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Gestational Oxidative Stress and OGTT: Are Pregnant Women’s Fears Justified?
(Dove Medical Press Ltd, 2024) Genç, Şerife Özlem; Erdal, Hüseyin
Pregnancy induces significant metabolic, immunological, and endocrinological changes to support fetal growth. The 75-gram oral glucose tolerance test (OGTT) is standard for gestational diabetes screening, but concerns exist about its potential to induce oxidative stress, affecting both maternal and fetal health. The aim of the study is examining changes in oxidative stress markers and thiol/disulfide homeostasis in pregnant women to evaluate these concerns. Patients and Methods: Thirty pregnant women undergoing gestational diabetes screening between the 24th and 28th weeks participated. Blood samples were collected at 0, 60, and 120 minutes as part of the OGTT protocol. Oxidative stress markers were analyzed only in samples from 0 and 120 minutes, while the 60-minute sample was used solely for glucose measurement. Results: Results showed a significant increase in TOS (p = 0.008) and OSI (p = 0.035) post-OGTT, indicating an acute oxidative stress response. Thiol and disulfide levels showed non-significant changes, suggesting that antioxidant mechanisms were largely unaffected. Conclusion: Further research is necessary to explore the long-term implications of these findings and develop strategies to mitigate oxidative stress during pregnancy. This study provides insights into the acute oxidative stress response caused by OGTT in pregnant women. Although the OGTT induces oxidative stress, it does not significantly disrupt the body’s antioxidant capacity in the short term. These results highlight the need for more research to understand the effects of heightened oxidative stress on maternal and fetal health.
A rare case of limb anomalies: Rothmund-Thomson syndrome
(University of Nis, Faculty of Medicine, 2024) Memiş, Sebahattin; Demirtaş, Mehmet Semih
Introduction. Rothmund-Thomson syndrome (RTS) or congenital poikiloderma is a rare autosomal recessive genodermatosis with involvement of many systems. The risk of mesenchymal malignancy is high in this disease which is accompanied by skin findings such as skin atrophy, hypohyperpigmentation, short stature, growth retardation, hypogonadism, nail and tooth dysplasia, limb abnormalities, and gastrointestinal system symptoms such as chronic diarrhoea and vomiting. Case report. A syndromic patient with thumb aplasia in bilateral fingers, hypopigmented and hyperpigmented macular lesions on the skin, and hypogonadism was referred to the Pediatric Genetics Department and diagnosed with RTS. Conclusion. In this rare disease, early diagnosis, awareness of possible malignancies, and a multidisciplinary treatment approach plan are required.
Increased PCSK9 associated with cIMT in AS: A useful marker for subclinical atherosclerosis in patients with ankylosing spondylitis
(Turkish League Against Rheumatism (TLAR), 2024) Karakoyun, Ahmet; Akkubak, Yasemin; Göktepe, Mevlüt Hakan; Yılmaz, Pınar Diydem; Kadıyoran, Cengiz; Oğul, Mustafa; Kucuk, Adem
This study aims to investigate the relationship between proprotein convertase subtilisin/ kexin type 9 (PCSK9) levels and subclinical atherosclerosis (SA) in patients with ankylosing spondylitis (AS). Patients and methods: Between January 2022 and March 2022, a total of 56 patients (33 males, 23 females; mean age: 37.8±9.3 years; range, 20 to 60 years) who were under regular follow-up in our clinic and fulfilled the criteria of the Modified New York Diagnostic Criteria for AS and American College of Rheumatology (ACR) for AS were included. Age-and sex-matched 56 healthy volunteers (25 males, 31 females; mean age: 38.4±8.2 years; range, 20 to 60 years) were also recruited as the control group. Demographic, clinical, and laboratory data were recorded. The PCSK9 level and carotid intima-media thickness (cIMT) were evaluated using appropriate methods. Results: The mean serum PCSK9 levels in AS patients (609.3±149.9 vs. 136.3±120.8 ng/mL, p<0.001) and the mean cIMT values (0.51±0.19 vs. 0.43±0.08 mm, p=0.003) were higher than healthy controls. In the multivariate stepwise regression analysis, there was an independent relationship between SA and PCSK9 (?=0.324, p=0.001). Additionally, there was an independent relationship between carotid plaque and PCSK9 (?=0.265, p=0.006). Based on the receiver operating characteristic curve analysis, the optimal PCSK9 cut-off value for plaque was 472.0 ng/mL, sensitivity 90.9%, specificity 65.0% (area under the curve [AUC]=0.759; 95% CI: 0.660-0.857, p=0.005). The optimal PCSK9 cut-off value for SA was 459.5 ng/mL, sensitivity 63.2%, specificity 63.0% (AUC=0.625; 95% CI: 0.512-0.739, p=0.031). Conclusion: Our study showed that serum PCSK9 levels in patients with AS were higher than that in healthy individuals and were associated with SA and arterial plaque formation.
