Region-Based Semi-Two-Stream Convolutional Neural Networks for Pressure Ulcer Recognition.

Pressure ulcers are a common, painful, costly, and often preventable complication associated with prolonged immobility in bedridden patients. It is a significant health problem worldwide because it is frequently seen in inpatients and has high treatment costs. For the treatment to be effective and to ensure an international standardization for all patients, it is essential that the diagnosis of pressure ulcers is made in the early stages and correctly. Since invasive methods of obtaining information can be painful for patients, different methods are used to make a correct diagnosis. Image-based diagnosis method is one of them. By using images obtained from patients, it will be possible to obtain successful results by keeping patients away from such painful situations. At this stage, disposable wound rulers are used in clinical practice to measure the length, width, and depth of patients' wounds. The information obtained is then entered into tools such as the Braden Scale, the Norton Scale, and the Waterlow Scale to provide a formal assessment of risk for pressure ulcers. This paper presents a novel benchmark dataset containing pressure ulcer images and a semi-two-stream approach that uses the original images and the cropped wound areas together for diagnosing the stage of pressure ulcers. Various state-of-the-art convolutional neural network (CNN) architectures are evaluated on this dataset. Our experimental results (test accuracy of 93%, the precision of 93%, the recall of 92%, and the F1-score of 93%) show that the proposed semi-two-stream method improves recognition results compared to the base CNN architectures.

The relationship between the clinical course of SARS-CoV-2 infections and ACE2 and TMPRSS2 expression and polymorphisms.

BACKGROUND: The viral spike (S) protein and host ACE2 and TMPRSS2 genetic variations may act as a barrier to viral infections or determine susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. OBJECTIVES: We investigated the relationship between the expression patterns and polymorphisms of the ACE2 and TMPRSS2 receptor genes associated with coronavirus disease 2019 (COVID-19) and the clinical course of SARS-CoV-2 infections. MATERIAL AND METHODS: We examined 147 COVID-19 patients (41 asymptomatic, 53 symptomatic and 53 cases treated in the intensive care unit (ICU)) and 33 healthy controls. The ACE2 and TMPRSS2 expression was determined using the One-Run RT-qPCR kit. Genotypic distributions of single nucleotide polymorphisms (SNPs) of ACE2 and TMPRSS2 were obtained using reverse transcription quantitative polymerase chain reaction (RT-qPCR). RESULTS: The expressions of ACE2 and TMPRSS2 were different between SARS-CoV-2-positive and -negative groups. The ACE2 rs714205GG genotype and G-allele showed significant differences in the asymptomatic SARS-CoV-2-positive group. A significant correlation was found between the expression of TMPRSS2 rs8134378GA, rs2070788GA, rs7364083GA, and rs9974589AC genotypes and SARS-CoV-2 positivity. The rs1978124 C-allele and rs8134378 A-allele expressions were significant in the symptomatic SARS-CoV-2-positive group. The TMPRSS2 rs2070788GA expression was different in all patient groups compared to the control group. There was a difference between SARS-CoV-2-positive and -negative groups regarding the CTTA haplotype formed by ACE2 variants. The AGCAG and AGAAG haplotypes formed by the TMPRSS2 variants were more common in the asymptomatic patient group than in other patient groups. CONCLUSIONS: Identifying the relationship between host genetic variants and COVID-19 susceptibility will contribute to further studies, enabling new vaccines and potential therapeutic approaches to be discovered.

Diagnostic values of HNP 1-3 and procalcitonin levels in synovial fluid aspirates in the differential diagnosis between septic arthritis and noninfectious arthritis.

INTRODUCTION: Although early diagnosis of septic arthritis may reduce mortality rates, and limit unnecessary surgical interventions, clinical parameters alone are not adequate for making the diagnosis of septic arthritis. Therefore, relevant laboratory parameters are used to enhance diagnostic sensitivity. The aim of our study was to assist in making the diagnosis of septic arthritis, and prevent delays in the diagnosis. For this purpose; we aimed to determine the diagnostic values of human neutrophil peptides 1-3 (HNP 1-3) and procalcitonin (PCT) in synovial fluids of patients with arthritis. By comparing the HNP 1-3 and procalcitonin levels, as well as CRP, in synovial fluid aspirates, we evaluated the significance of these data in the differential diagnosis of septic arthritis from noninfectious arthritis. METHODS: A total of 67 adults consisting of 37 septic arthritis and 30 noninfectious arthritis patients were included in our study. As bioindicators; levels of HNP 1-3, PCT, synovial and serum CRP levels were found to have significant ROC areas in discriminating septic arthritis patients from noninfectious arthritis patients. RESULTS: As a result, synovial fluid HNP 1-3 levels were significantly higher in septic arthritis patients compared to noninfectious arthritis patients (p < 0.001). The sensitivity, specificity, and accuracy of HNP 1-3 levels in the diagnosis of septic and noninfectious arthritis were found as 86%, 87%, and 87%, respectively (AUC of the ROC curve = 0.828). CONCLUSIONS: It was decided that the level of HNP 1-3 in the synovial fluid can be used as an alternative indicator in the diagnosis of septic arthritis.

