Consensus statement addressing controversies and guidelines on pediatric urolithiasis.

PURPOSE: We aimed to investigate controversial pediatric urolithiasis issues systematically, integrating expert consensus and comprehensive guidelines reviews. METHODS: Two semi-structured online focus group meetings were conducted to discuss the study's need and content, review current literature, and prepare the initial survey. Data were collected through surveys and focus group discussions. Existing guidelines were reviewed, and a second survey was conducted using the Delphi method to validate findings and facilitate consensus. The primary outcome measures investigated controversial issues, integrating expert consensus and guideline reviews. RESULTS: Experts from 15 countries participated, including 20 with 16+ years of experience, 2 with 11-15 years, and 4 with 6-10 years. The initial survey identified nine main themes, emphasizing the need for standardized diagnostic and treatment protocols and tailored treatments. Inter-rater reliability was high, with controversies in treatment approaches (score 4.6, 92% agreement), follow-up protocols (score 4.8, 100% agreement), and diagnostic criteria (score 4.6, 92% agreement). The second survey underscored the critical need for consensus on identification, diagnostic criteria (score 4.6, 92% agreement), and standardized follow-up protocols (score 4.8, 100% agreement). CONCLUSION: The importance of personalized treatment in pediatric urolithiasis is clear. Prioritizing low-radiation diagnostic tools, effectively managing residual stone fragments, and standardized follow-up protocols are crucial for improving patient outcomes. Integrating new technologies while ensuring safety and reliability is also essential. Harmonizing guidelines across regions can provide consistent and effective management. Future efforts should focus on collaborative research, specialized training, and the integration of new technologies in treatment protocols.

Hydrogen peroxide signaling modulates neuronal differentiation via microglial polarization and Wnt/ß-catenin pathway.

OBJECTIVE: Reactive oxygen species (ROS) are generated within the cell and serve as second messengers in fundamental cellular processes under physiologic conditions. Although the deleterious effects of high-level ROS associated with oxidative stress are well established, it is unclear how the developing brain reacts to redox changes. Our aim is to investigate how redox alteration affects neurogenesis and the mechanism that underlies it. MATERIALS AND METHODS: We investigated in vivo microglial polarization and neurogenesis in zebrafish after hydrogen peroxide (H2O2) incubation. To quantify intracellular H2O2 levels in vivo, a transgenic zebrafish line that expresses Hyper and termed Tg(actb2:hyper3)ka8 was used. Then, in vitro studies with N9 microglial cells, 3-dimensional neural stem cell (NSC)-microglia coculture, and conditioned medium experiments are carried out to comprehend the mechanism underlying the changes in neurogenesis upon redox modulation. RESULTS: In zebrafish, exposure to H2O2 altered embryonic neurogenesis, induced M1 polarization in microglia, and triggered the Wnt/ß-catenin pathway. N9 microglial cell culture experiments revealed that exposure to H2O2 resulted in M1 polarization in microglial cells, and this polarization was mediated by the Wnt/ß-catenin pathway. Redox modulation of microglia interfered with NSC differentiation in coculture experiments. Neuronal differentiation was significantly higher in NSCs cocultured with H2O2-treated microglia when compared to control microglia. Wnt inhibition prevented the effects of H2O2-treated microglia on NSCs. No significant alterations were observed in conditioned medium experiments. CONCLUSIONS: Our findings point to a robust interplay between microglia and neural progenitors influenced by the redox state. Intracellular H2O2 levels can interfere with neurogenesis by altering the phenotypic state of the microglia via the Wnt/ß-catenin system.

Effects of comorbidities associated with COVID-19 cases in Intensive Care Unit on mortality and disease progression.

OBJECTIVE: The patient's age, gender and the presence of certain concomitant diseases have been reported to play a part in the course and progression of COVID-19 in the literature. In this study, we aimed to compare the comorbidities causing mortality in critically ill Intensive Care Unit (ICU)-patients diagnosed with COVID-19. PATIENTS AND METHODS: The data as regards the COVID-19 cases followed up in the ICU were retrospectively reviewed. 408 COVID-19 patients with positive PCR test were included in the study. In addition, a subgroup analysis was performed in patients treated with invasive mechanical ventilation. While the primary aim of this study was to evaluate the difference in survival rates due to comorbidities in critical COVID-19 patients, we also aimed to assess the comorbidities in severely intubated COVID-19 patients in terms of mortality. RESULTS: A statistically significant increase in mortality was observed in patients with underlying hematologic malignancy and chronic renal failure (p=0.027, 0.047). Body mass index value in the mortal group was significantly higher in both the general study group and subgroup analysis (p=0.004, 0.001). CONCLUSIONS: Advanced age and comorbidities such as chronic renal failure and hematologic malignancy in COVID-19 patients are associated with poor survival prognosis in critically ill COVID-19 patients.

