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Objective: We aimed to evaluate the effect of mesh-urethra distance on sexual functions in continent patients who underwent transobturator tape (TOT) surgery due to isolated stress urinary incontinence. Material and Methods: Eighty-two continent patients who had undergone TOT surgery for stress urinary incontinence were included in the study. Objective treatment for stress urinary incontinence was defined as the absence of urine leakage during a stress test. Translabial perineal ultrasound was performed 6 months after the surgery. The successful surgical group was split into two subgroups based on the distance from the posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: < 5 mm and > 5 mm. In addition to these, band percentile, the descent of bladder neck and urethra length measured by perineal ultrasound, pubo-urethral distance, urethral thickness, detrusor thickness, cystocele descent, rectal descent, and uterine descent were evaluated. Preoperative and postoperative results of the standardized and internationally valid incontinence questionnaires Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) and Female Sexual Function Index (FSFI) were compared between groups. Results: The postoperative FSFI scores for the > 5-mm group were statistically significantly lower than those of the < 5-mm group, including the postoperative FSFI average, all subscales except lubrication, and average change scores due to the operation (p < .001). There was no statistically significant relationship between the percentile it occupied and postoperative FSFI level (p = .553), and FSFI preoperative-postoperative difference was not significant (p = .905). Conclusion: Sexual functions are more affected in patients with a mesh-urethra distance > 5 mm as observed via perineal ultrasound.
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AIM: Laparoscopic lateral suspension is a novel approach for repairing anterior and apical pelvic organ prolapse (POP). According to integral theory, urinary symptoms and pelvic pain are believed to originate from suspensory ligaments. We aimed to investigate the objective and subjective outcomes of adding sacroterine plication to apical prolapse surgery. METHODS: Sixty patients with Grade 2 or higher symptomatic apical POP were included in the study. The study sample was categorized into two groups: Group 1 underwent lateral suspension and Group 2 underwent lateral suspension and sacroterine plication. Anatomical cure was defined separately for the apical and anterior compartments as POP-Q scores for sites C and Ba of less than -1 cm for each compartment. A subjective cure was defined as the absence of bulge symptoms. Patient satisfaction, sexual function, prolapse-related quality of life, voiding dysfunction, nocturia, and constipation were assessed. RESULTS: In Group 1, anatomical cure rates for apical and anterior prolapse were 100% and 70%, respectively (p <0.001). In Group 2, these rates were 100% for apical prolapse and 73.3% for anterior prolapse (p <0.001). The subjective cure was 96.6% in both groups. Furthermore, improvement in sexual and urinary symptoms was more significant in the group that underwent sacroterine plication (p <0.001). CONCLUSIONS: The additional sacroterine plication (shortening) procedure with lateral suspension proved to be an effective and successful surgical approach for apical prolapse. Its routine addition to existing lateral suspension surgery can contribute significantly to the improvement of urinary and prolapse symptoms.
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Prolapso de Órgão Pélvico , Humanos , Feminino , Pessoa de Meia-Idade , Prolapso de Órgão Pélvico/cirurgia , Estudos Prospectivos , Idoso , Procedimentos Cirúrgicos em Ginecologia/métodos , Laparoscopia/métodos , Adulto , Resultado do Tratamento , Satisfação do PacienteRESUMO
OBJECTIVE: The objective of this study was to learn more about the prevalence and pathophysiology of depression and anxiety that may be caused by polycystic ovary syndrome and to make plans for taking necessary precautions for this vulnerable group. METHODS: This case-control study was conducted between January 2022 and October 2022. A total of 120 women with polycystic ovary syndrome and 143 controls were included in the study. All healthy volunteers and women with polycystic ovary syndrome were evaluated using self-administered questionnaires and physical examination. Anthropometric data such as weight and height and laboratory value were documented. RESULTS: There was no significant difference between the groups in terms of demographic characteristics. When the Hospital Anxiety and Depression Scale scores of both groups were compared, both depression and anxiety scores were found to be significantly higher in women with polycystic ovary syndrome compared with the control group (OR: 3.319, 95%CI, 1.563-7.047, p<0.001 and OR: 3.238, 95%CI, 1.659-6.315, p<0.001). In the Hospital Anxiety and Depression Scale questionnaire, the rate of irregular menstruation and Ferriman-Gallwey score were statistically significant in women with polycystic ovary syndrome with high depression and anxiety scores. While serum LH levels and LH/FSH ratios were significantly different in women with polycystic ovary syndrome with high depression scores, serum LH, LH:FSH ratios, and serum total testosterone levels were found significant in women with polycystic ovary syndrome with high anxiety scores. CONCLUSION: It is clear that depression and anxiety are more common in patients with polycystic ovary syndrome than in healthy women. Our findings support previous recommendations regarding routine screening for depression and anxiety in this population.
