Inverted (hobnail) high-grade prostatic intraepithelial neoplasia and invasive inverted pattern

High-grade prostatic intraepithelial neoplasia (HGPIN) is considered to be an important precursor for prostatic adenocarcinoma. The present study aimed to investigate the histological features of the uncommon inverted (hobnail) pattern of HGPIN in transrectal ultrasonographic (TRUS) prostatic needle biopsies from 13 cases. These 13 diagnosed cases of inverted HGPIN were identified out of a total of 2,034 TRUS biopsies (0.63%), obtained from patients suspected to have prostate cancer. The hobnail pattern is comprised of secretory cell nuclei, which are histologically localized at the luminal surface of the prostate gland, rather than the periphery, and exhibit reverse polarity. Histological examinations were performed and the results demonstrated that 5 of the 13 cases exhibited pure inverted histology, while HGPIN was observed to be histologically associated with other patterns in the remaining 8 patients. In addition, an association with adenocarcinoma was identified in 7 of the 13 cases. All 7 carcinomas accompanied by inverted HGPIN were conventional acinar adenocarcinoma cases; of note, for these 7 cases, the Gleason score was 7 for each. One acinar adenocarcinoma case accompanying inverted HGPIN demonstrated hobnail characteristics in large areas of the invasive component. It was observed that nuclei were proliferated in the invasive cribriform glands, which was comparable to that of inverted HGPIN, and were located on the cytoplasmic luminal surface; a similar morphology was also observed in individual glands. In conclusion, the results of the present study suggested that the hobnail HGPIN pattern may be of diagnostic importance due to its high association with adenocarcinoma and the high Gleason scores in the accompanying carcinomas

A comparison of adductor canal block before and after thigh tourniquet during knee arthroscopy: A randomized, blinded study

Background: Adductor canal block (ACB) provides effective analgesia management after arthroscopic knee surgery. However, there is insufficient data about performing ACB before or after inflation of a thigh tourniquet. We aimed to investigate the efficacy of ACB when it is performed before and after thigh tourniquet and evaluate motor weakness. Methods: ACB was performed before the tourniquet inflation in the PreT group, it was performed after the inflation of the tourniquet in the PostT group. In the PO group, ACB was performed at the end of surgery after disinflation of the tourniquet. Results: There were no statistical differences between the groups in terms of demographic data. Opioid consumption showed no statistically significant differences (for total consumption; p = 0.5). The amount of rescue analgesia administered and patient satisfaction were also not significantly different between groups. There was no significant difference in terms of static and dynamic VAS scores between groups (for 24 hours; p = 0.3, p = 0.2 respectively). The incidence of motor block was higher in the PreT group (eight patients) than in the PostT group (no patients) and in the PO group (only one patient) (p = 0.005). Conclusions: Using a tourniquet before or after ACB may not result in any differences in terms of analgesia; however, applying a tourniquet immediately after ACB may lead to muscle weakness

Histological Subgroups in Classic Kaposi Sarcoma: A Preliminary Study

Background and Design: Kaposi sarcomas (KS) are vascular tumors with a low malignant potential which include overlapping infectious, immunologic, and neoplastic processes. Recently, many histological subtypes have been defined. Material and Method: In the present study, 151 cutaneous classic KS lesions in 56 patients were retrospectively evaluated with regard to histological subtypes. Determination of the subtypes was based on the predominant histopathological component in the lesion. We examined changes in epidermis and dermis along with intratumoral inflammatory response characteristics in the lesions. By defining histopathological variants of the cases, differences regarding subtypes were investigated. Results: Cases that bear the ordinary characteristics of KS and those that can not be classified otherwise, comprised 82..8% of the study group. Twenty-six cases showed consistency with the subtypes outlined in the literature in terms of their histopathological properties. The most common histological subtype was the lymphangiectatic variant in 7.3% of the cases. Bullous (2.6%), lymphangioma like (2.6%), intravascular (2%), and pyogenic granuloma like (2%) variants were less common. The most uncommon histological subtype was micronodular (0.6%) type. Lymphangiectatic, bullous, intravascular, and pyogenic granuloma like variants were frequently observed in the nodular stage of KSs. Lympangioma like changes were seen to be present in the early KS lesions. Lymphangiectatic type was oftenly associated with bullous component, whereas pyogenic granuloma like type demonstrated superficial ulceration and intense inflammatory response. Lymphangioma like and intravascular types exhibited a characteristic appearance, while other variants were accompanied by components belonging to different subtypes. Conclusion: In KS, histopathological subtypes can develop as a result of different pathological processes. The next stage of the current study, which is one of the largest case series in the literature, will be investigation of the clinical and prognostic characteristics of the variants

