Relative Stagnation alla Turca

Turkey is the only founding member of the OECD that has not converged to the US in terms of per-capita GDP since 1950: its real GDP per capita is stuck at 20% of that of the US. At a proximate level, we show that Turkey's relative stagnation over the past 50 years is due to: (1) the relative decline in its labor force participation, and (2) the relative stagnation of its TFP. We argue that the first fact is due to policies of high personal income taxation, and high social security contributions for both employees and employers. The second fact we argue is due to price support policies in agriculture, which distorted the allocation of resources in favor of agriculture, thereby delayed the process of the structural transformation. We develop a dynamic general equilibrium model with agricultural and non-agricultural sectors. The production of the non-agricultural good can take place in the market or the household sector. We show the extent to which these policies can account quantitatively for Turkey's relative stagnationRelative Stagnation, Labor Force Participation, Income Taxes

Clinical and Experimental Studies on Gastrointestinal Anastomoses and Colorectal Cancer

The first section of this thesis discusses the role of stapling techniques in surgical practice. A prospective controlled clinical trial is described, where surgical stapling techniques were compared with conventional manual suturing techniques in the construction of gastrointestinal anastomoses. The following section deals with work on recurrence of colorectal cancer following surgical treatment. Two clinical studies are presented in this section, where "anastomotic techniques" and "anastomotic leaks" are examined respectively in relation to tumour recurrence. The final section of the thesis describes experimental studies in a rodent model, which were designed and conducted to investigate the association between anastomotic leaks and peri-anastomotic tumour growth. Suturing or stapling in gastrointestinal surgery Between April 1985 and April 1989 1,161 consecutive patients undergoing surgery under the care of 13 consultant surgeons throughout the West of Scotland and Highland regions were studied prospectively. All patients had operations that entailed the construction of a gastrointestinal anastomosis. If, at the time of surgery suturing and stapling techniques were considered equally appropriate, the method of anastomotic construction was determined by randomisation. Methods of data collection, bowel preparation, antibiotic prophylaxis, anastomotic materials and anastomotic techniques were standardised by the study protocol. Four hundred and ninety six patients received sutured and 508 received stapled anastomoses. In the remaining 157 patients randomisation was considered inappropriate. All patients were followed until death or discharge from the hospital. The incidence of clinically evident anastomotic dehiscence was 3. 3% in patients with sutured anatomoses, compared with 4.7% in the stapled group (p< 0.22). Sub-clinical (radiologically detected) leaks were encountered with a significantly higher frequency in the sutured group (14.4% versus 5.2%; p < 0.05). Surgical stapling also afforded significantly quicker anastomoses and operations (Mean anastomosis time + SEM: 28.1 +/-0.7 versus 14.3 +/-0.5 minutes, p< 0.001; Mean operating time +/-SEM: 115.5 +/-2.4 versus 103.9 +/-2.2 minutes, p <0.001). With regard to other important outcome measures such as operative mortality, incidence of infective complications, recovery of gastrointestinal function and duration of hospital stay, suturing and stapling techniques produced comparable results. Further detailed analyses are presented, where the randomised and non-randomised patients were stratified according to anastomotic technique and various surgical categories. These data are hoped to provide guidance to surgeons in their selection of anastomotic technique. Anastomotic techniques and recurrence of colorectal cancer Recently some concern has been expressed in the literature regarding a potential adverse influence on the recurrence of rectal cancer associated with the use of stapling techniques. Prompted by these reports, the effect of anastomotic technique on the incidence of recurrence following potentially curative resections was studied in 294 patients. One hundred and forty two of these patients had their anastomoses randomised to suturing and 152 to stapling. By the end of the second postoperative year the incidence of tumour recurrence (+/-SEM) was 29.4% (4.4%) in the sutured group, compared with 19.1% (3.9%) in the stapled group (p< 0.05). Cancer specific mortality was also significantly higher in patients with sutured anatomoses (22.3% +/-4.1% versus 10.9% +/-3.0% at 24 months, p< 0.01). Further analysis revealed that the influence of anastomotic technique on recurrence and mortality rates was independent of tumour stage and other co-variates. These results suggest that in patients undergoing potentially curative resections for colorectal cancer, the use of stapling instruments for anastomotic construction may be associated with a significant reduction in recurrence and cancer specific mortality rates compared with conventional manual suturing techniques. Potential explanations for this previously unreported observation are discussed. (Abstract shortened by ProQuest.)

