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Primary bilateral breast lymphoma in an elder male patient (vol 25, pg 1008, 2029)
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Is there any additional benefits of applying neuromuscular electrical stimulation simultaneously to exercise in chronic neck pain? A randomized controlled study
No full textBackground Neuromuscular electrical stimulation (NMES) may enhance the treatment results in the musculoskeletal rehabilitation by increasing the efficiency of the muscle contraction. Aims The aim of our study was to determine the effectiveness of NMES applied simultaneously to exercise on pain, static endurance of cervical deep flexor muscles, fear of movement, and disability in chronic neck pain. Methods A total of 32 patients with chronic neck pain were included. In Group I (mean age: 38 +/- 14.85 years), only clinical pilates exercises were performed while in Group II (mean age: 34 +/- 11.08 years), NMES was applied simultaneously on lower trapezius and serratus anterior muscles during the same exercises. The primary outcomes, the pain intensity, and disability were assessed with visual analog scale (VAS) and neck disability index (NDI), respectively. As secondary parameters, range of motion (ROM), The Deep Neck Flexor (DNF) Endurance Test and Tampa Scale of Kinesiophobia (TSK) were assessed. Results In both groups, within group changes were found statistically significant for all the parameters (p = 0.001). In between group comparison, the changes in right/left rotation ROM and in scores of VAS and DNF Endurance Test were found significantly greater in Group II (p = 0.01, d = 1.47; p = 0.003, d = 1.59; p = 0.001, d = 5.35; p = 0.001, d = 2.08, respectively). However, no significant differences were found in terms of ROM (except rotation), NDI and TSK between groups (p > 0.025). Conclusions Applying NMES simultaneously to exercise was found to be superior to the only exercise in terms of improving pain intensity, ROM of cervical rotation, and muscle endurance, however, no added benefits for disability were observed in chronic neck pain
Examining the Effect of Polypharmacy on Quality of Life and Frailty in Older Adults from the Perspective of Community-Based Rehabilitation
No full textObjective: Although the negative effects of polypharmacy on older adults are well-documented, studies exploring its relationship with frailty and quality of life within the framework of community-based rehabilitation (CBR) remain scarce. In this context, the aim of this study was to compare frailty and quality of life levels between older adults with and without polypharmacy and to examine the relationship between these parameters from a CBR perspective. The ultimate purpose of this study was to determine the usefulness of CBR. Method: A total of 120 community-dwelling older adults (60 with polypharmacy, 60 without polypharmacy), aged 65-75 years (mean age = 68.18 +/- 3.50), were included in a community-based assessment carried out under the coordination of Lokman Hekim University in Ankara, Turkey. The use of five to nine medications was taken as a reference for those with polypharmacy, and the use of less than two medications was taken as a reference for those without polypharmacy. The quality of life of the older adults in the study was assessed with the Nottingham Health Profile (NHP), and frailty was assessed with the Edmonton Frailty Scale (EFS). In line with CBR principles, the findings were interpreted with a focus on promoting community-wide strategies to support older adults. Results: The study found a statistically significant difference in NHP and EFS results between older adults with and without polypharmacy (p < 0.05). In addition, a statistically significant relationship was found between NHP and all subdomains of NHP and EFS (p < 0.05). Conclusion: Older adults with polypharmacy had higher levels of frailty and lower quality of life, and an increase in frailty was significantly associated with a decrease in quality of life in both groups. These findings highlight the importance of community-level preventive interventions to support healthy aging. Within the framework of CBR, strategies such as creating accessible physical activity areas at the neighborhood level; organizing informative seminars on frailty, quality of life, medication use and health literacy in collaboration with volunteer health professionals and local authorities; and creating volunteer support networks to increase social interaction can contribute to the control of these symptoms in older adults
