Objective: The aim of this study was to investigate the effect of percutaneous tracheotomy on mortality and length of stay in the intensive care unit (ICU) for patients with COVID-19-associated acute respiratory distress syndrome (ARDS). Materials and Methods: This study included patients with coronavirus disease-19 (COVID-19-associated) acute respiratory distress syndrome who were treated with invasive mechanical ventilation in a pandemic intensive care unit. Patients admitted to the pandemic intensive care unit between March and July 2021 were retrospectively reviewed. Patients who underwent percutaneous tracheotomy and did not have a tracheotomy during the follow-up were statistically compared in terms of laboratory and clinical characteristics such as mortality and length of stay in the intensive care unit. Results: The study included 102 orotracheally intubated patients diagnosed with COVID-19 acute respiratory distress syndrome. The number of tracheotomized and not-tracheotomized patients was 34 and 68, respectively. The mean age of the patients was 60.39 +/- 14.10 years. The mean time to perform percutaneous tracheotomy was 7.94 +/- 6.11 days. There was no significant difference in mortality rate between the two groups (p=0.298). However, patients who underwent tracheotomy had a longer length of stay in the intensive care unit compared to those who did not (35.00 +/- 24.60 days vs 13.20 +/- 11.69 days, p<0.001). Conclusion: Our study found no statistically significant difference in mortality rate between the two groups in our study. Additionally, the length of stay in the intensive care unit was not better in tracheotomized patients. While tracheotomy has some advantages in other severe lung diseases, its effect on mortality in patients with severe lung disease associated with COVID-19 should be evaluated further in randomized controlled trials.
Background: Familial hypokalemic periodic paralysis (FHPP) is an autosomal dominant disease presented by the presence of painless weakness attacks accompanied by a low level of serum potassium. Mutations in genes encoding ion channels Calcium voltage-gated channel subunit alpha 1S, SCN4, and KCNJ2 have been recognized in this disorder.Case Report: A 15-year-old male patient was admitted to our hospital with a complaint of muscle weakness, which started about 4 years ago, recurring almost twice a week. Especially when he ate carb-rich meals or stayed after a long time in the cold, he described a feeling of numbness and weakness. FHPP was diagnosed due to CACNA1S gene mutation from the family in which six members are affected in three generations.Conclusion: FHPP, which is an uncommon cause in cases presenting with sudden muscle weakness, is an important neu-romuscular emergency, which should be kept in mind and may cause mortal results when not treated.
Objective: Helicobacter pylori infection (HPI) might potentially lead to chronic infection and cancer development in the gastric mucosa. However, previous studies have shown that coronary artery disease might also be associated with this infection. On the other hand, this causal association has not been previously documented in the context of premature coronary atherosclerosis (PCA). In our study, we aimed to investigate the potential relationship between HPI and PCA. Materials and Methods: All consecutive patients (<= 40 years of age) (between the years 2009 and 2018) undergoing coronary angiography and gastroduodenoscopy were included in the study (n=199). Patients were divided into two groups (PCA and control). The statistically considered significant p value is <0.05. Results: One hundred ninety nine patients included those with PCA [n=61 (30%)] (51% male, average age 35 years old). HPI was detected in 70% of patients with PCA (n: 43). Statistically significant independent relationship between HPI and PCA was observed in the logistics regression analysis (p<0.001). Conclusion: HPI may be an independent risk factor for PCA.
Objective: Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that leads to structural and functional impairments and reduced quality of life, with heterogeneous manifestations. The origin and possible role of extracellular vesicles represented by exosomes (EVexo) in the pathogenesis of AS were examined in this study. Materials and Methods: Extracellular vesicles (EVs) were isolated from serum from ten AS patients and ten healthy controls through Izon qEV2/35 nm columns. After assessing the isolate purity by bicinchoninic acid assay (BCA) and Enzyme-Linked ImmunoSorbent Assay (ELISA), the relationship between EVexo concentration and AS was tested by the BCA method. The EVexo surface markers were analyzed by flow cytometry (FC) to verify EVexo presence and reveal its origin. Results: In FC analysis, CD86+TSG101+ and CD3+TSG101+ exosome percentages of AS group were significantly higher than the control group (p<0.05). A significant difference was found between the AS and control groups in terms of CD3+IL17+ and CD3+IFNg+ and CD86+TNF alpha+ and CD86+IL12(p35)+ exosome percentages (p<0.01). Conclusion: The exosomes whose ratio increased in the AS process were derived from T cells expressing increased levels of IL-17A and IFNg in their membranes, and macrophages expressing increased levels of TNF alpha and IL-12(p35) in their membranes. The EVexo profile did not change according to the AS course.
