Cyberbullying among adolescents in Turkey: the relationship between coping strategies and cyberbullying perpetration.

BACKGROUND: Cyberbullying is becoming a global threat with the ease of access to the internet. Although many studies addressed the relationship between coping strategies and cyber victimization, the role of coping strategies, protective or risk factors, on involvement in cyberbullying perpetration is unclear. Therefore, the present study aims to examine the effect of active, avoidant, and negative coping strategies and the sociodemographic variables (i.e., parents' education, gender, and family income) on cyberbullying perpetration behaviors. METHOD: The study was conducted on 1032 adolescents (mean age = 16.01 years; range = 14-18 years), 608 (58.9%) were female, and 424 (41.1%) were male. Personal Information Form, Cyberbullying Scale, and Coping Scale for Adolescents (the KIDCOPE) were used in data collection. Multiple regression analysis was performed for data analysis. RESULTS: The study's findings revealed that active coping strategy (ß = -.26, p < .001) was a protective factor for cyberbullying perpetration behaviors, whereas avoidant (ß = .31, p < .001) and negative coping (ß = .32, p < .001) strategies and the mother's education (ß = .10, p < .001) were risk factors. However, the study results showed that gender (ß = -.01, p > .05), family income (ß = .03, p > .05), and the father's education (ß = .01, p > .05) were not predicting factors of cyberbullying perpetration behaviors. CONCLUSIONS: The results are discussed in light of the relevant literature and presented some theoretical and practical implications.

Grief and mourning in Covid-19 pandemic and delayed business as a new concept.

The measures, restrictions, and death-related rituals in the COVID-19 pandemic have affected the mourning-related routines of individuals. Moreover, mourning processes have been affected by the restriction of death-related cultural rituals, funeral ceremonies performed only by the officials, and the prohibition of visiting graves. This study aims to investigate the experiences of individuals who lost their loved ones in Turkey during the COVID-19 pandemic. For that purpose, the phenomenological method is employed in the design of the study. Individual interviews were conducted with nine participants who lost their relatives during the COVID-19 pandemic. Data were collected through semi-structured interview forms prepared by the researchers. The study participants described the various factors contributing to the grief and mourning process in the COVID-19 pandemic. These factors were categorized into three following main categories: grief and mourning responses of the individuals lost loved ones, including cognitive, emotional, and behavioral responses; risk factors including the expectation of harm, unfinished business, and restriction of death-related religious-cultural rituals; and protective factors including relative support (i.e., family, spouse, friend, partner), tele-support (i.e., mobile phone, internet, social media), positive coping strategies (cognitive, behavioral, and religious-spiritual), and delayed business. The "delayed business" concept was also addressed within protective factors and explained in general terms. Finally, the findings were discussed considering the literature and presented some theoretical and practical implications.

PROJECT STAR (Midwestern Prevention Project): Overview.

The program designed to prevent substance use should be planned in multiple dimensions. One of these programs is Project Star. This study aims to evaluate the studies on the Project Star and identify the strengths and weaknesses of the program. For this purpose, the keywords "Project Star" and "Midwestern Prevention Project" were scanned from databases. The results of these studies were evaluated by giving a summary of the studies included in the study. As a result, the strengths of Project Star are that it is multidimensional, focuses on early development periods, includes the individual's ecological environment, and reduces substance use in later development periods, and not having an internet-based version. This situation has been identified as its weaknesses since its situation in other societies is unknown due to its cost and limited international applications.

Dermatologic comorbidities of the patients with severe COVID-19: A case-control study.

The current studies focus on the association between COVID-19 and certain comorbidities. To the best of our knowledge, the association between severe COVID-19 and dermatologic comorbidities has not been reported yet. In this study, we aimed to describe the dermatologic comorbidities of patients with severe COVID-19 and compare it with the control group. Patients who have died at Usak Training and Research Hospital due to COVID-19 and other diseases in the COVID-19 Intensive Care Units and Internal Medicine Intensive Care Units were recruited into the study. Two groups were compared with each other regarding the most common dermatologic comorbidities. A total of 198 patients including 111 patients with COVID-19 and 87 age and sex-matched patients with other diseases were enrolled in the study. The most common dermatologic comorbidities were pruritus (8.1%), eczema (6.3%), skin infections (3.6%), leukocytoclastic vasculitis (1.8%), and urticaria (0.9%) in the COVID-19 group while they were skin infections (9.2%), eczema (3.4%), pruritus (2.3%), and urticaria (1.1%) in the control group. None of patients in the control group had leukocytoclastic vasculitis. There were no significant differences between COVID-19 and control groups in terms of pruritus, eczema, skin infections, and urticaria (P values were .117, .517, .181, .505, and 1.000, respectively). In conclusion, although it is not statistically significant, it appears that pruritus and leukocytoclastic vasculitis are more common in severe COVID-19 patients. These cytokines-related diseases in the immuno-cutaneous systems may give some clues on the COVID-19 severity. Further studies are required to elucidate the relationship between the immuno-cutaneous system and COVID-19 severity.

