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Prosthetic joint infections caused by Mycobacterium tuberculosis: single centre experience
No full textBackgroundTuberculosis (TB) remains a significant global health threat; however, prosthetic joint infections (PJIs) attributable to Mycobacterium tubercu-losis are uncommon. A lack of clinical suspicion often leads to diagnostic delays, unnecessary long-term antibiotic treatments, and repeatedsurgical interventions. This study aims to enhance awareness of mycobacterial infections in the differential diagnosis of PJIs, particularly inendemic regions.Case(s) descriptionWe conducted a retrospective analysis of patients diagnosed with PJIs who had a positive culture for Mycobacterium tuberculosis in osteoartic-ular samples at a university hospital in Izmir, Turkey, from 2000 to 2024. We examined clinical features and treatment outcomes.Between 2000and 2024, Mycobacterium tuberculosis was cultured from 29 osteoarticular samples, with 10 patients meeting the criteria for PJIs. The cohortcomprised 8 females, with a median age of 66.5 years (range: 38-88 years). Notably, none of the patients had a prior history of tuberculosis. Ofthe six patients evaluated with a tuberculin skin test, four tested positive. The affected joints included the knee (6 patients) and hip (4 patients).The median interval from prosthesis implantation to infection onset was 30 months (range: 12-108 months). Sensitivity testing revealed that8 patients had Mycobacterium tuberculosis strains sensitive to rifampicin (R), isoniazid (I), ethambutol (E), and streptomycin (S). One patientexhibited resistance to isoniazid and streptomycin, while another was resistant only to isoniazid. Antituberculosis treatment regimens and sur-gical interventions are detailed in the accompanying table. Additionally, other microorganisms were identified during concurrent cultures in twopatients, including Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli. Pathological evaluations indicated necrotizinggranulomatous infections in 6 cases and granulomatous infections in 4 cases. The standard antituberculosis treatment duration was typically 12months. All patients were successfully treated with a two-stage revision and extended antituberculosis therapy.DiscussionMycobacterium tuberculosis should be included in the differential diagnosis of PJIs in endemic areas, particularly when routine bacterial culturesyield negative results and the response to antibiotic therapy is suboptimal.</p
Diş Hekimine Başvuran Hastaların Estetik Algılarının Görsel Anket Yöntemiyle Değerlendirilmesi
No full textDiş Hekimine Başvuran Hastaların Estetik Algılarının Görsel Anket Yöntemiyle Değerlendirilmesi FATMA GÜL DEMİR1 , SEMİHA HÜLYA ERTEN CAN1 , ASLI SİLKÜ OFLİOĞLU1 , METİN YANGIN21DOKUZ EYLÜL ÜNİVERSİTESİ DİŞ HEKİMLİĞİ FAKÜLTESİ2MİMAR SİNAN GÜZEL SANATLAR ÜNİVERSİTESİ FEN EDEBİYAT FAKÜLTESİAmaç: Bu çalışma, diş hekimine başvuran bireylerin estetik algıları ile yaş, cinsiyet ve meslek gibi demografik değişkenler arasındaki ilişkiyi değerlendirmek amacıyla yapıldı. Farklı diş ve gülüş parametrelerinin bireyler tarafından nasıl algılandığının belirlenmesiyle, estetik planlamalarda hasta beklentilerine daha uygun ve kişiye özgü yaklaşımlar geliştirilmesi hedeflendi.Yöntem: Bu çalışma, Dokuz Eylül Üniversitesi Diş Hekimliği Fakültesi Restoratif Diş Tedavisi Anabilim Dalına başvuran 503 (305 kadın, 198 erkek) gönüllü hasta üzerinde gerçekleştirildi. Katılımcıların %55.9’u sağlık alanında, %44.1’i sağlık dışı mesleklerde çalışmaktaydı. Veri toplamak amacıyla, 12 sorudan oluşan çevrim içi bir görsel anket (Google Forms) kullanıldı. Ankette; kanin dişi formu, dudak yapısı, dudak rengi, diş rengi, diş formu, dişeti görünümü, embraşür derinliği, orta hat simetrisi ve diastema varlığına ilişkin 9 estetik parametreye ait görseller yer aldı. Elde edilen veriler, IBM SPSS Statistics 27.0 yazılımında Pearson Ki-kare testi kullanılarak analiz edildi. İstatistiksel anlamlılık düzeyi p<0.05 olarak kabul edildi.Bulgular (sayısal ve/veya istatistiki veriler): Cinsiyetin estetik algı üzerindeki etkisi incelendiğinde, dudak yapısı, orta hat diasteması, dişeti görünümü orta hat simetrisi ve insizal embraşür derinliği parametrelerinde anlamlı fark saptandı(p<0.05). Kadınlar, dişeti görünümünün minimal olduğu, diastemasız ve simetrik gülüşleri daha estetik olarak değerlendirdi . Kanin dişi formu, rujlu–rujsuz gülüş, diş rengi ve diş formu tercihlerinde cinsiyet grupları arasında anlamlı fark tespit edilmedi(p> 0.05). Meslek değişkenine göre, kanin dişi formu, rujlu–rujsuz gülüş ve diş formu parametrelerinde anlamlı fark bulundu. (p<0.05). Sağlık çalışanları sivri kanin formunu, rujsuz doğal gülüşleri ve oval diş formunu; sağlık alanı dışında çalışan bireyler köşeli diş formunu daha estetik değerlendirdi. Yaş değişkenine göre, kanin dişi formu, orta hat diasteması, orta hat simetrisi ve diş formu parametrelerinde anlamlı fark bulundu(p <0.05). 