Assessment of psychometric properties,cross-cultural adaptation,and translation of the Turkish version of the ICU mobility scale

Background/aim The aim of the study was to carry out the cultural adaptation and translation of the ICU mobility scale (IMS) into Turkish and research the psychometric properties.Materials and methods This study was based on methodological design. The IMS was translated from English to the Turkish through a regularised translation process. Two physiotherapists assessed patients independently in the coronary intensive care unit. The measures such as construct validity, intra and interrater reliability, and internal consistency of the IMS Turkish version were assessed. Results A total of 70 intensive care patients were included in the study. The intrarater and interrater reliability of the IMS was excellent. The weighted Kappa value was 0.92 (0.87–0.96) for the intrarater reliability, and 0.87 (0.80–0.93) for the interrater reliability. There were significant correlations between the IMS and functional status score for the intensive care unit (r = 0.83), Perme intensive care unit mobility score (r = 0.84), Katz activities of daily living (r = 0.73), handgrip strength (r = 0.62), knee extension strength (r = 0.46), and age (r = –0.44).Conclusion This study suggests that the IMS Turkish version is a reliable and valid scale for assessing functional status and mobility level in ICU patients.     

Is microRNA 1910-3p (miR-1910-3p) a really distinctive marker for psoriasis?

Background/aimAlthough the cause of immune activation in the pathogenesis of psoriasis is still unclear, miRs are thought to have an effect on psoriasis. This work aimed to evaluate the role of miRs (miR-4649-3p, miR-6867-5p, miR-4296, miR-210, and miR-1910-3p) that target the FOXP3 mRNA and IL-17A mRNA in psoriasis. Materials and methods Forty-four psoriasis patients and 44 healthy controls were included in the study. Quantitative real-time PCR (qRT-PCR) was used for the measurement of miRs. Serum IL-17A levels were determined by an enzyme-linked immunosorbent assay (ELISA) method. Results Plasma miR-1910-3p levels were significantly lower in the patient group than the controls (P = 0.000, fc: 0.10). ROC analysis showed that plasma miR-1910-3p levels could significantly differentiate psoriasis patients from healthy controls [AUC = 0.912 (0.848–0.975), P = 0.000]. The plasma miR-4649-3p level was significantly higher in the psoriasis group compared to the controls (P = 0.000, fc: 2.99). Conclusion Decreased expression of miR-1910-3p increases the risk of developing psoriasis by approximately 50-fold and was able to use for the significant differentiation of psoriatic patients from healthy controls.     

The effect of weather variables on the severity,duration, and frequency of headache attacks in the cases of episodic migraine and episodic tension-type headache

Background/aimAlthough many headache patients report that the frequency and severity of attacks vary according to the season or weather in clinical practice, the relationship between the characteristics of the attacks and the weather is not very clear in episodic headaches. We aimed to compare the effects of weather variables (temperature, wind speed, wind direction, humidity, pressure, ultraviolet index, and sunshine duration) on episodic migraine (EM) and episodic tension-type headache (ETTH) attacks (incidence, duration, and severity).Materials and methodsFifty patients with EM and fifty patients with ETTH diagnosed according to International Classification of Headache Disorders-II are included in the study. Patients were given one diary for headache follow-up. The evaluation form on the relationship between the duration, frequency, and severity of the pain and the findings obtained from the headache diaries were compared with the daily weather data, and the two headache groups were compared with each other in terms of the effect of meteorological data on the pain characteristics.ResultsIt is determined that mean wind velocity in EM attacks is significantly higher when compared to the tension-type headache (TTH) attacks and mean UV index is significantly higher in TTH attacks (p = 0.018 and 0.039). Mean UV index in TTH attack days was reported higher in women than men (p = 0.044). Mean sunshine duration in TTH attack days was reported longer in women than men (p = 0.050). When mean age gets higher in patients with migraine, mean temperature in the days of attack gets lower (r = –0.146 and p = 0.046).Conclusion During the treatment of migraine and TTH patients, recommendations and warnings about weather conditions can be made. This information can guide patients to regulate their daily living activities. The importance of considering the weather-headache relationship during the review of the current treatment in cases of unresponsiveness to treatment should be kept in mind.     

