The present study aimed to evaluate the reasons behind the fact that some individuals did not contract coronavirus disease 2019 (COVID-19), considering certain socio-demographic data. The present cross-sectional study was conducted at a state hospital between February 1, 2022 and March 1, 2022. The study group consisted of individuals who never had COVID-19, and the control group consisted of individuals who did not know at the time of the study whether they had COVID-19. A data collection form consisting of 29 questions created based on a literature review was used. A total of 2,958 subjects (study group, 669; control group, 2,289) were included; of these, 53.1% were females and 46.9% were males. It was found that housewives (P<0.001), individuals with secondary school and lower education levels (P=0.02), those residing in rural areas (P=0.003), those who received a combination vaccine (P<0.001), those with chronic diseases (P=0.016), those who consumed more fruits (P=0.001), those who used N95 masks (P=0.002), those with pets (P<0.001) and those who did not follow the news regarding COVID-19 (P=0.016) had a higher probability of not contracting COVID-19. On the whole, the present study observed that socio-demographic factors affected the non-COVID-19 status.

This study aimed to demonstrate whether fullerenol C60, sevoflurane anesthesia, or a combination of both had protective effects on the liver and kidneys in lower extremity ischemia-reperfusion injury (IRI) in mice with streptozocin-induced diabetes. A total of 46 Swiss albino mice were divided into six groups as follows: control group (group C, n=7), diabetes group (group D, n=7), diabetes-ischemia/reperfusion (group DIR, n=8), diabetes-ischemia/reperfusion-fullerenol C60 (group DIR-FC60, n=8), diabetes-ischemia/reperfusion-sevoflurane (group DIR-S, n=8), and the diabetes-ischemia/reperfusion-fullerenol C60-sevoflurane (group DIR-S-FC60, n=8). Fullerenol C60 (100mg/kg) was administered intraperitoneally 30 min before the ischemia-reperfusion procedure to the fullerenol groups (DIR-FC60 and DIR-S-FC60). In the DIR groups, 2 hours (h) ischemia-2h reperfusion periods were performed. In the sevoflurane groups, sevoflurane was applied during the ischemia-reperfusion period with 100% O2. Liver and kidney tissues were removed at the end of the reperfusion procedure for biochemical and histopathological examinations. In liver tissue, hydropic degeneration, sinusoidal dilatation, pycnotic nuclei, prenecrotic cells, and mononuclear cell infiltration in parenchyma were significantly more frequent in group DIR than in groups D and group C. In terms of the histopathologic criteria examined, more positive results were seen in group DIR-FC60, and when group DIR-FC60 was compared with group DIR, the difference was significant. The best results in AST, ALT, glucose, TBARS levels, and SOD enzyme activities in liver tissue were in group DIR-FC60 compared with group DIR, followed by groups DIR-S-FC60 and DIR-S, respectively. Regarding TBARS levels and SOD enzyme activities in kidney tissue, the best results were in groups DIR-FC60, DIR-S-FC60, and DIR-S, respectively. According to our findings, it is clear that fullerenol C60 administered intraperitoneally 30 min before ischemia, alone or together with sevoflurane, reduces oxidative stress in distant organ damage caused by lower extremity IRI, and reduces liver and kidney tissue damage in histopathologic examinations.

Objective. This study aimed to investigate the necessity of using fluoroscopy in retrograde intrarenal surgery (RIRS). Material and Methods. A total of 612 patients who underwent RIRS for kidney stones were evaluated and divided into two groups. Group 1 routinely underwent the operation with fluoroscopy due to opaque stones (n: 504). In group 2, the procedure was performed without fluoroscopy because of nonopaque stones (n: 108). Both groups were assessed for stone size, location, and number. Success and complication rates were compared between the two groups. Conclusion. This study was designed with the thought of not using fluoroscopy in RIRS patients with nonopaque stones and having the same stone-free rates in opaque stones. In the statistical analysis, there was no difference between the groups with and without scope for stone side, size, localization, and number; likewise, the complication rates developed in the comparison of both groups, stone-free rates, and hospital stay were the same. Discussion. Advances in the calibration of instruments, the development of optical systems, and improvements in imaging system resolution have gradually reduced the need for fluoroscopy in RIRS. This study provides further evidence that fluoroscopy is unnecessary in RIRS procedures, thereby eliminating unnecessary radiation exposure.