Rotavirus vaccination status in rotavirus infection presenting to pediatric emergency department
(Aksaray Üniversitesi, 2025) Memiş,Sebahattin; Demirtaş, Mehmet Semih; Mutlu, Hüseyin; Erdal, İzzet; Kılıçaslan, Cengizhan; Kokulu, Kamil; Sert, Ekrem Taha; Yazıcı, Ramiz
Objectives
Yedi yaş altı çocuklarda yanık yaralanmalarının değerlendirilmesi
(Mersin Üniversitesi Sağlık Bilimleri Enstitüsü, 2024) Tuşat, Mustafa; Demirtaş, Mehmet Semih
Ebeveyn/bakıcı güvenlik ihmalinden kaynaklanan çocukluk çağı yanıkları, çocukluk çağı morbidite ve mortalitesinde rol oynayan önemli bir halk sağlığı sorunudur. Bu çalışmada, güvenlik ihmali sonucu oluşan yanık yaralanması nedeniyle acil servise başvuran çocukların tanımlayıcı özelliklerini araştırmayı amaçladık. Yöntem: Çalışmamız 01.01.2020 ile 31.12.2023 tarihleri arasında Aksaray Eğitim ve Araştırma Hastanesi Çocuk Acil Servisine başvuran yedi yaş altı toplam 122 yanık hastası ile yürütüldü. Sosyodemografik özellikler ve yanıkla ilgili bilgiler anket uygulamasıyla ve hasta dosyalarının geriye dönük taranmasıyla elde edildi. Bulgular: Yanıkların %84.4'ü (n=103) ev içinde, %15.6'sı (n=19) ev dışında meydana gelmiş idi. Evdeki yanıkların %45.1'i (n=55) oturma odasında/salonda ve %29.5'i (n=36) mutfakta meydana gelmiş idi. Su, çorba gibi sıcak sıvı dökülmesine bağlı yanıklar %49.2 (n=60); soba veya ütü temasına bağlı yanıklar %12.3 (n=15); çay ve kahve içimi sırasında dökülme sonucu yanıklar %20.5 (n=25) sıklıkta saptandı. Çocukların %72.1’inde (n=88) yanığın 12.00-21.50 saatleri arasında gerçekleştiği görüldü. Üç yaş altı çocuklarda en sık görülen yanık nedeni üzerlerine sıcak sıvı dökülmesi sonucu oluşan haşlanma yanıkları iken, beş yaş üstü çocuklarda en sık ateşle oynama ve elektrik çarpması sonucu oluşan yanıklar tespit edildi (p=0.005). Sonuç: Ebeveynler üç yaş altı çocuklarda haşlanma yanıkları konusunda daha dikkatli olmalıdır. Anneler, evde daha aktif ve yoğun çalıştıkları saatlerde gözetim ihmali durumuna dikkat etmelidir. Yanıkların görülme sıklığını azaltmak için ebeveyn eğitimi ve farkındalığı sağlanmalıdır.
