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PURPOSE Hereditary cancer syndromes infer high cancer risks and require intensive surveillance. Identification of high-risk individuals among patients with colorectal cancer (CRC) needs improvement. METHODS Three thousand three hundred ten unselected adults who underwent surgical resection for primary invasive CRC were prospectively accrued from 51 hospitals across Ohio between January 1, 2013, and December 31, 2016. Universal Tumor screening (UTS) for mismatch repair (MMR) deficiency was performed for all, and pathogenic germline variants (PGVs) were identified using multigene panel testing (MGPT) in those who met at least one inclusion criterion: MMR deficiency, diagnosed < 50 years, multiple primary tumors (CRC or endometrial cancer), or with a first-degree relative with CRC or endometrial cancer. RESULTS Five hundred twenty-five patients (15.9%) had MMR deficiency. Two hundred thirty-four of 3,310 (7.1%; 16% of the 1,462 who received MGPT) had 248 PGVs in cancer susceptibility genes. One hundred forty-two (4.3%) had a PGV in an MMR gene, and 101 (3.1%) had a PGV in a non-MMR gene. Ten with Lynch syndrome (LS) also had a non-MMR PGV and were included in both groups. Two (0.06%) had constitutional MLH1 hypermethylation. Of unexplained MMR-deficient patients, 88.4% (76 of 86) had double somatic MMR mutations. Testing for only MMR genes in MMR-deficient patients would have missed 18 non-MMR gene PGVs (7.3% of total PGVs identified). Had UTS been the only method used to screen for hereditary cancer syndromes, 38.6% (91 of 236) would have been missed, including 6.3% (9 of 144) of those with LS. These results have treatment implications as 5.3% (175 of 3,310) had PGVs in genes with therapeutic targets. CONCLUSION UTS alone is insufficient for identifying a large proportion of CRC patients with hereditary syndromes, including some with LS. At a minimum, 7.1% of individuals with CRC have a PGV and pan-cancer MGPT should be considered for all patients with CRC.

Aim: In this study, it was aimed to evaluate AYC.2.2 agar for susceptibility testing of Mycobacterium tuberculosis clinical isolates against first-line drugs. Materials & methods: In the present study, 208 M. tuberculosis clinical isolates were tested on AYC.2.2 agar, which was previously validated for the first-line drugs isoniazid, rifampicin, streptomycin and ethambutol. Results: Specificity, sensitivity, positive predictive value, negative predictive value and agreement for isoniazid–rifampicin–ethambutol–streptomycin were 100–100–97.2–99.3%, 94.8–94.8–79.3–94.3%, 100–100–82.1–98.03%, 97.03–98.03–96.7–98.08%, 98.07–98.5–94.7-98.07%, respectively. Conclusion: Results had shown that the newly developed AYC.2.2 agar promises as an alternative medium that can be used to perform susceptibility testing of M. tuberculosis isolates. However, further multicenter studies are needed to be used in routine mycobacteriology laboratories.

Postoperative pain cannot be treated adequately in all patients, even though there are new developments in analgesic agents and treatment techniques. Thisstudy investigates the effect of pre-incisional and post-incisional electro- acupuncture on mechanical hyperalgesia in rat incisional pain model. This study was carried out with 40 healthy Sprague-Dawley male rats. The rats were divided into 5 groups: Group 1; first electro-acupuncture, then incision. Group 2; first incision, then electro-acupuncture. Group 3; first sham electro-acupuncture, then incision. Group 4; first incision, then sham electro-acupuncture. Group 5; control (incision only). Electro-acupuncture was applied to the ST36 and SP6 acupuncture points on the right hind paw. Sham electro- acupuncture was applied to the right thigh. Von Frey filaments were used to measure hyperalgesia at baseline and at 4th, 6th, 24th and 48th hours. Shapiro Wilk test was used to determine whether the distribution of continuous variables was close to normal. Levene's test was used for homogeneity of variances. Bonferroni Correction Wilcoxon Sign test was used to determine whether the differences between follow-up times were statistically significant or not. Bonferroni Correction on Kruskal Wallis test was used to determine whether there was any difference between groups. If the Kruskal Wallis test statistics were significant, analysis was performed using Conover's multiple comparison test. p

We report the case of a 54-year-old woman who presented to the ear, nose, and throat (ENT) outpatient clinic with hearing loss, tinnitus, and fullness in her right ear. In the first clinical examination, a pouch hanging in the anterior upper quadrant was detected in the tympanic membrane of the right ear. A tick larva was found in the cyctic lesion located on the tympanic membrane. Our case was unique due to this unexpected diagnosis.

Aim: Antibiotic resistance studies about the Streptococcus have a great importance for the treatment of especially child throat infections in terms of public health and rational antibiotic use. For this purpose, we aimed to identify the macrolide resistance genes mef(E) and erm(B). Material and Method: The throat culture samples taken from 51 children presenting to the hospital with the complaint of sore throat were evaluated in the laboratory, and S. pyogenes was diagnosed using tests; gram staining, catalase, bacitracin and PYR. Susceptibility profile was determined with the Kirby-Bauer disk-diffusion method and minimum inhibitor concentration(MICs) of erythromycin and clindamycin was determined by VITEK 2 System. Results: S. pyogenes was possible macrolide resistance genes of mef(E) and erm(B) was determined by PCR. Macrolide resistance in S. pyogenes are determined in 51 pateients as follows; benzylpenicillin 0%, erytromycin 74.5%, clindamycin 31.4%. In patients with S. pyogenes, the genetic determinants of macrolide resistance mef(E) and erm(B) genes was investigated with the PCR method using primers specific to each gene. Total of 48% of the isolates (n=24) were positive for erm (B), 10% (n=5) for mef(E), in 42% (n=21) of the isolates both genes were detected. Conclusion: The results of our study show that macrolid resistance genes were found in five of the patients evaluated. When the anamnesis of these patients was examined, it was determined that there were patients that frequently presented to the hospital with throat infections and experienced re-infection within a few weeks after receiving treatment.