Objective: This study aims to determine the factors affecting the perception levels of operating room (OR) nurses and nurse anesthetists working in the OR regarding patient safety attitudes. Materials and Methods: This study was conducted using face-to-face interviews with 117 healthcare professionals working as OR nurses (n=60) and nurse anesthetists (n=57). The patient safety attitude questionnaire (SAQ), where the reliability analysis was also performed for the SAQ scale. and sociodemographic characteristics were used for this study. Qualitative variables were given as numbers and percentages (%), and the dataset belonging to quantitative variables that met the normal distribution criteria was given as mean (standard deviation), and data of quantitative variables that did not comply with normality were given as median, IQR, and 95% CI of the median. Results: There were significant differences between OR nurses and nurse anesthetists regarding job satisfaction (p=0.015) and total SAQ score (p=0.040). Significant differences were detected between men and women participants regarding smoking (p=0.020) and stress recognition (p=0.040). The reliability analysis of the scale was as follows: total (alpha: 0.791), job satisfaction (alpha: 0.883), teamwork climate (alpha: 0.856), safety climate (alpha: 0.864), perceptions of management (alpha: 0.881), stress recognition (alpha: 0.791), and working conditions (alpha: 0.530). Conclusion: It was shown that the patient safety attitudes of the healthcare professionals participating in this study are above average, although it is still insufficient, where the stress identification score of the female participant was higher, and it was also found that the nurses' job satisfaction and SAQ score were higher.
Objective: Concerns are growing about the prevalence of liver cancer as one of the most common health-threatening can-cers due to the numerous risk factors for this type of cancer such as hepatitis, obesity, diabetes and fatty liver. This review article was done to investigate the protective role of probiotics and their metabolites against liver cancer, where probiotics showed various useful effects for treatment of disease especially cancer.Materials and Methods: For this study, searches were carried out using keywords including probiotic, Bacteria, Lactobacil-lus, Bifidobacterium, Liver Cancer and Hepatocellular Carcinoma from reliable databases such as Google Scholar, PubMed, Science Direct, and Wiley.Results: This review revealed that, where products of probiotic bacteria had also therapeutic effects such as OK-432, Nisin, Bovicin HC5 (as important products), probiotic bacteria of the genus Lactobacillus and Bifidobacterium such as Lactobacillus plantarum, Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus rhamnosus strains were the most useful probiotic heyda Bo a i1 Ronak Bakhtia i2 Hatef Ajo da ifa 1 Se d Ataollah Sad t Sh ndi 3 bacteira against liver cancer.Conclusion: The use of probiotics due to their natural source and their secretory metabolites can be a good way to develop new therapies for various diseasesm with this systematic review showing that probiotics have shown therapeutic effects on liver cancer by having a wide range of properties such as anti-inflammatory and anti-apoptotic properties.
Objective: Several factors in our life process may directly contribute to frailty or are associated with diseases that can lead to frailty. In this study, we aimed to determine the factors and life events that contribute to frailty and affect gait speed using several tests. Materials and Methods: This cross-sectional study included patients aged 65 and above. The Tilburg Frailty Indicator (TFI), the timed up and go (TUG) test, and the gait speed (GS) test were used. Independent determinants for different types of frailty and TUG and GS scores were examined using multivariate logistic and linear regression models. Results: There were 263 individuals included in this study. The mean age of the individuals was 72.53 +/- 5.83 years old, and 46% of the individuals (n=121) were frailty. The total frailty score of the participants was 4.59 +/- 3.10, the mean TUG score was 10.28 +/- 3.11 s, and the GS score was 0.80 +/- 0.30 m/s. Female sex (adjusted odds ratio [aOR]=5.3), middle and bad health perception (aOR=6.8, aOR=58.3), poor living environment satisfaction (aOR=14.3), and TUG test score (aOR=1.6) were significantly associated with an increase in risk for frailty. Conclusion: In this study, as we have found that factors such as sex, health perception, and gait speed affect frailty and factors such as age, polypharmacy, and frailty affect gait speed; the quality of life of the elderly can be improved with suitable intervention for these factors.
