Research into the relationship between digital health literacy and healthy lifestyle behaviors: an intergenerational comparison.

Introduction: Digital health literacy wields a pivotal role in individuals' health status in terms of seeking and choosing appropriate and accurate information, and useful services from a vast array of choices. This study is aimed at assessing the validity and reliability of the Turkish version of Digital Health Literacy Instrument (DHLI) and examining the relationship between DHL and the healthy lifestyle behaviors of participants from X, Y, and Z generations. Methods: In this study, to conduct a cross-sectional web-based survey, an online self-report questionnaire was built, and a convenience sample with a snowball approach was used. The study was conducted among 1,274 respondents aged between 18 and 64 years. Data collection tools consisted of the Personal Information Form, Lifestyle Behavior Scale II (HLBS II), and DHLI. Cultural validation and psychometric testing of DHLI, exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha test, and bivariate and multivariate regression analysis were used for statistical analysis. Results: In the study, the Turkish version of the DHLI tool consisting of six dimensions proved to be valid and reliable, and deemed appropriate for use across all age groups. The average digital health literacy of the respondents was sufficient, but the mean of healthy lifestyle behavior scores was moderate. There was a positive significant relationship between the total mean scores of DHLI and HLBS. Among the subdimensions of DHLI, while the highest mean scores were in DHLI Reliability, DHLI Privacy, and DHLI Search, DHLI Navigation and DHLI Relevance showed the lowest mean scores. DHLI Reliability, DHLI Relevance, and DHLI Adding Content were statistically significant predictors of health-related behaviors of the respondents. Conclusion: The most important feature and novelty of this study is that, although the DHLI scale has been widely translated for use in many countries, it has been translated and adapted to Turkish for the first time herein. The study offers crucial evidence about Generation X, Y, and Z's DHL level and its positive relationships with health-related behaviors. Therefore, the community and its partners should lead the way in empowering individuals to understand and use online information in an effective, secure, and health-promoting manner, along with governments.

The effect of COVID-19 on the thromboembolic outcomes in atrial fibrillation patients in the long run.

BACKGROUND: While there has been a wealth of reports concerning the acute effects of the coronavirus disease 2019 (COVID-19), further information is needed to see how things unfold in the long run. This research aimed to ascertain whether the COVID-19 pandemic has increased the probability of thromboembolic events in atrial fibrillation (AF) patients. METHODS: In this retrospective study, we scanned 952 AF patients and classified 643 eligible ones per their history of catching COVID-19. Two hundred thirty-nine of 643 patients had a history of COVID-19 (Group 1), and 404 did not (Group 2). We then compared two years of thromboembolic events between the groups. RESULTS: Composite thromboembolic outcomes were seen in 76 (11.8%) patients. Of those, 32 (13.4%) were in Group 1, and 44 (10.8%) were in Group 2 (p = .03). 10 of 32 patients (31%) in Group 1 and 11 of 44 (25%) in Group 2 died because of thromboembolic events (p = .02). Histories of diabetes mellitus, chronic obstructive pulmonary disease, and COVID-19 independently predicted thromboembolic events in AF patients. CONCLUSIONS: Having caught COVID-19 is likely to be associated with increased long-term thromboembolic outcomes in AF patients. Albeit the study design does not permit us to infer causality, our results question the necessity of more intensive anticoagulant therapy and closer follow-up in AF patients with past COVID-19.

Does globalization mitigate environmental degradation in selected emerging economies? assessment of the role of financial development, economic growth, renewable energy consumption and urbanization.

While the acceleration of globalization in newly developing (emerging) economies contributes positively to economic developments on the one hand, it is a research topic that can have an impact on environmental pollution on the other hand. Therefore, this study analyzes the impact of globalization on environmental pollution for 14 emerging economies in the 1991-2018 period by including economic growth, financial development, renewable energy consumption, and urbanization in the ecological footprint model. In addition to the AMG forecaster, Driscoll-Kraay, PCSE, and FGLS estimation techniques are used for long-term forecasting. Causal linkages among variables are analyzed by the Dumitrescu-Hurlin panel bootstrap causality test. The findings show that the series are cointegrated, that is, a long-term relationship between the variables. In the long term, globalization and renewable energy consumption reduce environmental pollution, while economic growth and financial development play a role in encouraging environmental pollution. Causality analysis enumerates a causality from economic growth and financial development to environmental pollution, as well as a two-way causality between globalization and environmental pollution and renewable energy consumption and environmental pollution. Empirical findings can offer important implications for policies that will reduce environmental pollution in these countries.

