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Purpose: The aim of this study is to show whether radiologically diffusion tractography imaging (DTI) and electrophysiologically F responses methods support clinical examination in Amyotrophic Lateral Sclerosis (ALS). It is to determine the relationships between these two methods. Materials and Methods: Patients with a definite diagnosis of ALS according to the Revised-El Escorial and Awaji criteria at any stage of the disease, who applied to the Electromyography (EMG) laboratory of the Neurology Clinic of Istanbul University Cerrahpaşa, Cerrahpaşa Medical Faculty, prospectively and cross-sectionally, were included in the study. The revised ALS functional rating scale (ALSFRS-R) was scored. Electrophysiological studies included routine nerve conduction studies, F responses and needle EMG. In radiological examinations, diffusion tractography imaging (DTI) maps were obtained in brain and cervical Magnetic Resonance Imaging (MRI) and diffusivity and fractional anisotropy (FA) values were compared. Results: The mean age of the 12 volunteer patients included in the study was 55.92±9.68 (43-72), and consisted of 4 female and 8 male individuals. The mean ALSFRS-R score was 35.75±7.86 (24-46). MRI was performed in 11 of the patients, spinal imaging could not be performed in one patient. The mean age of the 11 patients who were imaging was 56.4±9.8 years and the disease duration was 2.7±1.9 years. Low values of DTI-FA were found to be associated with poor respiratory and speech scores as assessed by linear regression analysis. Repeater F responses in the ulnar nerves were also associated with a high ALSFRS-R score. Conclusion: In our study, we observed that low values of DTI-FA were associated with poor respiratory and speech scores. Showing the correlation of low FA with a vital function such as respiration may indicate that this technique will be helpful in the prognosis and progression of the disease. The increase of repeater F responses in the ulnar nerves in those with high ALSFRS-R scores suggests that it is worth investigating whether ALS can be used in differentiating from other anterior horn diseases. The results of this study suggest that DTI-FA, which is an advanced radiological evaluation, and repeater F responses as an electrophysiological method may support early diagnosis in ALS. more...

İletişim kavramı ile birlikte giderek genişleyen, teknolojinin dokunuşu ile de gündelik yaşamda her alana giren sosyal medya, bireylerin birbirleri ile daha kolay iletişim kurmalarına önemli etkilerde bulunmaktadır. Bu etkilerden en önemlileri; bireylerin daha hızlı iletişim kurmaları, sık ve sonsuz enformasyon paylaşabilmeleri ve mesafe gözetmeksizin ilişki sürdürebilmeleri olarak karşımıza çıkmaktadır. Ayrıca sosyal medya, kullanıcılarının içerik üretmelerine ve paylaşmalarına aracı olduğu için, bireyler bu üretimlerine karşı bir geri dönüş alabilmektedir. Bu durum da çalışmanın konusu olan narsisizm ve empati kavramlarının doğmasına sebebiyet vermektedir. Birey yaptığı paylaşımlar ve ürettiği içerikler ile kişisel özelliklerini yansıtabilmekte, aynı zamanda da yansıttığı bu özellikler ile bilişsel ve psikolojik bazı doyumlara ulaşabilmektedir. Narsisizm ve empati kavramları da ulaşılan bu doyum sonucu ortaya çıkmaktadır. Çalışma kapsamında bahsedilen tüm bu süreç incelenerek, sosyal medya kullanıcılarının narsistlik ve empatiklik düzeyleri uygulanan 400 anket ve yapılan nicel yöntem analizleri ile sonuçlandırılmıştır. Yapılan analizler sosyal medya kullanıcılarının, mecrayı kullanım süreleri, cinsiyetleri ve kullanım motivasyonlarından elde edilen verilerle yorumlanmıştır. Çalışmada katılımcıların cinsiyet, medeni durum ve gelir durumu gibi demografik özellikleri üzerine analizler yapılmıştır. Örneğin yapılan analizler sonucunda evli katılımcıların narsistik seviyelerinin daha yüksek olduğu ve yine evli olan kadın katılımcıların narsistik seviyelerinin evli erkeklere ve bekâr erkeklere göre daha yüksek olduğu sonucuna ulaşılmıştır. more...

Objective: The aim of the study was to examine whether the proportion of young elite football players with high functional movement screening (FMS) scores and reaching professionalism differs from the proportion of young elite football players with low FMS scores and non-professionals. Materials and Methods: Fifty-seven players were included in the study. The health files of the participants were retrospectively scanned. Physical information and FMS scores were recorded in the data form. The level of football career of the participants as of March 2022 was assessed on the website of the Turkish Football Federation. FMS scores were compared by dividing the participants into two groups as those with- and without professional football license. Results: The proportion of participants with a score above the FMS cut-off score and reaching the professional level was higher than the rate of non-professional participants with a score above the FMS cut-off score (p˂0.05). Conclusion: The quality of movement in young elite football players may be a determinant for being a professional football player. For this reason, starting from an early age, measuring the quality of movement regularly and trying to improve it may be important in realizing the career goals of elite young football players. more...

The semantic query problem is commonly called the semantic gap and is one of the significant problems in multimedia data retrieval. In this study, we focus on multimedia data retrieval by combining semantic information with data content to solve the semantic gap problem effectively. The main idea behind the combination of low-level content descriptors and the concept of multimedia data is to represent the content information with the semantic information by adding a low-level content descriptor as a new dimension to the index structure. This new dimension is represented by constructing an array index structure that uses a fuzzy clustering algorithm. Thus, a new high-dimensional index structure, named MM-FOOD, supporting querying of multimedia data, including fuzzy querying, is presented in this paper. This proposed index structure’s construction and query algorithms are explained throughout this paper. Our experiments show that our indexing mechanism is considerably efficient compared to the basic indexing approach, which stores low-level content and semantic concept descriptors in separate structures when the data size is large. more...

