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The Role of Hydroxychloroquine in the Management of Rheumatic Disorders: A Comprehensive Review
Get PDFA drug preferred for its antimalarial effect called hydroxychloroquine (HCQ) has long been used to manage and avoid malaria. Nevertheless, its exact mode of action is still unknown. HCQ works through a variety of strategies to influence distinct molecular and cellular pathways. Additionally, HCQ has been demonstrated to be an effective treatment for rheumatic conditions such as primary Sj & ouml;gren's syndrome, rheumatoid arthritis, antiphospholipid syndrome and systemic lupus erythematosus. Despite being widely regarded as safe, HCQ has been known to cause adverse responses; thus, doctors should closely evaluate rheumatism patients before taking these medications. The current study aims to emphasize the potential side effects of treatment while supporting the clinical usage of HCQ for autoimmune disorders
FeVAcS: A package for visualizing acoustic scattering from 1D periodic obstacles
Get PDFFeVAcS is an open-source finite element software specializing in one dimensional periodic acoustic analyses with scattering obstacles. Leveraging FEniCS Project's computational capabilities, it solves the Helmholtz equation variational form. This tool simplifies mesh generation, enhances acoustic visualization, and enables easy parameter manipulation for obstacle and domain geometries, along with wave property adjustments. Featuring a user-friendly browser interface, FeVAcS improves accessibility and result sharing. It serves as a vital tool for understanding complexities within exterior acoustic analyses
The effect of treatment duration on the prognosis of adhd: a multi-center naturalistic follow-up study
No full textObjective: This study aimed to evaluate the effect of medication duration over a 5-year period on the prognosis of Attention-Deficit/ Hyperactivity Disorder (ADHD) and the accompanying disruptive behavioral symptoms using a naturalistic methodology. Methods: The sample comprised 576 ADHD cases referred to 16 Child and Adolescent Psychiatry Clinics in 13 cities in T & uuml;rkiye, aged between 7-12 five years ago and 12-18 currently. Baseline and current Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) scores completed by parents were compared. Sociodemographic data, treatment processes, life events, and habits were recorded. Disorder severity and recovery levels were determined using the Clinical Global Impression Scale (CGI). Results: All current T-DSM-IV-S scores were significantly lower than the baseline scores. Longer duration of medication use, receiving psychotherapy, and higher socioeconomic status were associated with better CGI scores in the present study. However, increased baseline conduct disorder symptoms, being bullied, longer duration of Internet usage, dropping out of school, smoking, and older age were associated with worse CGI scores. Conclusion: Our study indicates that a longer duration of medication use is associated with better global improvement in children with ADHD. Better identification of the factors that may directly or indirectly affect the general improvement in ADHD cases and changing these factors may enable a more positive prognosis
Can a Single Strand of Hair Contaminate a Surgical Instrument Set? A Controlled Experimental Study
No full textBirch, J., Schnell, A. K., & Clayton, N. S. (2020). Dimensions of Animal Consciousness. Trends in cognitive sciences, 24(10), 789–801. https://doi.org/10.1016/j.tics.2020.07.007Background: Surgical site infections account for a substantial proportion of hospital-acquired infections, and the proper sterilization of surgical instruments is crucial for their prevention. Hair strands detected in sterile surgical sets are generally considered sufficient grounds for rejection, leading to delays in surgical procedures. The present study evaluates the impact of hair strands on the efficacy of sterilization and the potential for contamination. Patients and Methods: This controlled experimental study was conducted in the sterilization unit of a public hospital in Istanbul between January 15 and February 15, 2023. It was hypothesized that no microbial growth would occur in hair strands or on surgical instruments after sterilization, regardless of the contamination status or sterilization method. The surgical sets obtained for the study were divided into three groups: experiment group 1, to which uncontaminated hair strands were applied (n = 6); experiment group 2, to which hair strands contaminated with one of five bacterial pathogens were applied (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, and Enterococcus faecalis; n = 30); and the control group, to which no