Disrupted harmony of the skull skeleton: Middle ear resonance in acromegaly.

OBJECTIVES: This study aims to investigate whether the middle ear resonance frequency (RF) is affected in acromegaly, which causes growth in the skull bone. METHODS: Thirty acromegaly patients and 38 volunteers were included in the study. Pure tone average scores and middle ear RF values of the groups that underwent pure tone audiometry, tympanometry, and multifrequency tympanometry tests were compared. RESULTS: The pure tone mean was 14.95 ± 12.13 in acromegaly patients and 5.70 ± 8.52 in the control group (p:0.18). Sensorineural hearing loss(SNHL) was observed in 16.6% of the patients. The average middle ear RF was calculated as 815 ± 179.05 Hz in patients with acromegaly and 773 ± 127.15 in the control group. (p = 0.0001). CONCLUSION: This study is the first to evaluate middle-ear RF in acromegaly patients. Acromegaly-induced changes in soft tissues and bone structures impact middle ear functions. In this patient group, we found an increase in middle ear RF without conductive-type hearing loss and a 16.6% rate of SNHL.

Do single-session Epley maneuvers treat benign paroxysmal positional vertigo?

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular condition characterized by short-term vertigo attacks that significantly affect quality of life. OBJECTIVES: Examine how well a single Epley maneuver worked in an outpatient setting for people with posterior canal benign paroxysmal positional vertigo (PC-BPPV) and whether they needed a second Dix-Hallpike maneuver. DESIGN: Prospective. SETTINGS: Otorhinolaryngology department of a tertiary care center. PATIENTS AND METHODS: Sociodemographic data, body mass index (BMI), and systemic disease history of 75 patients diagnosed with PC-BPPV were recorded, and their relationship with success rates after the modified Epley maneuver was analyzed. MAIN OUTCOME MEASURES: Detect cases that could not be repositioned with the diagnostic control Dix-Hallpike test performed 20 minutes after the modified Epley reposition maneuver in the same session in PC-BPPV patients. SAMPLE SIZE: 75. RESULTS: Of the 75 patients, 31 were male (41.3%), 44 female (58.6%) with a mean (standard deviation) age of 58.6 (15.9) years age, 54.6% had one or more chronic diseases. BMI was 30 mg/kg2 and above in 31 patients (41.3%). The modified Epley maneuver was successful in 77.3%. No significant relationship was found between additional diseases or BMI in the patient group in whom the maneuver was unsuccessful. CONCLUSION: The success rates of repositioning maneuvers in treating patients diagnosed with PC-BPPV are high. However, more than a single maneuver is required in some resistant patients. Second diagnostic and repositioning maneuvers performed in the same session will reduce multiple hospital admissions. While it is helpful to repeat the maneuver in the patient group where it was unsuccessful, other factors causing the failure should be investigated. LIMITATIONS: Lack of follow-up results of patients after 7-10 days.

Could the thick of retinal nerve fiber layer be a potential measure of axonal loss in hearing loss?

OBJECTIVE: The objective of the study is to compare the optic coherence tomography (OCT) parameters of the healthy and affected sides of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to investigate the relationships between these and the improvement in hearing levels. METHODS: A bilateral eye evaluation of patients diagnosed with ISSNHL was performed with OCT. The ganglion cell complex (GCC) and retina nerve fiber layer (RNFL) thickness values were recorded and the differences between the two eyes were examined. RESULTS: An evaluation was made of 39 patients with a mean age of 44.82 ± 14.90 years. The RNFL thickness of the eyes was determined to be mean 89.87 ± 3.65 µm on the affected side and 103.87 ± 3.98 µm on the healthy control side (p = 0.0001). The mean GCC was determined to be mean 90.46 ± 3.49 µm on the affected side and 103.77 ± 3.96 µm on the healthy control side (p = 0.0001). CONCLUSIONS: A statistically significant difference was observed between the healthy and affected eyes of patients with ISSNHL with respect to mean GCC and mean RNFL thickness. OCT could be a useful technique for measuring this neural degeneration.

