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Comparison of discectomy with and without fusion in the surgical treatment of recurrent lumbar disc herniation
Full text linkObjectiveRecurrent intervertebral disc herniation is one of the most common problems encountered in spine surgery. This study aimed to compare the clinical outcomes of revision microdiscectomy and fusion surgeries in patients with recurrent lumbar disc herniation.Methods276 patients who underwent surgery with same surgeon for recurrent lumbar disc herniation between January 2012 and December 2023 were retrospectively analyzed. The patients were divided into three groups: Group 1 (revision microdiscectomy, n = 129), Group 2 (discectomy with posterolateral fusion, n = 123), and Group 3 (discectomy with posterolateral fusion and posterior lumbar interbody fusion, n = 24). Clinical outcomes were evaluated using pre- and postoperative VAS and JOA scores.ResultsPostoperative radicular and lumbar VAS scores were significantly higher in Group 1 compared with Groups 2 and 3. The recovery rates were highest in Group 3 (77%) and Group 2 (75.5%), while Group 1 showed a lower recovery rate (71.8%). Postoperative JOA scores improved significantly in all groups, with Group 3 showing the greatest improvement in total JOA scores and SLR test results.DiscussionFusion procedures were associated with better pain control and functional improvement but higher risks of complications, including screw malposition and cage displacement. Both revision microdiscectomy and fusion surgeries are effective for recurrent lumbar disc herniation. Revision microdiscectomy is effective in young patients with limited back pain but carries risks of recurrence and instability. Fusion surgeries provide superior pain relief and functional outcomes but carry higher risks of complications and longer recovery times.ConclusionBoth revision microdiscectomy and discectomy with fusion appear to be effective surgical options for the management of recurrent lumbar disc herniation. The selection of the surgical technique should be guided by patient-specific factors such as age and the predominance of low back versus radicular pain
Investigation of the relationship between burden of care, social support, and quality of life in parents caring for pediatric dialysis patients
No full textBackground and purpose: The objective of our study is to identify the social support requirements of parents caring for pediatric dialysis patients and evaluate how the burden of care impacts caregivers' quality of life. Methods: This study employed a descriptive cross-sectional study design. Data were obtained using the "Introductory Information Form," the "Zarit Burden of Caregiving Scale," the "World Health Organization Quality of Life Scale Short Form," and the "Multidimensional Perceived Social Support Scale." Results: The individuals reported some physical problems after starting caregiving; fatigue level increased and sleep duration reduced by 94.9 %. Participants reported some psychological problems such as increased desire to cry by 93,93.5 %, feeling of distress by 91.6 %, feeling of fear by 86 %. Social problems mentioned as relation with people decreased by 97.7 %, having financial problems reported by 76.7 %. The main burden of care for caregivers was 38.884 +/- 14.177, the perceived social support was 49.484 +/- 17.923, and the quality of life was 80.349 +/- 13.124. A statistically significant negative correlation (r = 0.303, p < 0.05) was found between burden of care and quality of life, positive correlation (r = 0.253) was observed between overall perceived social support and quality of life. Conclusion: Our results confirm that caregivers of pediatric patients have high care burden, low quality of life, and moderate social support. Implication for practice: Healthcare professionals should prioritize not only the well-being of patients but also parents, who play a crucial role in providing care at home. If the caregiver is overwhelmed, it is more probable that patients' needs will not be adequately met. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Role of inflammatory indices and CRP in diagnosing mesenteric lymphadenopathy in pediatric abdominal pain
No full textMeeting AbstractP-38-01
The effect of Baduanjin exercise training on balance and fall risk in elderly individuals A randomized controlled trial
