Multi-Dynamic-Multi-Echo-based MRI for the Pre-Surgical Determination of Sellar Tumor Consistency: a Quantitative Approach for Predicting Lesion Resectability.

PURPOSE: Pre-surgical information about tumor consistency could facilitate neurosurgical planning. This study used multi-dynamic-multi-echo (MDME)-based relaxometry for the quantitative determination of pituitary tumor consistency, with the aim of predicting lesion resectability. METHODS: Seventy-two patients with suspected pituitary adenomas, who underwent preoperative 3 T MRI between January 2020 and January 2022, were included in this prospective study. Lesion-specific T1-/T2-relaxation times (T1R/T2R) and proton density (PD) metrics were determined. During surgery, data about tumor resectability were collected. A Receiver Operating Characteristic (ROC) curve analysis was performed to investigate the diagnostic performance (sensitivity/specificity) for discriminating between easy- and hard-to-remove by aspiration (eRAsp and hRAsp) lesions. A Mann-Whitney-U-test was done for group comparison. RESULTS: A total of 65 participants (mean age, 54 years ± 15, 33 women) were enrolled in the quantitative analysis. Twenty-four lesions were classified as hRAsp, while 41 lesions were assessed as eRAsp. There were significant differences in T1R (hRAsp: 1221.0 ms ± 211.9; eRAsp: 1500.2 ms ±â€¯496.4; p = 0.003) and T2R (hRAsp: 88.8 ms ± 14.5; eRAsp: 137.2 ms ± 166.6; p = 0.03) between both groups. The ROC analysis revealed an area under the curve of 0.72 (95% CI: 0.60-0.85) at p = 0.003 for T1R (cutoff value: 1248 ms; sensitivity/specificity: 78%/58%) and 0.66 (95% CI: 0.53-0.79) at p = 0.03 for T2R (cutoff value: 110 ms; sensitivity/specificity: 39%/96%). CONCLUSION: MDME-based relaxometry enables a non-invasive, pre-surgical characterization of lesion consistency and, therefore, provides a modality with which to predict tumor resectability.

Evaluation of Telemedicine Support for Medics from the Perspective of Course Instructors.

INTRODUCTION: Health services in the theater/district areas often contain difficulties. Although telemedicine has a huge potential to support medics in the area, there are challenges as well. Our aim is to evaluate the telemedicine support that can be provided to the medics from the perspective of course instructors. MATERIALS AND METHODS: Our study was carried out in The University of Health Sciences, Türkiye. All of the instructors of a medic course were asked to fill a 13-question questionnaire and Likert-type scale, sent via e-mail. Among 79 instructors, 71 of them (55 physicians, 16 nonphysicians) responded and were included in the study. The distributions of the categorical variables in the groups were analyzed with the Pearson Chi-square. RESULTS: Of the 71 participants, 37 (52.11%) stated that there is a need for legal and ethical regulations for telemedicine (medical liability, malpractice, obtaining consent from the casualties, civilians, cross border missions, and rank-related problems) and patients' rights, additionally, to clarify the responsibilities of the doctors giving telemedicine support and the medics in the area. It was observed that physicians' and nonphysician group's opinions about the telepsychotherapy were statistically significantly different (χ2 = 8.675, P = .013). CONCLUSIONS: Most of the instructors believed that telemedicine could carry the knowledge and skills of specialist physicians to the field of operation. Access to high-quality health services in a short time through telemedicine support can increase the courage and commitment of the personnel. It is thought that with telemedicine, medics will not feel alone in the field, their worries about making wrong decisions will decrease, and their knowledge and skills will increase. Participants were particularly concerned about who will be held responsible for problems arising from interventions carried out using telemedicine, and strict legal and medical regulations are needed.

Investigation the relationship between xenophobic attitude and intercultural sensitivity level in nurses.