OBJETIVO: Comparar e investigar los parámetros de la tomografía de coherencia óptica (OCT) de los lados sanos y afectados de pacientes con pérdida auditiva neurosensorial súbita idiopática (PANSI). MÉTODO: La evaluación ocular bilateral de los pacientes diagnosticados con PANSI se realizó con OCT. Se registraron los valores de espesor del complejo de células ganglionares (CCG) y de la capa de fibras nerviosas de la retina (CFNR), y se examinaron las diferencias entre los dos ojos. RESULTADOS: Se evaluaron 39 pacientes, con una edad media de 44.82 ± 14.90 años. Se determinó que el grosor de la CFNR de los ojos era una media de 89.87 ± 3.65 µm en el lado afectado y 103.87 ± 3.98 µm en el lado de control sano (p = 0.0001). Se determinó que el CCG medio era 90.46 ± 3.49 µm en el lado afectado y 103.77 ± 3.96 µm en el lado de control sano (p = 0.0001). CONCLUSIONES: Se encontró una diferencia estadísticamente significativa entre los ojos sanos y afectados de pacientes con PANSI con respecto al CCG medio y al espesor medio de la CFNR. La OCT podría ser una técnica útil para medir esta degeneración neuronal.

Online Training or Face-to-Face Training from the Perspective of Ear, Nose, and Throat and Head and Neck Surgeons?

PURPOSE: To determine the preferences of Ear, Nose, and Throat (ENT) and Head-Neck Surgery (HNS) specialists and residents undergoing training for online or face-to-face training and the factors affecting the preference. METHODS: An 16-item questionnaire was created using Google Forms and was administered to residents undergoing training in ENT departments and to specialists working in the same field. The questionnaires were distributed online and requested to be completed between August and October 2020. The study participants were analyzed in two groups according to the preference for online training or face-to-face training. RESULTS: Evaluation was made of a total of 173 participants, as 68 (39.3%) in online training, and 105 (60.7%) in face-to-face training. Online training comprised 47 (69.1%) females and 21 (30.9%) males with a mean age of 38.9 ± 8years and face-to-face training comprised 68 (64.8%) females and 37 (35.2%) males with a mean age of 37.9 ± 7.5years (gender: P = 0.55, age: P = 0.10). Of the total sample, 39 (22.5%) subjects were single and 134 (77.5%) were married. Face-to-face training was preferred by 61.2% of the married respondents and by 59% of those who were single. While 43.4% stated that visuals and documents were similar in both forms of training, those who stated that documentation was better in face-to-face training constituted 90.2% of the group that preferred face-to-face training (P = 0.0001). Of the total participants, 65.4% stated that concentration was easier in face-to-face training (P = 0.0001). When the groups were compared according to areas of interest, more of those involved in rhinology and head-neck surgery were in face-to-face training, and those with an interest in otology were seen to be in online training (P = 0.002). A wish to continue online training after the pandemic was expressed by 80.9% of the whole sample, and 68.6% wished to continue with face-to-face training (P = 0.0001). Hybrid meetings were determined to have been selected by 86.1% (P = 0.0001). CONCLUSION: Online web seminars have an important role as a teaching and learning tool. There is a need for further research to evaluate how these clinically focused seminars can be presented at high quality and how they can provide benefit in training.

Does being a healthcare professional affect satisfaction after septorhinoplasty?

This study aims to determine the differences in satisfaction levels after septorhinoplasty between patients who are healthcare workers and those who are not. The study includes patients who underwent primary septorhinoplasty surgery, divided into two groups: healthcare workers and non-healthcare workers. The Rhinoplasty Outcome Evaluation (ROE) questionnaire was administered to the patients at the 6th postoperative month. Among the 37 patients, 18 were healthcare workers, and 19 were non-healthcare workers. The mean Rhinoplasty Outcome Evaluation score for healthcare workers at the 6th postoperative month was 75.69 ± 16.06, while in the non-healthcare worker group, the ROE scores were 60.31 ± 27.69. The findings from our study indicated that individuals in the healthcare profession exhibited significantly greater satisfaction rates following septorhinoplasty in comparison to those in the non-healthcare worker group, with a statistically significant difference noted (p: 0.046). Having more knowledge about septorhinoplasty surgery and its complications among healthcare workers may allow for more realistic expectations regarding the surgical intervention. Simultaneously, it may facilitate better communication with the surgeon and the expression of expectations. Clinicians should pay attention not only to the patient's intellectual level but also to their health literacy in communication with the patient.