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Ansiedade , Depressão , Síndrome do Ovário Policístico , Humanos , Síndrome do Ovário Policístico/psicologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/sangue , Feminino , Estudos Transversais , Estudos de Casos e Controles , Adulto , Fatores de Risco , Depressão/epidemiologia , Depressão/etiologia , Ansiedade/etiologia , Ansiedade/epidemiologia , Adulto Jovem , Inquéritos e Questionários , Prevalência , Adolescente , Escalas de Graduação Psiquiátrica , Hormônio Luteinizante/sangueRESUMO
OBJECTIVES: Hypertrophy of the labia minora and majora, or a prominent clitoral hood, are the primary reasons why women, particularly those seeking cosmetic gynecologists, may experience limitations in their social environments. At the same time, modern trends have made labiaplasty popular in recent years. This study investigated the effect of labiaplasty on women's genital self-perception and sexual functions. MATERIAL AND METHODS: The composite reduction labiaplasty technique was performed on 33 women aged 18-50 with Grades 2-4 labia minora hypertrophy. The exclusion criteria included menopausal and sexually inactive women, as well as women with vulvar disorders, a history of vaginal or labial surgery, other gynecological disorders, psychological disorders, and malignancies. The Female Sexual Function Index (FSFI) and Female Genital Self-Image Scale (FGSIS) questionnaires were administered to the study subjects before and three months after their surgery, during their follow-up appointments. RESULTS: The mean age of the subjects was 30.73 ± 3.94 years. Their mean parity was 1.12 ± 0.82. Almost 70% of them had a university degree. Their most common reason for desiring labiaplasty was aesthetic concerns (48.48%). Their total FGSIS scores were 11.85 ± 1.35 preoperatively and 24.48 ± 1.66 postoperatively, and their total FSFI scores were 13.29 ± 1.68 preoperatively and 24.48 ± 1.66 postoperatively. CONCLUSIONS: Labiaplasty surgery is a safe surgical procedure. It has a positive effect on women's genital self-image and sexual functions.
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AIM: This study aimed to examine the relationship between internalized stigma and happiness levels of individuals diagnosed with schizophrenia. METHOD: This cross-sectional study was conducted between March and June 2021 with 100 individuals diagnosed with schizophrenia conducted in a Community Mental Health Centre in the Eastern Black Sea region of Turkey. Data were collected using Internalized Stigma of Mental Illness and the Oxford Happiness Questionnaire. RESULTS: A negative statistically significant relationship was determined between the Internalized Stigma of Mental Illness and Oxford Happiness Questionnaire. In addition, there was a positive correlation between the stigma resistance subdimension of the Internalized Stigma of Mental Illness and Oxford Happiness Questionnaire. The internalized stigma levels of the participating patients accounted for 35.1% of their happiness levels. The stigma resistance subdimension of the Internalized Stigma of Mental Illness scale affected the patients' happiness levels. CONCLUSION: There was a negative significant relationship between the individuals' internalized stigma and happiness levels. More comprehensive interventions are needed to combat the stigma of mental disorders in Türkiye so that individuals diagnosed with schizophrenia can lead a happy life in society.
