HEALTH STATUS, CORONAPHOBIA, QUALITY OF LIFE, ANXIETY AND DEPRESSION IN PATIENTS WITH LYMPHEDEMA DURING COVID-19 PANDEMIC

Covid-19 has physical damage as well as serious impact on the mental health in the community. Symptoms such as anxiety, depression, fear, stress, and sleep problems were more commonly reported during Covid-19 pandemic. The aim of this study was to assess the health status, psychological conditions, quality of life, and possible risk factors of patients with lymphedema during the pandemic. The study included male and female patients aged ≥18 years with primary or secondary upper or lower extremity lymphedema (stage 1, 2, or 3) who were followed in our outpatient clinic. The patients were interviewed by phone. Health and social status were examined using a questionnaire, Covid-19 phobia was assessed using Covid-19 Phobia Scale (C19P-S), and quality of life was assessed using Lymphedema Quality of Life Questionnaire Arm or Leg (LYMQOL). Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). The HADS scores showed that 35% of the patients had severe risk for depression and 10% had severe risk for anxiety. Factors with negative effect on HADS were lower education level, sedentary lifestyle, failure to perform lymphedema exercises, weight gain, and lymphedema duration. The C19P-S scores were higher indicating greater phobia in the overall score and subscores in patients with primary lymphedema and secondary lymphedema without malignancy, younger patients, those who are not able to walk regularly, and those who are not able to perform self manual lymphatic drainage (self-MLD). Factors with negative effects on LYMQOL were stage 3 lymphedema, female gender, younger age, and longer disease duration. Patients who performed regular self-MLD and lymphedema exercises demonstrated positive effects on LYMQOL. The results of this study suggest that patients with lymphedema affected by the COVID-19 pandemic are mostly younger patients, individuals with primary lymphedema, individuals with non-malignant etiology, individuals who unable to perform regular walking, and those unable to perform self-MLD.

The effect of skeletal muscle area and attenuation in patients with sternum fracture due to blunt chest trauma

OBJECTIVE

This study aims to retrospectively investigate the imaging features of patients with sternum fracture (SF) and concomitant organ injuries. We also aimed to evaluate the potential prognostic effect of skeletal muscle area (TMA) and muscle attenuation (MuA) values.

PATIENTS AND METHODS

Computed tomography (CT) images of patients with SF were re-evaluated by two observers (Observer-1 and 2). Observer-3 has measured TMA and MuA values. Observer-1 has repeated the measurements blindly to the first measurement results to evaluate the inter-observer agreement. The length of hospital stay, death, hemiplegia, or quadriplegia were investigated from the archives. Mann-Whitney U-test or Student's t-test was used to investigate the relationship between linear variables. The intraclass correlation coefficient (ICC) score was used to evaluate the interobserver agreement. Logistic regression analysis was used to estimate the relative effect of variables by calculating unadjusted odds ratios (ORs) for categorical outcomes.

RESULTS

Sixty-five patients had SF and 53 patients had SF and concomitant organ injuries. The most common injuries accompanying SF were rib fracture (73.58%) and lung contusion (60.38%). Manubrium fracture was the most common fracture location (52.3%), and 18 patients (27.7%) had displaced SF. Eight patients (15.1%) were discharged with plegia and five (9.4%) died. Hemothorax, displaced SF and decreased MuA were predictors of prolonged hospital stay, and the presence of cardiac contusion, displaced SF, hemothorax, and vertebra body fracture were independent factors for death.

CONCLUSIONS

The presence of a displaced SF and decreased MuA value are important prognostic factors in patients with SF.

Medial olivocochlear suppression in musicians versus non-musicians

The medial olivocochlear efferent (MOCE) branch synapses with outer hair cells (OHCs), and the efferent pathway can be activated via a contralateral acoustic stimulus (CAS). The activation of MOCE can change OHC motile responses and convert signals that are capable of controlling the sensitivity of the peripheral hearing system in a frequency-specific manner. The aim of this study was to examine the MOCE system activity in professional musicians using transient evoked otoacoustic emission test and CAS. Musician group showed stronger suppression in all frequency bands in the presence of CAS.

