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Background: Pekmez is an important fruit-based food of Turkish culinary culture. The aim of this study is to determine the levels of acrylamide (AA), 5-hydroxymethyl-2-furfural (HMF) and other selected parameters in grape, mulberry and carob Pekmez. Methods: AA and HMF were analyzed by Liquid Chromatography and High Performance Liquid Chromatography, respectively. Also, glucose, fructose, pH, protein, total phenolic, and color (L*a*b*) were analyzed. The analyses were done by IBM SPSS Statistics 26 software. Results: The average AA, HMF, glucose, fructose, total reducing sugar, pH, protein, total phenolic, and colour (L*a*b*) values of Pekmez were 302 µg/kg, 25.7 mg/kg, 13.2%, 14.0%, 27.2%, 5.27, 1.16%, 4.64 mg GAE/g, and 4.83*5.60*1.52, respectively. AA indicates a moderate positive linear correlation with HMF, protein, total phenolic; whereas AA indicates a moderate negative linear correlation with glucose, fructose, total reducing sugar, pH, and L*a*b. Conclusion: It is presumed that heat treatment is a determinant in AA and HMF formulation. [ABSTRACT FROM AUTHOR]

Involvement of the renal artery is common in Takayasu arteritis. We, herein, present on a patient with Takayasu arteritis causing severe renal failure and a successful auto-transplantation. This case shows that early diagnosis and immediate appropriate interventions are life-saving in patients with Takayasu arteritis. Renal auto-transplantation performed in selected cases increases dialysis-free survival. [ABSTRACT FROM AUTHOR]

Background: Monitoring of chemokines, CXCL9 and CXCL10, in serum may present a non-invasive detection method for rejection. Objective: To investigate the relationship between urinary levels of CXCL9 and CXCL10 and graft function following renal transplantation. Methods: 75 living-related donor renal transplant recipients were studied. Urinary levels of chemokines were collected pre-operatively, on post-operative 1st day, 7th day, 1st month, 3rd month, and at the time of rejection. Chemokines levels were assayed using and enzyme-linked immunosorbent assay. Results: Clinical variables were monitored. 10 (15%) patients had biopsy-proven rejection during the follow-up period. The urinary CXCL9 level in those with rejection was significantly higher than that in those with non-rejection group at the 1st day (p<0.001), 7th day (p<0.001), and at the time of rejection (p=0.002). The urinary CXCL10 level was also significantly higher in those with rejection compared with non-rejection group at 1st day (p<0.001), 7th day (p<0.001), and at the time of rejection (p=0.001). Serum creatinine level was strongly correlated with the urinary CXCL9 and CXCL10 levels at the time of rejection (r=0.615, p=0.002; and r=0.519, p=0.022, respectively). Among those with T cell-mediated rejections the mean urinary CXCL10 level increased to as high as 258.12 ng/mL. Conclusion: Urinary CXCL9 and CXCL10 levels might have a predictive value for T cell-mediated rejection in early post-transplantation period. Measurement of urinary CXCL9 and CXCL10 levels could provide an additional tool for the diagnosis of rejection. [ABSTRACT FROM AUTHOR]

In this study, alternative tourism types and sights belonging to Safranbolu were identified through Geographic Information System (GIS) tools. In this manner, most favorable tourism activities, which are specific to field, and evaluation factors of these activities were determined. "Suitability classification values" of these factors were charted by receiving opinions from experts. Natural and cultural properties of study area were determined in the light of evaluation factors and a database was set via GIS. This database was examined according to evaluation factors of the activities and the most suitable and conditional suitable areas were determined. In this study, it is aimed to carry out the suitable place analysis for alternative tourism types of Safranbolu, which is a tourism town, such as riding, mountain biking, camping, trekking. 486 km² area for riding, 319 m² for trekking, 209 km² for mountain biking and 148 km² for camping were figured out as suitable. These results reveal that tourism activities should be more professionally organized in order to apply alternative tourism types such as riding, mountain biking, camping, trekking. In addition, organizations such as festivals and fairs should be arranged in order to introduce products special to Safranbolu. [ABSTRACT FROM AUTHOR]