Extended pharmacological thromboprophylaxis and clinically relevant venous thromboembolism after major abdominal and pelvic surgery: International, prospective, propensity score-weighted cohort study
No full textBackground: There is low-certainty evidence on the impact of extended pharmacological prophylaxis on venous thromboembolism-associated morbidity and mortality. The aim of this study was to determine the efficacy and safety of extended prophylaxis after major abdominopelvic surgery for the prevention of clinically relevant venous thromboembolism after hospital discharge. Methods: CArdiovaSCulAr outcomes after major abDominal surgEry (CASCADE) was a prospective, international, cohort study into which consecutive adult patients undergoing major abdominopelvic surgery were enrolled (January-May 2022). Extended prophylaxis was considered at least 28 days of anticoagulant prescription after surgery. The primary efficacy outcome was clinically relevant venous thromboembolism and the primary safety outcome was clinically relevant bleeding within 30 days after surgery (European Medicines Agency definitions). The independent association of these outcomes with extended prophylaxis was explored using mixed-effects logistic regression and propensity score weighting. Results: A total of 11 571 patients (median age of 58.0 years; 6399 (55.3%) women) from 29 countries were included. The extended prophylaxis prescription rate was 31.7% (3670 patients). The post-discharge venous thromboembolism and bleeding rates were 0.1% (12 patients) and 0.7% (85 patients) respectively. After weighting, extended prophylaxis was not significantly associated with increased bleeding risk (OR 1.07 (95% c.i. 0.64 to 1.81); P = 0.792) or decreased venous thromboembolism incidence, both in the overall cohort (OR 1.13 (95% c.i. 0.33 to 3.90); P = 0.848) and in a subgroup analysis of patients undergoing complex major surgery and with active cancer (OR: 1.36 (95% c.i. 0.33 to 5.57); P = 0.669). Conclusion: In modern practice, the incidence of postoperative venous thromboembolism is low. Extended prophylaxis appears safe, yet the clinical efficacy remains uncertain. Further work is required to define patients who stand to benefit. © 2025 Elsevier B.V., All rights reserved
Üstün Yetenekli Tanısı Konmuş ve Konmamış Öğrencilerin Fen Bilimlerine Yönelik Tutumlarının İncelenmesi
No full textFen Bilimleri dersi öğretim programının özel amaçlarında Fen eğitimi almış öğrencinin bilimsel süreç becerisi ve bilimsel düşünme alışkanlığı kazandırmayı hedeflenmektedir. Bu doğrultuda Fen okuryazarı öğrencilerin sağlıklı bilimsel tutumlar geliştirmesi gerekmektedir. Duyuşsal alan kapsamına giren fen bilimlerine yönelik tutumlarının belirlenmesi, öğrencilerin bilimin doğasını anlama ve bilimsel düşünmeyi içselleştirme derecesini fark etme imkânı verir. Bu çalışma, Fen bilimleri dersi amaçlarını kazandığı düşünülen üstün yetenekli öğrenciler ile ders başarısı ortalamanın üstünde olan öğrencilerin, fen bilimlerine yönelik tutumlarını incelemek amacıyla yürütülmüştür. Çalışmada nicel araştırma yöntemlerinden betimsel karşılaştırma deseni kullanılmıştır. Çalışmanın örneklemini 2023-2024 eğitim öğretim yılı içinde, Edirne ilinde yer alan üç devlet ortaokulunda öğrenim gören Fen Bilimleri dersinde başarılı üstün yetenekli tanısı konmamış 60 öğrenci ile Edirne Bilim ve Sanat Merkezinde eğitim alan ve üstün yetenekli tanısı konmuş 60 öğrenciden oluşmaktadır. Çalışmada veri toplamak amacıyla bilimsel tutum ölçeği kullanılmıştır. Uygulama öğrencilerin kendi okullarında ve ders saatleri dışında gerçekleştirilmiştir. Elde edilen veriler SPSS programında analiz edilmiştir. Üstün yetenekli tanısı konmuş öğrencilerin Fen Bilimlerine tutumlarının üstün yetenekli tanısı konmamış öğrencilere göre daha yüksek olduğu sonucuna ulaşılmıştır
Novel method for pulmonary embolism prognosis: Right to left ventricular volume ratio (RLVR) on pulmonary angiography (CTPA)