Assessment of the educational value of undescended testicle operation videos on YouTube
(İnönü Üniversitesi Tıp Fakültesi, 2024) Tuşat, Mustafa; Çalapoğlu, Ahmet Salih; Demirtaş, Mehmet Semih
Today, Youtube, which is also used as a source of health information, is one of the most visited social platforms. The aim of this study was to evaluate the content and reliability of videos on undescended testicular operations for surgeons and parents. Materials and Methods: On 25/9/2023, the keywords "undescended testicle operation," "orchiopexy," and "children" were searched on the YouTube search engine. The selected videos were divided into two groups: useful and misleading. In addition to the descriptive characteristics of the videos, the reliability, quality and content of the videos were analysed using the global quality score (GQS), modified DISCERN (mDISCERN), and video power index (VPI) score. Results: Of the 62 videos evaluated in our study, 69.4% (n=43) were of high quality, 14.5% (n=9) were of medium quality and 16.1% (n=4) were of low quality. GQS and mDISCERN scores were higher in the useful group (p=0.002, p=0.001, respectively). While 91.1% (n=51) of the videos in the useful group were addressed to healthcare professionals (p=0.024), 78.6% (n=44) of these videos were uploaded by physicians. A positive correlation was observed between GQS and mDISCERN scores (p<0.001). Conclusion: Videos uploaded by academicians, surgeons and addressed to health professionals were found to be reliable and of high quality. Undescended testicular operations videos uploaded to social platforms should be prepared by a committee with health professionals and checked for compliance with scientific standards.
Revolutionizing vision restoration: Unleashing the power of Bowman’s layer transplantation
(Ali Cangül, 2024) Akbulut Yağcı, Betül; Karataş, Ezgi; Utine, Canan Aslı
Bowman layer inlay and outlay transplantation is a cutting-edge surgical technique that has revolutionized the field of corneal transplantation. This novel technique entails the transfer of the Bowman layer, a slender layer of the cornea, with the purpose of rectifying diverse corneal abnormalities and enhancing visual results. The Bowman layer inlay and outward transplantation approach differs from typical corneal transplantation methods by specifically targeting and replacing the affected layer of the cornea, rather than replacing the whole cornea. This method has many benefits, including accelerated healing periods, less chance of rejection, and enhanced visual acuity. Bowman layer inlay and outlay transplanting is recommended for several corneal diseases and illnesses. Common indications for this operation include keratoconus, corneal dystrophies, corneal scarring, corneal ectasia, and corneal abnormalities. This article will examine the complexities of Bowman layer inlay and outward transplanting, its uses, and the possible advantages it provides to individuals with corneal diseases. Bowman layer inlay and outlay transplanting appropriateness for each unique instance is evaluated by a comprehensive review of the patient’s particular condition and demands.
Oertli vitrektomi cihazı: OS4
(Ahmet YILDIRIM, 2024) Gürlevik, Uğur; Dalokay, Cumali; Mutlu, Kayhan
Vitrectomy operations, which started with the construction of the first prototypes of vitrectomy devices in the early 1970s, have become increasingly widespread in parallel with technological developments until today. With the developments in pump systems, lighting systems, and laser systems, patient safety and surgeon comfort are increasing. There are many companies producing vitrectomy devices in the market. Each device has some features that are superior to the others. The current vitrectomy device of Oertli, which has been working in this field since the prototype of the first vitrectomy device, is OS4. In this review, we will give information about the OS4 vitrectomy device of Oertli.
