Study Group Research Articles

Persistent iatrogenic atrial septal defect after cryoballoon ablation for atrial fibrillation

Aims: Pulmonary vein isolation (PVI) by cryoballoon ablation (CB) technology is effective and safe treatment option for atrial fibrillation (AF). CB is performed by large diameter, 15Fr (4.95mm) transseptal sheath that may lead to creation of iatrogenic atrial septal defect (iASD). The objective of this study was to assess the incidence of iASD in patients who had undergone CB. Methods: Patients with AF having undergone Arctic Front® CB ablation and a subsequent transesophageal echocardiography (TEE) examination during post-ablation follow up period were consecutively enrolled. During all CB procedures, 15Fr transseptal sheath (Flex Cath, Medtronic, Minneapolis, MN) was utilized via single transseptal puncture (TsP). Results: Twenty-eight patients (15 females, mean age 55.8+15.5) with paroxysmal (n=24) or persistent (n=4) AF formed study group. iASD was present 11 (39.3%) of them after mean follow-up time of 17.3+6.2 months. The procedural time is significantly longer in patient with iASD (119.0+8.8 minutes, p=0.01). No patients died or suffered from any clinically significant cerebral ischemic event. There was no sign of increase in systolic pulmonary arterial pressure (sPAP). Conclusion: iASD after CB was found to be present in 39.3% of patient during a mean follow-up time of 17.3+6.2 months. The prolonged CB procedural time was the only factor that predicted iASD in our study. No adverse clinic events that might be related to iASD was observed during follow-up period.

Early Complications of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

Early Complications of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

PENGARUH PENGGUNAAN SOFTWARE MYOB SEBAGAI MEDIA PEMBELAJARAN DAN MINAT BELAJAR SISWA TERHADAP HASIL BELAJAR AKUNTANSI PERUSAHAAN JASA DI SMA

This research is motivated persistence of low learning outcomes accounting, lack of use of computer-based instructional media that support the activity and participation of students in the learning process accounting. One way to overcome this problem is to use MYOB software as a learning medium accounting to assist the teacher in the learning condition of innovative accounting. This study aims to determine the effect of using MYOB software media on learning outcomes accounting services company, and reveal the influence of student interest to the learning outcomes of accounting and how the interaction between media use MYOB, interest in learning and learning outcomes of accounting. The method used in this study is the experimental method, the study population was all students of class XI IPS SMAN 4 Jambi. Samples were taken by random sampling technique as many as 80 students. Data collection techniques for variable interest learns using questionnaires and to learn to use the test variable results. The validity of the test was tested with ITEMAN program and for data analysis using ANOVA technique 2 Land with prerequisite distribution normality test data using Lilliefors models, and test of homogeneity of variance using Bartlett's test, with a significance level of 5% research. Results calculated with SPSS 16, shows that the distribution of the data according to the normal curve, the sample is derived from a homogeneous population. Demonstrated that: (1) the results of the study group of students who were given learning with media MYOB higher compared with a group of students who were given learning with media LKS (Fhitung 1.362> 0.05); (2) Results of study accounting services firm group of students who have a high interest in learning, better when compared with the results of studying accounting services company in the group of students who have a low interest, both of which are taught using MYOB software media and the use of media LKS because of F 0.761> 0 , 05. (3) In the group of students who have a high interest in learning, learning outcomes accounting services firms students taught using MYOB software media is higher when compared with the results of studying accounting services firms students taught using media LKS (4) In the group of students who have interest in learning low, the result of learning accounting services firms students taught using MYOB software media is higher when compared with the results of studying accounting services firms students taught using LKS media. (5) There is an interaction between media software MYOB and interest in learning on learning outcomes Fhitung services firms accounting for 0.752, for p> 0.05. Keyword: Keywords: Software MYOB, interest in learning, learning outcomes accounting services company.

Trend change analysis in the assessment of body balance during posture adjustment in reaction to anterior-posterior ground perturbation.