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BACKGROUND: Trauma during pregnancy is one of the most important causes of non-obstetric maternal and fetal mortality and morbidity. The aim of our study is to evaluate the adverse perinatal outcomes that may occur according to the type and severity of the trauma. METHODS: In this retrospective cohort study, pregnant traumatized women aged 18-50 years and referred for consultation to the Prof. Dr. Cemil Tascioglu City Hospital's emergency services of the departments of gynecology and obstetrics, between January 1, 2017, and December 31, 2022, were evaluated. Demographic characteristics, trauma findings, Injury Severity Scoring (ISS), and obstet-ric outcomes were recorded. RESULTS: A total of 1825 trauma patients, including 900 pregnants were referred to our emergency gynecology clinic for consulta-tion. One hundred and fifty three pregnant patients, whose birth information we reached, were selected as the study group. The mean age of the patients was 25.56±5.99 years and the mean gestational week at the time of trauma was 21.59±9.89 weeks, the patients had fallen (67.97%), had been exposed to violence (30.07%), and had a traffic accient (1.96%). The patient's delivery and hospitalization status on the day of trauma, fracture and ISS ≥9 were statistically significantly at a higher rate in the 3rd trimester. Rates of hospitaliza-tion and 3rd trimester traumas were found to be significantly higher in the ISS ≥9 group. (P=0.0001, P=0.028, respectively). CONCLUSION: Compared to the general population, the rates of preterm premature rupture of membranes-premature rupture of membranes, fetal death, fetal distress, cesarean delivery, placental abruption, and preterm delivery increased in traumatized pregnant women. Patients with low ISS scores should also be followed closely during pregnancy in terms of perinatal complications, as well as the severe trauma group.
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Fraturas Ósseas , Placenta , Gravidez , Recém-Nascido , Humanos , Feminino , Adulto Jovem , Adulto , Escala de Gravidade do Ferimento , Estudos Retrospectivos , CesáreaRESUMO
BACKGROUND: We aim to share our popliteal sciatic nerve block (PSB) experience, which we applied to diabetic and nondiabetic patients in the operating room of our hospital. METHODS: The patients who underwent PSB for foot and ankle surgery between October 1, 2021, and December 31, 2021, in Sakarya University Training and Research Hospital were evaluated retrospectively. All nerve blocks were administered by a single anesthesiologist. Demographic data of the patients and the duration of the operation, the type of operation, the time of application of the nerve block, whether it was single or bifurcation block, and the onset times of motor and sensory block were also recorded in the perioperative period. RESULTS: It was determined that PSB was applied to 49 patients over a 3-month period. The mean age of the patients was 61.33 ± 14.03 years, and 12 patients (24.5%) were women. The reason why the patients were operated on was amputation in 21 (42.9%) and wound debridement in 27 (55.1%). There were 37 patients in the diabetic group and 12 patients in the nondiabetic group. There was no significant difference between the two groups in terms of demographic data and operation characteristics, but it was observed that there was a significant difference in both sensory and motor block formation times between the two groups (P < .001). CONCLUSIONS: In conclusion, we think that popliteal sciatic nerve block is easy to apply, the complication rate is low, and it is a suitable anesthesia method for patients who will undergo day surgery for foot ulcer.
