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1.
Int J Nurs Pract ; : e13262, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38751063

RESUMO

BACKGROUND: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. AIM: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. METHODS: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single-use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. RESULTS: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). CONCLUSIONS: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less.

3.
Jpn J Nurs Sci ; : e12589, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38351461

RESUMO

AIMS: The aim of this study was to research the effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position. METHODS: This study was a non-randomized and non-controlled, quasi-experimental repeated measures study. The study was conducted with 50 intensive care patients aged 18 and over in a general surgery intensive care unit in Turkey. With each patient in the supine position, the bed head was raised to an angle of 0°, 20°, 30°, and 45° without a pillow, and the hemodynamic parameters of central venous pressure, systolic and diastolic blood pressure, heart rate, breathing rate, and peripheral oxygen saturation were recorded after 0 and 10 min. RESULTS: It was found that the mean central venous pressure value measured at min 0 and 10 was higher when the intensive care patients' bed head angle was raised to 45° than when the bed head was at an angle of 0° or 20° (p < .05). It was found that the patients' other hemodynamic parameters were not affected by different bed head angles. CONCLUSIONS: It was concluded as a result of this research that in intensive care patients in the supine position, only central venous pressure was affected by bed head angle, and that central venous pressure measurement can be reliably made at a bed head angle of 30°.

4.
Eur J Pediatr ; 182(12): 5531-5542, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37782350

RESUMO

PURPOSE: Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU). METHODS: This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented. RESULTS: A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5-11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × µL, platelet count 153 vs. 212 cells × 103/ µL, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 µg/L, ferritin 644 vs. 334 µg/L, all for p< 0.001). Being between ages 5-12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971-8.627] and six times (95% CI 2.575-14.654), respectively, compared to being between the ages 0-5. A one-unit increase in log D-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079-3.233) and 1.4 times (95% CI 1.133-1.789), respectively.     Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care. WHAT IS KNOWN: • Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit. • The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not. WHAT IS NEW: • A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively. • Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay.


Assuntos
Síndrome de Linfonodos Mucocutâneos , Criança , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Pró-Calcitonina , Unidades de Terapia Intensiva , Ferritinas , Troponina , Estudos Retrospectivos
5.
Int J Surg ; 109(12): 4057-4061, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37720938

RESUMO

INTRODUCTION: Carotid body tumors (CBTs) are slow-growing benign tumors. Therefore, surgical resection is considered in case of tumor growth. The timing of surgery is of the utmost importance as the risk of iatrogenic surgical complications increases when resecting larger tumors, whereas on the other hand, resections for asymptomatic small CBT should be prevented. The primary aim of this study was to identify which tumor size or dimension is most accurate to predict nerve injury in patients undergoing resection of a CBT. MATERIAL AND METHODS: This retrospective cohort study included patients who underwent surgical resection of CBT at the university hospital in South-Holland. Baseline patient characteristics and tumor measurements were retrieved from the medical records. The authors assessed how the different methods of measuring the size of the tumor were interrelated using Pearson correlation. Logistic regression was used to assess which variables were independently associated with nerve injury, including age at surgery, Shamblin classification, and those dimensions that captured different aspects of tumor size (rather than measuring the same as shown by high correlations) as possible independent variables. RESULTS: In 125 patients, 143 CBTs were resected whereof in 35 cases cranial nerve injury occurred, (transient in 16 cases and permanent in 19 cases). The risks for nerve injury increased with larger tumor size and the Shamblin classification. Logistic regression analysis showed that the anterior-posterior (AP) diameter significantly increased the odds of a nerve injury, a doubling for every 1 cm increase in AP diameter [odds ratio (95% CI) 2.12 (1.29-3.48), P =0.003]. CONCLUSION: This study shows that measured tumor size in the AP plane is a strong predictor for postoperative nerve injury of a CBT resection. This predictor can be used in the daily clinic to give insight in operative risks. More research is needed in order to select the most appropriate time window for CBT resection.