Influence of Atrioventricular Nodal Reentrant Tachycardia Ablation on Right to Left Inter-atrial Conduction

Background: Radiofrequency (RF) catheter ablation is the procedure of choice for the potential cure of atrioventricular nodal reentrant tachycardia (AVNRT) with high success rates. We hypothesed that as a result of the close proximity of Koch’s triangle and low inter-atrial septal fibers, the RF ablation applied at this region may result in prolongation of inter-atrial conduction time (IACT). Methods: RF ablation of AVNRT was performed by conventional technique. IACT was measured before and 20 minutes after RF ablation during sinus rhythm. Number of ablations given and duration of ablation were noted. Results: The study group was consisted of 48 patients (36 [75%] female, 12 [25%] male, mean age 43.4 ± 14. 5 years). RF ablation was successful in all patients. Mean RF time was 4. 0 ± 3. 3 minutes and mean number of RF was 11. 9 ± 9, 8. The mean IACT was 70.1 ± 9.0 ms before ablation and 84.9 ± 12.7 ms after ablation, which demonstrated a significant prolongation (p<0.001). The prolongation of IACT was very well correlated with the number of (r=0.897, p<0.001) and duration of RF (r=0.779; p<0.001). Conclusions: RF ablation of AVNRT results in prolongation of IACT. The degree of prolongation is associated with the duration and number of RF ablations given. The relationship between this conduction delay and late arrhythmogenesis need to be evaluated

Is YouTube a quality source of information on sarcopenia?

Background: While sarcopenia is a prevalent disorder that affects muscle mass and quality, patients have limited knowledge of it. On the other hand, patients often use social media to obtain health-specific information. Therefore, the aim of this study was to investigate the YouTube videos about sarcopenia in terms of the knowledge value of what they present and to identify which of them can be considered as the quality sources of such information. Methods: The descriptive study included 53 videos retrieved by searching the keywords ‘sarcopenia’, ‘loss of muscle strength’, ‘sarcopenia treatment,’ ‘sarcopenia physiotherapy,’ and’sarcopenia rehabilitation’ on YouTube. The instructive characteristics of the videos were assessed with the Global Quality Scale, by which three quality groups were identified: poor-, moderate-, and high-quality videos. The DISCERN score was utilized to determine reliability. The sources of upload were identified as physicians, non-physician health personnel, health-related websites, universities and academic organizations, patients, and independent users. Finally, the lengths of videos, the number of views, likes, dislikes, and comments, and the DISCERN scores of the videos were compared using group comparisons. Results: The results suggested that there were 18 poor-quality, 16 moderate-quality, and 19 high-quality videos. Considering the sources of upload, physicians had the highest ratio in the high-quality group (83.3%). The lengths of videos and the DISCERN scores showed significant differences (p < 0.01). The numbers of views, likes, dislikes, and comments were similar in both quality and source groups. Conclusion: Most parts of the videos uploaded by physicians and academic organizations were included in the high-quality group. Overall, according to the results of the study, it can be asserted that high quality may be related to reliability. Furthermore, healthcare professionals and academics should consider using YouTube for increasing knowledge and raising awareness of patients about sarcopenia. © 2020, European Geriatric Medicine Society

Wolff-Parkinson-White Syndrome and Rheumatic Mitral Stenosis: an Uncommon Coincidence that can Cause Severe Hemodynamic Disturbance

The combination of rheumatic mitral stenosis and Wolff-Parkinson-White syndrome is a rare situation. In this case, we are reporting an 72-year-old man presenting with multi-organ failure due to the this combination and successfully treated with radiofrequency ablation during preexcitated atrial fibrillation

YouTube as a source of information on COVID-19 vaccination in rheumatic diseases

As the most well-known and popular video-sharing platform around the world, YouTube is an influential tool for the dissemination of health-related information. In addition, considering the increase in obtaining information from internet-based sources in pandemic conditions, YouTube has become more important in the presentation of information related to COVID-19. Therefore, the aim of this study was to evaluate videos related to COVID-19 vaccination in rheumatic diseases (RD) on YouTube. In this descriptive study, 334 video URLs listed with six search terms were recorded (26 July 2021). Three quality groups (high, intermediate, and low) were created based on the Global Quality Scores (GQS). Video sources were identified and various video parameters were compared between the quality groups. Following the implementation of the exclusion criteria, 56 videos remained for further analysis; of which 37 (66.07%) were evaluated as high quality, 12 (21.42%) as intermediate quality, and 7 (12.51%) as low quality. No significant difference was determined between the quality groups in per day values of views, likes, dislikes, and comments. The sources of high-quality videos were pharmaceutical company (n = 1; 100%), pharmacist (n = 1; 100%), society-organization (n = 17; 85%), and academic (n = 3; 75%). Although two-thirds of the videos were high quality, it should be kept in mind that intermediate and low-quality videos are also available. Users should not assume the quality of the videos based on the number of views, likes, dislikes, and comments, but should focus more on video sources

The relationship between COVID-19 and fibromyalgia syndrome: prevalence, pandemic effects, symptom mechanisms, and COVID-19 vaccines