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In this study, the electricity load demand, between 2012 and 2021, has been estimated using the load demand of the electricity generated from hydroelectric power plants in Turkey between 1970 and 2011. Among machine learning algorithms, Multilayer Perceptron, Locally Weighted Learning, Additive Regression, M5Rules and ZeroR classifiers are used to estimate the electricity load demand. Among them, M5Rules and Multilayer Perceptron classifiers are observed to have better performance than the others. ZeroR classifier is a kind of majority classifier used to compare the performances of other classifiers. Locally Weighted Learning and Additive Regression classifiers are Meta classifiers. In the training period conducted by Locally Weighted Learning and Additive Regression classifiers, when Multilayer Perceptron and M5Rules classifiers are chosen respectively, it is possible to obtain models with the highest performance. As a result of the experiments performed using M5Rules and Multilayer Perceptron classifiers, correlation coefficient values of 0.948 and 0.9933 are obtained respectively. And, Mean Absolute Error and Root Mean Squared Error value of Multilayer Perceptron classifier are closer to zero than that of M5Rules classifier. Therefore, it can be said the model performed by Multilayer Perceptron classifier has the best performance compared to the models of other classifiers.

Aim: The study aims to determine the physiological and pathophysiological distribution of the radiopharmaceutical (Ga 68 -PSMA-617) and investigate whether there are differences in distribution according to the laboratory, histopathological and clinical findings that can affect image evaluation. Also, we aimed to determine cut-off values to distinguish physiological and pathological uptake in prostate, bone, and lymph nodes., Materials and Methods: 229 prostate cancer patients who underwent Ga 68 -PSMA PET/CT at our department were retrospectively analyzed. The patients were grouped according to PET/CT results, Gleason scores, PSA values, received treatments, metastatic status and other laboratory values. The SUV values of the organs, tissues, and pathological lesions of the patients in these subgroups were compared among themselves., Results: No significant difference was detected in the physiological uptake of lymph nodes and bone between the groups. In the group with patients that received androgen deprivation therapy (ADT), the bone metastasis SUV values were found to be higher and the SUV values of the submandibular gland and renal cortex were found to be lower (Mann-Whitney U, p = 0.043; 0.004; 0.01, respectively). In the group with patients who received radiotherapy, the normal prostate tissue SUV values were determined to be higher (Mann-Whitney U, p = 0.009). The SUV values of the submandibular gland, muscle, liver, and blood pool were found to be lower in the group of patients with high serum LDH values. The cut-off SUVmax value was determined to be 6.945 (sensitivity 89.6%, specificity 98.1%) for primary prostate lesion; 4.72 for lymph node metastasis; 4.25 for bone metastasis. The serum PSA cut-off value to distinguish the negative/positive groups was found to be 1,505 (sensitivity 79.7%, specificity 77.3%)., Conclusion: In conclusion, PSMA-617 demonstrates a similar biodistribution with other PSMA ligands. The physiological uptake of lymph nodes and bone which are mostly metastasized in prostate cancer, are not affected by the factors we examined. It should be kept in mind that the normal prostate tissue uptake may increase in patients receiving radiotherapy, and the physiological/pathological uptake of the organs may differ due to the changes in PSMA expression in patients receiving ADT, tumor burden, and kidney function may affect the biodistribution., (© 2024. The Author(s).)

Introduction: Epidemiologic studies on pediatric acute lymphoblastic leukemias (ALL) have been conducted to evaluate the possible risk factors including genetic, infectious and environmental factors with the objective of idenfying the etiology. Mannose-binding lectin 2 (MBL2) plays an important role in first-line immune defense. HLA DRB1 alleles play a role in presentation of peptides to T cells and in activation of the adaptive immune response., Objective: In our study, we aimed to investigate both the MBL2 gene variant and HLA-DRB1 alleles in pediatric ALL patients., Materials: In this study, 86 high-risk ALL patients and 100 controls were included. Polymerase Chain Reaction (PCR)-Restriction Fragment Length Polymorphism (PCR-RFLP) and PCR-sequence specific primer (SSP) methods were used for detection of polymorphism of the MBL2 and HLA-DRB1 alleles, respectively., Results: The frequency of the MBL2 AB genotype was lower in female ALL patients, compared to male ALL patients (p = 0.034). An association was found between the MBL2 BB genotype and DRB1*07 and among patients with the MBL2 BB genotype; those who also carried the DRB1*07 and *04 alleles were significantly higher than those without the DRB1*07 and *04 alleles. (p = 0.048, p = 0.022, respectively)., Conclusion: This is the first study suggesting that the MBL2 BB genotype in association with the DRB1*07 or co-inheritance of the HLA-DRB1*04 and HLA DRB1*07 may have an impact on the etiopathogenesis of the disease., Competing Interests: Conflicts of interest The authors declare that there is no conflict of interest for the study., (Copyright © 2023 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. All rights reserved.)

