First detection of Ehrlichia chaffeensis, Ehrlichia canis, and Anaplasma ovis in Rhipicephalus bursa ticks collected from sheep, Turkey.

Anaplasmosis and ehrlichiosis are important tick-borne rickettsial diseases of medical and veterinary importance that cause economic losses in livestock. In this study, the prevalence of Anaplasma ovis, Ehrlichia canis and Ehrlichia chaffeensis was investigated in ticks collected from sheep in various farms in Van province, which is located in the Eastern Anatolian Region of Turkey. The ticks used in this study were collected by random sampling in 26 family farm business in 13 districts of Van province. A total of 688 ticks were collected from 88 sheep and 88 tick pools were created. All ticks identified morphologically as Rhipicephalus bursa. Phylogenetic analysis of Chaperonin and 16S rRNA gene sequences confirmed A. ovis, E. canis and E. chaffeensis in this study. Of the 88 tick pools tested, 28.41% (25/88) were positive for at least one pathogen. Anaplasma DNA was detected in five of the 88 pools (5.68%), E. canis DNA was detected in 19 of the 88 pools (21.59%), and E. chaffeensis DNA was detected in one of the 88 pools (1.14%) of R. bursa ticks. To our knowledge, this is the first report describing the presence of A. ovis, E. canis, and E. chaffeensis in R. bursa ticks collected from sheep in Turkey. Further studies are needed to investigate other co-infections in sheep in Turkey.

The effect of interleukin-20 on periodontal tissue destruction in individuals with periodontitis.

BACKGROUND AND OBJECTIVE: Periodontitis is an inflammatory disease that destroys periodontal tissues. Interleukin-20 (IL-20), on the other hand, is known as a potent angiogenic, chemotactic, and pro-inflammatory cytokine associated with various chronic inflammatory disorders. IL-20 has a significant role in the regulation of osteoclastogenesis and osteoblastogenesis. This study aimed to evaluate the effect of IL-20 on periodontal destruction. METHODS: In this study, a total of 60 participants were included, 30 of whom were systemically and periodontally healthy (control group), and 30 were systemically healthy but had periodontitis (periodontitis group). Gingival crevicular fluid (GCF) and serum samples were collected from the participants for biochemical analysis. Enzyme-linked immunosorbent assay was used to determine the levels of IL-20, tumor necrosis factor (TNF)-α, IL1ß/IL-10, RANKL/osteoprotegerin (OPG), and matrix metalloproteinase-8 (MMP8). For statistical analysis, the independent t-test, Pearson correlation coefficients, and the Chi-square test were used. RESULTS: GCF IL-20, RANKL, RANKL/OPG, serum IL-20, RANKL, RANKL/OPG, MMP-8, TNF-α, IL-1B, and IL-1ß/IL-10 values were found to be statistically significantly higher in the periodontitis group than in the control group. GCF OPG and serum IL-10 values were found to be statistically significantly higher in the control group than in the periodontitis group. No statistically significant difference was observed between the groups in serum OPG values. A statistically significantly positive correlation was observed between serum IL-20 value and serum RANKL, RANKL/OPG, MMP-8, TNF-α, IL-1ß values, and periodontal clinical parameters. The ROC curves showed: AUC = 0.788 for GCF IL-20, and AUC = 1.000 for serum IL-20. CONCLUSION: According to the results of the study, IL-20 was found to be associated with periodontitis. The role of IL-20 in periodontal pathogenesis is related to osteoclastogenesis and collagen degradation. It is conceivable that IL-20 may increase bone destruction by both affecting the RANKL/OPG ratio and proinflammatory cytokines.

An investigation on protection properties of Tantalum (V) oxide reinforced glass screens on unexposed breast tissue for mammography examinations.

