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Aim: COVID-19 is a virus capable of causing cardiovascular complications. This study investigates whether any cardiac effect is present in patients presenting with suspected COVID-19 in the light of Electrocardiography (ECG) findings.Material and Method: This prospective study involved patients with chest pain presenting to the pandemic clinic with suspected COVID-19. Patients were divided into two groups based on their PCR results, PCR-positive and -negative. All participants’ demographic characteristics, presentation symptoms and the duration thereof, physical examination findings, laboratory results, and ECG findings were recorded. Patients with positive PCR results were invited for checks on the 15th day, when repeat ECG was performed. Results: A-50 patients with positive PCR results and 50 with negative PCR results were included in the study. The mean age of the entire patient group was 52.30±16.02 years, and 56% were women. No difference was determined between the positive and negative PCR result patients in terms of age or sex (p=0.116; 0.687, respectively). Presentation high sensitive cardiac Troponin (hs-cTn) levels were significantly higher in the patients with positive PCR results than in the PCR-negative patients (p, Amaç: COVID-19 kardiyovasküler komplikasyonlara neden olabilen bir virüstür. Bu çalışmada, COVID-19 şüphesi ile başvuran göğüs ağrılı hastalarda kardiyak etkilenme olup olmadığı Elektrokardiyografi (EKG) bulguları eşliğinde araştırılmıştır.Gereç ve Yöntem: Bu çalışma, Pandemi polikliniğine COVID-19 şüphesi ile başvuran göğüs ağrılı hastalar üzerinde prospektif olarak yapıldı. Hastalar PCR sonucuna göre: PCR sonucu pozitif ve negatif olmak üzere iki gruba ayrıldı. Tüm katılımcıların demografik özellikleri, başvuru şikayetleri ve şikayetlerinin mevcudiyet süresi, fizik muayene bulguları, laboratuvar sonuçları ve EKG bulguları kaydedildi. PCR sonucu pozitif olan hastalar, 15. günde kontrole çağırılarak yeniden EKG çekildi. Bulgular: Çalışmaya 50 PCR sonucu pozitif ve 50 PCR sonucu negatif hasta dahil edildi. Tüm hastaların yaş ortalaması 52.30±16.02/yıl ve %56’sı kadındı. PCR sonucu pozitif olanlarla PCR sonucu negatif olanlar arasında yaş ve cinsiyet bakımından farklılık saptanmadı (Sırasıyla p=0.116; 0.687). Başvuru yüksek duyarlıklı kardiyak Troponin (hs-cTn) düzeyi, PCR sonucu pozitif olanlarda PCR sonucu negatif olanlara göre anlamlı olarak daha yüksekti (p

Graph-based genome reference representations have seen significant development, motivated by the inadequacy of the current human genome reference to represent the diverse genetic information from different human populations and its inability to maintain the same level of accuracy for non-European ancestries. While there have been many efforts to develop computationally efficient graph-based toolkits for NGS read alignment and variant calling, methods to curate genomic variants and subsequently construct genome graphs remain an understudied problem that inevitably determines the effectiveness of the overall bioinformatics pipeline. In this study, we discuss obstacles encountered during graph construction and propose methods for sample selection based on population diversity, graph augmentation with structural variants and resolution of graph reference ambiguity caused by information overload. Moreover, we present the case for iteratively augmenting tailored genome graphs for targeted populations and demonstrate this approach on the whole-genome samples of African ancestry. Our results show that population-specific graphs, as more representative alternatives to linear or generic graph references, can achieve significantly lower read mapping errors and enhanced variant calling sensitivity, in addition to providing the improvements of joint variant calling without the need of computationally intensive post-processing steps.

Objective: The COVID-19 virus has become a global threat by spreading all over the world. Countries are often unprepared for pandemics or other disasters, especially in the beginning, they experience organizational problems and the health system is adversely affected by this situation. The aim of this study is to analyze the patients who applied to the emergency department from the date of the first case in our country to the first day of the normalization process and to investigate the effects of different restraint decisions on the emergency patient characteristics.Material and Methods: This study was carried out retrospectively on patients who applied to the emergency department of Kırıkkale University Medical Faculty Hospital between 11.03.2020 and 01.06.2020. During this period, the dates of the critical restriction decisions regarding the pandemic were determined, and the patients were divided into four different periods according to the time of admission. Period-I: Between 11 March and 21 March, Period-II: Between 21 March and 3 April, Period-III: Between 3 April and 4 May, and Period-IV: Between 4 May and 1 June. Demographic data, application forms, units for which consultation was requested, diagnoses and hospitalization status of all patients were recorded. Obtained data were evaluated with SPSS 22.0 program and p, Amaç: COVID-19 virüsü tüm dünyaya yayılarak küresel bir tehdit haline gelmiştir. Ülkeler pandemi veya diğer afetler karşısında çoğu zaman hazırlıksız olup, özellikle başlangıçta organizasyon problemleri yaşamakta ve sağlık sistemi bu durumdan olumsuz etkilenmektedir. Bu çalışmanın amacı, ülkemizde ilk vakanın görüldüğü tarihten, normalleşme sürecinin başladığı ilk güne kadarki süreçte acil servise başvuran hastaları analiz ederek, alınan farklı kısıtlama kararlarının acil hasta karakteristiği üzerine etkilerini araştırmaktır. Gereç ve yöntemler:Bu çalışma 11.03.2020 ile 01.06.2020 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi acil servisine başvuran hastalar üzerinde retrospektif olarak yapıldı. Bu dönem içerisinde pandemi ile ilgili alınan kritik kısıtlama kararlarına ait tarihler belirlenerek, hastalar başvuru zamanlarına göre dört farklı döneme ayrıldı. Dönem-I: 11 Mart – 21 Mart tarihleri arası, Dönem-II: 21 Mart – 3 Nisan tarihleri arası, Dönem-III: 3 Nisan – 4 Mayıs tarihleri arası ve Dönem-IV: 4 Mayıs – 1 Haziran arası dönemleri kapsıyordu. Tüm hastaların demografik verileri, başvuru şekilleri, konsültasyon istenen birimler, tanıları ve hastaneye yatış durumları kaydedildi. Elde edilen veriler SPSS 22.0 programı ile değerlendirildi ve p