This study aimed to investigate the potential contribution of quantitative measurements of dural venous sinuses to the diagnosis of idiopathic intracranial hypertension (IIH) and the relationship between IIH and dural venous sinus dimensions on 3D post-gadolinium T1-weighted magnetic resonance (MR) images.A total of 129 individuals (57 IIH patients and 72 controls) who complained of headache and underwent both magnetic resonance venography (MRV) and precontrast/postcontrast 3D T1-weighted MR imaging between 2018 and 2021 were included in this retrospective study. Dural venous sinus and jugular vein diameters were measured in all cases using post-gadolinium 3D T1 TFE images. The presence of transverse sinus (TS) hypoplasia and occipital sinus variation, the number and size of arachnoid granulations in the TS, and the presence of brain parenchymal herniation were also evaluated. Cut-off values that maximized accurate diagnosis of IIH were established on the receiver operating characteristic curve. The sensitivity and specificity of the diagnosis of IIH based on quantitative measurements of the dural sinus were calculated.The ratios of the maximum to minimum TS diameters and the minimum TS diameters to minimum sigmoid sinus (SS) diameters were significantly higher in IIH patients than in the control group (p 0.001). The diagnostic sensitivity and specificity values of TSPractical measurements from multiplanar T1 sequences can be useful for both quantitative assessment and overcoming misinterpretation due to anatomical variation. more...

Aim: The aim of this study was to investigate the incidence and characteristics of injuries suffered by elite soccer academy athletes. Materials and Methods: A retrospective analysis was made of the health records between 2016 and 2019 of athletes in the elite male soccer academy of an elite football club. The cause, type, location, recurrence, and severity of the injuries, where the injuries occured and time lost due to the injuries were recorded. The injury incidence and prevalence were calculated. Results: Overall, total injuries and seasonal incidence rate were 1.49 (1.33-1.68) and 8.06 (7.16-0.04) per 1000 hours, respectively. The injury burden ranged between 11.83 (10.53-13.29) days and 51.43 (49.11-53.85) days. The injury characteristics were not statistically different according to age groups (p˃0.05). Conclusion: Youth soccer players in the U19 and U21 age groups had more injuries than other junior age groups in a typical soccer season. It was concluded that there were more match injuries, the thigh was the most injured area, muscle injuries were more common, and the hamstring was the most frequently injured muscle. more...

Objective: The purpose of this study is to examine and compare the scores of the functional movement screen (FMS) of professional male soccer players in different leagues. Materials and Methods: Previously collected data of 64 athletes who were competing in three different soccer leagues, using the FMS test battery procedure were analyzed. Asymmetry and dysfunction rates, total FMS scores, scores of FMS subgroups and scores of each test were compared. Results: There was no statistically significant difference between the FMS scores of soccer players who were competing in different leagues (p˃0.05). In addition, the difference between motor control, mobility and reflex core stabilization subgroup scores were not statistically significant (p˃0.05). When the tests were compared individually, only the rotatory stability test score was found to be statistically significantly different (p Conclusions: The rate of asymmetry and dysfunction is high in professional soccer players along with the scores of FMS tests were not significantly different according to the levels of players playing in the professional league, except for the rotation stability test. Players in the top professional league have higher scores in the rotation stability test and less dysfunction. Therefore, postural control is affected by the professional league level in soccer. more...

Aims: The study aimed to analyze the quality, adequacy and readability of websites created for patients with shoulder complaints associated with biceps tendon disorders. Methods: The terms 'shoulder injury', 'biceps tendinitis' and 'biceps tendon rupture' were searched in the most used search engines in United States (Google, Yahoo, and Bing). One hundred forty seven websites designed to inform patients were included in the study. The quality, popularity, adequacy and reliability were meausured. Results: Flesch reading ease scores of websites with content creation by health professionals were significantly lower than those without; in contrast, Flesch-Kincaid grade level (FKGL) and Koleman-Liau index scores were significantly higher (p more...

Objective To test the utility of the artificial learning algorithms using magnetic resonance (MR) images of the pituitary gland in predicting the prognosis of prolactinoma. Methods This single-center, retrospective study was conducted in the Pituitary Center of a tertiary care university hospital. A total of 224 images derived from 38 patients with treatment-refractoryprolactinoma, 23 patients with prolactinoma remission and 51 healthy individualswere used. Pituitary MRI protocols are of three sequences: T1-weighted imaging (T1WI), contrast-enhanced T1WI (CE-T1), and T2-weighted imaging (T2WI). A machine learning algorithm that includes image filtering and classification. Data were classified with support vector machine. Results No difference was found between the refractory and the remission groups in terms of age, sex, education, the baseline prolactin level and radiological features. Images were classified with a support vector machine; area under curve (AUC), accuracy, sensitivity and specificity of 0.90 (95% confidence interval, 0.679-1), 91.6%, 91.7%, 88.3%, respectively. Conclusion These results indicate that a new image of unknown nature can be correctly identified with the specified percentages. more...

The aim of this study was to investigate relationship Functional Movement Screening (FMS) scores and the Global Positioning Systems (GPS) data associated with musculoskeletal injuries soccer injuries in professional soccer players. The study included 19 soccer players with a mean age of 21.53 ± 1.98 years, a mean height of 180.58 ± 6.09cm, and a mean bodyweight of 73.08 ± 5.29 kg. The functional movement screening test battery was applied, and then GPS data associated with musculoskeletal injuries were recorded for each player during training sessions over a 6-week period. The recorded GPS data were mean total distance 5473.72 ± 344.49 m, mean distance per minute 69.11 ± 6.59 m, high-intensity running distance (14-20 km / h-1) 150.47 ± 46.92 m, very high intensity running distance (˃20 km / h-1) 34.94 ± 16.96 m, and body load of 108.43 ± 15.87. The GPS data of the participants with the FMS composite score above the cutoff point score and those below the cutoff point score were similar (0.05 more...

