Examination of Risk of Depression and Perception of Social Support in Pregnant Women Undergoing Intrauterine Intervention.

BACKGROUND: Interventions during pregnancy might increase the risk of depression becausethey may cause anxiety and stress in the mother. In these cases, it is important to provide social support to pregnant women. AIM: This study aimed to determine the relationship between the risk of depression and the perception of social support in pregnant women who had undergone intrauterine intervention (IUI). METHODS: The population of this descriptive study consisted of all pregnant women (n = 267) who attended a state hospital in Izmir between March and September 2022 and who had undergone IUI. Data were obtained using a sociodemographic data form, the Beck Depression Inventory (BDI), and the Multidimensional Scale of Perceived Social Support (MSPSS). Descriptive statistics and the Chi-square test were used in the study. RESULTS: In this study, of the women, 42.7% had ≥3 pregnancies; the gestational week of 93.6% of the pregnant women was between 13-24 weeks. The mean scores of the pregnant women were 11.12 ± 8.04 on the BDI and 61.06 ± 19.84 on the MSPSS. According to the results of the correlation analysis, there was a weak (<0.05) negative reverse correlation between the scales. CONCLUSIONS: In the results of this study, it has been determined that as perceived social support increases in pregnant women, symptoms of depression are less likely to occur. This result is important in terms of indicating the need for providing social support to pregnant women. Women should be able to identify depression risk factors during this process to receive appropriate care and support.

Is atrial fibrillation a risk factor for hearing loss?

OBJECTIVE: In the present study, we sought to evaluate the results of hearing loss in AF patients. PATIENTS AND METHODS: This study involved 50 patients with AF, as determined by means of electrocardiogram, and 50 patients without AF. The pure-tone audiometry (PTA) threshold values were measured at low, medium and high frequencies for both ears. The signal-to-noise ratio (SNR) DPOAEs and TEOAEs were also analyzed for both ears separately. RESULTS: Both the airway and bone conduction PTA thresholds at 3, 4 and 6 kHz (kilohertz) were significantly lower in the AF group than in the control group (p<0.05). The AF patients exhibited worse hearing and worse TEOAE results at 1, 2, 3 and 4 kHz. In fact, the TEOAE amplitudes of the AF group were significantly lower in both the right and left ears at 2, 3 and 4 kHz when compared with the control group (p<0.05). Moreover, the DPOAE amplitudes in the AF group were statistically significantly lower at 3.4 kHz in both ears when compared with the control group (p<0.05). CONCLUSIONS: In light of these findings, we believe that AF is a risk factor for hearing.

How advantageous is it to use computed tomography image-based artificial intelligence modelling in the differential diagnosis of chronic otitis media with and without cholesteatoma?

OBJECTIVE: Cholesteatoma (CHO) developing secondary to chronic otitis media (COM) can spread rapidly and cause important health problems such as hearing loss. Therefore, the presence of CHO should be diagnosed promptly with high accuracy and then treated surgically. The aim of this study was to investigate the effectiveness of artificial intelligence applications (AIA) in documenting the presence of CHO based on computed tomography (CT) images. PATIENTS AND METHODS: The study was performed on CT images of 100 CHO, 100 non-cholesteatoma (N-CHO) COM, and 100 control patients. Two AIA models including ResNet50 and MobileNetV2 were used for the classification of the images. RESULTS: Overall accuracy rate was 93.33% for the ResNet50 model and 86.67% for the MobilNetV2 model. Moreover, the diagnostic accuracy rates of these two models were 100% and 95% in the CHO group, 90% and 85% in the N-CHO group, and 90% and 80% in the control group, respectively. CONCLUSIONS: These results indicate that the use of AIA in the diagnosis of CHO will improve the diagnostic accuracy rates and will also help physicians in terms of reducing their workload and facilitating the selection of the correct treatment strategy.

Cognitive Science in a Nutshell.

We propose a novel characterization of the core of cognitive science as the study of how agents perform tasks, where agents and tasks are both broadly construed. We motivate the focus on agents and tasks through a discussion of their prevalence in cognitive science, their utility in identifying topics close to and distant from cognitive science, and their applicability to prominent issues in the field. We argue that our proposal clearly and succinctly highlights the distinctive characteristics of cognitive science and simultaneously motivates its interdisciplinary approach without losing sight of its roots in the study of information processing and cognitive representations.

