Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022.

Background: The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40-20) and inter-seasonal periods (weeks 21-39) during the pandemic between October 2020 and September 2022. Methods: Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons. Results: Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic. Conclusion: RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised.

Antimicrobial effects of nano titanium dioxide and disinfectants on maxillofacial silicones.

STATEMENT OF PROBLEM: Deficient hygiene of maxillofacial prostheses can be a source of infection, and various disinfectants, including nano-oxides, have been suggested for the disinfection of silicone prostheses. While maxillofacial silicones involving nano-oxides at different sizes and concentrations have been evaluated in terms of their mechanical and physical properties, reports are lacking on the antimicrobial effect of nano titanium dioxide (TiO2) incorporated into maxillofacial silicones contaminated by different biofilms. PURPOSE: The purpose of this in vitro study was to evaluate the antimicrobial effects of 6 different disinfectants and nano TiO2 incorporation into maxillofacial silicone contaminated with Staphylococcus aureus, Escherichia coli, and Candida albicans biofilms. MATERIAL AND METHODS: A total of 258 silicone specimens (129 pure silicones and 129 nano TiO2-incorporated silicones) were fabricated. Specimens in each silicone group (with or without nano TiO2) were divided into 7 disinfectant groups (control, 0.2% chlorhexidine gluconate, 4% chlorhexidine gluconate, 1% sodium hypochlorite, neutral soap, 100% white vinegar, and effervescent) in each biofilm group. Contaminated specimens were disinfected, and the suspension of each specimen was incubated at 37 °C for 24 hours. Proliferated colonies were recorded in colony-forming units per mL (CFU/mL). The differences in microbial levels among specimens were evaluated to test the effect of the type of silicone and the disinfectant (α=.05). RESULTS: Significant difference was found among disinfectants regardless of the silicone type (P<.05). Nano TiO2 incorporation showed an antimicrobial effect on S aureus, E coli, and C albicans biofilms. Nano TiO2 incorporated silicone cleaned with 4% chlorhexidine gluconate had statistically less C albicans than pure silicone. Using white vinegar or 4% chlorhexidine gluconate led to no E coli on either silicone. Nano TiO2 incorporated silicone cleaned with effervescent had fewer S aureus or C albicans biofilms. CONCLUSIONS: The tested disinfectants and nano TiO2 incorporation into silicone were effective against most of the microorganisms used in this study.

Educational material for social marketing and behaviours linked to early detection of breast cancer.

BACKGROUND: Social marketing is an effective tool to ensure a populationbased behaviour change for a healthy lifestyle. AIM: The aim was to investigate the effects of breast cancer-related printed educational materials on women's behaviours related to early detection and diagnosis of breast cancer within the framework of social marketing. METHOD: This pre-post test one-group study was conducted with 80 women in a family health centre. An interview form, printed educational materials and follow-up form were used to collect the study data. The data were collected at the baseline and through phone calls at the third month. RESULTS: Of the women, 36% had never performed breast self-examination (BSE), 55% had never had clinical breast examination (CBE), and 41% had never had mammography. There were no differences between the measurements made at the baseline and at the third month in terms of performing BSE, and having CBE and mammography. CONCLUSION: The importance of expanding social marketing approaches in terms of global health investments is emphasised. Adoption of positive health behaviours will lead to improvements in health status, as assessed through measures of morbidity and mortality status in cancer.

Risk Factors for Mortality in Denim Sandblasters Silicosis: Selecting Candidate for Lung Transplantation.

OBJECTIVE: This study aimed to review the risk factors for silicosis together with survival analysis and a perspective for lung transplantation with data from a single center. MATERIAL AND METHODS: We reviewed the medical records of denim sandblasters who were referred to our center between January 2006 and December 2011 and evaluated 219 patients with a history of denim sandblasting with a minimum follow-up period of 5 years until 2016. We analyzed several personal and occupational features, together with functional and radiologic data. RESULTS: Of the 219 denim sandblasters, 107 (49%) had been diagnosed with silicosis. In the logistic regression analysis, the duration of exposure was the only independent risk factor for the development of silicosis, indicating a 9% increased risk of silicosis for every month of exposure (p<0.001; odds ratio 1.09; 95% confidence interval 1.050-1.132). Of the patients, 7 (3%) died. A forced expiratory volume in the first second of <44% and a forced vital capacity of <47% were associated with an increased risk of mortality. Mortality was significantly higher in the international labor office category 3 patients, and 5-year survival rates of patients with A, B, and C lung opacities were 88%, 67%, and 25%, respectively. CONCLUSION: Silicosis still kills young workers. Severe radiologic involvement and decreased lung volumes are related to mortality, and lung transplantation is the only therapeutic option.

Serum C-reactive protein to albumin ratio as a novel inflammation biomarker in psoriasis patients treated with adalimumab, ustekinumab, infliximab, and secukinumab: a retrospective study.