Context: Pterygium is a degenerative disease that consists of conjunctival epithelia and fibrovascular tissue. Some studies suggest that there is a defect in the regulation of apoptosis in the epithelial cell cycle characterized by the development of the disease. But, still this matter being debated. Aims: In this study, the clinical, histopathological data, and the expression of the cell cycle regulator Cyclin D1, anti-apoptotic BCL-2, tumor suppressor p53, and cell proliferation marker Ki-67 were searched in pterygium samples. Subjects and Methods: The study enrolled 62 cases of primary pterygium who underwent excision between 2014 and 2017. Recurrent and pseudo-pterygium cases were excluded from series. The clinical data were obtained from the patient files and the slides were reevaluated for the histopathological data. Slides of all were stained by Cyclin D1, BCL-2, and Ki-67 by the immunohistochemical method. For each immunohistochemical marker, first the staining was determined as negative or positive. Then if there is a staining, the hot zone (the area containing more positive cells) was determined and staining percentage (SP) was assessed by counting positive cells/100 epithelial cells). Results: Solar elastosis, edema, inflammation, and epithelial dysplasia were found statistically different between the control group and the patient group (P value

The precisionFDA Truth Challenge V2 aimed to assess the state of the art of variant calling in challenging genomic regions. Starting with FASTQs, 20 challenge participants applied their variant-calling pipelines and submitted 64 variant call sets for one or more sequencing technologies (Illumina, PacBio HiFi, and Oxford Nanopore Technologies). Submissions were evaluated following best practices for benchmarking small variants with updated Genome in a Bottle benchmark sets and genome stratifications. Challenge submissions included numerous innovative methods, with graph-based and machine learning methods scoring best for short-read and long-read datasets, respectively. With machine learning approaches, combining multiple sequencing technologies performed particularly well. Recent developments in sequencing and variant calling have enabled benchmarking variants in challenging genomic regions, paving the way for the identification of previously unknown clinically relevant variants.

A direct way to spot structural features that are universally shared among proteins is to find proper analogues from simpler condensed matter systems. In most cases, sphere-packing arguments provide a straightforward route for structural comparison, as they successfully characterize a wide array of materials such as close packed crystals, dense liquids, and structural glasses. In the current study, the feasibility of creating ensembles of artificial structures that can automatically reproduce a large number of geometrical and topological descriptors of globular proteins is investigated. Towards this aim, a simple cubic (SC) arrangement is shown to provide the best background lattice after a careful analysis of the residue packing trends from 210 proteins. It is shown that a minimalistic set of ground rules imposed on this lattice is sufficient to generate structures that can mimic real proteins. In the proposed method, 210 such structures are generated by randomly removing residues (beads) from clusters that have a SC lattice arrangement until a predetermined residue concentration is achieved. All generated structures are checked for residue connectivity such that a path exists between any two residues. Two additional sets are prepared from the initial structures via random relaxation and a reverse Monte Carlo simulated annealing (RMC-SA) algorithm, which targets the average radial distribution function (RDF) of 210 globular proteins. The initial and relaxed structures are compared to real proteins via RDF, bond orientational order parameters, and several descriptors of network topology. Based on these features, results indicate that the structures generated with 40% occupancy via the proposed method closely resemble real residue networks. The broad correspondence established this way indicates a non-superficial link between the residue networks and the defect laden cubic crystalline order. The presented approach of identifying a minimalistic set of operations performed on a target lattice such that each resulting cluster possess structural characteristics largely indistinguishable from that of a coarse-grained globular protein opens up new venues in structural characterization, native state recognition, and rational design of proteins.

