Platelet indices as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis

OBJECTIVE

The aim of this retrospective cohort study was to investigate complete blood count parameters in patients with Behçet's disease (BD) who present with oral ulcers and patients with recurrent aphthous stomatitis (RAS) in order to determine whether they could be used as discriminatory biomarkers.

PATIENTS AND METHODS

This study was conducted between January 2019 and January 2023. The study population consisted of three groups: patients with BD who had oral ulcer manifestation (n=85, BD-Group), patients with idiopathic RAS (n=186, RAS-Group) and healthy controls (n=90, HC-Group). All data about participants, on their first application, including sociodemographic and clinical data, comorbidity status, laboratory results were collected retrospectively from the hospital computer records and patients' charts.

RESULTS

The groups were similar in terms of age (p=0.235) and sex distribution (p=0.450). Mean platelet volume (MPV) and plateletcrit values of the BD-Group were significantly lower, while platelet distribution width (PDW) was significantly higher, compared to the other two groups (p<0.001 for all). Low MPV (<9.15) (56.47% sensitivity and 90.86% specificity), high PDW (≥15.75) (75.00% sensitivity and 94.96% specificity) and low plateletcrit (<0.237) (55.29% sensitivity and 79.46% specificity) could significantly distinguish BD patients with oral ulcer onset from patients with RAS.

CONCLUSIONS

PDW, MPV, and plateletcrit may be useful biomarkers in the differential diagnosis of oral ulcers when distinguishing between BD and RAS. However, these results need to be supported by further comprehensive studies.

Investigation of the effect of rhamnetin on mice injected with solid and ehrlich ascites tumor

Rhamnetin is a flavonoid which contained in especially clove, such as apple, tea, and onion plant. Rhamnetin has been used in cancer research due to its antitumor and antioxidant properties. In this study, effects of rhamnetin administration at different doses on ascites and solid tumors were investigated in Balb/C mice bearing EAT model that originating from rat breast adenocarcinoma. Experimental procedure: Overall, 92 Balb-c mice were used in this study. EAT cells (1 × 10⁶ cells) that harvested from stock animals were injected to all rats via intraperitoneal and subcutaneous route. Rhamnetin (100 µg/kg-200 µg/kg) were given intraperitoneally and subcutaneously during 10 and 15 days to the animals bearing ascites tumor and solid tumor, respectively. Throughout experiments, weight changes were recorded in all groups. The maximum weight increase was observed in the control group among all groups (ascites and solid tumor groups). In the treatment groups, the least weight increase were determined in 200-µg/kg rhamnetin applied. The lowest increase in tumor volume was observed in the group that received 200-µg/kg rhamnetin (2.84) when compared to tumor control group (3.67). Result and conclusion: We determined that the number of live and dead cells in the treatment groups administered with the mean rhamnetin dose (2.5 µg/ml) was found in the count made in the EAT cell line after the incubation periods. We observed that rhamnetin plays an important role against cancer formation. We have obtained important results in our study, but detailed studies on the relationship between rhamnetin and cancer are needed.

Continuous heart rate variability monitoring of freely moving chicken through a wearable electrocardiography recording system

Identification and quantification of stress and stress inducing factors are important components of animal welfare assessment and essential parts of poultry management. Measurement of the autonomic nervous system's influence on cardiac function using heart rate and heart rate variability (HR/HRV) indices can provide a non-invasive assessment of the welfare status of an animal. This paper presents a preliminary study showing the feasibility of continuous long-term measurement of HR/HRV indices in freely moving chicken. We developed and evaluated an electrocardiography (ECG) based HR/HRV recording system that can be used as a poultry wearable backpack for research studies. The backpack system was first validated against a commercial ECG amplifier, and the corresponding estimations of HR values matched well with each other. Then, an in vivo proof-of-concept experiment was conducted on floor-reared chickens to collect ECG data for 2 weeks. The extracted HR/HRV values show strong alignment with circadian patterns and well-defined sleep cycles. Wearable devices, like the backpack ECG system used in this study, may be best suited for application in freely moving poultry to get an insight into circadian abnormalities and sleep quality for stress and welfare management.