Introduction and objective Legionnaires' disease, which is a waterborne disease leading to pneumonia that can result in death, is one of the major health issues today. The study aims to carry out a three-year retrospective review of routine Legionella follow-up analyses in various samples taken mostly from hospitals in the province of Erzurum and nearby provinces, and to discover a the frequency of isolation of the agent and serogroups from each kind of media. Material and methods The study included a total of 2,025 water samples taken from hospitals, hotels, Turkish baths and shopping malls in Erzurum,and 13 nearby cities between 2016 and 2018. Samples were filtered by 0.45 μm-diameter membrane filter paper in the Public Health Laboratory of Erzurum and examined for L. pneumophila using culture method, according to the criteria set out in ISO 11731-2. Results The presence of L. pneumophila was found in 65 of the 2,025 water samples taken in hospitals, and in none of 40 samples taken in hotels, Turkish baths and shopping malls. L. pneumophila serogroup 2-14 was detected in 46 (70.8%) of 65 samples found positive, whereas L. pneumophila serogroup 1 was detected in 18 (27.7%). Furthermore, both the L. pneumophila serogroup 2-14 and L. pneumophila serogroup 1 were detected simultaneously in one example (1.5%). The first three samples indicate that the highest positivity rates were in hot water taps (11.6%), hot water tanks (6.1%) and shower heads (4.8%). Conclusions The Prevalence rat of L. pneumophila was found to be quite low compared to other studies conducted in the western regions of Turkey. Legionella positivity was found to be higher in the hot water systems of hospitals and related points, compared to the other sample points.

Objective: In the study, 419 Mycobacterium tuberculosis complex strains (MTC), which were isolated from samples sent to the Regional Tuberculosis Laboratory in our city between 2015 and 2019 with suspected tuberculosis from Erzurum and surrounding cities were investigated. Methods: Our research is a retrospective cross-sectional study and clinical samples sent to the Regional Public Health Laboratory with suspicion of Tuberculosis within a five-year period from January 2015 to December 2019 were first evaluated by using Ehrlich-Ziehl-Neelsen staining technique. The samples were then simultaneously inoculated into the automated culture system (BACTEC MGIT 960) with Löwenstein-Jensen medium. Sensitivity research was conducted for isoniazide, rifampicin, streptomycin and ethambutol antibiotics with BACTEC MGIT 960 system to samples defined by MTC identification test (TBc ID) from reproduction positive tubes. Results: In our study, 337 (80.4%) of the 419 MTC strains investigated in our study were susceptible to all major anti-TB drugs, while 82 (19.6%) were found to be resistant to at least one major anti-TB drug. The distribution of resistance ratios was isoniazid (11.9%), streptomycin (11.7%), rifampicin (4.1%), ethambutol (3.6%). Multi-drug resistant (MDR)–TB ratio (isoniazid+ rifampicin) was found to be (3.6%). Conclusions: In our study, in the strains in which resistance to anti-TB drugs was investigated, the highest drug resistance was determined for isoniazid. The lowest drug resistance was determined for ethambutol.

Objective Lynch syndrome is the most common cause of inherited endometrial cancer, attributable to germline pathogenic variants (PV) in mismatch repair (MMR) genes. Tumor microsatellite instability (MSI-high) and MMR IHC abnormalities are characteristics of Lynch syndrome. Double somatic MMR gene PV also cause MSI-high endometrial cancers. The aim of this study was to determine the relative frequency of Lynch syndrome and double somatic MMR PV. Methods 341 endometrial cancer patients enrolled in the Ohio Colorectal Cancer Prevention Initiative at The Ohio State University Comprehensive Cancer Center from 1/1/13–12/31/16. All tumors underwent immunohistochemical (IHC) staining for the four MMR proteins, MSI testing, and MLH1 methylation testing if the tumor was MMR-deficient (dMMR). Germline genetic testing for Lynch syndrome was undertaken for all cases with dMMR tumors lacking MLH1 methylation. Tumor sequencing followed if a germline MMR gene PV was not identified. Results Twenty-seven percent (91/341) of tumors were either MSI-high or had abnormal IHC indicating dMMR. As expected, most dMMR tumors had MLH1 methylation; (69, 75.8% of the dMMR cases; 20.2% of total). Among the 22 (6.5%) cases with dMMR not explained by methylation, 10 (2.9% of total) were found to have Lynch syndrome (6 MSH6, 3 MSH2, 1 PMS2). Double somatic MMR PV accounted for the remaining 12 dMMR cases (3.5% of total). Conclusions Since double somatic MMR gene PV are as common as Lynch syndrome among endometrial cancer patients, paired tumor and germline testing for patients with non-methylated dMMR tumor may be the most efficient approach for LS screening.

Aim of the study: Ultrasonographic examination of intraosseous jaw pathologies may reveal interesting incidental, mobile hyperechoic particles (“snowflakes”) in anechoic areas. Purpose of this study is to explain and discuss this snowing-like ultrasonographic feature of intraosseous jaw pathologies. Material and methods: This study included 113 patients admitted to our clinic for examination: 43 (38.05%) males and 70 (61.9%) females with a mean age of 34.9 ± 17.2 years (range: 6–72 years). A total of 120 intraosseous lesions were evaluated prior to surgery using ultrasonography; these included non-neoplastic, odontogenic, and non-odontogenic lesions. Results: In total, 5 (4.1%) of the 120 lesions exhibited snowing-like feature on ultrasonography, including 2 (1.6% of total) of 3 incisive canal cysts, 2 (1.6% of total) of 7 dentigerous cysts, and 1 (0.8% of total) of 19 odontogenic keratocysts. Conclusions: Snowflakes evident on ultrasonography of intraosseous jaw lesions may be specific to certain pathologies. Future studies correlating radiologic and pathologic features of intraosseous jaw lesions should focus on ultrasonographic snowing-like appearance in different types of lesions and explore why they occur.

