Evaluation of quality and readability of internet information on voice disorders.

OBJECTIVES: The purpose of this study is to evaluate the readability and quality of Internet information related to vocal health, voice disorders and voice therapy. STUDY DESIGN: This is a cross-sectional study. METHODS: Eighty-two websites were included. Websites were then analyzed; their origin (clinic/hospital, non-profit, government), quality (Health On the Net [HON] certification and DISCERN scores) and readability (Atesman readability formula and Bezirci-Yilmaz new readability formula) were assessed. Statistical analysis was used to examine differences between website origin and quality and readability scores and correlations between readability instruments. RESULTS: Of the 82 websites, 93% were of private clinic/hospital, 6% were of non-profit organisation and 1% were of government. None of the 82 websites were HON certification, and the mean score of the item determining the general quality measure in DISCERN was 1.83 in a five-point scale. The mean of Atesman readability formula value was calculated as 50.46 (±8.16). This value is defined as 'moderately hard' according to the readability scale. The average of Bezirci-Yilmaz new readability formula value is 13.85 (±3.48). This value is defined as 13th and 14th grade. CONCLUSIONS: The quality of Internet-based health information about the voice is generally inadequate, and the sites examined in this study may be limited due to high readability levels. This may be a problem in people with poor literacy skills. For this reason, it is very important for speech and language therapists and other health professionals to evaluate and monitor the quality and readability of Internet-based information.

Management of wet ascitic type of peritoneal tuberculosis: single center experience.

OBJECTIVE: We aimed to present our experience with the management of 17 patients with ascites who underwent diagnostic laparoscopy or laparotomy, and histologic confirmation of wet ascitic type of peritoneal tuberculosis (TB). PATIENTS AND METHODS: Between January 2008 and March 2019, 17 patients whose ascites were investigated by a gastroenterologist and who were thought to have non-cirrhotic ascites were referred to our Surgery clinic for peritoneal biopsy. The clinical, biochemical, radiological, microbiological, and histopathological data of the patients who underwent diagnostic laparoscopy or laparotomy were analyzed retrospectively. Histopathological examination of peritoneal tissue samples in hematoxylin-eosin-stained preparations revealed necrotizing granulomatous inflammation with caseous necrosis and Langhans type giant cells. Ehrlich-Ziehl-Neelsen (EZN) staining was studied with the suspicion of TB. Acid-fast bacilli (AFB) were detected in EZN stained slide. Histopathological findings were also considered. RESULTS: Seventeen patients aged 18 to 64 years were included in this study. The most common symptoms were ascites and abdominal distention, weight loss, night sweats, fever and diarrhea. Radiological examination revealed peritoneal thickening, ascites, omental cacking, and diffuse lymphadenopathy. Histopathologically, necrotizing granulomatous peritonitis consistent with peritoneal TB were detected. While direct laparoscopy was preferred in sixteen patients, laparotomy was preferred in the remaining one due to previous surgical procedures.  However, seven were converted to open laparotomy. CONCLUSIONS: Diagnosis of abdominal TB requires high index of suspicion, and the treatment should be prompt to reduce the morbidity and mortality associated with delay in treatment.

Effects of agomelatine on rat liver regeneration following partial hepatectomy.

Primary or metastatic hepatic malignancies are common. Partial hepatectomy (PH) is the primary treatment for both benign and malignant hepatic neoplasms; it also is used for living donor liver transplantation. The regenerative potential of the liver after PH is 70-80% in humans. We investigated the protective and therapeutic effects of agomelatine (AGM) on rat liver regeneration following PH. We used 32 rats distributed equally into four groups: group 1, sham control; group 2, PH group; group 3, administered 20 mg/kg AGM orally once/day for 7 days following PH; group 4, administered 20 mg/kg AGM orally once/day 3 days before and 7 days following PH for 10 days. Liver samples were analyzed for antioxidants and free radicals. Tissue samples were processed and stained with hematoxylin and eosin to assess histopathological status and stained immunohistochemically for Ki-67. We found that PH reduced antioxidant enzymes and increased tissue reactive oxygen species, whereas AGM treatment had the opposite effect on these parameters. Our biochemical and histopathological findings were consistent. PH caused sinusoid congestion and dilation. Intensity of Ki-67 immunostaining of hepatocytes was increased in group 2, whereas these were reduced in group 4. Intensity of Ki-67 immunostaining of hepatocytes was increased in group 2, whereas it was reduced in the group 4 compared to group 1. We found that AGM was hepatoprotective following PH due to its antioxidant and free radical scavenger properties.

