Konya Numune Hastanesi

Aims: This study aimed to determine the prevalence of problematic smartphone use among university students and to examine whether addiction scores or daily usage duration is more strongly associated with musculoskeletal symptoms, posture, and related habits.Methods: A cross-sectional study was conducted between September and November 2022 on 207 university students. Data were collected via an online survey including demographic information, the Smartphone Addiction Scale-Short Version (SAS-SV), and the Modified Nordic Musculoskeletal Questionnaire (mNMQ). Statistical analyses included descriptive statistics, Cronbach's Alpha, Pearson correlation, multiple linear regression, and Independent samples t-test. The significance level was set at p

To evaluate the viability of simultaneous bilateral external dacryocystorhinostomy (ex-DCR) through a multidimensional analysis of surgical feasibility, patient-reported outcomes, complication incidence, and cost-efficacy. The study included 54 eyes of 27 patients who underwent bilateral simultaneous ex-DCR for bilateral symptomatic epiphora due to NLDO. Patient symptoms were systematically assessed using the validatedNasolacrimal Duct Obstruction Symptom Score (NLDO-SS)questionnaire. Additionally, all patients completed aThurstone scale-based questionnaireto evaluate the surgical process and postoperative period in terms of functional success, psychological relief, overall satisfaction, economic benefits, and medical outcomes. The mean patient age of 56.5 ± 13.1years (range: 22-78) at the time of surgery. Postoperatively, the mean NLDO-SS decreased to 12.7 ± 5.7 (range: 2-26), demonstrating a statistically significant reduction in total scores (p < 0.001). The mean surgical duration was 72.0 ± 15.5min (range: 52-125). No intraoperative or postoperative complications were observed in any patient.Anatomic successwas achieved in 53/54 eyes (success rate: 98.1%), whilefunctional successwas observed in 52/54 eyes (success rate: 96.2%). Postoperative patient evaluation using the Thurstone scale revealed functional success scores of 4.5 ± 0.8 for the right side and 4.4 ± 0.8, psychological relief (4.6 ± 0.8), overall patient satisfaction (4.7 ± 0.6), economic advantages (4.7 ± 0.5), and medical benefits (4.7 ± 0.5). Our preliminary findings demonstrate that single-session bilateral ex-DCR can be a safe and effective option in appropriately selected patients with high surgical success rates, reasonable operative duration, excellent patient satisfaction, and significant functional improvement without major complications.

While selective mutism (SM) is often conceptualized as a childhood anxiety disorder, longitudinal evidence suggests persistent difficulties into adolescence, yet the underlying cognitive and emotional mechanisms remain poorly understood. We aimed to address this gap by examining whether specific neurocognitive impairments and emotion regulation difficulties characterize adolescents with SM. Eighty-nine adolescents (42 SM, 47 HC), aged 11-17 years, were assessed using the Strengths and Difficulties Questionnaire (SDQ), the Difficulties in Emotion Regulation Scale (DERS) and a neuropsychological battery evaluating attention, inhibition, processing speed, memory and social cognition. Adolescents with SM demonstrated greater emotional awareness difficulties (p = 0.010), with no differences in total DERS scores. SDQ scores indicated higher inattention/hyperactivity (p < 0.001), alongside significantly higher prosocial behaviour (p < 0.001). Neurocognitive findings revealed intact verbal learning but impaired immediate and delayed recall (p < 0.001), better delayed visual memory (p = 0.001). Children with SM made fewer total errors on Wisconsin Card Sorting Test (p = 0.021) and showed higher foil accuracy on CPT (p = 0.007), but demonstrated significantly poorer Stroop colour-word (p = 0.001) and interference scores (p = 0.001). Adolescents with SM showed a distinctive cognitive-emotional profile, suggesting that internal emotional processing and external social sensitivity are dissociated during adolescence. Longitudinal and neurobiological research is warranted to elucidate mechanisms and refine treatment strategies.

Background: This study aimed to analyze trends in the population attributable fraction (PAF) for mortality attributable to dietary risks over a 22-year period between 2000 and 2021 and to determine which type of dietary risk has a significant effect on mortality from which NCDs. Methods: In this descriptive and ecological study, data were obtained from the Global Burden of Disease Study, 2021. Age-standardized and sex-specific PAFs for mortality attributable to dietary risks and PAFs for mortality attributable to selected and specific dietary risks were calculated for six noncommunicable diseases worldwide for the 22-year period. The trend of PAFs over time was assessed by joinpoint regression analysis. Results: The two diseases with the highest mean PAF for mortality attributable to dietary risks were hypertensive heart disease followed by ischemic heart disease (0.63±0.01 and 0.45±0.01, respectively). The mean PAF for mortality attributable to dietary risks differed between sexes for four diseases. All six diseases had dietary risk-attributable mortality starting at a young age. Over a 22-year period, PAF for mortality attributable to dietary risks followed a significant decreasing trend for all six diseases. When the PAFs for mortality attributable to selected and specific dietary risks were examined, the majority showed a decreasing trend. Conclusion: It is essential to clarify the relationship between NCDs and dietary risks. This is because the human body is exposed to nutritional and dietary risks every day, both as individuals and as a community.

