Karakus, Seckin; Saritas, Serdar

Objectives Pain, a common human experience, is also experienced by nursing students, and pain beliefs, thoughts, and behaviors toward pain play an important role in coping with pain. There is insufficient data about the relationship between pain beliefs and pain coping strategies. Thus, this study aims to reveal the relationship between pain beliefs and pain coping approaches of nursing students and affecting factors. Methods A descriptive, cross-sectional, and correlational design was used, and the data were collected with respondent characteristics form, the Numerical Rating Scale (NRS) and the Pain Beliefs Questionnaire (PBQ), by researchers from 380 nursing students in the nursing department. Results Nursing students who used non -pharmacological interventions to cope with pain had higher levels of psychological belief (PBQ-P) scores (4.97-0.86) than organic belief (PBQ-O) scores (3.90-0.71) and the difference was statistically significant (p<0.001). According to the multivariate linear regression analysis results, nursing students' gender, utilizing non -pharmacological interventions, and NRS scores affected PBQ-P scores by 87.1% (R 2 =0.871) and PBQ-O scores by 81.0% (R 2 =0.810). Conclusions As can be seen from the results of this study, the higher psychological beliefs of nursing students who use non -pharmacological interventions to cope with pain are an example of this situation. In light of the information in this study, it should be taken into consideration that both psychological and organic beliefs have a strong relationship with pain intensity and pain coping approaches. Nursing students, the nurses of tomorrow, should be aware of the impact of psychological and organic beliefs on individuals' pain experiences and coping approaches and should take this into account when planning nursing care.

Akagündüz, Digdem Dogan; Sahin, Hilal; Akagündüz, Baran

Objectives The incidence and mortality of gastrointestinal (GI) malignancies increase exponentially with age. Malnutrition is a documented poor prognostic factor in older patients with cancer. There is insufficient data about the prevalence of malnutrition and associated factors in older patients with GI cancer. Thus, we aimed to investigate the prevalence of malnutrition and related factors among older patients with GI cancer. Methods A total of 121 patients aged over 70 years diagnosed with various types of GI cancers applied to the medical oncology clinic included in this cross-sectional study. We evaluated the nutrition status with a mininutritional assessment (MNA) score. Results The prevalence of malnutrition was 76 (62.8%) in our study population. The mean age was 76.5 (range 70 to 90 years), and 71 (58.6%) were male. In the multivariate logistic regression model, lower BMI (OR: 3.379, 95% CI: 1.465-7.812, p = 0.005), having gastroesophageal cancer (OR: 5.797, 95% CI: 2.387-14.091, p <0.001), treating with palliative chemotherapy (OR: 4.597, 95% CI: 1.799-11.772, p = 0.002), and frailty according to G8 score (OR: 10.798, 95% CI: 4.495-25.924, p <0.001) were associated with malnutrition. Conclusions Our study revealed that palliative chemotherapy, low BMI, frailty, and gastroesophageal cancer are risk factors for malnutrition in older patients with GI cancer. Physicians need to be aware of patients who may be at risk for malnutrition. Patients at risk of malnutrition may benefit from interventions to enhance their nutrition. Further studies consisting of larger cohorts are needed to determine malnutrition and related factors in older patients with cancer.

Eren, Nurhan; Onk, Didem; Koç, Alparslan; Kuyrukluyildiz, Ufuk; Nalbant, Remziye Aysenur

Introduction This study aimed to evaluate hemodynamic changes using heart rate variability (HRV) measurements in diabetic and nondiabetic patients who will undergo laparoscopic cholecystectomy and to provide our preoperative measurements to guide us for better perioperative anesthesia management. Materials and methods The study included 143 patients aged 40 years and older who would undergo elective laparoscopic surgery, did not have any comorbidities other than diabetes mellitus (DM) type II, and were in the American Society of Anesthesiologists (ASA) class I -III risk group. Patients were divided into two groups: the control group (n = 77) and the DM group (n = 66). The preoperative glycated hemoglobin (HbA1C) level was measured. Peripheral oxygen saturation (SpO2) and hemodynamic parameters such as systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and HRV parameters were measured preoperatively, perioperatively, and postoperatively. Intra-abdominal pressure (IAP) was administered at 10-12 mmHg. Results Even though SAP, DAP, MAP, and HR decreased with induction, they increased with insufflation, and an overall decrease was seen at the postoperative 24th hour for all parameters. When the groups were evaluated, no difference was observed except that the DAP was significantly lower in the DM group (p = 0.029) at insufflation and the HR was higher in the DM group at induction, and the difference was significant (p = 0.001). Preoperative HRV parameters were significantly lower in the DM group. According to the HRV parameters, although a decrease was observed after induction and insufflation, conversely, an increase was observed postoperatively. When the postoperative and preoperative values were compared, the standard deviation of the NN (R -R) intervals (SDNN), SDNN index, high frequency (HF), low frequency (LF), and LF/HF parameters were found to be significantly lower in the DM group than in the control group. Conclusion Diabetic patients are more sensitive to increased intra-abdominal pressure (IAP) in laparoscopic surgery, and the effects on cardiac autonomic functions can be determined by HRV measurements without clinically reflecting on hemodynamic data. Additionally, in diabetic patients with preoperative LF and/or HF values less than 100, we believe that careful follow-up in terms of autonomic neuropathy complications and anesthesia management should be done more meticulously in these patients.