Postural adjustments (PA) occur to counteract predictable perturbations and can be impaired as a result of musculoskeletal and neurological dysfunctions. The most common way to detect PA is through electromyography measurements or center of pressure (COP) position measurements, where analysis in time domain and frequency domain are the most common. Aim of the research was to determine whether a new method of analyzing stabilographic measurements-the COP trend change analysis (TCI) of temporary posture corrections- can expand understanding of changes in balance strategy connected with PA. The study group involved 38 individuals (27women, 11men) aged 23±2.6 years. Measurements were performed using a stabilographic platform placed on a perturbation platform. The tests involved three measurements with forward and backward momentary movements of the platform. Participants were tested in three conditions-knowing the nature, time and direction of perturbation (Tr3), knowing only the nature of perturbation (Tr2) and without any information about the perturbation (Tr1). Statistically significant differences were revealed in the last second of Tr3 for the mean velocity of COP (p<0.05) and for two TCI parameters-TCI_dV (p<0.05) and TCI_dS (p<0.01). The increase in TCI_dV was related to the increase in the mean distance between trend changes (TCI_dS) and constant value of the mean time between trend changes (TCI_dT). The increase of the mean value of TCI_dS was the result of smaller number of posture corrections with the distance 0-2 mm and lager number with the distance 4-6 mm. Obtained results proved that the TCI analysis is a method enabling an extended analysis of PA, indicating the nature of changes occurring in posture corrections-longer momentary jumps of COP-related to a change in the strategy of maintaining balance before a known disorder, which has not been analyzed in this type of research so far.

Effectiveness of a Teacher Education Program for Respecting the Rights of the Child Using the Autonomous Study Group Method in Public Childcare Centers

Effectiveness of a Teacher Education Program for Respecting the Rights of the Child Using the Autonomous Study Group Method in Public Childcare Centers

Comparison the Perfusion/Diffusion Mismatching Judging From CT-Based and MR-Based Study

Background: The development of endovascular devices and clinical experience, recanalization rate after intraarterial thrombectomy (IA-Tx) has increased. Recent papers reported that the amount of perfusion/diffusion (P/D)-mismatching in digital analysis from computer tomography perfusion (CTP) image is well correlated well with P/D-mismatching from magnetic resonance image. The purpose of this study is compare the patient clinical outcomes after IA-Tx, judging from CTP based and magnetic resonance imaging (MRI) based study. Methods : 218 patients with anterior circulation large vessel occlusion (LVO) treated by IA-Tx were included in this analysis. In the MRI group (n=80), P/D-mismatching from MRI based image analysis by visual method and in the CTP group (n=138), and recently, P/D-mismatching was decided by automatized computer programmatic analyzed from CTP based image (Syngo.via program). Results: Favorable outcome (modified Rankin Score: 0–2), mortality, recanalization, and clinically significant hemorrhage was 56.3% (45/80), 6.25% (5/80), 81.3% (65/80) and 25% (20/80) in MRI group and 4.9% (62/138), 8.9%(18/138), 91.3%(126/138) and 40.6% (56/138) in CTP group (p=0.000, 0.235, 0.007 and 0.013). Reperfusion injury (27.5% vs, 15.0%, p=0.018) but favorable outcome was high 55.0% vs. 44.9 $, p=0.00) in the MRI study group. Conclusion : In our study, patient selection according to the P/D-mismatching from MR-based imaging and CTP-based image was not different in final clinical outcome. Recent IA-Tx, showed high recanalization rate but it also cause high incidence of reperfusion injury.