Exchange transfusion in neutropenic septicemic neonates: effect on granulocyte functions

Depletion neutropenia caused by overwhelming bacterial infection is associated with fatal outcome and is an objective indicator of the severity of sepsis. Studies on controlled evaluation of exchange transfusion in the management of severe neonatal sepsis have not considered neutropenia as an inclusion critcrion, and randomized, controlled trials on evaluation of ncutrophil functions after exchange transfusion are scarce. This prompted us to carry out the present study. Septicemic neonates were enrolled if they had neutropenia and were randomized to undergo exchange transfusion (study group, n = 20) or not (controls, n= 10). Granulocyte functions were assessed using the nitro blue tetrazolium (NBT) reduction test and the staphylococcicidal index. Blood was drawn for granulocyte function tests once from controls and donors, and before, immediately after and 6 h after exchange transfusion in the study group. Mortality was 35% in the study group and 70% in controls. Gram-negative organisms accounted for 80%, in the study group and 90% in controls. Mean total leukocyte count and neutrophil count increased significantly immediately after exchange transfusion and 6 h later. Absolute band count decreased significantly immediately after exchange transfusion and incrcased 6 h later. NBT reduction in septicemic neonates in the study group, as wclras in controls. was significantly decreascd as compared to donor cells. NBT reduction improved significantly immediately after exchange transfusion and 6 h later. The valucs of the perccntage of viable staphylococci recovered from neutrophils also improved significantly immediately after exchange transfusion and 6 h later. We conclude that exchange transfusion with fresh whole blood in severe neonatal septicemia with neutropenia improves survival, increases the neutrophil count and cnhances neutrophil function.     

A rare case of Moraxella lacunata producing combined native mitral and aortic valve endocarditis

We describe a case of infective endocarditis due to Moraxella lacunata involving the native mitral and aortic valves, complicated by cerebral emboli and resultant hemiparesis. The patient was treated with ceftriaxone and gentamicin and improved. This appears to be the first case reported in the medical literature of native multivalvular endocarditis produced by this rare organism.     

Breastfeeding among Turkish Mothers Living in Suburbs of Istanbul and Stockholm–A Comparison

ABSTRACT. The infant feeding pattern among 96 Turkish mothers living in a suburb of Istanbul and 30 living in a suburb of Stockholm, both with working class characteristics, was determined. The duration of breastfeeding among the Turkish immigrant group living in the Stockholm suburb was significantly reduced compared with the group with a similar social background but living in a native urban area. Infant feeding pattern among the Turkish immigrant mothers was more similar to that of Swedish populations. Attitudes to breastfeeding among the immigrant group had changed. Early weaning, reliance on commercially available infant foods and bottle feeding characterized their infant feeding practices. The majority of the infants of this group showed a tendency to overweight.     

Expression of M-CSF and its receptor (C-FMS) during factor-independent cell line evolution from hematopoietic progenitor cells cocultivated with gamma irradiated marrow stromal cell lines.

Gamma irradiation of plateau-phase clonal bone marrow stromal cell lines produces factor-independent growth of cocultivated clonal interleukin-3/granulocyte-macrophage colony-stimulating factor-dependent hematopoietic progenitor cell lines. The process is associated with three biologic changes including: (i) adherence of hematopoietic cells to stromal cells forming 'cobblestone islands'; (ii) an intermediate stage [during which the cells show proliferation in suspension in the presence in leukemogenic stromal factor (LSF), a factor similar to macrophage colony-stimulating factor (M-CSF) released by irradiated stromal cells, and transient hematopoietic cell surface expression of MAC-1, and c-fms (M-CSF receptor)]; and (iii) a third stage of factor-independence. A monoclonal antibody to M-CSF receptor inhibited proliferation of intermediate stage but not all factor-independent cell subclones. In the present studies, a subclonal factor-independent malignant subline of FDC-P1JL26 derived by cocultivation with gamma-irradiated stromal cells as well as the parent clone and intermediate stage cells were shown to express significant levels of M-CSF polyA+ mRNA and M-CSF of at least two sizes (23 and 15 kDa) as detected by 35S-methionine labelling and immunoprecipitation with polyclonal anti-M-CSF antiserum. There was no significant difference in intracellular M-CSF protein size between cells at each of the three stages of biologic change. This M-CSF was not detected on the cell surface by fluorescence-activated cell sorting (FACS). In contrast, c-fms expression at the cell surface was detected by FACS analysis and c-fms polyA+ mRNA was only detected during the intermediate stage of induction of factor-independence. FDC-P1JL26 parent cells, the subclone stimulated by LSF, and the factor-independent subclone, showed little or no detectable autophosphorylation of the c-fms receptor at tyrosine. There was no detectable rearrangement of the M-CSF or c-fms genes by Southern analysis between clonal lines during the three stages. While we cannot rule out an autocrine mechanism or mutated c-fms receptor mechanism, the data also suggest that evolution of hemopoietic cell factor-independence during cocultivation with irradiated stromal cells may involve a mechanism distal to the c-fms receptor/M-CSF interaction.     