Objective:In this study, our objective was to compare direct microscopic examination and direct fluorescence antibody (DFA) method for Giardia diagnosis in stool samples and to evaluate the possible risk factors related to Giardia infections.Methods:Stool samples of 185 patients with diarrhoea collected between June 2019 and July 2019 in Erzurum Yakutiye Research Hospital were included in the study. Microscopic examination of the samples was performed with native-lugol, and they were subsequently scanned by the indirect fluorescent assay microscope using the DFA method at 100-200X magnification. In addition, all patients filled a questionnaire prepared to determine the possible risk factors related to Giardia infection.Results:The age of the 185 participating patients who belonged to different groups was between 0 and 94 years. Giardia spp. cysts were detected in five stool samples (2.7%) using direct microscopic examination. Nine samples (4.9%) were DFA-positive. The incidence of giardiasis was noted to be 7.5% in children, 3.8% in adults, 7.3% in people living in rural areas, 2.9% in people living in urban areas, 10% in people having pets and 4.2% in people who do not have pets.Conclusion:By taking the DFA method as a reference, the sensitivity and specificity of the microscopic examination were found to be 44.4% and 99.4%, respectively. The Giardia positivity rate was higher in children, those living in rural areas, those having pets and those using well water as drinking water.

Bu çalışmadaki amacımız 0-18 yaş arası çocuklarda Sitomegalovirüs’e karşı oluşmuş IgM ve IgG tipi antikorların varlığını retrospektif olarak incelemek ve seroprevalans oranlarını belirlemektir. Bu çalışmada 2018-2019 yıllarında Erzurum merkezde aile hekimlerince farklı nedenlerle muayene edilen ve CMV IgM-IgG serolojisi araştırılan kişilere ait sonuçların retrospektif olarak değerlendirilmesi yapıldı. Hastalardan alınan kan serumları Halk Sağlığı Seroloji Laboratuvarında ELISA yöntemi kullanılarak Architect İ2000 cihazında firmanın çalışma prosedürüne uygun olarak çalışıldı. Kit üretici firmanın tavsiyeleri doğrultusunda test sonuçları, CMV IgM için; 0.99 index pozitif, CMV IgG için; 5.99 AU/ml pozitif olarak kabul edildi. Araştırma grubunda anti-CMV IgG seropozitifliği %95,7 (491/513), anti-CMV IgM seropozitifliği %2.4 (13/546) bulundu. CMV IgG ve IgM pozitifliği sırasıyla, kız çocuklarında %96.7 ve %2.4, erkek çocuklarda % 92.6 ve %2.4 idi. Kız çocukları arasında anti-CMV IgG pozitiflik oranları daha yüksek idi. Çalışmamızda 0-3, 4-6, 7-9, 10-12, 13-15 ve 16-18 yaş gruplarında anti-CMV IgG seropozitifliği sırasıyla %94.7; %69.6; %100; %97.5; %88.2 ve %99.3 idi. Anti-CMV IgM seropozitifliği ise aynı yaş gruplarında %10.5; 0; 0; %2.4; %4.4 ve %1.7 idi. Çalışma grubumuzdaki çocuklarda CMV seropozitiflik oranları yüksekti. Bu durum bölgemizdeki çocukların erken yaşlarda (konjenital veya edinsel) CMV etkenine maruz kaldığını göstermektedir.

Atherosclerosis is a chronic, progressive, inflammatory disease. Recognition of subclinical atherosclerotic vascular changes before clinical manifestation in an asymptomatic population is important for risk stratification and optimal management, which finally leads to the prevention of cardiovascular disease. We aimed to determine the risk of premature subclinical atherosclerosis by evaluating epicardial adipose tissue thickness (EATT) and arterial stiffness parameters in patients with ankylosing spondylitis (AS).We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS compared to 60 controls matched for age and sex. Patients with traditional cardiovascular risk factors were excluded. Arterial stiffness parameters and EATT (examined via echocardiography) values of all patients and control groups were measured.There was no difference between basal characteristic and echocardiographic parameters in patients with AS and in the control group. EATT and pulse wave velocity (PWV) were higher in the AS patients compared to the control group. EATT was 5.74 ± 1.22 mm and 4.91 ± 1.21 mm (EATT and PWV, markers of atherosclerosis and cardiovascular disease, were significantly higher in patients with AS than the control group. In addition, in this study, it has been shown that there is a significant relationship between PWV and EATT in patients with AS.

Introduction and objective Hepatitis A Virus (HAV), reportedly the most common cause of acute viral hepatitis in developing countries, infects millions of people worldwide each year. The aim of the study is to investigate the seropositivity of anti-hepatitis A virus (HAV) IgG and IgM in all age groups in Erzurum, and to determine the effect of various factors such as age, gender, climatic conditions and HAV vaccination (included in 2012 in the National Immunization Schedule on seroprevalence) on the seropositivity. Material and methods The serological results of 25,007 individuals referred to Erzurum Public Health Microbiology Laboratory between January 2015 – December 2018 were retrospectively reviewed to test for the presence of anti-HAV IgG and IgM. The patient ages were 0–93 years. Serum samples were analyzed by ELISA. S/CO values of ≥1.00 and >1.21 were considered positive for anti-HAV IgG and IgM, respectively; results below this value were considered negative. Results Anti-HAV IgG and IgM seropositivities were 87.3% and 0.2%, respectively. Anti-HAV IgG prevalence – 88.5% and 86.4%, anti-HAV IgM positivity – 0.1% and 0.3% in men and women. Anti-HAV IgG seroprevalence – 87%, 73.2%, 58.7%, 75.2%, 86.1%, 89.8%, 96.1%, 99.1%, 99.1% and 99.3%, respectively, at 0–4, 5–9 10–14, 15–19, 20–24, 25–29, 30–39, 40–49, 50–59 and >60 age groups. Anti-HAV IgM seropositivity – 0, 0.1%, 0.7%, 0.7%, 0.3%, 0, 0.1%, 0.2%, 0.1%, and 0.2%, respectively, in the same age groups. Anti-HAV IgM positivity was the highest in November – 36(0.97%. Conclusions In Erzurum, anti-HAV IgG prevalence is tremendously high, whereas prevalence of anti-HAV IgM is exceptionally low, especially in the paediatric age group. Therefore, HAV vaccine is provided free of charge in Turkey, including Erzurum, since 2012.