The effect of HA330 hemoperfusion adsorbent method on inflammatory markers and end-organ damage levels in sepsis: a retrospective single center study.

OBJECTIVE: In this study, we aimed at evaluating the impact of HA330 hemoperfusion adsorbent application on inflammatory markers and end-organ damage markers in patients with sepsis/septic shock. PATIENTS AND METHODS: Patients who were diagnosed with sepsis/septic shock and treated with HA330 hemoperfusion adsorbent in addition to the standard treatment were included in this retrospective study conducted at Inonu University Turgut Ozal Medical Center between January 1, 2019 and January 1, 2021. RESULTS: A total of 150 patients were included in the study. The mean±SD age of the patients was 51.9±17.7 years. 102 patients (68%) were in septic shock. Mean±SD APACHE II scores were 15.3±4.8. The need for mechanical ventilation was noted in 64 patients (42.7%). WBC, neutrophil count, hemoglobin, platelet count, BUN, creatinine, AST, ALT, CRP and procalcitonin levels were measured before and after the procedure. Overall, 104 patients (69.3%) died median (min-max) 2.5 (1-114) days after the cytokine adsorption, while 46 patients (30.7%) recovered from sepsis and were discharged. The increase in BUN levels and decrease in platelet count after the procedure were statistically significant (p≤0.001, 0.041, respectively) in the overall study population. The laboratory findings in 46 survivors indicated significantly decreased AST and ALT levels after cytokine adsorption compared to baseline pre-treatment levels. WBC, neutrophil count, CRP, procalcitonin, BUN and creatinine values were also decreased after cytokine adsorption in survivors, whereas the change was not statistically significant. There was also a non-significant tendency for an increase in platelet count and hemoglobin levels after cytokine adsorption compared to pre-treatment values in these patients. CONCLUSIONS: Although no effect of HA330 hemoperfusion application on inflammatory markers and end-organ damage markers was demonstrated in our study, we used the HA330 hemoperfusion adsorbent method as a last resort in terminal patients with a mortality rate of approximately 90% and for whom antibiotic treatment did not benefit. Therefore, multicenter, prospective studies are needed to clarify the effect of early HA330 hemoperfusion use in the treatment of sepsis.

Investigation of the Importance of Knee Position during Femoral Tunnel Reaming; Figure 4 versus Hyperflexion.

Introduction: We aimed to compare whether the visualisation provided by arthroscopic hyperflexion and Figure 4 has an effect on femoral tunnel placement in patients undergoing single bundle Anterior Cruciate Ligament Reconstruction (ACLR). Material and methods: We retrospectively evaluated 93 patients who underwent single-band ACLR for Anterior Cruciate Ligament (ACL) injury between 2016 and 2019. Eighty patients met the inclusion criteria with a minimum follow-up of 12 months. We divided the patients into Group 1 (figure 4) and Group 2 (hyperflexion). We analysed the demographic, radiological and functional outcomes of the patients. The functional Lysholm score, operative time, radiological Quadrant method (% proximal-distal and % anterior-posterior) measurements, tunnel lengths, axial and coronal plane angles, and iatrogenic chondral injury in the medial femoral condyle were evaluated. Results: Iatrogenic chondral injury developed in the medial femoral condyle in a total of seven patients in both groups: one patient in group 1 (Figure 4) and six patients in group 2 (Hyperflexion). Although statistically insignificant, iatrogenic medial femoral condyle damage was less in group 1. The statistical analysis between surgical operation time (p = 0.046) and tunnel lengths (p = 0.042) was significant. Conclusion: The position of figure 4 provides visualisation of lateral intercondylar notch better than hyperflexion. In the reaming stage, the medial femoral condyle is less damaged in group 1 (Figure 4). In ACLR, which has a long learning curve, short surgery time is seen as an important advantage for surgeons who have just started doing ACLR. We think that it can be used as an alternative method to hyperflexion in the learning process and maybe shorten the learning curve process.

