The use of mentalization-based techniques in online psychodynamic child psychotherapy.

Objective: Psychodynamic child psychotherapy is an evidence-based approach for a range of child mental health difficulties and needs to constantly adapt to meet the needs of children. This study is the first to investigate whether the use of mentalization-based interventions (i.e., a focus on promoting attention control, emotion regulation, and explicit mentalization) predicted a good therapeutic outcome in online psychodynamic child therapy sessions conducted during the COVID-19 pandemic. Methods: The sample included 51 Turkish children (Mage = 7.43, 49% girls) with mixed emotional and behavioral problems. Independent raters coded 203 sessions from different phases in each child's treatment using the Mentalization-Based Treatment for Children Adherence Scale (MBT-CAS). Results: Multilevel modeling analyses showed children with higher emotional lability benefited more from attention control interventions compared to those with lower emotional lability. Discussion: Interventions that focus on developing the basic building blocks of mentalizing may be effective components of therapeutic action for online delivery of psychodynamic child psychotherapy, especially for children with greater emotional lability.

Does Resveratrol Prevent Sevoflurane Toxicity in Newborn Rats?

Inhalation anesthetics have been shown to cause neurodevelopmental disorders and neurotoxic effects. In this study, we aimed to investigate the effect of resveratrol on the possible neurotoxic effect of sevoflurane and the brain-derived neurotrophic factor (BDNF) pathway in newborn rats. The animals were divided into four groups: control, sevoflurane, sevoflurane+resveratrol 25 mg/kg, and sevoflurane+resveratrol 50 mg/kg. The groups that received anesthesia were given 3% sevoflurane for 2 h on the postnatal seventh, eighth, and ninth days. Control gas was applied to the control group. The Morris water maze (MWM) test was performed on postnatal 35th day. After performing the open field test on the postnatal 41st day, the animals were dissected, and the hippocampal BDNF levels were determined by Western blot method. In the MWM test, there was a significant decrease in the time spent in the target quadrant in the sevoflurane anesthesia group compared with control group. This reduction was reversed with the resveratrol pretreatment. Sevoflurane exposure significantly decreased hippocampal BDNF levels compared with the control group. The resveratrol 25 mg/kg pretreatment did not reverse this reduction, whereas resveratrol 50 mg/kg ameliorated this impairment. Sevoflurane did not cause any significant difference in the rats' performance in the open field test. However, 50 mg/kg resveratrol pretreatment caused a statistically significant increase in this performance. Our results showed that sevoflurane impaired learning and memory functions in newborn rats and resveratrol reversed this deterioration. Also BDNF might play a role in this beneficial effect of resveratrol.

Fungal Infections in COVID-19 Intensive Care Patients.

Opportunistic fungal infections increase morbidity and mortality in COVID-19 patients monitored in intensive care units (ICU). As patients' hospitalization days in the ICU and intubation period increase, opportunistic infections also increase, which prolongs hospital stay days and elevates costs. The study aimed to describe the profile of fungal infections and identify the risk factors associated with mortality in COVID-19 intensive care patients. The records of 627 patients hospitalized in ICU with the diagnosis of COVID-19 were investigated from electronic health records and hospitalization files. The demographic characteristics (age, gender), the number of ICU hospitalization days and mortality rates, APACHE II scores, accompanying diseases, antibiotic-steroid treatments taken during hospitalization, and microbiological results (blood, urine, tracheal aspirate samples) of the patients were recorded. Opportunistic fungal infection was detected in 32 patients (5.10%) of 627 patients monitored in ICU with a COVID-19 diagnosis. The average APACHE II score of the patients was 28 ± 6. While 25 of the patients (78.12%) died, seven (21.87%) were discharged from the ICU. Candida parapsilosis (43.7%) was the opportunistic fungal agent isolated from most blood samples taken from COVID-19 positive patients. The mortality rate of COVID-19 positive patients with candidemia was 80%. While two out of the three patients (66.6%) for whom fungi were grown from their tracheal aspirate died, one patient (33.3%) was transferred to the ward. Opportunistic fungal infections increase the mortality rate of COVID-19-positive patients. In addition to the risk factors that we cannot change, invasive procedures should be avoided, constant blood sugar regulation should be applied, and unnecessary antibiotics use should be avoided.

[Investigation of Ganciclovir Resistance in Cytomegalovirus Strains Obtained from Immunocompromised Patients]. / Immün Yetmezlikli Hastalardan Elde Edilen Sitomegalovirüs Izolatlarindaki Gansiklovir Direncinin Arastirilmasi.

