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© 2022 Elsevier B.V.Objective: Objective methods to monitor the sleep of preterm infants at the neonatal intensive care unit (NICU) are required to prevent potentially adverse neurodevelopmental outcomes. This study aimed to determine the concordance of actigraphy and amplitude-integrated electroencephalogram (aEEG) against gold standard direct observation (DO) in assessing sleep/wake states of typically developing preterm infants. Methods: This prospective observational study was conducted in a single center level III NICU. Sleep variables were measured using Philips Respironics Mini-Mitter® Actiwatch-2 for 24 h and compared with 8-h matched data of aEEG and DO. Sensitivity-specificity analysis, Cohen's kappa, prevalence-adjusted and bias-adjusted kappa (PABAK), and Bland Altman plots were generated. Results: Seventeen preterm infants were recruited. A total of 11252 epochs were studied. Sensitivity (86.4%), agreement rate (67.9%), and predictive value for wake (47.9%) for the actigraphy were highest at the automatic activity threshold whereas specificity (54.5%) and predictive value for sleep (75.5%) were highest at low threshold. The sensitivity of aEEG was 79.3% and the specificity was 54.3%. At all thresholds, the agreement was largely equivalent with low kappas (0.14–0.17) and PABAK coefficients (0.22–0.35) for actigraphy and DO. Moderate agreement was observed between aEEG and DO according to the PABAK coefficient (0.44). Mean differences in sleep parameters were not different between DO and aEEG as well as DO/aEEG and actigraphy at medium threshold (p > 0.05). Conclusions: Actigraphy at medium threshold can be used in depicting sleep in typically developing preterm infants at NICU. aEEG may be an alternative adjunctive method to actigraphy for the evaluation of sleep/wake states in the NICU setting. Clinical trial registration number: NCT04145362

Background Isolated pulmonary vasculitis (IPV) is a single-organ vasculitis of unknown etiology and may mimic chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to review our clinical experience with pulmonary endarterectomy in patients with CTEPH secondary to IPV. Methods Data were collected prospectively for consecutive patients who underwent pulmonary endarterectomy and had a diagnosis of IPV at or after surgery. Results We identified nine patients (six female, median age 48 (23–55) years) with IPV. The diagnosis was confirmed after histopathological examination of all surgical materials. The mean duration of disease before surgery was 88.0 ±70.2 months. Exercise-induced dyspnea was the presenting symptom in all patients. Pulmonary endarterectomy was bilateral in six patients and unilateral in three. No mortality was observed, however, one patient had pulmonary artery stenosis and stent implantation was performed. All patients received immunosuppressive therapies after surgery. Mean pulmonary artery pressure decreased significantly from 30(19–67) mm Hg to 21(15–49) mm Hg after surgery (p Conclusions Isolated pulmonary vasculitis can mimic CTEPH, and these patients can be diagnosed with pulmonary endarterectomy. Furthermore, surgery has not only diagnostic but also therapeutic value for IPV when stenotic and/or thrombotic lesions are surgically accessible. A multidisciplinary experienced CTEPH team is critical for management of these unique patients.

BACKGROUND: Within the scope of minimally invasive dentistry, the use of different biocompatible remineralization agents on incisors affected by molar-incisor hypomineralization (MIH) gains importance. OBJECTIVE: To evaluate the effect of casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP) and calcium glycerophosphate (CaGP) in mineral density (MD) of white/creamy and yellow/brown demarcated opacities on incisors affected by MIH by means laser fluorescence (LF). METHODS: As a cross-over, randomized trial, twenty-two children with 167 incisors affected by MIH were recruited and randomly assigned to one of the two different agents and crossed over to other agents with two weeks washout in between. Incisors were examined by using LF at all before and after three months periods. RESULTS: The results of the paired t-tests for determining the period effect between the baseline findings showed significant difference in white/creamy and yellow/brown demarcated opacities of LF values for both groups (p