This study tested the relationship between servant leadership, unethical pro-organizational behavior (UPB) of employee, trust in managers, and employees' positive reciprocity beliefs (PRB). Data were collected from 392 employees who work in four and five-star hotels in Alanya, Turkey. Structural equation modeling and artificial neural network analyses provided evidence for direct and indirect relationships between servant leadership and employee UPB via trust in manager and PRB. Specifically, trust in manager and PRB strengthened the relationship of servant leadership with employee UPB. These findings suggest that servant leadership could have a previously unexplored dark side in certain contexts. The study enhances the servant leadership and UPB literature. It also suggests certain practical implications for hotel managers to be able to reduce employee UPB. The limitations and future research suggestions of the study are discussed. more...

Amaç: Bu çalışmanın amacı tercih edilen ekstremitenin glenohumeral eklem hareket hissi ile tercih edilmeyen ekstremitenin hareket hissi arasında fark olup olmadığını incelemektir. Gereçler ve Yöntem: Çalışmaya omuz ekleminde herhangi bir problemi olmayan, sağlıklı, sedanter 20 kişi (10 erkek, 10 kadın) dahil edildi. Katılımcıların yaş ortalaması 23,60±3,64 yıl idi. Veriler 6 Temmuz 2020 ile 3 Ağustos 2020 tarihleri arasında toplandı. Katılımcıların tercih edilen ve tercih edilmeyen taraf glenohumeral eklem hareket hissi ölçüldü. Hareket hissi ölçümü izokinetik dinamometre kullanılarak, 0,1°/s açısal hızda pasif hareket hissi eşik değeri ölçülerek belirlendi. Hareket hissi ölçümleri, 0°’den (0°-IR) ve 30°’den (30°-IR) internal rotasyon yönüne ve 0°’den (0°-ER) ve 30°’den (30°-ER) eksternal rotasyon yönüne olmak üzere 4 yöne doğru yapıldı. Bulgular: Katılımcıların tercih edilen taraf için internal rotasyon hareket hissi eşik değerleri 0°-IR, 30°- IR açı ve yönleri için sırasıyla 1,27±0,47°, 1,30±0,45°, eksternal rotasyon hareket hissi eşik değerleri 0°-ER, 30°-ER açı ve yönleri için sırasıyla 1,25±0,39°, 1,41±0,32° ve tercih edilmeyen taraf için internal rotasyon hareket hissi eşik değerleri 0°-IR, 30°-IR açı ve yönleri için sırasıyla 1,33±0,59°, 1,37±0,49°, eksternal rotasyon hareket hissi eşik değerleri 0°-ER, 30°- ER açı ve yönleri için sırasıyla 1,39±0,49°, 1,18±0,42° idi. Her iki tarafın pasif hareket hissi eşik değerleri arasında farklar istatiksel olarak anlamlı değildi (p more...

Purpose: There are studies in the literature evaluating students’ attitudes toward and knowledge of complementary and alternative medicine (CAM) practices, with most of this research focusing on medical, pharmacy, nursing and psychology students; however, few studies have been conducted with physiotherapy and rehabilitation (PTR) students. The aim of this study was to investigate knowledge, attitudes, and behaviors related to CAM among students of PTR. Method: This cross-sectional study was conducted between October 2018 to March 2019. A self-administered questionnaire form developed to identify the knowledge, attitudes, and behaviors regarding CAM practices among students of PTR. The questionnaire form included eighteen items that was sent via email to the participants. Results: A total of 504 participants were included in this study. Their mean age was 21.66±2.50 years, 69.84% was female and 30.16% was male. Most participants (76.99%) thought that various CAM practices could be beneficial adjuncts to modern medicine. The most used sources of CAM practices was reported as online resources (64.68%). Moreover, the most well-known CAM practice among the students was massage (82.90%). Conclusions and Suggestions: Majority of PTR students had a positive opinion about CAM practices. Incorporating evidence-based CAM practices with high levels of efficacy into the curricula can reliably increase physiotherapists’ knowledge about CAM practices. more...

The aim was to evaluate the effectiveness of superb microvascular imaging (SMI) in axillary lymph nodes (LNs).Benign and malignant LNs diagnosed via histopathological examination constituted the study subgroups. In addition to grayscale findings for morphological evaluation, vascular patterns and appearance of internal vessels were analyzed by both power Doppler ultrasound (PDUS) and SMI. The number of vascular branches was counted, and a vascularity index (VI) was calculated by SMI.Fifty-two LNs with suspicious findings in terms of metastasis (33 malignant and 19 benign) were evaluated. Diagnostic accuracy according to vascular patterns was 82% for PDUS and 92% for SMI. In the presence of asymmetric cortical thickening, there was a significant difference between benign and malignant LNs in the number of vascular branches of both thin and thick cortical sides (P0.01). Mean VI was significantly higher in the malignant group (P0.05). In differentiating malignancy, when a cutoff VI value was set to 9%, sensitivity was 69.7%, and specificity was 63.2%.Evaluating the vascularity of axillary LNs by SMI is a useful tool in determining the potential of axillary metastasis, especially in the absence of typical sonographic findings. Superb microvascular imaging can beneficially be used to select the most suspicious LN and suspicious area of the LN to sample. more...

Accommodation businesses are stressful workplaces due to their dynamic and demanding work environment. Role ambiguity and role conflict are major stress factors for hotel employees, causing low levels of satisfaction and performance and high levels of turnover. The main purpose of this study was to explore the mediating effect of job satisfaction on the relationship between role conflict, role ambiguity, and job performance. The data was collected through fully structured questionnaires from employees working in 3, 4 and 5 star hotels in Alanya, one of the leading tourism destinations in Turkey. The data was analyzed via structural equation modeling. The results revealed that both role conflict and role ambiguity have direct negative influences on job performance and job satisfaction for hotel employees. Moreover, it was also proved that job satisfaction mediates the effect of role conflict and role ambiguity on job performance. In line with the findings, theoretical and managerial implications, contributions, limitations, and future research directions were discussed. It was implied that role stress factors must be addressed seriously by hotel managers in order to increase job performance. more...