Diagnostic and early prognostic value of serum CRP and LDH levels in patients with possible COVID-19 at the first admission.

INTRODUCTION: COVID-19 is the infection caused by the new coronavirus. Specific treatment for COVID-19 has not been established, yet. It is important to determine the disease severity of the patients at the first admission. Therefore, the exploration of biomarkers is deemed necessary. We aimed to assess the diagnostic and early prognostic value of CRP and LDH levels in possible COVID-19 patients presenting with a severe clinical picture. METHODOLOGY: We evaluated the correlations of relevant routine laboratory test results with disease severity in COVID-19 patients admitted to our infectious diseases clinic. Patients were divided into severe and non-severe disease groups based on clinical findings, oxygen saturation levels in the arterial blood, biochemical test results, and radiological findings. Differences in the findings between the two disease severity groups were examined to determine potential biomarkers. RESULTS: Median age and the CRP and LDH levels in the severe disease group were statistically significantly higher compared to the nonsevere group (p < 0.0001). No other parameters statistically significant differences have been observed between the two groups (P > 0.05). CONCLUSIONS: CRP and LDH levels were positively correlated with lung lesions in early-stage COVID-19, potentially reflecting disease severity. Because LDH and CRP levels can potentially reflect the pulmonary function, they can be potential predictors of COVID-19- related respiratory failure. For avoiding poor prognosis; LDH and CRP should be considered as potential predictors for identifying the need for thoracic CT scans, close monitoring of pulmonary function, and aggressive supportive therapy early in the course of COVID-19.

Palliative care after stroke.

Stroke is the leading cause of disability and one of the most common reasons of death around the world. Information is not sufficient on the palliative care (PC) needs of stroke patients and factors affecting their prognosis. In this study, we have investigated the demographics and comorbidities of stroke patients followed-up in a PC center (PCC), and the factors efficient on their prognosis. Medical records of 132 patients followed-up in PCC with stroke diagnosis between years 2016 and 2017 were reviewed retrospectively. Patients diagnosed with stroke were grouped as ischemic stroke, intracerebral hematoma (ICH) and subarachnoid hemorrhage (SAH). Age, gender, PCC hospitalization period (LOS), Glasgow Coma Scale, comorbidities such as percutaneous endoscopic gastrostomy, tracheostomy, pressure ulcer (PU), and discharge status (home, intensive care unit, exitus) have been compared for the patients included in the study. While average age was 72.41 ± 16.03 and hospitalization period was 35.47 ± 36.13 days, 92 patients (69.7%) were diagnosed with ischemic stroke, 20 patients (15.2%) with ICH, and 20 patients (15.2%) were diagnosed with SAH. The rate of exitus in patients diagnosed with ischemic stroke was significantly higher than patients diagnosed with ICH and SAH (p = 0.02), and hypertension rate was higher in patients with ischemic stroke than patients diagnosed with SAH (p = 0.007). The age of patients with exitus were found to be significantly higher (p = 0.001). Length of stay (LOS) in PC was determined to be significantly higher in patients with tracheostomy and patients diagnosed with ICH compared to patients with SAH. Furthermore, PU rate was significantly higher in patients diagnosed with ICH than patients with SAH (p = 0.007). Patients who experienced stroke and their families need comprehensive palliative care for psychosocial support, determination of patient-focused care objectives, and symptom management. There is a need for studies on larger populations to eliminate prognostic uncertainties and provide successful symptom management in patients following stroke.

Nivel de conocimiento, actitud y experiencias de los profesionales de la salud respecto de la lactancia y la leche materna en una ciudad de Turquía: Estudio transversal / Knowledge level, attitude and own experience of health professionals about breastfeeding and breast milk in a city of Turkey: Cross-sectional study

Introducción. El consenso mundial acerca de la lactancia materna es que el bebé debe ser exclusivamente amamantado hasta los seis meses de vida. A pesar de ello, la tasa de lactancia materna exclusiva es baja durante los primeros seis meses de vida en muchos países, incluida Turquía. El objetivo de este estudio fue evaluar el conocimiento, las actitudes y las experiencias de los profesionales sanitarios en relación con la lactancia y la leche materna en una ciudad metropolitana de Turquía. Materiales y métodos. Este estudio se llevó a cabo entre julio de 2012 y diciembre de 2013. Los sujetos del estudio fueron profesionales de la salud que trabajaban en hospitales universitarios, hospitales de formación e investigación, hospitales públicos y privados, centros de servicios para niños, adolescentes, mujeres y de servicios de salud reproductiva, centros de salud general y centros de salud comunitarios ubicados en Ankara. Los datos se recogieron por medio de un cuestionario. El programa SPSS 11.5 se utilizó para el análisis estadístico. Resultados. En total, 715 personas participaron en este estudio. Entre los que tenían hijos propios, el 3,4% (n= 16) no había amamantado a sus bebés y el 7,6% (n= 36) había amamantado a sus bebés hasta el segundo año de vida. Se observó que el nivel de conocimiento sobre la lactancia y la lecha materna era deficiente en el 28,4% de los participantes, promedio en el 43,1% y adecuado en el 28,5%. Conclusión. Este estudio refleja la falta de conocimiento acerca de la lactancia y la leche materna entre los profesionales de la salud de Turquía. Si bien la gran mayoría de los participantes están de acuerdo con la recomendación de la OMS acerca de la duración de la lactancia materna, el porcentaje de profesionales de la salud que amamantaron durante el período recomendado fue muy bajo.

