The Relationship Between Intolerance of Uncertainty and Spiritual Well-Being Levels of COVID-19 Among Elderly: A Cross Sectional and Correlational Study.

The aim of this research is to relationship between intolerance of uncertainty and spiritual well-being levels during Covid-19 among elderly. This study was conducted with cross-sectional and corrational design. The research was conducted between January and June 2021 in Turkey's Eastern Anatolia Region. Introductory Information Form, Intolerance of Uncertainty Scale-Short Form (IUS), and Spirituality Index of Well-Being (SIWB) were used to collect data. The research was completed with 302 volunteers who met the following inclusion criteria. All participants belong to the Muslims. A negative significant correlation was found between IUS and SIWB; that is as the spirituality of the elderly individuals increased, the levels of intolerance of uncertainty decreased. It is recommended to identify the fears and intolerances of elderly individuals. For uncertainty, it is necessary to refine their spirituality. For this, it is recommended to organize spiritual education programs.

Determining the suitable settlement areas in Alanya with GIS-based site selection analyses.

Urbanization, which is defined as an irreversible global-scale problem nowadays, necessitates the foundation of new settlement areas. In general, no sufficient scientific assessment and analysis were performed during these processes, and thus, various natural disasters cost the loss of many lives and properties every year. Nevertheless, considering the areas that are risky in terms of natural disasters during the selection of settlement areas might prevent a large-scale loss of lives and properties because of natural disasters. Within the scope of this study, it was aimed to determine suitable settlement areas in the Alanya district, which is one of the significant points of interest for tourists in our country and has a large population and new settlement areas because of this increasing population. Within this scope, besides the risks of flood and landslide that are the most important natural disasters in the region, and a forest fire that is among the most significant risks for the region, also the biocomfort zones were included in the assessments. As a result of the study, it was determined that the most important natural disaster risk was flooding in a large portion of the region and that only 6.72% of the study area was suitable for settlement in terms of all the criteria examined in the present study.

Turkish Guideline for Diagnosis and Treatment of Allergic Rhinitis (ART).

OBJECT: To prepare a national guideline for Otorhinolaryngologist who treat allergic rhinitis patients. METHODS: The study was conducted by three authors, namely the writing support team. The support team made the study plan, determined the writing instructions, chose the subgroups including the advisory committee, the advisors for authors and the authors. A workshop was organized at the very beginning to explain the details of the study to the team. Advisors took the chance to meet their coworkers in their subgroups and determined the main headings and subheadings of the guideline, together with the authors. After key words were determined by the authors, literature search was done in various databases. The authors keep in touch with the advisors and the advisors with the advisory committee and the support group at every stage of the study. National and International published articles as well as the abstracts of unpublished studies, imperatively presented in National Congresses, were included in this guideline. Only Guideline and meta-analyses published in last seven years (2013-2017) and randomized controlled studies published in last two years (2015-2017) were included. After all work was completed by the subgroups, support team brought all work together and edited the article. RESULTS: A detailed guideline about all aspects of allergic rhinitis was created. CONCLUSION: The authors believe that this guideline will enable a compact and up-to-date information on allergic rhinitis to healthcare professionals. This guideline is the first in the field of Otolaryngology in Turkey. It should be updated at regular intervals.

Endoscopic inlay butterfly cartilage tympanoplasty in pediatric patients.