Assuntos
Tumor do Corpo Carotídeo , Humanos , Tumor do Corpo Carotídeo/cirurgia , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Nervos Cranianos/patologia
6.
Anatol J Cardiol ; 27(11): 628-638, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37466024

RESUMO

BACKGROUND: Hypertrophic cardiomyopathy is a common genetic heart disease and up to 40%-60% of patients have mutations in cardiac sarcomere protein genes. This genetic diagnosis study aimed to detect pathogenic or likely pathogenic sarcomeric and non-sarcomeric gene mutations and to confirm a final molecular diagnosis in patients diagnosed with hypertrophic cardiomyopathy. METHODS: A total of 392 patients with hypertrophic cardiomyopathy were included in this nationwide multicenter study conducted at 23 centers across Türkiye. All samples were analyzed with a 17-gene hypertrophic cardiomyopathy panel using next-generation sequencing technology. The gene panel includes ACTC1, DES, FLNC, GLA, LAMP2, MYBPC3, MYH7, MYL2, MYL3, PLN, PRKAG2, PTPN11, TNNC1, TNNI3, TNNT2, TPM1, and TTR genes. RESULTS: The next-generation sequencing panel identified positive genetic variants (variants of unknown significance, likely pathogenic or pathogenic) in 12 genes for 121 of 392 samples, including sarcomeric gene mutations in 30.4% (119/392) of samples tested, galactosidase alpha variants in 0.5% (2/392) of samples and TTR variant in 0.025% (1/392). The likely pathogenic or pathogenic variants identified in 69 (57.0%) of 121 positive samples yielded a confirmed molecular diagnosis. The diagnostic yield was 17.1% (15.8% for hypertrophic cardiomyopathy variants) for hypertrophic cardiomyopathy and hypertrophic cardiomyopathy phenocopies and 0.5% for Fabry disease. CONCLUSIONS: Our study showed that the distribution of genetic mutations, the prevalence of Fabry disease, and TTR amyloidosis in the Turkish population diagnosed with hypertrophic cardiomyopathy were similar to the other populations, but the percentage of sarcomeric gene mutations was slightly lower.


Assuntos
Cardiomiopatia Hipertrófica , Doença de Fabry , Humanos , Sarcômeros/genética , Sarcômeros/metabolismo , Sarcômeros/patologia , Mutação , Cardiomiopatia Hipertrófica/genética , Fenótipo
7.
Rev Lat Am Enfermagem ; 31: e3923, 2023.
Artigo em Espanhol, Inglês, Português | MEDLINE | ID: mdl-37194813

RESUMO

to examine the effect of the medium intensity coughing technique during subcutaneous low molecular weight heparin injection on pain severity and individual satisfaction in general surgery patients. the prospective, quasi-experimental study included 100 patients who had been prescribed a subcutaneous low molecular weight heparin injection once in 24 hours. Each patient received two injections by the same researcher, one using the standard injection technique with medium intensity coughing technique and the other only the standard injection technique. there was a statistically significant difference between patients' mean scores on pain severity and satisfaction levels after injections administered by the two techniques (p= 0.000). Also, it was found that gender affected pain severity relating to the injection but did not affect the level of individual satisfaction. the medium intensity coughing technique was found to reduce pain severity and increase patient satisfaction in general surgery patients receiving subcutaneous low molecular weight heparin injections. Trial registration: NCT05681338.


examinar el efecto de la técnica de tos de mediana intensidad durante la inyección subcutánea de heparina de bajo peso molecular sobre la severidad del dolor y la satisfacción individual en pacientes de cirugía general. estudio prospectivo, cuasi experimental, que incluyó a 100 pacientes a los que se les prescribió una inyección subcutánea de heparina de bajo peso molecular una vez cada 24 horas. Cada paciente recibió dos inyecciones por el mismo investigador utilizando técnica de inyección estándar con técnica de tos de intensidad media y solo técnica de inyección estándar. hubo una diferencia estadísticamente significativa entre las puntuaciones medias de los pacientes sobre la intensidad del dolor y los niveles de satisfacción después de las inyecciones administradas por las dos técnicas (p= 0,000). Además, se encontró que el género afectó la severidad del dolor relacionado con la inyección, pero no afectó el nivel de satisfacción individual. se encontró que la técnica de tos de intensidad media reduce la severidad del dolor y aumenta la satisfacción del paciente de cirugía general que reciben inyecciones subcutáneas de heparina de bajo peso molecular. Registro del ensayo: NCT05681338.


