RESUMEN
OBJECTIVE: Vocal cord paralysis (VCP) is a serious complication in thyroidectomy operations; however, its management remains unclear. The present study evaluated the voice parameters of patients who underwent surgery using Intraoperative Neurophysiologic Monitoring (IONM). PATIENTS AND METHODS: A total of 52 patients (41 females and 11 males) who underwent a total thyroidectomy operation were evaluated using objective and subjective voice analysis examinations before and after surgery. Acoustic parameters, such as Fundamental Frequency (F0), Shimmer, Jitter, Noise-to-Harmonic ratio (NHR), and aerodynamic parameters, including S/Z ratio and maximum phonation time (MPT), were analyzed. Objective findings, including the VHI-10 (Voice Handicap Index) and V-RQOL (Voice-Related Quality of Life), were also analyzed. The relationship between voice parameters and IONM values was investigated. RESULTS: The objective analysis (acoustic and aerodynamic parameters) showed no difference (p>0.05). However, the subjective analysis, which involved the VHI-10 and V-RQOL measures, revealed a significant difference before and after the operation (p<0.05). The Spearman correlation analysis showed that the NHR postoperative 1st-month parameter negatively correlated (rho=-0.317, p<0.059), while the F0 postoperative 6th-month parameter positively correlated (rho=0.347) with the amplitude difference before and after dissection (Right R2-R1 difference) for the right RLN measured in IONM. CONCLUSIONS: Patients who are planning to undergo a thyroidectomy procedure should undergo voice assessment during both the preoperative and postoperative periods. IONM could improve voice quality outcomes.
Asunto(s)
Parálisis de los Pliegues Vocales , Trastornos de la Voz , Masculino , Femenino , Humanos , Calidad de la Voz , Tiroidectomía/efectos adversos , Calidad de Vida , Acústica , Parálisis de los Pliegues Vocales/diagnóstico , Parálisis de los Pliegues Vocales/etiología , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/etiologíaRESUMEN
OBJECTIVE: The purpose of this study is to evaluate the effect of sarcopenia on overall survival and local relapse in head and neck cancer patients undergoing surgical excision. PATIENTS AND METHODS: This retrospective study includes head and neck cancer patients primarily treated with surgical excision in a tertiary care center. Patients were included if they had undergone an abdominal region Computer Tomography scan at least 45 days before the surgical excision. Hospital records were collected, and data analysis included patient demographics, comorbidities, tumor staging, surgical details, adjuvant therapy details, treatment complications, death records, and last follow-up appointment details. RESULTS: In this retrospective study, 138 head and neck cancer patients were included, with 69.6% males and 30.4% females. The mean age was 60.2±12.3 years, and the average follow-up time was 54.3±16.3 months. Sarcopenia was present in 48.6% of patients and absent in 51.4%. Sarcopenic patients had a significantly lower mean age compared to non-sarcopenic patients (p<0.05). The proportion of larynx cancer was significantly lower in the sarcopenia group compared to the non-sarcopenia group (p<0.05). According to the American Joint Committee on Cancer (AJCC) staging, stage IV was significantly higher in the sarcopenia group (p<0.05). Local relapse was significantly higher in the sarcopenia group (p<0.05). CONCLUSIONS: The findings of this study emphasize the importance of sarcopenia evaluation in determining prognosis and identifying patients who may benefit from specialized and intensive nutritional programs. Sarcopenia harms overall survival and local relapse in head and neck cancer patients.
Asunto(s)
Neoplasias de Cabeza y Cuello , Sarcopenia , Masculino , Femenino , Humanos , Persona de Mediana Edad , Anciano , Sarcopenia/patología , Estudios Retrospectivos , Neoplasias de Cabeza y Cuello/cirugía , Neoplasias de Cabeza y Cuello/complicaciones , Pronóstico , RecurrenciaRESUMEN
INTRODUCTION: This study aims to investigate the effect of different particle sizes and pressures on the shear bond strength (SBS) and the roughness (Ra) of polyetheretherketone. MATERIALS AND METHODS: A total of 117 polyetheretherketone specimens were fabricated and divided into a control (CN: no air-particle abrasion) and eight pre-treatment groups (air-abraded with 50- or 110-µm Al2O3 particles at 1(A), 1.5(B), 2(C), and 2.5(D) bar). The adhesive, Visio.link was used. Thermal aging was performed. Surface properties, SBS and failure mode were assessed. Data was analyzed by linear regression, Pearson correlation and Dunnett's T3 test for pairwise comparisons (p⟨0.05). RESULTS: The highest and lowest Ra were found in the 110D and CN groups respectively, and the highest SBS results were obtained from the 50B group. Pressure and particle size showed significant difference on the investigated properties (p⟨0.001). Only adhesive failure was observed in the CN, and resin cohesive failure was observed in addition to adhesive failure in the overall study groups. CONCLUSION: The air-borne particle abrasion procedures and the adhesive material combination are critical to the strength of the polyetheretherketone bond. The combination of visio.link with the pre-treatment option of 50-µm Al2O3 particles applied at 1.5-bar pressure delivered the most favorable results.
