The association between coronaphobia and attitude towards COVID-19 Vaccine: A sample in the east of Turkey.

PURPOSE: This study was conducted to examine the association between coronaphobia and attitude towards COVID-19 vaccine in the society. METHODS: This cross-sectional descriptive study was conducted with snowball sampling method between December 30, 2020 and January 10, 2021. The survey form was sent online to individuals who were 18 years of age and older. 1252 individuals who responded to the surveys were included in the study. The data were collected by using "Descriptive Information Form", "Attitudes towards the Covid-19 vaccine scale" and "Coronavirus 19 Phobia Scale (CP19-S)". Descriptive statistics and Pearson Correlation analysis were used in the evaluation of data. RESULTS: In the study, it was found that the participants had a mean ATV-COVID-19 scale positive attitude sub-dimension score of 2.81±1.04, while they had a mean negative attitude sub-dimension score of 2.95±0.78 and a mean total score of 2.89±0.78. It was found that the participants had a mean C19P-S psychological sub-dimension score of 21.03±5.36, a mean psychosomatic sub-dimension score of 10.30±4.11, a mean social sub-dimension score of 15.04±4.71, a mean economic sub-dimension score of 8.89±3.46 and a mean total scale score of 55.28±15.00. It was found in the study that there was a positive association between the participants' C19P-S and social sub-dimension and ATV-COVID-19 and positive attitude sub-dimension, while there was a negative association between ATV-COVID-19 and negative attitude sub-dimension (p<0.05). CONCLUSIONS: It was found that the participants had a moderate level of coronavirus phobia and positive attitudes towards the vaccine. It was found that positive attitudes towards COVID-19 vaccine increased as the coronavirus phobia increased.

European Union Project 'BestCARE': improving nursing care with best complementary therapy strategies.

AIM: This paper introduces the study on the European Union Project on complementary therapies and discusses project outputs and results. The goal of the European Union Project was to improve the professional knowledge and skills of women's health and oncology nurses regarding CT. BACKGROUND: The increasing and widespread use of complementary therapies in the women's health and oncology population requires nurses to be educated about their suitable and safe use. Many nurses do not have proper training in complementary therapies and therefore should not inform their patients about them. METHODS: The 'Improving the Nursing Care with Best Complementary Therapy Strategies Based on European Union Standards' (BestCARE) project was a strategic partnership within Erasmus plus for vocational education and training. The BestCARE project was coordinated by the Akdeniz University Nursing Faculty and was carried out with six partners from Turkey and Europe. RESULTS: Fifteen nurses from Turkey and Italy were trained in complementary therapies in England. In addition, training courses and seminars were held in Turkey and Italy for women's health and oncology nurses. The BestCARE programme consisted of 14 work packages. The BestCARE programme was implemented via websites, an e-learning training programme, training videos, reference and handbook, a curriculum proposal on complementary therapies and a simulation laboratory. CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The BestCARE project allowed nurses to gain knowledge, experience and skills about complementary therapies and created a cultural awareness and sensitivity towards patients, caregivers and health professionals.

Efficacy of tramadol versus meperidine for pain relief and safe recovery after adenotonsillectomy.

BACKGROUND AND OBJECTIVE: Adequate relief of pain after tonsillectomy is a common problem. We compared meperidine and tramadol when given at induction of anaesthesia with respect to their effects on postoperative pain relief and emergence characteristics after adenotonsillectomy in children. METHODS: Fifty children aged 4-7 yr undergoing tonsillectomy were randomly assigned to receive either tramadol 1 mg kg(-1) (n = 25) or meperidine 1 mg kg(-1) (n = 25) before commencement of the surgical procedure. Anaesthesia was induced with propofol (with cis-atracurium for muscle relaxation) and maintained with sevoflurane in oxygen and nitrous oxide. Postoperative pain was scored by a blinded observer using a facial pain scale in the recovery room at 0 (at arrival of the patient in the postoperative care unit) and at 10, 20 and 45 min thereafter. Agitation scores were also assessed by the same observer at 0 min. Heart rate and mean arterial pressure were recorded at regular intervals. The time to recovery to spontaneous respiration and the incidence of postoperative nausea and vomiting were noted. RESULTS: Facial pain scale scores were increased in the tramadol group at 0, 10 and 20 min (P < 0.05). No difference was observed in scores at the 45th min postoperation. Agitation scores were higher in the tramadol group than in the meperidine group. No statistical difference was found between the two groups. Heart rates and mean arterial pressures were similar in both groups. The time to recovery to spontaneous respiration was delayed with meperidine compared with tramadol (P < 0.05). The incidence of nausea and vomiting was not statistically different between groups. CONCLUSIONS: Meperidine was more effective for pain relief and provides better emergence characteristics than tramadol after tonsillectomy in children.