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Diabetes Mellitus , Bloqueio Nervoso , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Nervo Isquiático/diagnóstico por imagem , Estudos Retrospectivos , Ultrassonografia , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodosRESUMO
Carbon based metallic additives were widely researched to improve combustion charecteristics of spark ignition and compression ignition engines. It was proven that carbon nanotube additive shortens ignition delay period and improves combustion characteristics especially in diesel engines. HCCI is a lean burn combustion mode which provides high thermal efficiency and simultaneously low NOx and soot emission. However it has drawbacks such as misfire at leaner mixtures and knocking at high loads. Carbon nanotube could be used to improve combustion for HCCI engines as well. The aim of this study is to investigate the effects of multi-walled carbon nanotube addition to ethanol and n-heptane blends on HCCI engine performance, combustion and emission by experimentally and statistically. During the experiments, the mixed fuels formed with %25 ethanol, %75 n-heptane and 100, 150 and 200 ppm MWCNT additives were used. The experiment of these mixed fuels was carried out at different lambda and engine speed values. Response Surface Method was implemented to determine optimal additive amount and operation parameters of the engine. The variable parameter values to be used in the experiments were created with the central composite design, and a total of 20 experiments were performed. According to the obtained results, IMEP, ITE, BSFC, MPRR, COVimep, SOC, CA50, CO and HC response parameter values were obtained. Response parameter values were entered into the RSM environment and optimization studies were carried out depending on the response parameters targets. Among the optimum variable parameter values, the MWCNT ratio was determined as 102.16 ppm, lambda 2.7 and engine speed 1124.439 rpm. Response parameter values after optimization were determined as IMEP 4.988 bar, ITE 45.988 %, BSFC 227.846 g/kWh, MPRR 2.544 bar/CA, COVimep 1.722 %, SOC 4.445 CA, CA50 7 CA, CO 0.073 % and HC 476.452 ppm.
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The aim of this study was to determine the effects of 6 h/day cold (35.0 °C) acclimatization between the 9th and 15th days of incubation of Japanese quail embryos on hatchability, livability, chick quality, developmental stability, fear response, live weight, and slaughter-carcass characteristics. Two homologous incubators and a total of 500 hatching eggs were used in the study. Randomly selected half of the eggs were exposed to cold according to the eggshell temperature. The cold acclimation of Japanese quail embryos had no adverse effects on all mentioned traits, except for chick quality. Chicks in the control group had higher Tona scores (99.46) than those exposed to cold (99.00) (P < 0.05). In addition, there were differences among the treatment groups in terms of the parameters of mature weight (ß0), instantaneous growth rate (ß2), and inflection point coordinates of the Gompertz growth model (P < 0.05 for all). It was found that exposing embryos to cold during the incubation changed the shape of the growth curve. As the development of embryos exposed to cold slows down, a compensatory growth occurs in the early posthatch period. Thus, the growth rate increased in the period before the inflection point of the growth curve.
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Galinhas , Coturnix , Animais , Temperatura Baixa , Temperatura , MedoRESUMO
Coastal areas face significant pressures from a variety of human activities, owing primarily to population growth in these areas. Human activities produce a variety of contaminants, including trace metals, which are common forms of contamination that enter marine ecosystems. This study was carried out to provide information on trace element concentrations (Hg, Pb, Cd, Cu, and Zn) in the muscles of Rapana venosa (Valenciennes, 1846) available on Sinop coasts of the southern Black Sea and to evaluate the possible risk associated with their consumption. The minimum and maximum values (mg/kg wet weight) of trace elements in the edible tissue of R. venosa decreased in the following order: Zn (1.75-8.53) > Cu (0.41-4.6) > Cd (0.021-0.255) > Pb (0.013-0.037) > Hg (0.010-0.035). The measured levels of all the trace elements in the present study were lower than the limits permitted by the European Community Regulation (EU), Turkish guideline, and the UK Ministry of Agriculture, Fisheries and Food (MAFF). The hazard index value of Hg, Cd, Cu, and Zn for the veined rapa whelk is lower than standard 1, demonstrating that ingestion of this mollusk from the southern Black Sea does not result in overexposure to these contaminants. The risk index value for human cancer risk of Pb for all seasons was found to be insignificant. When comparing the levels of elements in males and females, significant differences were found in some months for all the metals. In general, the trace elements were detected in higher concentrations in females than in males. Both females and males have accumulated less trace elements with increasing age. This study was the first to show the distribution of trace elements as a function of age in R. venosa.
