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Guideline for the Use of Natriuretic Peptides in the Early Diagnosis and Management of Heart Failure in Primary Care (Joint Consensus Report by the Eurasian Society of Heart Failure and the Turkish Association of Family Medicine)
No full textHeart failure (HF) is a complex clinical condition associated with significant morbidity and mortality. Early diagnosis and effective management at the primary care level are essential for improving patient outcomes and reducing the burden on the healthcare systems. The Eurasian Society of HF and the Turkish Association of Family Medicine developed a guideline that underscores the critical role of natriuretic peptides (NPs) in the early detection, diagnosis, and management of HF. NPs, particularly the N-terminal pro-B-type NP, are a reliable biomarker for identifying HF, guiding treatment decisions, and monitoring disease progression. This guideline emphasizes the importance of measuring the levels of these peptides in primary care so as to detect individuals at risk, confirm the diagnosis of HF in symptomatic patients, and evaluate the treatment response. The recommended thresholds for NP levels account for variations arising from factors such as age, gender, and the presence of other health conditions. B-type natriuretic peptides (BNP) levels ? 35 pg/ml or N-terminus-proBNP levels ? 125 pg/ml are used to confirm the likelihood of HF in symptomatic patients, enabling timely diagnosis and appropriate intervention. Incorporating NP testing into routine clinical practice enables timely referrals and ensures appropriate management at all stages of HF. Beyond diagnosis, the measurement of NPs provides valuable information about treatment effectiveness and prognosis, allowing clinicians to individualize the treatment. By integrating NP testing into primary care, healthcare providers can facilitate early detection, optimize treatment strategies, and improve the quality of life for patients with or at risk of HF. Thus, this guideline highlights the essential role of primary care physicians in addressing the growing challenges of HF through the effective and evidence-based use of NPs. © 2025 Elsevier B.V., All rights reserved
Regorafenib Treatment for Recurrent Glioblastoma Beyond Bevacizumab-Based Therapy: A Large, Multicenter, Real-Life Study
No full textBackground/Objectives: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy. Methods: This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of <= 2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle. Results: The median age of the patients was 53 years (18-67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23-2.75) and a median overall survival of 4.1 months (95% CI: 3.52-4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not (p = 0.022). Progression-free survival was longer in patients with ECOG 0-1 than in those with ECOG 2 (p = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed. Conclusions: Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies
The effect of three different simulation methods used in urinary catheterization training
No full textBackground: This study was designed as a randomized study to determine the effects of three different simulation methods used in urinary catheterization training on nursing students' skills, satisfaction and self-confidence. Method: The students were divided into three groups and each group experienced urinary catheterization with a different simulation method. Results: Students' skill levels from the highest to lowest were determined as the virtual reality simulation group, task-trainer simulation group, high-fidelity simulation group and there was a statistically significant difference between their mean scores. It was determined that the students' satisfaction and self-confidence total score averages were similar in the virtual reality simulation group and the task-trainer simulation group, and were significantly higher than the high-fidelity simulation group. Conclusion: The findings obtained from the research show that it is appropriate to use virtual reality simulation method and task-trainer simulation method in urinary catheter training of first-year nursing students. Cite this article: Kurt, E., Nazik, E. & Zaybak, A. (2025, Month). The effect of three different simulation methods used in urinary catheterization training. Clinical Simulation in Nursing , 102, 101729. https://doi.org/10. 1016/j.ecns.2025.101729. (c) 2025 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.TUBITAK 1002-A Rapid Support Module [222S345]The present study was financially supported within the scope of TUBIcenter dotTAK 1002-A Rapid Support Module with the project number 222S345
The successful implantation of CRT-D using the catheter within catheter technique in a patient with a type IIIA persistent left superior vena cava
No full text[No abstract available
Advocacy skills assessment guide: a validity study
No full textBackground Nurses should act as individual/patient advocates, since it is part of their basic responsibilities. However, previous studies reported that although nurses know that they need to defend patients, they do not know what patient advocacy is and how to fulfil this role. They have difficulty in advocating for patients and cannot carry it out effectively. This study was conducted to evaluate the advocacy skills of nursing students, develop a guide for the advocacy skills of nurses working in the field, and to verify the content validity. Method This guideline development and validation study was conducted in four stages: [1] setting goals for social justice advocacy [2], selecting social justice advocacy skills [3], developing a social justice advocacy skill guide and [4] conducting the pilot study. The development and validation study involved 33 participants, student nurses, licensed nurses, professors, associate professors, assistant professors, and research assistants. For the content validity of the guide, the content validity index, i.e. the percentage of experts who answered 3 or 4 points answered by the experts, was calculated. Kendall W test was used to determine the degree of agreement between the scores of multiple experts. Results All content validity index (CVI) scores were in the good to excellent range. The CVI scores given by all specialists ranged from 0.73 to 1. As a result of the Kendall W test, it was found that there was agreement among the experts (p = 9. Conclusion The developed 'Advocacy Skills Evaluation Guide' was found to be a valid measurement tool
Hypospadias Reconstruction Training: Development of an Ex-Vivo Model for Objective Evaluation of Surgical Skills