Estimation of periostin as a biomarker for early pregnancy diagnosis in goats: a preliminary study.

BACKGROUND: Periostin (POSTN) is an extracellular matrix (ECM) protein that plays an important role in the metastatic process and cancer cell migration. As implantation is a similar mechanism to metastasis, it has been hypothesized that POSTN may also play a role in the implantation process. AIMS: The aim of the present study was to compare POSTN and progesterone levels during the early pregnancy stage in Damascus goats. METHODS: Forty goats were synchronized using progesterone based sponges and were mated upon estrus signs display. While ten goats were kept as control (CON) and were not allowed to mate. Blood samples were taken through jugular venepuncture from CON and synchronized goats on day 13, 15, 17, 19, and 21 of breeding. Progesterone and POSTN levels were determined by enzyme-linked immunosorbent assay (ELISA). Later the pregnancy diagnosis was confirmed by transabdominal ultrasonography on day 50 after mating. RESULTS: Progesterone level was influenced by status of pregnancy and day of observation with an interaction between the status of pregnancy and day of observation in goats. Whereas POSTN level was only affected by the day of observation. CONCLUSION: POSTN level did not vary with progesterone level during phase of embryonic implantation in goats; however, standardization and application of different procedures for POSTN assay in a large group of animals might be useful as an early pregnancy biomarker in goats.

Multidrug-Resistant Bacterial Sepsis and Inferior Vena Cava Thrombosis in Liver Transplant Recipients Used Synthetic Vascular Graft: Three Fatal Cases.

Synthetic vascular grafts are commonly used in liver transplantation. Thrombosis is a possible complication of using expanded polytetrafluoroethylene (e-PTFE) grafts. Herein, we report on 3 cases of liver recipients who died of intermittent sepsis episodes emerged concurrently with the thrombosis in synthetic vascular grafts and inferior vena cava (IVC) vein. Right lobe liver transplantation from living donors was performed for 3 patients by using e-PTFE grafts between the liver and IVC. Although heparin had been administered, thrombosis was developed in vascular graft and IVC extending to the right atrium; it was developed within 1-4 months of transplantations. All 3 patients suffered from recurrent sepsis episodes (4, 5, and 6 attacks for each patient) by different multidrug-resistant bacterial species. Treatment attempts including thrombolytic and antimicrobial drugs made, and surgical, endoscopic and radiological interventions could not resolve the clinical situation. The patients died of septic complications. We concluded that severe recurrent sepsis attacks may develop in liver transplant recipients when IVC and synthetic vascular graft were thrombosed. Removing the e-PTFE graft may be benefit for the treatment.

The prognostic significance of the risk scores at upper gastrointestinal bleeding.

BACKGROUND: Upper gastrointestinal system (GIS) bleeding is one of the most common causes of mortality and morbidity. The predictive values of pre-endoscopic Rockall score (PERS), full Rockall score (FRS), Glasgow-Blatchford score (GBS), pre-endoscopic Baylor score (PEBS), and full Baylor score (FBS) to predict bleeding at follow-up, endoscopic therapy, blood transfusion requirement, and death are investigated in our study. METHODS: This study was retrospectively conducted in patients admitted to emergency department with upper GIS bleeding. Demographic and clinical characteristics of the patients were recorded. The relationships of the aforementioned scores with in-hospital termination, bleeding at follow-up, endoscopic therapy, blood transfusion requirement, and death were explored. RESULTS: The study included a total of 420 subjects, of which 269 (64%) were men. All scoring systems were able to predict transfusion need and GBS was superior to other scores (P < 0.0001). In terms of endoscopic treatment, it was determined that only PERS, FRS, and FBS were statistically significant in predicting ability and PERS >3, FRS >5 and FBS >10 patients needed endoscopic treatment. All scoring systems were able to predict rebleeding. In comparison of two groups for rebleeding, it was found that PEBS was better able to predict bleeding during follow-up than both FRS and FBS, and PERS was better able to predict bleeding during follow-up than both FRS and FBS. All scoring systems were able to predict mortality. FRS and PERS scores had a greater discriminatory power for predicting death than the rest of the scores (P < 0.001). CONCLUSION: All scoring systems were effective for predicting need for blood transfusion, rebleeding, and death. GBS had more predictive power for transfusion need, PERS and PEBS for rebleeding, and FRS for mortality. PERS, FRS, and FBS were found to be effective in predicting endoscopic treatment.

