The effects of women's insight levels on breast cancer prevention behaviors: a cross-sectional study.

The aim of this study is to determine the effect of women's insight levels on their breast cancer prevention behaviors in primary health care services. A systematic sampling method was used to select a sample of 393 women in a province in Turkey. Socio-demographic Characteristics Form, Insight Scale and Scale for Determining Factors Affecting Women's Breast Cancer Prevention Behaviour were used as data collection tools. Data were collected face-to-face and then analyzed statistically using Student's t-test, one-way analysis of variance, Tukey HSD, Spearman correlation test and multiple regression analysis. The results showed that those who felt "healthy" had significantly higher mean breast cancer prevention behavior (p < .05). It was determined that there was a weak positive correlation between the level of insight and breast cancer prevention behaviors, and the increase in the level of insight had a significant positive effect of 0.37 ± 0.051 points on breast cancer prevention behaviors. It was found that there was a significant negative effect on prevention behaviors with 1.66 ± 0.796 points in those with a high education level and 1.58 ± 0.505 points in those with suspected disease. In conclusion, in this study, it was determined that insight level, education level, and awareness of early diagnosis affected the prevention behaviors of breast cancer.

Sexual quality of life and marital adjustment in pregnant women.

In a cross-sectional study, researchers investigated pregnant women's quality of sexual life and marital adjustment. The sample consisted of 312 pregnant women admitted to the gynecology and obstetrics outpatient clinic of State Hospital between June and November 2020. Data were collected using a personal information form, the Quality Scale-Female (SQLQ-F), and Marriage Adjustment Test (MAT). Participants with one child had a significantly higher median SQLQ-F score than those with three or more children. Participants with 8-12 wk of pregnancy had a significantly higher median SQLQ-F score than those with 25 wk of pregnancy or longer (p < 0.05). There was a positive correlation between SQLQ-F and MAT scores (r = 0.447. p < 0.001), suggesting that the higher the quality of sexual life, the better the marital adjustment. Health care professionals should be aware of the effect of sexual life on marital adjustment.

The relationship between beliefs toward mental illnesses, empathic tendency and social distancing in university students.

This study was conducted to determine the level of beliefs toward mental illnesses in university students and to examine its relationship with empathic tendency and social distance level. This descriptive and relational study was conducted at the Faculty of Health Sciences and Faculty of Nursing of a state university in Turkey. The sample of the study consisted of 678 students studying in the 4th grade of these faculties. Personal Information Form, the Beliefs Toward Mental Illness Scale (BMI), the Empathic Tendency Scale (ETS), and the Social Distance Scale (SDI) were used to collect data. It was determined that there was a high level of negative relationship between the students' mean BMI score and the age variable and the empathic tendency and social distance mean scores. It was seen that the mean Empathic Tendecy Scale and Social Distance Scale scores accounted for 86.6 % of the change in the mean BMI score (Adjusted R2 = 0.826). The mean BMI score of the students was found to be below the medium level. On the other hand, it was found that empathic tendency and social distance mean scores were above the medium level and had an effect on the mean BMI score. Psychosocial factors that are effective in the emergence of negative beliefs about mental illnesses in students should be investigated and studies should be carried out to increase awareness about negative beliefs.

Clinicoradiological evaluation of oxidative stress activity in acute cerebral infarction in the first 24 h and the qualitative importance of dysfunctional HDL in stroke.

BACKGROUND: Acute cerebral infarction (ACI) occurs as a result of instant disruption of vascular flow that causes disbalance between oxidative/antioxidative activity. We examined the relationship of serum neuro-oxidative stress parameters with stroke severity and infarct volume in ACI and emphasized the qualitative importance of high-density lipoprotein (HDL) on its relationship with myeloperoxidase (MPO) and paraoxonase-1 (PON1) in the acute period of stroke. METHODS: One hundred ACI patients applied within the first 24 h and 50 healthy volunteers were included. The patient group was evaluated with demographic data (including arrival serum biochemical assessment), clinical disability scores, infarct volume, serum oxidative/antioxidative parameters (lipid hydroperoxide (LOOH), MPO, PON1, MPO/PON ratio). The relevant serum parameters were compared with the control group. Dysfunctional HDL measurement was based on detecting dysfunctionality as a result of a high positive correlation between the dysfunctional feature of HDL and the MPO/PON ratio. The correlation of serum parameters, clinical disability score, and infarct volume were evaluated, and independent analyses of variability with comorbidities were performed. RESULTS: A negative correlation between PON1 and arrival NIH score/scale (NIHSS), LOOH and discharge modified rankin scale (mRS), triglyceride level, and infarct volume; a positive correlation between MPO\PON ratio and infarct volume was determined. Logistic regression analyses showed that hypertension, diabetes, and high HbA1C may be predictors of stroke severity, and diabetes mellitus, high HbA1C, infarct volume, and high NIHSS score may be predictors of early disability (p < 0.005). The ROC curve analysis revealed that determining the cut-off value for LOOH is of importance in determining early disability scores (7.2 and 6.2, respectively). DISCUSSION: The balance between oxidative and antioxidative stress parameters and their quantitative/qualitative changes is of importance, especially in the acute period of ACI. Dysfunctional HDL's evolution and its relationship with other oxidants are significant not only in the cardiovascular aspect but also in the clinicoradiological aspect.

