Category: Nevin Manimala

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):626-634. doi: 10.14744/tjtes.2024.77415.

ABSTRACT

BACKGROUND: Ischemia-reperfusion injury (IRI) is a phenomenon that affects transplant survival. The aim of our study was to examine the effects of IRI in isogenic and allogeneic muscle and skin transplantation models exposed to prolonged warm ischemia.

METHODS: Forty-eight Lewis rats and 16 Brown-Norway rats were used to create four groups: Isogenic Inguinal Flap Transplantation (IST), Isogenic Gastrocnemius Muscle Flap Transplantation (IMT), Allogeneic Inguinal Flap Transplantation (AST), and Allogeneic Gastrocnemius Muscle Flap Transplantation (AMT). Malonyldialdehyde (MDA) and superoxide dismutase (SOD) levels were measured on postoperative days 1, 7, 21, 35, 63, 100, and 120 in all groups. Donor-specific chimerism (DSC) in peripheral blood was evaluated in the allogeneic groups on postoperative days 7, 21, 35, 63, 100, and 120. The microRNA-21 and microRNA-205 levels were evaluated on postoperative days 1, 7, and 120 in all groups. At the end of the study, a histopathological examination was performed.

RESULTS: A statistically significant difference was found between the groups in terms of MDA and SOD levels. DSC was detected in the AMT group. A significant increase in microRNA-205 was observed, especially in the AMT group. There was no significant difference in the number of functional muscle units between the muscle transplantation groups.

CONCLUSION: The presence of DSC in the AMT group and the lack of a significant difference in the number of functional muscle units in the IMT and AMT groups are noteworthy findings.

PMID:39222497 | DOI:10.14744/tjtes.2024.77415

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):644-649. doi: 10.14744/tjtes.2024.78241.

ABSTRACT

BACKGROUND: Aortic dissection (AD) is a serious cardiovascular condition associated with high mortality rates. The systemic inflammatory response can influence the prognosis of AD, and in this context, the neutrophil-to-lymphocyte ratio (NLR) emerges as a simple and rapid inflammatory biomarker.

METHODS: This retrospective cohort study included 103 patients diagnosed with AD and treated in the emergency department between 2018 and 2023. Patient demographics, clinical features, and laboratory results were evaluated. Multivariate logistic regression analysis was performed to adjust for potential confounders such as age, mean systolic blood pressure, oxygen saturation, hemoglobin, lactate values, and the presence of coronary artery disease. The ability of NLR to predict mortality was analyzed using receiver operating characteristic (ROC) analysis.

RESULTS: The study population was divided into two groups: non-survivors (68% mortality rate) and survivors (32% survival rate). The non-survivor group had significantly higher NLR values compared to the survivor group (median NLR 7.66 vs. 2.5, p<0.001). Multivariate logistic regression analysis identified NLR as an independent predictor of in-hospital mortality (adjusted odds ratio [OR] 2.33, 95% confidence interval [CI] 1.42-3.82, p<0.001). ROC analysis for NLR demonstrated high discriminative power with an area under the ROC curve (AUROC) of 0.851 (95% CI 0.768-0.914). The determined cut-off point was >5.08 with a sensitivity of 77.14% and specificity of 81.82%.

CONCLUSION: The findings indicate that high NLR is strongly associated with increased mortality risk in patients with AD and can be used in emergency clinical settings to predict mortality.

PMID:39222496 | DOI:10.14744/tjtes.2024.78241

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):677-684. doi: 10.14744/tjtes.2024.70045.

ABSTRACT

BACKGROUND: Maxillofacial injuries, due to their diverse etiological causes, are often considered a component of multi-trauma and constitute a significant portion of trauma. This study aims to elucidate the incidence of maxillofacial traumas, particularly among military personnel, various clinical courses, and characteristics, thereby contributing to the literature.

METHODS: Forensic reports, primarily related to military personnel and organized between 2011 and 2016 at the Forensic Medicine Department of Gülhane Medical Faculty, Health Sciences University, were retrospectively examined. The study involved a detailed analysis of cases with maxillofacial injuries resulting from trauma, focusing on aspects such as age, gender, the origin of the trauma, degree of injury, the presence of bone and dental fractures, and the occurrence of psychiatric disorders as a result of the trauma.

RESULTS: This study demonstrated that maxillofacial traumas predominantly occurred in young male individuals, particularly among military personnel. The most common etiological factor identified was interpersonal violence. The majority of injuries were soft tissue damages, with the nasal bone being the most frequently fractured area. Injuries to the head and upper extremities were also detected in some of the cases, showing that multiple injuries are common in such cases. Post-traumatic psychological disorders developed in some cases, with anxiety disorders being the most commonly observed.

CONCLUSION: It has been determined that maxillofacial injuries can affect multiple body regions, necessitating a multidisciplinary approach. This study underscores the importance of developing comprehensive strategies and policies for understanding and managing maxillofacial traumas, providing a fundamental reference for future studies in this field.