The protective effect of vitamin D against carbon tetrachloride damage to the rat liver

We investigated the protective effect of vitamin D against liver damage caused by carbon tetrachloride (CCl₄). Twenty-four male rats were divided into four equal groups: G1, untreated controls; G2, administered CCl₄; G3, administered both CCl₄ and vitamin D for 10 weeks; G4, administered CCl₄ for 10 weeks and vitamin D for 12 weeks. At the end of experiment, intracardiac blood samples were taken and liver samples were removed. Hepatic damage due to CCl₄ was assessed using biochemistry and histopathology. Glutathione (GSH) levels decreased, while malondialdehyde (MDA) levels increased in liver tissues of G2. Alanine transaminase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl-transaminase (GGT) levels increased, while albumin (ALB) levels decreased. Hepatocyte degeneration, lobular disorder, sinusoid dilation, focal necrotic areas, hyperemia, and glycogen loss were observed. Hepatic fibrosis was observed around portal areas and central veins. Bridging fibrous septa were formed between portal veins. By immunohistochemistry, both matrix metalloproteinase-9 (MMP-9) and desmin reactivity were increased. All aspects of liver damage were at least partially prevented in rats treated with vitamin D. Vitamin D appears to act as an antioxidant and anti-fibrotic to protect the rat liver against damage.

Serum levels of nitrate, nitrite and advanced oxidation protein products (AOPP) in patients with nonalcoholic fatty liver disease

BACKGROUND

Oxidative stress is increased and anti-oxidant defense mechanisms are impaired in patients with hepatosteatosis. The aim of the present study was to evaluate the serum levels of several oxidant and anti-oxidant markers in patients with nonalcoholic fatty liver disease (NAFLD).

PATIENTS AND METHODS

Thirty-four patients with NAFLD, and 19 healthy controls were included. In this study, we measured serum nitrate and advanced oxidation protein product (AOPP) as the oxidizing products and nitrite as the anti-oxidizing marker. Nitrate and nitrite levels were measured using a calorimetric method, and levels of serum AOPP were measured by a spectrophotometric method using a commercial ELISA kit.

RESULTS

Serum nitrate and AOPP levels were significantly higher in the NAFLD group compared to the control group. Serum nitrite and N-N levels were similar between the two groups. Serum nitrate and N-N levels were found to be significantly higher in patients with elevated ALT levels compared to patients with normal ALT levels. Serum nitrite and AOPP levels were comparable between these groups. Mean platelet volume (MPV) was significantly lower in the NAFLD group compared to the control group.

CONCLUSIONS

Serum levels of oxidizing agents including nitrate and AOPP increase in patients with NAFLD. In contrast, serum nitrite, an antioxidant agent, does not adequately increase to compensate for the oxidizing effects in these patients.

Characterization of Anatolian traditional quince cultivars, based on microsatellite markers

We conducted simple sequence repeat (SSR) analyses of 15 traditional quince (Cydonia oblonga) cultivars from Anatolian gene sources for molecular characterization and investigation of genetic relationships. Three pear and two apple cultivars were used as references for SSR locus data analysis and to determine allele profiles between species. Eight SSR loci that were developed from apple and pear were used, and a total of 44 alleles were found among quince cultivars. The CH01F02 locus was found to have the highest identification probability, while the CH04E03 locus had the lowest identification probability. Analysis of similarity ratios between quince cultivars showed that the lowest similarity ratio was 18% (Eşme-Bardacık ± k), while the highest similarity ratio was 87% (Bursa-Osmancık ± k and Osmancık ± k-Viranyadevi). In the phylogenetic dendrogram, Eşme quince showed separate branching from other quince cultivars, and no synonymous accessions were found. These results suggest that SSR markers from pear and apple could be used to determine genetic variation among quince cultivars. These findings can be used to guide future quince breeding and management studies.

Penetrating colon injury: experience of a single centre

OBJECTIVE

Penetrating colonic injuries are amongst the most discussed intra-abdominal injuries because of the complexity of their management and the severe complications. Penetrating colonic injuries can be managed by either primary repair or diversion. There is a debate over which procedure has to be used under which circumstances. In this retrospective study we analyzed our experience to contribute to the answer.

PATIENTS AND METHODS

The records of patients with penetrating colonic injury between January 1995 and December 2006 at the General Surgery Department of Atatürk University School of Medicine, were reviewed retrospectively.

RESULTS

One hundred and forty-one patients were included in the study. Ten patients did not need any surgical treatment. Seventy-nine patients (56%) were treated without formation of a stoma and fifty-two patients (36.8%) with formation of a stoma. The overall complication rate was 50.3% (71 patients). The rate of septic complications was 33.3%.

CONCLUSION

There is an ongoing debate whether formation of a stoma is indicated in penetrating colonic injury or not. Our clinical experience showed that severe faecal contamination, shock at presentation, and high CIS grades are associated with increased postoperative complications and mortality. Therefore the treatment of penetrating colonic injury in the presence of these risk factors should be stoma formation rather than primary repair.