Mechanical characteristics and failure behavior of puckered and buckled allotropes of antimonene nanotubes: a molecular dynamics study.

In recent years, antimonene nanotubes have attracted considerable interest for diverse applications owing to their promising physical properties. In this study, classical molecular dynamics simulations with Stillinger-Weber potential were carried out to explore the fundamental mechanical characteristics of two stable allotropes of antimonene nanotubes (SbNTs), namely puckered (α-) and buckled (ß-) nanotubes. Mechanical properties and deformation mechanisms of antimonene nanotubes, including ultimate tensile strength, fracture strain, and Young's modulus, were thoroughly examined by considering chirality, diameter, temperature, and strain rate variables. Numerical simulations revealed that all SbNT specimens examined in this study exhibit brittle failures with a complete loss of load-bearing capability following the ultimate stress level. The brittle nature of the SbNTs with varied diameters remained unchanged under different temperatures and loading-rate conditions. Owing to their distinct crystal structure in the armchair and zigzag directions, α-SbNTs present a distinctive anisotropic behavior compared to ß-SbNTs. While the variation of the elastic modulus with temperature is not notable, the tensile strength and fracture strain of SbNTs deteriorated considerably at high temperatures. Furthermore, it was observed that the effects of diameter and temperature on zigzag α-SbNT are more pronounced due to its lower stability. Altogether, this study presents a comprehensive examination of the mechanical characteristics of the two stable antimonene allotropes and provides useful information for their potential utilizations in a wide range of applications.

Emergency Medicine Association of Turkey Disaster Committee Summary of Field Observations of February 6th Kahramanmaras Earthquakes.

An earthquake measuring 7.7 magnitude on the Richter scale occurred at 04:17am on February 6, 2023 in the Pazarcik district of Kahramanmaras province Turkey. In the hours following the 7.7 magnitude event in Kahramanmaras, a second 7.6 magnitude earthquake struck the region and a third 6.4 magnitude earthquake struck Gaziantep, causing extensive damage and death. A total of ten provinces directly experienced the earthquake, including Kahramanmaras, Hatay, Gaziantep, Osmaniye, Malatya, Adana, Diyarbakir, Sanliurfa, Adiyaman, and Kilis. The official figures indicate 31,643 people were killed, 80,278 were injured, and 6,444 buildings were destroyed within seven days of the earthquakes (as of 12:00pm/noon on Monday, February 13th). The area affected by the earthquake has been officially declared to be 500km in diameter. This report primarily relies on observations made by pioneer Emergency Physicians (EPs) who went to the disaster areas shortly after the first earthquake (in the early stages of the disaster). According to their observations: (1) Due to winter conditions, there were transportation problems and a shortage of personnel reaching disaster areas on the first day after the disaster; (2) On the second day of the disaster, health equipment was in short supply; (3) As of the third day, health workers were unprepared in terms of knowledge and experience for the disaster; and (4) The subsequent deployment of health personnel to the disaster area was uncoordinated and unplanned on the following days, which resulted in the health personnel working there not being able to meet even their basic needs (such as food, heating, and shelter). During the first week, coordination was most frequently reported as the most significant problem.

The Effect of Meteorological Factors on the COVID-19 Pandemic in Northeast Turkiye.