Validity and reliability study of the Mediterranean Lifestyle Index: Turkish adaptation.

Objective: The Mediterranean Lifestyle Index (MEDLIFE) differs from similar scales in that it concurrently includes diet and lifestyle. The current study translated MEDLIFE into Turkish, and assessed its reliability and validity. Methods: A questionnaire was administered to 300 individuals 19-65 years of age. The questionnaire was subsequently re-administered to 87 research participants. The questionnaire, asking for general information, MEDLIFE, and information regarding anthropometric measurements, was sent to the users of an online platform. The scale was converted into the applicable Turkish form by an expert group. Test-retest reliability was evaluated with the intraclass correlation coefficient (ICC). In addition, kappa coefficients (k) and Bland-Altman graphs were determined for each item to assess reliability. Results: The mean scores before and after were 14.5 ± 3.68 and 14.3 ± 3.81, respectively, and the intercorrelation coefficient r was 0.817 for test-re-test reliability. Conclusion: The validity and reliability of the scale in the Turkish language was confirmed. This study is the first to translate MEDLIFE into another language and may aid in assessing the scale's adaptability to other languages. Food consumption record and physical activity record studies must be performed to ensure validity.

The impact of COVID-19 pandemic and lockdown on emergency psychiatry department admissions.

This study aimed to explore the impact of the coronavirus disease 2019 pandemic and lockdown period measures on patients' visits to the psychiatric emergency department (PED) of a University Hospital in Istanbul. We compared the number and characteristics of patients during the initial lockdown with visits in the pre- and post-lockdown months. We also investigated the number of monthly PED visits and hospitalizations between March 11, 2020 and 2021 and compared it to the same period in 2019 and between March 2021 and 2022. PED visits in the initial lockdown period in our university increased by 109% compared to the prelockdown months in the previous year. Anxiety and depressive disorders were responsible for most of this increase. The decline in PED visits was 3.1% and 42% during the first and second year of the pandemic, respectively; however, among the major diagnostic categories, we found that the rates of anxiety, depressive disorders, and obsessive-compulsive disorder increased significantly in the first year, while psychotic disorders declined and bipolar disorders remained the same. In the second year, there was a trend toward prepandemic year ratios. These findings show that the pandemic affects PED admissions in different ways at different periods. These data may also help shaping the public policies necessary to meet the evolving needs in the field of mental health of society at different public crises in the future.

The Impact of Cold Spray and Ice Application During Intravenous Access on Pain and Fear in Children Aged 7-15 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial.

INTRODUCTION: Many strategies have been developed to prevent procedural pain in pediatric emergency units, where nurses play a vital role in ensuring patient comfort. Easy-to-use and inexpensive nonpharmacologic analgesic methods are important in emergency units. This study was conducted to determine the effect of cold spray and ice applied during venipuncture on the level of fear and pain in children aged 7 to 15 years. METHODS: This was a randomized controlled experimental study of 96 children between the ages of 7 and 15 years (cold spray group, ice group, and control group) who were scheduled to have venous access in the pediatric emergency clinic and met the sampling criteria. RESULTS: Evaluations of the children, parents, and observers in the groups found a statistically significant difference between the pain and fear scores after the intervention compared with the preintervention (P < .001). The pain and fear scores of the children in the control group were higher than the scores of those in the spray and ice groups (P < .001); the pain and fear scores of the children in the spray group were lower than the scores of the children in the ice group and statistically significant (P < .001). DISCUSSION: In conclusion, cold spray applied during intravenous access in children aged 7 to 15 effectively reduces pain and fear and should be used in the emergency unit.

Are YouTube videos on smell dysfunction a good source of information for patients seeking a cure for their illness?

OBJECTIVE: To conduct unbiased research into the quality and reliability of videos published on YouTube on the subject of smell dysfunction and treatment through two Ear, Nose, and Throat (ENT) specialists using three different tools. METHODS: The videos were separated into two groups (reliable: Group 1; non-reliable: Group 2) according to whether or not the content was scientifically reliable, proven, accurate, and useful, as determined by two ENT specialist physicians. The DISCERN reliability tool, Global quality scale (GQS), and JAMA scoring system were used as video scoring tools in the evaluations. RESULTS: Group 1 included 173 videos, and Group 2, 16 videos. The GQS (First ENT specialist) points were 3 (2-5) and GQS (Second ENT specialist) points were 3 (2-5) in Group 1, and 2 (2-3) and 2 (1-3) in Group 2, respectively (p = 0.0001). The points in the DISCERN and JAMA scoring systems were found to be higher in Group 1 than in Group 2 (p = 0.0001). CONCLUSION: Although the majority of videos on YouTube related to smell dysfunction are reliable, the number of unreliable videos is not inconsiderable. When videos related to medical information are accepted onto YouTube, weighting should be given to videos which include scientifically proven evidence uploaded by specialist professionals and institutions.

