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Introduction: It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia., Materials and Methods: The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed., Result: In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p < 0.05)., Conclusions: In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.

This study is the first comprehensive bibliometric analysis about meningioma to date. The aim of this study is to identify the most influential publications in this field through citation and co-citation analysis, to examine international collaborations, to identify the conceptual framework of the subject and emerging trending topics through keyword analysis, and to identify the most productive countries, authors and journals. 9619 articles on meningioma published between 1980 and 2023 were downloaded from the Web of Science (WoS) database and statistically analyzed. In this study, various bibliometric techniques were utilized, including trend keyword analysis, thematic evolution analysis, factor analysis, conceptual structure analysis, citation and co-citation analyses. Bibliometric network visualization maps were created to identify trend topics, citation analysis and cross-country collaborations. The Exponential Smoothing estimator was used to predict article productivity in the coming years. The first 3 countries that contributed the most to the literature were respectively; USA (2664, 27.7%), Japan (972, 10.1%), Germany (943, 9.8%). The first three most productive journals were respectively; Journal of Neurosurgery (number of article = 496), World Neurosurgery (399), Acta Neurochirurgica (378). The most productive author was Mcdermott MW (number of article = 88) and the most active institution was the University of California System (number of article = 470). In addition to high-grade meningiomas, the most studied topics from past to present have been magnetic resonance imaging, recurrence, radiation therapy, and skull base. As a result of the analyses to determine trend topics, the subjects studied in recent years were diagnostic and imaging methods, surgical and treatment methods, prognosis and survival, epidemiology and quality of life, and with the advancement of technology, machine learning and prediction models. Scientific collaboration was seen primarily in articles from western countries, especially the USA, European countries, and Canada. However, there was also a not insignificant effect in developing countries such as China, India, and Turkey., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Hematuria is the most common symptom of bladder cancer (BCa). It is well-known that the frequency of hematuria increases with the use of antithrombotic drugs (ATDs). We designed our study with the hypothesis that patients using antithrombotic drugs who present with the complaint of hematuria and are subsequently diagnosed with BCa may receive an earlier diagnosis, leading to lower tumor grades and stages. Data of 441 consecutive patients who presented to our urology outpatient clinic with macroscopic hematuria between 2020 and 2023 were retrospectively evaluated. A total of 88 patients (21.4%) with a primary diagnosis of BCa were included in our study. Patients were divided into 2 groups: those using ATDs during the episode of macroscopic hematuria (group 1) and those not using ATDs (group 2). Univariate and multivariate binary logistic regression analysis was performed to identify risk factors that could predict tumor grade. The incidence of multiple tumors (>1) was significantly lower in patients using ATDs (P = .033). The number of patients with tumor size larger than 3 cm was significantly higher in the group not using ATDs (P = .005). The rates of pathological T1 stage in the group using ATDs were significantly lower than those in the nonuser group (P = .038). According to the results of the multivariate model, the effect of pathology stage and ATD use on predicting tumor grade was significant (P = .002 and P < .001, respectively). The probability of having a high-grade tumor in patients with pathology stage T1 was 5.32 times higher than in patients with pathology stage TA. The probability of having a high-grade tumor in patients not using ATDs was 7.73 times higher than in those using ATDs. The effect of pathology stage and ATD use on predicting tumor grade was found to be significant. The probability of having a high-grade tumor was higher in patients not using ATDs compared to those using ATDs. In light of these results, we can state that the use of ATDs is a positive predictive factor in the early diagnosis of BCa, bringing along the chance of early diagnosis and treatment., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

The mechanical properties of polylactic acid (PLA), polyethylene terephthalate glycol (PETG), and PLA/PETG structures manufactured using the multi-material additive manufacturing (MMAM) method were studied in this work. Material extrusion additive manufacturing was used to print PLA/PETG samples with various PLA and PETG layer numbers. By varying the top and bottom layer numbers of two thermoplastics, the effect of layer number on the mechanical properties of 3D-printed structures was investigated. The chemical and thermal characteristics of PLA and PETG were investigated using Fourier transform infrared spectroscopy and differential scanning calorimetry. Tensile and flexural strength of 3D-printed PLA, PETG, and PLA/PETG samples were determined using tensile and three-point bending tests. The fracture surfaces of the samples were evaluated using optical microscopy. The results indicated that multi-material part containing 13 layers of PLA and 3 layers of PETG exhibited the highest ultimate tensile strength (65.4 MPa) and a good flexural strength (91.4 MPa). MMAM was discovered to be a viable way for producing PLA/PETG materials with great mechanical performance., Competing Interests: No competing financial interests exist., (Copyright 2024, Mary Ann Liebert, Inc., publishers.)

