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In this paper, the predictive torque control (PTC) based induction motor (IM) drive using an interval type-2 fuzzy neural network (IT2FNN) controller in the speed control loop is designed and tested in simulations. The states required for the proposed motor drive are estimated by extended complex Kalman filter (ECKF). The ECKF performs online estimations of stator currents, rotor fluxes, rotor mechanical speed, and rotor resistance. Compared to conventional extended Kalman filter (EKF), which estimates the same states/parameters, the designed ECKF has less computational burden because it does not contain matrix inverse and the matrix dimensions have been reduced. In addition, the rotor resistance estimated by ECKF is updated online to the PTC system. Thus, the performance of the PTC-based IM drive is improved against variations in the rotor resistance, whose value changes with operating conditions such as frequency and temperature. In order to force both the ECKF observer and the proposed IM drive, a challenging scenario containing the wide speed range operation of the IM is designed. Simulation results confirm the performance of the proposed speed-sensorless PTC-based drive that uses an IT2FNN controller in the speed control loop and the estimation performance of the ECKF observer.

In this study, a long short-term memory (LSTM) based estimator using rotating axis components of the stator voltages and currents as inputs is designed to perform estimations of rotor mechanical speed and load torque values of the induction motor (IM) for electrical vehicle (EV) applications. For this aim, first of all, an indirect vector controlled IM drive is implemented in simulation to collect both training and test datasets. After the initial training, a fine-tuning process is applied to increase the robustness of the proposed LSTM network. Furthermore, the LSTM parameters, layer size, and hidden size are also optimised to increase the estimation performance. The proposed LSTM network is tested under two different challenging scenarios including the operation of the IM with linear and step-like load torque changes in a single direction and in both directions. To force the proposed LSTM network, it is also tested under the variation of stator and rotor resistances for the both-direction scenario. The obtained results confirm the highly satisfactory estimation performance of the proposed LSTM network and its applicability for the EV applications of the IMs.

Intestinal obstruction such as atresia coli causes pathophysiological changes in gastrointestinal tissue due to the rise of intra-abdominal pressure. The aim of this study is to determine the intestinal damage with intestinal biomarkers in calves with atresia coli.

Kenan Celik,1 Mehmet A Cikrikcioglu,1 Gulistan Halac,2 Elif Kilic,3 Siddika Ayhan,3 Nihal Ozaras,4 Kemal Yildiz,5 Rabia S Yildiz,1 Mehmet Zorlu,1 Cumali Karatoprak,1 Mustafa Cakirca,1 Muharrem Kiskac1 1Department of Internal Medicine, 2Department of Neurology, 3Department of Biochemistry, 4Department of Physical Medicine and Rehabilitation, Medical Faculty, Bezmialem Vakif University, Fatih, 5Department of Internal Medicine, Private Medicana International Istanbul Hospital, Beylikdüzü, Istanbul, Turkey Background: Endocan is a recently introduced marker of endothelial dysfunction. The objective of this study was to compare serum endocan levels in patients with restless legs syndrome (RLS) and control subjects in order to elucidate whether RLS is associated with endothelial dysfunction. Methods: A total of 31 drug naïve female patients with RLS and 31 age- and BMI-matched women were included in the study. Patients with pathological or physiological conditions or with a history of medication use that could potentially influence endothelial functions were excluded, as well as those with alcohol or drug abuse history. The two groups were compared with routine blood tests and serum endocan levels. Results: Patients with RLS had lower serum endocan levels than the controls (P=0.037). There was a negative bivariate correlation between RLS severity score and serum endocan levels (r=-0.406, P=0.023). While white blood cell count was significantly higher in RLS group, 25-hydroxy vitamin D3, vitamin B12, transferrin saturation rate, and HDL-cholesterol were significantly lower. Creatininemia and diastolic blood pressure were also marginally insignificantly lower in RLS group. Due to the presence of differences between two groups in these variables, a linear regression analysis was performed that showed a positive association between endocan and creatininemia (β=0.310, P=0.022), and a negative association between endocan and RLS (β=-0.502, P

In this study, the flow phenomena over NACA4412 were experimentally observed at various angle of attack and Reynolds number of 25000, 50000 and 75000, respectively. NACA4412 airfoil was manufactured at 3D printer and each tips of the wing were closed by using plexiglas to obtain two-dimensional airfoil. The experiments were conducted at low speed wind tunnel. The force measurement and hot-wire experiments were conducted to obtain data so that the flow phenomenon at the both top and bottom of the airfoil such as the flow separation and vortex shedding were observed. Also, smoke-wire experiment was carried out to visualize the surface flow pattern. After obtaining graphics from both force measurement experiment and hot-wire experiment compared with smoke wire experiment, it was noticed that there is a good coherence among the experiments. It was concluded that as Re number increased, the stall angle increased. And the separation bubble moved towards leading edge over the airfoil as the angle of attack increased.

Effect of tip vortices on flow and laminar separation bubble over NACA4412 aerofoil at low Reynolds numbers and different angles of attack was investigated in detail by performing force and flow visualization via smoke wire technique. Experiments have been done at Reynolds number of 50000 and the wing model of aspect-ratio was 1 and 3, respectively. From the experimental results, the flow visualization results showed that tip vortices effect on the laminar separation bubble and the bubble reduces over the wing with low aspect ratio as the angle of attack increased. Moreover, it was noticed that stall angles decreased as aspect-ratio increased at the same Reynolds number.

Objective: The frequency of obesity and poor sleep quality among adolescents is increasing and causes many chronic problems. The objective was to investigate the correlation between body mass index (BMI), sleep quality, sleep duration and social jet lag (SJL) among adolescents., Methods: This study was cross-sectional. A cohort of 416 adolescents, ranging in age from 12 to 18 years participated in the study. Adolescents were divided into three groups according to BMI standard deviation score (SDS): adolescents with normal weight, adolescents with overweight and adolescents with obesity. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to determine the sleep quality of the adolescents. The calculation of SJL and sleep-corrected SJL was performed., Results: The mean age of the adolescents was 15.0±2.9 years. There were 222 males (53.4%). SJL and PSQI scores were significantly higher in the adolescents with obesity compared to the adolescents with normal weight and overweight (p<0.001). An analysis of the relationship between the PSQI and BMI SDS revealed a significant positive correlation (r=0.667; p<0.001)., Conclusion: Adolescents with obesity have poorer sleep quality and a longer duration of SJL compared to adolescents with normal-weight. Moreover, increased SJL was linked to an increase in BMI. Maintaining good sleep quality and reducing SJL may help reduce the risk of obesity., Competing Interests: Conflict of interest: None declared., (©Copyright 2024 by Turkish Society for Pediatric Endocrinology and Diabetes / The Journal of Clinical Research in Pediatric Endocrinology published by Galenos Publishing House.)

