Could ischemia-modified albumin levels predict the severity of disease in SARS-CoV-2 infection?

INTRODUCTION

Ischemia-modified albumin (IMA) level increases in inflammatory conditions. We aimed to investigate the association between IMA levels and the severity of coronavirus disease 2019 (COVID-19) infection in adult patients.

METHODOLOGY

We grouped adult patients with COVID-19 infection: Group A - mild symptoms, but normal computed tomography (CT), Group B - mild/moderate illness, and Group C - severe or critical illness. We measured IMA levels at the time of diagnosis of COVID-19 infection.

RESULTS

Mean age of the total number of patients (n = 90) was 54.43 (± 8.11) year, and 46.7% (n = 42) were female. IMA levels were highest in Group C and lowest in A (p < 0.001). The most important factor predicting COVID-19 disease severity was IMA. Type 2 diabetes was more frequent in Group C (n = 31) than in Group B (n = 30) (p = 0.042). Asthma was less frequent, and coronary artery disease was more frequent in Group C than in Group A (n = 29) and B (p = 0.009). Duration of hospitalization was highest in Group C (p < 0.001).

CONCLUSIONS

We analyzed a sample of patients with COVID-19 infection and found that IMA predicted severe COVID-19 disease. Disease severity grouping was based on patients' clinical and radiological features. IMA level measured when SARS-CoV-2 infection is diagnosed may be a useful marker in predicting likely disease severity or intensive care need.

Neurological manifestations of COVID-19 infection in acute and late phases: A case-control study

Background & Objective: The late-term neurological effects of COVID-19 are not fully understood yet. Herein, we aimed to determine if COVID-19-related acute and late-term neurological symptoms exist in the patient group that differs from the general population during the pandemic period. Methods: Two hundred fifty patients with a history of COVID-19, whose treatments were completed at least one month before enrollment, were examined together with a control group consisting of 150 individuals that lived in the same socio-cultural environment during the same period. A survey that included questions about possible neurological symptoms that might be related to the COVID-19 infection was completed in both groups. Results: The patient and control groups were mostly similar regarding the neurological symptoms in the pre-pandemic period. The control group did not report any new symptoms except ageusia during the pandemic period. Whereas a number of neurological symptoms such as headache, ageusia and anosmia, difficulty in thinking and planning, forgetfulness, clumsiness of one or both hands, dizziness, unsteadiness, numbness in both hands and feet, and neuropathic pain occurred during the infection. Neurological symptoms, except headache and unsteadiness, prolonged to the late-term with a decreased prevalence. Conclusion: The emergence of new neurological symptoms during the pandemic in those with COVID-19 disease, unlike the control group, suggested that these symptoms are related to the infection itself.

Effects of LSVT-BIG via telerehabilitation on non-motor and motor symptoms and quality of life in Parkinson's disease

BACKGROUND

Parkinson's disease (PD) is a neurodegenerative disease with motor and non-motor symptoms affecting the quality of life. This study aimed to investigate the effects of the Lee Silverman Voice Therapy (LSVT)-BIG rehabilitation program via telerehabilitation on quality of life, motor and non-motor symptoms in people with Parkinson's disease (PwPD), and their correlation with each other.

METHODS

Fifteen patients with mild-to-moderate PD (Hoehn and Yahr stages 1-3) were included in the LSVT-BIG exercise program with remote access for 16 sessions over four weeks. Motor and non-motor experiences before and after the program were evaluated with MDS-UPDRS parts 1, 2, and 3 and quality of life with PDQ-39. The correlation between MDS-UPDRS parts and PDQ-39 subgroups was examined.

RESULTS

Following the application of the LSVT-BIG rehabilitation program with remote access, MDS-UPDRS parts 1, 2, and 3 scores and PDQ-39 summary index (PDQ-39 SI) and subgroup scores (excluding social support) were improved. A moderate-strong correlation was determined between MDS-UPDRS parts 1 and 2 and the PDQ-39 parameters of the patients.

CONCLUSION

Both motor and non-motor symptoms may be associated with the quality of life in PD. We have concluded that LSVT-BIG treatment via telerehabilitation can improve motor and non-motor symptoms along with the quality of life in PwPD.

