Safflower protein as a potential plant protein powder: optimization of extraction and spray-drying process parameters and determination of physicochemical and functional properties.

BACKGROUND: The research about sustainable and alternative plant protein sources has accelerated with the increasing need for protein. Safflower meal has a potential to be used in protein production due to its high protein content. This research aimed to produce an alternative plant-based protein powder using safflower meal. Both extraction and spray-drying parameters of safflower protein powder production were optimized using response surface methodology to achieve maximum yield. Moreover, the physicochemical and functional properties of safflower protein were determined and compared with those of commercial protein powders (soy, sunflower, pea, fava bean, and rice). RESULTS: The optimum extraction conditions were found to be 33.06:1 mL-1 g solvent-to-meal ratio, pH 11.00, 23.34 °C extraction temperature, and 30.86 min extraction time, which were achieved with a protein yield response of 75.21%. The highest powder yield (51.28%) was recorded for drying conditions of inlet air temperature of 160.11 °C, aspiration rate of 54.17 m3 h-1, and feed flow rate of 16.01 mL min-1. According to the amino acid profile of safflower protein, the glutamic acid content (14 475 mg (100 g)-1) was highest, while the methionine content (96 mg (100 g)-1) was lowest. Moreover, safflower protein can be regarded as a high-quality protein due to its high essential amino acid ratio (41.55%). The experiments showed that safflower protein had high solubility and good foam and emulsifying properties. CONCLUSION: Safflower protein could be a nutritional and functional protein source for the food industry. © 2024 Society of Chemical Industry.

Assessing pressure injury knowledge among Jordanian and Turkish nursing students: A cross-cultural comparison.

AIM: Pressure injuries, a prevalent issue in healthcare settings, have profound physical and emotional implications for patients and healthcare providers. However, further evidence is needed regarding the level of nursing students' knowledge of pressure injuries in the Middle East, a region where healthcare is rapidly evolving. This study examines the knowledge levels regarding pressure injuries among nursing students in Jordan and Turkey. MATERIALS AND METHODS: This cross-sectional study collected data from a randomly selected sample of 282 nursing students studying in two private and two Public Universities in Turkey and Jordan. Data was collected using a demographic survey and the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0). RESULTS: The overall knowledge scores among students were alarmingly low, with significant differences between Jordanian and Turkish cohorts, with Turkish students scoring higher. Moreover, a significant difference was observed between students' knowledge levels from public and private universities in Jordan, but no difference was found between students of the two Turkish universities. CONCLUSION: The knowledge gap among nursing students regarding pressure ulcers is a critical issue that needs immediate attention. These findings highlight the urgent need for improved educational strategies and standardized competencies in this aspect. This study strongly advocates for changing teaching strategies and incorporating evidence-based pressure injury prevention education into nursing curricula, interprofessional education initiatives, and continuous professional development for faculty. These measures can significantly enhance nursing students' knowledge and improve patient care.

Perioperative Health Care Professionals' Knowledge of Evidence-Based Inadvertent Perioperative Hypothermia Management.

PURPOSE: To evaluate the perioperative health care professionals' knowledge of evidence-based inadvertent perioperative hypothermia management. DESIGN: A descriptive, cross-sectional study. METHODS: The research sample consisted of 219 perioperative nurses and anesthesia technicians working in the university hospital and participating in perioperative care. Data were collected by the researchers using a questionnaire that included descriptive characteristics of health care professionals and inadvertent perioperative hypothermia management between March and April 2021. Descriptive statistics, Shapiro-Wilk normality, Kruskal Wallis, Mann Whitney U, and Spearman correlation test were used to analyze the data. FINDINGS: In this study, only 29.2% of the health care professionals knew that the threshold value for inadvertent perioperative hypothermia was <36 °C. The mean knowledge score of health care professionals on the management of inadvertent perioperative hypothermia was 13.78 ± 3.47. The knowledge score of 79.5% of health care professionals was moderate level. A significant correlation was determined between inadvertent perioperative hypothermia management knowledge score and education status (P = .032), task (P < .001), and mean years in the profession (P = .02). CONCLUSIONS: The knowledge of the health care professionals working in the perioperative process about evidence-based practices related to inadvertent perioperative hypothermia management was determined to be moderate. We recommend increasing the level of knowledge of health care professionals by providing education on guidelines regarding inadvertent perioperative hypothermia management.