Objectives: Sheep Achilles tendons are used as an effective preclinical model of flexor tendon repair in plastic surgery, due to their biomechanical properties, which are similar to humans. The aim of this study was to examine the efficacy and biomechanical outcomes of suture materials and tendon repair techniques in flexor tendon repair., Material and Methods: 72 sheep tendons were obtained for a total of 12 different scenarios. Tendons were repaired using 4 different suture types and 3 different suture techniques. After repair, the tendons were fixed at both ends and subjected to biomechanical tests. Ultimate Failure Load (UFL) and 2-mm Gap Load (GL) per scenario were compared statistically within and between groups., Results: UFL and GL of all sutures were significantly different between the modified Kessler, Bunnell and Krackow techniques (P < 0.05), and between Monosorb, Ti-Cron and V-loc sutures (P < 0.05). UFL and GL according to repair technique were not significantly different for the Propilen suture (P > 0.05)., Conclusion: When UFL and GL were considered together, our findings indicate that optimal strength scenarios were for the modified Kessler technique using Monosorb or V-loc sutures., (Copyright © 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Background: Data on the burden of heart failure (HF) outside western countries are limited, but available data suggest it may present differently in other countries. The aim of this study was to examine the incidence, prevalence, and survival rates of HF in Türkiye, with a specific focus on how these rates vary according to age, sex, comorbidities, and socioeconomic status (SES)., Methods: We harnessed the extensive National Electronic Database of the Turkish Ministry of Health, covering Turkey's entire population from January 1, 2016, to December 31, 2022, to identify 2,722,151 cases of HF and their associated comorbidities using ICD-10 codes. Analyzing the primary endpoint of all-cause mortality, our study utilized anonymized data to examine patient demographics, comorbidities, socioeconomic status, and survival patterns, employing statistical techniques to delve into relationships and trends. The data were segmented by gender, socioeconomic status, and age, involving cross-tabulations and statistical metrics to explore connections, odds ratios, and survival rates., Findings: The estimated prevalence of HF was 2.114% in Türkiye at the end of 2022, with an annual incidence ranging between 3.00 and 6.06 per 1000 person years. Females were older than males (69.8 ± 13.9 years vs. 66.8 ± 13.9 years, respectively). The most common comorbidities were congenital heart diseases and anemia under the age of 20, and hypertension and atherosclerotic cardiovascular disease in the adult population. Only 23.6% (643,159/2,722,151) of patients were treated with any triple guideline-directed medical therapy (GDMT) and 3.6% (96,751/2,722,151) of patients were on quadruple GDMT. The survival rates for patients with HF at 1, 5, and 7 years were 83.3% (95% CI: 83.2-83.3), 61.5% (95% CI: 61.4-61.6), and 57.7% (95% CI: 57.6-57.8) among females, and 82.1% (95% CI: 82.0-82.2), 58.2% (95% CI: 58.1-58.3), and 54.2% (95% CI: 54.0-54.3) among males. Despite a tendency for an increase from the highest to the lowest SES, the prevalence of HF and mortality were paradoxically lowest in the lowest SES region., Interpretation: The prevalence, incidence, and survival rates of HF in Türkiye were comparable to western countries, despite the notable difference of HF onset occurring 8-10 years earlier in the Turkish population. Drug usage statistics indicate there is a need for effective strategies to improve treatment with GDMT., Funding: None., Competing Interests: The authors declare no conflicting interests., (© 2023 The Author(s).)

Objective: Peripartum cardiomyopathy (PPCM) diagnosis made by excluding identifiable causes of heart failure (HF) and occurs end of the pregnancy or during the postpartum period of five months. It presents a clinical HF spectrum with left ventricular systolic dysfunction., Background: The purpose of this study is to retrospectively evaluate the clinical characteristics, cardiac magnetic resonance (CMR) imaging features, and end-points consisting of left ventricle recovery, left ventricular assist device implantation, heart transplantation, and all-cause mortality., Method: Outpatient HF records between 2008 to 2021 were screened. Thirty-seven patients were defined as PPCM. Twenty-five patients had CMR evaluation at the time of diagnosis, and six patients were re-evaluated with CMR., Results: The mean age was 30.5 ± 5.6 years, and the mean LVEF was 28.2% ± 6.7%. In 13(35.7%) patients, LVEF recovered during the follow-up course. The median recovery time was 281(IQR [78-358]) days. LVEF on CMR was 35.3 ± 10.5, and three patients exhibited late gadolinium enhancement(LGE) patterns. Sub-endocardial and mid-wall uptake pattern types were detected. 18(75%) patients met the Petersen left ventricle non-compaction cardiomyopathy(LVNC) criteria. Patients with NC/C ratio lower than 2.3 had lower LVEDVi and LVESVi (124.9 ± 35.4, 86.4 ± 7.5, p = .003; 86.8 ± 34.6, 52.6 ± 7.6, p = .006), respectively. The median follow-up time was 2129 (IQR [911-2634]) days. The primary endpoint-free 1-year survival was 88.9% (event rate 11.1%), and 5-year survival was 75.7% (event rate 24.3%)., Conclusion: In a retrospective cohort of PPCM patients, 35.7% of patients' LVEF recovered, and the primary end-point of free-5-year survival was 75%. Twenty-five patients were assessed with CMR; three of four met the Petersen CMR-derived LVNC at initial evaluation., (© 2022 Wiley Periodicals LLC.)

