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Epidemiological studies indicate that elevated blood pressure (BP) is common among children. Early detection of elevated BP in children is important in the prevention of cardiovascular disease (CVD). Difficulties exist in the diagnosis of "elevated" BP in children of 8-12 years of age. Normative tables of sex, age, and height specific BP percentile levels are required. Reports provide normative tables of BP percentile levels in children. Elevated BP is defined as systolic and diastolic BP ≥ 90th age, sex, and height specific BP percentile. The study tests the internal consistency and reliability between the normative tables of BP in children. The main objective of the study is to assess the reliability of existing normative tables of BP in children by using ad hoc analysis of a prior survey. A cross-sectional survey was performed in elementary school children (8-12 years of age, n = 818) from Istanbul, Turkey. The survey was conducted in 2007-2008. Four different normative tables of BP were used to determine children with elevated BP. The reliability and internal consistency between the normative tables of BP in children were assessed. The prevalences of elevated systolic and diastolic BP in children differed significantly between the normative tables of BP. The internal consistency between the normative tables was poor (Cronbach α coefficient = 0.429). Kuder-Richardson 21 test indicated poor reliability between the local and international normative tables of BP. In conclusion, the study indicates that there are significant inconsistencies and poor reliability between the national and international normative tables of BP in children.

WOS: 000484127900010 PubMed: 31598597 Objectives: This study aims to investigate and compare the efficacy of platelet-rich plasma (PRP) injection, corticosteroid injection, and physical therapy in addition to exercise treatment on pain, shoulder functions, and quality of life in patients with subacromial impingement syndrome (SAIS). Patients and methods: Ninety patients (37 males, 53 females; mean age 48.99 years; range, 33 to 60 years) who were diagnosed as Stage 2 SAIS were included in the study. Patients were randomized into three groups. PRP injection was administered into the subacromial space of the affected shoulder in group 1, corticosteroid injection was administered in the subacromial joint space in group 2, and 10 sessions of physical therapy were given in group 3 five times weekly including transcutaneous electrical nerve stimulation, ultrasound, and hot packs. Moreover, an exercise program was administered in all groups. visual analog scale (VAS) was used to determine the resting and moving shoulder pain; while the Shoulder Disability Questionnaire, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, and the University of California, Los Angeles Shoulder Rating Scale (UCLA SRS) were used to evaluate the functionality of patients. Quality of life was analyzed using a generic Short Form 36 (SF-36). Results: All scores improved in all three groups compared with the period before treatment. Comparison of the groups showed higher scores in group 1 compared to groups 2 and 3 at week eight on QuickDASH, UCLA SRS, VAS at rest and during activity, and SF-36 pain subgroup scores. Conclusion: All three treatment modalities were effective in the treatment of SAIS. However, we suggest that the inexpensive and noninvasive methods of physical therapy and exercise should be the first preferred treatment in SAIS owing to causing no adverse events. Duzce University Research Fund (Scientific Research Projects)Duzce University [2015.04.03.393] This work was produced based on a research project funded by the Duzce University Research Fund (Scientific Research Projects) under grant number 2015.04.03.393.

Exact localization of the bifurcation of the common carotid artery using skin surface landmarks is important for various diagnostic and therapeutic purposes, including emergency cases. Traditional methods have confirmed their accuracy in only a certain percentage of cases and there are inconsistencies among various publications. The cervical computed tomography-angiographic examinations for any diagnostic purpose between June 2017 and December, 2017 in the authors' hospital were examined. Measurements were performed for (MT-CB) and (MT-SE) distances and the results were recorded [MT = The tip of the mastoid process; CB = common carotid artery bifurcation; SE = sternal extremity of the clavicle]. Cervical computed tomography angiography was found in the records of 91 patients in the 6-month period between June 2017 and December 2017. After exclusion criteria were applied, a total of 116 carotid bifurcation levels on the right and left sides were measured in 58 patients. The mean MT-CB distance was 6.29 ± 0.9 cm (range: 2.9-8.4 cm). The mean distance between MT and SE was 15.3 ± 1.7 cm (range: 9.9-19.0 cm). The (MT-CB): (MT-SE) ratios ranged from 29% to 51% with a mean of 41 ± 4.2% (95% CI: 39.88%-42.10%) and a median of 41.1% (P < 0.05) (Kolmogorov-Smirnov test). The distance ratio values did not change significantly according to age and gender (respectively P = 0.341, P = 0.093). These results show that the CB is usually located at two-fifths of the distance from the mastoid tip to the sternal extremity of the clavicle and closer to the mastoid tip.

Gestational diabetes mellitus (GDM) is a common complication during pregnancy. Evaluation of the quantitative physical activity in diabetic pregnant women is critical. The aim of this study was to test the reliability and validity of the Pregnancy Physical Activity Questionnaire (PPAQ) in Turkish patients with GDM. A total of 120 pregnant women between the ages of 18 and 44 years with GDM were included. The reliability of the questionnaire was measured by internal consistency and analysis of 2-week test-retest reliability. Of the patients, 74 completed the test-retest procedure. Concurrent validity was examined by comparing the PPAQ with the Short Form of the International Physical Activity Questionnaire (IPAQ) in 36 patients. Test-retest intraclass correlation coefficient scores varied between 0.72 and 0.95. The Spearman rank correlation analysis showed that the PPAQ total activity values were statistically significantly correlated with the total values of IPAQ-Short Form (

This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients. In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs. The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively). The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients’ jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.

Aim: The pathogenic bacterium on the hands of healthcare workers (HCWs) is considered as the main route of spread of hospital-acquired infections. This study determines the knowledge regarding hand hygiene among medical and nursing students in a Regional Referral Hospital.Material and Methods: 100 students participated in the study. Data was collected using the World Health Organization hand hygiene knowledge questionnaire (revised 2009). The questionnaire contains questions on the participant’s demographics, formal training in hand hygiene and questions to assess hand hygiene knowledge. Descriptive statistics of the variables were computed as Mean±SD and frequencies (n, %). The relationships between the categorical variables were investigated by using Pearson Chi-Square test. Also independent-samples t-test were used to investigate the difference between groups with regard to numerical variables. In all calculations, P< 0.05 is considered as the level of statistical significance. Statistical analysis was performed using SPSS 20 (IBM SPSS statistics, Somers, NY).Results: 90.8% of the students reported receiving formal training in hand hygiene. However only 2% of the students had good knowledge, 74% moderate knowledge and 24% low knowledge about hand hygiene. The study did not find any significant difference in the knowledge level between the students who had received formal training in hand hygiene and those who had not (p=0.392). Also, the mean knowledge score was not associated with gender (p=0.82), or profession (p=0.179). Conclusion: It is of importance to devise effective teaching methods that will help the students retain the knowledge on hand hygiene., Amaç: Sağlık çalışanlarının elindeki patojenik bakteri, hastane kaynaklı enfeksiyonların ana yayılma yolu olarak kabul edilmektedir. Bu çalışma, bir Bölge Sevk Hastanesindeki tıp ve hemşirelik öğrencilerinin el hijyenine ilişkin bilgilerini belirlemektedir.Gereç ve Yöntemler: Araştırmaya 44'ü tıp öğrencisi, 56'sı hemşirelik öğrencisi olan 100 öğrenci katılmıştır. Anket, katılımcının demografik bilgilerini, el hijyeni konusundaki resmi eğitimi ve el hijyeni bilgisini değerlendirmek için sorular içermektedir. Değişkenlerin tanımlayıcı istatistikleri Ortalama±SD ve frekanslar (n, %) olarak hesaplandı. Kategorik değişkenler arasındaki ilişkiler Pearson Ki-Kare testi kullanılarak araştırıldı. Ayrıca, sayısal değişkenler açısından gruplar arasındaki farkı araştırmak için independent-samples t-testi kullanıldı. Tüm hesaplamalarda, istatistiksel anlamlılık düzeyi olarak p

Emerging evidence indicates that dysbiosis of gut microbiota plays an important role in epilepsy, although the underlying mechanisms remain unclear due to the complex nature of both microbial composition and pathophysiology of epilepsy. We investigated effects of long-term probiotics supplementation on epileptic seizures, and inflammatory and oxidant/antioxidant biomarkers in a pentylenetetrazole(PTZ)-induced seizure model in rats. Male Wistar weaner-rats were divided into four groups. The first two groups received 1 ml/day saline solution, while the other groups received 0.05 mg/1ml/day vehicle or 109cfu/1ml/day probiotic-mixture, respectively, for 60 days by gavage. Seizure was induced by a single convulsive dose of PTZ. Seizures were evaluated using Racine's scale. Concentrations of pro-inflammatory cytokines in plasma and brain tissue were determined using ELISA, while oxidant/antioxidant biomarkers were measured using an automated-colorimetric method. Probiotics supplementation exhibited anticonvulsant effects against PTZ-induced seizures by retarding onset-times of both myoclonic-jerk and generalized tonic-clonic seizure, and by shortening duration of generalized tonic-clonic seizure. Additionally, it alleviated PTZ-induced increases in levels of pro-inflammatory cytokines IL-1β, IL-6, and IL-17A, but not of IFNγ, in plasma and brain tissue. Moreover, it restored PTZinduced fluctuations in levels of oxidants TOS and disulfide, and of antioxidants native thiol and total thiol. Our findings suggest that long-term probiotics supplementation exhibits protective effects against epileptic seizures, and alleviates (neuro)inflammation and oxidative stress related to pathophysiology of epilepsy. A probiotic-rich diet provided from childhood may provide prophylaxis against epileptic seizures, especially in susceptible individuals, as the neonate diet represents a fundamental extrinsic factor in establishing gut microbiota.

