Serum salusin-α and -ß levels in patients with parkinson's disease.

BACKGROUND: The etiology of Parkinson's disease (PD) is not well known and there is increasing evidence that oxidative stress also plays an important role in its pathogenesis. Salusins alpha (salusin-α) and beta (salusin-ß) affect the central nervous system, vasculature, and kidneys to increase the inflammatory response in endothelial cells, stimulate oxidative stress, and increase monocyte-endothelial adhesion. Neuroinflammation and oxidative stress play roles in the etiopathogenesis of PD. PURPOSE: To investigate whether salusin-α and -ß are related to PD and whether they are correlated with the development of atherosclerosis, body mass index, disease duration, and the Parkinson's Hoehn and Yahr stage. RESULTS: The low-density lipoprotein cholesterol (LDL-C), total cholesterol, and salusin-ß levels were significantly lower and age was significantly higher in Parkinson patients compared to healthy controls (ρ < 0.005). We found a negative linear correlation between salusin-ß and the Hoehn and Yahr stage (ρ < 0.001, r = -0.515) in the patients. CONCLUSIONS: There was a relationship between salusin-ß and PD and a correlation between the salusin-ß levels and Parkinson's stage. A possible underlying disease mechanism is an increase in oxidative stress and decrease in neuroprotective effects due to low salusin-ß levels. Therefore, the effects of salusin-ß in treating Parkinson disease should be evaluated. Further studies are needed to understand the effects of salusin-ß treatment on preventing or slowing the course of PD.

Relationship between fall behavior and quality of life of elderly individuals.

The aim of this study was to examine the association between the quality of life and the fall behavior in elderly individuals. The study was conducted as a descriptive and correlational study design. Data were collected with the Patient Information Form, The Fall Behavior Scale for the Elderly and the World Health Organization Quality of Life module for the elderly. There were 110 older people included in study. When the relationship between the Fall Behavior Scale for the Elderly and the World Health Organization Quality of Life Module for the Elderly sub-scale and total scores were examined, there was a statistically significant negative correlation between the Fall Behavior Scale for the Elderly safe movement sub-scale and the World Health Organization Quality of Life Module social participation sub-scale scores (p < .01).

Reliability and validity of the Turkish version of the Barriers to Nurses' Use of Physical Assessment scale.

AIM: This study aimed to translate the Barriers to Nurses' Use of Physical Assessment Scale into Turkish and assess the new version's validity and reliability. METHODS: This was a methodological study to verify the linguistic equivalence of the scale through the translation/back-translation method. Twelve experts in health assessment confirmed the scale's content validity. Along with the Barriers to Nurses' Use of Physical Assessment Scale, an information form, including socio-demographic features, was distributed to 380 nurses, who consented to participate in the research. Data were collected between July 2017 and April 2018. Internal consistency, factor analysis and test-retest reliability were used to determine consistency over time and intraclass correlations. RESULTS: The content validity index of the scale (0.963) was calculated following confirmation of its language equivalence. With the confirmatory factor analysis, it was determined that the fit index values were at an acceptable level and the model was suitable. The factor analysis clustered factors in seven domains. The overall internal consistency coefficient was 0.822. All subscales and the overall scale showed high intraclass correlations. CONCLUSION: The Turkish version of the Barriers to Nurses' Use of Physical Assessment Scale is a valid and reliable instrument.

The volumetric measurement of developing liver atrophy in patients with Chilaiditi's sign.