Acute localized exanthematous pustulosis (ALEP) is typically a benign drug reaction that occurs shortly after drug intake. We report a five-year-old male who developed a localized, zosteriform pustular rash on his back 10 days after treatment with oseltamivir and ceftriaxone for an upper respiratory tract infection. The lesions, which appeared three days prior to presentation, were mildly itchy and resolved completely without scarring within two days of treatment with topical betamethasone valerate and fusidic acid. No bacterial growth was detected in the pustular culture. This case highlights the rare occurrence of ALEP in a pediatric patient and suggests variations from the EuroSCAR diagnostic criteria, which usually indicate a 72-hour onset post-drug intake, noting instead a 7-14 day onset in atypical cases.To best of our knowledge, This is the first report of ALEP presenting with a zosteriform distribution., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Balan et al.)

Objectives: Nivolumab is used in a treatment called immunotherapy, which helps the immune system cells to attack cancer cells. The electrochemical properties and quantification of this drug were performed using single-use pencil tips., Evidence Acquisition: Here, a selective voltammetric method for the determination and electrochemical characterization of Nivolumab used in cancer therapy was developed for the first time using a disposable pencil electrode by cyclic voltammetry and differential pulse voltammetry techniques. Nivolumab exhibited an anodic signal at +0.879 V (vs. Ag/AgCl) in PBS (pH 3.0, 0.02 M NaCl) medium., Results: This procedure showed a linear response in phosphate buffer solutions (pH 3.0, 0.02 M NaCl) media within the concentration range of 0.01 mg mL -1 to 0.07 mg mL -1 and limit of detection and the limit of quantification values were determined to be 2.49 μg mL -1 and 8.30 μg mL -1 , respectively., Conclusions: The developed method offers an important analytical approach for the detection and characterization of NIVO. Precisely measuring and monitoring the levels of such drugs in real sample analyses or biological samples is critical for evaluating response to treatment, optimizing treatment strategies. Therefore, the method was applied to real sample analyses. Voltammetric results developed using PG electrode were compared with UV-Vis results. It has been determined that the results obtained are compatible with each other., (© 2023. The Author(s), under exclusive licence to Tehran University of Medical Sciences.)

Despite advances in cancer treatment, hepatocellular carcinoma (HCC), the most common form of liver cancer, remains a major public health problem worldwide. The immune microenvironment plays a critical role in regulating tumor progression and resistance to therapy, and in HCC, the tumor microenvironment (TME) is characterized by an abundance of immunosuppressive cells and signals that facilitate immune evasion and metastasis. Recently, anti-cancer immunotherapies, therapeutic interventions designed to modulate the immune system to recognize and eliminate cancer, have become an important cornerstone of cancer therapy. Immunotherapy has demonstrated the ability to improve survival and provide durable cancer control in certain groups of HCC patients, while reducing adverse side effects. These findings represent a significant step toward improving cancer treatment outcomes. As demonstrated in clinical trials, the administration of immune checkpoint inhibitors (ICIs), particularly in combination with anti-angiogenic agents and tyrosine kinase inhibitors, has prolonged survival in a subset of patients with HCC, providing an alternative for patients who progress on first-line therapy. In this review, we aimed to provide an overview of HCC and the role of the immune system in its development, and to summarize the findings of clinical trials involving ICIs, either as monotherapies or in combination with other agents in the treatment of the disease. Challenges and considerations regarding the administration of ICIs in the treatment of HCC are also outlined., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Akbulut, Aru, Aydın and Yanıkkaya Demirel.)

In this study, the effects of 100 nm boron nanoparticles (B-NPs) on the primary antioxidant status of Nile tilapia were researched via analysis of enzyme activities and related gene expressions. This is a new study which focuses on the relationship between B-NPs and oxidative stress that contribute to the literature in terms of its scope. Fish (n = 15) for each group were exposed to three different concentrations as 5, 25 (n 2 ) and 125 (n 3 ) mg/L during 96 h to see the response of the primary antioxidant system. According to the results, SOD expressions differed in all treatment groups compared to the control group (P < 0.05). CAT expressions were different in 5 and 125 mg/L groups compared to control and 25 mg/L groups (P < 0.05). GPX expressions were only different in 125 mg/L group (P < 0.05). The changes in enzyme activities of SOD and CAT were significantly different in 25 mg/L groups. GPX enzyme activities were not significant (P > 0.05). TBARS concentrations in 25 mg/L group were significantly different from those in the control and 125 mg/L groups (P < 0.05)., Competing Interests: Declaration of competing interest The authors 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 © 2023 Elsevier Ltd. All rights reserved.)

