The dependence of health insurance availability on years left before Medicare

We study the dependence of health insurance availability of near-elderly inpatients in the United States with respect to their ages. We show that the likelihood that near-elderly inpatients are uninsured continuously declines until the early ages of 60 but the trend is reversed for the last few years preceding Medicare coverage. In addition, compared to those covered by Medicaid or private insurance, the uninsured patients are more likely to be admitted into hospitals as emergency cases.Health insurance; Medicare

The efficacy of active warming in preventing unplanned hypothermia during perioperative period in pediatric surgery patients in a tertiary care center

Aim: To investigate the effects of using the active warming method on children with hypothermia in the perioperative period and examining the effects of hypothermia on awakening time, pain, shivering and hospital stay. Methods: This study included patients 18 years of age and younger who underwent surgery in the pediatric surgery department of a tertiary hospital. The active warming group consisted of 28 patients and the control group consisted of 29 patients. The first group of patients was actively warmed during the surgery and the second group was treated as the control group and did not actively receive any warming therapy. Preoperative body temperatures of the cases were measured. In addition, body temperatures were recorded every 15 minutes in the intraoperative and postoperative periods. Results: There was no statistically significant difference in preoperative body temperature between the control group and the active warming group. When body temperature were examined in the intraoperative period, there was no significant difference between the groups at the first 15 minutes of operation; however, the mean of the body temperature in active warming group was significantly higher than the control group at the 30th, 45th , and 60th minutes of operation. It was determined that patients in the control group had a longer stay in the hospital and the amount of time for waking at the end of the anesthesia was shorter in the active heating group than in the control group. Conclusions: The results of our study suggest that active heating with a carbon fiber resistant system is an effective method to prevent unplanned hypothermia in operated children

Granulocyte-macrophage colony-stimulating factor (GM-CSF) in subjects with different stages of periodontitis according to the new classification

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a multifunctional cytokine that regulates inflammatory responses in various autoimmune and inflammatory disorders. Objective: The purpose of this study was to analyze the gingival crevicular fluid (GCF) for GM-CSF, interleukin-1 beta (IL-1β), and macrophage inflammatory protein-1 alpha (MIP-1α) levels in patients with stage I, stage II, stage III, and stage IV periodontitis (SI-P, SII-P, SIII-P, and SIV-P). Methodology: A total of 126 individuals were recruited for this study, including 21 periodontal healthy (PH), 21 gingivitis (G), 21 SI-P, 21 SII-P, 21 SIII-P, and 21 SIV-P patients. Plaque index (PI), gingival index (GI), presence of bleeding on probing (BOP), probing depth (PD), and attachment loss (AL) were used during the clinical periodontal assessment. GCF samples were obtained and analyzed by an enzyme-linked immunosorbent assay (ELISA). Results: GCF GM-CSF, MIP-1α, and IL-1β were significantly higher in SII-P and SIII-P groups than in PH, G, and SI-P groups (p<0.05). There was no significant difference among the PH, G, and SI-P groups in IL-1β, GM-CSF, and MIP-1α levels (p>0.05). Conclusions: These results show that GM-CSF expression was increased in SII-P, SIII-P, and SIV-P. Furthermore, GM-CSF levels may have some potential to discriminate between early and advanced stages of periodontitis

Tissue Levels of CD80, CD163 and CD206 and Their Ratios in Periodontal and Peri-Implant Health and Disease

