"What doesn't defeat me makes me stronger" A Qualitative Study drawing on the Perspectives of Syrian Refugee University Students in Turkey.

Education is one of the most crucial instruments for refugee youth to remove the disadvantages and enhance their social and structural integration into society. However, the unequal education opportunities concerning the barriers avoid the integration of refugee students into society and make them prone to discrimination. This qualitative descriptive design study aimed at describing the experiences of the subjective perspectives of Syrian refugee students about higher education. The participants were final-year undergraduate Syrian refugee students. Data were collected by conducting in-depth semi-structured face-to-face interviews using a pilot-tested interview guide. The researchers followed a systematic data analysis procedure. The themes were finalized once the researchers had reached a consensus. The responses of the students were subsumed under the following three main themes: (1) Being 'other', (2) Hopes vs Realities, and (3) What doesn't defeat me makes me stronger. The participants reported feeling ignored and worthless due to the biases and assumptions of society, which result in stigma and discrimination. Additionally, refugee students revealed that their peers and even educators may sometimes share the same beliefs. However, the study also underlined the value of resilience in shaping the perspectives, even though they faced many challenging experiences.

COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group.

Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × µL, p = 0.028; platelet count 166 vs. 216 cells × 103/µL, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559). CONCLUSION: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD. WHAT IS KNOWN: • In some cases of MIS-C, the clinical symptoms overlap with Kawasaki disease. • Compared to Kawasaki disease, lymphopenia was an independent predictor of MIS-C. WHAT IS NEW: • Half of the patients had clinical features that overlapped with Kawasaki disease. • In patients whose clinical features overlapped with KD, procalcitonin levels were almost 15 times higher than normal. • Lethargy increased the risk of overlap with KD by 2.6-fold in MIS-C patients. • Transient bradycardia was noted in approximately 10% of our patients after initiation of treatment.

The Effects of Music Therapy on Patients With Coronary Artery Disease Before the Invasive Procedure: A Randomized Controlled Study.

PURPOSE: This study was designed to investigate the effects of music therapy provided to patients who would undergo Coronary Angiography before the invasive procedure on pain, anxiety, and vital signs to reduce the administration of sedatives and to ask the views of the patients regarding the music to which they listened. DESIGN: This study was a randomized controlled study. METHODS: The research sample included 62 patients; 31 in the experimental group and 31 in the control group, who were waiting for having femoral angiography in the waiting room of the invasive procedure and diagnostic laboratory of a training and research hospital in Izmir. Data were collected using "Patient Information Form", "Vital Signs Inspection Form", "State-Trait Anxiety Inventory", and "Visual Analog Scale". The experimental group listened to nonverbal and instrumental music in the forms of taqsim, saz semai, and peshrev at the speeds of 60 (Adagio) and 100 (Andante). Nihavend mode is the most used mode in music therapy and is suitable for the Turkish Cultural structure. The scale of nihavend mode has the same structure with the g minor scale of classical western music. For both groups, pain and anxiety levels were simultaneously measured before and after the process; vital signs were measured before, during, and after the process. FINDINGS: The findings obtained in this study showed that there was a statistically significant difference between the means of anxiety (P = .000) and pain (P = .001) of the patients in experimental and control groups after the procedure. A significant difference was determined between the means before and after the procedure for diastolic (P = .002) blood pressure and pulse wave velocity (P = .002) in vital signs. A significant difference was not determined between the mean of patients' systolic blood pressures (P = .082) and respiration rates (P = .836) before and after the procedure. CONCLUSIONS: The findings suggest that music therapy is effective in reducing blood pressure, respiration rate, anxiety, pain level, and sedative application for the patients. Music therapy within the scope of the nonpharmacological complementary therapies can be administered by the healthcare providers, given that the patients have no adverse effects or additional costs and thanks to ease of implementation.

An assessment of the protective effect of gonadotropin-releasing hormone agonist and antagonist on bleomycin-induced ovarian toxicity in rats.

