Serum total oxidant and anti-oxidant status in children with cancer.

BACKGROUND: Oxidative stress has a potential role in carcinogenesis. Anti-oxidant enzymes have a neutralizing effect on both cancer initiation and progression. We aimed to assess the oxidant and anti-oxidant levels of pediatric cancer patients and to compare the levels in healthy controls. MATERIALS AND METHODS: The study involved 105 pediatric cancer patients (40 undergoing chemotherapy, 65 survivors) and 40 healthy children. The serum total oxidant status (TOS) and total anti-oxidant status (TAS) were measured. RESULTS: The oxidative stress index was significantly lower in pediatric cancer patients compared to the levels in the controls (0.20 ± 0.07 vs. 0.26 ± 0.10; P = 0.001). The mean serum TAS level was significantly higher in patient groups compared to the level in the control (1.87 ± 0.48 vs. 1.63 ± 0.32 mmol/L, P = 0.001). The TAS level of children with cancer in survivors was also found to be significantly higher compared to the levels in the control group (1.85 ± 0.45 vs. 1.63 ± 0.32 mmol/L, P = 0.005). Radiotherapy, surgery, relapsed disease, presence of metastases, and receiving enteral nutritional support caused no change in the TAS/TOS level. CONCLUSION: It has been revealed for the first time that the serum total anti-oxidant level was high in children undergoing chemotherapy and the survivor group as well. Moreover, the oxidative stress index was low in children with cancer. Longitudinal prospective studies are needed to reveal the alterations in oxidant status among children with cancer.

Levels, distribution, sources and human exposure pathways of alkylphenol and alkylphenol ethoxylates in indoor dust in Turkiye.

Environmental phenolic chemicals, due to their widespread occurrence and potent estrogenic properties, pose a risk to human exposure. The phenolic organic contaminants alkylphenols (APs) and alkylphenol polyethoxylates (APEs) are used in various household applications, and they may enter to the environment during production and use, potentially appearing in indoor dust. However, little is known about the levels of environmental phenolics in indoor environments. In this study, five of these compounds namely octylphenol (OP), 4-Octylphenol Monoethoxylate (4-OPME), 4-tert-octylphenol (4-t-OP), 4-n-nonylphenol (4-n-NP) and nonylphenol diethoxylate (di-NPE) were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in household dust samples (n = 148) collected from Ankara, the capital of Turkiye. OP and 4-OPME was not present in any of the analyzed samples. The median concentrations of the 148 settling dust samples were 35, 520, and 1910 ng g-1 dust for 4-t-OP, 4-n-NP, and di-NPE, respectively. An assessment of the human (children and adults) exposure pathway to APs and APEs, which are recognized as endocrine-disrupting chemicals found in residential dust, revealed that it was approximately 3 times higher for children than for adults at both moderate and heavy exposure levels. The association between chemical exposure, house characteristics, and family lifestyle was investigated using a multivariate logistic regression model. According to the results of this model, while the high concentrations measured for 4-t-OP were not found to be associated with any of the household parameters, high levels of 4-n-NP and di-NPE were associated with the frequency of house cleaning, repairs made during the previous year, residential type, the number of occupants, flooring materials, and the purchase of new household items within the past year. This study provides a basis for prioritizing toxicology and exposure studies for EDCs and mixtures and may offer new tools for exposure assessment in health studies.

A content comparison of 4 commonly used adult upper limb amputee outcome measurements with application of the refinements of International Classification of Functioning, Disability, and Health linking rules.

INTRODUCTION: The application of the refinements of linking rules to the outcome measurement methods provides an opportunity to obtain information concerning what the available instruments actually measure and how the instrument measures certain outcomes. The purpose of the study was to analyze the content of 4 commonly used upper limb amputee scales using the refined International Classification of Functioning, Disability, and Health (ICF) linking rules. METHODS: The Upper Extremity Functional Status module of the Orthotics and Prosthetics User Survey (OPUS-UEFS), Trinity Amputation and Prosthesis Experience Scales, Southampton Hand Assessment Procedure (SHAP), and Quick Disability of the Arm, Shoulder, and Hand were analyzed by 2 health professionals for a content comparison based on ICF categories. The Kappa statistic was used to calculate the degree of agreement between 2 professionals. RESULTS: The scale questions were linked with 43 different ICF codes in this study. Trinity Amputation and Prosthesis Experience Scale addresses all ICF domains. All items of SHAP and most items of OPUS-UEFS were linked to the activity-participation domain. Quick Disability of the Arm, Shoulder, and Hand items were linked with activity-participation and body function domains. The perspectives of OPUS-UEFS and SHAP are descriptive. The perspectives of Quick Disability of the Arm, Shoulder, and Hand were descriptive and appraisal. The perspectives of Trinity Amputation and Prosthesis Experience Scale subscales were descriptive, appraisal, and needs or dependency. Estimated kappa values ranged from 0.44 to 0.91 for ICF codes. CONCLUSIONS: Most concepts in the scales were frequently linked to the activity-participation domain. We think that the results of this study will be a useful guide to clinicians and researchers in selecting relevant and appropriate outcome measurements for upper limb amputee rehabilitation.