OBJECTIVE: To present and to compare the results of microscopic and endoscopic inlay butterfly cartilage tympanoplasties (MIBCT and EIBCT) in pediatric patients with COM using tragal cartilage as a grafting material and to discuss the advantages and superiorities of endoscope use and IBCT in pediatric patients. MATERIAL AND METHODS: This retrospective study was carried out to evaluate the outcomes of 79 pediatric patients up to 16 years old who underwent either EIBCT (58 children) or MIBCT (21 children) between July 2013 and August 2017 at a tertiary referral hospital. Audiometric data including air-bone gap (ABG), air-bone gap gain, and air-conduction (AC) and bone-conduction (BC) thresholds, otologic examination findings involving size, side, and site of tympanic membrane perforations, the average lengths of surgery time, hospital stay, and follow-up period, technical success (TS), and functional success (FS) were all assessed by screening hospital records. The preoperative and postoperative averages of 0.5, 1, 2, and 3 kHz of pure-tone thresholds were used for the mean AC and BC thresholds according to the guidelines of the Committee on Hearing and Equilibrium. RESULTS: TSs of EIBCT and MIBCT were achieved in 91.4 % (53/58) and 85.7% (18/21), respectively. The overall mean of ABG of EIBCT and MIBCT improved from 21.97±7.06 dB vs 20.90±4.78 dB preoperatively to 9.84±4.31 dB vs 9.33±3.54 dB postoperatively (p<0.05) thus the ABG gain was 12.00±7.32 dB and 11.57±5.49 dB, respectively. The mean lengths of surgery time were 28.03±4.79 minutes and 40.76±3.98 minutes, the mean lengths of hospital stay were 9.24±1.4 hours and 9.42±1.32hours, the lengths of follow-up period were 21.40±9.15 months and 23.19±9.40 months, in the order given. CONCLUSION: EIBCT is a comfortable, attractive, and safer approach in pediatric patients with COM for both otologists and patients for many reasons including children's narrower external ear canal, endoscopes' wide field of view when compared with microscopes, instead of endaural, postauricular or transcanal circumferential insicions need for just a tragal incision for graft harvesting, and literature reports of satisfactory technical and functional results.

Lateral epitaxial heterojunctions in single nanowires fabricated by masked cation exchange.

Cation exchange is a versatile tool to control the composition of nanocrystals, and recently deterministic patterning could be achieved by combining it with lithography techniques. Regarding single nanocrystal structures, such spatial control of cation exchange enables the design of heterostructures, which can be integrated in functional optoelectronic elements. In this work, we fabricate nanowire CdSe/Cu2Se heterojunctions by masking cation exchange via electron-beam irradiation, such that cation exchange proceeds only in the non-irradiated sections. Interestingly, the heterojunction interfaces are almost atomically sharp, and the adjacent CdSe and Cu2Se domains exhibit epitaxial relationships. We show that the cation exchange at the CdSe/Cu2Se interface is only possible if the displaced Cd2+ ions can radially out-diffuse to the solution phase. If this exit pathway is blocked, the cation exchange cannot occur. Our technique allows one to transform already contacted single nanowires, and the obtained heterojunction nanowires manifest a noticeable gain in conductance.

Colloidal Monolayer ß-In2Se3 Nanosheets with High Photoresponsivity.

We report a low-temperature colloidal synthesis of single-layer, five-atom-thick, ß-In2Se3 nanosheets with lateral sizes tunable from ∼300 to ∼900 nm, using short aminonitriles (dicyandiamide or cyanamide) as shape controlling agents. The phase and the monolayer nature of the nanosheets were ascertained by analyzing the intensity ratio between two diffraction peaks from two-dimensional slabs of the various phases, determined by diffraction simulations. These findings were further backed-up by comparing and fitting the experimental X-ray diffraction pattern with Debye formula simulated patterns and with side-view high-resolution transmission electron microscopy imaging and simulation. The ß-In2Se3 nanosheets were found to be indirect band gap semiconductors (Eg = 1.55 eV), and single nanosheet photodetectors demonstrated high photoresponsivity and fast response times.

From CsPbBr3 Nano-Inks to Sintered CsPbBr3-CsPb2Br5 Films via Thermal Annealing: Implications on Optoelectronic Properties.