This study aimed to compare tissue levels of CD80 (pro-inflammatory macrophage-related surface marker), CD163, and CD206 (anti-inflammatory macrophage-related surface markers), and their ratios in periodontal and peri-implant health and disease. Altogether, 36 tissue samples were obtained from 36 participants with clinically healthy gingiva (n = 10), healthy peri-implant mucosa (n = 8), periodontitis lesions (n = 9), and peri-implantitis lesions (n = 9). CD80, CD163, and CD206 levels were assessed with immunoblotting. CD163 levels were found to be decreased (p = 0.004), and the CD80/CD163 ratio was found to be elevated (p = 0.002) in periodontitis lesions compared to healthy gingiva. Peri-implantitis lesions showed a tendency towards a higher CD80/CD163 ratio than in healthy peri-implant mucosa with a borderline difference (p = 0.054). No statistically significant difference was detected in CD80, CD163, and CD206 levels of periodontitis lesions when compared to peri-implantitis, and in healthy gingiva when compared to healthy peri-implant mucosa. A disruption in CD80/CD163 balance seems to be related to the pathogenesis of periodontitis and peri-implantitis, being less prominent in the latter. The reason behind this phenomenon may be either suppressed CD163 expression or reduced CD163+ anti-inflammatory macrophage abundance. </p

Clinical significance of NCOA5 gene rs2903908 polymorphism in Behçet`s disease

Behçet’s disease (BD) is an autoimmune multisystemic disease. The precise etiology of BD is not fully understood; however, it is thought that interactions between genetic and environmental factors play an essential role in its pathogenesis. The nuclear receptor coactivator-5 (NCOA5) gene encodes a coregulator for nuclear receptor sub- family 1 group D member 2 (NR1D2) and estrogen receptor 1 and 2 (ESR1 and ESR2). Also, the NCOA5 gene insufficiency leads to an elevated expression of IL-6, and increased levels of IL-6 were found to be related to the pathogenesis of BD. In this study, we aimed to clarify the impact of the NCOA5 rs2903908 polymorphism on susceptibility and clinical findings of BD. This study included 671 participants (300 BD patients and 371 healthy controls). The analyses of NCOA5 rs2903908 polymorphism was performed by using the TaqMan allelic discrim- ination assay. The frequency of TT genotype of the NCOA5 rs2903908 polymorphism was found significantly higher in BD patients compared to those in healthy controls (p=0.016, OR=1.46, 95 % CI=1.08–1.99). Also, the frequencies of CT genotype was observed significantly higher in BD patients with genital ulceration and uveitis than without genital ulceration and uveitis (p=0.002 and p=0.005, respectively). The most significant association was found between C allele frequencies of BD patients with and without uveitis (p=0.0001). Our study represents e first time that the NCOA5 rs2903908 polymorphism seemed to be linked to BD susceptibility and clinical findings

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The Relationship between Melatonin and Cannabinoid-1 Receptor in Cortical Dysplasia Generated Rats

WOS: 000343369600016Objectives: Cortical dysplasia is a developmental malformation that occurs as a result of defects in neuronal proliferation, migration and organization during the formation of brain cortex layers. Cannabinoid-1 Receptor (CB1R) plays a role in brain cortex development. Melatonin neuroprotective is an agent. In this study using an experimental cortical dysplasia model, CB1R expression and the effect of melatonin on CB1R were investigated. Methods: Eighteen female Wistar albino rats were randomly divided into three groups (n=6). A single dose of intraperitoneal (i.p) saline (20 ml/kg) was administered in the 15th day of pregnancy in the rats group 1 (sham group). A single dose of i.p BCNU (20 mg/kg) was administered in the 15th day of pregnancy in the rats in group 2 (BCNU) and group 3 (BCNU+ Melatonin). In addition, i.p melatonin (10 mg/kg) starting on day 15 of pregnancy and continuing until the day of delivery were administered to the rats in group 3 (BCNU+ Melatonin). Newborn brain sections were investigated using Luxol fast blue and anti-CB1R staining. Results: While the sham group had cerebral cortex stratification compatible with the normal newborn histology, it was observed that the stratification was disrupted in the group 2 and group 3. In the observed brain regions (cerebral cortex, cerebellar cortex and hippocampus), it was observed that CB1R immunoreactivity decreased in group 2 and 3. Conclusion: In an experimental cortical dysplasia model, it was seen that the administration of melatonin revealed a protective effect against the decrease in CB1R expression. It has been suggested that a decrease in CB1R expression would also play a role in cortical dysplasia formation mechanisms