Objective: Methanol poisoning has become a frequently encountered type of poisoning in our country recently. In case of poisoning, mortality and morbidity rates can be reduced by rapidly recognizing and treating the cases. The aim of this study is to investigate the relationship between survival and the demographic characteristics, physical examination findings and laboratory results of methanol poisoning patients admitted to the emergency department.Material and Methods: Patients were divided into 2 different groups as exitus after methanol poisoning and survivors after methanol poisoning. Demographic characteristics, presentation complaints, physical examination findings and laboratory results and clinical outcomes of all patients were recorded. Chi-square, Student t-test and Mann-Whitney U tests were used to compare the groups. A value of p, Amaç: Metanol zehirlenmesi ülkemizde son zamanlarda sıkça karşılaşılan bir zehirlenme türüdür. Zehirlenme durumunda vakaların hızla tanınıp tedavi altına alınması sayesinde mortalite ve morbidite oranları azaltılabilir. Bu çalışmanın amacı, acil servise başvuran metanol zehirlenmesi hastalarının demografik özellikleri, fizik muayene bulguları ve laboratuvar sonuçları ile sağ kalım arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntemler: Hastalar metanol zehirlenmesi sonrası eksitus olanlar ve hayatta kalanlar olmak üzere 2 farklı gruba ayrıldı. Tüm hastaların demografik özellikleri, başvuru şikayetleri, fizik muayene bulguları ve laboratuvar sonuçları ve klinik sonlanımları kaydedildi. Grupların karşılaştırılmasında Chi-square, Student t-test ve Mann-Whitney U testi kullanıldı. p

Graph-based genome reference representations have seen significant development, motivated by the inadequacy of the current human genome reference to represent the diverse genetic information from different human populations and its inability to maintain the same level of accuracy for non-European ancestries. While there have been many efforts to develop computationally efficient graph-based toolkits for NGS read alignment and variant calling, methods to curate genomic variants and subsequently construct genome graphs remains an understudied problem that inevitably determines the effectiveness of the overall bioinformatics pipeline. In this study, we discuss obstacles encountered during graph construction and propose methods for sample selection based on population diversity, graph augmentation with structural variants and resolution of graph reference ambiguity caused by information overload. Moreover, we present the case for iteratively augmenting tailored genome graphs for targeted populations and demonstrate this approach on the whole-genome samples of African ancestry. Our results show that population-specific graphs, as more representative alternatives to linear or generic graph references, can achieve significantly lower read mapping errors and enhanced variant calling sensitivity, in addition to providing the improvements of joint variant calling without the need of computationally intensive post-processing steps.

SummaryThe precisionFDA Truth Challenge V2 aimed to assess the state-of-the-art of variant calling in difficult-to-map regions and the Major Histocompatibility Complex (MHC). Starting with FASTQ files, 20 challenge participants applied their variant calling pipelines and submitted 64 variant callsets for one or more sequencing technologies (~35X Illumina, ~35X PacBio HiFi, and ~50X Oxford Nanopore Technologies). Submissions were evaluated following best practices for benchmarking small variants with the new GIAB benchmark sets and genome stratifications. Challenge submissions included a number of innovative methods for all three technologies, with graph-based and machine-learning methods scoring best for short-read and long-read datasets, respectively. New methods out-performed the 2016 Truth Challenge winners, and new machine-learning approaches combining multiple sequencing technologies performed particularly well. Recent developments in sequencing and variant calling have enabled benchmarking variants in challenging genomic regions, paving the way for the identification of previously unknown clinically relevant variants.

Purpose. To compare perioperative visual field (VF), balance functions (BF), and changes in the other ocular parameters in patients undergoing upper eyelid dermatochalasis (DC) surgery. Methods. One hundred and fifty-eight eyes of 79 patients who underwent DC surgery were included in the study. The VF, BF, intraocular pressure (IOP), pachymetry (PM), macular, and optic nerve measurements were recorded. Measurements were repeated at postoperative month 1. The preoperative and postoperative ocular measurements and the balance data were compared. Results. Nineteen of 79 (24.05%) patients were male and 60 of 79 (75.95%) were female, while the mean age of the patients was 58.65 ± 7.38 years. There were statistically significant differences in terms of VF and macular thickness between the preoperative and postoperative values. The improvements in mean defect, standard loss variance, and mean sensitivity values of global VF parameters in both eyes were statistically significant after surgery. Central macular thickness, mean macular thickness, and macular volume decreased significantly in all eyes after surgery (p<0.05). Conclusions. Although a marked improvement was observed in VF and peripheral vision after surgery, no significant change was found in BF parameters including primarily falling risk. The significant change in the macular parameters was only remarkable, and we think that the decrease was due to subtle vasospasm. There is a need for further comprehensive studies including especially patients older than 65 with a view to understanding the effect of DC surgery on BF.