CsPbBr3 nanocrystals passivated with short molecular ligands and deposited on a substrate were annealed from room temperature to 400 °C in inert atmosphere. Chemical, structural, and morphological transformations were monitored in situ and ex situ by different techniques, while optoelectronic properties of the film were also assessed. Annealing at 100 °C resulted in a 1 order of magnitude increase in photocurrent and photoresponse as a result of partial sintering of the NCs and residual solvent evaporation. Beyond 150 °C the original orthorhombic NCs were partially transformed into tetragonal CsPb2Br5 crystals, due to the desorption of weakly bound propionic acid ligands. The photocurrent increased moderately until 300 °C although the photoresponse became slower as a result of the formation of surface trap states. Eventually, annealing beyond 350 °C removed the strongly bound butylamine ligands and reversed the transition to the original orthorhombic phase, with a loss of photocurrent due to the numerous defects induced by the stripping of the passivating butylamine.

Endoscopic tympanoplasty: learning curve for a surgeon already trained in microscopic tympanoplasty.

The aim of this study was to evaluate the learning curve of endoscopic tympanoplasty for a surgeon already trained in microscopic tympanoplasty. We analyzed the clinical records of 81 patients who underwent transcanal endoscopic type 1 tympanoplasty and 30 control patients who underwent microscopic tympanoplasty between 2013 and 2015 in a tertiary hospital. All operations were performed by a single surgeon already trained in microscopic tympanoplasty. Patients were divided into four groups according to the date of surgery chronologically (group 1 early stage, group 2 intermediate stage, group 3 advanced stage and group 4 control). We evaluated the four groups according to surgery duration, audiometric results, and graft intake success. The operation duration shortened in accordance with the surgeon's experience and there were two subsequent steps during the learning curve: first, after 30 procedures; and second, after 60 procedures. The mean operation duration was 88.60 ± 21.10 min in group 1, and 62.00 ± 12.48 min in group 2. After 60 procedures, the mean operation duration was 43.81 ± 8.34 min in group 3. In the control group, the microscopic tympanoplasty duration was 69.93 ± 12.56 min. When we compared audiologic results (air conduction, bone conduction, and air-bone gap) and graft intake success rates, there were no significant differences between groups. Endoscopic tympanoplasty is a minimally invasive and effective technique. Mastering endoscopic tympanoplasty takes approximately 60 operations for a surgeon already trained in microscopic tympanoplasty. Graft intake success rates and hearing results are stable during the learning curve.

Simultaneous Bilateral Endonasal Endoscopic Dacryocystorhinostomy: A Low Cost, Fast, and Successful Method.

The etiology of primary nasolacrimal duct obstruction is largely unknown, and this disease may occur bilaterally in a small percentage of patients. In this retrospective study, the authors aimed to discuss the cost, operation time, complications, and success rate of simultaneous bilateral endonasal endoscopic surgery. Twenty-eight patients (16 female, 12 male) were enrolled in this study, with a mean age of 55 years old (range: 43-76). The success rate was 91% (51/56), and the mean operation time was 44 minutes. Only minor and transient complications were observed in 2 of the patients. Overall, the authors believe that a bilateral endoscopic dacryocystorhinostomy would be useful in a single session, based on its advantages of low morbidity, low cost, and high success.

Transseptal Subperichondrial Endoscopic Hypophysectomy With Preservation of Vital Nasal Structures.

INTRODUCTION: Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery. Here, the authors described an endoscopic transseptal subpericondrial hypophysectomy with minimal damage to normal anatomy and physiology and discussed advantages of this technique. METHODS: The authors performed endoscopic transseptal subpericondrial hypophysectomy to 2 patients and evaluated intraoperative and postoperative results. RESULTS: No complication was noted during surgery or postoperative period with endoscopic transseptal subpericondrial hypophysectomy technique. CONCLUSIONS: Endoscopic transseptal subpericondrial hypophysectomy is a safe technique and, requires only a short surgery time and does not require the removal of any physiological tissue or cause any bleeding.

Protective Effect of Selenium Against Cisplatin-Induced Ototoxicity in an Experimental Design.

