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SUMMARY OBJECTIVE: The aim of this study was to describe the effect size of mindfulness-based childbirth education on the fear of childbirth. METHODS: In this study, the meta-analysis method, one of the methods of synthesising quantitative research, was used. EBSCO, PubMed, Google Scholar, WOS, and CINAHL databases were used to determine the studies to be included in the meta-analysis. The keywords such as "mindfulness", "fear of childbirth", "mindfulness-based childbirth", "mindfulness education" and "childbirth" were searched in the international literature. Four experimental studies published between 2013 and 2022 that aimed to determine the effect of mindfulness-based childbirth education on the fear of childbirth, had a full text available and met the inclusion criteria, were included in the study. RESULTS: On the analysis of the data, mindfulness-based childbirth education was found to be effective in reducing the fear of childbirth (standard mean difference [SMD]=0.117, 95%CI: −1.049: −0.419, p<0.001, I2=36.98%). The results of this meta-analysis indicated that mindfulness-based education provided to pregnant women was found to be effective in reducing the fear of childbirth. CONCLUSION: Mindfulness-based childbirth education is considered to be used as an effective non-pharmacological midwifery and nursing intervention in reducing the fear of childbirth in pregnant women. This review was preregistered on PROSPERO (Ref No: CRD42022316472).
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SUMMARY OBJECTIVE: The aim of this study was to investigate the predictive importance of the previously validated log(ER)*log(PgR)/Ki-67 predictive model in a larger patient population. METHODS: Patients with hormone receptor positive/HER-2 negative and clinical node positive before chemotherapy were included. Log(ER)*log(PgR)/Ki-67 values of the patients were determined, and the ideal cutoff value was calculated using a receiver operating characteristic curve analysis. It was analyzed with a logistic regression model along with other clinical and pathological characteristics. RESULTS: A total of 181 patients were included in the study. The ideal cutoff value for pathological response was 0.12 (area under the curve=0.585, p=0.032). In the univariate analysis, no statistical correlation was observed between luminal subtype (p=0.294), histological type (p=0.238), clinical t-stage (p=0.927), progesterone receptor level (p=0.261), Ki-67 cutoff value (p=0.425), and pathological complete response. There was a positive relationship between numerical increase in age and residual disease. As the grade of the patients increased, the probability of residual disease decreased. Patients with log(ER)*log(PgR)/Ki-67 above 0.12 had an approximately threefold increased risk of residual disease when compared to patients with 0.12 and below (odds ratio: 3.17, 95% confidence interval: 1.48-6.75, p=0.003). When age, grade, and logarithmic formula were assessed together, the logarithmic formula maintained its statistical significance (odds ratio: 2.47, 95% confidence interval: 1.07-5.69, p=0.034). CONCLUSION: In hormone receptor-positive breast cancer patients receiving neoadjuvant chemotherapy, the logarithmic model has been shown in a larger patient population to be an inexpensive, easy, and rapidly applicable predictive marker that can be used to predict response.
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ABSTRACT: Malatya is an important production centre of apricots in Turkey, and the world. However, a major problem causing product loss, is late spring frosts. Cold damages the flowers and thus, fruit set and yield decrease. As a result, the farmer's income fluctuates from year to year. This study, stated apricot farmers demographics, and technical features of 52 interviewed apricot farms, in Malatya. Also, conjoint analysis (CA) is used to identify the farmers' preferences for agricultural insurance attributes. This method investigated the joint effect of a set of independent variables, on an ordinal scale of a measurement-dependent variable. Of the farmers, 76.9% have done agricultural insurance last year.
RESUMO: Malatya é um importante centro de produção de damascos na Turquia e no mundo. No entanto, um grande problema que causa a perda de produto são as geadas do final da primavera. O frio prejudica as flores e, com isso, a frutificação e a produção diminuem. Como resultado, a renda do agricultor varia de ano para ano. No estudo, objetiva-se constatar a demografia dos produtores de damasco e características técnicas de 52 fazendas de damasco entrevistadas, em Malatya. Além disso, a análise conjunta é usada para identificar as preferências dos agricultores por atributos de seguro agrícola. Este método investiga o efeito conjunto de um conjunto de variáveis independentes, em uma escala ordinal de uma variável dependente de medição. 76,9% dos agricultores fizeram seguro agrícola no ano passado.