INTRODUCTION: To evaluate the results of limbal conjunctival autograft transplantation (LCAT) in patients with primary and recurrent pterygium.METHODS: Forty-two eyes of 38 patients were included in the study. 26 of them were primary, while 16 were recurrent pterygium. Limbal conjunctival autograft transplantation was performed after the pterygium excision to all eyes. Patients having a follow-up of at least 12 months were evaluated with respect to demographic data, pterygium grade, surgical complications, recurrence rate, refractive astigmatism and visual acuity.RESULTS: The mean age of the patients was 44 ± 8.5. Twenty-six (68.4%) patients were male and 12 (31.6%) were female. No recurrence were observed in primary pterygium group, whereas two recurrences were observed in recurrent pterygium group. The overall recurrence rate was 4.7%. Buttonhole complication occurred while forming the graft in three patients. Conjunctival inclusion cyst developed in 2 patients with recurrent pterygium.DISCUSSION AND CONCLUSION: Limbal conjunctival autograft transplantation seems to be an effective and safe surgical option in both primary and recurrent pterygiums., GİRİŞ ve AMAÇ: Primer ve rekürren pterjiyumlu olgularda gerçekleştirdiğimiz limbal konjonktival otogreft transplantasyonu (LCAT) sonuçlarını değerlendirmek.YÖNTEM ve GEREÇLER: Çalışmaya 38 hastanın 42 gözü dahil edildi. Bunlardan 26’sı primer iken 16’sı rekürren pterjiyumdu. Tüm gözlere pterjiyum eksizyonu ile birlikte limbal konjonktival otogreft transplantasyonu uygulandı. En az 12 ay boyunca takip edilen hastalar, demografik veriler, pterjiyum evresi, cerrahi komplikasyonlar, nüks oranı, refraktif astigmatizma ve görme keskinliği açısından değerlendirildi.BULGULAR: Hastaların ortalama yaşı 44 ± 8.5 idi. Hastaların 26’sı (% 68.4) hasta erkek, 12'si (% 31.6) kadındı. Primer pterjium grubunda nüks görülmezken, tekrarlayan pterjium grubunda iki nüks gözlendi. Toplam nüks oranı %4.7 idi. Üç hastada greft oluşturulurken düğme iliği (buttonhole) komplikasyonu meydana geldi. Rekürren pterjiyumlu 2 hastada konjonktival inklüzyon kisti gelişti.TARTIŞMA ve SONUÇ: Hem primer hem de rekürren pterjiyum tedavisinde limbal konjonktival otogreft transplantasyonu etkili ve güvenilir bir cerrahi seçenek olarak gözükmektedir.

Ayan, Ayse/0000-0001-9488-2611; Kucuk, Mehmet Fatih/0000-0002-2548-7869; EROL, Muhammet Kazim/0000-0002-1720-8065 WOS: 000492324700003 PubMed: 31650451 Aims Determining whether nailfold capillary involvement is present in patients with Age-related macular degeneration (AMD) and whether there are different nailfold capillaroscopy findings between wet and dry types. Methods From January 2016 to December 2017, with an initial diagnosis of AMD, 53 consecutive adult patients (AMD group) and 91 age- and sex-matched healthy individuals were studied prospectively. There was no history of any other ocular disease and other disease affecting nailfold capillaries. All subjects underwent a complete ophthalmic examination. The classified and advanced stages of wet and dry types were not included. All nailfold capillaroscopy examinations were performed by the same rheumatologist. Results It was found that the frequency of major capillaroscopic findings such as capillary ectasia, micro-hemorrhage, tortuosity, neo-formation, bizarre capillary, and bushy capillaries increased in the AMD group according to the normal group, but no significant relationship was found for capillary aneurysm. In dry or wet type of AMD in terms of ectasia, micro-hemorrhage, tortuosity, neo-formation, bizarre structure, bushy structure, or aneurism of nailfold capillaries, no significant correlation was found. Conclusions Nailfold capillaroscopy can detect microvascular changes in the nailfold capillary, in early and late stages of AMD. There were morphological changes in the nailfold capillaries of AMD patients, suggesting that there are systemic superficial microvascular changes that may be due to the systemic nature of the disease.

To evaluate the effect of colour discrimination ability on the stereoscopic acuity by comparing individuals having congenital colour vision deficiency (CCVD) with healthy individuals.A comparative study.The study included 53 binocular males, of whom 26 (mean age, 36.04 ± 9.30 years) were in the healthy group and 27 (mean age, 33.04 ± 9.81 years) were in the CCVD group.The following tests were used: the Ishihara pseudo-isochromatic plate test for detecting CCVD, the Farnsworth Munsell 100 (FM100) hue test for colour discrimination ability, the TNO and Titmus stereo tests for stereoscopic acuity.In the CCVD group, 20 males were deutan and 7 males were protan. According to the FM100 hue test, total error score (TES), blue/yellow (b/y) local error score (LES), and red/green LES were significantly lower in the healthy group (30.23 ± 18.78, 15.15 ± 10.38, and 13.88 ± 11.93, respectively) than in the CCVD group (133.59 ± 67.45, 41.15 ± 22.03, and 89.15 ± 52.16, respectively) (p0.01 for each). The stereo test scores revealed significantly higher stereoscopic acuity in the healthy group (43.85 ± 33.92 arcsec for the TNO test and 40.00 ± 0.00 arcsec for the Titmus test) than in the CCVD group (93.33 ± 90.51 arcsec for TNO stereo test and 52.96 ± 24.62 arcsec for the Titmus test) (p0.05 for each). The TNO test score was significantly and positively correlated with the TES (r = 0.390, p = 0.049) and b/y LES (r = 0.490, p = 0.011) in the healthy group.Colour discrimination ability affected stereoscopic acuity. Moreover, stereoscopic acuity increased with increasing colour discrimination ability, which could be originated from the b/y colour region.