Bio-clinical evaluation of collateral score in acute middle cerebral artery occlusion.

BACKGROUND: Acute ischemic stroke (AIS) is characterized as a neurological deficit owing to an acute focal damage to the brain by cerebral infarction. A collateral score is the most significant factor evaluating the prognosis of AIS, its relationship with demographic data, serum biochemical parameters, and clinical disability in this field. METHODS: We conducted a single-center retrospective study with 100 patients with AIS within the first 6 h of ischemic stroke. Data for consecutive AIS patients were collected from February 2019 to May 2020. The collateral score was assessed by using developed scoring systems defined by Maas et al. The correlations between collateral score and demographic data, biochemical parameters, NIHSS scores (National Institutes of Health Stroke Scale), mRS (modified Rankin scale) scores were recorded. RESULTS: The research was performed in 100 patients (median age, 71.55 ± 11.46 years), and there was a statistically significant difference between elevated erythrocyte distribution width (RDW) and Maas collateral score (insular cortex) (p = 0.024) and lymphocyte/ monocyte ratio (LMO) and Maas collateral (leptomeningeal) score (p = 0.025).

Peroxisome Proliferator-Activated Receptor Gamma Pro12Ala/C161T Genotypes and Risky Haplotype Altering Risk of Breast Cancer: A Turkish Case-Control Study.

Breast cancer (BC) has a high incidence rate among women worldwide, and the mechanisms and etiology of this disease are not yet fully understood. The peroxisome proliferator-activated receptor gamma (PPARgamma), a nuclear hormone receptor that plays important roles in energy metabolism and cellular differentiation, is also suggested to be effective in cancer development. However, the results of studies investigating the cancer association with PPARgamma are inconsistent, creating a need for further investigation of the effects of this transcription factor on BC risk. We have examined the Pro12Ala-(rs1801282) and C161T-(rs3856806) polymorphisms of the PPARgamma gene in Turkish patients with BC in this case-control study. A total of 95 women diagnosed with BC as cases and 119 controls were genotyped for PPARgamma polymorphisms by polymerase chain reaction and restriction fragment length polymorphism techniques. The ProPro genotype and T161 allele were associated with an increased risk of BC comparing with the Ala12 allele and CC161 genotype, respectively (p < 0.001). The multivariate regression analysis confirmed that the ProPro genotype (p < 0.011), T161 allele (p < 0.001), smoking (p = 0.019), and advanced age (> 60 years) (p = 0.007) are risk factors for breast cancer. We also found that the PPARgamma Pro12Ala and C161T polymorphisms were in linkage disequilibrium (D':0.511, r2:0.099). It was determined that carrying ProPro-T161 risky PPARgamma haplotype was associated with a higher risk of BC compared to protective Ala12-CC161 haplotype (p < 0.01, OR:7.797, 95% CI:3.521-17.263). We concluded that PPARgamma Pro12Ala and C161T polymorphisms are associated with increased BC risk, and ProPro-T161 risky haplotype, which is in linkage disequilibrium, increases this effect.

Relationship between pattern reversal visual evoked potential P100 wave latency and dysfunctional HDL in patients with multiple sclerosis subjected to an optic neuritis attack: A case-control study.

Optic neuritis frequently occurs during the clinical course of multiple sclerosis (MS). In this condition, demyelination of the optic nerve occurs, which electrophysiologically causes a delay in P100 wave latency. Sensitive cholesterol homeostasis is critical for the formation of the myelin sheath and for myelin to become functionally mature. High-density lipoprotein (HDL) becomes dysfunctional under oxidative stress and plays an important role in the pathogenesis of MS. In this study, HDL levels of MS patients suffering from optic neuritis were compared with those of healthy individuals, and the relationship between pattern reversal visual evoked potential (PRVEP) P100 wave latency and HDL levels in patients with optic neuritis attacks was analyzed. PRVEP studies were performed in patients with MS who had an episode of optic neuritis, and P100 wave latencies were measured. Peripheral blood samples were collected from healthy participants and patients. Lipid levels and myeloperoxidase (MPO) and paraoxonase (PON) activities were measured, and the MPO/PON ratio was then calculated. The lipid profiles and dysfunctional HDL levels in the healthy and patient groups were compared. Finally, the relationship between these parameters and the PRVEP-P100 wave latency was examined. Total cholesterol and low-density lipoprotein (LDL) levels were significantly higher in the patient group (P = .044; P = .038, respectively). There was no statistically significant difference in HDL levels between groups (P = .659). The distribution of MPO values was similar between groups (P = .452). PON values were significantly lower, whereas the MPO/PON ratios were significantly higher in the patient group than in the control group (P = .025; P = .028, respectively). A statistically significant positive correlation was found between the elevated MPO/PON ratio, representing dysfunctional HDL, and both the mean and maximum PRVEP-P100 wave latencies (P < .001, R = 0.690; P < .001, R = 0.815, respectively). A dysfunctional form of HDL may lead to poor deactivation of remyelination-limiting factors and may ultimately be associated with poor outcomes in optic neuritis.