The primary aim of this study is to determine statistically significant relationship between nutrition and psychological status in adolescent students with the help of canonical correlation analysis, and then to reveal whether nutritional and psychological status of adolescents with gender has an effect on their educational success by using logistic regression analysis. Nutritional status and psychological status variable sets were created by using the Demographic Information Form, Beck Depression Inventory, Beck Anxiety Inventory, Conners-Wells Adolescent Self-Report Scale and Food Frequency Questinaire (FFQ), and antropometric measeruments. These assesments were applied face-to-face to the students with their consent and the scales were filled in by themselves. In the canonical correlation analysis, the variable set for Nutritional Status (U), were represented with body mass index (BMI) and also energy, iron, folic acid and calcium that were obtained by entering the FFQ into the Nutrition Information Systems (BeBiS Program). On the other hand the Psychological Status (V) variable set consisted of Beck depression scale, Beck anxiety scale and Conners-Wells scale scores. Finally, students' success levels were determined by taking their grade point averages over the e-school system of the Ministry of National Education for educational success. According to the canonical correlation analysis; the variable that contributed the most to the Nutritional Status (U) variable set was Body Mass Index while the variable that contributed the most to the V variable set was the Beck Depression Scale Score. The canonical correlation coefficient between the U and V variable sets was 22.4% and it was found statistically significant (p

Objective: Recently, some pregnant women in Türkiye are hesitant to undergo gestational diabetes mellitus (GDM) screening tests and this trend is more common. The objective of the study is to assess the pregnant women’s knowledges, decisions, reasons for hesitations about having the GDM screening tests and test rejection rates. Material and Methods: This cross-sectional study included 647 pregnant women who applied for an antenatal outpatient clinic and who had not yet been diagnosed with GDM and a survey was conducted using questionnaire designed by the authors. Results: At the beginning, 287 (44.4%) of the participants declared that they would have glucose challenge test, 169 (26.1%) would not and 191 (29.5%) were undecided. The rejection rate was lower in those who had knowledge about the screening tests. After a short information about the content of tests, 30% of the women who decided not to have the test and 78.3% of those who were undecided at the beginning, decided to have the test (p=0.001). Conclusion: The knowledge level of pregnant women about diabetes screening and diagnosis influences their decision-making. Organizing well-planned trainings for patients and healthcare professionals using public institutions and media may be effective in reducing the burden of diabetes on social health and the economic indicators.

Aim: It is aimed whether there is a relationship between dosimetric data of localized prostate cancer patients who have been treated with curative radiotherapy and gastrointestinal (GIS), genitourinary (GUS), anal and sexual side effects and whether there is a difference between dosimetric data and clinical findings between risk groups. Method : Eighty-seven patients who received curative radiotherapy for localized prostate cancer between 2014 - 2019 were included in the study. Dosimetrically; whether there was a relationship between V30, V40, V50, V60, V65, V70, V75 for rectum and bladder; D90 for the penile bulb, V72, V74, V76 for the bulbomembranous urethra, V30, V45, V53, Dmax for the anus and V45 (cc) for the intestine data and the side effects was analyzed. It was evaluated whether there was a relationship between testosterone values and sexual side effects. The Kolmogorov-Smirnov test, One Way ANOVA (F-test), and paired-sample T-test were used as statistical methods. For statistical significance, p

Objective: Assessment and comparison of oral health status in elders with and without Alzheimer's disease. Methods: This age and gender matched cross-sectional study included participants from an Alzheimer’s day care center, and a nursing home. Mental state, oral and periodontal health, Geriatric Oral Health Assessment Index (GOHAI), unstimulated salivary flow rate (USFR), and other dry mouth conditions were examined. Group comparisons, and correlation analysis were performed. Results: Thirty-six elders with AD and 37 elders without AD were included. Elders had similar GOHAI scores, USFR level (p>0.05). Elders with AD had lower probing depth (PD) and clinical attachment loss (CAL), and higher presence of no periodontitis than the elders without AD (p