Cisplatin is an effective chemotherapeutic agent in the treatment of several types of malignant solid tumors but its clinical use is associated with ototoxicity. In the present study, we investigated the effect of selenium administration on lipid peroxidation (malondialdehyde [MDA]) and cisplatin-induced ototoxicity in rats. Healthy wistar albino rats (n = 21) were randomly divided into 3 groups: control (C), cisplatin (Cis), cisplatin and selenium (Cis+Se). Cisplatin was administered for 3 days to Cis and Cis+Se groups. Cis+Se group received selenium 5 days before cisplatin injection and continued for 11 consecutive days. Hearing thresholds and lipid peroxidation (MDA) levels of the rats were recorded before injections and at the end of experimental protocol. The cochleas of animals were harvested for histologic and immunuhistochemical examinations. In biochemichal analyses, pretreatment with selenium prevented the elevation of MDA levels in Cis+Se group rats. Moreover, animals in Cis+Se group had better hearing threshold levels than animals in cis group. Samples obtained from the animals in Cis group revealed extensive loss of the normal microarchitecture of the organ of Corti. On the other hand, animals in Cis+Se group exhibited a preservation of the morphology of the organ of Corti and outer hair cells. In the immunohistochemical examinations of cochlear tissues stained with anti-caspase-3, a higher degree of immunopositivity was found in the Cis group. When Cis+Se group and Cis group were compared, significantly less immunopositivity occurred in the Cis+Se group (P < 0.05). Thus, it appears that pretreatment with selenium may reduce cisplatin-induced ototoxicity in rats.

The effect of long-term use of intranasal steroids on intraocular pressure.

Long-term use of topical nasal steroids (especially older generation steroids) has been shown to elevate intraocular pressure (IOP), but newer intranasal steroids are thought to have a minimal effect on IOP because of their low bioavailability. This study aimed to investigate alterations in IOP with two commonly used intranasal steroids for a 6-month period of time. One-hundred allergic rhinitis patients, divided equally into two groups, used mometasone furoate and fluticasone furoate intranasal steroids for 6 months. IOPs were measured before treatment and repeated at the 3rd, 6th, 12th, and 24th weeks of treatment. The IOPs of the groups were then compared. No statistically significant alteration was observed between the groups during the treatment time period. It was found that new generation intranasal steroids can be used safely, and there may not be an increased risk of IOP elevation in prolonged use in normal healthy people.

Ocular blood flow alterations during inferior turbinate radiofrequency reduction under local anesthesia.

BACKGROUND: Ocular blood flow alterations and blindness are uncommon and less-known adverse effects of nasal local anesthetic infiltrations. Our aim was to investigate ocular blood flow alterations during radiofrequency (RF) tissue reduction of inferior turbinates with the patient under local anesthesia by using a noninvasive method with optical coherence tomography. METHODS: A total of 120 patients with inferior turbinate hypertrophy were prospectively randomized into two groups. In group 1, a total of 61 patients underwent RF tissue reduction while under local anesthesia with epinephrine. In group 2, a total of 59 patients underwent RF tissue reduction of inferior turbinates while under local anesthesia without epinephrine. Optical coherence tomography measurements were performed before surgery and at 5, 15, 30, 45, and 60 minutes after local anesthetic infiltration. RESULTS: Choroid thickness measurements decreased gradually after local anesthetic infiltration until 30 minutes and increased to the same plane with the baseline at 60 minutes in group 1 (p < 0.05). In group 2, the choroid thickness measurement was significantly decreased after local anesthetic infiltration at 15 and 45 minutes (p < 0.05). When the choroid thickness measurements were compared between the groups, in group 1 blood flow was significantly lower than in group 2 at 30 minutes (p < 0.05). CONCLUSION: We observed a statistically significant reduction in choroid circulation after local anesthetic with epinephrine infiltration into inferior turbinates. Otolaryngologists should be careful after local anesthetic infiltration, and monitor the vision. Further studies with larger series would be needed to discuss safety of local anesthetics.