OBJECTIVE: The level of intercultural sensitivity is important for nurses to approach the individual's culture in care and treatment without prejudice. In this study, it was aimed to determine the effect of nurses' intercultural sensitivity level on xenophobic attitude. METHODS: This quantitative cross-sectional study was conducted at Van Training and Research Hospital between January and June 2022. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. SPSS-25 package program and R programming language 4.1.3 are used. RESULTS: This study was conducted with 235 nurses. According to the findings obtained in our study, the regression model determine the effect of intercultural sensitivity on xenophobia level was found to be F(1,233) = 69.857, p = 0.001, and 23.1 % (R2 = 0.231) of the variance in the dependent variable was explained by the independent variable. Intercultural sensitivity has a negative and significant effect on the level of xenophobia (ß = -0.480; t (233) = -8.358, p = 0.001). When comparing the performance of all variables with machine learning algorithms for the prediction model, the best performing algorithm was found to be Random Forest (RF). The contributions of these variables to the model were calculated with Shapley Additive Explanations (SHAP) values. The most important variables that should be included in the model to predict the xenophobia variable are the respect for cultural differences sub-dimension and intercultural sensitivity variables. CONCLUSION: It was determined that as the level of intercultural sensitivity of the nurses increased, their xenophobic attitudes decreased. Longitudinal studies on xenophobic attitude in nurses are recommended. It is recommended to make predictions with different machine learning models.

Segmentation and classification of skin burn images with artificial intelligence: Development of a mobile application.

AIM: This study was conducted to determine the segmentation, classification, object detection, and accuracy of skin burn images using artificial intelligence and a mobile application. With this study, individuals were able to determine the degree of burns and see how to intervene through the mobile application. METHODS: This research was conducted between 26.10.2021-01.09.2023. In this study, the dataset was handled in two stages. In the first stage, the open-access dataset was taken from https://universe.roboflow.com/, and the burn images dataset was created. In the second stage, in order to determine the accuracy of the developed system and artificial intelligence model, the patients admitted to the hospital were identified with our own design Burn Wound Detection Android application. RESULTS: In our study, YOLO V7 architecture was used for segmentation, classification, and object detection. There are 21018 data in this study, and 80% of them are used as training data, and 20% of them are used as test data. The YOLO V7 model achieved a success rate of 75.12% on the test data. The Burn Wound Detection Android mobile application that we developed in the study was used to accurately detect images of individuals. CONCLUSION: In this study, skin burn images were segmented, classified, object detected, and a mobile application was developed using artificial intelligence. First aid is crucial in burn cases, and it is an important development for public health that people living in the periphery can quickly determine the degree of burn through the mobile application and provide first aid according to the instructions of the mobile application.

Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature-An Exploratory Study.

PURPOSE: Neonates born at < 28 weeks of gestation are at risk for neurodevelopmental delay. The aim of this study was to identify quantitative MR-based metrics for the prediction of neurodevelopmental outcomes in extremely preterm neonates. METHODS: T1-/T2-relaxation times (T1R/T2R), ADC, and fractional anisotropy (FA) of the left/right posterior limb of the internal capsule (PLIC) and the brainstem were determined at term-equivalent ages in a sample of extremely preterm infants (n = 33). Scores for cognitive, language, and motor outcomes were collected at one year corrected-age. Pearson's correlation analyses detected relationships between quantitative measures and outcome data. Stepwise regression procedures identified imaging metrics to estimate neurodevelopmental outcomes. RESULTS: Cognitive outcomes correlated significantly with T2R (r = 0.412; p = 0.017) and ADC (r = -0.401; p = 0.021) (medulla oblongata). Furthermore, there were significant correlations between motor outcomes and T1R (pontine tegmentum (r = 0.346; p = 0.049), midbrain (r = 0.415; p = 0.016), right PLIC (r = 0.513; p = 0.002), and left PLIC (r = 0.504; p = 0.003)); T2R (right PLIC (r = 0.405; p = 0.019)); ADC (medulla oblongata (r = -0.408; p = 0.018) and pontine tegmentum (r = -0.414; p = 0.017)); and FA (pontine tegmentum (r = -0.352; p = 0.045)). T2R/ADC (medulla oblongata) (cognitive outcomes (R2 = 0.296; p = 0.037)) and T1R (right PLIC)/ADC (medulla oblongata) (motor outcomes (R2 = 0.405; p = 0.009)) revealed predictive potential for neurodevelopmental outcomes. CONCLUSION: There are relationships between relaxometry­/DTI-based metrics determined by neuroimaging near term and neurodevelopmental outcomes collected at one year of age. Both modalities bear prognostic potential for the prediction of cognitive and motor outcomes. Thus, quantitative MRI at term-equivalent ages represents a promising approach with which to estimate neurologic development in extremely preterm infants.