The Relationship Between Chronotype and Impulsivity, Attention-Deficit Disorder, Internet, Social Media, and Smartphone Addiction

BACKGROUND

The aim of our study is to investigate the relationship between chronotypes and impulsivity, attention-deficit disorder and smartphone, social media, and internet addiction in a sample of university students.

METHOD

The study was conducted at our university from May to July 2021. A total of 255 subjects were recruited in the study among the students from the medical faculty and the faculty of health sciences (departments of nutrition and dietetics, nursing, and physiotherapy and rehabilitation) of our university who received face-to-face education in 2020-2021. Sociodemographic data form, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, Morningness-Eveningness Questionnaire, Barratt Impulsiveness Scale-11 Short Form, Young's Internet Addiction Scale, Social Media Addiction Scale-Adult Form, and Smartphone Addiction Scale-Short Version were administered by the study investigators through face-to-face interviews.

RESULTS

Among the students, the intermediate type was most common (n = 157) and the evening type was least common (n = 44). The chronotypes differed in terms of the time spent daily on smartphone and internet (P = .001 and P < .001). The evening types showed significantly higher mean scores on the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, Morningness-Eveningness Questionnaire, Barratt Impulsiveness Scale-11 Short Form, Young's Internet Addiction Scale, Social Media Addiction Scale-Adult Form, and Smartphone Addiction Scale-Short Version when compared with other chronotypes. Female and male students showed comparable scores on all scales. Chronotypes were not different between genders.

CONCLUSIONS

The results of our study showed a greater frequency of smartphone, internet, and social media addiction among the evening types than in the other chronotypes. Greater impulsivity and attention problems as observed in the evening types may be predisposing these individuals to develop addiction to smartphone, internet, and social media.

Turkish Validity and Reliability of the Hammersmith Infant Neurological Examination (HINE) with High-Risk Infant Group: A Preliminary Study

Objective: The purpose of this study was to establish the reliability of the Turkish translation of the Hammersmith Infant Neurological Examination in infants at 8-12 months corrected age and compare Hammersmith Infant Neurological Examination scores to other predictive assessments.

Materials and Methods: Perinatal risk factors, term-age magnetic resonance imaging, general movements at 3-month corrected age, and 12-month corrected age The Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) scores were obtained in 35 high-risk infants. The Hammersmith Infant Neurological Examination was evaluated using intra-rater and inter-rater reliability. Hammersmith Infant Neurological Examination scores were compared to the findings from the three other assessments.

Results: Intra-rater and inter-rater reliability was high (intraclass correlation coefficient = 1.00; intraclass correlation coefficient = 0.969, P < .001, 95% CI = 0.939-0.984, respectively). Global Hammersmith Infant Neurological Examination scores were significantly lower in infants with magnetic resonance imaging evidence of brain injury than without (P < .05) and in infants without general movements Fidgety movements (P < .05), than with. There was a significant positive correlation between global Hammersmith Infant Neurological Examination scores and Bayley Scales-III cognitive (P < .001), language (P < .001), and motor composite scores (P < .001).

Conclusion: This study strongly supports the use of the Turkish translation of the Hammersmith Infant Neurological Examination. Users found it readily understandable and easy to use, and the scores were consistent with 3 different methods of predicting neurodevelopmental outcomes. These findings will aid the early diagnosis, management, and support for children with neurodevelopmental problems.

Survey of the Impact of the COVID-19 Pandemic on Ophthalmology Clinical Practice in Turkey

Objectives:

To investigate the effect of the novel coronavirus disease 2019 (COVID-19) pandemic on the clinical practice of ophthalmologists in our country.

Materials and Methods:

A questionnaire consisting of 22 questions was delivered to 250 ophthalmologists via e-mail and a smartphone messaging application. A total of 113 ophthalmologists completed the survey. The questions included the participants’ demographic data (age, years in practice, institution, and city), changes in their working conditions and institutional preventive measures implemented during the pandemic, their personal COVID-19 experiences, the prevalence of telemedicine applications, and their attitudes toward these practices.