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Resumo Fundamentos Os efeitos protetores da fase de leitura aberta mitocondrial do 12S rRNA-c (MOTS-C) em doenças cardiovasculares foram demonstrados em vários estudos. Entretanto, há pouca documentação da relação entre MOTS-C e fluxo sanguíneo coronariano no infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). Objetivo Nosso objetivo foi investigar o papel do MOTS-C, que é conhecido por ter propriedades citoprotetoras na patogênese do fenômeno de no-reflow, comparando a taxa de fluxo coronariano e os níveis de MOTS-C em pacientes com IAMCSST submetidos à ICP primária. Métodos 52 pacientes com IAMCSST e 42 pacientes sem estenose >50% nas artérias coronárias foram incluídos no estudo. O grupo IAMCSST foi dividido em dois grupos de acordo com o grau de fluxo TIMI (do inglês Thrombolysis In Myocardial Infarction) pós-ICP: (i) No-reflow: graus 0, 1 e 2 e (ii) grau 3 (sucesso angiográfico). Um valor de p <0,05 foi considerado significante. Resultados Os níveis de MOTS-C foram significativamente menores no grupo IAMCSST em comparação ao grupo controle (91,9 ± 8,9 pg/mL vs. 171,8±12,5 pg/mL, p<0,001). Além disso, a análise da curva Receiver Operating Characteristics (ROC) indicou que os níveis séricos de MOTS-C tinham um valor diagnóstico na previsão de no-reflow (Área sob a curva ROC [AUC]: 0,95, IC95%: 0,856-0,993, p < 0,001). Um valor de MOTS-C ≥84,15 pg/mL medido na hospitalização mostrou ter sensibilidade de 95,3% e especificidade de 88,9% na previsão de no-reflow. Conclusão MOTS-C é um preditor forte e independente de no-reflow e eventos cardiovasculares adversos maiores (ECAM) intra-hospitalar em pacientes com IAMCSST. Também foi observado que baixos níveis de MOTS-C podem ser um importante marcador prognóstico e podem ter um papel na patogênese do IAMCSST.
Abstract Background The protective effects of mitochondrial open reading frame of the 12S rRNA-c (MOTS-C) on cardiovascular diseases have been shown in numerous studies. However, there is little documentation of the relationship between MOTS-C and coronary blood flow in ST-segment elevation myocardial infarction (STEMI). Objective We aimed to investigate the role of MOTS-C, which is known to have cytoprotective properties in the pathogenesis of the no-reflow phenomenon, by comparing the coronary flow rate and MOTS-C levels in patients with STEMI submitted to primary PCI. Methods 52 patients with STEMI and 42 patients without stenosis >50% in the coronary arteries were included in the study. The STEMI group was divided into two groups according to post-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade:(i) No-reflow: grade 0, 1, and 2 and (ii) grade 3(angiographic success). A p value of <0.05 was considered significant. Results MOTS-C levels were significantly lower in the STEMI group compared to the control group (91.9 ± 8.9 pg/mL vs. 171.8±12.5 pg/mL, p<0.001). In addition, the Receiver Operating Characteristics (ROC) curve analysis indicated that serum MOTS-C levels had a diagnostic value in predicting no-reflow (Area Under the ROC curve [AUC]:0.95, 95% CI:0.856-0.993, p<0.001). A MOTS-C ≥84.15 pg/mL measured at admission was shown to have 95.3% sensitivity and 88.9% specificity in predicting no-reflow. Conclusion MOTS-C is a strong and independent predictor of no-reflow and in-hospital MACE in patients with STEMI. It was also noted that low MOTS-C levels may be an important prognostic marker of and may have a role in the pathogenesis of STEMI.
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The aim of this research was to determine the anti-inflammatory effect of betaine on sepsis-induced acute respiratory distress syndrome (ARDS) in rats through histopathological examination, radiologic imaging, and biochemical analysis. Eight rats were included in the control group, and no procedure was performed. Feces intraperitoneal procedure (FIP) was performed on 24 rats to create a sepsis-induced ARDS model. These rats were separated into three groups as follows: FIP alone (sepsis group, n=8), FIP + saline (1 mL/kg, placebo group, n=8), and FIP + betaine (500 mg/kg, n=8). Computed tomography (CT) was performed after FIP, and the Hounsfield units (HU) value of the lungs was measured. The plasma levels of tumor necrosis factor (TNF)-α, interleukin-1β (IL-1β), IL-6, C-reactive protein, malondialdehyde (MDA), and lactic acid (LA) were determined, and arterial oxygen pressure (PaO2) and arterial CO2 pressure (PaCO2) were measured from an arterial blood sample. Histopathology was used to evaluate lung damage. This study completed all histopathological and biochemical evaluations in 3 months. All evaluated biomarkers were decreased in the FIP + betaine group compared to FIP + saline and FIP alone (all P<0.05). Also, the parenchymal density of the rat lung on CT and histopathological scores were increased in FIP + saline and FIP alone compared to control and these findings were reversed by betaine treatment (all P<0.05). Our study demonstrated that betaine suppressed the inflammation and ameliorated acute lung injury in a rat model of sepsis.
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SUMMARY OBJECTIVE: Round shape is generally considered to reduce the risk of malignancy according to recent guidelines. On the contrary, according to some reports, spherically shaped thyroid nodules are associated with a higher risk of malignancy. Thus, we aimed to evaluate the malignancy risk of solid round isoechoic nodules detected at thyroid ultrasonography and compare it with that of solid ovoid isoechoic nodules. METHODS: Between 2017 and 2022, solitary solid round isoechoic nodules with diameters ³10 and £25 mm at thyroid ultrasonography were retrospectively selected and enrolled in the study. Age, size, nodule volume, serum thyrotropin levels, thyroid antibody levels, and cytopathological and histopathological results were recorded. RESULTS: A total of 457 solitary solid isoechoechoic nodules from 457 patients (262 females and 195 males; median age, 59 [31-70] years) were selected, of which 203 were solid round isoechoic nodules, and 254 were solid ovoid isoechoic nodules. A total of 54 surgical operations were performed on 457 nodules, and 31 of them resulted in malignancy. From the 31 malignant results, 25 originated from solid round isoechoic nodules and the remaining 6 originated from solid ovoid isoechoic nodules (p<0.025). CONCLUSION: We found that round nodules have higher malignancy rates than ovoid nodules. We think that ultrasonographic risk stratification systems used to target the most suitable nodules for the necessary biopsies can be dynamically updated, and sphericity can be added as a parameter in patient-based decision-making.