Introduction: In this study, we aim to evaluate the treatment responses and prognostic characteristics of Myasthenia Gravis (MG) patients followed in a tertiary neuromuscular diseases center in Turkey., Methods: One hundred seventy four MG patients (between years 2011 and 2022) in Antalya, Turkey were diagnosed, and evaluated on a classification of MG was based on Myasthenia. Gravis Foundation of America (MGFA) clinical classification. Exclusion of other possible diseases in the differential diagnosis and support by beneficial response to treatment with acetylcholinesterase inhibitors were also taken into consideration., Results: Mean age of participants was 54.86 (SD = 14.856; min-max = 22-84). Ninety (51.7%) were female. MG was more common in women under the age of 65 (58%) and in men over the age of 65 (64%). Generalized MG was seen in 75.3% of the patients. Anti-AChR positivities were detected in 52.3%, Anti-MuSK positivity in 4.6%, and seronegativity in 22.4%. Thymoma was detected in nearly 9.8% and thymectomy was performed in 28.7 percent. Most of the patients (57.5%) were using corticosteroids. Azathioprine was used by 39% and mycophenolate mofetil by 10.3% of patients. Mortality was higher and disease was more severe in late-onset (>50 years) MG patients (especially in the COVID-19 pandemic). Eight patients (four women, four men, mean age 75.5 years) died during follow-up. None of them died due to myasthenic worsening, two died due to malignancy and two due to infection. During the COVID pandemic, 16 patients (9.2%) had COVID infection. Four patients died due to COVID-19 infection, these four patients had serious comorbidities, and three of them were elderly (>75 years)., Conclusion: In conclusion, MG is more common in women between the ages of 20-40 and in men over the age of 65. The use of corticosteroids was more common under the age of 50, and the use of non-steroidal immunosuppressant agents was more common over the age of 50. Thymectomy is still an important supportive treatment approach in anti-AChR positive and seronegative generalized patients under 50 years of age. IVIG and plasmapheresis are effective treatments during acute exacerbations and bridging periods of treatments. Specific treatments are needed especially for resistant group of patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yaman and Kurtuluş Aydın.)

Hesperidin is a flavonoid commonly found in citrus fruits. Studies have shown that hesperidin has anti-inflammatory, analgesic, and antimicrobial properties, as well as its effectiveness in carcinogenesis. In this paper, we aim to investigate the molecular mechanisms of hesperidin-induced apoptosis in MCF-7 and MDA-MB-231 cancer cells. The inhibitory effect of hesperidin on cellular proliferation was evaluated with the MTT assay. Cell cycle analysis of hesperidin-treated cells was then performed, as well as immunocytochemical analysis of the effect on the apoptosis pathway (TUNEL, Bax, and Bcl-2 expression). Moreover, hesperidin induced cellular apoptosis in MCF-7 breast cancer cells by inhibiting Bcl-2 and enhancing Bax expression at protein levels. On the other hand, hesperidin caused apoptosis in the MDA-MB-231 breast cancer cell line, but it did not activate the Bax/Bcl-2 pathway. Hesperidin also induced cell cycle arrest at the S phase in the MCF-7 and MDA-MB-231 cell lines. These findings showed that hesperidin is a potential therapeutic candidate for preventing the progression of breast cancer. In addition, hesperidin could significantly stimulate the death mechanisms in ER/PR (+) MCF-7 cells by changing the expression balance of Bax and Bcl-2 proteins, but lead ER/PR (-) MDA-MB-231 breast cancer cells to apoptosis in a different way., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Gozde Ozge ONDER reports equipment, drugs, or supplies was provided by Scientific Research Coordination Unit of Erciyes University, Turkey (EUBAP, TKB-2020-10305)., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Erysipelas-like erythema is the pathognomonic skin manifestation of familial Mediterranean fever although not frequently seen in the pediatric population. This study aims to describe the differences between patients presenting with and without erysipelas-like erythema and to examine the relation of erysipelas-like erythema with subclinical inflammation in a large pediatric cohort of familial Mediterranean fever patients., Materials and Methods: This retrospective study from a single pediatric rheumatology referral center included familial Mediterranean fever patients with a follow-up for at least 6 months in the last 5 years. Patients were grouped according to the presence of erysipelas-like erythema and subclinical inflammation., Results: Among 515 patients with familial Mediterranean fever, 35 patients (6.8%) were found to present with erysipelas-like erythema, and the earliest age for erysipelas-like erythema was 2.9 years. All erysipelas-like erythema lesions were defined on lower extremities with concurrent arthritis in 21 patients (60.0%). Compared to other patients in the cohort, patients presented with erysipelas-like erythema had significantly higher frequencies of acute arthritis, subclinical inflammation, and biallelic exon 10 mutations, and they used significantly higher doses of colchicine at the latest visits (all P ≤ .002). Patients with subclinical inflammation more frequently presented with erysipelas-like erythema compared to others without subclinical inflammation (21.7% vs. 2.9%, P &lt; .001)., Conclusion: Erysipelas-like erythema is an uncommon but important finding that can be a sign of severe disease course and subclinical inflammation in the pediatric population with familial Mediterranean fever.