No full textIntroduction: Right ventricular dysfunction is the main cause of mortality in patients with acute massive pulmonary embolism (PE) and early diagnosis is extremely important. This study aimed to investigate whether the right/left ventricular volume ratio (RLVR) calculated using pulmonary angiography (CTPA) is a valuable tool for PE prognosis. Method: Clinical, echocardiographic and pulmonary angiography data of cases diagnosed with pulmonary embolism in the emergency department between January 2021 and December 2023 were retrospectively evaluated. Patients were stratified according to the presence of massive PE, one month mortality and pulmonary embolism severity index (PESI) score. Clinical, laboratory and radiographic parameters were compared to search for prognostic factors. Results: Of the 210 patients, the mean age was 67 ± 15 years, 46 % were male, and 42 % had massive PE. The right/left ventricular volume ratio was significantly higher in patients with massive PE, in those who died within one month after admission; and in patients with PESI Class III. When the cut-off value of right/left ventricular volume ratio was accepted as >1.7, its predictive value for acute PE mortality was higher than other CTPA and echocardioraphy measurements (AUC = 0.706). Conclusion: An increased right/left ventricular volume ratio on CTPA, a valuable tool for diagnosing right ventricular dysfunction, is associated with a worse prognosis in subjects with pulmonary thromboembolism. © 2025 Elsevier B.V., All rights reserved
How Gender-Sensitive Disaster Management is Addressed in the Turkish Parliament: A Qualitative Study from Feminist Bioethics Perspective
No full textBackgroundThe devastating earthquakes that struck T & uuml;rkiye and Syria on February 6, 2023, caused significant destruction and loss of life, to the extent that they have been termed the Disaster of the Century. Although women are disproportionately affected by disasters, they have historically been overlooked in disaster management. However, with the increased awareness brought about by the feminist movement regarding secondary inequalities arising from structural disparities such as gender roles and economic dependency, the concept of gender-sensitive disaster management has gained prominence. The primary aim of our study is to evaluate how gender-sensitive disaster management is addressed in the Turkish parliament. Its secondary aim is to contribute to the scope of feminist bioethics. Thirdly, the study is expected to contribute to the ethics and policies of disaster management in T & uuml;rkiye, a country prone to earthquakes, with a focus on the rights of women and vulnerable groups.MethodsIn the study, the transcripts of parliamentary sessions held between February 6, 2023, and April 23, 2023, as published on the official website of the Grand National Assembly of T & uuml;rkiye (GNAT), were analyzed using qualitative research methods. The research data consists of discourses extracted from a total of 29 transcripts, covering the first session following the earthquake (February 7, 2023) and the final session of the legislative year (April 23, 2023). The data were systematically retrieved using the keywords earthquake, disaster, gender, women, and health. The data were coded in Excel by assigning serial numbers to the documents, and the names of the speakers were anonymized to avoid potential biases that might arise while interpreting political materials. In this study, the source data consist of publicly available documents shared on the official website, specifically the Parliamentary Record Journal prepared by the GNAT Transcripts Services Department. These documents include verbatim quotations expressed by speakers and read by clerks, all accurately written and marked in quotation marks. As the study relies on publicly accessible sources without human participants, obtaining Ethics Committee approval is not required in our country.ResultsThe recurring statements of members of parliament within the context of disaster and gender were categorized under common themes. Accordingly, the main themes identified were Access to Humanitarian Aid, Gender Equality and Non-Discrimination, and Vulnerability. Within this framework, members of parliament expressed views on topics such as the Right to Life, Right to Shelter, and Right to Health (including hygiene, sexual and reproductive health, and access to food and water). Additionally, views were expressed on sub-themes such as Traditional Gender Norms, Equality in Care Work, Participation, Struggle and Solidarity, Privacy and Security (including physical, psychological, economic, and sexual violence), Intersectionality (disability, LGBTQ+, refugee rights), Advocacy, and Responsibility and Accountability.ConclusionsGender-sensitive disaster management has revealed its multidimensional impacts on the lives of women and vulnerable groups, emphasizing the importance of feminist ethical obligations in this context. Comprehensive policies are necessary at every stage of disaster management to ensure the consideration of equality
An Analysis of Newspaper Reports on the Success of Individuals with Autism Spectrum Disorder