hair strands were applied (n = 6). The soft tissue surgical instruments in each group were standardized by weight (3-3.5 kg) and sterilized using one of three methods: pressurized steam, ethylene oxide, or hydrogen peroxide. After sterilization, microbiological samples were collected by culturing swabs from the hair strands and surgical instruments under appropriate conditions in tryptic soy broth and various agar media. Results: No microbial growth was observed in any group after sterilization, regardless of the presence or contamination of hair strands or the sterilization method used. The biological indicators also identified no growth after sterilization. Conclusion: The present highlights the effectiveness of proper sterilization techniques, even in the presence of hair strands, and suggests that hair should not be treated as a potential source of contamination in all surgical settings. It should be noted, however, that the present study was conducted under controlled clinical microbiology laboratory conditions and so does not consider the complexity and variability of clinical environments. Surgical units should thus be encouraged to replicate these data or carry out similar studies and revise their practices based on their own results
Assessment of carbon trading within blockchain and subfield of artificial intelligence: a review
No full textHow can blockchain and AI revolutionise carbon trading? This article explores this question by reviewing the literature on blockchain's potential to create smart contracts for carbon trading. It also illustrates step-by-step guidance to write a smart contract that covers the essential aspects of the market. It is suggested that blockchain technology can address some shortcomings of the current system while usage of the data provided by ML makes contract actually smart
Bariyatrik cerrahi uygulanan hastalarda ameliyat sonrası ağrı şiddetinin uyku kalitesine etkisi
Get PDFAmaç: Bu araştırma, bariyatrik cerrahi uygulanan hastalarda ameliyat sonrası ilk 24 saat içinde yaşanan ağrı şiddetinin uyku kalitesi üzerindeki etkisini belirlemek amacıyla gerçekleştirilmiştir. Yöntem: Tanımlayıcı, kesitsel ve ilişki arayıcı nitelikte yürütülen bu araştırma, 1 Ekim 2024 – 15 Ocak 2025 tarihleri arasında İstanbul Atlas Üniversitesi Medicine Hastanesi Genel Cerrahi Kliniği'nde gerçekleştirilmiştir. Araştırma kapsamında etik kurul onayı, İstanbul Atlas Üniversitesi Girişimsel Olmayan Bilimsel Araştırmalar Etik Kurulu'ndan 30.09.2024 tarihli ve E-22686390-050.99-51835 etik kurul kararıyla alınmış; ayrıca kurum izni sağlanmış ve katılımcılardan yazılı bilgilendirilmiş onam alınmıştır. Örneklem büyüklüğü, %5 anlamlılık düzeyi (α = 0.05), %95 güç (1–β) ve Cohen'in (1988) sosyal bilimler için önerdiği orta düzey etki büyüklüğü (f = 0.25) esas alınarak G*Power 3.1 yazılımı ile hesaplanmış; minimum örneklem sayısı 160 olarak belirlenmiş, araştırma belirlenen dahil edilme kriterlerine uygun 165 katılımcı ile tamamlanmıştır. Veriler, "Hasta Tanıtım Formu", "Görsel Kıyaslama Ölçeği" ve "Richard-Campbell Uyku Ölçeği" aracılığıyla; araştırmacı tarafından hasta dosyası kayıtlarından ve yüz yüze görüşmeler yoluyla toplanmıştır. İstatistiksel analizler SPSS 22.0 programı kullanılarak gerçekleştirilmiş; Pearson korelasyon ve lineer regresyon analizleriyle değişkenler arası ilişkiler, bağımsız gruplar t-testi, tek yönlü varyans analizi (ANOVA) ve post-hoc testleriyle gruplar arası farklar incelenmiştir. Bulgular: Katılımcıların ameliyat sonrası ilk 24 saatteki ağrı şiddeti puan ortalamalarının orta düzeyde olduğu ve uyku kalitesi puanlarının da orta düzeyde uyku deneyimine işaret ettiği belirlenmiştir. Regresyon analizine göre, ağrı şiddetinde meydana gelen her bir birimlik artışın, uyku kalitesi puanını ortalama 9.43 birim azalttığı saptanmıştır (p<0.001). Sonuç: Elde edilen bulgular, bariyatrik cerrahi uygulanan hastalarda ameliyat sonrası dönemde ağrı şiddetinin uyku kalitesi üzerinde anlamlı ve olumsuz bir etkisi olduğunu ortaya koymaktadır. Bu doğrultuda, cerrahi hemşirelik bakımında ağrı yönetimi stratejileri, uyku kalitesini de göz önünde bulunduracak şekilde bütüncül bir yaklaşımla ele alınmalıdır. Anahtar Kelimeler: Bariyatrik cerrahiler, cerrahi hemşireliği, perioperatif bakım, postoperatif ağrı, uykuObjective: This study was conducted to determine the effect of postoperative pain severity on sleep quality during the first 24 hours following bariatric surgery. Methods: This descriptive, cross-sectional, and correlational study was conducted between October 1, 2024, and January 15, 2025, at the General Surgery Clinic of Istanbul Atlas University Medicine Hospital. Ethical approval for the study was obtained from the Non-Interventional Scientific Research Ethics Committee of