OBJETIVO: realizar una investigación imparcial sobre la calidad y la confiabilidad de los videos publicados en YouTube sobre el tema de la disfunción y el tratamiento del olfato, a través de dos especialistas en oído, nariz y garganta que utilizan tres herramientas diferentes. MÉTODOS: Los videos se separaron en dos grupos (confiables: Grupo 1; no confiables: Grupo 2) según si el contenido era o no científicamente confiable, probado, preciso y útil, según lo determinado por dos médicos especialistas en Otorrinolaringología. La herramienta de confiabilidad DISCERN, la escala de calidad global (GQS) y el sistema de puntuación JAMA se utilizaron como herramientas de puntuación de video en las evaluaciones. RESULTADOS: el Grupo 1 incluyó 173 videos y el Grupo 2, 16 videos. Los puntos GQS (Primer especialista en ORL) fueron 3 (2-5) y los puntos GQS (Segundo especialista en ORL) fueron 3 (2-5) en el Grupo 1, y 2 (2-3) y 2 (1-3) en el Grupo 2, respectivamente (p= 0.0001). Se encontró que los puntos en los sistemas de puntuación DISCERN y JAMA eran más altos en el Grupo 1 que en el Grupo 2 (p= 0.0001). CONCLUSIÓN: aunque la mayoría de los videos en YouTube relacionados con la disfunción del olfato son confiables, la cantidad de videos poco confiables no es despreciable. Cuando se aceptan videos relacionados con información médica en YouTube, se debe dar peso a los videos que incluyen evidencia científicamente probada y subidos por instituciones y profesionales especialistas.

Histopathological Findings in Turkish Patients Undergoing Sleeve Gastrectomy: Is Histopathologic Examination of Sleeve Gastrectomy Specimens Clinically Important?

PURPOSE: Sleeve gastrectomy (SG) is a widely used surgical method in the treatment of obesity. This study aimed to reveal the histopathological changes in SG materials and to investigate the prevalence of clinically important lesions requiring follow-up. MATERIALS AND METHODS: Three hundred five patients' data who underwent SG were analyzed. Cases were divided into three groups as normal, chronic inactive gastritis (CIG), and chronic active gastritis (CAG). Age, gender, and body mass index (BMI) of the three groups and the differences in the gastritis parameters of CIG and CAG groups were compared. RESULTS: Thirty-three patients (10.8%) were in the normal group, 145 (47.5%) were in the CIG group, and 127 (41.6%) were in the CAG group. Preoperative endoscopic examination was performed in all cases, but Helicobacter pylori (HP) treatment was not applied. HP were detected in 39.3%, atrophy in 3.9%, intestinal metaplasia (IM) in 4.9%, and lymphoid follicle (LF) in 30% of the cases. Inflammation, atrophy, IM, LF, and HP were significantly higher in the CAG group. The proton pump inhibitor (PPI)-related changes were seen in 20 cases and it was more frequent in the CIG group. Intramucosal signet ring cell carcinoma was detected in 1 case. Endocrine cell hyperplasia and dysplasia were present in 7 cases with CAG. Multiple grade 1 neuroendocrine tumors were detected in just 1 case. CONCLUSION: In our SG specimens, HP and clinically important lesions were significantly higher in the CAG group. Pathological examination should be carefully done as the lesions detected in SG specimens can change patient management.

The canonical Brucella species-host dependency is changing, however, the antibiotic susceptibility profiles remain unchanged.

