Could Pan-Immune-Inflammation Value be a Marker for the Diagnosis of Coronary Slow Flow Phenomenon?

Inflammation plays a key role in the pathogenesis of the coronary slow flow phenomenon (CSFP). The newly developed inflammatory marker, pan-immune-inflammation value (PIV), is associated with adverse cardiovascular events. This study investigated the predictive value of PIV for diagnosing CSFP in comparison to other inflammation-based markers. A total of 214 patients, 109 in the CSFP group and 105 in the normal coronary flow (NCF) group, were retrospectively included in the study. Coronary flow was calculated using the Thrombolysis in Myocardial Infarction frame count method. In addition to PIV, other inflammatory markers such as neutrophil-lymphocyte ratio, platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated for the patients. The average age of patients was 50.3 ± 8.4, with a male ratio of 55.1%. Compared to the NCF group, patients in the CSFP group had higher levels of hyperlipidemia, glucose, triglyceride, NLR, PLR, SII, and PIV, while their high-density lipoprotein cholesterol (HDL-C), was lower (p < 0.05). Logistic regression analysis demonstrated that HDL-C, glucose, triglyceride, and PIV were independent predictor factors for CSFP (p < 0.05). PIV is a strong and independent predictor factor for CSFP and superior in predicting CSFP compared to other inflammatory markers.

Telemedicine interventions for older adults: A systematic review

INTRODUCTION

Telemedicine may help improve older adults' access, health outcomes, and quality of life indicators. This review aims to provide current evidence on the effectiveness of telemedicine in the aged population.

METHOD

A systematic literature search was conducted in PubMed, Google Scholar, and Web of Science electronic databases between January 2015 and September 2021 using the keywords "telemedicine" or "telehealth" and "older people" or "geriatrics" or "elderly." The articles were classified under three headings according to the purposes: feasibility, diagnosis and management of chronic diseases, and patient satisfaction.

RESULTS

A total of 22 articles were included. Across most disciplines, evidence has shown that telemedicine is as effective as usual care, if not more so, in the feasibility, chronic disease management, and patient satisfaction of the elderly. However, a few studies reported challenges such as difficulty with technology, hearing problems, and the inability to perform hands-on examinations for physicians.

CONCLUSION

Findings from this review support the view that health care providers can use telemedicine to manage elderly individuals in conjunction with usual health care. However, future research is needed to eliminate barriers to increasing telemedicine use among older adults.

The Effect of Kangaroo Care on Paternal Attachment: A Randomized Controlled Study

BACKGROUND

During the first interaction between the father and the infant, touch can be very important especially father-infant skin-to-skin contact. Few studies have focused on the effect of kangaroo care (KC) on paternal attachment.

PURPOSE

This randomized controlled study was conducted to determine the effect of KC on paternal attachment.

METHODS

A total of 90 fathers of healthy newborns, including 45 in the intervention group and 45 in the control group who met the inclusion criteria, were included randomly in the study. Data were collected using the Introductory Information Form at study admission and the Father-Infant Attachment Scale (FIAS) at 3 months of age. T test, Mann-Whitney U test, and Kruskal-Wallis test were used for statistical analysis.

RESULTS

The mean FIAS scores for the intervention group (I) were higher than for the control group (C) (I: 80.57 ± 13.70; C: 56.76 ± 13.23) ( P < .05). Patience and tolerance (I: 13.70 ± 1.18; C: 11.57 ± 2.30), pleasure in interaction (I: 29.50 ± 2.86; C: 17.13 ± 5.93), and love and pride (I: 37.37 ± 2.85; C: 28.06 ± 5.82) mean scores for FIAS subdimensions in the intervention group were also higher than in the control group ( P < .05).

IMPLICATIONS FOR PRACTICE AND RESEARCH

Findings of this study demonstrate that KC has the potential to increase paternal attachment. Healthcare providers should provide discharge education for fathers on KC to increase father-infant attachment. There is a need for studies with larger samples in different cultures on the factors related to parents that affect father-infant attachment and evidence-based practices that increase attachment.