Background: The present study sought to explore the association between nasal mucociliary clearance time (MCT) and the frequency of peritonitis among patients with chronic kidney disease (CKD) treated by peritoneal dialysis (PD). Methods: This cross-sectional study enrolled 24 patients with CKD treated by PD and 24 healthy volunteers. Nasal muco ciliary function was assessed using the saccharin transit time test. In this procedure, a saccharin particle with a 1 mm diameter was meticulously placed on the anteromedial surface of the inferior nasal concha. The 2 groups were compared based on their mean MCT. Within the patient group, the number of peritonitis cases in the last year was evaluated, and the correlation between MCT and the occurrence of peritonitis was analyzed. Results: The patient group consisted of 15 females and 9 males, with a mean age of 52.6 years. The control group included 14 females and 10 males, with a mean age of 47.5 years. The mean duration of PD among the followed cohort was 20 months, ranging from 3 to 190 months. The comparison of mean MCT between patients with a history of peritonitis and those with out peritonitis did not reveal a statistically significant difference (P = .333). However, the neutrophil-to-lymphocyte ratio was significantly elevated in the group exhibiting prolonged MCT (P = .046). Conclusion: Although this study found no statistically significant direct relationship between peritonitis incidence and MCT, the research aimed to evaluate MCT as a potential indicator of susceptibility to respiratory tract infections, which play a role in the development of peritonitis. Cite this article as: Doğan B, Ergül F, Basut R, et al. The relationship between mucociliary clearance time and peritonitis frequency in patients receiving peritoneal dialysis. Turk J Nephrol. 2026;35(1):67-71.

The choice of vascular access (VA) plays a key role in the success of hemodialysis (HD). Despite their widespread use, central venous catheters (CVCs) are associated with higher rates of dysfunction, thrombosis, and catheter-related bloodstream infections (CRBSI). We investigated current practices in pediatric HD across European pediatric nephrology centers, focusing on VA choices, infection control measures, and CRBSI management. An online questionnaire was e-mailed to 119 members of the European Society for Pediatric Nephrology (ESPN) Dialysis Working Group and European Pediatric Dialysis Working Group (EPDWG). Descriptive statistics were used to summarize practices across centers, comparative analyses between centers in countries with Human Development Index (HDI) > 0.90 and < 0.90. Thirty-one centers across Europe participated in the survey. CVCs were the primary VA in 73.1% of the centers. Twenty (66.7%) centers reported malfunction as the most common CVC complication, followed by catheter thrombosis (19.4%) and CRBSI (12.9%). The diagnostic approach for CRBSI varied widely, with 35.4% of centers relying on a single positive catheter culture, while 57.9% did not collect a second culture from the peripheral vein or HD circuit. The most common empirical treatment was glycopeptides combined with third-generation cephalosporins. Nearly all centers used intravenous antibiotics for less than 3 weeks, and over half modified lock solutions with antibiotics following CRBSI diagnosis. Catheter removal practices were inconsistent, even in cases of severe infection. Centers reported a total of 548 HD patients. Exit-site infections and CRBSI were observed in 98 (17.8%) and 155 (28.2%) patients, respectively. CRBSI rates and CRBSI-related catheter replacements were significantly higher in centers from countries with HDI < 0.90 and in centers without a dedicated pediatric HD unit.Conclusion: The suboptimal adherence to current VA recommendations and wide variability in catheter care practices including the prevention, diagnosis, and management of CRBSI highlight the need for standardized pediatric-specific protocols to enhance catheter longevity and improve patient outcomes.What is Known:• Central venous catheters are widely used in pediatric hemodialysis but carry a high risk of complications, especially catheter-related bloodstream infections (CRBSI).What is New:• This multinational survey reveals significant variability in vascular access selection, CRBSI prevention, diagnosis, and treatment across European pediatric hemodialysis centers, with clear disparities by national HDI levels.• The findings highlight the need for standardization of vascular access care and CRBSI management and evidence-based pediatric-specific guidelines.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00431-025-06703-7.