Assessment of nutritional status and health behaviors in yoga-trained women versus exercisers

IntroductionRecreational physical activity is becoming more popular due to the increased public awareness about the beneficial effects on health status and quality of life. The aim of the study was to assess the nutritional status and health behaviors of women who regularly practice yoga as a form of physical recreation and to compare them with those who had not practiced before and had just signed up for yoga classes. A total of 143 women took part in this study.MethodsThe nutritional status was assessed based on the obtained anthropometric measurements. The following indicators were calculated: Body Mass Index (BMI) and waist-to-hip ratio (WHR), determining the visceral accumulation of fat tissue. Health behaviors were assessed using a standardized five-point scale Health Behavior Inventory (HBI).ResultsThere were significant differences in the value of the general health behavior index, the sten scale, and the subscale regarding proper eating habits in the study groups compared to women who had not practiced yoga before (control group). Health behaviors indicators, particularly proper eating habits, are significantly higher in women participating regularly in yoga exercises, indicating a higher awareness among yoga practitioners.ConclusionIt can be suggested that yoga participation as a recreational physical activity can be an appropriate option for pursuing healthy habits.

Epidemiological trends and susceptibility patterns of bloodstream infections caused by Enterococcus spp. in six German university hospitals: a prospectively evaluated multicentre cohort study from 2016 to 2020 of the R-Net study group.

To analyse recent epidemiological trends of bloodstream infections (BSI) caused by Enterococcus spp. In adult patients admitted to tertiary care centres in Germany. Epidemiological data from the multicentre R-NET study was analysed. Patients presenting with E. faecium or E. faecalis in blood cultures in six German tertiary care university hospitals between October 2016 and June 2020 were prospectively evaluated. In vancomycin-resistant enterococci (VRE), the presence of vanA/vanB was confirmed via molecular methods. In the 4-year study period, 3001 patients with BSI due to Enterococcus spp. were identified. E. faecium was detected in 1830 patients (61%) and E. faecalis in 1229 patients (41%). Most BSI occurred in (sub-) specialties of internal medicine. The pooled incidence density of enterococcal BSI increased significantly (4.0-4.5 cases per 10,000 patient days), which was primarily driven by VRE BSI (0.5 to 1.0 cases per 10,000 patient days). In 2020, the proportion of VRE BSI was > 12% in all study sites (range, 12.8-32.2%). Molecular detection of resistance in 363 VRE isolates showed a predominance of the vanB gene (77.1%). This large multicentre study highlights an increase of BSI due to E. faecium, which was primarily driven by VRE. The high rates of hospital- and ICU-acquired VRE BSI point towards an important role of prior antibiotic exposure and invasive procedures as risk factors. Due to limited treatment options and high mortality rates of VRE BSI, the increasing incidence of VRE BSI is of major concern.

İlkokul Birinci Sınıfta İlk Okuma Yazmayı Uzaktan Eğitim Yoluyla Öğrenen Çocukların, İkinci Sınıf Dinleme, Konuşma, Okuma, Yazma Becerilerine Etkisi

This study examines teachers' opinions on how the language skills in the second grade (listening, speaking, reading, writing) of students who learned initial literacy in the first grade of elementary school (2020-2021) through distance education due to the pandemic were affected. This study was conducted using a descriptive qualitative research model. The study group comprised 18 teachers who conducted first-grade initial literacy teaching via distance education in 2020-2021 academic year and worked in the second grade during 2021-2022 academic year. Each teacher had instructed first grade at least three times in their career. A semi-structured interview form served as the data collection tool, and thematic analysis was employed for data analysis. The data yielded four themes: listening skills, speaking skills, reading skills, and writing skills, with corresponding sub-themes identified and interpreted. Participants reported that the pandemic led to temporary school closures and a shift from face-to-face to distance learning for first-grade literacy. Consequently, students missed the opportunity to develop listening, speaking, reading, and writing skills through direct interaction in the classroom. They stated the limitations and conditions of distance education were cited as reasons for this shortfall. As a result, they stated that there are inadequacies in students' listening, speaking, reading and writing skills, and that these inadequacies have a negative impact on their listening skills in the second grade. This resulted in inadequacies in students' listening, speaking, reading, and writing skills, negatively impacting their second-grade. It was reported that there were lack of gains in the achievements of this group compared to the students of previous years, and that these were due to the fact that the initial literacy teaching was carried out through distance education.