The Determining Factors for Outcome of Pediatric Intensive Care Admitted Children After Stem Cell Transplantation.

INTRODUCTION: Requiring pediatric intensive care unit (PICU) admission relates to high mortality and morbidity in patients who received hematopoietic stem cell transplantation (HSCT). In this study, we aimed to evaluate the indications for PICU admission, treatments, and the determining risk factors for morbidity and mortality in patients who had allogeneic HSCT from various donors. MATERIALS AND METHODS: In this retrospective study, we enrolled to patients who required the PICU after receiving allogeneic HSCT at our Pediatric Bone Marrow Transplantation Unit between 2005 and 2020. We evaluated to indication to PICU admission, applications, mortality rate, and the determining factors to outcomes. RESULTS: Thirty-three (7%) patients had 47 PICU admissions and 471 patients underwent bone marrow transplantation during 16-year study period. Also, 14 repeated episodes were registered in 9 different patients. The median age of PICU admitted patients was 4 (0.3 to 18) years and 29 (62%) were male. The main reasons for PICU admission were a respiratory failure, sepsis, and neurological event in 20, 8, and 7 patients, respectively. The average length of PICU stay was 14.5 (1 to 80) days, 14 (43%) of patients survived and the mortality rate was 57%. Multiple organ failure ( P =0.001), need for respiratory support ( P =0.007), inotrope agents ( P =0.001), and renal replacement therapy ( P =0.013) were found as significant risk factors for mortality. CONCLUSIONS: Allogeneic HSCT recipients need PICU admission because of its related different life-threatening complications. But there is a good chance of survival with quality PICU care and different advanced organ support methods.

Cross-cultural adaptation of the Revised Neurophysiology of Pain Questionnaire into the Turkish language based on Rasch analysis.

BACKGROUND: The Revised Neurophysiology of Pain Questionnaire (Revised-NPQ-Tr) is used to evaluate the change in pain knowledge. No study has explored its validity and reliability for the Turkish language. OBJECTIVES: This study aims to determine the psychometric properties of the Turkish version of the Revised-NPQ-Tr in chronic spinal pain patients. METHODS: A total of 182 chronic spinal pain patients were included in the study. The Revised-NPQ-Tr results were analyzed using Rasch analysis to measure the psychometric properties. RESULTS: The Revised-NPQ-Tr indicates misfit to the Rasch model, as evidenced by the borderline significant p value (LR test = 27.626; df = 11; p = .004; Bonferroni-adjusted α = 0.004). Two items were differentially affected by educational status. Removal of poor-functioning items did not improve the psychometric properties of the questionnaire. The Revised-NPQ-Tr is unidimensional and there was no local dependence between items. The questionnaire exhibits known group validity. Test-retest reliability of the questionnaire was moderate [intraclass correlation coefficient (ICC) = 0.629]; however, the internal consistency of the questionnaire was found to be low (Cronbach's α = 0.330; person separation index = 0.373). CONCLUSION: Although the internal validity of the Revised-NPQ-Tr version was acceptable, its reliability was found to be low. Consequently, the results of Revised-NPQ-Tr should be interpreted carefully in the clinic.

Assessment of house dust trace elements and human exposure in Ankara, Turkey.

One of the impacts of the COVID-19 pandemic is leading people remain at homes longer than ever. Considering the elongation of the time people spend indoors, the potential health risks caused by contaminants including heavy metals in indoor environments have become even more critical. The purpose of this study was to evaluate the levels and sources of heavy metals in indoor dust, to assess the exposure to heavy metals via indoor dust, and to estimate the associated health risk. The highest median value was measured for Zn (263 µg g-1), while the lowest median concentration value was observed for Cd (0.348 µg g-1). The levels of elements measured in the current study were found to be within the ranges reported in the other parts of the world, mostly close to the lower end of the range. House characteristics such as proximity to the main street, presence of pets, number of occupants, and age of the building were the house characteristics influencing the observed higher concentrations of certain heavy metals in houses. Enrichment factor values range between 1.79 (Cr) and 20.4 (Zn) with an average EF value of 8.80 ± 6.80 representing that the targeted elements are enriched (EF>2) in indoor dust in Ankara. Positive matrix factorization results showed that the heavy metals in the house dust in the study area are mainly contributed from sources namely outdoor dust, carpets/furniture, solders, wall paint/coal combustion, and cigarette smoke. Carcinogenic and non-carcinogenic risk values from heavy metals did not exceed the safe limits recommended by EPA. The highest carcinogenic risk level was caused by Cr. The risk through ingestion was higher than inhalation, and the risk levels were higher for children than for adults.

