Bayındır Hastanesi

Many immigrants coming to the United States (US) are screened for sexually transmitted infections (STIs) according to national professional agency guidelines. Some curable infections such as gonorrhea and syphilis can preclude entry to the US, whereas testing for other infections, such as chlamydia, is not required for immigration screening. We critically review the rationale for and the practice of immigration STI screening at a time when common STIs are both readily treatable and already widespread in the US and when many individuals resettling in the US migrate through irregular pathways. In addition, we provide suggestions to improve current practices for immigrants, with a focus on distress migration, which may be associated with hazards leading to sexual violence and stigmatization. Recent actions by the federal government have also compounded structural stigma regarding immigration and health care and could negatively impact broader public health goals.

Aim: We aimed to investigate the utility of trigeminocervical reflex (TCR) and nociceptive flexion reflex (NFR) as objective measures for assessing pain—a common NMS—in patients with PD, targeting both the upper and lower body regions. Methods: All subjects were further classified into four groups: Group-I: Healthy individuals without PD or pain, Group-II: Individuals without PD but reporting non-specific musculoskeletal pain, Group-III: PD patients without pain, Group-IV: PD patients with pain as a NMS. The clinical assessment of PD was conducted using the Hoehn and Yahr Staging Scale (HYS) and the Unified Parkinson's Disease Rating Scale (UPDR). We divided the human body into upper and lower regions—utilizing the TCR for upper body pain and the NFR for pain around the lumbar and pelvic areas. Results: The Group-IV had a longer mean disease duration than those in Group-III (8.0±6.6 vs 3.0±3.5 and p=0.121). The mean UPDRS score significantly higher in Group-IV compared to Group-III (42.5±13 vs 27.4±15.3 and p=0.022). The mean VAS score was 7.0±0.7 in Group-II and 6.3±1.3 in Group-IV, with no significant differences in pain localization or VAS scores between the two-groups. Conclusion: Electrophysiological reflex assessments do not appear to be sufficiently reliable in evaluating pain perception in these patients.

Food-induced anaphylaxis (FIA) is a severe form of food allergy, and literature data about multi-triggered FIA is scarce. This study aimed to evaluate the differences between multi-triggered and single-triggered food anaphylaxis in children. The study included pediatric patients (age 100 IU/mL was identified as a predictive factor for multi-triggered FIA (Odds ratio (95% CI): 2.46 (1.40-4.30), p=0.001). FIA with multiple trigger foods was detected in approximately a quarter of the children with FIA. Multi-triggered FIA was associated with higher rates of atopic disease, asthma, eosinophilia, and increased total IgE levels. A total IgE level higher than 100 IU/mL was a risk factor for multi-triggered FIA. This suggests that high IgE levels may be a warning sign for clinicians to be vigilant for multiple food triggers in the screening and follow-up of FIA patients.

Pressure ulcers (PUs) are areas of localised tissue damage affecting the skin, soft tissue, muscle or underlying tissues which is caused by continuous pressure, friction or shear. Medical caregivers should primarily focus on patients at high risk of developing these injuries to prevent their development. However, once a PU has developed, different therapy options and proper surgical intervention are the main treatment options. The aim of this study was to investigate the effectiveness of PU topical therapeutic alternatives retrospectively. In this single-centre study, the medical records of hospitalised patients with stage 2 and deeper PUs were screened retrospectively. The patients' age, sex, Waterlow score, mobilisation status, hospitalisation period, PU stage, PU stage on day of discharge, and PU therapy used were recorded. Any evidence of healing was accepted as a successful treatment outcome. The medical records of 511 patients were screened for this study. At discharge day, 55.4% of patients with PUs did not show any evidence of healing. In suspected deep tissue injury (SDTI) PUs, there was a higher rate of therapy success (59.4% at day of discharge) (p<0.05). With regards to the hospitalisation period, when patients stayed >30 days, the rate of therapy success increased (p<0.05). The most effective topical therapy was multilayer silicone foam dressing (p<0.05). The topical application of rifamycin and povidone-iodine solution appeared to worsen the condition of the PU (p<0.05). In patients with PUs in this study, the topical therapy was more effective in SDTIs and if the hospitalisation was of long enough duration for the treatment to take effect. Multilayer silicone foam dressing therapy was found to be the most effective.

The prevalence of diabetes continues to increase both in our country and in the world. The International Diabetes Federation estimated that as of 2021, 537 million adults in the world were living with diabetes. In Türkiye, this number is over 9 million. This situation leads [...]

Pressure ulcers are a significant health issue, particularly among the elderly and immobile individuals, resulting in considerable human suffering and financial costs. They pose a clinical challenge for both healthcare providers and patients, as they can be difficult to heal, expensive to treat, with a significant negative impact on quality of life. Therefore, prevention is crucial. Here, we report the successful treatment of a 75-year-old male patient presenting with persistent sacral pressure ulcer infection with Vacuum-Assisted Closure (VAC) therapy. This patient had a history of bedridden dementia and a previous cerebral infarction, which predisposed him to persistent deep-pressure ulcers. With effective management, he experienced clinical improvement, highlighting the importance of using VAC therapy in challenging cases.

Despite the high success rate of canalith repositioning maneuvers (CRMs) in the treatment of benign paroxysmal positional vertigo (BPPV), a growing number of patients report residual dizziness symptoms that may last for a significant time. Although the majority of BPPV cases can be explained by canalolithiasis, the etiology is complex. Consideration of the individual patient's history and underlying pathophysiology of BPPV may offer the potential for treatment approaches supplementary to CRMs, as well as a promising alternative for patients in whom CRMs are contraindicated. This article provides a summary of the possible underlying causes of BPPV and residual dizziness, along with suggestions for potential management options that may be considered to relieve the burden of residual symptoms.

To compare the effects of fabricating methods of custom monoblock mandibular advancement devices (MADs) on usability and efficacy in patients with mild and moderate obstructive sleep apnea (OSA). Digitally fabricated custom MADs (dMADs) were produced for 11 OSA participants who had previously used conventionally fabricated custom MADs (cMADs). The participants answered a modified usability questionnaire for both MADs, and the average scores that were given to the questionnaire were evaluated by age, sex, and body mass index (BMI), and the scores of cMADs and dMADs were compared. After 6 months of usage of each MAD, the apnea-hypopnea index (AHI), mean and lowest oxygen saturations, and total sleep time were measured for efficacy assessment. Data were analyzed with Cronbach's alpha, Mann-Whitney U, Kruskal-Wallis, Wilcoxon signed-rank, one-way repeated measures analyses of variance, and Bonferroni tests (α = 0.05). Cronbach's alpha was found at 0.834 and 0.722 for the conventional and digital questionnaires, respectively. The usability scores of the dMADs were significantly higher than those of cMADs (p = 0.013). There was no difference in usability scores in terms of sex or BMI (p>0.05). No statistically significant difference was found for cMAD (p = 0.113) among age groups; however, there was a significant difference for dMAD (p = 0.046). The AHI, mean, and lowest oxygen saturation values were significantly affected by MAD usage (p<0.001). However, total sleep time values did not differ after the MAD treatments (p>0.05). Significantly lower AHI and significantly higher lowest oxygen saturation values were observed with dMAD, while both appliances led to similar results for mean oxygen saturation and total sleep time values (p>0.05). Participant usability scores were higher for digitally manufactured MADs than conventionally manufactured MADs. However, both conventional and digital MADs were found effective in decreasing the AHI levels and increasing the mean and lowest oxygen saturation values of the participants.