Current aspects of the treatment of combat surgical trauma

Objective. The history of providing assistance to victims with gunshot wounds dates back more than one century, but nevertheless surgical treatment of gunshot wounds is still relevant to this day. High-quality primary surgical treatment of a gunshot wound is the key to a speedy recovery of the patient (N.I. Pirogov). The pathogenesis of gunshot wounds determines the specific tactics of surgical treatment. Gunshot wounds are zonal in nature. According to the results of morphological studies, it can be concluded that a significant part of the changes in the zone of molecular concussion of the wound canal are reversible, and the complexity of pathogenesis and the lack of reliable criteria for assessing the condition of tissues does not exclude the possibility of leaving areas with reduced viability in the wound after treatment. For maximum effect during surgical treatment of gunshot wounds, non-viable tissues should be removed with minimal damage to viable ones. To meet these requirements, it is often impossible to visually assess the boundary between damaged and parabiotic tissues objectively intraoperatively. The use of modern physical methods of wound wrapping and preparing them for plastic closure, such as low-frequency ultrasound, hydrosurgical methods and VAC therapy allows you to radically clean the wound surface with minimal damage to viable tissues and perform plastic closure operations on soft tissue defects at an early date.Purpose of a study: to improve the methods of primary surgical treatment in patients with combat surgical trauma using low-frequency ultrasound.Material and methods. Our study is based on the analysis of the treatment results of 93 patients aged 10 and 70 years old. All patients had combat surgical trauma of various etiology and localization. Of these, 36 (38.7%) patients in main group underwent ultrasound cavitation of the wound canal and wound defects during primary surgical treatment (PST), followed by primary or primary delayed plastic surgery within a period not exceeding 48 hours after PST. Methods of plastic wound closure were both flaps with axial circulation and autodermotransplantation. In the remaining 57 (61.3%) patients of comparison group, primary surgical treatment was not performed, or was performed at the stages of evacuation, with further conservative treatment. Upon admission to the clinic, he underwent secondary surgical treatment, opening of purulent lumps, as well as staged necrectomies, while wound plastic surgery was performed after wound cleansing and was mainly represented by autodermotransplantation.Results. It was revealed that in the main group, the treatment time of patients in the main group was reduced by 2 times compared with the comparison group (16.3 and 34.2 bed days, respectively). The effectiveness of engraftment of autodermotransplants was evaluated according to V.I. Petrov's scheme. Lysis of autodermotransplants was noted 1.9 times less frequently in the main study group. It was also noted that there were no purulent complications in main group, unlike comparison group – 20.6%, the number of marginal necrosis was 2.6% in main group and 22.4% – in comparison group, lysis of autodermotransplanates in main group was 7.8%, in comparison group – 13.8%.Conclusion. This study allows us to conclude that the advantage of using ultrasonic cavitation during the usual surgical treatment of gunshot wounds followed by primary or primary delayed plastic surgery.

Mathematics Teachers' Experiences of Positive Error Climate

In the qualitative case study in which the question, "What are teachers' views on the applicability of positive error climate in the classroom?" was sought to be answered, 19 mathematics teachers working in different provinces of Turkey, having more than five years of professional experience and receiving master's degree education constituted the study group. Before this study, teachers' attitudes and behaviors toward errors were taken in writing. At the end of the eleven-week implementation, the teachers' opinions about the implementation were obtained through interviews, and content analysis was applied to the data with MAXQDA. 2020. Under the theme of positive error climate experience, teachers evaluated the application as effective, fun, providing permanent learning and increasing self-confidence. On the other hand, they stated the negative aspects as insufficient time, difficulties in classroom management, and causing mislearning. Seventeen participants stated that they would use the error climate in their classrooms.

Relationship Between Serum Brain-Derived Neurotrophic Factor and Neurotrophin-3 Levels and Hearing Thresholds in Age-Related Patients With Hearing Loss.