Comparison of extracorporeal shock wave therapy and high-intensity laser therapy on pain, grip strength, and function in patients with lateral epicondylalgia: a randomized controlled study.

This study aimed to compare the effects of extracorporeal shockwave therapy (ESWT) and high-intensity laser therapy (HILT) on pain, grip strength, and function in patients with lateral epicondylalgia. This prospective randomized controlled study included 42 patients (22 women and 20 men, mean age: 37) divided into 3 groups. The first group received physiotherapy (n = 14), the second received physiotherapy combined with ESWT (n = 14), and the third received physiotherapy combined with HILT (n = 14). All participants underwent 10 physiotherapy sessions for 2 weeks, 5 sessions per week. In addition to physiotherapy, the ESWT group received 4 ESWT sessions, 2 sessions per week, and the HILT group received 4 HILT sessions, 2 sessions per week. The outcomes were pain intensity as assessed by Visual Analog Scale, grip strength by hand dynamometer, and function by the Duruoz Hand Index and Patient-Rated Tennis Elbow Evaluation-Turkish version questionnaire. The participants were assessed at the beginning of the study (T1/week 0), at the end of treatment (T2/2nd week), and at follow-up (T3/6th week). At follow-up (T3), a significant improvement was observed in all outcomes compared to baseline (T1) in all groups (P < 0.05). Inter-group comparison of the mean differences between baseline and end values showed that the HILT group was superior in all outcomes (P < 0.05). This study showed that physiotherapy alone combined with ESWT and HILT positively affected the treatment of lateral epicondylalgia. Physiotherapy combined with HILT was found to be the most effective for improving pain, grip strength, and function. Clinical trial number: NCT674325.

Physiotherapy combined with therapeutic neuroscience education versus physiotherapy alone for patients with chronic low back pain: A pilot, randomized-controlled trial.

OBJECTIVES: The aim of this study was to investigate the effect of therapeutic neuroscience education (TNE) combined with physiotherapy on pain, kinesiophobia, endurance, and disability in chronic low back pain (CLBP) patients. PATIENTS AND METHODS: Between November 2016 and December 2017, a total of 31 patients with CLBP (5 males, 26 females; mean age: 42.3±10.8 years; range, 20 to 58 years) were randomly allocated to receive physiotherapy combined with TNE (experimental group, EG, n=16) and physiotherapy alone (control group, CG, n=15). All participants received physiotherapy consisting of five sessions per week for a total of three weeks. In addition to physiotherapy, the EG received TNE sessions consisting of two sessions per week for a total of three weeks. The primary outcomes were pain intensity as assessed by Visual Analog Scale (VAS) and kinesiophobia by Tampa Scale for Kinesiophobia (TSK), while and the secondary outcomes were trunk muscle endurance as assessed by the partial curl-up test (trunk flexor endurance [TFE]) and modified Sorensen test (trunk extensor endurance [TEE]) and disability by Roland-Morris Disability Questionnaire (RMDQ). RESULTS: All patients completed the study. The median VAS, TSK, TFE, TEE, and RMDQ scores for the EG significantly improved after three weeks, while there was only significant improvement in the VAS, TSK, and RMDQ scores in the CG. The TSK decreased more in the EG than in the CG. The significant difference was evident in TSK and TFE in favor of the EG (p<0.05). CONCLUSION: These results suggest that the combination of TNE with physiotherapy can improve kinesiophobia and trunk flexor muscle endurance of patients with CLBP in the short-term.

Continuous renal replacement therapy in critically ill children: single-center experience

Background/aim: Continuous renal replacement therapy (CRRT) has significant benefits in the treatment of critically ill children. The objective of this study is to describe the treatment indications, methods, demographics, and outcome of the patients who received CRRT in our pediatric intensive care unit and neonatal care unit, and, according to these results, we also aim to make improvements in our unit-based interventions. Material and methods: In this single-centered study, we retrospectively evaluated medical charts of the patients admitted to our intensive care units and received CRRT between February 2010 and November 2015. Results: Fifty of 60 patients were included in this study. Newborns made up 28% (n = 14) of the patients. The mean body weight was 18.4 kg (2.3-98 kg). CRRT indications were fluid overload (30%), acute kidney injury (40%), metabolic disease (24%), electrolyte impairment (4%), and drug intoxication (2%). The most common method of CRRT was continuous venovenous hemodiafiltration (CVVHDF) (72%). The mean duration of CRRT was 135 hours (1-864) and totally 143 filters, polyarylethersulfon (n = 23.46%) and polyacrylonitrile (n = 27.54%) were used. Overall survival was 42%. The survival rate of newborns was significantly higher (P = 0.046). Conclusion: CRRT is a lifesaving method that can be applied to critically ill children with acute kidney injury and fluid overload at any age and weight by experienced teams.