The protective effect of the proteasome inhibitor bortezomib on the uterus of ovariectomized rats.

Bortezomib (BORT) is an anti-tumour agent that inhibits proteasome, which is responsible for the degradation of many intracellular proteins. Although some side-effects and chemotherapeutic effects of BORT are known, there has not been enough research regarding its effects on different tissues of proteasome inhibition in the senile period (post-menopausal). The aim of this study was to investigate the safety of using BORT during the post-menopausal period. The post-menopausal effects of BORT were investigated on ovariectomized (OVX) Spraque-Dawley rats. The female rats were separated into three groups: control, ovariectomized (OVX), and OVX + BORT. OVX and OVX + BORT groups consisted of six rats in each. BORT was administered intraperitoneally in a dosage of 0.2 mg/kg two days a week for four weeks after OVX. The uteri of the rats were investigated using morphometrical, histopathological, and immunohistopathological methods. A striking atrophy in the endometrium and myometrium was observed due to an estrogen deficiency in the OVX group. The partial protective effect of BORT administration was observed morphometrically and histopathologically. In immunohistochemical research, cytoplasmic NF-KB activity was observed in the presence of proteasome inhibition in the endometrium. In light of these findings, the limited protective effects of post-menopausal BORT administration are worth mentioning.

Is there a correlation between the pineal gland calcification and migraine?

OBJECTIVE: The pineal gland calcifications have been associated with some diseases such as cerebral infarction, Alzheimer's disease and intracerebral hemorrhage while most cases are considered idiopathic and physiologic. However, there are limited data in the current literature about the association of pineal calcification and migraine. Our aim was to evaluate this association between migraine and pineal calcification by computed tomography of the brain. PATIENTS AND METHODS: In our study, we assessed the computed tomography images of patients, who referred to the neurology outpatient clinic with the complaint of headache and were diagnosed with migraine without aura based according to 2004 criteria of the International Headache Society. 503 migraine patients and 500 control subjects without migraine diagnosis were included in this study. RESULTS: When migraine and control groups were compared by pineal calcification, the rates were determined as 80, 6% and 55% in migraine and control group, respectively. The difference was statistically significant (p < 0.001). In addition, it was seen that pineal calcifications, detected in migraine patients, did not show age-related increase. CONCLUSIONS: According to our data, we can point that pineal calcification may be associated with migraine.

Investigation of Heschl's gyrus and planum temporale in patients with schizophrenia and bipolar disorder: a proton magnetic resonance spectroscopy study.

BACKGROUND: Superior temporal cortices include brain regions dedicated to auditory processing and several lines of evidence suggest structural and functional abnormalities in both schizophrenia and bipolar disorder within this brain region. However, possible glutamatergic dysfunction within this region has not been investigated in adult patients. METHODS: Thirty patients with schizophrenia (38.67±12.46years of age), 28 euthymic patients with bipolar I disorder (35.32±9.12years of age), and 30 age-, gender- and education-matched healthy controls were enrolled. Proton magnetic resonance spectroscopy data were acquired using a 3.0T Siemens MAGNETOM TIM Trio MR system and single voxel Point REsolved Spectroscopy Sequence (PRESS) in order to quantify brain metabolites within the left and right Heschl's gyrus and planum temporale of superior temporal cortices. RESULTS: There were significant abnormalities in glutamate (Glu) (F(2,78)=8.52, p<0.0001), N-acetyl aspartate (tNAA) (F(2,81)=5.73, p=0.005), creatine (tCr) (F(2,83)=5.91, p=0.004) and inositol (Ins) (F(2,82)=8.49, p<0.0001) concentrations in the left superior temporal cortex. In general, metabolite levels were lower for bipolar disorder patients when compared to healthy participants. Moreover, patients with bipolar disorder exhibited significantly lower tCr and Ins concentrations when compared to schizophrenia patients. In addition, we have found significant correlations between the superior temporal cortex metabolites and clinical measures. CONCLUSION: As the left auditory cortices are associated with language and speech, left hemisphere specific abnormalities may have clinical significance. Our findings are suggestive of shared glutamatergic abnormalities in schizophrenia and bipolar disorder.