OZET Amac: Cox Orantili Hazard (COH) modeli sagkalim analizinde en sik kullanilan cok degiskenli regresyon modelidir. Ancak uygulamada orantili hazard (OH) varsayimini saglamak her zaman mumkun olmamaktadir. Bu durumda Parametrik Hizlandirilmis Basarisizlik (Olum) Zamani (HBZ) modelleri uygulanir. Bu calismada HBZ ve COH modelleri meme kanseri tanisi olan hastalara uygulanarak sonuclar karsilastirilmistir. Gerec ve Yontem: Bu calismada 697 erken evre meme kanserli hastanin retrospektif sagkalim verileri analiz edilmistir. Bagimli degisken olan genel sagkalim ve 13 bagimsiz degiskenle test edilmistir. Anlamli cikan degiskenler coklu regresyon analizi olan COH modeli ile yapilan regresyonla tahmin edilmeye calisilmistir. HBZ modeli icin verilerin olasi log-normal, log-lojistik, Weibull ve ustel dagilimlarina ait Hazard Fonksiyonlarina bakilmistir. Bulgular: Yas gruplari, tumor derecesi, noral invazyon ve ekstra kapsul tutulumu COH varsayimini saglamamasina ragmen, istatistiksel olarak anlamli cikan 9 bagimsiz degisken cok degiskenli COX modeline girdiginde sadece metastatik lenf nodu sayisi ve menopoz degiskenleri anlamli bulunmustur. HBZ modeli icin, bagimli degisken olan genel sagkalima ait, AIC degerine ve hazard fonksiyonu dagilimlarina gore en uygun HBZ modelinin Log-lojistik oldugu gorulmustur. Log-lojistik regresyonu sonucunda ise metastatik lenf nodu sayisi, menopoz ve tumor boyutu degiskenleri anlamli cikmistir. Sonuc: Literaturde COH modeli en sik kullanilan sagkalim modellerinin basinda gelir. Hazardlarin orantili olmadigi durumlarda COH regresyon modeli yerine HBZ regresyon modeli gibi modellerin kullanimi daha uygun olabilir.

Amac : Klinik bir taniya karar verme surecinde, surekli bir veri icin ikili siniflandirma sisteminde optimum kesim noktasi arastirilirken cogunlukla ROC (alici isletim karakteristigi) analizi tercih edilir. Optimum kesim noktasi, duyarlilik ve secicilik arasindaki iliskinin grafiksel bir gosterimi olan ROC egrisinden tespit edilir. Ancak ROC egrisindeki kesim noktasinin cok net belirlenemedigi durumlarda, ROC egrilerinde duzlestirmenin onemini vurgulanmistir. Bu calismanin amaci, ROC egrilerine Kernel duzlestirme yonteminin uygulanmasi yerine bir secenek olarak LOWESS (yerel agirlikli sacilim grafigini duzlestirme) yonteminin kullanilmasini onermek ve bir uygulama ile gostermektir. Yontemler : ROC yontemi yerine onerilen LOWESS yontemi, karmasik iliskileri bir regresyon denklemiyle ifade etmek yerine daha cok gorsel bir ifade icin tercih edilir. Calismamizda, ROC egrisi ve LOWESS yontemiyle elde edilen egrilerde net ve dogru kesim noktalarinin bulunmasi bir uygulama ile irdelenmis ve yontemler tartisilmistir. Uygulamada ise, akciger rezeksiyonu sirasinda asiri sivi uygulamasinin akciger yaralanmasi icin bir risk faktoru oldugu bilindiginden; postoperatif pulmoner komplikasyon varligi icin anlamli risk faktorleri olarak; intraoperatif sivi infuzyon artis hizi, ARDS (akut respiratuar distres sendromu), AAH (akut akciger hasari), pnomoni, atelektazi, bronkoskopi ihityaci ve hava kacagi/yoklugu kullanilmistir. Bulgular : Kesim noktasinin, ROC yontemine gore 5,5-6 mL/kg/h arasindaki bir noktada olabilecegi dusunulurken, LOWESS yontemine gore ise 6,125 mL/kg/h noktasinda olacagi saptanmistir. Sonuc : Siniflama yaparken; egrilerin daha iyi yorumlanabilmesi ve kesim noktasinin daha iyi belirlenmesi icin ROC egrisine karsi bir secenek olarak parametrik olmayan LOWESS duzlestirme yonteminin kullanilmasi onerilmektedir.