Results:

Nearly half (47.8%) of the 113 ophthalmologists were 36 to 45 years old. In terms of years in practice, the largest proportion of respondents (28.3%) had 6-10 years of experience. Most of the participants worked in private/foundation universities (37.2%), while 22.1% worked in education and research clinics. Participants working at public universities most often reported that they or a close contact had to work in COVID wards (89.5%). Triage was performed in 51.5% of ophthalmology outpatient clinics, with 88.0% of these participants reporting that patients with fever, cough, or dyspnea were directed to the pandemic clinic without ophthalmological examination. All participants working in public hospitals, education and research clinics, and public university hospitals had postponed elective surgeries, whereas 12.5% of those working in private practice and 20.5% of those working in private/foundation universities reported that they continued elective surgeries. While 80.8% of the participants did not conduct online interviews or examinations, 40.4% stated that they considered telemedicine applications beneficial. Seventy-seven percent of participants expressed concern about a decrease in their income during the pandemic, with this being especially common among participants working in private practice (87.5%) and private/foundation university hospitals (85.7%).

Conclusion:

Ophthalmologists across our country have been affected by this pandemic at a level that will change their clinical approach. We think that ophthalmologists impacted by the difficulty of providing personal protective equipment and economic concerns should be supported more during the pandemic.

The gender differences in the implementation and maintenance of a structured-enhanced education and follow-up program in primary prevention for coronary artery disease

Background

Primary prevention programs for coronary artery disease (CAD) may be effective in improving health-related behavioral outcomes. However, successful implementation and maintenance of these programs can vary amongst genders. The primary aim of this study is to assess the gender differences in a structured, enhanced education and follow-up program for CAD prevention in an area where the diverse population and economy are major problems.

Methods

SANKO CAD Prevention Project (SCAD-PPI) was designed as a longitudinal study and utilized medical school students to conduct the project under the supervision of professors. It began in 2014 and had two different education and training phases. In the first phase, every school year for second year Medical students underwent a year-long, especially designed training program on primary prevention for CAD. In the second phase, which took place in the second year of the study, a series of conferences regarding the primary prevention for CAD were organized by the University and local municipalities for underserved populations. Participants were prospectively assigned to an intervention where pre- and post-conference knowledge was collected and assessed. Every intervention was conducted by specially trained third year Medical students and an education booklet, which was specially designed for the study, was given to the participants. Every other month thereafter, for 6 months, each participant was followed-up via phone calls. At the 6 months follow -up, data was collected to assess the impact of the program on behavioral outcomes. Every year a new class assigned to undergo the same training program and serve to the local population at different locations within the same city and suburbs.

Results

A total of 172 participant were enrolled; 61% were women, mean age was 40±11.9 years with no significant difference in between the groups.; 67% of women were not working (p&lt;0.001). While BMI rates were higher in women (27.9±5.5 kg/m2, p&lt;0.016), smoking rates were higher in men (p&lt;0.001). Overall, knowledge on CAD risk factors, primary prevention measures, diet, and daily exercise habits were poor in both groups. After the enhanced education and follow-up program there was a significant improvement on the knowledge of CAD risk factors and primary prevention measures in both groups (p&lt;0.001). Importantly, the follow-up program led both groups to implement those positive changes into their lives and maintain a healthy lifestyle.

Conclusion

This is the first study which showed that a longitudinally structured training program of medical students could be utilized to implement an enhanced education and follow–up program for primary prevention of CAD in an economically challenged, underserved population with successful outcomes in both genders. This model program is not only beneficial for public interest, but also enhances active interaction of medical students with patients at a very early stage of their career.

Funding Acknowledgement

Type of funding sources: None.