A 56-year-old female patient who had involuntary weight loss underwent 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for detection of malignancy. The scan revealed non-metabolic soft tissue density in the posterior wall of the stomach requiring endoscopy. Endoscopical examination was performed 9 days after PET/CT and cascade stomach was detected. Cascade stomach is a rare entity that can be diagnosed by radiographic barium evaluations and endoscopy, the appearance on CT is largely incidental and CT has rarely been relied on for the diagnosis. We present this incidental case of cascade stomach on PET/CT to be familiar with the appearance., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Society of Nuclear Medicine | Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.)

This study was carried out to evaluate organochlorinated pesticide (OCPs) concentrations in the water column and sediments of İznik Lake. Water samples and sediment were collected in different regions (six sampling sites) of the lake between January and December 2019 and tested for OCPs by gas chromatography-mass spectrometry (GC-MS). The results revealed that OCP residues throughout the sites varied depending on the anthropogenic activities of the region. OCPs detected in surface waters ranged from 0.01 to 60.80 μg/L and sediments from 0.06 to 14.21 ng/g dw. Endrin ketone, endrin aldehyde, endosulfan II, endrin, heptachlor epoxy, beta-BHC, gamma-BHC, ppDDD, and ppDDT concentrations exceeded the maximum residue limits indicated by the World Health Organization (WHO) for surface waters. Of the 18 analyzed OCP components, 17 were detected in sediment samples, and it was noted that they reached the highest concentration in summer. The presence of relatively high OCP levels according to WHO regulations in the waters of İznik Lake, around which agricultural activities have been increasing rapidly in recent years, is a serious concern, and therefore, appropriate actions should be taken into consideration by the regulatory authorities., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: To determine the interval between disease onset and admission to pediatric rheumatology clinic of patients with juvenile idiopathic arthritis (JIA) and, to identify the factors that affect the admission time (AT) to rheumatology center., Methods: We designed a retrospective observational study in children with JIA. The study variables were age, gender, JIA subtype, acute phase reactants (APR), disease activity scales, presence of a pediatric rheumatologist, and distance to a pediatric rheumatology center. Outcome parameter was the duration between onset of symptoms and first visit of rheumatologist. The parameters were evaluated with variance analysis and regression models., Results: 198 patients (female:120 (60.6%)) were included. There were 112 (56.5%) patients in oligo-articular JIA, 27 (13.6%) in rheumatoid factor negative poly-articular JIA, 22 (11.1%) in enthesitis related arthritis (ERA), 29 (14.6%) in systemic-JIA, 4 (2%) in rheumatoid factor positive poly-JIA, two patients each in undifferentiated and psoriatic arthritis. The median AT in the systemic-JIA and other groups was 16 (IQR 10.5-27.5) and 71 (IQR 33.5-211) days, respectively. There was a significantly longer AT in the ERA group than others (p=0.005). We found a correlation between longer AT and older age, low back pain, enthesitis, and low erythrocyte sedimentation rate (ESR). In the multivariate analysis, only low ESR and enthesitis contributed an increase in AT [OR 2.05 (1.07-3.93), 6.22 (1.29-29.99)]., Conclusions: The older age, low back pain, enthesitis and low ESR contribute to the late AT. JIA requires high suspicion in children with poorly defined findings and low APR.

Background: Reduced memory specificity (i.e., overgeneral memory) is a characteristic of autobiographical memories widely studied in clinical populations, and it is explained by rumination, functional avoidance, and executive dysfunction. Though the relationship of autobiographical memory specificity with mood and anxiety disorders has been shown, how it relates to dissociation is not well-established. Thus, we aimed to investigate whether dissociative experiences are related to overgeneral memory while considering concurrent depression as a possible confounding factor., Methods: We conducted a systematic review in compliance with The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and searched PubMed and Web of Science databases using autobiograph* and dissoc* as our keywords., Results: Of the 768 studies identified, 9 studies fulfilled the inclusion criteria. A meta-regression analysis was conducted to analyze the relationship between dissociative experiences and depression scores with autobiographical memory test scores. Our research revealed that depression scores, but not dissociative experiences, are significantly related to reduced memory specificity., Conclusion: While the possible overlap between dissociation and depression should be considered in the interpretation of the findings, dissociative experiences do not seem to pose vulnerability for reduced specificity of autobiographical memory. The number of studies on the topic is limited, and they do not have longitudinal follow-ups. The heterogeneous reporting of memory scores and low scores of dissociative experiences in the samples are also limitations of the existing studies., (2022 authors.)