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Gastrópodes , Mercúrio , Metais Pesados , Oligoelementos , Animais , Masculino , Feminino , Humanos , Oligoelementos/análise , Cádmio/análise , Mar Negro , Ecossistema , Chumbo , Moluscos , Mercúrio/análise , Medição de Risco , Metais Pesados/análise , Monitoramento AmbientalRESUMO
Objectives: This study aims to assess the lack of response to treatment in individuals undergoing mid-urethral sling surgery for stress urinary incontinence (SUI) using ultrasound findings of the pelvic floor. Methods: The study included patients who underwent the tension-free vaginal tape (TVT) procedure for stress urinary incontinence within the period spanning from January 2016 to January 2021. The physical examination involved maintaining bladder filling at an average volume of 200-400 mL, and treatment failure was determined by the presence of SUI during the Valsalva maneuver. Results: The study comprised a total of 214 patients, where it was observed during the stress test that 32 patients (25.8%) had an unsuccessful outcome following mid-urethral sling surgery. In the unsuccessful group, the distance of the mesh-posterior urethra was lower (4.09±0.39 vs. 4.91±0.51; p<0.001), the posterior urethrovesical angle was lower when at rest, but the angle increased more significantly during the Valsalva maneuver, and the bladder neck angle was narrower (p<0.001). Conclusion: We obtained lower mean values of mesh-posterior urethral distance in unsuccessful patients compared to those found in the group of cured patients. Pelvic floor ultrasound can predict the success of TVT surgeries but there is as yet little data and there is a need to find in the near future more standard and objective parameters for the diagnosis of urinary incontinence.
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OBJECTIVES: To assess the effect of different thromboprophylaxis regimens on clinical outcomes and mortality of critical ill patients with coronavirus disease -19 (COVID-19). METHODS: We investigated the medical records of patients with positive COVID-19 (using polymerase chain reaction test) who were admitted to the intensive care unit (ICU) at Sakarya University Hospital, Sakarya, Turkey, from March 2020 to January 2021. We included patients under anticoagulant therapy in the clinical course. The patients were allocated to 3 groups: Group A - low-dose (prophylactic) low-molecular-weight-heparin (LMWH) therapy, Group B - high-dose (therapeutic) LMWH therapy, and patients that received aspirin additional to the high-dose (therapeutic) LMWH as Group C. Primary outcomes were overall mortality rates and length of stay (LOS) in ICU. Secondary outcomes were rates of major hemorrhagic and thrombotic events. RESULTS: Records of 475 patients were reviewed and 164 patients were included. No significant difference was detected in mortality rates between groups (p=0.135). Intensive care unit stay was 13 (9-24.5) days in Group A, 11 (8.75-23) days in Group B, and 13 (9-17) days in Group C without a significant difference (p=0.547). No significant difference was detected between groups in terms of thrombotic (p=0.565) and hemorrhagic events (p=0.615). CONCLUSION: A high-dose anticoagulation therapy and addition of aspirin to LMWH therapy did not decrease the mortality rates and LOS in ICU in critical ill COVID-19 patients. In addition, it did not increase the incidence of major hemorrhage and major thrombotic events.
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COVID-19 , Trombose , Tromboembolia Venosa , Anticoagulantes/efeitos adversos , Aspirina/uso terapêutico , Estado Terminal/terapia , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Estudos Retrospectivos , Trombose/prevenção & controle , Tromboembolia Venosa/prevenção & controleRESUMO
This study was carried out to determine the relationship between the spiritual orientation and psychological well-being levels of inpatients diagnosed with COVID-19 and the factors affecting the psychological well-being of patients. This cross-sectional study was conducted with 136 patients diagnosed with COVID-19 who were hospitalized in the COVID-19 clinics of a state hospital between May and July 2021 and volunteered to participate in the study. To collect the study data, the Personal Information Form, Spiritual Orientation Scale (SOS) and Psychological Well-Being Scale (PWBS) were used. There was a positive correlation between the mean scores obtained from the overall SOS and PWBS (r = .335, p < .001). Of the participants, those who were women, who were over 65-year-old patients, who were hospitalized for 8-14 days and who had chronic diseases had lower levels of psychological well-being. The inpatients with a diagnosis of COVID-19 had high levels of spirituality and psychological well-being. It was found that there is a relationship between the spiritual orientation and psychological well-being of inpatients hospitalized with the diagnosis of COVID-19. The fact that nurses take spirituality into account while providing care to patients diagnosed with COVID-19 may be effective in protecting their patients' mental health.