Olfactory disfunction and its relation olfactory bulb volume in Parkinson's disease.

OBJECTIVE: Olfactory dysfunction is the most frequently seen non-motor symptom of Idiopathic Parkinson's disease (IPD). The aim of this study is to analyze selective olfactory dysfunction, and olfactory bulb volume (OBV) in subtypes of IPD, and compare them with those of the healthy controls. PATIENTS AND METHODS: Our study included 41 patients with IPD and age and gender matched 19 healthy controls. IPD patients were either tremor dominant (65.9%; TDPD) or non-tremor dominant (34.1%; NTDPD) type. All patients underwent neurological, ear, nose, and throat examinations, and orthonasal olfaction testing. Magnetic resonance imaging (MRI) technique was used to measure the volume of the olfactory bulb. RESULTS: A significant decrease in olfactory identification scores was found in the patient group. The patients had difficulty in discriminating between odors of mothballs, chocolate, Turkish coffee and soap. OBV did not differ between the patient, and the control groups. In the TDPD group, odor identification ability was decreased when compared to the control group. However, odor test results of NTDPD, control and TDPD groups were similar. OBV estimates of the TDPD group were not different from those of the control group, while in the NTDPD group OBVs were found to be decreased. In all patients with Parkinson's disease OBV values did not vary with age of the patients, duration of the disease, age at onset of the disease, and Unified Parkinson's Disease Rating Scale motor scores (UPDRS-m). CONCLUSIONS: Olfactory function is a complex process involving olfactory, and cortical structures as well. In Idiopathic Parkinson's disease, changes in OBV do not seem to be directly related to olfactory dysfunction.

Behavioral variables associated with obesity in police officers.

Past research has documented that non-behavioral variables (such as long work hours, exposure to police stressors) are associated with obesity risk in police officers, but limited research has examined behavioral variables that might be targeted by Employee Assistance Programs for police weight management. The present study compared non-obese and obese officers for behavioral variables found associated with obesity in other adult samples: physical activity (cardiovascular, strength-training, stretching), sleep duration, and consumption of alcohol, fruit and vegetables, and snack foods. Participants included 172 male police officers who completed questionnaires to report height and weight, used to calculate body mass index (BMI = kg/m(2)) and to divide them into "non-obese" and "obese" groups. They also reported the above behaviors and six non-behavioral variables found associated with obesity risk: age, health problems, family support, police work hours, police stressors, police support. ANCOVAs compared each behavioral variable across obesity status (non-obese, obese), with the six non-behavioral variables used as covariates. Results revealed that cardiovascular and strength-training physical activity were the only behavioral variables that differed significantly between non-obese and obese police officers. The use of self-reported height and weight values may provide Employee Assistance Program with improved cost, time, and officer participation.

Setting maximum limits for trace elements in baby food in European legislation: the outcome of International Measurement Evaluation Programme®-33.

The Institute for Reference Materials and Measurements (IRMM) of the Joint Research Centre (JRC), a Directorate-General of the European Commission, operates the International Measurement Evaluation Programme® (IMEP). It organises various types of inter-laboratory comparisons in support of European Union policies. This paper presents the results of a proficiency testing exercise (PT) focusing on the determination of total cadmium (Cd) and total lead (Pb) mass fractions in baby food in support to Commission Regulation (EC) 1881/2006 of 19 December 2006 setting maximum levels for certain contaminants in foodstuffs. The test material used in this exercise was soya-based baby food formula purchased in a local pharmacy and prepared by the Reference Materials Unit of the IRMM for this exercise. Sixty-six laboratories from 23 countries registered to the exercise and 61 of them reported results. Each participant received one bottle containing approximately 15 g of test material. Participants were asked to quantify the measurands in the powder and in the reconstituted formula. Reference values independent from the participants' results were established using isotope dilution inductively coupled plasma mass spectrometry. The total Cd mass fraction was determined by IRMM and LGC Ltd (UK), while the total Pb was determined by IRMM. The standard deviation for proficiency assessment σ^ was set at 22% of the assigned value for all measurands. Laboratories were rated with z- and ζ- (zeta) scores in accordance with ISO 13528. The outcome of this exercise is clearly influenced by the very low level of Cd and Pb content in the test material which triggered: a high number of 'less than' values; overestimated values especially for Pb very likely due to contamination; and a visible method influence in the case of Pb (methods based on atomic absorption were not sensitive enough to attain such low limits of detection). The results were also evaluated with regard to the reported limit of detection and some incoherencies were observed.

