SUMMARY OBJECTIVE: It has been determined that adropin has a role in tissue healing. This study aimed to determine the effects of head trauma on the tissues and blood levels of patients admitted to the emergency department. METHODS: The study group was divided into two to compare the adropin level in healthy individuals and patients with head trauma. Blood tests from patients and healthy volunteers were compared using the adropin kit. Adropin levels, Glasgow Coma Scale, and revised scores of trauma patients were recorded and analyzed. RESULTS: All patients in the trauma group had significantly higher adropin levels than the control group. Among these patients, the adropin level of the discharged patients was higher than the others. In addition, patients with high Glasgow Coma Scale and normal blood pressure were found to have higher adropin levels than the others. CONCLUSION: Although adropin cannot make a sharp distinction in determining the prognosis, the increase in its level in trauma patients shows that it triggers a protective mechanism. OBJECTIVE healing department METHODS kit analyzed RESULTS others addition CONCLUSION prognosis mechanism

Abstract: This study aimed to examine the relationship between the burnout of physicians and nurses and their moral sensitivity during the pandemic. This was a descriptive and correlational study. This study was carried out with physicians and nurses who were continuing to work actively during the pandemic. Snowboard sampling method was utilized. The total mean score of the participants on the MSQ was 90.78±19.10. The total mean score of the COVID-19 Burnout Scale was 34.52±9.65. A statistically weak and significant correlation was found between the COVID-19 Burnout Scale and the MSQ total score, as well as the “benefit” and “conflict” sub-dimensions. It was determined that as MSQ total scores, “benefit” and “conflict” scores decreased in healthcare workers, COVID-19 burnout scores increased. In our study, the moral sensitivity of the participants was found to be moderate, and their burnout levels were found to be high. Although there was a weak relationship, it was observed that burnout levels increased as moral sensitivity levels increased. It is crucial that we learn from pandemic experiences and transfer this knowledge to future generations. In particular, we must assimilate these important lessons into training in order to develop and protect the moral sensitivity of healthcare professionals.

Resumen: Este estudio pretendía examinar la relación entre el burnout de médicos y enfermeras y su sensibilidad moral durante la pandemia. Se trató de un estudio descriptivo y correlacional, y se llevó a cabo con médicos y enfermeras que seguían trabajando activamente durante la pandemia. Se utilizó el método de muestreo de Snowboard. La puntuación media total de los participantes en el MSQ fue de 90,78±19,10. La puntuación media total de la Escala de Burnout COVID-19 fue de 34,52±9,65. Se encontró una correlación estadísticamente débil y significativa entre la Escala de Burnout COVID-19 y la puntuación total del MSQ, así como las subdimensiones “beneficio” y “conflicto”. Se determinó que, a medida que disminuían las puntuaciones totales del MSQ y las puntuaciones de “beneficio” y “conflicto” en los trabajadores sanitarios, aumentaban las puntuaciones de burnout de la COVID-19. En nuestro estudio, se observó que la sensibilidad moral de los participantes era moderada y que sus niveles de burnout eran elevados. Aunque existía una relación débil, se observó que los niveles de burnout aumentaban a medida que lo hacían los de sensibilidad moral. Es crucial que aprendamos de las experiencias pandémicas y transmitamos estos conocimientos a las generaciones futuras. En particular, debemos asimilar estas importantes lecciones en la formación para desarrollar y proteger la sensibilidad moral de los profesionales sanitarios.

Resumo: Esse estudo objetivou examinar a relação entre o burnout de médicos e enfermeiras e sua sensibilidade moral durante a pandemia. Esse era um estudo descritivo e correlacional. Esse estudo foi realizado com médicos e enfermeiras que continuaram trabalhando ativamente durante a pandemia. O método da amostragem em snowboard foi utilizado. A média total dos participantes no MSQ foi 90,78±19,10. A média total na Escala de Burnout pela COVID-19 foi 34,52±9,65. Uma correlação fraca e significante foi encontrada entre os escores totais na Escalas de Burnout pela COVID-19 e MSQ, assim como nas subdimensões “benefício” e “conflito”. Determinou-se que como os escores totais na MSQ e os escores “benefício” e “conflito” diminuiram em trabalhadores de cuidados à saúde, os escores de burnout pela COVID-19 aumentaram. Em nosso estudo, a sensibilidade moral dos participantes foi considerada ser moderada e seus níveis de burnout considerados serem altos. Embora tenha havido uma correlação fraca, foi observado que os níveis de burnout aumentaram quando os níveis de sensibilidade moral aumentaram. É essencial que aprendamos das experiências com a pandemia e passemos esse conhecimento para as futuras gerações. Em particular, nós devemos assimilar essas importantes lições em treinamentos, de forma a desenvolver e proteger a sensibilidade moral de profissionais de cuidados à saúde.