Asunto(s)
Benzofenonas , Cetonas , Ensayo de Materiales , Tamaño de la Partícula , Polietilenglicoles , Polímeros , Presión , Propiedades de Superficie , Cetonas/química , Polietilenglicoles/química , Resistencia al Corte , Recubrimiento Dental Adhesivo , Análisis del Estrés DentalRESUMEN
OBJECTIVE: This study aimed to investigate the relationship between hypercortisolism and temporal muscle thickness (TMT) in Cushing's disease (CD). METHODS: A retrospective review of medical records was conducted for patients with CD who presented to our clinic between 2012 and 2022. Biochemical data and TMT measurements from sella imaging were evaluated during diagnosis and the first postoperative year. RESULTS: A total of 44 patients were included in the study, with an average age of 43.9 years, of which 38 were female. The mean TMT at the time of diagnosis was 19.07 ± 1.71 mm, with no significant difference between males and females (p = 0.097), and no correlation between the TMT and age at diagnosis (p = 0.497). There was an inverse relationship between TMT and serum cortisol levels, 24-h UFC, and midnight salivary cortisol at the time of diagnosis of CD (p < 0.05, for all). One year after surgery, TMT significantly increased in all patients compared to baseline (p < 0.001). Furthermore, patients who achieved postoperative remission had significantly higher TMT values compared to those who did not achieve remission (p = 0.043). Among the patients who achieved remission, those who achieved remission through surgery had significantly higher TMT compared to those who could not reach remission with surgery and patients who started medical treatment and achieved biochemical remission (p = 0.01). Patients with severe myopathy and sarcopenia had significantly lower TMT values than the others (p < 0.001). CONCLUSION: Temporal muscle thickness was found to be associated with disease activity and disease control in Cushing's disease.
RESUMEN
OBJECTIVES: Systemic sclerosis (SSc) represents extremely rare disease with majority of data coming from adults. Studies comparing juvenile- (jSSc) and adult-onset (aSSc) patients are limited. We aimed to compare clinical features, treatment modalities and survival rates of jSSc and aSSc patients. METHODS: A retrospective study among pediatric and adult Scl patients has been performed. Demographic characteristics, clinical features, autoantibody profiles, and treatment data were retrieved from the databases. Survival analysis was done using Kaplan-Meier plot and factors associated with mortality were identified with multiple regression analysis. RESULTS: A total of 158 adults and 58 juvenile Scl patients were identified. The mean age at the disease onset was 37±14.7 vs. 8.8 ± 4.1 years, mean age at diagnosis 42±15.2 vs. 10.4 ± 3.8 years and mean follow-up duration was 6.3 ± 4.9 years vs. 6.6 ± 4.9 years for aSSc and jSSc patients, respectively. The frequency of interstitial lung disease (ILD) (50.9% vs 30%, p<0.001) and systemic hypertension (17.9% vs 0, p = 0.009) was significantly higher among aSSc. While aSSc patients had presented mostly with limited cutaneous subset (74.1%), diffuse cutaneous subset was the dominant subset among jSSc (76.7%), (p<0.001). The mortality rate was significantly higher among adults (p = 0.005). The ILD (p = 0.03) and cardiac insufficiency (p = 0.05) were independent risk factors of mortality in both aSSc and jSSc patients. CONCLUSION: Juvenile and adult-onset Scl represent rarely seen conditions with different clinical phenotypes. Pediatric patients with LS are more commonly seen by pediatric rheumatologists, in contrary to adults. Diffuse disease subset is the dominant form among juvenile patients, whereas limited form is the main disease subset among adults. On the other hand, juvenile-onset patients have a better survival than those with adult-onset.