INTRODUCTION: The utilization of radiation shielding material positioned between the both breasts are crucial for the reduction of glandular dose and the safeguarding of the contralateral breast during mammographic procedures. This study proposes an alternative substance for shielding the contralateral breast from radiation exposure during mammography screening. METHODS: In this study, we present an analysis of the shielding effectiveness of transparent glass that has been doped with Tantalum (V) oxide encoded as BTZT6. The evaluation of this shielding material was conducted using the MCNPX code, specifically for the ipsilateral and contralateral breasts. The design of the left and right breast phantoms involved the creation of three-layer heterogeneous breast phantoms, consisting of varying proportions of glandular tissue (25%, 50%, and 75%). The design of BTZT6 and lead-acrylic shielding screens is implemented using the MCNPX code. The comparative analysis of dose outcomes is conducted to assess the protective efficacy of BTZT6 and lead-acrylic shielding screens. RESULTS: The utilization of BTZT6 shielding material resulted in a reduction in both breast dose and skin dose exposure when compared to the lead-acrylic shield. CONCLUSION: Based on the findings acquired, the utilization of BTZT6 shielding material screens during mammography procedures involving X-rays with energy levels ranging from 26 to 30 keV is associated with a decrease in radiation dose. IMPLICATIONS FOR PRACTICE: It can be inferred that the utilization of BTZT6 demonstrates potential efficacy in mitigating excessive radiation exposure to the breasts and facilitating the quantification of glandular doses in mammography procedures.

The effect of postoperative hepatic fibrosis factors on morbidity in mitral valve replacement surgery: A single center ten years' experience.

Background: Previous studies have shown that hepatic fibrosis indices and rates can be used to predict cardiovascular mortality and morbidity. Our aim with this study was to investigate the effect of aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio and fibrosis-4 (FIB-4) index calculated with ALT, AST, and platelet biomarkers, which are simple, fast, and relatively inexpensive and were used in previous studies to predict cardiovascular disease prognosis, on the prediction of postoperative morbidity and early mortality after mitral valve replacement (MVR) surgery. Methods: By scanning the hospital electronic health record system, 116 patients who underwent isolated MVR or MVR + tricuspid valve intervention were identified from 178 patients who underwent MVR with the standard sternotomy procedure between 2011 and 2021. The study was completed with 81 of these patients. Patients were divided into AST/ALT <2 (Group 1) and >2 (Group 2). In addition, the same patients were divided into FIB-4 index <3.25 (Group 3) and >3.25 (Group 4), and a total of four groups were formed. Results: The mean age of Group 2 was significantly higher than Group 1 (P = 0.049). In addition, the mean age of Group 4 was significantly higher than Group 3 (P = 0.003). Postoperative complications did not differ between Groups 1 and 2 (P > 0.05). While noninvasive mechanincal ventilation (NIMV) requirements did not differ between Groups 3 and 4 (P > 0.05), MV duration and intensive care unit stay were significantly longer in Group 4 (P < 0.05). Conclusion: The AST/ALT ratio, which has been shown to be a predictor of cardiovascular mortality in various studies, was not useful in predicting mortality and morbidity in our study. However, a high FIB-4 index, another hepatic fibrosis index, was found to be associated with increased perioperative bleeding, duration of mechanical ventilation, and cardiac intensive care unit stay, which are important criteria in the prediction of morbidity in cardiovascular surgery.

The effect of alpha-lipoic acid on oxidative parameters, SCUBE-1 and SCUBE-2 in hepatic ischemia-reperfusion injury in cholestatic rats.