Effect of Tea Tree Oil and Coconut Oil on Nipple Crack Formation in the Early Postpartum Period

Background: The aim of the study was to determine the effect of tea tree oil and coconut oil applied to the nipples during the early postpartum period on nipple crack formation. Methods: This randomized controlled experimental research included a total of 90 women in the research sample abiding by the research criteria, with 30 each in the intervention groups (coconut oil or tea tree oil application) and 30 in the control group. Women in the intervention groups applied coconut oil or tea tree oil to the nipples on the 3rd, 7th, and 10th days postpartum, whereas the control group did not have any intervention. Data in the research were collected with the Descriptive Information Form for Mothers, Early Postpartum Period Breast Problem Assessment Form, and Visual Analog Scale (VAS). Analysis of data used the chi-square test, Kruskal-Wallis test, and Friedman's test. Results: Mean age of women participating in the research was 28.23 ± 5.21 years. The differences between the groups applying coconut oil and tea tree oil on the 3rd, 7th, and 10th days postpartum and the control group were significant in terms of incidence of nipple cracks. In addition, the difference in mean VAS points for nipple pain in the groups using coconut oil and tea tree oil and the control group was found to be statistically significant (p < 0.05). Conclusions: According to the research findings, coconut oil and tea tree oil were determined to reduce nipple crack formation and nipple pain. It is recommended to increase the use of coconut oil and tea tree oil related to breast problems in nursing care during the postpartum period. Clinical Trials Registration Number: NCT05456438.

Predictors of eHealth literacy in pregnant women: A structural equation model analysis

OBJECTIVE

To develop and evaluate a theoretical model to explain the relationships between eHealth literacy and perception of health, and perception of pregnancy risk in pregnant women.

METHOD

This cross-sectional study was carried out with 238 pregnant women in one of the hospitals in Turkey between March 15, 2021 and May 15, 2021. Data were collected using an Information Form, eHealth Literacy Scale, Perception of Health Scale, and Perception of Pregnancy Risk Questionnaire.

RESULTS

The mean scores of the pregnant women participating in the study on eHealth literacy and perception of health were 30.45 ± 6.56 and 51.42 ± 6.91, respectively and their mean score on perception of pregnancy risk was 42.6 ± 29.38. The direct effect of the eHealth Literacy Scale on the "Risk for Baby" subscale of the Perception of Pregnancy Risk Questionnaire was insignificant whereas the scale's effect became significant with the Perception of Health Scale (β = -0.006; 0.057).

CONCLUSION

To reduce the perception of risk in pregnant women, it is important to improve not only their eHealth literacy but also their knowledge and attitudes about being healthy.

Adherence to Compression Garment Wear and Associated Factors Among Patients with Breast Cancer-Related Lymphedema: A Pilot Study from a Turkish Tertiary Center

Background: Compression garments are the basis of the maintenance phase of the breast cancer-related lymphedema (BCRL) treatment. The aim of this study is to investigate the adherence to compression garment wear and the associated factors among patients with BCRL. Methods and Results: Patients who received standard therapy and training on compression garment wear from a single center were asked to fill out a 28-item questionnaire on compression garment wear. Adherence to compression garment wear and the associated factors were examined. These factors were compared between patients who were wearing and who were not wearing compression garments as recommended. The study was completed with 60 patients. Twenty-five percent of the patients used custom-made compression garment. The rate of patients wearing compression garments as per recommendation was 51.7% (n = 31). The most common reasons for not wearing/discontinuation included functional difficulties in daily life (33%) and discomfort (28.8%). Compared according to the factors with potential impact on wearing, the rate of garment wear as per recommendation was statistically significantly higher in patients who had modified radical mastectomy than in those who had breast-conserving surgery (p = 0.038). Conclusion: Although standard information was provided to the patients, the adherence to compression garments was nonoptimal. The economic status of the patients is one of the main factors affecting the choice of compression garments and thus their adherence. To improve the adherence to this method, which is the basis of maintenance treatment of lymphedema, training programs to reduce patient beliefs and anxiety that are tailored to individual needs can be useful. Clinical trial registration number: NCT04832386.

RISK FACTORS FOR DEVELOPING UPPER LIMB CELLULITIS AFTER BREAST CANCER TREATMENT

Cellulitis is one of the most important troubling complications of breast cancer treatment. Therefore, elucidating the risk factors for cellulitis in patients that have undergone breast cancer treatment is crucial. This is a retrospective medical record study among 523 patients who had received breast cancer treatment and were referred to the Lymphedema Clinic. Data on age, height, weight, BMI (body mass index), education level, arm dominance, history of previous surgery, axillary lymph node dissection, radiotherapy, and chemotherapy were noted. The time between operation and onset of lymphedema, duration of lymphedema, history of cellulitis, and number of cellulitis attacks were recorded. Circumference measurements were taken at four points on the upper limb. Univariate analysis showed that longer duration of lymphedema, larger circumference of the unaffected arm and larger circumference of the arm with lymphedema were associated with higher risk of cellulitis (p=0.008, p=0.007, p< 0.001, respectively). The incidence of cellulitis was higher in patients with lymphedema than patients who had no lymphedema (p< 0.001). Moreover, the frequency of cellulitis was higher in patients with lower education level (p=0.015). It was deter-mined that patients with cellulitis needed more compression garments (p< 0.001) and multi-layered bandage therapy (p< 0.001) than those without. Regression analysis revealed that presence of lymphedema (p=0.036), duration of lymphedema (p=0.048), radiotherapy (p=0.01) and educational level (0.019) are significantly associated with developing upper extremity cellulitis. It is important to consider these risk factors for the prevention and management of cellulitis in patients who undergo treatment for breast cancer. Early detection and treatment of lymphedema also remains essential for these patients.