On March 11, 2020, the World Health Organization, realizing the level of spread worldwide and the severity of the condition, accepted coronavirus disease 19 (COVID-19) as a pandemic. Subsequently, quarantine conditions were implemented around the world, and these triggered particular results. Like all other individuals, fibromyalgia syndrome (FMS) patients were affected by these conditions. The stress load in pandemic conditions, difficulties in accessing healthcare services, changes in exercise compliance, variations in physiotherapy programs, and remote work conditions all had an impact on FMS patients. Although general expectations were negative, some FMS patients were able to manage the pandemic conditions and even turn them in their favor. This is thought to be due to this patient group having established strategies to cope with stress in the pre-pandemic period, and they had sufficient ability to adapt to changing situations. FMS-related symptoms occur in a subset of individuals following COVID-19. One of the factors is the increased psychological burden after COVID-19. There is evidence that neuroinflammatory pathways affect neuroplasticity in the central nervous system and trigger the onset of FMS-related symptoms. Among the probable mechanisms are alterations in inflammatory and anti-inflammatory pathways. Changes in the autonomic nervous system with the effect of SARS-CoV-2 may induce the emergence of FMS-related symptoms. FMS and COVID-19 can coexist, and FMS may create a tendency to vaccine hesitancy. Future studies should focus on elucidating FMS-related symptoms occurring post-COVID-19. There is a need to determine distinctions between the FMS clinical status that emerged following COVID-19 and the regular patient group in terms of diagnosis, treatment, and follow-up. © 2022, The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR)

Publication activity in the field of Sjögren’s syndrome: a ten-year web of science based analysis

Bibliometric analysis is widely utilized to evaluate global research productivity in different research topics. However, to date, there has been no assessment of worldwide research productivity associated with Sjögren’s syndrome. Therefore, the aim of this study was to evaluate the global research productivity in the field of Sjögren's syndrome using bibliometric analysis. The Web of Science database was scanned with the search terms ‘Sjögren’s syndrome’ and ‘Sjögren syndrome’ for publications in the period 2010–2019. Original articles and reviews were selected for analysis. The most active countries were determined, and the number of articles, citations, research productivity adjusted by population and gross domestic product were analyzed. A total of 3856 articles were identified from 65 different countries. A statistically significant trend was observed in the direction of increase (in terms of the number of articles; from 282 to 461) in the 10-year period. A total of 3004 (77.90%) articles were from high-income countries. The five most productive countries were the United States (n = 714, 18.51%), China (n = 428, 11.09%), Japan (n = 308, 7.98%), Italy (n = 299, 7.75%) and France (n = 249, 6.45%). When the number of articles was adjusted according to population, Norway was the most productive country, followed by Greece and the Netherlands. In analysis according to gross domestic product, Greece was the leading country, followed by Norway and the Netherlands. The results of this study demonstrated a remarkable growth in global research productivity on Sjögren’s syndrome between 2010 and 2019. More than three quarters of the articles were from high-income countries. When population and gross domestic product were considered, relatively small European countries came to the fore. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature

Reactive arthritis after COVID-19: a case-based review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 19 (COVID-19) pandemic, which is deeply affecting the whole world. In this new case for the scientific world, scientists are investigating the etiopathogenesis of viral infection-induced damage and have started to focus on the short and long-term immune system effects and alterations after SARS-CoV-2 infection. The case is here reported of a 53-year-old female patient with acute monoarthritis after SARS-CoV-2 infection, who responded adequately to 150 mg/day diclofenac treatment, and the available case reports are comprehensively reviewed. With the focus on arthritis after SARS-CoV2 infection, which emerges as a new pathological condition associated with COVID-19, it was aimed to examine the possible immunological mechanisms of post-COVID-19 arthritis based on the current data on SARS-CoV-2 and the known pathogenetic background of viral arthritis

Fibromyalgia syndrome: epidemiology, diagnosis and treatment

Fibromyalgia syndrome (FMS) profoundly impacts patients’ quality of life with its symptoms and clinical signs. Fibromyalgia syndrome impairs daily living activities, reduces work efficiency and raises health-related costs. Although the prevalence rates vary depending on geographical location and diagnostic criteria, it is a common disorder worldwide. Females have a higher prevalence of fibromyalgia syndrome, with varied rates, and there is an increase in prevalence rates with age. Although its etiopathogenesis has not been fully elucidated, various hypotheses have been proposed that central sensitization is at the core of the process. Fibromyalgia syndrome diagnostic approaches have advanced significantly over time, moving away from pain assessments alone and emphasizing multiple clinical signs of FMS. This condition has raised physicians’ and researchers’ awareness of non-pain symptoms. Considering the complicated etiopathogenesis of fibromyalgia syndrome, diverse pathways connected with symptoms, and multiple clinical presentations, it becomes clear that drug and non-drug treatments should be chosen in combination. © 2022 Termedia Publishing House Ltd.. All rights reserved