Objective: Interleukin-1 inhibitors are effective agents used in colchicine resistance or intoler- ance during the treatment of familial Mediterranean fever. This study aims to review the char- acteristics of patients treated with interleukin-1 inhibitors and their long-term follow-up in a large pediatric cohort of familial Mediterranean fever patients., Materials and Methods: The study was conducted in a pediatric rheumatology reference cen- ter. The patients treated with interleukin-1 inhibitors for at least 6 months were included and compared to other patients with familial Mediterranean fever. Clinical and laboratory charac- teristics of the cohort were recorded., Results: Among 542 patients with familial Mediterranean fever, 6.1% (n = 33) were treated with interleukin-1 inhibitors. Colchicine resistance was the reason in 82.8% and renal amyloidosis in 17.2% of the patients. Patients with interleukin-1 inhibitors had earlier disease onset and higher frequencies of acute arthritis, chest pain, and erysipelas-like erythema with pathogenic exon 10 mutations of the MEFV gene (all P < .04). All patients diagnosed with renal amyloidosis also received interleukin-1 inhibitors. Six patients were switched from anakinra to canakinumab or vice versa to control ongoing disease activity. Attack frequency was reduced in all patients., Conclusion: Interleukin-1 inhibitors are used in a relatively small number of pediatric patients with familial Mediterranean fever. Patients presenting with earlier disease onset, acute arthri- tis, chest pain, and erysipelas-like erythema and carrying pathogenic exon 10 mutations of the MEFV gene may show a higher need for interleukin-1 inhibitors. In pediatric familial Mediterranean fever patients who are resistant to colchicine, interleukin-1 inhibitors seem to be highly effective agents.

Introduction and aim Acute kidney injury (AKI) is part of the multiple organ dysfunction syndrome in critically ill patients and is a common condition in intensive care units (ICUs). Renal replacement therapy (RRT) is the cornerstone of treatment for AKI in critically ill patients. This patient population has a high mortality rate despite RRT. There are two methods of RRT for patients in ICUs: intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT). Both CRRT and IHD similarly provide adequate metabolic control. We aimed to compare these two RRT modalities in terms of ICU stay, mortality, and laboratory recovery in these patients with high mortality. Materials and methods A total of 120 patients with AKI who needed RRT in the ICU were included in the study (CRRT, n:40; IHD, n:80). Acute Physiology and Chronic Health Evaluation (APACHE) II, Sepsis-related Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score (SAPS)-II scores at the time of admission to the ICU were calculated. Mean arterial pressure, urea, creatinine, sodium, potassium, calcium, pH, lactate, and bicarbonate levels were measured before and after dialysis. Patients were classified as living and deceased. Factors affecting the length of stay in the intensive care unit and 30-day mortality were evaluated. The variability in laboratory parameters between groups before and after dialysis was examined. The groups were compared with these parameters. Results Sixty-one point seven percent (61.7%, n:74) of the patients were female. The mean age was 62.90±13.64 years. At the time of admission to the ICU, the patients' SAPS II score was 45.05±12.76, APACHE II score was 22.05±6.32, and SOFA score was 8.26±2.48. 66.7% (n:80) of the patients included in the study died, and the length of stay of these patients in the ICU was 12.85±10.23 days. When the groups were compared, SAPS II, APACHE II scores, and SOFA scores were significantly higher in the CRRT group than in the IHD group (p:0.038, p:0.015, p:0.027, respectively). Although the length of stay in the ICU was shorter in the CRRT group, it was not statistically significant (p:0.075). There was no statistically significant difference between the groups in terms of mortality (p: 0.891). SAPS-II, APACHE II, and SOFA score affected 30-day mortality while age, gender, and RRT modalities were not associated with mortality. The improvement in laboratory parameters between the pre and post-RRT groups was statistically more significant in the IHD group (p<0.001). It was determined that there was a statistically greater decrease in mean arterial pressure in the IHD group (p<0.001). Conclusions It was determined that there was no difference between the CRRT and IHD modalities applied in patients with AKI admitted to the ICU in terms of mortality and length of stay in the ICU. It was observed that both modalities improved on laboratory parameters, but the improvement was greater in the IHD group. However, it was determined that there was a statistically greater decrease in mean arterial pressure in the IHD group., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Yılmaz Aydın et al.)