Aims: Left ventricular non-compaction cardiomyopathy (LVNC) is a poorly understood entity resulting in heart failure. Whether it is a distinct form of cardiomyopathy or an anatomical phenotype is a subject of discussion. The current diagnosis is based on morphologic findings by comparing the compacted to non-compacted myocardium. The study aimed to compare demographic and prognostic variables of patients with dilated cardiomyopathy (DCM) and LVNC. Emphasis was given to cardiac magnetic resonance (CMR) imaging analysis. Data on survival were also assessed., Methods and Results: We retrospectively evaluated the characteristics and outcomes of 262 non-ischaemic cardiomyopathy patients with LVNC and DCM phenotypes. Petersen's CMR criteria of non-compacted to the compacted myocardial ratio 2.3 were used to diagnose LVNC. The primary endpoint was a composite endpoint of major adverse cardiovascular events comprising cardiovascular-related death, left ventricular assisted device implantation, or heart transplantation. A total of 262 patients with CMR data were included in the study. One hundred fifty-five patients who fulfilled CMR criteria were diagnosed as LVNC. CMR findings revealed that LVNC patients had higher left ventricular end-diastolic (137.2 ± 51.6, 116.8 ± 44.6, P = 0.002) and systolic volume index (98.4 ± 49.5, 85.9 ± 42.7, P = 0.049). Cardiac haemodynamics, cardiac output (5.61 ± 2.03, 4.96 ± 1.83; P = 0.010), stroke volume (73.9 ± 28.8, 65.1 ± 25.1; P = 0.013), and cardiac index (2.85 ± 1.0, 2.37 ± 0.72; P < 0.0001), were higher in LVNC patients. Of all the 249 patients, 102 (40.9%) patients demonstrated late gadolinium enhancement (LGE). According to Petersen's criteria, the Kaplan-Meier survival outcome did not reveal significant differences (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: [0.89-2.63], P = 0.11). The presence or pattern of LGE did not show significant importance for endpoint-free survival. Most of the sub-epicardial LGE pattern was found in LVNC patients (94.4%). When receiver operator characteristics analysis was applied to NC/C ratio to discriminate the primary endpoint, a higher NC/C ratio of 2.57 was associated with adverse events (HR: 1.90, 95% CI: [1.12-3.24], P = 0.016)., Conclusions: Our study questions the criteria being used for the diagnosis of LVNC. Further evaluation of CMR variables and association of these findings with demographic variables and survival is mandatory., (© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Searching for an optimum transportation facility location with emergency equipment and staff is essential for a specific region or a country. In this direction, this study addresses the following problems. First, the performances of the Weiszfeld, tree-seed, and whale optimization algorithms are compared, which is the first of its kind in the literature. Second, a new approach that tests the importance parameters' effectiveness in searching for an optimum transportation facility location with emergency equipment and staff is proposed. The Weiszfeld algorithm finds viable solutions with compact data, but it may not handle big data. In contrast, the flexibility of the tree-seed and whale optimization algorithm is literally an advantage when the number of parameters and variables increases. Therefore, there is a notable need to directly compare those algorithms' performances. If we do, the significance of extending the number of parameters with multiple weightings is appraised. According to the results, the Weiszfeld algorithm can be an almost flexible technique in continuous networks; however, it has reasonable drawbacks with discrete networks, while the tree-seed and whale optimization algorithms fit such conditions. On the other hand, these three methods do not show a fluctuating performance compared to one another based on the locating transportation facilities, and thus they deliver similar performance. Besides, although the value of accuracy is high with the application of the conventional technique Weiszfeld algorithm, it does not provide a significant performance accuracy advantage over the meta-heuristic methods., Competing Interests: The authors have declared that no competing interests exist.

