Relationship between Psychological Resilience, Perceived Stress, Death Anxiety and Progression of Disease in Individuals with COVID-19

Introduction

This study examines the association between perceived stress, death anxiety, psychological resilience and the sociodemographic and clinical features of patients with Coronavirus Disease 2019 (COVID-19).

Methods

304 patients with COVID-19 diagnosis, who were admitted to İstanbul University İstanbul Faculty of Medicine Hospital "COVID-19 Patients Monitoring Center" were recruited. No sample selection was made, all the patients who were followed up and treated in the center were included. Data was collected by the researchers through face-to-face interviews using the Sociodemographic Information and Disease Progression Form, Psychological Hardiness Scale (PHS), Perceived Stress Scale (PSS), and Templer Death Anxiety Scale (TDAS).

Results

Women scored higher in PSS and TDAS. Participants with chronic diseases reported higher death anxiety whereas perceived stress was higher in individuals with psychiatric disorders and ones without a history of intensive care unit stay. Participants without psychiatric disorders, who had longer hospitalization and who fully recovered scored higher in PHS-Control. Patients' report of negative attitudes from their relatives/friends was associated with lower scores in PHS. Perceived stress was correlated with death anxiety and psychological resilience.

Conclusion

Being female, comorbid physical and mental illnesses, continuation of disease symptoms and low psychological resilience were found to be risk factors in terms of stress and death anxiety in COVID-19 patients. These vulnerable groups need to be closely evaluated with a bio-psychosocial approach and provided psychological support during the course of the disease. Health institutions are recommended to conduct medical treatment in cooperation with psychological care.

Association of maternal serum Netrin-1 and Netrin-4 levels with placenta accreta spectrum

OBJECTIVE

This study aimed to evaluate maternal serum Netrin-1 and Netrin-4 levels in pregnancies complicated with placenta accreta spectrum.

PATIENTS AND METHODS

This cross-sectional study enrolled 49 pregnant women with the diagnosis of placenta accreta spectrum as the study group. Gestational age-matched 30 uncomplicated pregnant women with prior cesarean delivery and normal placentation were randomly selected as the control group. Maternal serum Netrin-1 and Netrin-4 levels were measured between weeks 34 and 36 of gestation.

RESULTS

There was no significant difference between the groups in terms of demographic characteristics. Maternal serum Netrin-1 levels were significantly lower in placenta accreta spectrum cases compared with those in the control group (p=0.038). There was no significant difference between the groups in terms of maternal serum Netrin-4 levels (p>0.05). There was a significant negative correlation between maternal serum Netrin-1 levels and the number of prior cesarean deliveries (r=-0.313, p=0.005).

CONCLUSIONS

The observed decrease in maternal serum Netrin-1 levels in placenta accreta spectrum cases associated with increased angiogenesis might be one of the factors involved in the pathophysiology of this disease.

Validation of the Turkish version of the self-evaluation of negative symptoms scale (SNS)

OBJECTIVES

The Self-Evaluation of Negative Symptoms Scale (SNS) is a self-report scale that evaluates a patient's subjective experience on all five domains of the negative symptoms. This study aimed to present the adaptation and validation study of the Turkish version of SNS(SNS-TR).

METHODS

Seventy-five patients and 50 controls were recruited for this study. After the approval of the translation, participants were asked to fill out SNS-TR by themselves. They were interviewed with the Brief Negative Symptoms Scale (BNSS), Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale for Schizophrenia (CDSS).

RESULTS

SNS-TR showed good internal consistency in the reliability analysis with Cronbach's alpha= 0.873. Subscale-total score correlation coefficients were significant (p < 0.01). In the validity analyses, the total and subscale scores of SNS-TR showed positive correlations with the total and subscales of BNSS, with only one exception of BNSS lack of distress subscales. The total score of SNS-TR demonstrated a significant correlation with PANSS-total, PANSS-negative subscale, PANSS-general subscale, and CDSS scores. Confirmatory factor analysis showed acceptable values for the five-factor structure, similar to the original version.

CONCLUSION

To conclude, our study indicates that SNS-TR is an easily applicable self-evaluation tool with good psychometric properties for assessing negative symptoms. KEY POINTSSNS is a novel and easily applicable self-report scale for examining negative symptoms in schizophrenia patients, allowing them to evaluate their subjective experience on all five domains of the negative symptoms.It shows good internal consistency (α= 0.873) which is similar to the original version (α = 0.867).Confirmatory factor analysis scores were found in acceptable ranges and SNS-TR confirm the five-factor structure.Using this scale in clinical practice would empower both the physician's examinations and patient participation through treatment and follow-up course.

