The Incidence and Risk Factors of Early Periprosthetic Joint Infections.

Objective: Periprosthetic joint infections (PJI) represent major complications in arthroplasty, contributing to increased patient morbidity and imposing substantial financial burdens. Meticulous surveillance of PJI occurrences and identification of associated risk factors is imperative for accurately gauging the incidence rates and implementing proactive infection control measures. This study aimed to ascertain the early incidence of PJI and elucidate the key risk factors involved in its occurrence. Materials and Methods: This monocentric, prospective descriptive study conducted between June 2018 and June 2019, including all patients aged 18 years and above who underwent hip and knee arthroplasty. The research documented and evaluated patient demographic characteristics, clinical findings, laboratory results, treatment practices, and potential risk factors associated with the surgical process. After the 90-day postoperative period, patients were categorized into PJI and non-PJI groups, allowing for a comprehensive comparison of identified risk factors. Results: This study identified a cohort of 590 patients, of whom 185 underwent hip arthroplasties (31.4%) and 405 underwent knee arthroplasties (68.6%). The average age of the patients was 65.2 years, with females constituting 80.2% of the population. The overall incidence of early PJI was found to be 2.88% (n=17). Following hip arthroplasties, the PJI incidence was 4.86%, while knee arthroplasties exhibited a lower incidence of 1.9%. Several potential risk factors associated with PJI were identified, including comorbid diseases (adjusted odds ratio [aOR]=3.35, 95% confidence interval [CI]=1.18-9.47), preoperative length of stay (aOR=0.89, 95% CI=0.79-1.01), postoperative erythrocyte suspension replacement (aOR=1.96, 95% CI=0.71-5.44), and a National Nosocomial Infections Surveillance System (NNIS) score of 1 or higher (aOR=3.10, 95% CI=1.10-8.71). These factors were identified as potential contributors to the risk of PJI in patients undergoing hip and knee arthroplasties. Conclusion: Compared to other reported outcomes in the literature, this study observed a higher incidence of early-stage PJI. The higher incidence may be due to PJI surveillance deficiencies such as difficulty in post-discharge surgical site infection (SSI) follow-up, reporting, and bacterial sampling. This discrepancy underscores the importance of actively monitoring patients with risk factors for PJI development, including medical comorbidities and a high NNIS score. Implementing prospective active surveillance in such cases is deemed crucial for the timely identification and management of PJI.

Assessment of metacognition and retinal optical coherence tomography findings in shift workers.

It is known that working in the shift system, especially the night shift, affects physical, mental, and social well-being. We investigated the changes in the inner retinal layers and choroidal layer of the eyes of nurses working night and day shifts using optical coherence tomography (OCT). We also explored the effect of night shift work on metacognition and the relationships between these variables. A total of 79 nurses participated in the study, of whom 40 worked night shifts. The researcher gave the participants sociodemographic information and the Metacognition Questionnaire-30 (MCQ-30) form. Retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, inner nuclear layer (INL) thickness, inner plexiform layer (IPL) thickness, central macular thickness (CMT), and subfoveal choroidal thickness (SFCT) were measured with OCT. It was found that the level of metacognitive activity associated with cognitive confidence was higher (p = 0.044) for nurses who worked night shifts and that the level of metacognitive activity associated with cognitive awareness was lower (p = 0.015) for nurses who worked night shifts. RNFL-nasal superior (NS) thickness was lower in night shift workers than the day shift group (p = 0.017). Our study revealed significant relationships between metacognition and the OCT findings among night and day shift workers. Our study revealed that RNFL measurements and metacognitive activity may differ and there may be a relationship between these parameters in nurses who work shifts. Further research is needed to investigate the long-term effects of night shift work on retinal health.

The Impact of Vaccination Among Hospitalized Patients with the Diagnosis of COVID-19.

Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients. Materials and Methods: This multi-center point-prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status. Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower (p=0.021). Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection.

Reward Processing Deficits During a Spatial Attention Task in Patients With ADHD: An fMRI Study.

OBJECTIVE: In this study, we aimed to explore how cues signaling rewards and feedbacks about rewards are processed in ADHD. METHOD: Inside the scanner, 16 healthy children and 19 children with ADHD completed a spatial attention paradigm where cues informed about the availability of reward and feedbacks were provided about the earned reward. RESULTS: In ventral anterior thalamus (VA), the controls exhibited greater activation in response to reward-predicting cues, as compared with no-reward cues, whereby in the ADHD group, the reverse pattern was observed (nonreward > reward). For feedbacks; absence of rewards produced greater activation than presence in the left caudate and frontal eye field for the control group, whereas for the ADHD group, the reverse pattern was again observed (reward > nonreward). DISCUSSION: The present findings indicate that ADHD is associated with difficulty integrating reward contingency information with the orienting and regulatory phases of attention.

Gray Matter Increase in Motor Cortex in Pediatric ADHD: A Voxel-Based Morphometry Study.