Schizophrenia is a choronic, complex and powerfully inherited mental illness that seriously affects quality of life. The illness is one of the most researched psychiatric disorders from past to present. This study aims to provide a holistic summary of the global scientific outputs through bibliometric analyses and reveal the trend topics. The articles published between the years 1975 and 2020 were downloaded from the Web of Science (WoS) database and analyzed using bibliometric methods. The literature review was conducted using the keyword ''schizophren*'' in the ''Research Area'' category. The relation between the number of publications of the countries and the Gross Domestic Products and Human Development Index values were analyzed using Spearman's correlation coefficient. The number of articles between the years 2021 and 2032 was estimated through linear regression analysis.There were 103,992 publications, 51,117 of which were articles. The number of studies has increased in direct proportion to the development level of the countries. Schizophrenia Research was the most active journal. The most used research topics are cognition, negative symptoms, bipolar disorder, antipsychotics, depression, clozapine, quality of life. Trend keywords used in recent years are 'inflammation', 'biomarker', 'oxidative stress', 'Brain Derived Neurotrophic Factor (BDNF)', 'social cognition', 'metacognition', 'motivation', 'social functioning', 'functioning', 'mental health', 'metabolic syndrome', 'functional connectivity', 'adherence' and 'recovery' indicated new research frontiers in this field. Although schizophrenia has not been fully elucidated, studies are growing like an avalanche. Our study includes the most up-to-date and most comprehensive data ever made in this field., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: The number of original scientific researches on intracranial aneurysms has risen over the last 30 years. Despite the rise in the number of articles, there is no up-to-date exhaustive bibliometric research in the literature. This study aimed to contribute to the literature via a bibliometric analysis of the original scientific researches on intracranial aneurysms published over the last 30 years., Methods: The literature review was done using the Web of Science. All articles and its citations containing aneurysm keywords were analyzed in the "title" section of articles published in the research areas: Neurosciences Neurology during 1980-2019. Correlation analyses between the number of articles produced by the countries and their economic and development indicators of gross domestic product, and Human Development Index were analyzed using the Spearman correlation coefficient. Linear regression analysis was utilized to estimate the number of articles to be published in the future., Results: There were a total of 21,673 publications on intracranial aneurysms. Of these publications, 13,371 (61.7%) were articles. The three countries that produced the most articles were the USA (4098), Japan (2668), and China (937). A statistically significant correlation was found between the development indicators of world countries and publication productivity ( p <0.001). The three journals that produced the most publications were Neurosurgery , Journal of Neurosurgery , and American Journal of Neuroradiology . The most cited article was published in Journal of Neurosurgery ., Conclusion: This bibliometric study provides a collection of data that will help design future research on intracranial aneurysms more efficiently and make innovations at greater speed.

In non-compaction cardiomyopathy (NCCM), there are several echocardiographic and cardiac magnetic resonance (CMR)-based quantitative diagnostic indices, current criteria mainly placed on morphological features, and none of the diagnostic indices includes left ventricular (LV) function. LV function and hemodynamics could be normal in NCCM patients. Evaluation of left ventricular function at the subclinical stage, strain echocardiographic parameters could be used alternative to standard echocardiographic examinations. The aim of this study to evaluate; NCCM patients, their first-degree relatives, ventricular motion patterns, strain characteristics, and the predictive capabilities of these features for early diagnosis of cardiomyopathy. This cross-sectional, case-control study included 32 NCCM patients, 30 first-degree relatives (father, mother, siblings and children) and 31 healthy volunteers. All patients evaluated with baseline echocardiography, strain measurements, and ventricular wall motion pattern. There were no differences between the groups in terms of age, weight, and body surface area. We observed a statistically significant decrease in ejection fraction (EF), fractional shortening (FS), E/E' and global strain values in patients' relatives compared to healthy volunteers (Patients' relatives: LVEF:60.9 ± 7.2%, FS:0.34 ± 0.07, E/E':7.51 ± 1.83, GLS: - 18.6 ± 3.6, GLSr: - 1.1 ± 0.1, GCS: - 17.1 ± 3.1, GCSr: - 1.2 ± 0.1, GRS:37.1 ± 6.2, GRSr:1.7 ± 0.1; all p values< 0.05). 'Rigid Body Rotation (RBR)' movement pattern was also observed in some of the patient's relative's like in the patients. RBR movement pattern determined patients; EF, longitudinal strain-strain rate, and basal layer rotation values were significantly lower, but radial strain values were higher with the RBR movement pattern (for all values p < 0.05). RBR movement pattern, deterioration of strain parameters, and accompanying echocardiographic features like LVEF, fractional shortening (FS), E/E' in patients' relative groups may contribute to reveal the subclinical status of disease and could be predictive for early diagnosis of cardiomyopathy.

This study aims to investigate the relationship between individuals' attitudes about acceptance of aesthetic surgery (e.g. rhinoplasty, autoplasty, blepharoplasty, and mammaplasty) and some of the worship practices in Islamic religion such as performing prayer, fasting, and going to pilgrimage. Although many people think that aesthetic surgery is inappropriate in Islamic religion, no studies in the literature were found to have investigated this issue. This study collected data through a questionnaire administered to 96 patients who applied to our Plastic Surgery Clinic and underwent various surgical operations and 96 patients who were recommended plastic surgery but rejected to have one; the questionnaire aimed to identify the participants' frequency of religious worship practices and appropriateness of aesthetic surgery to their beliefs. The participants responded on the frequency of religious worship levels according to the options in the questionnaire. The "Acceptance of Cosmetic Surgery Scale" was utilized in order to identify their attitudes towards aesthetic surgery. Levels of performing prayers, fasting, and going to pilgrimage in the groups that accepted surgery and in the groups that rejected surgery were significantly different (p < 0.001, p = 0.008, p < 0.001). In two different groups, the Acceptance of Aesthetic Surgery Scale scores were significantly different within the prayer groups and fasting groups (p < 0.001, p < 0.001, p = 0.001, p < 0.001). While the group that accepted surgery indicated no significant differences between those who thought about going to pilgrimage and who did not (p = 0.650), there was a significant difference in the group that rejected surgery (p < 0.001). While 14.6% of the participants in the group that accepted surgery considered aesthetic surgery a sin, this proportion was 56.3% in the group that rejected surgery, and this difference was significant (p < 0.001). In both surgery groups, there were differences in the scale scores of those who considered aesthetic surgery a sin and those who did not (p < 0.001, p < 0.001). There was a significant relationship between worship practices, one of the biggest indicators of the level of belief in Islamic religion, and aesthetic surgery attitudes. However, despite the fact that belief levels affect the decision of having an operation in plastic surgery, in case of serious health problems, the decision of having an operation becomes more important religious beliefs.

