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Hyperuricemia during hypertension is associated with aberrant vascular functions and increased oxidative stress, which affects endothelial dysfunction. Nevertheless, the molecular mechanisms underlying the effects of uric acid on vascular smooth muscle cells (VSMCs) through oxidative stress remain unclear. The aim of the present study was to investigate the dose- and time-dependent effects of uric acid on oxidative stress and p53 protein expression in VSMCs. VSMCs were incubated with various concentrations of uric acid (0-50 mg/dl) for different time periods (1-24 h). Thiobarbituric acid reactive substances (TBARs), protein carbonylation and nitric oxide (NO) levels were determined using appropriate assay kits. Superoxide anion release was detected using the Görlach method. Western blotting was performed to determine the protein expression levels of p53. The findings demonstrated that the application of uric acid led to an increase in protein carbonylation and superoxide anion levels while causing a decrease in NO levels. Conversely, no significant effect was observed on TBARS levels. Additionally, it was observed that high concentrations of uric acid suppressed p53 expression at 6, 12 and 24 h. The present study provided evidence that the influence of uric acid on oxidative stress was more closely associated with time than dose; however, not all effects observed were strictly time-dependent., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Dogru et al.)

Purpose: The primary outcome of this study is to compare the success rates of ONB techniques performed either with ultrasound guidance or with the blind technique. The second outcome is to compare the incidences of perioperative bleeding and the presence of recurrent tumors in the control cystoscopy performed in the 3rd postoperative month in both groups., Materials and Methods:  The study was conducted in the urology operating room of Mugla Sitki Kocman Training and Research Hospital between December 2019 and March 2023. A total of 122 patients were included in the study: 22 females with a mean age of 56.63 ± 12.99 years and 100 males with a mean age of 63.18 ± 8.00 years. In one group (group 1), ONB was performed under ultrasound guidance by the same anesthesiologist, and in another group (group 2), ONB was performed blindly based on anatomical signs by the same urologist., Results: Adductor muscle contraction was not observed in 53 patients (91.4%) in group 1 and in 49 patients (76.6%) in group 2 (p = 0.027)., Conclusion: The success rate of ONB was higher when using an ultrasound-guided technique than when using a blind technique.

Purpose: The present study aimed to investigate the value of calprotectin and other inflammatory parameters in patients with glaucoma and systemic diseases accompanying pseudoexfoliation syndrome (PEX-S)., Methods: This prospective study included 45 PEX-S patients and 45 non-PEX control patients. Patients were investigated for the presence of glaucoma, cardiovascular disease (CVD), ischemic brain disease (IBD), Alzheimer's disease, and neurosensory hearing loss (NSHL). After excluding diseases that may affect inflammatory parameters, a detailed biomicroscopic examination, and blood tests were performed for the patients., Results: Glaucoma, CVD, NVK, Alzheimer's disease, and NSHL were high in the PEX-S group ( P = 0.01, P = 0.01, P = 0.04, P = 0.04, and P = 0.03, respectively). Calprotectin, ferritin, neutrophil-to-platelet ratio, and lymphocyte-to-platelet ratio were found to be high in the PEX-S group ( P < 0.01, P = 0.04, P < 0.01, and P < 0.01, respectively). On evaluating the relationship between PEX-S and glaucoma and systemic diseases, it was found that elevated calprotectin increased the risk of glaucoma by 4.36 times and elevated neutrophil-to-lymphocyte ratio (NLR) increased the risk of CVD by 3.23 times in PEX-S patients ( P = 0.02 and P = 0.03, respectively)., Conclusion: This study demonstrated the value of calprotectin elevation in detecting concomitant glaucoma in PEX-S patients and, in addition, the value of NLR elevation in detecting concomitant CVD., (Copyright © 2023 Copyright: © 2023 Indian Journal of Ophthalmology.)

