The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During the COVID-19 Pandemic and the Impact of Pandemic on Tinnitus.

OBJECTIVES: This study aimed to examine the frequency of anxiety disorder, coronavirus anxiety and health anxiety in tinnitus patients during the pandemic and also, determined the psychophysiological impact of COVID-19 on tinnitus. METHODS: This cross-sectional study was conducted in a tertiary central pandemic hospital from 15 July 2021 to 15 December 2022. In total, 124 patients with tinnitus and 77 healthy controls participated in the study. The sociodemographic data, a set of valid and reliable assessment instruments were used to measure outcomes of anxiety disorder, coronavirus anxiety, health anxiety and severity of tinnitus. RESULTS: Patients with tinnitus were found to experience higher levels of coronavirus anxiety, health anxiety and anxiety disorder than controls (p < 0.05). In tinnitus patients, the frequency of coronavirus anxiety was 22.6% and anxiety disorder was 18.5%. Notably, the levels of tinnitus severity were moderate to severe in more than half of the patients (51.6%) and also most of them (81.3%) reported that the severity of tinnitus during the pandemic was higher compared with the pre-pandemic. CONCLUSION: Tinnitus patients had high levels of anxiety disorder, coronavirus anxiety and health anxiety. In line with these findings, it was evaluated that there was a relationship between the COVID-19 pandemic with psychological problems and tinnitus. Therefore, the predominance of tinnitus symptoms at presentation should not lead the clinician to neglect the underlying psychopathological problems in these patients.

The incidence of concha bullosa: a retrospective radiologic study.

AIM: This study was conducted to discuss the incidence, directions, and types of concha bullosa using studies in the literature. MATERIALS AND METHODS: The images of patients who presented to the ENT clinic with different ENT symptoms in the last 7 years and had paranasal sinus tomography were analyzed retrospectively. RESULTS: The study consisted of a total of 3133 patients, including 1534 females (48.96%) and 1599 males (51.03%). The age range of the cases was between 12 and 85 years, and the mean age was 57.25 years. Middle concha bullosa was detected in 1402 (44.74%) of the cases. Of these cases, it was determined that 320 (22.82%) had right, 311 (22.18%) had left, and 771 (54.99%) had bilateral middle concha bullosa. Of middle types of concha bullosa, lamellar type concha bullosa was detected in 575 (41.01%) patients, bulbous type in 363 (25.89%), and extensive type in 464 (33.09%). Of the cases with lamellar type middle concha bullosa, it was found that 130 (22.60%) had right side, 105 (18.26%) had left side, and 340 (59.13%) had bilateral lamellar type middle concha bullosa. Of the cases that were determined to have bulbous type middle concha bullosa, 97 (26.72%) had right side, 99 (27.27%) had left side, and 167 (46.00%) had bilateral bulbous type middle concha bullosa. Of the cases that were determined to have extensive type middle concha bullosa, 93 (20.04%) had right side, 107 (23.06%) had left side, and 264 (56.89%) had bilateral extensive type middle concha bullosa. The incidence of superior concha bullosa was determined in 487 (15.54%) of 3133 cases. Of these, bilateral superior concha bullosa was detected in 332 (68.17%) cases and unilateral in 155 (31.82%) cases. CONCLUSIONS: Our study has the largest case series among studies investigating the incidence of concha bullosa. The incidence of concha bullosa appears to be common in the community. Additional studies may be useful to determine whether its high incidence is associated with other sinus pathologies and the extent of its effect on other rhinological complaints.

Cochlear pathology in preeclamptic rats: protective effects of vitamin D and magnesium sulfate.

