The effect of home education on myopia progression in children during the COVID-19 pandemic

ObjectivesTo evaluate the effect of the COVID-19 pandemic restrictions on myopia progression (MP) in school age children.MethodsA total of 115 children aged 8–17 years with a diagnosis of myopia who had been followed-up for at least three years, were included in this study with a retrospective and single-centre design. The subjects’ age, the history of myopia in the family, the time spent in front of a screen, the digital devices used during home education (computer, tablet, smartphone, television), the time spent in open air (hours/day), the refractive error (RE) (spherical equivalent value) detected before the home education period and the changes in the myopia over the years, were recorded.ResultsThe mean age was 12.06 (±2.29) years. Only the right eyes were included. The glasses use duration was 3.57 (±0.74) years. The annual MP amount 0.49 (±0.26), 0.41 (±0.36) and 0.54 (±0.43) dioptres (D) for the 2017, 2018 and 2019 years before home education, respectively, (p > 0.05), and 0.71 (±0.46) D in 2020, during home education. The increase in MP amount in 2020 compared to the 2019 and 2018 years was statistically significant (p < 0.003). MP was statistically significantly less in children who participated in open-air activities for 2 h a day and those who lived in detached houses (p = 0.004, p = 0.006, respectively).ConclusionDuring home confinement, education programmes of school children should be designed while taking into account preventive measures for MP, in particular for allowing children to spend at least 2 h of outdoor time per day.Subject terms: Outcomes research, Paediatrics     

Effect of diluted povidone iodine in adenoviral keratoconjunctivitis on the rate of subepithelial corneal infiltrates

AIM: To evaluate the clinical characteristics of adenoviral keratoconjunctivitis, the management modalities, as well as the incidence of subepithelial corneal infiltrates (SEI). METHODS: Patients with characteristic clinical symptoms and signs, who presented to our clinic within the first week of symptoms and received the diagnosis of adenoviral keratoconjunctivitis between January 2013 and April 2016, were included in the study. A total of 211 patients were included in the study. Patients were evaluated for the incidence of clinical signs, late complications, management preferences, and the effect of diluted povidone-iodine (d-PVP-I) 2%. RESULTS: Patients’ mean age was 33.03±14.76y. We observed an increase in the number of cases according to the years. At presentation and/or early follow-up, the clinical signs were conjunctival hyperemia (100%), conjunctival follicules (79.1%), edema of the eyelids (39.3%), chemosis (16.1%), pseudomembrane formation (16.6%), and corneal epitheliopathy (29.9%). During late follow-up 13.3% patients developed conjunctival subepithelial fibrosis, and 39.8% developed SEI. A significant decrease in the incidence of SEI development was observed in patients who used d-PVP-I 2% (P=0.032; 33.3% vs 45.9%, respectively in patients who received d-PVP-I 2% and who did not). CONCLUSION: Adenoviral keratoconjunctivitis has a tremendous effect on patient’s comfort and abilities in short-term. Additionally, almost half of the patients develop visual problems related to SEI. According to our clinical experience, using d-PVP-I 2% in the first days of adenoviral keratoconjunctivitis might be helpful in reducing the risk of SEI as a complication.     

Identification of genetic biomarkers in urine for early detection of prostate cancer

Prostate cancer screening is a challenging and vital issue in the aspects of the current tests and risk assessments. Prostate cancer risk assessments are currently carried out by using blood, urine and tissue biomarkers with radiological imaging methods. Here, we introduce a novel noninvasive screening tool for a further in-depth selection of eligible cases for prostate biopsies which is based on sequencing somatic and hereditary HOXB13 mutations in urine samples. This approach provides diagnostic information to the physician about the presence of prostate cancer while aiming to screen for specific prostate biopsies and save biopsies potentially when there are no mutations related to prostate cancer. Findings suggest that this method is reliable, cost-effective, and has a promising potential in prostate cancer screening.     