PMID:39222495 | DOI:10.14744/tjtes.2024.70045

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):664-670. doi: 10.14744/tjtes.2024.07834.

ABSTRACT

BACKGROUND: This study aims to determine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the associated risk factors in children admitted to the Emergency Department (ED) due to traumas.

METHODS: EChildren aged 3-16 years admitted to the ED for traumas were included in the study. The control group consisted of children aged between 3-16, who visited the pediatric ED for non-traumatic reasons. The Revised Conners Parent Rating Scale (CPRS-R) was administered to parents who agreed to participate following initial intervention and stabilization. Trauma patients were divided into two groups: those diagnosed with ADHD and those without ADHD. Risk factors likely to increase the identification of ADHD were assessed.

RESULTS: The study included 917 children, with both groups showing similar characteristics regarding age, sex, demographic, and cultural factors. The most common reason for ED visits was extremity traumas, accounting for 296 (35.2%) cases. The majority of trauma patients (95.9%) were discharged from the ED after outpatient interventions. All subscale scores of the CPRS-R, except for the social problems subscale, were significantly higher in the study group compared to the control group. Factors that increased the risk of ADHD included admission with extremity traumas (p<0.001), previous ED admissions due to traumas (p<0.001), and having a family member previously diagnosed with ADHD (p<0.001).

CONCLUSION: The prevalence of ADHD symptoms may be higher in children admitted to the ED due to traumas. Furthermore, extremity traumas, previous trauma-related ED-admissions, and a family history of ADHD increase the risk of ADHD.

PMID:39222494 | DOI:10.14744/tjtes.2024.07834

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):635-643. doi: 10.14744/tjtes.2024.87099.

ABSTRACT

BACKGROUND: The Modified Early Obstetric Warning System (MEOWS) is a score-based or color-coded system that detects changes in physiological parameters and enables earlier diagnosis and care of worsening obstetric patients. The aim of this study is to evaluate the tool’s performance and contribute to its use in Türkiye by translating MEOWS into Turkish.

METHODS: This prospective and descriptive study, approved by the local ethics committee, included 350 obstetric in-patients who gave birth at Samsun Training and Research Hospital, Gynecology and Children’s Hospital between April and August 2022. The study involved patients with a gestational week greater than 28 weeks and up to six weeks postpartum.

RESULTS: The average age of the patients was 28.9±5.9 (18-40) years, with trigger values occurring in 34.6% (n=121) and morbidity occurring in 30.9% (n=108) of the cases. The most common trigger among the individual physiological indicators was high systolic blood pressure (28.3%). When the performance of MEOWS was evaluated, a statistically significant correlation was found between trigger and morbidity (Kappa=0.605; p<0.001). The sensitivity of MEOWS in estimating morbidity was 77.78% (95% confidence interval [CI]: 68.76-85.21%), specificity was 84.71% (95% CI: 79.55-89.00%), Positive Predictive Value (PPV) was 69.42% (95% CI: 62.40-75.64%), Negative Predictive Value (NPV) was 89.52% (95% CI: 85.67-92.43%), and accuracy was 82.57% (95% CI: 78.18-86.40%).

CONCLUSION: MEOWS was found to be an effective screening tool for predicting morbidity in this study and performs well in Turkish with sufficient sensitivity, specificity, and accuracy. However, the inclusion of long-term results would provide a more comprehensive understanding of the effectiveness of MEOWS.

PMID:39222490 | DOI:10.14744/tjtes.2024.87099

APMIS. 2024 Sep 2. doi: 10.1111/apm.13463. Online ahead of print.

ABSTRACT

Several investigations have been carried out to explore the genetic association of TLR4 codon variants, specifically Asp299Gly and Thr399Ile, and susceptibility to sepsis, but the results have been contradictory. The present study aimed to conduct a meta-analysis to draw a definitive conclusion regarding the role of TLR4 genetic variants (Asp299Gly and Thr399Ile) in sepsis. A thorough literature search was conducted using the PubMed, Scopus, and Science Direct databases. The inclusion and exclusion criteria were established to ensure the accuracy of the data. The Comprehensive Meta-Analysis Software v4 was utilized to perform the meta-analysis and related analyses. A total of 13 studies were analyzed, including 2328 sepsis cases and 2495 healthy controls for the TLR4 Asp299Gly variant. Eight studies provided genotype data for the rs4986791 polymorphism. The Asp299Gly variant showed a marginal protective effect in the allele (p = 0.08, odds ratio = 0.71) and dominant (p = 0.09, odds ratio = 0.71) genetic models, although it was not statistically significant. The trial sequential analysis indicated that further case-control studies are necessary to draw definitive conclusions about the TLR4 polymorphisms in sepsis. The TLR4 Asp299Gly variant may have a protective effect against sepsis. However, additional research with larger sample sizes across diverse populations is required to validate this finding.