Asunto(s)
Enfermedades Pulmonares Intersticiales , Esclerodermia Localizada , Esclerodermia Sistémica , Humanos , Estudios Retrospectivos , Autoanticuerpos , Enfermedades Pulmonares Intersticiales/complicaciones , FenotipoRESUMEN
OBJECTIVE: Although it was stated that supine percutaneous nephrolithotomy (PCNL) was associated with relatively shorter surgical times and comparable success and complication rates, there is no consensus in the current literature concerning the safety and efficacy of supine PCNL in patients with horseshoe kidneys. We aimed to compare supine and prone PCNL regarding safety and efficacy in patients with horseshoe kidneys. METHODS: Data of the patients with horseshoe kidneys who underwent PCNL for renal stones larger than 2â¯cm between January 2010 and May 2021 were retrospectively reviewed. The study patients were categorized as Group 1 (i.e., supine PCNL-SPCNL) and Group 2 (i.e., prone PCNL-PPCNL). Both groups were compared regarding demographic, clinical, and surgical data. RESULTS: Sixty-five patients were included. Among these patients, 31 (47.7%) were in Group 1, while 34 (52.3%) were in Group 2. Both groups were statistically similar in terms of demographic data, stone characteristics, perioperative parameters, and complication rates (pâ¯>â¯0.05). There was no statistical difference in terms of additional treatment rates, stone-free rates in the postoperative second-day and third-month evaluations (pâ¯>â¯0.05). Mean surgical time was significantly longer in Group 2 (113⯱â¯17.1â¯min) than in Group 1 (90.6⯱â¯11.3â¯min) (pâ¯=â¯0.000). CONCLUSION: Although it is traditionally performed in the prone position, the supine approach is as safe and effective as the prone approach. In addition, the supine approach is associated with significantly shorter surgical times.
Asunto(s)
Riñón Fusionado , Cálculos Renales , Nefrolitotomía Percutánea , Nefrostomía Percutánea , Humanos , Posición Supina , Posición Prona , Estudios Retrospectivos , Resultado del Tratamiento , Cálculos Renales/cirugíaRESUMEN
OBJECTIVE: The aim of our study was to present our case series of the trial of labor after a caesarean (TOLAC) and determine significant predictors for a successful vaginal birth after a caesarean (VBAC). PATIENTS AND METHODS: Women with previous single caesarean deliveries who underwent TOLAC between January 2016-December 2019 were included in the study (n = 474). All files were analyzed in terms of demographic characteristics, obstetric history, history of index pregnancy and medical characteristics of previous caesarean delivery. For each current pregnancy, we recorded time from the previous delivery, the BISHOP and TOLAC scores at admission, induction of labor, gestational age at delivery, estimated fetal weight, intrapartum characteristics, mode of delivery and intra-operative findings. RESULTS: Among 474 women who had a previous caesarean delivery and gave consent for TOLAC, 216 resulted in a successful vaginal delivery, whereas 258 underwent repeat caesarean delivery. One hundred and seventy-nine women gave up trial of vaginal delivery during labor. The success rate of VBAC after exclusion of caesarean cases due to maternal requests was 73.2%. The induction rate was significantly higher in cases with successful VBAC (40% vs. 29.1%). The risk of uterine rupture was 0.42% in cases with labor induction. ROC analysis showed significant predictive values of the TOLAC score, body mass index (BMI), the number of previous VBACs and the number of previous vaginal deliveries, birth weight and the BISHOP score at admission. CONCLUSIONS: Our data showed us that major determinants for successful VBAC following labor are the BISHOP score at admission, number of previous vaginal deliveries, body mass index, birth weight and the TOLAC score calculated at admission.
Asunto(s)
Parto Vaginal Después de Cesárea , Peso al Nacer , Cesárea , Femenino , Humanos , Masculino , Embarazo , Estudios Retrospectivos , Esfuerzo de PartoRESUMEN
OBJECTIVE: To combine non-contrast computerized tomography (NCCT)-based parameters with stone and patient characteristics that are already known to affect shock wave lithotripsy (SWL) success and assess this novel model's effectiveness in predicting SWL success for single ureteral stones in different locations. MATERIALS AND METHODS: Data of patients treated by SWL for a single ureteral stone between January 2017 and January 2019 were retrospectively reviewed. Demographic parameters of patients and stone characteristics were combined with NCCT-based parameters. NCCT-based parameters included the presence or absence of hydronephrosis, perinephric stranding, periureteral edema, diameter of the proximal ureter, ureteral wall thickness (UWT) at ureteral stone site. The logistic regression method was used for the development of a useful predictive model. Subsequently, the receiver operating curve was used to determine cut-off levels, and a scoring system was developed for prediction of SWL success. RESULTS: Stone-free rate was 77,1% (267/346) in the entire cohort. Univariate analysis revealed that age, stone volume, density, perinephric stranding, diameter of proximal ureter, and UWT, were associated with SWL success. In multivariate analysis, proximal ureteral stone location, stone volume, density, and UWT were independent predictors of SWL success. The formula used during logistic regression analysis was: 1/[1 + exp {-8.856 + 0.008 (stone volume) + 0.002 (stone density) + 0.673 (UWT) + 1026 (proximal ureteral stone)}]. The scores of 0, 1, 2, 3 and 4 were associated with 97,8%, 83,4%, 60,8%, 33,2% and 11,1% success rates, respectively, in the prediction model based on these parameters. CONCLUSION: We conclude that our model can facilitate decision-making for SWL treatment of ureteral stones in different locations.