Investigation of burnout and quality of work life of cardiac surgery nurses: A cross-sectional study.

BACKGROUND: The care processes of cardiac surgery patients are difficult, complex and stressful. Nurses, who have an important role in the care of these patients, may experience burnout or poor quality of work life may be affected because of difficult care processes, and professional difficulties. AIM: This study analysed burnout and quality of work life in cardiac surgery nurses. STUDY DESIGN: This cross-sectional study was conducted with 68 nurses in the clinic and intensive care unit of a university hospital's cardiovascular surgery department. Clinical nurses care for inpatients in this department, while intensive care nurses care for patients in the intensive care unit. The 'Sociodemographic and Descriptive Characteristics of Nurses Form', 'Maslach Burnout Inventory' and 'Nursing Work Quality of Life Scale' were used to collect the data. RESULTS: The mean score of emotional exhaustion sub-dimension of Maslach Burnout Inventory was 15.25 ± 5.08 (min: 7, max: 27), the mean score of the personal accomplishment sub-dimension was 17.48 ± 4.90 (min: 8, max: 27), and the mean score of depersonalization sub-dimension was 5.60 ± 2.70 (min: 0, max: 13). The mean scores of the emotional exhaustion sub-dimension (t: -2.380, p: .020, risk ratio [RR]: 1.67, confidence interval [CI]: [14.21, 18.82]) and the personal accomplishment sub-dimension (t: -2.604, p: .011, RR: 1.00, CI: [16.08, 19.92]) were higher in intensive care nurses. The mean total score of the nursing quality of work life scale was 107.20 ± 14.60 (min: 72, max: 149). A negative statistically significant relationship was found between the mean scores of emotional exhaustion (r: -0.243, p: .045) and depersonalization sub-dimension (r: -0.325, p: .007) of the Maslach Burnout Scale and the mean total score of the nursing quality of work life scale. CONCLUSION: In this study, it can be said that cardiac surgery nurses had moderate levels of emotional burnout, personal accomplishment and quality of work life, and low levels of depersonalization. At the same time, it can be seen that intensive care nurses have higher levels of emotional burnout. The increased emotional burnout and depersonalization in nurses decreased the quality of work life. RELEVANCE TO CLINICAL PRACTICE: This study provided an understanding of burnout and quality of work life of cardiac surgery nurses. Strategies can be developed to reduce burnout and improve the quality of the work life of cardiac surgery nurses. Particular attention should be paid to intensive care nurses who experience more burnout on several sub-dimensions. This may be a good approach to improving the quality of patient care.

The effect of different pre-treatments on unformulated pulse-based milk analogs: physicochemical properties and consumer acceptance.

This is the first part of a study on developing pulse-based milk analogs using chickpea, faba bean, and cowpea as raw materials. The objectives of the present study were to determine the processing conditions for pulse-based milk analog production at laboratory-scale and to investigate the effects of some pre-treatments such as dry milling (control), soaking and wet milling, blanching, blanching and dehulling, vacuum, and germination on lipoxygenase (LOX) activity of the raw material and some physicochemical and sensory properties of the final products. Dry milling provided the lowest LOX activity and the highest yield while soaking and wet milling resulted in a substantial increase in LOX activity, lower product yield, and a final product with lower whiteness value, regardless of the pulse type. Germination caused a significant decrease in LOX activity in all pulse types, while milk analogs produced from germinated pulses received the lowest acceptability scores from consumers. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05836-7.

Combined levothyroxine and testosterone treatment for restoring erectile dysfunction in propylthiouracil-induced hypothyroid rats.