Background/aim: This study investigated the possible degeneration in cochlear morphology induced by preeclampsia (PE) and the therapeutic/preventive effect of vitamin D (Vit D) and magnesium sulfate (MgSO4) used separately and together on feto-maternal outcomes. Materials and methods: We created PE in rats using a reduced uterine perfusion pressure (RUPP) animal model and recorded blood pressure (BP), embryonic survival (ES), and embryonic weight (EW) and evaluated cochlear morphology by electron microscopy. Results: The PE group had elevated BP, a decreased number and weight of live pups, and significant degeneration in the cochlea compared to the sham group. In the PEV group, we observed significant beneficial effects of Vit D supplementation at 14.5 and 19.5 dpc in terms of BP (p < 0.05), EW (p < 0.001), and cochlear degeneration compared to the PE group. In the PEM group, BP (p < 0.05) and cochlear degeneration nearly reached the level found in the sham group. However, although the EW was statistically different in the PE group, it did not reach sham group levels. We also observed that BP returned to sham level (p < 0.01) and noticed significant increases in the EW (p < 0.0001) and ES (p = 0.017) in the PEMV group compared to the PE group. According to the scanning electron microscope results, combined administration of VitD and MgSO4 is more effective than separate administration in improving cochlear degeneration induced by PE. Conclusion: The administration of Vit D and MgSO4 during pregnancy has beneficial effects on PE pathology and may play a significant role in preventing PE-related complications, including cochlear degeneration.

Firearm-Related Lower Extremity Injuries: Treatment Approaches and MESS Score Usability.

OBJECTIVE: To evaluate isolated firearm-related lower extremity injury (LEI) treated according to the current treatment of damage control orthopaedics (DCO) or traditional early comprehensive treatment (TECT), and to validate the usability of Mangled Extremity Severity Score (MESS). STUDY DESIGN:   Observational study. Place and Duration of the Study: Department of Orthopaedic Surgery, Diyarbakir Gazi Yasargil Training and Research Hospital, Turkiye, from November 2017 to November 2022. METHODOLOGY: A total of 93 adult patients with isolated firearm-induced LEI requiring surgical intervention for open bone fractures at a level I trauma centre were included. The study assessed the severity of LEI using MESS based on the patients' medical records. RESULTS: DCO technique was used for 54.8% (51) of patients. There were statistically significant differences in terms of amputations and limb salvage between the DCO and TECT groups (χ2:6,234, p<0.05). The mean MESS was 8.9 ± 0.7 in all fatalities, 6.3 ± 1.1 in limb amputations, and 3.8 ± 1.5 in salvaged limbs. Moreover, the DCO and TECT groups showed statistically significant differences regarding postoperative non-union (χ2:3,720, p<0.05), with DCO groups experiencing a higher rate of non-union (18.2%) as compared to TECT groups [7.1%, Exp (B):3.77]. CONCLUSION: In isolated LEI caused by firearms, MESS could predict outcomes (i.e. mortality, amputation, or limb salvage) and assist in the choice between DCO or TECT techniques. DCO was preferred by orthopaedic surgeons when treating severe LEI caused by firearms. KEY WORDS: Mangled Extremity Severity Score, Firearm, Damage control orthopaedics, Early comprehensive treatment.

Early-life intraguild predation risk produces adaptive personalities in predatory mites.

Animal personalities are defined by within-individual consistency, and consistent among-individual variation, in behavior across time and/or contexts. Here we hypothesized that brief early-life experience of intraguild predation (IGP) risk has enduring phenotypic effects on personality expression in boldness and aggressiveness in later life. We tested our hypothesis in predatory mites Phytoseiulus persimilis, which are IG predators with ontogenetic role reversals, i.e., they are potential IG prey during early life but IG predators as adults. Adult P. persimilis females, which had experienced IGP risk early in life or not, were subjected to three tests each for boldness and aggressiveness. IGP-experienced individuals were on average bolder and more aggressive. Boldness was moderately repeatable, aggressiveness was weakly repeatable. Strikingly, early-life IGP experience shifted the within-group personality composition toward consistently bold and aggressive personalities. Phenotypic adjustment of personality expression was adaptive, as indicated by the positive correlation between personality scores and egg production.

Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms: A Prospective, Multicenter Study.

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.