No full textOBJECTIVE To objectively evaluate technical skill acquisition in hypospadias repair procedures during surgical training using noninvasive wearable sensor technology. METHODS We combined subjective video evaluations with objective electromyography (EMG) measurements in a hands-on hypospadias training course. Surgeons wore wireless EMG and accelerometer sensors on their dominant hand while performing tasks on ex-vivo cadaveric calf penises. The study focused on 4 skills as follows: urethral mobilization, dorsal inlay graft harvest/ implantation, meatal-based flap urethroplasty, and dorsal plication. Machine learning techniques analyzed muscle activation patterns and attributes for assessing surgical precision. RESULTS The course included 18 participants (10 female, 8 males; average age 40.18 +/- 8.46 years) categorized as novice (n = 10, 5 years). Video evaluations did not reveal significant differences due to short-term training. However, EMG measurements showed significant reductions in average EMG power, total time, dominant frequency, and cumulative muscle workload after training. Additionally, the mean power spectral density of the EMG signal decreased notably post-training. CONCLUSION This study presents a structured approach for hypospadias training and highlights the effectiveness of wearable sensor technology for objective skill assessment. While video evaluations did not detect significant changes, EMG data provided measurable differences in skill acquisition, suggesting that wearable sensors could enhance objective evaluations of surgical proficiency in residency programs
Tissue Transfer in the Management of Wound Complications in Patients With Haemophilia: Report of Two Cases
No full text[No abstract available
Inchanting and Spelling Practices that Give Blessings-Curses in Anatolia
No full textBüyü konusunda, büyünün temel unsurlarından biri olan afsunculuk terimi önemlidir. Afsunculuk, genel olarak ferdin veya toplumun esenliği için yapılan bir uygulama türüdür. Genel anlamda bakıldığında, dinden ve dinin kutsal bildiği temellerden faydalanır. Genellikle din alanında ve din adamlarıyla iş görür; duaya ve kurbana başvurur. Tekniği kısmen büyünün taklit ve temas tarzıdır. Anima kelimesi, Latincede “can” veya “ruh” anlamında kullanılmıştır. Bazı kişilerin, gizemli bir majik etki veya güç taşıdığı düşünülürdü ve birçok olağanüstü olayın nedeni olarak kabul edilirdi. Bu etkiye Melanezya kökenli “mana” denir. Büyücü-hekim, günümüz medyumları gibi ölülerle iletişim kurar ve onların mesajlarını iletirdi. Orta Çağ’daki nekromanlar gibi, ölülerin ruhlarını ve diğer varlıkları kontrol etme yeteneğine sahip olduklarını iddia ederlerdi. Animistik dünya görüşüne göre, hastalıkların nedeni canın bedeni terk etmesi ve başka bir varlığın bedene girmesi olarak görülürdü. Büyücü-hekim, canı geri getirmeye ve diğer varlığı bedenden çıkarmaya çalışırdı. Kötü varlığı uzaklaştıran ilaç, mana ile ilişkilendirilirdi; bu, büyücü-hekim için geçerli olabilirdi. İşte bu nedenle “afsunculuk” terimi ortaya çıkmıştır. Afsunculuk yapan hekim, hastanın yaşamına af sunar ve bunu ise büyüleri yoluyla gerçekleştirdiğini iddia eder. Bu kişiler, simyacılardan önce gelen bir tür doğal ilaç uzmanı olarak tanımlanabilirler. Çalışmada ilk olarak, Hitit ve en son olarak da Yunan-Roma dönemlerine ait kaynaklardan bereket-lanet büyüleriyle alakalı bilgiler derlenerek; bu bilgiler, büyünün insan hayatının neredeyse tüm alanlarında var olduğunu göstermiştir. Sonuç olarak, büyünün insanlar için vazgeçilmez bir olgu olduğu anlaşılmıştır.In the subject of magic, the term incantation, which is one of the basic elements of magic, is important. Incantation is generally a type of practice done for the well-being of the individual or society. Generally speaking, it benefits from religion and the foundations that religion deems sacred. It usually works in the field of religion and with clergy; it resorts to prayer and sacrifice. Its technique is partly the imitation and contact style of magic. The word “anima” was used in Latin to mean “soul” or “spirit”. Some people thought that it carried a mysterious magical effect or power and was considered the cause of many extraordinary events. This effect is called “mana”, which is of Melanesian origin. Like today’s mediums, the witch doctor communicated with the dead and conveyed their messages. Like the necromancers of the Middle Ages, they claimed to have the ability to control the spirits of the dead and other beings. According to the animistic worldview, the cause of illness was seen as the soul leaving the body and another being entering the body. The witch doctor tried to bring the soul back and remove the other being from the body. The medicine that removed the evil being was associated with mana; this could be valid for the witch doctor. This is why the term “incantation” emerged. The doctor who performed the spell claimed to do this by offering forgiveness to life through spells. These people can be defined as a type of natural medicine specialist that came before the alchemists. First, information about blessing-curse spells was compiled from sources belonging to the Hittite and lastly the Greek-Roman periods; this information showed that magic existed in almost all areas of human life. As a result, it was understood that magic was an indispensable phenomenon for people.Dokuz Eylül Üniversites
Aerogels based on proteins extracted from plant sources: Different production methodologies
No full textAerogels based on protein offer an exciting and biodegradable solution for the delivery of proteins and nutrients in food supplements, and they can also be used as carriers for drug delivery. Comparing freeze drying with supercritical drying and five different protein sources (mallow leaves, sugar beet leaves, faba beans, pumpkin seeds, and sunflower seeds), it is observed that aerogels obtained by supercritical drying from mallow leaves and sugar beet leaves show a good homogeneous porosity, higher adsorption capacity (3.48 % after 48 h), and higher surface areas (127.2 and 259 m2/g). Consequently, these aerogels were chosen to conduct the impregnation of alpha-tocopherol (alpha-TOC), which was selected as a model drug to explore the feasibility of utilizing this aerogel for drug delivery. The amount of alpha-TOC loaded through the supercritical impregnation technique is approximately 0.5 mg alpha-TOC/mgaerogel for both the sugar beet and mallow aerogels. From the dissolution test, both aerogels allow a prolonged release of about 24 hours with respect to the pure alpha-TOC that occurs in 1 hour. By adjusting the pH value of the starting aqueous solution, the solubility of the protein in water was increased to obtain a homogeneous porosity dispersion