Quantitation of antibodies against SARS-CoV-2 spike protein after two doses of CoronaVac in healthcare workers

Quantitation of antibodies to the spike protein of severe acute respiratory syndrome coronavirus 2  (SARS-CoV-2) was performed for the detection of adaptive immune response in healthcare workers (HCWs) vaccinated with CorovaVac. We prospectively recruited HCWs from a university hospital in Turkey. Serum samples from 1072 HCWs were obtained following 28 days of the first, and 21 days of the second dose. Detection and quantitation of SARS-CoV-2 antispike antibodies were performed by the chemiluminescent microparticle immunoassay (SARS-CoV-2 IgG II Quant; Abbott). Results greater than or equal to the cutoff value 50.0 AU/ml were reported as positive. After the first dose, antispike antibodies were detected in 834 of 1072 (77.8%) HCWs. Seropositivity was higher among females (84.6%) than males (70.6%) (p < 0.001) and was found to be highest in both women and men between the ages of 18-34. After the second dose, antibodies were detected in 1008 of 1012 (99.6%) HCWs. Antibody titers were significantly higher in those who had coronavirus disease-2019 before vaccination than those who did not (p < 0.001). Antibody positivity and median antibody titers were significantly less in HCWs with chronic diseases compared to those without (p < 0.05 and p < 0.001, respectively). In conclusion, our findings indicated that a relatively high frequency (99.6%) of humoral immunity was produced in HCWs aged 18-59 after two doses of CoronaVac. Quantitation of antibodies may help facilitate longitudinal monitoring of the antibody response, which will be especially useful in deciding the dose of the vaccine in vulnerable groups such as those over 60 years of age and those with chronic diseases.

Quality of Life for Women with Breast Cancer-Related Lymphedema: The Importance of Collaboration between Physical Medicine and Rehabilitation and General Surgery Clinics

Background: The aim of this study was to examine the clinical characteristics and quality of life (QOL) of patients with BCRL (breast cancer-related lymphedema).Methods: In this cross-sectional descriptive study, patients' characteristics such as age, body mass index (BMI: kg/m²), history of chemotherapy (CT), radiotherapy (RT), hormone replacement therapy (HRT), neoadjuvant therapy (NT), cancer stages, and types of surgery were recorded. Patients were evaluated using the ‘Disabilities of the Arm, Shoulder and Hand questionnaire’ (DASH), the ‘Lymphedema Quality of Life Questionnaire’ (LYMQOL-ARM), and a visual analogue scale (VAS). Results: A total of 68 women with the mean age of 52.50±9.33 and BMI 29.240 ± 5.05 kg/m² were recruited after breast cancer surgery in this study: thirty-three patients (48.5%) in Stage 0; 24 (35.3%) in Stage 1; 10 (14.7%) in Stage 2; and 1 (1.5%) in Stage 3. No statistically significant difference was found in the QOL according to treatments received after the diagnosis of breast cancer surgery, RT (except the appearance domain of QOL), CT, HRT, or NT. In patients who had received axillary dissection in combination with RT, a statistically significant association was observed between QOL related to body image and symptoms (p=0.009 and p=0.017, respectively). A statistically significant difference was found only in body image and clinical symptom domains according to the lymphedema stage (p=0.027 and p=0.002, respectively). It was observed that as shoulder pain (VAS) and disability (DASH) scores increased, scores of all domains of QOL increased except the overall domain in QOL (p<0.05). Conclusion: It was observed that clinical symptoms and body image parameters in QOL were associated with the lymphedema stage and the number of lymph nodes dissected. It was concluded that axillary dissection with axillary RT and RT alone after breast cancer surgery is associated with body image. Our study revealed that body image perception is related to the quality of life in patients with BCRL. Optimal management of the negative effects of self-reported lymphedema evaluated in the latency phase on quality of life requires coordination between Physical Medicine and Rehabilitation and General Surgery Clinics.

Assessment of Antioxidant Effect of Beta-Glucan on the Whole Blood Oxidative DNA Damage with the Comet Assay in Colorectal Cancer

OBJECTIVE

The present study aims to evaluate the antioxidant effect of beta glucan on oxidative DNA damage by comet assay.

METHODS

A total of 19 adult females and males diagnosed with stage 3-4 colorectal cancer and a control group of 20 age-matched healthy subjects were enrolled in the study. Blood samples of the participants were analyzed using Comet Assay for the parameters of DNA damage.