Introduction Although various studies have been conducted on the relationship between meteorological factors and coronavirus disease 2019 (COVID-19), this issue has not been sufficiently clarified. In particular, there are a limited number of studies on the course of COVID-19 in the warmer-humidity seasons. Methods Patients presenting to the emergency departments of health institutions and to clinics set aside for cases of suspected COVID-19 in the province of Rize between 1 June and 31 August 2021 and who met the case definition based on the Turkish COVID-19 epidemiological guideline were included in this retrospective study. The effect of meteorological factors on case numbers throughout the study was investigated. Results During the study period, 80,490 tests were performed on patients presenting to emergency departments and clinics dedicated to patients with suspected COVID-19. The total case number was 16,270, with a median daily number of 64 (range 43-328). The total number of deaths was 103, with a median daily figure of 1.00 (range 0.00-1.25). According to the Poisson distribution analysis, it is found that the number of cases tended to increase at temperatures between 20.8 and 27.2°C. Conclusion It is predicted that the number of COVID-19 cases will not decrease with the increase in temperature in temperate regions with high rainfall. Therefore, unlike influenza, there may not be seasonal variation in the prevalence of COVID-19. The requisite measures should be adopted in health systems and hospitals to manage increases in case numbers associated with changes in meteorological factors.

Effects of different intraabdominal pressures on internal jugular vein, liver and kidney functions in obese patients undergoing laparoscopic sleeve gastrectomy.

OBJECTIVE: The aim of this study was to investigate whether there was a difference in laparoscopic sleeve gastrectomy (LSG) performed with either 10 mmHg or 13 mmHg intraabdominal pressures. Effects of these pressures on the internal jugular vein (IJV) diameter and flow along with the liver and kidney function tests were evaluated. MATERIALS AND METHODS: The patients were divided into two groups with respect to the intraabdominal pressure performed during LSG (either 10 or 13 mmHg). The patients' age, comorbidities, surgical history, height, weight, body mass index, family history, duration of surgery, length of hospital stay, serum liver and kidney function tests (Urea, creatinine, Aspartate transaminase, Alanine transaminase, Gamma-glutamyltransferase, Alkaline phosphatase, bilirubin) and the right IJV diameter and flow measured by Duplex ultrasound before intubation (t1), 10 min after insufflation (t2), and at the end of insufflation (t3) were recorded. RESULTS: Preoperative and postoperative kidney and liver function values of the patients in both groups were within the reference range. In both groups, there was a significant decrease in the IJV diameter and flow measurement values at t2 compared to t1, and a significant increase was observed at t3 compared to t2 (p < 0.05). The mean IJV diameter and flow were significantly higher in the 10 mmHg pressure group compared to the 13 mmHg group (p < 0.05). CONCLUSION: Neither of the peak pressures performed intraabdominal during LSG caused an adverse effect on liver or kidney functions. Our study emphasizes that low insufflation pressure does not have an advantage in terms of liver and kidney functions. But laparoscopic sleeve gastrectomy with low intra-abdominal pressure may be beneficial especially in patients who require central vein catheterization during the operation. We consider that LSG performed with CO2 pneumoperitoneum at 10 mmHg is a safe, effective and feasible method that can facilitate the insertion of the intraoperative central venous catheter due to lesser charges in the IJV diameter and flow compared to the standard technique.

Greenhouse gas emissions, economic globalization, and health expenditures nexus: does population aging matter in emerging market economies?

Papers on population aging and the effects of environmental quality on health expenditure have critical policy consequences. However, findings in the relevant literature are mixed, and papers generally focus on developed countries. To provide new information to the literature, this paper examines the impact of globalization, economic growth, greenhouse gas emissions, and population aging on health expenditures in emerging market economies with annual data for the period 2000 to 2018. The paper follows a second-generation advanced panel data method that considers cross-sectional dependency. The estimation results reveal that population aging, economic growth, and greenhouse gas emissions have an increasing effect on health expenditures, while globalization has a decreasing effect. Furthermore, one-way causality running from population aging to health expenditures is confirmed, while a feedback causality relationship is observed between health expenditures and other indicators (globalization, economic growth, and greenhouse gas emissions). After all, the outputs of this paper can provide critical policy implications about the relationships between aging, globalization, air quality, and health expenditures in developing countries.

Environmental quality and health expenditures efficiency in Türkiye: the role of natural resources.