OBJECTIVE: The aim of the study was to evaluate the protective effects of alpha-lipoic acid (ALA) on the liver, oxidative parameters, and signal peptide-CUB-epidermal growth factor-like domain-containing proteins 1 and 2 (SCUBE-1 and -2) in an experimental cholestatic hepatic ischemia-reperfusion (IR) model. MATERIALS AND METHODS: Twenty-four female rats were included in the study and divided into four groups of six rats each. Group 1 was the control group, in which only laparotomy was performed; Group 2 underwent laparotomy and received alpha-lipoic acid (ALA) on a daily basis; bile duct ligation was performed in Group 3; bile duct ligation was performed, and ALA was administered to Group 4. All rats underwent relaparotomy on the seventh day, followed by 30 minutes of hepatic ischemia and 60 minutes of reperfusion in Groups 3 and 4. Liver tissue and blood samples were taken for histopathological and biochemical examinations. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TBIL), direct bilirubin (DBIL), albumin, ischemia modified albumin (IMA), SCUBE-1, SCUBE-2, total antioxidant status (TAS) and total oxidant status (TOS) levels were also examined. RESULTS: The SCUBE-1 and SCUBE-2 values in Group 4 were lower than in Group 3, but no significant difference was observed between all the groups. The AST, TBIL, and DBIL levels were significantly higher in Groups 3 and 4 than in Groups 1 and 2 (p<0.0001). Although TOS was the highest in Group 3, the measurements were similar across the groups (p=0.464). IMA and TAS were similar between Groups 3 and 4 but significantly higher in these groups than in Groups 1 and 2 (p=0.001). The hepatic injury observed in Groups 3 and 4 was significantly higher than that observed in Groups 1 and 2 (p<0.0001). In the histopathological examination, neutrophilic infiltration and bile duct proliferation were less commonly detected in the portal areas in Group 4 than in Group 3, and necrotic foci were not observed due to the administration of ALA. CONCLUSIONS: The promising effects of ALA, known for its powerful antioxidant properties, on the IR injury of the liver can allow it to enter clinical practice in the future.

A new marker of coronary collateral flow in patients presenting with acute myocardial infarction.

OBJECTIVE: Multimerin-2 is an adhesion substrate between pericytes and basal membranes during angiogenesis. The present study aimed to assess the relationship between serum Multimerin-2 and coronary collateral flow grade. PATIENTS AND METHODS: Between April 2022 and August 2022, 88 patients with subacute ST-elevation myocardial infarction were included in this study. The main inclusion criteria were patients who present 12-48 hours after symptom onset and aged between 18 and 90 years. The patients were divided into two groups according to the Rentrop classification: poor collateral group (Rentrop grade 0-1) and good collateral group (Rentrop grade 2-3). Biochemical and hematological parameters were measured before coronary angiography. RESULTS: Serum Multimerin-2 levels were found to be significantly different between the two groups, and levels were higher in the Rentrop 2-3 group than in the Rentrop 0-1 group (3,527.9 ± 1,194.2 pg/ml and 946.7 ± 249.1 pg/ml; p < 0.00). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.918 (p = 0.001), and the best cut-off value of 849 pg/ml had a sensitivity of 90.1% and a specificity of 84.1% for predicting Rentrop grade 2-3 coronary flow. The number of patients with low left ventricular ejection fraction (LVEF) by echocardiography at 30 days was significantly higher in patients with poor collateralization. CONCLUSIONS: Multimerin-2 levels were found to be higher in patients with Rentrop grade 2-3 coronary flow than Rentrop grade 0-1 coronary flow after myocardial infarction. We detected a potential relationship between MMR-2 and good coronary collateral formation.

Dexmedetomidine alleviates vacuolization and necrosis in tubular epithelial cells induced by aortic cross-clamping.

OBJECTIVE: Acute kidney injury (AKI) is one of the main causes of mortality in patients undergoing emergency surgery due to an abdominal aortic aneurysm. This study aimed to determine the potential nephroprotective characteristics of dexmedetomidine (DMD) for the establishment of a standard therapeutic method for AKI. MATERIALS AND METHODS: Thirty Spraque Dawley rats were allocated to 4 groups: control, sham, ischemia-reperfusion, and ischemia/reperfusion (I/R)+dexmedatomidine. RESULTS: Necrotic tubules, degenerative Bowman's capsule and vascular congestion were observed in the I/R group. In addition, there was an increase in tissue malondialdehyde (MDA), interleukin (IL)-1 and IL-6 levels in tubular epithelial cells. In contrast, we observed decreased tubular necrosis, IL-1, IL-6 and MDA levels in the DMD treatment group. CONCLUSIONS: DMD has a nephroprotective effect against acute kidney injury resulting from I/R, which is related to aortic occlusion used in the treatment of ruptured abdominal aortic aneurysms.