Investigation of long-term COVID-19 patients' quality of life and affecting factors: Data from single COVID-19 follow-up center.

Background: Patients with COVID-19 experienced changes in their quality of life. However, far less is known about how quality of life changes in long-term COVID-19 follow-ups. Aim: This article aims to explore the relationship between quality of life change and long-term COVID-19 patient status in the COVID-19 follow-up center. Patients and Methods: This study was designed retrospectively with patients admitted to the COVID-19 follow-up center between January and May 2021. The single group consisted of 125 patients. Their status and 36-Item Short-Form Health Survey (SF-36) variables were compared at two different time intervals. The first admission indicates the first 3 months, and the second admission covers 3-6 months after being diagnosed with COVID-19. Results: Cough and chest pain increased in the second admission (P < 0.001). No significant differences were found in SF-36 change according to age. The general health subgroup scores were lower in females than males (P = 0.004). The SF-36 Form's subgroups for physical function, physical role, emotional role, bodily pain, energy, mental health, general health, and social function showed improvement (P = 0.001, P = 0.001, P = 0.026 P < 0.001, P = 0.007, P = 0.031, P <0.001, P <0.001, respectively). In addition, comparing with the SF-36 subgroups in terms of treatment places, a significant result was found between the inpatient and intensive care unit (ICU) in the general health subgroup (P = 0.044). Conclusions: The results show that quality of life may worsen during follow-up for COVID-19. In summary, these findings have significant implications for understanding long-term COVID-19 patients with a multidisciplinary approach and the necessity of follow-up centers to detect the unpredictable results of long-term COVID-19.

COVID-19 outcomes in patients with antiphospholipid syndrome: a retrospective cohort study.

BACKGROUND: Aim of this study is to investigate COVID-19 outcomes in patients with antiphospholipid syndrome (APS). METHODS: A retrospective cohort was formed from APS patients. Patients were screened for a record of positive SARS-CoV 2 PCR. In PCR­positive patients, clinical data and information regarding COVID-19 outcomes were collected from medical records. RESULTS: A positive PCR test was detected in 9/53 APS patients, while 66.7 %, 33.3 % and 11.1 % of APS patients with COVID-19 were under hydroxychloroquine, LMWH or warfarin, and acetylsalicylic acid, respectively. There were 3/9 patients found to be hospitalized and one died. No new thrombotic event was reported in any of the patients during COVID-19 infection. CONCLUSION: Baseline use of hydroxychloroquine, antiaggregants and anticoagulants may be associated with an absence of new thrombotic event (Tab. 2, Ref. 33).

Systemic inflammation in both open-angle and angle-closure glaucoma: role of platelet-to-lymphocyte ratio.

AIM: To analyse the effect of systemic inflammatory status in patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) by calculating platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). METHODS: This retrospective case-control study included 200 patients with POAG, 22 patients with PACG and 100 healthy subjects. The participants' white-blood-cell, lymphocyte, neutrophil, and platelet counts were recorded from previous blood assays. NLR and PLR were calculated manually. Results were compared among the groups. RESULTS: Both the POAG and PACG groups had higher platelet counts and PLR values than the control group (p=0.001 and p=0.001; respectively). The difference in NLR between POAG, PACG and control groups was not statistically significant (p=0.076). The POAG group had higher NLR values than the control (p=0.035). CONCLUSION: Both the POAG and the PACG groups exhibited higher platelet and PLR levels than the control. These results indicate a potential role of systemic inflammation in the pathogenesis of POAG and PACG (Tab. 4, Fig. 1, Ref. 35).

The relationship between teamwork attitudes and caring behaviors among nurses working in surgical clinics: A correlational descriptive study.

AIM: This study was planned and carried out to determine how teamwork attitudes of nurses working in surgical clinics affect their caring behaviors. MATERIALS AND METHODS: The research was conducted as a relational descriptive study. The research population consisted of 126 nurses working in the surgical clinics of a state hospital. A total of 116 nurses who agreed to participate in the study were admitted to the study. Data were collected using the Descriptive Characteristics Question Form, the Teamwork Attitudes Questionnaire (TAQ), and the Caring Behaviors Inventory-24 (CBI-24). Data were analyzed using counts, percentage distributions, Mann-Whitney U test, and Kruskal-Wallis tests, Games-Howell post hoc test, and Spearman's correlation. RESULTS: The nurses participating in the study were found to have a mean score of 112.11 ± 17.86 for the TAQ and a mean score of 4.95 ± 0.54 for the CBI. There was a statistically positive correlation between the nurses' teamwork attitudes and caring behaviors (P < 0.05). CONCLUSION: It can be said that the teamwork attitudes of the nurses had a positive effect on their caring behaviors. It may be suggested to plan relevant research studies examining especially observational behavioral assessments.