Early renal transplantation after donor renal angiography affects initial graft function.

BACKGROUND: Renal angiography of a living donor is a common radiologic examination before transplantation. However, the contrast agent used during this procedure can cause contrast nephropathy. There are insufficient data regarding whether this radiocontrast exposure detoriates renal function and survival after transplantation. In this study, we analyzed the effects of radiocontrast exposure to donors before transplant surgery on the incidence of delayed graft function (DGF) and on the outcomes of recipients at 1 year posttransplantation. METHODS: We divided 80 living donor transplantations according to the duration between the renal angiography and the transplantation procedure: Group 1 as early transplantation at ≤ 20 days (n = 42) versus group 2 of late transplantation at ≥ 20 days (n = 38). We retrospectively collected acute rejection episodes and graft survival at 1 year, monthly serum creatinine values of, DGF, proteinuria at 1 month, GFR at posttransplant day 3 month 1, and 1 year. RESULTS: There were 10 group 1 recipients (23.8%) and 2 group 2 (5.3%) subjects who experienced ≥ 1 acute rejection episode in the 1st posttransplant year (P = .02); 1 patient in each group experienced graft loss at 1 year (P = .941). DGF was observed in 9 (22%) versus 1 patient (2.6%) in group 2 (P = .009). Posttransplant day 3 creatinine values were significantly higher (P = .005) with significantly lower GFR values (P = .043) in group 1. However, creatinine and GFR levels were similar at 1 month and 1 year. Month 1 proteinuria levels were significantly higher in group 1 (P = .014). There was a significant negative correlation between renal angiography time and month 1 proteinuria (P = .014). CONCLUSIONS: Early renal transplantation (within 2 weeks after renal angiography) in living kidney donors can detoriate initial graft function and cause DGF.

Adult violence with the mother and sibling as predictors of partner violence.

The present study provides the first available evaluation of how violence with the mother and siblings during adulthood is associated with the occurrence of partner violence in young adults. Because a pattern of reciprocal partner violence is well documented, the authors hypothesized that reciprocal violence would also be found for adults and their mothers and for adults and their siblings. The authors also hypothesized that reciprocal violence with the mother and sisters would explain variance in partner violence even when controlling for other known predictors (poverty, poor family support, stress, anger, low self-esteem). Study participants included 377 college adults (114 men, 263 women; mean age = 24.4 years) who completed questionnaires to report their present violence to and from their mothers, sisters, brothers, and romantic partners. Violence is measured with a modified Conflict Tactics Scale. No sibling gender differences are found in violence reported as adults. Factor analysis confirms good fit for three clusters of reciprocal violence for adults: violence with the mother, violence with siblings, violence with the romantic partner. Violence with the mother and siblings significantly explains variance in partner violence even after controlling for other contextual variables, but only for women. One interpretation of present results is that because women receive less socialization than men to use violence, these two within-family models of violence have more significance for increasing their risk of partner violence. Partner violence prevention programs could include participation of mothers and siblings to enhance development of more peaceful conflict resolution patterns within and outside the family.

The effects of early aerobic exercise after single-level lumbar microdiscectomy: a prospective, controlled trial.