examinar o efeito da técnica de tosse de média intensidade durante injeção subcutânea de heparina de baixo peso molecular na intensidade da dor e satisfação individual em pacientes submetidos à cirurgia geral. estudo prospetivo, quasi experimental que incluiu 100 pacientes que haviam recebido uma injeção subcutânea de heparina de baixo peso molecular em 24 horas. Cada paciente recebeu duas injeções pelo mesmo pesquisador usando a técnica de injeção padrão com técnica de tosse de média intensidade e apenas técnica de injeção padrão. houve diferença estatisticamente significativa entre as pontuações médias dos pacientes quanto à gravidade da dor e níveis de satisfação após as injeções administradas pelas duas técnicas (p = 0,000). Além disso, verificou-se que o sexo do paciente afetou a intensidade da dor relacionada à injeção, mas não afetou o nível de satisfação individual. a técnica de tosse de média intensidade reduz a intensidade da dor e aumenta a satisfação de pacientes submetidos à cirurgia geral recebendo injeções subcutâneas de heparina de baixo peso molecular. Registro do ensaio clínico: NCT05681338.


Assuntos
Contusões , Heparina , Humanos , Anticoagulantes , Heparina de Baixo Peso Molecular , Medição da Dor , Estudos Prospectivos , Fatores de Tempo
8.
Pediatr Infect Dis J ; 42(9): e348-e349, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37257098

RESUMO

This report describes a case in which diplopia was developed as a finding of postinfectious anti- N -methyl- d -aspartate receptor encephalitis. Infectious encephalitis, especially herpes simplex virus, is essential as it is one of the triggers of autoimmune encephalitis. Even if the cases present unexpected clinical findings, we should be vigilant in terms of autoimmune processes, such as diplopia seen in our case.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Encefalite por Herpes Simples , Herpesvirus Humano 1 , Humanos , Autoimunidade , Encefalite por Herpes Simples/complicações , Encefalite por Herpes Simples/diagnóstico , Diplopia/diagnóstico , Diplopia/etiologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico
9.
Omega (Westport) ; 87(3): 999-1016, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34344255

RESUMO

The aim of this study was to describe the experiences and practices of nurses providing palliative and end of life care. The study was conducted in the palliative care unit of a territory hospital in Turkey. The sample consisted of 11 nurses who had been working as palliative care nurses for at least one year. The face to face interview method was used to collect data, with a semi-structured in-depth individual interview. 5 main themes and 24 sub-themes were emerged in relation to the experiences and practices of the nurses. The majority of participant nurses pointed that inadequacy in the number of nurses, secondary nursing care activities, refusal of treatment, cultural and ethical problems were barriers in the provision of nursing care. They frequently experienced ethical issues when caring for end of life patients, and for this reason they felt the need for ethics counselling which they could consult.


Assuntos
Enfermeiras e Enfermeiros , Assistência Terminal , Humanos , Assistência Terminal/métodos , Cuidados Paliativos , Morte , Hospitais , Pesquisa Qualitativa
10.
Artigo em Inglês | MEDLINE | ID: mdl-36526576

RESUMO

OBJECTIVE: To compare volume and surface area measurements of the lateral pterygoid (LPM), medial pterygoid (MPM), and masseter muscles (MM) as calculated on magnetic resonance imaging (MRI) based on the position of the temporomandibular joint disk, mouth position, and patient sex, and to calculate the correlations of the measurements among the muscles. STUDY DESIGN: Measurements of muscle volume and area were performed on the MRIs of 51 patients. Wilcoxon, Kruskal-Wallis, and Mann-Whitney U tests were used to calculate the significance of differences in measurements. The Spearman correlation coefficient calculated the correlation of measurements among the muscles. The significance of difference was established at P < .05. RESULTS: Volume and area of the left MPM in patients with disk displacement without reduction (DDWOR) were larger than in patients with normal disk position (P ≤ .040). MM volumes were smaller with DDWOR than with DD with reduction bilaterally (P ≤ .031). The volume and area of LPM and MM were significantly different between closed and open mouth positions (P < .001). Differences in volume and area between females and males were significant for all muscles in volume (P ≤ .021) and for MPM and MM in area (P ≤ .021). Significant positive correlations were found among all muscles for volume and area. CONCLUSION: Volume and area measurements of the masticatory muscles varied according to disk and mouth position and patient sex and exhibited significant positive correlations.