Evaluation of mental foramen location in the 10-70 years age range using cone-beam computed tomography.

INTRODUCTION: Mental foramen (MF) locations were determined according to gender and age in terms of the vertical distance from the surrounding anatomical structures and the vertical and horizontal size of the MF. MATERIALS AND METHODS: One hundred-seven male and 103 female patients in the age group between 10 and 70 years were included in our retrospective study and were examined using cone-beam computed tomography (CBCT). The right and the left MF locations were determined from panoramic and cross-sectional images. On the cross-sectional CBCT images, the distance of the MF upper limit from the alveolar crest edge, the distance of the MF lower limit from the lower edge of the mandible, and vertical size of the MF were measured. RESULTS: MF location differed in males and females (P < 0.001); it was generally located at the first and second premolar in females, and at the level of the second premolar in males. However, the MF location was not different on the right and left sides (P = 0.436). The distance of the MF from the surrounding anatomic structures were found to be lower in females than in males in all measurements (P < 0.001). The horizontal size of the MF was found to be less on the left side (P < 0.001). CONCLUSIONS: Knowing both the position and the distance of the MF from the surrounding anatomical structures is not only useful information for surgery, but will also help avoid complications such as paresthesia.

Measuring the resistance of different substructure materials by sticking them to dentine with two different resin cements in vitro.

INTRODUCTION: The resistance of three different substructure materials - metal (Cr-Co), zirconium (Zr), and ceramics (IPS Empress II) - was measured by sticking them to dentine with two different resin cements, a dual-cure resin cement (Panavia F 2.0 Light) and a self-adhesive resin cement (BisCem). MATERIALS AND METHODS: In an in vitro study, 72 central upper front teeth were selected with no decay or apparent breakage and with complete development, removed for periodontal reasons. Labial and incisal surfaces of all teeth were prepared. Molds were obtained to prepare metal (Co-Cr), Zr, and ceramic (IPS Empress II) blocks for use in the study. The compressive strengths of the obtained material infrastructures were examined after thermal cycle processing by performing cementation to the teeth with two different cements. The data obtained were analyzed statistically. The Mann-Whitney U-test was used for comparisons of the groups with two options, and Kruskal-Wallis variance analysis was used to compare more than two groups. P<0.05 were considered statistically significant. RESULTS: While the highest result between samples was 117.86 ± 47.94 N in the dual-cure (Panavia)-ceramic group, the lowest value was observed at 6.53 ± 3.12 N in the self-adhesive (BisCem)-metal group. There was a significant difference between dual-cure (Panavia) and self-adhesive (BisCem) groups. CONCLUSION: In this study, we measured the bond strength; our most durable resistance groups were found to be, in order, Panavia-ceramics >Panavia-metal >Panavia-Zr >self-adhesive-ceramics >self-adhesive-Zr >and self-adhesive-metal.

Laparoscopic temporary clipping of uterine and ovarian arteries for the treatment of interstitial ectopic pregnancy.

PURPOSE OF INVESTIGATION: To assess the effect of laparoscopic temporary clipping of uterine and ovarian arteries for the treatment of interstitial ectopic pregnancy. MATERIALS AND METHODS: A 29-year-old woman with vaginal bleeding and pelvic pain was admitted to the current clinic. She had secondary amenorrhea for nine weeks. Transvaginal ultrasonography revealed normal empty uterus and right interstitial ectopic pregnancy with viable embryo. Laparoscopic temporary clipping of uterine and ovarian arteries, interstitial pregnancy resection, and primary myometrial suturing was performed. RESULTS: Following dissection Latzko pararectal space for the visualization of both uterine arteries, four vascular clips were placed (two to uterine arteries, two to infundibulopelvic ligaments). Excision of interstitial pregnancy and primary myometrial suturing was performed with minimal blood loss. The patient was discharged from the hospital after one day without any remarkable complications. CONCLUSIONS: To the best of the authors' knowledge, this is the first case of interstitial pregnancy that was successfully treated by temporary laparoscopic clipping of uterine and ovarian vessels prior to interstitial ectopic pregnancy resection.

Saccharomyces boulardii CNCM I-745 reduces the duration of diarrhoea, length of emergency care and hospital stay in children with acute diarrhoea.

