INTRODUCTION: In this study, it was aimed to determine the fatigue levels of Chronic Obstructive Lung Disease (COPD) and asthma patients.


METHODS: This descriptive study was conducted on 1014 volunteer patients. As a data collection tool; questionnaire and “COPD and Asthma Fatigue Scale” were used. The data obtained from the research were evaluated with the computer with number, percentage, mean, independent groups t test, one way ANOVA, pearson correlation, and cronbach alfa.
RESULTS: It was determined that 42.9% of the patients had been diagnosed for 1-5 years, 52.3% had never smoked, 48.3% experienced fatigue constantly, 49.3% sometimes experienced fatigue, and 41.2% experienced fatigue throughout the day. It was determined that those with a disease duration of 11 years or more, those who smoke and quit, and those who experience constant and all-day fatigue have higher scores on the fatigue scale than the others. The mean score of the patients from the fatigue scale was 34.66±7.99. It was determined that the patients got the lowest 14 and the highest 54 points from the scale used.

DISCUSSION AND CONCLUSION: It has been determined that patients with Chronic Obstructive Pulmonary Disease (COPD) and asthma are moderately fatigued.

INTRODUCTION: Postural stability is a process that involves integrating sensory inputs and generating an appropriate motor response. Attention Deficit Hyperactivity Disorder (ADHD) can cause difficulty in motor performance and postural stability. The impact of methylphenidate (MPH) treatment on balance and risk of falling remains unclear. The purpose of this study was to evaluate the effects of MPH treatment on balance, risk of falling, and sensorimotor integration in children with ADHD.
METHODS: In this cross-sectional study children diagnosed with ADHD for the first were classified into the ADHD group(n=33), children with ADHD who were treated with MPH for at least 3 months were classified into the treatment group(n=32), and healthy children were classified into the control group (n=20). Risk of falling, static postural balance, and sensorimotor integration were evaluated using the Biodex Balance System.
RESULTS: The sway index scores in the ADHD group were statistically significant higher than those in the control group in all experimental conditions (p< 0.05). The sway index scores in the ADHD group were statistically significant higher than the treatment group in both eyes open /firm surface and eyes closed /firm surface conditions(p < 0.05).The ADHD group had significantly higher risk of falling scores in the Biodex analyses compared to the control group(p < 0.05). There was no statistically significant difference in risk of falling scores between the treatment group and the control group(p > 0.05).
DISCUSSION AND CONCLUSION: Postural balance and fall risk may have been affected in children with ADHD. MPH treatment can positively affect impaired balance and risk of falling.

INTRODUCTION: The neuropathological changes in Alzheimer's disease may begin 10- 20 years before clinical findings. Identifying biomarkers in the preclinical period will be useful for early diagnosis and treatment. In our study, we aimed to evaluate the peripheral blood count parameters as potential biomarkers in different stages of Alzheimer's disease.
METHODS: Fourty-eight patients with MCI, 76 AD patients and 117 healthy controls were included consecutively. Cognitive functions of the cases were evaluated with Mini Mental State Examination (MMSE) and Clock Drawing Test. Those with low MMSE scores were also administered the Clinical Dementia Rating (CDR) scale. DSM-IV and NINCDS-ADRDA criteria were used for the diagnosis of Alzheimer's disease, and Alzheimer's disease was divided into mild and moderate-to-severe stages. The neutrophil/lymphocyte ratio (NLR) was obtained by dividing the absolute neutrophil count by the lymphocyte count, and the platelet/lymphocyte ratio (PLR) was obtained by dividing the absolute platelet count by the lymphocyte count.
RESULTS: The platelet distribution width (PDW) levels of the mild cognitive impairment group were higher than those of moderate-to-severe Alzheimer's patients and the control group (p= 0.001). NLR and PLR levels of all mild and moderate-to-severe Alzheimer's patients were higher than the control group (p= 0.005 and p< 0.001).
DISCUSSION AND CONCLUSION: Our study supports the role of inflammation in cognitive decline. We suggest that neutrophil/lymphocyte and platelet/lymphocyte ratios and PDW value may be potential biomarkers for Alzheimer's disease and mild cognitive impairment respectively.

INTRODUCTION: The Centers for Disease Control and Prevention (CDC) recommends vaccinating children aged 6 months and older against COVID-19, but the desired vaccination rate in children has not been achieved. We aimed to detect the parental acceptance rate of COVID-19 vaccines in Turkish parents and to identify the factors influencing parental acceptance by using a “modified Vaccine Hesitancy Scale (VHS)”.

METHODS: A modified-VHS survey containing 7-item was prepared by adapting the “VHS 5-point Likert questions” to the COVID-19 vaccines. The questionnaire including modified-VHS and demographic questions was conducted with parents applied to pediatrics clinics between September 2021 and July 2022.
RESULTS: A total of 423 answers were included in the study. Of these, 42.3% (n=179) approved of vaccinating their children under 16 years of age against COVID-19, 8.5% (n=36) were hesitant, and 49.2% (n=208) did not approve. Parents over 35 years old and parents with a child >5 years old were found more likely to accept COVID-19 vaccines (p<0.01, p<0.01). The history of a deceased child, the presence of chronic disease in the household, previous COVID-19 positivity in the household (negative effect), and the COVID-19 vaccination status of the parent and household were other factors (p=0.047, p=0.048, p=0.043, p <0.001, p <0.001). A very strong and positive correlation was found between our modified-VHS and parental acceptance of vaccinating their children against COVID-19 (I': 0.706, p<0.001).