Increased mean platelet volume in patients with idiopathic subjective tinnitus.

Tinnitus is the perception of sound with no external stimulus and idiopathic subjective tinnitus is the most common type in adults. Mean platelet volume (MPV) alterations were shown in some inflammatory diseases and were evaluated as a clinically useful marker. Our aim was to investigate MPV alterations in idiopathic subjective tinnitus patients. A total of 101 patients and 54 age- and sex-matched healthy control subjects were enrolled in the study. Patients included in the study had complaints of tinnitus for at least 3 months. All patients underwent detailed otolaryngologic examination, blood sampling, pure tone audiometry, magnetic resonance imaging of ear, and vertebrobasilar artery Doppler ultrasonography to make the differential diagnosis of tinnitus. Blood sampling consisted of renal-liver-thyroid function tests, lipid profile, and complete blood count. All tests and examinations except the imaging modalities were also performed for the control group. There were no differences in age and sex distribution of groups. Mean platelet volume values were significantly increased in tinnitus patients when compared with controls (p = 0.001). We think that MPV can be qualified as a useful marker in tinnitus patients.

The effects of dust storms on quality of life of allergic patients with or without asthma.

OBJECTIVES: This study aims to investigate the quality of life of allergic patients with or without asthma during dust storms. PATIENTS AND METHODS: A total of 148 allergic patients (66 males, 82 females; mean age 35.7±15.5 years; range 18 to 65 years) were classified as those with (group 1, n=80) or without (group 2, n=68) concomitant asthma between January 2012 and January 2013. The quality of life [Short Form-36 (SF-36)] scores, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), nasal symptom and visual analog scale (VAS) scores at the time of diagnosis were obtained. The particulate matter (PM10) and sulfur dioxide (SO2) values of that day from the General Directorate of Meteorology were recorded. The day of dust storm and PM10 and SO2 measurements along with SF-36, RQLQ, nasal symptom and VAS scores were recorded again. RESULTS: The absolute change in the RQLQ subparameters including eye and nasal symptoms, practical problems and global scores was statistically significant (p=0.022, p=0.036, p=0.026 and p=0.032, respectively). There were statistically significant changes in the SF-36 subgroups of general health, physical functioning, vitality, and mental health (p=0.026, p=0.042, p=0.008 and p=0.026, respectively). In the multivariate logistic regression model, specific and general quality of life was 4.6 times worse in RQLQ and 3.8 times in SF-36 after the dust storm in patients with asthma, while 2.1 times worse in RQLQ and 1.9 times in SF-36 in patients with pure allergic rhinitis. The attributable risk of asthma was found to be 2.5 times higher in RQLQ and 1.9 times higher in SF-36. CONCLUSION: Dust storms may deteriorate the quality of life of patients with allergic rhinitis and asthma and lead to related personal and societal problems.

[Effect of Continuous Positive Airway Pressure Treatment on Depression, Anxiety and Perceived Stress Levels in Patients with Obstructive Sleep Apnea Syndrome]. / Obstrüktif Uyku Apne Sendromu Olan Hastalarda Sürekli Pozitif Havayolu Basinci Tedavisinin Depresyon, Kaygi ve Algilanan Stres Düzeylerine Etkisi.