Three-year analysis of confirmatory testing outcomes in individuals with positive anti-HIV screening results
(Effect Publishing Agency ( EPA ), 2024) Kalaycı, Hacer Özlem; Gürpınar, Ahmet Burak; Erdal, Hüseyin; Çalgın, Mustafa Kerem
Despite the increase in preventive health measures and awareness-raising efforts against HIV worldwide, it continues to be a significant global public health problem today. This study aims to determine anti-HIV seropositivity, trends in false-positive rates, and demographic characteristics of patients with reactive anti-HIV test results. In this retrospective study, anti-HIV test results of a total of 55,763 patients between January 2021 and December 2023 were analyzed. Samples were studied with anti-HIV fourth-generation ELISA test (Roche Diagnostics, Mannheim, Germany). Reactive samples were sent to the National HIV-AIDS Confirmation and Viral Hepatitis Reference Laboratory for confirmation. Of the 55,763 samples evaluated, 169 (0.30%) were found to be reactive with the anti-HIV fourth-generation ELISA test (Cobas e 601, Roche, Mannheim, Germany). The confirmation test result of 75 patients was positive and 94 patients were negative. Patients with positive confirmation test results constituted 0.13% of all patients examined. Of the patients with positive confirmation results, 68 (90.7%) were male and 7 (9.3%) were female. When we examined the age groups, the HIV positivity rates were found to be 59% in the <35 age group and 57.8% in the 35-55 age group. As a result of this retrospective study, the results of HIV seropositivity in gender and age groups were found to be consistent with both our country's data and other studies conducted in our country. The high rate of false positive results in screening tests showed the importance of confirmatory tests.
Prognostic indicators in patients with isolated thoracic trauma: A retrospective cross-sectional study
(Turkish Association of Trauma and Emergency Surgery, 2024) Yazıcı, Ramiz; Bulut, Bensu; Genc, Murat; Akkan Öz, Medine; Hanalıoğlu, Damla; Kokulu, Kamil; Sert, Ekrem Taha; Mutlu, Hüseyin
Thoracic trauma is a significant cause of mortality, especially among those arriving at hospitals. This study explores the associations between mortality, the shock index (SI), and specific metabolic and biochemical markers in patients with isolated thoracic trauma. METHODS: This retrospective cross-sectional study included all consecutive adult patients presenting with isolated thoracic trauma to a high-volume emergency department from January 2019 to December 2023. The predictive capability of SI levels and selected biomarkers upon admission for estimating mortality was assessed by determining the areas under the receiver operating characteristic curves (AUCs). Optimal cutoff values were determined using the Youden index method. RESULTS: The study involved 352 patients, with 285 (81%) being males and an average age of 50.0±17.7 years. The mortality rate was 9.6%. Mortality was significantly associated with higher shock index (odds ratio [OR]: 14.02, [95% confidence interval [CI] 0.8470.916], AUC=0.885, p=0.001), glucose/potassium ratio (OR: 1.24 [95% CI 1.14-1.35], AUC=0.869, p<0.001), and lactate levels (OR: 4.30 [95% CI 2.29-8.07], AUC=0.832, p<0.001). The optimal cutoff values determined for the shock index, glucose/potassium ratio, ionized calcium, and lactate were 1.02 (sensitivity, 94.1%; specificity 69.5%; positive predictive value [PPV], 24.8; negative predictive value [NPV], 99.1), 36.85 (sensitivity, 76.5%; specificity, 87.7%; PPV, 40.0; NPV, 97.2), 1.23 (sensitivity, 94.1%; specificity, 56.0%; PPV, 18.6; NPV, 98.9), and 1.98 (sensitivity, 70.6%; specificity, 80.5%; PPV, 27.9; NPV, 96.2), respectively. CONCLUSION: This study demonstrates that higher shock index, glucose/potassium ratio, and lactate levels are significantly associated with increased mortality in patients with isolated thoracic trauma. These findings suggest that these markers can be effective prognostic indicators, potentially guiding clinical decision-making and improving patient outcomes.