The aim of this study is to evaluate the effect of GnRH agonist or GnRH antagonist therapy on bleomycin-administered rats by examining ovarian follicle counts and AMH levels. A total of 30 female Wistar albino rats aged 4-6 months were randomly divided into 4 groups. First, an intramuscular injection of bleomycin (30 mg/m2) was administered to all except the control group on the 1st, 8th and 15th days. The control group (Group I) was administered 0.1 mL intramuscular saline on those days. The bleomycin group (Group II) was followed up without any further treatment. The bleomycin + GnRH agonist group (Group III) was administered subcutaneous GnRH agonist triptorelin (1 mg/kg) at the same time as the bleomycin injections. The bleomycin + GnRH antagonist group (Group IV) was administered 1 mg/kg cetrorelix acetate subcutaneously, concurrently with the bleomycin. Although AMH levels were lower in the bleomycin group than in all the other groups, there was no statistically significant difference between the groups in terms of AMH levels (p > .05). In the bleomycin + cetrorelix acetate and bleomycin + triptorelin groups, significantly higher primordial, secondary and tertiary follicle counts were determined compared to the bleomycin group (p < .001). In conclusion the harmful effects of bleomycin on ovarian reserve can be reduced by the simultaneous administration of GnRH agonist or GnRH antagonist.

Are Maternal Personality Traits an Etiological Factor in Adolescents with Functional Chest Pain?

BACKGROUND: In the etiology of functional chest pain (FCP), parental personality traits are worth considering in the context of the biopsychosocial model. The αlpha factor sub-dimension of the five-factor personality model (5FPM) includes agreeableness, conscientiousness, and neuroticism. There is increasing evidence that this dimension may be related to psychosomatic diseases. It was aimed to investigate how maternal personality traits affect adolescents with FCP. The hypothesis was determined that adolescents diagnosed with FCP can have lower quality of life and be more depressive/anxious and their mothers can have factor-α personality traits and be more depressive/anxious. METHODS: The sample of this single-center, cross-sectional, case-control study consisted of 25 adolescents with FCP and their parents. The control group consisted of 35 age and sex matched healthy adolescents and their parents. Psychopathology was screened using the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) and psychiatric comorbidities were excluded. The Child Depression Inventory (CDI), the Spielberger State-Trait Anxiety Inventory (STAI), and KINDL forms were completed by the adolescents. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Five-Factor Personality Inventory short form (FFPI) were completed by the parents. RESULTS: Mothers of adolescents with FCP scored significantly higher compared with mothers of healthy controls in agreeableness and conscientiousness and scored significantly lower in neuroticism. Higher levels of mothers' neuroticism scores were associated with higher CDI and STAI-1 scores in FCP group. Agreeableness (Exp (B) = 10.097; p = .004; confidence interval [CI] = 2.049-49.745) and conscientiousness (Exp (B) = 16.414; p = .011; CI = 1.902-141.682) were statiscally significant in regression model. CONCLUSIONS: This study showed for the first time that mother's alpha factor personality traits may be one of the factors that contribute to the presence of FCP.

Clinical Effects and Predictive Factors Affecting the Clinical Severity of Scorpion Envenomations in Western Turkey.

BACKGROUND: Scorpion envenomation is a common medical emergency in many countries, including Turkey. Severe systemic symptoms occur more easily in children and mortality rates are higher. The aim of this study is to describe the clinical effects and predictive factors affecting the clinical severity of scorpion envenomations in Western Turkey. METHODS: Two hundred one children (138 mild cases, 34 moderate, and 29 severe) with scorpion envenomation aged between 1 month and -17 years were included in the study. The patients' demographic and laboratory characteristics were compared among clinical severity subgroups. RESULTS: The patients' median age was 7 (4-11) years. The median age of the severe group was significantly lower than that of the mild and moderate groups (p < 0.001). Seventeen patients (8.5%) developed myocarditis, while no pulmonary edema was observed in any case. Leukocyte, neutrophil and platelet (PLT) counts, and plateletcrit (PCT) and glucose levels increased significantly with the severity of envenomation (p < 0.001). PLT counts and PCT levels exhibited positive correlation with leukocyte and neutrophil counts (p < 0.001, r = 0.781, r = 0.638, r = 0.772, and r = 0.629, respectively). Supraventricular tachycardia developed in 1 (5.9%) patient, and dilated cardiomyopathy in another (5.9%). No mortality occurred in any case. CONCLUSION: Increased PLT counts and PCT levels may be helpful in evaluating clinical severity in patients with scorpion sting envenomation. The possibility of myocarditis development in children should be remembered and cardiac enzymes should be checked, even if patients are asymptomatic and cardiac enzymes are normal on admission.

Management of a glottic squamous cell carcinoma with cutaneous metastasis.