The environmental pollution caused by climate change and global warming pose significant risks to health. This raises the question how environmental disturbances can affect health expenditures. Based on this, this study examines the asymmetric effect of environmental quality on health expenditures in Türkiye using the non-linear ARDL (NARDL) model for the 1975-2019 period. In addition to environmental quality, natural resources, economic growth, and trade openness variables are also included in the health expenditure model. The findings support the existence of an asymmetric cointegration relationship between the series. The findings also indicate that positive environmental pollution shocks affect health expenditures positively in the long run, while negative environmental pollution shocks do not have a statistically significant effect on health expenditures. Positive and negative natural resource shocks affect health expenditures negatively in the long run. Despite the effect of positive economic growth shocks on health expenditures is positive but statistically insignificant, the effect of negative economic growth shocks is positive and significant. Besides, positive trade openness shocks have a negative effect on health expenditures and negative trade openness shocks have a positive effect. The findings prove that the steps to be taken to protect the environment in the current period will increase the effectiveness of health expenditures in the future. This situation has a guiding feature for policy-makers in terms of policy decisions.

The relationship between health expenditure indicators and economic growth in OECD countries: A Driscoll-Kraay approach.

Introduction: The main purpose of the study is to examine the relationship between health expenditure indicators and economic growth in OECD countries. Methods: In this context, health expenditures and economic indicators data of 21 OECD countries were analyzed by the Driscoll-Kraay standard error approach within the scope of panel data analysis. While Gross Domestic Product (GDP) and income per capita were used as dependent variables, the amount of out-of-pocket health spending, per capita health expenditure, the amount of public health expenditure, the ratio of drug expenditures to gross domestic product, the share of current health expenditures in GDP were used as independent variables. Results: According to the results, in the model (Model 1) where real GDP level was used as the dependent variable, all health expenditure indicators were positively related to the economic growth. When the estimation results of Model 1 are examined, it is predicted that there will be an increase of 0.09% in GDP in case of a 1% increase in the share allocated to health services from GDP. In case of a 1% increase in the amount of out-of-pocket spending on healthcare, it is foreseen that there may be an increase of 0.04% in the real GDP. In the model (Model 2) where the per capita income variable is the dependent variable, it is seen that the increase in out- of-pocket health spending has a decreasing effect on the per capita income level, while the increase in public expenditures has an increasing effect on the per capita income level. From the findings of Model 2, it was found that if a 1% increase in the share of current health expenditures in GDP, there may be an increase of 0.06% in the amount of per capita income. Discussion: Concludingly, it is possible to say that that public resources allocated to health services play an important role in the economic growth.

A 10-year bibliometric analysis of publications in emergency medicine.

OBJECTIVE: Emergency medicine (EM) research is growing at a rapid pace. It is important to understand the scope and trends over time in order to identify gaps and future areas for growth. This study aimed to describe trends in scientific publications within EM over the past decade. METHODS: We searched the Web of Science database's Emergency Medicine category for all scientific publications published between 2010 and 2019. Data were presented via descriptive statistics. Inferential bibliometric analyses included clustering of the selected parameters of keywords, Keyword Plus, titles, and abstracts; Bradford's law to evaluate core journals, and the Sankey diagrams to evaluate the flows between research themes over time. RESULTS: We identified 32,858 articles written by 85,693 authors. The mean citations per document were 11. The top five countries with the highest number of publications were the United States (n = 42,221), Turkey (n = 6595), Canada (n = 6545), Australia (n = 5867), and China (n = 5322). The journals with the highest number of publications: the American Journal of Emergency Medicine, Journal of Emergency Medicine, Resuscitation, and Pediatric Emergency Care. The most frequent topics were cardiovascular emergencies, resuscitation, mortality, patient outcomes, emergency imaging, triage, education, and management. CONCLUSION: This bibliometric study is a quick snapshot of research in the EM field in the last decade and may provide insights into the scientific agendas of the EM professionals.

Emergency department management after the 2020 Aegean Sea - Izmir earthquake.