Chronic critical illness in critically ill COVID-19 patients.

OBJECTIVES: To evaluate the presence of chronic critical illness (CCI) in COVID-19 patients and compare clinical characteristics and prognosis of patients with and without CCI admitted to intensive care unit (ICU). METHODS: It was a retrospective, observational study at a university hospital ICU. Patients were accepted as CCI if they had prolonged ICU stay (≥14 days) and got ≥1 score for cardiovascular sequential organ failure assessment (SOFA) score and ≥2 score in other parameters on day 14 of ICU admission which was described as persistent organ dysfunction. RESULTS: 131 of 397 (33%) patients met CCI criteria. CCI patients were older (p = 0.003) and frailer (p < 0.001). Their Acute Physiology and Chronic Health Evaluation (APACHE) II and SOFA scores were higher, PaO2/FiO2 ratio was lower (p < 0.001). Requirement of invasive mechanical ventilation (IMV), steroid use, and septic shock on admission were higher in the CCI group (p < 0.001). CCI patients had higher ICU and hospital mortality than other patients (54.2% vs. 19.9% and 55.7% vs. 22.6%, p < 0.001, respectively). Regression analysis revealed that IMV (OR: 8.40, [5.10-13.83], p < 0.001) and PaO2/FiO2 < 150 on admission (OR: 2.25, [1.36-3.71], p = 0.002) were independent predictors for CCI. DISCUSSION: One-third of the COVID-19 patients admitted to the ICU were considered as CCI with significantly higher ICU and hospital mortality.

Genotype distribution of hepatitis C virus in the province of Gaziantep, a 10-year evaluation.

Hepatitis C virus (HCV) can cause both acute and chronic hepatitis infections. Gaziantep is located southeast part of Turkey and has a border with Syria. More than 400,000 Syrian refugees live in Gaziantep. The aim of this study was to evaluate distribution of HCV genotypes among Syrian patients and in people who inject drugs.Serum samples form 1,628 individuals (786 female, 842 male) which were sent to our laboratory for genotyping between January 2013 and December 2022, were analyzed retrospectively. Three different HCV genotyping assays (Qiagen, RTA and Abbott) were used during the 10-year study period.Out of the 1,628 patients, genotype 1 was detected in 51.5%, genotype 3 in 21.4%, genotype 4 in 20%, genotype 5 in 4.6%, genotype 2 in 1.3%. Mixed genotype was found in 20 patients. Of the patients, 1,143 were Turkish patients and among those patients genotype 1 (66.8%) was the most common genotype followed by genotype 3 (29%). Among Syrian patients (n = 477), genotype 4 (64.2%) was predominant genotype followed by genotype 1 and genotype 5. Genotype 3 was detected in 277 (79.6%) prisoners. All of them were male and probably the main source of HCV infection was intravenous drug abuse. While genotypes 1 and 4 were common in females, genotypes 1 and 3 were common in males.In the future genotype 3 may become an increasing problem due to the persons who inject drugs. Less frequent genotypes such as 4 and 5 may become more frequent due to Syrian patients.

Effects of Different Crystalloid Fluids on Renal Tissue in an Experimental Model of Hemorrhagic Shock.

Objective: The type of fluid that should be used in uncontrollable hemorrhages remains an area of research. This study was designed to compare the effects of resuscitation with Ringer's lactate (RL) solution versus a normal saline (NS) solution on hemodynamics, renal tissue histopathology, coagulation, and apoptosis in a rat model of hemorrhagic shock. Methods: The study employed groups designated as the control, hemorrhage, NS, and RL groups. Heart rate, mean arterial pressure, and respiratory rate were monitored. Annexin A5 values were assayed, rotational thromboelastometry analysis was performed, and excised kidney tissue samples were histopathologically analyzed. Results: Blood pressure levels were found to be significantly higher in the control group than those measured in the other groups. While the clotting time (CT) and clot formation time (CFT) in the hemorrhage group were significantly longer than those in the control and RL groups, the CT and CFT measured in the control group were significantly shorter compared to the RL group. The mean Annexin A5 level was in the hemorrhage group, which was significantly higher compared to the other groups. In the renal histopathological evaluation, the scores of proximal tubular injury, distal renal tubular injury, and interstitial renal tubular injury were found to be significantly lower in the control group compared to the other groups. Conclusion: This study demonstrated that NS or RL can be used safely to improve the hemodynamic symptoms resulting from hemorrhagic shock as a means to reduce apoptosis, and to decrease findings in favor of coagulopathy in bedside coagulation tests during the early stages of hemorrhagic shock until the time of starting a blood transfusion.

