen mutasyonu yönünden değerlendirilmesi amaçlanmıştır. Çalışmaya bilinen CD19 mutasyonlu hasta, bu hastanın yeni doğan bebeği ile hastanın annesi ve iki sağlıklı kontrol dahil edilmiştir. Mutasyon analizi için ilk olarak CD19 genindeki mutasyon bölgesini kapsayan primerler dizayn edilip PZR-RFLP işlemi gerçekleştirilmiştir. Oluşan DNA fragmentleri agaroz jel elektoroforezinde görüntülenip genotiplemesi yapılmıştır. Hastamızın CD19 geninin ekzon 6’da saptanan çerçeve kayması mutasyonu (c.973_973insA) yönünden bebeğinin ve annesinin taşıyıcı olduğu PZR-RFLP yöntemi ile gösterilmiştir. PZR-RFLP yönteminin, bilinen mutasyonların belirlenmesinde kullanılabilecek ucuz, hızlı ve güvenilir bir yöntem olduğu kanısındayız., CD19 molecule on the B lymphocyte surface forms the CD19 complex together with CD21, CD81, CD225 in mature B cells and regulates B lymphocyte activation with antigen stimulation. Mutations that will occur in the gene encoding the CD19 molecule affect CD19 protein expression and the picture of primary immunodeficiency (PIY). In this study, we aimed to evaluate the 3-month-old baby of our patient, who was followed up with a diagnosis of CD19 deficiency, in terms of the same gene mutation using the RFLP method. The patient with known CD19 mutation, the newborn baby of this patient and the patient's mother were included in the study. First, primers covering the mutation region in the CD19 gene were designed for mutation analysis and the PCR-RFLP procedure was performed. The DNA fragments formed were imaged and genotyped in agarose gel electrophoresis. In terms of the frame shift mutation (c.973_973insA) of the CD19 gene detected in exon 6 of our patient, it was shown by the PCR-RFLP method that her baby and mother were carriers. It is concluded that the PCR-RFLP method is an inexpensive, fast and reliable method that can be used in the detection of known mutations.

Light-activated photodynamic therapy (PDT) has long been used in dermatology, carcinology, otolaryngology, gynecology, gastroenterology, urology, etc. and it’s a type of treatment that approved for various diseases. PS used in PDT is a substance that can absorb light with the suitable wavelength and form reactive oxygen species (ROS). ROS shows antimicrobial activity by producing cytotoxic effects in target cells without mutagenic or genotoxic effects. In addition, microorganisms cannot develop resistance in this process. The light-induced formation of the harmful radicals such as reactive oxygen (ROS) and reactive nitrogen (RNS) species that are capable of killing cells depends on the intensity and the wavelength of the light and the type and amount of the PS used. It is envisaged that the concentration of these reactive species studied in the study will be adjusted by various factors so as to eliminate the internal and external microorganisms that can cause infection in the damaged tissue without causing harm to healthy tissues. Furthermore, the hydrogel dressings containing a fixed photosensitizer dye in the matrix are synthesized so as to protect the moisture balance on the wound area, to promote tissue formation, to reduce pain by cooling the wound area, to prevent the contamination of the wound while being permeable to gases and to contribute to the healing of the wound by absorbing excess liquid formed by the damaged tissue., Işıkla aktive olan fotodinamik tedavi (FDT), uzun zamandan beri dermatoloji, kanseroloji, kulak burun boğaz, jinekoloji, gastroenteroloji, üroloji vb. Çeşitli hastalıklar için onaylanmış bir tedavi türüdür. FDT'de kullanılan FS, uygun dalga boyunda ışığı absorblayarak reaktif oksijen türlerini (ROS) oluşturabilen bir maddedir. ROS, hedef hücrelerde mutajenik veya genotoksik etki olmadan sitotoksik etkiler üreterek antimikrobiyal aktivite göstermektedir. Ek olarak, bu süreçte mikroorganizmalar da direnç geliştiremezler. Fotosensitizör maddede bulunan kromofor gruplar spesifik dalga boyundaki ışığa maruz kalmasıyla hücreleri öldürme yeteneğine sahip olan reaktif oksijen türleri (ROS) ve reaktif azot (RNS) gibi zararlı radikallerin üretimi; ışığın dalga boyuna, şiddetine, kullanılan PS’ün miktarına ve çeşidine bağlıdır. Bu araştırmada oluşan bu reaktif türlerin konsantrasyonu çeşitli faktörler ile ayarlanarak vücut dokularına zarar vermeden hasarlı dokuda enfeksiyona neden olabilecek iç ve dış kaynaklı mikroorganizmalardan arındırması öngörülmektedir. Ayrıca fotosensitizör boyar maddenin içerisine sabitlendiği hidrojel yara örtüsünün; yaranın nem dengesini koruması, doku oluşumunu arttırıcı etki göstermesi, yarayı soğutarak acıyı azaltması, gaz geçişini optimum düzeyde tutarak ortam kaynaklı kontaminasyonu engellemesi, matriks sisteminin emici özelliği sayesinde hasarlı doku üzerindeki fazla sıvıyı emerek yaranın daha çabuk iyileşmesine katkı sağlaması gibi fiziksel özelliklere sahip olması hedeflenmiştir.