Asunto(s)
Litotricia , Cálculos Ureterales , Femenino , Humanos , Litotricia/métodos , Masculino , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Cálculos Ureterales/complicaciones , Cálculos Ureterales/diagnóstico por imagen , Cálculos Ureterales/terapiaRESUMEN
BACKGROUND: The clinical and pathological features of inflammatory bowel disease (IBD) and Familial Mediterranean Fever (FMF) are similar. OBJECTIVE: Here, the frequency of Mediterranean Fever (MEFV) gene mutation and its effect on the outcome of IBD were evaluated. METHODS: DNA sequence analysis detected the variants on the MEFV gene in patients with IBD. The relationship between mutations and the need for steroids, immunomodulators, biologics, and surgery was assessed. RESULTS: We evaluated 100 patients with IBD (55 with ulcerative colitis (UC) and 45 with Crohn's disease (CD)) and 60 healthy individuals as controls. The frequency of MEFV gene mutation was 26.7% (n = 12) and 14.5% (n = 8) for UC and CD, respectively. No relationship was found between MEFV gene mutation and the need for steroids, immunomodulators, and biologics (p = 0.446; p = 0.708; p > 0.999, resp.); however, in UC, the need for surgery in those with mutation (p = 0.018) and E148Q mutation alone was significant (p = 0.037). CONCLUSION: The rate of MEFV gene mutations was high in patients with UC who required surgery. These patients have frequent and severe attacks, indicating that the mutations are related to disease severity. MEFV mutation as a modifier factor of IBD should be considered.
RESUMEN
BACKGROUND AND PURPOSE: Anosmia or hyposmia, often accompanied by changes in taste, is recognized as a common symptom that can assist in the diagnosis of coronavirus disease 2019 (COVID-19). The pathogenesis of olfactory dysfunction in COVID-19 is not yet fully understood. MR imaging represents a useful anatomic imaging method for the evaluation of olfactory dysfunction associated with varying etiologies, including viral infection, trauma, and neurodegenerative processes. This case-control study was conducted to compare quantitative measurements of olfactory anatomic structures between patients diagnosed with COVID-19 associated with persistent olfactory dysfunction and healthy controls. MATERIALS AND METHODS: This study has a retrospective design. Cranial MR imaging was performed on all participants in both the patient and control groups. The bilateral olfactory bulb volume, olfactory tract length, and olfactory sulcus depth were measured in all patients. RESULTS: A total of 116 people aged 18-60 years, including 36 patients diagnosed with COVID-19 and 80 controls, were included in the study. All measured values were compared between the patient and control groups. The right, left, and total olfactory bulb volume values were significantly lower in the patient group than in the control group. The patient group also had significantly lower right and left olfactory sulcus depth and olfactory tract length values compared with those in the control group. CONCLUSIONS: MR imaging findings can be used to demonstrate olfactory injury in patients with COVID-19. The olfactory pathway may represent an alternative route for virus entry into the central nervous system.
Asunto(s)
COVID-19 , Estudios de Casos y Controles , Humanos , Imagen por Resonancia Magnética , Estudios Retrospectivos , SARS-CoV-2RESUMEN
BACKGROUND: Tuberous sclerosis (TS) is an autosomal dominant and hereditary disorder. Cardiac rhabdomyoma and arrhythmias are the most deleterious risk factors linked to TS. Although arrhythmias in pediatric patients with TS who have cardiac rhabdomyoma have been frequently reported, arrhythmia in patients who have TS without rhabdomyoma is rarely reported in the literature. The study aimed to assess the susceptibility of pediatric patients who have TS without cardiac rhabdomyoma to cardiac arrhythmia using electrocardiographic (ECG) markers. METHODS: This prospective study included 10 patients who had TS without cardiac rhabdomyoma. The control group was made up of 30 healthy children of the same age and sex as the patient group. P wave, P wave dispersion, QT dispersion, QTc dispersion, TP-e interval, and TP-e interval dispersion were calculated on 12-lead surface ECGs for each patient in both groups and compared. RESULTS: P wave, P wave dispersion, QT dispersion, and QTc dispersion were found to be significantly higher in the patient group (P<0.001). Furthermore, patients had a greater Tp-e interval and Tp-e interval dispersion than healthy children (P<0.001). CONCLUSION: Pediatric patients with TS without cardiac rhabdomyoma might be prone to atrial and ventricular arrhythmias according to their prolonged ECG markers. Our findings suggest that patients with TS without cardiac rhabdomyoma need close monitoring for atrial and ventricular arrhythmias.