Arterial lesions in Behçet's disease.

BACKGROUND: Arterial involvement is a rare but serious condition in the course of Behçet's disease. We aimed to assess the results of therapeutic approaches in our patients with arterial lesions caused by Behçet's disease. PATIENTS AND METHODS: The records of 534 patients with Behçet's disease between 1987 and 2002 were retrospectively evaluated for the presence of arterial lesions. All patients were followed up regularly at 3 to 6 months intervals. RESULTS: Arterial lesions were diagnosed in 21 (3.9%) patients. Eight of these patients had pulmonary artery aneurysms (PAA), and the other 13 patients had non-pulmonary arterial lesions. Urgent surgical intervention was performed in three patients with PAA leading to death in all three. In addition, three other patients died due to massive haemoptysis at home despite to immunosuppressive therapy. Only two out of eight patients with PAA are still alive who were treated with cyclophophamide and corticosteroids. Thirteen operations were performed in 7 out of 13 patients having non-pulmonary arterial lesions. Although ten of the operations were primary operations, three reoperations had to be performed. A stent-graft was applied for the management of an iliac artery aneurysm in one patient. Only one patient died 8 years after the first non-pulmonary arterial involvement following a type IV thoracoabdominal aortic aneurysm repair. Five patients with arterial occlusive lesions were successfully treated by corticosteroids. CONCLUSIONS: Pulmonary artery aneurysms in Behçet's disease patients have a poor prognosis despite any form of therapy. High dose corticosteroids alone can be successfully used for isolated non-pulmonary arterial occlusive lesions, unless disabling symptoms occur. Surgery or stent-graft insertion is indicated for non-pulmonary arterial aneurysms because these aneurysms entail high risk of complications.

Inhibition of bacterial growth by lignocaine in propofol emulsion.

Contamination of propofol, in an emulsion formulation, has been associated with infective complications. Local anaesthetics,some of which are known to have antibacterial properties, are frequently added to the solution to reduce pain on injection. We examined the growth rates of E. coli, S. aureus, S. epidermidis and P. aeruginosa in propofol with and without lignocaine 0.1%-2% after incubation for 2, 5 and 24 hours at 37 degrees C. Growth of microorganisms in each solution was compared by counting the number of colony forming units (CFU). Propofol supported the growth of all microorganisms. An increase in the number of CFUs was observed in all drug combinations 2, 5 and 24 hours after inoculation except for S. aureus (P<0.05). No difference was found in CFU numbers between 2 and 5 hours for this microorganism. With E. coli, a significant decline in colony counts was observed in mixtures of 1% and 2% lignocaine (P<0.05). With the other microorganisms only 2% lignocaine showed a significant reduction in the number of CFUs (P<0.05). We conclude that lignocaine in recommended clinical doses (0.05%-0.1%) did not exhibit adequate antibacterial activity to prevent infective complications.

The effect of aprotinin on ischemia-reperfusion injury in the rabbit kidney.

