Exposure to recreational and electronic noise sources increases the risk of noise-induced hearing loss (NIHL) in pediatric and young adult populations—frequently referred to as Generation Z. Extended high-frequency audiometry (EHFA) is commonly used for the early detection and prognostication of NIHL. Here, we used EHFA to evaluate the potential hearing loss associated with the use of technological devices in Generation Z individuals. Subjects and Methods: This was a cross-sectional, descriptive investigation. Individuals aged 10-22 years who presented to our clinic with any complaint between January 15, 2023, and January 15, 2024 and who were scheduled for routine hearing assessment were included. All participants underwent conventional audiometry covering conventional frequencies (CFs) as well as EHFA. Participants were divided into two groups based on weekly use of personal listening devices (PLDs): less than 10 h/week and 10 h/week or more. Differences between the groups were analyzed with respect to CFs and extended high frequencies (EHFs), as well as the presence of vertigo, tinnitus, and subjective hearing loss. Results: No significant differences were observed between the groups regarding the presence of symptoms, vertigo, tinnitus, or hearing loss (p=0.47, p=0.75, p=0.10, and p=0.99, respectively). No significant differences were observed in the average CFs between the right and left ears (p=0.53 and p=0.38, respectively). In the right ear at 10 kHz, the mean threshold for participants using PLDs less than 10 h/week was 7.50±7.70, compared to 5.0±10.88 for those using PLDs 10 h or more per week (p=0.02). For all other frequencies, average thresholds in both ears were higher in participants with weekly PLDs ≥10 h compared to those with <10 h, although these differences were not statistically significant (p>0.05). Conclusions: EHFs tended to be higher in individuals using PLDs for ≥10 h/week, although the differences were not statistically significant at most frequencies. A significant difference was observed only at 10 kHz in the right ear; however, this may reflect interindividual variability rather than a consistent exposure effect. This study is the first in which NIHL in Generation Z was the focus, and replication in larger cohorts is warranted.

Purpose: Real-world evidence comparing surgical techniques for symptomatic hemorrhoidal disease (HD) remains limited, despite the availability of multiple approaches. This study aimed to evaluate short-term, interim outcomes from a prospective, nationwide cohort study that compared the effectiveness of different operative techniques based on patient-reported outcome measures (PROMs) in patients with symptomatic HD. Methods: A prospective, nationwide cohort study was conducted at 20 tertiary care centers across Turkiye between July 2022 and July 2024. Adult patients aged 18 years or older with symptomatic HD (grades I–IV) who underwent surgery during this period were included. The choice of procedure was determined by the operating surgeon, and patients were categorized into excisional, fixative, and ablative groups according to the surgical approach used. The primary outcomes were changes in the Hemorrhoidal Disease Symptom Score, Short Health ScaleHD, visual analog scale for pain, and patient satisfaction, assessed from the preoperative period to postoperative day 7 and postoperative week 6. Results: The study included a total of 315 patients after excluding those who did not fulfil the inclusion criteria. Among them, 239 (78.9%) were male, with a mean age of 43.7±11.7 years. The distribution of patients across surgical groups was 207 (65.7%) in the excisional group, 30 (9.5%) in the fixative group, and 78 (24.8%) in the ablative group. All groups demonstrated significant improvements in PROM scores from preoperative to postoperative assessments. However, no statistically significant differences were observed between groups at any time point for PROM scores or for changes in PROM scores across consecutive evaluations (P≥0.05 for all comparisons). Urinary retention occurred more frequently, and hospital stays were longer in the fixative group (P=0.006 and P<0.001, respectively). The excisional group had a greater need for narcotic use and longer duration of use (P=0.003 and P<0.001, respectively). Conclusion This real-world cohort study shows that all 3 surgical approaches are effective for HD, providing comparable short-term symptomatic relief and patient satisfaction. These techniques appear equally valid treatment options, and the choice of procedure may best be individualized based on patient-specific characteristics and surgeon preference.Trial registration: ClinicalTrials.gov identifier: NCT05429060