Purpose of review To give an overview regarding the potential usefulness of vessel wall imaging (VWI) in distinguishing various intracranial vascular diseases, their common imaging features, and potential pitfalls. Recent findings VWI provides direct visualization of the vessel wall and allows the discrimination of different diseases such as vasculitis, atherosclerosis, dissection, Moyamoya disease, and reversible cerebral vasoconstriction syndrome. Recent studies showed that concentric and eccentric involvement in the vessel wall, as well as the enhancement pattern were found important for the distinguishing these diseases and evaluating their activity. Summary Most of the imaging techniques currently used are based on luminal imaging. However, these imaging methods are not adequate to distinguish different diseases that can demonstrate similar radiological findings. VWI is being increasingly used as a noninvasive imaging method to offset this limitation. more...

Purpose To assess the effectiveness and safety of autologous intraparenchymal blood patch (IBP) application in reducing the frequency of pneumothorax (PTX) after percutaneous transthoracic pulmonary core needle biopsy. Methods The records of patients who underwent the transthoracic pulmonary core needle biopsy procedure under CT guidance between January 2015 and October 2018 were screened retrospectively. Patients whose traversed pulmonary parenchymal length was ≥20 mm during biopsy were included in the study irrespective of lesion size. The IBP procedure was made a department policy in November 2017; patients who underwent biopsy after this date comprised the IBP group, while those who underwent the procedure before this date comprised the control group. IBP recipients received 2-5 mL of autologous blood injection to the needle tract. Demographic data, procedural reports, tomography images, and the follow-up records of patients were assessed. Results A total of 262 patients were included in the study. Of the 91 patients that received an IBP, PTX developed in 13 (14.1%), with 7 (7.7%) requiring a thoracic tube. Of the 171 patients who did not receive an IBP, PTX developed in 45 (26.3%), with 19 (11.1%) requiring a thoracic tube. Patients who received an autologous IBP showed a significantly lower rate of PTX development versus those who did not (P = 0.01). Similarly, a significantly lower number of patients who received the blood patch required chest tube placement (P = 0.015). Conclusion Autologous IBP is a safe, inexpensive and easy to use method that reduces the rate of PTX development and thoracic tube application after percutaneous core needle biopsies of the lung. more...

OBJECTIVES The aim of this study was to investigate the efficacy of 2-dimensional (2D) shear wave elastography (SWE) in the diagnosis of acute cystitis (AC) in children. METHODS Between June 2019 and March 2020, 126 children with AC and 126 healthy participants were prospectively investigated by 2D SWE and B-mode ultrasound. Elastographic measurements were performed by drawing the contours of the posterior wall of the bladder between the ureter orifices using a free region of interest. The quantitative 2D SWE values of the patients and the healthy group were compared. RESULTS The mean 2D SWE values of the bladder wall were significantly higher in patients with AC compared to the healthy group (P = .001). On B-mode ultrasound imaging, the bladder wall thickness of patients with AC was higher than that in the healthy group (P = .001). On 2D SWE, when the cutoff value used was 9.25 kPa, the sensitivity, specificity, positive predictive value, and negative predictive value were 92.1%, 88.1%, 89.3%, and 92.6%, respectively, whereas when the cutoff value used was 1.72 m/s, the sensitivity, specificity, positive predictive value, and negative predictive value were 90.5%, 88.9%, 89.1%, and 90.7%. There was a statistically significant positive correlation between the 2D SWE values and wall thickness measurements (P more...

Objective Carbon monoxide (CO) poisoning is one of the most common poisonings worldwide. The affinity of hemoglobin for CO is significantly higher than that for oxygen, and the formation of carboxy-hemoglobin leads to a decrease in the capacity of blood to transport oxygen to tissues, tissue hypoxia, and early perfusion changes in the affected tissue. This study aimed to investigate the utility of arterial spin labeling perfusion imaging (ASL-PI) in revealing cerebral vascular hemodynamic changes in patients presenting to the emergency room with CO poisoning and to compare findings with those from diffusion-weighted imaging (DWI). Method This study was conducted between November 2016 and May 2019 and was approved by the local ethics committee. DWI and ASL-PI examinations were performed in 83 patients who presented to the emergency room with CO poisoning. Four regions—the cerebral cortex, basal ganglia, cerebral white matter, and cerebellum—were evaluated for alterations in perfusion and diffusion, and findings from DWI and ASL-PI were compared. Results The study group included 39 (50.6%) females and 38 (49.4%) males, with a mean (±SD) age of 40.08 ± 20.41 years (range, 7–86 years). DWI revealed restricted diffusion in 10 regions in 6 (7.8%) patients, including the basal ganglia (n = 2), cerebral white matter (n = 2), cerebral cortex (n = 3), and the cerebellum (n = 3). ASL-PI revealed hypo-perfusion in 64 regions in 36 (46.8%) patients, including the basal ganglia (n = 21), cerebral white matter (n = 12), cerebral cortex (n = 23), and cerebellum (n = 7). Conclusion ASL-PI provided additional information when used to identify perfusion changes in the brains of individuals who experienced CO poisoning and was superior to DWI as it revealed early changes in the brain. Considering its limitations, ASL-PI can be routinely used with DWI in cases of CO poisoning. more...

Craniocervical dissection is one of the most common causes of stroke in children. Although the most common cause of dissection is trauma, spontaneous dissections in which no cause can be revealed may also occur. The diagnosis of this type of dissection in children can be challenging with the preferred non-invasive imaging methods (MRA, CTA). Intracranial vessel wall imaging is a promising novel method for identifying specific signs of dissection. We report an 11-year-old girl with spontaneous ICA dissection, whose diagnosis was confirmed by an MRI of the intracranial vessel wall. Vessel wall imaging has contributed substantially to the diagnosis and follow-up of this case. more...

