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Background: Flare Assessment in Rheumatoid Arthritis (FLARE-RA) is a patient-reported outcome measure (PROM) to evaluate the flare-related symptoms of individuals with Rheumatoid Arthritis (RA) in the last three months. Objective: The present study aimed to demonstrate the translation, cultural adaptation and psychometric properties of the Turkish version of the FLARE-RA. Methods: A cross-sectional psychometric analysis study was conducted with a total of 80 patients (61 Women, 19 Men; 49.6 ± 15.4 years). Patients filled-out the Global Health Assessment (GHA), Visual Analog Scale (VAS), Disease Activity Score-28 (DAS-28), Rheumatoid Arthritis Quality-of-Life Questionnaire (RAQoL), Health Assessment Questionnaire (HAQ) in addition to the Turkish FLARE-RA. In addition, participants’ Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) were recorded. Thirty patients refilled the FLARE-RA again, one-week later. Results: In the cross-cultural adaptation, translation procedures and pilot study, each item of the Turkish version of the FLARE-RA was found to be comprehensible. The ICC (two-way random-effect, single-measure model) and alpha values of the Turkish FLARE-RA were 0.97 and 0.96, respectively. The MDC95 values calculated for the FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms scores were 2.01, 1.60, and 1.18, respectively. FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms scores were highly correlated with VAS-rest, VAS-activity, DAS-28, RAQoL, and HAQ scores (r > 0.50). On the other hand, scores of FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms were moderately correlated with the GHA-patient subscale, GHA-clinician subscale, ESR, and duration of morning stiffness (0.35 < r < 0.50). Conclusion: The present study results demonstrated the reliability and validity of the Turkish FLARE-RA. FLARE-RA is a practical tool to assess the flare of RA patients.

Background: Gestational diabetes mellitus (GDM) is one of the prediabetes conditions in which high blood sugar levels and body weight increase during pregnancy. The underlying molecular and biochemical mechanisms of GDM are poorly defined. Introduction: Aromatase enzyme activity is responsible for the conversion of androgens to estrogens and has a share in the regulation of body fat distribution and liver receptor homolog-1 (LRH-1), which plays a critical role in cholesterol transport, acid homeostasis, and steroidogenesis in GDM patients. This study aims to determine the levels of aromatase enzyme and LRH-1 in GDM patients and to investigate the relationship between the levels of aromatase enzyme and LRH-1 and the levels of insulin, HbA 1c and total cholesterol. Method: This prospective cross-sectional study was conducted over eleven months (September 2020 to July 2021). The study population was selected at Harran University Teaching and Research Hospital. The study included 32 GDM patients and 32 healthy pregnants. The automated assay measured serum fasting blood glucose, HbA1c, and insulin levels (AVIDA 1800 Chemistry System; Siemens). Aromatase enzyme activity and LRH-1 levels were determined by using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Result: Aromatase activity decreased in GDM patients while LRH1 increased. Significant differences in means levels of fasting blood glucose (p=0.11), insulin (p= 0.001) and HbA1c (p= 0.001) between the patients and control groups. There was a significant negative correlation between the levels of aromatase and insulin (r=-370, p =0.037). In addition, a positive significant correlation coefficient (r=0.645, p=0.001) was found between HbA1c and total cholesterol among the patients' group. Conclusion: Our findings indicate that there is a negative relationship between aromatase activity and insulin levels. Aromatase and LRH 1 may play a role in the pathogenesis of GDM, and the use of LRH-1 agonists in treating the disease may be considered an alternative treatment in the future. However, additional studies are required to reveal the possible functions of these two proteins in GDM with their mechanisms.

Objectives In the current study, we synergistically evaluated vascular endothelial growth factor (VEGF) gene expression levels and signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1) gene expression levels in diabetic patients without retinopathy, non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). Methods 94 blood samples from 26 healthy controls, 29 non-DR, 22 NPDR, and 17 PDR patients were collected in sterile EDTA tubes. Total RNA was obtained from these samples without waiting and then converted to cDNA. The expression levels of the VEGF and SCUBE1 genes were determined by quantitative real-time polymerase chain reaction (qPCR). Results SCUBE1 gene expression levels were 2.15 (p=0.015), 1.75 (p=0.799), 2.37 (p=0.037) times higher, and VEGF gene expression levels were 1.71 (p=0.023), 1.75 (p=0.012), 1.85 (p=0.031) times higher in the non-DR, NPDR, and PDR groups compared to the control group, respectively. VEGF gene expression levels were significantly higher in participants with HbA1c levels ≥5.7% compared to those with Conclusions As a result, SCUBE1 gene expression levels are higher than VEGF gene expression levels, especially in the PDR group. Therefore, SCUBE1 may contribute to the pathology of DR just like VEGF by generating angiogenesis. However, we believe there is a need for experimental animal model studies with DR examining SCUBE1 gene expression levels in tissue samples.