Analyzing the effects of energy productivity: the case of European Union countries.

The surge in fossil fuel consumption, culminating in global warming and climate change, compels nations to implement protective measures. Consequently, the concepts of "sustainable growth" and the "green economy" have gained prominence in response to heightened environmental consciousness. In light of these imperatives, nations have embarked on the formulation of sustainable and environmentally conscious policies, with the dual objective of safeguarding the environment and fostering economic growth. These factors have collectively contributed to the growing significance of energy policies within European nations, spurring a burgeoning momentum in research areas pertaining to energy efficiency and energy productivity. While extant literature has demonstrated the positive environmental impact of energy productivity, there exists a paucity of research pertaining to its economic implications. Energy productivity, defined as achieving equivalent or greater output with reduced energy consumption, bears the potential to influence economic output, thereby exerting cascading effects on various facets of the economy, including growth and exports. The principal aim of this study is to highlight that the augmentation of energy productivity can yield not only environmental advantages but also economic benefits. To achieve this objective, we conduct econometric analyses on panel data spanning the years 2000 to 2020 across the 27 member states of the European Union. Specifically, we explore the effects of energy productivity on diverse economic parameters, encompassing economic growth, high technology exports, medium and high technology exports, total exports, and trade volume. Employing the Driscoll-Kraay standard errors estimator, our findings evince that energy productivity exerts statistically significant and positive influences on economic growth, medium and high technology exports, total exports, and trade volume.

The effect of well-known burn-related features on machine learning algorithms in burn patients' mortality prediction.

BACKGROUND: Burns is one of the most common traumas worldwide. Severely injured burn patients have an increased risk for mortality and morbidity. This study aimed to evaluate well-known risk factors for burn mortality and comparison of six machine learn-ing (ML) Algorithms' predictive performances. METHODS: The medical records of patients who had burn injuries treated at Izmir Bozyaka Training and Research Hospital's Burn Treatment Center were examined retrospectively. Patients' demographics such as age and gender, total burned surface area (TBSA), Inhalation injury (II), full-thickness burns (FTBSA), and burn types (BT) were recorded and used as input features in ML models. Pa-tients were analyzed under two groups: Survivors and Non-Survivors. Six ML algorithms, including k-Nearest Neighbor, Decision Tree, Random Forest, Support Vector Machine, Multi-Layer Perceptron, and AdaBoost (AB), were used for predicting mortality. Several different input feature combinations were evaluated for each algorithm. RESULTS: The number of eligible patients was 363. All six parameters (TBSA, Gender, FTBSA, II, Age, BT) that were included in ML algorithms showed a significant difference (p<0.001). The results show that AB algorithm using all input features had the best predic-tion performance with an accuracy of 90% and an area under the curve of 92%. CONCLUSION: ML algorithms showed strong predictive performance in burn mortality. The development of an ML algorithm with the right input features could be useful in the clinical practice. Further investigations are needed on this topic.

Does locally applied epidermal growth factor stop anastomotic leak in the colon?

AIM: Anastomosis leakage is one of the most common complications after colorectal surgery. Studies have shown that the incidence of anastomotic leakage is between 0.5-30%. The aim of our study was to investigate the efficacy of local application of of epidermal growth factor (EGF) on colon anastomosis healing. MATERIAL AND METHODS: 28 Wistar rats were randomly divided into 4 groups. Sham group, control group, saline injection group, EGF injection group. Anastomosis line was determined as 3 cm distal to ilealcecal junction. The rats were reoperated on the 7th postoperative day. The colon segment was cut out 3 cm proximal and distal to the anastomotic line.The bursting pressure of each removed colon segment was measured and the segments were fixed with 10% formaldehyde for pathology examination. Anastomosis line was stained with hematoxylin eosin and histopathological evaluation was performed. Evaluation parameters were inflammatory cells, fibroblast, angiogenesis (neovascularization) and collagen amounts. RESULTS: Bursting pressure was higher in the EGF group than in the control group and saline injection group. There was statistically significant difference between EGF and positive control group. (p<0,05) Histopathological examination revealed that the inflammatory cell density was higher in the positive control group than in the other groups. Fibroblast cell density, neovascularization and collagen content were higher in EGF group than the others. However, no statistically significant difference was found between the control group,saline injection group and EGF injection group. CONCLUSION: As result of our study,we think that local application of EGF may have a positive effect on healing of colon anastomosis. KEY WORDS: Colonic Anastomosis, Egf, Experimental, Healing.