Amaç: Total kalça protezi uygulamalarında çimentolu, çimentosuz ve hibrid tespit yöntemlerinin sonuçları tartışılmaya devam etmektedir. Çalışmamızın amacı, çimentosuz total kalça protezi olgularımızın klinik ve radyolojik sonuçlarını literatür eşliğinde değerlendirmektir. Gereç ve Yöntem: Çalışmamızda çimentosuz total kalça protezi uygulanan olgular geriye dönük olarak değerlendirildi. En az 1 yıllık takibi olan 80 hastanın 95 kalçası çalışmaya dahil edildi. Klinik değerlendirmede Harris kalça skoru (HKS) kullanıldı. Radyolojik değerlendirmede ise komponentlerin malpozisyonuna ve gevşemeye bakıldı. Ayrıca hastalar heterotopik ossifikasyon, dislokasyon ve diğer komplikasyonlar açısından incelendi.Bulgular: Hastaların 47 (%58.7)’si kadın, 33 (%41.3)’ü erkekti. Olguların yaş ortalaması 52.312.8 idi. Otuz altı (%45) hastada sağ kalça, 29 (%36) hastada sol kalça ve 15 (%18.7) hastada bilateral kalça protezi uygulandı. Cerrahi yaklaşım olarak, hastaların 74 (%77.9)’ünde posterolateral, 21 (%22.1)’inde anterolateral insizyon kullanıldı. Ortalama takip süresi 3818.8 ay idi. Hastaların ameliyat öncesi ve son kontroldeki toplam Harris kalça skorları sırasıyla 28.5210.93 ve 87.097.03 idi. Radyolojik değerlendirmede hastaların 12 (%12.6)’sinde asetabuler malpozisyon tespit edildi. Hastaların 8 (%8.4)’inde intraoperatif kırık saptandı. Sonuç: Çimentosuz total kalça protezi uyguladığımız hastalarımızda, kısa ve orta dönemde Harris kalça skoru değerlendirmesine göre başarılı klinik sonuçlar elde edilmiştir. Çimentosuz tespitte erken dönemde sıkı stabilizasyon sağlanır, fakat intraoperatif kırık ve asetabuler komponentlerin malpozisyonu açısından dikkatli olunmalıdır.

Chimeric antigen receptors (CARs) are artificial receptors introduced mainly into T cells. CAR-induced immune cell (CARi) products have achieved impressive success rates in treating some difficult-to-treat hematological malignancies. Here, we describe effects of the global COVID-19 pandemic on CARi publication landscape. Due to the pandemic, the total number of publications decreased in 2020 compared to 2019 in all fields of cancer immunotherapy except CARi. Nearly exponential increases in the number of CARi publications slowed-down in 2020 for the first time in the past 11 years. There were more CARi than coronavirus publications until 2020 when coronavirus publications increased over 5,000% compared to 2019 (575 publications in 2019 vs. 30,390 in 2020). Unlike cancer immunotherapy where the majority of the publications consist of conference abstracts and review articles, majority of the coronavirus publications are original research articles. There are more coronavirus publications in Pubmed than Embase. The opposite is true for CARi publications. Our analysis of the data from the FDA Adverse Event Reporting System (FAERS) show significantly higher death rate in patients treated with Kymirah than Yescarta (28.14% vs. 16.02%). Kymirah and Yescarta are the two main CAR T cell products for treatment of DLBCL and/or B-ALL. However, despite being highly significant, this result is not easily interpretable due to multiple confounding variables in the FAERS data. Our analysis additionally suggest that the significant effects of co-stimulatory domains (4-1BB vs. CD28) consistently reported in preclinical studies do not translate into clinical results. Our manual curation of the CARi publications in PubMed shows that only 5.2% of the publications report results from CARi clinical trials, although we found 663 clinical trials listed on ClinicalTrials.gov database. In conclusion, publication landscape in CARi as well as other fields of cancer immunotherapy has changed due to the global COVID-19 pandemic. This trend will likely continue in the near future. CARi research is now in need of increased measures by publishers to reduce repetitive and/or duplicate publications and more stringent criteria for data entry into public databases including PubMed, Embase, ClinicalTrials.gov, and FAERS to advance this important field of medical research.

Objective: In-stent restenosis is a major problem concerning percutaneous coronary interventions. Brachial artery flow-mediated dilation, a non-invasive indicator of endothelial dysfunction, and its relationship with future cardiovascular events is well known.The aim of this study was to identify factors thought to have an effect on in-stent restenosis and to test the predictive value of flow-mediated dilatation.Method: 74 consecutive patients who were treated with bare-metal stents and recommended control coronary angiography during their follow-up were included into the study. Patients were categorized into 2 groups in the form of those having in-stent restenosis (n=35) and no in-stent restenosis (n=39). Clinical, biochemical, angiographic parameters and also flow-mediated dilatation was evaluated.Results: Flow-mediated dilatation was significantly impaired in patients with in-stent restenosis than in patients with no in-stent restenosis (5.1(4.8) % vs. 9.2(4.1) %, p

Background: The aim of this study was the validation of AYC.2.2 agar and AYC.2.1 broth for the breakpoint values of first- and second-line drugs for Mycobacterium tuberculosis. Method: A total of 12 isolates including 5 reference strains and 7 well-defined clinical isolates were tested for their antituberculosis susceptibilities. Inhibitory effects of first- and second-line antituberculous drugs including isoniazid, rifampicin, streptomycin, ethambutol, amikacin, capreomycin, kanamycin, para-aminosalicylic acid, ethionamide, rifabutin, ofloxacin, levofloxacin, and moxifloxacin were tested. Results: According to the minimal inhibitory concentration values obtained in 7H10 agar, 7H9-S broth, AYC.2.2 agar, and AYC.2.1 broth, category agreement is 100%, and very major discrepancy (MAD), MAD, and minor discrepancy ratios were determined as 0 for all drugs. Conclusion: It was concluded that breakpoint values by CLSI recommendation for 7H10 agar can be also used for AYC.2.2 agar and AYC.2.1 broth. In addition, further multicenter studies are needed to use the new medium in routine mycobacteriology laboratories.