BACKGROUND: Sexual dysfunction may indicate severe endocrine diseases. Recent research has suggested a link between hypothyroidism, low testosterone (T) levels, and erectile dysfunction (ED); however, the exact cause is unknown. AIM: We sought to investigate possible beneficial effects of levothyroxine and T alone or in combination on ED in propylthiouracil (PTU)-induced hypothyroid rats. METHODS: Adult Wistar rats (n = 35) were divided into 5 groups: control, PTU-induced hypothyroidism, PTU + levothyroxine, PTU + Sustanon (a mixture of 4 types of T: propionate, phenylpropionate, isocaproate, and decanoate) and PTU + levothyroxine + Sustanon. PTU was given in drinking water for 6 weeks. Four weeks after PTU administration, levothyroxine (20 µg microgram kg/day, oral) and Sustanon (10 mg/kg/week, intramuscular) were given for 2 weeks. Serum levels of total T, triiodothyronine (T3), and thyroxine (T4) were determined. In vivo erectile response and in vitro relaxant responses were measured. Localization of neuronal nitric oxide synthase (nNOS), endothelial NOS (eNOS), and phosphodiesterase type 5 (PDE5) were determined using immunohistochemical analysis. The relative area of smooth muscle to collagen was measured using Masson trichrome staining. OUTCOMES: Outcome variables included in vivo erectile function, in vitro relaxant and contractile responses of corpus cavernosum (CC) strips; protein localization of eNOS, nNOS, and PDE5; and smooth muscle content in penile tissue. RESULTS: The rat model of hypothyroidism showed a significant decline in serum levels of total T, T3, and T4. Levothyroxine increased T3 and T4 levels, whereas Sustanon normalized only total T levels. Combined treatment enhanced all hormone levels. Rats with hypothyroidism displayed the lowest erectile response (P < 0.001 vs controls). Combined treatment returned reduced responses, while partial amelioration was observed after levothyroxine and Sustanon treatment alone. Acetylcholine (P < 0.01 vs controls), electrical field stimulation (P < 0.001 vs controls), and sildenafil-induced relaxant responses (P < 0.05 vs controls) were decreased in the CC strips from hypothyroid rats. The combined treatment increased the reduction in relaxation responses. Levothyroxine and Sustanon restored decreases in eNOS and nNOS expression in the hypothyroid group. There was no significant difference in PDE5 expression among groups. Monotreatment partially enhanced reduced smooth muscle mass, while combined therapy completely recovered. CLINICAL IMPLICATIONS: The combination of thyroid hormones and T is likely to be a therapeutic approach for treatment of hypothyroidism-induced ED in men. STRENGTHS AND LIMITATIONS: Beneficial effects of levothyroxine and Sustanon treatment were shown in vitro and in vivo in PTU-induced hypothyroid rats. The main limitation of the study was the lack of measurement of androgen-sensitive organ weights and luteinizing hormone, follicle-stimulating hormone, and prolactin levels. CONCLUSION: These findings demonstrate that neurogenic and endothelium-dependent relaxation responses are reduced by hypothyroidism, which is detrimental to T levels and erectile responses. Levothyroxine and Sustanon combination medication was able to counteract this effect.

Determination of Knowledge and Attitudes of Cardiac Surgery Nurses Regarding the Enhanced Recovery After Surgery Protocol.

PURPOSE: This study aimed to examine the knowledge and attitudes of cardiac surgery nurses regarding the enhanced recovery after surgery protocol. DESIGN: This was a descriptive, cross-sectional study. METHODS: The sample consisted of 50 nurses working in the cardiovascular surgery clinic of a university hospital in the province of Izmir, Turkey. A questionnaire consisting of three sections was prepared by the researchers to collect data. The first section of the form captured sociodemographic and descriptive characteristics; the second section examined the level of knowledge about the enhanced recovery protocol for cardiac surgery; the third section captured the nurses' attitudes regarding the enhanced recovery protocol. The questionnaire was distributed to the nurses and the research data were collected after a certain amount of time. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, and correlation analysis were used in the analysis of the data. FINDINGS: The mean age of the nurses was 31.26 ± 6.74 (min = 23, max = 47); 78% were female; 76% had a bachelor's degree; 48% were employed in the intensive care unit. The mean score of the nurses regarding their level of knowledge on the enhanced recovery protocol for cardiac surgery was 18.70 ± 5.29 (min = 0.00, max = 28.00); the mean score regarding attitude toward the enhanced recovery protocol after surgery was 30.00 ± 3.86 (min = 12.00, max = 33.00). There was a positive, moderate, statistically significant correlation (r = 0.396, P = .005) between the mean knowledge level score and the mean attitude level score. CONCLUSIONS: Results showed that nurses' knowledge was at a moderately positive level. Increasing the level of knowledge increased positive attitudes. Recommendations include disseminating protocol information and providing necessary training to increase positive attitudes in an effort to ensure protocol adherance.

