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We conducted a cross-sectional study to assess vocal and swallowing functions after horizontal glottectomy. Our study population was made up of 22 men aged 45 to 72 years (mean: 58.3) who underwent horizontal glottectomy and completed at least 1 year of follow-up. To compare postoperative results, 20 similarly aged men were included as a control group; all glottectomy patients and all controls were smokers. We used three methods-acoustic and aerodynamic voice analyses, the GRBAS (grade, roughness, breathiness, asthenicity, and strain) scale, and the voice handicap index-30 (VHI-30)-to assess vocal function objectively, perceptually, and subjectively, respectively. We also assessed swallowing function objectively by fiberoptic endoscopic evaluation of swallowing (FEES) and subjectively with the M.D. Anderson dysphagia inventory (MDADI). The 22 patients were also subcategorized into three groups according to the extent of their arytenoid cartilage resection, and their outcomes were compared. Acoustic and aerodynamic analyses showed that the mean maximum phonation time was significantly shorter and the fundamental frequency was significantly lower in the glottectomy group than in the controls (p = 0.001 for both), and that the mean jitter and shimmer values and the mean harmonics-to-noise ratio were all significantly higher (p = 0.001 for all); there were no significant differences among the three arytenoid subgroups. Self-assessments revealed that there were no statistically significant differences among the three subgroups in GRBAS scale scores except for the breathiness score (p = 0.045), which was lower in the arytenoid preservation subgroup than in the total resection subgroup; there were no statistically significant differences among the three subgroups in VHI-30 scores. Finally, swallow testing found no statistically significant differences in FEES scores or MDADI scores. We conclude that horizontal glottectomy caused a deterioration in vocal function, but swallowing function was satisfactory.

Nitrite salts of sodium or potassium are being used for the protection of meat products. They provide color and taste of meat and they protect against clostridia. On the other hand, nitrite ions can interact with amines to form nitrosamines which are known as carcinogenic substances. They may also react with hemoglobin and reduce its oxygen carrying capacity. Thus, its concentration in food-stuff has to be controlled carefully by highly sensitive methods. A new DP polarographic method is established for the determination of nitrite. Nitrite cannot be determined directly with any analytical methods. Long and tedious procedures are necessary for many of them. In this polarographic method arsenite, As(III), ion is used for the reduction of nitrite. The nitrite is determined from the As(III) quantity left over after the reaction with nitrite. The peak of arsenite has been used since it is sharp and responds well for the standard addition of arsenite. The optimum conditions for the quantitative reaction between nitrite and arsenite have been studied. It was found that the pH for the reaction medium has to be 5-7, since nitrite is decomposed at lower pH values. The reaction medium has to be stirred for about 5 min with nitrogen gas in order to expel the NO gas formed and thus to shift the equilibrium to products side. The limit of detection, LOD, was found to be as 2 × 10(-7) M. No interference was observed from most common ions., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: Systolic alterations in left ventricular (LV) myocardial function have been reported previously in patients with diastolic dysfunction (DD). Recent advances in real-time three-dimensional echocardiography (3DE) enable the measurement of a set of parameters previously difficult to obtain with standard two-dimensional echocardiography (2DE). The aim of this study was to evaluate global 3DE LV contraction in patients with and without DD who had normal ejection fraction (EF)., Methods: Sixty-five patients (average age 56 ± 6 years; 31 females and 34 males) with normal EF (>50 %) referred to echocardiographic examination for the evaluation of DD were included. In addition to measuring conventional echocardiographic parameters, they were also evaluated with 3DE. End diastolic volume, end systolic volume, EF, corrected standard deviation (SD) of time to minimal systolic volume for 16 segments its dispersion, average excursion of the segments and the SD of segmental motion (excursion-SD) were recorded., Results: When we tested the differences among three groups of diastolic function (normal, Grade 1, and Grade 2), the results showed that coronary artery disease, left atrial volume, septum, posterior wall, E, A, E/A, deceleration time, E' septum, E' lateral, and excursion-SD were significantly different. An ordered logistic regression analysis revealed that excursion-SD (p < 0.001) and septum (p < 0.001) measurements were statistically significant for predicting DD grade., Conclusion: In our patient population, a decline in excursion-SD values was observed with increasing DD grade. In other words, the amount of segmental difference in terms of excursion was reduced.

Objective: The aim of this study was to analyze the influence of deviated nasal septum (DNS) type on nasal mucociliary clearance, quality of life (QoL), olfactory function, and efficiency of nasal surgery (septoplasty with or without inferior turbinate reduction and partial middle turbinectomy)., Methods: Fifty patients (20 females and 30 males) with septal deviation were included in the study and were divided into 6 groups according to deviation type after examination by nasal endoscopy and paranasal computed tomography. The saccharin clearance test to evaluate the nasal mucociliary clearance time, Connecticut Chemosensory Clinical Research Center smell test for olfactory function, and sinonasal outcome test-22 (SNOT-22) for patient satisfaction were applied preoperatively and postoperatively at the sixth week after surgery., Result: Nasal mucociliary clearance, smell, and SNOT-22 scores were measured before surgery and at the sixth week following surgery. No significant difference was found in olfactory and SNOT-22 scores for any of the DNS types (both convex and concave sides) (P > 0.05). In addition, there was no difference in the saccharin clearance time (SCT) of the concave and convex sides (P > 0.05). According to the DNS type, the mean SCT of the convex sides showed no difference, but that of the concave sides showed a difference in types 3, 4, 5, and 6. These types had a prolonged SCT (P < 0.05). Olfactory scores revealed no difference postoperatively in types 5 and 6 but were decreased significantly in types 1 to 4 (P < 0.05). There was no significant difference in the healing of both the mucociliary clearance (MCC) and olfactory functions. SNOT-22 results showed a significant decrease in type 3., Conclusion: All DNS types disturb the QoL regarding nasal MCC and olfaction functions. MCC values, olfactory function, and QoL scores are similar among the DNS types. Both sides of the DNS types affect the MCC scores symmetrically. Septal surgery improves olfaction function and QoL at the sixth week following surgery but disturbs nasal MCC; thus, the sixth week is too early to assess nasal MCC.

Objective: In the current study, we aimed to explore whether there is alteration between pre- and post-treatment micronucleus (MN) frequencies induced by internal and external ionizing radiation., Materials and Methods: The study enrolled a total of 67 patients including patients admitted to our hospital for treatment of hyperthyroidism (n = 17), scanning with low-dose I-131 (n = 15), and ablative therapy with high-dose I-131 (n = 15) at Department of Nuclear Medicine as well as patients with different diagnoses receiving external radiotherapy with various doses and durations at Department of Radiation Oncology (n = 20). Thirty-two patients who received radioactive iodine and returned for a follow-up visit at 1 month., Results: Considering both pre- and post-treatment MN frequencies of each group, lowest MN frequencies were detected for patients undergoing screening with low-dose I-131, and highest MN frequencies were found in radiotherapy patients. Comparison of pre- and post-treatment MN frequencies among hyperthyroidism, when pre- and post-treatment MN frequencies compared among hyperthyroidism, I-131 whole body scanning, ablation, and radiotherapy patient groups differences between MN frequencies were significant for each group (P < 0.05)., Conclusion: Our study showed that MN analysis might be of value in determining chromosome damage that could potentially occur in patients exposed to internal and external radiation.

