Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Health screening: a survey of children's growth and development in Turkey.

To determine the status of children's growth and development, visual acuity and blood pressure at four to six years of age. This descriptive study included 447 children enrolled in kindergartens in Turkey. Height, weight, developmental level, visual acuity and blood pressure of each child were assessed. Most children were in the normal ranges for height and weight. Application of the Denver II Developmental Test revealed no children in the abnormal category. The authors identified 66 children (14.8 per cent) with visual acuity problems. Five children (1.1 per cent) had systolic blood pressures above the recommended value for their age. A preschool screening programme is needed when children begin education, either kindergarten or primary school

Fontibacillus pullulanilyticus sp nov isolated from soil

WOS: 000383677500002PubMed ID: 27112372Gram stain-negative, motile, catalase-, and oxidase-positive strain, designated DSHK107T was isolated from soil of Cukurova University campus in Adana, Turkey. Its taxonomy was investigated using a polyphasic approach. The strain grew at 20-42 degrees C (optimum, 30 degrees C), at pH 6.0-9.0 (optimum, pH 7.0) and in 0-2.0% NaCl (w/v). 16S rRNA gene sequence analysis revealed that the strain belonged to the genus Fontibacillus; strain DSHK107T showed highest sequence similarity to type strains Fontibacillus aquaticus GPTSA 19T (97.8%) and Fontibacillus panacisegetis P11-6T (97.0%). The major fatty acid of strain DSHK107T was anteiso-C15: 0 (46.7). The polar lipids of strain DSHK107T consisted of dihosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, four unknown phospholipids, four unknown lipids, three unknown glycolipids, two unknown aminophospholipids, an unknown aminolipid, and an unknown aminophosphoglycolipid. The major isoprenoid quinone was MK-7. The DNA G_C content of DSHK107T was 42.1 mol%. DNA-DNA hybridization showed that the strain DSHK107T shared low DNA-DNA relatedness with F. aquaticus DSM 17643T, Fontibacillus solani A4STRO4T, and F. panacisegetis DSM 28129T (47, 58, and 59.3%, respectively). Thus, our results support the placement of strain DSHK107T within a separate and previously unrecognized species. On the basis of a taxonomic study using a polyphasic approach, strain DSHK107T is considered to represent a novel species of the genus Fontibacillus, for which the name Fontibacillus pullulanilyticus sp. nov. is proposed. The type strain is DSHK107T (=NCCB 100560(T)=DSM 100116T).Karadeniz Technical UniversityKaradeniz Teknik University [KTU BAP FBB-2015-5165]This study was supported by Karadeniz Technical University (KTU BAP FBB-2015-5165). We thank Prof. Dr. Fikrettin Sahin (Yeditepe University) for fatty acid analyses. Also we thank Dr. Alvaro Peix (Universidad de Salamanca-IRNA-SACSIC) for providing Fontibacillus solani A4STR04T

Development Of Ion-Imprinted Cryogels For Selective Removal Of Arsenic From Environmental Waters

Arsenic present by nature as metalloid, having transportability in the environment via diverse sources. Because of both natural processes and anthropogenic activities, arsenic is found in environmental water sources. The aim of this study is to design ion-imprinting-based cryogel adsorbents for the removal of arsenic species from environmental waters. Since trivalent arsenic exhibit a high afgfinity for sulfhydryl groups, cysteine-based functional monomer, i.e. MAC, was synthesized and MAC-As(III) complex was prepared. Ion-imprinted polymeric adsorbents were fabricated via cryopolymerization. Elemental analysis studies have shown that the cryogel monolith contains 192.8 mu mol/g mol MAC/g polymer. The maximum adsorption capacity of ion-imprinted cryogels at an initial arsenic concentration of 10 ppm was found to be 372.5 mu g/g at pH 8.0. Arsenic removal rate of the imprinted cryogels from environmental water sample was determined as 94.8% In the studies carried out for the removal of arsenic from the environmental waters, 94.8% removal efficiency was achieved. Reusability assays of ion-imprinted cryogels were performed and there was no significant decrease in adsorption capacity.WoSScopu