Asunto(s)
Arritmias Cardíacas/diagnóstico , Electrocardiografía , Esclerosis Tuberosa/complicaciones , Adolescente , Arritmias Cardíacas/etiología , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Neoplasias Cardíacas , Humanos , Lactante , Masculino , Estudios Prospectivos , RabdomiomaRESUMEN
OBJECTIVE: This study aimed to investigate in vitro fertilization (IVF) outcomes in women with hypogonadotropic hypogonadism (HH) and unexplained infertility and investigate factors affecting the pregnancy rate among HH patients. MATERIALS AND METHODS: This retrospective cohort study was conducted at Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Turkey, a tertiary care referral center. The medical records of 143 women who underwent IVF treatment at this hospital between 2015 and 2020 were reviewed. Sixty-three had hypogonadotropic hypogonadism (HH) and 74 had unexplained infertility. Demographics, hormonal profile, IVF cycle characteristics, and pregnancy rates were recorded. The factors affecting the ongoing pregnancy rates were evaluated among HH patients. RESULTS: Anti-Mullerian hormone (AMH) levels were lower among women with HH compared to those with unexplained infertility (1.64±1.2 vs. 3.0±2.13). IVF cycle characteristics and ongoing pregnancy outcome (20.28% vs. 22.97%) were similar between the groups; however, the total dose of human menopausal gonadotrophin (HMG) used (5127.74±1845.8 vs. 2035.71±1387.45) was higher in the HH group. Increased estradiol level (2596.35±1085 vs. 1869.9±1203.4), endometrial thickness (10.82±1.74 vs. 8.43±2.33), higher number of total oocytes retrieved (12.14±4.34 vs. 8.43±5.44) were correlated with higher ongoing pregnancy rates among the HH group. CONCLUSIONS: IVF success rates were similar between the HH and unexplained infertility groups. Although AMH level was not a prognostic factor for IVF success, higher doses of HMG were needed to achieve pregnancy in the HH group. The factors affecting the ongoing pregnancy rates in the HH group were higher estradiol level, increased endometrial thickness, and a higher number of oocytes retrieved.
Asunto(s)
Fertilización In Vitro , Hormonas/sangre , Hipogonadismo/sangre , Infertilidad Femenina/terapia , Adulto , Femenino , Humanos , Infertilidad Femenina/sangre , Embarazo , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
PURPOSE: The aim of this study is to investigate the effect of treatment modalities on survival among unoperat ed and locally-advanced non-small cell lung cancer (NSCLC) patients aged 70 years and older, representing real-life data. METHODS: From 2005 through 2017, medical records of 2259 patients with lung cancer from Okmeydani Training and Research Hospital-Istanbul/Turkey were reviewed retrospectively. Patients with locally advanced NSCLCâ¯≥â¯70 years of age who did not undergo surgery for lung cancer were reviewed. In total, 130 patients were eligible for the final analysis. Patients were stratified into four groups as: chemotherapy (CT), concurrent chemoradiotherapy (cCRT), sequential chemoradiotherapy (sCRT), and radiotherapy (RT) only. RESULTS: Of the 130 patients included in the analysis; CT, cCRT, sCRT, and RT only were applied to 25(19.2%), 30(23.1%), 31(23.8%), and 44(33.8%) patients, retrospectively. Twelve (9.2%) patients were female. Median age was 72 years (range, 70-88). Sixty (46.2%) patients had stage IIIA disease and 70(53.8%) patients had stage IIIB disease. Median progression-free survival(mPFS) in patients treated with CT, cCRT, sCRT, and RT were 8.0, 15, 10, and 9.0 months, respectively(pâ¯=â¯0.07). Corresponding median overall survival (mOS) were 10, 33, 20, and 15 months (pâ¯=â¯0.04). In multivariate analysis, stage IIIB disease [hazard ratio (HR), 2.8], ECOG-PS 2(HR, 2.10), and ECOG-PS 3-4(HR, 5.13) were found to be the negative factors affecting survival, while cCRT (HR, 0.45) and sCRT (HR, 0.50) were the independent factors associated with better survival. CONCLUSION: This study showed that the use of combined treatment modality was associated with better survival in elderly patients with locally advanced NSCLC, with the greatest survival observed in patients treated with cCRT. We therefore suggest that cCRT, when feasible, should be strongly considered in locally advanced NSCLC patients 70 years and over.