Background: Exacerbation is an independent risk factor for chronic obstructive pulmonary disease (COPD)-related morbidity and mortality. Despite optimal care, there may be risk factors that lead to difficulties in managing exacerbations that may be associated with prolongation of length of hospital stay (LOS)., Methods: This is a multicenter prospective observational study of COPD patients hospitalized with exacerbations. Prolonged LOS was calculated according to the 50th percentile and defined as ≥ 9 days. Potentially predicting factors of LOS were stratified into 4 pillars as patient-related, disease and exacerbation-related, treatment-related and, hospital utility-related. These categories were systematically documented throughout the duration of the hospitalization., Results: A total of 434 patients, 361 males and 73 females, with a mean age of 69.2 ± 9.3 years, were included in the study. Variables of each pillar were tested with univariate analysis to identify potential risk factors for prolonged LOS. Subsequently significant factors excluding factors associated with hospital utility were tested with multivariate logistic regression analysis for detecting potential associated factors for difficult-to-manage COPD exacerbation. Biomass exposure, past history of non-invasive mechanical ventilation (NIMV), low bicarbonate levels at admission, antibiotic switching, need for theophylline, increasing oxygen requirement, need for in-hospital non-invasive mechanical ventilation, nutritional support and physiotherapy were found as defining factors., Conclusions: The DiMECO study can help to identify COPD exacerbators who are at risk for prolonged hospitalizations that may associate with difficult-to-manage COPD exacerbations. Difficult to manage COPD exacerbation may serve as a provocative framework, underscoring the necessity for a better understanding of the multifaceted approaches to the management of COPD exacerbations. This conceptualization warrants further investigation across diverse clinical settings to validate its applicability and efficacy., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the local institutional ethics committee of Gazi University. The clinical trial number is 687/2018. Written informed consent for participation was obtained from each enrolled participant. The study was conducted in accordance with the Declaration of Helsinki. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Most questionnaires provide little information about children's or parents' views on functioning and do not attempt to understand their priorities or expectations. The Gait Outcomes Assessment List (GOAL) questionnaire was developed to fill this gap by identifying the most important goals of the patient and family for a gait intervention., Research Question: To investigate the test-retest reliability and concurrent and discriminant validity of the GOAL questionnaire in children with cerebral palsy (CP) in Türkiye., Methods: In this study, we included 81 children with CP aged 5-18 years and their families. The parent and child version 5.0 of the GOAL was used. Standardized item, domain and total (across all domains) GOAL scores were calculated for each participant. Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). The Gillette Functional Assessment Questionnaire (FAQ) was used for validation., Results: The mean age of the children was 10.4 ± 3.3 years (range 5-18), and 64.2 % were boys. The test-retest reliability was excellent for the GOAL-Child and GOAL-Parent total GOAL scores (ICC: 0.97 for the child and ICC: 0.96 for the parent). All standard errors of measurement (SEMs) for domain scores and total scores were fewer than 20 points. The children's total scores on the GOAL questionnaire showed a significant difference between the GMFCS levels (p <0.001). The parents' total scores on the GOAL questionnaires also showed a significant difference between the GMFCS levels (p <0.001). There were moderate positive correlations between the GOAL child and parent questionnaire total scores and the FAQ walking level according to Spearman's rho (GOAL child and FAQ walking rho: 0.66, p<0.001; GOAL parent and FAQ walking rho: 0.58, p<0.001)., Significance: The results demonstrate that the child and parent versions of the GOAL 5.0 are valid and reliable for the comprehensive assessment of Turkish children with CP., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The Gait Outcomes Assessment List (GOAL) is a trademark. Unni Narayanan, one of the developers of this trademark, is the author of this article. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The effectiveness of using only glucocorticoids (GCs) in mild multisystem inflammatory syndrome (MIS-C) cases was compared with combined treatment [GCs + Intravenous immune globulin (IVIG)]., Methods: This retrospective cohort study was conducted between June 1, 2020, and June 1, 2022, in a tertiary care center in Istanbul, Turkey. Clinical and investigational data of the MIS-C patients were analyzed. The patients were divided into two groups: those who received only GCs and those who received the GCs + IVIG combination. The primary outcome focused on assessing the deterioration of the patient's clinical condition, the occurrence of shock, admission to the pediatric intensive care unit (PICU), and the need for additional immunosuppressive medication. Secondary outcomes included evaluating the course of cardiovascular and infection-related complications observed at the one-year follow-up., Results: Ninety-seven MIS-C patients with a median age of 41 (3- 214) months were enrolled. Fifty-six (57.7%) patients were male. All the patients had fever at admission with a temperature of 39 °C (37.5 °C-40.1 °C). Thirty-two patients (33%) had cardiac findings on echocardiography [left ventricular dysfunction (n= 13, 13.5%), coronary artery involvement (n= 11, 11.3%), and dilation of cardiac cavities and/or increased cardiac muscle thickness (n= 8, 8.2%)]. Thirteen patients (13.5%) required intensive care. All patients received GCs [only GCs (group I; n= 65, 67%)], and 32 patients (33%) with severe manifestations and/or cardiac involvement received GCs + IVIG (group II). No mortality was observed. None of the patients had any complaints at the one-year follow-up, and all echocardiography findings were normal., Conclusion: This study provides preliminary evidence that GC monotherapy is a safe treatment alternative for mild MIS-C cases without cardiac involvement., Competing Interests: Declaration of competing interest No conflict of interest was declared by the authors., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Inborn errors of immunity (IEI) increase morbidity and mortality risks, particularly from respiratory tract infections. Hence, vaccination becomes pivotal for IEI patients. This study aims to examine the vaccination and respiratory tract infection rates in a diverse IEI patient cohort undergoing immunoglobulin replacement therapy (IGRT)., Materials and Methods: We retrospectively evaluated IEI patients on IGRT at a tertiary care center. Data on vaccinations and respiratory infections were extracted from medical records., Result: : The study included 33 patients (mean age= 37.7 ± 11.4 years; 17 male). The most common clinical phenotype in our cohort was primary antibody deficiencies (90.9%). Only two patients had a genetic diagnosis, both of whom were brothers diagnosed with Wiskott-Aldrich syndrome (WAS). Almost half (48.5%) of our patients had bronchiectasis and 81.8% were on prophylactic antibiotics. All patients with IEI included in the study were regularly receiving IGRT. The vaccination rate of patients against respiratory tract infections was 42.4%, 57.6%, and 78.8% for influenza, pneumococcus, and COVID-19, respectively. Only one patient (7.1%) who received the influenza vaccine developed an upper respiratory tract infection. However, viral panel analysis could not be performed for this patient as they did not present to the hospital. The COVID-19 vaccination rate was notably higher than that of other vaccines, likely due to increased awareness during the pandemic, aided by public advisories and media influence., Conclusions: We observed higher vaccination rates for the COVID-19 vaccine compared to other vaccines (influenza and pneumococcal vaccines). Although we observed the potential impact of social and governmental influence in increasing vaccination rates, it is crucial to acknowledge that vaccination decisions in IEI patients must be individualized.