DISCUSSION AND CONCLUSION: The acceptance rate of COVID-19 vaccination for children by Turkish parents is low and the Modified-VHS questionnaire can be used to determine parental COVID-19 vaccine hesitancy.

INTRODUCTION: uMMP7 is a molecule that has been associated with a wide range of diseases in recent years. Our aim in this study is to examine the relationship of uMMP7 with comorbid conditions, short-term mortality and acute kidney injury (AKI) prognosis in patients hospitalized in our clinic due to AKI.

METHODS: 160 patients who were followed up in our clinic with the diagnosis of AKI were included in the study. The relationship among age, gender, creatinine level at admission, basal creatinine level, post-discharge creatinine level, initial glomerular filtration rate (GFR), basal GFR, control GFR, comorbidities, transition to permanent renal replacement therapy (RRT), mortality and uMMP7 levels of the patients were examined.

RESULTS: Results: Of the comorbid diseases, the uMMP7 level was found to be significantly lower only in hypertension patients(p=.001).This was associated with the use of angiotensin converting enzyme inhibitor (ACEI). A significant and positive relationship was found between the uMMP7 level and the creatinine level at admission, and a statistically significant and negative relationship was found with the GFR level at admission. According to the AKIN criteria, the uMMP7 level of Grade 3 patients was significantly higher than those who are grade 1 or grade 2(p=.004). According to the RIFLE criterion, the uMMP7 level of grade 3 patients was found to be significantly higher compared to the grade 2 patients.

DISCUSSION AND CONCLUSION: As the severity of AKI increases, uMMP7 level increases. uMMP7 level was significantly lower in hypertension patients, and this was associated with the use of ACEI.

INTRODUCTION: Gestational diabetes mellitus (GDM) is a carbohydrate intolerance and can have negative consequences for both mother and infant. Healthy nutrition and physical activity are the cornerstones for the prevention and treatment of GDM. This study is aimed to evaluate the adherence to the Mediterranean diet, nutrition, and physical activity status in pregnant women diagnosed with GDM.
METHODS: This study was carried out with 51 pregnant women with GDM and 51 pregnant women without GDM (control group) aged ≥18 years, between ≥24–≤29 gestational weeks. Demographic, obstetric, and health status of individuals were questioned, and anthropometric measurements were evaluated. In addition, the Mediterranean Diet Adherence Screener (MEDAS) and the General Practice Physical Activity Questionnaire (GPPAQ) were applied, and three-day diet records were collected.
RESULTS: Pregnant women with GDM have a higher rate of meeting their daily energy and protein requirements and higher carbohydrate intake (p<0.05). The MEDAS scores of pregnant women diagnosed with GDM (5.71±1.51) were found to be lower than the control group (8.02±2.15) (p=0.001). The rate of poor adherence to the Mediterranean diet and physical inactivity are higher in women with GDM (p=0.001 for all).
DISCUSSION AND CONCLUSION: The findings suggest that pregnant women with GDM are more inactive, have poorer adherence to the Mediterranean diet, and may have more diet-related risk factors compared to healthy pregnant women. Considering the effects of nutritional and physical activity habits during pregnancy on fetal, neonatal and maternal health, it is important to encourage healthy behaviors, especially in pregnant women at risk.

INTRODUCTION: This research was planned to develop a measurement tool to determine compassion fatigue in nurses to provide intensive care, oncology and palliative care and to conduct a validity and reliability study of the developed measurement tool.
METHODS: The study was conducted using a mixed-method design, with 313 nurses working in oncology, intensive care, and palliative care departments at two training hospitals and one state hospital. The item pool for the scale consisted of 81 items, which were reviewed by experts. After the content validity process, the candidate scale was reduced to 45 items. Data were analyzed using qualitative methods (content analysis) and quantitative methods, including normality tests, exploratory factor analysis, maximum likelihood, varimax rotation, Pearson correlation test, and Cronbach's alpha internal consistency coefficient.
RESULTS: It was found that 66% of the participants were aged between 26 and 31, 61% were female, and 94% had a bachelor's degree. The exploratory factor analysis revealed a 5-factor structure with 27 items: physical impact, working conditions, care, psychological impact, and social-spiritual impact. The scale's content validity index was 0.79, the total variance explained was 41.498%, and item-total correlation values ranged from 0.330 to 0.673. The Cronbach's alpha reliability coefficient for the scale was 0.782, omega was 0.781, and CR (composite reliability) was 0.830.
DISCUSSION AND CONCLUSION: Conclusion: The analysis found that the “Compassion Fatigue Scale Intensive Care and Palliative Care Nurses (MERY)” is a valid and reliable measurement tool to determine the compassion fatigue levels of intensive care, oncology and palliative care nurses.

