PNEUMATIC RETINOPEXY: Analysis of Risk Factors and Complications in 850 Cases.

BACKGROUND: To study out types and incidence of the complications and reveal the risk factors that affect anatomical and visual success of pneumatic retinopexy with a high number of rhegmatogenous retinal detachment cases. METHODS: Eight hundred and fifty eyes of the 837 patients who admitted at a tertiary center, between January 2015 and January 2022 for the diagnosis of rhegmatogenous retinal detachment, then underwent pneumatic retinopexy and had at least sixth month follow-up, were included in the study. The multivariate logistic regression model was created to investigate the factors affecting anatomical and visual success. RESULTS: The anatomical success rate was 53.4% with the first pneumatic retinopexy and 99.8% after subsequent procedures. Visual acuity of >0.4 logMAR (<20/50 Snellen), proliferative vitreoretinopathy, and macular involvement was determined as significant preoperative risk factors for single operation and visual success in all univariate and multivariate analyses. In addition, pseudophakic/aphakic lens status was associated with single operation failure in all analyses. Besides, in all analyzes for single operation and visual success, new or missed tears, proliferative vitreoretinopathy, delayed subretinal fluid, macular hole, and subretinal gas were identified as significant postoperative risk factors. Among these, new or missed tears was determined as the most common complication with a rate of 24%. CONCLUSION: There are many risk factors influencing the success of pneumatic retinopexy. These factors and complications should always be considered, before applying this rapid, effective, inexpensive, and minimally invasive method.

Evaluating of neonatal early onset sepsis through lactate and base excess monitoring.

Early-onset sepsis (EOS) is one of the leading causes of neonatal death and morbidity worldwide and timely initiation of antibiotic therapy is, therefore, of paramount importance. This study aimed to evaluate the predictive effect of lactate and base excess (BE) values in the cord arterial blood gas and the 6th hour of life venous blood gas analysis on clinical sepsis in newborns. This is a cohort case-control study. In this study, 104 cases were divided into clinical and suspected sepsis groups according to the evaluation at the 24th hour after delivery. Lactate and BE values were evaluated in the cord arterial blood gas analysis (ABGA) and at the postnatal 6th-hour venous blood gas. The cord ABGA and postnatal 6th-hour results were compared in the clinical and suspected sepsis groups. Clinical sepsis was found to be associated with a lactate value above 2 mMol/L at postnatal 6th-hour venous blood gas (p = 0.041). This association was the highest when the clinical sepsis group's postnatal 6th-hour lactate cut-off value was determined as 3.38 mMol/L (sensitivity 57.9% and specificity 68.5%) (p = 0.032). However, no association was found between clinical sepsis diagnosis and venous BE's value in cord ABGA at the postnatal 6th hour. We found that a venous lactate value above 3.38 mMol/L at the postnatal 6th hour was the cut-off value that could indicate early-onset clinical sepsis. However, none of the biomarkers used in diagnosing EOS can accurately show all cases.

Incidental Papillary Microcarcinoma and Papillary Thyroid Carcinoma in Multinodular Goiter.

Introduction: This study aimed to examine the incidence of incidental papillary microcarcinoma (PMC) and papillary thyroid carcinoma (PTC) in patients with benign multinodular goiter (MNG) and to compare their relationship with some prognostic factors from a new perspective. Methods: Bilateral total thyroidectomy (BTT) was used to evaluate the data of 716 patients who underwent a surgery for MNG. The prognostic data for these tumors and the relationship between patients with bilateral and multifocal tumors were evaluated using statistical tests. Results: Papillary carcinomas were detected in 201 patients, PMC in 134 of them, and PTCs in 67. Bilaterality was more common in patients with PTCs than in those with PMC. The incidence of bilaterality in male patients with PTC was statistically more common. The presence of intra-tumoral lymphocytes was higher in multifocal PTC cases than in unifocal PTC cases. Conclusion: The results revealed that the number of PMC s was high in incidental tumors, and patients with PTC with male sex, bilaterality, multifocality, and tumor capsule invasion were associated with poor prognosis.

Effectiveness of the BNT162b2 and the CoronaVac vaccines and boosters in healthcare workers.

The evidence on the waning protection of COVID-19 vaccines has been reviewed by the World Health Organization and has led to consideration of the need for booster doses. This study aimed to evaluate vaccine effectiveness against COVID-19, and the COVID-19 infections among healthcare workers who received various types (inactive or m-RNA) and doses (2 to 4 doses) of the COVID-19 vaccine. The study was conducted with a total of 3,009 healthcare workers between August 1 and November 30, 2021 at a university hospital. Six different vaccination statuses were evaluated in the study. The effectiveness for COVID-19 infection, after adjusting for age, sex, and position, was highest in those who received two doses of CoronaVac and two doses of BNT162b2 (89.3%, 95% CI 72.2-95.9%) and was lowest in those who received two doses of CoronaVac (29%, 95% CI - 8-53%). The adjusted effectiveness of two doses of CoronaVac for COVID-19 infection was not significant (21.0%, 95% CI - 20.7-48.3%) but increased significantly with a booster dose of CoronaVac or BNT162b2. One or two doses of the BNT162b2 booster demonstrated higher effectiveness in comparison to a single dose of the CoronaVac booster. These results indicate the need for a booster dose, and heterologous boosting with BNT162b2 may be a better option for higher effectiveness for those who received two doses of CoronaVac. Future studies should evaluate the need for further booster doses and their long-term effects.

The heat wave knowledge, awareness, practice and behavior scale: Scale development, validation and reliability.

Heat waves are extreme weather and climate events that threaten public health by increasing morbidity and mortality. To reduce the health effects of heat waves, it is necessary to increase the knowledge level of the public, conduct awareness and protection activities and monitor these activity outcomes. The present study aimed to develop and validate a Turkish language scale of heat wave knowledge, awareness, practice and behavior for Turkish nationality. After item generation and creating dimensions, content validity analysis was performed. To evaluate the validity and reliability of the knowledge construct, the difficulty index, discriminant index and Kuder Richardson 20 (KR20) were used. The validity and reliability of the awareness, practice and behavior constructs were evaluated with exploratory and confirmatory factor analyses, and Cronbach's alpha was used. The 15 items had a good difficulty, discrimination index and KR20 in the knowledge construct. The 14 items were yielded in EFA; 13 items were retained in CFA, and Cronbach's alpha values of 0.878, 0.768, 0.855, and 0.858 were obtained for total items, practice, awareness and behavior, respectively. Eventually, a Turkish language scale was developed that is reliable and valid for assessing heat wave knowledge, awareness, practice and behavior.