Comparison of immune modulatory properties of human multipotent mesenchymal stromal cells derived from bone marrow and placenta

Multipotent mesenchymal stromal cells (MSC) can be isolated from many tissues, including bone marrow (BM) and placenta (PL). Human placenta can be obtained readily without invasive procedures. There may be differences, however, in differentiation capacity and immunomodulation by MSC isolated from BM or PL. The early pregnancy factor (heat shock protein 10; EPF/Hsp10) is a small protein that exhibits immunomodulatory properties. We compared BM- and PL-MSC, and assessed their efficacy for suppressing T-cell proliferation in vitro and the role of EPF/Hsp10 in this process. PL-MSC were collected from whole placenta after removal of the amniotic and chorionic membranes followed by serial enzymatic digestions. The PL-MSC were compared to BM-MSC, obtained from healthy donors. Differentiation capacity, cytokine secretion, expression and secretion of immunomodulatory molecules, immunophenotype and real time proliferation were assessed using cytokine arrays, ELISA assays, flow cytometry, immunohistochemical staining and western blotting. Whereas BM-MSC consisted of a homogeneous cell population with strong expression of mesenchymal markers, PL-MSC consisted of a mixed population of cells with variable CD73, CD90 and CD105 expression. PL-MSC exhibited a significantly greater proliferation rate than BM-MSC. The presence of both stem cells and more mature cells in the PL-MSC cultures resulted in decreased differentiation capacity and reduced efficacy of immune suppression in co-cultures with T-cells. Although robust intracellular expression of EPF/Hsp10 in both BM- and PL-MSC was observed, secretion of the protein in response to immune activating stimuli remained below detectable levels. Secretion of pro-inflammatory cytokines was significantly greater in BM-MSC than PL-MSC, whereas no difference was observed in the secretion of hematopoiesis supporting growth factors. Development of culture methods for isolation of pure populations of PL-MSC may improve the quality of the product and reproducibility of results.

Diagnostic Contribution of Ultrasonography in Breast Cancer-Related Lymphedema

Background: Many assessments have been reported and used in evaluating lymphedema. The aim of this study was to investigate the diagnostic contribution of ultrasonography in unilateral breast cancer-related lymphedema. Methods and Results: Upper extremity circumferences were measured with a measuring tape from ulnar styloid at the wrist to the axilla at 4 cm intervals. The point with the highest difference between the upper extremities and the control point with no difference between the lower extremities were marked. Skin and subcutaneous thicknesses were measured from four quadrants (volar medial-lateral and dorsal medial-lateral) at the marked points and also subcutaneous tissue changes were graded according to the subcutaneous echogenicity grade (SEG) scale ultrasonographically. The correlations between circumferential and ultrasonographic measurements were investigated. Receiver operating characteristic curve analysis was made to estimate the diagnostic accuracy of the difference in ultrasonographic subcutaneous thickness measurements between the two arms. The study was completed with 34 female patients. Circumferential and subcutaneous tissue thickness measurements were moderately positively correlated in the volar quadrants and strongly positively correlated in the dorsal quadrants of the affected extremity. In the unaffected extremity, a strong positive correlation was identified in all quadrants. The clinical stages of lymphedema and SEG were weakly positively correlated in the volar medial quadrant. The difference between the two upper extremities was found to have a high (0.83%) sensitivity, and an acceptable (0.75%) specificity in the differentiation of Grade II and Grade III lymphedema. Conclusion: A correlation was established between circumferential measurements and ultrasonographic measurements. Ultrasonography can be used complementary to circumferential measurements in diagnosing lymphedema. Clinical trial registration number: NCT04213001.