BACKGROUND: This article aims to provide an up-to-date resource on disaster management by reporting about the destructive fea-tures of the earthquake that occurred on October 30, 2020, and about the hospital and emergency service organization during a pandemic. METHODS: This study was carried out with a multicentered, cross-sectional retrospective design on the victims of the 2020 Aegean Sea - Izmir earthquake. Local ethics committee approval was obtained. The data obtained by obtaining permission from two hospitals and ambulance services (transport data) located in the region where earthquake-related destruction was most prominent were evalu-ated. Patient data including demographic data, time of arrival to the emergency department, duration of stay under the debris, triage codes (green: not urgent, slightly injured; yellow: may be delayed, injured; red: critically injured; and black: dead), type of injuries, dura-tion of stay in the emergency department, crush syndrome, rhabdomyolysis, need for invasive procedures (e.g., surgery and dialysis), intensive care admission, hospital admission, and discharge were evaluated. RESULTS: In total, 313 patients (60.4% females) were included in the study according to the inclusion criteria. The mean age of the participants was 38.0±21.0 years, with the youngest being a 6-month-old baby and the oldest a 91-year-old individual. Approximately 41.5% of the earthquake victims presented to the emergency department within the first 3 h of the earthquake, and patients with yellow triage code were the most common in the 1st h. Further, 35.2% of the patients who were rescued from under the debris were discharged alive. Four patients were discharged alive after being rescued from under the debris 24 h following the earthquake, of whom three were rescued after >48 h (longest duration, 91 h). Further, 32 (15.9%) patients who survived upon presentation to the emergency department had rhabdomyolysis, 4 (1.9%) underwent hemodialysis in the emergency department due to acute renal failure, and 8 (3.8%) underwent other emergency operations such as fasciotomy and amputation. In total, 122 patients died and 191 patients were discharged from the hospitals. Furthermore, 139 patients were discharged from the emergency department, 15 were admitted to the intensive care unit, 41 were hospitalized in the relevant clinics, and 112 were directly transferred to the morgue following preliminary evaluation. CONCLUSION: Emergency services should be ready in terms of accurate registration, correct data entry, correct triage assignment, sufficient resources, adequate team, sufficient equipment, and adequate treatment areas for disasters such as earthquakes. Further, ade-quate disaster trainings should be provided, feasible disaster relief plans should be prepared, and regular exercises should be conducted.

Analysis of the dynamics of environmental degradation for 18 upper middle-income countries: the role of financial development.

This study aims at investigating the dynamics of environmental degradation by focusing on the financial development-CO2 emissions link. In this purpose, economic growth, renewable energy consumption, trade openness and urbanization are integrated into the CO2 emissions model as other explanatory variables. In this study, 18 upper-middle-income countries with the highest growth rate in the world are examined for the period 1990-2018 by AMG method, which considers the cross-sectional dependence and slope heterogeneity. In addition, the causal linkages between variables are explored by Dumitrescu-Hurlin panel bootstrap causality technique. As a result of the study, it is found that financial development and renewable energy consumption reduce CO2 emissions. In addition, it is determined that economic growth, urbanization, and trade openness deteriorate the environmental quality. As a result of causality analysis, while one-way is found from renewable energy consumption to CO2 emissions, a bidirectional causality is observed between financial development and CO2 emissions. Empirical findings provide several policy suggestions that decrease CO2 emissions in these countries.

Modified balloon-assisted coiling instead of acute stenting in the treatment of ruptured wide necked intracranial aneurysms.

BACKGROUND: The aim of this study was to investigate the safety and efficiency of the modified balloon assisted coiling (mBAC) technique in endovascular treatment (EVT) of ruptured wide-necked aneurysms (WNAs) to avoid stent placement in the acute phase of subarachnoid hemorrhage (SAH). METHODS: The local neurointerventional radiology database was retrospectively reviewed to identify patients who underwent EVT due to ruptured WNAs by the authors. According to the EVT technique performed, the study sample was divided into 3 groups: conventional BAC, stent assisted coiling (SAC), and mBAC. The patient demographics, aneurysm features, technical and clinical complications, aneurysm occlusion grades, morbidity, and mortality rates were comparatively analyzed. RESULTS: This study involved a total of 113 patients who had ruptured WNAs. The mBAC technique was performed on 26 aneurysms (23 saccular and 3 fusiform) in 26 patients to avoid acute phase stenting. The mean continuous balloon inflation time was 7.1 ± 2.12 min. The initial and follow-up angiographic and clinical outcomes were better in the mBAC group than in the SAC group (p < 0.05). CONCLUSIONS: The mBAC technique offers a prolonged, continuous balloon inflation time during the whole coiling process in the treatment of ruptured WNAs. The mBAC technique has the potential to obviate the need for SAC in patients who are candidates for stenting during the acute phase of SAH, and it might be considered a safe and effective endovascular approach with low complication rates and good angiographic and clinical outcomes.