Pompe disease is a rare metabolic disorder that is characterized by the deficiency of the acid aglucosidase. As a result, glycogen accumulates in several tissues including motor neurons, skeletal, cardiac, and smooth muscles. The course of the disease varies according to the type of mutations, and the clinical phenotype can be affected by the enzyme levels. Late-onset Pompe disease (LOPD) is a challenging issue for clinicians as it has a milder phenotype with later onset of symptoms and slower disease progression. One of the most important differentials in the diagnosis of LOPD is inflammatory myositis as both diseases have some common clinical and laboratory features. Herein, we presented a 30-year-old female patient initially diagnosed as polymyositis and treated with immunosuppressive therapy without a benefit on her symptoms and later diagnosed as LOPD.

Objective: TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018. Methods: The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treatments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens. Results: TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a conventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31. Conclusion: TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey

Amaç: Akciğer kanseri dünya genelinde kansere bağlı ölümlerin önde gelen nedenidir. Tanısal cihazlar ve teknolojik gelişmelere bağlı tedavi seçeneklerinde ilerlemeye rağmen, akciğer kanseri hastalarında genel mortalite oranı hala yüksektir. Akciğer kanseri hastalarında sağkalım oranları, özellikle ilerlemiş inoperabl hastalıkta, immunoterapi gibi yeni tedavi seçeneklerine rağmen düşüktür. p53, kanser hastalarının %60-70'inde mutasyona uğramaktadır ve bu nedenle son zamanlarda yapılan çalışmalar göstermektedir ki, serum anti-p53 antikorunun, over, özefagus, meme ve akciğer kanseri gibi bazı kanser türlerinin dedekte edilmesinde biyobelirteç olarak dikkate alınabilir. Bu çalışmada, akciğer kanseri hastalarında, serum anti-p53antikor düzeylerinin tanısal ve prognostik önemini araştırmayı amaçladık. Yöntem: Çalışmaya akciğer kanseri (AK) tanısı nedeniyle evreleme için 18F-FDG-PET / BT görüntüleme amacı ile bölümümüze sevk edilen hastalar, toraks BT'sinde şüpheli pulmoner nodül olup, patolojik FDG birikimi göstermeyen hastalar (NAPN= Non-avid FDG gösteren pulmoner nodül) ve sağlıklı gönüllüler dahil edildi. Serum anti-p53antikor düzeyleri tüm hastalarda ELISA yöntemi ile ölçüldü. Hastaların ortalama takip süresi 13 ay idi. Bulgular: Çalışmaya toplam 65 AK hastası (58E/7K), 47 NAPN hastası (20E/27K) ve 34 sağlıklı gönüllü (26E /8K) dahil edildi. Ortalama serum anti-p53antikor seviyeleri AK hastalarında 3.4ng/mL, NAPN hastalarında 3.77ng /mL, sağlıklı gönüllülerde 3.07 ng/ mL idi. AK hastaları ile NAPN hastaları arasında serum anti-p53antikor düzeyi için istatistiksel olarak anlamlı fark yoktu (p = 0.678). Hatta, hastalar ve sağlıklı gönüllüler arasında serum anti-p53Ab düzeyi için istatistiksel olarak anlamlı fark yoktu (p = 0.377). Hastaların iki yıllık medyan sağkalımı 14 aydı. Hastaların sağkalım hızında, serum anti-p53Ab düzeyinin > 3.4 ng/ mL veya, Objective: Lung cancer is the leading cause of cancer-related deaths worldwide. Despite advancement in diagnostic tools and treatment options with technological developments, overall mortality rates in lung cancer patients remains high. Survival rates in lung cancer patients is low especially in advanced diseased inoperable patients in spite of new treatment options like immunotherapy. p53 is mutated in 60-70% of cancer patients and for this reason has been extensively studied recent researches suggest that serum anti-p53Ab can be considered as biomarkers to detect many types of cancers; as ovarian cancer, esophageal cancer, breast cancer and lung cancer. In this study we aimed that are there any diagnostic and prognostic importance of serum anti-p53Ab levels in lung cancer patients. Method: Patients were included who were referred to our department with the purpose of 18F-FDG-PET/CT imaging for staging due to lung cancer diagnosis (LC) and patients who were performed 18F-FDG-PET/CT for diagnosis in the cause of the suspected pulmonary nodule in thorax CT but not detected pathologic FDG accumulation (NAPN=pulmonary nodule with non-avid-FDG) and healthy volunteers. Serum anti-p53Ab levels were measured with ELISA method in the all patients. Mean follow up time of patients were 13 months. Results: A total of 65 LC patients (58M/7F), 47 patients with NAPN (20M/27F), and a total of 34 healthy volunteers (26M/8F) were included in this study. Median serum anti-p53Ab levels are 3.4ng/mL in LC patients, 3.77ng/mL in NAPN patients, 3.07ng/mL in healthy volunteers. There is no statistically significant difference for serum anti-p53Ab level between LC patients and NAPN patients (p=0.678). Moreover there is no statistically significant difference for serum anti-p53Ab level between patients and healthy volunteers (p=0.377). Two-year median survival of patients was 14 month. It has been found that there is no effect of serum anti-p53Ab level whether >3.4 or

