The adverse impact of surveillance intervals on the sensitivity of FDG-PET/CT for the detection of distant metastases in head and neck cancer patients.

The presence of distant metastases at initial evaluation influences treatment selection, since no effective systemic treatment for disseminated head and neck squamous cell carcinoma (HNSCC) is currently available. The reported sensitivity for the detection of distant metastases by contrast-enhanced (ce)CT and FDG-PET(/CT) differs substantially between studies. We hypothesized that these sensitivity values are highly dependent on the reference standard use, e.g., follow-up term. Therefore, we analyze our results of FDG-PET/CT (including chest ceCT) with long-term follow-up and compare these findings with data from the literature, with particular interest in the different reference standards. Forty-six HNSCC patients with high-risk factors underwent pretreatment screening for distant metastases by FDG-PET/CT (including chest ceCT). In 16 (35%) patients, distant metastases were detected during screening (6 patients) or during a mean follow-up of 39.4 months after screening (10 patients). The sensitivity and negative predictive value were 83.3 and 97.2% when 6 months, 60.0 and 89.9% when 12 months, and 37.5 and 72.2% when 30 months follow-up were used as reference standard, respectively. This is comparable with reported studies with similar reference standards. This critical appraisal on the reference standards used in our and reported studies shows room for improvement for the detection of distant metastases to refrain more patients from unnecessary extensive locoregional treatment for occult metastatic HNSCC.

The effects of testicular stromal stem cells on surgically injured testicular tissue in rats.

This study investigated the effects of transplanted testicular stromal stem cells (tSSCs) on surgically damaged testis tissue. Ten-week-old male Wistar albino rats were divided into three groups: control (n = 6), damage (DG) (n = 6) and testicular stromal stem cell (TSSC) (n = 6) groups. Surgically induced damage was inflicted on the left testes of both the DG and TSSC groups, with no intervention on the right testes. In the TSSC group, damaged testes were treated with transplanted tSSCs, followed by orchiectomy after 15 days. Testes tissues were stained with haematoxylin-eosin (H&E), and recovery rates of functional structures were assessed by modified Johnsen scoring. The effects of tSSCs on testicular tissue were demonstrated by immunohistochemistry using BAX, BCL-2 and caspase 3. Serum testosterone levels were analysed using the enzyme-linked immunosorbent assay (ELISA) method. Surgical damage caused germ cell degeneration in some seminiferous tubules and a decrease in interstitial areas. With tSSC treatment, improvements in testicular architecture were identified through spermatogenesis in the seminiferous tubules and normal histological structures in the interstitial areas. Correspondingly, in the modified Johnsen score, the DG group showed a significant difference compared to the other groups (p = 0.001). High expressions of BAX, BCL-2 and caspase-3 in the DG group revealed prominent features of apoptosis. With the injection of tSSCs, these expressions significantly normalized according to H score analysis (all p = 0.004). Although serum testosterone levels in the tSSC group were higher compared to the control and DG groups, this difference was not statistically significant (p = 0.119). This study suggests transplanting tSSCs could accelerate tissue healing after testicular sperm extraction (TESE) surgery for azoospermia patients, potentially paving the way for a new and important clinical treatment.

Experiences of Operating Room Professionals During the 2020 Izmir Earthquake: A Qualitative Approach.

OBJECTIVE: In the aftermath of earthquakes, the availability of emergency units and operating rooms (OR) in hospitals can make a difference in the survival of those injured. OR professionals' experience during earthquakes is vital for ensuring safe and effective surgical procedures. This study was conducted to explore perceptions and describe the experiences of OR professionals, aiming to improve OR processes during and after earthquakes. METHODS: This phenomenological study employed semi-structured interviews to collect qualitative data from 16 OR professionals who experienced the earthquake. Purposeful sampling was utilized for face-to-face interviews, and MAXQDA20 was used for content analysis. RESULTS: The primary themes included workplace perspectives, during-earthquake experiences, ethical considerations, and post-earthquake experiences. The workplace was described as unique, dynamic, stressful, and disciplined. Participants experienced fear and panic during the earthquake. Abandoning patients was deemed unethical, resulting in ethical quandaries for professionals when their safety was at risk. CONCLUSION: Participants displayed responsibility and ethical conduct while remaining with the patients during the tremor. Implementing practices is crucial in mitigating fear and chaos and improving information management. As such, it is highly recommended that hospital disaster plans incorporate the active participation of OR professionals.

Effects of Surgical and Natural Menopause on Body Image, Self-Esteem, and Dyadic Adjustment: A Descriptive and Comparative Study.

