Does HPV‐18 co‐infection increase the risk of cervical pathology in individuals with HPV‐16?

Abstract Objective We aimed to investigate differences between HPV‐16 mono‐ and HPV‐16/18 co‐infections in terms of cervical dysplasia and invasive cancer. Methods This multicentre, retrospective study spanned from December 2017 to December 2020, involving women who visited gynaecological oncology clinics for colposcopy with either HPV‐16 or HPV‐16/18 positivity. A total of 736 patients, 670 in Group 1 (HPV‐16 positivity) and 66 in Group 2 (HPV‐16/18 positivity), were compared for the presence of CIN2+ lesions detected by colposcopic biopsy or endocervical curettage (ECC). Exclusions included hysterectomized patients, those with prior gynaecological cancers, and patients with HPV positivity other than types 16 and 18. Results Among the included patients, 42.4% had a diagnosis of CIN2+ lesions. The cytology results demonstrated abnormal findings in 45.3% in Group 1 and 42.2% in Group 2, with no significant difference between the groups. ECC revealed CIN2+ lesion in 49 (8.7%) patients in group 1, while only 1 (1.7%) patient had CIN2+ lesion in group 2. There was no difference between 2 groups in terms of ECC result ( p  = 0.052). In group 1, 289 (43.1%) patients had CIN2+ lesion, while 23 (34.8%) patients had CIN2+ lesions in group 2. There was no difference between group 1 and 2 in terms of diagnosis of CIN2+ lesions ( p  = 0.19). Conclusion This multicentre retrospective study found no significant differences between HPV‐16 mono‐ and HPV‐16/18 co‐infections regarding cervical pathologies. Larger studies are needed to validate and further explore these findings.

Evaluation of the prognostic value of papillary muscle‐free strain in patients with hypertrophic cardiomyopathy

Background The prognosis of hypertrophic cardiomyopathy (HCM) varies from mild disease with a normal life expectancy to heart failure and sudden cardiac death (SCD). The identification of patients who are at high risk for SCD remains challenging. Aims In this study, we evaluated the prognostic value of papillary muscle‐free strain in HCM patients. Methods and Results Seventy‐nine patients with a diagnosis of HCM were included in this study. Patients were divided into low/intermediate‐risk ( n  = 57) and high‐risk ( n  = 22) groups. Two‐dimensional (2‐D) echocardiography and strain imaging were performed for each patient. The mean age of the study population was 53.85 ± 15.88 years; 47 (59.5%) of them were male. During a mean follow‐up duration of 74.45 ± 17.03 months, 12 patients died. A comparison of the low‐intermediate and high‐SCD risk groups revealed that patients in the high‐SCD risk group had greater maximal wall thickness, interventricular septum thickness, posterior wall thickness, and left ventricular mass index (LVMI) and lower (less negative) global longitudinal, anterolateral papillary muscle (ALPM) and posteromedial papillary muscle (PMPM) free strain. Additionally, a history of syncope and ICD implantation were found to be more common in patients with high SCD risk scores. The SCD risk score was positively correlated with the global longitudinal strain, ALPM‐free strain, and PMPM‐free strain ( r  = .528, r  = .658, and r  = .600, respectively; p  < .001 for all). Our results showed that the LVMI, presence of syncope, global longitudinal strain, and ALPM‐free strain were predictors of death. Conclusions Decreased papillary muscle‐free strain values might have prognostic value in patients with HCM.

The role of calcitonin gene‐related peptide and substance P in the pathogenesis of dialysis headache

Aim The present study aims to establish the role of serum CGRP and SP levels in the disease pathophysiology in patients with dialysis headache not accompanied by primary or secondary headaches, and also whether there is a correlation between these vasoactive peptides and the severity of headache. Method This study was designed as prospective and multicenter. A total of 30 dialysis headache patients and 30 patients without headache as the control group in the Nephrology outpatient clinics which implement similar dialysis procedures were included in the study. Blood samples were taken from all the patients before hemodialysis, and post‐hemodialysis samples were collected. CGRP and SP contents in serum samples were measured using the ELISA method with detection kits. Results A total of 60 patients were included in the study with 17 female and 13 male patients in the dialysis headache group and 18 female and 12 male patients in the control group, and there were no significant differences in sex and age between the groups. CGRP levels in the headache group were found to be significantly higher compared with the control group both before and after hemodialysis. Furthermore, pre‐hemodialysis CGRP levels were significantly higher than post‐hemodialysis CGRP levels in both the headache and control groups. Serum SP levels in the headache group were found to be higher compared with the control group both before and after hemodialysis, there was no significant difference between the groups. Even though SP levels in both groups decreased after hemodialysis, there was again no significant difference between the groups. No correlation was found between the patients' severity of headache and serum CGRP and SP levels. Conclusion This study concludes that CGRP and SP, even though the latter is not statistically significant, play a role in the pathophysiology of the dialysis headache, and further studies with a larger and more specific patient population may reveal the relationship between the neuropeptides and dialysis headache more clearly.