PURPOSE: The Chilaiditi's sign is a hepatodiaphragmatic interposition of the colon and is a rare diagnosed condition. This condition may cause a problem in liver transplantation applications which are progressively increasing in number. Although not reported in the literature, we observed that liver atrophy developed in the intestinal interposition region in patients with Chilaiditi's sign in computed tomography (CT) images. This study aimed to determine the amount of liver atrophy caused by the interposed colon, the factors that change the rate of atrophy, and the effects of this situation on the liver parenchyma. MATERIALS AND METHODS: A total of 30,000 patients who presented to radiology department with any reason between March 2012 and March 2013 and who underwent thoracoabdominal or abdominal CT imaging were retrospectively analyzed. The volumes of the liver right lobe and lateral/medial segments of the left lobe were estimated in cm3 using Volume Viewer application in 75 cases (20 females, 55 males) in which Chilaiditi's sign was observed in CT images. RESULTS: 17-27% of the lobes affected from the colon interposition were seen to develop atrophy. The ratio of right lobe volume to total liver volume was found to be higher in patients with left lobe atrophy (74%) than right lobe atrophy (55%) (p < 0.001). Similarly, the rate of the volume of the left lobe to the total liver volume was found to be higher in cases with right lobe atrophy (45%) compared to left lobe atrophy (26%) (p < 0.001). CONCLUSION: Hepatodiaphragmatic interposition of the colon can cause liver atrophy. This condition should especially be considered in the liver transplantation applications. Compensatory hypertrophy may develop in the unaffected liver lobe and CT is very useful for diagnostic imaging.

The effects of yakson or gentle human touch training given to mothers with preterm babies on attachment levels and the responses of the baby: a randomized controlled trial.

This study was carried out to determine the effects of the yakson or gentle human touch methods applied by mothers on their preterm new-borns on the mother's attachment levels and the baby's response. The yakson and gentle human touch methods are touch-based methods where stimuli with stress-reducing effects are given to preterm new-borns. This study was conducted with 90 women and their new-borns (Yakson = 30, gentle human touch = 30, control = 30) who were hospitalized at the neonatal intensive care unit of a state hospital in Turkey between August 2016 and August 2017. As a result, it was determined that the yakson and gentle human touch methods practiced on the new-borns by their mothers increased mother-baby attachment, contributed to sleep-calmness states, vital signs and weight gain of the baby and reduced their durations of hospital stay.Supplemental data for this article is available online at https://doi.org/10.1080/07399332.2021.1958817 .

Spiritual Care Needs of Patients in Oncology Units and Nursing Practices in Turkey: A Qualitative Study.

This descriptive qualitative study was planned to determine the spiritual care needs of patients hospitalized in the oncology department and nursing care practices. Twenty-five patients and 15 nurses were interviewed. Concerning the spiritual care practices expected from nurses, the following themes were determined: Interest-Compassion, Smiling Face, Confidence, Being Informative, Morale, and Understanding. The themes for spiritual nursing practices were Chatting-Suggesting, Smiling Face, Giving Opportunities for Religious Practice, Love and Belonging, Giving Hope-Precedent Examples, and Giving Information. Patients expected nurses to ask about their spiritual needs. However, nurses did not ask about spiritual issues because they were afraid of affecting patients adversely.

Social Support Promotes Mental Health During the COVID-19 Outbreak: A Cross-Sectional Study from Turkey.

BACKGROUND: Coronavirus-19 (COVID-19) has several negative effects on mental health, given its rapid transmission, hygiene and isolation measures and associated social and financial difficulties. In this study, we aimed to investigate the mental health burden of the Turkish population and vulnerable groups during the COVID-19 outbreak, especially exploring the effects of social support. SUBJECTS AND METHODS: We assessed depression, anxiety, stress symptoms and perceived social support among 894 people all over Turkey, using the Depression Anxiety Stress Scales (DASS-21) and Multidimensional Scale of Perceived Social Support (MSPSS) two months after the declaration of the first COVID-19 case in Turkey. RESULTS: According to DASS-21 subscale scores, the findings showed that the prevalence of moderate to severe depression, anxiety and stress-related symptoms was 24.8%, 21.9% and 12.6%, respectively. Female gender, being single, having a lifetime psychiatric disorder, lower education level and financial concerns were significantly associated with higher DASS-21 scores. Also, there was a negative correlation between all subgroups of perceived social support, especially from the family, and the total DASS-21 score. CONCLUSIONS: Vulnerable groups should be identified and protected to reduce adverse psychiatric outcomes of COVID-19. Besides, further strategies should be provided to maintain protective factors, such as social support, under stressful conditions.