Takotsubo cardiomyopathy (TTC), also known as left ventricular apical ballooning syndrome or stress cardiomyopathy, is characterized by transient left ventricular systolic dysfunction and the absence of obstructive lesion in the epicardial coronary arteries. The most common presentation is acute substernal chest pain, although occasionally dyspnea and syncope, and rarely shock with ST-segment elevation and elevated cardiac biomarkers have been observed. Inverted (reverse) TTC is a rare pattern characterized hypokinesis of the basal and midventricular segments. Presently described was case of a 27-year-old woman with ventricular fibrillation following endoscopic nasal sinus surgery.

Entering college with posttraumatic stress disorder (PTSD) symptomatology has been linked to poor academic performance and increased risk for dropping out of college; however, little is known regarding the mechanisms by which PTSD symptoms have deleterious effects on college outcomes. Drawing from a self-regulated learning (SRL) perspective, which suggests that students' learning behaviors and outcomes can be influenced by contextual and developmental factors, we hypothesized that students who enter college with high PTSD symptomatology may experience difficulties in effort regulation, which in turn, may have deleterious effects on their academic performance and college persistence. These hypothesized relationships, as well as the potential gender differences in these relationships were examined using a longitudinal study design and a multigroup structural equation modeling approach. Of the 928 1st-year students who participated in the study, 484 (52.2%) students who reported lifetime exposure to traumatic events constituted the final sample of the study. The prevalence of PTSD among the trauma-exposed participants was 12.4%. After controlling for participation in on-campus activities and American College Testing (ACT) assessment scores, the relationship between PTSD symptomatology in the 1st semester of college and 2nd-year enrollment was mediated by effort regulation and 1st-year cumulative grade-point average (GPA). Specifically, participants who started college with higher levels of PTSD symptomatology also reported lower levels of effort regulation, which in turn, had a significant indirect effect on 2nd-year enrollment through 1st-year GPA. Results also indicated that the paths in the hypothesized model were not significantly different for men and women. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Introduction: Slow coronary flow (SCF) is an angiographic phenomenon characterized by delayed opacification of epicardial coronary arteries without an obstructive coronary disease. Serum soluble urokinase-type plasminogen activator receptor (suPAR) levels seem closely related to atherosclerosis due to increased inflammation and prothrombotic state. We studied whether circulating suPAR is related to SCF., Material and Methods: The present study was cross-sectional and observational. It included 75 individuals who underwent coronary angiography with suspected CAD and had angiographically normal coronary arteries of varying coronary flow rates. The relationship between suPAR, C-reactive protein (CRP) and SCF was investigated. Forty patients with isolated SCF (mean age: 46.0 ±4.14 years) and 35 age- and gender-matched control participants with normal coronary flow (NCF) and normal coronary arteries (NCA) (mean age: 46.0 ±5.7 years) were included in the study. We used logistic regression analysis to determine the predictors of SCF., Results: The clinical characteristics were not statistically significantly different between SCF and NCA groups. Serum suPAR level was significantly higher in the SCF group than the control group (2.5-5.4 ng/ml vs. 0.1-1.4 ng/ml; p < 0.001). Also the serum CRP level was higher in the CSF group than the control group (1.57 ±0.43 mg/l vs. 0.53 ±0.23 mg/l; p < 0.001)., Conclusions: This study revealed significantly increased serum suPAR levels in patients with SCF. Although we cannot draw conclusions on the underlying pathological process of SCF, we believe that these findings may be pioneering for further studies investigating the specific roles of circulating suPAR in the SCF phenomenon in the coronary vasculature., Competing Interests: The authors declare no conflict of interest.

BRAF(V600E) mutation was analyzed by real-time polymerase chain reaction in 96 consecutive cases with classical variant papillary thyroid cancer, and immunohistochemical staining of Na+/I- symporter (NIS) protein was evaluated. Localization (intracellular or membranous), density, and the intensity of cytoplasmic staining were characterized semiquantitatively. Extrathyroidal invasion, surgical margin positivity, and lymph node metastasis were compared with BRAF(V600E) mutation and NIS expression. Eighty-eight patients who had at least 24-month follow-up were also included in survival analysis. BRAF(V600E) mutation was determined in 78.1% (75/96) and functional NIS activity in 74% (71/96) of the cases. There were statistically significant differences in mean ages between BRAF(V600E) mutation-positive (48.6) and BRAF(V600E) mutation-negative cases (37.3; Levene test, P=.419; Student t test, P=.001). The surgical margin positivity (46.7%) and extrathyroidal extension percentage (54.7%) in the BRAF(V600E) mutation-positive group were higher than the negative (28.6% and 33.3%, respectively) group, without statistical significance (P=.138 and P=.084, respectively). Functional NIS activity was higher in BRAF(V600E) mutation-positive cases (78.1%) than mutation-negative ones (57.1%; P=.047). The possibility of moderate and intense cytoplasmic staining in BRAF(V600E) mutation-positive cases (72%) was 6.3 times higher than the possibility of weak staining (28%) in the mutation-positive cases (95% confidence interval, 2.2-18.8; P=.001). Functional NIS expression is higher in patients with classical variant papillary thyroid cancer with BRAF(V600E) mutation. However, the clinical features were not found to be associated with NIS expression. There may be different mechanisms determining the outcome of therapy., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Enzymatically-induced degradation of bovine serum albumin (BSA) by serine proteases (trypsin and α-chymotrypsin) in various concentrations was monitored by means of Fourier transform infrared (FT-IR) and ultraviolet circular dichroism (UV-CD) spectroscopy. In this study, the applicability of both spectroscopies to monitor the proteolysis process in real time has been proven, by tracking the spectral changes together with secondary structure analysis of BSA as proteolysis proceeds. On the basis of the FTIR spectra and the changes in the amide I band region, we suggest the progression of proteolysis process via conversion of α-helices (1654 cm(-1)) into unordered structures and an increase in the concentration of free carboxylates (absorption of 1593 and 1402 cm(-1)). For the first time, the correlation between the degree of hydrolysis and the concentration of carboxylic groups measured by FTIR spectroscopy was revealed as well. The far UV-CD spectra together with their secondary structure analysis suggest that the α-helical content decreases concomitant with an increase in the unordered structure. Both spectroscopic techniques also demonstrate that there are similar but less spectral changes of BSA for the trypsin attack than for α-chymotrypsin although the substrate/enzyme ratio is taken the same., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Acinetobacter baumannii is an opportunistic pathogen which is one of the most important agents of nosocomial infections. Being resistant to many antibiotics, complicates the treatment of the infections caused. Fluoroquinolones are used in the treatment of nosocomial and community-acquired infections and it is important to determine the mechanisms of resistance to these antibiotics. The aims of this study were to investigate ciprofloxacin (CIP) and levofloxacin (LEV) minimum inhibitor concentrations (MIC), clonal relationships, mutations that occur in DNA gyrase and topoisomerase IV genes and overexpression of efflux pumps in nosocomial A.baumannii isolates. A total of 81 A.baumannii strains, 79 CIP-resistant and two CIP-susceptible, isolated from different clinical samples in Ege University Faculty of Medicine, Department of Medical Microbiology were included in the study. CIP and LEV MIC values were determined by broth microdilution method. Clonal relationship among the strains was investigated by ERIC-PCR (Enterobacterial repetitive intergenic consensus-polymerase chain reaction). Mutations that occur in gyrA and parC genes were detected by DNA sequence analysis in 16 strains representing each clone and subtype. Overexpression of the efflux pumps was evaluated by broth microdilution and fluorometric accumulation experiments were carried out in the presence of pump inhibitors, among the representative strains. MIC(50) and MIC(90) values for CIP were 256 µg/ml and ≥ 256 µg/ml, while the values were 32 µg/ml and 128 µg/ml for LEV, respectively. Overall, CIP MIC values were found to be higher than that of LEV among the A.baumannii strains studied. Isolates were grouped into six main groups and 10 different clusters (39 strains in cluster A, 20 in B, 13 in C, two of each in I and J, one of each in D-H clusters), but it was observed that the majority of them were clonally related. The most common and important mutations detected in the gyrA and parC genes of the representative isolates were, Ser83Leu, Asp87Glu and Ser80Leu, respectively. While the overexpression of efflux pumps was observed in seven of the representative strains by microdilution method, in 11 by fluorometric assay and the results were positive in five of the strains by both methods. CIP was found to be better than LEV for detecting the overexpression of pumps by the use of microdilution method. It was concluded that, the reason of high fluoroquinolone MIC values of the studied nosocomial and clonally related A.baumannii strains were related to target mutations and overexpression of efflux pumps besides the plasmid-mediated mechanisms, such as Qnr might also have played a role.

