Shin'etsu Region, Japan

Effect of Progressive Neck Motor Control Exercises on Temporomandibular Joint Dysfunction

In this randomised controlled study, the effects of progressive neck motor control exercise therapy on craniocervical pain, posture, function and kinesiophobia in individuals with different types of temporomandibular dysfunction (myofascial, disc displacement with reduction, disc displacement without reduction) and their differences with the control group will be compared. Participants diagnosed by a dentist according to three different types of temporomandibular dysfunction will be included in the study. Participants will be divided into groups by block randomisation method. A total of 6 groups will be included in the study, including participants with three different types of temporomandibular dysfunction who voluntarily agree to participate in the study and meet the inclusion criteria, and the control group of each group. The study groups will receive the same treatment and patient education for 6 weeks, while the control groups will receive only patient education.

INVESTIGATION OF THE EFFECT OF SOLUTION-FOCUSED APPROACH TRAINING ON TRAUMATIC BIRTH PERCEPTION, VAGINAL BIRTH SELF-EFFICACY AND BIRTH TYPE PREFERENCE.

Pregnancy, birth and postpartum period; It is one of the most special behaviors of women. In this period when the woman plays a very important role after intercourse, her psychological health status can have an impact on her psychological and emotional life, including the course of pregnancy, birth and the period after birth.Sociodemographic characteristics, previous pregnancy or birth history, pregnancy and birth information obtained through hearsay, information obtained from unreliable sources, low health literacy level, not being able to receive adequate and effective prenatal care, and being in your first pregnancy are some of the factors that affect the psychosocial health of women.Although birth, which is the result of pregnancy, is a normal and physiological process, it is one of the unique experiences that affects the woman physically, psychologically and socially and causes significant changes in her life. Although birth is under the influence of all processes of a woman's life, it is especially closely related to how the pregnancy goes and how it is perceived. Although cesarean birth is a preferred method of birth only when vaginal birth is contraindicated or unsafe, this method of birth may be preferred by women for reasons such as the perception of traumatic birth and low self-efficacy for vaginal birth. When we look at the cesarean section rates in live births, it is seen that the total cesarean section rate, which was 48.0% in 2014, increased to 54.4% in 2019 . In our country, where the prenatal care rate is 98%, the fact that cesarean section rates are at such high levels poses a risk for mother-child and public health. Caesarean section birth, which is life-saving in case of medical necessity, increases the maternal morbidity and mortality rate by 2-4 times compared to vaginal births when performed off-label. Also, birth by cesarean section; It poses a risk in situations such as mother-baby bonding, starting and continuing breastfeeding, postpartum recovery and returning to daily life after discharge. Psychosocial and cognitive factors such as a negative past birth experience, negative birth stories, low self-efficacy for vaginal birth, and perceiving birth as traumatic play a role in women's preference for cesarean delivery. In a study conducted with 384 pregnant women in Trabzon province, 56.8% of these pregnant women perceived the birth as moderately traumatic, and 27.1% as highly traumatic. Birth is perceived as traumatic; It may be caused by situations such as fear of birth and low self-efficacy towards birth. Lack of knowledge about birth, labor pain, having a first birth, pain during birth, and inability to cope with the situations encountered cause an increase in the fear of birth and a decrease in birth self-efficacy in these pregnant women. Self-efficacy in birth is defined as "the woman's ability to see in herself the power to cope with the act of birth and her confidence in her abilities". The concept of self-efficacy is a subjective concept, and the level of self-efficacy can also affect the labor process and the fear of birth and therefore the perception of birth as traumatic. Another phenomenon that affects the birth process and the choice of birth method is the "perception of traumatic birth". The perception of traumatic birth is defined as the woman's perception of the birth process as a risk of injury and/or death for herself and her baby. Perception of birth as traumatic can cause depression, increased fear of birth, and negative birth experience in pregnant women.In order for the pregnancy, birth and postpartum period not to deviate from its naturalness and to be completed in a physiologically and psychosocially healthy way, support can be provided to the process through birth preparation classes and various prenatal trainings given to expectant parents. It has been determined that prenatal education given to pregnant women in the third trimester reduces the fear of birth and negative perceptions about birth.The training given to pregnant women by health professionals such as midwives, obstetricians and nurses during the antental period contributes to increasing the pregnant woman's health awareness, increasing her ability to cope with problems related to pregnancy and birth, strengthening her self-efficacy for vaginal birth, and having a positive birth experience. Solution-oriented approach training is of particular importance in helping pregnant women cope with their problems, perceiving pregnancy and birth, and protecting and improving their mental health.Solution-focused approach training is a type of counseling practice called "brief therapy" that was developed under the leadership of Steve de Shazer and Insoo Kim Berg between 1970 and 1980. The aim of this training is to try to solve the individual's basic problems with a short and pragmatic approach and to help the client determine the goal they want to achieve. In solution-focused approach training, unlike classical psychotherapy methods, the focus is on the "solution" instead of the "problem" and the person's past successes, good and strong aspects in his life are emphasized instead of dealing with the problem itself. It focuses on the strengths of the person being trained and the things they want to achieve, and emphasizes that the solution to the problem will come from the person himself and that his self-confidence will increase as a result. In other words, it aims to increase the individual's self-confidence and self-efficacy. One of the most important features of this training is that it provides effectiveness in a short time and lasts 6-10 sessions.