Tissue subjected to a period of ischemia undergoes functional and morphological damage that increases during the reperfusion phase. In this study, the protective effect of aprotinin, which is a protease inhibitor, was assessed in a rabbit unilateral renal ischemia-reperfusion (I/R) model. New Zealand rabbits, weighing 1.5-2 kg, were randomized to receive either aprotinin 30.000 KIU x kg(-1) and 10.000 KIU x kg(-1) x h(-1) i.v. infusion (group I, n= 7) or equivalent volumes of 0.09% sodium chloride (SF) (group II, control, n= 7) i.v. 15 minutes before a 45 minutes interruption of left renal artery blood flow and then 45 minutes of reperfusion. Blood samples were obtained before and after the ischemia-reperfusion period for measurement of nitric oxide serum (NO) levels with the nitrite/nitrate colorimetric method. Histological changes were evaluated by quantitative measurements using a numerical score (0-4) and immunohistochemical analysis of inducible nitric oxide synthase (iNOS) expression was determined. A Wilcoxon W -test was used for statistical analysis of biochemical measurements and mean values were expressed as +/-sd. Histological examination revealed the distinctive pattern of ischemic renal tissue injury with obvious signs of epithelial necrosis. The intensity of epithelial necrosis was more extensive in the SF group. Immunohistochemical analysis showed that there was severe immunostaining in the tubular epithelium in both cortical and medullary regions and iNOS expression was more intense in SF-only cases. The staining results for aprotinin cases did not differ much from the non-ischemic kidney. Biochemical analysis revealed an increase in serum NO levels in both groups (P< 0.05), but this was more evident in the SF group (mean NO levels were 38.63 +/- 19.03 micromol x L(-1) in group I, 50.63 +/- 24.28 micromol x L(-1) in group II). No statistically important difference was observed between the two groups. These results suggest that aprotinin may be beneficial in the prevention of systemic inflammation after transient renal ischemia.

Active center cleft residues of pokeweed antiviral protein mediate its high-affinity binding to the ribosomal protein L3.

Pokeweed antiviral protein (PAP) is a ribosome-inactivating protein (RIP) which catalytically cleaves a specific adenine base from the highly conserved alpha-sarcin/ricin loop (SRL) of the large ribosomal RNA and thereby inhibits the protein synthesis. The ribosomal protein L3, a highly conserved protein located at the peptidyltransferase center of the ribosomes, is involved in binding of PAP to ribosomes and subsequent depurination of the SRL. We have recently discovered that recombinant PAP mutants with alanine substitution of the active center cleft residues (69)NN(70) (FLP-4) and (90)FND(92) (FLP-7) that are not directly involved in the catalytic depurination at the active site exhibit >150-fold reduced ribosome inhibitory activity [(2000) J. Biol. Chem. 275, 3382--3390]. We hypothesized that the partially exposed half of the active site cleft could be the potential docking site for the L3 molecule. Our modeling studies presented herein indicated that PAP residues 90--96, 69--70, and 118--120 potentially interact with L3. Therefore, mutations of these residues were predicted to result in destabilization of interactions with rRNA and lead to a lower binding affinity with L3. In the present structure-function relationship study, coimmunoprecipitation assays with an in vitro synthesized yeast ribosomal protein L3 suggested that these mutant PAP proteins poorly interact with L3. The binding affinities of the mutant PAP proteins for ribosomes and recombinant L3 protein were calculated from rate constants and analysis of binding using surface plasmon resonance biosensor technology. Here, we show that, compared to wild-type PAP, FLP-4/(69)AA(70) and FLP-7/(90)AAA(92) exhibit significantly impaired affinity for ribosomes and L3 protein, which may account for their inability to efficiently inactivate ribosomes. By comparison, recombinant PAP mutants with alanine substitutions of residues (28)KD(29) and (111)SR(112) that are distant from the active center cleft showed normal binding affinity to ribosomes and L3 protein. The single amino acid mutants of PAP with alanine substitution of the active center cleft residues N69 (FLP-20), F90 (FLP-21), N91 (FLP-22), or D92 (FLP-23) also showed reduced ribosome binding as well as reduced L3 binding, further confirming the importance of the active center cleft for the PAP--ribosome and PAP--L3 interactions. The experimental findings presented in this report provide unprecedented evidence that the active center cleft of PAP is important for its in vitro binding to ribosomes via the L3 protein.