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SUMMARY OBJECTIVE: While abdominal pain is one of the most prevalent reasons for seeking medical attention, diagnosing elderly adults with acute appendicitis (AA) may be difficult. In this study, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Alvarado ratings were evaluated for diagnostic accuracy in patients who reported to the emergency department complaining of abdominal pain and received surgery for AA. METHODS: The data of patients over the age of 65 years who reported to the ER and had appendectomy after being diagnosed with AA were evaluated in this retrospective cohort study. For each patient, the diagnostic accuracy of the Alvarado and RIPASA scores was determined individually. RESULTS: A total of 86 patients were included in the research. The average patient was 71.2 years old, with a male preponderance of 46.5%. Alvarado's score was found to have an area under the curve (AUC) of 0.799, the Youden's index of 0.549, and a p-value of 0.001 after a receiver operating characteristic (ROC) study of the Alvarado score in identifying the diagnosis of AA. The AUC was 0.886 (95%CI 0.799-0.944), the Youden's index was 0.642, and a p-value of 0.001 was found in the ROC analysis of the RIPASA score in identifying the diagnosis of AA. CONCLUSIONS: When comparing the two scores used to diagnose AA, we found no statistically significant difference between the RIPASA and Alvarado scores (p=0.09), although the Youden's index for the RIPASA score was higher.
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SUMMARY OBJECTIVE: We aimed to investigate whether sarcopenia measured from pectoralis muscles is a risk factor for long-term mortality in left ventricular assist device patients. METHODS: Patients aged >18 years implanted with a left ventricular assist device in a single center between 2013 and 2019 were retrospectively included. Patients without a thoracic computed tomography scan performed within 3 months of left ventricular assist device implantation and without computed tomography scans appropriate for pectoralis muscle measurement were excluded. Pectoralis muscle measurements were made on thoracic computed tomography slices, and pectoralis muscle indices were calculated for each patient. Sarcopenia was defined as being in the gender-specific lowest tertile of pectoralis muscle index. Survival was compared between patients with and without sarcopenia. RESULTS: The study was conducted on 64 left ventricular assist device patients who met the inclusion criteria. Notably, 21 (32.8%) of the study patients were sarcopenic. Diabetes mellitus and sarcopenia were more common in patients with 2-year mortality in our cohort. Patients with sarcopenia had a worse 2-year survival (p<0.001). Sarcopenia had an adjusted hazard ratio of 4.04 (95% confidence interval (CI) 1.36-12.02, p=0.012), while diabetes mellitus was associated with an adjusted hazard ratio of 3.14 (95%CI 1.17-8.39, p=0.023). CONCLUSION: Sarcopenia defined by low pectoralis muscle index increases the risk for 2-year mortality in left ventricular assist device patients.
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Abstract Introduction Until now, only few studies have reported the correlation between vesicle-associated membrane protein-8 (VAMP-8) A/G gene polymorphism and acute myocardial infarction. Whereas, theoretically, VAMP-8 plays a pivotal role in the pathogenesis of acute myocardial infarction through platelet activation, secretion, and aggregation. Objective To investigate the association between VAMP-8 A/G gene polymorphism and the risk of acute myocardial infarction. Methods A cross-sectional study was carried out at Saiful Anwar General Hospital during June 2013 - May 2014. A Mae II enzyme with restriction fragment length polymorphism method was used to genotype VAMP-8 A/G gene polymorphisms in acute myocardial infarction and control groups. A multiple logistic regression test was used to analyze the association between VAMP-8 A/G gene polymorphism and the risk of acute myocardial infarction. Results A total of 35 controls and 97 acute myocardial infarction patients from our Hospital during the period were enrolled for our study. Our results found that VAMP-8 A/G gene polymorphism was not associated with the risk of acute myocardial infarction. Moreover, we also failed to confer the association between VAMP-8 A/G gene polymorphism and both smoking and hypertension among patients with acute myocardial infarction. Furthermore, in the setting of premature acute myocardial infarction, the correlation also failed to confirm. Conclusion In our population, there is no association between VAMP-8 A/G gene polymorphism and the risk of acute myocardial infarction.
