Search

INTRODUCTION: The frequency of obesity and poor sleep quality among adolescents is increasing and causes many chronic problems. The objective was to investigate the correlation between body mass index (BMI), sleep quality, sleep duration and social jet lag (SJL) among adolescents. METHODS: This study was cross-sectional. A cohort of 416 adolescents, ranging in age from 12 to 18 years participated in the study. Adolescents were divided into three groups according to BMI standard deviation score (SDS): adolescents with normal weight, adolescents with overweight and adolescents with obesity. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to determine the sleep quality of the adolescents. The calculation of SJL and sleep-corrected SJL was performed. RESULTS: The mean age of the adolescents was 15.0±2.9 years. There were 222 males (53.4%). SJL and PSQI scores were significantly higher in the adolescents with obesity compared to the adolescents with normal weight and overweight (p

Abstract It is known that telomere length (TL) (evaluated with T/S ratio) is shortened in the presence of obesity. In this study, we aimed to investigate how obesity in adolescents and non-alcoholic liver disease (NAFLD) within the obese group affect TL and the clinical significance of the human telomerase reverse transcriptase (hTERT) gene MNS16A VNTR variant in terms of NAFLD. Adolescents with exogenous obesity and healthy controls (aged 10–19 years) who applied to our adolescent outpatient clinic between May-October 2023 were included in this study. We performed upper abdominal ultrasonography to investigate the presence of NAFLD in adolescents with obesity and divided into two groups: those without hepatosteatosis (obese NAFLD (-)) and those with hepatosteatosis (obese NAFLD (+)). We recorded body weight, height, waist circumference, and blood pressure measurements and measured the T/S ratio (telomere sequence copy number/gene single copy number) by the Quantitative Polymerase Chain Reaction method. The groups were compared using frequentist and Bayesian methods. Eighty-three obese adolescents [63 NAFLD(+) 20 NAFLD(-)] and 69 lean controls were included in the study. Pairwise comparisons revealed that T/S ratio was significantly lower in the obese NAFLD (-) group than the obese NAFLD (+) and the control group (p = 0.025, p = 0.007, respectively). T/S ratio was lower in the LL allele group than in the other alleles (p = 0.022) and slightly higher in the obese group with metabolic syndrome compared to the obese group without metabolic syndrome (p = 0.072). hTERT-MNS16A-VNTR gene variant LL allele had a negative correlation with T/S ratio among the obese adolescent group. Patients with LL alleles had higher ALT, GGT, HOMA-IR, and ALT/AST. Diastolic blood pressure had a significant correlation with the T/S ratio. The T/S ratio was shorter in the obese adolescent group compared to healthy ones but was higher in the NAFLD (+) obese compared to the NAFLD (-) obese. ALT level and ALT/AST ratio were higher, T/S ratio was lower in the hTERT MNS16A VNTR variant LL allele group among obese adolescents. In addition, there was a significant correlation between the T/S ratio and diastolic blood pressure in obese adolescents.

Objective: Coronavirus Disease-2019 (COVID-19), has affected the whole world and is still an important disease with its mutations. In our study, we aimed to evaluate the effects of antithrombotic agents [acetylsalicylic acid (ASA), P2Y12 inhibitors, oral anticoagulants (OACs)] and statin treatments used before hospitalization on COVID-19 mortality and clinical severity.Methods: A retrospective study was conducted on 5577 patients hospitalized with positive swab tests or findings consistent with COVID-19 on computed tomography. The 6-month mortality, in-hospital mortality, need for intensive care and intubation, and recurrent hospitalization outcomes of patients receiving chronic ASA (n=1210), P2Y12 inhibitors (n=357), OACs (n=1192), and statin (n=607) treatment were evaluated.Results: The 6-month mortality rate was 13.5% (n=754), in-hospital mortality rate was 11.2% (n=627), the rate of admission to the intensive care unit was 16.1% (n=897), the need for intubation was 8.8% (n=493), and the rate of recurrent hospitalization was 10.4% (n=579). ASA and OACs reduced all outcomes. P2Y12 inhibitors provided benefit in other endpoints except intubation. Statins used before hospitalization did not provide a statistically significant decrease in 6-month mortality (p: 0.06), but were associated with a decrease in the rates of in-hospital mortality, need for intensive care, recurrent hospitalization, and intubation. Conclusion: We found that long-term ASA, P2Y12 inhibitors, OACs and statin treatments used before hospitalization in patients hospitalized with COVID-19, reduced COVID-19 mortality and clinical severity. We think that these treatments may be beneficial in selected patient groups where post-COVID effects are observed.