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 +/- 0.74. Sepsis (qSOFA >= 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 +/- 0.963) compared to upper-middle (0.17 +/- 0.482) and high-income (0.36 +/- 0.714) countries ( P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

The aim of this study is to examine the factors affecting seizure recurrence in pediatric patients diagnosed with epilepsy. Three hundred patients presenting to the pediatric neurology clinic between 2015 and 2018 and diagnosed with epilepsy and treated with single antiseizure drug were included in the study. Medical histories and clinical and laboratory findings were retrieved retrospectively from the hospital data system. The combined and adjusted effects of risk factors on seizure recurrence were evaluated using multivariate binary logistic regression analysis. Boys had a higher rate of seizure recurrence than girls. Seizure recurrence was also higher in patients with abnormal neurological examinations at the time of diagnosis compared to those with normal neurological examinations. Seizure recurrence was significantly higher in patients with global growth retardation. Epilepsy patients with abnormal MRI findings also had a higher rate of seizure recurrence than patients with normal neuroimaging findings. In addition, seizure recurrence was significantly higher in epilepsy patients with comorbidities such as cerebral palsy and autism spectrum disorders compared to patients without comorbidities. No significant association was observed between seizure recurrence and the first drug, perinatal asphyxia history, localization of epileptiform discharges on EEG, family history of epilepsy, family history of febrile seizures, history of stay in the neonatal intensive care unit during the perinatal period, or preterm delivery. Abnormal neurological examination, abnormal neuroimaging and accompanying comorbidities, and global growth retardation at the time of diagnosis are important factors affecting seizure recurrence in pediatric patients with epilepsy.

Background/Aim: Piriform aperture, an anatomical structure usually in the form of a pear, is created by the maxilla and nasal bone. The shape and width of PA have significant effects on nasal breathing and are also aesthetically important. In the present study, it was aimed to reveal normal morphometric values by evaluating the craniofacial parameters of young Turkish male cases at the piriform aperture with the help of computerized tomography. Methods: A total of six craniofacial parameters were examined from the 3-dimensional computerized tomography reconstruction images of 103 young adult male cases with golden ratios between the ages of 21 and 30 years. Three indices were calculated from these craniofacial parameters and nine parameters were evaluated. The cases were divided into four groups according to the ratio of the piriform aperture. The descriptive values for the data obtained from craniofacial parameters and indices were calculated as mean and standard deviation. In terms of measurements, the differences between the groups were examined with ANOVA analysis. Results: In our study, there were five cases in the 1st group, 39 cases in the 2nd group, 38 cases in the 3rd group, and 19 cases in the 4th group. Two cases were not included in any of the groups. Significant differences were detected between the groups in terms of maximum cranial width, bizygomatic width, nasal width and upper face index parameters (P

Objective: The aim of this study is to evaluate reliability and validity of the Turkish version of the Family Nutrition and PhysicalActivity (FNPA-TR) screening tool. This study was conducted as a methodological research. The data were collected between Mayand June 2018. The population of the study consisted of 1126 first and fourth grade students and their families in three primary publicschools that represent three socioeconomic statuses (high, medium, low) in Istanbul, Turkey.Materials and Methods: Data were collected from 727 students and their families with an introductory information form and theFNPA-TR screening tool. The validity of content scale was evaluated by comparing the relationship between FNPA-TR scores andanswers given to non-scale questions measuring the eating behaviour. In this study, Cronbach’s alpha, Kaiser-Meyer-Olkin, Varimaxrotation and ICC coefficients statistical tests were used to measure validity and reliability.Results: The Cronbach alpha coefficient for the internal consistency of the scale was 0.724. The test-retest reliability coefficient of thescale had a medium to very high level that ranged from 0.422 to 0.925. The Kaiser-Meyer-Olkin test result was found to be appropriateas 0.771.Conclusion: The study shows that the FNPA-TR scale is a valid and reliable measurement tool for the Turkish population.

Objective It was aimed to be obtained descriptive values with respect to the outbreak time course, demographic structure, and symptom distribution by the help of case-based data, and to be compared countries by being grouped according to their similarities of outbreak indicators. Methods The data were obtained from open-access database. Univariate tests and cluster analysis were used to analyze the data. Results After the symptoms onset, the prolonged admission to the hospital significantly increases the risk of death. The average age and percentage of the male gender of the deceased cases were found to be significantly higher. In addition, the symptoms including fever, throat complaints, and dyspnea were determined in 70%. Countries were divided into four clusters according to their similarities in terms of three outbreak indicators. The differences among the clusters with regard to mean age, urban rate, and average of the outbreak indicators were found significant. Conclusion Delaying treatment from the moment the symptoms appear will increase the risk of death and the average time to recovery or death was 2.5 weeks. It can be stated that the most important measure is to focus on methods that can detect the cases before symptoms. The indicators that have a very important role in defining the pandemic are also related to each other. Therefore, multivariate methods, which take these relationships into account, are able to produce more accurate information in determining the similarities of countries.

Objective We aimed to explore anxiety status across a broad range of HCWs supporting patients with COVID-19 in different global regions. Method This was an international online survey in which participation was on voluntary basis and data were submitted via Google Drive, across a two-week period starting from March 18, 2020. The Beck Anxiety Inventory was used to quantify the level of anxiety. Results 1416 HCWs (70.8% medical doctors, 26.2% nurses) responded to the survey from 75 countries. The distribution of anxiety levels was: normal/minimal (n = 503, 35.5%), low (n = 390, 27.5%); moderate (n = 287, 20.3%), and severe (n = 236, 16.7%). According to multiple generalized linear model, female gender (p = 0.001), occupation (ie, being a nurse dealing directly with patients with COVID-19 [p = 0.017]), being younger (p = 0.001), reporting inadequate knowledge on COVID-19 (p = 0.005), having insufficient personal protective equipment (p = 0.001) and poor access to hand sanitizers or liquid soaps (p = 0.008), coexisting chronic disorders (p = 0.001) and existing mental health problems (p = 0.001), and higher income of countries where HCWs lived (p = 0.048) were significantly associated with increased anxiety. Conclusions Front-line HCWs, regardless of the levels of COVID-19 transmission in their country, are anxious when they do not feel protected. Our findings suggest that anxiety could be mitigated ensuring sufficient levels of protective personal equipment alongside greater education and information.

Bartonella henselae is the causative agent of cat scratch disease (CSD). In this study, we aimed to investigate the clinical data of patients with suspicion of CSD and delineate current epidemiological features.A total of 785 patients with suspected CSD were included in the study. B. henselae IgM antibody was determined by indirect fluorescent antibody (IFA) test using a commercial kit (Euroimmun, Germany). Sex, age, clinical pre-diagnosis and animal contact information of the patients were obtained from hospital electronic database records.Seventy-eight (9.9%) of 785 samples were seropositive. Out of 78 patients, 46 with animal contact data were further analyzed. Of these patients, 56% were male, and 41% were under 18 years of age. Seropositivity was more commonly observed in fall and winter. The most common finding was lymphadenitis (63%). Thirty-five patients (76%) had a previous history of animal contact (cat/dog). Of the 46 seropositive patients, 78.3, 15.2, 4.4, and 2.1% had titers of 1:80, 1:160, 1:320, and 1:640, respectively.Our study confirms that CSD is not rare in Turkey. Thus, it should always be considered in the differential diagnosis of patients presenting with lymphadenopathy in all age groups, particularly children. Questioning of cat exposure should never be neglected, especially in areas with intense population of stray cats, such as Istanbul.