35 yaşın altındaki bireyler sivri kaninleri, diastemasız, simetrik gülüşleri, üçgen/oval diş formunu tercih ederken; ileri yaş grubundakiler yuvarlatılmış kanin ve kare diş formunu daha estetik buldu.Sonuç(lar): Estetik gülüş algısının yaş, cinsiyet ve meslek gibi demografik değişkenlerle yakından ilişkili olduğu belirlendi. Kadınlar, genç bireyler ve sağlık çalışanları; daha simetrik, daha doğal ve düzenli morfolojileri tercih etti. Erkek katılımcılar, ileri yaş grupları ve sağlık dışı alanlarda çalışan bireyler; keskin konturları estetik bulurken, minimal asimetrileri daha kabul edilebilir olarak değerlendirdi. Bu bulgular, estetik diş hekimliği uygulamalarında demografik farklılıkların dikkate alınmasının, bireye özgü tedavi planlamalarında hasta memnuniyetini artırmada önemli bir belirleyici olduğunu ortaya koydu.Anahtar Kelime(ler): Demografik faktörler, Estetik algı, Görsel anket çalışması, Gülüş estetiğiEvaluation of Aesthetic Perceptions of Patients Visiting the Dentist Using a Visual Questionnaire MethodFATMA GÜL DEMİR1 , SEMİHA HÜLYA ERTEN CAN1 , ASLI SİLKÜ OFLİOĞLU1 , METİN YANGIN21DOKUZ EYLÜL UNIVERSITY FACULTY OF DENTISTRY2MİMAR SİNAN GÜZEL SANATLAR UNIVERSITY, FACULTY OF ARTS AND SCIENCESObjective: This study was conducted to evaluate the relationship between the aesthetic perceptions of individuals visiting the dentist and demographic variables such as age, gender, and occupation. By determining how different teeth and smile parameters are perceived by individuals, the aim was to develop more patient-centered and personalized approaches in aesthetic planning.Method: This study was conducted on 503 volunteer patients (305 women, 198 men) who visited the Department of Restorative Dentistry at Dokuz Eylül University Faculty of Dentistry. 55.9% of the participants worked in the health sector, while 44.1% worked in non-health professions. An online visual questionnaire (Google Forms) consisting of 12 questions was used to collect data. The questionnaire included images related to 9 aesthetic parameters: canine tooth shape, lip structure, lip color, tooth color, tooth shape, gingival appearance, embrasure depth, midline symmetry, and diastema presence. The data obtained were analyzed using the Pearson Chi-square test in IBM SPSS Statistics 27.0 software. The statistical significance level was set at p<0.05.Findings: When examining the effect of gender on aesthetic perception, significant differences were found in the parameters of lip structure, midline diastema, gingival display, midline symmetry, and incisal embrasure depth (p<0.05). Women rated smiles with minimal gingival display, no diastema, and symmetry as more aesthetically pleasing. No significant differences were found between gender groups in canine tooth form, lipstick-free smile, tooth color, and tooth form preferences (p> 0.05). According to the occupation variable, a significant difference was found in the canine tooth shape, smile with or without lipstick, and tooth shape parameters (p<0.05). Healthcare workers evaluated pointed canine shape, natural smiles without lipstick, and oval tooth shape as more aesthetic; individuals working outside the healthcare field evaluated angular tooth shape as more aesthetic. According to the age variable, significant differences were found in the canine tooth shape, midline diastema, midline symmetry, and tooth shape parameters (p<0.05). Individuals under the age of 35 preferred pointed canines, diastema-free, symmetrical smiles, and triangular/oval tooth shape; while those in the older age group found rounded canines and square tooth shape more aesthetic.Conclusion: Aesthetic smile perception was found to be closely related to demographic variables such as age, gender, and occupation. Women, younger individuals, and healthcare professionals preferred more symmetrical, natural, and regular morphologies. Male participants, older age groups, and individuals working in non-healthcare fields found sharp contours aesthetically pleasing, while minimal asymmetries were preferred.Keyword(s): Aesthetic perception, Demographic factors, Smile aesthetics, Visual survey study</p
Geometric Analysis of Luciobarbus barbulus (Heckel 1847) Otoliths With Body Shape