Abstract Background Recently, natural tissue repair has become popular in the treatment of pelvic organ prolapsed. In this study, we compared patients who underwent cystocele repair with the rug-weaving plication technique, a natural tissue repair method implemented since 2022 for anterior prolapse, with those treated using conventional colporrhaphy. Methods We retrospectively reviewed the data of 65 patients who underwent anterior vaginal wall repair with the rug-weaving plication technique (n = 33, Group 1) or conventional colporrhaphy (n = 32, Group 2). We recorded the patients’ clinicodemographic and surgical data. At the 6-month postoperative follow-up, we assessed patients’ complaints, degree of prolapse (using the simplified Pelvic Organ Prolapse Quantification system), and pelvic floor muscle strength (using the Modified Oxford Score). Anterior vaginal wall thickness was measured using transvaginal ultrasonography. We compared clinicodemographic and surgical data and postoperative outcomes between the two groups. Results The two groups were comparable in terms of age (p = 0.326), number of pregnancies (p = 0.307), number of parities (p = 0.555), preoperative anterior wall simplified Pelvic Organ Prolapse Quantification grade (p = 0.380), preoperative apical prolapse simplified Pelvic Organ Prolapse Quantification grade (p = 0.518), postoperative Modified Oxford Score (p = 0.857), operation time (p = 0.809), postoperative haemoglobin (p = 0.674), and amount of bleeding (p = 0.951). Compared with Group 2, Group 1 had significantly higher postoperative anterior vaginal wall thickness (p

Introduction: Insulinoma is a rare disease, however the most common cause of hypoglycemia due to excess insulin secretion. Diagnosis and localization can be challenging. This study evaluated the clinical features, diagnostic workup, management, and outcomes of patients with insulinoma. Methods: The records of 13 patients with insulinoma who were followed up at İstanbul University, İstanbul Faculty of Medicine were retrospectively reviewed. Results: The mean age of the 13 patients (female/male: 11/2) was 43.9±12.5 years at diagnosis. The mean tumor diameter was 14.3±6.7 mm and localized at the head in 30.8%, at the tail and/or body in 61.6%, and at both the head and body in 7.6% of patients. The tumor was correctly localized by magnetic resonance imaging in 10/13 patients, 68Ga DOTATATE positron emission tomography/computed tomography in 4/8, endoscopic ultrasound in 3/7, and selective arterial calcium stimulation in 4/4 patients. Eleven patients were operated. Distal pancreatectomy was performed in 4 patients, distal pancreatectomy plus splenectomy in 3, and enucleation in 4 of the patients. The median follow-up duration was 4 years. In 8 patients, cure was achieved with surgery alone. Somatostatin receptor analog (SSRA) treatment was initiated in 2 cases and one of whom developed lymph node metastasis 2.5 years after surgery under SSRA treatment and she was reoperated. These patients had stable disease at the last visit. Conclusion: Insulinomas are usually small tumors, but they can cause severe symptoms. A multidisciplinary approach is required for diagnosis and treatment. In some patients, different imaging modalities may be necessary for tumor localization.