Investigation of coronavirus anxiety, health anxiety, and anxiety symptom levels in vertigo patients during COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic adversely affects the mental health of vertigo patients. Thus, this study aimed to investigate the effects of coronavirus anxiety, health anxiety, anxiety symptom levels, and demographic variables on vertigo and its severity in vertigo patients during the pandemic. METHODS: This cross-sectional study was conducted from May 15 to November 15, 2021. In total, 118 patients with vertigo and 82 healthy controls participated in the study. Besides demographic and clinical data, Coronavirus Anxiety Scale (CAS), Hospital Anxiety Depression Scale-Anxiety Subscale (HAD-A), and Short Health Anxiety Inventory (SHAI) were applied to all participants. Additionally, Vertigo Symptom Scale-Short Form (VSS-SF) was administered to vertigo patients. RESULTS: According to the findings, vertigo patients experienced higher levels of coronavirus anxiety, health anxiety, and anxiety disorder compared to the healthy controls. In vertigo patients, the rate of coronavirus anxiety was 20.3%, and the rate of anxiety disorder was 32.2%. Majority of the patients (80.5%) were found to have severe-level vertigo. Additionally, most of the patients (82.1%) reported that the severity of vertigo during the pandemic was higher than before the pandemic. CONCLUSIONS: The COVID-19 pandemic causes serious mental health problems in vertigo patients, and pathological levels of these problems increase the discomfort of vertigo. Therefore, psychological assessment should be considered in these patients, and required psychological support and guidance services should be provided.

Spider mite males undress females to secure the first mating.

Intense mate competition favors the evolution of extraordinary mating strategies such as the ability of males to identify premature females that are close to becoming mature and associate with them until they are sexually receptive (dubbed precopulatory mate guarding). Owing to possible take-overs by rival males, precopulatory guarding is a high-risk, time- and energy-intensive strategy. Here, we provide experimental evidence that guarding spider mite males undress females by actively removing the exuvia during ecdysis to adult; females undressed by guarding males eclose faster than unguarded females. Such behavior is adaptive because it maximizes the guard's chances of being the first mate.

Predictors of one-year mortality following hip fracture surgery in elderly.

Background: Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. To investigate the effects of admission and post-operative levels of distribution width of red blood cells (RDW), albumin, and RDW/albumin (RA) ratio on predicting 1-year mortality following hip fracture surgery. Methods: A retrospective study was conducted on 275 elderly patients who underwent hip fracture surgery in a tertiary hospital between January 2018 and January 2022. Deaths within one year of hip fracture were defined as the deceased group. The survivors were defined as those who survived for at least one year. The relationship between admission and post-operative levels of RDW, albumin, RA, and mortality within one year after hip surgery was assessed statistically, including binary logistic regression analysis. The study also assessed other factors related to mortality. Results: One-year mortality was 34.7%. There was a 3.03-year (95% CI [1.32-4.75]) difference between the deceased (79.55 ± 8.36 years) and survivors (82.58 ± 7.41 years) (p < 0.001). In the deceased group, the mean hemoglobin (HGB) values at admission (p = 0.022) and post-operative (p = 0.04) were significantly lower. RDW values at admission (p = 0.001) and post-op (p = 0.001) were significantly lower in the survivor group. The mean albumin values at admission (p < 0.001) and post-operative (p < 0.001) in the survivor group were significantly higher than in the deceased group. A significant difference was found between the survivor group and the deceased group in terms of mean RA ratio at admission and post-operative (p < 0.001). Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD) (OR 3.73, 95% CI [1.8-7.76]), RDW (OR 1.78, 95% CI [1.48-2.14]), and albumin (OR 0.81, 95% CI [0.75-0.87]), values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture. Conclusion: Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly.

The role of Mangled Extremity Severity Score in amputation triage in a transport health facility with catastrophic earthquake admissions.