This study was performed to assess the incidence of infectious complications in patients undergoing autologous and allogeneic hematopoietic stem cell transplantation (HSCT). The characteristics of microbiologically documented infections in 114 consecutive patients undergoing HSCT (84 autologous, 30 allogeneic) were analyzed. Conditioning and the pre-engraftment period until one month was defined as the early period; the post-engraftment period until one year was defined as the late period. All patients received antibiotic prophylaxis and hematopoietic growth factors during neutropenia. Febrile patients received imipenem-cilastatin or cefepime plus amikacin or ceftazidime plus amikacin. A total of 117 episodes with microbiologically documented infections were seen 90 of 114 patients and 79% of the patients experienced at least one febrile episode during their post-transplant course. Of these episodes, 69 (59%) were in the early period and 48 (41%) were in the late period. In the early period, 38.8% of causative organisms were gram-positive, 51.5% were gramnegative and 7.7% were fungi. The most common pathogens were coagulase-negative Staphylococcus (CoNS) and E. coli in the early period. In the late period, 44.6% of causative organisms were gram-positive, 44.6% were gram-negative and 6.8% were fungi. CoNS and E. coli were also the most commonly isolated agents in this period. Resistance to methicillin was detected in 47.4% of S. aureus and 86.5% of CoNS isolates. The isolation rate was in accordance with previous reports; similar percentages of gram-positive and gram-negative isolates were found in patients undergoing HSCT in both periods. However, a remarkably low rate of viridans streptococci and fungi were observed. The spectrum of pathogens detected in these cases serves as the basis for recommendations on the choice of empiric antimicrobial treatment regimens. Therefore, studies reporting local microbiological findings are necessary. We suggest that local microbiologic surveillance should be known before empiric antimicrobial therapy is started in each institution.Bu çalışma otolog ve allogeneik kök hücre nakli yapılan hastalarda infeksiyöz komplikasyonları değerlendirmek için yapılmıştır. Kök hücre nakli yapılan 1/4 hasta (84 otolog, 30 allogeneik) incelendi. Hazırlama ve birinci ayı içine alan pre-engrafman dönemi erken dönem, birinci yıla kadar engrafman sonrası dönem ise geç dönem olarak tanımlandı. Tüm hastalar nötropenik dönemde antibiyotik profilaksisi ve büyüme faktörü aldılar. Ateşli hastalar imipenem-silastatin veya sefepim + amikasin yada seftazidim + amikasin aldılar. Yüzondört olgunun 90`ında 117 mikrobiyolojik tanımlanmış infeksiyon atağı izlendi. Nakil sonrası dönemde hastaların %79`u en az bir febril epizod gösterdi. Bunların 69 (%59)`u erken, 48 (%41)`i geç dönemde idi. Erken dönemde etken mikroorganizmaların %38.8`i gram-pozitif %51.5`i gram-negatif ve %7.7`si mantar idi. Erken dönemde en sık rastlanan patojenler koagülaz-negatif stafilokok (KNS) ve E. coli idi. Geç dönemde ise etken mikroorganizmaların %44.6`sı gram-pozitif, %44.6`sı gram-negatif ve %6.8`i mantardı. Bu dönemde de KNS ve E. coli en sık rastlanan mikroorganizmalardı. S. aureus`ta %47.4, KNS de ise %86.5 metisilin direnci saptandı. Mikroorganizma izolasyon oranları daha önce bildirilenlerle benzerdir. Ancak viridans streptokok ve mantarlar nispeten düşük bulunmuştur. Bu olgulardaki etken spektrumun bilinmesi ampirik tedavi rejimlerinde antibiyotik seçiminde yol gösterici olmaktadır. Bu nedenle lokal sonuçların bildirimi önemlidir ve her kurumda ampirik antibiyotik başlamadan önce lokal mikrobiyolojik sürveyans sonuçlarının bilinmesi yararlı olur.