Objective: The aim of this study was to investigate whether there is an effect of trifluoperazine on Tc-99m  methoxyisobutylisonitrile (MIBI) uptake in patients with advanced nonsmall cell lung cancer (NCLC)., Materials and Methods: A total of 23 patients with biopsy-proven advanced NCLC who had no previous history of chemo-radiotherapy, underwent baseline dual phase planar, single photon emission computed tomography and whole body Tc-99m MIBI scintigraphy performed at 20 and 120 min. After oral administration of trifluoperazine (5 mg, 2 times a day, for 5 days), dual phase Tc-99m MIBI scintigraphy was repeated. For each patient, and for both studies, regions of interest were drawn over the tumor area (T) and over the normal lung area (L) on the contralateral side in transverse slices where tumor was visualized clearly. Then, early and delayed T/L ratios and washout rate (WR) were calculated., Results: Tc-99m MIBI was accumulated in the cancer tissue in all of the patients. Delayed ratio after the oral administration of trifluoperazine (DR2) was significantly higher (P = 0.039) than delayed ratio before trifluoperazine (DR1). We found no significant differences of early ratio before trifluoperazine (ER1) and early ratio after trifluoperazine (ER2), and washout rate before (WR1) and washout rate after trifluoperazine (WR2)., Conclusion: In patients with advanced NCLC, trifluoperazine treatment in addition to chemotherapy might be useful. However, our results need to be confirmed in larger series of patients.

Purpose: To investigate the reliability and validity of the Neonatal Discharge Assessment Tool (N-DAT) designed to assess risk factors related to infants' and parents' readiness for discharge to home., Design and Methods: The sample was composed of 238 high-risk preterm infants, born at gestational age of 24 to 37 weeks, and their parents. High scores on the N-DAT indicated higher risk for discharge of preterm infants and their parents. Psychometric analyses of the N-DAT included content validity, internal consistency reliability, and construct validity., Results: Content validity of the N-DAT items was supported by experts (content validity index = .98). Internal consistency reliability was supported by a Cronbach's alpha for the total instrument of .94. N-DAT total and subscale score correlations ranged from .42 to .89. Known-groups analysis indicated that infants born at <31 weeks' gestation and infants who were rehospitalized during 8 weeks after discharge had significantly higher N-DAT total and subscale scores than infants born at ≥31 weeks or not rehospitalized. Also, mothers who reported experiencing problems with infant care at home had significantly higher N-DAT Competencies subscale scores than mothers who did not report problems., Practice Implications: The N-DAT is a reliable and valid instrument to evaluate the risks related to discharge of preterm infants so that nurses can provide parents with the necessary knowledge, skills, and resources they need prior to discharge., (© 2016, Wiley Periodicals, Inc.)

The Na(+)-coupled betaine symporter BetP senses changes in the membrane state and increasing levels of cytoplasmic K(+) during hyperosmotic stress latter via its C-terminal domain and regulates transport activity according to both stimuli. This intriguing sensing and regulation behavior of BetP was intensively studied in the past. It was shown by several biochemical studies that activation and regulation depends crucially on the lipid composition of the surrounding membrane. In fact, BetP is active and regulated only when negatively charged lipids are present. Recent structural studies have revealed binding of phosphatidylglycerol lipids to functional important parts of BetP, suggesting a functional role of lipid interactions. However, a regulatory role of lipid interactions could only be speculated from the snapshot provided by the crystal structure. Here, we investigate the nature of lipid-protein interactions of BetP reconstituted in closely packed two-dimensional crystals of negatively charged lipids and probed at the molecular level with Fourier transform infrared (FTIR) spectroscopy. The FTIR data indicate that K(+) binding weakens the interaction of BetP especially with the anionic lipid head groups. We suggest a regulation mechanism in which lipid-protein interactions, especially with the C-terminal domain and the functional important gating helices transmembrane helice 3 (TMH3) and TMH12, confine BetP to its down-regulated transport state. As BetP is also activated by changes in the physical state of the membrane, our results point toward a more general mechanism of how active transport can be modified by dynamic lipid-protein interactions., (© 2016 by The American Society for Biochemistry and Molecular Biology, Inc.)

Introduction: Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L., Materials and Methods: Baseline (group I) serum pool with glucose concentration of 5.55 (5.44-5.61) mmol/L was prepared from patient sera. Spiking with 20% dextrose solution, sample groups were obtained with glucose concentrations: 17.09, 34.52, and 50.95 mmol/L (group II, III, IV, respectively). Total of 21 biochemistry analytes and thyroid tests were studied on Abbott c8000 and i2000sr with commercial reagents. Bias from baseline value was checked statistically and clinically., Results: Creatinine increased significantly by 8.74%, 31.66%, 55.31% at groups II, III, IV, respectively with P values of < 0.001. At the median glucose concentration of 50.95 mmol/L, calcium, albumin, chloride and FT4 biased significantly clinically (-0.85%, 1.63%, 0.65%, 7.4% with P values 0.138, 0.214, 0.004, < 0.001, respectively). Remaining assays were free of interference., Conclusion: Among the numerous biochemical parameters studied, only a few parameters are affected by dramatically increased glucose concentration. The creatinine measurements obtained in human sera with the Jaffe alkaline method at high glucose concentrations should be interpreted with caution. Other tests that were affected with extremely high glucose concentrations were calcium, albumin, chloride and FT4, hence results should be taken into consideration in patients with poor diabetic control.