Introduction: We aimed to evaluate 304 premenopausal women admitted to our clinic for oligomenorrhoea, and to screen for Cushing's syndrome (CS) in this population., Material and Methods: The study included 304 premenopausal women referred to our clinic for oligomenorrhoea. Anthropometric measurements and Ferriman-Gallwey score were evaluated, and thyroid hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, prolactin, dehydroepiandrosterone sulphate (DHEA-S), and 17-hydroxyprogesterone (17-OHP) levels were measured in all patients. If basal 17-OHP was > 2 ng/mL, we evaluated adrenocorticotropic hormone (ACTH)-stimulated 17-OHP levels. CS was screened by 1 mg-dexamethasone suppression test, and if the cortisol value was > 1.8 μg/dL, we performed additional confirmatory tests, and if necessary, pituitary magnetic resonance imaging (MRI) and inferior petrosal sinus sampling (IPSS) were performed., Results: The most common cause of oligomenorrhoea was polycystic ovary syndrome (PCOS) that was detected in 81.57% of cases, followed by hyperprolactinemia at 7.23% and hypothalamic anovulation at 5.26%. The prevalence of premature ovarian failure (POF) was 1.6%, and non-classical congenital adrenal hyperplasia (NCAH) was 1.97%. CS was detected in 7 (2.30%) patients. All the patients with CS were found to have Cushing's disease (CD). Although 3 patients with CD had classical signs and symptoms, 4 had none. Patients with CD had similar total testosterone values to those in the PCOS and NCAH groups, but they had significantly higher DHEA-S compared to both groups (CD vs. PCOS, p = 0.001 and CD vs. NCAH, p = 0.030)., Conclusions: We found higher prevalence of CS in patients with oligomenorrhoea even in the absence of clinical signs. Therefore, we suggest routine screening for CS during the evaluation of patients with oligomenorrhoea and/or PCOS. The likelihood of CS is greater in patients with high androgen, especially DHEA-S levels.

Amyloidosis has been well known since Rudolph Virchow named the condition in the 19th century. Most physicians were aware of the association between amyloidosis to chronic suppurative conditions and multiple myeloma. However, familial Mediterranean fever, although probably as ancient as the Galenic era, was appropriately identified only in the 21st century. The nomenclature was variable throughout history, but the name "FMF" has been universally adopted since the report from Heller and colleagues in 1958. In 1967, Sokmen and Ozdemir of Ankara University published a report on 194 patients, of whom 64 had amyloidosis. Familial Mediterranean fever constituted the cause in half of the cases. Goldfinger and Ozkan demonstrated efficacy of colchicine for treatment of familial Mediterranean fever in 1972, and further studies revealed that colchicine is also efficient for prevention of amyloidosis. However, since then, several single-center and multicenter amyloid A amyloidosis studies from Turkey have been published. Almost invariably, familial Mediterranean fever is the most common cause of systemic amyloidosis. No downward trends in percentages have been observed. Recent studies have shown that cases of amyloidosis in patients with familial Mediterranean fever are decreasing. Also, cases of amyloidosis in conjunction with suppurative conditions are on the decrease worldwide. However, according to registry data from the Turkish Society of Nephrology, the percentage of incident hemodialysis patients with amyloidosis is not decreasing. The question arises: Why is a complication that is 98% preventable still causing end-stage renal disease? We believe the lack of a stable and comprehensive registry for familial Mediterranean fever, including associated cases of amyloidosis, is the reason we cannot properly answer this question. In this work, we use a historical approach to present why a familial Mediterranean fever registry is direly needed.

Background: Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis., Objectives: The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement., Methods: This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography., Results: MGD (28%), meibomian gland loss (MGL) (29.5%), upper meiboscore (0.61 ± 0.81), lower meiboscore (0.46 ± 0.61), DED (22%) were significantly higher in the psoriasis group compared with the control group (p = 0.008, p < 0.001, p = 0.027, p = 0.041, p = 0.044, respectively). There was a significant relationship between MGD and psoriasis area severity index (PASI) (p = 0.015, Odds Ratio = 1.211). There was a significant positive relationship between MGL with PASI (p < 0.001, r = 608) and psoriasis duration (p < 0.001, r = 0.547)., Study Limitations: Smaller study group and inability to detect quality changes of meibum with meibography were limitations of the study., Conclusions: Psoriasis may affect the meibomian gland morphology, may cause structural changes in meibomian glands, and as a result of these may cause MGD and DED. Therefore, ophthalmologists and dermatologists should be aware of this situation and co-evaluate the patients in this respect., (Copyright © 2021 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)

