The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample.

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18−30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals' knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required.

Blended Learning Is a Feasible and Effective Tool for Basic Pediatric Spinal Deformity Training.

STUDY DESIGN: Descriptive study. OBJECTIVE: Assessing the applicability of blended learning to specific domains of spine surgery. METHODS: After the needs assessment, a blended pediatric spine deformity course program was designed. A total of 33 participants, including orthopedic and neurosurgeons, registered for the course and all of them completed an online entrance quiz. Thus, they were eligible to have online part of course, which included the theoretical part of the course and also a discussion forum where the discussions about the topics facilitated by faculty. Thirteen of 33 subjects participated second part of the blended pediatric spine deformity course. This face-to-face (F2F) part consisted of case discussions for each topic and discussions facilitated by faculty members. The same quiz was also taken before and after the F2F part. All quiz results were compared statistically. RESULTS: There were 11 lectures within the online part and 6 case discussions in the F2F part. The quiz scores were improved significantly by having a complete blended pediatric deformity course (P < .05). CONCLUSIONS: The current study has demonstrated that blended learning format, including online and F2F, is feasible and effective in training for a domain of spine surgery, pediatric deformity in this specific context.

Pleural Thickening after Pleural Effusion: How can we Follow-Up in Children?

INTRODUCTION: No clear information exists about the factors affecting pleural thickening following parapneumonic effusion in children. We aimed to investigate factors that affect the resolving time of pleural thickening after parapneumonic effusion. METHODS: Between the years of 2007-18, 91 patients, which were followed due to diagnosis of pleural thickening after parapneumonic effusion, were assessed. Ages, complaints, physical examination findings, laboratory results, chest x-ray and ultrasonography findings, treatments, duration of treatment and recovery time of the patients were examined terms in of pleural thickening resolving time. RESULTS: The mean age of patients was 7.5 ± 5.0 years. Pleural thickening resolving time was 151 ± 6.8 days. The resolving time for pleural thickening was delayed with older ages, longer duration of complaints, fever before hospital admission and treatment, lower oxygen saturation at the time of admission, crackles in the physical examination, higher white blood cell count and pleural fluid density (p = 0.018, p = 0.001, p = 0.021, p = 0.020, p = 0.024, p = 0.025, p = 0.021, p = 0.019). In addition, the amount of effusion measured by thorax ultrasonography, fibrinolytic usage, and complications had a role in the delayed resolving time (p = 0.034, p = 0.001, p = 0.034). Pleural thickening resolved in 80% of the patients. CONCLUSION: In this report, 80% of pleural thickening, following parapneumonic effusion resolved within 5 months. Patients who do not have a complication during follow-up are not required to monitor with frequent chest x-ray. Patients with a higher amount of pleural effusion, complications and need for fibrinolytic treatment should be followed more carefully.

Depression and hopelessness in pre-clinical medical students.

BACKGROUND: Mental distress seriously affects the quality of life of medical students. Medical students face mental health problems such as depression, anxiety and hopelessness. The pre-clinical years include substantial changes in a student's life, such as moving cities and losing friends, which can complicate an already stressful life, leading to depression and hopelessness. This study aims to determine the levels of depression and hopelessness, and the habits that can affect these levels, among pre-clinical medical students. METHODS: A descriptive cross-sectional study was conducted using anonymous questionnaires composed of the Beck Depression Scale (BDS), the Beck Hopelessness Scale (BHS), and questions about sociodemographic and perceived reasons for happiness or unhappiness. We invited pre-clinical medical students to join the study. Particularly during the pre-clinical years, medical students face the adverse effects of changing cities, social circles co-workers RESULTS: A total of 1015 (70.5%) students participated in the study. The prevalence of depression among pre-clinical students was found to be 27.7 per cent and mild levels of hopelessness were found in 54.4 per cent. A meaningful positive correlation was found between the BDS scores and BHS scores of medical students (r = 0.535; p < 0.0001). The BDS scores of students who were ex-smokers, daily consumers of fizzy beverages and energy drinks, and students with chronic diseases were significantly higher (p < 0.05). The BHS scores of the students who were ex-smokers and daily consumers of fizzy drinks, as well as intersex students, had significantly higher scores than the other groups (p < 0.05). DISCUSSION: A healthy social life and effective psychological counselling services are very much needed for mental well-being among medical students in their pre-clinical year.