First insight into polybrominated diphenyl ethers in car dust in Turkey: concentrations and human exposure implications.

The presence of polybrominated diphenyl ethers (PBDEs) in the car is due to their use as a flame retardant additive in various car components such as dashboard, plastic parts, seat and headliner cushion foams, insulated cables, and electronic circuits. Ingestion of dust inadvertently or dermal contact to dust are significant pathways of human exposure to pollutants including PBDEs. There are no studies documenting presence of car dust associated flame retardants in Turkey. In the current study, a total of 13 PBDEs congeners were investigated in 62 car dust samples collected from Bursa province of Turkey using glass-fiber filters and a vacuum cleaner. Results of the study showed that congener concentrations were within the range of

Nurses' knowledge and care practices for infection prevention in neutropenic patients.

BACKGROUND: Neutropenia-associated infections can prolong hospitalization, increase re-admission, mortality and morbidity rates. AIM: To determine nurses' knowledge and infection control care practices in neutropenic patients. DESIGN: This descriptive study was conducted between January 2012 and May 2012, at oncology adult inpatient units of a university hospital in Turkey. Sample consisted of 51 staff nurses. METHODS: Data were collected by a form included sociodemographic characteristics, neutropenia knowledge questions, and infection control care practices. Each nurse was observed by researcher three times for infection control care practices. RESULTS: The mean score of nurses' knowledge was 21.3 ± 2.4 (min. 17; max. 27). For all three observations hand hygiene adherence was found low both in medication preparation, administration and vital signs assessment. Sterility disrupted in almost all preparation of parenteral medications. CONCLUSIONS: Even nurses' knowledge related with neutropenia and care of neutropenic patient was found above average their infection control care practices were found insufficient.

Hepatic hydatid disease in children and adults living in different areas in Turkey.

OBJECTIVE: To compare the clinical features of the hepatic hydatid disease in the operated children and adults living in the east and west part of Turkey. METHODS: Between January 2001 and May 2005, 105 patients were operated with the diagnosis of hepatic hydatid cyst in Trakya and Yuzuncu Yil University Hospitals, Turkey. The patients (n=105) were retrospectively evaluated in 4 groups; Edirne Ch: (18 children under 18 year-old) and Edirne Ad: (20 adults) were from Edirne, Van Ch: (22 children under 18 year-old) and Van Ad: (44 adults) from Van. The patients in each group were analyzed according to their clinical and radiological findings. RESULTS: The frequency of hepatic hydatid cysts in children was significantly higher in boys in Edirne Ch group and in girls in Van Ch group (p<0.05). In adults, the disease was also seen significantly higher in males in Edirne Ad group and females in Van Ad group (p<0.05). There were no difference symptoms of the disease, concomitant extra hepatic cysts and total cyst number in children and adults in the same region (p>0.05). The number of huge hepatic cysts and history of contact with animal were more common in children and adults living in Van. CONCLUSION: While the course of hepatic hydatid disease has the similar clinical features among the children and adults in the same region, remarkable regional differences have been found on it.

Serum, urinary and stone zinc, iron, magnesium and copper levels in idiopathic calcium oxalate stone patients.

Many theories have been put forward to explain the mechanism of stone formation and growth. The aim of this study was to investigate the urinary, serum and stone levels of zinc, iron, magnesium, and copper in patients with calcium oxalate stones and to investigate urinary and serum element levels in healthy controls and to find a possible connection between the elements and calcium oxalate stone formation. A total of 104 patients with calcium oxalate stones ranging in age from 3 to 79 years (mean 44.0 +/- 18.1) and 77 healthy controls ranging in age from 18 to 77 (mean 44.2 +/- 17.9) were included in this study. The mean urinary iron and copper levels in stone patients were significantly higher than healthy controls (P = 0.000). The mean urinary zinc and magnesium levels in healthy controls were significantly higher than stone patients (P = 0.000). There was no significant difference in the serum levels of magnesium and copper in stone patients and healthy controls. Serum zinc and iron level were significantly high in healthy controls as compared to stone patients. Each stone had all 4 elements. Zn and Mg have inhibitory effect on calcium oxalate stone formation. Fe and Cu could be promotor of the calcium oxalate stone formation.