Objectives: We aimed to investigate serum neudesin levels that has neural, metabolic functions in patients with polycystic ovary syndrome (PCOS)., Material and Methods: The study included 180 women (age range, 18-44 years) with a diagnosis of PCOS and a control group that included 100 healthy females (age range, 18-46 years). Body mass index (BMI), waist circumference, Ferriman-Gallwey score, was evaluated and plasma glucose, lipid profile, estradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulfate (DHEA-S), FSH, LH, free T3, free T4, thyroid stymulating hormone (TSH), anti-thyroperoxidase (anti-TPO) antibody and neudesin levels were evaluated in all participants., Results: BMI and waist circumference were similar between two groups. Ferriman-Gallwey score was significantly higher in the patient group. Fasting blood glucose, HbA1C, lipid parameters except triglyceride levels, free T3, free T4, TSH, anti-TPO were similar between the two groups. Triglyceride, insulin and HOMA values were significantly higher in PCOS patients. While follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin and DHEAS levels were similar, LH was significantly higher in patients with PCOS. Serum neudesin level was significantly lower in PCOS patients with respect to controls (p = 0.015). Neudesin was positively correlated with insulin (r = 0.224, p = 0.037), and progesterone (r = 0.716, p = 0.001). Multiple regression analysis revealed that neudesin correlated with only progesterone (beta = 0.308, p = 0.001)., Conclusions: Due to the association of decreased levels of neudesin with PCOS and correlation of neudesin with progesterone, neudesin may be related with one of patophysiologic pathways of PCOS. Still, it is not certain that decreased neudesin is involved in the pathogenesis of PCOS or is the result of the disorder.

Aim: To investigate and compare the quality of life, satisfaction, contrast sensitivity, glare, depth perception, and intraocular lens (IOL) rotation in patients who underwent trifocal toric and bifocal toric IOLs., Methods: A total of 80 eyes of 40 patients were included in this prospective study. Twenty patients in each group were implanted with trifocal toric and bifocal toric IOL, respectively. Preoperative and postoperative 6-month measurements were recorded for both patient groups. Comprehensive anterior and posterior segment examinations, distance-intermediate-near visual acuity values and the visual function scale questionnaire results were evaluated at these examinations. Patient satisfaction, contrast sensitivity, glare, intermediate-near and distance stereopsis and IOL rotation were also evaluated., Results: No significant difference was found between the groups in terms of distance and near visual acuities ( P =0.269, P =0.451). Intermediate visual acuity was significantly increased in the trifocal toric group ( P <0.001). The visual function scale results were increased after surgery in both groups ( P =0.001 and P <0.001), with no difference determined between them ( P =0.158 and P =0.691). The number of patients wearing glasses was low in both groups and there was no significant difference between the groups ( P >0.05). The overall satisfaction in the trifocal toric group was significantly higher than in the bifocal toric group ( P =0.03). The highest sensitivity was observed at 6 cpd spatial frequency in all patients under photopic conditions (1.80±0.24 logU, 1.74±0.20 logU). Distance-intermediate-near binocular depth perception results in both groups were higher in the trifocal toric group ( P =0.02, 0.048, 0.003, respectively). Although there was no significant difference for 3 meters stereopsis, the trifocal toric group had higher depth perception ( P =0.577). Mean rotation was 5.76°±3.93° in the trifocal toric group and 12°±7.1° in the bifocal toric group., Conclusion: Better results in the middle distance are obtained in the trifocal toric group and less IOL rotation due to digital system-coordinated surgery. Moreover, the overall satisfaction in the trifocal toric group is significantly higher than in the bifocal toric group., (International Journal of Ophthalmology Press.)

