Risk assessment of a mixture of pharmaceuticals and personal care products (PPCPs) in thermal waters of Kütahya, Türkiye

The increasing global consumption of pharmaceuticals and personal care products (PPCPs) and their persistence in the environment have raised concerns about their potential ecological and human health risks, especially in aquatic systems. Thermal waters, widely used for therapeutic and agricultural purposes, remain underexplored regarding PPCP contamination. This study presents a comprehensive environmental risk assessment (ERA) of 104 PPCPs in thermal waters from 22 sampling points across nine geothermal fields in Kütahya, Türkiye. A total of five PPCPs (caffeine, DEET, ephedrine, carbamazepine, and chlorphenamine) were quantified using a validated LC–MS/MS method. Caffeine exhibited the highest detection frequency (100%) and maximum concentration (43.191&nbsp;ng&nbsp;L−1), followed by DEET (90.9%) and ephedrine (77.2%). Risk quotients (RQs) were calculated based on predicted no-effect concentrations (PNECs) derived from ECOSAR v2.2, and the mixture risk quotient (MRQ) approach was applied to assess the cumulative ecological risks of PPCP mixtures. The results indicate that although most individual compounds pose low to medium ecological risk levels (RQ &lt; 1), MRQ values exceeded concern thresholds (MRQ &gt; 1) in several locations, suggesting potential chronic threats, especially to algae and invertebrates. No significant correlation emerged between PPCP levels and water parameters, indicating their persistence. Geological and hydrogeological factors, such as fault-controlled mixing between shallow and deep aquifers, were identified as pathways for contamination. These findings highlight the need for regulatory oversight of PPCPs in thermal waters and recommend safeguards, such as isolating well intakes from shallow aquifers, to reduce ecological and health risks.</p

Evaluation of Auditory Verbal Performance of Pediatric CI Users with Inner Ear Malformations

Background: Cochlear implant can be applied to individuals with both normal and abnormal inner ear anatomy, but it may be contraindicated for individuals with some abnormal inner ear anatomy (e.g. labyrinthine aplasia). Individuals with inner ear malformations such as IP-II, IP-I, cochlear hypoplasia, or common cavity may benefit optimally from cochlear implant similarly to individuals with normal inner ear anatomy. Although auditory input is similar, it remains unclear how auditory verbal performance develops in individuals with inner ear malformations. Therefore, the purpose of this study was to determine the auditory verbal performance of cochlear implant users with inner ear malformations.Methods: A total of 32 cochlear implant users, 15 with inner ear malformations and 17 with normal cochlear anatomy, aged 3-12 years, were included in the study. The Turkish version of the ''Parents' Evaluation of Aural/Oral Performance of Children'' questionnaire was used to examine the auditory verbal performance of the participants. Additionally, the factors affecting auditory verbal performance in inner ear malformations were also investigated.Results: No significant difference was found in the subtest scores of ''Quiet'', ''Noise'' and ''Total'' between cochlear implant users with normal anatomy and those with inner ear malformations (p&gt;0.05). A significant difference was found in the subtest scores of ''Quiet'' between unilateral cochlear implant users with normal anatomy and those with inner ear malformations (p=0.04). No significant difference was found in any subtest scores between unilateral and bilateral cochlear implant users with inner ear malformations (p&gt;0.05).Conclusions: Many studies have shown that the use of cochlear implants at an early age in children with hearing loss has a significant effect on many developmental areas such as listening skills, speech intelligibility, learning skills, speech and language development. Despite the inner ear malformation, the fact that the subtest results of these individuals are similar to normal anatomy shows us that auditory verbal performance is independent of anatomy. The effect of anatomy on auditory verbal performance is especially evident in quiet conditions and in the case of unilateral cochlear implant use.</p

The Effect of Mobile Application-Based Training on Bowel Preparation Quality in Pre-Colonoscopy Patients