How the COVID-19 outbreak affected patients with diabetes mellitus?

Background

Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients.

Methods

This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression.

Results

Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level.

Conclusions

It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits.

Histomorphology of the Malpighian Tubules and the Chemical Composition of the Spherocrystals in the Tubule Epithelial Cells of Adult Leptophyes albovittata (Kollar, 1833) (Orthoptera, Tettigoniidae)

In insects, the number, cytological and histological structures, and the spherocrystals of the Malpighian tubules (MTs) can vary considerably in different insect groups. These differences are considered important because they can be used as taxonomic characters. For this purpose, the ultrastructure of the MT epithelial cells in Leptophyes albovittata (Kollar, 1833) (Orthoptera, Tettigoniidae) was examined by light microscopy, scanning electron microscopy, and transmission electron microscopy. The wall of each tubule consists of a single layer of cells. These cells have round-shaped nuclei. Two different cell types were demonstrated in the tubule cell. These are cells that have electron-dense cytoplasm and electron-lucent cytoplasm. It was observed that the cytoplasm of these cells has many spherocrystals. The chemical composition of the spherocrystals was found to be high in carbon, phosphorus, and manganese in tubule cells.

A longitudinal study of lateral ventricle volumes in deficit and non-deficit schizophrenia

Although it is generally accepted that negative symptoms of schizophrenia are associated with larger lateral ventricles, this general assumption could not be validated in patients with primary negative symptoms. To elucidate this issue, we conducted a five-year longitudinal study, including deficit (n = 13) and non-deficit (n = 26) schizophrenia patients with healthy controls (n = 18). Analysis with linear mixed effects modeling showed that both the left and the right lateral ventricles of the deficit patients enlarged more than the non-deficit patients. Our results suggest that structural alterations in deficit patients might follow a different trajectory than those in non-deficit patients.

The Ovariol Morphology and Ultrastructure of Poecilimon ataturki Ünal, 1999 (Orthoptera, Tettigoniidae) and the Histochemical Features of the Yolk Granules

This study presents the oocyte development of Poecilimon ataturki Ünal, 1999 (Orthoptera, Tettigoniidae) with histology, morphology, and histochemistry by using a stereomicroscope, a light microscope, a scanning electron microscope, and a transmission electron microscope. The ovary in this species is a panoistic type which contains many ovarioles which consist of terminal filament, germarium, and vitellarium. Germarium is the region that has undifferentiated cells which generate the oocytes and follicular cells. In the vitellarium region, yolk granules start to cover the whole oocyte. In histochemical studies, to determine the content of the yolk granules, proteins, and carbohydrates in oocytes were treated with a bromophenol blue (BPB) method, a mercury bromophenol blue (mBPB) method, and a periodic acid Schiff (PAS) method, respectively. As a result of these methods, the yolk granules gave positive results in ovariole sections treated with the PAS and the BPB, while the mBPB staining was negative.

Morphological and ultrastructural characterization and cuticular armature of the proventriculus in Bolua turkiyae Ünal, 1999 (Orthoptera: Tettigoniidae)

The alimentary canal is divided into three parts in insects as foregut, midgut, and hindgut. The intima of the foregut in orthopteran species is covered by cuticular layer which is differentiated into some spicules, microspines, lamellae, teeth, and ordenticles. Arrangement of these cuticular structures and histomorphological features differ in the pharynx, esophagus, crop, and proventriculus parts of the foregut. Moreover, the arrangement of these cuticular structures can vary among insect species. Consequently, these structures can be used as taxonomical characters. In this study, the morphological and ultrastructural features of the proventriculus which is the last part of the foregut in Bolua turkiyae Ünal, 1999 (Orthoptera: Tettigoniidae) were investigated. B. turkiyae is an endemic species and there is no detailed information about the biology of this species. With the use of a light microscope and a scanning electron microscope it was revealed that sclerotized structures with microspines in different morphologies and arrangements are present on the inner surface of the proventriculus. These structures show a high level of similarity despite some differences in Orthoptera.