Endothelial nitric oxide synthase G894T, intron 4 VNTR, and T786C polymorphisms in retinopathy of prematurity

BACKGROUND

Our objective in this study was to assess the association between eNOS gene, that achieves synthesis of nitric oxide especially in the endothelial cells known to have an important role in angiogenesis and vasculogenesis, G894T, intron 4 VNTR (27-bp repeat) and T786C functional polymorphisms and retinopathy of prematurity (ROP), which is an important cause of morbidity in premature or low birth weight babies.

METHODS

A total of 139 babies who were followed up in our neonatal intensive care unit because of premature birth in our hospital or admitted to our unit. 69 of them had retinopathy of prematurity and comprised the patients group. The remaining 70 babies who did not have ROP comprised the control group. An additional of 1 ml of blood samples were drawn from babies who were in the study groups during routine laboratory analysis. eNOS gene polymorphisms were determined by using polymerase chain reaction method.

RESULTS

eNOS G894T, intron 4 VNTR and T786C gene polymorphisms did not differ between the patient and control groups (p >  0.05). Using logistic regression analysis; while gender did not differ between two groups; gestational age, birth weight, time on mechanical ventilation differ between two groups. After adjustment for variables other than eNOS gene polymorphisms, we found no significant difference in the genotype distribution of eNOS G894T, intron 4 VNTR and T786C polymorphisms (p >  0.05).

CONCLUSION

We observed no association between ROP and eNOS gene polymorphisms but needs more investigation.

[Microsurgical penile reconstruction in case of intersexuality and after penis carcinoma]

BACKGROUND

 The goals of penile reconstruction and phalloplasty include aesthetics as natural as possible and the ability of patients to void while standing and to have sexual intercourse. This article presents two more rare indications and techniques, the phalloplasty using free radial forearm flapin case of intersexuality and after penectomy due to penis carcinoma.

PATIENTS AND METHODS

 In transsexual individuals numerous phalloplasties in Gottlieb and Levine`s technique, by means phalloplasty of free radial forearm-flap of the non-dominant forearm, were performed in our department over the last few years. However, this technique also has its significance for phalloplasty in non-transgender persons.Two patients are considered in detail with regard to indication and surgical technique and were followed up in a multimodal setting.Patient 1 is genetically male, thirty-five years old with a micropenis in the case of pseudohermaphroditism masculine and androgen resistance.Patient 2 is a fifty-one-year old genetically male and as a result of a penis carcinoma his penis had to be amputated at the level of penis root. After absence of recurrence for 1,5 years, the penile reconstruction took place after complete resection of the remaining residual penile stump and corpora cavernosa. Both patients underwent multimodal follow-up 15 months postoperatively with regard to phalloplasty sensors and donor-site restrictions.

RESULTS

 An aesthetic and functional acceptable result could be obtained for both patients. Both patients are able to void while standing. The multimodal follow-up 15 months postoperatively revealed relevant differences in the sensory findings of both patients, which are due to the different anatomy of reinnervation.

CONCLUSION

 In microsurgical experienced departments, the technique of A. radialis phalloplasty can also be used successfully in more rare indications, as shown here, a satisfying result can be achieved in terms of function and aesthetics. The complications shown here do not differ from those using phalloplasty in transgender persons.

The Penetration of Ofloxacin into Human Aqueous Humor Given by Various Routes

This study was designed to measure the concentration of ofloxacin in aqueous humor after topical, oral and intravenous administration in 50 patients undergoing cataract extraction. In Group 1, ofloxacin 0.3% eyedrops were topically instilled ten times and the aqueous humor concentration was 2.73 ± 0.88 μg/ml. In Group 2, ofloxacin 0.3% eyedrops were topically instilled six times and the aqueous humor concentration was 0.84 ± 0.61 μg/ml. Aqueous humor concentration 12 hours after 200 mg oral dose in Group 3, was 0.38 ± 0.12 μg/ml. In Group 4, patients were given ofloxacin as a single intravenous 200 mg dose and the aqueous humor concentration 2 hours after the end of infusion was 0.45 ± 0.11 μg/ml. Concentrations were determined by high performance liquid chromatography (HPLC) with fluorescence detection.