Diagnostic role of serum testican and ubiquitin levels in patients with head trauma
(Pharmamed Mado Ltd, 2024) Yazıcı, Ramiz; Basa Kalafat, Ayşe Fethiye; Mutlu, Hüseyin; Sarı, Eyüp; Kalafat, Utku Murat; Atik, Dilek; Cander, Başar
We aimed to determine if testican-1 and ubiquitin can serve as early indicators for diagnosing worsening clinical course (presence of intraparenchymal pathology) and mortality in patients with moderate traumatic brain injury (TBI).In this study, we conducted an observational and prospective study in the Emergency Department (ED) of a tertiary care hospital. The department admitted an average of 25,000 patients per month between October 2020 and March 2021. We focused on patients over 18 years old with moderate traumatic brain injury (Glasgow coma score (GCS): 9–13). We compared the prognostic values of blood testican and ubiquitin levels with Receiver Operating Characteristic (ROC) analysis for intracranial pathologies resulting from head trauma. Additionally, we used logistic regression analysis to compare the effectiveness of these markers in diagnosing intraparenchymal injury. The study included a total of 89 patients, with 45 in the case group (moderate TBI) and 44 in the healthy control group. It was found that levels of ubiquitin and testican levels were significantly higher in patients with intraparenchymal pathology (p = 0.048, p = 0.046, respectively). The cut-off point for detecting intraparenchymal pathology was 161.3 pg/mL for testican (Area under curve (AUC): 0.810; min: 0.654; max: 0.965, p = 0.002) and 44.42 ng/mL for Ubiquitin (AUC: 0.863; min: 0.727; max: 1.000, p < 0.001). High testican-1 and ubiquitin levels were independent markers for intraparenchymal pathology in moderate head trauma.
Effectiveness of senna in treating chronic constipation in geriatric patients presenting to the emergency department: a randomized, double-blind, multicenter study
(Turkish Geriatrics Society, 2024) Sanalp Menekşe, Tuğba; Sarıtaş, Ayhan; Güçlü Utlu, Sibel; Akan, Ayşe Şule; Tekin, Erdal; Ergin, Mustafa
Chronic constipation is prevalent in the geriatric population. Undiagnosed and untreated constipation can lead to complications and decreased health-related quality of life. The aim of this study was to compare the therapeutic effectiveness of senna alone with a combination of bisacodyl and senna in patients diagnosed with chronic constipation. Materials and Method: This prospective, multicenter, double-blind, randomized controlled trial included patients aged 65 years and older who presented to the emergency department with chronic constipation, diagnosed according to the Rome IV criteria, between July and October 2023. Patients were randomly assigned to either the senna group (20 mg sennoside B) or the senna + bisacodyl group (3 mg sennoside B + 5 mg bisacodyl). Participants took the drugs twice daily for 28 days. The Constipation Scoring System and Patient Assessment of Constipation Quality of Life scores were calculated before and after treatment for each patient. Results: The study included 105 patients, with 54 in the senna group and 51 in the senna + bisacodyl group. There was a statistically higher need for dose reduction because of drug side effects in the senna + bisacodyl group compared with the senna group (p=0.026). Following treatment, the senna group had a higher score on the Constipation Scoring System and Patient Assessment of Constipation Quality of Life compared with the senna + bisacodyl group, and the difference was statistically significant (p<0.001, p=0.012). Conclusion: In geriatric patients, short-term treatment of chronic constipation with senna is more effective than senna+bisacodyl regarding constipation severity and quality of life.
Evaluating the quality and reliability of YouTube videos on scabies in children: A cross-sectional study
(Public Library of Science, 2024) Özdemir Kaçer, Emine; Kaçer, İlayda
Recently, there has been an increase in scabies cases among young children in low- and middle-income countries. With the rise of online health information, platforms such as YouTube have become popular sources of disease-related content, but the accuracy of this information remains a concern. Aim This study evaluates the reliability and quality of YouTube videos concerning scabies in children to address the lack of research in this area. Materials and methods A cross-sectional analysis was conducted on April 1, 2024, reviewing the first 200 relevant YouTube videos with the search terms “scabies” and “scabies in children.” Videos were assessed using modified DISCERN (mDISCERN), Global Quality Score (GQS), and Journal of the American Medical Association (JAMA) scoring systems. Statistical analysis included descriptive statistics, Kruskal-Wallis tests, and Spearman correlation analysis. Results Out of 200 videos, 107 met the inclusion criteria. The average mDISCERN score was 2.17, GQS was 2.63, and JAMA was 2.05, indicating generally poor quality. Videos by patients had the highest quality scores, while those from academic institutions had the highest JAMA scores. Longer videos with higher view counts were associated with better quality. Conclusion This study reveals that the majority of YouTube videos on scabies in children are of low quality. There is a need for healthcare professionals to produce more accurate and reliable content to improve the quality of information available on YouTube. Further research should focus on enhancing the quality of health information on digital platforms.