AIM: Although several rehabilitation programs to improve functioning and pain after lumbar microdiscectomy have been suggested, little is known about the most effective exercise program. We aimed to investigate the effects of aerobic exercise program starting one month after single-level lumbar microdiscectomy on pain and functioning. DESIGN: Prospective, non-randomized, controlled trial. SETTING: Outpatient clinic. POPULATION: Forty patients with single-level first-time lumbar microdiscectomy were included in the study. Eighteen patients were allocated to the aerobic exercise group while 22 patients to the control group. METHODS: Both groups were given the same home exercise program. The exercise group received 20 sessions of treadmill exercise one month after the surgery in addition to the home exercise program. Low back pain and leg pain of the patients were evaluated by Visual Analogue Scale score (VAS), functioning was evaluated by Roland-Morris Disability Index (RMDI), anxiety and depressive symptoms were evaluated by Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Patients were evaluated within the last week before surgery, at the postoperative II and VIII month. RESULTS: Significant improvements of low back pain VAS, leg pain VAS, functioning score, BAI score, BDI score were found in both groups after surgery (P<0.05). There was no significant difference in pain score, BAI score, BDI score change at II and VIII months between the groups (P>0.05). Functional improvement was significantly more pronounced in the aerobic exercise group than in the control group at the end of the aerobic exercise program (P<0.05). However, there was no significant difference in the numeric change of RMDI scores at VIII month (P>0.05). CONCLUSION: The results of this study showed that aerobic exercise starting one month after first time single-level lumbar microdiscectomy resulted in a more pronounced functional improvement than the home exercise program during the exercise sessions. It was seen that functional recovery did not last when exercise program was discontinued. CLINICAL REHABILITATION IMPACT: We suggest that suitable patients with single-level microdiscectomy should be encouraged to participate in aerobic exercise program one month after the surgery to regain functioning.

[Efficiency, risks, and advantages of using robotic support systems in interventional medicine]. / Leistungsfähigkeit, Risiken und Vorteile des Einsatzes der Robotik in medizinisch-operativen Disziplinen.

During the past decade, robotic systems were evaluated for the first time in practically all surgical disciplines. With only a few exceptions (radical prostatectomy), mechatronic systems did not achieve a breakthrough in any field of application. Second generation robotic devices with better integration of complementary technologies (preoperative therapy planning, intraoperative diagnostic work-up, navigation, etc.) and augmented functionality are now ready to be introduced into clinical practice. It is hoped that the specific advantages of robotics will result in increased use compared to previous systems. Robotics is a key technology if new surgical strategies ("scarless surgery") are to succeed.

Transient salt wasting in POMC-deficiency due to infection induced stress.

Obesity is a multifactorial disorder influenced by genetic, behavioral, environmental and cultural factors. A twelve month old male patient was admitted to the hospital because of malaise, irritability, disquietness and obesity. His BMI was 19.8 kg/m (2) and BMI SDS was 1.38. Mental development was normal, and motor skills were mildly delayed most probably due to his obesity. His physical examination was totally normal except obesity and red hair. A history of hypoglycemia on the fourth day of life, which resolved after oral glucose administration, was reported. The child had been hyperphagic from the first weeks of life and had aggressive behavior when food was denied. The body weight of the patient increased dramatically during the first year of life. Based on the clinical features and laboratory findings (the overgrowth syndrome, red hair, hypoglycemia and hypocortisolism) the patient was diagnosed as POMC deficiency and the diagnosis was confirmed by genetic studies. Hypoglycemia and apnea episodes ceased as he was put on hydrocortisone but he developed relative mineralocorticoid deficiency during a urinary tract infection. In POMC deficiency, relative mineralocorticoid deficiency should be in mind in episodes of severe stress and therapy should be initiated.

Evaluation of mist production and tissue dissection efficiency using different types of ultrasound shears.

BACKGROUND: Ultrasound shears often are applied in minimally invasive surgery because they facilitate fast and secure tissue dissection, thereby reducing operative time. Although the technical principle underlying all the shears is almost identical, considerable differences exist between specific instruments. However, production of disturbing mist should be avoided. METHODS: To obtain quantitative measurements regarding mist production, a novel hermetically sealed test system was developed. Tissue dissection efficiency was evaluated by means of a standardized cutting test. The dissection time and the numbers of cuttings were recorded. In this study, four different ultrasound dissectors from three manufacturers were assessed. One manufacturer provided two instruments: a conventional instrument and an improved version, which was designed particularly to reduce mist emission. RESULTS: The fastest ultrasound dissector emitted the highest quantity of disturbing mist. However, improved dissection efficiency does not linearly correlate with mist production. This clearly could be shown for the improved "less mist production instrument," which turned out to work faster than the comparable standard dissector but produced significantly less mist. CONCLUSION: Ultrasonic shears are effective for bloodless tissue dissection but may impede surgical proceeding by mist production. The findings of this study demonstrate that emission of mist can be reduced not only by lowering the dissection power, resulting in a prolonged dissection time, but also by modifying the technical design of an instrument. Further development of ultrasonic cutting devices therefore should account for the desired results.