Nursing Students' Technological Equipment Usage and Individual Innovation Levels.

Technological equipment is an indispensable part of many people's lives. In parallel with this development, the role of innovation is critical to nurses' ability to provide patient care. Today, nursing students have grown up with technology. Therefore, the field is expected to be more open to innovation in nursing care. It is thought that the use of technological equipment influences the level of innovation. The purpose of this study was to determine nursing students' technological equipment usage, individual innovation levels, and the relationship between them. This descriptive study employed a correlational design during the 2015-2016 academic year at a Nursing Department in the Faculty of Health Sciences in Istanbul. The study population comprised 199 nursing students. The study sample included 165 students who volunteered to participate and were chosen at random. Most (93.3%) of the students were women, and the mean age was 20.92 ± 1.63 years. Data were collected using a devised structured-question form, the Technological Device Use Habits Scale, and the Individual Innovation Scale. Participants' mean scores on the Technological Equipment Usage (a subscale of the Technological Device Use Habits Scale) and on the Individual Innovation Scale were 135.15 ± 27.09 and 61.02 ± 8.89, respectively. Students' technological equipment usage subscale was higher than the other subscales; furthermore, their individual innovation levels revealed that they were "questioners." Several factors affected students' technological equipment usage and individual innovation levels including their age, income, work status, usage of social networking sites, Internet connection type, and if they considered themselves as innovative. The role of technological innovation is critical to nurses' ability to provide patient care.

Eating Behaviors and Related Factors in Psychiatric Patients.

The aim of this study was to determine the risk of eating disorders and associated risk factors in individuals with psychiatric disorders. Patients who were hospitalized in a psychiatry clinic of the university hospital between the dates of February 2014 and July 2014 constitute sample for the study. The study sample consisted of a total of 216 patients. Data were collected using a questionnaire form and the Eating Attitude Test. The mean age of the patients was 37±0.5, and 56.9% of the patients were female. Problems in eating behavior were observed in 11.6% of the patients, and a statistically significant relationship was found between the risk of eating disorders and diagnosis, gender, exercise and self-perception of weight. The risk of eating disorders was more frequently observed in patients diagnosed with depression, in female patients with a self-perceived weight problem and do not exercise.

The relation between scapula fracture and the severity of trauma in blunt thoracic trauma

Background/aim: The aim of this study was to determine the level of presence of scapula fractures (SFs) in cases of blunt thoracic trauma and to identify other injuries accompanying SF. Materials and methods: Blunt thoracic trauma cases with SF determined on direct radiography or computerized tomography (CT) were categorized as Group 1. Group 2 was constituted by selecting cases with high injury severity score (ISS) with no SF. The demographic characteristics and all injuries of the patients were evaluated. Results: SF was determined in 77 (11.3%) patients (Group 1), and Group 2 consisted of 607 patients. The ISS was significantly higher in Group 1 (27.7 ± 16.1) than Group 2 (15.9 ± 9.5) (P < 0.001). The rate of SF with direct radiography was only 9.1%, and more than 90% of patients were evaluated using CT. The most common accompanying injury to SF was rib fracture (44.2%), and the odds ratio was 2.4 (95% CI: 1.51­3.72). Conclusion: The incidence of SF in cases of blunt trauma was higher than in previous studies. The use of CT in blunt trauma can determine SF that cannot be identified through physical examination or radiography, and the most commonly observed accompanying damage in these patients is rib fracture.

Effects of oral care with glutamine in preventing ventilator-associated pneumonia in neurosurgical intensive care unit patients.

