To evaluate endoscopic push-through technique cartilage myringoplasty results.
This prospective study was performed on patients with anterior tympanic membrane perforations and endoscopic ...push-through technique cartilage myringoplasty was performed between 2011 and 2013. The patients who did not have any cholesteatoma or otorrhea in the previous 3 months, and had an air bone gap ≤25 dB in their preoperative audiograms were included in the study. They were followed up with endoscopic examination and audiograms at 2nd, 6th, 12th, and 24th postoperative months. Pure tone averages were calculated at 0.5, 1, 2, and 4 kHz frequencies.
Of 32 patients, 19 were females and 13 were males. The mean age was 40.3 years (range, 16 to 62 years), and the mean follow-up period was 12.4 months (range, 6 to 24 months). Graft success rate was 87.5% in this study. Preoperative mean air conduction hearing threshold was 25.9 dB, and the mean air-bone gap was 11.9 dB while these values improved to 19.5 dB and 5.3 dB respectively in the postoperative period. The mean hearing gain was 6.4 dB. The analysis of preoperative and postoperative mean air conduction thresholds and air bone gap values of the patients revealed statistically significant differences.
Underlay cartilage myringoplasty with endoscopic push-through technique in anterior quadrant tympanic membrane perforations is an effective, minimally invasive and feasible method.
Objectives
To determine the effect of intravesical onabotulinum toxin‐A (BoNT‐A) treatment on sexual functions in female patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS).
...Methods
Female patients with IC/BPS refractory to previous treatments were included in the study between January 2020 and April 2022. Patients were treated with the trigone‐sparing injection (Group 1) or trigone‐included injection (Group 2) techniques. 100 Units of BoNT‐A was applied submucosally on 20 different points. The patients were evaluated with visual analog scale (VAS), O'Leary‐Sant Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Female Sexual Function Index (FSFI) questionnaires, 3‐day voiding diary, uroflowmetry, and post‐voiding residual volume analysis in the preoperative period, as well as on the 30th and 90th days postoperatively. For the repeated measurements, analysis of variance was used to assess the time‐dependent variation across groups.
Results
The baseline FSFI score of the patients was 15.96 ± 3.82. Following the treatment, the FSFI scores were 22.43 ± 4.93 and 24.41 ± 5.94 on the 30th and 90th days, respectively (p < .001). We observed statistically significant improvement in all FSFI subdomains (p < .05). Statistically significant improvements with treatment on ICSI, ICPI, and VAS scores were achieved (p < .05). Preoperative FSFI scores were similar in Group 1 and Group 2 (p = .147). While the preoperative FSFI scores were 17.00 ± 3.73 and 14.84 ± 3.72 for Group 1 and Group 2, respectively, the scores after the treatment were 22.85 ± 5.01 and 21.98 ± 5.01 on the 30th day, and 24.62 ± 6.06 and 24.19 ± 6.05 on the 90th day postoperatively. Significant improvement was observed in FSFI scores with treatment, and no difference was observed between the two groups in terms of treatment response (p = .706).
Conclusions
Intravesical BoNT‐A injection in the treatment of women with refractory IC/BPS improves sexual functions. It also significantly improves pain and symptom scores. Both trigone‐sparing and trigone‐including injections are similarly safe and effective.
Abstract Purpose To evaluate the relationship between maternal diabetes and the development of retinopathy of prematurity (ROP) in infants with a birth weight of 1500 g or more. Design Retrospective ...case control study. Subjects and Controls: Data of 78 premature infants from diabetic mothers were compared with data of 258 controls . Methods We examine the relationship between maternal diabetes and the development of ROP and Type 1 ROP, adjusting for multiple risk factors. In order to identify the risk factors of outcome variables, multivariable logistic regression analysis was used. Prior to multivariable logistic regression analysis, the association of each independent variable with the outcome variables, a univariate estimate was performed. The crude and adjusted odds ratio (OR) values and their 95% confidence intervals (CI) were given. Main Outcome Measures The development of ROP and the development of Type 1 ROP. Results The study was conducted on 336 preterm infants, 78 were from diabetic mothers and 258 were from non-diabetic mothers. The rate of ROP (78.2% in case group and 14.7% in control group) and the rate of Type 1 ROP (20.5% in case group and 4.7% for controls) were found significantly higher in case group (p=0.001 for both). Maternal diabetes was shown to be an independent risk factor for both ROP and Type 1 ROP (OR with 95% CI: 25,040 12,728- 49,264; 6,311 2,647- 15,048 respectively and p< 0.001 for both). Conclusion Our data suggests that the presence of maternal diabetes is significantly associated with the development of ROP and Type 1 ROP in premature infants with a birth weight of 1500 g or more.