The relationship between surgical intensive care unit nurses' patient safety culture and adverse events.

BACKGROUND: Adverse events are often encountered in surgical intensive care units (ICUs), and most of them occur due to preventable errors. Establishment of a patient safety culture is recommended for preventing and reducing these errors. AIMS: This study was performed to investigate the relationship between surgical ICU nurses' patient safety culture and adverse events. DESIGN: This was a cross-sectional descriptive study. METHODS: The study was performed in the surgical ICUs of four university hospitals in Izmir province, Turkey and was conducted in accordance with the Declaration of Helsinki and approved by an Ethics Committee. The sample comprised 113 nurses working in the surgical ICUs of the hospitals between November 2018 and February 2019. Data were collected using a questionnaire that comprised a demographic form, adverse events form, and patient safety culture hospital questionnaire. Student's t test, one-way analysis of variance, and logistic regression analyses were used to evaluate the data. P values <.05 were considered significant. RESULTS: At the end of the study, nurses' level of patient safety culture was found to be intermediate (65.5%), with the highest average positive response rate (PRR) obtained for teamwork within the units (65.5%) and the lowest average PRR obtained for the frequency of adverse event reporting (25.3%). There was a significant correlation between patient safety culture and adverse events (r = 0.027, P < .05). CONCLUSIONS: Surgical ICUs nurses' level of patient safety culture was average, and there was a significant correlation between patient safety culture and adverse events. RELEVANCE TO CLINICAL PRACTICE: Managers should establish a reliable system for reporting adverse events and encourage ICU nurses to report them. It is very important to adopt a non-punitive approach at instances when an adverse event is reported.

Evaluation of chronic pruritus and associated skin findings in patients with diabetes mellitus.

Background/aim: To explore the dermatological lesions associated with chronic pruritus in patients who were followed up at our clinic for type 1 and type 2 diabetes mellitus (DM). Materials and methods: The study population consisted of 249 patients with DM, who presented to the endocrinology clinic at Ankara University Faculty of Medicine between January 2022, and March 2022, regardless of whether they had reported experiencing pruritus symptoms. The visual analog scale and 5-D itch scale were used to determine the severity of itching in patients. Dermatological examination findings were also evaluated. Results: Of the 249 patients with DM, mean duration since diabetes was diagnosed was 12 ± 9.2 [median 10 (0.3-46)] years, and the mean HbA1c levels were 8.1% ± 2.1%. Pruritus was detected in 77 (30.9%) patients and the mean duration of diabetes diagnosis was 13.4 ± 9.7 years. Examination of the microvascular and macrovascular complications showed that the incidence of retinopathy, nephropathy, neuropathy and peripheral arterial disease was 31.2% (p = 0.003), 31.2% (p = 0.005), 66.2% (p < 0.001) and 10.4% (p = 0.038), respectively, in the group with pruritus. These incidences were significantly higher in the group with pruritus than in those without pruritus. Dermatological examination showed that the most common condition was xerosis (64%), followed by fungal skin infection (16%) and bullous pemphigoid (8%). No skin findings were noted in 7% of patients who complained of itching. Conclusion: Chronic pruritus may be associated with several factors such as poor glycemic control, high BMI and microvascular and macrovascular complications in patients with DM. Especially in patients with severe generalized pruritus who do not respond to standard antipruritic treatments, the use of DPP-4 inhibitors, a class of oral antidiabetic agents, should be questioned and all medications being used by the patient should be reviewed.

Monitoring starch hydrolysis with micro visco-amylo-graph for the production of chickpea milk and optimization of the parameters with response surface methodology.