Mortality due to K. pneumoniae bacteremia is on rise, particularly in regions with high rates of carbapenem and colistin resistance. We aimed to define risk factors for colistin resistance and its impact on mortality. Patients diagnosed with "carbapenem-resistant K. pneumoniae (CRKp)" bacteremia between 2014 and 2018 were divided into two groups as "colistin susceptible (ColS)" and "colistin resistant (ColR)" based on broth microdilution method. Retrospective case-control study was conducted to compare characteristics and outcomes. Multiple logistic regression model was used to define independent risk factors for acquired colistin resistance and Cox proportional hazard model for 28-day mortality. A total of 82 patients (39 ColS and 43 ColR) were included. Mean age was 61.5 years, and 50 (61%) were male. Colistin resistance was significantly increased with duration of hospital stay (p = 0.007) and prior colistin use (p = 0.007). Overall, the 28-day mortality rate was 66%. Age (p = 0.014) and colistin resistance significantly increased 28-day (p = 0.009) mortality. Microbiological response to treatment within 7 days favors survival. PFGE analysis revealed an outbreak with K. pneumoniae ST78 and ST45 clones. Patients treated with combined antimicrobials had significantly lower 28-day mortality (p = 0.045) in comparison to monotherapy. However, types of combinations did not show significant superiority on each other. Colistin resistance increases 28-day mortality in CRKp bacteremia. Although combined regimens are more effective than monotherapy, existing antibacterial combinations have no apparent superiority to each other. New treatment options are pivotal.

This study aims to provide both a model by using cumulative cases and cumulative death toll for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreak in four countries, China, Italy, South Korea, and Turkey, starting from the first diagnosis and to compare associated indicators. The most successful estimation was obtained from the cubic model with natural logarithm for China, Italy, South Korea, and Turkey. The success of the models was around 99%. However, differences began to emerge in China, Italy, and South Korea after the second week. Although the highest number of new cases per 1 million people in China was 9.8 on February 28, 2020; it was 108.4 on March 21, 2020, in Italy; and this was 16.6 on March 5, 2020, in South Korea. On the other hand, the number of new cases was 24.6 per 1 million people on March 27, 2020, in Turkey. The log-cubic model proposed in this study has been set forth to obtain successful results for aforementioned countries, as well as to estimate the course of the COVID-19 outbreak. Other factors such as climacteric factors and genetic differences, which may have an impact on viral spreading and transmission, would also have strengthened the model prediction capacity.

BackgroundThe aim of this study is to explain the changes of outbreak indicators for coronavirus in China with nonlinear models and time series analysis. There are lots of methods for modelling. But we want to determine the best mathematical model and the best time series method among other models.MethodsThe data was obtained between January 22 and April 21, 2020 from China records. The number of total cases and the number of total deaths were used for the calculations. For modelling Weibull, Negative Exponential, Von Bertalanffy, Janoscheck, Lundqvist-Korf and Sloboda models were used and AR, MA, ARMA, Holt, Brown and Damped models were used for time series. The determination coefficient (R2), Pseudo R2 and mean square error were used for nonlinear modelling as criteria for determining the model that best describes the number of cases, the number of total deaths and BIC (Bayesian Information Criteria) was used for time series.ResultsAccording to our results, the Sloboda model among the growth curves and ARIMA (0,2,1) model among the times series models were most suitable models for modelling of the number of total cases. In addition Lundqvist-Korf model among the growth curves and Holt linear trend exponential smoothing model among the times series models were most suitable model for modelling of the number of total deaths. Our time series models forecast that the number of total cases will 83311 on 5 May and the number of total deaths will be 5273.ConclusionsBecause results of the modelling has providing information on measures to be taken and giving prior information for subsequent similar situations, it is of great importance modeling outbreak indicators for each country separately.

BackgroundThe coronavirus, which originated in Wuhan, causing the disease called COVID-19, spread more than 200 countries and continents end of the March. There is a lot of data since the virus started. However, these data will be explanatory when accurate analyzes are made and will allow future predictions to be made. In this study, it was aimed to model the outbreak with different time series models and also predict the indicators.MethodsThe data was collected from 25 countries which have different process at least 20 days. ARIMA(p,d,q), Simple Exponential Smoothing, Holt’s Two Parameter, Brown’s Double Exponential Smoothing Models were used. The prediction and forecasting values were obtained for the countries. Trends and seasonal effects were also evaluated.ResultsChina has almost under control according to forecasting. The cumulative death prevalence in Italy and Spain will be the highest, followed by the Netherlands, France, England, China, Denmark, Belgium, Brazil and Sweden respectively as of the first week of April. The highest daily case prevalence was observed in Belgium, America, Canada, Poland, Ireland, Netherlands, France and Israel between 10% and 12%.The lowest rate was observed in China and South Korea. Turkey was one of the leading countries in terms of ranking these criteria. The prevalence of the new case and the recovered were higher in Spain than Italy.ConclusionsMore accurate predictions for the future can be obtained using time series models with a wide range of data from different countries by modelling real time and retrospective data.

BackgroundColorectal adenomas are precancerous neoplastic lesions which may potentially differentiate to the colorectal carcinoma. We investigated whether adiponectin, resistin and apelin 12 serum levels might change in case of colorectal neoplasia. Aims In this study we intended to determine relationship between serum levels of adiponectin, resistin, apelin-12 and presence of colorectal adenoma using case-control approach. Methods Patients undergoing screening colonoscopy in the Abant Izzet Baysal University Medical Faculty Gastroenterology Polyclinics between years 2010 and 2013 were selected for study. Results In this study there were not any difference between groups according to age, body mass index, waist circumference and mean arterial blood pressure (all p>0.05). Adiponectin, resistin and apelin-12 serum levels were not statistically different between groups (p=0.642, p=0.890, p=0.618; respectively). On the other side: Serum apelin-12 levels were found to be statistically higher in patients with severe dysplastic adenoma group compared to both non-dysplastic and without adenoma groups (p=0.014). There was a negative correlation between the number of colorectal adenomas and serum adiponectin levels (p=0.035, r=-0.41). Conclusion Apelin-12 does increase in severe dysplastic adenomas. Apelin-12 is an angiogenic adipocytokine with oncogenic potential. The relation between cancer development and apelin has been shown in different types of tumors. Apelin-12 might be a candidate marker for detecting dysplastic colorectal adenomas.

WOS:000585282300007 PubMed ID: 32373916 Objectives: To investigate the effects of risk factors on recurrence and death in breast cancer patients, taking into account the dependence between recurrence and death as well as the heterogeneity among individuals. The other aim of this study was to make predictions of death risks with a dynamic model that includes patient's history and different horizons. Methods: The data of 465 patients who had undergone surgery at the Istanbul University Oncology Institute, Istanbul, Turkey, between 2009 and 2016 were used. For data analysis in this retrospective study, the authors applied the joint frailty model, and the predictions were obtained using dynamic prediction methods that consider the patient's history. The Brier score was used to evaluate the accuracy of the estimations. Results: A positive relationship was found between recurrence and death, and heterogeneity was found among patients (p

Background: The aim of this study is to determine the global average size of normal hearing and congenital severe hearing loss human cochlea and evaluate the effect of common variables on heterogeneity. Methods: Cochrane, PubMed, Web of Science, and Scopus were systematically searched using the terms ‘cochlear length’, ‘cochlear measurement’, ‘cochlear A value’, and ‘cochlear dimensions’ to retrieve studies published from 1938 to the end of 2019. Studies containing the mean and standard deviation measurements of the cochlear lateral wall length (LW), length of the organ of Corti (OC), and the cochlear basal diameter (A value) were included in the meta-analysis. Study-level characteristics, such as gender, age, hearing status, country, continent, material, method, and subtype of method were determined as predictor covariates. The quality assessment of the studies was carried out individually by two researchers using the form provided by the Joanna Briggs Institute. The data were pooled with the random-effects model. Meta-regression and subgroup analyses were conducted. This meta-analysis was organized using the PRISMA statement. Estimation of the overall effect for the length of OC, LW, and the A value. Findings: The meta-analysis consisted of 53 studies with a total of 4,580 materials. The first model based on age and gender were found to have no effect on the outcomes. In the second model, hearing status and method were predictors of outcomes. The ratio of residual variance due to heterogeneity was I2 = 0%. These results were not significant. The coefficient of determination of the second model was R2 = 100% (p = 0.038). The overall effect value for OC was 33.088 (95% CI: 32.636 – 33.539) mm. For the third model, in which studies conducted with patients having congenital sensorineural hearing loss were excluded, the OC length was 33.291 (95% CI: 32.824 – 33.758) mm. Interpretation: The length of OC shows a wide global variation in humankind. This meta-analysis suggests that the cochlea of ​​patients with congenital sensorineural hearing loss is significantly shorter. Funding Statement: None. Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The study protocol was approved by the Clinical Research Ethics Committee of Istanbul Medeniyet University Goztepe Training and Research Hospital (April, 020/0195).