Assuntos
Músculos da Mastigação , Transtornos da Articulação Temporomandibular , Masculino , Feminino , Humanos , Músculos da Mastigação/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/patologia , Músculos Pterigoides/diagnóstico por imagem , Músculos Pterigoides/patologia , Imageamento por Ressonância Magnética/métodos , Disco da Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/patologia
12.
J Tissue Viability ; 31(2): 358-364, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35153132

RESUMO

AIM OF THE STUDY: This study was conducted to translate the ELPO risk assessment scale for the development of pressure injuries due to surgical positioning to Turkish and to test its validity and reliability in the Turkish Population. MATERIALS AND METHODS: The data were collected using the patient identification form, the risk assessment scale for the prevention of injuries due to surgical positioning, and the Braden Scale. This scale consisted of a total of seven items, each of which contained five sub-items. It is rated between 1 and 5 in the Likert type. The total score of the scale ranges between 7 and 35. The risk of developing pressure injuries increases in patients as the score increases. RESULTS: A total of 184 patients were included in the study sample. The mean age of the group was 55.96 ± 17.90, and the content validity index was 0.944. The sensitivity of the test was 60%, the specificity was 66%, and the accuracy was 66%. There was a negative, weak, statistically significant correlation between the total scores of the risk assessment scale for the prevention of injuries due to surgical positioning and the Braden scale. The mean total score of the scale was 18.45 ± 2.96 (12-26) and 35.9% (n = 66) of the group were at high risk. CONCLUSIONS: The ELPO, which includes the risks specific to patients during surgery, can be used as an assessment scale for the development of pressure injury due to surgical positioning for Turkish population.


Assuntos
Lesões por Esmagamento , Úlcera por Pressão , Humanos , Úlcera por Pressão/epidemiologia , Úlcera por Pressão/etiologia , Úlcera por Pressão/prevenção & controle , Reprodutibilidade dos Testes , Medição de Risco , Traduções
13.
Braz. oral res. (Online) ; 36: e140, 2022. tab
Artigo em Inglês | LILACS-Express | LILACS, BBO | ID: biblio-1420937

RESUMO

Abstract This study evaluated the influence of socio-demographic, clinical, and parental psychological factors on oral health-related quality of life (OHRQoL) and determined their predictors in preschool-aged children with traumatic dental injury (TDI). The study sample consisted of 324 dyads of children and their parents attending the Clinics of Pediatric Dentistry at Istanbul University. After clinical examination, the Sense of Coherence (SOC), Generalized Self-Efficacy Scale, Early Childhood Oral Health Impact Scale, and Multidimensional Health Locus of Control Scale-MHLC questionnaires were administered to the parents. The statistical analyses included Spearman correlation coefficients, Mann-Whitney U tests, Kruskal-Wallis tests, multiple linear regression, and confirmatory factor analysis. Having mixed TDI, a non-nuclear family, fewer children, and weak parental SOC were important predictors of worse overall OHRQoL and its sections of child and family. Lower internal health locus of control and dental pain due to TDI were predictors of worse overall OHRQoL and child impact, respectively. Consideration of these predictors may help oral health professionals to develop prevention and treatment programs for TDI and oral health literacy programs for families.