Early choroidal structure and choroidal vascularity index change after carotid stenting.

PURPOSES: We aimed to evaluate changes in subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) in the first postoperative day and month in patients with severe internal carotid artery (ICA) stenosis after ICA stenting. METHOD: The patients who diagnosed with severe ICA stenosis and was performed ICA stenting were included in the study. Patients with any ocular disease and refractive error more than 3 diopters were not included in the study. The imaging of the choroid was performed using enhanced depth imaging (EDI) techniques by spectral domain optical coherence tomography (SD-OCT) (OptovueRTVue XR, Optovue Inc., Fremont, CA).The choroidal vascularity index (CVI), total choroidal area (TA), luminal area (LA), and stromal area (SA) were measured in the subfoveal 2 mm area. These measurements before ICA stenting was compared with the first day and first month after ICA stenting. RESULTS: The study included 41 eyes from 41 patients (11 women [26.83%]; 30 men [73.17%]). The mean age of patients was 62.25 ± 4.85 (57-71) years. The differences in subfoveal CT, TA, LA, SA between before ICA stenting and 1 day after ICA stenting, before ICA stenting and 1 month after ICA stenting was statically significant(p<0.05 for each). CONCLUSION: We have observed increases in SFCT, CVI, LA, SA, and TA on the 1st day and 1st month after ICA stenting in patients with severe carotid stenosis.  Improvement in choroidal thickness and choroidal vascular flow is seen even in the early period of ICA stenting.

A Novel Factor in Determining the Risk of Ischemic Cerebrovascular Events in Patients with Atrial Fibrillation: Pulmonary Hypertension.

OBJECTIVES: Pulmonary hypertension (PH) is closely related to clinical decompensation and poor clinical outcomes in atrial fibrillation (AF) patients. However, the association between PH and ischemic cerebrovascular events (ICE) in AF patients has not been investigated. The authors purposed to examine this relationship. MATERIALS AND METHODS: The researchers conducted an observational study on 371 AF patients between January and November 2021. In line with the European Society of Cardiology guideline recommendations, echocardiographic parameters suggestive of PH were performed. The study population was stratified into two groups based on the presence (n = 98, 31%) or non-presence (n = 219, 69%) of PH. Also, we did logistic regression analyses for the independent predictors of the ICEs in AF patients. RESULTS: Ischemic cerebrovascular events were significantly more frequent in the PH group than the non-PH group (n = 30, 13% vs. n = 18, 18%, p = 0.03). At univariable analysis, hypertension, diabetes mellitus, PH (OR = 0.23 [95% CI, 0.13-0.41], p = 0.005) and diastolic dysfunction were significantly related to ICE in AF patients. Moreover, at multivariable analysis, age, diabetes mellitus, PH (OR = 0.19 [95% CI, 0.10-0.36], p = 0.01), and diastolic dysfunction were predictive of ICE. CONCLUSIONS: Pulmonary hypertension is likely associated with ischemic cerebrovascular events in patients with AF, requiring further investigation to determine its association.

The Cardiopulmonary Effects of Medical Masks and Filtering Facepiece Respirators on Healthy Health Care Workers in the Emergency Department: A Prospective Cohort Study.