Plant-based milk products are gaining attention since it has been demonstrated that the consumption of animal-derived foods had to be reduced to combat global climate change. The production of plant-based milk includes a starch hydrolysis step for raw materials with high starch content such as cereals and pulses, since the gelatinized starch forms a thick slurry which causes an unsuitable consistency for a drinkable product. The objectives of this work were to investigate the effects of slurry concentration (solid to solvent ratio), enzyme including temperature, enzyme amount and mixing (rotation) speed on the pasting properties especially final viscosity of a crude chickpea milk and also to investigate the potential use of Micro Visco Amylo-Graph for monitoring starch hydrolysis. Response surface methodology, based on Box Behnken Design, was used to assess the parameters and to optimize the hydrolysis conditions for the minimum final viscosity. In conclusion, it was observed that slurry concentration and enzyme including temperature were the most critical factors that affect either the pasting properties or the final viscosity of the crude chickpea milk. Briefly, lower final viscosities were obtained from samples which were prepared at lower beginning concentrations and treated with higher enzyme amounts at lower temperatures.

Risk factors for rectal colonization of carbapenem-resistant Enterobacteriaceae in a tertiary care hospital: a case-control study from Turkey

Background/aim: This study aimed to evaluate the risk factors of patients colonized with carbapenem-resistant Enterobacteriaceae (CRE). Materials and methods: The study was conducted between January 2010 and March 2016. The colonized group consisted of patients who had a CRE strain in their rectal swab cultures, whereas patients with negative rectal surveillance cultures for CRE who were concurrently hospitalized in the same units with the colonized group patients were included in the control group. Results: The number of patients in the colonized and the control group was 71 and 120, respectively. Both groups were evaluated for demographic and healthcare-associated characteristics. Isolated microorganisms in rectal surveillance cultures for CRE were Klebsiella pneumoniae (75.5%), Escherichia coli (15.5%), Enterobacter cloacae (4.2%), Klebsiella oxytoca (1.4%), and Klebsiella terrigena (1.4%). The isolates were resistant to imipenem, meropenem, and ertapenem (52.1%, 73.2%, and 100%, respectively). In multivariate analysis, presence of decubitus, colistin usage, glycopeptide usage, and fluoroquinolone usage were found to be independent risk factors for CRE colonization. There was no significant difference between the two groups with regards to mortality (P = 0.070). Conclusion: These results are in agreement with the current literature. The findings of this study could be useful for improvement of infection control strategies related to CRE

Sexual Counseling Provided by Cardiovascular Nurses: Attitudes, Beliefs, Perceived Barriers, and Proposed Solutions.

BACKGROUND: Although sex lives of patients with cardiovascular disease (CVD) are affected in various ways and degrees, nurses working with these patients refrain from talking about sexual matters with their patients or encounter barriers trying to do so. OBJECTIVE: The purpose of this descriptive study was to identify attitudes and beliefs of cardiovascular nurses regarding talking to their patients about sexual problems, perceived barriers, and proposed solutions. METHODS: The sample included 170 nurses working for the cardiology and cardiac surgery departments of 1 university hospital, 2 ministry of health hospitals, and 2 private hospitals in Turkey. Data were collected between April and August 2015 through a 4-section questionnaire including the Sexual Attitude and Beliefs Scale. Descriptive, parametric, and nonparametric statistics were used to analyze the data. RESULTS: Most (73.5%) reported not talking to their patients about sexual issues, and only 35.9% stated that they had been educated on how to do so. The major reason for nurses avoiding discussions about sex with their patients was not considering sexuality as a patient care priority (86.4%). Establishing privacy for the patient (91.2%) was the solution proposed by most nurses. The average score of the nurses on the Sexual Attitude and Beliefs Scale was only medium. CONCLUSION: Most of the nurses were untrained about how to talk about sexual problems with their patients and therefore were unable to talk about it freely.

Cardiovascular surgery nurses' level of knowledge regarding delirium.