AimThe aim of our study is to show whether the administration of hydrogen-rich saline solution (HRSS) intraperitoneally before left main coronary artery (LAD) ischemia protects the myocardium against ischemia-reperfusion (IR) injury. Materials and methodsAfter ethics committee approval, 24 Wistar Albino rats were divided into 4 groups, 6 rats in each group. For experimental IR, myocardial ischemia was performed by LAD ligation. Left thoracotomy was performed without ischemia in the Control group (Group C). Left thoracotomy was performed without myocardial ischemia to the rats in the HRSS group, and HRSS was given intraperitoneally (ip) at a rate of 10 ml/kg throughout the procedure. In the MIR-HRSS group, a single dose of 10 ml/kg HRSS was administered 5 min before reperfusion. Histopathological and biochemical parameters were compared in myocardial tissue samples taken at the end of the reperfusion period. ResultsWhen the groups were compared among themselves in terms of TOS and TAS levels, there was a significant difference between the groups (p = 0.006, p = 0.002). The severity of cardiomyocyte degeneration was significantly greater in MIR group than that in the control and HRSS groups (p = 0.002 and p = 0.001, respectively), as well as severity score of cardiomyocyte degeneration was higher in MIR-HRSS group compared with HRSS group (p = 0.035). ConclusionOur study shows that HRSS is protective in IR injury, with the application of HRSS 5 min before reperfusion, interstitial edema severity, subendocardial haemorrhage are reduced, and oxidant status parameters are increased, while antioxidant status parameters are decreased. We believe that when it is supported by other studies, the protective effects of HRSS on IR damage will be shown in detail and its indications will be expanded.

To detect changes in body temperature during outpatient procedures and to identify factors associated with hypothermia in the paediatric population undergoing radiotherapy under sedation. The observational study was conducted between July and October 2022 at Ankara City Hospital, Turkey, and comprised paediatric cancer patients aged from 1 month to 18 years who needed sedation or general anaesthesia during radiotherapy. Baseline body temperature T1 was measured before transportation to the radiotherapy room, while body temperature T2 was taken after radiotherapy. Data was analysed using SPSS 20. A total of 152 radiotherapy sessions related to 13 children were evaluated. There were 8(61%) boys and 5(38%) girls with overall mean 4.46±3.45 years (range: 2-13 years). The mean body surface area as 0.70±0.212. Radiotherapy was performed in 9(69%) patients, while 4(31%) patients underwent tomotheraphy. The dose used was 180cGy in 12(92.3%) patients. Hypothermia was observed in at least one session in 12(92.3%) patients. There was significant difference in body temperature at baseline and post-radiotherapy (p<0.05). There were significant changes in body temperature during outpatient procedures in the paediatric population undergoing radiotherapy under sedation.

This study compares the analgesic effects and dermatomal blockade distributions of single and double injection bilateral thoracic paravertebral block (TPVB) techniques in patients undergoing reduction mammaplasty. After obtaining ethics committee approval, 60 patients scheduled for bilateral reduction mammaplasty were included in the study. Preoperatively, the patients received one of single (Group S: T3-T4) or double (Group D: T2-T3 & T4-T5) injection bilateral TPVBs using bupivacaine 0.375% 20 ml per side. All patients were operated under general anesthesia. The T3-T6 dermatomal blockade distributions on the midclavicular line were followed by pin-prick test for 30 min preoperatively and 48 h postoperatively. All patients received paracetamol 1 g when numeric rating scale (NRS) pain score was ≥ 4, and also tramadol 1 mg/kg when NRS was ≥ 4 again after 1 h. The primary endpoint was NRS pain scores at postoperative 12th h. The secondary endpoints were dermatomal blockade distributions and NRS scores through the postoperative first 48 h, time until first pain and the analgesic consumption on days 1 and 2. Fifty-two patients completed the study. The NRS pain scores at 12th h were similar (right side: P = 0.100, left side: P = 0.096). The remaining NRS scores and other parameters were also comparable within the groups (P ≥ 0.05). Only single injection TPVB application time was shorter (P < 0.001). The single injection TPVB technique provided sufficient dermatomal distribution and analgesic efficacy with the advantages of being faster and less invasive.

This study aimed to determine whether a standard anesthetic protocol consisting of combined spinal epidural anesthesia (CSEA) in conjunction with controlled hypotensive anesthesia (CHA), which was used for conventional total knee arthroplasty (cTKA), could provide equally effective anesthetic conditions for robotic total knee arthroplasty (rTKA). Data were collected from the medical records of 113 patients (median age=67 years; age range=55-84) who underwent elective unilateral cTKA (n=52) or rTKA (n=61) without a tourniquet from 2021 to 2023. The primary outcome measure was the rate of patients whose anesthetic method did not provide adequate motor and sensory block during the surgery and had to be converted to general anesthesia. The secondary outcome measure was to compare perioperative variables, including pain scores, analgesic consumption, blood loss, transfusions, and complications. In 6 patients (11.5%) in group rTKA, it was required to convert CSEA to general anesthesia at 160-180 minutes due to the pain at the operative knee and/or to the movement of the operative leg during surgery compared to none / zero in group cTKA (P=.008). Motor and sensory blocks terminated earlier than the total surgery time in those patients. Mean total surgery time was significantly higher in group rTKA than in group cTKA (151.25 ± 24.51 (120-240) minutes vs. 116.72 ± 4.99 (105-125) minutes, P < .001). Total surgery times tended to decrease gradually in group rTKA after the 11th case, indicating a learning curve for surgical performance. Conversion to general anesthesia was required only in 1 patient after the 11th case compared to the previous 5 patients. Mean pain scores and rescue analgesic consumption were higher in group rTKA at postoperative 0 hour and between 0 and 4 hours (P < .05) but similar at the following time points (P > .05). Blood loss, transfusion, and complication rates were similar (P > .05). Hospital discharge times were higher in group rTKA (P < .05). Although our standard CSEA protocol failed due to the regression of motor and sensory block during surgery in 11.5% of patients in rTKA, the CSEA technique combined with controlled hypotensive anesthesia provided similar anesthetic conditions in the remaining patients in group rTKA as in group cTKA. The CSEA may be considered an effective and safe anesthetic method for rTKA if interventions are applied to extend the duration of the CSEA for this novel surgical technique. Level III, Therapeutic Study.