The purpose of this study was, conducted with experimental design, to investigate the effect of reminiscence therapy on cognition, depression, activities of daily living of institutionalized mild and moderate Alzheimer patients. The study was conducted with a total of 62 patients (31 intervention group and 31 control group) in four home care in Ankara, Turkey. Study was done between the July 1, 2013 and December 20, 2014. Reminiscence therapy sessions were held with groups consists of 4-5 patients, once a week with 30-35 minute duration for 12 weeks. Standardized Mini Mental Test was used in sample selection. Patients were listed through their mini mental test scores, and randomized as odd numbers to control group and even numbers to intervention group. Data were collected with forms developed by researcher 'Data Sheet' and 'Activities of Daily Living Follow-up Form' as well as scales 'Standardized Mini Mental Test' and 'Geriatric Depression Scale'. Chi-square, Mann Whitney-U test, variance analyses in repeated measures and Bonferroni tests were used for analysis. The increase in mean Standardized Mini Mental Test score and the decrease in mean Geriatric Depression Scale score of the individuals in the intervention group compared to the control group at the end of the reminiscence therapy was statistically significant (P < 0.05). At the end of reminiscence therapy sessions, increase in cognition and decrease in depression were found statistically significant in intervention group., (© The Author(s) 2015.)

The purpose of this study was to examine the relationship between depressive symptomatology and college outcomes among African American students, as well as to determine whether these relationships were moderated by gender and type of university. Participants included 569 African American first-year students attending two public universities in the Southeast United States: a historically Black college/university (HBCU) and a predominantly White institution (PWI). Using a longitudinal study design, data were collected at three time points. Results indicated that, after adjusting for the effects of the control variables (gender, type of institution, high school GPA, participation in on-campus activities, institutional and goal commitments), depressive symptomatology present in the first semester of college was associated with increased likelihood of dropping out of college before the end of the second year of college. The relationship between these two variables was mediated by first-year cumulative GPA. Results also indicated that the hypothesized relationships did not vary as a function of gender and the university type.

Objective: This study aimed to evaluate vocal changes in pregnancy according to trimesters both objectively and subjectively., Methods: Fifty pregnant women and 15 nonpregnant women were included in the study. Eighteen of the 50 pregnant women were in the first trimester, 17 in the second trimester, and 15 in the third trimester of their pregnancies. The fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), and minimum and maximum pitch were determined during acoustic voice analysis. Laryngologic examination was evaluated via reflux finding score (RFS). Voice Handicap Index 10 (VHI-10) was used for subjective analysis., Results: Maximum phonation time (MPT), VHI-10, and RFS were the parameters that differed significantly. MPT was significantly shorter in the third trimester. Acoustic analysis revealed that F0, jitter, shimmer, NHR, and minimum and maximum pitch values were not significantly different in any groups. RFS was higher in the first and third trimesters than the second trimester and control groups. VHI-10 scores were significantly higher in the third trimester., Conclusions: Our results showed that MPT is decreased during the third trimester, although acoustic parameters did not differ. VHI-10 results deteriorated in the third trimester significantly., (Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

The aim of this randomized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia. Seventy women with fibromyalgia syndrome were randomly assigned to either balneotherapy with mud-pack and hot pool treatments (35) or control (35) groups. After randomization, five patients from balneotherapy group and five patients from control group were dropped out from the study with different excuses. All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme. The patients in balneotherapy group had heated pool treatment at 38 °C for 20 min a day, and mud-pack treatment afterwards on back region at 45 °C. Balneotherapy was applied on weekdays for 2 weeks. All patients continued to take their medical treatment. An investigator who was blinded to the intervention assessed all the patients before and after the treatment, at the first and the third months of follow-up. Outcome measures were FIQ, BDI and both patient's and physician's global assessments. Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessments in terms of patient's and physician's global assessment, total FIQ score, and pain intensity, fatigue, non-refreshed awaking, stiffness, anxiety and depression subscales of FIQ. No significant difference was found between the groups in terms of BDI scores. It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone.

Senescent cells secrete several molecules that help to prevent the progression of cancer. However, cancer cells can also misuse these secreted elements to survive and grow. Since the molecular and functional bases of these different elements remain poorly understood, we analyzed the effect of senescent mesenchymal stromal cell (MSC) secretome on the biology of ARH-77 myeloma cells. In addition to differentiating in mesodermal derivatives, MSCs have sustained interest among researchers by supporting hematopoiesis, contributing to tissue homeostasis, and modulating inflammatory response, all activities accomplished primarily by the secretion of cytokines and growth factors. Moreover, senescence profoundly affects the composition of MSC secretome. In this study, we induced MSC senescence by oxidative stress, DNA damage, and replicative exhaustion. While the first two are considered to induce acute senescence, extensive proliferation triggers replicative (i.e., chronic) senescence. We cultivated cancer cells in the presence of acute and chronic senescent MSC-conditioned media and evaluated their proliferation, DNA damage, apoptosis, and senescence. Our findings revealed that senescent secretomes induced apoptosis or senescence, if not both, to different extents. This anti-tumor activity became heavily impaired when secretomes were collected from senescent cells previously in contact (i.e., primed) with cancer cells. Our analysis of senescent MSC secretomes with LC-MS/MS followed by Gene Ontology classification further indicated that priming with cancer profoundly affected secretome composition by abrogating the production of pro-senescent and apoptotic factors. We thus showed for the first time that compared with cancer-primed MSCs, naïve senescent MSCs can exert different effects on tumor progression.