Background: Acute hepatitis-associated aplastic anemia (AHAAA) is a rare clinical syndrome characterized by the development of aplastic anemia 2-3 months following an episode of acute hepatitis. Several immunosuppressive agents, but not mycophenolate mofetil (MMF), and bone marrow transplantation are the standard treatment options for AHAAA. Case Report: In this report, we present a case of a young boy with AHAAA manifesting as acute liver failure. The etiology was type 1 autoimmune hepatitis responsive to the second-line therapeutic combination of steroids and MMF. The liver has fully recovered, but bone marrow failure ensued. After 4 months, Clinical and laboratory improvement occurred without the need for bone marrow transplantation. An important aspect of this case is the full recovery of aplastic anemia without calcineurin inhibitors, anti-thymocyte globulin utilization, or bone marrow transplantation. Conclusion: Our case history supports MMF as a potentially crucial adjunctive therapy for patients with AHAAA who poorly respond to standard procedures.
Objective: This cross-sectional study evaluated the association between food addiction, dietary quality, and metabolic parameters and determined food addiction prevalence in overweight and obese adults. Materials and Methods: This study was conducted with 134 obese and overweight adults. Food addiction was evaluated with the Yale Food Addiction Scale (YFAS), and dietary quality was assessed with the Healthy Eating Index-2010 (HEI-2010). The HEI-2010 scores range from 0 to 100 (> 80: good dietary quality, 51-80: needs improvement, < 51: poor dietary quality). Results: 19.4% of the participants had a food addiction. The ratio of those with poor dietary quality (61.5%) in participants with food addiction was higher than those without food addiction (52.8%) (p > 0.05). The ratio of participants with high AST levels to participants with food addiction (34.6%) is higher than those without food addiction (17.6%) (p < 0.05). Participants without food addiction have lower cholesterol intake than participants with food addiction (p < 0.05). YFAS symptom scores were positively correlated with AST, SBP, and DBP levels and negatively correlated with the age of the participants (p < 0.05). Conclusion: It was founded that a relationship may exist between food addiction, dietary quality, and metabolic parameters of obese and overweight adults. Especially in treating obesity, it is essential to make appropriate interventions to increase dietary quality.
Objective: The aim of this study is to determine the prevalence of potentially inappropriate medication (PIM) use in older Turkish adults on the basis of three criteria as well as to investigate its relationship with frailty. Materials and Methods: This cross-sectional study was conducted in an outpatient clinic. The Turkish Inappropriate Medication Use in the Elderly (TIME), Beers 2019, and Screening Tool of Older Person's Prescriptions Version 2 (STOPPv2) criteria were used to detect PIM. Frailty was determined using the Fried Frailty Index categorized as 0 points, non-frail; 1, pre-frail; and >= 2, frail. Results: Of the 382 patients, 179 (46.9%) were identified with at least one PIM according to the three sets of criteria. The prevalence rates of PIM based on the TIME, Beers 2019, and STOPPv2 criteria were 46.1%, 30.6%, and 26.2%, respectively. No association was found between PIM and frailty (p=0.593 for the TIME criteria, 0.562 for the Beers 2019 criteria, and 0.524 for the STOPPv2 criteria). The risk of PIM presence was higher when the TIME criteria were applied than when the other criteria were used (odds ratio [OR]: Beers 2019 vs. TIME, 0.5231 and STOPPv2 vs. TIME, 0.4072; p<0.001 for all). The number of prescribed medications and older age were associated with the use of any PIM (ORs, 1.3143 and 1.0301, respectively). Conclusion: The TIME criteria showed the highest PIM frequency in older Turkish adults and had moderate-to-significant concordance with non-country-specific criteria. Further studies are needed to evaluate the relationship between frailty and PIM.
Unsafe personal listening device (PLD) usage has recently been linked to noise-induced hearing loss (NIHL). This study aims to investigate the public's behavior toward PLD usage and raise awareness about its adverse effects on users. A total of 100 participants were surveyed to obtain information about their PLD usage behavior and its effects on hearing levels using pure tone audiometry. In our study, out of 100 participants, 67 used PLD, and 47.7% of them were under 25 years old. Additionally, 4.28% of PLD users reported experiencing hearing loss, while 34.3% reported vestibular symptoms. The long-term effects of PLD usage, particularly among young people, require further investigation. Therefore, this study highlights the importance of promoting safe listening practices, particularly among younger generations.
Objective: Hand injuries are a common reason for emergency room visits, and it is critical to managing the pain process effectively. This study aims to look at the demographics, pain assessment, and management of patients who visited the emergency department with hand injuries. Materials and Methods: Healthy patients over 18 who presented to the emergency room within the first 24 hours of an acute hand injury between December 2020 and February 2021 were included. The Numerical Pain Rating Scale was em-ployed to assess pain severity. The etiology of the trauma, pain scale, analgesic treatment, imaging requests, consultation, and tetanus vaccine situation were all documented. Results: The patient’s pain severity was classified at admission. It was found that 38.8% had mild pain, 39.2% moderate, and 21.9% had severe pain. The average pain scores of the patients were determined as 4.89±2.14. Analgesic was executed in 13.5% of the patients who applied, and 86.5% did not receive painkillers. Analgesia was applied to 2% of the patients with mild pain, 14.7% with moderate pain, and 31.6% with severe pain. We found that as pain severity increased, analgesia was more, and it was found to be statistically significant (p=0.0001). Conclusion: Analgesia is a neglected step in trauma care. Emergency physicians should prioritize pain relief. All patients with hand trauma should be pain-scored and given appropriate analgesia.