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COVID-19 , Pacientes Internados , Idoso , Teste para COVID-19 , Estudos Transversais , Feminino , Humanos , Pacientes Internados/psicologia , Masculino , Espiritualidade , Inquéritos e Questionários , TurquiaRESUMO
OBJECTIVE: The vast majority of patients who hospitalized with coronavirus disease 2019 are given empirical antibiotic therapy. However, information on the frequency, microorganism species, and resistance rates of secondary bacterial infections in coronavirus disease 2019 patients are insufficient. We aimed to show the frequency of secondary infections and resistance conditions in patients with coronavirus disease 2019 hospitalized in the intensive care unit. METHODS: The results of tracheal aspirate culture, blood culture, and urine culture obtained from coronavirus disease 2019 patients - at least 2 days after their admission to the intensive care unit - were examined microbiologically. RESULTS: A total of 514 patients hospitalized in intensive care unit were included in our study. Tracheal aspirate, blood, or urine cultures were collected from 369 patients (71.8%). Bacterial reproduction was detected in at least one sample in 171 (33.3%) of all patients. The rate of respiratory tract infection and/or bloodstream infection was found to be 21%. Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa in tracheal aspirate culture; Coagulase-negative staphylococci, K. pneumoniae, and A. baumannii in blood culture; and Escherichia coli, K. pneumoniae, and Enterococcus faecalis in urine culture were the most common microorganisms. A. baumannii was resistant to most antibiotics except colistin and P. aeruginosa strains were resistant to most antibiotics except amikacin, colistin, cefepime, and imipenem. In K. pneumoniae, the highest meropenem sensitivity (73%) was observed; there was a strong resistance to most of the remaining antibiotics. CONCLUSIONS: We think that our study can be useful in choosing empirical antibiotic therapy in the coronavirus disease 2019 pandemic and reducing the mortality that may occur with secondary infection.
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Acinetobacter baumannii , Infecções Bacterianas , COVID-19 , Coinfecção , Pneumonia , Antibacterianos/uso terapêutico , Infecções Bacterianas/complicações , Infecções Bacterianas/tratamento farmacológico , COVID-19/complicações , Humanos , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa , SARS-CoV-2RESUMO
SUMMARY OBJECTIVE: The vast majority of patients who hospitalized with coronavirus disease 2019 are given empirical antibiotic therapy. However, information on the frequency, microorganism species, and resistance rates of secondary bacterial infections in coronavirus disease 2019 patients are insufficient. We aimed to show the frequency of secondary infections and resistance conditions in patients with coronavirus disease 2019 hospitalized in the intensive care unit. METHODS: The results of tracheal aspirate culture, blood culture, and urine culture obtained from coronavirus disease 2019 patients - at least 2 days after their admission to the intensive care unit - were examined microbiologically. RESULTS: A total of 514 patients hospitalized in intensive care unit were included in our study. Tracheal aspirate, blood, or urine cultures were collected from 369 patients (71.8%). Bacterial reproduction was detected in at least one sample in 171 (33.3%) of all patients. The rate of respiratory tract infection and/or bloodstream infection was found to be 21%. Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa in tracheal aspirate culture; Coagulase-negative staphylococci, K. pneumoniae, and A. baumannii in blood culture; and Escherichia coli, K. pneumoniae, and Enterococcus faecalis in urine culture were the most common microorganisms. A. baumannii was resistant to most antibiotics except colistin and P. aeruginosa strains were resistant to most antibiotics except amikacin, colistin, cefepime, and imipenem. In K. pneumoniae, the highest meropenem sensitivity (73%) was observed; there was a strong resistance to most of the remaining antibiotics. CONCLUSIONS: We think that our study can be useful in choosing empirical antibiotic therapy in the coronavirus disease 2019 pandemic and reducing the mortality that may occur with secondary infection.