Objectives: Intimate partner violence (IPV) is an important public health problem in many countries including Turkey, with serious short- and long-term physical and mental health consequences, as well as significant social and public health costs. To understand the violence characteristics and the individual risk factors for both the married women victims and the perpetrator partners are the objectives of this study., Methodology: 243 married women, who have consulted to hospitals and village clinics between 2008 and 2009 with the mean age of 36.76 (SD = 11.59), accepted to participate in the study voluntarily. Participants were divided into two groups as "victimized" (58.8%, n = 143) and "non-victimized" (41.2%, n = 100) women. Victimized group consisted of women who have had any type of violence from their husbands during their life. A 61-item questionnaire was prepared that included items on demographics, IPV experience, attitudes about IPV and knowledge of legal rights., Results: As compared to non-victimized group, women in victimized group mostly lived in villages than in town/city centers, were illiterate, had bride-price agreement and were younger when married. Place of accommodation, age and number of pregnancies were associated with the risk of victimization., Conclusions: In order to prevent IPV, further qualitative research is required to evaluate the involved risk factors and training programs on how to behave against violence in association with the legal rights should be designed for poorly educated women in their natural settings and hospitals., (Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Objectives: To determine the effects of an asthma training and monitoring program on children's disease management and quality of life., Material and Methods: The sample consisted of 120 children and their parents. Data were collected during, at the beginning, and at the end of the 3-month monitoring period using four forms and a quality of life scale. After an initial evaluation, approaches to control symptoms and asthma triggers and measures that might be taken for them were taught to the children and parents. The children recorded the conditions of trigger exposure, experience of disease symptoms, their effects on daily activities, and therapeutic implementations on a daily basis., Results: During the 3-month monitoring period, the number of days when the children were exposed to triggers (p=0.000) and experienced disease symptoms decreased to a statistically significant level (p=0.006). Majority of domestic triggers disappeared, but those stemming from the structure of the house and non-domestic triggers indicated no change (p>0.05). Moreover, 30.8% of the children applied to a physician/hospital/emergency service, 4.2% of the children were hospitalized, and 30% of them could not go to school. The number of times when the children applied to a physician/hospital/emergency (p=0.013), the number of times they used medicines (p=0.050), and the number of days they could not go to school (p=0.002) decreased at a statistically significant level, and their quality of life increased (p=0.001)., Conclusion: Asthma training and monitoring program decreased children's rate of experiencing asthma symptoms and implementations of therapeutic purposes and increased their life quality., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Aims: Estimation of left ventricular (LV) filling pressures is a clinical challenge in patients with preserved ejection fraction (EF). In the present study, we investigated whether LV and atrial longitudinal strain and strain rate (SR) parameters derived by speckle tracking echocardiography (STE) could be used to predict invasively measured LV end-diastolic pressure (LVEDP) in this patient population., Methods and Results: LVEDP was measured before coronary angiography was performed in 65 patients with preserved EF (≥50%) referred to elective cardiac catheterization; besides, patients enrolled underwent comprehensive echocardiographic examination before the procedure. In addition to conventional echocardiographic parameters used to evaluate diastolic function LV longitudinal strain and SR, as well as peak atrial longitudinal strain during LV systole, measurements were performed using STE. Only log-diastolic blood pressure, systolic SR, early diastolic SR, SR during isovolumetric relaxation (SRIVR), and mitral early diastolic flow velocity/SRIVR significantly correlated with LVEDP. When age-adjusted stepwise linear regression analysis was performed, SRIVRT values (β= -20.682, t = -3.292; P = 0.002) and log-diastolic blood pressure levels (β= 21.118, t = 3.784; P < 0.001) were independently correlated with LVEDP., Conclusion: When compared with conventional echocardiographic parameters, other longitudinal strain, and SR indices, SRIVRT independently predicted LVEDP in conjunction with log diastolic blood pressure. We suggest that SRIVRT is a valuable parameter to evaluate diastolic function in patients with preserved EF., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Objective: We aimed to assess the effects of electronic nicotine delivery system (ENDS) or also termed electronic cigarette vapor on the laryngeal mucosa of rats., Materials and Methods: Sixteen female Wistar albino rats were divided into two groups. The study group was exposed to ENDS vapor for 1 hour/day for 4 weeks. The control group was not subjected to any chemical or physical stimulus. The vocal folds of the study and control group rats were evaluated histopathologically by hematoxylin and eosin staining and immunohistochemically by Ki67 staining. Epithelial distribution, inflammation, hyperplasia, and metaplasia were evaluated., Results: Epithelial distribution and inflammation did not differ between the two groups. Two cases of hyperplasia were detected in the study group but there was no hyperplasia in the control group. Four cases of metaplasia were detected in the study group and one case in the control group. Statistical analysis revealed no significant difference between the study and control groups (P = 0.131 and 0.106, respectively)., Conclusions: Exposure to ENDS for 4 weeks caused hyperplasia and metaplasia of the laryngeal mucosa of rats but this was not significant statistically. These results implemented that further studies with larger cohort and longer duration are required to evaluate long-term effects., (Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

In this study a new solid-state ion selective electrode which is easy to prepare and sensitive to arsenate ion concentration is prepared. The solid salts used in the electrode composition were Cu2S, Ag3AsO4 and Ag2S. The principal component of the electrode was Ag3AsO4. The measurements were made in constant ionic strength using 0.1M NaNO3 and at room temperature. The potentiometric response of electrodes prepared in various compositions was investigated against arsenate ion concentration. The highest slope was obtained with 40% Ag3AsO4, 30% Cu2S and 30% Ag2S. This electrode showed linear response for arsenate ion in the 10(-5)-10(-1) M concentration range. An analytically useful potential change occurred, from 1×10(-6) to 1×10(-1) M arsenate. The slope of the linear portion was about 19±2 mV/10-fold change in arsenate concentration. The lifetime of the electrode was more than two years, when used at least 4-5 times a day, and the response time was about 20-30s depending on the concentration changes. The interference of most common ions and the effect of pH (6-10) have been investigated. This electrode has been used for the determination of arsenate ion in beer sample., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objective: The aim of this study is to detect the accuracy rate of emergency physicians' (EPs') interpretations of cranial computed tomography (CT) of a special patient group, the patients younger than the age of 2 years with mild head trauma., Methods: The study took place in a research and training hospital within a period of 3 months and included a total of 156 patients. The scans were interpreted by the EPs, and the predicted results were recorded in the patients' files; simultaneous interpretations of the on-call radiologist were also recorded. The interpretations were scanned retrospectively at the end of each month, compared, and recorded., Results: With reference to the radiologists' reports, the sensitivity and the specificity of EPs' interpretations of cranial CT were 76.9% and 95.1%, respectively. Concordance of both groups' interpretations was 93.6%. The area under the curve (AUC) value in receiver operating characteristic (ROC) analysis, which reflects these results, was calculated as 0.860 (95% confidence interval, 0.740-0.981). This value was found to be statistically significant (P < .001). False-negative and false-positive values were 23% and 4.9%, respectively. No negative clinical outcomes were observed due to nonconcordance interpreted cases (6.4%)., Conclusions: Emergency physicians can interpret safely the cranial CTs of patients younger than the age of 2 years with mild head trauma, until the radiologists' reports are obtained. However, the anatomic diversities of these patients' age group should be taken into consideration., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Pericardiocentesis is a life-saving procedure performed in cardiac tamponade cases occurring in infective, inflammatory or malignancy conditions, or following percutaneous coronary intervention, cardiac device implantation or catheter ablation. In spite of advanced imaging methods, a substantial risk of complication persists. Emergent surgical intervention may be required, in particular during advancement of the catheter into the heart chambers or in cases of wall rupture. Furthermore, in all these cases, patients have a high risk of surgery because of existing comorbidities. This case presents a patient suspected of tuberculous pericarditis who underwent diagnostic pericardiocentesis complicated by right ventricular puncture. The catheter in the right ventricle was withdrawn via a second catheter placed in the pericardial cavity. Spontaneous blood control was established, and with no increase in pericardial effusion surgical intervention was not required. This method can be applied in certain conditions, including cardiac injury caused by pericardiocentesis or intracardiac manipulations, thus eliminating the need for high-risk surgical intervention.