Bone turnover markers are differentially affected by pre-analytical handling.

Given that bone turnover markers are often shipped to central laboratories, it is essential to be aware of factors that will affect stability. We have evaluated how sample type, time before separation of blood samples, and time between separation and analysis affect the stability of four bone turnover markers. INTRODUCTION: Bone turnover markers are often shipped to central laboratories for analysis, which require knowledge of the stability of the markers of interest in different sample materials. The aim of the current study was to evaluate how time before separation of blood samples and time between separation and analysis affect the stability of four bone turnover markers in serum and plasma samples. METHODS: Serum, EDTA, and Lithium heparin (LiHep) plasma samples from seven osteoporosis patients and three healthy controls were collected and stored at room temperature for up to 72 h before separation and analysis. After separation, samples were stored at room temperature for up to 72 h and re-analyzed. The bone turnover markers N-terminal pro-collagen type 1 extension pro-peptide (P1NP), bone-specific alkaline phosphatase (BAP), C-terminal teleopeptide cross links of collagen type 1 (CTX), and osteocalcin (OC) were analyzed using the automated iSYS IDS platform. RESULTS: P1NP and BAP were stable in both plasma and serum for 72 h before centrifugation. CTX levels were higher in EDTA plasma at all time points compared to LiHep plasma and serum. The use of EDTA plasma prolonged the stability of CTX as compared to LiHep plasma and serum. Osteocalcin showed high tendency to degrade in all sample types and concentrations were significantly lower after 24 h of storage. CONCLUSIONS: For the bone turnover markers P1NP and BAP, the use of both plasma and serum is recommended. Samples for CTX analysis should be taken as EDTA plasma. Samples for osteocalcin analysis can be taken in either type of plasma or serum, but should be analyzed within 3 h or preserved at - 18 °C.

Self-reported environmental health risks of nurses working in hospital surgical units.

AIM: This study investigated the occupational health risk factors among nurses who work in public hospital surgical units. BACKGROUND: Nursing has a significant place in healthcare systems around the world. Surgical units are environments with certain risks, especially because of the possibility of exposure to various chemical, biologic or physical hazards. METHODS: This study was conducted with 229 nurses who were working in the 11 surgery units of a big university hospital. In this cross-sectional study, a personal information form and an occupational risk factors scale were administered to respondents. We performed factor and reliability analyses for the scale; the overall reliability of the 41 items was α = 0.924, and the factor analysis found the scale was feasible. RESULTS: Biologic and psychological risk factor levels were found to be high. Physical, chemical, ergonomic and radiation risk factor levels were moderate. The general occupational risk factor score was moderate. Nurses working night duty were confronted with physical and psychological risk factors at a higher rate compared with those working in the daytime. CONCLUSION: Reported occupational health problems by nurses were correlated with the descriptive properties of the nurses including age, sex, marital status, education level, working hours, mode of working and status of occupational health and safety training. IMPLICATIONS FOR NURSING: Nurses experience different occupational risks. If these risks are identified, healthier working environments can be provided to the nurses by taking necessary precautions. IMPLICATIONS FOR SOCIAL POLICY: The health care provided by nurses who work in a healthy environment would be more efficient and of better quality, which will result in better economic and social outcomes for individual and communities.

[Culturally sensitive communication in end-of-life care: the care for Muslim patients as an example]. / Cultuursensitieve communicatie bij het levenseinde.