Background: Spinal cord injury (SCI) could cause motor, sensory loss, severe functional insufficiency, and social problems. This study aims to provide a holistic summary of the global scientific outputs about SCI through bibliometric analyses and reveal the trend topics., Methods: All publications about SCI published between 1980 and 2018 in Web of Science (WoS) index were downloaded (Access date: 01.09.2019) and analyzed using bibliometric methods. In the Title search section in WoS, the documents with the words "spinal cord injury" were identified. Correlation analysis between SCI publication productivity and economic development indicators of the world countries were analyzed using the Spearman correlation coefficient., Results: There were 20,322 publications, 13,662 of which were articles. The top 3 productive countries were the USA, China, and Canada. British Columbia (403; 2.9%), Toronto (401; 2.9%), and Miami (387; 2.8%) were the prominent cities. The top productive journals were Spinal Cord (1,399; 10.24%), Archives of Physical Medicine and Rehabilitation (835; 6.11%), and Journal of Neurotrauma (631; 4.61%). A statistically significant, high-level correlation was found between the number of publications about SCI and the countries' gross domestic product and gross domestic product per capita (r = 0.711, P < 0.001; r = 0.699, P < 0.001)., Conclusions: This study provides a systematic analysis of SCI and could be a beneficial guide for clinicians and scientists., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Despite the increasing number of publications on celiac disease, there is a lack of studies that made a holistic bibliometric evaluation of the studies on this topic., Aims: The purpose of this study is to analyze the publications about celiac disease by using bibliometric methods and this way to demonstrate the celiac disease-related trends, top effective articles, journals, and international collaborations between the countries and institutions., Methods: All articles published between 1980 and 2018 on celiac disease were downloaded from Web of Science and analyzed with bibliometric methods. The correlations between economic development and publication productivity of the countries were investigated with Spearman's rank correlation coefficient. Linear regression analysis was used to estimate the number of publications and citations., Results: The literature review showed that there were 6545 articles about celiac disease published between the years 1980 and 2018. The top productive country that produced most publications about celiac disease was the Italy. The most prolific journals were the Journal of Pediatric Gastroenterology and Nutrition and Scandinavian Journal of Gastroenterology. There was a moderate positive significant correlation between the number of publications and gross domestic product (r = 0.639, p < 0.001)., Conclusions: Despite the advanced research on the diagnosis, pathophysiology, and treatment of celiac disease, the global research level about the disease is low. Therefore, the international collaboration about the disease should not remain at only regional contexts; the exchange of knowledge and common studies especially in developing or underdeveloped countries should be supported in terms of prevalence and clinic studies.

There is an increasing interest in the effects of preoperative anxiety on the course and outcomes of surgical treatments and also in the studies about the anxiety-decreasing interventions. The present study aims to identify the relationship between the preoperative anxiety level of the individuals prior to aesthetic surgery operations such as nose, ear, eyelid, and mammoplasty and religious rituals such as performing prayers, fasting, and going to pilgrimage. The frequency of performing the religious rituals was identified through a questionnaire. The questionnaire included questions about the religious rituals such as performing prayers, going to a pilgrimage, and fasting as well as questions about sociodemographic features such as gender, age, and education level of the patients. Preoperative anxiety level was measured using the "Anxiety Specific to Surgery Questionnaire." The nonparametric Mann-Whitney U test was used for the scale score comparisons of the two independent groups. The scale score comparisons of more than two groups were performed using the Kruskal-Wallis test. The relationships between age and scale scores were analyzed using the Spearman's correlation coefficient. The study involved 117 patients who were planned to undergo an aesthetic surgery operation. The scale scores were significantly different according to the pilgrimage groups (p = 0.004). The scale scores were significantly different according to the level of fasting (p = 0.022). No significant differences were found between the scales scores of the groups who reported the frequency of performing prayer as never, sometimes or five times (p = 0.515). In conclusion, the present study found that Muslim people who performed religious rituals more often experienced less preoperative anxiety levels in plastic surgeries, which indicates that the belief level is an effective factor in preoperative anxiety levels. The findings of the present study indicate that patients' beliefs and worship practices should be taken into consideration by doctors, operating room personnel, and even all health workers in order to decrease the anxiety levels of patients who will undergo surgery.