Brucellosis is a chronic disease caused by Brucella species with a wide range of hosts, from marine mammals to terrestrial species, but with strict host preferences. With the zoonotic character, the prevalence of human brucellosis cases is a reflection of animal infections. This study aimed to identify 192 Brucella isolates obtained from various sources by Bruce-ladder PCR and to determine their antibiotic susceptibilities by gradient diffusion method (E-test). As a result of the PCR, all human isolates (n = 57) were identified as B. melitensis. While 58 (82.9%) of the cattle isolates were identified as B. abortus, 59 (90.8%) of the sheep isolates were identified as B. melitensis. In addition, 12 (17.1%) of the cattle isolates and 6 (9.2%) of the sheep isolates were determined as B. melitensis and B. abortus, respectively. The primary host change behavior of B. melitensis was 1.9 times higher than that of B. abortus. While gentamicin and ciprofloxacin susceptibilities of Brucella isolates were 100%, tetracycline, doxycycline, streptomycin, trimethoprim/sulfamethoxazole and rifampicin susceptibilities were 99%, 99%, 97.4%, 91.7% and 83.9%, respectively. The lowest sensitivity of the isolates was determined against to cefoperazone as 26%. A triple-drug resistance was detected in 1 B. abortus isolate that included simultaneous resistance to cefoperazone, rifampicin, and trimethoprim/sulfamethoxazole. The high susceptibility profiles we found against to antibiotics such as tetracycline, doxycycline gentamicin and ciprofloxacin, used widely in treatment, are encouraging. However, the change in the canonical Brucella species-primary host preference suggests the need to reconsider eradication program, including updating vaccine formulations.

Probiotics, Live Biotherapeutic Products (LBPs), and Gut-Brain Axis Related Psychological Conditions: Implications for Research and Dietetics.

It is well-known that probiotics have key roles in the crosstalk between the gut and brain in terms of nutrition and health. However, when investigating their role in nutrition and health, it can be important to discriminate probiotics used as foods, food supplements, or drugs. For clarification of this terminology, the Food and Drug Administration (FDA) has established a new "live biotherapeutic products" (LBP) category, expressing pharmaceutical expectations and to reduce confusion in the literature. Growing evidence advises that the community of microorganisms found in the gut microbiota is associated with psychological conditions. Hence, it is thought that LBPs may positively affect depression, anxiety, bipolar disorder, and schizophrenia by reducing inflammation, improving gut microbiota, and balancing gut neurometabolites. This review focuses on the specific position of probiotics as LBPs in psychological conditions. Condition-specific potential pathways and mechanisms of LBPs and the prominent strains are discussed in the light of novel studies for future research, dietetic and pharmaceutical applications.

Evaluation of an Immersive COVID-19 Data Visualization.

COVID-19 restrictions have detrimental effects on the population, both socially and economically. However, these restrictions are necessary as they help reduce the spread of the virus. For the public to comply, easily comprehensible communication between decision makers and the public is thus crucial. To address this, we propose a novel 3-D visualization of COVID-19 data, which could increase the awareness of COVID-19 trends in the general population. We conducted a user study and compared a conventional 2-D visualization with the proposed method in an immersive environment. Results showed that the our 3-D visualization approach facilitated understanding of the complexity of COVID-19. A majority of participants preferred to see the COVID-19 data with the 3-D method. Moreover, individual results revealed that our method increases the engagement of users with the data. We hope that our method will help governments to improve their communication with the public in the future.

Comparison of four different nutritional risk screening tools in hospitalized children / Comparação de quatro ferramentas diferentes de triagem de risco nutricional em crianças hospitalizadas