Full text linkBackground: While studies have reported the potential effectiveness of Baduanjin exercises and physical activity recommendations in addressing balance disorders and the increased fall risk commonly observed in elderly individuals, it remains unclear which approach yields superior outcomes. This study aimed to compare the effects of Baduanjin exercise training and physical activity recommendations on balance and fall risk in elderly individuals. Methods: Sixty elderly individuals were included the study. The participants were randomly divided into experimental (n = 30) and control group (n = 30). A Baduanjin exercise training was given to experimental group and physical activity recommendation was given to control group. Both groups performed the exercises training or physical activity recommendation 5 days a week for 8 weeks. The Berg balance scale and the timed up and go test were used to assess balance and fall risk, respectively. All assessments were repeated before and after the 8-week program for both groups. Results: There was a significant increase both in the Berg balance scale and the timed up and go test in both groups (P < .05), but the increases in the experimental group were greater than in the control group (P < .05). Conclusion: The results of this study suggest that both Baduanjin exercise training and general physical activity recommendations are effective in enhancing balance and mitigating fall risk among elderly individuals. Nevertheless, Baduanjin exercise training exhibited greater efficacy in achieving these outcomes compared to physical activity recommendations
The relationship between nutritional status and prealbumin levels in children with loss of appetite and iron deficiency: a prospective cross-sectional study
Full text linkBackground: Prealbumin, a hepatic protein with a short half-life, has emerged as a sensitive biomarker for assessing nutritional status. This study aimed to evaluate the relationship between nutritional status and prealbumin levels in children experiencing loss of appetite due to iron deficiency and to compare the diagnostic value of prealbumin with established nutritional indices. Methods: A total of 260 children aged 2-15 years were enrolled and categorized into four groups: control (n = 65), appetite loss only (n = 65), iron deficiency only (n = 65), and both conditions (n = 65). Nutritional status was assessed using laboratory biomarkers and indices such as the Controlling Nutritional Status (CONUT) score, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI). Prealbumin levels were measured using the enzyme-linked immunosorbent assay (ELISA). Results: Prealbumin levels were significantly lower in all patient groups than in controls (p < 0.001). Prealbumin showed strong positive correlations with total cholesterol (r = 0.528), albumin (r = 0.489), and PNI (r = 0.489), and a strong negative correlation with the CONUT score (r = -0.546) (all p < 0.001). ROC analysis demonstrated that prealbumin had high diagnostic accuracy in distinguishing appetite loss (AUC = 0.911) and iron deficiency (AUC = 0.892). Logistic regression confirmed that prealbumin was significantly associated with both conditions (p < 0.001), whereas other indices (CONUT, PNI, and NRI) were not. Conclusion: While appetite loss is a clinically reported symptom, reduced prealbumin levels reflect the underlying nutritional impact of this condition. Prealbumin is a sensitive and reliable biomarker for assessing nutritional deterioration associated with both appetite loss and iron deficiency in children and outperforms commonly used nutritional indices. Its use may improve early recognition and management of nutritional risk in pediatric populations. Further research is needed to explore the diagnostic and prognostic value of nutritional indices (CONUT, PNI, and NRI) in children
Retrospective Evaluation of Omalizumab Treatment Efficacy in Patients with Bullous Pemphigoid