Objectives/hypothesis: To evaluate the psychological effects of dysphonia in voice professionals compared to non-voice professionals and in both genders., Study Design: Cross-sectional analysis., Methods: Forty-eight 48 voice professionals and 52 non-voice professionals with dysphonia were included in this study. All participants underwent a complete ear, nose, and throat examination and an evaluation for pathologies that might affect vocal quality. Participants were asked to complete the Turkish versions of the Voice Handicap Index-30 (VHI-30), Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). HADS scores were evaluated as HADS-A (anxiety) and HADS-D (depression). Dysphonia status was evaluated by grade, roughness, breathiness, asthenia, and strain (GRBAS) scale perceptually. The results were compared statistically., Results: Significant differences between the two groups were evident when the VHI-30 and PSS data were compared (P = .00001 and P = .00001, respectively). However, neither HADS score (HADS-A and HADS-D) differed between groups. An analysis of the scores in terms of sex revealed that females had significantly higher PSS scores (P = .006). The GRBAS scale revealed no difference between groups (P = .819, .931, .803, .655, and .803, respectively). No between-sex differences in the VHI-30 or HADS scores were evident, Conclusions: We found that voice professionals and females experienced more stress and were more dissatisfied with their voices., Level of Evidence: 4., (© 2015 The American Laryngological, Rhinological and Otological Society, Inc.)

BCG (Bacillus Calmette-Guérin) vaccine is a widely used vaccine with the recommendation of World Health Organization to protect children against miliary tuberculosis (TB) and TB meningitis. Severe side effects related to this vaccine mostly manifest in the presence of underlying immunosuppressive disease. In this report, an infant case with unknown chronic granulomatous disease (CGD) who developed disseminated BCG infection after administration of BCG vaccine, was presented. High fever, left axillary lymphadenopathy and hepatosplenomegaly have developed in a 3-month 28-day female infant, without a known health problem, following BCG vaccination. The acid-fast bacilli (ARB) was isolated from the material of excised lymph node cultivated in Löwenstein-Jensen medium, and the isolate was identified as Mycobacterium bovis. Mycobacterium tuberculosis complex DNA was detected in the axillary lymph node sample by polymerase chain reaction. Anti-tuberculous treatment included 20 mg/kg of rifampicin+10 mg/kg of isoniazid+15 mg/kg of ethambutol+30 mg/kg of streptomycin was started. The patient was then further evaluated for immunodeficiency and on the basis of the results of dihydroamine and LAD (lymphocyte adhesion defect) tests, diagnosed as autosomal recessive CGD. Based on the anamnesis, there was no known immunodeficiency history both in the case during neonatal period and her family members. Interferon-gamma therapy, which is recommended for the patients with CGD living in endemic areas, was initiated. Our patient's fever dropped at the 15th day of anti-tuberculosis treatment, and she was discharged on the 35th day and continued to receive treatment at home. The patient was followed up at outpatient clinic and had no additional complaints; her hepatosplenomegaly was back to normal at the third month. As a result, since BCG vaccine is contraindicated in CGD carriers, newborns with a family history of CGD should be immunologically examined and BCG vaccine should be avoided until the results are obtained. In addition, newborns without a family history, diagnosed as disseminated mycobacterial infection following BCG vaccination, should be evaluated for an underlying immunodeficiency condition.

Risk assesment, preoperative drug regulation, the anesthesia and analgesia techniques are very important and the effectivity on success of surgery is great. So, these topics in arthroplasty were reviewed under current knowledge.

More than half of the students entering college report a history of potentially traumatic events; however, little is known about the relationship of trauma exposure and posttraumatic stress disorder (PTSD) symptomatology to college students' mental health and access to social support or whether these relationships may show variations as a function of race and gender. The purpose of this study was to explore whether the relationships between PTSD symptoms and both depression and social support were moderated by gender and race. Data were collected from 631 African American (AA) and 299 European American (EA) freshmen students attending 2 universities in the Southeast. The majority of the students (74.3% of the AA and 68.2% of the EA sample) reported lifetime exposure to at least 1 traumatic event. PTSD symptomatology was significantly and positively associated with depression symptoms for all groups (i.e., AA and EA males and females); however, the relationship between these 2 variables was strongest for EA men. Similarly, the relationship between PTSD symptoms on the avoidance cluster and social support was stronger for EA males than other groups; avoidance symptoms did not significantly predict social support for AA men., ((c) 2015 APA, all rights reserved).)

Objective: To project the surgical resuscitation methods that we apply to the lower part of the face and the eyes with the aim of preventing functional and psychological problems that can occur in patients with facial paralysis., Materials and Methods: Twenty-two patients with facial nerve paralysis due to acoustic neuroma, trauma, cholesteatoma, and parotid carcinoma were included in this study. In the lower facial region, the temporal muscle was suspended to the lower lip. In the upper facial region, eyelid gold implantation was performed. The reanimation results of the upper and lower facial regions were graded as excellent, good, fair, and poor in consideration of the symmetry after rest and smile according to May classification in the third month after the surgery., Results: The study group comprised 15 men (68.2%) and 5 women (31.8 %) (mean age, 63.82 ± 14.18 years; range, 8-78 years). Of the patients, 18.2% (n = 4) had acoustic neuroma, 40.9% (n = 9) had facial trauma, 27.3% (n = 6) had cholesteatoma, and 13.6% (n = 3) had parotid carcinoma.Reanimation techniques were applied to 40.9% (n = 9) of the patients during the first 2-4 years, whereas 59.1% (n = 13) of patients underwent surgery after 4 years.In a total of 17 patients (77.3%) who had lower lip intervention, 4 patients (23.5%) had excellent results, 7 patients (41.2%) had good results, and 6 patients (35.3%) had moderate results.In the 22 patients who underwent the eyelid procedure, 5 patients (22.7 %) had excellent results, 13 patients (59.1 %) had good results, and 3 patients (18.2 %) had moderate results. Poor results were not observed in any patient., Conclusion: Facial paralysis is a disease that causes serious functional and psychological problems in patients. Therefore, the choice of treatment method is dependent on the etiology, duration of paralysis, expectations of the patient, and experience of the surgeon. Being less invasive methods, obtaining immediate results, requiring single surgical stage, and having long-lasting results and dynamic muscle transfer and static suspension methods are preferred.