There is a continuing debate about whether monoallergen subcutaneous immunotherapy (SCIT) is able to modulate immune and clinical responses toward main causal allergen in polysensitized patients.
To ...investigate short-term immunologic changes and clinical effectiveness of SCIT with Dermatophagoides pteronyssinus in monosensitized and polysensitized patients who have rhinitis with or without asthma.
Nineteen monosensitized and 24 polysensitized patients participated in this prospective, self-placebo-controlled, interventional study. Cluster immunotherapy with D pteronyssinus was administered after 2 months of placebo in both groups. Immunologic parameters, including CD203c expression on basophils after allergen stimulation, total IgE, specific IgE, and specific IgG4, were evaluated at baseline, after placebo, and after immunotherapy. Clinical effectiveness was assessed using monthly symptom-medication scores, visual analog scale, quality-of-life questionnaire, and nasal allergen provocation test.
At baseline, polysensitized patients had higher CD203c expression on basophils than monosensitized patients (P = .007). Activated basophils expressing CD203c, total IgE, and specific IgG4 were significantly increased after immunotherapy compared with baseline and placebo in the polysensitized group (P < .025). After immunotherapy, specific IgE and D pteronyssinus-induced CD203c expression were significantly higher in polysensitized than monosensitized patients (P < .05). The total symptom scores and the Mini Rhinoconjunctivitis Quality of Life Questionnaire scores in polysensitized patients and the visual analog scale scores in both groups were lower after immunotherapy compared with baseline and placebo (P < .025). Titrated nasal allergen provocation test with D pteronyssinus increased after immunotherapy in the monosensitized group (P < .05).
This study indicates that monosensitized and polysensitized patients have distinct humoral response and basophil behavior to SCIT. However, a single-allergen immunotherapy corresponding to the most clinically troublesome allergy in polysensitized patients can lead to early clinical efficacy comparable to that seen in monosensitized patients.
clinicaltrials.gov Identifier: NCT01795846.
To develop a Turkish version of the 25-item Cardiff Visual Ability Questionnaire for Children (CVAQC) and to evaluate the validity and reliability of the questionnaire.
The study involved two main ...phases. The first phase involved a cross-cultural adaptation of the CVAQC from English into Turkish. The second phase involved the completion of the Turkish version of the CVAQC by 150 partially sighted children (6-18 years old) and validity and reliability checks. Extent and construct validity were investigated using Rasch analysis and reliability by internal consistency and person separation index (PSI).
An adequate conceptual equivalence was achieved following the linguistic adaptation process. The dataset for validation comprised 150 participants, 88 (58.7%) of whom were male. Evidence of disordered thresholds was found for one item (item 17). This item was recorded by collapsing two categories and ordered thresholds were evident. All items of the CVAQC were found to fit the Rasch model (χ² (df)=59.90 (2), p=0.159). The internal construct validity was good (mean item fit (SD) -0.054 (1.132), person fit (SD) -0.629 (2.079)) indicating a single underlying construct. The reliability was good with Cronbach's α of 0.91 and PSI of 0.94. Differential item functioning (DIF) was tested for age, sex, diagnosis, degree of visual impairment, and comorbidity. Evidence of DIF was found on age for one item (item 10, reading the board at school).
The Turkish version of the CVAQC is a valid, reliable, and unidimensional questionnaire for partially sighted children aged 6-18 years.
Ankara University Ethics Committees registry number 06-177-12.
Purpose The hypothalamic-pituitary-adrenal (HPA) axis in the etiopathogenesis of fibromyalgia is not clear. This study aimed to analyze the effects of a 6-week aerobic exercise program on the HPA ...axis in patients with fibromyalgia and to investigate the effects of this program on the disease symptoms, patients’ fitness, disability, and quality of life. Subjects and Methods Fifty fibromyalgia patients were randomized to Group 1 (stretching and flexibility exercises at home for 6 weeks) and Group 2 (aerobic exercise three times a week and the same at-home exercises as Group 1 for 6 weeks). Serum levels of cortisol, adrenocorticotropic hormone, insulin-like growth factor-1, and growth hormone were analyzed at baseline and at the end of, and 1 hr after an exercise stress test. Results Group 2 showed better improvement in morning stiffness duration and pain. Growth hormone levels significantly increased after intervention and cortisol levels significantly decreased at time-time interaction in both groups. No significant differences in adrenocorticotropic hormone and insulin-like growth factor-1 were found. Conclusion The results of this study seem to support the hypothesis that there is a dysregulation of the HPA axis in patients with FM, and that a six-week exercise program can influence symptoms and affect the HPA axis hormones.
To detect whether stabilization splint (SS) treatment of painful myofascial type temporomandibular diseases (TMD) changes the masseter muscle morphology using ultrasound (US).