Diode laser therapy for endobronchial malignant melanoma metastasis leading bilateral main bronchus obstruction

Bronchoscopically detected endobronchial metastases of tracheal or bronchial wall were very rare and prevalence of these lesions were about 2%. Breast, renal and colon carcinomas were the most common cancers causing endobronchial metastasis. Also some other tumors can also make endobronchial metastasis. These tumors can be listed as thyroid, ovary, parotis, maxillary, bone, nasopharynx, prostate, bladder, uterus, plasmocytoma, melanoma, testicular and sarcoma. Malignant melanomas develop by the malign transformation of the melanocytes and constitutes 4% of the skin cancers. Malignant melanoma mainly metastasis to regional lymph nodes, bones and central nervous system. On the other hand, lungs are also one of the metastasis areas of these tumors. Lung metastases usually occur by tumor emboli arriving to the pulmonary arteries. Bronchoscopically detected endobronchial metastases of malign melanoma cases are very rare. Endobronchial treatment with diode laser and rigid bronchoscopy was applied to our case which presented with left total atelectasis and endobronchial metastase in the entrance of right main bronchus. As known, Nd YAG and Nd-YAP lasers have been in use for a long time and their efficiency have been approved in endobronchial treatment. On the other hand, although diode laser has been safely used in urology, dermatology and endovasculer surgery, its role in the therapeutic bronchoscopy is new and limited. Our case is presented as an example of a rarely seen endobronchial metastasis and as an example of its management with a new device.     

Sphenoid sinus carcinoma mimicking retrobulbar optic neuritis

Sphenoid sinus carcinomas occur rarely compared with other sinonasal tumors. A case of sphenoid sinus squamous cell carcinoma presenting with acute, isolated optic neuropathy and visual loss is presented herein along with the related literature. A 37-year-old man with sudden decrease in visual acuity in his left eye of 15 days' duration was referred. He had received high-dose intravenous corticosteroid therapy with the provisional diagnosis of retrobulbar neuritis, and his visual acuity had temporarily improved at this time. Magnetic resonance study showed a space-occupying lesion in the left posterior ethmoid and sphenoid sinuses, adjacent to the intracanalicular optic nerve, and an increase in optic nerve signal intensity. An excisional biopsy of the sphenoid lesion revealed squamous cell carcinoma. After stereotactic radiotherapy and chemotherapy following surgery, a total loss of vision and optic atrophy developed in the left eye. No other complication, tumor recurrence, or metastasis occurred during 30 months of follow-up.     

Improving Heart Rate Variability in Sleep Apnea Patients: Differences in Treatment with Auto-titrating Positive Airway Pressure (APAP) Versus Conventional CPAP

The effect of positive airway pressure treatments in different modalities on the cardiovascular consequences of the disease in sleep apnea patients is still unclear. We aimed to compare auto-titrating positive airway pressure (APAP) and conventional continuous positive airway pressure (CPAP) in terms of improving heart rate variability (HRV) in obstructive sleep apnea patients. This was a prospective study done in a tertiary research hospital. All patients underwent a manual CPAP titration procedure to determine the optimal pressure that abolishes abnormal respiratory events. Then patients underwent two treatment nights, one under APAP mode and one under conventional CPAP mode with a 1-week interval. Forty newly diagnosed obstructive sleep apnea patients were enrolled in the study. We compared heart rate variability analysis parameters between the APAP night and the CPAP night. This final analysis included the data of 28 patients (M/F: 22/6; mean age = 46 ± 10 years). Sleep characteristics were comparable between the two treatment nights, whereas all-night time domains of HRV analysis such as HF, nuLF, and LF/HF were different between APAP and CPAP nights (2.93 ± 0.31 vs. 3.01 ± 0.31; P = 0.041; 0.75 ± 0.13 vs. 0.71 ± 0.14; P = 0.027; and 4.37 ± 3.24 vs. 3.56 ± 2.07; P = 0.023, respectively). HRV analysis for individual sleep stages showed that Stage 2 LF, nuLF, nuHF, LF/HF parameters entirely improved under CPAP treatment whereas APAP treatment resulted in nonsignificant changes. These results suggest that despite comparable improvement in abnormal respiratory events with APAP or CPAP treatments, CPAP may be superior to APAP in terms of correcting cardiovascular alterations in sleep apnea patients.     