Abstract Objective: With this radio-anatomical study, we aimed to describe the distribution of the depth of the olfactory fossa based on the Keros classification in the pediatric population in our region and to reduce complication rates by providing normative data. Methods: This was a retrospective study conducted with computed tomography imaging of the paranasal sinuses of 390 pediatric patients referred over a six-year period in Sakarya and Kocaeli University Faculty of Medicine. Patients were divided into 3 groups as 1–6, 6–12, and 12–18 years old. The depth of the olfactory fossa was measured and classified according to the Keros classification. The incidence of Keros asymmetries was also investigated. Results: The distribution of the depth of a total of 780 olfactory fossa according to the Keros classification was 24.7% Keros I, 65.9% Keros II, and 9.4% Keros III. When the groups were evaluated with each other and within each group, it was seen that the prevalence of Keros I type was significantly higher in the first group (p < 0.05), and the prevalence of Keros type II was significantly higher in the second and third groups (p < 0.05). Apart from this, the number of Keros type III increased in the third group compared to the first two groups and showed a statistically significant difference (p < 0.05). Among all patients, asymmetry of the olfactory fossa was detected in 29 patients (7.4%). Although the number of olfactory fossa asymmetry was low in group I, it was not significantly different between the groups (p > 0.05). Conclusion: In our study, high Keros I rate and low Keros III rate in children aged -6 were remarkable. Especially for children under the age of six, questions arise about the validity of the Keros classification. More detailed studies in larger populations, in different ethnicities, and with various age groups are needed. Level of evidence: Level 3. Objective radioanatomical radio anatomical data Methods 39 sixyear six year Medicine 16 1 6 1–6 612 12 6–12 1218 18 12–1 old investigated Results 78 247 24 7 24.7 659 65 9 65.9 94 4 9.4 p 0.05, 005 0.05 , 0 05 0.05) 0.05. . 2 7.4%. 74 7.4% (7.4%) Conclusion - remarkable populations ethnicities needed evidence 1– 61 6–1 121 12– 24. 65. 9. 00 0.0 7.4 (7.4% 6– 0. 7. (7.4 (7. (7 (

ABSTRACT BACKGROUND: Critical diseases usually cause hypercortisolemia via activation of the hypothalamic-pituitary-adrenal axis. OBJECTIVES: To investigate the relationship between serum total cortisol level and mortality among coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU), at the time of their admission. DESIGN AND SETTING: Prospective study developed in a pandemic hospital in the city of Şırnak, Turkey. METHODS: We compared the serum total cortisol levels of 285 patients (141 COVID-19-negative patients and 144 COVID-19-positive patients) followed up in the ICU. RESULTS: The median cortisol level of COVID-19-positive patients was higher than that of COVID-19 negative patients (21.84 μg/dl versus 16.47 μg/dl; P < 0.001). In multivariate logistic regression analysis, mortality was associated with higher cortisol level (odds ratio: 1.20; 95% confidence interval: 1.08-1.35; P = 0.001). The cortisol cutoff point was 31 μg/dl (855 nmol/l) for predicting mortality among COVID-19-positive patients (area under the curve 0.932; sensitivity 59%; and specificity 95%). Among the COVID-19 positive patients with cortisol level ≤ 31 μg/dl (79%; 114 patients), the median survival was higher than among those with cortisol level > 31 μg/dl (21%; 30 patients) (32 days versus 19 days; log-rank test P < 0.001). CONCLUSION: Very high cortisol levels are associated with severe illness and increased risk of death, among COVID-19 patients in the ICU.

Abstract Introduction There are no definitive parameters to guide the etiology and severity of pediatric antrochoanal polyps. Objective The aim of our study is to compare the values of blood cell distribution parameters in cases of pediatric antrochoanal polyps (ACPs) with those of the control group. These values may be guiding parameters in determining the etiology of ACPs and evaluating the severity of the disease and the risk of recurrence. Methods Blood count values of patients operated for pediatric ACPs were retrospectively analyzed and compared with the data of the control group with the same age and gender distribution. The ACPs group was divided into subgroups in terms of inflammation, severity, and recurrence, and these subgroups were statistically compared as well. Results When the ACP patient group and the control group were compared, there was no statistically significant difference between the two groups. When we compared the patients considering the CT findings, there was a statistically significant difference between the stage III patients and the control group in terms of mean platelet volume (MPV) and platelet-to-lymphocyte ratio (PLR) values (p < 0.05 in both). Similarly, the MPV and PLR values were significantly higher in the recurrence patient group than in the control group. (p < 0.05 in both). Conclusion As a result of the data obtained, it can be suggested that inflammatory parameters in pediatric cases of ACPs vary in terms of recurrence and the severity of the disease.

