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Predictive value of preoperative neutrophil-to-lymphocyte ratio for post-tonsillectomy hemorrhage: Age-specific insights from a pediatric cohort
No full textObjective: To evaluate the predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) for postoperative hemorrhage following pediatric tonsillectomy and to explore its age-specific performance. Methods: This retrospective study included 100 pediatric patients who underwent tonsillectomy at a single tertiary center between January 2021 and December 2025. Fifty patients with postoperative hemorrhage and 50 without bleeding were analyzed. Preoperative NLR values were compared between groups. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were performed to assess the predictive capacity of NLR. Subgroup analysis was conducted for patients aged ≤7 years. Results: The bleeding group had significantly higher preoperative NLR values compared to controls (2.72 ± 2.21 vs. 1.79 ± 0.72, p = 0.023). ROC analysis yielded an AUC of 0.632 for all patients and 0.697 for those aged ≤7 years. An NLR threshold of 2.35 provided 40 % sensitivity and 86 % specificity for predicting hemorrhage, while an NLR cut-off of 2.08 improved sensitivity (64 %) and specificity (83 %) in younger children. Multivariate analysis confirmed NLR as an independent predictor of postoperative bleeding (OR = 1.68, p = 0.016). Conclusion: Elevated preoperative NLR is associated with an increased risk of postoperative hemorrhage after pediatric tonsillectomy, particularly in children aged ≤7 years. Preoperative NLR measurement may serve as a useful adjunct in perioperative risk stratification
Gebelikte sigara içmenin ve sigara dumanına maruziyetin yenidoğan antropometrik ölçümleri ve apgar skoruna etkisi
Full text linkGebelikte sigara içme veya sigara dumanına maruz kalma, anne ve fetus sağlığını tehdit etmektedir. Bu araştırma, gebelikte sigara içmenin ve sigara dumanına maruziyetin yenidoğanın doğum ağırlığı, boy uzunluğu, baş çevresi ve Apgar skoru üzerine etkisini araştırmak amacıyla tanımlayıcı ve ilişki arayıcı tipte bir çalışma olarak yapılmıştır. Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi'nde Şubat 2024-Aralık 2024 tarihleri arasında normal doğum yapmış 331 gebe, çalışmaya dahil edilmiştir. Gebeler, gebelikte sigara içme ve sigara dumanına maruziyet durumuna göre, grup 1 "gebelikte hem sigara içiyor hem de maruz kalıyor (n=91)", grup 2 "gebeliğinde sigara içmiyor ve maruz kalmıyor (n=120)" ve grup 3 "gebeliğinde sigara içmiyor ama maruz kalıyor (n=120)" şeklinde değerlendirilmiştir. Gebelerin %36,9'u 25-29 yaş aralığında, yaş ortalaması 26,64±4,58 ve eşlerin yaş ortalaması 30,62±5,21, gebe ve eşleri çoğunlukla lise mezunu (%53,5 ve %46,5), %84,9'u ev hanımı, %89,4'ü çekirdek ailede yaşadığı saptanmıştır. Gebelerin %53,5'i primipar, %46,5'i multipar olduğu, %79,2'si ayda bir kez antenatal kontrole gittiği belirlenmiştir. Gebelerin %61,6'sı gebelikte sigara dumanına ve %92,7'si dumana ev ortamında maruz kaldığı saptanmıştır. Gebe ve eşinin yaş ortalaması, eşin eğitim düzeyi, parite sayısı ile gebelikte sigara içme ve dumanına maruz kalma durumu arasında anlamlı düzeyde ilişki saptanmıştır. 1. ve 3. grupta, gebe ve eşlerin yaş ortalaması ile eşlerin eğitim düzey ortalamasının anlamlı düzeyde daha düşük (p1,3). Sonuç olarak sigara içen ve sigara dumanına maruz kalan gebelerin, içmeyen gruba kıyasla ortalama gebelik haftasının, yenidoğan doğum ağırlığı, boy uzunluğu ve baş çevresinin anlamlı düzeyde daha düşük olduğu, ortalama Apgar skorları arasında anlamlı ilişki bulunmadığı saptanmıştır. Anahtar kelimeler: Gebelik, Sigara içme, Dumana maruziyet, Yenidoğan antropometrik ölçümler, Apgar skoruSmoking or exposure to cigarette smoke during pregnancy threatens the health of mother and fetus. This research was conducted as a descriptive and correlational researching to investigate the effect of smoking and exposure to smoke during pregnancy on newborn birth weight, height, head circumference and Apgar score. A total of 331 pregnant women who gave birth normally between February 2024 and December 2024 at Zeynep Kamil Women's and Children's Education and Research Hospital were included in the research. Pregnant women were evaluated into groups according to smoking and exposure to smoke during pregnancy, Group 1 " Both smoking and exposure during pregnancy (n=91)", Group 2 was evaluated as "Non-smoker and non-exposure during pregnancy (n=120)" and Group 3 as "Non-smoker but exposure during pregnancy (n=120)". It has been determined that 36.9% of the pregnant women were between 25-29 years of age, the average age was 26.64±4.58 years old and the average age of the spouses was 30.62±5.21 years old, the pregnant women and their