Introduction: Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) has emerged as a novel marker of endothelial injury, inflammation, and oxidative stress. This study aimed to investigate the effect of MHR on primary nephrotic syndrome (NS) and its relationship with the severity of proteinuria., Methods:  This study enrolled 161 patients newly diagnosed with primary NS and 100 healthy individuals. Demographic characteristics of the patients, primary NS diagnosis, basal laboratory parameters, the amount of 24-hour urinary protein excretion, and MHR were recorded. The groups were compared regarding these parameters., Results:  MHR was significantly higher in patients with primary NS compared with the healthy group (12.89 ± 4.86 and 9.71 ± 2.30, respectively; p < 0.001). There was no difference between the groups in terms of age and sex. The amount of protein in the 24-hour urine in patients with a diagnosis of primary NS was 6.91 ± 3.73 g/day. The correlation analysis showed a positive correlation between MHR and the amount of proteinuria (r = 0.519, p < 0.001) and creatinine level (r = 0.167, p = 0.034). The multivariate regression analysis found that the severity of proteinuria was independently correlated to MHR (p < 0.001). According to the receiver operating characteristic curve analysis, the optimal cut-off level for MHR in NS was 10.08 (area under the curve of 0.704, sensitivity of 68%, and a specificity of 62%)., Conclusion:  Our study is the first to compare the severity of proteinuria and renal functions with MHR in patients with primary NS. We believe that MHR can be used as a biomarker to determine inflammation, endothelial injury, and the level of oxidative stress, and may be useful to predict prognosis in patients with primary NS., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Yılmaz Aydın et al.)

Objectives: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain., Patients and Methods: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety- Depression Scale [HADS]) were recorded., Results: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001)., Conclusion: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2021, Turkish Society of Physical Medicine and Rehabilitation.)

Objective: In this study, we aimed to investigate the awareness of patients with coronary artery disease (CAD) about secondary prevention and the channels through which they obtained information on this issue., Methods: A standard questionnaire including 45 questions was given to the patients (n=912) who were admitted to the cardiology outpatient clinics to investigate their secondary prevention awareness and lifestyle., Results: Of the participants, 508 (55.7%) stated that they knew the condition of their vessels after coronary angiography; 493 (54.1%) stated that they did not exercise; 299 stated that they did not follow any specific diet. Men were more frequently aware of all risk factors except diet, blood glucose, and blood pressure compared to women (p<0.001). Women were more frequently aware that blood glucose and blood pressure are risk factors for CAD compared to men (p<0.001). The high-income patient group was more aware of all the risk factors, except blood glucose compared to the low/medium income patient group (p<0.001). The frequency of awareness, except for blood glucose and antiplatelet drugs, increased as the education level increased (p<0.001). However, the frequency of awareness of blood glucose and antiplatelet drug use was higher in the literate/elementary school/secondary school group (p<0.001). In addition, it was concluded that patients' sexual life and psychological problems after being diagnosed with the disease were rarely questioned by cardiology specialists., Conclusion: Awareness of patients with CAD about secondary prevention was found to be very low.

Purpose: This study assessed radiopacity of resin-based computer-aided-design/computer-aided-manufacturing (CAD/CAM) materials by areal grayscale pixel value measurement., Methods: Radiopacities of six resin-based CAD/CAM block materials and resin composite were evaluated and compared to that of enamel and dentin. Specimens of 1-mm thickness were placed on photostimulable phosphor plate and irradiated with digital x-ray unit. On the radiographic image, regions of interests were determined for each specimen and areal grayscale pixel values were measured. Elemental analysis was performed with energy-dispersive x-ray spectroscopy (EDS) on field emission scanning electron microscope (FESEM) images of the specimens. Data were analyzed statistically (α = 0.05)., Results: Radiopacity values of the restorative materials were significantly different from each other (P < 0.05). Radiopacity values of two resin-based CAD/CAM materials were significantly lower than that of dentin (P < 0.05). All tested restorative materials contain zirconium, three materials contain barium, and only resin composite contains lanthanum., Conclusion: Four CAD/CAM materials with higher amounts of zirconia or barium (>18%) had radiopacity values significantly higher than the dentin; while two materials with lower amounts of zirconia (<4%) and/or no-barium, had radiopacity values significantly lower than the dentin. EDS analysis suggests materials containing elements with higher atom numbers such as zirconia and barium could exhibit higher radiopacity.