Objectives: Risk scores for left ventricular assist device (LVAD) therapy are known to predict morbidity and adverse events in addition to mortality. This study evaluates the capacity of popular LVAD risk scores to predict cardiopulmonary exercise parameters., Methods: Adult patients undergoing continuous flow LVAD implantation were prospectively followed. Five risk scores were calculated before implantation: Model for End-stage Liver Disease (MELD), MELD excluding international normalized ratio (MELD-XI), MELD including sodium (MELD-Na), HeartMate2 Risk Score (HMRS) and Destination Therapy Risk Score (DTRS). Cardiopulmonary exercise tests (CPETs) were performed before and after implantation; peak oxygen consumption (vO2max), the lowest ventilation to carbon dioxide output ratio (vE/vCO2) and exercise time were measured., Results: Ninety-two patients were implanted during the study period; of these, 30 patients completed preimplantation and postimplantation CPETs (CPET cohort). The mean preimplantation and postimplantation CPET dates were 29 ± 10 days before and 109 ± 5 days following implantation. CPET parameters significantly improved after implantation (P < 0.05). In multivariate analysis, MELD, MELD-XI, MELD-Na and HMRS independently predicted both preimplantation and postimplantation vE/vCO2, while MELD-Na and HMRS were also independent predictors of preimplantation and postimplantation vO2max, respectively., Conclusions: Four preimplantation LVAD risk scores (HMRS, MELD, MELD-Na and MELD-XI) independently predict important cardiopulmonary exercise parameters such as vE/vCO2 and vO2 max in LVAD therapy. Out of these 4 risk scores, MELD-Na and HMRS appear to be the best predictors of preimplantation and postimplantation CPET parameters, respectively., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Background: Recurrent aphthous stomatitis is a common disease characterized by single or multiple, self-healing, well-circumscribed, periodic ulcers occurring in the oral cavity. Although the relationship between recurrent aphthous stomatitis and oxidative stress has been extensively reviewed in the past, its relationship with prolidase enzyme levels has not been previously investigated., Aim: The aim of this study is to investigate plasma antioxidant status and prolidase enzyme levels in patients with recurrent aphthous stomatitis., Methods: The serum total oxidant status, total antioxidant status, oxidative stress index, prolidase and paraoxonase levels of 34 recurrent aphthous stomatitis patients (mean age 35.1) and 34 healthy controls (mean age 37.7) were compared in this study., Results: Total oxidant status was significantly higher in the recurrent aphthous stomatitis group (P < 0.005). The mean total oxidant status value was 5.19 mmol/L in the recurrent aphthous stomatitis group, while it was 2.90 mmol/L in the control group. Oxidative stress index was significantly higher in the recurrent aphthous stomatitis group (P = 0.016*). The mean oxidative stress index level was 0.28 AU in the recurrent aphthous stomatitis group, while it was 0.18 AU in the control group. When control and patient groups were compared, there was no significant difference between groups with regard to the total antioxidant status (P = 0.343). The total antioxidant status levels were 1.09 and 1.14 mmol/L in control and patient groups, respectively. There was no statistically significant difference between PON1 levels of recurrent aphthous stomatitis and control groups (P = 0.218). Mean PON1 levels were 326 U/L in the recurrent aphthous stomatitis group and 381 U/L in the control group. Prolidase levels were not significantly different between recurrent aphthous stomatitis and control groups (P = 0.955). The mean prolidase level was 219.79 U/L in the recurrent aphthous stomatitis group and 219.26 U/L in the control group., Limitations: The limitation of this study is the small size of both patient and control groups and exclusion of pediatric patients., Similar studies performed in pediatric patient populations with a comparison to adults may be useful in providing meaningful results., Conclusions: We detected that the total oxidant status and oxidative stress index was higher in patients with recurrent aphthous stomatitis as compared to healthy controls. We could not demonstrate a significant difference in total antioxidant status, PON1 and prolidase values., Competing Interests: None