There was a significant difference between Group 1 and the other groups, but not between Group 2 and Groups 3, 4.

It was concluded that ofloxacin penetrates the corneal and the blood-aqueous barriers and can achieve good aqueous levels when given topically and systematically. Ofloxacin can be applied topically for external bacterial infections such as conjunctivitis and keratitis. Systematically administered ofloxacin reached higher levels than the MIC for some bacteria which cause endophthalmitis.

Sensing textile seam-line for wearable multimodal physiological monitoring

This paper investigates a novel multimodal sensing method by forming seam-lines of conductive textile fibers into commercially available fabrics. The proposed ultra-low cost micro-electro-mechanical sensor would provide, wearable, flexible, textile based biopotential signal recording, wetness detection and tactile sensing simultaneously. Three types of fibers are evaluated for their array-based sensing capability, including a 3D printed conductive fiber, a multiwall carbon nanotube based fiber, and a commercially available stainless steel conductive thread. The sensors were shown to have a correlation between capacitance and pressure; impedance and wetness; and recorded potential and ECG waveforms.

Significance of serum endothelial cell specific molecule-1 (Endocan) level in patients with erectile dysfunction: a pilot study

This study aimed to measure the serum endocan level of patients with erectile dysfunction (ED) and to investigate the possible association between the Endothelial-specific molecule-1 (Endocan) level and ED. Twenty healthy and sixty-four male patients included in the study were divided into four groups: severe ED (19 patients), moderate ED (24 patients), mild ED (21 patients) and control group (20 healthy men). The erectile function of all the patients was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire. The body mass index (BMI) of each participant was determined, together with levels of fasting blood glucose, total testosterone, low- and high-density lipoprotein cholesterol, triglyceride and endocan in serum samples. No significant difference was found between the three ED groups and the control group in terms of the mean age, BMI and the levels of cholesterol and fasting blood glucose (P>0.05). The mean serum endocan level was found to 1.076±0.5, 0.674±0.40 and 0.671±0.3 ng ml^-1 in the severe, moderate and mild ED groups, respectively. This indicated that the highest value was obtained from the severe ED group, and the difference between the severe ED group and the other groups was statistically significant. In the control group, the serum endocan level was 0.73±0.46 ng ml^-1, which was significantly higher compared to the moderate and mild ED groups (P<0.05). The significant difference between the control and ED groups in terms of the serum endocan level can assist in the evaluation of endothelial pathologies in the etiology ED.

A new model as an early life manipulation: Fake mother

Introduction

Early life stressful events cause long-term neural changes that are associated with psychiatric disorders.

Objective

Early life manipulations focus on commonly the impact of remaining separate from the mother in a specific period of time. The maternal odor is required for pups to approach the mother for nursing. What happens when there is a mother that smell like a real mother but does not take care her own pups?

Aim

To investigate the fake mother effects on adult rat's behavioral changes, NMDR2B protein level changes in prefrontal cortex and hippocampus.

Methods

Wistar rats were used. Fake mother (n:13), early handling (n:12), maternal separation (n:14) and control (n:12) were the study groups. A fake mother is an object that smells like a real dam. When the real mother is separated from own pups fake mother stays with the pups for an hour. Manipulations were made during the postnatal first 14 days. Behavioral tests (social interaction test, elevated plus maze, novel object recognition test) were made between postnatal 62 and 78 days. NMDAR2B protein levels in prefrontal cortex and hippocampus were evaluated by using ELISA at postnatal 78 days.

Results

In social interaction test, fake mother group exhibited less social behavior and more aggressive behavior than the other groups. Their long-term memory functions were the lowest. NMDAR2B protein levels in the hippocampus increased in rats that exposed to early stressful life events.

Conclusion

These results support that being raised by fake mother increases aggressive behavior and decrease social behavior in adulthood.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Graphene based nanosensor for aqueous phase detection of nitroaromatics

Nitroaromatics sensor composed of monolayer graphene and molecularly imprinted chitosan thin film was fabricated and responded selectively against imprinted nitrotriazolone.

