Correlation of Cervical Spinal Degeneration with Rise in Smartphone Usage Time in Young Adults.

AIMS: The study aimed to define the association between spinal degeneration parameters and the rise in smartphone usage time. This was a cross-sectional study. SUBJECTS AND METHODS: Young adults aged 20-35 years, who presented to our outpatient clinic due to neck pain between 2016 and 2018, were examined. Cervical disc degeneration, disc placement, Modic changes, and sagittal balance were retrospectively measured using magnetic resonance imaging (MRI) in 107 relatively patients. Data about daily phone usage times of the participants were obtained by a questionnaire filled in at the time of admission. RESULTS: The total number of disc distances analyzed was 535 (Group 1; n = 200, Group 2; 335). In Group 1, the disc displacement was present in 30%, and in Group 2, the disc displacement was present in 35%. In terms of DD severity, the total DD score was >10 in 18 (18/40; 45%) patients in Group 1, and in 39 patients (39/67; 58%) in Group 2. The mean Cobb angle of Group 1 was 10.3° ± 6.57° (range, 2° to 34°), and that of Group 2 was 7.6° ± 5.14° (range, 1° to 26°) (Pcobb = 0.048). Modic changes were detected in 17 of the 107 patients (15.8%). Of the 17 patients, 3 (3/40, %7.5) were Group 1 and 14 (14/67, %20.9) were Group 2. MC was detected in 4 vertebrae in Group 1, and 24 vertebrae in Group 2 (P = 0.001). CONCLUSIONS: The analysis of cervical spine MRI data of young adult patients with neck pain shows that the smartphone usage time is effective in cervical sagittal balance disruption, disc degeneration, and development of Modic changes.

Aggressive Posterior Retinopathy of Prematurity Treated with Intravitreal Bevacizumab: Late Period Fluorescein Angiographic Findings.

OBJECTIVE: To evaluate vascularization end limit of the peripheral retina and describe vascular development patterns of patients at the late period with aggressive posterior retinopathy of prematurity (APROP) who were treated with a single intravitreal injection of bevacizumab. METHODS: All patients were examined with RetCam III and fluorescein angiography (FA) within 90-100 gestational week. The vascularization end limit according to the zones and vascular structural abnormalities were noted. RESULTS: A total of 116 eyes of 58 patients were included. The mean gestational age and birth weight were 28.31 ± 2.5 (23-33) weeks and 1156.29 ± 386.38 (360-2300) g, respectively. The mean age at the time of FA was 95.09 ± 3.8 (90-100) weeks. According to the vascular termini, four eyes (3.4%) were in zone II posterior, 30 eyes (25.8%) were in zone II anterior, 22 eyes (18.9%) were in zone III with a distance of > 2 disc diameter (DD) from ora serrata, and 60 eyes (51.7%) were in zone III with a distance of < 2 DD from temporal ora serrata. Abnormal vascular findings were detected in 86.2% of patients (100/116 eyes) including circumferential vessels (43.1%), abnormal vascular branching (25.9%), closely packed vascular shunts (6.8%), and vascular leakage (10.3%). CONCLUSION: FA gives us quantitative data for treatment decision at late period of APROP patients treated with bevacizumab. Fluorescein leakage and persistent avascular areas still detected at FA at 90-100 gestational weeks increase the risk for late complications. FA can detect the abnormalities that can not be detected via indirect ophthalmoscope and be useful for follow-up and further treatments of APROP.

The relationship of erythropoietin receptor expression and prognosis in glioblastoma multiforme patients.