CMV is a virus that is asymptomatic in healthy individuals but can cause serious mortality and morbidity in transplant patients and patients with acquired immunodeficiency syndrome (AIDS). Ganciclovir (GCV) is a nucleoside analog that significantly reduces morbidity and mortality in CMV-related infections and is used as the first choice in treatment. It is the first drug shown to be effective in the treatment of CMV disease in humans, and is also homologous to acyclovir. Long-term antiviral therapy is required to prevent or treat CMV disease, but this can cause antiviral resistance which was reported to be 8-14% in CMV. In CMV strains, GCV resistance is most common in the UL97 kinase gene region. The aim of this study was to investigate GCV resistance in CMV strains obtained from the patients with immune deficiency. A total of 49 patients, including 20 children, 29 adults, who were followed in the department of hematology were included in the study. Fifty-three samples from 49 patients with CMV DNA viral load ≥ 103 copies/ml were examined for GCV resistance. In the study, DNA sequences were determined by Sanger sequence analysis method 3500 Abi Prism Genetic Analyser (Applied Biosystems, Thermo Fisher Scientific, USA) in the 674 bp part of the UL97 gene region. The next generation sequencing (NGS) method was applied to the samples that could not be evaluated with this method. GCV resistance was not detected in 35 (66%) of 53 samples with the Sanger method. C592G, C607S and M460I GCV resistance mutation was detected in three patients. Since the sequences were mixed, resistance analysis could not be evaluated with Sanger in 15 patient samples and the resistance was not detected in these samples studied with NGS. Antiviral resistance mutation was detected in three of 49 patients (6.1%). In 20 patients included in the study, three variant sequences (A442G, C592F, A427V) reported in the literature and determined to be sensitive to drugs by phenotypic tests and 78 variant sequences that were not reported in the literature were detected. As a result, the detection of antiviral resistance is important in the follow-up of the patients and guides the clinician in planning of the treatment. It was concluded that the samples that could not be evaluated with the Sanger method should be studied with NGS and further studies are needed to determine the role of the variant sequences detected for the first time in drug resistance.

Family-centred service: Perspectives of paediatric residents from a non-Western country.

OBJECTIVES: The concept of family-centred service (FCS), which is recognized as the standard of paediatric health care, emerged from Western countries, and integration of FCS can be challenging especially in non-Western countries. This study aims to explore family-centred behaviours of paediatric residents and their perspectives on FCS being trained in a non-Western country before and 6 months after an educational workshop. It was hypothesized that the workshop will increase the awareness of paediatric residents regarding FCS and improve their self-reported family-centred practices. STUDY DESIGN: Ninety-nine residents who are in a 4-year paediatric residency program were included. A 2-hr interactive workshop was conducted for all participants. The measure of processes of care for service providers was used to measure self-reported family-centred practices of paediatric residents, and a study specific questionnaire was utilized to understand their perspectives towards FCS prior to and 6 months after the workshop. RESULTS: There were statistically significant increases in the measure of processes of care for service providers scores suggesting improvements in self-reported family-centred practices of participants 6 months after the workshop. Moreover, the percentage of participants describing themselves as knowledgeable and competent increased. Viewpoints of paediatric residents on the implementation of FCS and several challenges perceived by participants were highlighted. CONCLUSION: This is the first study conducted in a non-Western country exploring perspectives of paediatric residents towards the implementation of FCS and measuring their self-reported family-centred practices before and after an educational workshop. The study revealed that although a 2-hr interactive workshop improved the self-reported family-centred practices of participants, they still found FCS challenging.

Post-traumatic glioblastoma multiforme: a case report.

Malignant glioma development after trauma is a rare occurrence. We report a glioblastoma multiforme case that developed after a depressed skull fracture. A 65-year-old man was admitted because of right sided hemiplegia, epilepsy and changes in consciousness due to a malignant glial tumor. He had been operated on for a left calvarial depression fracture caused by cerebral laceration thirty-five years before. Radiologic imaging revealed a large contrast-enhanced mass lesion at the left frontotemporoparietal junction under the depression site. The patient underwent urgent surgery, and radical excision of the mass was achieved. The histopathologic diagnosis was a high-grade glial tumor. Although the possibility of a pre-existing tumor rather than a trauma-induced tumor is very high, the presented case suggests that traumatic cerebral lesions may also be a predisposing factor for the development of malignant glial tumors.