spouses were mostly high school graduates (53.5% and 46.5%), 84.9% were housewives and 89.4% lived in nuclear families. It was determined that 53.5% of the pregnant women were primiparous, 46.5% were multiparous, and 79.2% went to antenatal check-ups once a month. It was found that 61.6% of the pregnant women were exposed to smoke during pregnancy and 92.7% were exposed to smoke at home. There was a significant correlation between the average age of the pregnant woman and her husband, the educational level of the husband, the number of parities and smoking and exposure to smoke during pregnancy. In the 1st and 3rd groups, the average age of the pregnant women and their spouses and the average educational level of the spouses were significantly lower (p1.3). In conclusion, It was determined that the average gestational week, newborn birth weight, length and head circumference were significantly lower in pregnant women who smoked and were exposed to smoke compared to the nonsmoking group, and there was no significant relationship between the average Apgar scores. Keywords: Pregnancy, Smoking, Exposure to smoke, Newborn anthropometric measurements, Apgar scor
The Efficacy of Doxorubicin in Capsule Contracture Associated with Silicone Implants
Full text linkBackgroundCapsule contracture (CC) is a significant complication of silicone implant use. It leads to patient dissatisfaction and reoperations following aesthetic breast augmentation and reconstruction. Prolonged inflammation and abnormal fibrosis are known to play roles in the development of CC. This study investigates the efficacy of Doxorubicin, known for its potent anti-inflammatory and antiproliferative effects, in the prevention and treatment of CC.MethodsThe study was conducted on 24 female Wistar-Albino rats, divided into control, experimental control, and Doxorubicin groups. Silicone implants were placed in the back regions of the experimental control and Doxorubicin groups. The Doxorubicin group received 4 mg/kg Doxorubicin hydrochloride injections into the implant pocket once weekly for four weeks. The samples were analyzed using histological and immunohistochemical methods.ResultsLight microscopic examination revealed that collagen fibers forming the capsule in the Doxorubicin group were organized and of low density, with no inflammatory cell infiltration observed. Immunohistochemical analyses demonstrated significantly lower levels of COL-1, alpha-SMA, TNF-alpha, and IL-6 in the Doxorubicin group.ConclusionDoxorubicin was shown to prevent CC formation by suppressing inflammatory processes and collagen synthesis. The observed reductions in alpha-SMA and TNF-alpha, key mediators of inflammation and fibrosis, support the potential efficacy of Doxorubicin in this process. While periprosthetic injection avoided systemic toxicity, further studies exploring different doses and administration methods are necessary.No Level AssignedThis journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266
Turkish validity and reliability study of the Feeling Safe During Surgery Scale
No full textBACKGROUND: This study was conducted methodologically to evaluate the Turkish validity and reliability of the Feeling Safe During Surgery Scale and to assess its suitability for the Turkish population. METHODS: This methodological validity and reliability study collected data from 148 patients who underwent elective surgery with regional anesthesia in the general surgery clinics of a university hospital in Istanbul between December 1, 2021 and June 30, 2022. Data were obtained through face-to-face interviews with patients using the Patient Information Form, developed by the researchers based on the literature, and the Turkish version of the Feeling Safe During Surgery Scale, originally created in Swedish. The Statistical Package for the Social Sciences (SPSS) Amos 26 was used for data analysis. RESULTS: The content validity index of the scale was determined to be 0.96. Confirmatory factor analysis indicated that the Turkish version of the Feeling Safe During Surgery Scale was acceptably compatible with the original scale. The adapted Turkish version was found to have a comprehensible language structure and appropriate content. Cronbach's alpha coefficient for the total score was alpha=0.839, indicating a high level of reliability. Consequently, the Turkish version of the Feeling Safe During Surgery Scale was determined to be valid, reliable, and stable over time. CONCLUSION: The Turkish version of the Feeling Safe During Surgery Scale is a valid and reliable instrument that can be used in the Turkish population for assessing the sense of safety in patients undergoing elective surgery with regional anesthesia in surgical units
Synaptic Function and Dysfunction: New Frontiers in CNS Disorders
