The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Self-care practices, patient education in women with breast cancer-related lymphedema

Objectives: This study aims to evaluate self-care practices, sociodemographic and clinical factors that affect self-care and patient education among women with breast cancer-related lymphedema (BCRL)

Effects of web-based concept mapping education on students' concept mapping and critical thinking skills: A double blind, randomized, controlled study

Background: Using concept maps in nurse education improves students' critical thinking skills. Offering web-based concept mapping education can increase motivation for learning in students actively using the Internet.Objectives: To examine the effects of web-based concept mapping education on nursing students' concept mapping and critical thinking skills.Design: This is a double-blind, randomized, controlled, experimental study.Settings: A nursing faculty at a state university in Turkey.Participants: Second-year nursing students taking the course surgical nursing in the spring term of the academic year of 2018/2019.Methods: The experimental group (n = 201) was offered web-based concept mapping education before starting practicums. Data were collected using a students' information form, concept map evaluation keys, and the Critical Thinking Motivational Scale at the end of the practicums. A structured questionnaire was used to reveal opinions of the students about concept mapping.Results: There was a significant difference in concept mapping scores between the students offered web-based concept mapping education (16.45 +/- 10.91) and those not receiving this education (12.70 +/- 9.31) (p=.000). Also, there was a significant difference in students' scores for the subscales of Critical Thinking Motivational Scale expectancy, attainment and utility between the groups. The students reported that concept maps facilitated their learning and management of nursing processes but that they occasionally experienced difficulty.Conclusion: It can be concluded that web-based concept mapping education improves concept mapping skills and motivation for critical thinking skills. Web-based education could be utilized as a tool to enhance nursing students' concept mapping and critical thinking skills

Effects of web-based concept mapping education on students' concept mapping and critical thinking skills: A double blind, randomized, controlled study

Background: Using concept maps in nurse education improves students' critical thinking skills. Offering web-based concept mapping education can increase motivation for learning in students actively using the Internet

Investigation of inadvertent hypothermia incidence and risk factors

Objective: This study was conducted to determine the incidence of inadvertent hypothermia in operative patients and the risk factors that are involved in the development of hypothermia