Background Acute left colonic diverticulitis (ALCD) ranges from localized diverticulitis to perforation and fecal peritonitis, and treatment varies from conservative management to emergency surgery. The risk factors for recurrence following nonoperative management of ALCD is still controversial. We aimed to define the factors predicting severity level, progression and recurrence risk of ALCD to timely select patients requiring surgery. Methods This is a multicenter study where patients were included on accrual. Patients in our clinic between December 2017 and June 2019 with ALCD above 18 years of age were included (n=144) in this study, while 18 years and younger, pregnant or nursing mothers, those with Crohn's disease, ulcerative colitis, colorectal and/or anal cancer were excluded from this study. Laboratory parameters, Modified Hinchey Scores, clinical features, demographics, diet, smoking, alcohol consumption, body mass index, previous diverticulitis episodes, chronic diseases of patients with ALCD, as well as recurrences within 18 months after discharge were evaluated. Results The findings showed that smoking was more common in patients with previous episodes (p=0.04) and patients who underwent emergency surgery (p=0.04). Recurrence was higher in Modified Hinchey 1b and 2 (p=0.03) than 0 and 1a. Patients who were older than 50y had a higher propensity to undergo emergency surgery than the patients younger than 50y (p=0.049). Nausea, fever, respiratory rate, procalcitonin, total bilirubin and direct bilirubin levels were higher in patients with Modified Hinchey 4 (p=0.03, 0.049, 0.02, 0.001, 0.002, 0.001, respectively). Recurrence was higher in patients with a smoking history, previous ALCD episodes, lower body mass index and pandiverticulitis. Conclusion Laboratory parameters, body mass index, age, clinical features, previous episodes of diverticulitis and smoking may predict the severity and progression of ALCD. Smoking and having low BMI seem to be precursors of ALCD recurrence, especially when the patient with MHS 1b or 2 had at least one previous episode of ALCD. Control colonoscopy results are predictive of recurrence.

Background: The pathogenic bacterium on the hands of healthcare workers (HCWs) is considered as the main route of spread of nosocomial infections.Objectives:To determine bacterial contamination of the hands of healthcare workersduring routine patient care in Masaka Regional Referral Hospital, Uganda.Methods: This cross-sectional, descriptive study included 70 health care workers, who were actively providing healthcare in the hospital. Doctors, nurses, midwives,laboratory technicians, and pharmacistsof the hospital were included in the study. The hand impressions of the participants were taken on 5% blood agar and processed as per guidelines. The criteria used for identification of bacteria werebased on colony morphology, Gram staining, catalase test (for Gram-positive cocci), coagulase test (for suspected Staphylococcus aureus) and other standard biochemical tests.Results: Out of 70 samples, 62(88.6)% showed growth of microorganisms. The most commonly isolated genus was Bacillus found in 46(74.2%) of isolates, followed by Coagulase negative Staphylococcus(CoNS) found in 39(62.9%) of isolates, Micrococcus 18(29%) of isolates, Pseudomonas found in 13(21%) isolates, Acinetobacter 9(14.5%) and Staphylococus 7(11.3%). Bacillus was found in all 5 midwives (100%), 3(75%) of drug dispensary workers, 9(69.2%) doctors, 3(60%) laboratory technicians and 25(64.1%) of nurses. Prevalence of Coagulase negative Staphylococcus was also found to be highest in 9(69.2%) of doctors, 2(40%) laboratory attendants, 4(10%) laboratory technicians, 3(60%) midwives and 20(51,3%) nurses. The prevalence rate of pathogenic bacteria is highest among doctors followed by nurses.Conclusion: The bacterial contamination on the hands of healthcare workers remains high and measures need to be taken to effectively implement hand hygiene.International Journal of Human and Health Sciences Vol. 06 No. 02 April’22 Page: 178-182

Amaç: Bu çalışmada, hastanemiz erişkin ve çocuk endokrin polikliniklerinde diabetes mellitus (DM) ve obezite tanısı almış hastalarda, üriner sistem enfeksiyon etkeni olarak izole edilen patojenlerin dağılımı, bu patojenlerin antimikrobiyallere direnç oranları, glukozüri ve piyüri varlığının araştırılması amaçlanmıştır.Gereç ve Yöntemler: Ocak 2012-Şubat 2014 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Hastanesi Erişkin ve Çocuk Endokrin polikliniklerinde DM ve obezite tanısı almış 107 hastaya ait kayıtlar geriye dönük olarak incelenmiştir. Bu hastalardan alınan idrar örneklerinin biyokimyasal/mikrobiyolojik laboratuvar sonuçları değerlendirilmiştir. Verilerin istatistiksel değerlendirmesinde SPSS 22.0 programı ile Fisher Exact ve Pearson Chi-Square testleri kullanılmıştır.Bulgular: Hastaların 75 (%70)’i çocuk, 32 (%30)’si erişkin; 84 (%78,5)’ü kadın, 23 (%21,5)’ü erkek, yaş ortalaması 25,1±23 idi. Diabetes mellitus ve obezite tanısı olan hasta sayısı sırasıyla 76 (%71,0) ve 31 (%29,0) idi. İdrar kültürlerinin 28 (%26)’inde (DM tanılı hastaların %30,2’si ve obezite tanılı hastaların %16,1’inde) bakteri üremesi olmuştur. Etken olarak en sık E. coli saptanmıştır. Piyüri ve glikozüri olan hastalarda daha fazla bakteri üremesi saptanmış olup, piyüri-bakteri üremesi arasında istatistiksel olarak anlamlı ilişki bulunmuşken, glikozüri ile anlamlı ilişki tespit edilmemiştir.Sonuç: Glukozürinin, her ne kadar enfeksiyon riskini artırsa da tek başına belirleyici bir parametre olamayacağı ancak hastaların mevcut risk göz önünde tutularak değerlendirilmeleri gerektiği; ayrıca piyüri varlığı ile idrar yolu enfeksiyonu arasında kuvvetli bir ilişki olduğu görülmüştür. Ancak tam idrar tetkiki sonucuna göre ampirik tedaviye başlamak yerine idrar kültüründe izole edilen etkene ve duyarlılık profiline göre antibiyotik tedavisinin başlanmasının uygun olacağı düşünülmüştür.

Objective: Rose oil (from Rosa damascene) has several effects which are analgesic, antispasmodic, antioxidant and neuroprotective role. Its antiepileptic effect has not been yet studied enough. In the present study, it was aimed to investigate acute effects of rose oil on the epileptiform activity in penicillin-induced epilepsy model in rats. Methods: Forty-two male Wistar rats weighing 230 to 260 g were divided into six groups with seven rats in each group. Control (+Penicillin), RO alone, Diazepam, and different doses of Rose oil including 100, 500 and 1000 mg/kg. Rats were pretreated with different doses of RO 30 min prior to penicillin treatment. Electrocorticogram recordings were taken from each animal for 2 hours after penicillin treatment. Results: Only the dose of 100 mg/kg of rose oil reduced significantly epileptic spikewave frequency of epileptiform activity. However, comparing in terms of latency and spike-wave amplitude of epileptiform activity, there were no significant difference between the groups. Conclusions: In conclusion, acute administration of rose oil reduces spike-wave frequency of penicillin-induced epileptiform activity in rats. Therefore, these findings indicate that rose oil has antiepileptic effects. Amaç: Gül yağı analjezik, antispazmodik, antioksidan ve nöroprotektif etkilere sahiptir. Anti-epileptik etki üzerine yapılan çalışmalar ise yetersizdir. Sunulan çalışmada, gül yağının sıçanlarda penisilin ile tetiklenen epilepsi modelinde epileptiform aktivite üzerine akut etkilerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: 230-260 gr ağırlığında kırk iki erkek wistar sıçan her grupta yedi olmak üzere altı gruba ayrıldı. Gruplar kontrol (penisilin), yalnız gül yağı, diazepam ve gül yağının 100, 500 ve 1000 mg/kg olmak üzere farklı dozlarından oluşmaktadır. Sıçanlara penisilin uygulamasından 30 dakika önce gül yağının farklı dozları uygulandı. Penisilin uygulamasından sonra 2 saat boyunca her bir hayvandan elektrokortikogram kayıtları alındı. Bulgular: Gül yağının sadece 100 mg/kg dozu epileptiform aktivitenin epileptik diken-dalga frekansını önemli derecede azalttı. Bununla birlikte epileptiform aktivite latens ve diken-dalga amplitüdü açısından karşılaştırıldığında gruplar arasında anlamlı bir fark yoktu. Sonuç: Gül yağının akut olarak uygulanması sıçanlarda, penisilin ile tetiklenen epileptiform aktivitenin diken-dalga frekansını azaltmaktadır. Böylece bulgularımız gül yağının anti-epileptik etkilere sahip olduğunu göstermektedir.