Neuroprotective effects of Geranium Robertianum L. Aqueous extract on the cellular Parkinson's disease model.

OBJECTIVE: In recent years, botanical medicines alone or in conjunction with existing therapies have attracted considerable popularity as an alternative treatment for Parkinson's Disease (PD). For instance, Geranium robertianum L. (Geraniaceae family) has been used in folk medicine for its antioxidant and anti-inflammatory properties. However, its neuroprotective potential has not been well demonstrated. MATERIALS AND METHODS: Herein and for the first time, we have investigated the in vitro neuroprotective effects of leaf extract of G. Robertianum over a wide dose range (0-200 µg/mL) on the PD model using retinoic acid (RA)-differentiated SHSY-5Y cells and 1-methyl-4-phenylpyridinium (MPP+)-induced neurotoxicity. The neuroprotective effects were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase (LDH) release assays. The antioxidant activity of the extract was measured by total antioxidant status (TAS) and total oxidant status (TOS). The effect of leaf aqueous extracts on acetylcholinesterase (AChE) activity was also determined. Finally, cell death mechanisms were analyzed by flow cytometry. RESULTS: Our results showed that G. Robertianum leaf extract ameliorated cytotoxicity and oxidative damage by MPP+. Moreover, G. Robertianum extract exhibited a protective activity against MPP+ induced apoptosis. CONCLUSIONS: The current findings could lead to a promising new candidate for a possible cure of Parkinson's disease through neuroprotective mechanisms with respect to antioxidant and apoptosis inhibitory properties of G. Robertianum water extracts.

Radioprotective effects of dexmedetomidine on X-ray-induced testicular damage.

OBJECTIVE: Approximately 70% of cancer patients require radiotherapy. However, despite its effectiveness in the treatment of cancer, radiotherapy can also affect and damage surrounding healthy tissues in addition to tumorous tissues. Since testicular tissues are highly radiosensitive, radiotherapy can cause impairments in spermatogenesis leading to infertility. The purpose of this study was to examine the potential radio-protective effect of dexmedetomidine (Dex), an α2-adrenoceptor agonist, on oxidative stress and apoptosis in testicular tissues caused by x-irradiation in rats. MATERIALS AND METHODS: Thirty male Sprague-Dawley rats were allocated into three groups of ten (n=10): control, irradiation (IR), and IR + Dex groups. The IR group was exposed to a single dose of 2 Gy IR. The IR+Dex group was given a single intraperitoneal (i.p.) dose of 100 µg/kg Dex before IR. The control group received a single dose of saline solution i.p. Testicular tissues removed 24 hours after IR were subjected to histochemical, biochemical, and immunohistochemical analysis. RESULTS: IR resulted in increased malondialdehyde (MDA) activity and significant changes in testis tissues. However, the application of Dex elevated glutathione levels by preventing MDA formation. In addition, Dex decreased tubular epithelial apoptosis via elevated Cleaved Caspase-3 expressions. CONCLUSIONS: Dex exhibited a radio-protective effect against lipid peroxidation and apoptosis caused by IR.

Ultrasensitive detection of circulating LINE-1 ORF1p as a specific multi-cancer biomarker.

Improved biomarkers are needed for early cancer detection, risk stratification, treatment selection, and monitoring treatment response. While proteins can be useful blood-based biomarkers, many have limited sensitivity or specificity for these applications. Long INterspersed Element-1 (LINE-1, L1) open reading frame 1 protein (ORF1p) is a transposable element protein overexpressed in carcinomas and high-risk precursors during carcinogenesis with negligible detectable expression in corresponding normal tissues, suggesting ORF1p could be a highly specific cancer biomarker. To explore the potential of ORF1p as a blood-based biomarker, we engineered ultrasensitive digital immunoassays that detect mid-attomolar (10-17 M) ORF1p concentrations in patient plasma samples across multiple cancers with high specificity. Plasma ORF1p shows promise for early detection of ovarian cancer, improves diagnostic performance in a multi-analyte panel, and provides early therapeutic response monitoring in gastric and esophageal cancers. Together, these observations nominate ORF1p as a multi-cancer biomarker with potential utility for disease detection and monitoring.