Factors affecting poultry meat consumption status and consumption habits of students from Faculty of Veterinary Medicine

Bu araştırma, Burdur, Konya ve Elazığ illerinde yer alan üniversitelerin veteriner fakültelerinde eğitim görmekte olan farklı sınıflardaki öğrencilerin kanatlı eti tüketim düzeylerine etkili olan faktörlerin güncel olarak ortaya konması amacıyla yapılmıştır. Araştırmanın materyalini, 2018-2019 eğitim-öğretim yılı içerisinde üç farklı fakültede toplamda 242 öğrenci ile yapılmış olan anketlerden elde edilen veriler oluşturmaktadır. Elde edilen veriler SPPS programı ile analiz edilmiştir. Araştırma sonucunda; öğrencilerin %51,7’sinin aylık bireysel gıda harcama tutarının 250 TL altında olduğu belirlenmiştir. Yine bu öğrencilerin bireysel gıda harcamaları içerisinde hayvansal gıda harcama tutarlarının 100 TL ve altında olanların oranı ise %59,1 olarak bulunmuştur. Öğrencilerin aylık kanatlı eti tüketim oranları incelendiğinde; hiç tüketmeyenlerin oranı %5,8, 500 gr’dan az tüketenlerin oranı %31 ve 500-999gr arası tüketenlerin oranı ise %37,2 düzeyinde tespit edilmiştir. Ankete katılan öğrencilerin aylık ortalama 1,1 kg kanatlı eti tükettikleri belirlenmiştir. Öğrencilerin eğitim gördükleri şehir, sınıf düzeyi ve barınma durumları ile kanatlı eti tüketim miktarı arasında istatistiki olarak anlamlı bir ilişkinin olmadığı belirlenmiştir. Nitekim, cinsiyet, gelir düzeyi, gıda maddelerine ayrılan aylık bütçe ile hayvansal gıdalara ayrılan aylık bütçe miktarı arasında istatistiki olarak anlamlı bir ilişkinin olduğu belirlenmiştir.This research was carried out to in Burdur, Elazığ and Konya provinces in order to evaluate the factors affecting the poultry meat consumption status and consumption habits of students belonging to different classes of veterinary faculties. The material of the study was obtained from surveys conducted with 242 students in three different faculties during the academic year 2018-2019. The data were analyzed by SPPS. According to the results of the research; It has been determined that 51.7% of the students are under 250 TL of the monthly individual food expenditure. The ratio of animal food expenditures in individual food expenditures of those students to be 100 TL and below is determined as 59.1%. When the monthly poultry meat consumption rates of the students are examined; The rate of those who did not consume was 5.8%, the rate of those consuming less than 500 gr and 31% of those consuming 500-999gr was determined as 37.2%. It was determined that the students who participated in the survey consumed 1.1 kg of poultry meat per month. It was determined that there was no statistically significant relationship between the poultry meat consumption and the city, class level and shelter status of the students. In fact, a statistically significant relationship was found between the gender, income level, monthly budget for food and amount of monthly budget allocated to animal food