Full text linkBackground/Objectives: Bullous pemphigoid (BP) is a manageable condition, and the primary goal of treatment is to control the disease while minimizing the use of corticosteroids due to their potential side effects with long-term use. The primary aim of this study was to assess the effectiveness of omalizumab (OMZ) treatment in bullous pemphigoid patients using both objective and subjective indicators, including bullous pemphigoid disease area index (BPDAI) score, peripheral eosinophil count, serum total IgE level, systemic corticosteroid dosage, and pruritus severity (VAS pruritus). The secondary aim was to explore potential predictors of treatment response, such as baseline BPDAI, age, gender, lesion distribution, serum total IgE, peripheral eosinophil count, maximum and minimum corticosteroid dose, and comorbidities, as well as to evaluate the time to clinical response and corticosteroid tapering. Methods: This retrospective analysis included 25 BP patients treated with OMZ as add-on therapy to systemic corticosteroids between January 2023 and December 2024 at Health Sciences University, Basaksehir Cam and Sakura Training and Research Hospital, Dermatology and Venerology Clinic. No other systemic immunosuppressants were permitted. All patients were already receiving systemic corticosteroids at enrolment. This retrospective analysis included 25 BP patients receiving omalizumab (300 mg/4 weeks) as an add-on to systemic corticosteroids, initiated primarily for steroid-refractory disease and/or persistent, sleep-disrupting pruritus. Baseline was defined immediately before the first OMZ dose; assessments were performed at baseline and week 12. Clinical (BPDAI, VAS pruritus) and laboratory (eosinophil count, total IgE levels) parameters were assessed at baseline and week 12. Results: OMZ treatment significantly reduced disease severity, as evidenced by a mean decrease in the BPDAI score of 105.0 +/- 48.9 (95% CI 84.8-125.2) compared to baseline (p < 0.001). Peripheral eosinophil count also decreased by 0.6 +/- 0.3 (95% CI 0.4-0.7) after treatment (p < 0.001). Total serum IgE levels declined significantly in 92% of patients (95% CI 244.5-2171.3) compared to pretreatment (p < 0.001), although two patients (8%) showed an increase (202.0 +/- 258.8) after OMZ treatment. OMZ treatment led to a mean systemic corticosteroid dose reduction of 37.0 +/- 14.1 mg (95% CI 31.1-42.8 mg), with a median corticosteroid tapering time of 4 weeks (3.0-4.0). Additionally, pruritus severity, measured by pruritus VAS, decreased by 6.2 +/- 1.4 (95% CI 5.6-6.7) following treatment (p < 0.001). OMZ was well tolerated, with no serious adverse events. Conclusions: Within a 12-week observation window, we observed improvements in disease activity and pruritus alongside reduced corticosteroid exposure. Given the retrospective, uncontrolled add-on design, these findings do not establish causality but support further prospective controlled evaluation of omalizumab as a steroid-sparing option. Importantly, OMZ treatment significantly reduced the mean corticosteroid dose, pruritus VAS score, total IgE levels, and eosinophil count, indicating therapeutic activity and supporting its use as an effective steroid-sparing option in the management of bullous pemphigoid
The Effect of Nursing Interventions in Women With Gestational Hypertension: A Systematic Review and Meta-Analysis
Full text linkPregnancy-related hypertensive disorders are significant global causes of maternal morbidity and mortality. Quality nursing care is essential for pregnant women with hypertension to ensure a healthy pregnancy and delivery. This study aimed to systematically synthesize evidence on the effectiveness of nursing interventions for women with gestational hypertension. A systematic review and meta-analysis were conducted following PRISMA guidelines. Literature was searched across seven electronic databases from August 1 to September 27, 2023. Thirteen studies, encompassing 1458 women with gestational hypertension, were included. Quality assessment indicated that 10 randomized controlled trials were rated as good, one as fair, and all quasi-experimental studies as good quality. Various nursing interventions were analyzed, including training programs, home-based comprehensive nursing, case management, vascular symptom management, music therapy, and clinical nursing pathways. Meta-analysis results revealed that nursing interventions significantly reduced systolic and diastolic blood pressure, anxiety, depression, and hospital length of stay. These findings suggest that nursing interventions can effectively improve health outcomes for women with gestational hypertension, positively impacting at least one outcome in all included studies. PROSPERO Registration NumberCRD4202344482
Sağlık çalışanlarının dijital sağlıklı beslenme okuryazarlığının beslenme bilgi düzeyine ve vücut ağırlığı üzerine etkisinin değerlendirilmesi