Thirty-five patients ...with painful myofascial TMD receiving SS treatment were studied. Masseter thickness, length, internal echo-fibrillary structure and vascularization were evaluated using gray-scale and power Doppler US just before and 3 months after the SS application. Visual analog scale (VAS) and mouth opening measurements were used to measure the outcome of treatment.
A significant shortening in the masseter muscle length (R: -3.67 mm, P: .010; L: -3.97 mm, P: .005) and thickness (R: -0.93 mm, P: .005; L: -0.90 mm, P: .016) was noted. No change in the internal echo-fibrillary structure or vascularization was detected. A significant decrease in VAS scores (Median: 5-0.5 P < .05) and mouth opening (42.77 ± 7.86 mm to 38.69 ± 6.21, P < .05) was also detected.
SSs modify and reduce the dimensions of masseter muscle.
Objectives. The main aim of this study was to investigate the clinical utility and sensitivity to change of faces pain scale (FPS) in patients with shoulder pain, chosen as a chronic pain model. The ...secondary aim was to determine the association of FPS with psychologic status and quality of life of these patients.
Methods. Thirty Turkish patients with chronic shoulder pain were included in the study. Pain intensity was evaluated by visual analog scale (VAS), which is a commonly used pain scale besides FPS. Depression and quality of life were screened by Beck Depression Inventory (BDI) and Short Form‐36 (SF‐36). All assessments were done before and after the physical therapy.
Results. There was a statistically significant decrease in pain severity after the treatment as indicated by FPS and VAS (P = 0.000). The standardized response mean (SRM) value of FPS of 2.35 was accepted as a good responsiveness. The FPS showed a strong correlation with VAS (r = 0.62 and 0.73) both before and after the treatment. Also, moderate to strong correlations were detected between the FPS and physical functioning (PF), physical role (PR), bodily pain (BP), emotional role (ER), general health (GH), mental health (MH) subscales of SF‐36 (r = −0.58–0.80), and BDI scores (r = 0.39) before the treatment. However, there were moderate and weak correlations with FPS and PR and social functioning (SF) subscales of SF‐36 only after the treatment (r = −0.52 and r = −0.39).
Conclusions. FPS is a satisfactory tool to assess pain in patients with chronic pain conditions and demonstrates sensitivity to detect changes after the treatment.
Problem-based learning (PBL) is most commonly used in medical education to enhance self-regulated learning (SRL) skills. Self-efficacy beliefs affect students' motivation through self-regulatory ...processes. The purpose of this study is to examine the relationship between medical students' self-reported SRL skills and their self-efficacy in PBL.
A cross-sectional study was conducted with second (286; 83.1%) and third (275; 80.2%) year students at the Ankara University School of Medicine. The SRL perception (SRLP) scale and self-efficacy for problem-based learning (SPBL) scale were used in the study.
The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale) and the subscales of SPBL and the students' views on benefiting from PBL. The female students' mean score was higher for the 'planning and goal setting' subscale of SRLP (p=0.017), and the second-year students' mean score was higher than that of the third-year students for the 'lack of self-directedness' subscale of SRLP (p=0.001) with small effect sizes (Cohen's d is 0.17 and 0.27). There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the 'responsibility' subscale of SPBL (p=0.003; Cohen's d=0.26).
The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students' development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum, learning environment, individual differences, and how these can affect the SRL process.
Purpose(s)
To evaluate results of neoadjuvant chemotherapy (NACT) following debulking surgery in patients with extensive metastatic disease and/or poor medical performance
Method(s)
Advanced stage ...epithelial ovarian cancer patients were treated with either NACT followed by debulking surgery or primary surgery followed by adjuvant chemotherapy after assessment of the extent of disease by laparoscopy or laparotomy.
Results
Out of 297, 223 patients were in the primary surgery group, whereas 74 of them met NACT criteria. Optimal cytoreduction rates were 63.2 % in primary surgery group and 60.8 % in NACT group, respectively (
p
: 0.709). In the primary surgery group, the overall survival was significantly higher (
p
: 0.002). Mean patient age was more advanced (
p
: 0.014) and the performance status of patients was poorer (
p
< 0.001) in NACT group. Only patient group (primary surgery or neoadjuvant chemotherapy) (
p
: 0.001) retained significance as predictors of survival in multivariate analyses.
Conclusion(s)
Improved rate of optimal cytoreduction with NACT in advanced ovarian cancer patients does not prolong survival. The extent of disease at diagnosis is the primary determinant of survival. Randomizing patients with equally extensive disease and performance status to either NACT or primary debulking surgery in a future study will better clarify benefits attributed to NACT.
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