Attitudes and current practice in alcohol screening, brief intervention, and referral for treatment among staff working in urgent and emergency settings: An open, cross-sectional international survey.

BACKGROUND: The aim of the study was to ascertain the views and experiences of those working in urgent and emergency care (UEC) settings towards screening, brief intervention, and referral to treatment (SBIRT) for alcohol, to inform future practice. OBJECTIVES: To explore i) views towards health promotion, ii) views towards and practice of SBIRT, iii) facilitators and barriers to delivering SBIRT, iv) training needs to support future SBIRT practice, and v) comparisons in views and attitudes between demographic characteristics, geographical regions, setting and occupational groups. METHODS: This was an open cross-sectional international survey, using an online self-administered questionnaire with closed and open-ended responses. Participants were ≥18 years of age, from any occupational group, working in urgent and emergency care (UEC) settings in any country or region. RESULTS: There were 362 respondents (aged 21-65 years, 87.8% shift workers) from 7 occupational groups including physicians (48.6%), nurses (22.4%) and advanced clinical practitioners (18.5%). Most believed that health promotion is part of their role, and that SBIRT for alcohol prevention is needed and appropriate in UEC settings. SBIRT was seen to be acceptable to patients. 66% currently provide brief alcohol advice, but fewer screen for alcohol problems or make alcohol-related referrals. The most common barriers were high workload and lack of funding for prevention, lack of knowledge and training on SBIRT, lack of access to high-quality resources, lack of timely referral pathways, and concerns about patient resistance to advice. Some views and attitudes varied according to demographic characteristics, occupation, setting or region. CONCLUSIONS: UEC workers are willing to engage in SBIRT for alcohol prevention but there are challenges to implementation in UEC environments and concerns about workload impacts on already-burdened staff, particularly in the context of global workforce shortages. UEC workers advocate for clear guidelines and policies, increased staff capacity and/or dedicated health promotion teams onsite, SBIRT education/training/resources, appropriate physical spaces for SBIRT conversations and improved alcohol referral pathways to better funded services. Implementation of SBIRT could contribute to improving population health and reducing service demand, but it requires significant and sustained commitment of time and resources for prevention across healthcare organisations.

Investigation of the effect of Ramadan fasting on serum levels of melatonin, cortisol, and serotonin: the case of Turkey.

INTRODUCTION: The aim of this study is to examine the effects of Ramadan fasting on melatonin, cortisol, and serotonin levels. METHODS: In this study, the blood of 19 healthy male individuals between the ages of 26 and 51, registered in Agri (Turkey) Family Health Center and fasting during Ramadan, was studied. The study was carried out in 2021-2022. The SPSS-22 package program was used in the analysis of the data. Wilcoxon analysis was used in the study. RESULTS: It was determined that the pre-test-post-test melatonin and cortisol levels of the individuals were not statistically significant (p>0.05). It was determined that the pre-test-post-test serotonin difference of the individuals was statistically significant (p<0.05). CONCLUSION: It has been determined that Ramadan fasting increases the serotonin level of individuals but does not change the levels of melatonin and cortisol. It was determined that the level of happiness of individuals increased after Ramadan fasting. Longitudinal studies on the effects of Ramadan fasting are recommended.

Effect of Awake Prone Positioning on ROX Index in Critically-ill Patients With Respiratory Failure due to COVID-19.