Is Hyperuricemia Overlooked when Treating Pediatric Tuberculosis Patients with Pyrazinamide?

The treatment of tuberculosis (TB) requires long-term multiple drug use. Hyperuricemia is frequently reported in adults, but there are few data for the pediatric population. This study aimed to review drug-related side effects in pediatric patients that received treatment for TB. Patients with active TB undergoing treatment were followed for drug-related side effects. During the 7 year period, 23 patients with a mean age of 7.9 ± 4.66 years were treated. Drug-related side effects were observed in 14 patients. Hyperuricemia occurred in 12 of the 14 patients, vs. hepatotoxicity in 2. In all, eight of the patients with hyperuricemia had ≥2 episodes during pyrazinamide (PZA) therapy. Based on these findings, we devised an algorithm that could be used for the management of hyperuricemia in patients receiving PZA because of TB, and recommend that hyperuricemia be closely monitored during PZA therapy.

Unenhanced urinary CT: value of parenchymal attenuation measurements in differentiating acute vs. chronic renal obstruction.

OBJECTIVE: We aimed to search if the renal parenchymal attenuation measurements on unenhanced CT scans could be useful in differentiating acutely obstructed kidneys from chronic cases or unobstructed kidneys. MATERIAL AND METHODS: Unenhanced CT scans of 101 patients were retrospectively reviewed. Thirty-two patients with unilateral acute renal obstruction, 34 patients with unilateral chronic renal obstruction due to various reasons and 35 control subjects were included in the study. The parenchymal densities of both kidneys were measured, from the upper poles, middle portions, and lower poles of each kidney. The mean parenchymal densities of both kidneys were calculated in all three groups of subjects. Secondary signs of renal obstruction such as perinephric stranding, size of ureteral stone, degree of hydronephrosis were also noted for each kidney. RESULTS: The mean parenchymal attenuation value on the acutely obstructed side was lower than the unobstructed side, 24.21 ± 3.68 and 30.68 ± 4.75 respectively (p<0.001). The mean parenchymal attenuation value on the acutely obstructed side (24.21 ± 3.68) was lower than both the chronically obstructed side (30.85 ± 4.53), and the control subjects (29.62 ± 3.03 on corresponding side). There was no statistically significant attenuation difference between right and left kidneys in the control group and chronic obstruction group. CONCLUSION: Renal parenchymal attenuation measurements and attenuation differences of both kidney of same patient could be useful in differentiating acute unilateral obstruction from chronic cases.

[The relationship between smoking and nasal polyposis]. / Sigara içme ile nazal polipozis arasindaki iliski.

OBJECTIVES: Research on the role of environmental factors in the pathogenesis of nasal polyposis (NP) is limited. The aim of this study was to evaluate the effect of smoking on NP. PATIENTS AND METHODS: A total of 125 patients (80 men, 45 women; mean age 44+/-12 years; range 19 to 78 years) with NP were evaluated with regard to the presence or absence of smoking, polyp stage, paranasal sinus computed tomography (CT) score, total IgE level, blood eosinophil count, and symptom scores. RESULTS: The rate of smoking in NP patients was 16.8% (21 patients), being significantly low (p<0.001) compared to the general rate of smoking previously reported in the study area (34.2%). There was no association between smoking and polyp size, paranasal sinus CT score, total IgE level, and blood eosinophil count (p>0.05). The frequencies of allergy, asthma, and aspirin allergy were not different between smokers and nonsmokers (p>0.05). Symptom scores did not differ significantly between smokers and nonsmokers, except for nasal obstruction score, which was significantly low in nonsmokers (p=0.034). CONCLUSION: Our results showed that the rate of smoking in patients with NP and the severity of nasal obstruction in smokers compared to nonsmokers were significantly low. Tissue studies in patients with NP may provide useful data on the relationship between smoking and NP.