Abstract Background Nonalcoholic fatty liver disease (NAFLD) has become an important health issue in adolescents. Although several parameters and indices have been investigated for the evaluation of NAFLD in adults, these indices are limited in adolescents. In this study, body mass index, waist circumference, triponderal mass index, HbA1c, homeostatic model assessment insulin resistance (HOMA-IR), triglyceride/high-density lipoprotein (Tg/HDL), the lipid accumulation product (LAP) index, the triglyceride-glucose (TyG) index and the aminotransferase (AT) index were examined together, and their diagnostic values in the clinical treatment of NAFLD were compared. Materials and methods Seventynine adolescents (10–19 years old) with obesity who were admitted to a pediatric clinic between January and August 2022 and who were diagnosed with exogenous obesity without any comorbidities were included in the study. The presence of NAFLD was evaluated by liver magnetic resonance imaging. The laboratory findings were obtained retrospectively from system records. Parameters were compared between the NAFLD (+) and NAFLD (-) groups. Logistic regression analysis was used to determine the most effective factors for NAFLD treatment. Receiver operating characteristic (ROC) analysis was performed with significant indices. Sex, HOMA-IR, TyG and AT indices were evaluated together with multivariate analysis to design a diagnostic scale. Results HbA1c, HOMA-IR, AT indices and TyG indices were greater in the NAFLD (+) group (P = 0.012; P = 0.001; P = 0.012; P = 0.002, respectively). There was a positive correlation between liver fat percentage and HOMA-IR, the TyG index, the AT index, and Tg/HDL. According to the regression analysis, male sex and elevated HOMA-IR were determined to be significant risk factors for the presence of NAFLD. A probability scale with 4 parameters [sex, HOMA-IR, the TyG index, and alanine aminotransferase (ALT)] was designed with 82.5% specificity and 80% sensitivity. Conclusion Evaluation of the HOMA-IR and TyG indices, especially in high-risk patients, will support the diagnosis of NAFLD via ultrasonography. A probability scale with ALT, HOMA-IR, TyG, and sex data with a diagnostic accuracy of 80% may aid in the diagnosis of NAFLD in adolescents with obesity.

The study examines a different aspect of the films of actor, screenwriter, and director Yılmaz Güney, who brought a new sense of reality to Turkish cinema. Güney's film Umut (The Hope), which he acted and directed in 1970, is a turning point for Yılmaz Güney cinema and Turkish cinema. The breath of Marxism can be felt in almost all of Yılmaz Güney's films after The Hope. In his films, Güney aimed to convey to the audience the fundamental contradictions of Turkish capitalism, the socioeconomic inequalities it created, and the resulting class differences. It can be argued that Güney's films discussed within the scope of the study Umut, 1970 (The Hope), Endişe, 1974 (The Anxiety), Sürü, 1978 (The Herd), Düşman, 1979 (The Enemy) focus on social class differences in the capitalist system by relying on Marxist ideology. Although the reasons for these differences in the movies are associated with factors such as politics, ideology, religion, culture, family, and education, it is thought that the most significant share of the factors that play a role in the formation of social classes is given to the economy. The study started with the problem of proving this claim. The films discussed within the study's scope revealed that the economy is the critical factor determining social class differences.

The effect of thyroid gland on the male reproductive system (neonatal–prepubertal and adult periods) has been investigated for many years. Hypertyhroidism may cause male infertility by effecting spermatological parameters such as loss of motility and decreased of sperm concentration. However, the mechanisms of male infertility caused by hyperthyroidism are still not fully explained. The aim of this study was to investigate the effect of hyperthyroidism on testicular endoplasmic reticulum stress and the protein kinase RNA–like endoplasmic reticulum kinase (PERK) mediated antioxidant pathway in adult male rats. 24 Sprague Dawley adult male rats were used. Rats were divided into two groups: control group (received intraperitoneal injections of saline solution 1 mL·day-1 for 8 week) and hyperthyroidism group (received intraperitoneal injections of l–thyroxine 0,3 mg·kg-1·mL-1·day-1 for 8 week). The serum free triiodothyronine (fT3) (P