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Humanos , Pneumonia , Infecções Bacterianas/complicações , Infecções Bacterianas/tratamento farmacológico , Acinetobacter baumannii , Coinfecção , Pseudomonas aeruginosa , Testes de Sensibilidade Microbiana , SARS-CoV-2 , COVID-19/complicações , Antibacterianos/uso terapêuticoRESUMO
ABSTRACT: The optimal surgical treatment of intertrochanteric femur fractures (ITF) to minimize the increased mortality in geriatric patients with high anesthetic risk was investigated by comparing closed external fixation (EF), a minimal invasive and biological osteosynthesis technique, proximal femoral nail (PFN) and hemiarthroplasty (HA) methods.Three different surgical methods were performed to 167 patients who were admitted to our clinic for ITF between 2014 and 2020 and considered at high risk (American Society of Anesthesiologists III - American Society of Anesthesiologists IV) by the Anesthesiology and Reanimation Department. Patients with multi-trauma, osteoarthritis, those with malignancies and developmental hip dysplasia were excluded from the study. Group I included patients who underwent closed reduction - external fixation (nâ=â46), Group II included patients who underwent partial arthroplasty (nâ=â77), and Group III included those who received PFN (nâ=â44). All fractures were classified according to the Modified Evans (Kyle) method and divided into 2 categories as type 1-2 (stable) and type 3-4 (unstable).The mean operation duration was 23 minutes and follow-up time was 14âmonths in Group 1, in which there was no in-hospital mortality. Five patients died due to non-operative reasons within 1âyear. The mean operation duration and follow-up time in Group 2 were 40 minutes and 12âmonths, respectively. Six patients (7.8%) died during the operation or hospitalization, while 17 patients died due to comorbidities within 1âyear. In Group 3, the mean operation duration and follow-up time were 40 minutes and 13âmonths, respectively. One patient died during the operation and 1 patient (nâ=â2, 4.5%), within 24âhours in the postoperative intensive care unit. Seven patients died due to comorbidities within 1âyear. Statistical analysis revealed that the mean duration of operation, postoperative hospital stay, overall mortality and blood product transfusion amount were significantly lower in the EF group compared to other treatment methods.Closed EF is the most reliable surgical method that can minimize mortality in geriatric patients compared to other surgical options, due to the short duration of the operation, no evacuation of the fracture hematoma, early mobilization, lack of blood transfusion requirement, and early union.
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Pinos Ortopédicos , Fixadores Externos , Fraturas do Fêmur/cirurgia , Fêmur/cirurgia , Fixação de Fratura/efeitos adversos , Hemiartroplastia/efeitos adversos , Fraturas do Quadril/cirurgia , Idoso , Feminino , Fraturas do Fêmur/complicações , Fraturas do Fêmur/mortalidade , Fixação Intramedular de Fraturas , Fraturas do Quadril/mortalidade , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Concentrations of Cd, Hg, Pb, As, Al, Cu, Fe, and Zn were determined in the muscles of wild and farmed European seabass in Sinop markets between September and December in 2020, using inductively coupled plasma mass spectrometry after microwave digestion. In the study, iron (Fe), zinc (Zn), aluminum (Al), and copper (Cu) were found higher than the other metals both in wild and cultured Dicentrarchus labrax. These are essential elements, but excess amounts act as a poison. Arsenic (As) concentration was higher than cadmium (Cd), mercury (Hg), and lead (Pb) both in wild and cultured D. labrax. The estimated maximum total dietary intakes of these eight metals from both wild and farmed European seabass were below the maximum acceptable daily intake values set by the Turkish Food Codex and European Union Regulation. Results showed that according to metal amounts, consumption of D. labrax had no threat to consumers' health. The target hazard quotient (THQ) revealed that harmful health impacts may not occur. Furthermore, risk index (RI) indicated that there may have a lower risk of developing cancer in the future who have been exposed to Pb and As through fish intake. Although the fish are not overly contaminated, the metal level is rising. Increased amounts of heavy metals in fish in different areas could be due to an increase in farm inflow water, domestic sewage, and a number of other anthropogenic sources, all of which should be looked into further. Precautions should be made to safeguard this fish from metal contamination and to reduce the risk to human health.