No full textCentral nervous system (CNS) disorders, such as Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), and migraines, rank among the most prevalent and concerning conditions worldwide. Despite ongoing research, the pathophysiology of these disorders remains incompletely understood, primarily due to their complex etiology. Current pharmacological treatments mainly focus on alleviating symptoms rather than addressing the underlying causes of these diseases. CNS disorders are marked by impairments in neurocognitive and neuromuscular functions, and cognitive processes like learning and memory. This deterioration not only impacts the quality of life of affected individuals but also places a significant burden on their families. Neuroplasticity is a key property of the nervous system that enables brain repair and functional recovery. However, in CNS disorders, neuroplasticity is often compromised. Neuroplasticity, which is regulated by gene expression, is also modulated by environmental factors and epigenetic mechanisms, thereby reshaping neuronal networks in response to various biological and environmental stimuli and brain function. Importantly, neuroplasticity plays a critical role in repairing the brain, especially in the context of neurodegenerative diseases, where damaged neurons can reorganize and re-establish lost functions. Targeting neuroplasticity mechanisms holds significant potential for developing therapeutic interventions to improve treatment outcomes and prevent CNS disorders. A deeper understanding of neuroplasticity in neurological diseases could open new avenues for enhancing patient quality of life. This review aims to provide a comprehensive overview of synaptic function and the neuroplasticity mechanisms that are disrupted in neurological disorders
Bilişsel performansı düşük olan ve olmayan yaşlı bireylerde hızlı otomatik adlandırma performansının karşılaştırılması
No full textBu çalışmanın amacı, bilişsel performans düzeyi farklılıklarının hızlı otomatik adlandırma (HOA) görevleri üzerindeki etkilerini incelemektir. Araştırmaya 60–74 yaş aralığında, MoCA puanlarına göre bilişsel performansı düşük ve düşük olmayan olmak üzere eşit sayıda katılımcının yer aldığı iki grup (toplam 90 kişi) dahil edilmiştir. MoCA'ya göre yapılan gruplamanın geçerliliği, dikkat, yürütücü işlev ve işleyen belleği değerlendiren İz Sürme ve Sayı Menzili testleriyle elde edilen anlamlı grup farklılıkları ve korelasyon analizleriyle desteklenmiştir. Tüm katılımcılara harf, sayı, renk ve nesne adlandırma görevlerinden oluşan HOA görevi uygulanmıştır. HOA görevlerinden elde edilen doğru yanıt sayısı, reaksiyon süresi, revizyon sayısı ve toplam süre ölçütleri, yaş, eğitim yılı ve bilişsel performans değişkenleri dikkate alınarak çoklu doğrusal regresyon analizleriyle değerlendirilmiştir. Bulgular, renk adlandırma görevinde yüksek bilişsel performansa sahip bireylerin daha fazla doğru yanıt verdiğini göstermiştir. Sayı görevinde anlamlı fark görülmemiş olsa da sembolik ve sembolik olmayan bileşik doğruluk puanları gruplar arasında anlamlı fark ortaya koymuştur. Reaksiyon süresi açısından, özellikle nesne ve karma görevlerde bilişsel performansa bağlı anlamlı farklar saptanmıştır. Bu görevlerde düşük bilişsel performans grubundaki bireylerin yanıt süresi daha uzundur. Revizyon sayısı açısından yalnızca renk görevinde ve sembolik olmayan bileşik puanda anlamlı grup farkı gözlenmiş, düşük performans grubundaki bireylerin daha fazla düzeltme yaptığı belirlenmiştir. Tüm görevlerin tamamlanma sürelerinde gruplar arasında anlamlı fark saptanmış; bilişsel performansı düşük olmayan bireylerin görevleri daha kısa sürede tamamladığı görülmüştür. Sonuç olarak, HOA görevleri içerisinde özellikle süreye dayalı ölçütlerin bilişsel performans düzeyini yordamada daha etkili olduğu ve sembolik olmayan uyaranların bilişsel farklılıkları yansıtmada daha duyarlı olduğu söylenebilir.The aim of this study is to examine the effects of differences in cognitive performance levels on Rapid Automatized Naming (RAN) tasks. The study included two groups of participants aged between 60 and 74 years, with equal numbers classified as having low and non-low cognitive performance based on their MoCA scores (a total of 90 individuals). The validity of grouping based on MoCA scores was supported by significant group differences and correlation analyses obtained from the Trail Making and Digit Span tests, which assess attention, executive function, and working memory. All participants completed a RAN task consisting of letter, number, color, and object naming subtests. The number of correct responses, reaction time, number of revisions, and total duration obtained from the RAN tasks were analyzed using multiple