PURPOSE: The study was designed as a randomized, controlled, experimental study aiming to determine the effects of oral care with glutamine in preventing ventilator-associated pneumonia in patients admitted to neurosurgical intensive care unit. METHODS: The universe consisted of patients who are admitted to neurosurgical intensive care unit between January 2014 and August 2015, while the sample consisted of 88 patients who fulfilled the inclusion criteria and were randomly selected. The study group received oral care with 5% glutamine, whereas the control group received oral care with 2% chlorhexidine gluconate solution. DATA COLLECTING TOOLS: All date was acquired using Patient Information Form, Acute Physiological and Chronic Health Evaluation scale (APACHE II), Beck Oral Assessment Scale (BOAS), Mucosal Plaque Score (MPS) and Clinical Pulmonary Infection Score (CPIS). One-way ANOVA test was used for comparing parameters with normal distribution between groups along with descriptive statistical methods. Kruskal-Wallis Test was used for comparing parameters without normal distribution between groups. RESULTS: In the control group, mean BOAS score was 9.33±1.8 mean MPS score was 3.68±0.87 and mean CPIS score was 4.07±1.78. In the study group, mean BOAS score was 10.16±2.78, mean MPS score was 3.93±1.04 and mean CPIS score was 3.78±2.25. There was no statistically significant difference in mean scores at 1st day, 3rd day, 5th day and discharge (p>0.05). However, BOAS, MPS, CPIS and APACHE II scores was significantly lower at discharge than 1st day in both groups. CONCLUSION: There was no significant difference in using 5% glutamine or 2% chlorhexidine gluconate solution for oral care for the prevention of ventilator-associated pneumonia. Similar studies with bigger sample size and longer term should be conducted for better results.

Lung transplantation in IIP: A review.

The idiopathic interstitial pneumonias (IIP) encompass a large and diverse subtype of interstitial lung disease (ILD) with idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP) being the most common types. Although pharmacologic treatments are available for most types of IIP, many patients progress to advanced lung disease and require lung transplantation. Close monitoring with serial functional and radiographic tests for disease progression coupled with early referral for lung transplantation are of great importance in the management of patients with IIP. Both single and bilateral lung transplantation are acceptable procedures for IIP. Procedure selection is a complex decision influenced by multiple factors related to patient, donor and transplant centre. While single lung transplant may reduce waitlist time and mortality, the long-term outcomes after bilateral lung transplantation may be slightly superior. There are numerous complications following lung transplantation including primary graft dysfunction, chronic lung allograft dysfunction (CLAD), infections, gastroesophageal reflux disease (GERD) and airway disease that limit post-transplant longevity. The median survival after lung transplantation is 4.7 years in patients with ILD, which is less than in patients with other underlying lung diseases. Although long-term survival is limited, this intervention still conveys a survival benefit and improved quality of life in suitable IIP patients with advanced lung disease and chronic hypoxemic respiratory failure.

The effect of nursing care protocol on the prevention of central venous catheter-related infections in neurosurgery intensive care unit.

PURPOSE: This clinical study was planned to determine the effect of Nursing Care Protocol on the prevention of central venous catheter-related infections in neurosurgery intensive care unit. METHOD: The study was conducted between January 2012 and December 2013. The sampling consisted of 160 patients compatible with study inclusion criteria (80 protocol and 80 control patients). Routine care was applied to the control group while the protocol group received catheter care according to the protocol formed in accordance with the suggestions of the Centers for Disease Control and Prevention. The data were collected from Patient Information Form, Follow-Up Form, and APACHE II scores. RESULTS: A significant difference existed between the two groups in terms of mean APACHE II scores on discharge (p<0.05) whereas no significant difference in terms of mean fever, number of leucocytes and lymphocytes, C-reactive protein, and days of catheter carriage (p<0.05). Hemoculture positivity was less in protocol group, and this difference was statistically significant (p<0.05). CONCLUSION: The suggested nursing care protocol is significantly efficacious in the prevention of CVC-related infections. Training of healthcare workers on using this protocol is recommended.

Comparison of tuberculin skin test and quantiferon-TB gold in tube test for diagnosis of latent tuberculosis infection in health care workers: A cross sectional study.