ABSTRACT Objective: Early detection of malnutrition risk in hospitalized children can improve health outcomes and quality of life; however, the number of studies where the pediatric screening tool is appropriate for Turkish children is limited. Therefore, this article aims to determine the prevalence of malnutrition risk in pediatric patients evaluated with Screening Tool for Risk on Nutritional Status and Growth, Screening Tool for the Assessment of Malnutrition in Pediatrics, Pediatric Yorkhill Malnutrition Score, and Simple Pediatric Nutrition Screening Tool with original and adjusted cutoffs and to evaluate which pediatric screening tool is appropriate for Turkish children. Methods: In this cross-sectional study, four published nutritional risk screening tools (Screening Tool for Risk on Nutritional Status and Growth, Screening Tool for the Assessment of Malnutrition in Pediatrics, Pediatric Yorkhill Malnutrition Score, Pediatric Nutrition Screening Tool) were applied to pediatric inpatients (n=604) aged 1 month to 17 years, admitted to a pediatric ward for at least 24 hours. Results: Pediatric Nutrition Screening Tool with adjusted cutoffs had the greatest recognition rate (94.2%) of acute malnutrition. Having a high nutritional risk by Pediatric Yorkhill Malnutrition Score was associated with an increased risk of acute (OR: 6.57 for Screening Tool for Risk on Nutritional Status and Growth, 5.84 for Screening Tool for the Assessment of Malnutrition in Pediatrics, and 20.35 for Pediatric Yorkhill Malnutrition Score) and chronic malnutrition (OR: 1.27 for Screening Tool for Risk on Nutritional Status and Growth, 3.28 for Screening Tool for the Assessment of Malnutrition in Pediatrics, and 1.72 for Pediatric Yorkhill Malnutrition Score). Classifying the at-risk category by the Pediatric Nutrition Screening Tool was related to raised odds of malnutrition (OR: 2.64 for original and 5.24 for adjusted cutoffs). This positive association was also observed for acute (OR: 4.07 for original cutoffs, and 28.01 for adjusted cutoffs) and chronic malnutrition (OR: 1.14 for original cutoffs, and 1.67 for adjusted cutoffs). Conclusion: Pediatric Nutrition Screening Tool with adjusted cutoffs and Pediatric Yorkhill Malnutrition Score have higher diagnostic accuracy than other screening tools in assessing the nutritional status of hospitalized Turkish children and detecting children, particularly with acute malnutrition.

RESUMO Objetivo: A detecção precoce do risco de desnutrição em crianças hospitalizadas pode melhorar a saúde e a qualidade de vida, porém o número de estudos em que a ferramenta de triagem pediátrica é apropriada para crianças turcas é limitado. O objetivo deste estudo foi determinar a prevalência do risco de desnutrição em pacientes pediátricos avaliados com Ferramenta de Triagem para Risco no Estado Nutricional e Crescimento, Ferramenta de Triagem para Avaliação de Desnutrição em Pediatria, Escore de Malnutrição Pediátrica de Yorkhill e Ferramenta de Triagem de Nutrição Pediátrica Simples com pontos de corte originais e ajustados para avaliar qual ferramenta de triagem pediátrica é apropriada para crianças turcas. Métodos: Neste estudo transversal, quatro ferramentas de triagem de risco nutricional publicadas (Ferramenta de Triagem para Risco no Estado Nutricional e Crescimento, Ferramenta de Triagem para Avaliação de Desnutrição em Pediatria, Escore de Malnutrição Pediátrica de Yorkhill, Ferramenta de Triagem de Nutrição Pediátrica) foram aplicadas a pacientes pediátricos (n=604) com idades entre 1 mês e 17 anos, internados em uma enfermaria pediátrica por pelo menos 24 horas. Resultados: A Ferramenta de Triagem de Nutrição Pediátrica com pontos de corte ajustados obteve a maior taxa de reconhecimento de desnutrição aguda (94,2%), enquanto a Ferramenta de Triagem para Avaliação de Desnutrição em Pediatria teve a maior taxa na identificação da desnutrição crônica (67,4%). Essas associações positivas foram mais notáveis para desnutrição aguda (OR: 6,57 para Ferramenta de Triagem para Risco no Estado Nutricional e Crescimento, 5,84 para Ferramenta de Triagem para Avaliação de Desnutrição em Pediatria e 20,35 para Escore de Malnutrição Pediátrica de Yorkhill) do que para desnutrição crônica (OR: 1,27 para Ferramenta de Triagem para Risco no Estado Nutricional e Crescimento, 3,28 para Ferramenta de Triagem para Avaliação de Desnutrição em Pediatria e 1,72 para Escore de Malnutrição Pediátrica de Yorkhill). A classificação da categoria de risco pela Ferramenta de Triagem de Nutrição Pediátrica foi relacionada a maiores chances de desnutrição (OR: 2,64 para pontos de corte originais e 5,24 para pontos de corte ajustados). Essa associação positiva também foi observada para desnutrição aguda (OR: 4,07 para pontos de corte originais e 28,01 para pontos de corte ajustados) e crônica (OR: 1,14 para pontos de corte originais e 1,67 para pontos de corte ajustados). Conclusão: A Ferramenta de Triagem de Nutrição Pediátrica com pontos de corte ajustados e Escore de Malnutrição Pediátrica de Yorkhill têm maior precisão diagnóstica do que outras ferramentas de triagem na avaliação do estado nutricional de crianças turcas hospitalizadas e na detecção da desnutrição aguda em particular.