OBJECTIVE: The aim of this study is to determine the effects of continuous positive airway pressure (CPAP) treatment on depression, anxiety, and perceived stress levels and to identify factors predictive of treatment efficacy in patients with obstructive sleep apnea syndrome (OSAS). METHOD: This study included 51 patients admitted to the Adiyaman University Medical School Otorhinolaryngology Department or Eskisehir Yunus Emre State Hospital between January and September 2014 with one or more complaints including snoring, excessive daytime sleepiness, or apnea witnessed by the partner. Diagnosis of OSAS was made by polysomnography and CPAP treatment was initiated. Depression levels were assessed in all study subjects using the Hospital Anxiety and Depression Scale (HADS) at the start of treatment and at 3 months. Anxiety levels were assessed using both the HADS and the State and Trait Anxiety Inventory (STAI), and perceived stress level was assessed using the Perceived Stress Questionnaire (PSQ). RESULTS: After CPAP treatment, we observed significant decreases in both the Depression and Anxiety Subscales of the HADS, in the Trait Anxiety subscale of the STAI, and in the PSQ. An evaluation of the initial parameters that predict improvements in these scales revealed that snoring time predicted decreases in all scale scores. CONCLUSION: In OSAS patients CPAP treatment has positive effects on psychological parameters like depression, anxiety, and perceived stress. We suggest that possible psychogenic benefits should be considered when deciding to start CPAP treatment, particularly in patients with pronounced and extended snoring who may also have social problems.

Retinal Nerve Fiber Layer Thickness Alteration in Apneic Children.

PURPOSE: We examined retinal nerve fiber layer (RNFL) thickness alterations in children with chronic upper airway obstructions (UAOs) and obstructive sleep apnea syndrome (OSAS). We also investigated whether it was affected by an adenotonsillectomy operation. METHODS: Forty-two children aged 3 to 8 years with chronic UAO resulting from adenotonsillar enlargement and 34 age-matched controls were included in the study. Patients underwent a Brouillette scoring questionnaire to be divided into mild (N = 10), moderate (N = 22), severe (N = 10), and total (N = 42) UAO groups. According to the scoring, the severe UAO group was defined as the severe OSAS group, the moderate group was suspicious for OSAS, and the mild UAO group was defined as the non-OSAS group. The patients' demographic data for age, sex, and body mass index were obtained. Ophthalmologic evaluations were performed with optical coherence tomography. Central corneal thickness, macular thickness, intraocular pressure (IOP), and RNFL thickness were measured. An adenotonsillectomy was performed on all patients, and eye examinations and scoring were repeated after the surgery. RESULTS: Higher IOP levels were obtained between the total UAO group and the control group (p > 0.05). There were significant differences between UAO groups and the control group except for the moderate UAO group. There was no significant difference in RNFL thickness (p > 0.05) between preoperative UAO groups and the control group. However, after surgery, some significant differences emerged in the superior, inferior, and average RNFL thickness (p < 0.05). Also, IOP levels were significantly lower in the mild, moderate, and total UAO groups after the operation (p < 0.05). CONCLUSIONS: Upper airway obstruction and OSAS seem to worsen some RNFL and IOP parameters in children, and eye examinations may be useful in these patients.

Relationship between disease activity and hearing impairment in patients with rheumatoid arthritis compared with controls.

The characteristics of hearing impairment (HI) in rheumatoid arthritis (RA) are still poorly understood, and their association with disease activity is based on conflicting information. This study compared HI between RA patients and controls and between active and remission RA groups using multi-frequency audiometry. This study enrolled 88 RA patients and 50 controls. The pure-tone hearing thresholds at 500 to 4000 Hz for air (AC) and bone (BC) conduction were compared between RA and controls as well as between active and remission RA patients using DAS28-CRP scores. The pure-tone hearing thresholds for AC and BC were significantly higher at high frequencies (2000 and 4000 Hz) in the RA group for both ears compared with controls. In addition, the BC threshold at 1000 Hz for the right ear was higher in the RA group than controls. When active and remission RA patients were compared, the thresholds were higher only at 4000 Hz for both ears for AC and BC in patients with active RA. The air-bone gap differed significantly at 2000 and 4000 Hz in both ears. This study demonstrated that patients with RA have a heightened risk of HI, and disease activity increases this risk, particularly at high frequencies. Clinicians who manage RA should be aware of HI and consider performing audiological evaluations in RA patients with active disease in particular.