PMID:39222487 | DOI:10.1111/apm.13463

Australas J Ageing. 2024 Sep 2. doi: 10.1111/ajag.13359. Online ahead of print.

ABSTRACT

OBJECTIVE: This study assessed perceived acceptability of online rural volunteer-led exercise classes among volunteer leaders and older people during the COVID-19 pandemic and interrogate differences in acceptability between older people who were currently participating in regular exercise and those who were not.

METHOD: A case study was conducted of an existing volunteer-led exercise program using a cross-sectional preintervention survey (38 volunteer exercise leaders and 172 program participants).

RESULTS: Thirty per cent (n = 11) of the volunteer leaders reported an interest in running the online classes. Motivations included providing opportunities for participants and keeping themselves and participants fit. Thirty-four per cent (n = 42) of the older participants reported an intent to join the online classes, which was primarily attributed to the desire to keep active and to socialise. However, over 60% of the respondents across both categories did not want to engage in online exercise classes. This was primarily attributed to a preference for face-to-face classes and lack of confidence in conducting or using online activities or services. Older participants who did not regularly exercise were statistically more likely to report perceived challenges attending an online class, and to identify the use of internet-based technologies as a barrier to attendance.

CONCLUSION: Digital literacy was a challenge for the older respondents, particularly for those who were not currently engaged in regular exercise. Organisations implementing online exercise programs should recognise that this form of delivery will pose challenges to cohorts of rural older people who are not undertaking regular physical activity and address the individual and environmental barriers to digital uptake.

PMID:39222465 | DOI:10.1111/ajag.13359

Rheumatology (Oxford). 2024 Sep 2:keae477. doi: 10.1093/rheumatology/keae477. Online ahead of print.

ABSTRACT

OBJECTIVE: The 6-min walk test (6MWT) is a simple test widely used to assess sub-maximal exercise capacity in chronic respiratory diseases. We explored the relationship of 6-min walk distance (6MWD) with measurements of physiological, clinical, radiographic measures in patients with myositis-associated interstitial lung disease (MA-ILD).

METHOD: We analyzed data from the Abatacept in Myositis Associated Interstitial lung disease (Attack My-ILD) study, a 48-week multicentre randomized trial of patients with anti-synthetase antibodies and active MA-ILD. 6MWD, forced vital capacity (FVC), diffusing capacity (DLCO), high resolution CT, and various physician/patient reported outcome measures were obtained during the trial. Spearman’s correlations and repeated-measures analysis with linear mixed-effects models were used to estimate the associations between 6MWD and various physiologic, clinical and radiographic parameters both cross-sectionally and longitudinally.

RESULTS: Twenty participants with a median age of 57, 55% male and 85% white were analyzed. Baseline 6MWD did not associate with baseline PFTs. Repeated-measures analysis showed 6MWD over time associated with FVC over time, but not with DLCO. 6MWD over time also correlated with UCSD dyspnea score, Borg scores, as well as global disease activity and muscle strength over time. Emotional role functioning, vitality, general health and physical functioning scores by short form 36 also correlated with 6MWD over time.

CONCLUSIONS: : Exploratory work in a small cohort of MA-ILD demonstrated 6MWD over time associated with parallel changes in FVC and patient reported outcomes of dyspnea, but not with DLCO. Larger studies are needed to validate the reliability, responsiveness and utility of the 6MWT in MA-ILD.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT03215927.

PMID:39222437 | DOI:10.1093/rheumatology/keae477

Br J Gen Pract. 2024 Feb 29;74(740):123. doi: 10.3399/bjgp24X736581. Print 2024 Mar.

NO ABSTRACT

PMID:39222424 | DOI:10.3399/bjgp24X736581

Psychol Rep. 2024 Sep 2:332941241278335. doi: 10.1177/00332941241278335. Online ahead of print.

ABSTRACT

Behavioral niceness has an important place in maintaining interpersonal relationships. Scale studies are needed to determine the level of niceness that plays a role in individuals’ development of healthy daily interactions with other people. In this study, firstly, the psychometric properties of the Niceness Scale, which consists of six items, were examined in a Turkish sample (N = 404). Confirmatory factor analysis confirmed the six-item one-dimensional structure, and item response analysis revealed a high level of discrimination across all items. The relationship of the Niceness Scale with previously validated and reliable scales was examined, and it was found that criterion-related validity was achieved. Furthermore, a network analysis revealed the relationships between the variables more clearly. In the scale’s measurement invariance analysis, consistency was found for both genders. Then, the reliability of the Niceness Scale was proven with different reliability values. In a different Turkish sample (N = 372), it was determined that depression played a statistically significant mediating role in the relationship between niceness and subjective happiness. In conclusion, this study revealed that the one factor and six-item Niceness Scale are valid and reliable in the Turkish sample. Moreover, boosting niceness has been determined to reduce negative situations such as depression and therefore enhance subjective happiness. All these important implications about niceness are discussed in light of the literature.

PMID:39222409 | DOI:10.1177/00332941241278335