Purpose: To compare the results obtained from three non-cycloplegic handheld photorefractometers with cycloplegic autorefractometry (Topcon KR-8100; Topcon Corporation, Tokyo, Japan) measurement in children. Methods: The refractive status of 238 eyes in 119 healthy children was assessed. The values acquired using photorefraction with the non-cycloplegic PlusoptiX A12 (Plusoptix GmbH, Nuremberg, Germany), Retinomax K-plus 3 (Righton, Tokyo, Japan), and Spot Vision Screener (Welch Allyn, Skaneateles Falls, NY) devices were compared with those obtained from the cycloplegic Topcon KR-8100. The agreement between the measurements was assessed using the intraclass correlation coefficient. Results: The mean age was 10.1 ± 3.2 years (range: 6 to 17 years). The mean spherical value for the right eyes was 0.38 diopters (D) (range: −4.50 to 6.25 D) for the Plusoptix A12; 0.45 D (range: −4.50 to 6.25 D) for the Spot Vision Screener; −1.15 D (range: −8.75 to 6.50 D) for the Retinomax K-plus 3; and 0.62 (range: −4.50 to 6.00) for the Topcon KR-8100. The mean spherical equivalent value for the right eyes was 0.41 D (range: −4.50 to 7.90 D) for the Plusoptix A12; 0.18 D (range: −4.75 to 6.13 D) for the Spot Vision Screener; −1.30 D (range: −10.50 to 6.38 D) for the Retinomax K-plus 3; and 0.67 D (range: −4.00 to 6.00 D) for the Topcon KR-8100 (for the right eyes). Conclusions: The photorefractometer method was beneficial in the measurement of refractive errors of school-aged children. The PlusoptiX A12 photorefractometer method may eliminate the need for cycloplegia in the detection of refractive errors in children. [ J Pediatr Ophthalmol Strabismus . 2018;55(5):306-311.]

Amaç: Kompleks ve çok boyutlu bir klinik sendrom olan Fibromiyalji sendromunda (FMS),birçok somatik ve psikolojik yakınmalar olduğu için, hastanın yaşadığı travmatik olayları; romatolojik ve psikiyatrik hastalarla karşılaştırarak, travmanın hastalığa ne kadar etkisi olduğunu araştırmak istedik.Gereç ve Yöntem: Çalışmaya 111 FMS hastası ile kontrol grubu olarak 209 osteoartrit (OA), 60 romatoid artrit (RA) ve 59 depresyonlu hasta alınmıştır. Çalışmada veri toplamak için sosyodemografik bilgi formu, Çocukluk Çağı Travma Ölçeği (ÇÇTÖ), Disosiyatif Yaşantılar Ölçeği (DYÖ), Stresle Başa Çıkma Tarzları Ölçeği (SBÇTÖ), Travmatik Yaşantılar Ölçeği (TYÖ) ve Beck Anksiyete Ölçeği (BAÖ) kullanılmıştır.Bulgular: FMS, OA, RA hastalarının ÇÇTÖ ve DYÖ puanları, depresyonlu hastalardan anlamlı derecede düşük bulunmuştur. FMS, OA, RA hastaları arasında ise anlamlı fark saptanmamıştır. FMS, OA ve RA hastalarının benzer şekilde stresle başa çıkma yollarını yoğun kullandıkları, buna karşın depresyonlu hastaların ise stresle başa çıkma yollarının tamamını daha az kullandıkları görülmüştür. TYÖ puanları açısından gruplar arasında anlamlı fark bulunmamıştır. Ancak ölçeğin her bir sorusuna verilen ‘evet’ cevapları karşılaştırıldığında;‘duygusal ihmal, vücutça istismar ve cinsel tacize uğrama’sıklığı depresyonlu hastalarda daha fazla saptanmıştır. FMS ve depresyonlu hastalarda anksiyete oranı yüksek ve benzer görülmüştür. Sonuç: Travma hem fonksiyonel hem de organik kökenli ağrılara yol açabilir. Fonksiyonel ağrıları olan FMS hastalarının travma durumları, dissosiyatif yaşantı özellikleri depresyonlu hastalardan farklı ancak organik etkenli ağrıları olan OA ve RA hastaları ile benzerdir. Travmaya bağlı stresle başa çıkma yolarını FMS, OA ve RA hastalarının sık kullandıkları, depresyonlu hastaların ise daha az kullandığı görülmektedir

Amac: Parametrik kovaryans analizi (ANCOVA) varsayimlarinin saglanamamasi ve/veya bagimli degiskenin iki degerli/siralayici olcekli olmasi durumunda, parametrik olmayan ANCOVA yaklasimlarindan yararlanilmaktadir. Parametrik olmayan ANCOVA metodolojisinde Quade, Puri & Sen ve McSweeney & Porter metotlari, Rankli ANCOVA yontemleri olarak bilinmektedir. Ancak yaygin kullanilan programlarda, bu metotlarin uygulanmasina yonelik modul(ler) bulunmamaktadir. Bu calismanin amaci Rankli ANCOVA yaklasimlarini tanitmak, yazarlar tarafindan gelistirilen web tabanli bir programda uygulamasini yapmak ve bu yaklasimlarin avantajlarindan bahsetmektedir. Gerec ve Yontemler: Rankli ANCOVA yaklasimlarinin teorik ozellikleri ve uygulama adimlari tanimlanmis ve her bir yaklasimin uygulanmasina yonelik web tabanli bir program olusturulmustur. Sigara kullanma durumunun biyokimyasal tetkik sonuclari uzerindeki etkisinin incelendigi saglik alanindaki bir calismadan simule edilen veriler yardimiyla web tabanli bir program uzerinde her bir yaklasimin uygulamasina da yer verilmistir. Bulgular: Her ne kadar, bu calismada aciklanan yaklasimlar icin yaygin kullanilan istatistik programlarinda ozel bir modul olmasa da, bu yaklasimlarin kolaylikla uygulanabilecegi simule verilerle olusturulmus klinik bir calisma uzerinde gosterilmis, yaklasimlarin sonuclari verilmistir. Sonuc: Bircok arastirmada orneklem genisliginin kisitli olmasi ve/veya bagimli degiskenin normal dagilim gostermemesi durumunda, faktoriyel modeller icin parametrik yontemlerin kullanilmasi, Tip I hata oraninin artmasina ve testin gucunun azalmasina neden olmaktadir. Bu hatayi azaltmak icin calismada onerilen yaklasimlarin kullanilmasi tavsiye edilmektedir. Bu yaklasimlarin, web tabanli program sayesinde de yaygin kullanima ulasacagi dusunulmektedir.

Ankarali, Handan Camdeviren/0000-0002-3613-0523; ankarali, seyit/0000-0003-3752-0846 WOS: 000438869800011 Aim of the work: To compare fibromyalgia syndrome (FMS), osteoarthritis (OA) and rheumatoid arthritis (RA) patients in terms of their measured quality of life (QoL). Patients and methods: Fifty-nine FMS patients, 165 OA and 57 with RA were assessed. QoL Short Form (SF) scales, World Health Organization QoL (WHOQoL) Brief and Quick-Dash scales were measured. Covariance analysis was used for group comparisons. Results: The mean age of FMS patients was 40.4 +/- 10.9 years; OA was 54.5 +/- 15.7 years and RA 46.9 +/- 15 years (p < 0.001) mostly were females. The disease duration in FMS was 4 +/- 3.6 years; in OA was 6 +/- 4.8 years and 5.1 +/- 4.3 years in RA. After effects of age, gender and educational level on scores were eliminated, at least one SF scale was found to be significantly higher in FMS and OA in terms of Physical and Role function, General health, Vitality, Social function, Emotional role, mean of Mental health subscale in addition to the physical (PCS) and mental (MCS) summary scales. The Quick-Dash score was higher in the RA group. Physical sub-dimension scores of WHOQoL Brief scale were significantly lower in RA group. In addition, social relations sub-dimension score was found to be higher in OA than RA group. MCS scores of SF-36, SF-12 and SF-6D were found higher than PCS scores in the three diseases. PCS score was found significantly higher only in FMS group. Conclusions: RA patients had worse QoL than FMS and OA according to PCS and MCS. SF-12 and SF-6D can be used instead of SF-36 or WHOQoL Brief scales for faster results. (C) 2017 Egyptian Society of Rheumatic Diseases. Publishing services provided by Elsevier B.V.