Assessment of Serotonin Metabolite 5-hydroxyindoleacetic Acid Levels in Urine Sample for Diagnosis and Treatment Efficacy in Children with Dysfunctional Voiding and Their Interaction with Biofeedback Therapy

Objective:Dysfunctional voiding (DV), which is explained as an incoordination between the external urethral sphincter and the bladder, is a situation developing in neurologically normal children. Serotonin has some effects on the lower urinary tract which cannot be fully explained. The selective 5-hydroxyindoleacetic acid (5-HIAA) agonist improves voiding efficacy in the rat model with voiding dysfunction as serotonin. Serotonin decomposes to 5-HIAA which excreted from urine. We considered that a problem in neuromodulator levels can lead to DV and evaluated the levels of 5-HIAA in urine.Materials and Methods:Our study included 130 children aged 5-15 years who were diagnosed with DV and 48 children with no urological complaints as controls. Urine samples were taken only once in control group, and 3 times [before and after the biofeedback treatment (sixth month and twelfth month)] in the study group to determine the difference and the interaction between 5-HIAA and biofeedback therapy.Results:Biofeedback therapy was found to be an effective method in the treatment of DV. However, there was no significant difference in the level of mean urine 5-HIAA/creatinine (u5-HIAA/Cr) between study (6.139±3.652) and control groups (6.374±4.329) (p=0.751). The mean u5-HIAA/Cr levels in the DV group at baseline and at the end of biofeedback therapy (6th month) were 6.249±4.132 and 6.19±4.715, respectively (p=0.951). The mean u5-HIAA/Cr levels in the DV group at baseline and at 12 months were 5.901±3.291 and 6.644±4.206, respectively (p=0.557). There was no significant difference in u5-HIAA/Cr levels between pre-treatment and post-treatment in the DV group.Conclusion:We still do not know if a problem at the level of neurotransmitter metabolite in the central nervous system plays a role in the etiology of DV. We evaluated this relationship, but we could not find a significant result. New studies are needed to get more information about the role of neuromodulators in the etiology and treatment of DV

Methods for conducting international Delphi surveys to optimise global participation in core outcome set development: a case study in gastric cancer informed by a comprehensive literature review

Copyright © 2021, The Author(s) Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: Core outcome sets (COS) should be relevant to key stakeholders and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to be conducted in a single language potentially excluding those not fluent in that tongue. The aim of this study is to summarise current approaches for optimising international participation in Delphi studies and make recommendations for future practice. Methods: A comprehensive literature review of current approaches to translating Delphi surveys for COS development was undertaken. A standardised methodology adapted from international guidance derived from 12 major sets of translation guidelines in the field of outcome reporting was developed. As a case study, this was applied to a COS project for surgical trials in gastric cancer to translate a Delphi survey into 7 target languages from regions active in gastric cancer research. Results: Three hundred thirty-two abstracts were screened and four studies addressing COS development in rheumatoid and osteoarthritis, vascular malformations and polypharmacy were eligible for inclusion. There was wide variation in methodological approaches to translation, including the number of forward translations, the inclusion of back translation, the employment of cognitive debriefing and how discrepancies and disagreements were handled. Important considerations were identified during the development of the gastric cancer survey including establishing translation groups, timelines, understanding financial implications, strategies to maximise recruitment and regulatory approvals. The methodological approach to translating the Delphi surveys was easily reproducible by local collaborators and resulted in an additional 637 participants to the 315 recruited to complete the source language survey. Ninety-nine per cent of patients and 97% of healthcare professionals from non-English-speaking regions used translated surveys. Conclusion: Consideration of the issues described will improve planning by other COS developers and can be used to widen international participation from both patients and healthcare professionals.This study is funded by the National Institute for Health Research (NIHR) Doctoral Research Fellowship Grant (DRF-2015-08-023). JMB is partially funded by the NIHR Bristol Biomedical Research Centre and the MRC ConDUCT-II Hub for Trials Methodology Research. PRW was funded by the MRC North West Hub for Trials Methodology Research (Grant ref: MR/K025635/01).info:eu-repo/semantics/publishedVersio