Öztürk, Akin; Karakasli, Ahmet; Erbil, Gueven; Gökgöz, Mehmet Burak; Yapici, Furkan

Background The human vertebral column generates movements under versatile, dynamic loads. Understanding how the spine reacts to these movements and loads is crucial for developing new spine implants and surgical treatments for intervertebral disc injuries. Mechanically uni-axial compression models have been extensively studied. However, the spine's daily loading is not limited to compression, so it is crucial to measure its behavior in all movements (flexion-extension, rotation, and axial compression). Methods This study utilized L1-L5 segments from 19 healthy adult sheep spines. The L2-L3 disc of the first spine underwent only histological evaluation without biomechanical testing to define basic histological parameters. The remaining 18 were divided into three groups of six and subjected to biomechanical tests. Different mechanisms for three groups of spinal segments were prepared, and tests were performed on Shimadzu AG-IS 10 KN (Universal Drawing Press, Kyoto, Japan). An axial load (800 N) was applied to the first group, an axial load with 15 degrees of flexion to the second group, and an axial load with 10 degrees of rotation plus 15 degrees of flexion to the third group. A biomechanical evaluation of the maximum elongation amounts (MEAs) was performed and compared between the groups. Then, the L2-L3 discs were removed from the sheep spines, and a histological examination of the discs was conducted using Hematoxylin-Eosin (HE), Alcian Blue (AB), and Masson's Trichrome (MT) staining. Results The mean MEA +/- Standard Deviation (Range) was 1.39 +/- 0.38 (0.91-1.94) for Group 1, 2.02 +/- 0.75 (0.91-3.01) for Group 2, and 2.47 +/- 1.09 (0.64-3.9) for Group 3. Biomechanically, although MEAs increased from Group 1 to Group 3 (meaning that the mean MEAs increased as the number of types of applied force increased), there was no statistically significant difference between the groups regarding the MEAs (P = 0.092). Histologically, no significant differences were observed between all groups after HE staining. In all groups, hypercellularity, edema in the connective tissue, separation between tissue layers, delamination, and signs of swelling and necrosis in the cells were observed similarly. For the AB staining, there was a decrease in the glycosaminoglycan (GAG) structure in the tissue samples compared to the control tissue, but no significant differences were observed between the groups. However, it was observed that the stratification in Group 3 was slightly more deteriorated than in the other groups. For the MT staining, collagen structure deterioration was observed in all groups. It was observed that the amount of collagen was significantly reduced compared to the control tissue. Conclusion As a result, when the axial load is applied biomechanically, there is more displacement of the vertebral discs in Group 3 with multidimensional movements. Furthermore, histological studies revealed deterioration between tissue layers when exposed to complex movements, and the degradation of stratification in group 3 compared to other loading combinations in groups 2 and 3 may indicate the role of complex loads in the formation of disc herniation.