Background and Objectives: Idiopathic sudden sensorineural hearing loss (ISSHL) is a rapid loss of hearing, exceeding 30 dB in at least 3 consecutive frequencies within 3 days, without any identifiable cause despite thorough investigations. Currently, the etiology and pathogenesis of ISSHL have not been fully elucidated. This study aimed to assess the size of the cochlear nerve in patients with ISSHL and explore its relationship with pretreatment audiograms and treatment response. Subjects and Methods: A total of 125 patients (59 [47.2%] women; mean age 47.7±13.8 years [minimum-maximum: 21-76]) and 60 healthy participants (27 [45%] women; mean age 45.7±16.8 years [minimum-maximum: 20-76]) as a control group were included in this study. The size of the cochlear nerve was assessed on the affected side, compared to the control group, as well as on the unaffected side. Pretreatment and posttreatment audiological values were also analyzed. Results: The cross-sectional area (CSA), vertical diameter (VD), and horizontal diameter (HD) of the CN were found to be smaller on the affected side of ISSHL patients compared to the control group (p<0.01; p=0.04; p=0.02, respectively). In the study group (affected side of ISSHL patients), there were no significant differences in VD, HD, and CSA values between pretreatment audiogram types (p=0.23; p=0.53; p=0.39, respectively), and initial hearing levels (p=0.16; p=0.22; p=0.23, respectively). Furthermore, there were no significant differences in VD, HD, and CSA values between the recovery groups according to Furuhashi criteria (p=0.18; p=0.37; p=0.27, respectively). Conclusions The size of the CN may be a risk factor for ISSHL, but it does not affect the type of audiogram curves and was not prognostic in terms of treatment response.

Purpose: To investigate the diagnostic and prognostic significance of the blood-count derived systemic immunoinflammatory parameters in patients with thyroid-associated ophthalmopathy (TAO). Methods: In this retrospective case-control study, the blood-count parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, and systemic immune-inflammatory index (SII), thyroid peroxidase antibody, and anti-thyroglobulin antibody were evaluated in 46 patients with TAO and 46 matched controls. The associations of the immunoinflammatory parameters with clinical outcomes were analyzed among TAO patients. Results: Significant differences were found in NLR, PLR, SII, and lymphocyte count between the controls and the TAO group (p < 0.05 for all). In logistic regression analysis, these inflammatory parameters did not have any prognostic effect on the clinical outcomes of the TAO (p > 0.05 for all). The patients, who needed systemic treatment due to any ocular involvement of TAO during the follow-up period, had significantly lower platelet count (p = 0.001) and PLR (p = 0.02) at the time of initial diagnosis when compared to the no treatment-needed group of the TAO patients. The initial platelet count was significantly associated with the subsequent steroid need due to TAO during the follow-up period (β = -0.02, p = 0.03). Conclusions NLR, PLR, and SII may serve as potential inflammatory markers in the identification of the TAO, although they have no evident prognostic significance in TAO. However, the relatively lower platelet count at initial diagnosis may be associated with the need for systemic therapy during the follow-up in patients with TAO.

Purpose: To investigate the diagnostic and prognostic significance of the blood-count derived systemic immunoinflammatory parameters in patients with thyroid-associated ophthalmopathy (TAO). Methods: In this retrospective case-control study, the blood-count parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, and systemic immune-inflammatory index (SII), thyroid peroxidase antibody, and anti-thyroglobulin antibody were evaluated in 46 patients with TAO and 46 matched controls. The associations of the immunoinflammatory parameters with clinical outcomes were analyzed among TAO patients. Results: Significant differences were found in NLR, PLR, SII, and lymphocyte count between the controls and the TAO group (p < 0.05 for all). In logistic regression analysis, these inflammatory parameters did not have any prognostic effect on the clinical outcomes of the TAO (p > 0.05 for all). The patients, who needed systemic treatment due to any ocular involvement of TAO during the follow-up period, had significantly lower platelet count (p = 0.001) and PLR (p = 0.02) at the time of initial diagnosis when compared to the no treatment-needed group of the TAO patients. The initial platelet count was significantly associated with the subsequent steroid need due to TAO during the follow-up period (β = -0.02, p = 0.03). Conclusions NLR, PLR, and SII may serve as potential inflammatory markers in the identification of the TAO, although they have no evident prognostic significance in TAO. However, the relatively lower platelet count at initial diagnosis may be associated with the need for systemic therapy during the follow-up in patients with TAO.