Recent developments in the probiotics as live biotherapeutic products (LBPs) as modulators of gut brain axis related neurological conditions.

Probiotics have been defined as "living microorganisms that create health benefits in the host when taken in sufficient amounts. Recent developments in the understanding of the relationship between the microbiom and its host have shown evidence about the promising potential of probiotics to improve certain health problems. However, today, there are some confusions about traditional and new generation foods containing probiotics, naming and classifications of them in scientific studies and also their marketing. To clarify this confusion, the Food and Drug Administration (FDA) declared that it has made a new category definition called "live biotherapeutic products" (LBPs). Accordingly, the FDA has designated LBPs as "a biological product that: i)contains live organisms, such as bacteria; ii)is applicable to the prevention, treatment, or cure of a disease/condition of human beings; and iii) is not a vaccine". The accumulated literature focused on LBPs to determine effective strains in health and disease, and often focused on obesity, diabetes, and certain diseases like inflammatory bowel disease (IBD).However, microbiome also play an important role in the pathogenesis of diseases that age day by day in the modern world via gut-brain axis. Herein, we discuss the novel roles of LBPs in some gut-brain axis related conditions in the light of recent studies. This article may be of interest to a broad readership including those interested in probiotics as LBPs, their health effects and safety, also gut-brain axis.

Human immunodeficiency virus type 1 impairs sumoylation.

During infection, the human immunodeficiency virus type 1 (HIV-1) manipulates host cell mechanisms to its advantage, thereby controlling its replication or latency, and evading immune responses. Sumoylation is an essential post-translational modification that controls vital cellular activities including proliferation, stemness, or anti-viral immunity. SUMO peptides oppose pathogen replication and mediate interferon-dependent anti-viral activities. In turn, several viruses and bacteria attack sumoylation to disarm host immune responses. Here, we show that HIV-1 impairs cellular sumoylation and targets the host SUMO E1-activating enzyme. HIV-1 expression in cultured HEK293 cells or in CD4+ Jurkat T lymphocytes diminishes sumoylation by both SUMO paralogs, SUMO1 and SUMO2/3. HIV-1 causes a sharp and specific decline in UBA2 protein levels, a subunit of the heterodimeric SUMO E1 enzyme, which likely serves to reduce the efficiency of global protein sumoylation. Furthermore, HIV-1-infected individuals display a significant reduction in total leukocyte sumoylation that is uncoupled from HIV-induced cytopenia. Because sumoylation is vital for immune function, T-cell expansion and activity, loss of sumoylation during HIV disease may contribute to immune system deterioration in patients.

The Potential Use of Saliva as a Biofluid for Systemic Inflammatory Response Monitoring in Children with Pneumonia.

OBJECTIVE: To investigate the levels of C-reactive protein, procalcitonin, calprotectin, interleukin 1 beta (IL-1ß), IL-6, and tumor necrosis factor-alpha (TNF-α) in both saliva and serum in children with community-acquired pneumonia and to compare the saliva response with the systemic response. METHODS: Forty hospitalized children with community-acquired pneumonia aged between 1 mo and 15 y; and 40 healthy controls were included. Both serum and saliva samples were collected on admission and at the time of discharge. RESULTS: Calculated differences between values for each serum and salivary parameter on admission and before discharge named delta (Δ) values were used for correlation analysis. Salivary Δ values of each parameter were moderately/strongly correlated with their corresponding serum Δ levels [IL-1ß ÷ (r = 0.554, p < 0.001); IL-6 ÷ (r = 0.484, p = 0.002); PCT ÷ (r = 0.737, p < 0.001); TNF-α ÷ (r = 0.587, p < 0.001); CRP ÷ (r = 0.703, p < 0.001); and calprotectin ÷ (r = 0.774, p < 0.001)]. CONCLUSIONS: This study will evaluate the reflection of systemic changes in saliva and the efficacy of saliva in pediatric patients with pneumonia. Results will highlight saliva potential use as a biofluid for systemic monitoring in this patient group.