Supplementing diets for broilers that are low in crude protein and amino acids with protease

The study evaluated supplementation of broiler diets with a protease enzyme. Six hundred Ross 308 female broiler chicks were acquired at one day of age and randomly distributed to three treatments with five replicates of 40 chicks each. The experimental treatements consisted of i) a positive control diet with normal levels of crude protein, digestible lysine and digestible sulphur containing amino acids (PC); ii) a negative diet with reduced levels of crude protein, digestible lysine and digestible sulphur containg amino acids (NC); and iii) the NC diet augmented with Ronozyme ProAct protease at 200 mg/kg (NC+ENZY). Compared to the other diets, feeding the PC produced the highest final bodyweight (BW), bodyweight gain (BWG), and feed intake (FI) and best feed conversion ratio (FCR) over 0 - 42 days. The PC diet also produced the highest hot and cold carcass yields, ileal protein digestibility and improved the serum biochemistry parameters. Relative to the NC, the NC+ENZY diet increased BW, BWG and FI, improved FCR, increased ileal protein digestibility, hot and cold carcass yields, and the crude protein content of meat. However, it decreased serum triglyceride and very low density lipoprotein (VLDL) cholesterol levels and the crude fat content of meat of broilers. As a result, protease supplementation at the level of 200 mg/kg may not remove the detrimental effects that are caused by a 6% reduction in crude protein and digestible amino acids on performance, hot and cold carcass yields and ileal digestibility of crude protein of broilers. Keywords: broiler, growth performance, low crude protein diet, meat, nutrient digestibility, protease, serum biochemistry parameters

Metreleptin replacement treatment improves quality of life and psychological well-being in congenital generalized lipodystrophy

The near total lack of subcutaneous fat in congenital generalized lipodystrophy (CGL) leads to the accumulation of fat in ectopic organs and severe insulin resistance, which are associated with serious metabolic abnormalities. Cosmetic aspects of the disease are likely to affect the quality of life (QoL) and physiological well-being in these individuals. Metreleptin, recombinant human leptin, replacement treatment has been shown to have benefits in treating the metabolic abnormalities of CGL. In a patient with CGL caused by a homozygous AGPAT2 pathogenic variant, we examined QoL and mood alterations (depression and anxiety) caused by this chronic disease. Metreleptin replacement treatment led to dramatic metabolic improvement in our patient. It was also was associated with improvements in QoL, depression and anxiety scores. We suggest that there is need for studies to document the benefit of metreleptin replacement treatment on QoL and physiological well-being in patients with CGL.

Accessory glands of male reproductive system in Pseudochorthippus parallelus parallelus (Zetterstedt, 1821) (Orthoptera: Acrididae): A light and electron microscopic study

The accessory glands of male reproductive system in insects play a significant role in the reproduction process by protecting sperm in spermatheca, preventing female to accept other males after mating and stimulating oviposition. The number, structure, and arrangement of the tubules of accessory glands can change from species to species. In this study, the accessory glands belonging the male reproductive system in Pseudochorthippus parallelus parallelus (Zetterstedt, 1821) (Orthoptera, Acrididae) were examined with stereomicroscope, light microscope, scanning (SEM), and transmission (TEM) electron microscopes at Gazi University, Faculty of Science in 2017-2019. P. parallelus parallelus is a widespread species that is located at the extending areas from Italy to the Northern Europe and also in Turkey. The accessory glands of P. parallelus parallelus' male reproductive system are composed of about 10 tubules. The tubules can be classified into two groups according to the thickness of their muscle tissues. Both groups have single layered epithelial cells with mitochondria, well-developed endoplasmic reticulum, spherical nucleus with electron dense chromatin, secretory vesicles and multivesicular bodies in their cytoplasm. In addition, apocrine type secretion is seen in epithelial cells.

Cortisol response patterns in depressed women and their healthy daughters at risk: Comparison with healthy women and their daughters

A dysfunctional hypothalamic pituitary adrenal (HPA) axis is widely accepted as a significant pathophysiological aspect of Major Depressive Disorder (MDD). Despite studies suggesting that a dysfunctional HPA axis might be present before the clinical syndrome becomes apparent, the functioning of the HPA axis in high-risk populations has not been well defined. The aim of the present study was to investigate the HPA axis functioning of mothers suffering from MDD and their healthy daughters compared to age- and sex-matched healthy controls. This design allowed a comparison of HPA axis functional differences among daughter and mother groups. HPA axis function was evaluated with a modified dexamethasone/corticotropin-releasing hormone (Dex/CRH) test, which was performed after obtaining the diurnal adrenocorticotropic hormone (ACTH) and cortisol values at 8:00, 16:00, and 23:00 h. We found that MDD mothers and their daughters had low morning cortisol and the MDD mothers additionally had low-morning ACTH compared with controls. Dexamethasone suppressed both cortisol and ACTH in all groups and subsequent HPA axis stimulation by CRH-evoked a lower cortisol response but a higher ACTH response among subjects with MDD mothers. Although high-risk daughters had comparable cortisol levels after CRH infusion, the AUC for ACTH was greater than those of controls. These patterns of results suggest that multiple level HPA dysfunctions are present in both MDD patients and their high-risk carrying daughters. However, insufficient cortisol secretion was only present in MDD mothers, while the daughters could compensate cortisol levels during CRH challenge.