A 33-year-old male presented to our clinic with low vision in both eyes that started during the previous week. Visual acuity was 20/63 in the right eye and 20/50 in the left eye. Fundus examination revealed signs of hypertensive retinopathy; thus, a multidisciplinary approach was adopted for the diagnosis and treatment of this patient. We consulted the nephrology and cardiology departments on this case. Upon diagnosing malignant hypertension and renal failure, the patient was put on hemodialysis. His visual acuity was 20/20 at 6 months, whereas foveal assessment on optical coherence tomography angiography revealed neither marked superficial and deep capillary density loss and foveal avascular zone enlargement nor a decrease in disc flow and radial peripapillary capillary density. Early diagnosis and treatment of malignant hypertension are critical in preventing progression of end-organ damage including the eyes. Optical coherence tomography angiography may be useful in cases when fundus fluorescein angiography is relatively contraindicated (e.g., renal failure).

Objective Silent sinus syndrome (SSS) is a clinical syndrome that occurs as a result of chronic maxillary sinus atelectasis (CMA) and is seen with progressive enophthalmos and hypoglobus. The aim of this study was to investigate the correlation between radiological findings and clinical findings in patients with radiologically asymmetrical reduced maxillary sinus volume. Material and method A comparison was made of patients with CMA through evaluation of paranasal sinus computed tomography, magnetic resonance imaging examination of maxillary sinus volume of the CMA side and the contralateral side, thickness of the retroantral fat tissue, infraorbital bone curve, uncinate process lateralisation measurement, middle concha diameter, and calculation of the change in location of the inferior rectus muscle. Results The study included 16 patients. Although a statistically significant difference was determined between the healthy and the pathological sides in respect to maxillary sinus volume, thickness of the retroantral fat tissue, infraorbital bone curve, uncinate process lateralisation measurement, and middle concha diameter (p = 0.00, p = 0.002, p = 0.020, p = 0.020, p = 0.007), no significant difference was determined in respect to the change in location of the inferior rectus muscle (p = 0.154). A positive correlation was determined between the increase in sulcus depth and maxillary sinus volume and inferior orbital bone curve (p Conclusion In CMA patients suspected of having SSS, radiological maxillary sinus volume analysis, determination of retroantral fat thickness, measurement of the infraorbital bone curve, and measurement of the uncinate process lateralisation can be used as objective tests. However, it should be kept in mind that radiological findings may not always be compatible with the ophthalmological examination findings.

PurposeJuvenile myoclonic epilepsy (JME) is commonly associated with photoparoxysmal response (PPR) with a reported prevalence of 25–42%. In this study, we aim to explore the relationship between the PPR and Optical Coherence Tomography (OCT) parameters in order to determine whether optic nerve fiber layer or other structural differences have a pathophysiological role of photosensitivity in patients with JME.MethodsWe studied 53 consecutive patients with Juvenile myoclonic epilepsy (JME) at our outpatient department. The interictal electroencephalogram (EEG) findings for each patient were analyzed for the presence of photoparoxysmal features. The peripapillary Retina Nerve Fiber Layer (RNFL) thickness, ganglion cell thickness, macular thickness and choroid thickness levels were analyzed using OCT.ResultsWe classified the patients into two groups as those with PPR (Group 1) and those without PPR (Group 2). There were statistically significant differences in the average RNFL thickness values of the left eye between the two groups (p

Aim:The aim of this study was toinvestigate the effect of carbon monoxide(CO) poisoning on temperament andassociated disorders.Materialand Methods: The study was conducted inhealthy volunteers and patientswho presented to the Emergency Department of Kirikkale University Hospital after exposure to CO. Patients with a carboxyhemoglobinlevel of ≥10% were consideredto have CO poisoning. Patients withpsychiatric disease or an illness that could increase CO levels andthose who smoked orwere using medication wereexcluded. Healthy volunteers were evaluated once, and CO poisoning patients wereevaluated at the time of presentationand 3 months after discharge using the Temperament Evaluation of Memphis, Pisa,Paris, and San DiegoAutoquestionnaire (TEMPS-A) temperament scale. Repeated analysis ofvariance was appliedfor comparisons. A pvalue of, Amaç: Buçalışma karbonmonoksit zehirlenmesinin mizaç ve ilişkili olduğu bozukluklarüzerindeki etkisini araştırmak amacıyla yapılmıştır.Gereçve Yöntemler: Çalışma Kırıkkale Üniversitesi hastanesiacil servisine karbonmonoksit (CO) maruziyeti sebebiyle başvuran hastalar vesağlıklı gönüllü (SG) katılımcılarla yapıldı. Karboksihemoglobin düzeyi ≥%10ölçülen hastalar KZ olarak kabul edildi. Psikiyatrik hastalığı veya ilaçkullanımı olanlar ve CO düzeyini yükseltecek hastalığı veya sigara içiciliğiolanlar çalışmaya dahil edilmedi. SG bir kere, KZ olanlar ise acil servise ilk başvuruanında taburcu edilirken ve taburcu olduktan üç ay sonra TEMPS-A (TemperamentEvaluation of Memphis, Pisa, Paris and San Diego-Autoquestionaire)mizaç ölçeği ile değerlendirildi. Grupların karşılaştırılmasındaRepeated measures ANOVA testi kullanıldı ve p

Background/aim: Many autoimmune diseases occur concomitantly with celiac disease (CD). We aimed to determine the frequency of Sjögren's syndrome (SS) in CD patients based on SS-specific serology verified by minor labial salivary biopsy. Materials and methods: Eight-two patients with CD were included in the study. After examination for objective evidence of sicca complex, all patients were tested for serological presence of rheumatoid factor (RF) and antinuclear antibodies (ANAs) and for ANA profile. Minor labial salivary biopsy was performed for patients with positive serology and/or clinical signs of SS. Results: Of the patients included, 24 (29.3%) had dry eye symptoms while 20 (24.4%) had dry mouth symptoms. Dry eye was detected by Schirmer test in 10 patients (12.2%) and by ocular staining score in only 2 patients (2.4%). All samples were negative for RF while 12 (14.6%) samples were positive for ANAs. Of 82 patients with CD, the diagnosis of SS was established in only one patient (1.2%), while one patient (1.2%) was diagnosed with morphea and 4 patients (4.9%) were classified as having undifferentiated connective tissue disease. Conclusion: The prevalence of SS in CD is low, so there is no need for serologic screening of all patients with CD for SS.