Amaç: Bu çalışmada, osteoartrit tanısı almış hastaların, ağrı eşiği, ağrı şiddeti ve ağrının bıraktığı etkileri değerlendirmek için görselliğe ve kolay anlaşılabilirliğe önem veren, şiddeti daha ayrıntılı tanımlayan yeni bir ölçek geliştirilmesi planlandı. Gereç ve Yöntem: Çalışma, kesitsel tipte planlanan bir anket ve ölçek araştırmasıdır. Gönüllü olup araştırmaya alınma kriterlerine uyan, osteoartrit tanısı almış 76 hastaya anket uygulandı. Geliştirilen ölçekte, 3’ ü çok şiddetli, 3’ ü az şiddetli ağrı deneyimini ve 2’ si oteoartrit kaynaklı ağrı etkisini sorgulamaktaydı. Ölçekte, görsellik ve kolay anlaşılma ön plana çıkartıldı, ağrıyı daha ayrıntılı değerlendirme fırsatı sunuldu ve ağrı eşiğini belirlemede alternatif bir yaklaşım sunuldu. Bulgular: Ölçeğe uygulanan faktör analizi ile yapı geçerliliğinin olduğu ve 3 faktör içerdiği belirlendi. Ölçek maddelerinin iç tutarlılıkları iyi düzeyde ve istatistik olarak anlamlı bulundu. Sorulara verilen cevaplardan elde edilen puanlar arası uyum yüksek düzeyde çıktı. Çok ve az şiddetli ağrıları sorgulamaya yönelik hazırlanan sorulara verilen cevaplar birlikte dikkate alınarak hastalar ağrı eşiği düşük ve yüksek olarak iki gruba ayrıldı. Ayrıca osteoartrit ağrı şiddetinin, deneyimlenmiş en kötü karın ağrısından anlamlı farklılık göstermediği, ancak en kötü diş ve baş ağrısına göre daha hafif olduğu belirlendi. Sonuç:. SH-ağrı şiddeti ve ağrı eşiği ölçeğinin, yapı geçerliliğinin olması, iç tutarlılığa sahip olması, ölçekte yer alan sorulara verilen cevaplar arası uyumun yüksek olması ve ağrı şiddeti ile ağrı etkileri arasında anlamlı korelasyonun bulunması nedenleriyle geçerliliği ve güvenilir sonuçlar ürettiği söylenebilir., Purpose: In this study, it was planned to develop a new scale that fore grounder visibility and ease of understanding to assess the effects of severity of pain, the pain threshold, and pain severity in osteoarthritis arthritis patients.Materials and Methods: It is a scale survey planned in cross-sectional type. A questionnaire was administered to 76 patients who were diagnosed with osteoarthritis who were voluntary and matched to the criteria for inclusion in the study. In the scale, three questions are related with very severe pain, three questions with less severe pain and 2 questions with questioning the pain severity and sensory effect of osteoarthritis. Results: According to factor analysis, there is construct validity of scale, and detected 3 factors. The internal consistency of the items of the scale was good and statistically significant. The agreement between the scores obtained from the answers to the questions was good. Taking into consideration the answers to the questions prepared to question the very severe pain and less severe pain, the patients were divided into two groups as low and high pain thresholds. In addition, the severity of pain in osteoarthritis patients was found to be lower than headache and toothache but at the level of abdomen. Conclusion: It can be said that the SH- pain severity and pain threshold scale validity and reliability because of structural validity, internal consistency, high agreement between responses to the questions in the scale, and significant correlation between pain severity and pain effects.

Amaç: Masthücrelerinin (MCs) rolleri birçok tümörde çeşitli biyolojik süreçlerdegösterilmiştir. MCs, artan anjiyogenez yoluyla tümör progresyonunda rol oynar.Triptaz ve kimaz, mast hücre granüllerinde depolanır. Bu çalışmanın amacı,prostat adenokarsinomalarında (PA) triptaz ve kimaz arasındaki ilişkiyiaraştırmaktır. Gereçve Yöntem: Bu çalışma, 2012-2014 yılları arasında TıpFakültesi Hastanesi Patoloji Bölümü'nde histopatolojik olarak PA tanısı alan134 hastanın parafine gömülü numunesinde yürütülmüştür. Parafine gömülü PAnumuneleri 3 μm kalınlığında kesilmiştir. Kesitler triptaz ve kimaz ile boyanmıştır.Bulgular:MastHücre Kimazının (MCC), intratümöral bölgelerde peritümöral bölgelere göre daha çokbiriktiği gözlenmiştir (sırasıyla ortalama: 14,28 ± 14,06, ortalama: 12,12 ±12,56). Mast Hücre Triptazı (MCT), intratümöral ve peritümöral bölgelerde MCC'dendaha fazla birikmiştir (P, Objective: Theroles of mast cells (MCs) have beendemonstrated in various biologic processes in the many tumors. MCs play someroles in tumor progression via increasing angiogenesis. Tryptase and chymaseare stored in the mast cell granules. The aim of this study was to investigate therelationship of tryptase and chymase inprostatic adenocarcinomas (PA).Materials and Methods: This study was conducted on atotal of 134 paraffin-embedded PAsamples, which were histopathologically diagnosed at the Department ofPathology of medicine Hospital between 2012 and 2014. Paraffin-embedded PA samples 3 μmin thickness, were then cut. The slides were stained with tryptase and chymase.Result: MastCell Chymase (MCC) was observed that intratumoral areas more acumulate thanperitumoral areas (respectively; mean: 14,28 ± 14,06, mean: 12,12 ± 12,56).Mast Cell Tryptase (MCT) was more acumulated than MCC in intratumoral andperitumoral areas (P

Ankarali, Handan Camdeviren/0000-0002-3613-0523; ankarali, seyit/0000-0003-3752-0846 WOS: 000437476300004 Objectives: The aim of this study to develop a new scale to evaluate pain threshold, sensory effects of pain and pain severity in patients with Fibromyalgia Syndrome (FMS). Material and Methods: This is a cross-sectional survey study and a questionnaire was administered to 52 voluntary patients diagnosed with FMS. In the proposed scale, thereare six questions about severe and less severe pain experience,two questions about the pain severity and sensory effect of FMS. In statistical analysis we used reliability analysis, factor analysis for construct validity, and other statistical tests to compare differences. Results: Exploratory factor analysis showed construct validity of the scale, and detected three factors. The internal consistency of the items of the scale was statistically significant. The agreement between the scores was good. Based on the answers, the patients were divided into two groups as low and high pain thresholds. There was no significant difference between these two groups in terms of severity of pain and sensory change due to fibromyalgia. In addition, the severity of pain in patients is lower than headache and at the level of stomachache and toothache. Discussion and Conclusion: The proposed scale allows the assessment of pain severity to be more detailed and paying attention to visually, it allows determining the pain threshold. It is suggested to compare the pain threshold determined by this scale with the pain threshold determined by different methods.

Background: Acquisition of basic clinical skills by undergraduate medical students is becoming of greater concern. Clinical skills laboratories may provide a comfortable environment for training and may allow students to gain adequate performance level. The aim of this study is to evaluate students' performance and confidence levels before and after training of selected procedural skills; also to explore students' expectation towards skills laboratory training. Methods: Two questionnaires were conducted before and after training sessions in the clinical skills laboratory, school of medicine, University of Jordan, Amman, Jordan. The skills selected for this study: suture practice, venous access, arterial access, intradermal and intramuscular injection, central venous cannulation, male and female urinary catheterization, nasogastric tube placement and rectal examination. Although fifty-seven 6th year medical students filled the first questionnaire at the beginning before training, only 29 students could attend all training sessions, and fill the second questionnaire. Results: For all trained clinical skills, the mean students' performance scores and confidence levels were significantly increased after training (P

Introduction: The aim of this study was to determine the prevalence of rotavirus and adenovirus in patients who applied with the complaint of acute gastroenteritis to the emergency department of our tertiary health care provider hospitals. Methods: 1712 patients with the complaint of acute gastroenteritis were included in the study and the study was done retrospectively from patient records.Results: Stool (faeces) samples have been sent from 1712 patients who applied to emergency services with the complaint of acute gastroenteritis for 3 years. Of these, 17.5% (n=301) rotavirus antigen and 3.5% (n=61) adenovirus antigen were detected as positive. It was observed that 56% (n=203) of the positive cases were male and 44% (n=159) were female. The rotavirus antigen was statistically significantly higher in the 0-4 age group than the other age groups. Conclusion: Acute gastroenteritis is an important health problem in children. Especially, the frequency of rotavirus was observed to be higher in children under 4 years of age and in this age group patients the use of rotavirus rapid diagnostic tests rather than viral culture methods may be helpful to early diagnosis thus to reduce unnecessary antibiotic use.

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Tascilar, Nida/0000-0003-0780-0783 WOS: 000427844400006 PubMed: 28456888 It is known that quality of life in myasthenia gravis is positively correlated with subjective sleep quality, still no data is available regarding the relationship between QOL and polysomnographically detected sleep parameters and disorders. In this study, we tried to highlighten this relationship, by performing polysomnography. Sleep-related complaints were evaluated in face-to-face interviews with 19 clinically stable MG patients and 26 healthy controls. During the interviews questionnaires assessing sleep quality, excessive daytime sleepiness, fatigue, depression, anxiety, and Turkish version of the MG-QOL 15-item scale [(MG-QOL15(T)] were administered and then an overnight polysomnography was performed. Sleep disorders, especially obstructive sleep apnea and fatigue were higher, whereas subjective sleep duration was significantly lower, in patients than controls. Excessive daytime sleepiness and poor sleep quality were not different between patients and controls. Other than percentage of sleep stage III, which was negatively correlated with MG-QOL15(T) scores, neither other sleep parameters nor sleep disorders were correlated with MG-QOL15(T) scores. MG composite, subjective sleep duration, fatigue severity and Hamilton depression rating scale scores were found to be positively correlated with MG-QOL15(T) scores. It was shown that decreasing disease severity and enhancing psychological well-being will improve patients' quality of life. We recommend that our findings should be repeated in a large prospective cohort of MG patients.