Exploring the Experiences, Perceptions and Social Dynamics of Electronic Cigarette Users: A Qualitative Study

ABSTRACT Introduction Electronic cigarettes, or e‐cigarettes, are rapidly gaining popularity throughout the globe as safer alternatives to traditional cigarette smoking. There are significant public health concerns due to the uncertainty of long‐term health consequences. This study aims to examine the experiences, attitudes and social dynamics of e‐cigarette users to provide guidance for public health policies and interventions. Methods In this qualitative descriptive study, semi‐structured interviews were conducted. Fifteen e‐cigarette users were recruited using a snowball sampling strategy, where initial participants referred other suitable users. All participants had at least 6 months of regular e‐cigarette use. Data were collected through face‐to‐face interviews with open‐ended questions. The interviews were transcribed verbatim and reviewed by the researchers. This review identified four main themes and eight sub‐themes. Results The four main themes identified as a result of the analysis are as follows: (1) initiation and usage experiences; (2) perceptions of health effects; (3) social and environmental factors and (4) addiction and future plans. Participants primarily began using e‐cigarettes out of curiosity, due to the appealing fragrance and the belief that they were less harmful than traditional cigarettes. Usage patterns varied among participants, with some reporting minimal cravings in the early morning hours. Opinions on the long‐term health effects of e‐cigarettes were diverse, with many participants acknowledging uncertainty. Peers and family members perceived e‐cigarettes as more socially acceptable than traditional smoking, resulting in fewer negative reactions. Finally, participants' levels of addiction and intentions to quit varied, with some expressing a desire to reduce or cease usage due to health concerns. Conclusion The findings of this study indicate that the adoption of e‐cigarettes is influenced by a confluence of factors, including curiosity, the perception of reduced damage in comparison to conventional cigarettes and social acceptance. Notwithstanding these claimed advantages, users have a diverse array of beliefs and understandings concerning the enduring health consequences of e‐cigarettes. The presence of varying levels of addiction and the corresponding aspirations to cease the behaviour highlight the necessity for focused public health interventions. Patient or Public Contribution E‐cigarette users were actively involved in this study, providing essential insights and feedback throughout. Their first‐hand experiences shaped the interview guide and contributed to the identification of key themes. Participants also reviewed and confirmed the accuracy of the interview transcripts, ensuring the reliability of the data.

Evaluating the multifaceted impact of Cephalaria extract on dough quality: Antioxidant, antimicrobial, and cytotoxic properties

Summary Cephalaria syriaca , known as cephalaria, is an annual, pilose plant with pink‐purple flowers growing wild in wheat fields. Viscoelastic properties of gluten‐free doughs can be improved by adding cephalaria. However, this addition results in some undesirable properties in bread such as bitter taste and dark internal colour. This study aimed to reduce these effects by obtaining cephalaria obtained from distilled water and ethanol extracts and to increase the potential use of extracts in bread production. Different proportions of water and ethanol extracts obtained from oil‐free cephalaria were added to bread by creating a model with Mixture Design, and the optimum concentration was determined by farinograph trials. The antioxidative, antimicrobial, and cytotoxic effects of extract and the effect of cephalaria on yeast activity were examined. Cephalaria extracts had no measurable antimicrobial effect and no antifungal effect on Rhizopus stolonifer , while an antifungal effect was found against A . niger and P . expansum . The IC50 value was found to be 4.15 mg mL −1 for ethanol extract while the water extract had no effect on cells. The addition of extract had no negative effect on the number of yeasts in sourdough fermentation. The study has improved the usage of cephalaria by using water and ethanol extracts in dough.