BackgroundFlow diverter (FD) devices provide a safe and effective treatment option especially for wide-necked intracranial aneurysms. One of the main concerns in patients treated with FD devices is patency of arterial branches jailed by the stent. However, there are no long-term data from magnetic resonance perfusion (MRP) studies regarding jailed branches. In this study we aimed to reveal the MRP findings in patients with jailed middle cerebral artery (MCA) cortical branches during long-term follow-up after flow diversion.MethodsPatients who underwent FD stent treatment for MCA aneurysms with a resulting jailed cortical branch were included. Follow-up clinical, angiographic, and MRP examination findings were recorded. Different MRP parameters were measured in the MCA territory regarding the jailed branches.ResultsEighteen patients treated endovascularly with flow diversion for a total of 20 MCA aneurysms were included. At angiographic follow-up (median 35 months, range 7–95 months) complete occlusion was observed in 13 (65%) aneurysms and partial occlusion was observed in 6 (30%). The mean transit time (MTT) prolongation, MTT ratio, time-to peak (TTP) prolongation, and TTP ratio were 1.34, 1.20, 1.18, and 1.06 s, respectively, when compared with the contralateral side in the MCA territory. MTT, TTP, and cerebral blood volume values of the patients showed statistically significant differences compared with the contralateral side (PConclusionsFlow diversion treatment of complex bifurcation aneurysms can be effective and safe. MRP examination may reveal perfusion changes in the territory vascularized via a jailed branch, and these changes are rarely accompanied by clinical findings. more...

© 2022 Elsevier B.V.Background: Bipolar disorder (BD) is characterized by recurrent mood episodes that may progress over time. Staging models may be used to follow the long-term course of BD. BD is associated with microstructural changes in white matter (WM). This study aims to compare the WM integrity within patients groups who are in different stages of BD and healthy controls and investigate whether WM integrity changes may be a biomarker that can be used in the clinical staging of BD. Methods: The study sample included euthymic 54 patients diagnosed with BD according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and 27 healthy volunteers. Early-stage patients (n = 26) were determined as patients who have not had any mood episodes after the first manic episode, and late-stage patients (n = 28) determined as patients with recurrent mood episodes. MRI was performed using a 1.5 Tesla MR system and DTI sequences were acquired. Results: Region of interest (ROI) analyses showed that late-stage patients had significantly reduced fractional anisotropy (FA) in the right sagittal stratum and genu of the corpus callosum compared with healthy controls and early-stage patients. Regression models show that corpus callosum genu and right sagittal stratum FA values are predictive for the late-stage patient group. Limitations: There are some limitations of the ROI method. The cross-sectional design is another limitation of this study. Conclusions: WM integrity of corpus callosum genu and right sagittal stratum may be a biomarker for clinical staging of BD. Identifying stage-specific biomarkers may help us predict the neuroprogressive course of BD. Longitudinal studies would be required to detect stage-specific biomarkers. more...

Novel coronavirus disease 2019 is a viral infectious disease which commonly involve the lungs with primarily radiologic manifestations of atypical or organizing pneumonia. It can cause multisystemic involvement including central nervous system symptoms. One of these neurologic manifestations is posterior reversible encephalopathy syndrome (PRES). It is suggested that the increased levels of cytokines and inflammatory mediators in the course of the disease are responsible for cerebrovascular endothelial dysfunction and disruption of the blood-brain barrier. To the best of our knowledge, no pediatric PRES has been reported related to coronavirus disease 2019. Here, we present a pediatric PRES case associated with severe acute respiratory syndrome coronavirus 2 infection. more...

Background: Hand hygiene compliances of healthcare students have been examined extensively. However, there has been no study in this area for the students of the department of physiotherapy and rehabilitation. The aim was to evaluate hand hygiene compliance of the department of physiotherapy and rehabilitation students after a briefing on hand hygiene. Methods: Before the summer practice, the students were briefed on hand hygiene. Then their hand hygiene compliance were assessed. Their sociodemographic characteristics, clinical summer practice data, and hand hygiene compliance based on the recommendations commented in the Centers for Disease Control and Prevention Guideline for Hand Hygiene in Health Care Settings were assessed with a questionnaire prepared by the researchers. Results: Of 53 students, 52 met inclusion criteria. The average correct answer rate was 82.69%. Students had inadequacies in selecting suitable hand hygiene techniques and in complying with hand hygiene indications in some situations related to their profession. Moreover, the students suggested that there was a great need for education (n = 24; 39.34%) and improvements in physical conditions (n = 21; 34.43%). Conclusions: As a conclusion, department of physiotherapy and rehabilitation students were aware of the importance of hand hygiene in terms of prevention of healthcare-associated infections. However, for department of physiotherapy and rehabilitation students, educational programs about hand hygiene is needed in order to gain optimal competence and to be able to protect and improve health care workers and patients safety. more...