Use of hyperbaric oxygen therapy of purpura fulminans in an extremely low birth weight preterm: A case report.

Purpura fulminans (PF) is a rare and fatal complication of septic shock or diffuse intravascular coagulation (DIC) resulting in skin and soft tissue necrosis. PF can be caused by congenital or acquired protein C (PC) or protein S (PS) deficiency. The most common cause of PF in a neonate is sepsis. In our extremely low birth weight preterm case, due to PF that started in the right-hand fingers, examination was made and protein S deficiency was detected as well as MTHFR (A1298C) and Factor V Leiden (R506Q) homozygous mutations. While being unresponsive to fresh frozen plasma (FFP) and unfractionated heparin (UFH) therapy, we want to highlight the curative treatment with hyperbaric oxygen (HBOT), which has not previously been used in extremely low birth weight preterm infants for this purpose.

Intermittent systemic exposure to lipopolysaccharide-induced inflammation disrupts hippocampal long-term potentiation and impairs cognition in aging male mice.

Age-related cognitive decline, a common component of the brain aging process, is associated with significant impairment in daily functioning and quality of life among geriatric adults. While the complexity of mechanisms underlying cognitive aging are still being elucidated, microbial exposure and the multifactorial inflammatory cascades associated with systemic infections are emerging as potential drivers of neurological senescence. The negative cognitive and neurobiological consequences of a single pathogen-associated inflammatory experience, such as that modeled through treatment with lipopolysaccharide (LPS), are well documented. Yet, the brain aging impacts of repeated, intermittent inflammatory challenges are less well studied. To extend the emerging literature assessing the impact of infection burden on cognitive function among normally aging mice, here, we repeatedly exposed adult mice to intermittent LPS challenges during the aging period. Male 10-month-old C57BL6 mice were systemically administered escalating doses of LPS once every two weeks for 2.5 months. We evaluated cognitive consequences using the non-spatial step-through inhibitory avoidance task, and both spatial working and reference memory versions of the Morris water maze. We also probed several potential mechanisms, including cortical and hippocampal cytokine/chemokine gene expression, as well as hippocampal neuronal function via extracellular field potential recordings. Though there was limited evidence for an ongoing inflammatory state in cortex and hippocampus, we observed impaired learning and memory and a disruption of hippocampal long-term potentiation. These data suggest that a history of intermittent exposure to LPS-induced inflammation is associated with subtle but significantly impaired cognition among normally aging mice. The broader impact of these findings may have important implications for standard of care involving infections in aging individuals or populations at-risk for dementia.

Therapeutic and Nutraceutical Effects of Polyphenolics from Natural Sources.

The prevalence of cardiovascular disease, oxidative stress-related complications, and chronic age-related illnesses is gradually increasing worldwide. Several causes include the ineffectiveness of medicinal treatment therapies, their toxicity, their inability to provide radical solutions in some diseases, and the necessity of multiple drug therapy in certain chronic diseases. It is therefore necessary for alternative treatment methods to be sought. In this review, polyphenols were identified and classified according to their chemical structure, and the sources of these polyphenol molecules are indicated. The cardioprotective, ROS scavenging, anti-aging, anticancer properties of polyphenolic compounds have been demonstrated by the results of many studies, and these natural antioxidant molecules are potential alternative therapeutic agents.

A novel combined index of D-dimer, fibrinogen, albumin, and platelet (FDAPR) as mortality predictor of COVID-19.