BACKGROUND: The purpose of this study is to assess the diagnostic utility of the Mangled Extremity Severity Score (MESS) in the prediction of amputation after a major earthquake, and its utility in disaster triage. METHODS: Study results were presented from a tertiary hospital in Diyarbakir, which was affected by the earthquake but served as a transport hub for other cities in the region affected by the earthquake. MESS was calculated and its diagnostic value is analyzed in predicting amputations. MESS scores were divided into low risk, intermediate risk, and high risk groups by the researchers based on their diagnostic value analysis. RESULTS: 79 patients were included in the study. Based on the outcome of amputation or salvage, patients were divided into two groups. 24.1% (n = 19) of the patients had amputations. Both gender and mean age did not differ statistically significantly between the groups (p > 0.05). Compared with the salvage group, the amputation group had a significantly longer prehospital stay and higher rate of vascular injury and higher median MESS (p = 0.007, p < 0.001, p < 0.001; respectively). Based on MESS scores, amputation outcomes were predicted with an accuracy of 0.889 (95% CI 0.798-0.949). Those with a MESS score below 9 were considered low risk (sensitivity = 100%) whereas those with a MESS score above 12 were considered high risk (specificity = 98.33%). CONCLUSION: In transport centers, MESS may be useful for surgical triage of earthquake-induced limb crush injuries.

Seasonal Distribution of Bell's Palsy.

Bell's palsy (BP) is the most frequently diagnosed acute partial or complete paralysis of the facial nerve which has an unclear etiology and mostly affects one side of the face. Adverse weather conditions are considered to increase the likelihood of developing BP. The retrospective study included 199 BP patients aged 2-82 years that presented to the Ear, Nose, and Throat (ENT) clinics at Kumluca State Hospital and Serik State Hospital, Antalya, Turkey and received treatment between January 2017 and December 2020. The 199 patients comprised 106 (53.3%) men and 93 (46.7%) women with a mean age of 42.23 ± 12.99 years. The highest incidence of BP was observed in winter (December-February) (35%), followed by fall (23%), summer (22%), and spring (20%) (p < 0.05). Accordingly, the incidence of BP was significantly higher in November, December, January and February compared to other months of the year (p < 0.05). The results indicated that BP shows seasonal variation and its peak incidence is in winter (December-February). Further studies are needed to explain the reasons for seasonal differences in BP. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02796-2.

Evaluation of Childhood Traumas, Depressive Symptoms, and Dissociative Experiences in Tinnitus Cases.

OBJECTIVE: Tinnitus is described as the perceived sound without any external stimulus and is a common problem, but its mechanism is not fully understood. This study aimed to evaluate childhood traumas and dissociative experiences, which may be predisposing factors in patients with tinnitus. METHODS: The study included 90 voluntary patients (45 patients with tinnitus and 45 in the control group) aged older than 18 years who applied to the otorhinolaryngology clinic between November 2018 and February 2019 and were diagnosed with subjective tinnitus. A personal information form together with childhood trauma, hospital anxiety and depression, and dissociative experiences scales were used to assess the patients. RESULTS: Of all participants, 55.60% were males, 28.90% were 20-30 years old, 71.10% were married, 40% were primary school graduates, and 68.90% were employed. In addition, 77.78% of patients did not visit a psychiatrist and 75.56% did not have any chronic diseases. The mean total score of Childhood Trauma Scale for the tinnitus group was 54.37±10.17, the mean total score of The Hospital Anxiety and Depression Scale for the tinnitus group in the depression subscale was 12.22±5.41 and in the anxiety subscale was 10.54±3.5, and Dissociative Experiences was 13.48±4.68. A positive significant relationship was found between the childhood traumas of the tinnitus cases in their depressive symptoms, and dissociative experiences (p<0.05). CONCLUSIONS: The study results found a positive relationship between the childhood traumas and dissociative experiences of tinnitus cases, which can be considered as predisposing factors in patients with tinnitus who should also be investigated for childhood trauma, and the treatment approach should be multidisciplinary.

The Effect of Nasal Steroid and Antihistamine Use on Total Oxidative Stress and Antioxidant Status in the Treatment of Allergic Rhinitis.