Relative changes in the pattern of diseases presenting in dermatology outpatient clinic in the era of the COVID-19 pandemic.

As an increasing number of COVID-19 cases, there were changes in the number of patients who attended the dermatology outpatient clinics. We aimed to investigate the change profiles of dermatologic diseases in the first and second months of the COVID-19 pandemic in Turkey by comparing with the corresponding period of the previous year. The total number and diagnosis of patients, who attended a tertiary care hospital for the dermatology outpatient clinic between 1 April 2020 and 31 May 2020, were included in this study. These data were compared with the corresponding period of the previous year. The percentage of the patients with scabies, contact dermatitis, psoriasis, pityriasis rosea, urticaria, and alopecia areata were statistically significantly increased a month after the occurrence of the COVID-19 pandemic, while the percentage of patients with scabies, alopecia areata, telogen effluvium, acne vulgaris, and xerosis cutis were statistically significantly increased 2 months after the occurrence of the COVID-19 pandemic (P < 0.05). An increase in the number of certain diseases such as urticaria and pityriasis rosea may indicate the risk of asymptomatic COVID-19 carriage in these patients. Polymerase chain reaction (PCR) and/or antibody-based further studies should be performed to explore whether certain dermatologic diseases are related to asymptomatic COVID-19 cases.

Dermatological diseases presented before COVID-19: Are patients with psoriasis and superficial fungal infections more vulnerable to the COVID-19?

Recent studies have focused on the comorbid conditions of the COVID-19. According to the current studies, numerous diseases including lung disease, cardiovascular disease and immunosuppression appear to be at higher risk for severe forms of the COVID-19. To date, there are no data in the literature on the comorbid dermatologic diseases and COVID-19. We tried to analyze the previous dermatological comorbidity of 93 patients with COVID-19 (51 males, 42 females) who presented to the dermatology outpatient clinics for the last 3 years. The most common dermatologic diseases in patients with COVID-19 who have dermatologic diseases for the last 3 years were superficial fungal infections (24, 25.8%), seborrheic dermatitis (11, 11.8%), actinic keratosis (10, 10.8%), psoriasis (6, 6.5%), and eczema (6, 6.5%), respectively. In addition, the number of COVID-19 patients who presented to dermatology in the last 3 months was 17 (11 men, 6 women). The median age of these patients was 58 (minimum 18, maximum 80) years, and the most common dermatologic diseases before diagnosed COVID-19 were superficial fungal infections (5, 25%), psoriasis (4, 20%), and viral skin diseases (3, 15%). The possible similarity between cutaneous and mucosal immunity and immunosuppression suggests that patients with some dermatologic diseases especially superficial fungal infections and psoriasis may be more vulnerable to the COVID-19.

The effect of the "stay-at-home" policy on requests for dermatology outpatient clinic visits after the COVID-19 outbreak.

The Coronavirus Disease 2019 (COVID-19) emerged late in Turkey but it showed a rapid progression later. We aimed to investigate the changes in the number of patients who requested a dermatology outpatient clinic visit due to the increased social and medical burden caused by COVID-19 in Turkey during the first days of the pandemic. We also examined the most common dermatologic diseases diagnosed during the COVID-19 outbreak. A statistically significant negative correlation was found between the number of COVID-19 patients in the country and the number of patients requesting a dermatology outpatient clinic visit in the secondary and tertiary care hospitals during self-quarantine. In the first 10 days after the COVID-19 outbreak, acne (28.2%), urticaria (12.8%), scabies (12.8%), irritant contact dermatitis (10.3%), and xerosis cutis (10.2%) were the most common diseases seen in the dermatology clinic at the secondary care hospital, while acne (23.3%), warts (5.4%), seborrheic dermatitis (4.5%), urticaria (3.8%), and psoriasis (3.32%) were the most common diseases seen in the dermatology clinic at the tertiary care hospital. This is our first study on the frequency and nature of outpatient dermatology visits during this novel coronavirus pandemic. Understanding the trends and impacts of dermatologic diseases on patients and health systems during this pandemic will allow for better preparation of dermatologists in the future.