Objectives: To investigate in detail the exact relationship between Pseudomyopia, also termed accommodative spasm, and psychiatric disorders., Methods: Twenty-one young people between the ages of 12-18 who were diagnosed with pseudomyopia between March 2019 and July 2020 in the ophthalmology eye clinic of a university hospital, Turkey were included in the study. A difference of at least 2.20 D between refractive error measurements before and after cycloplegic drop was accepted as pseudomyopia. Scl-90-r symptom screening scale was applied to each case. Afterwards, each case was evaluated by k-sads-pl-dsm-5-t semi-structured technique according to age. The relationship between psychiatric disorders in cases of pseudomyopia was examined., Results: The average age of patients in the study was 15,4 ± 1,9 (12-18), 13 (61,9%) girl and 8 (38,1%) boy. The mean initial refraction was -4,19D ± 2,48D (-1,75D /-8,50D), and the result refraction was +0,38D ± 0,22D (0,25D / -1,00D). The average amount of accommodation was 4,56D ± 2,59D (2,25D / 9,50D). Following the SCL-90-R screening scale and psychiatric evaluation, five generalized anxiety disorders, three obsessive compulsive disorders, three panic disorders, one social anxiety disorder, one posttraumatic stress disorder, one conversion disorder, one major depressive disorder were diagnosed. As a result, 15 (71,4%) of 21 patients were treated with a psychiatric diagnosis. In addition, a positive correlation (p: 0,010-r: 0,621, p: 0,029-r: 0,546) was detected between anxiety- somatization scores and accommodation amount., Conclusions: It is necessary to request psychiatric consultation in each case of pseudomyopia. Comorbidity of anxiety and depressive disorders is more common in pseudomyopia cases. In addition, as the severity of psychiatric symptoms increases, the amount of accommodation also appears to increase., Competing Interests: Conflicts of interest/Competing interests: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Purpose: The aim was to compare the effects of yoga and home exercise program on lower extremity functional status, pain, and quality of life in children with enthesitis related arthritis (ERA)., Methods: Twenty-one children with ERA were divided into two groups as yoga (n = 11) and home exercise (n = 10). Yoga group performed supervised yoga exercises twice a week for eight weeks. Home exercise group performed video-based exercises for the same period. Pain in rest and activity, lower extremity functional status, and quality of life were evaluated at baseline and following eight weeks., Results: The groups were similar at baseline (p > 0.05). All the parameters, except parent reported quality of life, significantly improved in yoga group (p < 0.05), where only stair climb test times significantly improved in home exercise group (p < 0.05)., Conclusions: Yoga seems promising for improving lower extremity functional status, pain, and quality of life as an exercise intervention in rehabilitation programs of children with ERA., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Purpose: This study aimed to reveal the cause of meibomian gland disease and meibomian gland loss in patients with Sjögren's syndrome (SS) as the leading factor for dry eyes., Methods: The study included a total of 30 patients with SS and dry eye symptoms and a control group of 50 age- and gender-matched healthy subjects. The dryness parameters of all the participants were evaluated. At first, meibography was performed to measure meibomian gland loss using noninvasive methods. Later, meibomian gland expression and secretion quality were evaluated using silt-lamp biomicroscopy. Correlations between the measurements were analyzed statistically., Results: In patients with SS, MG loss was significantly greater than in the control group (19.7 ± 71%, 12.7 ± 9.6%, P < 0.001). All dry eye parameters (tear film breakup time, Schirmer's test score, OSDI, stain score, dry eye disease) were statistically significant in the SS group. There was an extremely negative correlation between upper MB loss and BUT (P = 0.08, r: 0.781). There was an extremely positive correlation between upper MB loss and staining (P = 0.015, r: 0.739). An extremely negative correlation was determined between sub-MB loss and BUT (P = 0.18, r:-0.781), and a moderately positive significant correlation was found between sub-MB loss and staining (P = 0.031, r: 0.659)., Conclusion: The results of this study demonstrated that patients with SS were at a higher risk of being exposed to meibomian gland loss, which directly leads to the severe dry eye symptoms associated with SS., Competing Interests: None