Resumen Introducción Hasta la fecha, solo unos pocos estudios han reportado la correlación entre el polimorfismo A/G del gen de la proteína de membrana asociada a vesículas-8 (VAMP-8, por sus siglas en inglés) y el infarto agudo de miocardio. Si bien, en teoría, VAMP-8 juega un papel fundamental en la patogénesis del infarto agudo de miocardio a través de la activación, secreción y agregación plaquetaria. Objetivo Investigar la relación entre el polimorfismo A/G del gen VAMP-8 y el riesgo de infarto agudo de miocardio. Métodos: Se llevó a cabo un estudio transversal en Siful Anwar General Hospital entre junio del 2013 y mayo del 2014. Se utilizó la técnica de polimorfismos de longitud de fragmentos de restricción con la enzima Mae II para genotipificar los polimorfismos A/G del gen VAMP-8 en grupos de infarto agudo de miocardio y de control. Se aplicó una prueba de regresión logística múltiple para analizar la relación entre el polimorfismo A/G del gen VAMP-8 y el riesgo de infarto agudo de miocardio. Resultados Se incluyeron un total de 35 controles y 97 pacientes con infarto agudo de miocardio de nuestro Hospital durante el periodo del estudio. Nuestros resultados encontraron que el polimorfismo A/G del gen VAMP-8 no estaba relacionado con el riesgo de infarto agudo de miocardio. Por otra parte, tampoco pudimos establecer una relación entre el polimorfismo A/G del gen VAMP-8 y tanto tabaquismo como hipertensión en pacientes con infarto agudo de miocardio. Asimismo, en el contexto de infarto agudo de miocardio prematuro, tampoco se confirmó la correlación. Conclusión: En nuestra población, no existe una relación entre el polimorfismo A/G del gen VAMP-8 y el riesgo de infarto agudo de miocardio.
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Humans , Myocardial Infarction , Polymorphism, Genetic , Membrane ProteinsABSTRACT
Abstract Introduction: Dialysis patients may have a very high prevalence and death rate for COVID-19. The aim of this study is to show the level of antibody against SARS-CoV-2 in hemodialysis and staff working in the same dialysis center. Methods: Anti-SARS-CoV-2 IgG antibodies were studied in 156 hemodialysis patients and 27 staff. After a 5-minute resting period, blood pressure was measured and then subsequent to an approximately 12-hour fasting period, blood sample were drawn for biochemistry parameters and anti-SARS-CoV-2 IgG antibodies. Results: Three of hemodialysis patients were diagnosed with COVID-19 in March and their PCR tests were positive. The symptoms of these patients were extreme fatigue and muscle weakness. Anti-SARS-CoV-2 IgG antibodies tests were performed on all patients and staff in July. In total, 13/156 (8.3%) patients were diagnosed as COVID-19 based on anti-SARS-CoV-2 antibodies. The other 10 patients were asymptomatic. The staff and 143 hemodialysis patients had IgG (-). Hemodialysis patients who had anti-SARS-CoV-2 IgG (+) antibodies had decreased level of haemoglobin and high levels of C-reactive protein and alkaline phosphatase. Conclusions: Antibody tests are particularly important for detecting people with COVID-19 who have few or no symptoms. It has also been seen that the spread of infection in the dialysis center can be prevented by very strict precautions.
Resumen Introducción: Los pacientes que se realizan diálisis tienen una prevalencia y una tasa de mortalidad muy alta en lo que respecta a la COVID-19. El objetivo de este estudio fue mostrar la concentración de anticuerpos contra el SARS-CoV-2 en los pacientes de hemodiálisis de un centro y en el personal que trabaja en ese lugar. Material y métodos: Se investigaron los anticuerpos IgG contra el SARS-CoV-2 en 156 pacientes que reciben hemodiálisis y en 27 trabajadores. Se midió la tensión arterial luego de 5 minutos de reposo y, luego de un ayuno de aproximadamente 12 horas, se extrajeron muestras de sangre para determinar variables bioquímicas y la concentración de anticuerpos IgG contra el SARS-CoV-2. Resultados: En marzo, a través de pruebas PCR, se les diagnosticó COVID-19 a tres pacientes en hemodiálisis. Los síntomas de estos pacientes fueron fatiga extrema y debilidad muscular. En julio se realizaron pruebas de anticuerpos IgG contra el SARS-CoV-2 a todos los pacientes y al personal. En total, de los 156 pacientes, 13 (8,3 %) fueron diagnosticados con COVID-19 según los anticuerpos contra el SARS-CoV-2. Los otros 10 resultaron asintomáticos. El personal y 143 pacientes en hemodiálisis tuvieron resultados negativos para IgG. Los pacientes en HD con resultados positivos para IgG contra el SARS-CoV-2 presentaron niveles disminuidos de hemoglobina y niveles altos de proteína C reactiva y fosfatasa alcalina. Conclusiones: Las pruebas de anticuerpos son particularmente importantes para detectar personas con COVID-19 que tengan pocos síntomas o ninguno. También se ha visto que es posible prevenir la propagación de la infección en el centro de diálisis mediante precauciones muy estrictas.
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Resumo Fundamento As arritmias ventriculares (AVs) são a principal causa de mortalidade e morbidade hospitalar em pacientes com síndrome coronariana aguda (SCA) e sua relação com o tiol é desconhecida. Objetivo Investigar a relação entre os níveis plasmáticos de tióis e os níveis de troponina em pacientes com SCA e estimar o desenvolvimento de AV intra-hospitalar durante a internação. Método O estudo incluiu 231 pacientes consecutivos com SCA com supradesnivelamento do segmento ST (SCA-SDST) e pacientes com SCA sem supradesnivelamento do segmento ST (SCA-SSDST). Após a aplicação dos critérios de exclusão, 191 pacientes foram incluídos na análise estatística. Os pacientes foram classificados em dois grupos: grupo SCA-SDST (n=94) e grupo SCA-SSDST (n=97). Os níveis plasmáticos de tiol, dissulfeto e troponina foram medidos e a razão de troponina para tiol nativo (RTTN) foi calculada. Considerou-se estatisticamente significativo um valor de p bilateral inferior a 0,05. Resultados Tiol nativo plasmático, tiol total, dissulfeto e suas razões foram semelhantes entre os grupos. A RTTN se mostrou significativamente maior no grupo SCA-SDST em comparação com o grupo SCA-SSDST. Houve correlação negativa significativa entre os níveis de troponina e tiol. Verificou-se que o tiol nativo é preditor independente do desenvolvimento de AV em pacientes com SCA-SDST e em todos os pacientes com SCA. Verificou-se que o RTTN é preditor independente do desenvolvimento de AV em pacientes com SCA-SSDST e em todos os pacientes com SCA. Conclusão Os níveis plasmáticos de tiol podem ser usados para identificar pacientes com alto risco de desenvolvimento de AV intra-hospitalar em pacientes com SCA. A correlação entre os níveis de troponina e tiol pode sugerir que os tióis possam ser marcadores importantes para o diagnóstico e prognóstico da SCA com a ajuda de estudos futuros.