The effect of tinea versicolor on thiol/disulphide homeostasis.

INTRODUCTION: Tinea versicolor is a superficial fungal infection caused by Malassezia spp. Malassezia spp. is a member of the normal human skin flora. It becomes a pathogen by transforming from the yeast form to the mycelium form. The oxidant/antioxidant homeostasis may be responsible for this. Thiol/disulphide homeostasis is a new marker indicating oxidative stress. This homeostasis is affected in many illnesses. AIM: To investigate the thiol/disulphide homeostasis in patients with tinea versicolor. MATERIAL AND METHODS: Forty-two patients with tinea versicolor (median age: 36 years, min.-max.: 19-58) and 36 healthy controls (median age: 32 years, min.-max.: 18-60) were included in the trial. The levels of native thiol, disulphide, and total thiol were measured by an automated method in the patient and control groups. Disulphide/total thiol, disulphide/native thiol and native thiol/total thiol rates were calculated as percentage. RESULTS: For the patient group and the control group, the native thiol levels were found to be 464.32 ±51.48 mmol/l and 465.18 ±51.32 mmol/l, disulphide levels - 19.80 ±7.08 mmol/l and 21.27 ±8.90 mmol/l, total thiol levels - 503.92 ±53.65 mmol/l and 508.07 ±56.59 mmol/l, respectively. No statistical difference was detected between the two groups. CONCLUSIONS: Thiol/disulphide homeostasis was not affected in tinea versicolor. According to our findings, oxidative stress seems to have no role in the pathogenesis of tinea versicolor.

Which intraperitoneal insufflation pressure should be used for less postoperative pain in transperitoneal laparoscopic urologic surgeries?

PURPOSE: To determine whether using different intraperitoneal insufflation pressures for transperitoneal laparoscopic urologic surgeries decreases postoperative pain. MATERIALS AND METHODS: 76 patients who underwent transperitoneal laparoscopic upper urinary tract surgery at different insufflation pressures were allocated into the following groups: 10mmHg (group I, n=24), 12mmHg (group II, n=25) and 14mmHg (group III, n=27). These patients were compared according to age, gender, body mass index (BMI), type and duration of surgery, intraoperative bleeding volume, postoperative pain score and length of hospital stay. A visual analog scale (VAS) was used for postoperative pain. RESULTS: Demographic characteristics, mean age, gender, BMI and type of surgeries were statistically similar among the groups. The mean operation time was higher in group I than group II and group III but this was not statistically significant (P=0.810). The mean intraoperative bleeding volume was significantly higher in group I compared with group II and group III (P=0.030 and P=0.006). The mean length of postoperative hospital stays was statistically similar among the groups (P=0.849). The mean VAS score at 6h was significantly reduced in group I compared with group III (P=0.011). At 12h, the mean VAS score was significantly reduced in group I compared with group II and group III (P=0.009 and P<0.001). There was no significant difference in the mean VAS scores at 24h among three groups (P=0.920). CONCLUSION: Lower insufflation pressures are associated with lower postoperative pain scores in the early postoperative period.

Prophylactic effects of alpha-blockers, Tamsulosin and Alfuzosin, on postoperative urinary retention in male patients undergoing urologic surgery under spinal anaesthesia.

PURPOSE: Postoperative urinary retention (POUR) is one of the most common complications after surgical procedures under spinal anaesthesia. Recent studies have shown the beneficial effects of alpha-adrenergic blockers in preventing POUR. The aim of this prospective study was to investigate and compare the prophylactic effects of tamsulosin and alfuzosin on POUR after urologic surgical procedures under spinal anaesthesia. MATERIALS AND METHODS: A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded. RESULTS: There were 60 patients in each Group. Their mean age was 35.95±15.16 years. Fifteen patients in Group I (25%), 3 patients in Group II (5%) and 4 patients in Group III (6.7%) required catheterization because of urinary retention. In tamsulosin group and alfuzosin group, there were a significantly lower proportion of patients with POUR compared with the placebo Group (p=0.002 and p=0.006). The beneficial effects of tamsulosin and alfuzosin on POUR were similar between both Groups (p=0.697). CONCLUSION: This study suggests that the use of prophylactic tamsulosin or alfuzosin can reduce the incidence of urinary retention and the need for catheterization after urologic surgical procedures under spinal anaesthesia.