Adapting nature's own solution: The effect of rhamnolipid and lytic bacteriophage cocktail on enteric pathogens that proliferate in mucilage.

The mucilage event witnessed in the Sea of Marmara in 2021 has emerged as a prominent environmental concern, capturing public attention due to its detrimental effects on ecological, economic, and aesthetic dimensions. Addressing the multifaceted impacts of mucilage demands a nature-centric scientific approach, given its global ramifications spanning economy, public health, international relations, and tourism. Consequently, this study sought to explore alternative approaches for the removal of pathogenic enteric bacteria associated with mucilage occurrences, diverging from conventional methodologies. Specifically, the primary objective was to assess the efficacy of rhamnolipid and a bacteriophage cocktail in mitigating the proliferation of enteric pathogens within mucilaginous environments. During the study, 91 phage isolations were obtained from 45 water samples taken and 10 phages were selected for the broad host range and because of the efficacy tests, a phage cocktail was created with 5 phages. It was found that the mixture of rhamnolipid, phage cocktail and rhamnolipid-phage cocktail reduced bacterial load by 7-9 log10, 9-12 log10 and 9-11 log10 respectively under laboratory conditions. When the study was carried out in seawater, reductions of 4-5 log10, 3 log10 and 4 log10 were achieved. This study has shown that the combined use of rhamnolipid, phage cocktail and rhamnolipid-phage cocktail can be considered as the most effective natural solution proposal for reducing bacterial load, both in laboratory conditions and in sea surface water.

Clinico-topographic evaluation of anterior versus posterior acute ischemic stroke and correlation with early mortality-based scale prediction.

Objective: Posterior circulation ischaemic strokes (PCIs) are a clinical syndrome associated with ischemia related to stenosis, in situ thrombosis, or embolic occlusion of the posterior circulation and differ from anterior circulation ischaemic strokes (ACIs) in many aspects. In this study, ACIs and PCIs were evaluated in terms of clinico-radiological and demographic aspects, and the relevance of objective scales to early disability and mortality was investigated. Methods: The definition of ACIS or PCIS was classified according to the Oxfordshire Community Stroke Project (OCSP). There are mainly two groups divided into ACIs and PCIs. ACIs were included as total anterior circulation syndrome (TACS), partial anterior circulation syndrome (PACS) (right and left), and lacunar syndrome (LACS) (right and left), and PCIs were posterior circulation syndrome (POCS) (right and left). Arrival NIH Stroke Scale/Score (NIHSS) and Glasgow Coma Scale (GCS) scores were evaluated in clinical assessment and modified SOAR Score for Stroke (mSOAR) was for early mortality-based scale prediction. All data were compared, and mean, IQR (if applicable) values and ROC curve analysis were determined. Results: A total of 100 AIS patients, 50 of whom were ACIs and 50 were PCIs, were included in the study and were evaluated within the first 24 h. Hypertension was the most common disease for both groups. The second most common was hyperlipidemia (82%) in the ACIs and diabetes mellitus (40%) in the PCIs. The frequency of right hemisphere ischemia was higher in ACIs (63.6%) and PCIs (48%). The mean NIHSS and GCS score (also median IQR) was higher in the right ACIs and the highest NIHSS mean was in the right partial anterior circulation syndrome (PACS) (respectively median (IQR): 9.5 (13) and median (IQR):14.5 (3)). The mean NIHSS and GCS score of bilateral posterior circulation syndrome (POCS) were the highest in PCIs (median (IQR):3 (17), (IQR):15 (4) respectively). The mSOAR mean was the highest in the right PACS in ACIs (median (IQR):2.5 (2)) and in bilateral POCs among PCIs (median(IQR):2(2)). Conclusion: The association of PCIs with hyperlipidemia and the male gender was interpreted, and anterior infarcts were found to cause higher early clinical disability scores. The NIHSS scale was effective and reliable, especially in anterior acute strokes, but also emphasized the necessity of using the GCS assessment together in the first 24 h in the assessment of PCIs. mSOAR scale is a helpful predictor in estimating early mortality not only in ACIs but also in PCIs, similar to GCS.