Meta Analysis of Studies about Breast Self Examination between 2000-2009 in Turkey

Aim: The aim of this study was to analyze studies in Turkey about self-breast examination and produce conclusive, reliable and detailed basis for future studies. Methods: Studies performed between 2000 and 2009 (until the end of September) were retrieved from databases using breast cancer, breast examination, breast cancer screening and risk factors as key words. Fifty-nine studies were identified and 18 of them (15 journal articles and three theses) were used for the meta-analysis. Results: Married women and women with a family history of breast cancer were found to perform self-breast examination more frequently than single women and women without a family history of breast cancer, respectively (OR=1.02 %CI 0.82-1.63; OR=1.16 %CI 0.82-1.63). According to the health belief model scales, women performing self-breast examination were determined to have 1.7 times higher susceptibility (OR=1.70), 1.34 times higher seriousness perception (OR=1.34), 3.32 times higher health motivation (OR=3.32), 5.21 times more self-efficacy/confidence (OR=5.21) and 2.56 times higher self-breast examination benefit perception (OR=2.56). Conclusion: Nursing care models caused an increase in self-breast examination by women, and thus, it may be useful to organize and evaluate such health-related programs and consider women health perceptions

TC and MF leaves as natural alternatives

With increasing interest in bio-functional properties of foods, particularly meat-derived bioactive peptides, as well as the plant-derived phytochemicals on lifestyle-related diseases, a common research field has been expanded in recent years. The aim of this research was to examine how the addition of culinary plants known as Thymus capitatus [TC] and Micromeria fruticosa [MF], may enhance the biological and physicochemical properties of beef burgers. Fine powders of TC and MF dried leaves were mixed with burgers [1.5 and 3% {w/w}], then the samples were stored separately at 4 degrees C/7 days and -18 degrees C/40 days. Data suggested the occurrence of protein-polyphenol polymerization [PPP] was obvious in beef burgers treated with TC and MF causing a remarkable reduction in the protein solubility. SDS-PAGE data showed that sarcoplasmic proteins were affected more than the myofibrillar proteins, especially the samples stored at 4 degrees C. IC50 values of the antihypertensive activities in the herb-treated burgers were significantly higher than the control group. However, hydrolysates of TC- and MF-treated burgers exhibited statistical higher antioxidant capacities than the baseline and control samples. Findings of the current study indicate that the utilization of TC and MF leaves in the meat industry could be regarded as a natural and healthy alternative to synthetic antioxidant preservatives, as well as a nutraceutical compound for various uses

Antitumoral effects of <i>Salvia absconditiflora</i> Greuter & Burdet <span style="font-size:8.0pt;mso-bidi-font-size:11.0pt" lang="EN-US">syn. <i>Salvia cryptantha</i> Montbret & Aucher ex Benth. on Breast cancer </span>

390-397This work aims to investigate the antiproliferative properties of Salvia cryptantha on breast cancer. Salvia cryptantha (SC) extracts were studied for cytotoxicity against the breast cancer cell lines. In-vitro apoptosis studies of breast cancer cells were performed by nnexin V staining in flow cytometry analyses. Immunohistochemistry studies for Ki-67 and p16 in the tumoral tissue sections of Dimethyl Benzanthracene (DMBA) induced mammary tumor in rats were performed. In-vivo anticancer activity testing was carried out by inhibiting the growth of mammary tumor in rats. SC showed cytotoxicity to three cancer cell lines. Annexin-positive cells level in SC treated cell lines were higher than the untreated control cells. The expression of the Ki-67 decreased in treatment groups compared with the control group. The expression of p16 protein was much higher for the rats treated by SC, compared with the untreated control group. In vivo studies showed that mean tumor volume inhibition ratio in SC treated group was 38 % compared with the untreated rats. These results indicate that Salvia cryptantha has antitumoral potential against breast cancer. </span