Adequate bowel preparation is necessary to ensure accurate diagnosis and evaluation during colonoscopy. The aim ofthis study is to systematically investigate the impact of education provided through mobile applications on bowelpreparation quality in individuals undergoing colonoscopy. Studies published between January 2010 and June 2023 weresearched on the MEDLINE, CINAHL, Cochrane Library, Scopus databases, and Google Scholar with the keywords“colonoscopy, bowel preparation, mobile application, and patient education.” Randomized controlled trials (RCTs)involving mobile applications for bowel preparation, with adult patients (aged 18–80) as participants, were included in thestudy. In this context, eight RCTstudies have been included in the research. In the studies in which evaluations were madewith the Boston and Ottawa bowel preparation scales, it was concluded that the bowel preparation quality of the groupstrained with the mobile applications was better. Compliance with bowel preparation instructions and satisfaction with theeducation program were higher in the mobile application groups compared to the control group. No significant differencewas found in the studies where the results of colonoscopy quality markers were given. Mobile applications contributepositively to patient education in pre-colonoscopy bowel preparation processes. However, methodological differencesand limitations among studies may restrict the generalization of results.</p

Awareness of HPV and HPV vaccine among women with high-risk HPV types in the Mediterranean region

Aim: To evaluate awareness of HPV and the HPV vaccine among women with high-risk HPV types in the Mediterranean region. Methods: This observational cross-sectional study included 1,418 women who underwent colposcopy due to high-risk HPV positivity. Seven hundred seventy-six participants who fully completed the survey and provided all requisite data for the study were assessed. A survey containing 9 questions about HPV, HPV vaccine, and the source of information of HPV, relationship between HPV and cervical cancer was applied to patients who were given a colposcopy appointment due to high-risk HPV positivity. Results: Seventy percent of women underwent an HPV test during a visit to the doctor, while the proportion of those tested for screening purposes was identified as 22.2%. About 79.5% of participants reported lacking any awareness of HPV before undergoing the test. The source of their initial information of HPV, 49.2% of participants indicated health experts, while 31.4% cited social media. The percentage of participants informed about the HPV vaccine is 20.7%. Only 8.9% of participants reported receiving vaccinations. Conclusion: The fact that even women with a positive HPV test who are referred to the gynecological oncology clinic and who are in risk groups for cervical cancer have limited knowledge about HPV and the HPV vaccine shows how important it is to raise awareness in society about this issue. The use of social media, particularly the creation of content by healthcare professionals, appears to be a crucial measure for raising awareness of HPV and the HPV vaccine

Effect of sesame oil and Nigella sativa oil on the prevention of amiodarone-induced phlebitis: a randomized controlled trial

Background Amiodarone, widely used in arrhythmia management, often causes phlebitis when administered via peripheral infusion. This study evaluated the effects of Nigella sativa oil and sesame oil in preventing amiodarone-induced phlebitis.Material and methodThe study was a randomized controlled trial with three parallel groups. This study included 108 patients who received amiodarone infusion in the coronary intensive care unit between November 2023 and August 2024. This three-arm, block-randomized controlled trial was conducted in line with CONSORT guidelines. Patients were randomly assigned to one of three groups: sesame oil (n = 36), Nigella sativa oil (n = 36), or control (n = 36). In the intervention groups, five drops of the respective oil were applied topically to a 10-cm area around the catheter site. The application was performed once before the infusion and then every 6 hours thereafter. The control group received no intervention. Patients were monitored hourly during the 26-hour infusion and every six hours for 48 hours after the infusion, for a total monitoring period of 74 hours. Phlebitis was assessed using the Visual Infusion Phlebitis Scale. This study was prospectively registered on ClinicalTrials.gov (NCT06030141) on November 15, 2023.ResultsPhlebitis was observed in 25% of patients in the sesame oil group, 33.3% in the Nigella sativa oil group, and 80.6% in the control group. A significant difference in phlebitis severity was observed between the groups (p < 0.001), with the highest severity in the control group, the lowest in the sesame oil group, and moderate levels in the Nigella sativa oil group.ConclusionThis study demonstrated that sesame and Nigella Sativa oils were effective in both preventing and reducing the severity of amiodarone-induced phlebitis. The use of sesame oil and Nigella sativa oil in peripheral intravenous catheter care may help reduce amiodarone-induced phlebitis, maintain vascular access integrity, and improve patient comfort. As natural, safe, and cost-effective agents, these oils can be readily incorporated into clinical nursing practice to enhance patient safety and quality of care