Amaç: Bu çalışmanın amacı düşük frekanslı kesikli manyetik alan (KEMA) tedavisinin kronik venöz yetmezliği olan hastalarda ödem, yaşam kalitesi, depresyon ve eklem hareket açıklığı üzerine etkisini incelemektir.Gereç ve Yöntemler: Bu çalışmaya kronik venöz yetmezlik tanısı almış, CEAP (Klinik, Etyolojik, Anatomik, Patofizyolojik) sınıflamasına göre C3-C6 olan 44 hasta dahil edildi. Hastaların demografik bilgileri çalışma öncesinde toplandı ve analiz edildi. Klinik değerlendirmelerde ise Venöz Yetmezlikte Epidemiyolojik ve Ekonomik Çalışma-Yaşam Kalitesi Anketi (VEINES-QOL), Beck Depresyon Ölçeği (BDÖ), eklem hareket açıklığı ve çevre ölçümleri kullanıldı. Hastalar tedavi (n=21) ve kontrol grubu (n=24) olarak rastgele sayı oluşturucu kullanılarak iki gruba ayrıldı. Tüm testler çalışmanın başlangıcında ve bitişinde olmak üzere iki kez uygulandı. İlk değerlendirmenin ardından düşük frekanslı elektromanyetik alan terapisi haftanın 5 günü 6 hafta boyunca uygulama grubuna uygulandı. Bireylere aynı zamanda kompresyon çorabı verilerek 6 hafta kullanmaları istendi. Kontrol grubu ise 6 hafta boyunca sadece kompresyon çorabı kullandı.Bulgular: Her bir grubun ilk ölçüm, son ölçüm değerleri karşılaştırıldığında, tedavi grubunda etkilenen ekstremitede ayak bileği dorsi fleksiyon ve plantar felksiyon hareketlerinde ve depresyon ölçümlerinde anlamlı fark bulundu (p=0.000, p=0.007, p=0.000). Çevre ölçümleri, depresyon ve yaşam kaliteleri bakımından gruplar karşılaştırıldığında depresyon değerlendirmesi ve ayak bileği (CB) ve ayak bileği üstündeki bölgenin (CB1) çevre ölçümlerinde anlamlı fark olduğu saptandı (p

Amaç: Stres üriner inkontinanslı kadınlarda pelvik taban kas eğitimine ek olarak uygulanan elektromyografik biofeedback eğitiminin yaşam kalitesi, idrar kaçırma miktarı ve pelvik taban kas kuvveti üzerine etkisinin araştırılması amaçlandı. Gereç ve Yöntemler: Çalışmaya stres üriner inkontinanslı 52 kadın hasta dâhil edildi. Hastalar pelvik taban kas eğitimi (n=27) ve pelvik taban kas eğitimiyle birlikte elektromyografik biofeedback eğitimi (n=25) alanlar olarak iki gruba ayrıldı. Hastaların algılanan yaşam kalitesi ve algılanan kuruluk hissi için bir vizüel analog skala kullanıldı. Pelvik taban kas kuvveti, vajinal basınç manometresi ile; idrar kaçırma miktarı ise 1 saatlik ped testi ile değerlendirildi. Değerlendirmeler, tedavi öncesi ve 8 haftalık tedavi sonrasında yapıldı. Bulgular: Pelvik taban kas eğitimi ve pelvik taban kas eğitimine ek olarak uygulanan elektromyografik biofeedback eğitimleri grup içi analizlerinde, tedavi öncesi ve sonrası algılanan kuruluk hissi, algılanan yaşam kalitesi, pelvik taban kas kuvveti ve idrar kaçırma miktarında iyileşme olduğu saptandı (p0.05). Tartışma ve Sonuç: Stres üriner inkontinanslı kadınların tedavisinde pelvik taban kas eğitimine ek olarak uygulanan elektromyografik biofeedback eğitiminin ilave bir iyileştirici etkisi olmadığı saptandı.nce.

Amaç: Kompleks ve çok boyutlu bir klinik sendrom olan Fibromiyaljisendromu (FMS), birçok somatik ve psikolojik yakınmalara neden olduğu içinyaşam kalitesini bozmaktadır. Çalışmanın amacı, FMS tanısı almış kişilerin,yaşam kalitesini en kısa sürede ve en verimli şekilde ölçen ölçeğibelirlemektir. Ayrıca SF12, SF8 ve SF6D formlarının güvenilirliği vegeçerliliği de incelenmiş olacaktır.Gereç ve Yöntemler:DüzceÜniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon AD’ da tanısıkonulan, çalışmaya katılmayı kabul eden ve soruları tam dolduran 59 FMS hastasıdeğerlendirildi. SF36, WHOQoLBreef, QuickDush, SF12, SF8 ve SF6D ölçekleri ileFMS hastalarının yaşam kalitesi sorgulandı. Bulgular: Elde edilen veriler doğrultusunda ölçeklerin iç tutarlılığı veölçek puanlarının tekrarlama derecesi yüksek bulundu. SF36 ölçek puanları ileSF ölçeklerinin diğer 3 kısa formundan elde edilen puanlar arasındaki ilişkilerincelendiğinde, SF12 ve SF6D ölçeklerinin geçerliliği SF8’ den daha iyibulundu. Tartışma ve Sonuç: Geçerlilik için yapılan bütün hesaplamalar değerlendirildiğinde,FMS’de SF12 ve SF6D ölçekleri yaşam kalitesini ölçmede SF36 yerinekullanabilir. SF8’in ise bütün alt boyutlarda SF12 ve SF6D kadar etkiliolmaması ve mental sağlık alt boyutunun bulunmaması nedenleriyle FMS’de yaşamkalitesini ölçmek amacıyla kullanımı önerilmemektedir., Aim: Fibromyalgia syndrome (FMS), a complex and multidimensional clinicalsyndrome, disrupts quality of life because it causes many somatic andpsychological complaints. The aim ofthe study is to determine the scale that measures the quality of life of theFMS patients in the shortest and most efficient way. The reliability andvalidity of SF12, SF8 and SF6D forms will also be examined.Materialsand Methods: Fifty-nine FMS patients who were diagnosed at Physical Medicine andRehabilitation Department of Medical Faculty in Düzce University, who acceptedto participate in the study and filled the questions were evaluated. Thequality of life of FMS patients was questioned with SF36, WHOQoLBreef,QuickDush, SF12, SF8 and SF6D scales.Results: The internal consistency and repeatebilityof the scales were found to be high by using of the obtained data. When the relationshipsbetween SF36 scale scores and the scores obtained from the other 3 short formsof SF scales were examined, the validity of SF12 and SF6D scales was found tobe better than SF8.Discussion andConclusion: As a result, when all calculations for validity and reliability areevaluated, scales SF12 and SF6D in FMS can be used instead of SF36 in measuringquality of life. In allsub-dimensions, SF8 was not as effective as SF12 and SF6D, and due to lack ofsub-dimension of mental health was not suitable for use in FMS.

Ankarali, Handan Camdeviren/0000-0002-3613-0523 WOS: 000396689600003 PubMed: 28095093 Objective: The aim of this study was to investigate the effect of manual foot plantar massage ( classic and friction massage) on functional mobility level, balance, and functional reach in patients with type II diabetes mellitus ( T2 DM). Methods: A total of 38 subjects diagnosed with T2 DM were included in the study. A healthy control group could not be formed in this study. After the subjects' socio-demographic data were obtained, Timed Up & Go ( TUG) Test, functional reach test ( FRT), one-leg standing test with eyes open-closed, and Visual Analogue Scale ( VAS) to measure foot pain intensity were performed. The results were also divided and assessed in three groups according to the ages of the individuals ( 40-54, 55-64, and 65 and over). Results: As a result of statistical analysis, a difference was found in the values obtained from TUG, FRT, and one-leg standing test with eyes open and closed ( p < 0.05). Following the massage, TUG values significantly decreased comparison with those before the massage, whereas the values of FRT and one-leg standing test with eyes open and closed significantly increased compared with those before the massage ( p > 0.05). According to age groups, there were statistical differences ( p < 0.05) between the TUG, one-leg standing test with eyes open and closed test values of the individuals before and after the massage. Conclusions: The results of our study indicated that application of plantar massage to patients with T2 DM caused an improvement in balance, functional mobility, and functional reach values. An increase in body balance and functional mobility may explain the improvement in TUG. Foot massage to be added to rehabilitation exercise programs of DM patients will be important in improving balance and mobility of patients.