Objective: Feedback from multiple international centers has revealed inhaler device handling errors in obstructive lung disease patients over several years. This study evaluates the effectiveness of an easy-to-apply and continuous inhaler device education method that may be implemented in a hospital setting and continued at home. Materials and Methods: A total of 60 patients with Chronic Obstructive Pulmonary Disease (COPD) who had >2/10 critical errors in using their inhaler devices were included in the study. They received training on how to use their inhalers, and were then divided into two equal groups. Group 1 consisted of control patients who did not receive any additional education. Group 2 patients had the steps for inhaler administration recorded as voice commands on their mobile phones, and also received reminders for medication administration time. All patients were followed for six months to evaluate the outcome of the training. Results: Among the patients, 86.7% were unaware that they were misusing their inhaler devices. In Group 1, the success rate was 56.7% after the first education session in the clinic. However, after six months, none of the patients in Group were successful. On the other hand, in Group 2, the success rate was 46.7% at the end of the first education session, and this was maintained at the sixth-month follow-up. Conclusion: Patients may not be aware of their mistakes in handling inhaler devices, and may forget the correct steps over time. This study supports the use of phone applications for providing continuous education, which may help to increase the success of inhaler treatment. Such applications could be adapted for use in clinical settings.
Objective: The complications of Coronavirus Disease 2019 (COVID-19) have increased among kidney transplant recipients (KTR) due to chronic immunosuppression and comorbidities. Additionally, acute kidney injury (AKI) is frequently observed during COVID-19. This study aimed to investigate the impact of COVID-19 on kidney allograft survival. Materials and Methods: The retrospective, single-center investigation study included 88 patients who had a functioning kidney allograft prior to COVID-19 diagnosis. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection was confirmed with a polymerase chain reaction (PCR) test and thoracic computerized tomography. AKI and dialysis require-ments were analyzed using laboratory, demographic, and clinical parameters. Results: The median age of the patients was 44.5 (34.3-53.8) years, and the median allograft survival was 59.0 (20.8-116.5) months. The mean baseline estimated glomerular filtration rate (eGFR) was 58.2 (21.2-92.8) ml/min/1.73 m2 before the COVID-19 diagnosis. The frequency of AKI was 70.4% (62 patients), and dialysis therapy was required in nine patients (10.2%). The clinical features of COVID-19 and inflammatory markers had no statistical significance in predicting dialysis requirements. However, logistic regression analysis indicated that serum protein level (p=0.034), serum albumin level (p=0.048), hemoglobin (p=0.028), baseline eGFR (p=0.033), and age (p=0.041) were significantly predictive for dialysis requirements. Conclusion: Age, anemia, and decreased baseline eGFR are related to severe AKI and dialysis therapy in KTR during COVID-19.
Objective: The term post-COVID (coronavirus disease) is used to refer to the presence of prolonged symptoms 12 weeks or more after the disease treatment. This study aimed to evaluate the presence of symptoms and anxiety in patients with COVID-19 who did not require inpatient care at the third and sixth months following symptom onset. Materials and Methods: The study is a prospective cohort study involving 471 university employees who contracted COVID-19 between October 2020 and October 2021. Data were obtained through the disease contact follow-up program implemented at the university and phone interviews conducted at the third and sixth months from symptom onset. Results: The study group comprised 361 individuals at three months and 109 at six months from symptom onset. The study found that symptoms persisted in 116 (32.1%) people in the third month and in 47 (13.0%) people in the sixth month. The most common symptoms at three months were shortness of breath, fatigue, and fatigue, while fatigue, fatigue, and shortness of breath were the most common symptoms at six months. Conclusion: Understanding the long-term effects of coronavirus will enhance the management of the disease. As a result, the follow-up of symptomatic COVID-19 and post-COVID-19 patients will become more systematic and effective.
