Is there a relationship between thyroid hormone levels and suicide attempt in adolescents?

Background: Thoughts about suicide are quite common in adolescent. While such thoughts can be caused by many reasons, the most wellknown of these are mood disorders. There are studies related to coexistence of thyroid pathologies and mood disorders in adult. Objectives: In this study, we aimed to investigate the difference of thyroid hormone levels in between adolescents with suicide attempt history and normal population. Methods: The study was prospective and was designed as a case-control study. Demographic characteristics of the patients were obtained and Serum fT3, fT4 and TSH levels were examined. Results: 222 cases were included in the study, including 101 cases and 121 controls. As for TSH levels, the mean serum levels of the whole group was 1.96 ± 1.08 mU/L, while the mean serum levels of the control group was 2.33 ± 1.5 mU/L and the mean serum levels of the case group was 0.50 ± 0.3 mU/L which revealed that the mean serum levels of the case group was significantly lower (p<0.01). Conclusion: It was found that serum TSH levels were significantly lower in case group than control group and the individuals with subclinical hyperthyroidism had more suicide attempts than the ones in control group

Molecular Epidemiology of Beta-Lactamases in Ceftazidime-Resistant Pseudomonas aeruginosa Isolates

Pseudomonas aeruginosa is an important opportunistic pathogen that cause mainly nosocomial infections especially in the immunocompromised patients, the elderly and patients with severe burns. The bacterial feature of developing high degree of resistance against several antibiotics leads to increased morbidity and mortality of P.aeruginosa infections. The aims of this study were to investigate the antibiotic susceptibilities of P.aeruginosa strains isolated from hospitalized patients and to determine the presence of resistance enzymes namely PER, GES, KPC, VIM, IMP and OXA. A total of 195 P.aeruginosa strains isolated from different clinical samples (29 sputum, 67 wound, 53 tracheal aspirate, 23 blood, 18 urine, 3 cerebrospinal fluid, 2 pleural fluid) of inpatients (134 male, 61 female) in Afyon Kocatepe University School of Medicine Hospital between 2010-2012, were included in the study. The isolates were identified by conventional methods and automated systems (VITEK 2, BioMerieux, France), and their antibiotic susceptibilities were detected by disk diffusion and E-test methods. Inducible beta-lactamase (IBL), extended-spectrum beta-lactamase (ESBL) and metallo-beta-lactamase (MBL) productions of the isolates were phenotypically investigated by double disk induction, double disk synergy and E-test methods, respectively. The presence of resistance genes encoding PER, GES, KPC, VIM, IMP and OXA enzymes were determined by real-time polymerase chain reaction, and sequence analysis was applied to positive samples. In our study, the antibiotic resistance rates of 195 P.aeruginosa strains were found as follows: ceftazidime 100%, tazobactam/piperacillin 90.8%, aztreonam 60.5%, cefepime 50.2%, imipenem 48.2%, meropenem 47.2%, ofloxacin 47.2%, piperacillin 44.1%, levofloxacin 31.3%, ciprofloxacin 26.2%, gentamicin 11.8%, amikacin 8.7% and tobramycin 6.2%. With the use of phenotypical methods, IBL, ESBL and MBL production rates in the isolates were detected as 89.2% (174/195), 30.7% (60/195) and 26.7% (52/195), respectively. Molecular studies showed that, five strains harboured OXA-10, four OXA-14, four VIM-2, two IMP-1, 26 GES-1 and 87 ABC transporter permease genes, while PER and KPC genes were not detected in any of the isolates. In conclusion, it was considered that the detection of beta-lactamase genes in bacteria and the identification of beta-lactamase types may provide facilities in selection of antibiotics, monitorization of therapy, prevention of resistance development of infection control programs

Comparison of bupivacaine alone and in a combination with lidocaine for caudal block in patients undergoing circumcision: A historical cohort study

Objective: Optimal analgesia following ambulatory surgery is an important matter in patient satisfaction, and it reduces unnecessary hospital admissions. This study investigated whether a caudal block with bupivacaine alone or in a combination with lidocaine can alter postoperative pain scores, complications, and peroperative and postoperative analgesic consumption

Endotracheal intubation practice from a pediatric emergency clinic of a tertiary hospital in Turkey