Barkay, Orcun; Erol, Serpil; Senbayrak, Seniha

Introduction Chronic hepatitis B (CHB) continues to be a significant global public health problem. Conventional serological markers play a pivotal role in diagnosing and prognosticating CHB, but atypical serological profiles deviating from established norms pose challenges. Methods A cohort of 35 CHB patients who did not receive an antiviral treatment with atypical serological markers was followed for five years (2017-2022). Demographics, serological parameters, and changes were documented. Serological parameters and serum viral loads (hepatitis B virus (HBV)-deoxyribonucleic acid (DNA) levels) were assayed at the central laboratory during their routine follow-ups. Three groups of atypical serological markers are defined: hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) positivity; hepatitis B e antigen (HBeAg) and anti-hepatitis B e-antigen (anti-HBe) positivity; and isolated core (anti-hepatitis B core (anti-HBc) immunoglobulin G (IgG)) positivity. Patients with concomitant HBsAg and anti-HBs were also stratified into seroreversion groups. Changes in serological markers and HBV-DNA levels across the study period were documented and evaluated at the end of the study period. Statistical analysis was conducted using the Kruskal-Wallis test and IBM SPSS Statistics software for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA). Results In a cohort of 35 patients with atypical hepatitis B serology, demographic analysis revealed that 51.4% (n=18) were female and 48.6% (n=17) were male, with a mean age of 45.7 years. Educational distribution showed that 45.7% (n=16) completed primary education, 22.8% (n=8) had a high school education, and 31.5% (n=11) held university degrees. Among these patients, 10 displayed the concurrent presence of HBsAg and anti-HBs, with 60% (n=6) being female. Serum HBV-DNA was detectable in all cases. After five years, 60% (n=6) exhibited seroconversion from HBsAg to anti-HBs, particularly notable in females (66.7%). These patients showed lower HBsAg titers and serum HBV-DNA levels (p = 0.048, p = 0.036). A subset of 15 patients demonstrated simultaneous HBeAg and anti-HBe positivity. The HBeAg seropositivity waned over time, with 40% (n=6) and 26.7% (n=4) females and males, respectively, retaining positivity by the fifth year. During this period, serum HBV-DNA levels decreased. The remaining five patients sustained HBeAg and anti-HBe positivity. Among 10 patients solely positive for anti-HBc IgG, three had concurrent HBV-DNA positivity. Strikingly, three patients with negative HBV-DNA developed anti-HBs positivity after five years. Conclusion The complexity of CHB infection demands a comprehensive understanding. Atypical serological profiles suggest distinct disease stages, immune response variations, and viral mutations. This study enhances comprehension of viral replication, immune responses, and disease progression, potentially guiding tailored therapeutic strategies.

Alkan, Hilmi; Karaman, Yavuz; Güven, Sahan; Biçici, Vedat; Subasi, Izzet Ozay; Yasar, Niyazi Erdem; Firat, Ahmet

Introduction Lateral pain around the greater trochanter (LTP) is a common complication after total hip arthroplasty (THA) that can significantly reduce quality of life. The aim of this study was to analyze the relationship between lateral trochanteric bursa repair, subcutaneous fat thickness, and trochanteric pain during the THA procedure.Materials and methods A total of 98 patients who underwent THA for hip arthrosis between 2021 and 2022 were evaluated retrospectively. For all evaluated patients, subcutaneous thickness was measured between the fascia and the skin at the incision site. Bursa repair was performed in 47 patients, while bursa excision was done in 51 patients. The data obtained included demographic information, functional scores, comorbidities, bursa repair and skin thickness values, radiographic evaluations, and other specific markers. These were compared between patients diagnosed with LTP following THA and the controls.Results No difference was observed between the study groups in terms of subcutaneous fat thickness, bursa repair, and other demographic or radiographic evaluations. As expected, there were statistically significant differences between the groups in terms of the visual analog scale (VAS) score (p=0.030) and the Harris hip score (HHS) (p=0.045). When comparing the groups with and without LTP, the VAS score was higher in the group with LTP, while the HHS was found to be lower.Conclusion Trochanteric pain is not associated with bursa repair or subcutaneous thickness. LTP cannot be predicted based on comorbidities such as smoking, BMI, or radiographic measurements.

Barkay, Orcun; Binay, Umut D.; Karakeçili, Faruk

Introduction The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on global public health, with profound changes in people's psychological and behavioral responses to the virus. Our aim is to evaluate the evolution of people's responses to COVID-19. Methods This observational study compares two groups of YouTube videos (495 videos in the first group and 620 videos in the second group) posted during different periods of the pandemic to examine the evolution of people's emotions, behaviors, and precautions toward COVID-19. We analyzed the titles of these videos to gain insights into the evolving public responses to the pandemic and how they may impact future public health interventions. Results Our results show a shift in focus from basic prevention measures to a more nuanced approach to prevention and management, characterized by a greater emphasis on vaccination and travel-related precautions in the second group of videos. These findings can inform public health policies and interventions aimed at mitigating the impact of COVID-19 and other pandemics. Furthermore, this study highlights the potential of social media platforms, such as YouTube, as a tool for monitoring and understanding public responses to pandemics and other health crises. Conclusion Continued analysis of public responses and behaviors can help inform effective public health interventions and policies as the COVID-19 pandemic continues to evolve.