Histological and ultrastructural features of the rectum in Poecilimon cervus Karabağ, 1950 (Orthoptera: Tettigoniidae)

The morphology and ultrastructure of the rectum in Poecilimon cervus Karabağ, 1950 (Orthoptera, Tettigoniidae) were analyzed by light microscope, scanning (SEM) and transmission electron microscopes (TEM). The rectum is the final part of the digestive tract that plays an important role in water reabsorption in insects and so provides osmoregulation. In the transverse sections, six rectal pads and columnar epithelium can be distinguished. The cuticular intima lines the lumen at the apical side of the epithelium. In the cytoplasm, there are numerous mitochondria, some endocytic vesicles, secreting vesicles whose sizes differ according to the area in the cell, and a nucleus with globular in shape. With this study, we aimed to demonstrate the ultrastructure of the rectum of P. cervus and differences or similarities of with other species.

Ultrasound-guided intrauterine insemination versus blind intrauterine insemination: a randomized controlled trial

PURPOSE

This study was performed to determine the effects of ultrasound (US) guidance during intrauterine insemination (IUI) on pregnancy rate.

MATERIALS AND METHODS

This study is a prospective randomized controlled trial which was performed in Women's Health Research and Education Hospital, Infertility Unit. The study enrolled 130 couples who were scheduled to undergo IUI. The couples were randomized according to a computer-generated list into two groups; 1) the ultrasound-guided IUI group included 64 couples (n = 64) treated for 99 cycles 2) blind IUI group included 66 couples (n = 66) treated for 104 cycles. All women underwent controlled ovarian stimulation before IUI. The study's main measurements were pregnancy rate per cycle; pregnancy rate per woman.

RESULTS

The pregnancy rates were similar in both the ultrasound-guided (USG) (16.2%, 16/99) and non-ultrasound-guided (NUSG)(12.5%, 13/104) groups (p = 0.386).

CONCLUSIONS

The present results suggest a routine ultrasound guidance during IUI is not essential as it does not increase pregnancy rates but it can be used in such cases to overwhelm some sort of difficulties.

First Report of Bacterial Blight of Pomegranate Caused by Xanthomonas axonopodis pv. punicae in Turkey

Pomegranate (Punica granatum L.) is an increasingly important fruit crop that is widely cultivated in Turkey. Typical bacterial blight symptoms were observed since spring of 2011 in pomegranate orchards located in Antalya Province. Symptoms were characterized by dark brown, angular to irregularly shaped spots on leaves and fruit; cankers on stems, branches, and trunks; and split trunks. The pathogen was isolated from leaf spots on naturally infected plants showing typical symptoms onto yeast dextrose chalk agar. Bright yellow bacterial colonies were consistently isolated. Bacterial strains were characterized as gram negative, oxidase negative, catalase positive, tobacco hypersensitivity positive, and able to produce acid from L-arabinose, D-galactose, D-glucose, and D-mannitol but not from D-xylose. Pathogenicity of the representative bacterial strain Serik-4 was performed on 2-year-old pomegranate plants cv. Hicaz. Leaves were sprayed until runoff with bacterial cell suspensions containing 10⁷ CFU/ml. Inoculated plants were covered with transparent plastic bags to maintain moisture for 48 h. Negative control plants were inoculated with sterile distilled water. Plants were then incubated in a greenhouse at 30°C for 14 days. Symptoms on leaves included dark brown, angular to irregularly shaped water soaked lesions along the veins of the inoculated plants 10 days after inoculation. No lesions developed on the control plants. The symptoms on inoculated plants were similar to those on naturally infected plants. Yellow bacterial colonies were re-isolated from the inoculated plants and identified as the same as the original strain by conventional tests and FAME analysis, thus fulfilling Koch's postulates. Fatty acid methyl ester profiling of the representative strain Serik-4 using GC-MIDI (Microbial Identification Inc, Newark, DE) identified the genus of the bacterium as Xanthomonas. The identity of Serik-4 was further confirmed by amplifying the 16S rRNA gene with the universal primers 27F and 1492R (3) and sequence analysis (GenBank Accession No. KM007073). The 16S rRNA gene sequences of Serik-4 was 99% identical to the corresponding gene sequences of the Xanthomonas axonopodis pv. punicae strain present in the NCBI database (JQ067629.1). High incidence of bacterial blight caused by X. axonopodis pv. punicae on pomegranate has been previously reported in India (2), Pakistan (1), and South Africa (4). To our knowledge, this is the first report of bacterial blight on pomegranate caused by X. axonopodis pv. punicae in Turkey. References: (1) M. A. Akhtar and M. H. R. Bhatti. Pakistan J. Agric. Res. 13:95, 1992. (2) R. Chand and R. Kishun. Indian Phytopathol. 44:370, 1991. (3) D. J. Lane. Page 115 in: Nucleic Acid Techniques in Bacterial Systematics, 1991. (4) Y. Petersen et al. Australas. Plant Pathol. 39:544, 2010.