OBJECTIVE: To compare the diagnostic efficacy and agreement of the traditional tuberculin skin test with QuantiFERON-Tuberculosis Gold In-Tube test for latent tuberculosis infection in healthcare workers. METHODS: The cross-sectional analytical study was conducted between March 1 and 31, 2008, at a specialist tuberculosis hospital in Istanbul, Turkey, and comprised healthcare workers who had been employed for at least one year at the hospital and volunteered to take part. Tuberculin skin test and QuantiFERON-Tuberculosis Gold In-Tube test were both performed simultaneously and their results were compared Using SPSS 12. RESULTS: Out of 34 subjects, 20(58.8%) had a positive tuberculin skin test, and 7(20.6%) had a positive QuantiFERON-Tuberculosis Gold In-Tube test. The two tests agreed in only 15(44.1%) cases and disagreed in 19(55.9%). In 16(47.1%) subjects, the QuantiFERON-Tuberculosis Gold In-Tube test was negative and tuberculin skin testwas positive, while in 3(8.8%) participants QuantiFERON-Tuberculosis Gold In-Tube test was positive and tuberculin skin test was negative. Kappa test revealed discordance between the two tests (k=-0.13; p=0.92). CONCLUSIONS: Latent tuberculosis infection prevalence was higher based on tuberculin skin test than QuantiFERON-Tuberculosis Gold In-Tube test. The results of the two tests were discordant.

Can pregnancy-associated plasma protein-A be a marker for the assessment of atherosclerosis risk in patients with chronic plaque psoriasis?

INTRODUCTION: Psoriasis is an immune-mediated chronic inflammatory dermatosis. Several studies have shown that patients with psoriasis have a much greater risk of cardiovascular diseases than the normal population. The chronic inflammation observed in psoriasis is thought to have a role in the development of atherosclerosis and vascular endothelial injury. AIM: To examine serum pregnancy-associated plasma protein-A (PAPP-A) levels, which has been regarded as a marker of early stage atherosclerosis in patients with psoriasis that do not have concurrent conventional cardiovascular risk markers. MATERIAL AND METHODS: Forty-one patients diagnosed with a chronic plaque type of psoriasis and 42 equally matched healthy volunteers were included in this study. The PAPP-A levels were compared between patient and control groups and the association between PAPP-A levels and disease duration and severity were evaluated in the patient group. RESULTS: Statistically, serum PAPP-A levels were significantly higher in the psoriasis group than in the control group (p = 0.015). Serum PAPP-A levels were found to be positively correlated with severity (p = 0.036, r = 0.329) and duration (p = 0.014, r = 0.269) of the disease. CONCLUSIONS: As a marker of early stage atherosclerosis, PAPP-A levels were elevated in the psoriasis group and were correlated with disease duration and severity. This elevation reveals the presence of atherosclerosis in patients with psoriasis. Further studies are needed to confirm the use of PAPP-A as an available and inexpensive screening test and cardiovascular risk assessment for all centers.

Sexual dysfunction and anxiety levels of type 2 male diabetics.

AIM: This descriptive study aims to identify sexual dysfunction and anxiety levels of male patients with type 2 diabetes. METHOD: The sample is composed of 150 patients who were seen at the Endocrinology and Diabetes Clinic of one university hospital in Istanbul, Turkey. The data were collected using an "Information Form", the "International Index of Erectile Function", and the "State-Trait Anxiety Inventory (STAI)". RESULTS: The mean age of the sample was 56.2±8.71, the sexual dysfunction total score was on average 46.44±15.66, and 82% of the sample experienced erectile dysfunction. According to the STAI, the patients had "mild" anxiety on average, whereas according to the TAI, they had "moderate" anxiety levels. There were no statistically significant differences between the sexual dysfunction total scores and the State Anxiety Scores (p>0.05), whereas there was a negative weak correlation between the trait anxiety levels (p<0.05). CONCLUSION: These results show that the sexual function and anxiety of diabetic patients should be evaluated at regular intervals.

Catheter indwell time and phlebitis development during peripheral intravenous catheter administration.