BACKGROUND: Studies have shown that nurses have a crucial role in the recognition of delirium; however, they have insufficient knowledge regarding the issue. OBJECTIVE: The aim of the study is to determine the knowledge level of cardiovascular surgery nurses regarding delirium. METHODS: A survey design was used. The population of the study consisted of 124 nurses employed at the cardiovascular surgery wards and intensive care units of universities as well as state and private hospitals located in two different cities in Turkey between May and June 2014. The sample consisted of 97 nurses employed at the aforementioned institutions and time. Data were collected using the questionnaire form depicting the demographic characteristics of the nurses and the knowledge form including the level of nurses' knowledge regarding delirium. For the evaluation of data, number, percentage, Kruskal-Wallis, Mann-Whitney U- and independent-samples t-test were used. RESULTS: Nurses were between 18 and 47 years of age with a mean 29·8 (SD = 6·80, the youngest = 18 and the oldest = 47) years. They spent a minimum of 1, a maximum of 25 and a median value of 3 (interquartile range, IQR: 5) years working in cardiovascular surgery. As for the scores received from the knowledge form regarding delirium, the lowest was zero, the highest was 60, and the average score was 41·18 ± 12·50 (a moderate level of knowledge). It was found that the nurses working in intensive care units, those who were chief nurses and those who received in-service training scored higher than the others. CONCLUSIONS: Cardiovascular surgery nurses had a moderate level of knowledge regarding delirium. This may result in the neglect of delirium or a misdiagnosis. RELEVANCE TO CLINICAL PRACTICE: It is recommended that training is provided that includes recognition, assessment and application of appropriate interventions to minimise the incidence of delirium.

Investigation of the effects of chest physiotherapy in different positions on the heart and the respiratory system after coronary artery bypass surgery.

This trial was conducted to investigate the effect of chest physiotherapy in different positions on the heart and the respiratory system after coronary artery bypass surgery. Patients are divided into two groups of 30 patients each in the study. To the patients in the first group (30 patients), percussion-vibration was performed in the 45° supine position, while slightly laterally lying and endotracheal aspiration was performed in the supine position. To the patients in the second group (30 patients), percussion-vibration was performed in the 0° supine position, while slightly laterally lying and endotracheal aspiration was performed in the supine position. The procedures are repeated two times for all patients and their means were taken. The pre- and postapplication values of patients were measured from central venous and arterial catheters and the values of patient monitors were recorded. Comparison of the two groups in terms of respiratory values did not reveal a significant difference, but chest physiotherapy with the head of the bed at 0° was determined to improve cardiac functions. Evaluation of the groups in terms of pre- and postphysiotherapy applications showed a significant increase in mixed venous oxygen saturation in both groups. Chest physiotherapy with the head of the bed elevated to 45° may be recommended in patients who carry a risk of pulmonary complications and who are candidates for chest physiotherapy at an early stage.

The effect of hesperetin on ischemia-reperfusion injury in rat ovary.

PURPOSE: Hesperidin (HES), a citrus fruit extract, has beneficial effects on various ischemia/reperfusion (I/R) models. We aimed to evaluate the possible positive effects of hesperetin (HPT), an active metabolite of HES, on a rat ovarian I/R model. METHODS: We divided 24 Wistar Albino rats into four groups. Group I (n = 6) was sham operated, Group II (n = 6) was the I/R group, Group III (n = 6) was the I/R + solvent group and Group IV (n = 6) was the I/R + HPT group. Three hours of ischemia and 3 h of reperfusion were performed on each rat in Groups II, III, and IV. Dimethyl sulfoxide (DMSO) was given intraperitoneally to the rats in the III. Group, and 50 mg/kg of HPT dissolved in DMSO was given intraperitoneally to the rats in the IV. Group 30 min before reperfusion. After 3 h of reperfusion, the ipsilateral ovaries of the rats were examined immunohistochemically to detect apoptosis. RESULTS: Hematoxylin and eosin (H and E) staining demonstrated less edema and hemorrhage in the group where HPT was applied. Caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining showed significantly lower apoptosis in the group where HPT was used when compared to either the I/R or solvent group. CONCLUSIONS: To the best of our knowledge, this is the first study that shows the beneficial effects of HPT in an ovarian I/R injury. HPT improved tissue damage and apoptosis caused by I/R injury. To identify the possible positive effects of HPT in ovarian torsion of humans and use in clinical practice, more studies must be performed.