Suffering and death are an inevitable part of life. In our increasingly multicultural society, healthcare professionals are frequently confronted with ideas on suffering and death that are different from their own. As Muslims are the largest migrant group in the Netherlands, this article focuses specifically on their perspective, illustrated by a clinical case. The different experience of these phenomena, influenced by culture and religion, can lead to confusion and frustration for patients, their relatives, and healthcare professionals alike. It is essential that healthcare professionals are aware of both their own views and those of the patient, and have some knowledge of other cultures and religions. Healthcare professionals can use cultural (self-)reflection and culturally sensitive communication, examples of which are provided in this article, to build mutual trust and understanding. This may improve the patient-physician relationship and may make end-of-life communication, complex as it will ever be, a little more comprehensive.

Properties of microalgal enzymatic protein hydrolysates: Biochemical composition, protein distribution and FTIR characteristics.

Chlorella vulgaris SAG 211-12, a green microalga, as model organism was cultivated photomixotrophically using various organic carbon and nitrogen sources at Erlenmeyer scale. The modified medium selected for the experiments was standard BG11 supplemented with 5 g l-1 glucose and 1 g l-1 proteose peptone (PP). To evaluate the effects of light/dark cycles, 12:12; 18:6 and 24:0 light/dark cycle conditions were examined on hourly basis. 24:0 continuous illumination condition was chosen to continue 2 l continuous stirred tank photobioreactor (CSTR) experiments under 1 vvm aeration, 120 rpm mixing time, 23 ± 2 °C, and 70 µE m-2 s-1 illumination conditions. The results showed significant effect of the culture conditions on the cellular composition. To enhance digestibility of the intact cell; dry biomass was digested with pancreatin enzyme solution and in vitro protein digestibility (IVPD) of crude biomass (UTS), cell debris (CVA) and protein hydrolysates (CVH) was measured. IVPD values of UTS, CVA and CVH were found to be 33-41%, 46-58%, 67-89%; respectively with no significant changes regarding culture conditions (p > 0,05). Results also showed the positive effect of the enzyme treatment for digestion which is a key advantage for nutritional characteristic of the algal biomass.

Comparison of tubular and panel type photobioreactors for biohydrogen production utilizing Chlamydomonas reinhardtii considering mixing time and light intensity.

Two different photobioreactor designs; tubular and panel, were investigated for the biohydrogen production utilizing a green microalgae Chlamydomonas reinhardtii strain CC124 following the two stage protocol. Mixing time and light intensity of the systems were adjusted to compare the productivity of both aerobic culture phase and the following anaerobic biohydrogen production phase. The results showed there was an effect on both phases related with the design. During the aerobic phase bigger illumination area serving more energy, tubular photobioreactor reached higher biomass productivity of 31.8±2.1 mg L(-1) h(-1) which was about 11% higher than the panel photobioreactor. On the other hand biohydrogen productivity in the panel photobioreactor reached a value of 1.3±0.05 mL L(-1) h(-1) based on the efficient removal of biohydrogen gas. According to the results it would be a good approach to utilize tubular design for aerobic phase and panel for biohydrogen production phase.

Cathecol-O-methyl transferase Val158Met genotype is not a risk factor for conversion disorder.

Alterations in catechol-O-methyltransferase (COMT) activity are involved in various types of neurological disorders. We examined a possible association between the COMT Val158Met polymorphism and conversion disorder in a study of 48 patients with conversion disorder and 48 control patients. In the conversion disorder group, 31 patients were Val/Met heterozygotes, 15 patients were Val/Val homozygotes and 2 patients were Met/Met homozygotes. In the control group, 32 patients were Val/Met heterozygotes and 16 patients were Val/Val homozygotes. There was no significant difference between the groups. We conclude that the COMT Val158Met genotype is quite common in Turkey and that it is not a risk factor for conversion disorder in the Turkish population.

Chronic melatonin treatment reverses disruption of prepulse inhibition in pinealectomized and pinealectomized-plus-ovariectomized rats.