Tuberculosis (TB) is one of the oldest health problems in the world and it remains unresolved. Multidrug-resistant-TB and extensively resistant-TB are a serious problem for control programs. The evaluation of available antibiotics has gained importance in recent years for the treatment of resistant TB. Beta-lactam antibiotics inhibit cell wall biosynthesis in the bacteria; the presence of beta-lactamase enzyme in TB bacilli raises the question of whether this group of antibiotics can be used in treatment. As a result, it has been reported that the combination of beta-lactam antibiotics with beta-lactamase is effective against Mycobacterium tuberculosis both in vitro and in vivo. The aim of this article is to review and discuss up-to-date knowledge and future perspective on beta-lactam antibiotics and TB.

Objective: This study aimed to investigate the prevalence of temporomandibular disorders (TMD) in patients with chronic hemodialysis and evaluate the risk factors of developing TMD.Methods: One hundred forty-six subjects were included in the study. The examination for TMD was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Axis I protocol was used to evaluate the prevalence of TMD sub-diagnoses.Results: The prevalence of TMD was 41.5% in hemodialysis patients and significantly higher than in the control group. The most common symptom was TMJ pain, and the most common TMD subtype was muscular type. Female patients had significantly higher TMD than males. C-reactive protein, hemoglobin, parathyroid hormone, and albumin were significantly associated with TMD.Conclusion: There was an elevated prevalence of TMD in hemodialysis patients.

No-reflow phenomenon (NRP) is an important problem in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Endocan is synthesized and secreted by activated vascular endothelium, and it has been shown to be related to endothelial dysfunction and inflammation. We aimed to evaluate the relationship between endocan levels and NRP. Consecutive patients (n = 137) with STEMI who had undergone coronary angiography and pPCI were enrolled into the study. The clinical characteristics of the patients were obtained and endocan levels were measured. Endocan levels were significantly higher in the NRP (+) group compared with the NRP (−) group ( P < .001). In multivariate analysis, endocan ( P < .001, OR = 2.39, 95% CI = 1.37-4.15) was found to be an independent predictor of NRP. An endocan value of >2.7 ng/mL has 89.6% sensitivity and 74.2% specificity for the prediction of the NRP (area under the curve: 0.832, P < .001). The present study demonstrated that the endocan level is an independent predictor of the NRP in patients with STEMI who underwent pPCI. Endocan levels may be helpful in detecting patients with a higher risk of insufficient myocardial perfusion and worse clinical outcome.

Objective: In this study, our aim was to compare the diagnostic methods with each other and show the presence of Cryptosporidium oocysts by using molecular, serological and microscopic methods in stool samples which were collected from immunosuppressive and immunocompetent patients with diarrheaMethods: Total 172 stool samples were collected from 80 immunosuppressive patients and 92 immunocompetent patients (between 0-94 years) with diarrhea. These stool samples were obtained from the different clinics of Ataturk University, Yakutiye Research Hospital between January 2014 and July 2014. Patient group composed of 49 persons between 0-14 years and 123 persons between 15-94 years. On the other hand, 141 patients were using tap water while 41 of them were using well water. Modified acid-fast staining, ELISA and DFA techniques were applied to detect the Cryptosporidium parasite positivity. Nested PCR method was performed to the samples which were detected positive with one of the above methods.Results: The positivity was detected in 5.8%, 4.1% and 3.5% by ELISA, DFA technique and Modified acid-fast staining method, respectively. Cryptosporidium DNA was detected in only 1.2% by PCR method. The rates of positivity were 6.3% and 5.4% in immunosuppressive and immunocompetent patients, respectively. The positivity was detected in 10.2% and 4.1% in 0-14 age group and 15-94 age group patients, respectively. On the other hand, 4.3% and 12.9% positivity rates were detected in tap water and well water users respectively. Conclusion: Our study pointed out that the investigation of Cryptosporidium oocysts as diarrhea agents in especially immunosuppressive patients, individuals in childhood and well water users may be useful. Because cryptosporidiosis is a common disease in children and immunosuppressive individuals. Additionally, we think that ELISA method can be preferred to other methods in terms of high sensitivity and ease of application.

Objective:The aim of this study was to evaluate the fractal dimension (FD) analysis in the temporomandibular joint for changes in trabecular bone structure on cone beam computed tomography (CBCT) images of patients with rheumatoid arthritis (RA).Materials and Methods:In this study 17 female RA patients and 16 healthy female individuals who were underwent CBCT imaging with for diagnostic purposes such as pathologic lesion and implant treatment planning, were evaluated and fractal analysis was performed using Image J (National Institutes of Health, Bethesda, MD) program with box-counting method. The results were analysed using Student t-test with SPSS 20.0 (SPSS, Chicago; IL, USA) software program.Results:According to the results, FD values of RA patients have wide range (for right side minimum: 0.919, maximum: 1.169 and for left side minimum: 0.958, maximum: 1.155). Statistical analysis of FD values showed significance between RA patients and the healthy individuals for both right/left sides (for the right side, the RA patients had a mean FD of 1.055, and the control group had a mean FD of 1.113; for the left side, the RA patients had a mean FD of 1.060, and the control group had a mean FD of 1.111) (p

Objective:This study evaluated the use of a deep-learning approach for automated detection and numbering of deciduous teeth in children as depicted on panoramic radiographs.Methods and materials:An artificial intelligence (AI) algorithm (CranioCatch, Eskisehir-Turkey) using Faster R-CNN Inception v2 (COCO) models were developed to automatically detect and number deciduous teeth as seen on pediatric panoramic radiographs. The algorithm was trained and tested on a total of 421 panoramic images. System performance was assessed using a confusion matrix.Results:The AI system was successful in detecting and numbering the deciduous teeth of children as depicted on panoramic radiographs. The sensitivity and precision rates were high. The estimated sensitivity, precision, and F1 score were 0.9804, 0.9571, and 0.9686, respectively.Conclusion:Deep-learning-based AI models are a promising tool for the automated charting of panoramic dental radiographs from children. In addition to serving as a time-saving measure and an aid to clinicians, AI plays a valuable role in forensic identification.