Introduction: Worldwide consensus about breastfeeding is that the infant should exclusively be breastfed until six months of life. Despite this, the rate of exclusive breastfeeding for the first six months of age is low in so many countries including Turkey. The aim of this study was to evaluate the knowledge, the attitudes and the own experiences of health professionals about breastfeeding and breast milk, in a metropolitan city in Turkey. Materials and methods: This study was performed between July 2012 and December 2013. Study subjects included healthprofessionals working in the university hospitals, research and training hospitals, public and private hospitals; child, adolescent, women and reproductive health services centers, family health centers, and community health centers located in Ankara. A questionnaire was used to collect data. SPSS 11.5 package program was used for statistical analysis. Results: A total of 715 people participated in this study. From those who had children themselves 3.4% (n= 16) had not breastfed their babies at all, and 7.6% (n= 36) had breastfed their baby until second year of age. It was found that 28.4% of the participants had poor, 43.1% had average and 28.5% had good knowledge level about breastfeeding and breast milk. Conclusion: This study reflects the lack of knowledge about breastfeeding and breast milk among the health professionals in Turkey. Although a great majority of participants agree the recommendation of WHO about the duration ofbreastfeeding, the percentage ofbreastfeeding of health care professionals during recommended period was very low.

Knowledge level, attitude and own experience of health professionals about breastfeeding and breast milk in a city of Turkey: Cross-sectional study. / Nivel de conocimiento, actitud y experiencias de los profesionales de la salud respecto de la lactancia y la leche materna en una ciudad de Turquía: Estudio transversal.

INTRODUCTION: Worldwide consensus about breastfeeding is that the infant should exclusively be breastfed until six months of life. Despite this, the rate of exclusive breastfeeding for the first six months of age is low in so many countries including Turkey. The aim of this study was to evaluate the knowledge, the attitudes and the own experiences of health professionals about breastfeeding and breast milk, in a metropolitan city in Turkey. MATERIALS AND METHODS: This study was performed between July 2012 and December 2013. Study subjects included healthprofessionals working in the university hospitals, research and training hospitals, public and private hospitals; child, adolescent, women and reproductive health services centers, family health centers, and community health centers located in Ankara. A questionnaire was used to collect data. SPSS 11.5 package program was used for statistical analysis. RESULTS: A total of 715 people participated in this study. From those who had children themselves 3.4% (n= 16) had not breastfed their babies at all, and 7.6% (n= 36) had breastfed their baby until second year of age. It was found that 28.4% of the participants had poor, 43.1% had average and 28.5% had good knowledge level about breastfeeding and breast milk. CONCLUSION: This study reflects the lack of knowledge about breastfeeding and breast milk among the health professionals in Turkey. Although a great majority of participants agree the recommendation of WHO about the duration ofbreastfeeding, the percentage ofbreastfeeding of health care professionals during recommended period was very low.

INTRODUCCIÓN: El consenso mundial acerca de la lactancia materna es que el bebé debe ser exclusivamente amamantado hasta los seis meses de vida. A pesar de ello, la tasa de lactancia materna exclusiva es baja durante los primeros seis meses de vida en muchos países, incluida Turquía. El objetivo de este estudio fue evaluar el conocimiento, las actitudes y las experiencias de los profesionales sanitarios en relación con la lactancia y la leche materna en una ciudad metropolitana de Turquía. MATERIALES Y MÉTODOS: Este estudio se llevó a cabo entre julio de 2012 y diciembre de 2013. Los sujetos del estudio fueron profesionales de la salud que trabajaban en hospitales universitarios, hospitales de formación e investigación, hospitales públicos y privados, centros de servicios para niños, adolescentes, mujeres y de servicios de salud reproductiva, centros de salud general y centros de salud comunitarios ubicados en Ankara. Los datos se recogieron por medio de un cuestionario. El programa SPSS 11.5 se utilizó para el análisis estadístico. RESULTADOS: En total, 715 personas participaron en este estudio. Entre los que tenían hijos propios, el 3,4% (n= 16) no había amamantado a sus bebés y el 7,6% (n= 36) había amamantado a sus bebés hasta el segundo año de vida. Se observó que el nivel de conocimiento sobre la lactancia y la lecha materna era deficiente en el 28,4% de los participantes, promedio en el 43,1% y adecuado en el 28,5%. CONCLUSIÓN: Este estudio refleja la falta de conocimiento acerca de la lactancia y la leche materna entre los profesionales de la salud de Turquía. Si bien la gran mayoría de los participantes están de acuerdo con la recomendación de la OMS acerca de la duración de la lactancia materna, el porcentaje de profesionales de la salud que amamantaron durante el período recomendado fue muy bajo.