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Quimioradioterapia/estadística & datos numéricos , Terapia Neoadyuvante/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Estudios de Casos y Controles , Quimioradioterapia/métodos , Terapia Combinada , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Terapia Neoadyuvante/métodos , Estadificación de Neoplasias/métodos , Supervivencia sin Progresión , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Turquía/epidemiologíaRESUMEN
BACKGROUND: The aim of this study was to determine the normal reference values for olfactory sulcus depth, olfactory tract length and olfactory bulb volume in the paediatric population with routine magnetic resonance imaging (MRI) and determine the relationship, if any, between these values and patient sex and age. MATERIALS AND METHODS: Ninety patients with a median age of 8 years (age range: 3-17 years), consisting of 45 males and 45 females with normal brain MRI scans were evaluated. The patients were divided into three subgroups based on age range, with n = 30 per subgroup; group 1: young children (3-6 years), group 2: children (7-11 years) and group 3: adolescents (12-17 years). In the cranial MRI examination of all groups, the right, left and total olfactory bulb volume values were measured in mm3, the right and left olfactory tract length values and the right and left olfactory sulcus depth values were calculated manually in mm. Demographic data including sex and age were recorded. RESULTS: There was no significant difference between the age groups in terms of sex. Right-left olfactory sulcus depth; right-left olfactory tract length and right-left total olfactory bulb volume values increased significantly when they are compared in terms of age groups (p < 0.0001, = 0.028; < 0.0001, < 0.0001; < 0.0001, < 0.0001; < 0.0001, respectively). There was no significant difference between right and left olfactory tract length and olfactory bulb volumes in all groups (p = 0.792 and p = 0.478), but the right olfactory sulcus depth was significantly larger than the left (p = 0.003). CONCLUSIONS: Especially as the age progresses, olfactory tract length and olfactory bulb volume dimensions of olfactory nerve and olfactory sulcus depth should be checked during diagnosis of respective illnesses in paediatric population.
Asunto(s)
Trastornos del Olfato , Bulbo Olfatorio , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Masculino , Bulbo Olfatorio/diagnóstico por imagen , Corteza PrefrontalRESUMEN
BACKGROUND: Self-efficacy has become a cross-disciplinary concept. In the field of healthcare, this concept is considered crucial for nurses; who play an important role in improving the health and well-being of the community. AIMS: The aim of this study was to develop a "Relationship-with-the-patient self-efficacy scale" (RPSES). METHODOLOGY: A sample of 331 university students (310 females and 21 males; 168 from the midwifery and 162 from the nursing departments) were enrolled in the study. Out of 24 items, 8 behavior items with the highest factor loadings were selected regarding the nurse-patient-relationship self-efficacy according to the results of the preliminary exploratory factor analysis. RESULTS: The final exploratory factor analysis revealed that the selected 8 items of RPSES had a single factor, explaining 83.28% of the total variance. The Cronbach alpha reliability coefficient was c alculated as 0.97. CONCLUSION: This scale has beendemonstrated to be a valid and reliable instrument.The analyses unfolded that RPSES scores of the students were not different between men and womenand did not differ by the departments the students attended; however, the RPSES scores were different by the grade levels of the students (juniors and seniors). The fourth graders' RPSES scores were higher than those of third graders.