14.
Pediatr Nephrol ; 36(5): 1195-1205, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33130981

RESUMO

BACKGROUND: C3 glomerulopathy (C3G) is characterized by heterogeneous clinical presentation, outcome, and predominant C3 accumulation in glomeruli without significant IgG. There is scarce outcome data regarding childhood C3G. We describe clinical and pathological features, treatment and outcomes, and risk factors for progression to chronic kidney disease stage 5 (CKD5) in the largest pediatric series with biopsy-proven C3G. METHODS: Sixty pediatric patients with C3G from 21 referral centers in Turkey were included in this retrospective study. Patients were categorized according to CKD stage at last visit as CKD5 or non-CKD5. Demographic data, clinicopathologic findings, treatment, and outcome data were compared and possible risk factors for CKD5 progression determined using Cox proportional hazards model. RESULTS: Mean age at diagnosis was 10.6 ± 3.0 years and follow-up time 48.3 ± 36.3 months. Almost half the patients had gross hematuria and hypertension at diagnosis. Nephritic-nephrotic syndrome was the commonest presenting feature (41.6%) and 1/5 of patients presented with nephrotic syndrome. Membranoproliferative glomerulonephritis was the leading injury pattern, while 40 patients had only C3 staining. Patients with DDD had significantly lower baseline serum albumin compared with C3GN. Eighteen patients received eculizumab. Clinical remission was achieved in 68.3%. At last follow-up, 10 patients (16.6%) developed CKD5: they had lower baseline eGFR and albumin and higher frequency of nephrotic syndrome and dialysis requirement than non-CKD5 patients. Lower serum albumin and eGFR at diagnosis were independent predictors for CKD5 development. CONCLUSIONS: Children with C3G who have impaired kidney function and hypoalbuminemia at diagnosis should be carefully monitored for risk of progression to CKD5. Graphical abstract.


Assuntos
Complemento C3 , Falência Renal Crônica , Síndrome Nefrótica , Adolescente , Criança , Complemento C3/análise , Humanos , Rim , Falência Renal Crônica/diagnóstico , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/epidemiologia , Diálise Renal , Estudos Retrospectivos , Albumina Sérica
15.
Curr Med Imaging ; 16(9): 1105-1110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33135608

RESUMO

OBJECTIVES: To evaluate impacted mandibular third molar tooth region and obtain linear measurements using CBCT images and to assess the relationship between the impacted third molar and the mandibular canal. METHODS: CBCT scans of 351 patients (208 females, 143 males) were assessed. Age, gender, and impaction site were recorded for each patient. The relationship of third molars with the vertical axis of second molars, 2nd molar resorption and the relationship between third molar apices and the mandibular canal were assessed. In addition, the distance between ramus and second molar, mesiodistal width of the third molar, the angle between third molar and second molar, and width of the third molar capsule were measured. Binary Logistic Regression, Chi-Square Test, and General Linear Model were used for statistical analysis. RESULTS: The highest percentage of impaction was found for mesioangular followed by transversal and vertical. The transversal impacted third molars revealed a significant association with adjacent second molar root resorption (p<0.001). There was a statistical significance between the second molar resorption and distance between ramus and second molar (p<0.001). The mesioangular impacted third molars revealed significant relation with the mandibular canal (p<0.05). The most frequent variation found was the dental canal followed by the retromolar canal. In general, higher measurement values were obtained for men when compared to women (p<0.05). CONCLUSION: CBCT assessment of the third molar region provided useful information regarding impacted mandibular third molar surgery operations.


Assuntos
Dente Serotino , Dente Impactado , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem
16.
Ann Vasc Surg ; 68: 159-165, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32502676

RESUMO

BACKGROUND: Carotid body tumors (CBTs) are rare highly vascularized and slow enlarging tumors arising from the paraganglionic tissue at the carotid bifurcation. Main treatment options for CBTs are surgical resection or "wait and scan" strategy. The choice for either strategy may be equally good medically in many patients. A structured "shared decision making" (SDM) might be helpful for guiding patients. OBJECTIVES: To develop an SDM strategy for the surgical treatment, we aim to (1) identify considerations and factors involved in the decision making of patients with CBTs and (2) evaluate the current practice in our clinic and explore the opinions of patients on their treatment. METHODS: This exploratory study was conducted in patients of the Leiden University Medical Centre (LUMC), The Netherlands. Patients who met the inclusion criteria were invited for a semi-structured interview. All conversations were fully audiotaped and transcripted. RESULTS: Fifteen patients were included and interviewed. Ten of these patients underwent previously surgical resection of at least one tumor. Five patients underwent the wait and scan policy. The most important factors influencing decision making in CBT treatment are family, fears, co-consultants, and doctor-patient relationship. CONCLUSIONS: This study has identified the factors influencing decision making in CBT and should be considered during consultations. The decision for surgery or not was mainly influenced by physician preferences and family members' prior experiences.