WOS: 000410002100004 Objective: The aim of this study is evaluation of StaResMet (R) (AYCMED Medikal ve Tibbi Cihazlar San. ve Tic. A. S., Samsun, Turkey) as a new colorimetric test kit for rapid detection of the methicillin resistance in Staphylococcus aureus isolates. Methods: Methicillin resistance was determined by the microdilution method according to Clinical & Laboratory Standards Institute (CLSI) recommendations. The StaResMet (R) kit and VITEK (R) 2 Compact (bioMerieux, Marcy l'Etoile, France) automated system were used according to the recommendations of the manufacturers. The broth microdilution test was considered as reference method for the comparison of the tests. S. aureus ATCC 29213 (methicillin-susceptible) and ATCC 43300 (methicillin-resistant) were used as quality control strains. Isolates were accepted as resistant to methicillin if they had a cefoxitin minimum inhibitory concentration of = 8 ae g/ ml according to the CLSI criteria. Results: It was found that out of 277 isolates, 118 S. aureus isolates were methicillin-resistant and 159 were susceptible to methicillin. It was determined that 118 S. aureus isolates were resistant to methicillin by the broth microdilution method, VITEK (R) 2 Compact and StasResMet (R) kits. 159 isolates were susceptible to methicillin by three methods. According to these results, specificity, sensitivity, positive and negative predictive values of StaResMet (R) kit were 100%. Conclusions: StaResMet r kit has a potential use for rapid detection of methicillin-resistant S. aureus (MRSA).

Purpose Pitting inhibition efficiency of SO4− and NO3− on AISI 316L stainless steel in contact with Cl−-containing fiber dyeing solutions together with the influence of the anions on absorption behavior of the solutions were investigated. The purpose of the study is to experimentally determine an optimized dyeing solution efficient on both – inhibition of the steel’s pitting and exhaustion of the dyes dissolved. Design/methodology/approach Methods such as electrochemical cyclic polarization, UV-visible range spectrophotometry and scanning electron microscopy have been used to assess the performance of two inhibitors on both pitting inhibition of the steel and dissolving ability over the reactive dyes. To find out a promising dyeing solution mixture in both aspects, Cl content of the original dyeing solution was replaced gradually with the inhibiting anions, where the total anionic content was kept constant to unchange the dye exhaustion potential of the solution. Then, those solutions came out with diverse pitting inhibition, and dye absorption levels were compared together for reducing/avoiding the pitting issues of the reactive dyeing vessels of the industry. Findings Rather high absorption levels detected by visible range spectrophotometry on the solutions showing sound inhibition levels indicated possibility of unaltered reactive dyeing qualities with an enhanced vessel lifetime as the inhibitive anions replace Cl−. Nitrate performed better than sulfate both on inhibition and absorption in the dyeing solutions. Also, 316L vessels became open to an extra anodic protection in inhibitor added solutions. Research limitations/implications The findings are valid for a certain group of reactive dyes and dyeing solutions held at 70°C. However, the testing methods are available to almost any dyeing solution and dyeing temperature. Originality/value The work presents a combined testing of pitting inhibition and absorption behavior of dyeing solutions involving Cl− that has not been reported so far. It shows that solution recipes least harmful to the steel vessels can be outlined for various reactive or other types of dye groups.

Amaç: Atriyal fibrilasyon, popülasyondaen sık görülen aritmidir ve prevalansı yaşla artar ayrıca en sıkrastlanılan morbidite ve mortalite oluşturan aritmidir. Genellikle persistanatriyal fibrilasyonun başlangıcı paroksismal atriyal fibrilasyonun (PAF)tekrarlayan bölümleridir. Paroksismal atriyal fibrilasyonun öngörülmesi, buaritminin önlenmesine ve dolayısıyla olumsuz sonuçların önlenmesine nedenolabilir. Bu çalışmada paroksismal atriyal fibrilasyonu öngörebilecek dokuDoppler görüntüleme (TDI) ve pik hızlanma süresi (pkAcc) parametreleriniaraştırmayı amaçladık. Gereç ve Yönetemler: 20-73 yaşları arasında (ortalama47,5) PAF tanısı almış 50 kişi ile hasta grubu oluşturuldu.. Hasta grubu ilebenzer temel demografik özelliklere sahip olan ve persistan veya PAF bulunmayan50 kişi ile kontrol grubu oluşturuldu.Tüm kontrol ve çalışma gruplarınatranstorasik ekokardiyografik (TTE) değerlendirme yapıldı. Doku Dopplerparametreleri ve pkAcc TTE'de ölçüldü ve istatistiksel analizler yapıldı.Bulgular: TTE değerlendirmesinde, hastagrubunda sol atriyum ejeksiyon fraksiyonu çalışma grubundan daha düşüktü (%50,6 vs.% 59,2, p, Aim: Atrialfibrillation is the most common arrhythmia in the population and its prevalanceincreases with age; and also is the most morbid and mortal arrhythmia. Usuallythe beginning of the persistant atrial fibrillation is recurrent episodes ofthe paroxysmal atrial fibrillation (PAF). Prediction of the paroxysmal atrialfibrillation can cause prevention of this arrhythmia and thus prevention of theadverse outcomes. We aimed to investigate tissue Doppler imaging (TDI) and peakacceleration time (pkAcc) parameters that can predict the paroxysmal atrialfibrillation in this study.Material and Methods: 20-73years old (mean 47,5) 50 individuals that are diagnosed with PAF included thepatient group. 50 individuals who have the similar baseline demographiccharasteristics with patient group and who have no persistant or PAF includedthe control group. Transthoracic echocardiogaphic (TTE) evaluation is appliedall of the control and study groups. Tissue Doppler parameters and pkAcc ismeasured in TTE and statistical analyses is performed. Results: InTTE evaluation, left atrium ejection fraction is lower in the patient groupthan the study group (%50,6 vs. %59,2, p