Background: Hemiplegic shoulder pain is one of the most common complications after stroke. Although there are many treatment strategies for this complication, sometimes very resistant cases are also seen., Objectives: To evaluate the effect of suprascapular nerve pulsed radiofrequency (PRF) treatment for hemiplegic shoulder pain (HSP)., Study Design: A prospective randomized-controlled trial., Setting: University hospital., Methods: This study included 30 patients with HSP following stroke. The patients were randomly assigned to receive PRF to the suprascapular nerve (PRF group, n = 15) or suprascapular nerve block (NB) with lidocaine (NB group, n = 15). The patients were randomized into 2 groups (n = 15 both). In addition, the patients received physical therapy to the shoulder, including hot pack, transcutaneous electrical nerve stimulation, and stretching and strengthening exercise (5 days per week for 3 weeks in a total of 15 sessions). Visual Analog Scale (VAS) for pain, the Goal Attainment Scale (GAS) during upper-body dressing, and shoulder range of motion (ROM) were assessed at baseline, 1 month, and 3 months after the procedure., Results: Between the groups, comparison revealed that decrease in the VAS score was statistically significantly higher at the first (3.5 1.9 vs. 1.2 1.0) and third month (4.2 1.7 vs. 1.2 0.9) in the PRF group compared with the NB group (P < 0.01). The PRF group had significantly higher increases in shoulder ROM compared with the NB group (P < 0.05).The positive changes in GAS score at month 3 in the PRF group was significantly higher than that in the NB group (P < 0.05)., Limitation: There is a need for further studies with a longer follow-up period., Conclusions: In light of these findings, the combination of PRF applied to the suprascapular nerve and physical therapy was superior to the combination of suprascapular NB and physical therapy., Key Words: Hemiplegic shoulder, stroke, pain, radiofrequency, suprascapular nerve.

Research on investigation and determination of geographic origins of olive oils is increased by consumers' demand to authenticated olive oils. Classification algorithms which are machine learning methods can be employed for the authentication of olive oils. In this study, different classification algorithms were evaluated to reveal the most accurate one for authentication of Turkish olive oils. BayesNet, Naive Bayes, Multilayer Perception, IBK, Kstar, SMO, Random Forest, J48, LWL, Logistic Regression, Simple Logistic, LogitBoost algorithms were implemented on 61 chemical analysis parameters of 49 olive oil samples from 6 different locations at Western Turkey. These 61 parameters were obtained from five different chemical analyses which are stable carbon isotope ratio, trace elements, sterol compositions, FAMEs and TAGs. This study is the most comprehensive study to determine the geographical origin of Turkish olive oils in terms of these mentioned features. Classification performances of the algorithms were compared using accuracy, specificity and sensitivity metrics. Random Forest, BayesNet, and LogitBoost algorithms were found as the best classification algorithms for authentication of Turkish olive oils. Using the classification model in this study, geographic origin of an unknown olive oil can be predicted with high accuracy. Besides, similar models can be developed to obtain useful information for authentication of other food products., Competing Interests: Conflict of interestThe authors have declared that they have no conflict of interest., (© Association of Food Scientists & Technologists (India) 2019.)

Purpose: Cancer is the leading cause of death in economically developed countries and the second leading cause of death in developing countries. The relationship between genetic polymorphisms and cancer risk has been extensively researched. In the present study, we evaluated the association between polymorphisms in two DNA repair genes, ERCC2 Lys751Gln (rs13181) and XRCC2 Arg188His (rs3218536) and the risk of colorectal, stomach, HCC, prostate and lung cancer., Methods: This study was planned by the Medical Biology Unit and Department of Internal Medicine, Pathology and Surgical Medicine Sciences of Ataturk University. A total of 40 colon cancer, 40 gastric cancer, 40 hepatocellular carcinoma (HCC), 40 prostate cancer, and 40 lung cancer patients and 40 healthy individuals over 18 years of age were enrolled in the study (Controls). All patients and healthy subjects underwent ERCC2 Lys751Gln rs13181 and XRCC2 Arg188His rs3218536 genotyping. After collection of 10 ml venous blood from the patients, DNA was isolated and single nucleotide polymorphism (SNP) analysis was performed using Roche 480 Real-Time PCR device. Results were analyzed using SPSS version 23.0 software., Results: There were statistically significant differences in ERCC2 Lys751Gln rs13181 polymorphism variants GG colon and GT in the colon control and GG,TTprostate cancer groups when compared with the control group.. GG variant of XRCC2 Arg188 rs3218536 was higher in the gastric patient group. AG variant of XRCC2 Arg188 rs3218536 was higher in gastric control group Conclusion: The results of the present study demonstrate that ERC22 Lys751Gln polymorphisms may be associated with the development of colon and prostate cancers in the Turkish population. This was a small-scale study, and the results should be corroborated with further research including larger groups of patients with each cancer type and more healthy controls.