BACKGROUND Pulmonary thromboembolism (PE) is a major disease in respiratory emergencies. Thoracic CT angiography (CTA) is an important method of visualizing PE. Because of the high radiation and contrast exposure, the method should be performed selectively in patients in whom PE is suspected. OBJECTIVES The aim of the study was to identify the role of clinical scoring systems utilizing CTA results to diagnose PE. MATERIAL AND METHODS The study investigated 196 patients referred to the hospital emergency service in whom PE was suspected and CTA performed. They were evaluated by empirical, Wells, Geneva and Miniati assessments and classified as low, intermediate and high clinical probability. They were also classified according to serum D-dimer levels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated and evaluated according to CTA findings. RESULTS Empirical scoring was found to have the highest sensitivity, while the Wells system had the highest specificity. When low D-dimer levels and "low probabilty" were evaluated together for each scoring system, the sensitivity was found to be 100% for all methods. Wells scoring with a cut-off score of 4 had the highest specificity (56.1%). CONCLUSIONS Clinical scoring systems may be guides for patients in whom PE is suspected in the emergency department. The empirical and Wells scoring systems are effective methods for patient selection. Adding evaluation of D-dimer serum levels to the clinical scores could identify patients in whom CTA should be performed. Since CTA can only be used conservatively, the use of clinical scoring systems in conjunction with D-dimer levels can be a useful guide for patient selection.

Objective To determine the frequency of sicca complex, Sjogren's Syndrome (SS) and Fibromyalgia (FM) in patients with Irritable Bowel Syndrome (IBS). Methods Seventy seven IBS patients who fulfilled the Rome-III criteria were included in the study. All patients were assessed for FM according to the American College of Rheumatology (ACR) 2010 criteria. After examination for objective evidence of sicca complex by Schirmer test, TBUT and Ocular Staining Score (OSS), serological tests were performed. And the diagnosis of SS was made according to the American College of Rheumatology (ACR) classification criteria for SS - 2012. Results Thirteen (16.9%) of IBS patients had FM. Dry eye was detected in 20(26.0%), 7(9.1%) and 29(37.7%) patients by OSS, Schirmer test and TBUT, respectively. Of 77 patients with IBS, the diagnosis of SS was established in two patients (2.6%). Conclusion The frequency of Sjogren's Syndrome among patients with IBS is relatively higher than the general population. All IBS patients should be questioned for dryness of the mouth and eyes, and if necessary, should be evaluated for SS.

Introduction: Sinceancient times, it is believed that weather conditions have an impact on humanbehavior. The studies obtained different results because, this effect is amatter of debate retains the current popularity. Glass punching is a sudden,impulsive self-destructive behavior. In addition to weather conditions, it canbe related to many underlying causes. This study was carried out to investigatethe demographic features and related to weather conditions of patients whoapplied to the emergency department due to glass punching.Material andMethods: Our work was performed between 01 January 2013 and 31 December2014. Patients who applied to emergency service due to glass punching wereretrospectively investigated. Weatherdata are taken from the Turkish State Meteorological Service. Results: Sixty-ninepatients were included in the study. Patients in the study group; 82.6 % (n=57)were male, 81.2% (n=56) were single, 27.5% (n=19) university students, 15.9%(n= 11) were unemployed, 73.9 % (n=51)the injury was dominant hand, 37.7% (n=26) of the blood alcohol test waspositive, 14.5% (n=10) had a previously diagnosed psychiatric disorder.Conclusion: Punchingglass related to many reasons. The development of this action can not beexplained only by changes in weather conditions. However, it can be said thatsome patients are affected by changes in weather conditions, especiallyvariables such as air temperature or pressure., Giriş: Eskiçağlardan beri hava koşullarının insan davranışları üzerinde etkisi olduğunainanılmaktadır. Yapılan çalışmalarda elde edilen farklı sonuçlardan dolayı, bu etkihalen popülerliğini koruyan bir tartışma konusudur. Cama yumruk atma eylemi,ani gelişen, dürtüsel bir kendine zarar verme davranışıdır; hava koşullarınınyanında altta yatan birçok sebeple ilişkilendirilebilir. Bu çalışma cama yumrukatma sebebiyle acil servise başvuran hastaların demografik özelliklerini vehava koşullarından etkilenip etkilenmediğini araştırmak amacıyla yapılmıştır.Gereç- Yöntem:Çalışmamız 01.Ocak.2013 ile 31.Aralık.2014 tarihleri arasında “Cama yumrukatma” eylemi sonucu acil servise başvuran hastalar üzerinde retrospektif olarakyapılmıştır. Hava koşullarına ait veriler Meteoroloji Genel Müdürlüğündenalınmıştır.Bulgular: Çalışmaya69 hasta dahil edildi. Çalışma grubunun % 82.6’sı (n=57) erkek, % 81.2’si(n=56) bekar, % 27.5’si (n=19) üniversite öğrencisi, % 15.9’u (n=11) işsiz,%73.9’unda (n=51) yaralanma dominant elde, %37.7’sinin (n=26) kan alkol testi pozitif,%14.5’inde (n=10) ise önceden tanısı konmuş psikiyatrik hastalık mevcut idi. Camayumruk atma sebebiyle başvuran hastaların olay günü veya olaydan bir gün öncekihava koşullarından etkilenmediği; ancak etiyolojik faktörlerin bir kısmınınhava koşulları ile ilişkisi olduğu tespit edildi.Sonuç: Camayumruk atma eylemi pek çok sebeple ilişkilidir. Bu eylemin gelişimi, yalnızca havakoşullarındaki değişikliklerle açıklanamaz. Ancak bazı olguların havakoşullarındaki değişikliklerden etkilendiği, özellikle hava sıcaklığı veyabasınç gibi değişkenlerin bu eylemi tetiklediği söylenebilir.