BACKGROUND:: Glioblastoma multiforme (GBM) is the most common primary brain tumor characterized with poor prognosis and short survival. In addition to the standard treatment protocols, targeted molecular treatment options are under trial. In the recent trials, erythropoietin and erythropoietin receptor were found to be linked with the progression of GBM cells. AIM:: In this study, we compared the expression of EPOR with survival in GBM patients with mortality. MATERIALS AND METHODS:: Twenty-six patients operated for GBM in 2012-2014 were enrolled in this study. Tumor tissues were stained with EPOR, epidermal growth factor receptor, vascular endothelial growth factor, and assigned as (1+), (2+), and (3+) according to their immunohistochemical staining levels. The average postoperative follow-up time was 9.3 months. Kaplan-Meier's survival test and Spearman's correlation test were used in statistical analysis. RESULTS:: EPOR 1(+) stained group showed a median survival of 8 months (95% confidence interval [CI]: 0.954-15.046). EPOR 2(+) stained group showed a median survival of 6 months (95% CI: 2.901-9.090) EPOR 3(+) stained group showed a median survival of 2 months (95% CI: 0.400-3.600). (Kaplan-Meier P = 0.002). CONCLUSION:: These results portrayed that EPOR staining levels were inversely proportional with average survival time. In the future, specific inhibitors of this molecule could be used to form a novel treatment option for GBM.

Evaluation of Device-associated Nosocomial Infections in a Paediatric Intensive Care Unit.

OBJECTIVE: The aim of this study was to evaluate the rate of device-associated healthcare-associated infections (DA-HAI) in a paediatric intensive care unit (PICU). In addition, the identities of the responsible micro-organisms and of their antibiotic sensitivities were determined. SUBJECTS AND METHODS: Patients who had been treated and followed-up in a PICU for more than 48 hours between January 2008 and December 2013 were included in the study. Device-associated nosocomial infections were defined by the Centers for Disease Control (CDC) criteria. RESULTS: Nosocomial infections were detected in 244 of the 7376 patients over the six-year period. A diagnosis of DA-HAI was made in 75 (30.7%) of these infections. The rates of device utilization were 26% for mechanical ventilators, 6% for central venous catheters and 0.9% for urethral catheters. The rate of device-associated infections was 30.7%, and their frequency was 1.9/1000 patient-days. The device-associated nosocomial infection rates for mechanic ventilators, central and urethral catheters were 5.6, 1.62 and 3.77 per 1000 patient-days, respectively. Of these infections, Pseudomonas aeruginosa was the most frequent pathogen. Patients who developed hospital infections had longer durations of ICU hospitalizations and more often had to use mechanical ventilators and central and urinary catheters. CONCLUSIONS: The duration of hospitalization and the use of mechanical ventilators and central and urinary catheters were related to the increases in nosocomial infections. Therefore, target-oriented active surveillance should be regularly performed, and the superfluous employment of invasive devices should be avoided.

Some synthetic cyclitol derivatives alleviate the effect of water deficit in cultivated and wild-type chickpea species.

Cyclitols were prepared from corresponding allylic hydroperoxides, synthesized by photooxygenation of the appropriate cyclic alkenes. These hydroperoxides were then separately treated with a catalytic amount of OsO4. Synthesized dl-cyclopentane-1,2,3-triol 9 (A), dl-cyclohexane-1,2,3-triol 12 (B), and dl-cycloheptane-1,2,3-triol 15 (C) were used in the investigation of plant stress. Antioxidants, lipid peroxidation, and water status of chickpea species exposed to synthetic cyclitols under water deficit were examined. Cyclitol derivatives significantly decreased leaf water potential, lipid peroxidation and H2O2 levels of wild and cultivated species under water deficit. Cyclitol treatments affected antioxidant enzyme activities differently in both species under water deficit. The highest SOD activity was found in A10-treated Cicer arietinum (cultivar) and C10-treated Cicer reticulatum (wild type) under water deficit. CAT activity increased in C. arietinum exposed to A cyclitols, while it increased slightly and then decreased in cyclitol-treated C. reticulatum under stress conditions. AP and GR activities were significantly increased in C. arietinum under water deficit. AP activity increased in C derivatives-treated C. arietinum, while it remained unchanged in C. reticulatum on day 1 of water deficit. GR activity was increased in A derivaties-treated C. arietinum and C derivatives-treated C. reticulatum on day 1 of water deficit and decreased with severity of stress (except for B10-treated C. arietinum). The level of AsA in C treatments and GSH in A treatments increased in C. arietinum on day 1 of water deficit, while in C. reticulatum, AsA and GSH levels decreased under stress conditions. We conclude that exogenous synthetic cyclitol derivatives are biologically active and noncytotoxic, resulting in higher antioxidant activities and lower water potential, thus increasing the water deficit tolerance of chickpea under water deficit, especially of cultivated chickpea. We also propose that synthetic cyclitol derivatives can reduce reactive oxygen species and membrane damage and are beneficial for stress adaptation.