Chronic Post Surgical Pain-Cardiac

Cardiovascular diseases pose a significant global health concern, particularly among the elderly population, leading to a surge in surgical interventions. Enhanced Recovery After Surgery (ERAS®) protocols, specifically ERAS® Cardiac, target improved perioperative pain management to optimize patient outcomes. Effective pain control aims to alleviate acute discomfort, prevent chronic pain development, facilitate early mobilization, reduce hospital stays, and enhance patient satisfaction and functional recovery. While pain intensity peaks within the initial days following cardiac surgery and gradually subsides, inadequate acute pain management can predispose patients to chronic pain, impairing their quality of life. Multimodal opioid-sparing analgesia strategies are recommended, with recent advancements in ultrasound-guided regional anesthesia techniques showing promise in enhancing acute pain relief and reducing opioid consumption, particularly through truncal fascial plane blocks and parasternal blocks. However, the impact of these techniques on chronic postsurgical pain remains incompletely understood. This multicenter study aims to investigate the incidence of chronic postsurgical pain following cardiac surgery, exploring the influence of various factors and their implications on patients' quality of life.

Pain, Central Sensitization, Kinesiophobia and Stress Level in Individuals with Temporomandibular Dysfunction

Temporomandibular dysfunction (TMD) is a musculoskeletal and neuromuscular system-related condition that affects the masticatory muscles, temporomandibular joint, and other related structures. Psychological factors are stated as comorbid in individuals with TMD. Individuals with TMD-related pain show higher levels of stress, anxiety, depression, somatic awareness, pain catastrophizing, and kinesiophobia compared to controls. Therefore, recent research has focused on pain catastrophe, kinesiophobia, and central sensitization, especially in individuals with TMD. Therefore, the aim of this study is to examine the relationship between pain, central sensitization, kinesiophobia and stress level in individuals with temporomandibular dysfunction. Ninety patients aged 18-65 years, who have TME-related complaints for at least 3 months, and diagnosed with TMD as a result of clinical and radiological evaluation by a dentist will be included in the study.

Study to Evaluate Efficacy and Safety of Romosozumab Compared With Bisphosphonates in Children and Adolescents With Osteogenesis Imperfecta

Effect of Modified ERAS Protocol on Clinical Outcomes in Pediatric Patients With Appendectomy

Appendicitis is a common clinical condition and often requires emergency treatment. Although appendectomy is a safe surgical procedure, there is a risk of complications. Pain is common, especially in the postoperative period, and the lack of care management leads to delayed mobilization and oral intake, delayed recovery and prolonged length of hospital stay. However, pain, nausea-vomiting, thirst, fear and stress could be managed with perioperative care. In addition, it is reported that the care provided based on the ERAS protocol shortens the length of hospital stay. In this respect, the aim of this study was to investigate the effect of ERAS protocol-based care on the length of hospital stay of children who were planned to undergo appendectomy. Postoperative pain level, stress and fear level, time to first mobilization, flatulence, defecation and oral intake, nausea, thirst were the secondary outcomes of this study.

Program to Assess Adverse Events and Change in Disease Activity of Oral Upadacitinib in Adult Participants With Moderate to Severe Systemic Lupus Erythematosus