Amaç: Safra taşıileusu kolelitiazisin nadir bir komplikasyonudur.Tekrarlayan kolesistit atakları sonucu gelişen kolesistoduodenal fistül yoluile safra kesesi taşının intestinal sisteme geçmesi sonucunda oluşur.Çalışmamızın amacı merkezimizde safra taşı ileusu tanısı alan hastalarıngörüntüleme bulgularını sunmaktır.Gereç ve Yöntemler: Aralık 2016-Ocak 2019 tarihleri arasında hastanemiz radyoloji birimine başvuran hastalardanultrasonografi tetkikinde safra kesesi taşı öyküsü olan hastaların dosyalarıretrospektif olarak incelendi. Bu hastalardan safra taşı ileusu tanısı alanhastalar tespit edildi. Hastaların hastaneye geliş şikayetleri, yaşları,cinsiyetleri, eşlik eden hastalıkları ve radyolojik görüntüleme bulguları ilefistül lokalizasyonu, taşın boyutu, obstrüksiyon seviyeleri değerlendirildi.Bulgular: Bilinen safrataşı öyküsü olan 342’si (%35.7) erkek, 616’sı (%64.3) kadın toplam 958 hastadansafra taşı ileusu tanısı alan 5 hasta tespit edildi. Hastaların 3’ü kadın (yaşortalaması 76.67±13.05/ yıl), 2’si erkek (yaş ortalaması 59±1.41 /yıl) idi. Hastalarındirekt grafilerinde ileus bulguları mevcuttu. Yapılan ultrasonografi tetkikindetüm hastalarda safra kesesi net olarak vizüalize edilemedi. Değerlendirilebilenbarsak segmentlerinde ileusu düşündürecek çap artışı tespit edildi. İleusnedenine yönelik yapılan bilgisayarlı tomografide hastaların hepsindeintrahepatik safra yollarında hava, kolesistoduedonal fistül, barsak lümenindetaşlar ve bu seviye proksimalinde ileus ile uyumlu görünüm izlendi. Taşlarınboyutları ortalama 26.2±16.3 mm (16-55 mm) idi.Sonuç: Safra taşı ileusu intestinal obstrüksiyonunnadir nedenlerinden biri olmakla birlikte intestinal obstrüksiyon bulguları ileacile başvuran ileri yaş ve kolelitiazisöyküsü olan hastalarda safra taşı ileusu mutlaka akla gelmelidir., Objective: Gallstone ileus is a rare complicationof cholelithiasis. It occurs as a result of the passage of bile stones intointestinal system via bilioenteric fistulae, which are formed by recurrentattacks of cholecystitis, and obstruction of the intestinal lumen. Theobjective of our study was to discuss the imaging findings of gallstone ileusamong patients diagnosed at our center.Material and Methods: Among patients that admitted to ourhospital’s radiology department between December 2016 and January 2019, themedical records of those with a history of gall bladder stone detected onultrasonography were retrospectively evaluated. Among those, cases of gallstoneileus were identified. Admission complaints, age, sex, comorbidities,radiological imaging findings, fistula localization, stone size, andobstruction level were recorded and analyzed.Results: Among 958 patients with bile stones, 342(35.7%) were male and 616 (64.3%) were female. Gallstone ileus was identifiedin five patients. Three of them were female (mean age 76.67± 13.05 years) and 2were male (meanage 59±1.41 years). Ileus signs were detected on plain radiograms forall patients. The gallbladders were not clearly visualized by ultrasonographyin any of patients with gallstone ileus. A diameter increase suggestive ofileus was detected in visualizable intestinal segments. Computed tomography toidentify the cause of ileus revealed air in the bile ducts, cholecystoduodenalfistula, stones in intestinal lumen, and an appearance consistent with ileusproximal to that segment. The mean size of the stones was 26.20±16.3 mm (16-55mm).Conclusion:Although gallstone ileus is a rare cause ofintestinal obstruction, it should be definitely remembered in the differentialdiagnosis in patients with advanced age and a history of cholelithiasis whopresent to the emergency department. more...

Aim: The purpose of this study is to present superficial venous vascular anatomic variations of the saphenofemoral junction, which is a very important region in variceal treatment, by ultrasonography technique. Material and Method: Seventy nine patients who were referred to our radiology department and pre-diagnosed for venous insufficiency between February 2017 and July 2018 were included in the study and a total number of 158 venous vascular anatomy of saphenofemoral regions were evaluated by B- mode and color doppler ultrasonography. The superficial venous vascular anatomy of the saphenofemoral regions were evaluated in detail, classified according to the anatomical classifications of Glasser and Daseler, and the frequencies of variations were calculated. Results: In our study, the most common group according to the Glasser classification was type 2C observed in 30 (19%) saphenofemoral regions followed by type 2B and 2C. Type H (VIII) was the most common type of saphenofemoral region according to the Daseler classification followed by Type F (VI) and type E (V). Between 1 to 5 superficial venous branches draining to saphena magna were observed at the level of saphenofemoral junction. Three venous branches draining to the saphena magna were observed in 78 (49%) saphenofemoral junctions followed by two venous branches in 50 (32%) saphenofemoral junctions, four venous branches in 25 (16%) saphenofemoral junctions, one venous branch in 3 (2%) saphenofemoral junctions and five venous branches in 1 (1%) saphenofemoral junction, respectively. Conclusion: We think the assessment of the detailed anatomy of the major superficial venous structures at the level of the saphenofemoral junction by doppler ultrasonography will help to elucidate the etiopathogenesis of the varicose veins as well as contribute to the selective treatment planning and consequently the treatment results. more...

BACKGROUND: The Functional Movement Screen (FMS) is a clinical assessment tool used to determine musculoskeletal dysfunctions and asymmetries in athletes. OBJECTIVE: The aim of this study was to investigate whether FMS scores differed between elite youth male soccer players with low body fat percentage and those with normal body fat percentage and between those with and without a history of soccer injury. METHODS: Fifty-three elite youth male soccer players were included in the study. The participants’ injury histories were recorded, followed by body composition assessment and FMS tests. The participants were grouped according to body fat percentage and injury history for data analysis. RESULTS: The mean age, weight and height of the participants were 17.11 ± 0.91 years, 68.78 ± 7.41 kg and 1.77 ± 0.57 meters, respectively. Comparisons of the groups according to body fat percentage and injury history revealed no differences in FMS scores (p> 0.05). CONCLUSION: Lower body fat percentage did not confer an advantage or disadvantage to elite youth male soccer players in terms of FMS scores FMS scores provide limited information to predict injuries in elite youth male players. more...