OBJECTIVE: Intravenous catheters have been indispensable tools of modern medicine. Although intravenous applications can be used for a multitude of purposes, these applications may cause complications, some of which have serious effects. Of these complications, the most commonly observed is phlebitis. This study was conducted to determine the effect of catheter indwell time on phlebitis development during peripheral intravenous catheter administration. METHODS: This study determined the effect of catheter indwell time on phlebitis development during peripheral intravenous catheter administration. The study included a total of 103 individuals who were administered 439 catheters and satisfied the study enrollment criteria at one infectious diseases clinic in Istanbul/Turkey. Data were compiled from Patient Information Forms, Peripheral Intravenous Catheter and Therapy Information Forms, reported grades based on the Visual Infusion Phlebitis Assessment Scale, and Peripheral Intravenous Catheter Nurse Observation Forms. The data were analyzed using SPSS. Results : The mean patient age was 53.75±15.54 (standard deviation) years, and 59.2% of the study participants were men. Phlebitis was detected in 41.2% of peripheral intravenous catheters, and the rate decreased with increased catheter indwell time. Analyses showed that catheter indwell time, antibiotic usage, sex, and catheterization sites were significantly associated with development of phlebitis. CONCLUSION: The results of this study show that catheters can be used for longer periods of time when administered under optimal conditions and with appropriate surveillance.

Examination of SARS-CoV-2 RNA in joint synovial fluid of patients with COVID-19 and acute knee arthritis.

BACKGROUND: It has not yet been fully established that there is coronavirus disease 2019 (COVID-19) involvement in the synovial fluid and it remains a topic of debate. OBJECTIVE: The aim of this study was to evaluate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in knee joint synovial fluid of patients with COVID-19. METHODS: This retrospective study was conducted with an initial screening of patients who were admitted to a tertiary pandemic hospital due to COVID-19 symptoms, and underwent treatment for COVID-19 between March and June 2020. RESULTS: A total of 2476 patients were hospitalized or received treatment for a possible diagnosis of COVID-19. While the RT-PCR test was positive in 318 patients (12.8%), 2158 (87.2%) were computed tomography positive but reverse transcription-polymerase chain reaction (RT-PCR) negative. Twelve patients were consulted due to acute joint effusion. Of five patients with knee joint effusion and a positive RT-PCR test, the synovial tissue RT-PCR test was positive in only one patient. CONCLUSION: This paper is the first to show the presence of SARS-CoV-2 in synovial fluid. This can be considered of importance for the determination and elimination of the route of transmission, thereby preventing further development and spread of the disease.

Estrogen-induced expression of Fos-related antigen 1 (FRA-1) regulates uterine stromal differentiation and remodeling.

Concerted actions of estrogen and progesterone via their cognate receptors orchestrate changes in the uterine tissue, regulating implantation during early pregnancy. The uterine stromal cells undergo steroid-dependent differentiation into morphologically and functionally distinct decidual cells, which support embryonic growth and survival. The hormone-regulated pathways underlying this unique cellular transformation are not fully understood. Previous studies in the mouse revealed that, following embryo attachment, de novo synthesis of estrogen by the decidual cells is critical for stromal differentiation. In this study we report that Fos-related antigen 1 (FRA-1), a member of the Fos family of transcription factors, is a downstream target of regulation by intrauterine estrogen. FRA-1 expression was localized in the differentiating uterine stromal cells surrounding the implanted embryo. Attenuation of estrogen receptor α (Esr1) expression by siRNA mediated silencing in primary uterine stromal cells suppressed FRA-1 expression. Furthermore, chromatin immunoprecipitation demonstrated direct recruitment of ESR1 to an estrogen response element in the Fra-1 promoter. Down-regulation of Fra-1 expression during in vitro decidualization blocked stromal differentiation and resulted in a marked decrease in stromal cell migration. Interestingly, FRA-1 controls the expression of matrix metalloproteinases MMP9 and MMP13, which are critical modulators of stromal extracellular matrix remodeling. Collectively, these results suggest that FRA-1, induced in response to estrogen signaling via ESR1, is a key regulator of stromal differentiation and remodeling during early pregnancy.