Blood Transfusion in Patients With Lung Cancer

Blood is a living tissue composed of specific structures, each with distinct functions. Blood transfusion is a tissue or even organ transplantation. Unnecessary blood transfusion should not be done, and the missing component should be replaced in the patient. The need for transfusion seen in medical diseases is often in the form of chronic anemia, except for a few conditions that cause sudden bleeding. Repeated transfusions may be required in these patients during the course of their disease and related problems may arise. For this reason, while determining the indication for transfusion, it is absolutely necessary to perform the benefit-harm analysis correctly. The main purpose of approaching the anemic patient is to provide and maintain hemoglobin levels that will allow oxygen to reach the tissue at an adequate level. This critical level may vary from patient to patient, the age of the patient and other accompanying diseases are among the determining factors. The most important factor in transfusion indication is the insufficiency of cardiopulmonary compensation mechanisms due to anemia in the patient and the patient becoming symptomatic. Red blood cell (RBC) transfusions are common in the treatment of cancer patients. Generally, patients with oncological and hematological malignancies use approximately 34% of the RBC source. In cancer patients, similar to other patient populations, the indication for RBC transfusion is to alleviate anemia, which is actually symptomatic. However, the decision to transfuse should not be guided solely by the hemoglobin concentration. No single criterion can be used as an indicator of RBC transfusion. The clinical condition of the patient must be taken into account. Anemia can be seen in approximately 90% of patients during chemotherapy treatment. Cytotoxic drugs often cause the loss, destruction and reduction of RBCs that cause anemia. Especially lung and gynecological cancers are highly associated with anemia. Platinum-based chemotherapeutics are often preferred in the treatment of such cancers. Anemia in cancer can reduce quality of life and increase cancer-related fatigue and may be a poor indicator of clinical outcomes. That is why, in clinical practice, transfusions are often performed in cancer patients. In general, a hemoglobin level of 7 g / dL is a suitable indicator for red blood cell (RBC) transfusion in stable patients without complications. However, patients with cardiovascular disease or acute coronary syndrome can be transfused at a hemoglobin level of 8 g / dL. Although the indications for transfusion in patients with other types of complications are unclear, cancer patients have reported improved clinical well-being when kept at about 7 g / dL in hemoglobin levels, but no study results suggested an absolute hemoglobin level that is optimal for patients with cancer. With this study, it is aimed to develop clinical practices to prevent unnecessary transfusion practices in lung cancer patients, to encourage the application of other supportive treatment options, and to take preventive measures before anemia develops. Patients who have been followed up and receiving chemotherapy in our chest diseases department in the last 5 years will be included in our study. Patients who were diagnosed with lung cancer between 01/01 / 2014-31 / 12/2018, followed up in the chest diseases service and given chemotherapy will be included in the study. Patient data will be retrospectively collected using file records and hospital automation system (clinical course, blood bank data, consultation records, etc.). The study will begin after the approval of the ethics committee and will continue for 6 months. Exclusion Criteria; Patients with known hematological malignancies other than lung cancer, patients who were diagnosed with anemia before chemotherapy treatment, who received treatment for this reason, patients who were diagnosed with lung cancer in our clinic but did not continue chemotherapy treatment in our clinic afterwards, and patients who are thought to impair data integrity due to incomplete data will be excluded from the study. Patients' data to be followed; Exclusion Criteria; Patients with known hematological malignancies other than lung cancer, patients who were diagnosed with anemia before chemotherapy treatment, who received treatment for this reason, patients who were diagnosed with lung cancer in our clinic but did not continue chemotherapy treatment in our clinic afterwards, and patients who are thought to impair data integrity due to incomplete data will be excluded from the study. Patients' data to be followed; Demographic characteristics, comorbid diseases, cancer type and stage, how long it was followed up with this diagnosis, Hb value before starting chemotherapy, whether RBC transfusion was performed during the follow-up period, which Hb value of blood transfusion was applied, how many units of RBC or other blood were taken during the follow-up period. product replacement, how many cures of chemotherapy they received in total, which chemotherapy drugs they took, whether there was a delay in treatment due to treatment-related anemia, the most frequent indications and complications of transfusion (allergic reaction, febrilereax., infection and thromboembolic complications), whether they received additional radiotherapy. , whether they received GMC-SF due to anemia, blood groups, survival times, how many times there was cancer progression under treatment, and if there is distant metastasis, the location of metastasis was aimed to be screened. In the analysis of the data; The compliance of the data to normal distribution will be examined by Shapiro Wilk and Kolmogorog Smirnov tests. Kruskall-Wallis, Mann-Whitney U, student-t and chi-square tests will be used for comparisons between groups. General linner modeling, Wilcowon and Friedman tests will be used in serially tracked data. Data will be given as percentage, mean (std deviation) and median (minimum-maximum). The chi-square test will be used to compare qualitative data. Categorical data will be presented in the form of frequency and percentage.

Asymptomatic Bacteriuria, Urinalysis Abnormality at the Initiation of SGLT2 Inhibitors and UTI Risk

Motor Imagery and Muscle Architecture

The aim of this study is to examine the effects of plyometric training on biceps femoris longus (BFl) and vastus lateralis (VL) muscle architecture (fiber length, penation angle and muscle thickness) in healthy football players. Individuals will be randomly placed into two different groups, the training group and the control group. Imagery ability, self-efficacy and motivation will be evaluated with various questionnaires and scales in order to compare the homogeneity of the groups. Measurements of muscle architecture will be taken bilaterally from BFl and VL muscles by means of an ultrasound device. Functional performance will be evaluated with the single leg jump test. Following the initial evaluations, individuals in the training group will receive plyometric training consisting of ten different exercises for 8 weeks, 3 sessions per week. In this training, individuals will not participate in a real plyometric training. Volunteers will watch videos to be prepared (action observation) and imagine them performing those exercises (motor imagery). All trainings will be given on the basis of telerehabilitation via distance education tools. Cognitive fatigue at the beginning and end of the session; at the end of each session, the technical quality and efficiency of the training will be evaluated. Evaluations of muscle architecture and functional performance will be taken again from the individuals in the control and training groups at the end of the 4th and 8th weeks. The received ultrasound images will be calculated through the MicroDicom software. In-group and between-group comparisons will be analyzed using the Statistical Package for the Social Sciences program and appropriate tests.