Evidence from the literature has shown that Saccharomyces boulardii provides a clinically significant benefit in the treatment of acute infectious diarrhoea in children. In this multicentre, randomised, prospective, controlled, single blind clinical trial performed in children with acute watery diarrhoea, we aimed to evaluate the impact of S. boulardii CNCM I-745 in hospitalised children, in children requiring emergency care unit (ECU) stay and in outpatient settings. The primary endpoint was the duration of diarrhoea (in hours). Secondary outcome measures were duration of hospitalisation and diarrhoea at the 3(rd) day of intervention. In the whole study group (363 children), the duration of diarrhoea was approximately 24 h shorter in the S. boulardii group (75.4±33.1 vs 99.8±32.5 h, P<0.001). The effect of S. boulardii (diarrhoea-free children) was observed starting at 48 h. After 72 h, only 27.3% of the children receiving probiotic still had watery diarrhoea, in contrast to 48.5% in the control group (P<0.001). The duration of diarrhoea was significantly reduced in the probiotic group in hospital, ECU and outpatient settings (P<0.001, P<0.01 and P<0.001, respectively). The percentage of diarrhoea-free children was significantly larger after 48 and 72 h in all settings. The mean length of hospital stay was shorter with more than 36 h difference in the S. boulardii group (4.60±1.72 vs 6.12±1.71 days, P<0.001). The mean length of ECU stay was shorter with more than 19 h difference in the probiotic group (1.20±0.4 vs 2.0±0.3 days, P<0.001). No adverse effects related to the probiotic were noted. Because treatment can shorten the duration of diarrhoea and reduce the length of ECU and hospital stay, there is likely a social and economic benefit of S. boulardii CNCM I-745 in adjunction to oral rehydration solution in acute infectious gastroenteritis in children.

Nine-year Follow-up of a Patient with Thoracic Outlet Syndrome and Paget-Schroetter Syndrome.

Thoracic outlet syndrome (TOS) is a challenging clinical condition with regards to its diagnosis and treatment. Its management may turn out to be challenging a case when an adverse complication such as Paget-Schroetter syndrome (PSS) also co-exists. Herein, we report a nine-year follow-up of a patient with TOS (a 41-year old cardiovascular surgeon) who had suffered multiple PSS episodes and repeat TOS surgeries. In essence, we want to highlight the diverse clinical indings of TOS and discuss its management in light of the relevant literature.

Macular injury resulting from a high-powered tank laser telemetry device.

A high-powered laser is an essential part of a modern military rangefinder; however, this paper presents three cases with macular injury resulting from a high-powered tank laser telemetry device. All injuries occurred when another user deliberately pointed the telemetry target unit at the patient's eyes. The devastating effect of this high-powered laser resulted in a permanent foveal scar in the second patient and a macular hole formation in the third patient. This report emphasises that education plays a primary role in preventing accidental laser injuries. Using general guidelines and safety regulations will prevent accidental macular injuries.

Amniotic fluid lamellar body count as a novel biochemical marker for timing elective caesarean delivery.

The aim of this study is to evaluate the performance of amniotic fluid lamellar body count (LBC) on the timing of elective caesarean delivery (CS) at ≥ 39 weeks. After allocating the study group (group I, transient tachypnoea of newborn (TTN), n = 14), an age-matched control group (group II, no TTN, n = 79) was selected for amniotic fluid LBC analysis. The median amniotic fluid LBC levels in group I were significantly lower than in the control group. Furthermore, the median values of mean lamellar body volume, median lamellar body distribution width and lamellar bodycrit in group I were also significantly lower than in group II. The best amniotic fluid LBC value to predict TTN was 40.15 × 10(3)/µl, with 82.3% sensitivity and 64.3% specificity. The favourable sensitivity and specificity values to predict the TTN for amniotic fluid LBC may suggest using it as an elective caesarean delivery-time scheduling marker.

Guided and magnetic self-assembly of tunable magnetoceptive gels.

Self-assembly of components into complex functional patterns at microscale is common in nature, and used increasingly in numerous disciplines such as optoelectronics, microfabrication, sensors, tissue engineering and computation. Here, we describe the use of stable radicals to guide the self-assembly of magnetically tunable gels, which we call 'magnetoceptive' materials at the scale of hundreds of microns to a millimeter, each can be programmed by shape and composition, into heterogeneous complex structures. Using paramagnetism of free radicals as a driving mechanism, complex heterogeneous structures are built in the magnetic field generated by permanent magnets. The overall magnetic signature of final structure is erased via an antioxidant vitamin E, subsequent to guided self-assembly. We demonstrate unique capabilities of radicals and antioxidants in fabrication of soft systems with heterogeneity in material properties, such as porosity, elastic modulus and mass density; then in bottom-up tissue engineering and finally, levitational and selective assembly of microcomponents.