COVID-19 pneumonia causes acute respiratory distress syndrome (ARDS). Prone positioning (PP) is beneficial to pulmonary physiology and improves oxygenation in patients with ARDS. We aimed to investigate the effect of the PP on oxygenation, respiratory rate (RR) and ROX index in non-intubated patients with COVID-19 associated respiratory failure and to determine whether ROX index predicts intubation. Awake critically-ill patients with confirmed diagnosis of COVID-19 who underwent PP were enrolled in the retrospective, single-center study. Oxygenation parameters were recorded 1 h before PP, during PP and 1 h after return to supine position (after PP). Intubation was defined as the endpoint. Seventy-one patients with a median age of 64 [55-73] years were enrolled in the study. PaO2/FiO2 and SpO2/FiO2 improved during PP, this improvement did not persist after PP. RR improved during and after PP in both intubated and non-intubated patients (for all P < .001). ROX index improved only in non-intubated patients (P < .001) but not in intubated patients (P = .07). Area under the curve (AUC) of ROX index for intubation before PP, during PP and after PP were 0.74 [0.61-0.88] (P = .002), 0.76 [0.62-0.91] (P = .001), and 0.76 [0.64-0.89] (P = .001), respectively. ROX index >6.83 before PP had a negative predictive value (NPV) of 0.85; ROX index >8.28 during PP had a NPV of 0.88 and ROX index >7.48 after PP had a NPV of 0.85. In logistic regression adjusted for APACHE II score, ROX index ≤6.83 before PP had an odds ratio (OR) 4.47 [1.39-14.38], ROX index ≤8.28 during PP had an OR 7.96 [2.29-27.64] and ROX index ≤7.48 had an OR 3.98 [1.25-12.61] for prediction of intubation. In conclusion, awake PP improves oxygenation and decreases RR. ROX index improved only in non- intubated patients and a higher ROX index predicts lower risk of progressing to mechanical ventilation with intubation.

Changes in cerebral oxygen saturation with the Trendelenburg position and increased intraabdominal pressure in laparocopic rectal surgery.

Objectives: Position changes and increased intra-abdominal pressure in laparoscopic interventions lead to some physiopathological changes. There is no definite information in the literature regarding cerebral oxygen saturation in patients undergoing colorectal surgery. Our aim was to investigate whether there is oxygen saturation change in the brain tissue in pneumoperitoneum and the Trendelenburg position during laparoscopic rectal surgery. Material and Methods: Cerebral oxygen saturation was measured in 35 patients who underwent laparoscopic rectal surgery in the Trendelenburg position. Measurements were made under general anesthesia in the pneumoperitoneum and the Trendelenburg position. Results: The values that are statistically affected by the position are systolic blood pressure, mean arterial blood pressure and cerebral oxygen saturation. The Trendelenburg position does not disturb the cerebral oxygen saturation and it causes an increase in saturation. After pneumoperitoneum occurred, changes in systolic blood pressure, mean arterial blood pressure and brain oxygen saturation were detected. Cerebral oxygen saturation increases with the formation of pneumoperitoneum. Conclusion: The Trendelenburg position and increased intraabdominal pressure during laparoscopic rectal surgery do not impair brain oxygen saturation.

The effect of dobutamine treatment on salvage of digital replantation and revascularization.

PURPOSE: One of the most common causes of a failure after replantation and revascularization surgeries is 'no reflow' from proximal artery that occurs, especially following crush and avulsion injuries. In this study, we aimed to evaluate the effect of dobutamine treatment on salvage of replanted and revascularized digits. METHODS: The patients with no reflow phenomenon detected in the salvage operations of replanted/revascularized digits between the years 2017 and 2020 were included in the study. Dobutamine treatment was infused at a rate of 4 µg·kg-1·min-1 intraoperatively and of 2 µg·kg-1 min-1 postoperatively. Demographic data (age, sex), digit survival rate, ischemia time, and level of injury were retrospectively analysed. Pre-infusion, intraoperative and postoperative values of cardiac index (CI), mean arterial pressure (MAP), and heart rate (HR) were recorded. RESULTS: The phenomenon of 'no reflow' was encountered in 35 digits of 22 patients who underwent salvage surgery due to vascular compromise. The survival rate in the revascularization group was 75%, while it was 42.1% in the replanted digits. Metaphysis level of proximal phalanx was the most common localization for 'no reflow' phenomenon. The least values of CI, MAP and HR to obtain sufficient perfusion in salvaged digits were as follows: 4.2 l.min-1.m-2, 76 mm Hg, and 83 beat·min-1, respectively. CONCLUSIONS: It was demonstrated that dobutamine infusion at a rate of 4 µg·kg-1·min-1 intraoperatively and at 2 µg·kg-1·min-1 postoperatively has favorable effects on the vascular compromise derived from no reflow of proximal artery.