Transcription factor STAT5A is a substrate of Bruton's tyrosine kinase in B cells.

STAT5A is a molecular regulator of proliferation, differentiation, and apoptosis in lymphohematopoietic cells. Here we show that STAT5A can serve as a functional substrate of Bruton's tyrosine kinase (BTK). Purified recombinant BTK was capable of directly binding purified recombinant STAT5A with high affinity (K(d) = 44 nm), as determined by surface plasmon resonance using a BIAcore biosensor system. BTK was also capable of tyrosine-phosphorylating ectopically expressed recombinant STAT5A on Tyr(694) both in vitro and in vivo in a Janus kinase 3-independent fashion. BTK phosphorylated the Y665F, Y668F, and Y682F,Y683F mutants but not the Y694F mutant of STAT5A. STAT5A mutations in the Src homology 2 (SH2) and SH3 domains did not alter the BTK-mediated tyrosine phosphorylation. Recombinant BTK proteins with mutant pleckstrin homology, SH2, or SH3 domains were capable of phosphorylating STAT5A, whereas recombinant BTK proteins with SH1/kinase domain mutations were not. In pull-down experiments, only full-length BTK and its SH1/kinase domain (but not the pleckstrin homology, SH2, or SH3 domains) were capable of binding STAT5A. Ectopically expressed BTK kinase domain was capable of tyrosine-phosphorylating STAT5A both in vitro and in vivo. BTK-mediated tyrosine phosphorylation of ectopically expressed wild type (but not Tyr(694) mutant) STAT5A enhanced its DNA binding activity. In BTK-competent chicken B cells, anti-IgM-stimulated tyrosine phosphorylation of STAT5 protein was prevented by pretreatment with the BTK inhibitor LFM-A13 but not by pretreatment with the JAK3 inhibitor HI-P131. B cell antigen receptor ligation resulted in enhanced tyrosine phosphorylation of STAT5 in BTK-deficient chicken B cells reconstituted with wild type human BTK but not in BTK-deficient chicken B cells reconstituted with kinase-inactive mutant BTK. Similarly, anti-IgM stimulation resulted in enhanced tyrosine phosphorylation of STAT5A in BTK-competent B cells from wild type mice but not in BTK-deficient B cells from XID mice. In contrast to B cells from XID mice, B cells from JAK3 knockout mice showed a normal STAT5A phosphorylation response to anti-IgM stimulation. These findings provide unprecedented experimental evidence that BTK plays a nonredundant and pivotal role in B cell antigen receptor-mediated STAT5A activation in B cells.

Evaluation of diastolic dysfunction and repolarization dispersion in Behcet's disease.

Behcet's disease is a generalized chronic inflammatory disease characterized by genital, ocular, and cardiovascular involvement. Recently, left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in Behcet's disease. From January 1996 to May 1998, we investigated left ventricular systolic and diastolic function, valvular heart disease, ischemic heart disease and repolarization dispersion in 71 cases, 40 men and 31 women (mean age, 36.8+/-10.3 years) with Behcet's disease. All of the results were compared with the control group of 33 men and 22 women (mean age, 37.9+/-9.6 years). Exercise stress test or myocardial perfusion scintigraphy was performed for the documentation of ischemia. All the patients and the controls were recorded by M-mode, 2-D and Doppler echocardiography. Ventricular wall thickness, valvular apparatus, left ventricular systolic and diastolic parameters were evaluated. Repolarization dispersion parameters were calculated as the difference between maximal and minimal values of QT from 12-lead electrocardiogram recording at baseline, immediate and end of recovery from the exercise stress tests. The measured parameters were compared with the control group by using statistical methods. In the Behcet's group of 22 patients (31%) E/A ratio was <1. In the control group of five cases (10%) E/A ratio was <1 (P=0.003). In the Behcet's group isovolumic relaxation time (IRT) and mitral deceleration time (MDT) were longer than the control group (P=0.002, P=0.041, respectively). A mean QT of 368+/-30 ms and mean QT dispersion of 73+/-14 ms in the patient group compared with a mean QT of 395+/-39 ms and mean QT dispersion of 38+/-12 ms in the controls. There was no statistical difference between the mean QT values of the patient and control groups however, ventricular dispersion parameters in the Behcet's patients were longer than in the controls (P<0.001). There was also statistical significance for the QT dispersion between the Behcet's patients with and without diastolic dysfunction (P<0.01). In conclusion, the study reveals that the patients with Behcet's disease have a high incidence of increased diastolic dysfunction and repolarization dispersion. A positive correlation may exist between diastolic dysfunction and QT dispersion.