No full textThis study aims to change the negative attitudes towards individuals with ASD, to analyse the news published about their success. The news reports published in The New York Times and The Washington Post newspapers, which were only about the success stories of individuals with ASD, were analysed by document analysis and content analysis, which are qualitative research methods. In this study, 40 news from the two international newspapers were analysed. It was revealed that success stories in the area of art were published more than other areas. In this study, it is noteworthy that the role of teachers, who are important sources of inspiration in the educational life of individuals with ASD, in success stories is quite low. In this respect, it may be suggested that in future studies, newspapers in the international newspapers may publish news in which the effect of teachers on the success stories of individuals with ASD is mentioned more
Investigation Of The Relationship Between Teachers' Individual Creativity And Self-Efficacy Beliefs For Applying Constructivist Approach
No full textThe aim of this research is to examine the relationship between teachers' individual creativity and self-efficacy beliefs aimed at applying constructivist approach. The relational survey method was used in the research. As a data collection tool, the Personal Information Form, the ”Organizational Creativity Scale“ and the ”Teachers' Self-Efficacy Belief Scale for Applying a Constructivist Approach" were used. In the light of the sub-problems, it was examined whether the scale scores were differentiated in terms of various variables (age, seniority year, type of school). The results are classified according to sociodemographic variables. Based on the findings obtained, it was concluded that the teachers' individual creativity and self-efficacy beliefs towards applying the constructivist approach are at a high level. The individual creativity of the teachers did not differ according to age, seniority year, and the type of school where the working at. It has been concluded that the teachers' self-efficacy beliefs towards applying the constructivist approach are at a high level. While teachers' self-efficacy beliefs about applying the constructivist approach did not differ in terms of age, type of working at, seniority year variable. It has been concluded that the relationship between teachers' individual creativity and self-efficacy beliefs aimed at implementing constructivist approach is at a significant level in terms of total score and sub-dimension scores, at a high level and in a positive direction in general
Real-world outcomes and prognostic factors in primary mediastinal B-cell lymphoma: a multicenter study of 157 patients
No full textPrimary mediastinal B-cell lymphoma (PMBCL) is a rare and distinct subtype of non-Hodgkin lymphoma. No consensus exists on optimal frontline treatment, and the use of R-CHOP ± radiotherapy (RT) and DA-EPOCH-R ± RT remains common, yet comparative real-world data are limited. In our multicenter retrospective study, we analyzed PMBCL patients, stratified by the first-line therapy (R-CHOP-21 ± RT or DA-EPOCH-R ± RT). Primary outcomes were complete response (CR) rate, progression-free survival (PFS), and overall survival (OS), alongside assessment of treatment-related toxicities and prognostic factors for PFS and OS. We included 157 patients [R-CHOP ± RT group (n = 80) and DA-EPOCH-R ± RT group (n = 77)] with a median age of 31 years, of whom 68.2% were female. CR rates were similar for R-CHOP ± RT (75%) and DA-EPOCH-R ± RT (76.6%). RT use was higher in the R-CHOP group (41.2% vs. 19.5%, p = 0.002). DA-EPOCH-R had significantly higher toxicity (29.9% vs. 16.2%, p = 0.033). The median follow-up of the entire cohort was 29 months with 2-year PFS and OS rates of 73.9% and 83.6%, respectively. Also, PFS and OS did not differ between regimens. In patients achieving CR with R-CHOP, RT omission did not impact survival. Multivariate analysis identified older age, poor performance status, superior vena cava syndrome and splenic involvement as independent OS predictors, while pericardial effusion, splenic involvement and hemoglobin < 10.5 g/dL were linked to inferior PFS. R-CHOP-21 ± RT and DA-EPOCH-R ± RT provide comparable efficacy in PMBCL. Due to the higher toxicity of DA-EPOCH-R, for those achieving CR following R-CHOP, selective RT omission may be a reasonable alternative. Established and disease-specific prognostic factors should guide individualized treatment strategies. © 2025 Elsevier B.V., All rights reserved