Objectives/hypothesis: To assess the nasal functions, nasal resistance, and olfactory function in middle turbinate surgery., Study Design: Randomized controlled trial., Methods: This prospective controlled study was carried out on patients who underwent laminectomy for aeration of the middle turbinate. Patients participating in the study were divided into two groups-group 1: medial laminectomy (n = 34) and group 2: lateral laminectomy (n = 38). Patients underwent the preoperative visual analogue score, sinonasal outcome test-22 (SNOT-22), peak nasal inspiratory flowmeter, and Connecticut Chemosensory Clinical Research Center smell test. All patients were reevaluated 3 months after the operation., Results: The study group comprised 72 consecutive patients. The mean age of the patients was 31.03 ± 9.7, with a range of 17 to 54 years. A total of 47.2 % (n = 34) had medial and 52.8% (n = 38) had lateral laminectomy. Bilateral turbinate intervention was performed in 27.8% (n = 20), whereas unilateral middle turbinate intervention was performed in 72.3% (n = 52). Overall, both groups showed strong significant improvement over time in visual analogue scale results, SNOT-22 scores, peak flowmeter results, and olfactory function between preoperative and postoperative scores (P < 0.001). There was no significant difference between the groups for all parameters (P > 0.05)., Conclusions: This study revealed that medial laminectomy for aeration of the middle turbinate was as effective as lateral laminectomy., Level of Evidence: 1b. Laryngoscope, 125:1062-1066, 2015., (© 2014 The American Laryngological, Rhinological and Otological Society, Inc.)

In general, there are five lumbar vertebras in normal human subjects. But occasionally there are six. In such a situation, a radiologist need to discern between lumbarization of S1 (S1 vertebra becomes segmented and mimics L5) or due to hypoplastic 12(th) ribs, hence the T12 vertebra is wrongly assumed to be L1. These interesting images serve a multimodality approach to right aplasia/left hypoplasia of 12(th) rib, injury of left 11(th) rib and subluxation of left 11(th) Costovertebral joint in a patient with lumbar back pain.

Background: Sleep disturbance in an intensive care unit is a common problem. One of the main factors causing sleep disturbances in an intensive care unit is nocturnal patient care interventions., Aims and Objectives: This study aims to determine the impact of patient care interventions performed at night in a neurosurgical intensive care unit on patients' sleep and their nursing care satisfaction., Methods: The descriptive study was conducted on 82 patients in a neurosurgical intensive care unit between January 2009 and March 2010. The data were collected by data collection instruments and Newcastle Satisfaction with Nursing Scales. The data were statistically analyzed by frequency, mean, standard deviation, chi-square, and Mann-Whitney U test., Results: The study showed that 53.7% of the patients experienced sleep disturbances in the neurosurgical intensive care unit. Because of nursing interventions at night, 39.1% of these patients had their sleep affected, but this problem did not cause any negative impact on the patients' satisfaction (Newcastle Satisfaction with Nursing Scales score = 88.21 ± 9.83). The patients received, on average, 42.21 ± 7.45 times patient care interventions at night; however, the frequency of patient care interventions at night showed no effect on sleep disturbances in this study (p > .05). The most frequently given patient care interventions were, respectively, vital signs monitoring, neurological assessment, and repositioning in bed. These interventions were performed commonly at 6 a.m., 12 a.m., and 7 p.m., Conclusion: In this study, despite the patients reporting sleep disturbances in the neurosurgical intensive care unit because of nocturnal patient care interventions that prevented them from sleeping, the patients' satisfaction on the given nursing care was not negatively impacted. To reduce sleep disturbances because of nursing care initiatives and promote uninterrupted sleep in the intensive care unit, it can be useful to develop new protocols regulating night care activities.

Background: Urinary cytology has low sensitivity and specificity in urinary neoplasm., Aim: We planned to assess whether the examination of bladder washing before biopsy (WBB) plays a role in better cytologic diagnosis of bladder wash fluid collected after biopsy procedure (WAB) in papillary urothelial neoplasms., Materials and Methods: We included 36 patients with papillary lesion of bladder. Prior to the biopsy, the bladder is washed and fluid is collected for cytology; later transurethral resection (TUR) is performed, then bladders are washed again and the fluid is separately collected for cytology. Both fluids were centrifuged and stained with May-Grünwald Giemsa (MGG). First the WAB slides were evaluated and diagnosed. After evaluation of the WBB slides, the WAB slides were rediagnosed. Presence of cellularity, papillary structure, fusiform cells, background bleeding, and cytolysis in WBB and WAB were evaluated separately., Results: We determined that 31 WBB samples were hypercellular, and 12 of them remained as hypercellular in WAB. Papillary structures were observed in 20 WBB samples; and in one WAB cytology. In 29 cases where no fusiform cells are identified in WBB, 22 showed fusiform cells in WAB. Cytolysis in WABs was noted in 15 cases whose WBBs did not show cytolysis. The decrease in cellularity, papillary structure (P < 0.001, both), cytolysis (P = 0.008), and fusiform cells (P < 0.001) were statistically significant. After seeing the WBB slides, we reevaluated the WAB slides. Out of the eight out of 36 (22.2%) samples diagnosed with degeneration previously, five (62.5%) samples were rediagnosed as benign, two (25%) as cytologic atypia which favor reactive, and one (12.5%) as malignant., Conclusion: Due to the better quality, initial evaluation of WBB may help more effective diagnoses of WAB slides.

Fine particles with a characteristic size smaller than 100 nm (i.e. nanoparticlesspread out in nowadays life. Silicon or Si, is one of the most abundant chemical elements found on the Earth. Its oxide forms, such as silicate (SiO4) and silicon dioxide, also known as silica (SiO2), are the main constituents of sand and quartz contributing to 90% of the Earth's crust. In this work, three genotoxicity systems "sister chromatid exchange, cytokinesis block micronucleus test and single cell gel electrophoresis (comet) assay" were employed to provide further insight into the cytotoxic and mutagenic/genotoxic potential of SiO2 nanoparticules (particle size 6 nm, 20 nm, 50 nm) in cultured peripheral blood lymphocytes as in vitro. It was observed that there is a significant decrease in Mitotic index (MI), Cytokinesis block proliferation index (CBPI), proliferation index (PRI) values expressed as Cell Kinetic parameters compared with negative control (p < 0.05). There is a statistically significant difference between negative control culture and culture exposed to SiO2 (6 nm, 20 nm, 50 nm) (p < 0.01, p < 0.01, p < 0.05, respectively). It is found that SiO2 nanoparticles at different size (6, 20, 50 nm) progressively increased the SCE frequency and DNA damage on the basis the AU values compared with negative control (p < 0.05). Results showed that the genotoxic/mutagenic and cytotoxic effects of SiO2 nanoparticules is dependent to particule size.

Aim: The literature is inconclusive concerning the prognostic factors and therapeutic management of papillary thyroid microcarcinoma (PTMC). Herein we report on our extensive experience with PTMC in relation to clinicopathological characteristics and prognostic factors., Methods: In all, 248 patients that were diagnosed and treated for PTMC between 2007 and 2012 were retrospectively analyzed. Demographic and tumor characteristics at presentation, and recurrence during follow-up were noted., Results: Total thyroidectomy and radioactive iodine (RAI) ablation treatment were performed in all patients. Bilateral involvement, vascular and capsular invasion, extra-thyroidal extension, and lymph node metastasis occurred significantly more frequently in patients with tumor size>5 mm (P<0.05). Multivariate statistical analysis showed that a clinically suspected diagnosis (OR:0.095; P=0.043) and elevated thyroglobulin (TG) level (OR: 1.083; P=0.011; cut-off value≥7.98 ngmL(-1)) were significant and independent risk factors for lymph node metastasis, with a sensitivity of 57% and specificity of 83%. After a median follow-up of 2 years (range:0.3-11 years), 10 (4%) of the 248 patients had recurrent disease. According to multivariate analysis, lymph node metastasis (OR: 51.4; P=0.003) was the only independent predictor of recurrence., Conclusion: Our findings revealed that serum TG level and a clinically suspected diagnosis were risk factors for lymph node metastasis, while nodal metastasis was a predictor of recurrence.