Assuntos
Tumor do Corpo Carotídeo/terapia , Tomada de Decisão Clínica , Tomada de Decisão Compartilhada , Participação do Paciente , Procedimentos Cirúrgicos Vasculares , Conduta Expectante , Adulto , Tumor do Corpo Carotídeo/diagnóstico por imagem , Tumor do Corpo Carotídeo/patologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Países Baixos , Seleção de Pacientes , Medição de Risco , Fatores de Risco , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Adulto Jovem
17.
J Biosci Bioeng ; 127(2): 241-245, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30348486

RESUMO

Ficus carica (common fig) dried fruit extract was used to synthesize iron oxide nanoparticles in this study. Biomaterials in the common fig dried fruit extract synthesized the iron nanoparticles by reducing the iron precursor salt and then acted as capping and stabilizing agents. The nanoparticles were produced smaller than 20 nm diameters and oxidized due to the high phenolic compound content in the common fig dried fruit extract. Nanoparticles were characterized by energy dispersive X-ray spectroscopy (EDX), transmission electron microscopy (TEM), UV-visible spectroscopy, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), dynamic light scattering (DLS). First, color change and pH reduction occurred immediately due to the iron nanoparticle synthesis. TEM images showed that the nanoparticles were at 9 ± 4 nm diameters and the metallic core-oxide shell form. The nanoparticles were in spherical shapes with a monodisperse distribution. EDX, XRD and FTIR analysis signals showed the iron oxyhydroxide/oxide formation. Absorption peaks were detected at 205 nm and 291 nm due to the iron metallic core hydrolysis products. The intensity-average diameter of nanoparticles was calculated at 475 nm diameter by DLS analysis. Colloid stability was determined as moderate at 20.7 mV.


Assuntos
Compostos Férricos/química , Compostos Férricos/síntese química , Ficus/química , Química Verde/métodos , Nanopartículas Metálicas/química , Extratos Vegetais/química , Biocatálise , Coloides/síntese química , Coloides/química , Dessecação , Frutas/química , Microscopia Eletrônica de Transmissão , Tamanho da Partícula , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X
18.
Int Urol Nephrol ; 49(12): 2105-2109, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28956280

RESUMO

INTRODUCTION: We evaluated the bladder oxidative stress in neurogenic bladder children treated with intravesical amikacin for recurrent UTI and whether urinary isoprostane f2 alpha (F2-IsoP) is a good biomarker in this particular condition. METHODS: This prospectively designed controlled study was approved by the Adnan Menderes University institutional ethics committee (Adnan Menderes University, 2015/649). Between January 2016 and January 2017, twenty-six children with meningomyelocele who had been doing CIC were recruited. Serum and urine samples were collected during urinary tract infection (UTI) (group 1) and after management of UTI with intravesical amikacin (group 2) besides standard oral antibiotic treatment. While oxidative stress parameters SOD, GSH, GPX, MDA, F2-IsoP and NO were analyzed in the serum samples, only F2-IsoP was analyzed in the urine. All data were compared with 23 normal healthy control children (group 3). RESULTS: Median age, CIC duration and number of CIC per day of patients' group were 84 (60-147) months, 60 (30-90) months and 4 (4-6), respectively. Male-to-female ratio was 1:16. There was no statistical difference between groups in terms of serum oxidative stress parameters (p > 0.05). However, statistically significant urine F2-IsoP changes exist between groups (p = 0.011) (Fig. 1). But there were no correlations between urine F2-IsoP and disease clinical data such as CIC duration or number of CIC per day. Serum glutathione levels in group 2 were higher than group 1 and 3, as well (p = 0.023, Kruskal-Wallis test). Fig. 1 Comparison of median urinary isoprostane f2 alpha levels CONCLUSION: Higher urine F2-IsoP levels after management of UTI with intravesical amikacin may reflect increased lipid peroxidation and oxidative stress in children with NB. This detrimental effect on bladder should be considered in the long-term treatment period.