Can ChatGPT provide quality information about fever in children
(John Wiley and Sons Inc, 2024) Özdemir Kaçer, Emine; İpekten, Funda
Artificial intelligence (AI) systems hold great promise in improving medical care and health problems. Aim: We aimed to evaluate the answers by asking the most frequently asked questions to ChatGPT for the prediction and treatment of fever, which is a major problem in children. Methods: The 50 questions most frequently asked about fever in children were determined, and we asked them to ChatGPT. We evaluated the responses using the quality and readability scales. Results: While ChatGPT demonstrated good quality in its responses, the readability scale and the Patient Education Material Evaluation Tool (PEMAT) scale used with materials appearing on the site were also found to be successful. Among the scales in which we evaluated ChatGPT responses, a weak positive relationship was found between Gunning Fog (GFOG) and Simple Measure of Gobbledygook (SMOG) scores (r = 0.379) and a significant and positive relationship was found between FGL and SMOG scores (r = 0.899). Conclusion: This study sheds light on the quality and readability of information regarding the presentation of AI tools, such as ChatGPT, regarding fever, a common complaint in children. We determined that the answers to the most frequently asked questions about fire were high-quality, reliable, easy to read and understandable.
Artificial intelligence application for identifying toxic plant species: A case of poisoning with Datura stramonium
(Elsevier Ltd, 2024) Kokulu, Kamil; Sert, Ekrem Taha
The management of plant poisonings in the emergency department (ED) presents various challenges. Foremost among these is the identification of the specific botanical species responsible for the toxic effect. In cases of plant poisoning, it is crucial to accurately identify the plant in order to promptly evaluate if it has cardiotoxic, neurotoxic, hepatotoxic, or anticholinergic properties. Furthermore, it is typically not possible to determine the identity of these plants through blood tests conducted in the ED. Case report: An otherwise healthy 23-year-old male patient presented to the ED with symptoms of restlessness, altered mental state, and hallucinations that occurred 2 h after consuming herbal tea. On physical examination, he was tachypneic, tachycardic, and disoriented. The pupils were bilaterally mydriatic. The patient's symptoms were consistent with both sympathomimetic and anticholinergic (antimuscarinic) toxidromes. We were unable to promptly reach a botanist to identify the plant to which the patient had been exposed. Therefore, we employed Google Gemini, an artificial intelligence software, to ascertain the plant's identity. Google Gemini identified the plant we photographed as Datura stramonium, commonly known as jimson weed, which is known to cause anticholinergic toxicity. The botanist we contacted later confirmed that the plant was D. stramonium. The patient's symptoms were alleviated with the use of intravenous diazepam and physostigmine. Conclusion: We propose that the utilization of artificial intelligence applications with visual recognition capabilities could be beneficial for physicians, patients, and foragers of edible wild plants to accurately identify plants and distinguish toxic species.
Protective feature of anzer propolis in contrast-induced nephropathy in rats
(Effect Publishing Agency ( EPA ), 2024) Sarıtaş, Hazen; Görücü, Fatma; Demirel, Hasan Hüseyin; Bülbül, Aziz; Sarıtaş, Tuba Berra; Koç, Yusuf; Sarıtaş, Zülfükar
The study aims to ascertain whether Anzer Propolis, a natural antioxidant compound, can protect the kidneys from iopromide. Material and Method: This study was done in 2021. Four groups of 32 adult male Wistar albino rats, weighing between 250 and 300 g, were formed. Control (C) group contained eight rats. Intraperitoneal ethanol was administered to the Ethanol (E) group (n=8), 8 g/ kg intraperitoneal iopromide to the contrast-induced nephropathy (CIN) group (n=8), and a 100 mg/kg dose of Anzer Propolis on the date of application to the Anzer Propolis group (AP) (n=8), as well as the prior day, by gastric gavage and then 8 g/kg iopromide was administered intraperitoneally. Termination was carried out at the 48th hour. Histopathological examination was performed for CIN in the right and left kidneys. Results: Following has been examined as a part of the research: serum urea, creatinine, IL6, interleukin (IL)-1?, total oxidant status (TOS), tumor necrosis factor (TNF-?), total antioxidant status (TAS), myeloperoxidase (MPO). TAS had a statistically significant increase in AP, in comparison to CIN, C and E groups (p<0.05). The pathological examination showed, vacuolar degeneration formations in tubular epithelial cells, and increase in mononuclear cell infiltration areas in the interstitial region in CIN. CIN had significantly higher values in comparison to AP (p<0.05). Conclusion: Propolis protects the kidney tissue against the toxicity caused by CIN and negative effects of free radicals; most likely due to the antioxidant and antitoxic properties. Propolis is a promising natural substance for preventing CIN. There is a need for further research on the properties of propolis.