WOS: 000458593300004, PubMed: 30476633, …

Aim: In this study, the seroprevalence of IgM- and IgG- type antibodies against Toxoplasma, Cytomegalovirus (CMV) and Rubellavirus was investigated in pregnant women with routine controls performed by family physicians in the city center of Erzurum in atwo-year period. It was aimed to compare the obtained data with other studies conducted in our country and in the world. Materials and Methods: The specific results of IgM and IgG serology of Toxoplasma, CMV and rubella of 6798 pregnant womenperformed by family physicians in the city center of Erzurum between 01.01.2018 and 31.12.2019 were investigated and evaluatedaccording to different age groups in this retrospective cross-sectional study. The serum samples were studied using the Architecti2000 systems with the Chemiluminescent Microparticle Immunoassay (CMIA) method in Erzurum Public Health MicrobiologyLaboratory. Results: The data of 6798 people between the ages of 15-50 were reached in our study. Toxoplasma, Rubella and CMV- (n = 6586)specific IgM antibody seropositivity rates were found as 0.5%, 0.3% and 0.6%, respectively, while Toxoplasma-, Rubella- and CMV-specific IgG antibody seropositivity rates were found as 20.9%, 88.3% and 99.2%, respectively. Toxoplasma IgG seropositivity rateswere determined to increase in parallel with increasing age. Rubella IgG seropositivity rates were decreasing in the 15-24, 25-34 and35-49 age groups, respectively. The lowest Toxoplasma IgM and CMV IgM seropositivity rates were found in the 35-49 age groups. Conclusions: The two-year seroprevalence of Toxoplasma, CMV and Rubella was determined in pregnant women in our region withthis study. Although these seroprevalence rates in Erzurum are generally compatible with other studies conducted in our country,Toxoplasma IgM and rubella IgG seropositivity rates were found to be lower compared to the overall incidence of our country.

Deaths related with human immunodeficiency virus (HIV) infections have been decreased by the introduction of combined anti-retroviral therapy (ART) into the clinical practice. Combined ART usually consists of two nucleoside/nucleotide analogs reverse transcriptase inhibitors (NRTI) that is called backbone and a third drug that belongs to either non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTI), protease inhibitors (PI), integrase strand transfer inhibitors (INSTI) or entry inhibitors. During abacavir therapy which is a member of NRTI, hypersensitivity reactions can occur approximately 4-9% of the patients that lead difficulties for the management of HIV infections. It is known that, the development of hypersensitivity reactions to abacavir is strongly associated with the presence of HLA-B*57:01 allel, therefore, HLA-B*57:01 screening should be performed prior to abacavir use. Since there is no data on HLA-B*57:01 prevalence in HIV-1-infected cases in Turkey, this is the first study that screened HLA-B*57:01 allels among HIV-1 infected adults in Turkey. A total of 100 HIV-1-infected patients (81 male, 19 female; mean age: 42.31±11.97 years) who have admitted to the Department of Infectious Diseases and Clinical Microbiology of Ondokuz Mayis University School of Medicine, Samsun, Turkey, were included in the study. Genomic DNAs were isolated from the blood samples of patients by using a commercial spin column procedure (QIAamp® DNA Blood Mini Kit; QIAGEN GmbH, Germany). HLA-B*57:01 genotyping was performed by the method of sequence-specific primer (SSP)-based amplification using a commercial OlerupSSP® HLA-B*57:01 high-resolution test kit (Olerup SSP AB, Sweden) according to the manufacturer's protocol. The products of polymerase chain reaction were electrophoresed on a 2% agarose gel stained with Olerup SSP GelRed dye (Olerup SSP AB, Sweden), and the bands were evaluated under UV light. In our study, three (2 male, 1 female) out of 100 patients were found positive for HLA-B*57:01 gene with a prevalence of 3%, which is a moderate level. Although the medical usefulness of HLA-B*57:01 screening before the abacavir therapy is emphasized, it was also noted that this application is not cost-effective for the populations with low HLA-B*57:01 prevalence, in contrast to populations with high prevalence. Considering of the incidence of HIV/AIDS in Turkey which is 0.12, the value and cost-effectiveness of HLA-B*57:01 screening in HIV-1 positive cases before abacavir therapy should be analysed by further studies.

WOS: 000374722700029, PubMed: 26164686, Objectives: Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24 hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. Results: Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7 +/- 10.2 ms vs. 102.2 +/- 7.5 ms, p = 0.02; 40.6 +/- 7.6 ms vs. 33.6 +/- 5.9 ms, p < 0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5 +/- 7.8 ms vs.11.2 +/- 4.4 ms, p < 0.001; 9.0 +/- 7.3 ms vs. 6.0 +/- 3.8 ms, p = 0.002, and 7.4 +/- 5.2 ms vs. 5.1 +/- 3.2 ms, p = 0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r = 0.429, p < 0.001) and left atrial volume (r = 0.428,p < 0.001). Conclusions: In this study, there was significant EMD and Pd in patients with T2DM as compared with healthy volunteers. Additionally, interatrial EMD was correlated with Pd and left atrial volume index. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