Abstract Background Ventricular arrhythmias (VAs) are the main cause of in-hospital mortality and morbidity in acute coronary syndrome (ACS) patients and its relationship with thiol is not known. Objective To investigate the relationship between plasma thiol levels and troponin levels in patients with ACS and to estimate in-hospital VA development during hospital stay. Method The study included 231 consecutive ST-segment elevation ACS (STE-ACS) and non-ST-segment elevation ACS (NSTE-ACS) patients. After application of exclusion criteria, 191 patients were included in the statistical analysis. Patients were classified into two groups: STE-ACS group (n=94) and NSTE-ACS group (n=97). Plasma thiol, disulphide and troponin levels were measured and troponin-to-native thiol ratio (TNTR) was calculated. A two-sided p value of less than 0.05 was considered to be statistically significant. Results Plasma native thiol, total thiol, disulphide and their ratios were similar between the groups. TNTR was significantly higher in the STE-ACS group compared to the NSTE-ACS group. Troponin and thiol levels correlated negatively and significantly. Native thiol was found to be an independent predictor of VA development in STE-ACS patients and in all ACS patients. TNTR was found to be an independent predictor of VA development in NSTE-ACS patients and in all ACS patients. Conclusion Plasma thiol levels can be used to identify ACS patients at high risk for in-hospital VA development. Correlation between troponin and thiol levels may suggest that thiols may be an important marker for diagnosis and prognosis of ACS with the help of future studies.
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Humans , Acute Coronary Syndrome/diagnosis , Arrhythmias, Cardiac , Sulfhydryl Compounds , Troponin , Biomarkers , HospitalsABSTRACT
ABSTRACT Background: Despite the association of fibrinogen-to-albumin ratio (FAR) with the extent, severity, and complexity of coronary artery disease (CAD) in patients with ST-elevation myocardial infarction (STEMI) and stable CAD, no studies to date have specifically addressed this issue in patients with non-STEMI (NSTEMI). Objectives: This study aimed to evaluate whether a relationship exists between FAR and the SYNergy between Percutaneous Coronary Intervention with TAXus (SYNTAX) score in patients with NSTEMI. Methods: In this prospective cross-sectional study, 330 patients with NSTEMI who had undergone coronary angiography in an academic medical center were divided into two groups: those with an intermediate/high (≥23) SYNTAX score (241 patients) and those with a low SYNTAX score <23 (89 patients). SYNTAX score was computed by two highly experienced cardiologists (who were blinded to the study data) using an online SYNTAX calculator. Fibrinogen and albumin levels were measured in all patients, and FAR was calculated. Results: Multivariate logistic regression analysis showed that FAR (odds ratio [OR]: 1.478, 95% confidence interval [CI]: 1.089-2.133, p = 0.002), low-density lipoprotein (OR: 1.058, 95% CI: 1.008-1.134, p = 0.026), and troponin I (OR: 1.219, 95% CI: 1.015-1.486, p = 0.031) were independent predictors of the SYNTAX score. In a receiver operating characteristics analysis, a cutoff FAR value of 95.3 had an 83% sensitivity and an 86% specificity (area under the curve [AUC]: 0.84, p < 0.001) for the prediction of SYNTAX scores ≥23 in NSTEMI patients. Conclusion: These results indicate that FAR is a useful tool to predict intermediate-high SYNTAX scores in NSTEMI patients.
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Abstract Introduction Microsurgery of the ear requires complete evaluation of middle ear surgical anatomy, especially the posterior tympanic cavity anatomy. Preoperative assessment of the middle ear cavity is limited by the permeability of eardrum and temporal bone density. Therefore, middle ear exploration is an extremely useful method to identify structural abnormalities and anatomical variations. Objective The aim of this study is to determine anatomic variations of the middle ear in an autopsy series. Methods All evaluations were performed in the Forensic Medicine Institute Morgue Department. The cases over 18 years of age, with no temporal bone trauma and history of otologic surgery included in this study. Results One hundred and two cadavers were included in the study. The mean age was 49.08 ± 17.76 years. Anterior wall prominence of the external auditory canal was present in 27 of all cadavers (26.4%). The tympanic membrane was normal in 192 ears (94%) while several eardrum pathologies were detected in 12 ears (6%). Agenesis of the pyramidal eminence and stapedial tendon was found in 3 ears. While the ponticulus was bony ridge-shaped in 156 of 204 ears (76.4%), it was bridge-shaped in 25 ears (12.3%). The ponticulus was absent in 23 ears (11.3%). While complete subiculum was present in 136 of all ears (66.7%), incomplete subiculum was present in 21 ears (10.3%). Subiculum was absent in 47 ears (23%). Facial dehiscence was found in 32 ears and the round window niche was covered by a pseudomembrane in 85 ears (41.6%). A fixed footplate was present in 7.4% of all ears, and no persistent stapedial artery was seen in any cases. Conclusion The pseudomembrane frequency covering the round window niche was found different from reports in the literature. In addition, the frequency of the external auditory canal wall prominence has been reported for the first time.