Asunto(s)
Enfermeras Obstetrices/psicología , Relaciones Enfermero-Paciente , Autoeficacia , Estudiantes de Enfermería/psicología , Encuestas y Cuestionarios/normas , Adulto , Análisis Factorial , Femenino , Humanos , Masculino , Psicometría/instrumentación , Reproducibilidad de los ResultadosRESUMEN
INTRODUCCIÓN Y OBJETIVOS: La clasificación de Bosniak para las lesiones renales quísticas se publicó por primera vez en 1986 con base en los hallazgos de tomografía computarizada (TC). El objetivo de nuestro estudio fue investigar el rol de la resonancia magnética (RM) y su impacto en la clasificación de Bosniak para compararla con la TC, y determinar cómo la RM puede alterar el tipo de tratamiento de los quistes renales complejos. MATERIAL Y MÉTODOS: Se recogieron retrospectivamente los datos de 144 pacientes. Después de aplicar los criterios de exclusión, 2 radiólogos especialistas en ecografía abdominal evaluaron 102 lesiones quísticas renales con una categoría Bosniak de al menos IIF en TC o RM entre 2013 y 2016. Se registraron los datos demográficos, la categoría de Bosniak, la concordancia interobservador y las enfermedades de los pacientes tratados con cirugía. RESULTADOS: La concordancia entre la RM y la TC fue del 75,5%. La categoría Bosniak se vio incrementada tras la RM en 17 pacientes, y se cambió el tipo de tratamiento en 10 pacientes, que posteriormente fueron tratados quirúrgicamente. Tras la RM, la categoría Bosniak pasó de III a IIF en 6 pacientes de 8 y provocó un cambio en el tipo de tratamiento. Se realizó cirugía en un paciente de estos 6, y el informe de anatomía patológica se informó como benigno. Se detectó progresión durante el seguimiento al decimoctavo mes en un paciente de 5, y se practicó cirugía en este caso. La enfermedad se informó como carcinoma de células renales (CCR). De los 51 pacientes tratados mediante cirugía, 35 (68,6%) recibieron informe anatomopatológico de CCR. Se detectó progresión en 7 pacientes de 51 que recibieron seguimiento (13,7%), y los resultados de la enfermedad se informaron como CCR. La mayoría de los tumores malignos eran de grado y estadio bajo. CONCLUSIONES: La RM se puede emplear con éxito en la evaluación de lesiones quísticas renales. En particular, el manejo de las lesiones Bosniak IIF y de todas aquellas clasificadas como Bosniak III debe incluir evaluación mediante RM antes de optar por el tratamiento quirúrgico. El incremento en la categoría de Bosniak es más factible con RM que con TC, debido a su resolución de alto contraste. Por lo tanto, se requieren más estudios para identificar si esta fue la causa del sobretratamiento en pacientes con lesiones Bosniak III
INTRODUCTION AND OBJECTIVES: The Bosniak classification of cystic renal lesions was first published in 1986 based on computed tomography (CT). In the present study, we aimed to investigate the effect of magnetic resonance imaging (MRI) on Bosniak category compared with CT, and to determine how this effect changed the treatment modality in the evaluation of complex renal cysts. MATERIAL AND METHODS: Data of 144 patients were collected retrospectively. After exclusion criteria, 102 cystic renal lesions with a Bosniak category of at least IIF on CT or MRI between 2013 and 2016 were evaluated by 2 abdominal radiologists. The demographic data, Bosniak category, interobserver agreement, and pathologic data of patients who underwent surgery were recorded. RESULTS: The coherence between MRI and CT was 75.5%. The Bosnia:k classification of 17 patients was upgraded with MRI, and the treatment modality changed in 10 patients, and they underwent surgery. The Bosniak category was downgraded from III to IIF in 6 patients out of 8 whose Bosniak category was downgraded with MRI and the treatment modality changed. Surgery was performed in one patient out of these 6 patients, and the pathology was reported as benign. Progression was detected in the follow-up at month 18 of 1 patient out of 5, and surgery was performed. The pathology was reported as renal cell carcinoma. The pathology result was reported as RCC in 35 (68.6%) patients out of 51 who underwent surgery. Progression was detected in 7 patients out of 51 who were followed up (13.7%), and the pathology results were reported as RCC. The majority of the malignant tumors were low stage and grade. CONCLUSIONS: MRI may be successfully used in the evaluation of renal cystic lesions. In particular, the challenging Bosniak IIF and all Bosniak III lesions must be evaluated using MRI before making the decision for surgery. The upgrading of Bosniak category with MRI is more possible compared with CT due to its high-contrast resolution, therefore further studies are required to identify whether it was the cause of overtreatment of Bosniak III lesions
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedades Renales Quísticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Imagen por Resonancia Magnética , Enfermedades Renales Quísticas/clasificación , Enfermedades Renales Quísticas/cirugía , Neoplasias Renales/diagnóstico por imagen , Enfermedades Renales Quísticas/patologíaRESUMEN
BACKGROUND: Longitudinal melanonychia (LM) can present a diagnostic challenge and dermoscopy is of utmost importance for its evaluation and differential diagnosis of LM. OBJECTIVE: This report aimed to describe an unusual dermoscopic pattern in a group of patients that presented with LM. METHODS: The clinical course and features of five LM patients that presented with an unusual 'zigzag' dermoscopic pattern were analyzed retrospectively. RESULTS: In all, four of the five patients were children (age range: 10-13years). In all five patients, the thumb nail was affected. A nail matrix biopsy was available for only one patient and was reported as lentigo. In two (one child and one adult) out of the five patients, spontaneous total regression of the LM was observed. CONCLUSIONS: The peculiar 'zigzag' dermoscopic pattern of LM described herein seems to occur primarily in children. Although this pattern is a benign in nature, it is not clear if it is related to trauma. Further investigation is warranted to clarify the association between the histopathological findings and the zigzag pattern observed via dermoscopy.