Evaluation of the Mortality and Morbidity of Premature Infants During a Five-Year Period in the Neonatal Intensive Care Unit.

Background Premature birth is the most important cause of perinatal mortality and morbidity. This study aimed to evaluate mortality and morbidity in premature infants over a five-year period at a university hospital providing tertiary intensive care health services. Methodology All premature infants born alive at ≤37 gestational weeks and hospitalized in neonatal intensive care units were included in the study. Data such as maternal and perinatal characteristics, characteristics of the newborn, respiratory and related problems, neonatal morbidities, and causes of death were retrieved retrospectively from file records. Results A total of 1,780 patients (53.7% male and 46.3% female) were included in the study. High-risk pregnancy was present in 55% of women. Respiratory distress syndrome (RDS) developed in 50.4% of the patients, intracranial hemorrhage in 8.4%, and necrotizing enterocolitis in 5.6%. Mortality was observed in 20.9% of the patients. The most frequent cause of death was RDS and related complications (11.8%), and 66.4% of mortality occurred during the early neonatal period, that is, the first 24 hours of life. Conclusions High-risk pregnancies were significantly associated with neonatal morbidity and mortality. Therefore, the management of maternal health factors should be the priority for controlling neonatal mortality.

Clinical Effects and Predictive Factors Affecting the Clinical Severity of Scorpion Envenomations in Western Turkey.

BACKGROUND: Scorpion envenomation is a common medical emergency in many countries, including Turkey. Severe systemic symptoms occur more easily in children and mortality rates are higher. The aim of this study is to describe the clinical effects and predictive factors affecting the clinical severity of scorpion envenomations in Western Turkey. METHODS: Two hundred one children (138 mild cases, 34 moderate, and 29 severe) with scorpion envenomation aged between 1 month and -17 years were included in the study. The patients' demographic and laboratory characteristics were compared among clinical severity subgroups. RESULTS: The patients' median age was 7 (4-11) years. The median age of the severe group was significantly lower than that of the mild and moderate groups (p < 0.001). Seventeen patients (8.5%) developed myocarditis, while no pulmonary edema was observed in any case. Leukocyte, neutrophil and platelet (PLT) counts, and plateletcrit (PCT) and glucose levels increased significantly with the severity of envenomation (p < 0.001). PLT counts and PCT levels exhibited positive correlation with leukocyte and neutrophil counts (p < 0.001, r = 0.781, r = 0.638, r = 0.772, and r = 0.629, respectively). Supraventricular tachycardia developed in 1 (5.9%) patient, and dilated cardiomyopathy in another (5.9%). No mortality occurred in any case. CONCLUSION: Increased PLT counts and PCT levels may be helpful in evaluating clinical severity in patients with scorpion sting envenomation. The possibility of myocarditis development in children should be remembered and cardiac enzymes should be checked, even if patients are asymptomatic and cardiac enzymes are normal on admission.

Evaluation of the use of Different Spreader Techniques in Primary Open Septorinoplasty in Terms of Nasal and Olfactory Functions.

BACKGROUND: In this study, the authors aimed to investigate the use of spreader and determine the efficacy and superiority of different spreader techniques in septorhinoplasty in terms of nasal and olfactory functions. METHODS: A total of 60 patients who had undergone septorhinoplasty with the open technique were included in the study. In addition to open septorhinoplasty, 20 patients also underwent bilateral spreader graft placement and 20 bilateral spreader flap placement. For the remaining 20 patients, open septorhinoplasty was performed without spreader grafts or flaps. The patients completed the Nasal Obstruction Symptom Evaluation (NOSE) scale consisting of five questions, and the Brief Smell Identification Test was used to detect olfactory dysfunction. RESULTS: The preoperative mean NOSE score of all patients was 10.87 (1-18), while the postoperative mean value was 1.83 (0-10). The preoperative mean olfactory score was 6.23 ±â€Š2.20 in all patients while it was 7.33 ±â€Š1.75 postoperatively. There was a statistically significant difference between the preoperative and postoperative NOSE and olfactory scores in all patients, but no statistically significant difference was observed between the three groups. CONCLUSION: Spreader graft or flap techniques used in septorhinoplasty are safe in terms of nasal obstruction and olfactory function, and there is no statistically significant difference between them.