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Arsênio , Bass , Mercúrio , Metais Pesados , Venenos , Poluentes Químicos da Água , Alumínio/análise , Animais , Arsênio/análise , Cádmio/análise , Cobre/análise , Monitoramento Ambiental/métodos , Humanos , Ferro/análise , Chumbo/análise , Mercúrio/análise , Metais Pesados/análise , Venenos/análise , Medição de Risco , Esgotos , Água/análise , Poluentes Químicos da Água/análise , Zinco/análiseRESUMO
AIM: This study was carried out to investigate the relationship between the negative automatic thoughts of patients with schizophrenia and their levels of social functionality. DESIGN AND METHODS: This cross-sectional study was conducted 142 patients with schizophrenia. The data were collected using the Personal Information Form, Negative Automatic Thoughts Questionnaire (NATQ) and Social Functioning Assessment Scale (SFAS). FINDINGS: There was a strong negative correlation between the mean scores obtained from the overall NATQ and SFAS. In addition, negative automatic thoughts of the patients with schizophrenia had a negative effect of 47.2% on their social functionality. PRACTICE IMPLICATIONS: It was found that the patients had moderate levels negative automatic thoughts and social functionality; and that their negative automatic thoughts affected their social functionality negatively.
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Esquizofrenia , Humanos , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
Concentrations of toxic metals (Cd, Hg and Pb) in the edible tissues of seven commercial fish species (Mullus barbatus, Merlangius merlangus, Scophthalmus maximus, Mugil cephalus, Engraulis encrasicolus, Trachurus mediterraneus and Sarda sarda) collected from Sinop coasts of the southern Black Sea were detected in 11 years. In several fish samples, the concentrations of elements (Cd, Hg and Pb) were not detected or were below the detection level. The present study showed that Pb was the most and Cd was the least accumulated metal in the studied fish species. The concentrations of those metals are below the international organizations' recommended limit. It was shown that the estimated metal dose values for daily average consumption and hazarded quotients (HI) in fish samples are below safety levels for human consumption (HIË1). From the human health point of view, this study showed that there was no possible health risk to people due to intake of any studied species under the current consumption rate in the country for 11 years. This study could be useful as a baseline data for metals exposure.
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Metais Pesados , Poluentes Químicos da Água , Animais , Mar Negro , Monitoramento Ambiental , Peixes , Contaminação de Alimentos , Humanos , Metais/análise , Metais/toxicidade , Metais Pesados/análise , Metais Pesados/toxicidade , Medição de Risco , Poluentes Químicos da Água/análise , Poluentes Químicos da Água/toxicidadeRESUMO
Future university campuses will be characterized by a series of novel services enabled by the vision of Internet of Things, such as smart parking and smart libraries. In this paper, we propose a complete solution for a smart waste management system with the purpose of increasing the recycling rate in the campus and provide better management of the entire waste cycle. The system is based on a prototype of a smart waste bin, able to accurately classify pieces of trash typically produced in the campus premises with a hybrid sensor/image classification algorithm, as well as automatically segregate the different waste materials. We discuss the entire design of the system prototype, from the analysis of requirements to the implementation details and we evaluate its performance in different scenarios. Finally, we discuss advanced application functionalities built around the smart waste bin, such as optimized maintenance scheduling.