Unsupervised delineation of stratum corneum using reflectance confocal microscopy and spectral clustering

BACKGROUND

Measuring the thickness of the stratum corneum (SC) in vivo is often required in pharmacological, dermatological, and cosmetological studies. Reflectance confocal microscopy (RCM) offers a non-invasive imaging-based approach. However, RCM-based measurements currently rely on purely visual analysis of images, which is time-consuming and suffers from inter-user subjectivity.

METHODS

We developed an unsupervised segmentation algorithm that can automatically delineate the SC layer in stacks of RCM images of human skin. We represent the unique textural appearance of SC layer using complex wavelet transform and distinguish it from deeper granular layers of skin using spectral clustering. Moreover, through localized processing in a matrix of small areas (called 'tiles'), we obtain lateral variation of SC thickness over the entire field of view.

RESULTS

On a set of 15 RCM stacks of normal human skin, our method estimated SC thickness with a mean error of 5.4 ± 5.1 μm compared to the 'ground truth' segmentation obtained from a clinical expert.

CONCLUSION

Our algorithm provides a non-invasive RCM imaging-based solution which is automated, rapid, objective, and repeatable.

Auto-adjusting mandibular repositioning device for in-home use

Obstructive Sleep Apnea (OSA) is a form of respiratory dysfunction that affects 20% of adults in the world. Among the first-line treatments that are used to mitigate the effects of OSA are continuous positive airway pressure (CPAP) and mandibular repositioning devices (MRD). Although CPAP provides a more efficacious therapy than MRDs, recent studies suggest that both are comparable in overall effectiveness due to greater patient preference and adherence to MRD therapy. In this paper, we present the Auto-Positioner, a novel add-on for MRDs that adjusts the extent to which the mandible (lower jaw) is advanced in response to respiratory signals indicating labored breathing during sleep, and to changes in sleeping position known to affect individual patient's airway patency.

Relationship between genetic polymorphisms of drug efflux transporter MDR1 (ABCB1) and response to losartan in hypertension patients

OBJECTIVE

Losartan is a selective angiotensin II receptor type 1 blocker and a substrate of drug efflux transporter MDR1 (ABCB1). MDR1 shows inter-individual variations due to genetic polymorphisms. C3435T, G2677T and C1236T polymorphic alleles of the MDR1 gene encoding the transporter have been shown to alter the transport, bioavailability and efficacy of certain drugs. The purpose of this study was to investigate the relationship between genetic polymorphisms of MDR1 (C3435T, G2677T/A and C1236T) and response to the treatment in newly diagnosed hypertensive patients being treated with losartan.

PATIENTS AND METHODS

A total of 74 newly diagnosed hypertension patients were included in the study. Genotyping was performed using PCR-RFLP. Systolic and diastolic mean blood pressure changes of the patients were expressed as a percentage (± SD). Blood pressure values prior to initiation of the treatment and subsequent measurements 6 weeks after starting the treatment were compared.

RESULTS

Regarding the C3435T polymorphism, a mean decrease of systolic blood pressure in individuals with CT or TT genotype (n= 55; 11.6% ± 9.7 mmHg) was significantly higher compared with that of the CC genotype (n = 19; 6.7% ± 9.6 mmHg, p = 0.03). No significant systolic blood pressure changes observed in G2677T/A and C1236T genotypes (p = 0.13 and 0.07, respectively). There was not any significant difference in diastolic blood pressure changes between pre- and post-treatment for any of the genotypes with C3435T, G2677T/A, or C1236T variations.

CONCLUSIONS

This study revealed that hypotensive response to losartan was significantly affected by the C3435T genetic polymorphism of MDR1 and hypertensive patients with MDR1 3435T allele may present a better response to losartan treatment.