Characteristics and prognosis of ovarian metastatic tumors: review of a single-institution experience

BACKGROUND

To evaluate the clinico-pathological characteristics and role of surgery in patients with ovarian metastasis.

MATERIALS AND METHODS

Clinical data from 51 patients with pathologically confirmed ovarian metastasis were reviewed.

RESULTS

Ovarian metastasis accounted for 14% of all malignant ovarian neoplasms (51/364). Of the 51 metastatic ovarian tumor cases, 24 originated from gynecologic malignancies, while 27 originated from non-gynecologic malignancies. Optimal cytoreduction was performed in 88% and 37% of patients with metastases of gynecologic and non-gynecologic origin, respectively. Patients with ovarian metastasis had a two-year survival rate in 82% of the gynecologic group and 70% of the non-gynecologic group (p = 0.35). The five-year survival rate of patients with non-gynecologic tumor origin (29%) was significantly worse (p = 0.04) than the survival rates of those with tumors of gynecologic origin (61%). In the non-gynecologic group, the five-year survival rates were significantly different between patients who were performed optimal cytoreductive surgery vs those without this procedure (42% and 20%, respectively; p = 0.04).

CONCLUSION

Although complete surgical resection is not achievable in approximately two-thirds of patients with metastases of non-gynecological origin, optimal tumor cytoreduction appears to improve survival, which is statistically significant in all patients with ovarian metastatic tumors.

Molecular characterization of sour orange (Citrus aurantium) accessions and their relatives using SSR and SRAP markers

Citrus production with its many varieties is of importance since it provides economically important products for Turkish exports. Sour orange is a rootstock commonly used for propagating the different scion varieties. Knowledge of the genetic diversity of the rootstock accessions would be useful in order to improve citrus breeding programs. We studied genetic relationships and diversity of 51 accessions of sour orange (Citrus aurantium) and their relatives using SSR (simple sequence repeat) and SRAP (sequence-related amplified polymorphism) molecular markers. Twenty-one SRAP primer combinations were tested on these accessions and relatives, producing 167 polymorphic fragments, with a mean of 8.0 and a mean polymorphism information content value of 0.47. Seventeen SSR primers also produced 30 polymorphic fragments, with a mean of 1.4 per primer and a mean polymorphism information content value of 0.39. The unweighted pair-group method with arithmetic average analysis using combined SSR and SRAP data showed a similarity range from 0.71 to 1.00 among the accessions. In the cluster analysis, sour orange relatives were indicated as a separate group from sour orange. 'Macrophylla' and 'Mexican lime' were the accessions most distinct (0.71) from the others. We conclude that genetic diversity in these sour orange accessions is lower and some of them were identical.

Diagnosis and management of cesarean scar pregnancy

OBJECTIVE

To evaluate the diagnosis and management modalities of cesarean scar pregnancy according to our experience.

DESIGN AND SETTING

Retrospective study at the Women's Health Research and Education Hospital.

PATIENTS

Six patients were diagnosed and treated for cesarean scar pregnancy (CSP) with dilatation and curettage, methotrexate (MTX), or laparatomy.

RESULTS

One patient chose the surgical option due to her desire to have a tubal ligation. In the second case methotrexate was applied initially, but two weeks later suction curretage was applied due to abdominal pain and vaginal bleeding. Suction curettage was used as an initial treatment for four patients. There were not any complications in three of four patients. One patient had heavy vaginal bleeding which started after curettage. On ultrasonographic examination, increasing hemorrhage was seen between the uterus and the bladder so subtotal hysterectomy was performed.

DISCUSSION

Ultrasound should be used effectivelly in evaluation of pregnant patients with previous cesarean deliveries. There is still no unique treatment modality for CSP, so treatment should be tailored for each patient. Before the 7th week, abortion should be considered. After the 7th week, MTX and/or surgical options should be preferred.