Chronic obstructive pulmonary disease (COPD) that is the third leading cause of death in the world is one of the main economic burden. The cost is primarily due to COPD exacerbations and hospitalizations. We aimed to determine the factors associated with increasing costs in severe COPD exacerbation. It was a multicenter and prospective observational recording study. 294 patients who severe COPD exacerbation were included in the study. An amount of more than 429.58 euros was accepted as increasing costs (IC). Factors associated with IC were determined by regression analysis. Mean age was 69.90 ± 9.79/years (minimum: 40 maximum: 95), mean costs were 594.9 ± 70.9 euros. About 83.7% of the patients were male, 24.1% (71) were active smokers, and 81% (238) had at least 1 comorbidity. Factors associated with IC in the regression analysis were delay of discharge (due to prolonged consultation), antibiotic use longer than 7 days, need to enteral/parenteral feeding, application of pulmonary rehabilitation (physiotherapy) at hospitalization, and refusal to be discharged. The increasing costs in severe COPD exacerbation depends not only treatment but also the patient's social status and hospital-related factors. We think that the cost of severe COPD exacerbation can be reduced by interventions on interchangeable factors such as patient's social status and hospital-related factors.

Objective: Recent literature suggests that goal-oriented and family-based interventions in enriched environment have a beneficial effect on neuromotor and cognitive development. We aimed to examine the short-term effects of SAFE (Sensory strategies, Activity-based motor training, Family collaboration, and Environmental Enrichment) early intervention approach on motor, cognitive, speech and language, and sensory development in preterm infants., Methods: The study's sample population consisted of 24 preterm infants with corrected ages between 9 and 10 months. Infants in the control group participated in the family training program in accordance with the neurodevelopmental therapy principles (NDT). Infants in the treatment group were included in the family training program according to the principles of the SAFE Early Intervention Approach. Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS), Test of Sensory Functions in Infants (TSFI), Canadian Occupational Performance Measure (COPM), and Bayley Scales of Infant and Toddler Development III (Bayley III) were used to evaluate infants in both groups before and after 10 weeks of treatment (AHEMD-IS). The Depression, Anxiety, Stress Scale Short Form was used to assess the parents' mental health (DASS-SF)., Results: The interaction effects (time × group) revealed significant differences for Bayley-III cognitive and language scores, TSFI total score, and AHEMD-IS total score in favor of the SAFE group (p < .05). However, there were no differences in Bayley-III motor composite score, COPM Performance score, and COPM Satisfaction score between the interaction effects (time × group) of the groups (p > .05)., Conclusions: SAFE early intervention approach improved cognitive, speech and language, sensory outcomes and provide enriched home environment in all domains when compared to NDT-based home program. SAFE is a promising novel early intervention approach for preterm infants., (© 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Objective: In this study, it was aimed to reveal the frequency of fascioliasis in cattle slaughtered in the slaughterhouses of Ağrı province., Methods: The study was carried out on 230 cattle. The presence of Fasciola hepatica eggs in stool and bile fluid samples taken from each cattle was investigated by sedimentation-zinc sulfate flotation method, and the presence of adult parasites in the liver and bile ducts by postmortem examination., Results: The study was conducted on 230 cattle samples. Fasciola spp. eggs were observed in 43 (18.7%) of the stools examined. As a result of the postmortem examination of the liver and gall bladder, F. hepatica adults were found in 52 (22.6%) cattle. All cattle positive in stool examination were also positive in liver and gallbladder examination. Fasciola gigantica adults were not detected in any of the cattle, and there was no statistically significant difference in terms of gender and race., Conclusion: In this study conducted on cattle in the Ağrı region, F. hepatica was found to be significantly common. The data obtained show that in order to prevent economic losses in animal husbandry, which is an important source of livelihood of the local people, effective prevention and control programs should be planned and implemented, and both sheep and cattle breeders should be made aware of the prevention of this infection.

In the last few decades, the search for metal nanoparticles as an alternative to cancer treatments and antibiotics has increased. In this article, the spectroscopic (ultraviolet-visible (UV-vis), electron-dispersing X-ray (EDX), and Fourier transform infrared (FT-IR)), microscopic (field emission scanning electron microscope (FE-SEM), transmission electron microscope (TEM), and atomic force microscope (AFM)), structural (X-ray diffractometer (XRD) and zetasizer), and analytic (thermogravimetric/differential thermal analyzer (TGA-DTA)) characterization of the silver nanoparticles (AgNPs) produced from Papaver rhoeas (PR) L. leaf extract are presented. PR-AgNPs are generally spherical and have a maximum surface plasmon resonance of 464.03 nm. The dimensions of the manufactured nanomaterial are in the range of 1.47-7.31 nm. PR-AgNPs have high thermal stability and a zeta potential of -36.1 mV. The minimum inhibitory concentration (MIC) values (mg L -1 ) of PR-AgNPs on Staphylococcus aureus , Escherichia coli , Bacillus subtilis , Pseudomonas aeruginosa , and Candida albicans are 1.50, 0.75, 3.00, 6.00, and 0.37, respectively. In the study, the cytotoxic and proliferative effects of PR-AgNPs using the MTT (3-(4,5-dimethylthiazol-2-yl)-diphenyltetrazolium bromide) method on various cancer cell lines (CACO-2 (human colon adenocarcinoma cell), MCF-7 (human breast cancer cell), T98-G (glioblastoma multiforme cell), and healthy HUVEC (human umbilical vein endothelial cell)) cell lines are presented. After 24 and 48 h of the application, the half-maximum inhibitory concentration (IC 50 ) values (μg mL -1 ) of PR-AgNPs on HUVEC, CACO-2, MCF-7, and T98-G lines are 2.365 and 2.380; 2.526 and 2.521; 3.274 and 3.318; 3.472 and 3.526, respectively. Comprehensive in vivo research of PR-AgNPs is proposed to reveal their potential for usage in sectors such as nanomedicine and nanochemistry.