Objective:The objective of this study was to investigate the impact of the Coronavirus Disease 2019 (COVID-19) on inflammatory rheumatic diseases (IRD) by comparing them with non-IRD (nIRD) and healthy controls (HC). Materials and Methods:In this cross-sectional study, subjects were screened for contact with COVID-19, new-onset symptoms, and adherence to precautionary measures against COVID-19.The Impact of Event Scale-Revised (IES-R) and Depression Anxiety and Stress Scales (DASS-21) were used to evaluate the psychological effect of the pandemic and health status.Additionally, therapy adherence and clinical characteristics were noted.Results: A total of 279 subjects were recruited (IRD 47.3%; nIRD 29.7%).The number of patients who believed that the risk of COVID-19 increased due to their diseases or received therapy was higher in IRD than nIRD (38.6% vs 7.2%).Maintaining physical distancing was highest in the IRD and lowest in HC (p=0.037).Approximately 40% of the patients discontinued or extended the dose interval of Tumor Necrosis Factor Inhibitor (TNFi) without obtaining physician's advice.DASS-21 anxiety, depression and stress rates were lowest in IRD.COVID-19 contact history was an independent risk factor for DASS-21 stress and anxiety, while female gender was an independent risk factor for DASS-21 anxiety. Conclusion:Confirmed COVID-19 infection was similar in HC, IRD, and nIRD.HC were substantially more likely to experience mental health issues than other groups.Most patients with IRD discontinued or extended the ongoing treatment without physician's recommendation during the COVID-19 outbreak.Therefore, patient adherence and disease control could be improved through closer monitoring and recognition of early signs of psychological discomfort during the COVID-19 pandemic.
Background: Von Hippel-Lindau disease (VHL) is a rare multisystem neurocutaneous disorder. The abnormalities in the corpus callosum have been observed in patients with phacomatosis, but this has not been previously described in VHL. In this report, we present a unique case of VHL with corpus callosum agenesis. Case Report: A 7-year-old boy was referred to the hospital because of left flank pain and vomiting. The abdominal ultrasound revealed multiple small simple cysts in both kidneys and pancreas. A radiological suspicion of VHL was raised, and further imaging examinations were recommended. Brain magnetic resonance imaging demonstrated a parallel arrangement of the lateral ventricles, confirming the diagnosis of complete agenesis of the corpus callosum. Brain hemangioblastomas were not detected. Conclusion: Our case is the first to report a corpus callosum agenesis in a child with VHL, thus expanding the spectrum of neurocutaneous disorders associated with callosal anomalies.
Although droplets and aerosol are considered the main transmission routes of SARS-CoV-2, indirect contact has been indi-cated to play a critical role in transmission. The aim of this study is to evaluate the presence of SARS-CoV-2 RNA on different environmental surfaces in public areas in Cyprus. Using RT-qPCR, samples from 50 swab specimens collected from high -touch surfaces were analyzed for viral RNA. Six surfaces (12.0%) in all were positive for SARS-CoV-2. Among the examined surfaces within supermarkets, SARS-CoV-2 was detected in 22.2% (n=4/18) of the sampling points, with shopping trolley handles and POS keyboards being the most frequently contaminated items. In the hospital setting, two (n=2/5, 40%) samples were positive for SARS-CoV-2. Our results indicate that, at the current stage of the pandemic, viral contamination of public spaces exists in the community. Lifting protective measures may have contributed to fomite transmission in public spaces.
Objective: This study aims to investigate the effects of tibialis posterior muscle (TP) fatigue on dynamic plantar pressure (DPP) characteristics during different walking speeds.Materials and Methods: Thirty healthy volunteers walked at normal and fast paces in three trials. The Footscan (R) 3D system was used to obtain the distribution of dynamic plantar pressure before and after the TP fatigue protocol. The study measured the peak pressure (PP) of the hallux, toes 2-5, metatarsals (Meta 1-5), midfoot (MF), medial heel (MH) and lateral heel (LH), as well as the percentage of contact area (CA%) of the forefoot (FF), MF and hindfoot (HF), foot progression angle (FPA) and the minimum and maximum values of the subtalar angle.Results: The results showed significant differences in the PP of Meta 4, MH and MF at a normal pace after the tibialis posterior muscle fatigue protocol. At a fast pace, significant differences were found in the PP of the MF and CA% of FF and MF. Before the fatigue protocol, there were significantly different values in the peak pressure of the hallux, toes 2-5 and MH between the two walking speeds. After the fatigue protocol, there were significantly different values in the peak pressure of toes 2-5, MH and LH between the two walking speeds. The study also found a significant difference in FPA between the two walking speeds (p<0.05).Conclusion: The study provides evidence that TP fatigue may lead to injuries during long-term walking or sports activities. These results highlight the importance of endurance training and minimizing its negative effects on foot biomechanics by reducing fatigue.