Age-related hearing loss (ARHL) is a general term used to describe the sensorineural type of hearing loss occurring in both ears in older adults. Neurotrophins are the most promising candidates for supporting the auditory nerve by increasing neuronal survival. This study aimed to help elucidate the pathophysiology of ARHL by determining whether any relationship exists between brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) levels in serum samples from patients diagnosed with ARHL. Seventy-seven individuals, a study group of 41 patients diagnosed with ARHL, and a control group of 36 participants without hearing loss were evaluated. Serum samples were collected and used to measure serum BDNF and NT-3 levels with the new Nepenthe enzyme-linked immunosorbent assay method. Median pure-tone average results in the 2000, 4000, and 6000 Hz ranges were 52.5 (44.3-67.3) dB HL in the ARHL group and 13.5 (11.1-17.1) dB HL in the control group. The difference was statistically significant (p = .001). Although NT-3 and BDNF levels were both lower in ARHL patients than in participants without hearing loss, only the BDNF levels were significantly (p = .002) lower. Mean left and right ear word recognition scores were also lower in ARHL patients than in control groups. The ARHL group was further divided into two subgroups based on word recognition scores to evaluate significant differences in BDNF and NT-3 levels. No statistically significant difference was observed in BDNF and NT-3 levels between these subgroups. However, there was a significant difference in word recognition scores. Low BDNF levels in the ARHL group suggest that BDNF may play a role in the pathogenesis of ARHL. Patients with low (ARHL1) and high (ARHL2) word recognition scores were compared for the first time in the literature in terms of BDNF and NT-3 levels. However, the results were not statistically significant. This article is a preliminary study and was written to provide guidance for our next comprehensive project.

Mathematical modeling of foreign bodies with different density in biological and non-biological models in the experiment

Background. Modeling allows investigating both existing and predicted processes and is widely used in basic science and in many industries. The aim is to develop a mathematical model for determining the size of the foreign bodies (FB) and their radiographic density in non-biological and biological models to improve the results of diagnosis for gunshot ricochet wounds. Materials and methods. In the biological non-living model (a piece of pork) and non-biological models (polystyrene, foam rubber), we place the FB made of paper, leather, rubber, plastic, and lithium-ion batteries. The number of the FB is 9 of each type. Number of models is 3 each: pork, polystyrene, foam rubber. We measure the dimensions of the FB and models with a metric ruler. For each model, we select the FB, which we label with the study number. We immerse the FB to the same depth using a Billroth general surgical medium hemostatic clamp in the following sequence: paper, leather, rubber, plastic, and lithium-ion battery. Multislice computed tomography (MSCT) of the models is performed on the Revolution EVO (2021) apparatus with measurement of the sizes and radiographic density of the FB and models. Radiographic density was measured in conventional units on the Hounsfield scale. For each study group, the ratio of the actual sizes of the removed FB and according to MSCT data was determined in the MathCad 15 computer math software, depending on the radiological density of the FB and the model. Results. According to MSCT data, the radiographic density of the models on the Hounsfield scale is as follows: polystyrene — –990.0 ± 0.3 units; foam rubber — –985.0 ± 0.2 units; pork — 62.0 ± 0.3 units; radiographic density of the foreign bodies: paper — –743.0 ± 10.3 units, leather — –258.0 ± 14.2 units, rubber — –12.0 ± 2.6 units, plastic — 183.0 ± 14.6 units, lithium-ion batteries — 3071 units. Visualization of paper in non-biological and biological models and leather in non-biological models is problematic due to the similar radiographic density of the models and the inability to measure the dimensions. When the FB (rubber, plastic, battery) is immersed in polystyrene, the coefficient of length (CL) is 1.0612, the coefficient of width (CW) is 1.928; in foam rubber: CL is 0.9926, CW is 1.9641; in pork: CL is 0.8394, CW is 1.534. Comparing the average coefficients of the ratio (CL and CW), we find that the coefficient in a biological model is closest to 1. This means that the FB from rubber, plastic, and batteries are best detected in pork. Conclusions. The actual dimensions of the FB placed in biological and non-biological models differ from those obtained by MSCT. Data correction is performed through calculated coefficients for length and width. The radiographic density of the model affects the radial visualization of the FB. The use of mathematical modeling in determining the sizes and radiographic density allows reducing the measurement error and determine the structure of the FB.