Abstract Background Racism in the healthcare system has become a burgeoning focus in health policy-making and research. Existing research has shown both interpersonal and structural forms of racism limiting access to quality healthcare for racialised healthcare users. Nevertheless, little is known about the specifics of racism in the inpatient sector, specifically hospitals and rehabilitation facilities. The aim of this scoping review is therefore to map the evidence on racial discrimination experienced by people receiving treatment in inpatient settings (hospitals and rehabilitation facilities) or their caregivers in high-income countries, focusing specifically on whether intersectional axes of discrimination have been taken into account when describing these experiences. Methods Based on the conceptual framework developed by Arksey and O’Malley, this scoping review surveyed existing research on racism and racial discrimination in inpatient care in high-income countries published between 2013 and 2023. The software Rayyan was used to support the screening process while MAXQDA was used for thematic coding. Results Forty-seven articles were included in this review. Specifics of the inpatient sector included different hospitalisation, admission and referral rates within and across hospitals; the threat of racial discrimination from other healthcare users; and the spatial segregation of healthcare users according to ethnic, religious or racialised criteria. While most articles described some interactions between race and other social categories in the sample composition, the framework of intersectionality was rarely considered explicitly during analysis. Discussion While the USA continue to predominate in discussions, other high-income countries including Canada, Australia and the UK also examine racism in their own healthcare systems. Absent from the literature are studies from a wider range of European countries as well as of racialised and disadvantaged groups other than refugees or recent immigrants. Research in this area would also benefit from an engagement with approaches to intersectionality in public health to produce a more nuanced understanding of the interactions of racism with other axes of discrimination. As inpatient care exhibits a range of specific structures, future research and policy-making ought to consider these specifics to develop targeted interventions, including training for non-clinical staff and robust, transparent and accessible complaint procedures.

Background Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. Methods Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. Results Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). Conclusion The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.

ABSTRACT A substantial percentage of the population remains at risk for cervical cancer due to pre-existing human papillomavirus (HPV) infections, despite prophylactic vaccines. Early diagnosis and treatment are crucial for better disease outcomes. The development of new treatments heavily relies on suitable preclinical model systems. Recently, we established a mouse papillomavirus (MmuPV1) model that is relevant to HPV genital pathogenesis. In the current study, we validated the use of Papanicolaou (Pap) smears, a valuable early diagnostic tool for detecting HPV cervical cancer, to monitor disease progression in the MmuPV1 mouse model. Biweekly cervicovaginal swabs were collected from the MmuPV1-infected mice for viral DNA quantitation and cytology assessment. The Pap smear slides were evaluated for signs of epithelial cell abnormalities using the 2014 Bethesda system criteria. Tissues from the infected mice were harvested at various times post-viral infection for additional histological and virological assays. Over time, increased viral replication was consistent with higher levels of viral DNA, and it coincided with an uptick in epithelial cell abnormalities with higher severity scores noted as early as 10 weeks after viral infection. The cytological results also correlated with the histological evaluation of tissues harvested simultaneously. Both immunocompromised and immunocompetent mice with squamous cell carcinoma (SCC) cytology also developed vaginal SCCs. Notably, samples from the MmuPV1-infected mice exhibited similar cellular abnormalities compared to the corresponding human samples at similar disease stages. Hence, Pap smear screening proves to be an effective tool for the longitudinal monitoring of disease progression in the MmuPV1 mouse model.IMPORTANCEPapanicolaou (Pap) smear has saved millions of women's lives as a valuable early screening tool for detecting human papillomavirus (HPV) cervical precancers and cancer. However, more than 200,000 women in the United States alone remain at risk for cervical cancer due to pre-existing HPV infection-induced precancers, as there are currently no effective treatments for HPV-associated precancers and cancers other than invasive procedures including a loop electrosurgical excision procedure (LEEP) to remove abnormal tissues. In the current study, we validated the use of Pap smears to monitor disease progression in our recently established mouse papillomavirus model. To the best of our knowledge, this is the first study that provides compelling evidence of applying Pap smears from cervicovaginal swabs to monitor disease progression in mice. This HPV-relevant cytology assay will enable us to develop and test novel antiviral and anti-tumor therapies using this model to eliminate HPV-associated diseases and cancers.

