Does mean platelet volume and neutrophil to lymphocyte ratio increase in primary hyperparathyroidism arising from a single adenoma

Aim: Primary hyperparathyroidism (PHP) is commonly caused by adenomas. Studies have shown mild inflammation in PHP and elevated levels of some inflammatory markers to support this. In addition, excess parathyroid hormone (PTH) and calcium (Ca) cause atherosclerosis by disrupting endothelial function. Mean platelet volume (MPV) describes the size and indirect activity of platelets and its value is expected to increase with inflammation and associated atherosclerosis. Neutrophil to lymphocyte ratio (NLR) is another parameter associated with inflammatory response. This study was performed to investigate the MPV and NLR levels in PHP developing from a single parathyroid adenoma. Method: Patient records from 2016-2021 were retrospectively scanned from the computer system and 40 patients with PHP developing from a single parathyroid adenoma were selected based on exclusion criteria. The values of PTH, Ca, 25-Hydroxyvitamin D, phosphorus, MPV and number of blood cells were recorded. NLR was calculated. The results were compared with the results of 36 healthy controls. Results: MPV (8.7±0.6 fl and 7.6±0.6 fl, respectively; p=0.001) and NLR (2.6±1.7 and 1.7±0.8, respectively; p=0.000) were higher in the PHP group compared to the control group. Ca and PTH correlated positively with MPV (p=0.003 and p=0.000, respectively) and NLR (p=0.011 and p=0.023, respectively). Conclusion: MPV and NLR were found to be higher in patients with PHP developing from a single adenoma than in healthy individuals

Effects of Virtual Experiments Oriented Science Instruction on Students’ Achievement and Attitude

This study was conducted to identify the effects of virtual experiment technique on seventh grade students' electricity achievement and attitudes towards science laboratory. The subjects were 69 seventh grade students in two classes of the same teacher. Randomly assigned experimental group students received virtual experiments oriented instruction, whereas control group students performed physical experiments. Achievement test and attitude scales were given as pretests prior to instruction and as posttests after four weeks of instruction. Two separate covariance analysis were conducted in this study and both of them indicated statistical significant differences. In accordance with these significant results, it can be concluded that virtual experiments have a substantial role in education by providing safe medium and interactive genuine models for students. Therefore, it is suggested that virtual experiments can be used in different contexts and various steps of education whenever possibleThis study was conducted to identify the effects of virtual experiment technique on seventh grade students' electricity achievement and attitudes towards science laboratory. The subjects were 69 seventh grade students in two classes of the same teacher. Randomly assigned experimental group students received virtual experiments oriented instruction, whereas control group students performed physical experiments. Achievement test and attitude scales were given as pretests prior to instruction and as posttests after four weeks of instruction. Two separate covariance analysis were conducted in this study and both of them indicated statistical significant differences. In accordance with these significant results, it can be concluded that virtual experiments have a substantial role in education by providing safe medium and interactive genuine models for students. Therefore, it is suggested that virtual experiments can be used in different contexts and various steps of education whenever possible

New and Simple Approach for Preventing Postoperative Peritoneal Adhesions: Do not Touch the Peritoneum without Viscous Liquid—A Multivariate Analysis

Background. Postoperative peritoneal adhesions (PPAs) are an unsolved and serious problem in abdominal surgery. Method. Viscous liquids of soybean oil, octyl methoxycinnamate, flax oil, aloe vera gel, and glycerol were used in five experiments, using the same methodology for each. Liquids were applied in the peritoneal cavity before and after mechanical peritoneal trauma. Results were evaluated by multivariate analysis. Results. Compared with the control group, macroscopic and microscopic adhesion values before (P < .001) and after (P < .05) application of viscous liquids significantly reduced PPAs. Values were significantly lower when liquids were applied before rather than after peritoneal trauma (P < .0001). Discussion. Viscous liquids injected into the peritoneal cavity before or after mechanical peritoneal trauma decrease PPA. Injection before trauma was more effective than after trauma. In surgical practice, PPA formation may be prevented or decreased by covering the peritoneal cavity with an appropriate viscous liquid before abdominal surgery

Clinical Study Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients

Background. The aim of this study is to discuss the laparoscopic approach and assess the immunohistochemical expression profiles of synaptophysin, Ki-67, and inhibin and patient outcomes in adrenal masses through a series of cases treated at our institution. Method. The study was conducted on 58 patients who were diagnosed with adrenal masses. All cases were operated on laparoscopically for adrenal masses. Results. Both inhibin and synaptophysin were found positive in 45 patients (77,6%). Ki-67 was negative in 11 patients, whereas it was found positive in 42 with a rate of 1%. The size of the masses ranged from 1 up to 9 cm (mean 4,3 ± 1,5). Urine hormone excretion was measured within normal ranges in 47 out of 58 patients (81%). Most of the diagnosed patients were harboring Cortical Adenoma ( : 38; 65,5%). All of the masses were successfully resected without complication except 3 patients. Because of complications of bleeding, the operation was converted to open surgery for 2 patients. Conclusion. Morbidity, mortality, and healing were comparable, regardless of tumor size, yet involvement in both laparoscopic and adrenal surgery was required. Our results suggested that laparoscopic adrenalectomy should replace open surgery as the standard treatment for most adrenal masses