Pulmonary aspiration of gastric content is a serious perioperative complication. The objective of this prospective study was to assess the relationship between the gastric volumes suctioned endoscopically and quantitative (antral cross-section area) and qualitative (empty vs. nonempty) examination of the gastric antrum. Furthermore, the study aimed to determine the best antral cross-section area cutoff value for a truly empty antrum in infants. This study was performed in a pediatric gastrointestinal endoscopy unit. Antral sonography was performed in supine and right lateral decubitus positions in 46 fasted infants prior to upper gastrointestinal endoscopic evaluation. Antral cross-sectional area measurements in both positions and qualitative evaluation of the antrum (according to a three-point grading system) were recorded. Gastric contents were endoscopically suctioned and measured. Forty-six patients (aged under 24 months) were included. According to the three-point qualitative grading system, 76.1% of patients were classified as grade 0. The best cutoff value for the antral cross-section area in the right lateral decubitus position, indicating an empty antrum, was determined to be 2.40 cm2. At this specific cutoff value, the sensitivity was 100%, the specificity was 68.6%, and the negative predictive value was 100%. Gastric ultrasonography can confirm an empty or nearly empty stomach in healthy infants.

ObjectiveWe aimed to investigate the factors associated with UTI in patients with T2D whether being treated with SGLT-2i or not.MethodsAdult patients with T2D, whose urine culture results were available, were analyzed retrospectively. Urine culture was obtained from mid-flow urine. Antibacterial treatment was given to the patients with UTI, which was defined by positive urine cultures and/or clinical findings. We grouped the patients as follows: Group A, those treated with SGLT-2i; and Group B, those not treated with SGLT-2i.ResultsA total of 101 patients were included. Median age was 56 (45–67), 56.4% (n = 57) of the patients were female. Urine culture was positive in 54.9% (n = 28) and 16% (n = 8) of Group A (n = 51) and Group B (n = 50), respectively. Of those for whom urine culture was positive, Escherichia coli was isolated in 83.3% (n = 30), and both Escherichia coli and Klebsiella pneumoniae (K.pneumoniae) were isolated in 16.7% (n = 6). Klebsiella pneumoniae was isolated only from Group A. The need for and duration of hospitalization were higher in Group A (p < 0.001). UTI was detected in 60 patients. ROC analysis showed that a HbA1c of > 5.8% was associated with UTI with good accuracy (AUC: 0.835, p < 0.001). In multiple logistic regression analysis, SGLT-2i use and glucosuria were positive predictors for UTI (p = 0.004, Odds Ratio: 1984.013; and p = 0.028, and Odds Ratio: 12.480, respectively).ConclusionBesides the association of HbA1c and BMI with UTI, SGLT-2i use and glucosuria predicted UTI. Urine culture is important with respect to the choice of antibacterial treatment, especially in those patients under SGLT-2i treatment. The effect of SGLT-2i on the development of UTI is independent of baseline BMI score or HbA1c.

In this study, we sought to compare the effects of general and regional anesthesia techniques on the length of hospital stay and morbidity-mortality in geriatric patients who have had hip fractures and underwent surgical treatment. A total of 331 patients who were 65 or older and had had surgical treatment for elective or urgent hip fractures were classified into two groups; regional and general anesthesia. Recorded variables were: age, sex, American Society of Anesthesiologists (ASA) score, comorbid disease, length of stay at the clinic, mortality, morbidity, intraoperative loss of blood, the necessity of blood transfusion, and type of fracture. These variables were compared in the control groups and evaluated retrospectively. For the regional anesthesia group, length of stay in the clinic, loss of blood, and necessity of blood transfusion were significantly lower compared to the general anesthesia group (p<0.05). Additionally, we found general anesthesia mortality and morbidity rates were significantly higher than regional anesthesia (p<0.05). Finally, we determined that increased age and number of comorbid diseases increased the morbidity and mortality rates significantly (p<0.05). This study evaluated regional anesthesia's advantages over general anesthesia when treating geriatric hip fractures. This includes reduced morbidity-mortality rates, bleeding, and shorter length of hospital stay.