Objectives: This study aims to evaluate the alterations of retinal layers in rheumatic patients treated with hydroxychloroquine but without the signs or symptoms of retinopathy by using spectral domain ocular coherence tomography (SD-OCT). Patients and methods: The retinal layers of a total of 402 eyes including 114 patients treated with hydroxychloroquine (for rheumatoid arthritis (n=40), Sjogren’s syndrome (n=47) and connective tissue diseases (n=27) and age-matched 87 healthy controls were evaluated with SD-OCT. The macular cube protocol, optic disc cube protocol and horizontal and vertical HD 5-line raster scan protocol were applied. The measured parameters were compared between hydroxychloroquine users and healthy control group. The results of these parameters were also compared with other disease groups using hydroxychloroquine. The correlation of these parameters with the duration of drug consumption and dose was assessed. Results: All layers of outer fovea, superior and inferior quadrants of retinal nerve fiber layers of hydroxychloroquine users were thinner than nonusers. Connective tissue disease group had longer duration and higher cumulative dose of hydroxychloroquine than other diagnostic groups. This group had thinner mean retinal nerve fiber layers values than the other groups as well. There were significant and negative correlations between cumulative dose of drug and parafoveal region thickness of outer fovea and inferior quadrant of retinal nerve fiber layers. Thickness of parafoveal and perifoveal layers was negatively correlated with the dose of drug per kg of body weight. Conclusion: Our study results show that SD-OCT may be the golden standard technique for the follow-up of antimalarial-induced retinotoxicity in

Choroidal osteoma is an extremely rare osseous tumor of the choroid where choroidal neovascularization (CNV) is the major cause of visual loss. We report the case of a 28-year-old female with CNV secondary to choroidal osteoma, who developed RPE tear after intravitreal ranibizumab treatment.

To report a retrospective series of choroidal neovascularization (CNV) patients treated with intravitreal ranibizumab with good baseline vision from causes other than age-related macular degeneration (AMD).We retrospectively reviewed 12 eyes of 12 patients with CNV secondary to non-AMD who received intravitreal ranibizumab injections. Patients with baseline best-corrected visual acuity (BCVA) above 20/63 were included in the study. All patients were followed up at least for 12 months. BCVA measurement, fundus examination, and OCT examination of the patients were performed at each visit. Optical coherence tomography (OCT), fundus photo, fundus autofluorescence, and fundus fluorescein angiography examination of the eyes were obtained. Primary outcome measures were the changing in BCVA and central foveal thickness (CFT). Any ocular or systemic side-effects were recorded.The ages of patients ranged from 17 to 60. Twelve patients were diagnosed with non-AMD associated CNV: myopia (n = 3), central serous chorioretinopathy (n = 3), idiopathic (n = 2), multifocal choroiditis (n = 2), punctate inner choroidopathy (n = 1), and photo toxicity (n = 1). The improvement in visual acuity was statistically significant (p = 0.001). In the 12-month visit, all eyes had improvement in visual acuity except two eyes. The reduction of the mean CFT was statistically significant (p = 0.001). The CFT of all patients decreased in the 12-month visit. There was no significant difference in comparison of the mean intraocular pressure (p = 0.790). The group received a total of 52 intravitreal injections. The mean number of intravitreal injections was 4.3 (ranged from 3-8).Ranibizumab seems to be an effective and safe treatment option for CNVs secondary to non-AMD causes in patients with relatively good baseline BCVAs.