Prevalence and risk factors of attention deficit hyperactivity disorder in children admitted to the emergency department due to traumas
(Turkish Association of Trauma and Emergency Surgery, 2024) Yazıcı, Ramiz; Mutlu, Hüseyin; Kılıçaslan, Cengizhan; Sert, Ekrem Taha; Kokulu, Kamil; Kara, Halil; Kılıçaslan, Murat; Ekici, Mustafa; Bulut, Bensu
This study aims to determine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the associated risk factors in children admitted to the Emergency Department (ED) due to traumas. METHODS: EChildren aged 3-16 years admitted to the ED for traumas were included in the study. The control group consisted of children aged between 3-16, who visited the pediatric ED for non-traumatic reasons. The Revised Conners Parent Rating Scale (CPRS-R) was administered to parents who agreed to participate following initial intervention and stabilization. Trauma patients were divided into two groups: those diagnosed with ADHD and those without ADHD. Risk factors likely to increase the identification of ADHD were assessed. RESULTS: The study included 917 children, with both groups showing similar characteristics regarding age, sex, demographic, and cultural factors. The most common reason for ED visits was extremity traumas, accounting for 296 (35.2%) cases. The majority of trauma patients (95.9%) were discharged from the ED after outpatient interventions. All subscale scores of the CPRS-R, except for the social problems subscale, were significantly higher in the study group compared to the control group. Factors that increased the risk of ADHD included admission with extremity traumas (p<0.001), previous ED admissions due to traumas (p<0.001), and having a family member previously diagnosed with ADHD (p<0.001). CONCLUSION: The prevalence of ADHD symptoms may be higher in children admitted to the ED due to traumas. Furthermore, extremity traumas, previous trauma-related ED-admissions, and a family history of ADHD increase the risk of ADHD
Hormone-binding proteins and their associated hormones in patients with nephrotic syndrome
(Bayrakol Medical Publisher, 2024) Turgut, Mustafa; Hatemi, Hasan Huesrev
In the current study, we aimed to evaluate SHBG and TBG levels and their related hormone levels in patients with nephrotic syndrome and the control group. Material and Methods: The current study was conducted at Istanbul University Cerrahpa & scedil;a Faculty of Medicine, Department of Internal Medicine, with a total of 33 patients and 11 healthy controls. The study groups were divided into 3 groups: normal serum creatine level, high serum creatine level and control group. SHBG, TBG, T3, T4, fT3, fT4, TSH, testosterone, free testosterone, prolactin, FSH, and LH levels were determined in all groups. Proteinuria, hypoalbuminemia, and hyperlipidemia were present in the patient groups. Results: The mean age was 31.0 +/- 11.0 years (Group 1), and 46 +/- 15 years (Group 2) in patients with nephrotic syndrome. In the control group, the mean age was 29.0 +/- 7.0 years. TBG, T3, T4, fT3, fT4 and TSH levels were found to be lower in the patient groups than in the control group. No statistically significant correlation was detected between SHBG and TGB and albumin, globulin and proteinuria, which are indicators of nephrotic syndrome. Discussion: Nephrotic syndrome has important effects on the metabolism and regulation of protein or protein-protein-bound hormones and prohormones. This study indicates that individuals with nephrotic syndrome experience notable changes in SHBG, TBG, and related hormones. It can be said that this situation occurs as a result of the loss of both hormones and the proteins that bind these hormones from the kidneys.