The effect of long-term care and follow-up on complications in patients with external fixators.

The present study aimed to determine the effect of long-term care and follow-up on complications in patients with external fixators. This study was conducted as a study research. The study sample included a total of 60 patients treated with external fixators for fractures, of whom 30 were in the control and 30 were in the study group. No intervention was made on the control group patients. The patients in the study group received external fixator pin site wound care, pin site massage and neurovascular follow-up. The study group patients were also given discharge training about external fixator pin site care two days before their discharge and were also provided with training manuals to guide their home care. Both groups were visited weekly at their homes to record their complications. Nine complications developed in eight patients (26.7%) in the study group, and 19 complications developed in 19 patients (63.3%) in the control group. Pin site infections were 11.6% of the total sample. The percentage for pin loosening, stiff joint, nerve and vessel injury and pain and swelling was 5%, 25%, 1.7% and 3.3%, respectively.

Determination of the Relationship Between the Development and Recurrence of Subacute Thyroiditis and Human Leukocyte Antigen Subtypes.

Background: There are several studies investigating the role of human leukocyte antigens (HLA) in the development and recurrence of subacute thyroiditis (SAT). The HLA subtypes associated with SAT were usually determined in a population-based manner and HLA-B*35, HLA-B*18:01, HLA-C*04:01, and HLA-DRB1*01 were detected to play a role in the disease susceptibility and prognosis. The aim of this study was to determine HLA alleles associated with the tendency of recurrence and prevention of SAT within the Turkish population. Methods: This prospective study was conducted with 51 SAT patients and 720 healthy bone marrow donor volunteers. HLA-A, -B, -C, -DRB1, and -DQB1 were genotyped using next-generation sequencing. Results: The frequency of HLA-A*02:09, HLA-B*35:01/35:02/35:03, HLA-C*04:01, HLA-DRB1*12:01, and DRB1*13:03 were associated with an increased risk of SAT development (Odds Ratio: 22.4, 9.5, 10.3, 4.2, and 3.5, respectively). While HLA-A*02:09, HLA-B*35:01, HLA-B*44:02 HLA-C*07:18, and HLA-C*16:04 were associated with nonrelapsing SAT, HLA-DR*12:01was associated with relapsing SAT. HLA-B*35:02, HLA-B*35:03, and HLA-C*04:01 were more frequent both in relapsing and nonrelapsing groups according to control group. The frequency of HLA-B*18:01, reported as a risk factor previously, was similar in the SAT and control groups (p = 0.959). HLA-DRB1*11:01 was associated with a lower risk of SAT development. Conclusions: Along with -B*358 and -C*04, HLA-A*02:09 was detected as an important risk factor for SAT development in our population. HLA-DRB1*11:01 appears to be the protective HLA subtype against SAT. HLA-A*02:09, HLA-B*35:01, HLA-B*44:02, HLA-C*07:18, HLA-C*16:04, HLA-DQ*06:03, and HLA-DR*12:01 subtypes can establish a tendency to relapsing or nonrelapsing SAT.

Common human leucocyte antigensassociated with the development of subacute thyroiditis and COVID-19.

PURPOSE: Case reports of subacute thyroiditis (SAT) following coronavirus disease-19 (COVID-19) have been reported. Because the relationship between SAT and human leucocyte antigen (HLA) alleles is known, we aimed to determine HLA alleles that may predispose a patient to coronavirus infection and/or post-COVID-19 SAT. METHOD: This retrospective study was conducted in 51 patients with SAT and 190 healthy bone marrow donor volunteers. HLA-A, -B, -C, -DRB1, and -DQB1 were genotyped using next-generation sequencing. The study population was grouped into four groups according to SAT and COVID-19 history. RESULTS: The frequency of HLA-DQB1*04:02 was higher in the COVID-19(-) participants than in the COVID-19(+) participants (=0.045). The presence of HLA-DQB1*04:02 was associated with a lower risk of developing COVID-19 in all groups. The frequencies of HLA-B*35:01, HLA-B*35:03, HLA-DRB1*12:01, and HLA-DRB1*14:01 were different in the SAT(+) group than in the SAT(-) group in COVID-19(-) group. The frequencies of HLA-C*12:03, HLA-DQB1*06:04, HLA-DRB1*13:02, and HLA-DRB1*13:03 were different in the SAT(+) group than in the SAT(-) group in the COVID-19 (+) group. The difference in the frequency of these HLA types remains significant when the four groups are included together as follows: In the COVID-19(+) group, the frequencies of HLA-DRB1*13:02, and HLA-DRB1*13:03 were higher in the SAT(+) group than in the SAT(-) group. In the COVID-19(-) group, the frequencies of HLA-B*35:03, HLA-DRB1*12:01, and HLA-DRB1*14:01 were higher in the SAT (+) group than in the SAT(-) group. CONCLUSION: HLA alleles associated with SAT susceptibility may vary with COVID-19 history.