Outcomes with General Anesthesia Compared to Conscious Sedation for Endovascular Treatment of Medium Vessel Occlusions: Results of an International Multicentric Study.

Optimal anesthetic strategy for the endovascular treatment of stroke is still under debate. Despite scarce data concerning anesthetic management for medium and distal vessel occlusions (MeVOs) some centers empirically support ageneral anesthesia (GA) strategy in these patients. We conducted an international retrospective study of MeVO cases. Apropensity score matching algorithm was used to mitigate potential differences across patients undergoing GA and conscious sedation (CS). Comparisons in clinical and safety outcomes were performed between the two study groups GA and CS. The favourable outcome was defined as amodified Rankin Scale (mRS) 0-2 at 90days. Safety outcomes were 90-days mortality and symptomatic intracranial hemorrhage (sICH). Predictors of afavourable outcome and sICH were evaluated with backward logistic regression. After propensity score matching 668 patients were included in the CS and 264 patients in the GA group. In the matched cohort, either strategy CS or GA resulted in similar rates of good functional outcomes (50.1% vs. 48.4%), and successful recanalization (89.4% vs. 90.2%). The GA group had higher rates of 90-day mortality (22.6% vs. 16.5%, p < 0.041) and sICH (4.2% vs. 0.9%, p = 0.001) compared to the CS group. Backward logistic regression did not identify GA vs CS as apredictor of good functional outcome (OR for GA vs CS = 0.95 (0.67-1.35)), but GA remained asignificant predictor of sICH (OR = 5.32, 95% CI 1.92-14.72). Anaesthetic strategy in MeVOs does not influence favorable outcomes or final successful recanalization rates, however, GA may be associated with an increased risk of sICH and mortality.

Academic Self-problems of Candidate Teachers of Native Language: “I am not sure what or how to learn.” But I must be sure of what I can teach.”

Academic self-concept is an individuals’ self-definition using their experiences in the educational process or their views on their own skills and interests. This study aims to determine the academic self-perception of teacher candidates of native language. This study was conducted with a qualitative approach in a phenomenological design. The study group consisted of 10 female and 6 male native language teacher candidates at a university located in the eastern part of Turkey. During the data collection process, semi-structured interviews were conducted with open-ended questions, the data collected with a voice recorder was converted into a written text. Participant views were subjected to content analysis. The first, last, and focus codings were completed for “coder reliability;” and an external controller was also used. In this study, the data source was diversified with reminder notes and observation reports for stability and transparency. The findings revealed that most participants had high verbal abilities and interests, and weak numerical abilities and interests. Additionally, the views that they were unable to make the right choices in line with their abilities and interests and therefore could not achieve their academic self-concept and goals are remarkable.

Central auditory functions in post-COVID-19 adults; a case control study

BackgroundThis study aimed to evaluate the central auditory abilities in post-coronavirus disease 2019 (COVID-19) adults by using Central Auditory Tests (CATs). This study included a complaining group (GI), a non-complaining group (GII), and a control healthy group (GIII). All subjects were evaluated using CATsResultsResults demonstrated statistically significant differences across groups as regards Speech Perception in Noise Test (SPIN), Duration Pattern Sequence Test (DPT), Gap in Noise Test (GIN), and Memory Test (ANOVA, p-value ≤ 0.05). The post-hoc test revealed that, except for recognition memory, both study groups showed statistically significant differences from the control group. Also, significant differences were detected between both GI and GII groups regarding SPIN−10 signal-to-noise ratio (S/N), DPT, GIN threshold, memory for content, and memory for sequenceConclusionsCOVID-19 led to central auditory processing disorders (c)APD.