Association between serum fetuin-A level and erectile function

Recent studies have shown that ED is an early symptom of atherosclerosis. Fetuin-A, a glycoprotein secreted by the liver, kidneys and choroid plexus, has been linked to systemic fibrosis and calcification in human and rat studies. Deficiency of this compound may play a role in atherosclerosis and cardiovascular disease progression. The aim of the study was to examine whether serum fetuin-A level is related to erectile function or severity of ED. Sixty ED patients without cardiovascular disease were assigned to one of the three groups (mild, moderate or severe ED) depending on ED severity. Twenty healthy volunteers were included as the control group. The International Index of Erectile Function-5 questionnaire was used to measure erection quality in all four groups. Mean age, body mass index, total testosterone, low- and high-density lipoprotein cholesterol, and triglyceride levels did not significantly differ between the three erectile dysfunction and control groups (P > 0.05). The group with severe ED had a significantly lower mean fetuin-A level than the mild ED and control groups. For both mild and moderate ED groups, the mean serum fetuin-A level was significantly lower in comparison with the control group (P < 0.001). Serum fetuin-A level may be used as a supplemental biochemical parameter in preliminary evaluation of ED.

Relationship of galectin-3 to left ventricular geometry and hypertrophy in chronic hemodialysis patients

AIM AND BACKGROUND

Galectin-3 (Gal-3) is used to determine the prognosis of heart failure. Some studies revealed that Gal-3 promoted cardiac hypertrophy but there is no study in which the relationship between Gal-3 and left ventricular hypertrophy (LVH) geometry in patients without diastolic and systolic function impairment has been explored. The aim of the study was to analyze associations between plasma Gal-3 levels, LVH, and LV geometry in maintenance hemodialysis (HD) patients without systolic and diastolic dysfunction.

PATIENTS AND METHODS

The study group included 105 patients (53 women and 52 men)--with an average age of 58.2 ± 12.6 years, treated with HD for an average of 45 ± 32 months--and 60 healthy controls. The Gal-3 and other biochemical parameters were measured and color Doppler echocardiography was performed. For this study LVH was considered present when the LV mass index (LVMI) exceeded 95 g/m(2) in women and 115 g/m(2) in men. Left ventricular geometry was classified into the four groups on the basis of left ventricular mass and relative wall thickness (RWT).

RESULTS

Concentric hypertrophy (CH, 40.9 %, n = 43) was the commonest geometric pattern in our study. The Gal-3 levels in CH patients were not different from the patients with eccentric hypertrophy (EH). Plasma levels of Gal-3 correlated with LVMI (r = 0.617, p < 0.001), parathyroid hormone (PTH, r = 0.408, p < 0.001), uric acid (r = 0.281, p = 0.004), C-reactive protein (CRP, r = 0.412, p < 0.001), and RWT (r = 0.281, p = 0.004) but were inversely correlated with albumin (r = - 0.466, P < 0.001) in the whole group. Plasma levels of Gal-3 were associated with LVMI (r = 0.812, P < 0.001), RWT (r = 0.318, p = 0.001), and CRP(r = 0.381, p < 0.001) in maintenance hemodialysis patients.

CONCLUSION

The Gal-3 level is related to left ventricular hypertrophy and it is independent of left ventricle geometry. The relationship between LVH and Gal-3 might be direct or it may also be inflammation-related.

Management, clinical outcomes, and complications of acute cannula-related peripheral vein phlebitis of the upper extremity: A retrospective study

OBJECTIVE

Acute phlebitis due to peripheral vein catheter use is frequently observed in clinical practice, and requires surgical therapy in severe cases. In this retrospective study, we aimed to increase awareness, evaluate current treatment options, and develop recommendations to optimize treatment outcomes.

METHODS

A total of 240 hospitalized patients with a diagnosis of upper extremity phlebitis from 2006 to 2011 were evaluated in terms of initial clinical features, parameters, co-morbidities and treatment regimes. Severity of phlebitis was graded according to the Baxter scale by assessing clinical symptoms such as pain, erythema, induration, swelling, or palpable venous cord (grade 0-5). Patients were divided in two subgroups: conservative (n = 132) and operative (n = 108) treatment.

RESULTS

Surgical intervention rates and severity were higher for cannula insertion in the cubital fossa region than for cannula insertion in the forearm and hand region (p < 0.05). Baxter scale grades were higher in the surgical treatment group than in the conservative treatment group (4.47 vs. 2.67, respectively).