Needlestick and sharps injuries among nurses in the healthcare sector in a city of western Turkey

The aims of this study were to determine the rate of bloodborne infections after needlestick and sharps injuries in nurses at work, to estimate the number of vaccinations administered, and to assess whether universal precautions were being followed. The study involved 289 nurses working in five hospitals and six primary healthcare centres. Between 1 April 2002 and 31 June 2002, a total of 139 practising nurses were included in the study following a needlestick or sharps injury. The results of completed questionnaires were collated, and Chi-squared test was used for analysis. The rate of hollow-bored needle-related injuries was 76.2% (106/139). Most nurses (69.1%) did not report any details of their injuries and 32.4% (45/139) of nurses had not been vaccinated against hepatitis B virus (HBV). Only 5.3% of the nurses who responded to the compliance question indicated that they always complied with universal precautions. Of 139 nurses, 1.4% and 7.9% showed evidence of HBV infection and hepatitis C virus (HCV) infection, respectively. All those who had hepatitis B were aged 30 years or under, whereas most of those who were anti-HCV positive (81.8%) were over 30 years old (P < 0.05). Nurses working in the Turkish healthcare sector are frequently exposed to bloodborne infections. Precautions and protection from needlestick and sharps injuries are important in preventing infection of nurses. Education about the transmission of bloodborne infections, vaccination and post-exposure prophylaxis must be implemented. Further investigations are warranted to elucidate the risk to nurses of contracting these potentially serious infections.     

Correlation between the intima-media thickness and Framingham risk score in patients with sleep apnea syndrome

Background

In the present study, we want to demonstrate the correlation between obstructive sleep apnea syndrome (OSAS) whose independent effect on carotid artery intima-media thickness (IMT) was demonstrated, with Framingham risk score (FRS) showing the overall cardiovascular risk.

Methods

IMT of the carotid artery was measured with ultrasonography and 10-year risk of coronary heart disease (CHD) was defined with FRS in 90 consecutive patients referred to our sleep clinic and who underwent polysomnography (PSG), with vascular risk factors and without a clinical atherosclerotic disease.

Results

IMT and FRS were found to be statistically significantly increased in the severe OSAS group compared to the other two groups. Carotid IMT was found to be significantly positively correlated with, apnea-hypopnea index (AHI), oxygen desaturation index (ODI) and time duration with oxygen saturation (SpO₂) <90%, and negatively correlated with minimum oxygen saturation at sleep (minimum SpO₂) and mean SpO₂. In control and mild OSAS group IMT and FRS have significantly positive correlation (r: 0.501, P: 0.027; r: 0.625, P<0.001), while in severe OSAS group no significant correlation was detected between IMT and FRS (r: 0.321, P: 0.06). In the regression analysis AHI and ODI were found to be an independent predictor of carotid IMT. ODI was found to have an independent effect on the progression of atherosclerosis.

Conclusions

Increased carotid IMT in severe OSAS group could not be explained with the classical risk factors. In this respect, FRS might be insufficient to determine correctly the cardiovascular risk and protection strategies against the disease in OSAS patients.KEYWORDS : Carotid artery, Framingham risk score (FRS), sleep apnea     

The Role of Serum Galectin-3 Levels in Patients with Sarcoidosis

IntroductionGalectin-3 is a multifunctional protein, the levels of which increase in the presence of diseases that progress with pulmonary fibrosis. This study investigated the role of galectin-3 levels in the staging and assessing of the severity of sarcoidosis.Methods and SubjectsSeventy-three subjects were studied; 25 were healthy individuals and 48 patients had pathologically confirmed diagnosis of sarcoidosis in which other potential causes had been ruled out. Galectin-3 levels were measured and compared in terms of such parameters as hemogram, biochemistry, age, body mass index, and smoking status.ResultsThe mean galectin-3 levels of the sarcoidosis patients (14.87 ± 5.57) were significantly higher than those in the healthy subjects (11.81 ± 2.67), and the mean galectin-3 levels differed significantly among different stages of the disease (p < 0.05). The serum galectin-3 level in patients with stage 2, 3, and 4 sarcoidosis was found to be higher than in patients with stage 0 and 1 sarcoidosis and the control group. In addition, serum galectin-3 levels in the sarcoidosis patients had significant positive correlations with blood urea nitrogen, alkaline phosphatase, white blood cells, red blood cell, hemoglobin, and neutrophil levels (34.9% [p < 0.05]; 40.1% [p < 0.05]; 41.2% [p < 0.01]; 43.3% [p < 0.01]; 34.7% [p < 0.05]; and 40.6% [p < 0.01], respectively) and a significant negative correlation with the platelet distribution width levels (p < 0.05).ConclusionSerum galectin-3 levels are significantly elevated in sarcoidosis patients with parenchymal involvement at stage 2 or higher, suggesting that serum galectin-3 levels can be used to estimate disease severity in sarcoidosis.