Abstract Hypoxia occurs in the splanchnic region during exercise associated with sympathetic activity. In the elderly, vascular insufficiency and low vascular endothelial growth factor (VEGF) expression are observed. Compared to young people, sympathetic signals of older individuals are blunted and more resistant to splanchnic blood flow alterations during exercise. VEGF induces vasodilation responses and hence may retain blood in the splanchnic vascular bed. We hypothesized that regular mild-intensity exercise triggers weak VEGF expression in the digestive tract of the elderly. The effects of exercise on the levels of VEGF, superoxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA) and total antioxidant capacity (T-AOC) in the stomach, jejunum, ileum and colon tissues were evaluated. With exercise, the VEGF levels in the stomach and colon increased. Although the SOD, GPx, and MDA levels decreased in the stomach, they increased in the colon. T-AOC increased in the stomach and there was no change in the jejunum, ileum and colon. The hypoperfusion during exercise was not equal in all regions of the gastrointestinal tract in the aged subjects. Hypoxia and other exercise-related mechanisms could have led to this VEGF induction. The stomach, jejunum, and ileum might have developed resistance to ischemia. The induction of VEGF may be beneficial in aging-associated impaired gastrointestinal homeostasis and neovascularization.

A infecção pelo Parvovírus B19 costuma ser assintomática, mas as expressões clínicas podem incluir crise aplástica transitória, eritema infeccioso, hidropisia fetal não imune e aplasia crônica da série vermelha. Esse vírus também se associa à artrite reumatoide e a outras doenças autoimunes do tecido conjuntivo; entretanto, não conseguimos identificar na literatura nenhum caso de miosite aguda em adulto desenvolvida depois de infecção pelo Parvovírus B19. Por essa razão, gostaríamos de apresentar um caso raro de miosite aguda desenvolvida depois de infecção pelo Parvovírus B19. Nos pacientes que apresentam sintomas de febre, rash nas pernas e miosite, devem ser consideradas as infecções virais, como a causada pelo Parvovírus B19.

Parvovirus B19 infection is often asymptomatic, but clinical expressions may include transient aplastic crisis, erythema infectiosum, non-immune hydrops fetalis, and chronic red cell aplasia. This virus has also been associated with rheumatoid arthritis and other autoimmune connective tissue diseases; however, we could not identify any acute adult myositis case developed after a Parvovirus B19 infection in the literature. For this reason, we would like to present a rare case of acute myositis developed after Parvovirus B19 infection. In patients presenting with symptoms of fever, rash on the legs and myositis, viral infections such as Parvovirus B19 should be kept in mind.

Sister chromatid exchange (SCE) and chromosome aberrations (CA) in peripheral lymphocytes has been widely used in assessing exposure to mutagens and carcinogens. One of the extensively studied genotoxins is benzo[alpha]pyrene (BaP). We studied the ability of BaP to induce SCE and CA in 16 glutathione S-transferase M1 (GSTM1)-positive and 15 GSTM1-null individuals by analyzing 72-h whole-blood lymphocyte cultures, either BaP-untreated (controls) or treated with 5 µM of BaP for 24 or 48 h. There was no differences in the level of BaP-induced chromosomal aberrations between GSTM1-positive or null individuals when the cells were BaP-exposed for 24 h (0.083 ± 0.059 vs. 0.090 ± 0.058) or 48 h (0.092 ± 0.057 vs. 0.096 ± 0.050. The frequency of SCE in controls was GSTM1-positive = 2.96 ± 0.35 and GSTM1-null = 3.23 ± 0.56 while that for BaP-treated lymphocytes was GSTM1-positive = 5.56 ± 0.83 and GSTM1-null = 6.09 ± 1.11 and were not statistically significant. The rates of BaP-induced in vitro chromatid and chromosome-type gaps and breaks were similar in all groups, although GSTM1-null genotype chromatid-type breaks were more frequent (0.064 ± 0.039 per metaphase) than chromosome-type breaks (0.032 ± 0.027 per metaphase) after 48 h treatment with BaP (p < 0.001). These findings suggest that BaP-induced in vitro SCE and CA are not influenced by the GSTM1 genotype.