The Assessment of the Long-Term Impact of Radiotherapy on Biophysical Skin Properties in Patients after Head and Neck Cancer

Background and Objectives: Chronic radiotherapy-induced skin injury (cRISI) is an irreversible and progressive condition that can significantly impact a patient’s quality of life. Despite the limited literature available on the assessment of the epidermal barrier in cRISI, there is a consensus that appropriate skincare, including the use of emollients, is the primary therapeutic approach for this group of patients. The aim of this study was to evaluate the biophysical properties of the skin during the late period (at least 90 days) following radiation therapy (RT) for head and neck cancer. Materials and Methods: This was a single-center prospective non-randomized study. It involved the analysis of 16 adult patients with head and neck cancer who underwent RT at the Greater Poland Cancer Center, along with 15 healthy volunteers. The study and control groups were matched for gender and age (p = 0.51). Clinical assessment, based on the LENT-SOMA scale, was conducted for all patients. Evaluation of the skin’s biophysical properties included: an analysis of transepidermal water loss (TEWL), stratum corneum hydration (SCH), and skin visualization using high-frequency ultrasonography (HF-USG). Results: A significantly higher TEWL was observed in the irradiated area compared to the control area in the study group (p = 0.004). However, there was no statistically significant difference in SCH (p = 0.073). Additionally, no significant difference was observed in the values of TEWL and SCH in the irradiated area between the group of patients with and without clinically obvious RISI (p = 0.192 and p = 0.415, respectively). The skin thickness of the irradiated area, assessed by HF-USG, did not differ significantly from the skin thickness of the control area (p = 0.638). Furthermore, no difference in skin thickness was observed in patients with clinical features of cRISI in the irradiated and control areas (p = 0.345). The mean time after RT was 6.1 years. Conclusions: This study marks the first demonstration of epidermal barrier damage in patients in the long term following RT for head and neck cancer. The impairment of the epidermal barrier was observed independently of evident cRISI features. This observation underscores the necessity to recommend appropriate skin care, including the use of emollients, for all patients following RT. We also suggest that HF-USG examination is generally inconclusive in determining the degree of skin damage in the late period after RT.

Efficacy of Phlogenzyme® in men following transurethral laser enucleation of prostate hyperplasia: results of a randomized trial

Introduction. The most advanced and effective method of surgical treatment for benign prostatic hyperplasia (BPH) is transurethral laser enucleation of the prostate (tLEP). Recently, there has been a growing interest in exploring new approaches to reduce the risk of complications following tLEP.Objective. To evaluate the efficacy of using Phlogenzym® as part of a comprehensive treatment plan for patients following tLEP to reduce dysuria (urinary discomfort), leukocyturia (white blood cells in urine), and prevent infectious and fibrosis-related complications.Materials &amp; methods. An open-label, randomized trial enrolled 105 patients undergoing tLEP. The patients were randomly assigned to two groups: the study group (n=50) received standard postoperative care in combination with Phlogenzym® for 30 days, while the control group (n=55) received standard care (α1-adrenergic blocker for 28 days) only. uring the follow-up period, which lasted for 1, 3, and 6 months postoperatively, complaints were evaluated using the IPSS-QoL, and IIEF-5 questionnaires, as well as indicators of urinalysis and urine culture, prostate volume measurements, residual urine volume, and uroflowmetry data.Results. Among all patients, the median preoperative values for prostate volume, IPSS, QoL score, and median peak urine flow rate were 90 cc, 18 points, 5 points, and 7.9 mL/s, respectively, with no significant differences between the groups. One month after surgery, in the study group, there was a more significant decrease in prostate volume (57% vs. 41%), although this difference was not statistically significant (p &gt; 0.05). At the 6-month follow-up, bacteriuria was less common in the study group (42% vs. 67%), and there was a consistent trend toward a reduction in the incidence of fibrous complications, although these differences were not statistically significant either (p &gt; 0.05). No adverse events occurred during the follow-up period.Conclusion. Our experience suggests that the use of Phlogenzym® is safe during the postoperative period following tLEP surgery. The use of this drug leads to a reduction in prostate volume postoperatively and significantly reduces the bacteriuria by the six-month follow-up. Additionally, there is a persistent positive trend towards reducing the overall incidence of fibrotic complications in the surgical site. The results achieved and the absence of significant side effects characterize Phlogenzym® as having a favorable clinical profile.