INTRODUCTION: Oral cavity malignancies constitute 30% of head and neck cancers. The most common distant metastatic sites of glottic carcinoma are usually lung, liver and bone. Although the cutaneous metastasis of head and cancers have been reported with an incidence of 0.7-2.4%, skin metastasis of glottic carcinoma is extremely rare. CASE REPORT: A 69-year-old male patient was admitted to the emergency department with hemoptysis, dyspnea, weakness in lower extremities and difficulty in swallowing. There were subcutaneous lesions with a diameter of 2-5 cm in the scalp, posterior chest wall, nose and abdomen. In addition, there was an ulcerating, painful mass on the right lateral part of the tongue. The biopsy of lesions on tongue and skin revealed a glottic squamous cell carcinoma with cutaneous metastasis.Management and outcome: The patient was treated with cisplatin 50 mg/m2 on day 1, cetuximab 500 mg/m2 on day 1 and 5-fluorouracil 1000 mg/m2 daily on days 1 and 2, repeated every two weeks. After the first cycle of chemotherapy, the lesions on the skin regressed and dysphagia improved. DISCUSSION: There are limited data about the incidence, diagnostic measures and treatment modalities of glottic cancer with cutaneous metastasis. Our case could provide an important experience to literature by its atypical presentation and treatment-sensitive nature.

Increased asymmetric dimethylarginine in vitamin B12 deficient adolescents.

OBJECTIVE: Vitamin B12 deficiency induces hyper-hyperhomocysteinemia by inhibiting intracellular methionine re-methylation. Hyper-hyperhomocysteinemia increases the risk of atherosclerosis. Asymmetric dimethylarginine is an endogenous inhibitor of nitric oxide synthase and its level elevates in cardiovascular diseases. In this study, we aimed to examine the relationship between asymmetric dimethylarginine and arterial stiffness and atherosclerosis in adolescents with vitamin B12 deficiency. METHODS: A total of 88 adolescents with age ranging between 11 and 17 years of age were enrolled for this study. Among them, 50 patients had vitamin B12 deficiency 200 pg/ml. In all cases, the levels of asymmetric dimethylarginine were measured with high performance liquid chromatography method. The carotid artery intima media thickness and left ventricular mass index were measured using echocardiography. All these measurements of the study groups were compared. RESULTS: Both plasma levels of asymmetric dimethylarginine and carotid artery intima media thickness were significantly higher in the vitamin B12 deficiency group than in the control group. Correlation analysis showed significant negative correlation of vitamin B12 with homocysteine, asymmetric dimethylarginine, and carotid artery intima media thickness (p<0.05). CONCLUSION: Our results suggest that endothelial dysfunction starts in the early stage of adolescent vitamin B12 deficiency, and vitamin B12-deficient adolescents have increased circulating asymmetric dimethylarginine, showing that endothelial dysfunction and increased carotid artery intima media thickness be related to atherosclerosis.

Blood pressure is normal, but is the heart?

BACKGROUND: There is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. METHODS: Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, ß-blocker, or diuretics. RESULTS: There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 ± 3.41 versus - 21.01 ± 3.82 (P < 0.001), and global radial strain was 40.6 ± 9.8 versus 54.8 ± 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. CONCLUSIONS: Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.

Congenital Hemophilia A Presenting With Hashimoto's Encephalopathy and Myocarditis: The First Reported Case.

Here, we report a case of hemophilia A with myocarditis, encephalopathy, and spontaneous intramedullary hemorrhage. A 14-month-old male infant presented with loss of consciousness, generalized tonic-clonic convulsions, and cardiac failure. The neurological examination was normal. Myocarditis was diagnosed. After administration of fresh frozen plasma, the aPTT did not return to normal. The factor VIII (FVIII) level was 10.2% the normal level, and the patient was diagnosed with hemophilia A. The cerebrospinal fluid (CSF) evaluation was unremarkable, with the exception of elevated CSF protein levels. An electroencephalogram revealed diffuse slowing of background activity. The spinal MRI revealed chronic bleeding in areas of the medulla spinalis. Tests for the antibodies associated with autoimmune encephalitis were negative. Anti-thyroglobulin (THG) (11.8 U/mL [normal, 0 to 4 U/mL]) and anti-thyroid peroxidase (TPO) (53.9 U/mL [normal, 0 to 9 U/mL]) antibodies were present in the serum. The patient received 1 g/kg intravenous immunoglobulin G (IVIG) for 2 days based on a diagnosis of myocarditis and Hashimoto's encephalopathy. After the first month of treatment his clinical findings were negative. He developed an inhibitor to FVIII 1 month after initiation of FVIII replacement therapy. Hemophilia A has various clinical presentations. Autoimmunity may lead to early inhibitor development in patients with hemophilia.