Objective: This study aims to evaluate the play doughs which are sold in bookstores located in Düzce and are mostly used in the pre-school education institutions in terms of bacteriological due to its closely relation to child health. Methods: In total 50 samples from five different containers which belong to ten different companies were included in the study. Each of the containers was evaluated in six times as pre-play, first post-play day, first post-play week, second post-play week, third post-play week and fourth post-play week. Firstly Gram staining, later conventional methods such as catalase test, glucose test, nitrat test, voges proskauer test and Phoenix 100 BD automatize system were used for the identification of the bacteria in the samples in which growth existed. Z-test for differences between two dependent proportions was used for determining statistically the growth in pre-play and post-play period. Results: In the analysis done it figured out that while no growth existed in any culture of two companies (20%) out of 10, growth in all cultures of two products existed. In consequence of identification it was determined that all the bacteria growthing were Bacillus licheniformis and Bacillus cereus which belong to Bacillus genus. It was determined that 51 (33%) of all Bacillus were B. licheniformis and 104 (67%) of them were B. cereus. In consequence of the culture study done after play, it was seen that bacterial growth decreased a little in play dough although it did not make sense statistically from first day to fourth week. Conclusion: The growthing pathogen can cause health problems such as initially food poisoning and eye infections, and edible label on most of paly dough containers available in market and used in pre-school institutions in order to strengthen hand muscles of children makes the situation worse and more dangerous. Besides, the reliability of some play douhgs which can threaten child health in our country in the sense of bacteriological were emphasized for the first time according to the literature search done.

Objective: The objective of this study is to introduce theoretical characteristics of Heckman sample selection regression model,to clarify when it is required to be used and to show its usage in health area. Material and Methods: Heckman selection model, which is an appropriate tool for addressing the sample selection bias, was used for determining the risk factors of Gleason score for three datasets which have 2000 observations obtained from simulation study. The data was about the prostate cancer patients. In the data, there were benign tumor structures or stage 1 tumors in the study besides malign tumors but Gleason score was not calculated when tumor is benign. So sample selection bias is a matter for nonresponse Gleason score answers in our data. Also the model was performed for the datasets that have 0.30; 0.50 and 0.70 of censored proportion (nonresponse Gleason score) individual number by considering actual structures between variables with the help of simulation. Results: There was no significant relationship between Gleason score and smoking, family history. But we found that age, PSA(prostate specific antigen) and weight variables have significant relationship with Gleason score (p

Aim: Tobacco and alcohol use among adolescents is an important issue that hasbeen frequently addressed in recent years. In this study we aimed to determinethe prevalence of tobacco and alcohol use among high school students and thefactors affecting the use of these substances.Materials and Methods: This cross-sectional study was carried out with 1997students from three different high schools in the 2015–2016 academic year. Allof the students who volunteered were included in the study that was designed bycluster sampling method. The data were analyzed by mean, standard deviation,number and frequencies, chi-square and multiple polytomous logistic regression analyses.Results: The rate of the students who have smoked at least once in their liveswas found to be 35%, and the rate of those who were smoking almost every day20.1%. These rates for alcohol use were 18.7% and 1.8%, respectively. It was foundthat the rates of tobacco and alcohol use were statistically significantlyhigher in students from industrial vocational high schools, male students, 12thgrade students, students who perceived their academic success to be low, studentswho had received a disciplinary punishment, and those who were frequentlyabsent from school, had gotten into trouble with the police, had friends using tobacco,alcohol or another substance, or had undergone psychological treatment (p, Amaç: Ergenlerdesigara ve alkol kullanımı son yıllarda sıklıkla ele alınan önemli bir konudur.Bu çalışmanın amacı, lise öğrencileri arasında sigara ve alkol kullanmasıklığını ve bu maddeleri kullanmalarını etkileyen faktörleri belirlemektir.Gereç ve Yöntemler:Kesitseltipteki bu çalışma 2015–2016 öğretim yılında üç lisede öğrenim gören 1997 öğrenciile gerçekleştirilmiştir. Küme örnekleme yöntemi ile tasarlanan çalışmadagönüllü olan öğrencilerin tamamı çalışma kapsamına alındı. Verilere ortalama,standart sapma, sayı ve frekanslar, ki-kare, çoklu lojistik regresyon analizleriuygulandı. Bulgular: Yaşamboyu en az bir kez sigara kullanan öğrencilerin oranı %35, hemen her gün sigarakullananların oranı %20,1 olarak bulunmuştur. Alkol kullanımı için ise bu oranlarsırasıyla %18,7 ve %1,8’dir. Endüstri meslek lisesindeokuyan öğrencilerde, erkek öğrencilerde, 12. sınıftaki öğrencilerde, akademikbaşarısını düşük algılayanlarda, disiplin cezası alan, devamsızlık yapan,polisle başı derde giren, arkadaşı sigara, alkol ya da başka bir maddekullanan, ya da psikolojik tedavi almış olan öğrencilerde sigara ve alkolkullanma oranlarının istatistiksel olarak anlamı düzeyde daha yüksek olduğubelirlenmiştir (p

Background Cases with abnormal category, determined by thyroid fine-needle aspiration (FNA), frequently undergo surgical resection, despite the majority of cases being identified as benign after resection. Additional diagnostic markers are needed to guide the management of patients with abnormal thyroid nodules. Materials and methods The retrospective study enrolled 150 cases diagnosed abnormal by FNA cytology that had undergone molecular testing with three markers (BRAF V600E, NRAS, and KRAS) on the cell block. Seventy-one cases had a surgical follow-up. Results When NIFTP is not considered as malignant, positive predictive values (PPVs) of cytology and combined cytology and molecular testing (CC-MT) were 67.6% (95% CI: 0.555-0.782) and 89.2% (95% CI: 0.746-0.970) (P = .004), respectively. The sensitivity of the CC-MT was 68.8%, specificity was 82.5%, and the false-positive rate was 17.4%. When NIFTP is considered as malignant, PPVs of cytology and CC-MT were 83.1% (95% CI: 0.743-0.918) and 94.6% (95% CI: 0.873-1.018) (P = .047), respectively. The sensitivity of the CC-MT was 59.3%, specificity was 83.3%, and the false-positive rate was 16.7%. Conclusion The addition of molecular testing with a small panel to FNA cytology may increase the PPV of cytology in abnormal categories. Small panel (BRAF V600E, KRAS, and NRAS) with high specificity and high PPVs may be used particularly for the detection of thyroid malignancy. Cell blocks can be an especially useful and straightforward method for molecular diagnostic studies.

Objective: Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age characterized by irregular menstruation and hirsutism and is associated with an increased risk for cardiovascular diseases. Increased inflammatory response and oxidative stress may also present in these patients. In this study, we aimed to compare the neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), and dynamic thiol-disulphide homeostasis (dTDH) between the patients with PCOS and healthy individuals and to investigate the correlation between these parameters and cardiovascular risk factors in patients with PCOS. Materials and methods: A total of 60 participants were included in this study. The patient group consisted of 36 patients who were diagnosed with PCOS and the control group consisted of 24 healthy individuals without PCOS. Complete blood count and hormonal tests were performed using blood samples. The NLR, MPV, and dTDH were compared between the patient and control groups. Results: There was no statistically significant difference in the native thiol, total thiol, disulphide levels and disulfide/native, disulfide/total and native/total thiol ratios between the patient and control groups (p = 0.494, p = 0.446, p = 0.338, p = 0.717, p = 0.723, and p = 0.717, respectively). In addition, there was no statistically significant difference in NLR and MPV between the groups (p = 0.531 and p = 0.196). Conclusion: Our study results showed no significant difference in the NLR, MPV, dTDH levels, and inflammatory biomarkers including leukocyte count between the PCOS patients and healthy controls. Based on these findings, we conclude that the diagnosis of PCOS alone in overweight patients has no considerable effect on these biomarkers. Keywords: Polycystic ovary syndrome, Thiol/disulfide homeostasis, Neutrophil-to-lymphocyte ratio, Mean platelet volume

Background: Chronic obstructive pulmonary disease (COPD) is common worldwide. COPD has negative effects on the quality of life of the patient due to restrictions on daily activities. It can cause a major healthcare burden according to the stage and grade of disease.Objective: The purpose of this study was to determine the physical and psychological functional capacity factors affecting patients’ functional performance and to develop a COPD-specific functional status model using these factors.Methods: A group of randomly selected patients (n=183) diagnosed with COPD at a university hospital in Turkey comprised the study sample. Physical examinations were carried out on all patients and they completed questionnaires that included socio demographic and disease characteristics, the Hospital Anxiety and Depression Scale, Functional Performance Inventory and Short Form-36 Survey. The proposed theoretical model was analyzed in the LISREL program using the structural equation modeling approach.Results: We found that the independent latent variable of the physiological functional capacity yielded a significant positive effect on the dependent latent variable of functional performance, while the psychological functional capacity produced no significant effect.Conclusions: The COPD-specific functional status model should prove to be an effective and beneficial tool for issues such as treatment maintenance and for the preservation or improvement of patients’ quality of life. [Ethiop.J. Health Dev. 2019; 33(2):81-87]Keywords: Chronic obstructive pulmonary disease, functional status, functional performance, functional capacity, structural equation modeling