Emergency Department Overcrowding in Turkey: Reasons, Facts and Solutions.

INTRODUCTION: The purpose of this study was to determine the factors affecting the long waiting times of the patients in a university hospital. METHODS: This study included 3000 of the adults above 18 years and pediatric trauma patients under 18 years who applied to emergency department between February 2009 and April 2009. The examination period of the physician, length of stay, length of hospitalization, waiting times for hospitalization and follow up times in the emergency department were recorded. Moreover, the patients were divided into four groups according to the reasons for waiting. RESULTS: In our study, the time period between 4 pm-12 pm was determined as the busiest time for the applications. Average length of stay in the emergency department for 3000 patients was 146.7±160.2 minutes. The length of stay for the patients consulted was longer than the length of stay for the ones who were not consulted. Because of the fact that our hospital did not have appropriate bed capacity, 41.1% of the patients waited less than two hours, 13. 4% of the patients waited more than 8 hours. It was also found that the waiting times of the Group two patients (206,7±145,2 minutes) was longer than Group one (95,5±73,9 minutes) patients and the waiting times of Group three patients (470,7±364,7 minutes) was longer than Group one patients. CONCLUSIONS: In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments.

Acute lumbosacral polyradiculoneuropathy heralding transformation to systemic lupus erythematosus in a patient with discoid lupus.

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease with which a variety of neuropathic disorders have been associated. Among these, the acute inflammatory demyelinating polyradiculoneuropathy variant of Guillain-Barré syndrome has been well established. However, acute axonal lumbosacral polyradiculoneuropathy accompanied by albuminocytological dissociation in the cerebrospinal fluid has been extremely rarely reported in SLE. We report on a 47-year-old woman with discoid lupus presenting with acute onset of flaccid paraplegia. Extensive investigations suggested the diagnoses of axonal lumbosacral polyradiculoneuropathy and SLE. Treatment with intravenous methylprednisolone and cyclophosphamide resulted in clinical recovery. Development of immune-mediated polyneuropathy in a patient with discoid lupus should forewarn the clinician regarding transformation into the systemic form of the disease.

Inorganic-organic hybrids derived from oxovanadium sulfate motifs: synthesis and characterization of [VIVO(mu 3-SO4)(2,2'-bpy)]infinity.

The hydrothermal reaction of V2O5, V2O3, 2,2'-bpy and Na2SO4 in dilute sulfuric acid yields a novel hybrid, [VIVO(mu 3-SO4)(2,2'-bpy)]infinity, which demonstrates the potential of constructing a new class of robust composite solids composed of a (V/O/SO4)-based framework decorated with organic functionalities by combining appropriate vanadyl sulfate motifs with a variety of organic ligands.

Sustained release properties of alginate microspheres and tabletted microspheres of diclofenac sodium.

This study focused on the properties of diclofenac sodium (DNa) alginate (alg) microspheres and tabletted DNa alg microspheres using different polymers as additives. DNa alginate microspheres were prepared by the emulsification method and different polymers such as Eudragit (Eud) NE 30 D, Eudragit (Eud) RS 30 D and Aquacoat, which were incorporated into alg gel to control the release rate of drug. The release properties of DNa alg microspheres (1:1) were affected by the size, drug load of microspheres and also by the incorporated polymers, pH and ionic strength of dissolution medium. Tabletting of alg microspheres using carrageenan (carr), alg, pectin, NaCMC, tragacanth (trgh) and HPMC as additives in a (50:50) ratio produced tablets with good physical properties and also better controlled release of DNa. Dissolution studies were carried out in pH 7.2 phosphate buffer and phosphate buffers whose pH values were gradually changed from pH 3 to 7.4. The rank order of DNa release from tablets was carr < alg < pectin < NaCMC < trgh < HPMC which relates to the viscosity and swelling properties of polymers. The drug release was very slow from trgh and HPMC based tablets, but addition of carr or alg in different ratios could adjust the release rate of drug.