Diabetes care at school has recently appeared on the agenda of international diabetes organizations, the basic principles of which have been newly determined. The aim of this review was to summarize the activities and output of the Diabetes at School Program - a program that has been delivered in Turkey for the last 10 years - and to focus on different aspects of Diabetes Care at School through a national model. Recently, a detailed set of national regulations, including the basic principles proposed by the International Society for Pediatric and Adolescent Diabetes and the experience in Turkey, was prepared and has come into force. The future agenda includes giving priority to socio-economically disadvantaged regions, provision of an Individual Treatment Plan at School for each child with diabetes and ensuring that each school has an action plan for the care of children with diabetes. We believe that if all countries have programs and structured national regulations similar to the Diabetes at School Program, this will enable significant progress in the level of care delivered to children with diabetes.

Aim: This study aimed to determine the incidence, predisposing factors, clinical presentation, and treatment options for portomesenteric and splenic vein thrombosis (PMSVT) in patients undergoing l...

Objective: To retrospectively analyze the data of patients who underwent relaparotomy in our clinic, to indicate the incidence, indications and mortality rate of relaparotomy. Methods: Our study included 47 patients who underwent relaparotomy in our clinic between the study dates. Demographic characteristics of the patients, indications for the first operation and the surgical procedure performed during the first operation, the center where the first operation was performed, the indications for relaparotomy and the surgical procedure performed during relaparotomy, the time between two operations, the number of blood transfusion products given, and the mortality after relaparotomy were noted. In our clinic, the incidence of obstetric and gynecological relaparotomy and the mortality rate after relaparotomy were calculated. Results: Of the patients included in our study, 89.4% consisted of patients who underwent obstetric relaparotomy, and 10.6% underwent gynecological relaparotomy. In our clinic, the incidence of obstetric relaparotomy was 0.1%, and the incidence of gynecological relaparotomy was 0.06%. We found the mortality rate of our clinic after relaparotomy to be 2.1% (1/47). We found that the first operations of patients who underwent obstetric relapatomy were cesarean section most frequently with a rate of 81% (34) and a previous cesarean section was the most common indication in 23.8% (10). It was determined that total abdominal hysterectomy was performed most frequently in 80% (4) of the first operations of patients who underwent gynecological relaparotomy, and abnormal uterine bleeding was the most common indication in 60% (3). We determined that the most common indication for both obstetric and gynecological relaparotomy in patients who underwent relaparotomy was hematoma-hemorrhage (64.3% and 40%, respectively). We found that hematoma evacuation-bleeding control was the most common procedure performed in relaparotomy in both obstetric and gynecological relaparotomy (52.4% and 40%, respectively). Conclusion: After the necessary preparations are made, the decision to relaparotomy should be made without delay. Patients with risk factors should be informed in advance and we should recommend that their first surgery be performed in tertiary hospitals as much as possible. We think that we can reduce the need for relaparotomy by controlling the bleeding during the first operation.

© 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.Aim: Nail involvement is common in psoriatic arthritis. This study assesses clinical characteristics, nail psoriasis prevalence, and impact of nail psoriasis on disease activity in patients with psoriatic arthritis (PsA). Method: This cross-sectional multicenter study was conducted by the Turkish League Against Rheumatism using PsA patients recruited from 25 centers. Demographic and clinical characteristics of PsA patients, such as disease activity measures, quality of life, and nail involvement findings were assessed during routine follow-up examinations. Patients were divided into two groups according to the presence or absence of nail psoriasis and compared using the χ2 test or Fisher exact test for categorical variables and the t-test or Mann-Whitney U test for continuous variables. Results: In 1122 individuals with PsA, 645 (57.5%) displayed nail psoriasis. The most frequent features of fingernails were ridges (38%), followed by pitting (21%) and onycholysis (19%). More females were present in both groups (with and without nail psoriasis; 64% vs 67%, P < 0.282). Patients with nail psoriasis were older, indicated more pain and fatigue, experienced greater swelling, tender joint counts, and skin disease severity, and had a higher disease activity score compared with those without nail psoriasis (all P < 0.05). Conclusion: We demonstrate an increased prevalence of nail psoriasis observed in patients with psoriatic arthritis. Patients with nail involvement experience increased disease activity, lower quality of life, and diminished mental and physical status compared with those without nail involvement.