Istanbul Atlas University on September 30, 2024, with decision number E-22686390-050.99-51835. Institutional permission was granted, and written informed consent was obtained from all participants. The sample size was determined using the G*Power 3.1 software, based on a significance level of 5% (α = 0.05), a statistical power of 95% (1–β), and a medium effect size (f = 0.25) as recommended by Cohen (1988) for studies in the social sciences. The minimum required sample size was calculated as 160, and the study was completed with 165 participants who met the inclusion criteria. Data were collected through patient record reviews and face-to-face interviews conducted by the researcher, using the "Patient Information Form," the "Visual Analogue Scale," and the "Richard-Campbell Sleep Questionnaire". Statistical analyses were performed using SPSS version 22.0. Relationships between variables were analyzed using Pearson correlation and linear regression analyses, while group differences were assessed using independent samples t-tests, one-way analysis of variance (ANOVA), and post hoc tests. Results: The participants' mean postoperative pain scores during the first 24 hours were found to be of moderate severity, and their sleep quality scores also indicated a moderate level of sleep experience. Regression analysis revealed that each one-unit increase in pain severity was associated with a decrease of approximately 9.43 units in sleep quality scores (p < 0.001). Conclusion: The findings clearly demonstrate that postoperative pain severity has a significant and adverse impact on sleep quality in patients undergoing bariatric surgery. Accordingly, pain management strategies within surgical nursing care should be approached holistically, with specific attention to maintaining and enhancing sleep quality during the postoperative period. Keywords: Bariatric surgery, perioperative care, postoperative pain, sleep, surgical nursin
Midkine (MDK) in cancer and drug resistance: from inflammation to therapy
Get PDFMidkine (MDK) is a heparin-binding growth factor implicated in the pathogenesis of various diseases, including cancer, chronic inflammation, and multidrug resistance (MDR). While its expression is minimal in adult tissues, it becomes markedly elevated during embryogenesis and in response to injury, infection, or hypoxia. MDK modulates inflammatory responses by recruiting immune cells and enhancing proinflammatory cytokine production. In oncogenesis, it promotes tumor proliferation, angiogenesis, epithelial-to-mesenchymal transition (EMT), and therapeutic resistance. Elevated MDK levels are frequently associated with aggressive tumor behavior and poor clinical outcomes. This review synthesizes current knowledge on MDK's expression profiles, molecular mechanisms, and functional roles across pathological conditions. It also discusses MDK's emerging value as a diagnostic and prognostic biomarker, and highlights recent advances in therapeutic strategies including small molecule inhibitors, RNA-based approaches, and receptor-blocking peptides. Overall, MDK represents a promising target for future personalized therapies, although further preclinical and clinical validation is warranted to confirm its translational potential
Beyond the guidelines: outcomes of extremely delayed hip fracture surgery in elderly
No full textBackgroundHip fractures are a significant public health issue among the elderly. While early surgical intervention's effects on morbidity are well-documented, the impact of delayed surgery on mortality and morbidity is less understood. This study aims to examine the medium-term morbidity and mortality in patients who underwent delayed surgery with an average preoperative waiting period of 14 days.MaterialsThis retrospective study used data from hospital records, Social Security Institution death records, and telephone surveys. Included were patients aged 65 and older with femoral neck or pertrochanteric fractures. Excluded were those younger than 65, with pathological or subtrochanteric fractures, and without adequate preoperative and postoperative follow-up. Preoperative waiting time, mobilization status, ASA score, NLR, and mortality rates were recorded. Postoperative follow-ups occurred at 2, 6, and 12 weeks, 6 months, 1 year, and annually. Various statistical methods investigated the impact of preoperative waiting time on mortality and mobility.ResultsA total of 289 hip fracture surgeries were followed for an average of 5.1 years (range: 0-8.5 years). The mean age was 79 (range: 65-100), with 174 females (60.2%) and 115 males (39.8%). The average preoperative waiting time was 14 days (range: 0-49 days). ROC analysis indicated the critical mortality threshold was 12 days. The one-month