[Progressive multifocal leukoencephalopathy: a complication in chronic B-cell lymphatic leukaemia]. / Progressieve multifocale leuko-encefalopathie.

BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a rare infectious cause of sub-acute neurological symptoms, and occurs predominantly in immunocompromised patients. PML is caused by reactivation of the JC virus. CASE DESCRIPTION: A 79-year-old man with a history of chronic B-cell lymphatic leukaemia (B-CLL) presented at our hospital with a neurological deficit of the left side of his body. He was initially diagnosed with a right-hemisphere stroke. Two months later he returned with progressive paresis and on an MRI of the brain we saw an increase in abnormalities of the white matter. On suspicion of PML we conducted PCR for JC virus on cerebrospinal fluid (CSF), which was negative. Histopathological investigations of a brain biopsy confirmed the diagnosis of PML, four months after he first presented. CONCLUSION: PML is a rare cause of sub-acute neurological symptoms. PML can be difficult to diagnose as a PCR of CSF for JC virus in the early stages of PML can give a false negative result. If PML is suspected, histological investigation of a brain biopsy is necessary.

A Serial Munchausen Syndrome by Proxy.

Munchausen syndrome by proxy (MSBP) is a form of child abuse that describes children whose parents or caregivers invent illness stories and substantiate the stories by fabricating false physical signs. Through this case report, a serial MSBP case is presented along with psychiatric evaluation of the perpetrator mother who was sent to the Forensic Psychiatric Observation Department of the Council of Forensic Medicine to assess whether she has any mental disorder. Although there are several studies on MSBP, we present this case because the perpetrator mother was caught on the camera surveillance system of the hospital while closing the nose and mouth of the victim for fabricating the illness, and she also said that she had done the same thing to her two elder children to exclude their illnesses. Her two children had died and could not be diagnosed. Moreover, we discuss the psychopathology of the perpetrators, which is a less known area of MSBP. This is a very serious form of child abuse, with a high risk of repetition, and failure to diagnose might result in the death of the child.

Violence against women: A series of autopsy studies from Istanbul, Turkey.

Death is the most severe consequence of violence against women. The purpose of this study was to determine the frequency of violence-related deaths among women and the general characteristics of fatal violence cases against women in Istanbul, Turkey. A total of 20,486 forensic autopsies performed between 2006 and 2010, in Istanbul, were retrospectively analyzed. Of these, 537 violence-related deaths among women were included in the study. The victims were investigated in terms of sociodemographic characteristics, exposed type of violence, and autopsy findings. Out of all female deaths (n = 4165), 12.9% were due to violence against women, which comprised 2.6% of all autopsies (n = 20,456) performed during the study period in Istanbul. The median age of the victims was 43 years, and a significant proportion of victims (49.7%) were between the ages of 21 and 40 years. The deaths occurred most commonly in private residences (51.2%, n = 275), whereas the street was the crime scene for 14.5% (n = 78) of cases. Firearm injuries (50.1%, n = 269) were the most common cause of death, followed by stab wounds (28.3%, n = 152) and strangulation (8.4%, n = 45). Among the identified perpetrators, 52.3% were victims' spouses or boyfriends. The perpetrators were female in 4.4% (n = 16) of cases. Istanbul is the most important and cosmopolitan city of Turkey, representing the country's cultural characteristics. Therefore, the data obtained in this study may be strong indicators of violence against women in Turkey.

Custody and prison deaths autopsied in Istanbul between 2010 and 2012.

The occurred death of a convict in prison, police custody cell or in a hospital always attracts public attention and can be considered as a complex phenomenon. The aim of this study is to evaluate the data obtained from autopsies performed to the custody and prison deaths in Istanbul and to discuss the possible solutions by comparing with the literature. It is also aimed to discuss the postponement of the sentence and presidential amnesty facts in Turkey. Deaths of inmates, which occurred in hospitals, prisons, prison medical rooms, police vans and police custody cells between 2010 and 2012 in Istanbul, Turkey were included in the study. Totally 125 cases were found and 98.4% of them were male. Natural deaths accounted for a great majority of deaths (83.2%). The most common natural cause was cardiovascular diseases. Unnatural deaths accounted for 15.2% of the deaths. Death reason cannot be determined for 1.6% of the cases. More than half of the cases (56%) were died at the hospital, 34.4% were died at the prison, 4% of them at the police van, 3.2% were died under police custody and 2.4% were died at the prison medical room. Moreover, twelve of these cases had applied to Third Specialization Board previously for postponement of the sentence or Presidential amnesty. Totally five of these cases found suitable for postponement of the sentence. Prison conditions should be improved, prisoners with chronic diseases should be examined periodically and if appropriate their sentences should be postponed until they heal.