The purpose of this study is to identify the effect of religious beliefs on the attitudes of pregnant women toward the health of the fetus. Pregnancy, one of the important periods of life, is a special period in terms of affecting both the mother's and the baby's health. Health beliefs and attitudes are the factors that have effects on mother-baby death rates (mortality)-which is one of the most important criteria showing health level of societies. However, the literature has limited number of studies on this issue. Volunteer participants who applied to the Gynecology and Obstetrics Polyclinic were administered a questionnaire in order to identify the frequency of performing worship practices. Women's beliefs about their roles in determining their fetus's health were measured using Fetal Health Locus of Control (FHLC) scale. FHCL scale is composed of 3 sub-scales which include Internality Locus of Control (FHLC-I), Chance Locus of Control (FHLC-C), and Powerful Others Locus of Control (FHLC-P). Non-normally distributed scale scores were analyzed with Mann-Whitney U test for two independent groups and Kruskal-Wallis test for three independent groups. The scores obtained from all the sub-scales of the FHLC scale according to the praying groups were statistically significant (p = 0.008, p < 0.001, p < 0.001, respectively). The sub-scale scores were not statistically significant according to the tendency of giving alms (p = 0.269, p = 0.695, p = 0.079, respectively). The FHLC-I and FHLC-P scores did not indicate differences according to the tendency of going to pilgrimage (p = 0.914, p = 0.578), but FHLC-C scores were significantly higher in those who tended to go to pilgrimage (p = 0.004). There was a significant relationship between the tendency of performing prayer and going to pilgrimage and attitudes toward performing double-triple tests and oral glucose tolerance test (p = 0.002, p = 0.035, respectively). Religious beliefs were influential on the attitudes of pregnant women toward the health of the fetal. Gynecologists should consider patients' religious belief sensitivity while recommending them screening tests or planning their medication.

Notalgia paresthetica (NP) is a common clinical disorder characterized by hyperpigmentation, pruritus, paresthesia, and/or pain, located on the back. There is no effective treatment for patients with NP. We investigated the efficacy of a product containing bee venom (0.04%) and capsaicin (0.025%) for treating NP. Twenty patients (10 men and 10 women) with NP were included in this open-label pilot study. A biopsy was performed for each patient to exclude other dermatologic diseases. The patients were asked to apply the product to the pruritic areas once daily for 2 weeks. No other product was used during the study. The Visual Analogue Scale (VAS) score was used to evaluate the efficacy of the product. VAS scores before and after treatment were statistically different (  p = 0.005). The pretreatment median of VAS score was 8 (7-10) (8.20 ± 1.03), while the median after treatment was 3 (1-7) (3.40 ± 1.71). The product containing bee venom and capsaicin is effective in treating  NP. A double-blind and placebo-controlled study has been planned and initiated with a greater sample size.

Environmental pollution and exposure of people to heavy metals cause many bad obstetric outcomes. Our aim is to demonstrate the role of cadmium (Cd), lead (Pb), mercury (Hg), and selenium (Se) in preterm labor etiology with a case-control study. In this study, between November 2017 and April 2018, preterm delivery mothers and term delivery mothers were compared in Çorum, Turkey. All deliveries were performed with cesarean sections and there were 30 mothers in the control group and 20 in the study group. The maternal blood, maternal urine, umbilical cord blood, and heavy metal levels in the amnion fluid in both groups were studied. Graphite furnace atomic absorption spectrometry was used to determine the blood concentration of Cd, Pb, Hg, and Se. We found lower levels of selenium in blood and urine of preterm delivery mothers and umbilical cord and amnion fluids of preterm infants (p < 0.01). We found a statistically significant positive correlation at selenium levels between mother's blood and umbilical cord blood (r (50) = 0.896, p < 0.001) and between maternal urine and amniotic fluid (r (50) = 0.841, p < 0.001). We have not found a similar correlation between mother and fetus of other metals (p > 0.05). We found that selenium levels were lower in mothers who were preterm birth in the light of the data in our study. We could not determine the positive or negative correlation of Cd, Pb, and Hg levels in blood, urine, and amniotic fluid samples with preterm birth.

Competing Interests: There are no conflicts of interest.

Introduction: Influenza subtypes vary by clinical, radiological, and prognostic courses and may go along with viral pneumonia. We aimed to identify clinical, radiological, and prognostic aspects of influenza epidemic during years 2016-2017., Materials and Methods: Influenza cases reported to the Public Health Directorate in our city was assessed retrospectively. Clinical, radiological, and prognostic parameters were compared based on influenza subtypes., Result: We analyzed samples from 197 cases with suspected influenza. Mean age of the subjects was 51.17 ± 26.74. We found influenza A/H1N1, influenza A/H3N2, and influenza B in 59 (30.0%), 29 (14.7%), and 3 (1.5%) cases, respectively. Comorbidity was present in 48 (24.4%) cases. Most common radiological finding was interstitial pattern. Seventy-one and 79 per cent of H1N1 and H3N2 cases were influenza pneumonia, respectively. The prevalence of overall mortality was 5.5% with a predominance in H1N1 over H3N2. Influenza vaccination had been performed in 6.8% and 3.4% of H1N1 and H3N2 cases, respectively. We detected no mortality in any vaccinated patient. We identified 6 pregnant women, 2 of which ended up with preterm birth, and another one with abortion., Conclusions: Often manifested as lower respiratory tract infection, influenza may cause epidemics with increased mortality rate. Influenza should be suspected when interstitial pattern was seen on radiological images. H1N1 cases course worse. Since the prognosis is better in vaccinated patients, seasonal influenza vaccination among the community needs to be elevated. In addition, protective measures like vaccination should be taken in pregnancy to avoid preterm delivery or abortion.