Purpose: After the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the body, it can cause morphological changes in various tissues, particularly those of the respiratory system. In pregnant individuals with COVID-19, vertical transmission of SARS-CoV-2 may occur and has been associated with pregnancy complications such as miscarriage, fetal malformations, fetal growth restriction, and stillbirth. This study aimed to investigate the histopathological changes observed in the placentas of women infected with COVID-19 during pregnancy. Materials and Methods: In this study, the histopathological features of the placenta of 29 women with COVID-19 at any period of pregnancy were evaluated. Results: The women included in the study ranged in age from 18 to 40 years, with a mean age of 30.3. The birth weeks of one patient was the 32nd week, eight patients was the 40th week, and the others were at 36 and 39 weeks. None of the patients had comorbidities. In histopathological examination, calcifications, congestive chorionic villi, intervillous hemorrhage and increase in syncytial knots were common findings. Fibromuscular stenosis was observed in 3 cases and marked distal villous hypoplasia in 2 cases. Conclusion: The placenta possesses several mechanisms that act as barriers to prevent the transmission of viral infections to the fetus. Studies have demonstrated an increase in placental pathologies, particularly a higher frequency of maternal vascular malperfusion, in pregnant women with COVID-19. Moreover, these studies have shown that placental abnormalities, including both fetal and maternal vascular malperfusion, may occur in the placentas of mothers infected with COVID-19 during pregnancy.

Background/Objectives: Emergency department (ED) physicians may hesitate to order medically indicated imaging (MI) for pregnant patients, potentially delaying or omitting necessary diagnostic procedures. This study aimed to assess the attitudes and practices of ED physicians regarding MI procedures in pregnant patients, considering their level of training. Methods: A total of 300 physicians participated, including ED general practitioners (n = 100), emergency medicine (EM) residents (n = 100), and EM specialists (n = 100). The first section of the questionnaire collected demographic data, professional experience, and previous training related to the subject. The second section included questions based on a modified version of the American College of Radiology (ACR) Appropriateness Criteria to assess attitudes and behaviors. Results: A majority (88.7%) of participants found the management of pregnant trauma patients challenging and expressed a preference to avoid such cases. A statistically significant difference was observed between physician groups regarding the approach to unstable pregnant patients, with EM specialists and residents more likely to disregard gestational age when deciding on imaging (p < 0.001). Physicians who had received relevant training were significantly more likely to advocate immediate imaging regardless of gestational age in unstable patients (p = 0.001). Conclusions: This study highlights the diversity and statistical heterogeneity in ED physicians' attitudes and behaviors toward MI use in pregnant patients. These variations are influenced by training, clinical experience, and accessibility of updated guidelines. Enhancing education and standardizing procedural guidance may improve decision-making and ultimately reduce maternal and fetal morbidity and mortality. Based on these findings, we propose a clinical algorithm to support imaging decisions in emergency settings.

Recent cardiovascular outcome trials have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors reduce cardiovascular events, but results regarding their effects on subclinical atherosclerosis are conflicting. In this study, we aimed to investigate the effect of dapagliflozin, a selective SGLT2 inhibitor, on subclinical atherosclerosis by monitoring pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM). Forty-eight patients with T2DM and on dapagliflozin treatment were included in the study. Demographic variables, anthropometric indices and laboratory parameters were obtained from the patient files. Baseline and 6th-month PWV and cIMT values were obtained. The percentage changes from baseline in all continuous variables with six months of dapagliflozin were calculated. Compared to baseline values, we found that cIMT decreased from 0.70 (0.50-1.10) mm to 0.60 (0.40-1.00) mm and PWV decreased from 9.52 ± 1.59 m/s to 9.16 ± 1.55 m/s in the 6th month of treatment (p < 0.001 and p < 0.001, respectively). The percentage decrease in cIMT (ΔcIMT) was 14.65 ± 11.88% and in PWV (ΔPWV) was 3.76 ± 4.08%. ΔcIMT was positively correlated with baseline cIMT, BMI and fat mass values (p = 0.019, p = 0.023 and p = 0.030, respectively). 1PWV was positively correlated with baseline systolic blood pressure (p = 0.020). According to the results of our study, dapagliflozin treatment reduces PWV and cIMT, and the decrease in these markers was greater among patients with higher baseline SBP, cIMT, BMI and fat mass. These results suggest that, if supported by more comprehensive studies, the cardiovascular benefits of dapagliflozin may be greater in patients with higher baseline cardiovascular risk.