Objectives: This study aims to investigate the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on visual memory performance and fatigue in healthy individuals., Patients and Methods: Between April 10, 2022 and May 25, 2022, a total of 60 physical therapy and rehabilitation students (27 males, 33 females; mean age: 20.6±1.6 years; range, 18 to 24 years) were included in the study. The individuals were divided into two groups as the experimental group (n=30) and the control group (n=30). The experimental group received taVNS, mobile device supported games, and low-medium intensity aerobic exercises, while the control group received mobile device supported games and aerobic exercises. The personal information form was applied to all participants. The level of fatigue was measured using a computer-based evaluation and Fatigue Severity Scale (FSS) to analyze the visual memory performance., Results: All parameters used to evaluate visual memory performance showed a significant difference, while the FSS scores showed no significant difference (p>0.05). Only one sub-parameter in the control group was significantly different, while none of the other sub-parameters or FSS scores were significantly different (p>0.05). There was a significant difference between the two groups in terms of two of the visual memory sub-parameters, although no significant difference was found for the results of one parameter and the FSS (p>0.05)., Conclusion: Our study results show that taVNS can produce positive effects on visual memory performance, although it does not apparently affect fatigue., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2023, Turkish Society of Physical Medicine and Rehabilitation.)

Objective: Parasitizing in the small intestines of cattle, buffalo and bison, Toxocara vitulorum is seen in countries with humid tropical and subtropical climates, including Türkiye. Adult parasites can cause digestive disorders such as loss of appetite, weakness, diarrhea or constipation, and sometimes death, especially in calves. This study was planned to investigate the distribution of T. vitulorum in cattle of the Ağrı region., Methods: In this study, stool samples of the size of a walnut were taken from the rectum of 200 calves 0-6 months old and 200 cattle older than 1 year in the province of Ağrı and its districts, and the preparations were prepared using the saturated zinc sulfate flotation method and the preparations were examined under a light microscope., Results: T. vitulorum eggs were detected in 70 (35%) of 200 calves aged 0-6 months and 21 (10.5%) of 200 cattle over one year old. The difference in positivity between cattle over one year old and calves was statistically significant (p=0.001). With fecal examination ın 22 of the calves (11%), Trichostrongylidae spp. eggs were detected., Conclusion: It was determined that the prevalence of T. vitulorum in calves was high in Diyadin, Eleşkirt, Doğubayazıt, Hamur, Taşlıçay, Tutak and Patnos districts of Ağrı province. We believe that larger-scale studies should be conducted on the spread of this parasite, which causes significant low yields in cattle breeding.

Objective: Carbon monoxide poisoning is an important cause of morbidity and mortality all over the world. In our study, it was aimed to determine the clinical and laboratory parameters that may be effective in deciding the need for hyperbaric oxygen therapy in the management of cases., Materials and Methods: From January 2012 to the end of December 2019, 83 patients who applied to a university hospital pediatric emergency department in İstanbul with the diagnosis of carbon monoxide poisoning were included. Demographic characteristics, carbon monoxide source, exposure duration, treatment approach, physical examination findings, Glasgow Coma Score, laboratory results, electrocardiogram, cranial imaging, and chest x-ray were evaluated from the records., Results: The median age of the patients was 56 (37.0-100.0) months and 48 (57.8%) of them were male. The median time of exposure to carbon monoxide was 5.0 (0.5-3.0) hours in those who received hyperbaric oxygen therapy and was significantly higher than those who received normobaric oxygen therapy (P < .001). Myocardial ischemia, chest pain, pulmonary edema, and renal failure were not detected in any of the cases. The median lactate level was detected as 1.5 (1.0-2.15) mmol/L in those who received normobaric oxygen therapy and 3.7 (3.17-4.62) mmol/L in those who received hyperbaric oxygen therapy, and the difference between them was statistically significant (P < .001)., Conclusions: A guideline containing precise clinical and laboratory parameters for hyperbaric oxygen therapy in children has not been developed yet. In our study, carbon monoxide exposure duration, carboxyhemoglobin levels, neurological symptoms, and lactate levels were found to be guiding parameters in determining the need for hyperbaric oxygen therapy.

Objective: Lymnaea stagnalis known as the great pond snail, is one of the intermediate hosts of Fasciola hepatica , a zoonotic parasite. In this study, it was aimed to determine the larval forms of F. hepatica by polymerase chain reaction (PCR) in L. stagnalis species snails collected from the vicinity of Ağrı province., Methods: In this study, 150 L. stagnalis snails were collected from the Ağrı province. The freshwater snails brought to the laboratory were dissected, then their soft tissues were examined under a microscope. DNA extraction was performed on the dissected snails. After DNA extraction, PCR was performed using primers targeting the cytochrome c oxidase subunit 1 gene region., Results: In the microscopic examination, larval forms of F. hepatica could not be detected. However, it was concluded that two (1.3%) L. stagnalis freshwater snails were infected with the larval forms of F. hepatica in the PCR., Conclusion: It was determined that L. stagnalis served as an intermediate host to F. hepatica in the study area.

Background: Although studies on epileptic seizures occurring during acute asthma attacks are limited, there is widespread belief among families and physicians that salbutamol causes seizures., Aims: To investigate whether salbutamol triggers seizures in patients with epilepsy and asthma., Study Design: A retrospective cohort study., Methods: Epilepsy and asthma in patients aged 2-18 years who were admitted to the pediatric emergency department because of asthma attacks between January 2016 and December 2016 in a university hospital were evaluated retrospectively. The inclusion criteria were age 2–18 years, previous diagnosis of epilepsy and asthma, and admission to the pediatric emergency department due to asthma attacks., Results: 276 medical records were evaluated. The seizure group had a longer period of diagnosis for epilepsy than the seizure absent group in the pediatric emergency department (5.4 years and 3.1, respectively). According to the logistic regression analysis, the duration of seizures in the emergency department, duration of asthma diagnosis, duration of epilepsy diagnosis, uncontrolled asthma, and severity of asthma attack in the pediatric emergency department have significantly increased the possibility of having a seizure during an asthma attack in our study population., Conclusion: This study shows that patients using salbutamol have a lower risk of epileptic seizures than those who do not use salbutamol. This result should be verified by studies containing a large number of patients.

Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population., Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded., Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0-15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9-10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU., Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: To assess the incidence and course of COVID-19 in patients with severe asthma/chronic spontaneous urticaria using biological agents., Materials and Methods: A total of 202 patients (142 with asthma, and 60 with urticaria) were enrolled. The subjects were asked via face-to-face or telephone interview whether they had been diagnosed with COVID-19 and the course of the disease., Result: Study group consisted of 132 women, and 70 men (median age= 48 years). Median omalizumab dose was 300 mg/month in asthma (min-max= 150-1200 mg). The mepolizumab dose of two patients diagnosed with EGPA was 300 mg/month. Thirty one (15.3%) patients were diagnosed with COVID-19, 22 (71%) of whom were receiving omalizumab and nine (29%) were receiving mepolizumab. Asthma or chronic spontaneous urticaria diagnosis, age, sex, smoking, weight, comorbidities, atopy, and biological agent use were not statistically different between patients with or without COVID-19. Nine COVID-19 patients were hospitalized, and three of them required intensive care. Mepolizumab usage was higher in hospitalized patients (5, 55.6%), whereas omalizumab usage was higher in home-treated patients (18, 81%). The mean duration of biological use in home-treated patients was significantly higher than that of the hospitalized patients (35.64 months vs. 22.56 months, p= 0.024). Biological treatment was interrupted in 47 (23%) patients, selfinterruption due to the infection risk was the foremost reason (34%)., Conclusions: The incidence of COVID-19 among patients with asthma and urticaria on mepolizumab and omalizumab was higher compared to studies from other countries. The disease course appeared mild in patients receiving long-term biological therapy.

Objective: To investigate intestinal and blood parasites in people who have a history of traveling abroad during the Coronavirus disease-2019 pandemic and returning to Turkey., Methods: In this study, 104 patients with gastrointestinal system and/or fever complaints who had traveled abroad during the pandemic period and returned to Turkey were included. Parasitic agents were investigated by taking blood and stool samples from the patients. Additionally, urine samples were obtained from patients with hematuria or dysuria with the suspicion of schistosomiasis. A direct microscopic examination, the Crypto-Giardia immunochromatographic test, and ELISA methods were used in the examination of the stool samples. In order to detect Plasmodium species, blood samples were examined by preparing both the rapid diagnostic test and thick drop and thin smear preparations., Results: One or more parasite species were detected in 38 (38.5%) of 104 patients included in the study. While intestinal parasites were detected in 16 (32%) of 50 patients who traveled to Iran and 16 (33.3%) of 48 patients who traveled to Northern Iraq, blood parasites were not found. Schistosoma mansoni was detected in all 5 of the patients with a history of traveling to Sudan. Plasmodium falciparum was detected in 1 patient who traveled to the African continent., Conclusion: It is vital to take precautions to prevent parasitic diseases, such as malaria and schistosomiasis, during travels to African countries. During travels to neighboring countries of Turkey, such as Northern Iraq and Iran, hygiene should be paid attention to, so as to prevent contracting intestinal parasitic diseases. In addition, it was concluded that people who plan to travel abroad should have information about the endemic parasitic diseases of the country that they are going to., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 Turkish Society for Parasitology)

Objective: This study aimed to investigate the frequency of gastrointestinal helminth parasites in stray dogs in Ağrı province and its districts and to reveal the zoonotic importance of these parasites., Methods: Fecal samples were collected from a total of 279 stray dogs in the center of Ağrı and the districts of Diyadin, Doğubayazıt, Eleşkirt, Hamur, Patnos, Taşlıçay, and Tutak. After macroscopic examination of the stool samples, they were examined microscopically by the native and multiplexing (Fulleborn flotation and Benedek sedimentation) methods., Results: Helminth eggs belonging to one or more species were detected in 80 (28.7%) of the 279 stool samples examined. In total, 31 (11.1%) T. canis , 24 (8.6%) T. leonina , 17 (6.1%) Taenia spp., 15 (5.4%) Capillaria spp., 10 (3.6%) Alaria spp., 5 (1.8%) T. vulpis , and 3 (1.1%) A. caninum egg were detected in the stool samples., Conclusion: In this study, which was performed for the first time in Ağrı, it was revealed that stray dogs in Ağrı province and its districts were infected with helminths, which may consequently affect human health significantly. Therefore, necessary precautions should be taken to preserve the health of both humans and dogs.

Background: Primary hyperparathyroidism (pHPT) caused by a single benign parathyroid adenoma is a common endocrine disorder that is affected by regional differences. Living in different geographical regions reveals differences in the laboratory results and pathological findings, but studies on this subject are not sufficient. The article focuses on biochemical and pathological effects of geographical differences in parathyroid adenoma. In addition, the present study seeks to elaborate on treatment methods and effectiveness of screening in geographical area of Bulgaria and Turkey., Method: In this prospective study, 159 patients were included from 16 centres. Demographic characteristics, symptoms, biochemical markers and pathologic characteristics were analysed and compared between 8 different regions., Results: Patients from Turkish Black Sea had the highest median serum calcium (Ca) level, whereas patients from Eastern Turkey had the lowest median serum phosphorus (P) level. On the other hand, there was no significant difference between Ca, parathormone (PTH) and P levels according to regions. Patients from Eastern Turkey had the highest adenoma weight, while patients from Bulgaria had the lowest adenoma weight. The weight of adenoma showed statistically significant differences between regions (p < 0.001). There was a correlation between adenoma weight and serum PTH level (p = 0.05) and Ca level (p = 0.035)., Conclusion: This study has provided a deeper insight into the effect of the regional differences upon clinicopathological changing and biochemical values of pHTP patients with adenoma. Awareness of regional differences will assist in biochemical screening and treatment of this patient group., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests. Availability of data and material (data transparency):, (Copyright © 2021. Published by Elsevier Taiwan LLC.)