Background: Current approaches to identifying drug-drug interactions (DDIs), include safety studies during drug development and post-marketing surveillance after approval, offer important opportunities to identify potential safety issues, but are unable to provide complete set of all possible DDIs. Thus, the drug discovery researchers and healthcare professionals might not be fully aware of potentially dangerous DDIs. Predicting potential drug-drug interaction helps reduce unanticipated drug interactions and drug development costs and optimizes the drug design process. Methods for prediction of DDIs have the tendency to report high accuracy but still have little impact on translational research due to systematic biases induced by networked/paired data. In this work, we aimed to present realistic evaluation settings to predict DDIs using knowledge graph embeddings. We propose a simple disjoint cross-validation scheme to evaluate drug-drug interaction predictions for the scenarios where the drugs have no known DDIs., Results: We designed different evaluation settings to accurately assess the performance for predicting DDIs. The settings for disjoint cross-validation produced lower performance scores, as expected, but still were good at predicting the drug interactions. We have applied Logistic Regression, Naive Bayes and Random Forest on DrugBank knowledge graph with the 10-fold traditional cross validation using RDF2Vec, TransE and TransD. RDF2Vec with Skip-Gram generally surpasses other embedding methods. We also tested RDF2Vec on various drug knowledge graphs such as DrugBank, PharmGKB and KEGG to predict unknown drug-drug interactions. The performance was not enhanced significantly when an integrated knowledge graph including these three datasets was used., Conclusion: We showed that the knowledge embeddings are powerful predictors and comparable to current state-of-the-art methods for inferring new DDIs. We addressed the evaluation biases by introducing drug-wise and pairwise disjoint test classes. Although the performance scores for drug-wise and pairwise disjoint seem to be low, the results can be considered to be realistic in predicting the interactions for drugs with limited interaction information.

Objective: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT)., Subjects and Methods: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid., Results: Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041)., Conclusions: Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease.

Aim: To investigate the difference in radiation exposure to the patients between oblique and posteroanterior view, initial approach techniques in fluoroscopy-guided lumbosacral transforaminal epidural steroid injections., Patients & Methods: Total amount of Kerma area product, elapsed time of the procedure and fluoroscopy time were obtained from medical records retrospectively., Results: 28 patients were included in each group. Fluoroscopy time was significantly lower in group 1, but there was no statistically significant difference in terms of procedure time and Kerma area product., Conclusion: Radiation risk does not change between these approaches.

Aim: To investigate the prevalence of pseudoexfoliation syndrome (PEX) and its associations with ocular and systemic diseases in a population sample aged over 40y., Methods: A total of 2356 subjects were randomly chosen for the sample population based on the database of the Turkish Statistical Agency in Eskisehir. Of the invited 2356 subjects, 2017 subjects participated, out of which 2009 were eligible for the study. Systemic diseases, drug use, smoking and body mass index were assessed using questionnaires. Measurements of central corneal thickness (CCT), anterior chamber depth (ACD) and intraocular pressure (IOP) were performed during June to December, 2015. After pupillary dilation, the anterior segment and lenses were evaluated using a slit lamp., Results: Prevalence of PEX in this sample was 5.0% ( n =100). Of patients with PEX, 26% also had glaucoma. Incidence of cataracts, and using drugs for hypertension, cardiac and psychiatric conditions was higher in patients with PEX compared to normal cases ( P <0.05). Hearing loss was more common in PEX cases (34.0% vs 5.4%; P <0.001). The mean CCT, ACD and IOP were not significantly different between PEX and non-PEX cases., Conclusion: This study is the first population-based, randomized trial in Turkey. Prevalence of PEX in patients over 40 years old was found to be 5.0%. Besides glaucoma and cataract, hypertension, hearing loss, using drugs for cardiac and psychiatric diseases were associated with PEX.