OBJECTIVE: This study explored the correlations between the use of complementary and integrative therapies (CITs) and symptoms among Turkish patients with familial Mediterranean fever (FMF). METHODS: This is a cross-sectional and descriptive study. The study was conducted with 1119 FMF patients who were registered to the social networking site for Behcet's and the FMF Patients Association (Befemder) in Turkey, between January 2018 and February 2019. Data were collected using an online survey, for which a three-part questionnaire was created using a Google form. Descriptive statistics, chi-square test and logistic regression analysis were used to analyze the data. RESULTS: It was determined that 53.2% of the individuals who participated in the research used various forms of CITs and that 32.8% used vitamin and mineral supplements (calcium, iron, and vitamin B12, C and D), 25.0% used nutritional supplements (fish oil and honey), and 24.6% used oral herbs (ginger, turmeric, green tea and rosemary) and mind-body methods (relaxation, respiration exercise and meditation). It was determined that the percentage of participants that used CITs was higher among women (odds ratio [OR] = 1.825; 95% confidence interval [CI] 1.421-2.344), those with joint pain (OR = 1.385; 95% CI 1.047-1.832), those with difficulty breathing (OR = 1.323; 95% CI 1.031-1.697), those with gastrointestinal symptoms (OR = 1.405; 95% CI 1.089-1.814) and those who had a family member with FMF (OR = 1.437; 95% CI 1.115-1.851). CONCLUSION More than half of the individuals used at least one type of CIT for symptom control.
Behcet Syndrome ; Cross-Sectional Studies ; Familial Mediterranean Fever/therapy* ; Female ; Humans ; Surveys and Questionnaires ; Turkey

Objective: To determine the anti-inflammatory effects of mucus obtained from different fish species on the carrageenan-induced acute paw edema in rats. Methods: Forty-two rats were randomly divided into seven groups. Acute paw edema was induced by 0.1 mL of 1% carrageenan, and a single dose of diclofenac and lyophilized mucus (25 mg/kg) of rainbow trout, brook trout, European sea bass, and gilthead sea bream were administered to rats through gastric gavage 1 h before carrageenan treatment. Rat paws were measured before and 1-4 h after carrageenan treatment. The mRNA expressions of cytokines (TNF-α, IL-1β, IL-6, IL-10, and TGF-β), antioxidant markers (catalase and superoxide dismutase), and COX-2 were investigated using quantitative polymerase chain reaction. The histopathological changes were evaluated by hematoxylin and eosin staining. Results: The inhibition percentage of carrageenan-induced paw edema by different fish mucus ranged from 52.46% to 74.86% at 4 h. Histopathological evaluation showed that all fish mucus diminished carrageenan-induced edema and inflammatory cell infiltration. The upregulation of IL-1β mRNA induced by carrageenan was decreased by the mucus of rainbow trout and gilthead sea bream while an increase in the expression of IL-6 mRNA was reduced by the mucus of rainbow trout, brook trout, and gilthead sea bream. In addition, the mRNA expression of superoxide dismutase was higher in the rainbow trout mucus group than the carrageenan group. Conclusions: Mucus obtained from different fish species may have anti-inflammatory effects.