Although melatonin has been implicated in several neurophysiological systems, data on the relationship of melatonin with psychosis such as schizophrenia are limited and contradictory. Chronic effects of melatonin on sensorimotor gating deficits have also not been investigated yet. We investigated the neurobehavioral effects of chronic administration of melatonin in pinealectomized (Px) and ovariectomized (Ovx) rats. Px or Ovx or both operations were carried out together to the rats. The control group of rats was sham operated. A sham ovariectomy was carried out to Px rats, and vice versa. Fifth month later, melatonin (5mg/kg) or vehicle was injected to rats for 28 days. Then, prepulse inhibition (PPI) of acoustic startle reflex, startle amplitude and startle reflex latency was measured. Locomotor activity, accelerod performance measurements, novel object recognition and passive avoidance tests were also evaluated. Px and Px+Ovx rats had impaired PPI compared to control rats. Melatonin reversed the impairments of PPI induced by Px or Px+Ovx. While melatonin treatment had no effect on locomotor activity of control rats, it significantly increased the locomotor activity of Px and Px+Ovx rats. Melatonin treatment (5mg/kg/day, 28 days) reversed the locomotor hyperactivity caused by Ovx. Accelerod performance, passive avoidance, and object recognition responses of Px, Ovx or Px+Ovx rats were not different from the control group. Our results indicate that chronic melatonin deficiency by reason of Px results in impairment of PPI reflex and replacement of melatonin exerts beneficial effects on the impaired PPI reflex in Px and Ovx rats. Thus, melatonin may be useful in the treatment of some disorders characterized by sensorimotor gating deficits such as schizophrenia.

Car-borne survey of natural background gamma dose rate in Çanakkale region, Turkey.

Natural background gamma radiation was measured along roads in the environs of Çanakkale region by using a car-borne spectrometer system with a plastic gamma radiation detector. In addition, activity concentrations of ²³8U, ²²6Ra, ²³²Th and 4°K in soil samples from the Çanakkale region were determined by using a gamma spectrometer with an HPGe detector. A total of 92,856 data of the background gamma dose rate were collected for the Çanakkale region. The background gamma dose rate of the Çanakkale region was mapped using ArcGIS software, applying the geostatistical inverse distance-weighted method. The average and population-weighted average of the gamma dose are 55.4 and 40.6 nGy h⁻¹, respectively. The corresponding average annual effective dose to the public ranged from 26.6 to 96.8 µSv.

Rat tail revascularization model for advanced microsurgery training and research.

We describe a time-saving microsurgical exercise for continuing microsurgical training and research. The rat tail replantation model was simplified by excluding bone detachment. Rats were divided into two groups: devascularization only ( N = 3) and revascularization after devascularization ( N = 7). The tail was devascularized by ligation and division of artery and veins in the first group to reveal if a collateral circulation from bone existed. The divided vessels were reanastomosed in the second group. The circulation of the rat tails was followed for 1 week. The tails showed total necrosis in the devascularization group, whereas only two of seven tails showed partial necrosis in the revascularization group. Reexploration showed thrombosis narrowing the lumen at the anastomotic site of the partially necrosed tails, most likely due to an anastomotic insufficiency. The present study revealed that total amputation is not necessary for tail devascularization. The rat tail revascularization model provides a practical tool for advanced and continuing microsurgical training and research.

Do local anesthetics have antibacterial effect on Staphylococcus aureus under in vivo conditions? An experimental study.

OBJECTIVE: The antimicrobial properties against Staphylococcus aureus of some common local anesthetic preparations such as prilocaine, bupivacaine, articaine, and combinations were evaluated in a live rat surgical wound model. METHODS: This study was conducted at the animal research laboratory of Eskisehir Osmangazi University in 2003. Clean surgical wounds were created after local anesthetic application and inoculated with S. aureus (10(2) colony forming units/mL). Four days later, tissue cultures were harvested from control animals and animals given local anesthetic to determine the quantity of bacteria. RESULTS: The tissue cultures demonstrated that none of the local anesthetics used in the study showed any inhibitory or bactericidal activity on S. aureus. There was no statistical difference in bacterial count between the local anesthetic-treated and control group wounds. CONCLUSION: The results of the present study did not show any antimicrobial activity of above-mentioned local anesthetics in surgically created wounds of rats.