Serqual Analysis Methods to Examine The Quality Of Insurance Services Of The Bank

Firmaların rekabette öne geçmelerini sağlayan en önemli etken ürün ve hizmetlerinin kaliteli olmasıdır. Ayrıca firmaların varlığını devam ettirebilmesi için ürün ve hizmetlerinin iyileştirilmesi ve geliştirilmesi zorunludur. Hizmet alınan ürün fiziki bir ürünse kalitesinin ölçülmesi nispeten kolaydır. Kalite ölçülürken, istenilen özelliklere bakılarak kalite hakkında fikir sahibi olunabilir. Ancak hizmet ürünlerinin fiziki ürünlerden farklı olarak soyut, değişken, stoklanamaz oluşu hizmet kalitesi ölçümünü zorlaştırmaktadır. Hizmet ürünlerinde kaliteyi belirleyen önemli unsurlardan bir tanesi müşterilerin beklenti ve algılarıdır. Hizmet sektörü içerisinde yer alan bankalar için de en önemli olan hususlardan birisi müşteri beklentilerini karşılamaktır. Bu beklentiler karşılanırken de, müşterinin bu hizmetten algıladığı kalitenin boyutu ön plana çıkmaktadır. Hizmet kalitesinin ölçümünde bilinen en yaygın ve en çok kabul görerek kullanılan model SERVQUAL modelidir. Bu model aynı zamanda, anlaşılması, uygulanması ve yorumlanması en kolay olan yöntemlerden biridir. Bankalar sigortacılık hizmet sektörünün dağıtım araçları içerisinde, verdikleri yaygın hizmet sebebiyle önemli bir yere sahiptir. Günümüzde gelişen rekabet ortamında kalite, mal ve hizmet üreten işletmeler için stratejik bir araç haline gelmiştir. Bir işletmenin rekabet avantajı sağlayacağı en geçerli yol, rakiplerden daha kaliteli hizmet üretmek ya da müşterilerin beklentilerine en iyi şekilde cevap verebilmektir. Bu çalışmada, bankanın sigortacılık hizmetinden yararlanan bir müşterinin hizmeti almadan önceki beklentisi ile hizmeti aldıktan sonraki algısı arasındaki farka göre hizmet kalite düzeyi SERVQUAL Analizi yöntemiyle belirlenmiştir. Türkiye'de bankalar aracılığıyla sunulan sigorta hizmet kalitesinin ölçülerek banka sigortacılığının geliştirilmesine katkı sağlanarak, banka sigortacılığı uygulayıcılarına yönelik keşifsel bir araştırma yapılmıştır.The most important factor which provides advantage to companies in the competative environment is the quality of their products and services. Moreover, it is essential for companies to develop and improve the quality of their products and services inorder to sustain their businesses. It is relatively easier to measure the quality of a product if it is a physical product. While measuring quality, it is possible to gain a perception related to the quality of the product by looking at certain properties of the product. However, different from physical products, the properties of service products, which are intangible, varied, and unstorable, make it harder to measure the quality of a service product. One of the vital elements which determines the quality of service products is customers expectaions and perceptions. It is essential for banks that are in the service csector to meet clients' expectations, too. While meeting these expectations, the client's perception of quality level gains priority. The most known and commonly accepted and applied model for measuring the quality of service sector is SERVQUAL model. This model, at same time, is the easest to comprehend, apply and interpret. Because of the fact that banks provide widespread service in the distribution tools of the insurance business, they have an important position in the service sector. Today, in the increasing competative environmet, quality has become a strategic tool for companies who produce products and services. The most efficent way in which a company could provide competative advantage is to produce higher quality service than its rivals or meet the expectations of its customers in the best way. In this study, the service quality level of a customer who receives an insurance service from a bank is determined with the comparison of the client's expectation before he or she receives the service and his or her perception after he or she recieves the service with the use of SERVQUAL Analysis method. By measuring the quality of insurance service provided by the banks and contributing to the the development of bank insurance, a heuristic research related to bank insurance performers was conducted