Targeted next-generation sequencing analysis in Italian patients with keratoconus.

To report variants in 26 candidate genes and describe the clinical features of Italian patients with keratoconus (KC). Sixty-four patients with a confirmed diagnosis of KC were enrolled in this genetic association study. Patients were classified into two study groups according to whether they had a confirmed diagnosis of progressive or stable KC. A purpose-developed Next Generation Sequencing (NGS) panel was used to identify and analyse the coding exons and flanking exon/intron boundaries of 26 genes known to be associated with KC and corneal dystrophies. Interpretation of the pathogenic significance of variants was performed using in silico predictive algorithms. The targeted NGS research identified a total of 167 allelic variants of 22 genes in the study population; twenty-four patients had stable keratoconus (n. 54 variants) and forty patients had progressive disease (n. 113 variants). We identified genetic variants of certain pathogenic significance in five patients with progressive KC; in addition, eight novel genetic variants were found in eight patients with progressive KC. Mutations of FLG, LOXHD1, ZNF469, and DOCK9 genes were twice more frequently identified in patients with progressive than stable disease. Filaggrin gene variants were found in 49 patients (76% of total), of whom 32 patients (80% of progressive KC group) had progressive disease. Targeted NGS research provided new insights into the causative effect of candidate genes in the clinical phenotype of keratoconus. Filaggrin mutations were found to represent a genetic risk factor for development of progressive disease in Italy.

The Effect of Continuous Positive Airway Pressure (CPAP) Therapy on Serum Caspase-3 Level in Patients with Obstructive Sleep Apnea (OSA).

Intermittent hypoxemia has an important role in the physiopathogenesis of obstructive sleep apnea (OSA) complications. Increased apoptosis due to intermittent hypoxemia may be an important clinical entity in OSA. In this study, we aimed to evaluate caspase-3 enzyme level, which is an indirect marker of increased apoptosis in patients with OSA and to evaluate the effect of OSA treatment with continuous positive airway pressure on caspase-3 enzyme level. This study included 141 consecutive patients admitted to the sleep-disordered breathing laboratory within 6 months. Caspase-3 was measured in routine blood samples obtained on the morning of polysomnography (PSG) performed at night. The compliance of the patients to CPAP treatment was evaluated and caspase-3 levels were checked again after treatment. A total of 141 patients, 39 females (27,7%) and 102 males (72,3%) were included in the study. The mean age of the patients was 49 ± 12 years (min-17, max-77). According to PSG results, OSA was detected in 95.7% (135/141) of the cases. Mild OSA was 35 (24.8%), moderate OSA 39 (27.7%) and severe OSA 61 (43.3%) cases. Median caspase-3 enzyme levels were similar in men and women in the study group. There was no statistically significant difference in hemogram parameters and caspase-3 enzyme levels between the groups divided according to the presence and severity of OSA. It was determined that caspase-3 enzyme level did not change significantly after 3 months of CPAP treatment in OSA compared to pretreatment. Caspase-3 was found to have a negative correlation with both the percentage of daily use of CPAP therapy and the percentage of CPAP device use for more than 1 h per night. It was found that the control caspase-3 level decreased statistically significantly as the percentage of daily use of CPAP therapy increased (r = -0.397, p = 0.030). It was found that the control caspase-3 level decreased statistically significantly as the percentage of CPAP therapy use for more than 1 h per night increased (r = -0.411, p = 0.024). The results of this study did not reveal a relationship between the severity of OSA and caspase-3 levels. However, blood caspase-3 levels decreased as treatment compliance increased, suggesting that CPAP treatment may correct increased apoptosis in OSA. There is a need for more comprehensive studies on this issue.