Background: In coronavirus disease 2019 (COVID-19) caused by SARSCoV2 viruses, coagulation abnormalities are strongly correlated between disease severity and mortality risk. Aims: The aim was to search for new indices to determine mortality risk. Fibrinogen times D-dimer to albumin times platelet ratio calculated with the formula (FDAPR index: ((Fibrinogen × D-dimer)/(Albumin × Platelet)) investigated as a mortality marker in COVID-19 patients. The hospitalization data of 1124 patients were analyzed from the electronic archive system. Hemogram, coagulation, and inflammatory markers were investigated in the study group. Materials and Methods: All statistical analyses like the student t-test, Mann-Whitney U, Kaplan-Meier, and Cox hazard ratio, were performed with the SPSS 22.0 program. Results: Prothrombin time was prolonged significantly in patients (P < 0.05) compared to healthy subjects (n = 30). D-dimer and fibrinogen were high, and albumin and platelet counts were low in COVID-19 patients (all, P < 0.001). When the data of 224 non-survivors and 900 survived patients were compared, D-dimer and fibrinogen were higher, and albumin and platelet lower (all, P < 0.001) compared to mild and severe patients. At the cut-off value of 0.49, the FDAPR index was performed with 89.1% sensitivity and 88.6% specificity. FDAPR index had the highest mortality predictive power (P < 0.01; HR = 5.366; 95% CI; 1.729-16.654). Conclusions: This study revealed that the FDAPR index could be used as a mortality marker of COVID-19 disease.

Comparison of C-MAC vs. McGrath video laryngoscopes on glottic exposure and endotracheal intubation success with stylet usage in obese patients.

OBJECTIVE: Cases of obesity are rising in parallel with the number of obese patients scheduled for anesthesia in which difficult airway is encountered. Video laryngoscopes (VL) have emerged as a popular device for the management of patients with difficult airway. The present study compares the success rate of intubation in obese patients using stylet in the ramped position using either a McGrath or C-MAC VLs. PATIENTS AND METHODS: Class II/III obese patients who were intubated with either McGrath (Group M, n=50) or C-MAC (Group C, n=50) laryngoscopes were assessed for the presence of difficult airway using the Difficult Airway Assessment tool, the Airway Difficulty Score and the Total Airway Score. The intubation attempts were made after the best glottic view, direct and indirect Cormack-Lehane (CL) score, and intubation time were recorded. In the event of failure, a further intubation attempt was made using a styled, and the intubation time was again recorded. If the intubation failed again, a third attempt was made using a C-MAC D-Blade. The Intubation Difficulty Scale score was recorded after the intubation. RESULTS: There was no statistically significant difference between groups in terms of demographic data, the number of patients with decreased CL score, the number of attempts required for intubation, or the first and second intubation time. The ADS Score, TAS Score, CL Score DL, and CL Score IN were found to be important risk factors for a second intubation requirement, and the cut-off value was found to be 8.50 for the ADS Score and 4.50 for the TAS Score in these patients. In the 38 patients who required a second intubation attempt, the procedure was successful in all, but one patient required a third attempt of intubation with C-MAC D-blade. CONCLUSIONS: Both McGrath and C-MAC were effective and comparable for best glottic view with no failed intubation. It was concluded that regardless of the type of video laryngoscope used, the use of a stylet in the first intubation attempt increases the success of intubation.

Wide QRS complex tachycardia due to typical atrial flutter with accessory pathway conduction.

A 62-year-old male patient was admitted with regular wide QRS complex tachycardia. After ajmaline administration, the heart rate slowed down disclosing atrial flutter with variable QRS morphologies. Electrocardiography after conversion to sinus rhythm showed narrow QRS complexes. Decremental atrial stimulation during electrophysiological study caused progressive pre-excitation. Spontaneously, typical atrial flutter occurred with pre-excited QRS complexes. Both accessory pathway and atrial flutter were ablated in the same session.

Assessment of quality of life, anxiety, depression, and sleep quality in women with fibromyalgia and their spouses.