CONCLUSIONS

The cubital fossa region is vulnerable to severe phlebitis and is not recommended as the first site of choice for cannulation. Phlebitis of Baxter scale grade 4 or 5 should be considered for early surgical intervention.

Usage of neck circumference as novel indicator of erectile dysfunction: a pilot study in Turkish population

Erectile dysfunction (ED) is the most common male sexual problem worldwide. The association between ED and components of metabolic syndrome (MtS) is well established. This study examined neck circumference (NC) as a possible indicator of MtS and also of ED. Ninety-two patients were included and divided into two groups. Group 1 consisted of 47 patients with ED and Group 2 consisted of 45 healthy volunteers. Questionnaires, differences in anthropometric and laboratory measurements between patients with ED and the control group, and a cut-off value for NC were investigated. The mean NC in ED patients was higher in Group 1 than in Group 2 (P = 0.001), and Group 1 also demonstrated more MtS criteria than Group 2 (P < 0.001). The cut-off point of NC was defined as 34.75 cm for ED and MtS. The cut-off values of waist circumference for ED and MtS were 105.5 and 102.5 cm respectively. In the light of these findings, NC may be a new component of MtS in ED patients. Additionally, NC may be a novel indicator of central obesity and ED. We suggest that NC values of 35 cm and over may predict ED in patients with MtS.

Tamoxifen Inhibits Cytochrome P450 2C9 Activity in Breast Cancer Patients

Tamoxifen has been reported to potentiate the anticoagulant effect of warfarin and also to increase the plasma level of phenytoin, which are mainly metabolized by CYP2C9. The aim of this study was to determine the influence of tamoxifen on CYP2C9 activity in vivo in humans. Thirteen breast cancer patients who would start tamoxifen following cytotoxic chemotherapy were enrolled in the study. A single oral dose of 25 mg losartan was given to the patients 2 days before and 2 weeks after starting tamoxifen therapy. Losartan and E3174 in 8-hour urine samples were measured by HPLC. Tamoxifen significantly increased the average urinary losartan/E3174 ratio from 0.73 (CI 95% = 0.15 - 2.30) to 1.66 (CI 95% = 0.68 - 5.20), after 2 weeks of treatment (p = 0.002). Tamoxifen inhibited CYP2C9 activity in breast cancer patients within two weeks of its administration. The inhibition of CYP2C9 activity may be a possible explanation for the drug-drug interaction of tamoxifen with CYP2C9 substrates.

Melanoma arising in chronic ulceration associated with lymphoedema

Chronic ulceration can be complicated by development of a malignancy. The most frequent associated malignances are squamous cell carcinoma and basal cell carcinoma, although melanoma, leiomyosarcoma and adenocarcinoma are less commonly seen. Chronic lymphoedema may also predispose to development of some malignancies, including lymphangiosarcoma, squamous cell carcinoma and Kaposi's sarcoma. Here, we report the case of a 77-year-old man with primary lymphoedema, who developed melanoma in a chronic foot ulcer of 60 years' duration. The patient underwent wide excision for the melanoma, and remains free from metastases at 1-year follow up.

The consistency of Gleason scores may effect the operation outcomes for laparoscopic radical prostatectomy: a single surgeon and a single pathologist data

INTRODUCTION

To evaluate the effects of consistency in preoperative and postoperative Gleason scores to the operation outcomes in patients who underwent laparoscopic radical prostatectomy.

MATERIALS AND METHODS

204 of 347 patients were included the study. 143 patients whose preoperative prostate biopsies were evaluated in the other Institute were not included into the study. The preoperative data of patients and operation outcomes were investigated from institute's files of patients. Patients were divided to three groups by using consistence of pre and postoperative Gleason scores. The tumor, node and metastasis classification were used for staging prostate cancer.

RESULTS

Mean age was 63 and the mean PSA level was 11 ng/dl overall. In statistical analysis PSA levels, Gleason score and rate of positive score were significantly low in Group I (p < 0.05). As in operative data, nerve sparing surgical technique was performed statistical significance higher in Group 1 than other Groups. External bleeding rate of Group II was significantly lower than the other Groups. In univariate and multivariate analysis, postoperative pathologic stage was statistical significant for consistency of pre and postoperative Gleason scores.