Assuntos
Amicacina/efeitos adversos , Antibacterianos/efeitos adversos , Estresse Oxidativo/efeitos dos fármacos , Bexiga Urinaria Neurogênica/complicações , Infecções Urinárias/tratamento farmacológico , Administração Intravesical , Amicacina/administração & dosagem , Antibacterianos/administração & dosagem , Biomarcadores/sangue , Biomarcadores/urina , Criança , Pré-Escolar , Feminino , Glutationa/sangue , Humanos , Masculino , Estudos Prospectivos , Infecções Urinárias/complicações
19.
J Biol Inorg Chem ; 22(1): 61-85, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27830402

RESUMO

New copper(II) complexes-dimeric-[Cu(nphen)(gly)(H2O)]+ (1) and [Cu(dmphen)(gly)(NO3)(H2O)] (2) (nphen = 5-nitro-1,10-phenanthroline, dmphen = 4,7-dimethyl-1,10-phenanthroline, and gly = glycine)-have been synthesized and characterized by CHN analysis, single-crystal X-ray diffraction techniques, FTIR, EPR spectroscopy, and cyclic voltammetry. The CT-DNA-binding properties of these complexes have been investigated by thermal denaturation measurements and both absorption and emission spectroscopy. The DNA cleavage activity of these complexes has been studied on supercoiled pUC19 plasmid DNA by gel electrophoresis experiments in the absence and presence of H2O2. Furthermore, the interaction of these complexes with bovine serum albumin (BSA) has been investigated using absorption and emission spectroscopy. The thermodynamic parameters, free-energy change (ΔG), enthalpy change (ΔH), and entropy change (ΔS) for BSA + complexes 1 and 2 systems have been calculated by the van't Hoff equation at three different temperatures (293.2, 303.2, and 310.2 K). The distance between the BSA and these complexes has been determined using fluorescence resonance energy transfer (FRET). Conformational changes of BSA have been observed using the synchronous fluorescence technique. In addition, in vitro cytotoxicities of these complexes on tumor cell lines (Caco-2, A549, and MCF-7) and healthy cells (BEAS-2B) have been examined. The antimicrobial activity of the complexes has also been tested on certain bacteria cells. The effect of mono and dimeric in the above complexes is presented and discussed. New copper(II) complexes-dimeric-[Cu(nphen)(gly)(H2O)]+ (1) and [Cu(dmphen)(gly) (NO3)(H2O)] (2) (nphen = 5-nitro-1,10-phenanthroline, dmphen = 4,7-dimethyl-1,10-phenanthroline and gly = glycine)-have been synthesized and characterized by CHN analysis, single-crystal X-ray diffraction techniques, FTIR and EPR spectroscopy. They have been tested for their in vitro DNA/BSA interactions by the spectroscopic methods. These complexes exhibited higher cytotoxic and antimicrobial activities. Complex 1 shows better DNA / BSA interactions in comparison to complex 2.


Assuntos
Cobre/química , DNA/metabolismo , Glicina/química , Fenantrolinas/química , Soroalbumina Bovina/metabolismo , Animais , Anti-Infecciosos/síntese química , Anti-Infecciosos/química , Anti-Infecciosos/metabolismo , Anti-Infecciosos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Antineoplásicos/metabolismo , Antineoplásicos/farmacologia , Bovinos , Técnicas de Química Sintética , Cristalografia por Raios X , Clivagem do DNA/efeitos dos fármacos , Modelos Moleculares , Conformação Molecular
20.
Dermatol Online J ; 22(6)2016 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-27617601

RESUMO

Median raphe cysts (MRC) are uncommon, benign congenital lesions that may present anywhere in the midline between the urinary meatus and the anus, with the shaft of the penis and the glans penis being the most common sites. We report a 52-year-old man with median raphe cyst unusually located in perianal region and treated by surgical excision.


Assuntos
Doenças do Ânus/patologia , Cistos/patologia , Pólipos/patologia , Doenças do Ânus/congênito , Doenças do Ânus/cirurgia , Cistos/congênito , Cistos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/congênito , Pólipos/cirurgia
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