The effect of home nurse visits on infant weight and breastfeeding: Systematic review and meta‐analysis

Aims The primary aim of this systematic review and meta‐analysis is to evaluate the effects of home nurse visiting on infant weight and breastfeeding; the secondary aim is to determine the duration, frequency and content of home visits. Methods A systematic search of the PubMed, CINAHL, Embase (Ovid), Web of Science, Google Scholar and DergiPark databases for publications between September 2000 and January 2019 was conducted using established methods in compliance with the PRISMA‐P declaration guideline. Two authors independently evaluated the studies for inclusion and bias, extracted the data and checked their accuracy. Results This meta‐analysis includes a total of 34 studies, 28 on breastfeeding and nine on infant weight. The average effect size of the 28 studies investigating the effect on breastfeeding was found to be OR: 2.24; 95% CI: 1.73–2.90; p  < 0.001. The average effect size of the nine studies investigating the effect on infant weight was found to be ES: 0.197; 95% CI: 0.027–0.368; p  < 0.05. Conclusion There is an association between nurse home visits and breastfeeding and infant weight. Home visits by nurses should continue to remain within the nursing role and be analysed appropriately for mother and baby health.

Knowledge, attitudes, and practices towards human papillomavirus (HPV) and HPV vaccination among male nurses

Aim This study aimed to determine the knowledge, attitudes, and practices of male nurses towards human papillomavirus (HPV) and HPV vaccination and to examine whether knowledge about the HPV vaccine affects attitudes and beliefs about HPV vaccines. Background HPV is responsible for ≈5% of all cancers worldwide. Therefore, vaccination against HPV is recommended to prevent HPV infections and HPV‐related cancers in men and women. Methods The study group included 383 male nurses who were asked to complete online questionnaires. The data were collected using the following tools: a sociodeomographical characteristics form, the Human Papillomavirus Knowledge Scale (HPVKS), and The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). Results It was determined that the general HPV knowledge of the male nurses participating in the study was at a moderate level, but their knowledge of HPV screening test, HPV vaccination, and current HPV vaccination programmes were at a low level. Male nurses' HPV vaccination rates were relatively low, and most of them did not intend to be vaccinated. In addition, CHIAS Attitudes and Beliefs scores of the male nurses were at an average level and HPV knowledge affected the attitudes and beliefs of the nurses. Conclusion These results demonstrate an opportunity to improve information and awareness about HPV and vaccines by nursing education.

Dietary inflammatory index in relation to salivary cytokine concentrations and periodontitis: A cross‐sectional analysis

Aim To examine the associations of dietary inflammatory index (DII) with salivary cytokine concentrations and periodontitis after controlling for body mass index (BMI), socio‐demographic factors and lifestyle. Materials and Methods Subgroups from two Finnish surveys, DILGOM 2007 and Health 2000, were included (total n  = 727). The DII scores were calculated based on a food frequency questionnaire. Periodontal status was assessed with a cumulative risk score in DILGOM 2007 and by pocket depth measurement in Health 2000. From saliva, interleukin (IL)‐1β, IL‐1 receptor antagonist, IL‐6, IL‐8, IL‐10 and tumour necrosis factor (TNF)‐α concentrations were measured. Results The DII scores did not differ between non‐periodontitis and periodontitis participants in pairwise comparison. After adjusting for energy intake, periodontal status, BMI, age, education level, smoking habit and physical activity, DII was not associated with salivary cytokine concentrations. After adjusting for salivary cytokine levels and other confounding factors, DII was associated with periodontitis in the Health 2000 subgroup but not in the DILGOM 2007 subgroup. Conclusions The current data support the evidence that diet is not associated with salivary cytokine levels but may be associated with periodontitis. The association observed between diet and periodontitis is related to factors other than diet‐dependent inflammatory tendency in the oral cavity.

Domains, competences and learning outcomes for undergraduate education in periodontology

Abstract Aim This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology. Review Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri‐implant diseases. Conclusions Specific learning outcomes have been proposed within each competence area, that is in Domain I ( n  = 10), Domain II ( n  = 13), Domain III ( n  = 33) and Domain IV ( n  = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student.

Prevalence of hirsutism in Turkey: Data of the dermatoendocrinology study group