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OBJECT 1
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OBJECTIFICATION THEORY 1
Objective Acute bacterial meningitis (ABM) declined after implementing conjugate Haemophilus influenzae type B and the pneumococcal vaccines worldwide. However, it still contributes to significant morbidity and mortality. The Biofire FilmArray Meningitis Encephalitis (FAME) panel can rapidly diagnose common bacterial and viral pathogens. Several studies suggested that the use of FAME may accelerate diagnosis and decrease the time to pathogen-specific therapy. However, the clinical utility is still controversial due to scarce data and relatively high costs. Therefore, we aimed to evaluate the diagnostic performance of FAME in children. Methods A retrospective multicenter cross-sectional study was conducted to evaluate FAME in diagnosing ABM in children with a suspected central nervous system infection between January 2017 and May 2021. Results This study consisted of 179 children diagnosed with central nervous system infection who had parallel testing done using FAME and traditional microbiological diagnostic methods. Twenty-two FAME results were positive; 8 (36.3%) were bacterial pathogens and 14 (53.7%) were viral pathogens . The most common viral pathogen was human herpesvirus 6 (n =6; 27.2%), followed by herpes simplex virus 1 (n =4; 18.1%), Enterovirus spp. (n = 2; 9%), Parechovirus (n = 2; 9%), and Cytomegalovirus (n = 1; 4.5%). Bacterial pathogens included S. pneumoniae (n = 3; 13.6%), H. influenzae (n = 3; 13.6%), Neisseria meningitidis (n = 1; 4.5%), and Streptococcus agalactiae (n = 1; 4.5%). Bacterial culture confirmed S. pneumoniae infection in only 1 of 8 (12.5%) patients, while 7 of 8 bacterial meningitis were only detected by FAME. Conclusion FAME may also help with diagnosis and pathogen identification in patients who have already had antibiotics before cerebrospinal fluid collection. The use of FAME to detect infections quickly may minimize the improper use of medications, treatment duration, and the cost of hospitalization. 1
Objective function values 1
Objective functions 3
Objective Histopathological analysis of the relationship between penile elastography and erectile dysfunction. Material and method 12 patients who applied to our clinic for erectile dysfunction in the last 1 year and accepted this study were included. Preoperative two-dimensional shear wave elastography imaging was performed in 12 patients and recorded in the Pascal (kPa) unit. Approximately 0.5 x 0.5 x 0.5 cm tissue samples were taken from the right and left cavernous tissue during penile prosthesis implantation operation. Tissue samples were sent to the pathology department. The percentage of the area covered by muscle fibers and elastic fibers in the corpus cavernosum was noted semi-quantitatively (ratio of muscle fibers and cavernous body elastic fiber score). All data obtained were compared with each other. Results Cavernous body elastic fiber score data(Grouped Score 1, 2 and 3) and percentage of cavernous body muscle fibers data (Grouped %10, %20, %30 horizontal ellipsis %100) were compared with Shear wave elastography data (kPa). The results were not statistically significant according to the Kruskal Wallis Test. Cavernous body elastic fiber score and the percentage of cavernous body muscle fibers were also compared, it was not statistically significant according to the Kruskal Wallis test and Spearman's correlation test. Conclusions Penile shear wave elastography can be used clinically to quantitatively assess the amount of smooth muscle cells and elastic fibers in the penis, but it deserves to be studied with a larger number of patients and a more specific interpretation of the pathology preparation. 1
OBJECTIVE MEASUREMENT 1
Objective The aim of this study was to investigate whether clomiphene citrate (CC) administration could be a new therapeutic agent in case of contraindication of estrogen therapy for hormone-dependent osteoporosis and to show the changes in bone structure by histomorphometric analysis in ovariectomized rats administered CC. Study design This study was carried out in the Experimental Surgery Laboratory of the Brain Research Centre of the Medical Faculty of Ege University. Four-month-old Sprague-Dawley rats were used for the experiment. The study was carried out on six groups of animals each consisted of eight rats. Four groups of rats were ovariectomized and 2 groups of rats were used as control group. For 6 weeks every day, rats were injected physiological saline solution (1 ml/kg), clomiphene citrate (1 or 10 mg/l ml/kg, Organon), 17 beta-estradiol (50 mu g/l ml/kg, within susame oil, Sigma) or susame oil (1 ml/kg, Sigma). Drug administrations were carried out according to the weekly weight measurements. Group 1(PSS), n = 8, non-ovariectomized, were injected with physiological saline solution. Group 2(CC-1), n = 7, non-ovariectomized, were injected with CC (1 mg/l ml/kg). Group 3(OVX + CC-1), n = 7, ovariectomized, were injected with CC (1 mg/l ml/kg). Group 4(OVX + CC-10), n = 6, ovariectomized, were injected with CC (10 mg/l ml/kg). Group 5(OVX + E), n = 8, ovariectomized, were injected with 17 beta-estradiol (50 mu g/l ml/kg). Group 6(OVX), n = 8, ovariectomized, were injected with susame oil (1 ml/kg) Bone-specific serum alkaline phosphatase (ALP) levels were measured and statistical analyses were made by Kruskal Wallis test. Left femur bone histomorphometric studies were done. The uteri were dissected out to measure their weight and ANOVA was used to show the intergroup differences. Results The level of ALP in group 3 was significantly higher than the other five groups. Bone histomorphometric examination showed that total bone volume in group 3, 4, and 5 was higher than group 6, and group 4 had the highest level of bone volume compared to the rest of the groups. Uterus weights in group 1 were significantly higher than group 3 and 6 (P = 0.02, P = 0.01) and uterus weights in group 5 were significantly higher than group 3 and 4 (P = 0.00, P = 0.01) Conclusions In ovariectomized rats, treatment with CC is seen as effective as estrogen treatment in preventing osteoporosis, without causing uterin hyperstimulation. Nevertheless, further investigations on more rats are needed to assess whether it is an alternative treatment method to estrogen. 1
Objective The objectives of the study were to determine which parents or teachers predict attention-deficit/hyperactivity disorder (ADHD) better in children and adolescents, and to detect both diagnostical and symptomatological agreement levels across informant reports. Method A total of 417 cases aged 6-14 from a non-referred community sample were assessed by a semi-structured interview, parent- and teacher-rated ADHD Rating Scale-IV. Also, impairment criteria were taken into account to ensure the gold standard diagnosis for ADHD. The measures of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated in each categorical sample. Besides, the agreement between parent and teacher reports of ADHD was investigated. Results Parents and teachers had similar diagnostic accuracy for predicting ADHD. Both parents and teachers predicted ADHD in similar accuracy in both boys and girls, separately. However, girls were found to be more predictable by both parents and teachers compared to boys. Parents with lower education levels had worse diagnostic accuracy than both parents with higher education levels and teachers. Low to moderate agreement and correlations between parent and teacher ADHD reports were detected. Conclusion In general, parents and teachers seem to predict ADHD in similar accuracy. Nevertheless, child gender and parental education level may alter the predictability power for ADHD. The findings can guide for clinicians that how to evaluate observation reports of parents and teachers to make accurate ADHD diagnosis in patients. 1