Objective: The aim of this study was to assess zinc levels in tinnitus patients, and to evaluate the effects of zinc deficiency on tinnitus and hearing loss., Methods: One-hundred patients, who presented to an outpatient clinic with tinnitus between June 2009 and 2014, were included in the study. Patients were divided into three groups according to age: Group I (patients between 18 and 30years of age); Group II (patients between 31 and 60years of age); and Group III (patients between 61 and 78years of age). Following a complete ear, nose and throat examination, serum zinc levels were measured and the severity of tinnitus was quantified using the Tinnitus Severity Index Questionnaire (TSIQ). Patients were subsequently asked to provide a subjective judgment regarding the loudness of their tinnitus. The hearing status of patients was evaluated by audiometry and high-frequency audiometry. An average hearing sensitivity was calculated as the mean value of hearing thresholds between 250 and 20,000Hz. Serum zinc levels between 70 and 120μg/dl were considered normal. The severity and loudness of tinnitus, and the hearing thresholds of the normal zinc level and zinc-deficient groups, were compared., Results: Twelve of 100 (12%) patients exhibited low zinc levels. The mean age of the zinc-deficient group was 65.41±12.77years. Serum zinc levels were significantly lower in group III (p<0.01). The severity and loudness of tinnitus were greater in zinc-deficient patients (p=0.011 and p=0.015, respectively). Moreover, the mean thresholds of air conduction were significantly higher in zinc-deficient patients (p=0.000)., Conclusion: We observed that zinc levels decrease as age increases. In addition, there was a significant correlation between zinc level and the severity and loudness of tinnitus. Zinc deficiency was also associated with impairments in hearing thresholds., (Copyright © 2015 Elsevier Inc. All rights reserved.)

This study aimed at investigating the impact of industrialization on the quality of agricultural soils in the district of Bandırma, Turkey, in terms of soil heavy metal contamination. Many soil and phosphogypsum samples were analyzed, and enrichment factors (EFs) were calculated. The average concentration gradient of metals in the soil (mg/kg) was As < Se < Sb < Pb < Co < Cd < V < Cu < Ni < Zn < Cr < P < Mn < Na < K < Mg < Fe < Ca < Al. According to the Pearson cross-correlation results for the element pairs of Fe-Mg (0.635), Fe-Cu (0.863), Fe-Cd (0.545), Cu-Cd (0.630), Mn-Cr (0.698), Mn-Al (0.523), Cr-Mg (0.543), Al-P (0.508), Na-K (0.616), and C-Zn (0.703), the metal enrichments in the soil were found to be moderately high and significant. In the majority of soil samples, Ni, Cu, Co, Zn, Se, Pb, and Cr were moderately enriched whereas Sb and Cd were extremely highly enriched. A factor analysis (FA) was applied to the cross-correlations of the elements to identify their sources. Six significant factors were extracted with the help of FA, explaining 77.22 % of the total variance, and the elements loaded on these factors were interpreted. The evaluations of the factors showed that the study area has been exposed to heavy metal pollution from anthropogenic sources considering the high levels of Cr, Cd, Cu, P, V, Zn, Ni, Sb, and Pb in the soil and the higher EFs falling in the range of 2.54-372.87. Moreover, the soil concentrations of Mn, Mg, Co, Al, K, and Ca were also high, but they were of lithogenic in origin according to the FA.

Osteoradionecrosis of the hyoid bone is a rare complication of therapeutic irradiation performed for head and neck cancer. In this article, we present a 52-year-old male patient who admitted with severe odynophagia following chemo-radiotherapy administration for tonsil carcinoma. Fluorine-18-fluorodeoxy-glucose positron emission tomography-computed tomography revealed a metabolic activity in hyoid bone. The pathological findings were consistent with fungal infection and hyoid bone necrosis. Hyoid osteoradionecrosis should be kept in mind in patients with intractable dysphagia following irradiation for head and neck tumors.

The purpose of this study was to investigate the relationship between the 3 dimensions of death acceptance (i.e., neutral, approach, and escape) and grief symptomatology, as well as whether the relationship between neutral acceptance and grief symptoms was mediated by meaning in life. Data were collected from 160 bereaved individuals. Only neutral acceptance was significantly associated with grief symptomatology; the relationship between the 2 variables was mediated by meaning in life. Participants who perceived death as a natural part of life reported having a greater sense of meaning in their lives, which, in turn, predicted lower grief symptomatology.

Objectives: This study aims to analyze the subjective and objective characteristics of tinnitus in sleep bruxism patients., Patients and Methods: The study included 57 patients (12 males; 45 females; mean age 33.89±12.50 years; range 19 to 55 years) with sleep bruxism and tinnitus (sleep bruxism group) and 24 patients (6 males, 18 females; mean age 43.75±16.19 years; range 21 to 58 years) only with tinnitus (control group). Sleep bruxism was diagnosed by the diagnostic criteria of American Academy of Sleep Medicine. Patients were performed pure tone audiometry to detect hearing thresholds at standard and high frequencies. Tinnitus frequency and loudness were assessed. Subjective aspects of tinnitus were identified by tinnitus handicap inventory., Results: The statistical analysis revealed that the sleep bruxism group had significantly lower hearing thresholds except 1000 Hz and 2000 Hz. Tinnitus frequency was between 3000 Hz and 18000 Hz in sleep bruxism group while it was between 6000 and 16000 Hz in control group with no statistically significant difference (p=0.362). Sleep bruxism group had significantly lower tinnitus loudness and tinnitus handicap inventory scores in comparison to control group (p=0.024 and p=0.000, respectively)., Conclusion: Tinnitus caused by sleep bruxism and temporomandibular joint issues has higher frequency and lower loudness compared to patients with only tinnitus.

Obesity is a significant cause of morbidity and mortality, and it is becoming increasingly prevalent worldwide. Altered pharmacodynamics and pharmacokinetics of drugs in obese patients require dose adjustment according to body weight. New oral anticoagulants (NOACs), which are more frequently used for anticoagulation, are recommended to be used at a fixed dose based on data derived from phase 2 and 3 studies. However, the representation of obese patients [>100 kg or a body mass index (BMI) of >30 kg/m2] in subgroups with a small sample size and reports of various emboli cases under drug treatment have raised suspicions about the adequacy of fixed dose use. To address this issue, we analyzed several patients with a body weight of >100 kg or BMI of >30 kg/m2 participating in NOAC studies and evaluated whether these numbers were sufficient to enable an accurate recommendation of fixed dose use in obese patients.