Scedosporium apiospermum is an emerging opportunistic pathogen that may lead to life-threatening infections especially in immunosuppressive individuals. In this report, S.apiospermum infection in a 62 year old male patient with acute myeloid leukemia was presented. During remission-induction chemotherapy, piperacillin-tazobactam therapy was started for febrile neutropenia. Since fever had continued, treatment was switched to imipenem and also amphotericin B deoxycholate was added to the treatment protocol. Because of allergic reaction to amphotericin B, caspofungin was started at the fifth day of neutropenic fever. Following imaging studies with high resolution computerized thorasic tomography, antifungal therapy was changed to voriconazole due to findings suggestive of invasive aspergillosis. Since galactomannan antigen was found negative at the first day of voriconazole therapy, bronchoalveolar lavage material from apical segment of the left lower lobe was cultured onto various microbiologic media. S.apiospermum (Teleomorph: Pseudallescheria apiosperma) was isolated on the fourth day of cultivation. According to CLSI M38-A2 microdilution procedure, minimum inhibitory concentrations (MIC) of voriconazole, caspofungin, amphotericin B and posaconazole were found as 0.06, 2, 8 and 4 µg/ml, respectively. Since neutropenia was resolved, the patient was discharged with continued voriconazole therapy. It was concluded that antifungal susceptibility tests should be performed for Scedosporium species and the results should be compared to the clinical response. The determination of MIC breakpoints may provide useful information for the recommendation and use of optimal choices for the treatment of Scedosporium infections.

Amaç: Osteoporoz ankilozan spondilit (AS) hastalarında sıklıkla rastlanan bir komplikasyondur. AS hastalarında osteoporoz tanısında kemik mineral yoğunluk (KMY) ölçüm endikasyonlarını içeren bir kılavuz henüz bulunmamaktadır. Bu çalışmanın amacı AS'li hastalarda Bath indeksleri ile KMY arasındaki ilişkiyi araştırmaktır. Yöntem ve Gereçler: AS tanılı 45 erkek hasta (ortalama yaş: 46.96±13.58 yıl) ile 41 sağlıklı erkek kontrol (ortalama yaş: 48.93±6.86 yıl) çalışmaya alındı. AS hastaları Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI) ile değerlendirildi. Hasta ve kontrol grubunda kemik mineral yoğunluk ölçümleri (KMY), kalça (femur boyun, femur ward üçgeni, femur trokanter) ve lomber total bölgesinden yapıldı. Bulgular: AS ve kontrol grubu arasında, lomber bölge ve femur ward KMY ve T skorunda AS grubu lehine anlamlı fark saptandı (p0.05). Sonuç: AS hastalarında kemik kaybını saptamada femur ward bölgesinin daha uygun olabileceği bulunmuştur. BASMI skorunun, AS hastalarında KMY ölçümleri için yararlı bir yöntem olabileceği sonucuna varılmıştır., Objective: Osteoporosis is a common complication of patients with ankylosing spondylitis (AS). There is no avaible data for the indications of bone mineral density (BMD) measurement related to osteoporosis diagnosis at AS patients. The aim of this study is to investigate the relationship between Bath indexes and BMD in patients with AS. Materials and Methods: 45 male AS patients (mean age: 46.96±13.58 years) and 41 healthy male controls (mean age: 48.93±6.86 years) were enrolled in the study. Patients with AS were evaluated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Spondylitis Metrology Index (BASMI) and Bath Ankylosing spondylitis Radiology Index (BASRI). The BMD of AS and control group patients were assessed at hip (femoral neck, Ward's triangle and femur trochanter) and lumbar area. Results: We have found a significant difference at the femoral ward triangle and lomber spine BMD and T scores in favour of AS patients (p