Objective: Obstruction of the internal thoracic arteries (ITAs) by the Nuss bars in minimally invasive repair of pectus excavatum (MIRPE) has been documented in the literature. In this study, we aim to investigate the patency of ITAs before and after repair of the pectus excavatum with the Nuss procedure, by using color Doppler ultrasonography (US). Materials and Methods: Nineteen patients who underwent Nuss procedure were included in this study prospectively. Color Doppler US examinations were performed for comparing ITA patency after insertion of the Nuss bars and after their removal. Patients were evaluated according to gender, age, symmetry of deformity, Haller index, and the number of Nuss bars inserted. Results: Nineteen patients operated with MIRPE (17 male and 2 females with a mean age 21.78 +/- 6.35) were enrolled in the study. Eight patients (42.1%) with normal ITA blood flow preoperatively had normal blood flow after removal of the bar. In preoperative examination, 6 patients had bilateral (n=2) or unilateral (n=4) obstruction of the ITA and 5 patients had bilateral (n=2) or unilateral (n=3) abnormally disturbed flow. After the bar removal only 2 (10%) of the affected patients (57.9 %) still had obstruction whereas patent blood flow of the ITAs has been noted in 9 patients. Conclusion: We have shown that after the Nuss bar removal, only 10% of the ITAs are compromised.

ABS TRACT Objective: Left ventricular hypertrophy (LVH) is highly predictive of cardiovascular (CV) events in dialysis patients. The impact of different left ventricular (LV) geometric patterns on cardiovascular outcome has not been well established. The aim of this prospective observational study was to define the patterns of LVH and find out their impact on future cardiovascular events in patients on continuous ambulatory peritoneal dialysis (CAPD). Ma te ri al and Met hods: Patients we re followed up between 1999 and 2006 for cardiovascular events. Left ventricular mass and geometric patterns were determined by echocardiography. Kaplan-Meier method and Cox re gression analysis were used to evaluate the impact of LV geometric patterns on CV event free sur vival. Results: Sixty-five CAPD patients were enrolled in the study and were followed for 76 ± 15 months. There were a total of 16 (14 fatal, two non-fatal) CV events. Mean event-free survival time for patients without LVH was 79 ± 3 months (95% CI of 73 to 86 months). The mean CV event-free survival for the patients with concentric LV hypertrophy and eccentric hypertrophy was 75 ± 3 months (95% CI of 69 to 81 months), and 76 ± 3 months (95% CI of 69 to 82 months) respectively. Patients with eccentric [hazard ratio (HR): 20.2] and concentric (HR:18.7) LV hypertrophy had shorter time to CV event when compared to the patients without LV hypertrophy (p= 0.042). Conclusion: Left ventricular hypertrophy is a marker of poor cardiovascular prognosis irrespective of its pattern. Both eccentric and concentric LV hypertrophy are associated with shorter CV eventfree survival compared to normal geometry and concentric remodeling.

We investigated the reliability and validity of the Turkish version of the Voice Handicap Index (VHI), and developed a short VHI form that would be more practical.The original VHI was translated to Turkish by 10 otolaryngologists, then it was translated back to English by a linguist, and the final text was prepared by the evaluation committee composed of three members. The translated version was administered to a group of 220 subjects twice with 7-14 days intervals. Based on the responses, statistical analyses were performed to assess its reliability and validity.Internal consistency reliability was found to be highly significant (Cronbach's alpha=0.97). Test-retest correlation coefficient was 0.93 for the total score. Factor analysis yielded three factors explaining 64.8% of the total variance. The corrected item-total correlation coefficients ranged from 0.50 to 0.80. The 10 most robust VHI items, namely, E7, E9, P10, F11, F12, E15, F16, P18, P20 and E29, were selected using the corrected item-total correlation coefficients, and a shortened form of the Turkish VHI was developed.As some items are thought to be contentious in the Turkish VHI, the short form of the Turkish VHI is more suitable for use in clinics.