Asunto(s)
Melanoma , Enfermedades de la Uña , Neoplasias Cutáneas , Adolescente , Adulto , Niño , Dermoscopía , Diagnóstico Diferencial , Humanos , Melanoma/diagnóstico , Enfermedades de la Uña/diagnóstico por imagen , Estudios Retrospectivos , Neoplasias Cutáneas/diagnósticoAsunto(s)
Fusariosis , Fusarium , Púrpura , Antifúngicos/uso terapéutico , Humanos , Huésped Inmunocomprometido , Púrpura/tratamiento farmacológico , PielRESUMEN
INTRODUCTION AND OBJECTIVES: The Bosniak classification of cystic renal lesions was first published in 1986 based on computed tomography (CT). In the present study, we aimed to investigate the effect of magnetic resonance imaging (MRI) on Bosniak category compared with CT, and to determine how this effect changed the treatment modality in the evaluation of complex renal cysts. MATERIAL AND METHODS: Data of 144 patients were collected retrospectively. After exclusion criteria, 102 cystic renal lesions with a Bosniak category of at least IIF on CT or MRI between 2013 and 2016 were evaluated by 2abdominal radiologists. The demographic data, Bosniak category, interobserver agreement, and pathologic data of patients who underwent surgery were recorded. RESULTS: The coherence between MRI and CT was 75.5%. The Bosniak classification of 17 patients was upgraded with MRI, and the treatment modality changed in 10 patients, and they underwent surgery. The Bosniak category was downgraded from III to IIF in 6 patients out of 8 whose Bosniak category was downgraded with MRI and the treatment modality changed. Surgery was performed in one patient out of these 6 patients, and the pathology was reported as benign. Progression was detected in the follow-up at month 18 of 1 patient out of 5, and surgery was performed. The pathology was reported as renal cell carcinoma. The pathology result was reported as RCC in 35 (68.6%) patients out of 51 who underwent surgery. Progression was detected in 7 patients out of 51 who were followed up (13.7%), and the pathology results were reported as RCC. The majority of the malignant tumors were low stage and grade. CONCLUSIONS: MRI may be successfully used in the evaluation of renal cystic lesions. In particular, the challenging Bosniak IIF and all Bosniak III lesions must be evaluated using MRI before making the decision for surgery. The upgrading of Bosniak category with MRI is more possible compared with CT due to its high-contrast resolution, therefore further studies are required to identify whether it was the cause of overtreatment of Bosniak III lesions.
Asunto(s)
Enfermedades Renales Quísticas/clasificación , Enfermedades Renales Quísticas/diagnóstico por imagen , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND: Genital infections are one of the most common reasons for a hospital visit in the scope of reproductive health problems. The information-motivation-behavioral skills (IMB), therefore, is an appropriate model to provide women with accurate genital hygiene behaviors and develop effective sexual and reproductive health training programs. AIMS: This interventional study was conducted to assess the effectiveness of genital infection awareness training provided to women based on the IMB model. MATERIALS AND METHODS: Study sample consisted of 62 women (nexperimental= 31, ncontrol= 31) who were chosen based on a nonprobability sampling method from vocational courses of Ankara Keçiören municipality. The data collection form developed by the researchers, knowledge evaluation questions (KEQ), and genital hygiene behavior inventory (GHBI) were used to collect data. Data were obtained at training centers and through phone interviews. Another interview was conducted 1 month later and posttest procedures were completed. The Chi-square test, McNemar's, Mann-Whitney U test, and Wilcoxon Signed-Rank tests were used to calculate mean scores. RESULTS: The mean (SD) age was 39.1 (8.4) years for the women in the experimental group and 37.5 (6.7) for the women in the control group (P = 0.481). Pretest knowledge mean scores M (SD)experimental = 15.7 (2.4); and GHBI mean scores M (SD)experimental= 76.9 (11.1) were calculated. Mean scores showed an increase after the training in the experimental group [M (SD)post-test= 19.1 (1.2); M (SD)GHBI= 94.7 (2.6)] (P < 0.001). CONCLUSION: Based on these findings, it was concluded that the genital infection awareness training provided to women based on the IMB model, improved knowledge and acted as a positive reinforcer for the hygiene behaviors of the women.