OBJECTIVE: Several studies report that ADHD is associated with reduced gray matter (GM), whereas others report no differences in GM volume between ADHD patients and controls, and some even report more GM volume in individuals with ADHD. These conflicting findings suggest that reduced GM is not a universal finding in ADHD, and that more research is needed to delineate with greater accuracy the range of GM alterations. METHOD: The present study aimed to identify GM alterations in ADHD using pediatric templates. 19 drug-naïve ADHD patients and 18 controls, all aged 7 to 14 years, were scanned using magnetic resonance imaging. RESULTS: Relative to the controls, the ADHD patients had more GM, predominantly in the precentral and supplementary motor areas. Moreover, there were positive correlations between GM volume in these areas and ADHD scale scores. CONCLUSION: The clinical and pathophysiological significance of increased GM in the motor areas remains to be elucidated by additional research.

Executive dysfunction and cognitive subgroups in a large sample of euthymic patients with bipolar disorder.

Bipolar disorder (BP), at the group level, is associated with significant but modest cognitive deficits, including executive dysfunction. Among executive functions, response inhibition deficits have been suggested to be particularly relevant to BP. However, BP is associated with significant heterogeneity in neurocognitive performance and level of functioning. Very few studies have investigated neurocognitive subgroups in BP with data-driven methods rather than arbitrarily defined criteria. Other than having relatively small sample sizes, previous studies have not taken into consideration the neurocognitive variability in healthy subjects. Five-hundred-fifty-six euthymic patients with BP and 416 healthy controls were assessed using a battery of cognitive tests and clinical measures. Neurocognitive subgroups were investigated using latent class analysis, based on executive functions. Four neurocognitive subgroups, including a good performance cluster, two moderately low-performance groups, which differ in response inhibition and reasoning abilities, and a severe impairment cluster were found. In comparison to healthy controls, BP patients were overrepresented in severe impairment cluster (27% vs 5.3%) and underrepresented in good performance cluster. BP patients with lower educational attainment and older age were significantly more likely to be members of cognitively impaired subgroups. Antipsychotic use was less common in good performance cluster. These results suggest that there is a considerable overlap of cognitive functions between BP and healthy controls. Neurocognitive differences between BP and healthy controls are driven by a subgroup of patients who have severe and global, rather than selective, cognitive deficits.

The effect of Nigella sativa oil against Aspiculuris tetraptera and Hymenolepis nana in naturally infected mice.

OBJECTIVE: To investigate the antiparasitic effect of Nigella sativa oil (NSO) on Aspiculuris tetraptera (A. tetraptera) and Hymenolepis nana (H.nana) in mice in January 2005. METHODS: Mice were obtained from the animal house facility of the Faculty of Medicine, Yuzuncu Yil University, Van, Turkey. The natural infections were determined by the cellophane tape method and the centrifugal flotation method of stool samples. The infected mice with A. tetraptera and H.nana were divided into 4 groups; 2 treatment and 2 control groups. Nigella sativa oil was given at the dose of 250 ul/kg body weight orally for 2 consecutive days in the 2 treatment groups. All the mice were sacrificed on the seventh day after the last treatment. Gastrointestinal tract of the sacrificed animals was opened and washed with a serum physiologic. The contents were examined under a stereo microscope for counting and identifying of the parasites. The treatment and the control groups were compared using Mann-Whitney U-Test. RESULTS: Nigella sativa oil reduced both A. tetraptera and its eggs. The difference was significant between Group 1 and Group 3 (p<0.05). Nigella sativa oil reduced H.nana eggs starting from second day of the treatment until necropsy day during 5 days, but it was not significant between Group 2 and Group 4 (p>0.05). CONCLUSION: Antiparasitic effect of NSO is related to its stimulating immune system.

[Some biochemical parameters in sheep infected with endoparasites (Fasciola spp., Dicrocoelium dendriticum, hydatid cysts, Trichostrongylidae and Protostrongylidae)]. / Endoparazitli (Fasciola spp., Dicrocoelium dendriticum, kist hidatik, Trichostrongylidae ve Protostrongylidae) koyunlarda bazi biyokimyasal parametreler.

This study was performed in order to investigate the variations of some blood biochemical parameters as well as the levels of Vitamin. B(12) and some macro elements in sheep infected with endoparasites. The blood samples were taken from the sheep that were to be slaughtered in the Van Municipality Slaughterhouse while the stool samples were taken after the slaughtering of the same animals. The postmortem examinations were made to investigate for the presence of Fasciola spp., D. dendriticum and cyst hydatid infections. The stool samples were examined helminthologically using native, sedimentation, flotation and Baermann-Wetzel methods. The control group was composed of animals not showing any internal organ parasites or parasites in the stool examination. Following the macroscopic and the stool examination, the animals found to have the same type of parasites were considered to be the study group. According to the analyses performed on the animals, the levels of total protein (in Trichostrongylidae, hydatid cysts), globulin, amylase, chlorine, and Vit.B(12) were found to be increased significantly, while the levels of albumin, magnesium, and phosphorus were found to be decreased significantly. The other parameters analyzed were not significant statistically between the groups.

Comparison of two methods (microscopy and enzyme-linked immunosorbent assay) for the diagnosis of amebiasis.