Resumo Introdução A otomicrocirurgia requer avaliação completa da anatomia cirúrgica da orelha média, especialmente da anatomia da cavidade timpânica posterior. A avaliação pré-operatória da cavidade timpânica é limitada pela permeabilidade do tímpano e densidade do osso temporal. Portanto, a exploração da orelha média é um método extremamente útil para identificar anormalidades estruturais e variações anatômicas. Objetivo Determinar as variações anatômicas da orelha média em uma série de autópsias. Método Todas as avaliações foram realizadas no necrotério do Instituto Médico-Legal. Os casos com mais de 18 anos, sem trauma do osso temporal e história de cirurgia otológica foram incluídos neste estudo. Resultados Cento e dois cadáveres foram incluídos no estudo. A média de idade foi de 49,08 ± 17,76 anos. A proeminência da parede anterior do conduto auditivo externo estava presente em 27 de todos os cadáveres (26,4%). A membrana timpânica era normal em 192 orelhas (94%), enquanto várias alterações do tímpano foram detectadas em 12 orelhas (6%). Agenesia da eminência piramidal e do tendão do estapédio foi encontrada em 3 orelhas. Enquanto o pontículo tinha formato de crista óssea em 156 das 204 orelhas (76,4%), tinha o formato de ponte em 25 orelhas (12,3%). O pontículo estava ausente em 23 orelhas (11,3%). Enquanto o subículo completo estava presente em 136 de todas as orelhas (66,7%), encontrava-se incompleto em 21 orelhas (10,3%). O subículo estava ausente em 47 orelhas (23%). Deiscência facial foi encontrada em 32 orelhas e o nicho da janela redonda estava coberto por uma pseudomembrana em 85 orelhas (41,6%). A platina fixa foi observada em 7,4% de todas as orelhas e a artéria estapediana persistente não foi vista. Conclusão A frequência da pseudomembrana que cobre o nicho da janela redonda foi diferente daquela encontrada na literatura. Além disso, a frequência da proeminência da parede do canal auditivo externo foi relatada pela primeira vez.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Ear, Middle/anatomy & histology , Endoscopy/methods , Anatomic Variation/physiology , Autopsy/statistics & numerical data , Stapedius/diagnostic imaging , Tympanic Membrane/anatomy & histology , Sex Distribution , Cholesteatoma, Middle Ear/pathology , Dissection/statistics & numerical data , Ear, External/anatomy & histologyABSTRACT
Abstract Purpose To investigate the effects of bradykinin on reperfusion injury in an experimental intestinal ischemia reperfusion model. Methods We used 32 Wistar-Albino rats. We composed 4 groups each containing 8 rats. Rats in sham group were sacrified at 100 minutes observation after laparotomy. Thirty minutes reperfusion was performed following 50 minutes ischaemia in control group after observing 20 minutes. Ischaemic preconditioning was performed in one group of the study. We performed the other study group pharmacologic preconditioning by infusional administration of 10 μg/kg/minute bradykinin intravenously. We sacrified all of the rats by taking blood samples to evaluate the lactate and lactate dehydrogenase (LDH) after resection of jejunum for detecting tissue myeloperoxidase (MPO) activity. Results Lactate and LDH levels were significantly higher in control and study groups than the sham group (P<0.001). There is no difference between the study groups statistically. (P>0.05). The results were the same for MPO levels. Although definitive cell damage was determinated in the control group by hystopatological evaluation, the damage in the study groups observed was lower in different levels. However, there was no significant difference between the study groups statistically (P>0.05). Conclusion Either ischeamic preconditioning or pharmacologic preconditioning made by bradykinin reduced the ischemia reperfusion injury at jejunum.