OBJECTIVE: Fibromyalgia syndrome (FMS) is a chronic disease that is more common in adult women and is characterized by widespread pain in the body, especially in the musculoskeletal system. Fatigue, sleep disturbance, anxiety disorder, and depression can be observed in this syndrome alongside pain. The aim of our study was to investigate the effect of FMS on the quality of life, psychological condition, and sleep quality of affected female patients and their spouses compared to women without FMS and their spouses. PATIENTS AND METHODS: Thirty female patients diagnosed with fibromyalgia and their spouses and 38 healthy women and their spouses similar in age to these patients voluntarily participated in our study (136 participants total). The diagnosis of the patients was made according to the American College of Rheumatology. Turkish versions of the Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index (PSQI) questionnaires with validity and reliability were applied to all participants. The statistical analyses were carried out using SPSS 24.0 for Windows (SPSS Inc., Chicago, IL, US). Differences with p-values of ≤0.05 were statistically significant, and all results are expressed with a 95% confidence interval. RESULTS: A total of 136 people, including women with FMS (n=30), spouses of FMS women (n=30), non-FMS control women (n=38), and spouses of the control women (n=38), were included in the study. The patient and control groups were similar in age and gender. However, participants in the study group had higher mean Body Mass Indexes compared to the controls. Quality of life and its sub-scales (except SF-36/Social function parameter), depression, anxiety status, and sleep quality were significantly different between the patients and controls. Additionally, quality of life and its sub-scales (except SF-36/Social function parameter), depression, and anxiety status were significantly different between the spouses of the patients and controls. There were no significant differences between the groups regarding the mean SF-36/SF (p=0.995 for both). Additionally, there was no significant difference between the spouse of the patient and control regarding the mean PSQI values (p=0126). CONCLUSIONS: We believe that new and more comprehensive studies are necessary regarding the spouses of women with FMS in depression, anxiety, sleep quality disorders that we frequently see in women with FMS, and other psychosocial conditions that we have not mentioned here. In conclusion, women with FMS and their spouses.

Position statement on the role of nurses in therapeutic patient education in atopic dermatitis.

In chronic skin diseases such as atopic dermatitis (AD), therapeutic failure due to poor patient adherence to treatment is commonly reported. Therapeutic patient education (TPE) is an approach to improve self-management and adherence. Several studies demonstrated that TPE programmes have positive effects on disease management resulting in decreased disease severity and improved quality of life in AD patients. Various healthcare professionals (dermatologists, nurses, psychologists, dieticians) have been involved. TPE performed by trained dermatology nurses are highly efficient and improve various health-related outcomes. The aim of this position paper is to analyse the aims, modalities and efficacy of TPE in AD, to identify specific roles of dermatology nurses, to assess qualification requirements, and to propose practical recommendations. Potential activities of nurses in ongoing and future TPE programmes for AD patients will be discussed.

Diagnosis and treatment of cardiac amyloidosis: position statement of the German Cardiac Society (DGK).

Systemic forms of amyloidosis affecting the heart are mostly light-chain (AL) and transthyretin (ATTR) amyloidoses. The latter is caused by deposition of misfolded transthyretin, either in wild-type (ATTRwt) or mutant (ATTRv) conformation. For diagnostics, specific serum biomarkers and modern non-invasive imaging techniques, such as cardiovascular magnetic resonance imaging (CMR) and scintigraphic methods, are available today. These imaging techniques do not only complement conventional echocardiography, but also allow for accurate assessment of the extent of cardiac involvement, in addition to diagnosing cardiac amyloidosis. Endomyocardial biopsy still plays a major role in the histopathological diagnosis and subtyping of cardiac amyloidosis. The main objective of the diagnostic algorithm outlined in this position statement is to detect cardiac amyloidosis as reliably and early as possible, to accurately determine its extent, and to reliably identify the underlying subtype of amyloidosis, thereby enabling subsequent targeted treatment.