Rapid Improvement of Pulmonary Functions in Children After Transcatheter Closure of an Atrial Septal Defect.

There are very few studies in the literature on respiratory system functions and complications of children with an atrial septal defect (ASD). The aim of this study is to investigate the pulmonary functions and pulmonary complications before and after transcatheter closure in children with an ASD. In this study, pulmonary function test parameters of 30 ASD patients between 5 and 18 years of age who were eligible to be treated by transcatheter ASD closure were compared with 30 healthy children. The patients undergoing transcatheter ASD closure received pulmonary function tests (PFT) at baseline (1 day before ASD closure), and 3 months after the procedure. Forced vital capacity (FVC), forced expired volume in 1 s (FEV1), peak expiratory flow, and mean forced expiratory flow during the middle half of FVC were measured. The mean age of the 30 ASD patients was 9.59 ± 3.1 years; and 20 (66.6%) were female and 10 (33.3%) were male. The mean age of the control group was 10.15 ± 2.21 years, and 19 (63.3%) were girls and 11 (36.6%) were males. ASD patients had significantly reduced FVC (73.11 ± 24.6%; 86.05 ± 26.1; p = 0.001, respectively), and FEV1 (81.34 ± 26.2% and 99.2 ± 19.6%; p = 0.001; respectively) at baseline. But significant improvement was observed in FVC values in the 3rd-month post-closure comparison of the patient group with the control group (73.11 ± 24.6%; and 88.36 ± 14.5%; p = 0.01, respectively); FEV1 values (81.34 ± 26% and 99.54 ± 18.2%; p = 0.005, respectively) and mean forced expiratory flow between 25 and 75% of vital capacity (MEF25-75) values (94.6 ± 33.4% and 124.2 ± -24.1%; p = 0.01, respectively) were also improved. There was no statistically significant relationship between the PFT measurements at baseline and after closure of the defect and age at transcatheter closure, gender, body height, body weight, ASD diameter, Q p/Q s, right ventricle systolic pressure, or mean pulmonary artery pressure values. At the 3rd month of ASD closure, there was no significant difference in the comparison of the PFT values of the patient and control group. Disturbance in the significant flow limitation of the peripheral airway of ASD patients was observed with PFT. Better pulmonary outcomes were observed in ASD patients after transcatheter closure.

A first case report of diffuse acneiform eruption caused by capecitabine in a patient with small-cell neuroendocrine lung carcinoma.

Capecitabine is a chemotherapeutic agent which is converted to fluorouracil by thymidine phosphorylase in human body. It is one of the commonly used agents in colorectal and metastatic breast cancers. Hand-foot syndrome is most commonly observed adverse effect of capecitabine; however, it has several adverse cutaneous and mucosal effects. To the best of our knowledge, no case with acneiform eruption has been reported so far. Here, we presented a 54-year-old man with development of capecitabine-related acneiform drug eruption.

Huge Left Atrial Pseudoaneurysm in a 5-Month-Old Baby Presented with Supraventricular Tachycardia.

UNLABELLED: Cardiac pseudoaneurysm is an extremely rare condition in children. It can be congenital or acquired and has been primarily described in the left side of the heart. The congenital form of pseudoaneurysm is thought to be related to muscular dysplasia of the muscular layer of the heart. The acquired form is related to myocardial infarction, infective endocarditis or chest trauma. In this report we described a 5-month-old baby with left atrial pseudoaneurysm who was referred to our hospital due to tachycardia and hemodynamic instability. After diagnosis of left atrial pseudoaneurysm, aneurysmectomy was performed and the left atrial wall was successfully repaired by surgery three days after admission. In conclusion, due to life threatening complications such as dissection, arrhythmias, compression of aneurysm and tromboembolic complications, pseudoaneurysm should be treated by surgery. KEY WORDS: Chest trauma; Left atrial pseudoaneurysm; Supraventricular arrhythmias.

The inflammatory cytokine interleukin-23 is elevated in lung cancer, particularly small cell type.