Subject(s)
Animals , Female , Vasodilator Agents/pharmacology , Bradykinin/pharmacology , Reperfusion Injury/prevention & control , Ischemic Preconditioning/methods , Disease Models, Animal , Intestine, Small/drug effects , Reference Values , Time Factors , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Peroxidase/analysis , LaparotomyABSTRACT
Abstract Background and objective The use of transversus abdominis plane block with different local anesthetics is considered as a part of multimodal analgesia regimen in laparoscopic cholecystectomy patients. However no studies have been published comparing bupivacaine and levobupivacaine for transversus abdominis plane block. We aimed to compare bupivacaine and levobupivacaine in ultrasound-guided transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy. Methods Fifty patients (ASA I/II), undergoing laparoscopic cholecystectomy were randomly allocated into two groups. Following anesthesia induction, ultrasound-guided bilateral transversus abdominis plane block was performed with 30 mL of bupivacaine 0.25% in Group B (n = 25) and 30 mL of levobupivacaine 0.25% in Group L (n = 25) for each side. The level of pain was evaluated using 10 cm visual analog scale (VAS) at rest and during coughing 1, 5, 15, 30 min and 1, 2, 4, 6, 12 and 24 h after the operation. When visual analogue scale > 3, the patients received IV tenoxicam 20 mg. If visual analogue scale remained >3, they received IV. tramadol 1 mg.kg−1. In case of inadequate analgesia, a rescue analgesic was given. The analgesic requirement, time to first analgesic requirement was recorded. Results Visual analogue scale levels showed no difference except first and fifth minutes postoperatively where VAS was higher in Group L (p < 0.05). Analgesic requirement was similar in both groups. Time to first analgesic requirement was shorter in Group L (4.35 ± 6.92 min vs. 34.91 ± 86.26 min, p = 0.013). Conclusions Bupivacaine and levobupivacaine showed similar efficacy at TAP block in patients undergoing laparoscopic cholecystectomy.
Resumo Justificativa e objetivo O uso do bloqueio do plano transverso abdominal com diferentes anestésicos locais é considerado como parte do regime de analgesia multimodal em pacientes submetidos à colecistectomia laparoscópica. No entanto, nenhum estudo comparando bupivacaína e levobupivacaína para bloqueio do plano transverso abdominal foi publicado. Nosso objetivo foi comparar bupivacaína e levobupivacaína em bloqueio do plano transverso abdominal guiado por ultrassom em pacientes submetidos à colecistectomia laparoscópica. Métodos Cinquenta pacientes (ASA I/II), submetidos à colecistectomia laparoscópica foram alocados aleatoriamente em dois grupos. Após a indução da anestesia, o bloqueio do plano transverso abdominal bilateral guiado por ultrassom foi realizado com 30 mL de bupivacaína a 0,25% no Grupo B (n = 25) e 30 mL de levobupivacaína a 0,25% no Grupo L (n = 25) para cada lado. O nível de dor foi avaliado usando a escala visual analógica de 10 cm em repouso e durante a tosse em 1, 5, 15, 30 minutos e em 1, 2, 4, 6, 12 e 24 horas após a operação. Quando a escala visual analógica > 3, os pacientes receberam 10 mg de tenoxicam por via intravenosa (IV). Se a escala visual analógica permanecesse > 3, os pacientes recebiam tramadol IV (1 mg.kg−1). Em caso de analgesia inadequada, um analgésico de resgate foi administrado. A necessidade de analgésico e o tempo até a primeira solicitação de analgésico foram registrados. Resultados Os escores da escala visual analógica não mostraram diferença, exceto no primeiro e quinto minutos de pós-operatório, onde a escala visual analógica foi maior no Grupo L (p < 0,05). A necessidade de analgésico foi semelhante em ambos os grupos. O tempo até a primeira solicitação de analgésico foi menor no Grupo L (4,35 ± 6,92 min vs. 34,91 ± 86,26 min, p = 0,013). Conclusões Bupivacaína e levobupivacaína apresentaram eficácia similar no bloqueio TAP em pacientes submetidos à colecistectomia laparoscópica.
Subject(s)
Postoperative Care/methods , Bupivacaine/administration & dosage , Cholecystectomy, Laparoscopic/instrumentation , Levobupivacaine/administration & dosage , Anesthesia, General/methodsABSTRACT
Abstract Introduction During clinical evaluations, in order to interpret patients' complaints caused by Eustachian tube dysfunction and to monitor the success of the treatment, standardized and disease-related scales are necessary. Objective The aim of this study was to investigate the validity and reliability of the Turkish version of Eustachian tube dysfunction questionnaire-7. Methods Forty patients diagnosed with Eustachian tube dysfunction and 40 healthy individuals were enrolled for the study. After language validation of the Eustachian tube dysfunction questionnaire-7 for Turkish, a scale was completed by the both Eustachian tube dysfunction and control groups. Two weeks after the first evaluation, 15 of the cases filled out the scale again without any treatment intervention. Known-groups method was used in validity analysis. Floor-ceiling effect, test-retest method, item-total score correlation and internal consistency analysis were used in reliability analyses. Results Cronbach's alpha coefficient was 0.714 for the entire questionnaire. The test-retest reliability coefficient for the total scale was determined as 0.792, indicating correlation between the two questionnaires completed by the same patient over time. In the Eustachian tube dysfunction group, total and each item scores were found significantly higher than the control group (p < 0.001). Conclusion The Turkish version of Eustachian tube dysfunction questionnaire-7 was found to be highly valid and reliable. This scale is recommended to use for screening of Eustachian tube dysfunction and evaluating treatment outcome.