No full textBackground: The Cyprinidae family is one of the most varied families in terms of number of species, representing approximately 1500 species in the world. Luciobarbus barbulus (Heckel 1847) is a little-known species, but it is widespread in the Tigris and Euphrates rivers. The aim of the study was to analyse the body shape and otoliths of L. barbulus species by geometric morphometry to better distinguish the population structure of the fish. Materials and Method: In this study, 34 barbulus and their otoliths were used. General Procrustes Analysis (superimposition), principal component analysis (PCA), multivariate regression analysis, Partial Least Squares and discriminant function analysis were applied. Results: Multivariate regression analysis revealed a 9.1174% effect of size on otolith shape. PCA calculated 33 components for the otoliths in the study, and the first 3 components explained 64.027% of the total shape variation. The Partial Least Squares (PLS) analysis revealed that there is no significant correlation between otolith and fish shape. As a result of the discriminant function analysis, 33.33% (4:12) of female otoliths and 36.36% (8:22) of male otoliths were correctly grouped. Conclusion: This study revealed that otolith shape analysis is an effective tool for deciphering the population structure of small pelagic species. It was also found that there is no difference between otolith and fish shape as otolith biomineralization is influenced by many factors
ASSOCIATION BETWEEN METABOLIC COMORBIDITIES AND RETENTION RATES OF FIRST-LINE b/tsDMARD TREATMENT IN PATIENTS WITH PSORIATIC ARTHRITIS: EUROPEAN REAL-WORLD RESULTS
No full textNursing Competence of Students: Congruence Between the Perceptions of Nursing Students’ and Their Preceptors’ Assessment Öğrencilerin Hemşirelik Yeterliği: Hemşirelik Öğrencilerinin Algıları ile Rehberlerinin Değerlendirmeleri Arasındaki Uyum
No full textObjective: This study aimed to evaluate the congruence between nursing students' self-assessments and their preceptors' assessments of nursing competence at graduation. Methods: This cross-sectional, descriptive study was conducted with a purposeful sample of 382 participants, including 191 nursing students and 191 nurses serving as student preceptors in the west of Türkiye. A descriptive characteristics form and the Holistic Nursing Competence Scale were used to collect data. The data were analyzed utilizing descriptive statistics, paired t-tests, and standardized mean differences. The study was documented according to the STROBE checklist. Results: At the group level, the nursing students' self-assessment for overall nursing competence (5.60 ± 0.88) was higher than the assessment by preceptors (5.37 ± 1.32) and significantly different (t = 2.277, P = .024, Cohen's d = .165). When congruence between students’ and preceptors’ assessments was examined at the single student-preceptor level, in comparison to their preceptors, students rated their nursing competence higher on every sub-scale and the overall competence scale. Conclusion: The present study revealed a lack of congruence between student self-assessments and preceptor assessments. Students rated their own competencies higher than the preceptors compared to the preceptors’ evaluations. The findings suggest that it is important to be careful when evaluating students' competence levels, and that it is necessary to use different assessment methods, such as rubrics, in addition to self-assessment
Lipodystrophy Severity Score to Assess Disease Burden in Lipodystrophy
No full textContext: Lipodystrophy syndromes are rare disorders characterized by deficient adipose tissue, leading to insulin resistance, dyslipidemia, and organ system abnormalities. Objective: Our goal was to develop a lipodystrophy severity score (LDS) to holistically capture the diverse manifestations of lipodystrophy into a numerical score to aid in prediction of clinical outcomes and/or treatment impact. Design: An 8-domain LDS was developed by 8 disease experts in consultation with patient organizations. The LDS was rated for feasibility and content validity by 28 additional clinicians and 9 patient representatives. LDS was compared to the Clinical Global Impression (CGI) of severity for 20 putative patient profiles, each at 2 different time points, and by comparing change in LDS to global impression of change. For external validation, LDS was calculated in 2 cohorts of patients with lipodystrophy treated with metreleptin. Results: LDS domains include Diabetes/Insulin Resistance, Microvascular Complications of Diabetes, Lipids, Cardiovascular, Liver, Kidney, Reproductive, and Other. Each domain is assessed by 1 or more questions assessing both lifetime and recent complications of lipodystrophy. The LDS had high content validity and feasibility and high reliability by intraclass correlation coefficients (>0.95). Global and domain-specific LDS were strongly correlated with CGI, as were changes in scores across visits (R = 0.79-0.99, P < .001 for all). In generalized lipodystrophy, metreleptin significantly reduced LDS (from 46 to 26 at 12 months, P < .001). The reductions were smaller in partial lipodystrophy (from 65 to 61 at 12 months, P = .04). Conclusion: The LDS can reflect the severity of diverse manifestations of lipodystrophy and monitor changes following interventions