This study aimed to assess body image, self-esteem, and dyadic adjustment in surgically menopausal, naturally menopausal, and perimenopausal women. This descriptive and comparative study was conducted in the clinics and polyclinic of a university hospital with a total of 274 women: 91 in the surgical menopause, 91 in the natural menopause, and 92 in the perimenopause groups. An Individual Introduction Form, the Body Cathexis Scale (BCS), Rosenberg Self-Esteem Scale (RSES), and Dyadic Adjustment Scale (DAS) were used for data collection. The women in the surgical menopause group had significantly higher mean scores for RSES and BCS and lower mean scores for DAS than the women in the natural menopause and perimenopause groups, with the higher BCS and RSES scores indicating lower self-esteem and body satisfaction. A weak negative correlation was found among dyadic adjustment, self-esteem, and body image of women in the surgical menopause group. Results showed that body image, self-esteem, and dyadic adjustment in menopausal women were impaired. This impairment was greater in the surgical menopause group than in the natural menopause group. Additionally, the presence of comorbid chronic diseases, less education, and being overweight negatively affected dyadic adjustment in women. Clinicians' awareness of the importance of the psychological aspects of menopause and the difference in the effects of menopause transition on mental well-being (body image, self-esteem, and marital harmony) according to the occurrence of menopause will enable them to help patients cope more easily with this process.

Assessment of mental health issues in pregnant women with fetal complications: Relation to attachment and anxiety.

PURPOSE: Pregnancy period is important for all women. The aim of this study was to evaluate mental status, antenatal depression, attachment, and anxiety in pregnant women with fetal complications. DESIGN AND METHODS: Mothers who had been diagnosed with fetal complications during pregnancy were interviewed after the delivery of their babies. FINDINGS: The results showed that anxiety and depression scores were significantly higher in the mothers who had received psychiatric support treatment. Maternal attachment scores were found low, depression scores were found high in mothers of children with congenital anomalies. CONCLUSION: According to the results of the study, a maternal attachment was low and depression was high in mothers with congenital anomalies. PRACTICE IMPLICATIONS: Possible psychological problems after birth can be prevented by psychotherapeutic nursing interventions during pregnancy to pregnant women who have babies with fetal anomalies.

Psychological problem areas of pregnant women diagnosed with abortus imminens as a result of assisted reproductive techniques: A comparative study.

PURPOSE: The study was to evaluate the anxiety, depressive symptoms, hopelessness, and perceived social support of women who became pregnant using assisted reproductive techniques and who were both diagnosed or not diagnosed with threatened miscarriage (TM). DESIGN AND METHODS: This comparative and descriptive study was carried out with 194 pregnant women with-TM (96) and non-TM (98). The study data were collected using the Pregnant-Women-Information-Form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS) and Multidimensional Scale of Perceived Social Support (MSPSS). FINDINGS: Women in the TM group were found to have higher mean scores from the BDI, BAI, and BHS, and a lower mean score from the MSPSS compared to the non-TM group (The group with TM had higher levels of anxiety, depression, and hopelessness than the group without TM, and the level of perceived social support by this group was lower). It was found that there was a strongly significant positive correlation in both groups between the BDI and BAI, and between the BDI and BHS. A strongly significant negative correlation was found between the BDI, BAI, BHS, and MSPSS in the TM group, whereas there was a moderately significant negative correlation in the non-TM group. It was found that there was a statistically significant difference between the mean BDI, BAI, BHS, and MSPSS scores according to age group, educational status, number of interventional in vitro fertilization attempts, and history of depression. In addition, there was a statistically significant difference between the mean BDI, BAI, and BHS scores according to previous abortion and family history of depression in the TM group. PRACTICE IMPLICATIONS: Monitoring symptoms of depression, anxiety, and hopelessness in women diagnosed with TM who have become pregnant after infertility treatment, intervening due to the risk factors involved, may prevent possible mental problems and have a positive impact on the healthy continuation of the pregnancy.

Emergency health care personnel's knowledge and experience of elder abuse in Izmir.

The aim of this study is to assess the knowledge, attitudes, and beliefs of emergency health care provider teams toward the identification and management of abused older people. This cross-sectional analytic study was conducted in four hospitals with emergency medical service. One hundred twenty five emergency room health care personnel in Izmir filled out a questionnaire. Of the respondents, 13.6% had never identified an abused older person. Health care personnel working at a university emergency department had a better knowledge base of elder abuse. Most of the participants felt uncomfortable in asking questions about older people abuse. A majority of them reported that it is difficult to properly intervene on the patient's behalf. Most of the participants perceived elder abuse to be uncommon in Turkey. Generally, older people abuse is unrecognized by health care providers; an extensive training and education effort needs to be developed and implemented.