X-Ray structure of glycerol kinase complexed with an ATP analog implies a novel mechanism for the ATP-dependent glycerol phosphorylation by glycerol kinase.

Glycerol kinase (GK) catalyzes the Mg-ATP-dependent phosphorylation of glycerol which yields glycerol 3-phosphate. The 2.8 A new crystal structure of GK complexed with an ATP analog revealed an unexpected position of the gamma-phosphoryl group, which was 7.2 A distant from the 3-hydroxyl group of glycerol, 5.5 A away from the 3-phosphate of the product (glycerol 3-phosphate) and is stabilized by a beta-hairpin structure. Based on the presented crystal structure and the previously determined structures of GK product complexes, we propose a 3-D model of a nucleophilic in-line transfer mechanism for the ATP-dependent phosphorylation of glycerol by GK.

Bruton's tyrosine kinase as an inhibitor of the Fas/CD95 death-inducing signaling complex.

Bruton's tyrosine kinase (BTK) is a member of the Src-related Tec family of protein tyrosine kinases. Mutations in the btk gene have been linked to severe developmental blocks in human B-cell ontogeny leading to X-linked agammaglobulinemia. Here, we provide unique biochemical and genetic evidence that BTK is an inhibitor of the Fas/APO-1 death-inducing signaling complex in B-lineage lymphoid cells. The Src homology 2, pleckstrin homology (PH), and kinase domains of BTK are all individually important and apparently indispensable, but not sufficient, for its function as a negative regulator of Fas-mediated apoptosis. BTK associates with Fas via its kinase and PH domains and prevents the FAS-FADD interaction, which is essential for the recruitment and activation of FLICE by Fas during the apoptotic signal. Fas-resistant DT-40 lymphoma B-cells rendered BTK-deficient through targeted disruption of the btk gene by homologous recombination knockout underwent apoptosis after Fas ligation, but wild-type DT-40 cells or BTK-deficient DT-40 cells reconstituted with wild-type human btk gene did not. Introduction of an Src homology 2 domain, a PH domain, or a kinase domain mutant human btk gene into BTK-deficient cells did not restore the resistance to Fas-mediated apoptosis. Introduction of wild-type BTK protein by electroporation rendered BTK-deficient DT-40 cells resistant to the apoptotic effects of Fas ligation. BTK-deficient RAMOS-1 human Burkitt's leukemia cells underwent apoptosis after Fas ligation, whereas BTK-positive NALM-6-UM1 human B-cell precursor leukemia cells expressing similar levels of Fas did not. Treatment of the anti-Fas-resistant NALM-6-UM1 cells with the leflunomide metabolite analog alpha-cyano-beta-methyl-beta-hydroxy-N-(2, 5-dibromophenyl)propenamide, a potent inhibitor of BTK, abrogated the BTK-Fas association without affecting the expression levels of BTK or Fas and rendered them sensitive to Fas-mediated apoptosis. The ability of BTK to inhibit the pro-apoptotic effects of Fas ligation prompts the hypothesis that apoptosis of developing B-cell precursors during normal B-cell ontogeny may be reciprocally regulated by Fas and BTK.

Venous lesions in Behçet's disease.