Diagnosis of amebiasis is usually performed on a clinical basis alone in most endemic countries having limited economic resources. This epidemiological study was conducted using modern diagnostic tests for amebiasis in the southeastern region of Turkey, an endemic area for amebiasis. The population of this study included patients with symptomatic diarrhea/dysentery attending both Yuzuncu Yil University, Van and Harran University, Sanliurfa, Turkey. A total of 380 stool specimens were collected and examined for Entamoeba by light microscopy (fresh, lugol, and trichrome staining) and stool antigen detection based- enzyme-linked immunosorbent assay (EIA) test (TechLab Entamoeba histolytica II). 24% (91/380) of stool specimens were positive for E. histolytica/Entamoeba dispar trophozoites/cysts microscopically using trichrome staining. 13% (51/380) of the stool specimens were found to be positive for E. histolytica by the EIA test, including 15% (14/91) of microscopy (+) stool specimens and 13% (37/289) of microscopy (-) stool specimens. Enteric parasites were common in these populations with 66% (251/380) of the study population harboring more than one parasite. In addition to the 13% (51/380) of patients determined to have E. histolytica by EIA, eighty-six patients (22.6%) had Blastocystis hominis, 54 (14.2%) Entamoeba coli, 44 (11.5%) Giardia lamblia, 16 (4.2%) Chilomastix mesnili, 15 (3.9%) Iodamoeba bütschlii, 12 (3.1%) Hymenolepis nana, 9 (2.3%) Endolimax nana, 9 (2.3%) Dientamoeba fragilis, and 8 (2.1%) had Ascaris lumbricoides. We concluded that E. histolytica infection was found in 13% of the patients presenting with diarrhea in Van and Sanliurfa Turkey.

Morphologic, functional and behavioral effects of titanium dioxide exposure on nerves.

OBJECTIVES: The purpose of this study was to explore morphologic, functional, and behavioral effects of titanium dioxide (TiO(2)) on nerves. MATERIAL AND METHODS: A total of 17 albino rats were used for nerve conduction experiments, hot-plate tests, and histological evaluation. TiO(2) was implanted unilaterally on the sciatic nerves of five rats. Ten days after surgery, test and control nerves were dissected and their signal transduction speeds were quantified by suction electrodes in a bath containing a Tyrode solution. Twelve rats were divided into three equal groups resulting in equal number of nerves (n=8) for TiO(2) implantation, surgical exposure of the nerves, and for use as controls. One week after surgery, hot-plate tests were undertaken for 10 consecutive days to determine response latencies of the nerves. At the termination of the experiments, the nerves were harvested, processed, and examined under a microscope. RESULTS: The signal transduction speeds of TiO(2)-implanted nerves was similar to control specimens (P>0.05). The avoidance responses of TiO(2)-implanted, surgically exposed, and control nerves were comparable (P>0.05). At the cellular level, TiO(2) did not lead to any signs of adverse reactions on nerves. CONCLUSIONS: TiO(2), the main oxide surrounding endosseous titanium implants, does not alter the structure and the function of myelinated nerves.

Vascular response to titanium dioxide: a study on the rat carotid artery.

The purpose of this study was to explore the effects of titanium dioxide (TiO(2)) on vascular smooth muscle contractility with the use of the rat carotid-artery model. TiO(2) powder was implanted on right carotid arteries of five albino rats, the left arteries of which were left intact and served as controls. Fourteen days after placement, bilateral carotid arteries were removed and contraction/relaxation of isolated vessel rings were measured for dose-dependent epinephrine and acetylcholine administrations by a force displacement transducer. The data of each tissue specimen were collected with the use of a computerized system and corresponding software at a sample rate of 1000 kHz, and were expressed as contraction force. Contraction forces of control and TiO(2)-implanted vessel rings were similar (P > 0.05). TiO(2) does not appear to have adverse effects on vascular contractility.

Effects of machined/turned, TiO2-blasted and sandblasted/acid-etched titanium oral implant surfaces on nerve conduction: a study on isolated rat sciatic nerves.

The purpose of this study was to explore the clinical relevance of the effects of machined/turned, TiO(2)-blasted and sandblasted/acid-etched titanium oral implant surfaces on nerve conduction. Isolated rat sciatic nerves were placed between two suction electrodes in a pyrex bath containing a tyrode solution. Evoked compound action potentials (cAPs) of the nerves were recorded before and after contact with the implants. The mandibular incisors of randomly selected animals were extracted and changes in cAP amplitudes were used as controls. The differences in final cAP values of Astra Tech implants and rat natural teeth were insignificant (P < 0.05), whereas the differences between other groups were significant (P < 0.05). Machined/turned-surface implants did not cause any change in cAPs. A slight decrease in cAPs was observed for TiO(2)-blasted and sandblasted/acid-etched implants, and the natural teeth. The reductions of cAPs in latter groups were not 50% after an application time of 300 min. The cAP changes of nerves contacting TiO(2)-blasted and sandblasted/acid-etched oral implants fall within physiologic limits in vitro. Machined/turned, TiO(2)-blasted, and sandblasted/acid-etched titanium implant surfaces do not lead to irreversible neurotoxic effects.