Background/aim: The prevalence of Helicobacter pylori is reported to be roughly 80% in Turkey, and only very few culture-based studies are available on antibacterial resistance in adult dyspeptic patients. This study was carried out in adult dyspeptic patients with an aim to: (i) detect H. pylori by invasive tests (culture, polymerase chain reaction, and histopathology) and (ii) determine the current resistance rates of H. pylori isolates to six antibiotics, including rifampicin., Materials and Methods: This study was conducted in 422 adult dyspeptic patients. The presence of H. pylori was demonstrated by culture, polymerase chain reaction, and the histopathology of gastric biopsy material. Antibacterial susceptibility was determined with the E-test., Results: The mean age of the patients was 50 ± 15 (range 18–90), and 265 (63%) of them were female. By culture, polymerase chain reaction, and histopathology, the presence of H. pylori was detected at rates of 35% (148/422), 67% (281/422), and 53% (224/422), respectively. The prevalence of H. pylori was determined as 75.6% (319/422). Metronidazole, levofloxacin, clarithromycin, and rifampicin resistance rates were 62%, 36%, 19%, and 12%, respectively. Monodrug, dual-drug, and multidrug resistance rates were ascertained as 36.9%, 29.4%, and 10.5%, respectively. All of the isolates were susceptible to amoxicillin and tetracycline., Conclusion: This study revealed the current prevalence of H. pylori in adult dyspeptic patients as 75.6%, and thereby, showed that infection with this pathogen remains highly prevalent. Although resistance to metronidazole and levofloxacin has increased over time, clarithromycin resistance rate has decreased. The high levels of resistance to metronidazole and levofloxacin limit the empirical use of these antibiotics in the eradication protocol. Owing to the low level of resistance determined for rifampicin, this antibiotic could be included in the eradication protocol, in the event of the need for rescue therapy in Turkey., Competing Interests: The authors have no conflict of interest to disclose., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

The objectives of this study are to monitor the physicochemical properties of two freshwater lakes with different chemical characteristics and trophic status over a year (2019) and assess the bacterial diversity by a high-throughput sequencing method for a certain time. Carlson Trophic Index analysis revealed that, whereas the deep lake, Iznik Lake, (TSI mean  = 48.9) has mesotrophic characteristics, the shallow lake Manyas Lake (TSI mean  = 74.2) was found at a hypertrophic status. The most important parameters controlling water qualities in the lakes were temperature, alkalinity, and phosphate levels. Although the bacterial communities were dominated by the same phyla (Cyanobacteria, Bacteroidetes, Actinomicrobia, Proteobacteria, and Verrucomicrobia) in both lakes, the communities differed distinctly at the lower levels. Whereas Sporichthyaceae in Manyas Lake accounted for 10% of the total reads, the major share of the sequences was assigned to Cyanobacteria Family I (8%) in Iznik Lake. The hypertrophic Manyas Lake had a more diverse bacterial community rather than Iznik Lake and contained higher numbers of unique Operational Taxonomic Units.

Rapid industrialization and excessive human population growth may cause deterioration in marine water quality and biodiversity. Heavy metals are one of the most common pollutants in the seas and marine organisms, including demersal and pelagic fish, can accumulate them from the environment. Assessment of the ecological risk of heavy metals from fish has an important role in public health. In this study, some heavy metal (Pb, Cd, As, Cr, Hg, Cu, Zn, and Fe) concentrations were determined in the muscle tissues of two commonly consumed fish species, Trachurus mediterraneus (Mediterranean horse mackerel) and Merlangius merlangus (Whiting), which are the fifth (14,222 tons/year) and sixth (6814 tons/year) highest commercial catches of marine fish species in Turkey, respectively. Heavy metal concentrations of samples collected from four sites (Adalar, İzmit Bay, Yalova, and Tekirdağ) in the Marmara Sea were determined using ICP-MS. Fish samples caught at Yalova station were found to have the highest heavy metal concentrations. According to the World Health Organization (WHO), in terms of the mean values, only As, and Cr were higher than permissible limits in T. mediterraneus, while Pb, Cd, As, and Cr were higher in M. merlangus. Arsenic concentrations were higher than maximum limits in both T. mediterraneus and M. merlangus. The estimated weekly intake (EWI) was calculated to assess the potential health impact. The EWI for arsenic, cadmium, lead, and mercury for some sites was above the provisional tolerable weekly intake.