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tients whose HAM-D scores could not be sufficiently decreased. In patients diagnosed with depression, using tTMS alone or adding it to the current treatment suggests that it may have a positive effect on the sense of smell and taste as well as depression treatment.

Agouti-Related Peptide (AgRP) is expressed primarily in the hypothalamic arcuate nucleus, stimulates appetite and decreases metabolism and energy expenditure. The aim of our study is to evaluate the relationship between serum Agouti-Related Peptide (AgRP) levels and metabolic syndrome in euthymic bipolar patients.

Forty euthymic bipolar patients who used only mood stabilizer for at least three months and 40 healthy volunteers as control group were included in the study. We measured fasting blood glucose levels and serum levels of AgRP, total cholesterol, triglyceride, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) of all participants. The main outcome measure was the difference between patients and control groups in terms of metabolic syndrome frequency and the relationship between serum AgRP level and metabolic syndrome is also investigated.

The metabolic syndrome was significantly more common in euthymic bipolar patients than in control group (p=0.039). Additionally, levels of blood glucose and triglyceride were significantly higher in the patient group than in the control group (p=0.006 and 0.01 respectively). Serum AgRP levels did not differ between the patient and control groups (p=0.35). Also, in euthymic bipolar patients, there was no significant difference in serum AgRP levels between patients with metabolic syndrome and those without (p=0.754).

We found significantly higher frequency of metabolic syndrome in euthymic bipolar patients than in the control group. However, there was no significant difference in the levels of serum AgRP between bipolar patients with and without metabolic syndrome in either study groups.

We found significantly higher frequency of metabolic syndrome in euthymic bipolar patients than in the control group. However, there was no significant difference in the levels of serum AgRP between bipolar patients with and without metabolic syndrome in either study groups.

Deterioration in sleep quality and sleep hygiene may result in impairments on mental and physical health leading to deterioration of quality of life (QoL) in healthcare shift workers. We aimed to determine the presence of sleep deterioration as well as poor sleep hygiene, and if any, the effects of these on health-related outcomes.

This study prospectively included healthcare professionals who did and did not work shifts (n=90 and n=66, respectively). read more The participants completed the Pittsburgh Sleep Quality Index (PSQI), Sleep Hygiene Index (SHI), Epworth Daytime Sleepiness Scale (EDSS), Short Form-36 quality of life scale (SF-36), and the Beck depression (BD) and Beck anxiety (BA) scales.

Although the total PSQI scores showed a tendency to increase in shift workers, no significant differences were observed in total scores as well as subdivisions, except for an increase in sleep latency. Increased SHI total score in shift workers were represent more deteriorated sleep hygiene behavior (p=0.002). Increased needs of daytime nap, variability of both go and get out of bed and stay in bed longer than usual were recorded respectively (p 0.001, p 0.001, p 0.001, p 0.001, p 0.001). SHI had prominent effects on QoL parameters such as vitality (r=-0.284, p=0.007), social function (r=-0.323, p=0.002), mental health (r=-0.274, p=0.009), and calculated mental component total score (r=-0.302, p=0.004).

In our study, we clearly detected prolonged sleep latency and poor sleep hygiene in shift workers which should be responsible for the deterioration of QoL.

In our study, we clearly detected prolonged sleep latency and poor sleep hygiene in shift workers which should be responsible for the deterioration of QoL.

The aims of the present study were 1) to identify the major psychosocial challenges faced by students of a university in Istanbul, during the initial period of the COVID-19 outbreak, 2) to assess how these interacted with their level of knowledge, attitudes, and practices toward COVID-19 and the related health measures in place.

As part of an international research, a total of 2583 university students from Istanbul participated in an online survey, which included questions in several domains including their studies and daily life before and after the outbreak, their concerns and worries about the pandemic, their level of knowledge on COVID-19, their views on the policies implemented by the government and their institution, their attitude and practices toward the protective measures.

Majority of the students reported to suffer from financial adversities due to the outbreak. The closure of residential facilities and the cancellation of face-to-face lectures resulted in the vast majority of the students mouggles, as well as to improve their compliance with the health measures in the future.

There is paucity of data on objectively measured lung function abnormalities in Nigerian children using diagnostic testing methods such as spirometry. Such assessments could prompt early diagnosis and therapeutic interventions.

This was a cross sectional study among children aged 6 to 12 years in South-Eastern Nigeria. We selected participants from one school using a multistage stratified random sampling technique. link2 A structured respiratory questionnaire was administered to obtain necessary data. The lung functions of the children were measured by spirometry. We used Lower Limits of Normal (LLN) based on GLI reference equations for African-American and mixed ethnicities to define abnormal spirometry. We studied the association between the exposures and lung function using logistic regression/chi-squared tests.