Renal and suprarenal insufficiency secondary to familial Mediterranean fever associated with amyloidosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Familial Mediterranean fever is an autosomal recessive disease that predominantly affects people of the Mediterranean coast. One of the most frequent complications of the disease is amyloidosis. This clinical entity is known as secondary (also called AA) amyloidosis.</p> <p>Case presentation</p> <p>In this report, we describe the case of a 33-year-old Turkish man with familial Mediterranean fever and chronic renal insufficiency. He was admitted to our clinic with symptoms of suprarenal insufficiency. The patient died three months later as a result of cardiac arrest.</p> <p>Conclusion</p> <p>Our aim is to make a contribution to the literature by reporting a case of combined insufficiency due to the accumulation of renal and adrenal amyloid in a patient with familial Mediterranean fever, which has very rarely been described in the literature. We hope that adrenal insufficiency, which becomes fatal if not diagnosed and treated rapidly, will come to mind as easily as chronic renal failure in clinical practice.</p

Burden and Depressive Symptoms Associated with Adult-Child Caregiving for Individuals with Heart Failure

Background. The primary purpose of this study was to investigate adult-child caregiver burden in heart failure (HF) patients. Secondary purpose of the study was to identify the possible influencing factors for caregiver burden and depressive symptoms in a young adult-child caregiver group. Methods. A total of 138 adult-child caregivers and 138 patients with HF participated in this study. Caregivers&apos; burden, depressive symptoms, and anxiety levels were assessed by using Zarit Caregiver Burden Scale (ZCBS), Beck Depression Inventory, and State-Trait Anxiety Inventory, respectively. Results. The mean ZCBS scores of the female caregivers were significantly higher than male caregivers. Approximately one-third of the adult-child caregivers had at least mild depressive symptoms. Caregivers with higher depressive symptoms had higher levels of caregiver burden. There were positive correlations between caregiving time, severity of depressive symptoms, and perceived caregiver burden. There was a negative correlation between education level of caregivers and perceived caregiver burden. Age, socioeconomic level, and marital status of patients were affecting factors for depressive symptoms in caregivers. Among caregiver characteristics, gender, marital status, and ZCBS scores seem to influence the depression in caregivers. Conclusions. The study findings suggest significant levels of burden and depressive symptoms even in adult-child caregivers of HF patients

Assessment of the requisites of microbiology based infectious disease training under the pressure of consultation needs

<p>Abstract</p> <p>Background</p> <p>Training of infectious disease (ID) specialists is structured on classical clinical microbiology training in Turkey and ID specialists work as clinical microbiologists at the same time. Hence, this study aimed to determine the clinical skills and knowledge required by clinical microbiologists.</p> <p>Methods</p> <p>A cross-sectional study was carried out between June 1, 2010 and September 15, 2010 in 32 ID departments in Turkey. Only patients hospitalized and followed up in the ID departments between January-June 2010 who required consultation with other disciplines were included.</p> <p>Results</p> <p>A total of 605 patients undergoing 1343 consultations were included, with pulmonology, neurology, cardiology, gastroenterology, nephrology, dermatology, haematology, and endocrinology being the most frequent consultation specialties. The consultation patterns were quite similar and were not affected by either the nature of infections or the critical clinical status of ID patients.</p> <p>Conclusions</p> <p>The results of our study show that certain internal medicine subdisciplines such as pulmonology, neurology and dermatology appear to be the principal clinical requisites in the training of ID specialists, rather than internal medicine as a whole.</p

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

Attaining Career Decision Self-Efficacy in Life: Roles of the Meaning in Life and the Life Satisfaction

WOS: 000494948800017The present study examines the roles of the meaning in life and the life satisfaction on university students' Career Decision Self-Efficacies (CDSE). Turkish university students [n = 440, 332 females (75.5%) and 108 males (24.5%)] aged 18-21 years [the mean age of 20.90 years (sd = 1.97)] were recruited from a state university located in the Eastern Black Sea Region in Turkey through a convenient sampling method. in the study, the Career Decision SelfEfficacy Scale- Short Form (Isik 2010), the Meaning in Life Scale (Demirbas 2010) and the Life Satisfaction Scale (Koker 1991) were used as instruments. the collected data were analyzed through the Pearson product-moment correlation coefficient technique and multiple linear regression analysis. Pearson correlations revealed that life satisfaction (r = 0.446, p < 0.01) and the meaning in life (r = 0.167, p < 0.01) were positively related to CDSE. Also, multiple linear regression revealed that life satisfaction and the meaning in life are significant predictors of CDSE