cumulative mortality rate was 6% for patients operated on within the first 12 days and 11% for those operated on after 12 days. One-year cumulative mortality rates were 21% for patients operated on within 12 days and 39% for those operated on after 12 days.ConclusionThis study confirms the relationship between surgical delay and increased mortality rates in hip fracture patients, with a 12-day threshold for high mortality risk exceeding typical reports. While no statistically significant relationship was found between preoperative waiting time and ambulation, one-third of postoperative patients could walk without support and nearly half could not walk at all. Despite being retrospective, this study with a large patient population demonstrates the significant impact of surgical delay on mortality and morbidity rates in hip fracture patients
Effects of a Salutogenic Model-Based Frailty Prevention Program (SAFRAPP) in pre-frail women: a randomized controlled trial
Get PDFBackground Frailty is a geriatric syndrome characterized by increased vulnerability to stressors and is more prevalent among women. As a dynamic condition, its progression can be prevented through early interventions. Therefore, this study aimed to evaluate the effect of Salutogenic Model-Based Frailty Prevention Program (SAFRAPP) among pre-frail women on preventing development of frailty and improving sense of coherence (SOC).
Methods A single-blinded, two-arm randomized controlled trial was conducted with a total of 84 pre-frail women aged 55 years and older. Participants were randomly assigned to the intervention group (n = 42) or the control (n = 42) groups. SAFRAPP was implemented in the intervention group for six weeks and consisted of health education, case management, and laughter yoga. The primary outcomes were frailty status and SOC. Secondary outcomes were well-being, quality of life, fear of falling, number of falls, and emergency visits. Data were collected at baseline and at 3-month, 6-month, and 9-month follow-ups from both groups. Pearson's chi-square test, independent samples t-test and repeated measures analysis of variance were used for data analysis.
Results The results revealed that nearly half of the pre-frail women in the intervention group transitioned to a robust stage, showing a statistically significant improvement compared to the control group at the 3-month, 6-month, and 9-month follow-ups (p 0.05)
Conclusions A nurse-led multicomponent intervention based on the Salutogenic Model appears to be effective in preventing the progression of frailty, improving sense of coherence, well-being, and quality of life among women aged 55 years and older. Future studies should investigate the potential for SAFRAPP in diverse populations and healthcare settings.
Trial registration Clinical Trials.gov Identifier: NCT04787432, date of registration: 08/03/2021
Evaluation of clinical and lifestyle factors associated with disease severity in adult patients with scalp seborrheic dermatitis: a retrospective analysis
No full textIntroduction: Scalp seborrheic dermatitis (SSD) is a prevalent and chronic dermatological condition. Although various mechanisms have been proposed, its precise etiology and exacerbating factors remain unclear. This study aimed to identify the factors influencing clinical severity in individuals with SSD; to assess the associations between severity and variables such as gender, age at disease onset, treatment history, and the presence of comorbid systemic or dermatological conditions; and to determine potential triggering factors. Methods: A total of 198 adult patients diagnosed with SSD were included in this retrospective study. Collected data included demographic characteristics, smoking and alcohol use, Fitzpatrick skin type, age at disease onset, duration of the most recent flare, frequency of hair washing, and the season during which the patient presented. Clinical severity of SSD was assessed by a dermatologist. In addition, the presence of systemic and dermatological comorbidities, as well as patient-reported triggering factors, was documented. Results: A statistically significant difference in SSD severity was observed between sexes, with higher severity noted in male patients (p = 0.006). No significant associations were found between SSD severity and age, Fitzpatrick skin type, smoking or alcohol use, season of presentation/flare up, or the presence of systemic diseases. However, SSD severity differed significantly based on the presence of onychomycosis (p = 0.001). Conclusions: The significant association between the frequency of onychomycosis and the severity of SSD highlights a potential link involving shared immunologic, microbial, and skin barrier dysfunctions underlying both conditions