Factors Affecting Knowledge Levels and Protective Behaviors to Prevent the Development of Skin Cancer in Organ Transplant Recipients as a High-Risk Group.

OBJECTIVES: Organ transplantrecipients are at high risk of skin cancer due to immunosuppressant therapy. This study investigated the factors affecting organ transplant recipients' knowledge and protective behaviors to prevent the development of skin cancer. MATERIALS AND METHODS: This was a cross-sectional descriptive study of kidney (n = 82) and liver (n = 31) transplant recipients seen at our hospitals in Turkey from June 2019 to February 2020. A sociodemographic and clinical characteristics form, the Skin Cancer and Sun Knowledge scale, the Sun Protection Behavior questionnaire, and the General Self-Efficacy scale were used to collect data. RESULTS: The mean age of organ transplant recipients was 46.63 ± 13.24 years. Self-efficacy and awareness that transplant increases the risk of skin cancer are 2 characteristics that affected the participants' knowledge level. The type of graft (kidney) affected participants' behavior in avoiding outdoor exposure between the hours of 10 am and 4 pm. Green/blue eye color and self-efficacy affected the participants' hatwearing behavior. These details showed that, as the patients' sensitivity and self-efficacy increased, their levels of knowledge and sun protection behaviors were positively affected. CONCLUSIONS: The knowledge level of patients was affected by (1) awareness that transplant is associated with an increased risk of skin cancer and (2) high levels of self-efficacy. We observed that (1) organ transplant recipients with high self-efficacy and kidney transplant recipients were more likely to avoid outdoor exposure between 10 am and 4 pm and that (2) organ transplant recipients with green/blue eyes and high levels of selfefficacy were more likely to wear a hat when outdoors. Organ transplant teams should provide education and counseling about skin cancer and sun protection in the follow-up care of transplant recipients.

Should we reconsider high-risk features in thyroid ultrasonography?

OBJECTIVE: Round shape is generally considered to reduce the risk of malignancy according to recent guidelines. On the contrary, according to some reports, spherically shaped thyroid nodules are associated with a higher risk of malignancy. Thus, we aimed to evaluate the malignancy risk of solid round isoechoic nodules detected at thyroid ultrasonography and compare it with that of solid ovoid isoechoic nodules. METHODS: Between 2017 and 2022, solitary solid round isoechoic nodules with diameters ³10 and £25 mm at thyroid ultrasonography were retrospectively selected and enrolled in the study. Age, size, nodule volume, serum thyrotropin levels, thyroid antibody levels, and cytopathological and histopathological results were recorded. RESULTS: A total of 457 solitary solid isoechoechoic nodules from 457 patients (262 females and 195 males; median age, 59 [31-70] years) were selected, of which 203 were solid round isoechoic nodules, and 254 were solid ovoid isoechoic nodules. A total of 54 surgical operations were performed on 457 nodules, and 31 of them resulted in malignancy. From the 31 malignant results, 25 originated from solid round isoechoic nodules and the remaining 6 originated from solid ovoid isoechoic nodules (p<0.025). CONCLUSION: We found that round nodules have higher malignancy rates than ovoid nodules. We think that ultrasonographic risk stratification systems used to target the most suitable nodules for the necessary biopsies can be dynamically updated, and sphericity can be added as a parameter in patient-based decision-making.