Pur po se: To evaluate the findings of fundus autofluorescence (FAF) imaging in acute and chronic central serous chorioretinopathy (CSC) patients. Ma te ri al and Met hod: A total of 40 eyes of 36 patients (8 females, 28 males) were analyzed retrospectively. The patients were divided into two groups as acute CSC when the complaints lasted less than six months and as chronic CSC for complaints of more than six months’ duration. Complete ophthalmologic examination was performed. Retinal thickness, pigment epithelium detachment (PED), and subretinal deposits were analyzed using OCT. Leakage points and serous retinal detachment were classified as hypoautofluorescence or hyperautofluorescence on FAF imaging. Re sults: The number of eyes with acute CSC was 21 (52.5%), and the number of eyes with chronic CSC was 19 (47.5%). The average retinal thickness was 422.14±99.6 microns in acute CSC eyes and 383.6±104.1 microns in chronic CSC eyes (p=0.240). We detected PED in 11 eyes and subretinal deposits in 21 eyes. The leakage points of all eyes showed hyperfluorescence in FFA. On FAF imaging, 33 leakage points demonstrated hypoautofluorescence and 7 leakage points showed hyperautofluorescence. The areas of serous retinal detachment were observed as hypoautofluorescence in 22 eyes and as hyperautofluorescence in 18 eyes. Dis cus si on: Subretinal deposits are detected mostly in chronic CSC and are observed as hyperautofluorescence on FAF imaging. (Turk J Ophthalmol 2013; 43: 94-8)

To examine peripheral electroneuromyographic findings in patients with ocular pseudoexfoliation syndrome (PEX) and to compare them controls without PEX. A case–control study design was used to examine 31 patients with PEX and compare the findings with those of 31 age- and sex-matched healthy controls. All patients underwent complete ophthalmologic examination that included peripheral electroneuromyography examination. Motor and sensorial nerve conduction of the median, ulnar, tibial, peroneal, and sural nerve and the sympathetic skin response were measured. The average sensorial nerve latency of the ulnar and sural nerve was significantly longer in the PEX group compared to the control group (p

Aim. To asses both choroidal thickness differences among Alzheimer’s type dementia (ATD) patients, mild cognitive impairment (MCI) patients, and healthy control (C) subjects and choroidal thickness relationships with cognitive performance.Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects) were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT) were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT). Detailed neurological examination including mini mental state examination (MMSE) test which evaluates the cognitive function was applied to all participants.Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p<0.05). The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were19.3±1.8,24.8±0.9, and27.6±1.2in ATD, MCI, and healthy controls, respectively (p<0.001). There were also significant correlation between MMSE score and choroidal thickness at each location (p<0.05).Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients.

Purpose: To assess cognitive performance differences among primary open-angle glaucoma (POAG) patients, normal-tension glaucoma (NTG) patients, and healthy control (C) subjects. Methods: A total of 60 participants (20 POAG, 20 NTG, and 20 C subjects) were included in this study. A detailed ophthalmologic examination was performed on all participants. A spectral domain-optical coherence tomography (SD-OCT) system was used to measure the ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) thicknesses. To assess the cognitive performance of all participants, detailed neurological examinations, including the mini-mental state examination (MMSE), were performed by the same neurologist. Results: There were no significant differences among the groups in terms of age (p =0.348) or gender (p =0.935). The mean RNFL thicknesses were significantly different among the groups (85.2 ± 14.7, 76.8 ± 10.3, and 91.4 ± 7.7 µm in the POAG, NTG, and C subjects, respectively; p

Background/aim Many autoimmune diseases occur concomitantly with celiac disease (CD). We aimed to determine the frequency of Sjogren's syndrome (SS) in CD patients based on SS-specific serology verified by minor labial salivary biopsy. Materials and methods Eight-two patients with CD were included in the study. After examination for objective evidence of sicca complex, all patients were tested for serological presence of rheumatoid factor (RF) and antinuclear antibodies (ANAs) and for ANA profile. Minor labial salivary biopsy was performed for patients with positive serology and/or clinical signs of SS. Results Of the patients included, 24 (29.3%) had dry eye symptoms while 20 (24.4%) had dry mouth symptoms. Dry eye was detected by Schirmer test in 10 patients (12.2%) and by ocular staining score in only 2 patients (2.4%). All samples were negative for RF while 12 (14.6%) samples were positive for ANAs. Of 82 patients with CD, the diagnosis of SS was established in only one patient (1.2%), while one patient (1.2%) was diagnosed with morphea and 4 patients (4.9%) were classified as having undifferentiated connective tissue disease. Conclusion The prevalence of SS in CD is low, so there is no need for serologic screening of all patients with CD for SS.

We would like to thank Ilhan et al. [1] for their comments regarding our article. In our study, we found out that choroidal thickness (CT) decreased in the eyes of patients with both Alzheimer's type dementia (ATD) and mild cognitive impairment (MCI) compared to the healthy control group. Therefore, we suggested that CT value could be used as a new biomarker in early diagnosis of ATD and MCI patients and follow-up of their progression [2].

Purpose: The author report the result of three consecutive monthly intravitreal ranibizumab injection for choroidal neovascularization (CNV) after bevacizumab injection for chronic central serous rethinopathy (CSR). Methods: A 48 year old man with chronic CSR was treated with intravitreal single dose 2.5 mg bevacizumab. One year after CNV was occurred, and three consecutive monthly intravitreal ranibizumab injections were performed. Results: Four weeks later the first ranibizumab dose, best corrected visual acuity was improved 20/80 to 20/20 and remained stable within one year. Conclusion: Repeat intravitreal ranibizumab injection in CNV after bevacizumab injection for chronic CSR appeared to be an effective treatment option.