Background: The use of neuroimaging, the General Movement Assessment (GMA), and the Hammersmith Infant Neurological Examination (HINE) to identify the risk of neurodevelopmental delay in early infancy is recommended., Aim: The aim of this study was to examine the predictive power of neuroimaging, GMA and HINE for neurodevelopmental delay and cerebral palsy (CP) in infants with hypoxic ischemic encephalopathy (HIE) who were treated with hypothermia., Study Design: Retrospective cohort., Subjects and Outcome Measures: This retrospective study included 47 (18 female and 29 male) infants who were treated with hypothermia due to HIE. Neonates with a diagnosis of HIE were followed and assessed using neuroimaging, GMA, HINE and the Bayley Scales of Infant and Toddler Development-II (Bayley II) between 3 m and 2 years of age., Results: Out of the 47 infants with HIE, no fidgety movements were observed in 5 infants. The sensitivity and specificity in determining the psychomotor developmental index (PDI) score were 97% and 100%, respectively, for MRI; 92.9% and 100% for GMA; and 91.9% and 80% for the HINE. The sensitivity and specificity in determining the mental developmental index (MDI) score were 95% and 85.7%, respectively, for MRI; 90.5% and 80% for GMA; and 91.9% and 50% for HINE. The sensitivity and specificity in determining CP diagnosis at the age of 2 years were 83.3% and 95%, respectively, for MRI; 83.3% and 100% for GMA; and 83.3% and 87.8% for HINE., Conclusion: The interpretation of MRI, GMA, and HINE that are performed within the early period of life may be the gold standard for the early detection of neurodevelopmental risks in 2-year-old infants with HIE. Clinical implementation of these methods in the early period in the follow-up of these infants offers useful information for the early identification of neurodevelopmental risk and for planning early intervention., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: Neutrophil gelatinase-associated lipocalin (NGAL) is one of the new biomarkers for detecting acute renal injury. There are studies showing the relationship between NGAL and renal injury in obese children. The aim of this study was to investigate whether urinary levels of NGAL, kidney injury molecule-1, and serum cystatin C are increased in insulin resistance (IR) patients before the development of diabetes., Methods: Cross-sectional, case-controlled study that included non-diabetic obese children and adolescent patients with IR and a non-diabetic obese control group with no IR, who attended a tertiary center pediatric endocrinology outpatient clinic between 2016-2018. Those with diabetes mellitus and/or known renal disease were excluded. NGAL and creatinine (Cr) levels were evaluated in the morning spot urine from all participants. Serum renal function was evaluated., Results: Thirty-six control and 63 IR patients were included in the study, of whom 68 (68.7%) were girls. The mean age of all participants was 13.12±2.64 years and no statistically significant difference was found between the two groups in terms of age or gender distribution. Median (range) spot urinary NGAL (u-NGAL) values in the IR group were significantly higher at 26.35 (7.01-108.7) ng/mL than in the control group at 19.5 (3.45-88.14) ng/mL (p=0.018). NGAL/Cr ratio was also significantly higher in the IR group compared to the control group (p=0.018)., Conclusion: Obese pediatric patients with IR were shown to have elevated levels of u-NGAL, a marker of renal injury. u-NGAL examination may show early renal injury before development of diabetes.

Objectives: The hyperinflammatory state and the viral invasion may result in endothelial dysfunction in SARS-CoV-2 infection. Although a method foreseeing microvascular dysfunction has not been defined yet, studies conducted in patients diagnosed with COVID-19 have demonstrated the presence of endotheliitis. With this study, we aimed to investigate the microvascular circulation in patients diagnosed with COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by nailfold videocapillaroscopy (NVC)., Methods: Thirty-one patients with SARS-CoV-2 infection, 25 of whom were diagnosed with COVID-19 and 6 with MIS-C and 58 healthy peers were included in the study. NVC was performed in eight fingers with 2 images per finger and 16 images were examined for the morphology of capillaries, presence of pericapillary edema, microhemorrhage, avascular area, and neoangiogenesis. Capillary length, capillary width, apical loop, arterial and venous width, and intercapillary distance were measured from three consecutive capillaries from the ring finger of the non-dominant hand., Results: COVID-19 patients showed significantly more capillary ramification (p < 0.001), capillary meandering (p = 0.04), microhemorrhage (p < 0.001), neoangiogenesis (p < 0.001), capillary tortuosity (p = 0.003). Capillary density (p = 0.002) and capillary length (p = 0.002) were significantly lower in the patient group while intercapillary distance (p = 0.01) was significantly longer compared with healthy volunteers. Morphologically, patients with MIS-C had a higher frequency of capillary ramification and neoangiogenesis compared with COVID-19 patients (p = 0.04)., Conclusion: Abnormal capillary alterations seen in COVID-19 and MIS-C patients indicate both similar and different aspects of these two spectra of SARS-CoV-2 infection and NVC appears to be a simple and non-invasive method for evaluation of microvascular involvement., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Coronavirus disease 2019 (COVID-19) continues to cause major mortality and morbidity worldwide even after a year of its emergence. In its early days, hypertension, diabetes, and cardiovascular diseases were noted as poor prognostic factors, while obesity gained attention at a later stage. In the present study, unfavorable clinical outcomes (transfer to the intensive care unit, invasive mechanical ventilation, and mortality) were investigated in obese patients with COVID-19., Materials and Methods: In this retrospective study we analyzed patients with positive polymerase chain reaction test in tertiary care hospital between March-May 2020. They were divided into 3 groups according to body mass index (BMI) as normal, overweight, and obese (BMI: 18.5 - 24.99 kg/m², 25 - 29.99 kg/m², and ≥ 30 kg/m², respectively). We compared clinical features and laboratory findings of these groups and recorded adverse clinical outcomes. Multivariate logistic analysis was performed for unfavorable outcomes., Results: There were 99 patients (35%), 116 (41%), and 69 patients (24%) in the normal-weight, overweight, and obese group, respectively. Among all patients, 52 (18%) patients were transferred to the intensive care unit (ICU), 30 (11%) patients received invasive mechanical ventilation (IMV), and 22 patients (8%) died. Obese patients had minimum 1 more comorbidity than normal BMI patients (73% vs. 50%, P = 0.002), and a longer median (interquartile range [IQR]) duration of hospitalization (8 [5 - 12] vs. 6 [5 - 9]) days, P = 0.006). Obese participants had higher concentrations of serum C-reactive protein, procalcitonin, ferritin than non-obese patients ( P <0.05 in all). In a multivariate analysis, obesity was associated with ICU admission (adjusted odds ratio [aOR]: 2.99, 95% confidence interval [CI]: 1.26 - 7.04, P = 0.012). Moreover, IMV requirement was associated with obesity (aOR: 8.73, 95% CI: 2.44 - 31.20, P = 0.001). Mortality occurred in 16%, 9%, and 1% of the obese group, overweight group, and normal-weight group, respectively (Chi-square trend analysis, P = 0.002)., Conclusion: Obesity is a risk factor for adverse outcomes and caused increased mortality, hence requiring close follow-up., Competing Interests: No conflicts of interest., (Copyright © 2021 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS.)