INTRODUCTION: The purpose of this study is to determine the post-treatment levels of total oxidant status (TOS) and total antioxidant status (TAS), that are increased due to pathophysiology, and to compare those with pre-treatment levels in allergic rhinitis patients.Material-Methods: Among 84 patients clinically diagnosed with allergic rhinitis, 31 patients were started only on nasal steroid treatment (mometasone furoate), and 53 patients were started on nasal steroid and oral antihistamine treatment (mometasone furoate + rupatadine fumarate 10 mg). Blood samples were taken from the patients at the first examination and at post-treatment month 1.TAS and TOS were measured from the blood samples. RESULTS: While no significant change was determined in mean TAS levels with treatment, a statistically significant decrease was determined in TOS values in post-treatment period (P < .01). There was no significant change in TAS and TOS values of patients only using nasal steroids, while a significant decrease was determined in post-treatment TOS values of patients using both nasal steroids and oral antihistamines (P < .001). It was determined that TOS values of women were significantly lower compared to men, and it was also reduced in seasonal allergic rhinitis compared to perennial allergic rhinitis (P < .05 for both). CONCLUSION: In allergic rhinitis patients, concomitant use of nasal steroids and antihistamines significantly decreases total oxidative stress. It may be stated that the addition of antihistamines to allergic rhinitis treatment positively affects treatment.

Inter- and intraspecific variation of spider mite susceptibility to fungal infections: Implications for the long-term success of biological control.

Spider mites are severe pests of several annual and perennial crops worldwide, often causing important economic damages. As rapid evolution of pesticide resistance in this group hampers the efficiency of chemical control, alternative control strategies, such as the use of entomopathogenic fungi, are being developed. However, while several studies have focused on the evaluation of the control potential of different fungal species and/or isolates as well as their compatibility with other control methods (e.g., predators or chemical pesticides), knowledge on the extent of inter- and intraspecific variation in spider mite susceptibility to fungal infection is as yet incipient. Here, we measured the mortality induced by two generalist fungi, Beauveria bassiana and Metarhizium brunneum, in 12 spider mite populations belonging to different Tetranychus species: T. evansi, T. ludeni, and T. urticae (green and red form), within a full factorial experiment. We found that spider mite species differed in their susceptibility to infection by both fungal species. Moreover, we also found important intraspecific variation for this trait. These results draw caution on the development of single strains as biocontrol agents. Indeed, the high level of intraspecific variation suggests that (a) the one-size-fits-all strategy may fail to control spider mite populations and (b) hosts resistance to infection may evolve at a rapid pace. Finally, we propose future directions to better understand this system and improve the long-term success of spider mite control strategies based on entomopathogenic fungi.

Population-specific effect of Wolbachia on the cost of fungal infection in spider mites.

Many studies have revealed the ability of the endosymbiotic bacterium Wolbachia to protect its arthropod hosts against diverse pathogens. However, as Wolbachia may also increase the susceptibility of its host to infection, predicting the outcome of a particular Wolbachia-host-pathogen interaction remains elusive. Yet, understanding such interactions and their eco-evolutionary consequences is crucial for disease and pest control strategies. Moreover, how natural Wolbachia infections affect artificially introduced pathogens for biocontrol has never been studied. Tetranychus urticae spider mites are herbivorous crop pests, causing severe damage on numerous economically important crops. Due to the rapid evolution of pesticide resistance, biological control strategies using entomopathogenic fungi are being developed. However, although spider mites are infected with various Wolbachia strains worldwide, whether this endosymbiont protects them from fungi is as yet unknown. Here, we compared the survival of two populations, treated with antibiotics or naturally harboring different Wolbachia strains, after exposure to the fungal biocontrol agents Metarhizium brunneum and Beauveria bassiana. To control for potential effects of the bacterial community of spider mites, we also compared the susceptibility of two populations naturally uninfected by Wolbachia, treated with antibiotics or not. In one population, Wolbachia-infected mites had a better survival than uninfected ones in absence of fungi but not in their presence, whereas in the other population Wolbachia increased the mortality induced by B. bassiana. In one naturally Wolbachia-uninfected population, the antibiotic treatment increased the susceptibility of spider mites to M. brunneum, but it had no effect in the other treatments. These results suggest that natural Wolbachia infections may not hamper and may even improve the success of biological control using entomopathogenic fungi. However, they also draw caution on the generalization of such effects, given the complexity of within-host-pathogens interaction and the potential eco-evolutionary consequences of the use of biocontrol agents for Wolbachia-host associations.