OBJECTIVES: Review of venous lesions in Behçet's disease (BD). DESIGN: Retrospective study. SETTING: University Hospital, Turkey. MATERIALS AND METHODS: One hundred and twenty nine patients with BD diagnosed and treated in our hospital during the last 10 years were reviewed. Fifty-two patients with 54 vascular lesions of Behçet's disease were identified. MAIN RESULTS: The incidence of isolated venous lesions in BD was 26%. Venous lesions developed after the initial diagnosis of BD in all patients within 10 years. Thirty-four (63%) of the 54 vascular lesions were venous and 15 (28%) were arterial. In 5 (9%) patients, both arterial and venous lesions were present. Deep vein thrombosis was the most frequent lesion (76%), followed by superficial thrombophlebitis (10%), superior vena cava thrombosis (10%) and inferior vena cava thrombosis (2%) and varicose veins (2%). CONCLUSIONS: Venous lesions are not rare and affect the prognosis of BD. For this reason, venous lesions of BD should always be sought at follow-up of patients with BD.

Vascular injury during lumbar disc surgery. Report of two cases; a review of the literature.

Iatrogenic vascular injuries are unusual complications of lumbar disc surgery. The incidence of such injuries is very low but probably underestimated because clinical manifestations may be extremely variable depending on the extension of trauma. Diagnosis is suspected when early signs of retroperitoneal haemorrhage appear, but may often be delayed for weeks or years due to formation of a pseudoaneurysm or an arteriovenous fistula which may be of gradual onset and produce initially only a few symptoms. Prompt diagnosis and aggressive treatment can improve the current mortality rate of more than 50%. Two cases are described that illustrate the full spectrum of acute and chronic manifestations of such injuries. One case of acute haemorrhage due to arterial trauma was immediately detected and the other case with arteriovenous fistula was recognized several years post-operatively.

The other function of DNA photolyase: stimulation of excision repair of chemical damage to DNA.

DNA photolyase is a light-dependent DNA repair enzyme. It binds to cyclobutane pyrimidine dimers in DNA and upon excitation with a blue light photon splits the cyclobutane ring and restores the pyrimidines to native forms. The enzyme is specific for pyrimidine dimers, and it is not known to catalyze any other reaction either in ground or in excited state. However, when photolyase binds to but cannot catalyze repair because of lack of photoreactivating light, it still aids DNA repair by stimulating the nucleotide excision repair system. Recently, it was found that yeast photolyase binds to other lesions in DNA. In particular, the binding to cisplatin damaged DNA was highly specific. However, in vivo experiments revealed that this binding, in contrast to binding, did not stimulate but actually inhibited the removal of cisplatin damage by excision repair and hence photolyase sensitized cells to killing by cisplatin. In the present study, it is demonstrated that Escherichia coli DNA photolyase binds specifically to cisplatin 1,2-d(GpG) intrastrand cross-link and stimulates the removal of the lesion by E. coli excision nuclease in vitro. In agreement with the in vitro data, in vivo experiments revealed that photolyase makes cells more resistant to cisplatin killing.

Giant lymphoid hamartoma of mediastinum (Castleman's disease).

The giant lymphoid hamartoma is known as a rare, benign, large, solitary, encapsulated mass of lymphoid tissue. It frequently involves mediastinum or pulmonary hilum. It may also occur in other various locations. Few of the patients may have general symptoms. The disease has been divided into two variants according to microscopic structure. These are hyaline vascular type and plasma-cell type. The hyaline vascular type is benign but the plasma-cell type meets malignancy criteria, so that the plasma-cell type has been subject to discussion whether it is suited to chemotherapy or not. Our case was a 55-year-old male with persistent cough. There was a mass having a size of 6 centimeters on left pulmonary hilum on chest radiograph. Left thoracotomy was performed and a hilar lymphoid mass removed. The biopsy finding was "hyaline vascular type giant lymphoid hamartoma". No other therapy was done. Patient is well six months after the operation.

Pleural involvement by hydatid cysts of the lung.

Hydatid cyst disease is encountered in Turkey frequently. Rupture of a pulmonary cyst into the pleural cavity is rare, but represents the most serious complication of the hydatid disease. Surgical intervention was carried out in all cases in our clinic when expansion of the lungs could not be achieved. Open ends of the bronchus were closed and the pericyst layer was sutured after the removal of the germinative layer. We here present 5 cases of hydatid cysts with the above mentioned complication.