BackgroundAnterior falcotentorial junction dural arteriovenous fistulas (AFDAVFs) are the most deeply located and most complex type of tentorial fistula due to their location and vascular anatomy. We aimed to make new angiographic definitions of AFDAVF nidus and functionality of the deep venous system of the brain and thereby provide a safer approach for endovascular treatment.MethodsWe retrospectively examined 18 patients with AFDAVF who received endovascular treatment at our neuroradiology department between June 2002 and May 2019. Pre- and post-treatment clinical assessments were performed using the modified Rankin Scale. AFDAVF niduses were defined as mixed-type or pure-dural-type on the basis of whether choroidal arteriovenous malformation was coexisting or not, respectively. The deep venous system was denoted as functional or nonfunctional.ResultsWe included 13 men and 5 women (mean (range) age, 47.2 (31–62) years). We evaluated 15 patients with pure-dural-type AFDAVFs and three with mixed-type AFDAVFs. Complete occlusion of the fistula was achieved in 15/18 patients. Three patients had transient neurologic symptoms. In two patients these were due to mild thalamic ischemia and in the third patient was due to tectal venous ischemia, all in mixed-type AFDAVF. One patient also developed Parinaud syndrome due to compression of the tectal plate by a thrombosed large vein of Galen. No patients died or developed permanent morbidity.ConclusionEvaluating AFDAVFs as described here using our new subtyping model will help improve analysis of the malformation and development of a safer endovascular strategy, and hence may prevent periprocedural complications and improve treatment safety. more...

Acute onset Facial palsy was reported in four vaccinated participants in the BNT162b2 (Pfizer-BioNTech) vaccine clinical trials published on December 10, 2020. So far, few cases of Facial palsy among the mRNA vaccine groups have been previously documented in the literature. Facial palsy is cited as medically attended adverse event following immunization on April 12, 2021, after the first dose of the approved Pfizer-BioNTech COVID-19 vaccines for preventive immunization for SARS-CoV-2 is administrated to the population in Turkey. This study is aimed to describe clinical and magnetic resonance imaging features of three patients, who developed acute onset peripheral facial paralysis after administration of the BNT162b2 vaccine, without any previous medical condition. The first patient presented with right sided facial palsy within the same day following the vaccine was administrated, while the second patient presented with left sided facial palsy 2 months after vaccination. The third patient, on the other hand, presented with right sided facial palsy and abducens nerve (CN VI) paralysis two days after vaccine was administrated. more...

Aim: We compared the two-dimensional shear-wave elastography (2D-SWE) values between the testes with same side operated inguinal hernia (IH) and the contralateral testes, as well as the testes of healthy volunteers without IH. Material and methods: A total of 189 participants (117 unilateral [117 testes] and 8 bilateral operated IH patients [16 testes] and 64 healthy volunteers [128 testes]), providing a total of 378 testicles, were investigated prospectively. All patients underwent B-mode ultrasonography (US) and 2D-SWE examinations. Operation type, the period between diagnosis and operation, the period since the operation, testes volumes, and 2D-SWE values were compared. Results: The B-mode US finding of the testes were normal in all participants. The mean testes’ volume of same side operated IH was significantly lower comparing to contralat-eral testes and the healthy group (p0.005). Conclusions: The 2D-SWE can be used as an effective imag-ing method to evaluate testicular stiffness with objective numerical values, to estimate the severity of histologic damage in patients with operated IH. more...

The aim of this study is to demonstrate the diagnostic effect of VWI in differentiating PACNS from other vasculopathies and its role in post-treatment follow-up in PACNS patients in this study. In this prospective study, we included patients with clinical suspicion of PACNS who presented with new-onset ischemic events and had significant intracranial large vessel stenosis on DSA or MRA. VWI was performed on all patients. The imaging findings and final diagnoses were recorded. Control VWI was performed on patients with PACNS diagnosis after at least 3 months of treatment, and the change in findings was also evaluated. Twenty-three patients were included in the study had a median age of 40 (range 12–58). The most common clinical manifestations were focal neurologic deficits. According to the initial clinical evaluation, 10 patients (43.5%) were classified as PACNS and 13 patients (56.5%) as indeterminate for PACNS. After incorporating the VWI findings, the diagnosis of PACNS was confirmed in all clinically diagnosed PACNS patients. Concentric wall thickening and contrast enhancement were statistically significant in the PACNS group (p more...

Background/aim: Strain elastography has the disadvantage of being operator-dependent. Interobserver variability is observed during image acquisition and interpretation. This study aimed to analyze the interobserver and intermethod variability of strain elastography in image interpretation and evaluate the diagnostic performance combining elasticity score and strain ratio with ultrasonography. Materials and methods: A retrospective study was conducted on 70 breast lesions evaluated with B-mode ultrasonography and strain elastography. B-mode ultrasonography findings, elasticity scores, and strain ratio values were evaluated using static images by two radiologists. BI-RADS assessment of the lesions and the decision of both observers as to whether the biopsy was required using B-mode ultrasonography, and the combined ultrasonography+elasticity score, and the combined ultrasonography+elasticity score+strain ratio were compared with the histopathological results. Also, the interobserver agreement was analyzed for all the combinations. Results: There was very good agreement (weighted kappa = 0.865) between the observers for the elasticity scores. Very good agreement was observed between the observers for BI-RADS assessments using the combined ultrasonography+elasticity score and the combined ultrasonography+elasticity score+strain ratio (weighted kappa = 0.848, and 0.902, respectively). Area under the curve of B-mode ultrasonography, the combined B-mode ultrasonography+elasticity score, and the combined B-mode ultrasonography+elasticity score+strain ratio, were calculated as 0.859, 0.866, and 0.916 for observer 1, and 0.851, 0.829, and 0.916 for observer 2, respectively. There were no statistically significant differences between the observers' diagnostic performances in any of the combinations (P = 0.703, 0.067, and 0.972, respectively). Conclusion: In the evaluation and further assessment of breast lesions, semiquantitative strain ratio calculation may help improve diagnostic accuracy by reducing interpretational variety, when used together with B-mode ultrasonography and elasticity scoring, especially for inexperienced individuals. more...