linear regression, considering age, years of education, and cognitive performance as variables. The findings indicated that individuals with higher cognitive performance provided more correct responses in the color naming task. Although no significant differences were observed in the number task, composite accuracy scores combining symbolic and non-symbolic tasks revealed significant group differences. In terms of reaction time, significant differences based on cognitive performance were found especially in the object and mixed tasks, with individuals in the low cognitive performance group demonstrating longer response times. Regarding the number of revisions, significant group differences were observed only in the color task and the non-symbolic composite score, with individuals in the low-performance group making more corrections. Significant group differences were found in the completion times of all tasks, with participants in the non-low cognitive performance group completing the tasks more quickly. In conclusion, among the RAN task metrics, time-based measures appear to be more effective in predicting cognitive performance level, and non-symbolic stimuli seem to be more sensitive in reflecting cognitive differences
Do Autonomic Nervous System and Perceived Exertion Responses Differ Between Walking and Virtual Reality-Engaged Walking?
No full textBackground: Walking, important for cardiovascular health and autonomic regulation, is often done on a treadmill. Aim: This study compared the physiological responses of treadmill and virtual reality walking, focusing on their effects on the autonomic nervous system, recovery, and perceived exertion. Methods: This study included 40 sedentary participants, assigned to a treadmill group (TG) or a virtual reality group (VRG). Both groups performed 20-minute treadmill walking, with the VRG additionally using the Wii Fit program. Autonomic assessments with the Polar H10 measured heart rate (HR), parasympathetic nervous system (PNS), sympathetic nervous system (SNS), stress index (SI), and the LF/HF ratio. At the same time, perceived exertion was assessed using the OMNI scale. Physiological responses were measured at baseline (T0), post exercise (T1), and at 10 (T2) and 30 minutes (T3) of recovery. Results: The study showed significant differences in HR (P = 0.040) and LF/HF (P = 0.038) between T0-T1 in the TG. In the VRG, significant changes were found in HR (P = 0.016), SNS (P = 0.010), SI (P = 0.014), and LF/HF (P = 0.020) between T0-T1, with an additional difference in LF/HF at T0-T2 (P = 0.032). OMNI scores significantly differed at all time points (P 0.05). Conclusion: Although perceived exertion was similar, the VR group showed greater SNS activation due to immersion, while recovery was identical for both methods. This understanding could contribute to developing rehabilitation strategies considering autonomic VR responses
Social Appearance Anxiety and Its Impact on Patients with Verruca Vulgaris: A Comparative Study with Healthy Controls
Full text linkAim: Verruca vulgaris, commonly known as warts, is a benign skin condition caused by the human papillomavirus. These lesions can appear on visible parts of the body, leading to concerns about appearance and social interactions. This comparative study seeks to evaluate the social appearance anxiety experienced by individuals afflicted with verruca vulgaris on prominently visible body regions, employing the Social Appearance Anxiety Scale (SAAS) for comparative analysis with healthy counterparts. Materials and Methods: A group of patients comprising 180 patients aged between 18 to 65 years, diagnosed with verruca vulgaris, alongside 170 healthy controls, participated in the examination. The participants undertook the SAAS, as well as the Hospital Anxiety and Depression Scales; supplementary assessments concerning dermatological quality of life and Visual Analog Scales (VASs) were also administered to the patient group. Results: The average mean SAAS score for the patient group was 58.47, contrasting with the control group's mean score of 20.92, which signifies a markedly elevated level of anxiety among patients with verruca vulgaris (P < 0.01). A noteworthy positive correlation was identified between SAAS and VAS scores (r = 0.325, P < 0.05). Conclusion: Visible verruca vulgaris lesions contribute to heightened social appearance anxiety. The findings suggest the need for integrating psychiatric care alongside dermatological treatment to address the psychological impact of the condition
Analysis of the protective effect of hydrogen sulfide over time in ischemic rat skin flaps