Objectives: The diagnosis of sarcoidosis is frequently challenging, requiring a search for less invasive, more reliable diagnostic methods. The bronchoalveolar lavage fluid (BALF) analysis has been used in the differential diagnosis of sarcoidosis for many years with a wide sensitivity and specificity rates. The objective of the study is to investigate whether diagnostic performance of the BALF analysis is altered by clinicoradiological findings of patients with sarcoidosis., Materials and Methods: The present study is a retrospective, single-center, observational study, designed in a sarcoidosis outpatient clinic in a training hospital. Patients who had undergone the bronchoalveolar lavage BAL procedure at diagnosis were included in the study. Demographics, clinical and detailed chest X-ray, and high-resolution computed tomography (HRCT) findings at diagnosis were recorded. According to the diagnostic performance, the BALF results were grouped as "diagnostic" and "non-diagnostic," and recorded parameters were compared between the groups., Results: Considering the BALF analysis of all the 257 patients, the mean lymphocyte ratio was 41±17.5 (5-80), and the mean CD4/CD8 was 5.5±4.7 (0.1-24.7). The BALF analysis was diagnostic in 56% (n=145) of patients. Diagnostic performance of the procedure did not correlate with any of the demographic data, smoking status, spirometric findings, chest X-ray staging, HRCT findings, and tomography scoring. Extrapulmonary involvement was significantly more frequent in the diagnostic group (66% vs. 34%, p=0.006)., Conclusion: BALF results signal sarcoidosis in more than half of the patients. The diagnostic role of BALF is greater in patients with extrapulmonary involvement.

Background/aims: The aim of this study was to compare the dynamic thiol/disulfide (SS) homeostasis and ischemia-modified albumin (IMA) concentration between healthy subjects and patients with mild acute pancreatitis (AP)., Materials and Methods: A total of 28 patients with AP (AP group) and 35 age- and sex-matched healthy individuals (control group) were included in this study. Serum thiols/SS and IMA concentrations were measured and compared between the two groups., Results: The mean serum native thiol (SH) and total thiol (TT) levels were significantly lower in the AP group than in the control group (224.7±80.3 μmol/L vs. 314.66±87.5 μmol/L, p<0.001 and 273.3±76.8 vs. 346.9±79 μmol/L, p<0.001, respectively). SS levels were significantly higher in the AP group than in the control group (24.2±11.1 μmol/L vs. 16.1±9.9 μmol/L, p<0.054). There were no differences in the IMA concentration and the mean IMA/albumin ratio (IMAR) between both the groups., Conclusion: We found that mild AP may affect serum thiol and SS levels, and cause impaired thiol/SS homeostasis.

Although definitive chemoradiation (CRT) has been used for locally advanced laryngeal cancer for more than 2 decades, studies focusing on CRT failures in advanced laryngeal cancer are scarce. In this study, we aimed to determine the failure patterns and the survival outcomes in the patients who had recurrence after concurrent CRT for laryngeal cancer. Clinical records of the patients who had definitive concurrent CRT for laryngeal cancer between 2001 and 2014 at a tertiary referral center were reviewed. The end points of the study were 1-, 2-, and 3-year overall survival (OS) and disease-specific survival (DSS).In our results, there were 48 failures and the mean time period from the first diagnosis of disease to the diagnosis of recurrence was 18.0 months (range 2-72; standard deviation: 15.6). The most common recurrence pattern was local recurrence in 21 (47.9%) patients followed by regional recurrence in 11 (22.9%) patients. The 1 and 3 years OS rates were 41.7%, and 19.2% for the entire cohort, and 64.5%, and 29.7% for the patients who had not systemic recurrence at presentation of recurrence, respectively. The 1 and 3 years DSS rates were 43.5%, and 20.0% for the entire cohort, and 69.0%, and 31.8% for the patients who had not systemic recurrence at presentation of recurrence, respectively. All patients who had systemic recurrence initially (n = 13) died within 9 months (median = 4 months, range: 1-9 months). This study reveals that survival outcomes are unfavorable in the CRT failures and careful patient selection is critical to minimize failures. In the presence of systemic recurrence, disease course is aggressive.

Objectives: Chronic respiratory diseases exert a global health burden with high health care costs, morbidity, and mortality. The aim of the present study was to investigate the effect of pulmonary rehabilitation (PR) on emergency admission and hospitalization rates of patients with chronic respiratory disease., Materials and Methods: In this retrospective cohort study, hospitalization rates and emergency admissions of patients before (December 2014-December 2015) and after PR (January 2015-December 2016) were investigated. Patients with chronic respiratory diseases were included. Chronic obstructive pulmonary disease (COPD) patients were classified based on the Global Initiative Chronic Obstructive Pulmonary Disease assessment scheme. PR was applied by three physiotherapists over 8 weeks (2 days/week). Data on patient demographics, clinical and anthropometric data, spirometry, exercise capacity, and quality of life before and after PR were acquired., Results: This study evaluated 51 patients, of whom 76% were men. A total of 37 (73%) COPD patients and 14 (27%) non-COPD patients (7 bronchiectasis, 4 interstitial lung disease, and 3 kyphoscoliosis) were included. The patients exhibited significantly improved incremental shuttle walk test (ISWT) and endurance test scores (p<0.05) after PR. Similar to exercise capacity, the patients exhibited significantly improved Modified Medical Research Council (mMRC) score, St. George's Respiratory Questionnaire (SGRQ), anxiety and depression scores (p<0.05) after PR. In COPD patients, differences in pre- and post-PR ISWT, COPD assessment test, mMRC, and SGRQ scores were statistically significant (p=0.001). The number of emergency admissions and hospitalizations significantly decreased after PR (p=0.001; p=0.001). The post-PR FEV 1 % of COPD significantly increased (p=0.029)., Conclusion: Pulmonary rehabilitation leads to an increase in exercise capacity as well as improved quality of life, resulting in a decrease in emergency admissions and hospitalization rates. Considering the cost of hospitalization, it is important to add PR to the management of patients with chronic respiratory diseases, in addition to medical therapy.

Introduction: Welding produces miscellaneous gases and particles that has various impact on respiratory system and long term exposure may result "welders'lung". The aim of this study is to describe the radiological findings of welders' and make an awereness for welders radilogical findings., Materials and Methods: The clinical and radiological findings of welders' who had hospital applications with respiratory symptoms between January 2010-January 2017 were evaluated retrospectively., Result: A total of 16 male welders with mean age 37 ± 8 years had the mean duration of welding occupation 12 ± 7 years. The most common symptoms were coughing (87%), sputum production (63%) and dyspnoea (63%).Thirteen welders were working in shipyards and 3 in construction business and other workplaces. Three (19%) patients had rhonchi on physical examination and these patients had decreased FEV1/FVC values below 70% on spirometry. Poorly-defined centrilobular micronodules that were not clearly visible on chest radiographs observed on thorax high resolution computed tomography. Bronchoscopy was performed to 7 patients. Iron-positive pigment granules and ferruginous bodies were revealed in 3 patients' bronchoalveolar lavage., Conclusions: Welders' chest X-ray deserve a closer look. In pulmonary radiology, there may be radiographical findings ranging from small ill defined nodules to groundglass opacites. Physcians should look more careful to welders' chest X-ray and incase of suspicious findings best can be detected on high HRCT. An awareness for the radiological findings will also reduce interventional procedures in these patients hereby, occupational history must be included in daily practice of physicians.