The 2019 coronavirus disease (COVID-19) has caused millions of cases worldwide. As the pandemic progresses, understanding the effects of this disease remains important. We aimed to examine the hematological effects of the disease. The research was carried out as a retrospective study, 50 patients using favipiravir and 50 patients not using favipiravir who had positive COVID-19 RT-PCR test in nasal and throat swabs were included in the study. INR, PTT, aPTT tests were evaluated on all patients. Results of patients using favipiravir; INR 1.3±0.2, PT(s) 16.4±3.4, aPTT(s) 40.7±10.1, while the results of patients who did not use favipiravir were INR 1,2±0.2, PT(s) 14.6±2.5, aPTT(s) was found 38.4±7.8. While PT and INR were found to significantly higher in patients using favipiravir (p

Objective: The aim of the study was to determine the effects of age, gender and season on vitamin D status in healthy urban population at reproductive age. Also, we investigated the distribution of population into different groups regarding 25(OH)D levels. Methods: Serum 25(OH)D levels of 21,317 participants: 5,364 men (25.1%) and 15,953 women (74.8%), aged between 18-45 years, applying to two medical centres for check-up located in the same city were retrospectively analyzed. Group I consisted of 14,720 participants (11,257 women and 3,463 men) in the first centre and Group II consisted of 6,597 participants (4,696 women and 1,901 men) in the second centre. Results: The mean 25(OH)D levels did not differ between women and men in both groups: 23.4 (SD = 14.4) and 23.1 (SD = 12.6) in Group I, and 22.6 (SD = 15.9) and 23.1 (SD = 14.3) in Group II, respectively, (p > 0.05). Similar trends exhibiting lower mean 25(OH)D levels at younger ages and higher levels at later ages were observed in both groups; a seasonal variation of 25(OH)D levels was observed in both genders with the highest levels in August and September and the lowest levels from February through April; percentages of women with 25(OH)D level of < 5 ng/ml were significantly higher than of men in Group I (1.4% vs. 0.2%, respectively, p < 0.001) and in Group II (4.1% vs. 1.1%, respectively, p < 0.001). Conclusion: There is a slight increase in serum 25(OH)D levels from 18 through 45 years of age in healthy population. The seasonal variation of 25(OH)D levels is prominent in both genders with men having slightly lower levels in some months of winter and higher levels in summer as compared to women. The prevalence of women having 25(OH)D levels less than 5 ng/ml is higher than that of men.

Objective: In this study, our aim is to define the cognitive profile specific to Huntington’s disease (HD) in comparison to Parkinson’s disease (PD) without any accompanying cognitive involvement and to search for its relationship with CAG repeat number. Materials and Methods: Demographic data and detailed cognitive test results of HD and PD patients were reviewed, analyzed retrospectively and were compared to results of healthy controls (HC). Cognitive test battery included minimental state examination (MMSE), Beck’s depression inventory, enhanced cued recall (ECR), semantic fluency, digit-span forwards and backwards, trail making part A (TMT A) and B, reciting months backwards, phonemic fluency, Stroop, clock drawing, Benton’s line orientation, Benton’s facial recognition and Hooper visual organization tests. Instrumental activities of daily living test (IADL) was given for evaluating independence of patients in daily life. The relationship between test results and CAG repeat number and CAP score (product of CAG repeat number and age) for HD were evaluated. Results: Age, disease duration and number of years of education were similar between HD and PD. All cognitive test results of HD group were significantly worse than those of HC. HD group also scored significantly worse than PD group in MMSE, ECR, semantic fluency, TMT A, reciting months backwards, phonemic fluency, Stroop 1-5, clock drawing, Hooper visual organization and Benton’s facial recognition tests. CAP score was significantly correlated with the results of Stroop part 3-4 and scores of IADL. Conclusion: This study showed that HD has a cognitive profile with certain particular features, which differentiates it from PD. We can also conclude that cognitive decline takes place earlier in the course of HD compared to PD and it is more severe. CAP score was found corelated with executive functions and ADL in HD, confirming that the severity of pathological involvement is directly related to the cognitive profile of patients as well as their life quality., NA

The current experimental pre-/posttest study sought to determine the effect of psychoeducation on the stress levels of parents of children with attention-deficit/hyperactivity disorder (ADHD). A total of 172 parents participated and were randomly assigned to experimental ( n = 86) and control ( n = 86) groups. There was no significant difference between mean pretest scores of parents in the experimental and control groups on the Caregiver Stress Scale ( p > 0.005); however, significant differences were found between pre- and posttest scores in the experimental group after psychoeducation and at 6-month follow up ( p < 0.001). There were also significant differences between pre- and posttest scores and pretest scores and 6-month follow-up scores in the experimental group ( p < 0.05). In the light of the findings, psychiatric nurses can use psychoeducation programs to support families of children with ADHD to reduce their stress levels. [ Journal of Psychosocial Nursing and Mental Health Services, 58 (7), 34–41.]

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