Both Fahr’s disease and SARS-CoV-2 infection can lead to thrombotic events. Fortunately, they are rare occurring together. There are no previous reports of SARS-CoV-2 infection in association with Fahr’s disease. We report here a case of SARS-CoV-2 infection with Fahr’s disease that presented with thalamic infarct. The patient improved with enoxaparin. Ischemic infarction may be seen in SARSCoV-2 patients with associated Fahr’s disease. Antithrombotic therapy may be helpful in preventing further deterioration.

PURPOSE: Beverages may affect the translucency of esthetic dental restorative materials. The aim of the present study was to investigate the effects of coffee and red wine on the translucency of a PICN material with two translucency levels, and finished with different methods. MATERIALS AND METHODS: 2M2 high translucent and translucent VITA Enamic hybrid ceramic blocks were investigated. Rectangular specimens with the dimensions of 12 mm × 14 mm × 2 mm were prepared. The specimens were finished and polished with different methods as suggested by the manufacturer. The translucency parameters of the specimens were evaluated before and after 24 hours, 7 days, and 28 days immersion in distilled water, coffee and red wine. Translucency parameters were measured using a portable spectrophotometer. RESULTS: At the end of 28 days, there was no statistically significant difference between the groups of specimens kept in coffee (P>.05). In the red wine groups, there was a statistically significant difference between the control group and all other groups (P<.05) at the end of 28 days. CONCLUSION: The translucency of hybrid ceramic for a restoration may not be important regarding the effects of coffee on translucency change because the specimens with different translucencies and finishing methods that were immersed to coffee had similar translucency parameters at the end of 28 days. The translucency of hybrid ceramic may be important in the case of red wine, however, since the results showed that highly translucent specimens exposed to red wine demonstrated better translucency parameters than specimens made from translucent blocks at the end of 28 days.
Beverages ; Ceramics* ; Coffee ; Immersion ; Methods* ; Water ; Wine

OBJECTIVE: To examine the effect of meningomyelocele sac size on prognosis by retrospective review of 64 cases operated for meningomyelocele between January 2009 and December 2012. METHODS: We evaluated newborn babies operated for meningomyelocele by retrospectively reviewing their files for head circumference, location and with of the defect, accompanying anomalies, treatments administered, drugs that mother used during pregnancy. Based on the defect size, 3 patient groups were created as 0–24 cm² (group I), 25–39 cm² (group II), and 40 cm² and above (group III). RESULTS: Throughout the study, 64 babies were evaluated. Mean head circumference was 37.4 cm (range, 30.7–50 cm). Based on their location, 49 of the defects (76.5%) were lumbar, 7 (10.9%) were thoracolumbar, 4 (6.2%) were thoracic, 3 (3.1%) were sacral, 1 (1.5%) was cervical. Mean size of the meningomyelocele sac was 4.7 cm×5.8 cm (range, 1 cm×1 cm—10 cm×8 cm), 13 of the babies (20.3%) had skin defect requiring flap. According to accompanying anomalies, 47 of the babies (73.4%) had hydrocephalus, 7 (10.9%) had club foot, 1 (1.5%) had diastematomyelia, 1 (1.5%) had tethered cord. Thirty-nine of the babies (60.9%) had paraplegia, 10 (15.6%) had paraparesis, 8 (12.5%) had monoplegia; neurological examination in the remaining 7 babies was normal. CONCLUSION: In our study, increased diameter of meningomyelocele sac was associated with greater amount of neural tissue within the sac, which worsens the prognosis. Sac localization was not changing prognosis but infection rates, hospitalization duration were increased in babies with bigger diameter of sacs.
Foot ; Head ; Hemiplegia ; Hospitalization ; Humans ; Hydrocephalus ; Infant, Newborn ; Meningomyelocele* ; Mothers ; Neural Tube Defects ; Neurologic Examination ; Paraparesis ; Paraplegia ; Pregnancy ; Prognosis* ; Retrospective Studies ; Skin