AIM OF THE STUDY: Interleukin (IL)-17 and IL-23 play roles in inflammation and autoimmunity. The function of the IL-17/IL-23 pathway has not been completely evaluated in cancer patients. We aimed to investigate serum IL-17 and IL-23 levels and their relationship with clinicopathological and biochemical parameters in lung cancer patients. MATERIAL AND METHODS: Forty-five lung cancer patients and 46 healthy volunteers were included in the study. IL-17 and IL-23 measurements were made with the ELISA method. The ages of patients (53-84 years) and healthy subjects (42-82 years) were similar. RESULTS: Serum IL-23 levels were higher in lung cancer patients than in healthy subjects (491.27 ±1263.38 pg/ml vs. 240.51 ±233.18 pg/ml; p = 0.032). IL-23 values were higher in small cell lung cancer (SCLC) patients than in non-small cell lung cancer (NSCLC) patients (1325.30 ±2478.06 pg/ml vs. 229.15 ±103.22 pg/ml; p = 0.043). Serum IL-17 levels were lower in the patients, but the difference was not statistically significant (135.94 ±52.36 pg/ml vs. 171.33 ±133.51 pg/ml; p = 0.124). Presence of comorbid disease (diabetes mellitus, hypertension or chronic obstructive lung disease) did not have any effect on the levels of IL-17 or IL-23. Erythrocyte sedimentation rate values were positively correlated with cytokine levels, but serum albumin levels were negatively correlated. CONCLUSIONS: Serum IL-23 levels are elevated in lung cancer patients, particularly those with SCLC. IL-17 and IL-23 values are correlated with inflammatory markers in the patients.

Evaluation of hypertension by ambulatory blood pressure monitoring in children with solitary kidney.

In this study, we aimed to investigate the blood pressure (BP) profile in children with a unilateral functioning solitary kidney (UFSK). A group of 49 patients between the ages of 5 and 18 years, and 30 healthy controls between the ages of 6 and 16 years were investigated. Gender, weight, height and body mass index (BMI) of patients and controls were recorded. BP profile was determined by ambulatory BP monitoring (ABPM). We have observed a higher risk of hypertension compared with healthy children. Also, masked hypertension is more frequently in the patients group and white-coat hypertension was observed in the control group. The mean night-time systolic BP (SBP) load (p = 0.01) and 24-h diastolic BP (DBP) load (p = 0.008) of children with multicystic dysplastic kidney (MCDK) was significantly higher than the healthy group. The mean night-time SBP load (p = 0.001) of children with unilateral renal agenesis (URA) and 24-h DBP load (p = 0.003) of children with unilateral atrophic or hypoplastic kidney were significantly higher than healthy group. We showed that the children with a solitary kidney had increased risk of hypertension. ABPM reflects the BP profile more precisely than casual BP measurement and it can be used to evaluate white-coat and masked hypertension in children with a solitary kidney.

Effect of montelukast on clinical score and cytokine levels of infants for clinically diagnosed acute bronchiolitis.

BACKGROUND: Acute bronchiolitis comprises a major cause for morbidity in infants with viral infection which induces an immune inflammatory response that may produce long lasting harmful effects. Currently, there is no effective therapy for bronchiolitis. OBJECTIVE: Our aim was to investigate the efficacy of five-day montelukast therapy in acute bronchiolitis management. METHODS: The study included 50 infants with acute bronchiolitis. The infants with first episode of acute bronchiolitis were randomly assigned to receive daily montelukast dose of 4mg over five days after admission or no treatment. Plasma eotaxin, IL-4, IL-8 and IFN-gamma levels were evaluated before and after treatment by ELISA method. In the present study, the primary outcome measure was change in clinical severity score, whilst secondary outcome measures were changes in plasma eotaxin, IL-4, IL-8, IFN-gamma levels. RESULTS: No significant differences was found in clinical severity score with five-day montelukast treatment (p>0.05, Mann-Whitney U test). There were no significant differences in plasma eotaxin, IL-4, IL-8, IFN-gamma levels between the groups (p>0.05 Mann-Whitney U test). There was significant decrease in plasma IFN-gamma levels following five-day montelukast treatment (p=0.027, Wilcoxon). There were no significant differences in plasma IL-4, IL-8, IFN-gamma levels between the groups after five-day montelukast treatment (p>0.05, Wilcoxon). There was significant increase in eotaxin levels after five-day montelukast treatment (p=0.009, Wilcoxon). CONCLUSION: Our study showed that montelukast affected plasma IFN-gamma and eotaxin levels after five days of treatment. Further studies are needed to demonstrate effects of montelukast on chemokine levels in bronchiolitis.

The effects of music therapy on pain in patients with neuropathic pain.