Easy Volumeter in Detection of Breast Cancer-Related Lymphedema: A Validity Study

Aim and Hypothesis: The standard volumeter is heavy and fragile, and using the same volumeter for different patients can result in hygiene problems. These disadvantages point to the need for the development of a new model of volumeter. The new volumeter put forward in this study is lighter, smaller, sturdier, and easier to clean, while also having its own scale. In this study, the validity of this newly designed volumeter is investigated. Materials and Methods: In the first step, the volume of standard cylinders was measured thrice using a standard volumeter and an easy-measurement volumeter, after which a total of 30 arm volumes of 15 volunteers were measured. In the final stage, the arms of 28 patients with breast cancer-related lymphedema were measured once with both volumeters and the mean results were compared. Results: There was a high degree of consistency between the measured volumes of cylinders of known volume when measured with a standard volumeter and the "Easy volumeter." The measured mean volumes with the two volumeters were assessed with paired sample t-test, resulting in a significance (p value) of 0.927, indicating no difference between the measurements of the two volumeters. The variance of measurement of the devices was assessed with a Levene's test, and the significance (p value) was obtained as 0.981. Based on this result, the null hypothesis cannot be rejected, meaning that there is no difference in the variances of measurements of the two volumeters. Likewise, a paired sample t-test was used to evaluate the differences between the mean measurements of the healthy volunteers group, and no difference was detected between the mean arm volumes measured with each volumeter (significance=0.105). The measurements between the two volumeters were also consistent in the lymphedema patient group (involved arm significance = 0.842 and normal arm significance = 0.075). Conclusion: Our study revealed the validity of the newly designed "Easy Volumeter" for the measurement of arm volumes, indicating its appropriateness for use in daily practice.

Is Continuous Passive Motion Effective in Patients with Lymphedema? A Randomized Controlled Trial

BACKGROUND

In this randomized controlled study, we aimed to evaluate the effect of shoulder flexion exercise using continuous passive motion (CPM) on lymphedema during the treatment of breast cancer-related lymphedema (BCRL).

METHODS

Thirty patients with BCRL were enrolled and completed the study. Fourteen patients were treated with complete decongestive therapy (CDT) and CPM in the intervention group, and 16 patients were treated with CDT alone (control group) for 15 sessions. The main outcome measures were included; the shoulder range of motion (ROM) assessed with a goniometer, limb volume difference measured using the water immersion method, function with the Disabilities of the Arm, Shoulder and Hand (DASH), and the quality of life using the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B4). Lymphedema volume measures were taken at baseline, on days 1, 2, 3, 4, 5, 10, and 15; and shoulder ROM, FACT-B4, and DASH were taken at baseline and on day 15.

RESULTS

All subjects were similar at baseline. After treatment significant improvement was found in ROM, volumetric differences, DASH, and FACT-B4 scores in both groups. No significant differences were observed in the volumetric differences, ROM, and the DASH, and FACT-B4 scores between the groups, except for the FACT-B4 physical well-being subscores, which were better in intervention group.

CONCLUSION

Our study results showed that CPM did not contribute to the reduction of BCRL.

Isomer decay spectroscopy of 164Sm and 166Gd: midshell collectivity around N=100

Excited states in the N=102 isotones 166Gd and 164Sm have been observed following isomeric decay for the first time at RIBF, RIKEN. The half-lives of the isomeric states have been measured to be 950(60) and 600(140) ns for 166Gd and 164Sm, respectively. Based on the decay patterns and potential energy surface calculations, including β6 deformation, a spin and parity of 6- has been assigned to the isomeric states in both nuclei. Collective observables are discussed in light of the systematics of the region, giving insight into nuclear shape evolution. The decrease in the ground-band energies of 166Gd and 164Sm (N=102) compared to 164Gd and 162Sm (N=100), respectively, presents evidence for the predicted deformed shell closure at N=100.

Synthesis, crystal structure, spectroscopic, fluorescent, thermal properties and EPR spectra of doped Cu2+ ions in [Cd(sac)2(H2O)2(meim)2] single crystal

The crystal structures of the six-coordinate complexes [Cd(sac)2(H2O)2(meim)2] (complex 1) formed by reaction of 4-methylimidazole(meim) with [Cd(sac)2(H2O)4]·2H2O (saccharinate=sac), was synthesized and characterized by elemental analysis, infrared (IR) and electron paramagnetic resonance (EPR) spectroscopy, thermal analysis and X-ray single crystal diffraction. X-ray diffraction analysis revealed that complex 1 crystallized in the monoclinic crystal system with space group P21/c. The Cd(II) center was six-coordinated with four nitrogen atoms from two sac and two 4-meim ligands, two oxygen atoms from two aqua ligands. Spectral and thermal analysis data for complex 1 was in agreement with the crystal structures. In addition complex 1 displayed blue fluorescent emission in the solid state at room temperature. Single crystal EPR spectra at room temperature are resolved and have exhibited that two different Cu(2+) complexes were located in different chemical environments which contained two magnetically nonequivalent Cu(2+) sites. In low temperature EPR spectra down to 110 °C did show no considerable change. At higher temperatures, however, both thermo gravimetric analyses (TGA) and EPR spectra showed detectable changes around 140 °C; the causes and the mechanisms of changes are discussed.