Evidence of both ontogeny and transplant dose-regulated expansion of hematopoietic stem cells in vivo

Recent assessment of the long-term repopulating activity of defined subsets of hematopoietic cells has offered new insights into the characteristics of the transplantable stem cells of this system; however, as yet, there is very little known about mechanisms that regulate their self-renewal in vivo. We have now exploited the ability to quantitate these cells using the competitive repopulating unit (CRU) assay to identify the role of both intrinsic (ontological) and extrinsic (transplanted dose-related) variables that may contribute to the regulation of CRU recovery in vivo. Ly5.1 donor cells derived from day-14.5 fetal liver (FL) or the bone marrow (BM) of adult mice injected 4 days previously with 5-fluorouracil were transplanted at doses estimated to contain 10, 100, or 1,000 long-term CRU into irradiated congenic Ly5.2 adult recipient mice. Eight to 12 months after transplantation, there was a complete recovery of BM cellularity and in vitro clonogenic progenitor numbers and a nearly full recovery of day-12 colony-forming unit-spleen numbers irrespective of the number or origin of cells initially transplanted. In contrast, regeneration of Ly5.1+ donor-derived CRU was incomplete in all cases and was dependent on both the origin and dose of the transplant, with FL being markedly superior to that of adult BM. As a result, the final recovery of the adult marrow CRU compartment ranged from 15% to 62% and from 1% to 18% of the normal value in recipients of FL and adult BM transplantation, respectively, with an accompanying maximum CRU amplification of 150- fold for recipients of FL cells and 15-fold for recipients of adult BM cells. Interestingly, the extent of CRU expansion from either source was inversely related to the number of CRU transplanted. These data suggest that recovery of mature blood cell production in vivo may activate negative feedback regulatory mechanisms to prematurely limit stem cell self-renewal ability. Proviral integration analysis of mice receiving retrovirally transduced BM cells confirmed regeneration of totipotent lymphomyeloid repopulating cells and provided evidence for a greater than 300-fold clonal amplification of a single transduced stem cell. These results highlight the differential regenerative capacities of CRU from fetal and adult sources that likely reflect intrinsic, genetically defined determinants of CRU expansion but whose contribution to the magnitude of stem cell amplification ultimately obtained in vivo is also strongly influenced by the initial number of CRU transplanted. Such findings set the stage for attempts to enhance CRU regeneration by administration of agents that may enable full expression of regenerative potential or through the expression of intracellular gene products that may alter intrinsic regenerative capacity.     

Identification of hemopoietic cells responsive to colony-stimulating factor by autoradiography

Binding of radiolabeled L-cell colony-stimulating factor (CSF) was studied using murine bone marrow and fetal liver cells. With 10(7) cells, saturation of binding was seen with approximately 500,000 cpm of 125I-CSF. Minimal binding was detected after one hour incubation with tracer at 37 degrees C; however, marked cellular uptake of radioactivity was noted after 24-hr exposure to CSF. As judged by autoradiographs, small numbers of myeloblasts, promyelocytes, and large mononuclear cells were labeled with 1-hr exposure to tracer. By 6 hr of incubation, 50%-70% of myeloblasts and promyelocytes and small numbers of late granulocytic cells were labeled. Virtually all myeloblasts and promyelocytes and approximately 50% of myelocytes, metamyelocytes, polymorphonuclear granulocytes, and monocytes were labeled after 24-hr exposure to the radioiodinated CSF. Label was not detected on erythroblasts, eosinophils, or megakaryocytes. Suspensions of fetal liver cells had lower uptake of radioactivity than bone marrow cells. This appeared to result from a lesser concentration of granulocytic cells in fetal liver, as labeling of individual cells was similar with both tissues. In additional experiments, CSF binding to marrow cells was assessed after 30-min exposure to tracer at 0 degrees C. Uptake of 125I-CSF exceeded that observed after 24-hr incubation at 37 degrees C. With this technique, cellular label was also confined to granulocytic and monocytic cells. These findings suggest that purified CSF reacts with and may stimulate immature and mature cells of the granulocytic and monocytic lineages.