Evaluation of healthcare workers first vaccinated with COVID-19 vaccine in Northwest Syria Observations of vaccine side effects in emergency departments

Aim In this study, we investigated the adverse effects of the COVID-19 vaccine administered to health workers in northwestern Syria. Materials and Methods The study retrospectively analyzed data from 260 health care workers who received the first dose of COVID-19 vaccine between May 1, 2021, and June 30, 2021, in the northwestern Syria region by searching the Syrian Immunization Group database (SIG) and patient records from hospital or health center emergency departments. Results The mean age of health care personnel was 35.86∓8.03 years, and 9.6% were women. Of those who participated in the study, 5.8% had comorbid diseases. 109 (42.1%) were vaccinated in hospital emergency departments and 151 (57.9%) in health center emergency departments. It was found that 63.5% (n=165) of those vaccinated experienced adverse reactions to the Oxford/AstraZeneca vaccine. The most common adverse reactions to the vaccine were fever in 128 individuals (49%), fatigue in 89 individuals (55.6%), headache in 54 individuals (20.8%), weakness in 53 individuals (20.4%), joint pain in 50 individuals (19.2%), injection site pain in 47 individuals (18.1%), and muscle pain in 33 individuals (12.7%). The side effects noted were classified as severe, moderate, and mild. Of these, fever 15.4% (n=40), fatigue 11.9% (n=31), and headache 9.6% (n=25) were the most common severe side effects. It was found that 14 (5.4%) individuals required hospitalization and medical treatment due to adverse reactions to the vaccine. When evaluating the side effects observed in hospitalized patients, the most common side effects were fever, chills, muscle pain, joint pain, fatigue, and weakness. Conclusion It was concluded that the Oxford/AstraZeneca vaccine administered to health care workers in northwestern Syria had no fatal side effects and that fewer side effects were generally observed in this study compared with the literature. Research on side effects through independent studies will help address global and regional concerns about vaccines

Effect of preparation design on the fracture resistance and fracture patterns of 3D printed one-piece endodontic crowns.

STATEMENT OF PROBLEM The impact of various preparation designs on the fracture resistance and fracture type of mandibular premolars restored with 3 dimensionally (3D) printed, 1-piece endodontic crowns remains unclear. PURPOSE The purpose of this study was to investigate the effect of different preparation designs on the fracture resistance and fracture patterns of mandibular premolars restored with 3D printed 1-piece endodontic crowns after thermal aging. MATERIAL AND METHODS Forty-five freshly extracted mandibular premolars received 3 different preparation designs: with at least 2 intact cuspal walls (2CW), with only 1 intact cuspal wall (1CW), and no cuspal wall present (NoCW). One-piece endodontic crowns were designed by using a computer-aided design (CAD) software program, 3D printed, cemented to the prepared teeth with self-adhesive resin cement, and thermocycled between 5 °C and 55 °C in artificial saliva. Subsequently, all specimens were subjected to a fracture test. The results were statistically analyzed using 1-way ANOVA (α=.05), and fracture types of all specimens were examined using a light microscope. RESULTS The analysis of fracture resistance values across separate designs revealed no statistically significant differences (P>.05). Mean fracture resistance values were 724.5 N in 2CW, 713 N in 1CW, and 861 N in NoCW. In 2CW and 1CW, the 1-piece endodontic crowns mostly displayed Type III fractures, whereas those in NoCW exhibited a combination of Type II and Type III fractures. CONCLUSIONS The mandibular premolar 1-piece endodontic crowns tested in this study exhibited similar fracture resistance and type of fracture with different preparation designs