Resumo Introdução No intuito de interpretar as queixas dos pacientes causadas por disfunções na tuba auditiva durante uma avaliação clínica, e para monitorar o sucesso do tratamento, há necessidade de escalas padronizadas relacionadas à doença. Objetivo Investigar a validade e a confiabilidade da versão turca do Eustachian tube dysfunction questionnaire-7. Método Quarenta pacientes diagnosticados com disfunção da tuba auditiva e 40 indivíduos saudáveis foram incluídos no estudo. Após a validação do Eustachian tube dysfunction questionnaire-7 para o idioma turco, o questionário foi aplicada aos grupos disfunção da tuba auditiva e controle. Duas semanas após a primeira avaliação, 15 pacientes preencheram o questionário novamente sem qualquer tratamento. O método de grupos conhecidos foi utilizado na análise de validade. Os efeitos teto e chão, o método teste-reteste, a correlação se escore de item-total e a análise de consistência interna foram utilizados nas análises de confiabilidade. Resultados O coeficiente alfa de Cronbach foi de 0,714 para todo o questionário. O coeficiente de confiabilidade teste-reteste para a escala total foi determinado como 0,792, indicando correlação entre os dois questionários preenchidos pelo mesmo paciente ao longo do tempo. No grupo disfunções da tuba auditiva, foi observado que os escores total e de cada item foram significativamente maiores do que no grupo controle (p < 0,001). Conclusão A versão no idioma turco do Eustachian tube dysfunction questionnaire-7 foi considerada altamente válida e confiável. Recomenda-se a utilização dessa escala para a triagem de disfunções da tuba auditiva e avaliação do resultado do tratamento.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Surveys and Questionnaires/standards , Ear Diseases/diagnosis , Eustachian Tube/physiopathology , Reference Standards , Turkey , Case-Control Studies , Reproducibility of Results , Statistics, Nonparametric , Ear Diseases/physiopathologyABSTRACT
The in vitro embryo culture systems need further improvement to enhance the efficiency of bovine embryo production. Growth factors play key roles in embryo production and quality. The objective of this study was to define the effects of leptin, insulin-like growth factor-1 (IGF-1), and their combination on embryonic development, apoptosis, and expression profiles of a panel of developmentally important genes during 8-day embryo culture. The oocytes were aspirated from slaughterhouse ovaries of mixed breed cows. Following IVM/IVF presumptive zygotes were obtained. To accomplish this objective, presumptive zygotes (16-18 h post-insemination) were cultured in vitro as control (no supplementation, n = 349), 5 ng/ml leptin (Group I, n = 322), 100 ng/ml IGF-1 (Group II, n = 347), and 5 ng/ml leptin and 100 ng/ml IGF-1 (Group III, n = 360). All groups were supplemented with 10% fetal calf serum (FCS) on Day 4, and blastocysts were harvested on day 8. The DNA fragmented nuclei of blastocyst were determined by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and expression profiles of a panel of developmentally important genes were assayed by real-time polymerase chain reaction (RT-PCR). The cleavage rate and embryo development to 8-16 cell stage were higher in groups II and III as compared to control (P < 0.05), respectively. Percentage of blastocyst and mean cell numbers per blastocyst did not differ among the groups. Addition of IGF-I and/or combination with leptin decreased the number of nuclei with fragmented DNA (P < 0.01) as compared to the control group. Although the expression of glucose transporter 1 (Glut1), desmosomal glycoprotein desmocollin III (DcIII) and insulin like growth factor 2receptor (Igf2r) transcripts did not change among thegroups, interferon-tau (IF-tau) and DNAmethyltransferase 3A (Dnmt3a) were down-regulated ingroup II while heat shock protein-70 (Hsp70) and IF-tauwere up regulated in group III.[...]
Subject(s)
Animals , Cattle , Semen Analysis/classification , Semen Analysis/trends , Embryo, Mammalian/chemistry , Insulin-Like Growth Factor I/administration & dosage , Insulin-Like Growth Factor I/analysis , Leptin/administration & dosage , Leptin/analysisABSTRACT
The in vitro embryo culture systems need further improvement to enhance the efficiency of bovine embryo production. Growth factors play key roles in embryo production and quality. The objective of this study was to define the effects of leptin, insulin-like growth factor-1 (IGF-1), and their combination on embryonic development, apoptosis, and expression profiles of a panel of developmentally important genes during 8-day embryo culture. The oocytes were aspirated from slaughterhouse ovaries of mixed breed cows. Following IVM/IVF presumptive zygotes were obtained. To accomplish this objective, presumptive zygotes (16-18 h post-insemination) were cultured in vitro as control (no supplementation, n = 349), 5 ng/ml leptin (Group I, n = 322), 100 ng/ml IGF-1 (Group II, n = 347), and 5 ng/ml leptin and 100 ng/ml IGF-1 (Group III, n = 360). All groups were supplemented with 10% fetal calf serum (FCS) on Day 4, and blastocysts were harvested on day 8. The DNA fragmented nuclei of blastocyst were determined by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and expression profiles of a panel of developmentally important genes were assayed by real-time polymerase chain reaction (RT-PCR). The cleavage rate and embryo development to 8-16 cell stage were higher in groups II and III as compared to control (P < 0.05), respectively. Percentage of blastocyst and mean cell numbers per blastocyst did not differ among the groups. Addition of IGF-I and/or combination with leptin decreased the number of nuclei with fragmented DNA (P < 0.01) as compared to the control group. Although the expression of glucose transporter 1 (Glut1), desmosomal glycoprotein desmocollin III (DcIII) and insulin like growth factor 2receptor (Igf2r) transcripts did not change among thegroups, interferon-tau (IF-tau) and DNAmethyltransferase 3A (Dnmt3a) were down-regulated ingroup II while heat shock protein-70 (Hsp70) and IF-tauwere up regulated in group III.[...](AU)