INTRODUCTION: This study aims to evaluate biceps muscle thickness and cutaneous stiffness using ultrasound in cases of secondary lymphedema in the arm following breast cancer and to investigate their relationship with clinical findings.
METHODS: Thirty patients, with an average age of 52 years, were assessed comparing the unaffected and lymphedematous arms. Arm volumes and edema ratios were calculated from circumferential measurements. Ultrasonography was used to assess lymphedema, measuring skin-subcutaneous tissue thickness, compliance ratio with and without compression, echogenicity, echo-free space, and shear wave elastography. Biceps muscle thickness was also measured. Clinically, the Lymphedema Quality of Life Scale was applied.
RESULTS: Most cases had stage 1 (63.3%) and stage 2 (33.3%) lymphedema. A statistically significant difference was found in the volumes of the unaffected and lymphedematous arms (p<0.001), with an edema ratio of 0.23±0.22. No significant difference was found between the two arms in skin-subcutaneous elastography and compliance ratio (p>0.05). The lymphedematous arm had significantly thinner biceps muscle thickness compared to the unaffected arm (p=0.025).
DISCUSSION AND CONCLUSION: The similarity in skin-subcutaneous elastography and compliance ratio values suggests that advanced-stage lymphedema-fibrosis has not developed, supporting the clinical staging of lymphedema in these cases. The significant decrease in biceps muscle thickness indicates sarcopenia, which may occur even without advanced-stage lymphedema. This underscores the importance of regular exercise, especially strength training, from the early postoperative period in breast cancer patients to prevent potential lymphedema. Further research on sarcopenia and exercise therapy in lymphedema cases is needed.

INTRODUCTION: This study aimed to investigate the relationship between arterial stiffness parameters and capillaroscopic findings in patients with rheumatoid arthritis (RA) and to explore the potential of these methods in detecting subclinical vascular changes that may contribute to cardiovascular risk.
METHODS: This prospective study included 90 patients diagnosed with rheumatoid arthritis (RA) and 90 healthy controls. Demographic and clinical data, including age, gender, body mass index (BMI), disease duration, and current medication use, were recorded. Arterial stiffness parameters such as pulse wave velocity (PWV), augmentation index (AIx75), reflection magnitude, peripheral resistance, and pulse pressure were measured using an oscillometric method. Simultaneously, nailfold video capillaroscopy (NVC) was performed to evaluate capillary morphology, density, and microvascular architecture.
RESULTS: PWV (7.39±1.56 m/s vs. 6.07±0.89 m/s; p<0.001), AIx75 (28.18±9.21% vs. 25.40±9.55%; p=0.048), reflection magnitude (60.35±8.18% vs. 57.56±9.92%; p=0.014), and peripheral resistance (1687.7±169.9 dyn·s/cm vs. 1619.9±184.1 dyn·s/cm; p=0.011) were significantly higher in RA patients compared to controls. RA patients also had significantly higher positivity rates of regular capillary ectasia (47.8% vs. 24.4%; p=0.001), tortuous capillaries (78.7% vs. 48.9%; p<0.001), filiform elongated capillaries (40.0% vs. 15.6%; p<0.001), and neoangiogenesis (56.7% vs. 31.1%; p=0.001). Additionally, patients with positive microhemorrhage showed significantly higher PWV [8.7 vs. 6.9; p=0.048] and pulse pressure [56 vs. 42; p=0.004]. Seropositive patients showed significantly higher peripheral resistance and lower pulse pressure values (p<0.05).
DISCUSSION AND CONCLUSION: Our findings indicate a notable association between microvascular changes and arterial stiffness in RA patients, suggesting that combined evaluation of capillaroscopy and arterial stiffness parameters may help detect subclinical vascular alterations.

Atypical teratoid/rhabdoid tumor (ATRT) is a rare, highly aggressive malignant embryonal neoplasm of the central nervous system (CNS), primarily affecting children under the age of 3. These tumors are characterized by the inactivation of the SMARCB1 (INI1) gene and exhibit heterogeneous pathology, frequently leading to diagnostic challenges. ATRT commonly arises in the posterior fossa, while sellar and suprasellar locations are rare, particularly in pediatric patients.
We report the case of a 17-month-old male presenting with ptosis and cranial nerve deficits. Magnetic resonance imaging (MRI) revealed a sellar tumor extending into the suprasellar and prepontine cisterns, with clival destruction and cavernous sinus invasion. Endoscopic transsphenoidal surgery was performed in two stages, achieving subtotal resection. Histopathological analysis confirmed ATRT with loss of SMARCB1 expression and a Ki-67 proliferation index of 40–50%. The patient received adjuvant chemotherapy and radiotherapy but succumbed to respiratory failure nine months after presentation.
A comprehensive literature review identified 39 sellar ATRT cases, highlighting their aggressive clinical course, complex surgical challenges, and poor outcomes. Endoscopic transsphenoidal surgery, combined with multimodal therapy, remains the optimal approach for managing sellar ATRTs. This case represents the youngest patient with clival ATRT and the first pediatric suprasellar ATRT reported in the literature, emphasizing the need for early diagnosis, innovative treatment strategies, and further research to improve outcomes.