Occupational lead exposure effect on liver functions and biochemical parameters.

The effect of occupational lead exposure on the liver function and on the blood biochemical parameters among the battery workers and the muffler repair workers was studied. The study included 22 battery and 38 muffler repair workers. Whole blood lead levels were determined by atomic absorption spectrophotometers. Total protein, albumin, globulin, cholesterol, triglyceride, total bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyltransferase (GGT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) levels were determined in the serum by spectrophotometry. The blood lead levels of the battery workers, muffler repair workers, and the controls were found to be 36.83 +/- 8.13 microg/dL, 26.99 +/- 9.42 microg/dL, and 14.81 +/- 3.01 microg/dL, respectively. Blood lead levels of the workers were significantly higher than those of controls (p < 0.001). The lead level of the battery workers was also significantly higher than that of muffler repair workers (p < 0.001). Although, statisticly significant, higher blood lead levels are not related to toxicity for battery and muffler repair workers. Total protein, globulin, cholesterol, LDH, and ALP levels were within normal levels, however, they were slightly higher than the control levels. Increased LDH among the workers seems to be related rather to other causes than to the liver injury.

Instrumentation and surgical technique for an innovative safe sigmoid approach for NOTES.

A set of new instruments was designed to establish an access to the abdominal cavity for NOTES via the rectosigmoid. It comprehends a metal overtube which is positioned using a modified TEM device. The entry point is targeted by transrectal ultrasound and secured by a purse-string suture. Closure is achieved by means of a linear stapler application. The applicability of the system could already be confirmed in animal survival studies.

An innovative, safe and sterile sigmoid access (ISSA) for NOTES.

BACKGROUND AND STUDY AIMS: The use of a transcolonic approach for natural orifice transluminal endoscopic surgery (NOTES) offers relevant advantages compared with a transgastric procedure. However both techniques are still limited by specific shortcomings that need to be resolved before the transluminal approach can be translated to human applications. In this article we describe an innovative method for a transcolonic procedure, which might represent the next step forward in NOTES. PATIENTS AND METHODS: In three acute and five survival porcine models we evaluated a specially designed guide tube, which is inserted via a transcolonic approach into the abdominal cavity after intraperitoneal instillation of a decontamination solution. After endoscopic evaluation of the abdomen the closure of the entry site was performed surgically. Main parameters obtained in the study were the feasibility and safety of the approach, the bacterial contamination due to the transcolonic procedure, and the safe closure of the entry site. Animals in the survival model were euthanized 10 days after the procedure. RESULTS: The transcolonic approach took place without complications. There was no bleeding or laceration of adjacent organs. The surgical closure guaranteed a leak-proof closure of the entry site. All pigs in the survival model showed an excellent postinterventional course. At necropsy, the colonic incision sites were completely closed and appeared well healed. No abscesses or any sign of inflammation could be identified. CONCLUSIONS: The transcolonic approach using an innovative guide tube is feasible and safe. The technique described offers mentionable advantages and therefore reduces the known shortcomings of NOTES. However, further studies are needed to approve our results of an initial evaluation.

Interfacial behavior of common food contact polymer additives.

Irganox 1076 (IN1076) and Irganox 1010 (IN1010), phenol containing species often used as antioxidant additives in food packaging polymers have both hydrophilic and hydrophobic functional groups. Consequently these additives are likely to absorb to surfaces where their free energy is minimized. Experiments described in this work examine the two-dimensional phase behavior and vibrational structure of IN1076 and IN1010 films adsorbed to the air/water interface. Surface pressure isotherms show that repeated compression of these films leads to continued irreversible loss of molecules and that on a per molecule basis, this loss is more pronounced for IN1076 than for IN1010. Differences in the surface properties of these two antioxidant additives are interpreted based on differences in molecular structure. Surface specific vibrational measurements of these organic films show very little conformational order, implying that even when closely packed, both antioxidant species have little affinity for forming highly organized domains. These findings have important ramifications for mechanisms that reduce antioxidant activity in polymers as well as descriptions of antioxidant blooming on polymer surfaces.