CONCLUSIONS

The modified Gleason scoring system is safe and usable for evaluating prostate biopsies and operative specimens. The consistency in pre and postoperative Gleason score effect the operation technique and also operation outcomes. Working with an experienced uro-pathologist provides to inform patients more accurate and better.

[Extensive fibromata pendulantia. Hydrosurgery as a therapy option using the Versajet technique]

Fibromata pendulantia often appear as small filiform skin tags with a narrow pedicle in the neck, axilla and groin areas. Hitherto, extensive fibromata pendulantia were resected either surgically (curette, scissors, scalpel) or by laser. The present case study of an adipose patient with disseminated fibromata pendulantia in the axillary region in the setting of pseudoacanthosis nigricans introduces the Versajet hydrosurgery technique as an alternative method. It is able to remove tissue and rinse the wound simultaneously by means of a high-pressure water jet.

The determination of the nursing care needs of the acute-term psychiatry patients

Objective

The aim of this study is to investigate how the patients perceive the hospital environment and how they express their needs with their opinions.

Method

This study was planned as a qualitative descriptive study. The sampling of the study is constituted by the acute-period patients hospitalized in the clinic of the Psychiatric Department for at least three days that can achieve an interview with the researcher and being voluntary to be included into the study. An “interview guidance” was formed by eleven questions to collect data. The interview guidance form contains the questions about how he or she spent one day in the clinical environment, what helps them in the clinical environment and what the needs are. The interviews were conducted by the researcher by making an explanation to the patients after signing their informed consents. During the interviews, voice records were taken with the permission of the patients and then these records were transcribed.

Results

It has been seen that the patients need rather safe areas where they will live their loneliness but where they will stay lonely, the people and the environments in which and by which they will be listened without being judged.

Conclusion

Psychiatric nurse can provide care specific to individual for the acute-period patients by taking into account the expressions of patients. By this means, she can provide the hospitalization to be more favorable experience and she can prevent resistances and negative attitudes that can reveal in the following periods related with the hospitalization.

[Merkel cell carcinoma and immunosuppression: report of three cases and review of therapeutic options]

Merkel cell carcinoma (MCC) is a cutaneous, neuroendocrine tumour of high malignancy that is described as a firm, purple tumour localised in the dermal layer. Due to its high progression rate, the 5-year survival rate is quoted as between 30 and 74 %. The course of disease is characterised by high relapse rate (30 - 77 %) and lymph node metastases (ca. 50 %). Therapy of MCC is based on a radical surgical excision combined with sentinel lymph node biopsy (stadium I), lymph node dissection (stadium II) and postoperative radiotherapy. We report three cases of MCC under immunosuppression and present therapeutic options of MCC in overview.

Beneficial effect of corticosteroids in catecholamine-dependent septic burn patients

Recent studies indicated the benefit of hydrocortisone in septic patients based on the significant reduction of catecholamines and improved outcome in common intensive care patients. The treatment of intensive care burn patients with corticosteroids was discussed with great caution due to the especially compromised immune status of severely burned patients. The purpose of this study was to investigate the influence of corticosteroids in burn patients during septic shock. In our burn unit, we started with the administration of cortisol in 2001. In this retrospective study, 10 severely burned patients received, > or = 24h after norepinephrine dependency, hydrocortisone infusions of 200 mg/24 h. The course of norepinephrine dose, hemodynamic measurements (Swan-Ganz-Catheter) and daily Sequential Organ Failure Assessment (SOFA-Score) were analyzed and compared to nine (catecholamine-dependent) burn patients without cortisol therapy. Statistical analysis by means of Fisher's Exact Test revealed beneficial effects (morbidity and mortality) of low dose cortisol therapy compared to control patients. However, the results of this study must be interpreted with caution because of its limited number of patients and its retrospective character. Further randomized prospective controlled studies are necessary to determine the efficacy and safety of cortisol therapy in burn patients.