RESULTS

Significantly increased DNA damage was observed in patients versus control group as indicated by greater values of tail moment, tail percent DNA and tail length. Following incubation with β-glucan, a substantial reduction was found in the aforementioned parameters of DNA damage. Comet assay revealed significant levels of endogenous DNA damage in patients as shown by remarkable increases in the tail moment, the percentage of DNA in the tail and the tail length values, in comparison with the control group. Following treatment of fresh whole blood with β-glucan incubation, DNA damages were significantly reduced but lower values were observed after β-glucan incubation in the patient group versus control group.

CONCLUSION

β-Glucan was found to reduce DNA damage substantially in colorectal cancer patients and show antimutagenic effects. Our results suggested that dietary β-glucan intake might be important in the genesis of colorectal cancer tumors.

Comparison of low level laser therapy and extracorporeal shock wave in treatment of chronic lateral epicondylitis

OBJECTIVE

The aim of this study was to compare the efficacy of extracorporeal shock wave therapy (ESWT) ver-sus low-level laser therapy (LLLT) in treating chronic lateral epicondylitis (CLE).

METHODS

In this prospective study, 52 patients (24 males, 28 females; mean age=48 years; age range=30-70 years) with a diagnosis of CLE were included and randomized into two groups (26 in each group): ESWT group (14 males, 12 females; mean age=48±10 years) or LLLT group (10 males, 16 females; mean age=48±11 years). ESWT was applied for 5 weeks with one session per week, while LLLT was applied with 15 sessions on consecutive days. All patients were evaluated using Disability of the Arm, Shoulder and Hand Questionnaire (DASH), Patient-Related Lateral Epicondy-litis Evaluation (PRTEE), and the 36-Item Short-Form Health Survey (SF-36) before and after the treatments.

RESULTS

In the comparison of baseline data between treatment groups, significant differences were observed only in SF-Physical functioning and SF-Energy/fatigue scores (p=0.035 and p=0.038, re-spectively), which were 77.1±17.2 and 56.3±17.2 in ESWT group and 66.5±18.0 and 44.8±21.5 in LLLT group, respectively. In the comparison of post-treatment data between groups, there were sig-nificant differences in all scores (p<0.05) except two subscales of SF-36, which were SF-role limita-tions due to emotional problems (p=0.092) and physical health (p=0.147), respectively. The other subscales of SF-36, PRTEE and DASH scores obtained after the treatments were better in ESWT group than in LLLT group. The comparison of pre-and post-treatment scores in each group revealed significant improvements in all scores (p<0.05), except SF-36 subscales, including energy/fatigue, emotional well-being, social functioning, and general health scores (p>0.05).

CONCLUSION

Evidence from this study revealed that although both treatment modalities were effective in the treatment of CLE, ESWT seemed to more effective in pain relief and functional recovery than LLLT.

LEVEL OF EVIDENCE

Level II, Therapeutic study.

Statistical errors in articles published in radiology journals

PURPOSE

We aimed to evaluate articles in radiology journals indexed in the Science Citation Index or Science Citation Index Expanded in terms of statistical errors. By this means, we aim to contribute to the production of high quality scientific publications.

METHODS

In this study, a total of 157 articles published in 2016-2017 in 20 radiology journals were reviewed randomly. Selected articles were evaluated for statistical errors regarding P values and statistical tests, and for errors in terminology and other errors related to interpretation. In addition, in order to examine whether the error rates of the articles published in the radiology journals differed according to the impact factor, the statistical errors were compared according to the impact factors of the journals.

RESULTS

Of the 157 articles published in radiology journals, 10 had no statistical errors, while 147 had at least one statistical error. The most frequently encountered error was "errors in summarizing data" with a rate of 66%. This was followed by "incorrect representation of P values" with a rate of 42%. The least frequently encountered error was "statistical symbol errors" with a rate of 3%. There was no statistically significant difference according to impact factors.

CONCLUSION

In conclusion, radiology journals, as do journals in different fields, include articles containing statistical errors. Even when the quality of the journal increases, there is no difference in these statistical error rates. In order to prevent statistical errors in manuscripts, there are responsibilities for both the researchers who conduct scientific studies and the editors who publish these studies in their journals. Researchers should have a basic statistical knowledge, and the editor must submit all manuscripts for a statistical review.