A total of 145 children performed acceptable and repeatable tests. There were 73 males (50.3%), mean age of 9.13 years (+1.5) and age range 6 to 12 years. Frequency of respiratory symptoms was cough- 64 (44.1%) and wheeze in 19 (13.1%). Using GLI for African-Americans, fifty-five (37.9%) children had abnormal spirometryobstructive pattern in 40 (27.6%) and restrictive pattern in 15 (10.3%). The two references showed significant differences in interpretation of abnormality (χ

 = 72.86;

 < .001). Respiratory symptom-wheeze was an independent determinant of abnormal lung function in this population.(OR = 0.31; 95%CI 0.10-0.94;

 = .04).

There is a high burden of respiratory symptoms and abnormal spirometry among these children. The need for objective evaluation of lung function especially for children with respiratory symptoms is evident.

There is a high burden of respiratory symptoms and abnormal spirometry among these children. The need for objective evaluation of lung function especially for children with respiratory symptoms is evident.

Operating rooms are a scarce resource but often used inefficiently. Operating room efficiency emerges as an important part of maximizing surgical capacity and productivity, minimizing delays, and optimizing lung cancer outcomes. The operative time (time between patient entering and leaving the operating room) is discrete and the one that the surgical team can most directly influence. We performed a systematic review to evaluate the literature and identify methods to improve the efficiency of the intraoperative phase of operations for lung cancer.

A literature search (in PubMed, Embase, Cochrane, and Scopus) was performed from inception up to March 9, 2020, according to the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

We identified 3 articles relevant to the intraoperative phase of lung cancer operating room efficiency. All 3 were consistent in showing clinically relevant time reductions in the intraoperative phase or procedures relevant to this phase. The authors demonstrated that the application of various improvement methodologies resulted in a substantial reduction in operative time, which was associated with a reduction in complications, and improved staff morale.

Our systematic review found that various improvement methodologies have the potential to significantly reduce operative time for lung cancer surgery. This increases the value of lung cancer surgery. These findings are consistent with the wider literature on improving surgical efficiency.

Our systematic review found that various improvement methodologies have the potential to significantly reduce operative time for lung cancer surgery. This increases the value of lung cancer surgery. These findings are consistent with the wider literature on improving surgical efficiency.

COVID-19 pandemic represents a serious health emergency that severely compromised our Public Health system, resulting in a rapid and forced reorganization and involved the management of chronic diseases too. The Scleroderma Unit of Modena and Reggio Emilia follows more than 600 patients suffering from systemic sclerosis (SSc) and recently became the referral center (HUB) in Emilia-Romagna for this rare connective tissue disease. The aim of the present study was to evaluate the extent by which the lockdown and the pandemic has impacted the activity of admissions to Scleroderma Unit of Modena and Reggio Emilia.

Our daily clinical activity is characterized by outpatient visits, videocapillaroscopy exam, ulcers treatment, therapeutic infusions in day hospital regimen, multidisciplinary visits following our dedicated SSc care pathway, and clinical trials. Our activity has been quickly rescheduled to ensure the proper assistance to our SSc patients during the COVID-19 pressure.

The use of telemedicine has certainly assured a robust continuity of health care. Furthermore, telephone pre-triage, nurse/medical triage, proper physical distancing and use of PPE/DPI allowed us to re-organize and continue SSc daily activity. link3 Specifically, therapeutic infusions in day hospital regimen and outpatient visits, including ulcers treatment, was guaranteed and maximized.

The management of scleroderma patients by an expert specialist reference center is crucial in order to ensure continuity of care and pursue the best SSc practice.

The management of scleroderma patients by an expert specialist reference center is crucial in order to ensure continuity of care and pursue the best SSc practice.[This corrects the article DOI 10.1177/1179547621996306.].

Chronic knee pain is a common musculoskeletal condition, which usually leads to decreased quality of life and a substantial financial burden. Various non-surgical treatments have been developed to relieve pain, restore function and delay surgical intervention. Research on the benefits of medical cannabis (MC) is emerging supporting its use for chronic pain conditions. The purpose of this study was to evaluate the cost-effectiveness of MC compared to current non-surgical therapies for chronic knee pain conditions.

We conducted a cost-utility analysis from a Canadian, single payer perspective and compared various MC therapies (oils, soft gels and dried flowers at different daily doses) to bracing, glucosamine, pharmaceutical-grade chondroitin oral non-steroidal anti-inflammatory drugs (NSAIDs), and opioids. We estimated the quality-adjusted life years (QALYs) gained with each treatment over 1 year and calculated incremental cost-utility ratios (ICURs) using both the mean and median estimates for costs and utilities gained across the range of reported values.