Growth, Survival and Fatty Acid Composition of Freshwater Crayfish (Astacus leptodactylus) Juveniles Fed Enriched Daphnia magna as an Alternative to Artemia

This experiment was conducted to investigate the effects Daphnia magna enriched with lipid emulsions as an alternative to Artemia, on growth, survival rate, and fatty acid composition of freshwater crayfish (Astacus leptodactylus Esch. 1823). The four treatment groups were (a) unenriched Artemia (UEA), (b) unenriched D. magna (UED), (c) D. magna enriched with redpepper emulsion (DER), and (d) D. magna enriched with anchovy oil emulsion (DEA). All tests were carried out in triplicate for 30 days. The crayfish (mean weight 0.12g) were fed ad libitum once daily. At the end of experiment, the highest eicosapentaenoic acid, 20:5n-3 (EPA) level was found in the DEA group (5.77%). The highest DHA (docosahexaenoic acid, 22:6n-3) level was found in the DER group (2.73%) which was statistically similar to the DEA group. In addition, high n-3 HUFA (high unsaturated fatty acid) levels were detected in enriched D. magna groups with emulsions. However, high EPA levels in enriched D. magna groups with emulsions were not reflected in crayfish tissues, but DHA level was reflected in crayfish tissues fed with anchovy oil emulsion. The crayfish fed with D. magna showed similar growth to that of the Artemia fed groups. The growth of the enriched D. magna groups did not differ

Knowledge, attitudes and behaviors of Inonu University faculty members regarding childhood vaccine refusal

Introduction Although there is a lot of scientific evidence that the benefits of vaccines outweigh their risks, hesitancy about the safety of vaccines can occur in every segment of the community. In this study, we aimed to determine the knowledge, attitudes, and associated factors of vaccine hesitancy among Inonu University faculty members regarding childhood vaccinations. Method This is a cross-sectional study, and 258 faculty members were included in the study. The questionnaire used in the study explored the sociodemographic characteristics of the faculty members and their knowledge, attitudes and behaviors regarding childhood vaccination. A chi-square test and a fisher exact test were used for statistical analysis. Results Of the faculty members, 31.8% were hesitant about childhood vaccines, 51.9% stated that there were studies reporting the side effects of vaccines, 48.1% did not agree with giving booster doses of vaccines, 35.7% stated that vaccines could cause autism due to the chemicals contained in the vaccines. The most important information sources of university faculty regarding childhood vaccines members are scientific publications and health professionals. Conclusions Faculty members level of hesitancy about vaccines was high and since health professionals and scientific articles are the most important information sources of faculty members, misinformation here may affect their knowledge, attitudes and behaviors about vaccination

Knowledge and behaviors of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal

Among 10 global problems of 2019 determined by the World Health Organization, vaccine refusal was one of the problems mentioned. In this context, health services and health personnel whose main objectives are to keep individuals healthy and to prevent diseases have major responsibilities. This study aims to analyze knowledge and behavior of nurses working at Inonu University Turgut Ozal Medical Center on childhood vaccine refusal. This study, conducted between June and July 2019, is a descriptive cross-sectional study. It was conducted in a hospital located in Malatya in eastern Turkey. At the time of the study, 850 nurses work in this hospital. Sample size was calculated to be 263 at a confidence interval of 95% and strength of 80%. Chi-square test and Fisher’s exact test were used in statistical analyses. In the present study, 31.7% of the participating nurses stated that they had concerns about childhood vaccines. Two-thirds of nurses stated that their knowledge on vaccines was from their education. The level of hesitance in those agreeing to the fact that vaccines caused autism and infertility, those stating that they did not trust vaccine-producing companies, and those stating that catching the disease was a better immunization method than vaccination was significantly higher than those not agreeing to these and those who were indecisive (p < .05). One-third of nurses was proven to have hesitance on childhood vaccines, and this rate is rather high. Nurses, being both health personnel and the communication channel for guiding parents, should be provided necessary training and practices in order to ease their hesitance on vaccination