The aim of this study was to investigate the effect of relaxing music on pain intensity in patients with neuropathic pain. A quasi-experimental study, repeated measures design was used. Thirty patients, aged 18-70 years, with neuropathic pain and hospitalized in an Algology clinic were identified as a convenience sample. Participants received 60 minutes of music therapy. Classical Turkish music was played to patients using a media player (MP3) and headphones. Participants had pain scores taken immediately before the intervention and at the 30th and 60th minutes of the intervention. Data were collected over a 6-month period in 2012. The patients' mean pain intensity scores were reduced by music, and that decrease was progressive over the 30th and 60th minutes of the intervention, indicating a cumulative dose effect. The results of this study implied that the inclusion of music therapy in the routine care of patients with neuropathic pain could provide nurses with an effective practice for reducing patients' pain intensity.

Representation of haptic objects during mental rotation in congenital blindness.

The representation of haptic objects by three groups of participants (sighted, blindfolded, and congenitally blind) was studied in a mental-rotation task. Three models were tested. The participants explored a standard object continuously with the left hand and tried to find the mirror object among two alternatives explored sequentially with the right hand. Sighted participants were tested in the visual version of the task. The accuracy of judgments was very high (> 95%) for all groups, and the blind group had the highest identification times. Correlation analyses were performed between (both single-trial and average) identification times and angular differences. The identification times of the sighted and blindfolded groups increased as linear functions of the angular difference between the mirror and the standard stimuli, supporting the classical model. The identification times of the blind group changed non-monotonically and were consistent with an antiparallel image (180 degrees rotation superimposed) in the mental representation. The dual code model did not fit the data well for any participant group. The performance differences between the blindfolded and blind groups may be attributed to a modified mapping function from the object-properties-processing sub-system to the visual buffer, which was conjectured to be available also to the blind group while processing haptic objects.

CD4+CD25(high), CD8+CD28- cells and thyroid autoantibodies in breast cancer patients.

AIM OF THE STUDY: To investigate the percentage of CD4+CD25(high) cells (including Treg cells) and CD8+CD28- cells in breast cancer patients with and without high levels of autoimmune thyroid antibodies. MATERIAL AND METHODS: Thirty-five women with breast cancer (9 of them having high thyroid antibodies) and fourteen healthy subjects were enrolled in this study. Flow cytometry was used to count CD4+CD25(high) cells and CD8+CD28- suppressive cells (CD8 cell subtypes). RESULTS: In the patient group, the percentage of CD28- cells in CD8+ lymphocytes were higher [67.50% (55.1180.33) vs. 51.56% (42.5766.38); p = 0.021] and the percentage of CD28+CD45RO- cells (memory cells) in CD8+ lymphocytes were lower than in the control group. CD4+CD25(high) cell percentage in CD4+ lymphocytes was elevated in the patient group [6.44% (4.528.74) vs. 2.97% (1.724.34); p < 0.001]. When the cytometric parameters were compared between patients (with high vs. normal thyroid antibodies), the distribution of CD8+ cell subgroups was also similar. CD4+CD25(high) cells among CD4+ lymphocytes were decreased in patients with high levels of thyroid antibodies [5.19% (3.426.17) vs. 6.99% (4.829.95); p = 0.043]. CONCLUSIONS: CD4+CD25(high) cells may play a role in autoimmunity of breast cancer patients, and may be a predictive marker. Advanced studies which evaluate the possible links between regulatory cells and autoimmunity should be established in cancer patients.

Fake paper identification in the pool of withdrawn and rejected manuscripts submitted to Naunyn-Schmiedeberg's Archives of Pharmacology.

Honesty of publications is fundamental in science. Unfortunately, science has an increasing fake paper problem with multiple cases having surfaced in recent years, even in renowned journals. There are companies, the so-called paper mills, which professionally fake research data and papers. However, there is no easy way to systematically identify these papers. Here, we show that scanning for exchanged authors in resubmissions is a simple approach to detect potential fake papers. We investigated 2056 withdrawn or rejected submissions to Naunyn-Schmiedeberg's Archives of Pharmacology (NSAP), 952 of which were subsequently published in other journals. In six cases, the stated authors of the final publications differed by more than two thirds from those named in the submission to NSAP. In four cases, they differed completely. Our results reveal that paper mills take advantage of the fact that journals are unaware of submissions to other journals. Consequently, papers can be submitted multiple times (even simultaneously), and authors can be replaced if they withdraw from their purchased authorship. We suggest that publishers collaborate with each other by sharing titles, authors, and abstracts of their submissions. Doing so would allow the detection of suspicious changes in the authorship of submitted and already published papers. Independently of such collaboration across publishers, every scientific journal can make an important contribution to the integrity of the scientific record by analyzing its own pool of withdrawn and rejected papers versus published papers according to the simple algorithm proposed in the present paper.