AIM: To assess C-reactive protein to albumin ratio (CAR) before and after treatment with biological agents in patients with psoriasis to determine whether CAR can be used as an inflammation biomarker. METHODS: Medical records of patients with psoriasis treated with biological agents at the Department of Dermatology, Gazi University Hospital were retrospectively evaluated between June 2018 and August 2019. The patients were divided into four groups based on the type of treatment (adalimumab, ustekinumab, infliximab, secukinumab). CAR was evaluated before and three months after treatment. RESULTS: The study enrolled 157 patients with psoriasis vulgaris (91 male) aged between 18 and 85. CAR significantly decreased in all treatment groups (adalimumab group P<0.001; ustekinumab P=0.006; infliximab P=0.007; secukinumab P<0.001). The most prominent decrease in CAR was observed in patients treated with secukinumab (median CAR before treatment 1.52 [1.01-3.04] and after treatment 0.84 [0.62-0.99]). CONCLUSION: CAR may be a good indicator of systemic inflammation in psoriasis patients treated with biological agents.

Erythrocyte Autoantibody Positivity in Serological Cross-matching.

OBJECTIVE: To investigate the erythrocyte autoantibody positivity detected in the serological cross-matching (XM), and its  possible effects on salient hemogram parameters. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Balikesir Atatürk City Hospital's Blood Transfusion Centre, Faculty of Medicine, Department of Anesthesiology and Reanimation, Balikesir University, Turkey, from 2017 to 2018. METHODOLOGY: Erythrocyte autoantibody positivity, which was detected in the traditional serological cross-matching for a pre-transfusion laboratory test were analysed retrospectively. Later, hemogram changes in the previous (no erythrocyte autoantibodies) and following (erythrocyte autoantibodies present) transfusions were investigated using statistical methods. RESULTS: Erythrocyte autoantibody positivity rate was 10.16% (342/3,365). There was no statistically significant difference in the increase of hemoglobin, hematocrit, and red blood cell between the period when erythrocyte autoantibodies were detected or not, (p = 0.27, 0.13, and 0.09, respectively). CONCLUSION: Erythrocyte autoantibodies positivity found on routine cross-match exmination, which must be considered together with parameters such as previous transfusion history, other pre-transfusion laboratory test results, and clinical presentation and management. Key Words: Transfusion, Erythrocye autoantibody, Alloantibody, Hemogram, Cross-matching.

Is mean platelet volume an inflammatory marker in acne patients treated with isotretinoin?

INTRODUCTION: Isotretinoin is a commonly used systemic retinoid for treating acne. However, isotretinoin may lead to elevated serum levels of triglycerides and cholesterol, and it may affect liver function tests. Moreover, the effect of isotretinoin on hematological parameters remains controversial. This study examines changes in the blood chemistry panel, hematological parameters, and inflammation biomarkers of patients diagnosed with acne and treated with isotretinoin. METHODS: The study included 70 patients (59 females and 11 males, between ages 18 and 37) with moderate to severe acne vulgaris treated with isotretinoin. The medical records and laboratory findings of the participants were reviewed retrospectively between March 2017 and September 2018. All the patients whose necessary laboratory test results could be obtained from the collected data were included in the study. RESULTS: Serum total cholesterol, HDL, LDL, triglyceride, mean corpuscular hemoglobin levels, and platelet/lymphocyte ratio increased, whereas white blood cell count and mean platelet volume (p = 0.036) decreased after isotretinoin treatment. CONCLUSIONS: The results of this study revealed that mean platelet volume decreased significantly 3 months after the initiation of isotretinoin treatment. Therefore, we suggest considering mean platelet volume as an inflammatory marker in patients with acne treated with isotretinoin. However, this research should be replicated under more randomized conditions in a prospective study to reach a definitive conclusion.

Comparison of automated vs. manual measurement to estimate fetal weight in isolated polyhydramnios.

Objective To understand the impact of the measurement method to predict actual birthweight in pregnancies complicated with isolated polyhydramnios in the third trimester. Methods A prospective study was conducted with 60 pregnant women between the 37th and 40th weeks of gestation. Routine biometric measurements were obtained by two-dimensional (2D) ultrasonography. When a satisfactory image was obtained, the image was frozen to get two measurements. First, calipers were placed to get the manual measurement. Then automated measurement was captured by the ultrasonography machine in the same image. The fetal weight was estimated by using the Hadlock II formula. Results The mean difference was found to be 0.03, -0.77, -0.02 and 0.17 for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL), respectively. Pearson's correlation coefficient between automated and manual estimated fetal weights (EFWs) and the actual birthweight was 0.919 and 0.796, respectively. The mean difference between actual and manual EFW measurement values was 46.16 ± 363.81 g (range between -745 g and 685 g) (P = 0.330). Also, the mean difference between actual and automated EFW measurement values was found to be 31.98 ± 218.65 g (range between -378 g and 742 g) (P = 0.262). The Bland-Altman test results have shown that, 666 g lower or 759 g higher values were obtained when the measurement was performed manually. On the other hand, EFW results were 396 g lower or 460 g higher than the actual birthweight with automated measurement tools. Conclusion The accuracy rate of fetal weight estimation with ultrasonography is high for both automated and manual measurements. Automated tools have a higher success to predict the EFW.