Psoriatic skin transcript phenotype: androgen/estrogen and cortisone/ cortisol imbalance with increasing DNA damage response
(Springer Science and Business Media B.V., 2024) Başar Kılıç, Şeyma; Taheri, Serpil; Mehmetbeyoğlu Duman, Ecmel; Öksüm Solak, Eda; Yılmaz Şükranlı, Zeynep; Rassoulzadegan, Minoo; Borlu, Murat
Patients prone to psoriasis suffer after a breakdown of the epidermal barrier and developpoorly healing lesions with abnormal proliferation of keratinocytes. Strong inflammatory reactions withgenotoxicity (short telomeres) suggest impaired immune defenses with DNA damage repair response(DDR) in patients with psoriasis. Recent evidence indicates the existence of crosstalk mechanismslinking the DDR machinery and hormonal signaling pathways that cooperate to influence bothprogressions of many diseases and responses to treatment. The aim of this study was to clarify whethersteroid biosynthesis and genomic stability markers are altered in parallel during the formation ofpsoriatic skin. Understanding the interaction of the steroid pathway and DNA damage response iscrucial to addressing underlying fundamental issues and managing resulting epidermal barrierdisruption in psoriasis. Methods: Skin (Lesional, non-lesional) and blood samples from twenty psoriasis patients and fifteen healthy volunteers were collected. Real-Time-PCR study was performed to assess levels of known transcripts such as: estrogen (ESR1, ESR2), androgen (AR), glucocorticoid/mineralocorticoid receptors (NR3C1, NR3C2), HSD11B1/HSD11B2, and DNA damage sensors (SMC1A, TREX1, TREX2, SSBP3, RAD1, RAD18, EXO1, POLH, HUS1). Results: We found that ESR1, ESR2, HSD11B1, NR3C1, NR3C2, POLH, and SMC1A transcripts were significantly decreased and AR, TREX1, RAD1, and SSBP3 transcripts were increased dramatically in the lesional skin compared to skin samples of controls. Conclusion: We found that the regulation of the steroidogenic pathway was disrupted in the lesional tissue of psoriasis patients and that a sufficient glucocorticoid and mineralocorticoid response did not form and the estrogen/androgen balance was altered in favour of androgens. We suggest that an increased androgen response in the presence of DDR increases the risk of developing psoriasis. Although this situation may be the cause or the consequence of a disruption of the epidermal barrier, our data suggest developing new therapeutic strategies.
Breaking the cycle: How physical therapy modalities impact emergency department visits in patients with chronic low back pain
(Galenos Publishing House, 2024) Akyıldız Tezcan, Ezgi; Çağlar, Ahmet; Sanalp Menekşe, Tuğba
Low back pain (LBP) is a common health problem worldwide and ranks among the top ten reasons for emergency department (ED) visits, although most cases do not require immediate care. This study aimed to compare ED visits for LBP during a 6-month follow-up period between patients receiving a home-based exercise program and those receiving additional physical therapy (PT) modalities, exploring a previously uninvestigated aspect. Materials and Methods: This retrospective study included 419 patients with chronic LBP treated at the Department of Physical Medicine and Rehabilitation from July 2021 to January 2023. Patients were divided into two groups: those who received a home-based exercise program and those who received PT modalities in addition to exercise programs. Using appropriate statistical methods, the two groups were analyzed for their ED visits and potential influencing factors during a 6-month follow-up period. p<0.05 was accepted as statistically significant. Results: Patients receiving physiotherapy had significantly fewer ED visits during the 6-month follow-up period (p=0.001). No association was observed between ED visits and patient demographics. Conclusion: The study demonstrated that integrating PT modalities into the management of chronic LBP resulted in fewer ED visits.

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