Full text linkŞentürk, B. (2025). Sağlık Çalışanlarının Dijital Sağlıklı Beslenme Okuryazarlığının Beslenme Bilgi Düzeyine ve Vücut Ağırlığı Üzerine Etkisinin Değerlendirilmesi. Yüksek Lisans Tezi, İstanbul Atlas Üniversitesi Lisansüstü Eğitim Enstitüsü, Beslenme ve Diyetetik Anabilim Dalı, İstanbul. Bu tez çalışması, İstanbul Atlas Üniversitesi Medicine Hastanesinde çalışan, 100 sağlık çalışanı ile gerçekleştirilmiş olup, farklı meslek gruplarındaki sağlık çalışanlarının dijital sağlıklı beslenme okuryazarlık düzeyini belirlemek ve bunun beslenme bilgi düzeyine ve vücut ağırlıkları üzerine etkisini değerlendirmek amacı ile gerçekleştirilmiştir. Veriler, araştırmacı tarafından hazırlanan kişisel anket formu, e-Sağlıklı Beslenme Okuryazarlığı Ölçeği (e-SBO) ve Yetişkinler İçin Beslenme Bilgi Düzeyi Ölçeği (YETBİD) kullanılarak yüz yüze anket yöntemi ile toplanmıştır. Bu çalışma sonucunda, çalışmamıza kadın sağlık çalışanlarının katılımının daha yoğun olduğu ve katılımcıların %73'ünün 19-30 yaş aralığında bulunduğu tespit edilmiştir. Çalışmamıza katılan kadın sağlık çalışanlarının %73.7'sinin normal kilolu; erkek sağlık çalışanlarının ise %58.3'ünün fazla kilolu olduğu bulunmuştur. Çalışmamıza katılan sağlık çalışanlarının %44'ü beslenme ile ilgili bilgilere sosyal medya aracılığı ile ulaşmakta ve bu sağlık çalışanlarının %70'i sosyal medyadaki beslenme ile ilgili paylaşımların bilgi düzeylerini arttırdığını düşünmektedir. Doktorların, diğer gruplara kıyasla temel beslenme ve besin-sağlık bilgi puanının daha iyi olduğu bulunmuştur. Beden kütle indeksi (BKİ) sınıflaması değişkeninin; sağlık çalışanlarının temel beslenme ve besin-sağlık ilişkisi ve besin tercihi alt boyut algılarını etkilemeyen bir değişken olduğu sonucuna varılmıştır. Bununla birlikte, sağlık çalışanlarında medeni durum, yaş, BKİ ve farklı meslek gruplarının; e-SBO Ölçeğinin alt boyut algılarını etkilemeyen bir değişken olduğu tespit edilmiştir. Sonuç olarak bizim çalışmamızda; Beslenme ve Besin-Sağlık Bilgisi (β=-0.063, p>0.05) ve vücut ağırlığının (β=-0.007, p>0.05) e-Sağlıklı Beslenme Okuryazarlığı Ölçeği'nin anlamlı bir yordayıcısı olmadığı; Besin Tercihi'nin (β=0.301, p0.05) and body weight (β=-0.007, p>0.05) were not significant predictors of the e-Healthy Nutrition Literacy Scale; Food Preference (β=0.301, p<0.05) was found to be a positive and significant predictor of the e-Healthy Nutrition Literacy Scale. In order to prevent incomplete, incorrect and misleading health and nutrition information shared on the internet, uncontrolled sharing should be prevented and dietitians should inform the public about where they can access accurate and reliable information about nutrition, and access to accurate information should be ensured, and e-SBO levels should be increased. Keywords: Nutrition Literacy, Digital Healthy Nutrition Literacy, Nutrition Knowledge, BM
Anticonvulsant Use in Older Age Bipolar Disorder in a Global Sample from the Global Aging and Geriatric Experiments in Bipolar Disorder Project
Full text linkBackground: Anticonvulsants are an essential treatment for bipolar disorder; however, there is relatively little known about their use in older age bipolar disorder (OABD). In this paper, which leverages a large international dataset, we aim to 1) describe the use of anticonvulsants in OABD compared to younger age bipolar disorder (YABD; ages <50 years old) and 2) explore any demographic/clinical correlates.Methods: A secondary analysis was conducted on the international data from the Global Aging and Geriatric Experiments in Bipolar Disorder project. The main objective was to report the prevalence of anticonvulsant use in OABD over 50 years old (mean age = 62.27) and the most prescribed anticonvulsant. Additional analysis explored any demographic and clinical correlates associated with anticonvulsant use. Generalized linear mixed models were used for this analysis.Results: Of the 2,691 participants with bipolar disorder who had anticonvulsant prescribing data, 34.4% (n = 926) used anticonvulsants at the time of study. Rates of anticonvulsant prescribing did not significantly differ between OABD and YABD groups (36.7% (n = 666) vs. 29.7% (n = 260)). Anticonvulsant prescribing patterns for OABD and YABD did not significantly differ, with valproate as the most prescribed anticonvulsant. OABD anticonvulsant users had less lithium use, more antidepressant use, more rapid cycling, more mood episodes and more cardiovascular comorbidities compared to nonusers.Conclusion: Anticonvulsant use was similar in OABD and YABD. A number of important clinical correlates of anticonvulsant use were identified