BACKGROUND: International COVID-19 guidelines recommend that health care workers (HCWs) wear filtering facepiece (FFP) respirators to reduce exposure risk. However, there are concerns about FFP respirators causing hypercapnia via rebreathing carbon dioxide (CO2). Most previous studies measured the physiological effects of FFP respirators on treadmills or while resting, and such measurements may not reflect the physiological changes of HCWs working in the emergency department (ED). OBJECTIVE: Our aim was to evaluate the physiological and clinical impacts of FFP type II (FFP2) respirators on HCWs during 2 h of their day shift in the ED. METHODS: We included emergency HCWs in this prospective cohort study. We measured end-tidal CO2 (ETCO2), mean arterial pressure (MAP), respiratory rate (RR), and heart rate values and dyspnea scores of subjects at two time points. The first measurements were carried out with medical masks while resting. Subjects then began their day shift in the ED with medical mask plus FFP2 respirator. We called subjects after 2 h for the second measurement. RESULTS: The median age of 153 healthy volunteers was 24.0 years (interquartile range 24.0-25.0 years). Subjects' MAP, RR, and ETCO2 values and dyspnea scores were significantly higher after 2 h. Median ETCO2 values increased from 36.4 to 38.8 mm Hg. None of the subjects had hypercapnia symptoms, hypoxia, or other adverse effects. CONCLUSION: We did not observe any clinical reflection of these changes in physiological values. Thus, we evaluated these changes to be clinically insignificant. We found that it is safe for healthy HCWs to wear medical masks plus FFP2 respirators during a 2-h working shift in the ED.

Targeted and Staged Treatment for Ruptured Wide-neck Intracranial Aneurysms: Bleb Coiling Strategy as a New Approach.

RATIONALE AND OBJECTIVE: This study aimed to investigate the feasibility, safety, and efficiency rates of the bleb coiling technique for the treatment of acute ruptured wide-neck bifurcation aneurysm (WBNAs) by comparing it with device-assisted coiling. MATERIALS AND METHODS: Patients with ruptured WNBAs who underwent endovascular treatment (EVT) were reviewed. The study sample was divided into five groups according to treatment type: bleb coiling, single catheter coiling, balloon-assisted coiling (BAC), neck remodeling mesh-assisted coiling, and stent-assisted coiling (SAC). The feasibility, safety, efficiency and complication rates of the bleb coiling technique were compared with each group. RESULTS: This study included 109 patients with ruptured WNBAs. Bleb coiling was performed in 24 blebs of 20 WNBAs. The mean time interval between initial and complementary treatment in the bleb coiling group was 12.53± 5 .27 weeks (min-max: 4-23 weeks). No rebleeding occurred during this interval time, and no mortality or new permanent neurologic deficit caused by the bleb coiling technique was noted. The bleb coiling technique had a lower complication rate than other techniques (p <0.05). CONCLUSION: The bleb coiling strategy led to favourable clinical outcomes with low complication rates and it can be considered as an alternative treatment option at acute phase of SAH in the endovascular treatment of ruptured WBNAs with coilable-bleb.

Predictive power of diastolic parameters on medical cardioversion success in acute atrial fibrillation.

BACKGROUND: Diastolic function assessment has been reported to provide valuable data in patients with atrial fibrillation (AF). The purpose of this study was to evaluate the effects of diastolic parameters on predicting the effectiveness of medical cardioversion in restoring sinus rhythm among patients with acute AF. METHODS: 40 non-valvular, new onset AF patients were included. All participants received an intravenous infusion of amiodarone. In patients whom sinus rhythm could not be restored with amiodarone, an electrical cardioversion was performed. Two groups, patients who achieved sinus rhythm with amiodarone (Group-1) and who failed to achieve sinus rhythm with amiodarone (Group-2) were compared with respect to initial echocardiographic measurements. RESULTS: Group-1 patients were younger comparing with Group-2 (mean age; 54.4 ± 13.9 years vs 63.3 ± 10.3 years, p = 0.028). Comparing with Group-1, Group-2 patients had; a higher left atrium volume index (17.1 ± 4.8 cm3 / m2 vs 22.6 ± 6.6 cm3 / m2 , p = 0.03); a shorter pulmonary vein S (49.6 ± 3.8 cm/sec vs 41.1 ± 3.0 cm/sec, p < 0.001); and a shorter pulmonary vein D peak velocity (55.9 ± 2.4 cm/sec vs 52.3 ± 1.8 cm/sec, p < 0.001). Moreover, both IVRT and DT were significantly shorter in Group-2, comparing with Group-1 (45.1 ± 2.1 msec vs 51.1 ± 2.5 msec, p < 0.001 and 51.3 ± 2.4 msec vs 56.5± 3.2 msec, p < 0.001, respectively). CONCLUSION: The present study revealed that admission pulmonary vein S and D wave peak velocities, IVRT, DT, and Pro-BNP levels could be predictors of failure of medical cardioversion among AF patients.