A Turkish patient with Hermansky-Pudlak syndrome.

A 34-year-old woman presented to our outpatient clinic with photosensitivity, photophobia, and facial pruritus (Figure 1). She had brown eyes and fair skin, hair, eyelashes, and eyebrows since birth. Her sister had similar skin and hair pigments. The patient had no systemic disease and was not taking any medication. Her parents were second-degree relatives. A dermatologic examination revealed small hyperkeratotic papules with an erythematous background, minimal desquamation, and some excoriation over the nose, zygomatic arch, and forehead consistent with actinic keratosis and solar damage. An ophthalmological examination demonstrated impaired visual acuity (60/100 in both eyes, reaching 80/100 in the left eye with best correction). Hypopigmentation at the albinotic retinal midperiphery (Figure 2) by fundoscopy was noted. She had no nystagmus or strabismus. The patient had no complaints or symptoms of the neurological, gastrointestinal, or respiratory system, and she had no recurrent skin or systemic infection.

Cutaneous drug reactions in children: a multicentric study.

INTRODUCTION: According to studies conducted in outpatients, it is estimated that 2.5% of children who are treated with a drug will experience a cutaneous adverse drug reaction (CADR). AIM: To analyze the CADR reports involving pediatric patients recorded by three different university hospitals for describing common, serious, and interesting cutaneous drug eruption patterns. MATERIAL AND METHODS: For this purpose, the patients' data from three different universities were reviewed retrospectively. Diagnosis was based on history, clinical findings and laboratory test results. The CADRs were classified into seven categories; urticaria, angioedema, maculopapular eruption, fixed drug eruption, erythema multiforme, acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms syndrome. RESULTS: A total of 122 patients who had CADRs were enrolled in the study. The most frequently detected cutaneous drug reactions were urticaria + angioedema. Most of patients had no previous experience with the same drug and the most common causative agent of CADRs was antimicrobials. CONCLUSIONS: Since CADRs are relatively rare, the current multicentric study can provide meaningful information about the cutaneous eruption patterns of commonly used drugs.

Routine flexible nephroscopy for percutaneous nephrolithotomy for renal stones with low density: a prospective, randomized study.

PURPOSE: We evaluated the usefulness of routine flexible nephroscopy during percutaneous nephrolithotomy. MATERIALS AND METHODS: Patients diagnosed with kidney stones who were scheduled to undergo percutaneous nephrolithotomy between March 2011 and July 2012 were randomized into 2 groups. Group 1 underwent standard percutaneous nephrolithotomy using rigid nephroscopy. Group 2 underwent flexible nephroscopy, in addition to standard percutaneous nephrolithotomy and laser lithotripsy or basket catheter stone extraction, as needed. Surgery was performed subcostally and with minimal percutaneous access in group 2 to use the advantages of flexible nephroscopy. We compared the 2 groups in terms of preoperative stone characteristics and postoperative success criteria, including the stone-free rate, bleeding, number of access sites, etc. RESULTS: The study included 61 males (76.3%) and 19 females (23.8%) with a mean ± SD age of 43.75 ± 12.4 years (range 19 to 74). There was no significant difference in stone size, HU density or stone location between the 2 groups. Comparison of perioperative and postoperative parameters revealed a higher stone-free rate (92.5% vs 70%), fewer access sites and a lower hematocrit decrease in group 2. The stone-free rate was higher in patients with stones with a density of less than 677.5 HU (100% in group 2 vs 64.7% in group 1). CONCLUSIONS: Routine flexible nephroscopy during percutaneous nephrolithotomy was associated with a higher stone-free rate, fewer interventions and less bleeding, especially in patients with low HU density stones.

Evaluation of dermatological consultations of patients treated in intensive care unit.

BACKGROUND: Skin disorders which require treatment are a common development in patients treated in intensive care units (ICUs). There are very few prospective studies about skin complications in adult ICUs. OBJECTIVE: The aim of this study is to evaluate skin disorders in ICU-treated adult patients who were consulted for dermatological problems. METHODS: Eighty-two of 591 patients admitted to ICUs who were consulted for dermatological problems were included in the study. The correlation between skin complications and associated comorbidities, age, gender and ICU length of stay were analyzed. RESULTS: Ninety dermatological complications were observed. Cutaneous drug reactions were significantly more frequent in female patients than males (p = 0.020). Candidal intertrigo was more frequent in diabetic patients than in nondiabetic patients (p = 0.042). CONCLUSION: Patients in ICUs may develop various skin disorders that need to be evaluated by dermatological consultations. Clinical features of the patients, especially gender and comorbidities, may predispose skin complications.