Purpose Traditional therapeutic approaches to the surgical management of hemorrhoid disease such as hemorrhoidectomies are plagued with severe postoperative pain and protracted recovery. Our pilot study aims to the laser hemorrhoidoplasty (LH) patients with symptomatic hemorrhoid disease that have failed conservative management for the first time in an Australian population. Methods Thirty patients were prospectively enrolled to undergo LH. Postoperative pain, time to return to function, and quality of life (QoL) were determined through the Hemorrhoid Disease Symptom Score and Short Health Scale adapted for hemorrhoidal disease and compared to a historical group of 43 patients who underwent a Milligan-Morgan hemorrhoidectomy by the same surgeon at 3, 6, and 12 months. Results The LH group had significantly lower mean predicted pain scores on days 1 and 2 and lower defecation pain scores and lower opioid analgesia use on days 1, 2, 3, and 4. The median time to return to normal function was significantly lower in the LH group (2 days vs. 9 days, P

Notwithstanding their beneficial characteristics, the agricultural utilization of organic wastes may have an adverse effect on soil properties if used improperly. To evaluate proper use, a laboratory study was conducted to investigate the effects of different sewage sludge application doses (0, 2, 4, and 8% weight/weight) on the consistency limits and the compaction characteristics of three differently textured soils. The application of sewage sludge significantly improved the consistency limits and reduced the compactibility. The efficacy depended on the amount applied. The rates of increase in liquid limit (LL) values at 8% sewage sludge were 58.7% for sandy loam, 43.4% for loam, and 16.2% for clay soil. As the application dose increased, the optimum moisture content (OMC) values increased and the maximum dry bulk density (MBD) values decreased. The highest application dose decreased the MBD by 9.5% in sandy loam, by 6.5% in loam, and by 13.7% in clay-textured soils. The rates of increase in OMC values were 73.4%, 53.8%, and 27.1%, for sandy loam, loam, and clay, respectively. The results presented in this study clearly indicated that the application of sewage sludge made the soils more resistant to mechanical forces, since the increase in the proportion of OMC over LL and PL implied that the soil was easier to till at higher moisture contents without any deformation, which also resulted in a higher workable range.

Environmental education is defined as raising self-sacrificing people with an awareness of all kinds of problems and solutions to create a more sustainable environment. Environmental literacy is essential in environmental education. The concept of environmental literacy means having a good education in the field of the environment and a high level of knowledge about the environment. This research is a descriptive study examining the environmental literacy levels and environmental pollution images of 7th grade pupils in primary education. The study was conducted with 76 pupils in four classes of a public secondary school in the city of Ankara in the 2018-2019 academic year. 35 (46.1%) female and 41 (53.9%) male pupils participated in the study. The Environmental Literacy Scale, the Environmental Sensitivity Scale, the Environmental Behaviour Scale, and the Cognitive Skills Interview Form developed by Sontay, Gökdere, and Usta (2015) were used in the study. In addition, the pupils were asked to draw environmental pollution themed pictures in order to explore their images of environmental pollution. The drawing method was used to reveal the pupils' perceptions about environmental pollution. [This study was presented at the 4th International GAP Conference on Social Sciences, 29 November-1 December, Sanliurfa, 2019.]

Dental caries and oral health problems are a major public health concern in our country and around the world. Society needs to improve tooth brushing habits, reduce sugar and carbohydrate intake and provide adequate fluoride to achieve dental and oral health goals. Additionally, we must reach out to disadvantaged and socio-culturally backward populations. Although scans that detect the issue could be significant, tooth brushing sessions with role models who turn behavioral changes into habits are even more crucial in solving the problem. Families should be taught the triangle of brushing teeth, reading books and then sleeping.

Introduction: Individuals diagnosed with rheumatoid arthritis (RA) face a heightened risk of developing metabolic dysfunction-associated fatty liver disease (MAFLD). The primary objective of this study was to examine the progression of hepatic fibrosis through non-invasive tests in patients with MAFLD, both those with RA and those without RA. Methods: In our retrospective study, a total of 120 MAFLD patients aged between 18 and 65 years, excluding those with juvenile RA, were included. Patients were divided into two main groups as patients with (n=60) and without (control group, n=60) RA. Fibrosis-4 (FIB-4) and NAFLD Fibrosis Score (NFS) (NAFLD/MAFLD fibrosis) scores were used to determine the risk of hepatic fibrosis in patients with MAFLD. These scores were compared between the two groups. The relationship between FIB-4 and NFS scores and other parameters was evaluated. SPSS 25.0 software was used for statistical analysis, and significance was accepted as p