Background: The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Thus, we aimed to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio., Methods: The present study included 50 patients whose EFT thickness ≥ 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram., Results: QTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7 ± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8, p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001), Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001)., Conclusion: The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia.

Background: Genicular nerve block has recently emerged as a novel alternative treatment in chronic knee pain. The needle placement for genicular nerve injection is made under fluoroscopic guidance with reference to bony landmarks., Objective: To investigate the anatomic landmarks for medial genicular nerve branches and to determine the accuracy of ultrasound-guided genicular nerve block in a cadaveric model., Study Design: Cadaveric accuracy study., Setting: University hospital anatomy laboratory., Methods: Ten cadaveric knee specimens without surgery or major procedures were used in the study. The anatomic location of the superior medial genicular nerve (SMGN) and the inferior medial genicular nerve (IMGN) was examined using 4 knee dissections. The determined anatomical sites of the genicular nerves in the remaining 6 knee specimens were injected with 0.5 mL red ink under ultrasound guidance. The knee specimens were subsequently dissected to assess for accuracy. If the nerve was dyed with red ink, it was considered accurate placement. All other locations were considered inaccurate., Results: The course of the SMGN is that it curves around the femur shaft and passes between the adductor magnus tendon and the femoral medial epicondyle, then descends approximately one cm anterior to the adductor tubercle. The IMGN is situated horizontally around the tibial medial epicondyle and passes beneath the medial collateral ligament at the midpoint between the tibial medial epicondyle and the tibial insertion of the medial collateral ligament. The adductor tubercle for the SMGN and the medial collateral ligament for the IMGN were determined as anatomic landmarks for ultrasound. The bony cortex one cm anterior to the peak of the adductor tubercle and the bony cortex at the midpoint between the peak of the tibial medial epicondyle and the initial fibers inserting on the tibia of the medial collateral ligament were the target points for the injections of SMGN and IMGN, respectively. In the cadaver dissections both genicular nerves were seen to be dyed with red ink in all the injections of the 6 knees., Limitations: The small number of cadavers might have led to some anatomic variations of genicular nerves being overlooked., Conclusions: The result of this cadaveric study suggests that ultrasound-guided medial genicular nerve branch block can be performed accurately using the above-stated anatomic landmarks.

Background: Ivabradine is a novel specific heart rate (HR)-lowering agent that improves event-free survival in patients with heart failure (HF)., Objectives: We aimed to evaluate the effect of ivabradine on time domain indices of heart rate variability (HRV) in patients with HF., Methods: Forty-eight patients with compensated HF of nonischemic origin were included. Ivabradine treatment was initiated according to the latest HF guidelines. For HRV analysis, 24-h Holter recording was obtained from each patient before and after 8 weeks of treatment with ivabradine., Results: The mean RR interval, standard deviation of all normal to normal RR intervals (SDNN), the standard deviation of 5-min mean RR intervals (SDANN), the mean of the standard deviation of all normal-to-normal RR intervals for all 5-min segments (SDNN index), the percentage of successive normal RR intervals exceeding 50 ms (pNN50), and the square root of the mean of the squares of the differences between successive normal to normal RR intervals (RMSSD) were low at baseline before treatment with ivabradine. After 8 weeks of treatment with ivabradine, the mean HR (83.6 ± 8.0 and 64.6 ± 5.8, p < 0.0001), mean RR interval (713 ± 74 and 943 ± 101 ms, p < 0.0001), SDNN (56.2 ± 15.7 and 87.9 ± 19.4 ms, p < 0.0001), SDANN (49.5 ± 14.7 and 76.4 ± 19.5 ms, p < 0.0001), SDNN index (24.7 ± 8.8 and 38.3 ± 13.1 ms, p < 0.0001), pNN50 (2.4 ± 1.6 and 3.2 ± 2.2 %, p < 0.0001), and RMSSD (13.5 ± 4.6 and 17.8 ± 5.4 ms, p < 0.0001) substantially improved, which sustained during both when awake and while asleep., Conclusion: Our findings suggest that treatment with ivabradine improves HRV in nonischemic patients with HF.