Objective: To assess the relationship between erectile dysfunction and platelet count and other platelet indices., Methods: The case-control study was done at Hitit University Erol Olcok Training and Research Hospital, Turkey, and comprised patient data between January 2014 and September 2016 that was compared with age-matched controls with no history of erectile dysfunction who were randomly chosen from patients attending the urology clinic. Platelet count and other platelet indices were measured in both cases and healthy controls. Erectile status of the patients was evaluated by using International Index of Erectile Function- 5 questionnaire., Results: There were 203 cases and 102 controls. The mean Index scores of the cases was 12.86±4.55 and that of the controls was 24.65±3.25 (p<0.001). Platelet levels were higher in cases than controls (p<0.001). But there was no statistically significant difference between the groups according to mean platelet volume values (p=0.309).., Conclusions: Platelet values can be used as an early biomarker for erectile dysfunction.

Introduction: The objective of this study is to make a comparison between the effectiveness of the diclo- fenac suppository alone and periprostatic local anaesthesia infiltration alone to reduce the pain during a transrectal ultrasound-guided prostate biopsy procedure., Material and Methods: Between January 2014 and December 2015, 100 patients from two centres who were scheduled for transrectal ultrasound guided prostate biopsy (TRUS Bx) were included in the study. Patients were divided into two groups; diclofenac suppository group (Group 1) and Lidocaine group (Group 2). After the prostate biopsy, patients were requested to fill out a visual analogue scale in order to evaluate their pain level during the procedure., Results: Since each group had been examined for VAS score, statistical differences were detected for VAS 0 and VAS 1. VAS 0 score was stated in 38 (71%) patients in Group 2, and in 25 (50%) patients in Group 1 (p = 0.040). VAS 1 score was stated in 9 (17%) patients in group 2 and 19 (38%) patients in Group 1 (p = 0.030)., Conclusions: Although statistical difference was detected at lower VAS scores (0 and 1) in favor of the lidocaine group during transrectal ultrasound guided prostate biopsies, there was not a significant difference in higher (>2) VAS scores; which was made with 100 mg of diclofenac suppository. Therefore, diclofenac suppository can be used as an alternative to periprostatic nerve block made with lidocaine.

Aim: To investigate diabetic retinopathy (DR) literature using the Institute for Scientific Information (ISI) Web of Science (WoS) database and to analyse the correlation results between socio-economic development datas and number of DR publications., Methods: The statistical analysis of the documents published during 1980-2014 was analysed. The data of this study were based on the database of WoS. "Diabetic retinopathy" was used as the keywords to search the WoS database., Results: The United States ranked first in the DR research with 1840 publications and 24.38% of the world production followed by England and Japan. Besides, the most productive country was Iceland. A high correlation was found between number of publications and 2014 gross domestic product (GDP) values of 81 countries ( r =0.800, P <0.001). We found a significant correlation between number of publications and Human Development Index (HDI) ( r =0.645, P =0.001). There is a moderate correlation between people with diabetes and number of DR publications for 81 countries ( r =0.514, P <0.01). It could be analysed that estimated publication number with DR title will be 445 according to the regression curve constituted with cubic model in 2015 ( R 2 =1.000)., Conclusion: More DR studies have been published in developed countries, DR and other complications of diabetes have gradually increased in developing countries over recent decades. It can be expected that the number of DR studies will gradually increase in developing countries.

Objective: In this study, patients admitted with the diagnosis of Eisenmenger syndrome (ES) in a tertiary referral center were analyzed., Methods: The data of 20 consecutive patients (mean age: 27.6+1.8 years, 7 male and mean follow-up time: 35.6 ± 9.1 months) with ES were retrospectively analyzed. Demographic characteristics, symptoms, physical examination, laboratory and hemodynamic parameters were analyzed at the time of first admission., Results: The most frequent underlying heart diseases were ventricular septal defect (VSD) with complex congenital disease (n:8, 40%) and isolated VSD (n:7, 35%). 6-minute walking test distance was 347.9 ± 33.7 meters and 15 patients (75%) had a functional capacity of NYHA Class III, at the time of admission. ES was diagnosed with catheterization in all patients and mean systolic pulmonary arterial pressure measured by catheterization was 112 ± 6.8 mmHg. Pulmonary function tests, FVC (forced vital capacity), FEV1 (forced expiratory volume), FEV1/FVC values were respectively, 3.1 ± 0.4, 2.5 ± 0.4 L and 76.7 ± 3.3%. Metabolic tests were performed in all patients at the first visit. Mean VO2 max was 16.7 ± 1.0 ml / kg/min and VE/VCO2 rate was 53.9 ± 3.2%. Although PH and partial pressure of carbon dioxide levels were within normal range in blood gas analysis, oxygen saturation and partial pressure of oxygen levels were low., Conclusion: The most common underlying heart disease of ES patients is VSD. In this cases exercise capacity is restricted and this restriction is reflected in laboratory parameters.