Could SCUBE-1 be a marker for subclinical atherosclerosis other than carotid artery intima-media thickness in patients with psoriasis?

BACKGROUND: Psoriasis is a chronic inflammatory disease that is associated with many inflammatory conditions such as atherosclerosis, hypertension, among others. SCUBE-1 is a protein that plays a role in angiogenesis. OBJECTIVES: The present study aimed to investigate whether SCUBE-1 could indicate subclinical atherosclerosis in psoriatic patients, and to compare SCUBE-1 levels, measurement of carotid artery intima-media thickness (CIMT), and metabolic parameters in psoriasis patients and healthy controls. METHODS: Forty-six patients with psoriasis and 43 healthy controls were included. The severity of the disease was assessed with Psoriasis Area Severity Index (PASI) in the patient group. Levels of SCUBE-1, CRP, lipids, and fasting glucose were measured with the enzyme-linked immunosorbent assay (ELISA) method, and CIMT measurements were performed by the same cardiologist. RESULTS: SCUBE-1 levels and CIMT values were significantly higher in the patient group (for both p < 0.05). Moreover, systolic blood pressure, CRP levels, and waist circumference were higher in the patient group even though both groups had similar BMIs (for all p < 0.05). A positive correlation was found between SCUBE-1 and CIMT values among patients, and multiple regression analyses revealed that SCUBE-1 and CIMT are significantly associated with psoriasis as well. STUDY LIMITATIONS: A low number of participants and not including any other inflammatory marker related to angiogenesis or atherosclerosis such as VEGF, adiponectin are the main limitations of the present study. CONCLUSION: Despite the severity of the disease, even in psoriasis patients with mild disease the SCUBE-1 level may be an indicator of subclinical atherosclerosis and indicate the risk of cardiovascular disease in the future.

The Role of EREG, PTPN1, and SERPINB7 Genes in the Pathogenesis of Psoriasis: May SERPINB7 Be Protective and a Marker of Severity for Psoriasis?

INTRODUCTION: Psoriasis is a chronic inflammatory dermatological disease with complex pathogenesis in which many immune system cells, including keratinocytes, play a role. Many genes regulate the proliferation of keratinocytes and other immune cells that have essential roles in the pathogenesis of psoriasis. The expressions of EREG, PTPN1, and SERPINB7 genes were shown as upregulated in psoriatic skins in a few studies previously. OBJECTIVES: We aimed to evaluate the expressions of these genes in psoriatic lesional skin and compared them with non-lesional adjacent skin of the same patients and normal skin of healthy controls. RESULTS: Our results revealed that the expressions of EREG and PTPN1 genes were upregulated, whereas the SERPINB7 gene expression was down regulated in the psoriatic skin of the patients than normal skin of controls. Moreover, the expression level of the SERPINB7 gene was also negatively correlated with the severity of the disease among patients. CONCLUSIONS: According to our results, overexpression of EREG and PTPN1 genes, and decreased expression of SERPINB7 gene may lead to the development of psoriasis.

Determining the correlation between old age adaptation, aging in place and depression in older adults: A descriptive correlational study.

We conducted this study to determine the correlation between old age adaptation, aging in place, and depression in older adults. We carried out the descriptive correlational study with older adults (n:319) Agri Provincial Directorate of Health between October 2021 and April 2022. "SPSS 25 and Amos 23 programs" were used in the analysis of the data. Python 3.11.1, Microsoft Power BI programs were used for machine learning and graphical visualizations. In the study, it was determined that the model for the relationship between aging at a place level, adaptation difficulty in older adults level, and geriatric depression level was significant (F(2,316) = 37.002, p = 0.001). The aging in place level and the adaptation difficulty in older adults level explain 18.5% of the total variance of the level of geriatric depression. In the regression model, it was determined that the increase in the level of aging in place (t = -6.081, p < 0.001) and the decrease in the level of adaptation difficulty in older adults (t = 4.107, p < 0.001) of the participants caused a statistical decrease in the level of "Geriatric Depression." It has been determined that adaptation difficulty in older adults has a moderator role in the relationship between geriatric depression level and aging in place level. In our data set, while the estimate of the presence of depression was 40 % with logistic regression analysis, it was 97 % with Random Forest. The study determined that as the level of aging in -place increased and the adaptation difficulty in older adults decreased, and depression decreased.