Seasonal Influenza Vaccine Effectiveness in Preventing Laboratory Confirmed Influenza in 2014-2015 Season in Turkey: A Test-Negative Case Control Study.

BACKGROUND: Influenza has an important public health impact worldwide with its considerable annual morbidity among persons with or without risk factors and its serious complications among persons in high-risk groups. The seasonal influenza vaccine is essential for preventing the burden of influenza in a population. Since the vaccine is reformulated each season according to the virus serotypes in circulation, its effectiveness can vary from season to season. Vaccine effectiveness is defined as the relative risk reduction in vaccinated individuals in observational studies. AIMS: To calculate influenza vaccine effectiveness in preventing laboratory-confirmed influenza in the Turkish population for the first time using the national sentinel surveillance data in the 2014-2015 influenza season. STUDY DESIGN: Test-negative case-control study. METHODS: We compared vaccination odds of influenza positive cases to influenza negative controls in the national influenza surveillance in Turkey to estimate influenza vaccine effectiveness. RESULTS: The influenza vaccine effectiveness against influenza A (H1N1) (68.4%, 95% CI: -2.9 to 90.3) and B (44.6%, 95% CI: -27.9 to 66.6) were moderate, and the influenza vaccine effectiveness against influenza A (H3N2) (75.0%, 95% CI: -86.1 to 96.7) was relatively high; all had low precision given the low vaccination coverage. Overall, the influenza vaccination coverage rate was 4.2% (95% CI: 3.5 to 5.0), which is not sufficient to control the burden of influenza. CONCLUSION: In Turkey, national surveillance for influenza should be strengthened and utilised annually for the assessment of influenza vaccine effectiveness with more precision. Annual influenza vaccine effectiveness in Turkey should continue to be monitored as part of the national sentinel influenza surveillance.

PET-CT guided curative conformal radiation therapy in limited stage small cell lung cancer.

BACKGROUND: The prognosis of small cell lung cancer (SCLC) has been improving with the advances in diagnostic and therapeutic modalities. Positron emission tomography/computed tomography (FDG-PET/CT) which has been studied in non-small cell lung cancer (NSCLC) for a long time, and it has only recently been applied to SCLC. Therefore we sought to observe firstly the prognostic importance of the FDG uptake in limited disease small cell lung cancer (LD-SCLC) patients and secondly the clinical outcomes and toxicity profiles of LD-SCLC patients treated with conformal radiation therapy (RT) using FDG-PET/CT simulation. METHODS: Between 2009 and 2011, 33 LD-SCLC patients with LD-SCLC underwent disease staging using FDG-PET/CT conformal RT. Thoracic radiation was administered at a daily fraction of 2 Gy. Total dose was prescribed according to the treatment protocol such as, concurrent or sequential chemotherapy and in some patients according to the response of CT. All patients underwent chemotherapy. Survival was estimated using the Kaplan-Meier method. RESULTS: The median age of the patients was 58 years (range, 38-77 years). The median follow-up time was 20 months (range, 6.6-47.6 months). The 3-year overall survival (OS) and locoregional control rates were 23% and 48%, respectively. CONCLUSIONS: There are few studies examining the impact of PET-CT and the prognostic significance of FDG-uptake on outcomes in patients with LD-SCLC. Higher RT doses in response to higher FDG uptake may be safely applied for the purpose of locoregional control.

Workplace physical violence, verbal violence, and mobbing experienced by nurses at a university hospital.

BACKGROUND/AIM: The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. MATERIALS AND METHODS: This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. RESULTS: The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. CONCLUSION: We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.

High FDG uptake predicts poorer survival in locally advanced nonsmall cell lung cancer patients undergoing curative radiotherapy, independently of tumor size.

OBJECTIVES: Despite radical radiotherapy and chemotherapy (CT), the prognosis of locally advanced nonsmall cell lung cancer (NSCLC) is poor. New prognostic indicators are being looked forward to improve the survival. [18F]-fluorodeoxyglucose (FDG) uptake on PET/CT has been observed as a prognostic marker mainly in early-stage disease. Our aim was to examine the prognostic value of FDG uptake in locally advanced NSCLC. MATERIALS AND METHODS: Between 2009 and 2011, 103 NSCLC patients underwent disease staging using FDG PET/CT before conformal radiotherapy. Thoracic radiation was administered at a daily fraction of 2 Gy. Total dose was prescribed according to the tumor response against CT. All patients underwent CT. Survival was estimated using the Kaplan-Meier method. RESULTS: The median age of the patients was 59 years (range 39-83). The median follow-up time was 22.63 months (range 6-48.03 months). There was a statistically significant difference in overall survival (OS) between the low (<10.7) and high (≥10.7) standardized uptake value (SUVmax) groups (p = 0.006) on univariate analysis (3-year OS was 42% in the low (<10.7) and 23% in the high (≥10.7) SUVmax groups). On multivariate analysis with determining tumor size, tumor SUVmax provided additional significant prognostic information on OS (HR 1.046; 95 % CI 1.009-1.085, p = 0.015). CONCLUSIONS: FDG uptake has predictive value in locally advanced NSCLC, independently of tumor size.