Aim: Airway management has primary importance to provide optimal ventilation and oxygenation in emergency services. Material and Methods: In the study, the resuscitation room records of patients aged 0-18 years in the pediatric emergency room of Healt Sciences University, Tepecik Education and Research Hospital between January 2017 and January 2020. We evaluated the patients who were admitted to the resuscitation room and underwent emergency or rapid sequential intubation. We compared the time elapsed from admission to the emergency room until the time of successful tracheal intubation in the resuscitation room.Results: The mean age of 111 patients in the study was 14.47 months (3.93-42.27), 65 (58.6%) of them were boys and 46 (41.1%) of them were girls. Nine (8.1%) patients were resuscitated outside the hospital and it continued in the resuscitation room. Successful tracheal intubation was achieved in 95 (85.5%) patients after the first attempt. Sedative or neuromuscular blocker agents were given to 71 (63.9%) patients before intubation and cardiopulmonary resuscitation was performed in only one of them. When the time elapsed from the time of admission until the patient was taken to the resuscitation room, vascular access was provided and successful intubation was achieved, there was no significant difference between working hours and out of working hours.Discussion: The intubation procedure, besides being a life-saving intervention, requires attention and care in terms of its risks and timing. It is very important to carry out the tracheal intubation procedure on time and the records should be kept properly and completely during the procedure

Parental Attitudes About Lumbar Puncture in Children With Suspected Central Nervous System Infection

Objectives This study aimed to evaluate parents' attitudes toward lumbar puncture (LP) for their children with suspected central nervous system infection to determine the reasons for rejection and related factors. Methods The survey was provided to parents of children (1 month to 18 years old) for whom LP was recommended because of a concern for central nervous system infection. Sociodemographic characteristics and other related factors of parents who did and did not approve of LP were compared statistically. The reasons for the disapproval of parents who refused LP were revealed. Results A total of 100 parents were included in the study. Eighty-two percent of the participating parents were mothers, and the median age of the mothers was 31 years (min: 17 years; max: 70 years). The median age of the fathers was 37 years (min: 22 years; max: 60 years). Among the parents, 34% did not give consent for LP. The most common reason for the participants to refuse LP was fear of paralysis of their children due to the procedure (82.3%). There was a statistical difference between the approval of the LP procedure and the person who informed the parents about the LP procedure and read the informed consent form (P = 0.004 and P = 0.038, respectively). As a result of the binary logistic regression analysis, it was seen that the rate of acceptance of the LP procedure by the parents informed by the specialist doctors was 7.1-fold (P = 0.02; 95% confidence interval, 1.3-37.6) higher than the parents informed by the resident physicians. Conclusion The informed consent process mainly influenced parents' attitudes toward LP. To increase the acceptance rates of LP, we should standardize the informed consent process so that it is not affected by factors such as seniority of the physician

Low disease activity state in juvenile-onset systemic lupus erythematosus

Objectives To determine the rate of achieving The Lupus Low Disease Activity State (LLDAS) in children with systemic lupus erythematosus (SLE) for tracing pertinent treatment modalities. Methods A total of 122 juvenile-onset SLE (jSLE) patients from six pediatric rheumatology centers in Turkey were enrolled in the study. LLDAS-50 was defined as encountering LLDAS for at least 50% of the observation time. According to the achievement of LLDAS-50, clinical features, immunological profiles, and treatments of patients with jSLE have been revealed. Results LLDAS of any duration was achieved by 82% of the cohort. Although only 10.8% of the patients achieved remission, 68.9% reached LLDAS-50. A significant difference was found between patients who reached LLDAS-50 and those who did not, in terms of the time to reach low-dose corticosteroid treatment (p = 0.002), the presence of subacute cutaneous findings (p = 0.007), and the presence of proteinuria (p = 0.002). Both of the groups were under similar treatment approaches. However, the number of patients being treated with corticosteroids at the last visit was found to be significantly higher in patients who achieved LLDAS-50 (p<0.001). Conclusion Targeting LLDAS in jSLE, even with long-term, low-dose corticosteroid use, seems to be an achievable goal in clinical practice

Whole slide histologic grading of breast cancer using convolutional neural networks.

Acibadem Maslak Hospital, Istanbul, Turkey; Virasoft, Istanbul,Turkey; Virasoft, Istanbul, Turkey; Acõbadem Medical Faculty, Istanbul, Turkey; Ozel Camlik Hospital,Istanbul, Turkey</p

Whole slide histologic grading of breast cancer using convolutional neural networks.

Acibadem Maslak Hospital, Istanbul, Turkey; Virasoft, Istanbul,Turkey; Virasoft, Istanbul, Turkey; Acõbadem Medical Faculty, Istanbul, Turkey; Ozel Camlik Hospital,Istanbul, Turkey</p