During last decades, laryngeal organ preservation strategies have emerged. The data about the oncological outcomes mainly come from multi-institutional prospective studies. In this study, we aimed to determine the oncological outcomes of different organ preservation regimens applied in routine practice. Patients who had definitive concurrent chemoradiation (CRT) for treatment of laryngeal cancer between January 2001 and June 2013 were retrospectively reviewed. There were 139 subjects who met the inclusion criteria. Three groups were defined: group A (n = 59) consisted of subjects who had concurrent cisplatin and radiotherapy (RT), group B (n = 47) consisted of subjects who had cisplatin/docetaxel-based concurrent CRT, and group C (n = 33) had induction chemotherapy before concurrent cisplatin and RT. The Kaplan-Meier estimated 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence-free survival (LRFS) rates for the whole study group were 66.5, 69.2, 69.6, and 88.9 %, respectively. None of these survival rates were statistically different when the treatment arms were compared. The 3- and 5-year LRFS rates were significantly lower in subjects with a T4a tumor (p = 0.030). According to our results, the oncological outcomes of three different platinum-based concurrent chemotherapy schemes were similar and high local control rates could be achieved with the use of these protocols. Neoadjuvant chemotherapy before concurrent CRT was not superior to conventional concurrent treatment.

Introduction: To evaluate long-term outcome of patients with granulomatous polyangitis (GPA) followed up in a tertiary university hospital., Patients and Methods: We reviewed medical records of 22 patients with GPA diagnosis confirmed by tissue biopsies between 2004 and 2014., Result: The mean time from the onset of symptoms to diagnosis was 7.8 ± 12.3 months [interquartile range (IR)= 4.0]. The most commonly involved organs were the upper respiratory tract (URT) (72.7%), lower respiratory tract (81.8%) and kidneys (72.7%). URT involvement indicated good prognosis (p= 0.046). Survival in the patients with and without URT involvement was 124.6 ± 6.9 months and 59.7 ± 22.9 months, respectively. End-stage renal failure (ESRF) requiring dilaysis and cardiac involvement were associated with mortality (p= 0.022 and p= 0.026, respectively). Of the 12 dialysis-dependent patients at diagnosis, 11 survived > 3 months and seven regained renal function permanently. Dialysis dependency was significantly lower in patients who received plasmapheresis (p= 0.047). Overall mortality rate was 18% (4/22). Mean survival was 55.9 ± 42.8 months (IR= 84.0)., Conclusions: Diagnosis of GPA may be delayed by the nonspecific nature of its symptoms. URT involvement was associated with good prognosis, whereas cardiac involvement and ESRF requiring dialysis were associated with poor outcome. Plasmapheresis may increase the rate of renal recovery in the patients with ESRF requiring dialysis.

Background: In this retrospective study, we aimed to evaluate the clinicopathological characteristics of the patients presenting with liver metastases from unknown primary site besides survival rates, treatment outcomes, and prognostic factors., Methods: In all, 68 patients followed-up at our center with adenocarcinoma of unknown primary (ACUP) metastatic to the liver between 2005 and 2013 were enrolled. All of the liver metastases were proven by liver biopsy and all yielded diagnosis of adenocarcinoma., Results: Median age was 61 years (29-90) and most of the patients were male (male/female: 43/25). The liver was the only metastatic site in 2 (3%) patients whilst 66 patients (97%) had extrahepatic metastases. The most common extrahepatic metastatic sites were lymph nodes (89.7%), lungs (32.4%), bones (25%), peritoneum (11.8%), brain (4.4%), and adrenal glands (2.9%). Of all 68 patients, 39 (57.4%) were treated with chemotherapy. Median overall survival (OS) was significantly higher in ACUP patients treated with chemotherapy [12.5 months (95% CI 8.3-16.7) vs. 4 months (95% CI 1.2-6.8), (p = 0.026), respectively]. In multivariate analysis, ECOG (Eastern Cooperative Oncology Group) performance status (p = 0.009), chemotherapy (p = 0.024), serum albumin (p = 0.012), and serum CA 19-9 level (p = 0.026) at initial diagnosis were identified as independent prognostic factors influencing survival for the patients with liver metastases from ACUP., Conclusion: Patients with liver metastases from ACUP have poor prognosis and chemotherapy improves survival. Decreased serum albumin level, increased CA 19-9 level and poor performance status are independent poor prognostic factors.

Sentinel lymph node biopsy (SLNB) is the current standard of care for breast cancers with no clinically palpable axillary lymph nodes. Almost 50 % of sentinel lymph node positive patients have negative non-sentinel nodes and undergo non-therapeutic axillary dissection. Five different scoring systems, reported in the literature, were compared for their predictive ability of non-SLN involvement in patients with SLN positive breast cancer. 242 patients who underwent breast surgery and SLNB were included in the study. Of these, 70 who were confirmed to have SLN metastasis and received complementary ALND and constituted the final study population. The nomograms (MSKCC, M.D. Anderson Cancer Center, Tenon model, Stanford and Turkish) were statistically compared for their prediction of non-SLN metastasis (95 % confidence interval). We have determined only two clinicopathologic (multifocality and size of the primary tumor) situations which have a statistically significant association between SLN metastasis with using a multivariate logistic regression analysis. Multifocality (P = 0.001) and size of the primary tumor (P = 0.001) were associated with a higher probability of-SLN metastasis. No predictive model was constructed that showed good area under the curve (AUC) discrimination in the validation series. Currently published predictive models lack accuracy when applied to a different population. Multi-institutional heterogenic population studies are important to determine the exact combination of scoring systems and/or nomograms.

Aim of the Study: Systemic chemotherapy for patients with pancreatic cancer has limited impact on overall survival (OS). Patients eligible for chemotherapy should be selected carefully. The aim of the study was to search for prognostic factors for survival in patients with gemcitabine (Gem)-refractory or with gemcitabine and cisplatin (GemCis)-refractory advanced pancreatic cancer., Material and Methods: We retrospectively evaluated patients with Gem- or GemCis-refractory advanced pancreatic cancer. Sixteen potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors., Results: Multivariate analysis included the four prognostic significance factors in univariate analysis. Multivariate analysis showed that liver metastasis and second-line chemotherapy were considered independent prognostic factors for survival., Conclusions: Liver metastasis and second-line chemotherapy were identified as important prognostic factors in advanced pancreatic cancer patients refractory to treatment with Gem or GemCis. This prognostic factors may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.