For decades, time series forecasting had many applications in various industries such as weather, financial, healthcare, business, retail, and energy consumption forecasting. An accurate prediction in these applications is a very important and also difficult task because of high sampling rates leading to monthly, daily, or even hourly data. This high-frequency property of time series data results in complexity and seasonality. Moreover, the time series data can have irregular fluctuations caused by various factors. Thus, using a single model does not result in good accuracy results. In this study, we propose an efficient forecasting framework by hybridizing the recurrent neural network model with Facebook’s Prophet to improve the forecasting performance. Seasonal-trend decomposition based on the Loess (STL) algorithm is applied to the original time series and these decomposed components are used to train our recurrent neural network for reducing the impact of these irregular patterns on final predictions. Moreover, to preserve seasonality, the original time series data is modeled with Prophet, and the output of both sub-models are merged as final prediction values. In experiments, we compared our model with state-of-art methods for real-world energy consumption data of seven countries and the proposed hybrid method demonstrates competitive results to these state-of-art methods. more...

A novel and low-cost white noise generator using an ordinary Zener diode as the source of noise is presented. The Zener diode is driven by a stable dc current source such that the noise signal power generated by the Zener diode increases with increasing frequency under right dc current biasing. A 6-stage MMIC amplifier block was designed to increase the noise power further. Since the gain-frequency response of the amplifier block has a negative slope as the frequency increases, the positive slope of the noise power produced by the Zener diode is balanced with the negative slope of the amplifier gain. The resulting amplified noise signal appears to have almost constant power at the output of the amplifier. As a result, the designed noise generator exhibits white noise characteristics, and is used as a tracking generator to measure insertion loss of a RF/microwave filter. more...

Amaç: Çalışmamızda sinonazal bölge anatomik varyasyonlarından olan Haller hücresinin görülme sıklığını ve sinüzit ile ilişkisini bilgisayarlı tomografi (BT) ile değerlendirilmesini amaçladık.Gereç ve Yöntem: Bolu İzzet Baysal Devlet Hastanesi’nde 1 Ocak 2017-30 Mayıs 2018 tarihleri arasında multislice (Toshiba) 16 kesitli BT ile çekilen sinüs BT görüntüleri retrospektif olarak incelendi, Haller hücresinin görülme sıklığı belirlendi. Maksiller sinüsdeki mukozal değişikliklerin değerlendirilmesinde Mc Gay Lund sınıflandırması kullanıldı. Bulgular: Çalışmamıza dahil edilen 196 hastadan sadece bir hastada herhangi bir varyasyon izlenmemiştir. Haller hücresi görülme sıklığı %15,8 olarak tespit edildi. Tüm hastalarda maksiller sinüzit görülme sıklığı ise %63,7 idi. Hastalarda Haller hücre varyasyonu bulunması ile aynı tarafta maksiller sinüzit mevcut olması arasında istatistiksel olarak bağlantı tespit edilmedi. Haller hücre varyasyonu olan hastalarda aynı yönde maksiller sinüzit bulunma oranı %54,9 iken kontrol grubunda %63,3 olarak tespit edilmiştir. İki grup arasında da sinüzit varlığı açısından istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Paranazal sinüslerin anatomisinin ayrıntılı bir şekilde ortaya konması hem tanı hem tedavi açısından önem arz etmektedir. more...

We investigated the effectiveness of shear wave elastography (SWE) in patients with lower extremity superficial venous insufficiency (VI). A total of 138 symptomatic patients, 51 asymptomatic volunteers, and a total of 359 lower extremities (257 symptomatic, 102 asymptomatic) were examined. All participants underwent Doppler ultrasound (US) evaluation to determine VI and SWE measurements performed by manually drawing vein wall and perivenous tissue with free region of interest at the great saphenous vein (GSV) and small saphenous vein (SSV). The GSV, SSV diameter, VI, and volume flow of reflux were compared with the SWE values. The SWE values of the symptomatic group for GSV and SSV were significantly higher than those of the asymptomatic control group regardless of whether VI was detected by Doppler US (P < 0.001). There was a statistically significant increase in SWE values for the symptomatic group who were diagnosed as having reflux in GSV and SSV (P < 0.001). A significant positive correlation between increased GSV, SSV diameter, and SWE values was seen (P < 0.001). Venous insufficiency can be diagnosed with a 84.7% sensitivity and 84.2% specificity when 2655 m/s was designated as cutoff value, and with a 85.4% sensitivity and 84.2% specificity when 22,350 kPa was designated as the cutoff value in GSV. Venous insufficiency can be diagnosed with a 84.3% sensitivity and 82.4% specificity when 2845 m/s was designated as cutoff value, and with a 85.7% sensitivity and 84.4% specificity when 27,100 kPa was designated as the cutoff value in SSV. Shear wave elastography may be used effectively in addition to conventional Doppler US examination in diagnosing and following VI. more...

PubMed ID: 29663478 Objective—To evaluate intraneural blood flow of the median nerve using superb microvascular imaging (SMI) and power Doppler ultrasonography (PDUS), and to examine their correlation with electroneuromyography in patients with carpal tunnel syndrome (CTS). Methods—A cross-sectional survey was used, and the study was conducted in the research unit of a training and research hospital. Patients diagnosed with CTS according to electroneuromyography studies were included in the study. Ultrasound measurements were taken using an Aplio-500 (Toshiba Medical System Corporation, Tokyo, Japan) device and a linear multifrequency 14-MHz probe. The cross-sectional area of the median nerve at the carpal tunnel level was measured by the direct tracing method using electronic calipers. The power Doppler ultrasonography and superb microvascular imaging scores were recorded by grading the vascularity between 0 and 3. Results—Evaluation was made of a total of 113 hands of 80 patients (18 men, 62 women) with a mean age of 34.67 ± 12.82 years. The mean duration of symptoms was 12.34 ± 6.66 months. When the patients were grouped as mild, moderate, and severe CTS, there was a statistically significant difference between the SMI and PDUS grades (P more...