Subasi, Izzet Ozay; Gür, Volkan

Introduction: Skiing and snowboarding are widely recognized winter sports with a notable risk of sportsrelated injuries. Comprehensive knowledge of the injuries sustained during skiing and snowboarding is imperative for preventative strategies and for understanding the injury patterns and epidemiological characteristics from surgeons' standpoint, particularly orthopedic surgeons, given that all anatomical regions and systems are susceptible to harm when engaging in these activities. Objective: Our research aims to investigate the injury patterns and epidemiological characteristics of individuals seeking medical attention at Erzincan University Faculty of Medicine Orthopedics and Traumatology Clinic, Erzincan, Turkey, after experiencing recreational skiing or snowboarding injuries. Methods: During the period spanning from 2018 to 2023, a retrospective analysis was conducted on patients aged between 18 to 65 years who had sustained isolated extremity injuries while participating in recreational winter sports at the Ergan Mountain Ski Center. The causes of injuries were categorized into two types (skiing and snowboarding) based on the subjective description of the injury scene. The study employed the chi 2 test for categorical variables and Student's t -test for continuous variables to conduct subgroup comparisons. Results: The study results revealed that most patients, precisely 53.2%, sustained injuries in their lower extremities, whereas 46.8% sustained injuries in their upper extremities. The most frequently injured area of the patients presenting with skiing injury was the region around the knee (31.2%), followed by around the shoulder (21.6%) and the foot and ankle (14.9%). The anatomical region most injured among patients who sustained snowboarding injuries was the hand and wrist, accounting for 23.9% of cases. Conclusion: Skiing and snowboarding injuries vary anatomically. While individuals with limited experience are at a higher risk of sustaining injuries, no statistically significant disparity was observed regarding the specific body parts affected among individuals of varying skill levels. Recognizing these sports -related injuries, which are growing in young people, will encourage the use of personal protective equipment to avoid injuries, assure ski resorts' environmental safety, and reduce sports -related morbidity.

Gür, Volkan; Yapici, Furkan; Subasi, Izzet Ozay; Gökgöz, Mehmet Burak; Tosun, Mustafa; Tardus, Ismail; Koçkara, Nizamettin

Introduction Venous thromboembolism (VTE), particularly pulmonary embolism (PE), is the third highest cause of death in trauma patients who survive beyond the first day. Musculoskeletal surgery is associated with several complications, some of which may be life-threatening, including deep vein thrombosis (DVT) and PE. Objective This research aims to describe risk variables for VTE after upper extremity (UE) fracture at a single institution and estimate the incidence of PE following UE fracture. Methods The writers accessed the database via their respective universities using the International Standard Classification (ICD) codes. The medical files of patients aged 18 and older who sought treatment at our emergency department for an injury to their UE and also sought treatment at the orthopedics and traumatology clinic between the years 2013 and 2021 were manually scanned. The patients who applied to the Chest Diseases Clinic within 30 days after the trauma and were diagnosed with PE in the ICD code scan were included in the study. Results UE trauma was the cause of admission to the emergency department for 3,265 patients, and 21 of those patients (0.64%) were found to have PE. Fifteen of the patients were male, and six were female. The median age was 59 years (IQR 17). There were no deaths associated with PE. One of the patients had a scaphoid fracture, seven patients had a humerus fracture, five patients had a distal radius fracture, two patients had an acromioclavicular joint injury, one patient had a shoulder dislocation, one patient had a finger fracture, four patients had wrist crush injury. Three patients had diabetes mellitus. Five patients were active smokers. JAK-2 gene V617F mutation was detected in one patient. One patient was diagnosed with prostate cancer, and one had gastric cancer. One patient had a central venous catheter. Two patients were being treated for hypothyroidism. Two patients had hypertension. Conclusion According to the findings of our research, the probability of developing PE in the days following of an injury to the UE was found to be 0.64%. Patients with UE injuries who are active smokers and who also have diabetes, hypertension, hypothyroidism, cancer, coagulation disorder (JAK2 gene V617F mutation), or a central venous catheter may benefit from anticoagulant prophylaxis. This is because these patients are at a higher risk of developing dangerous blood clots.

Okumus, Omer Faruk; Orbak, Recep; Karasu, Yerda Ozkan; Gül, Pinar

Objective This study aimed to examine patient complaints on recoloration development after polishing applications in primary and permanent teeth that differed in enamel composition and to determine the ideal polishing method. Methods A total of 30 permanent upper incisors and 30 primary molars were randomly divided into three groups of 10 using three different polishing techniques. Each polishing method (rubber, brush, and air polishing) was applied to the test surface of its own group. Milk and coffee were used in the coloring processes. A spectrophotometer was used for color measurements. Color change (& UDelta;E) was calculated between control and test surfaces and between the three measurement points. Results In the primary teeth's test surfaces, the rubber and brush groups were significantly more colored than the air-polishing group, when compared between after polishing and after coloration (p ` 0.05). Furthermore, the color difference of the permanent teeth between the initial measurements and after coloration was significantly higher in the rubber group's test surface compared to the air-polished group (p ` 0.05). The average & UDelta;E values in both primary and permanent teeth were as follows: rubber > brush > air polishing. Conclusions Compared to rubber or brush polishing, air polishing seems safer to avoid predisposition to postoperative enamel discoloration. Primary teeth are more colored than permanent teeth. The effect of polishing on postoperative coloring should always be considered, and air polishing should be preferred whenever possible.