Adiponectin levels, insulin resistance and their relationship with serum levels of inflammatory cytokines in patients with Behçet's disease

AIM

Increased frequency of cardiovascular disease and its possible relations with insulin resistance have been reported in patients with inflammatory diseases. The aim of our study was to investigate insulin resistance and serum adiponectin levels as cardiovascular risk markers in patients with Behçet's disease.

METHOD

Study population consisted of 40 patients with Behçet's disease (BD) and a control group composed of age, gender, body mass index-matched 46 healthy individuals. All patients were examined for signs of Behçet's disease. Body mass index, waist and hip circumference were measured. Insulin resistance was evaluated using the homeostasis model assessment-insulin resistance method. Erythrocyte sedimentation rate (ESR), lipid profile, high sensitive CRP (hsCRP), adiponectin, TNF-α, IL-6 and IL-8 levels were measured.

RESULTS

Erythrocyte sedimentation rate, serum hsCRP and IL-6 levels were significantly higher in patients with BD than those in the controls (P=0.001, P=0.001, P=0.001, respectively). Fasting plasma glucose, insulin levels and lipid profile were not different between the two groups. Insulin resistance and decreased levels of the serum adiponectin were not detected in the patients. There was no relationship between insulin resistance, adiponectin levels and inflammatory markers. Active and inactive patients did not differ in respect of any parameters.

CONCLUSION

Being a systemic vasculitis, BD may cause cardiovascular involvement. In this study, dyslipidemia, insulin resistance and low adiponectin levels were not detected among our patients with Behçet's disease. Our results suggest that there exists no increased risk for atherosclerotic cardiovascular disease associated with adiponectin levels and insulin resistance in patients with Behçet's disease.

Structural and spectral studies of N-(3-hydroxypyridine-2-yl)salicylideneimine and N-(3-hydroxypyridine-2-yl)-5-bromosalicylideneimine and their dimethyltin(IV) complexes

N-(3-hydroxypyridine-2-yl)salicylidineimine (1), N-(3-hydroxypyridine-2-yl)-5-bromo salicylideneimine (2) and their diorganotin(IV) complexes formulated as Me2Sn(OC6H4CH=NC5H3NO) (3) and Me2Sn(OC6H3BrCH=NC5H3NO) (4) were prepared and characterized by 1H-NMR, IR, mass spectroscopy and single crystal x-ray diffraction study. The crystal structures of 3 [orthorhombic, Pbna (no 60); a = 10.439(1) Å, b = 13.388(3) Å, c = 19.340(2) Å, Z = 4; V = 2703(1) Å3] and 4 [monoclinic, P21/a (no 14); a = 7.528(4) Å, b = 16.576(7) Å, c = 12.017(7) Å, β = 97.97(5), Z = 4; V = 1485(1) Å3] have been solved by standard methods and refined by full-matrix least squares (carried out on F 2) to R values of 0.066 and 0.046 respectively. The studied tin(IV) complexes (3 and 4) exhibit the distorted trigonal-bipyramidal geometries around Sn atoms, separately. The tautomeric effects of ligands and the substitution of Br atom to the common molecular structure were discussed beside of the coordination geometries of 3 and 4.

Synthesis, structural and spectral studies of bis-[N-(2,4-dimethoxy benzylidene)-2-mercaptoanilinato] Ni(II)

The Ni(II) complex of N-(2,4-dimethoxy ben-zylidene)-2-mercaptoaniline, [Ni(C15H14NO2S)2] was prepared and investigated. The structure derived from the two dimensional (2-D) NMR techniques, the infrared spectra, elemental analysis and mass spectra is consistent with that of the single crystal X-ray diffraction. Crystal system is monoclinic, space group Cc(no:9), number of formulae per unit cell Z=4. Cell parameters are a=14.283(4), b=13.828(4), c=14.345(5) Å, β=102.84(3)°, V= 2762(2) Å3. Two singly deprotonated ligands coordinate the metal atom in a distorted square planar geometry. The molecular geometry was also effected by C-H⋅⋅⋅N and C-H⋅⋅⋅O intramolecular hydrogen bonds.