No full textBackground. - Hydrogen sulfide (H2S) is a widely studied gasotransmitter, and its protective effect against ischemia-reperfusion damage has been explored in several studies. Therefore, a requirement exists for a comprehensive study about H2S effects on ischemia-reperfusion damage in flap surgery. The aim of this study is to examine the effect of hydrogen sulfide by creating ischemia-reperfusion injury in the vascular-stemmed island flap prepared from the rat groin area. Materials and methods. - "Wistar albino" rats weighing between 250 and 300 grams were divided into 4 groups (group 1, group 2, group 3, group 4). Each group was divided into 2 subgroups: subgroup A (control) and subgroup B (H2S). In each group, skin flaps were elevated as an island flap with a superficial epigastric artery pedicle, 6 x 4 cm from the groin area. In subgroup B (H2S), liquid hydrogen sulfide was injected through the tail vein 20 minutes before ischemia at a final concentration of 10 mM. Femoral artery and vein blood flows were stopped with separate microclips and left in ischemia, according to the planned ischemia hours of the flaps: group 1 as 1 hour, group 2 as 2 hours, group 3 as 3 hours, and group 4 as 6 hours. Later, microclips were removed, and blood flow restored again. After 12 hours of reperfusion, the rats were sacrificed by cervical dislocation, and tissue samples were taken. From the samples taken, neutrophil count in ischemic tissue, MDA (malondialdehyde) measurement, and damage in the tissue were evaluated by electron microscopy. Results. - On electron microscopy inspection at all hours (1, 2, 3, and 6), hydrogen sulfide was found to provide protection against ischemia, reperfusion damage, and apoptosis at the cellular level. There was a statistically significant (P = 0.035) decrease in the tissue neutrophil count at the 1st, 2nd, and 3rd hours. In the tissue MDA measurement, a statistically significant (P = 0.026) decrease in hydrogen sulfide was detected at the first hour. There was no statistically significant difference in the 6th hour tissue neutrophil count and 2nd, 3rd, and 6th hour tissue MDA measurement. Conclusion. - Electron microscopy results in this study showed that hydrogen sulfide had antiapoptotic effects on reperfusion damage in skin flaps at all hours. However, the neutrophil counts showed it had cytoprotective and anti-inflammatory properties during the 1st, 2nd, and 3rd hours following ischemia, but not during the 6th hour. Tissue MDA levels indicate that H2S mitigates significant I/R injury during the 1st hour but not in the subsequent 2nd, 3rd, and 6th hours. These results led to the hypothesis that, in order to offer a strong enough protective effect against I/R damage, H2S should be administered repeatedly or at varying concentrations. After more research on how H2S affects skin flaps, we believe that it can be used in plastic surgery practices. (c) 2025 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Association between a large change between the minimum and maximum monthly values of solar insolation and a history of suicide attempts in bipolar I disorder
Full text linkBackgroundThe rate of suicide attempts by patients with bipolar disorder is high. In addition to patient and country specific factors, environmental factors may contribute to suicidal behavior. Sunlight has multiple diverse impacts on human physiology and behavior. Solar insolation is defined as the electromagnetic energy from the sun striking a surface area on earth. We previously found that a large change in solar insolation between the minimum and maximum monthly values was associated with an increased risk of suicide attempts in patients with bipolar I disorder.MethodsThe association between solar insolation and a history of suicide attempts in bipolar disorder was again investigated using an international database with 15% more data and more sites at diverse locations and countries.ResultsData were available from 5641 patients with bipolar I disorder living at a wide range of latitudes in 41 countries in both hemispheres. A large change in solar insolation between the minimum and maximum monthly values was associated with a history of suicide attempts in patients with bipolar I disorder, a replication of our prior analysis. The estimated model also associated state sponsored religion in the onset country, female gender, a history of alcohol or substance abuse, and being part of a younger birth cohort with a history of suicide attempts.ConclusionsA large change between the minimum and maximum monthly values of solar insolation was associated with a history of suicide attempts in bipolar I disorder, replicating our prior research. Physicians should be aware that daylight has wide ranging physiological and psychiatric impacts, and that living with large changes in solar insolation may be associated with an increased suicide risk