MR cholangiopancreatography with T2-weighted prospective acquisition correction turbo spin-echo sequence of the biliary anatomy of potential living liver transplant donors.

OBJECTIVE: The objective of our study was to evaluate the ability of a respiratory navigator-triggered T2-weighted turbo spin-echo (TSE) sequence with a prospective acquisition correction (PACE) technique for MR cholangiopancreatography (MRCP) to depict the biliary anatomy of living donor liver transplantation (LDLT) donors. SUBJECTS AND METHODS: Forty potential LDLT donors who ranged in age from 19 to 54 years were prospectively evaluated with preoperative MRCP. MRCP was performed with a 1.5-T magnetic field using T2-weighted PACE TSE sequence. MRCP source data sets were processed with maximum-intensity-projection (MIP) and shaded surface display (SSD) algorithms. Findings were compared with intraoperative cholangiography. Biliary anatomy was classified according to the classification proposed by Huang and colleagues. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRCP for the detection of aberrant biliary anatomy were calculated. RESULTS: Intraoperative cholangiography and biliary exploration revealed that 27 donor candidates (67.5%) had conventional and 13 (32.5%) had aberrant biliary anatomy. Two donors (5%) had type B biliary anatomy; eight donors (20%), type C; two donors (5%), type D; and one donor (2.5%), unclassified. The sensitivity of MRCP source data sets in differentiating aberrant biliary anatomies from nonaberrant ones was 100%, the specificity was 88.9%, and the accuracy was 92.5%. PPV and NPV were 81.3% and 100%, respectively. The sensitivity of MIP images in differentiating aberrant biliary anatomies was 100%, the specificity was 88.9%, and the accuracy was 92.5%. PPV and NPV were 81.3% and 100%, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of the SSD images in detecting aberrant biliary anatomies were 100%, 77.8%, 85%, 68.4%, and 100%, respectively. CONCLUSION: Preoperative MRCP using a respiratory navigator-triggered T2-weighted TSE sequence with a PACE technique accurately depicts the biliary anatomy in LDLT donors and may guide intraoperative management of the biliary tract.

Reliability and validity of the Turkish version of the Rhinosinusitis Disability Index.

OBJECTIVES: The goal of this study was to determine the validity, reliability, and internal consistency of the Rhinosinusitis Disability Index (RSDI) for evaluating nasal and sinus diseases in Turkey. PATIENTS AND METHODS: The study included 120 patients (77 males, 43 females; mean age 39+/-12 years; range 18 to 65 years) with diagnoses of allergic rhinitis, chronic rhinosinusitis, nasal polyposis, and septal deviation. Each group consisted of 30 patients. The Turkish version of the RSDI was administered to all the patients together with the SF-36 quality of life scale as the gold standard reference test. For reliability, the RSDI was re-administered to 15 patients a week after the first. Internal consistency, reliability, and validity tests were carried out to evaluate the RSDI. RESULTS: The Cronbach's alpha coefficients were between 0.7175 and 0.9308 for the subscales of the RSDI, showing internal consistency. The correlation coefficients of the functional, emotional and physical subscales of the RSDI between the first and second administrations were 0.861, 0.883, and 0.902, respectively, indicating reliability. There were significant positive correlations between similar subscales of the RSDI and the SF-36. CONCLUSION: The results of this study indicate that the Turkish version of the RSDI can be used for evaluating sinonasal diseases.

Treatment of uremic pruritus with narrowband ultraviolet B phototherapy: an open pilot study.

We report the results of a pilot study of narrowband ultraviolet B phototherapy for the treatment of 20 patients with uremic pruritus. Ten patients completed the 6-week study period. A total of 8 patients were found to be responders. Of the remaining 10 patients who left the study before 6 weeks, 6 were satisfied with the response. In the follow-up period, 7 responders could be examined, and 3 were in remission 6 months after completing treatment. However, pruritus recurred in the remaining 4 responders. Narrowband ultraviolet B phototherapy may be an effective treatment for patients with uremic pruritus. Recurrence of pruritus, however, is a frequent problem.