Cytotoxic lesions of the corpus callosum in children: Etiology, clinical and radiological features, and prognosis

Objectives: Cytotoxic lesions of the corpus callosum (CLOCCs) are secondary lesions associated with entities like infection manifested by restricted diffusion on diffusion-weighted cranial magnetic resonance imaging. Our objectives are to evaluate the clinic-radiological spectrum of pediatric patients with cytotoxic lesions of the corpus callosum (CC). Methods: Children (0-18 years) admitted between February 2017 and May 2020 with splenial lesions showing diffusion restriction on MRI, either isolated or within involvement of other parts of the brain, were included retrospectively. The primary lesions of the CC (e.g. acute disseminated encephalomyelitis, acute ischemic infarction, and glioblastoma multiforme) were excluded. CLOCCs were divided into infection-associated, metabolic disorder-associated, and trauma-associated lesions, as well as CLOCCs involving other entities. Data were collected from the medical databases. Results: Forty-one patients were determined to have CLOCCs. Twenty-five (61%) were infection-associated, nine (22%) were trauma-associated, and three (7%) were metabolic disorder-associated cases, including 2 inherited disorders of metabolism. There were four (10%) patients with other entities, three with epilepsy, and one had an apparent life-threatening event. Six patients had a known etiology among the infection-associated group; one had multisystem inflammatory syndrome caused by COVID-19 and one had been infected by COVID-19 without any complications. All the infection-associated patients with isolated splenial lesions recovered totally, although six patients required intensive care hospitalization. Four trauma-associated patients had sequela lesions. Conclusions: CLOCCs are associated with a spectrum of diseases, including the new coronavirus, COVID-19 infection. Infection associated CLOCCs has the best prognosis, although severe cases may occur. Sequelae are possible based on the etiology. (C) 2021 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved

Cerebral Venous Sinus Thrombosis as a Rare Complication of Systemic Lupus Erythematosus: Subgroup Analysis of the VENOST Study

Kozak, Hasan Huseyin/0000-0001-6904-8545; Sahin, Sevki/0000-0003-2016-9965; Batur Caglayan, Hale/0000-0002-3279-1842; GUNES, TASKIN/0000-0002-9343-0573; Afsar, Nazire/0000-0001-8123-8560; Uzuner, Nevzat/0000-0002-4961-4332WOS: 000498868800011PubMed: 31562041Aim: Systemic lupus erythematosus (SLE) is an unusual risk factor for cerebral venous sinus thrombosis (CVST). As few CVST patients with SLE have been reported, little is known regarding its frequency as an underlying etiology, clinical characteristics, or long-term outcome. We evaluated a large cohort of CVST patients with SLE in a multicenter study of cerebral venous thrombosis, the VENOST study, and their clinical characteristics. Material and Method: Among the 1144 CVST patients in the VENOST cohort, patients diagnosed with SLE were studied. Their demographic and clinical characteristics, etiological risk factors, venous involvement status, and outcomes were recorded. Results: In total, 15 (1.31%) of 1144 CVST patients had SLE. The mean age of these patients was 39.9 +/- 12.1 years and 13 (86.7%) were female. Presenting symptoms included headache (73.3%), visual field defects (40.0%), and altered consciousness (26.7%). The main sinuses involved were the transverse (60.0%), sagittal (40.0%), and sigmoid (20.0%) sinuses. Parenchymal involvement was not seen in 73.3% of the patients. On the modified Rankin scale, 92.9% of the patients scored 0-1 at the 1-month follow-up and 90.9% scored 0-1 at the 1-year follow-up. Conclusions: SLE was found in 1.31% of the CVST patients, most frequently in young women. Headache was the most common symptom and the CVST onset was chronic in the majority of cases. The patient outcomes were favorable. CVST should be suspected in SLE patients, even in those with isolated chronic headache symptoms with or without other neurological findings