Does the endoscopic treatment of lower ureter stones affect uroflowmetric values? A prospective clinical trial.

OBJECTIVES: The aim of this study was to document if stones at the lower ureter alter the micturition capability of the patients and to investigate whether endoscopic removal of these stones restores normal urinary flow rates or not in the 3 months of follow-up. METHODS: Forty patients with lower ureteral stone (group 1) and 20 control subjects with proximal ureteral stone (group 2) were enrolled into the study. All patients underwent uroflowmetry testing before and 3 months after the treatment for endoscopic stone removal. The mean average and peak flow rates with a sufficient voided volume (≥150 ml) were evaluated before and after surgery and compared between the groups. RESULTS: Mean values of the peak flow rates before and after surgery were 20.3 and 27.5 ml/s in group 1 and 22.5 and 23.6 ml/s in group 2, and the mean average flow rate values before and after surgery were 10.5 and 13.6 ml/s in group 1 and 11.4 and 12.1 ml/s in group 2. Statistically significant differences were determined between before and after ureteroscopy values were determined in terms of average (p < 0.05) and peak flow rates (p < 0.01) in group I; however, there no significant difference was seen in the control group. CONCLUSION: We document for the first time in the literature that patients with lower ureteric stones have a reduction in their urinary stream which resolves with endoscopic removal of the stones.

Spectrophotometric intracutaneous analysis findings and characteristics in plantar verrues.

BACKGROUND: Spectrophotometric intracutaneous analysis (SIAscopy) is a non-invasive computerized method that provides insights beyond dermoscopic examination. This study aimed to show the various findings of the plantar verrucae with the SIAscopy evaluation, which displays the chromophores of the skin, melanin, hemoglobin, and collagen. METHODS: Plantar verrucae lesions scanned using SIAscopy, and their color, total melanin, dermal melanin, collagen, and blood views were recorded on a computer. These SIAgraphs were examined individually and compared to dermoscopic literature findings. RESULTS: The results of color view were in conformity with dermoscopic findings reported in the literature. Among the findings detected for the first time by a SIAscopic examination, a white halo around the vessel in view of total melanin, effacement in the keratinized areas, and whitening in the vascular areas were noted. There was a mottled collagen condensation, which was believed to be induced by dermal papillomatosis in the lesions in the view of collagen, and consequently, as a result of remittent light reflections due to the collagen structure in this area. There was a clarification in the vascular structures that were noticed in the color view in the blood view. It was noted that vascular structures that have not yet been thrombosed under the thickened epidermis could not be detected in color view. CONCLUSION: Our study reveals that SIAscopy, a rapid, non-invasive, and easy-to-use examination method similar to dermoscopy, can also diagnose other skin diseases, particularly pathogenetic processes that induce epidermal and papillary dermis changes, apart from pigmented lesions.

High frequency of hypertrichosis after cast application.

BACKGROUND: Hypertrichosis following cast application is commonly observed after removing casts, due to an unknown mechanism. OBJECTIVE: To determine the frequency and associated demographic and clinical risk factors of postcast hypertrichosis in patients who underwent cast application for bone fractures. METHODS: The study included 117 patients (50 females, 67 males, age range: 3-91 years). Demographic information of each patient (age, gender, fracture localization, type of cast, cast duration and pruritus) was recorded. After removing the cast, the presence of hypertrichosis, contact dermatitis and lymphedema of the cast area was evaluated. Demographic and clinical features of the patients were analyzed to determine the risk factors for postcast hypertrichosis. RESULTS: Postcast hypertrichosis was detected in 34.2% of patients. Patients with hypertrichosis were younger than those without hypertrichosis (p = 0.015). Duration of cast application, session of cast application, presence of lymphedema, contact dermatitis and pruritus between patients with hypertrichosis and without hypertrichosis were similar (p > 0.05). Age was the only parameter independently associated with developing postcast hypertrichosis (OR: 0.97, 95% CI: 0.95-0.99; p = 0.008). The frequency of hypertrichosis peaked significantly between 12 and 25 years (p = 0.026). CONCLUSION: A significant number of patients with cast application developed hypertrichosis. Patient age was closely associated with postcast hypertrichosis.