BAYDIN, AHMET/0000-0003-4987-0878 WOS: 000393517800005 PubMed: 27239621 Introduction: We aimed to investigate the demographical features, anxiety levels and clinical findings of the patients admitted to our Emergency department (ED) due to chest pain. Methods: Patients with chest pain older than 18 years were included into the study. Demographical features such as age, sex and education level, initial diagnosis in the ED, whether they were hospitalized or coronary intervention performed, were recorded. To determine the anxiety levels of the patients, State-trait Anxiety Inventory (STAI) was performed. Results: Two-hundred and eight adult patients with chest pain were included into the study. We could not determine a relationship between STAI levels of patients according to demographical findings, however, STAI scores tended to decrease by age. Considering the education levels of the patients, it was determined that STAI scores of university graduates were higher than others. The STAI scores of patients discharged from the ED were higher than those hospitalized. When patients were compared according to whether coronary intervention (CI) was performed or not, it was determined that patients who did not require CI had higher STAI scores. When coronary lesion localization of the patients hospitalized was investigated, any relationship could not be determined. Conclusion: In this study, we determined that anxiety levels of the patients with chest pain do not correlate with the severity of the disease. Higher anxiety levels of patients discharged from ED when compared to those with ACS is a challenging problem for both ED physicians and cardiologists. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.

Aim: The aim of the study was to compare the anti-HAV IgG and Anti-HAV IgM seropositivity in children aged 0-18 in Erzurum with studies in our country and other countries, and also to evaluate the effect of seasons on hepatitis A infection.Material and Methods: The study was conducted on the serum samples of 5086 patients aged 0-18 years, who were considered to have Hepatitis A or who applied with different complaints as a result of the examination of family physicians in Erzurum between 2015 and 2018. The results of these patients, obtained from Anti-HAV IgM and Anti-HAV IgG analysis by ELISA method in the Public Health Microbiology Laboratory, were evaluated retrospectively. Pearson chi-square test was used to analyze the categorical data such as gender, age and seasonal differences in anti-HAV IgM and Anti-HAV IgG positivity rates and p 0.05 was considered significant.Results: Anti-HAV IgG seropositivity was 69.0% (3510/5086) and Anti-HAV IgM positivity was 0.7% (33/5063). Anti-HAV IgM was positive in 1.1% of girls and 0.1% of boys. Anti-HAV IgG positivity was 89.9%, 83.3%, 62.5% 61.9% and 74.5% in the 0-3 age group, 4-7 age group, 8-11 age group, 12-15 age group and 16-18 age groups, respectively. Anti-HAV IgM positivity was 0, 0.2%, 0.2%, 1.0%, 0.9% in the 0-3 age group, 4-7 age group, 8-11 age group, 12-15 age group and 16-18 age groups, respectively. The highest anti-HAV IgM positivity was found in November (1.7%).Conclusion: Total anti-HAV IgG seropositivity rate in our province showed many similarities with studies in Turkey and developing countries. The prevalence of anti-HAV IgM was the highest in November.

Background: Because pyrazinamide (PZA) is only effective for Mycobacterium tuberculosis at an acidic pH, susceptibility tests are more difficult to perform than those for other anti-tuberculosis (TB) drugs. The purpose of our work was to investigate the effectiveness of colorimetric methods to detect PZA susceptibility and to detect pncA gene mutations in resistant isolates by sequence analysis. Methods: In this study, 30 clinical isolates and 2 reference isolates were used, 15 of which were resistant to PZA. The PZA susceptibility of all the isolates was determined by the BACTEC MGIT 960 reference method. As colorimetric methods, Resazurin Microtiter Assay (REMA), Nitrate Reductase Assay (NRA), Malachite Green Decolorization Assay (MGDA), and Crystal Violet Decolorization Assay (CVDA) methods were included in the study. In addition, mutations in the pncA gene were investigated using sequence analysis in PZA-resistant isolates. Results: As a result of the comparison of the colorimetric methods with the reference method, agreement was determined as 93.3% in REMA and NRA, 90% in MGDA, and 93.3% in CVDA. In 13 of 15 resistant isolates, the pncA gene mutation was detected by sequence analysis. Conclusions: As a result of the work, the results from the colorimetric methods were found to be at a high level of concordance with the reference method. They are also inexpensive and easily applicable methods.

Background: Effective control of tuberculosis is achieved by early diagnosis and drug susceptibility testing for initiation of appropriate treatment. The performance of crystal violet decolorization assay (CVDA) for susceptibility testing of Mycobacterium tuberculosis to isoniazid (INH) and rifampicin (RIF) was compared in a multicenter study. Methods: Seventy-two M. tuberculosis isolates were tested in two phases by CVDA. Results: In Phase I, the specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and agreement for INH were 100%, respectively. Specificity, sensitivity, PPV, NPV, and agreement for RIF were 98.2%, 100%, 94.1%, 100%, and 98.6%, respectively. In Phase II, specificity, sensitivity, PPV, NPV, and agreement were 98%, 100%, 95.4%, 100%, and 98.6% for INH, respectively. Specificity, sensitivity, PPV, NPV, and agreement for RIF were 96.3%, 88.2%, 88.2%, 96.3%, and 94.4%, respectively. Results in the study were obtained on average 10.9 ± 3.1 days in Phase I and 9.8 ± 2.2 days in Phase II. Conclusion: CVDA can be performed for drug susceptibility testing in developed and developing countries. In addition, further studies with larger sample size are needed for evaluation of this method. Fil: Coban, Ahmet Yilmaz. Akdeniz Üniversitesi; Turquía Fil: Alakbarova, Gumral. Medical Microbiology Laboratory. Thalassemia Center; Azerbaiyán Fil: Satti, Luqman. Armed Forces Institute of Pathology; Pakistán Fil: Tayyab, Nadia. Armed Forces Institute of Pathology; Pakistán Fil: Zaman, Gohar. Armed Forces Institute of Pathology; Pakistán Fil: Morcillo, Nora Susana. Provincia de Buenos Aires. Ministerio de Salud. Hospital "Dr. Antonio A. Cetrángolo"; Argentina Fil: Imperiale, Belén Rocío. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina Fil: Wainmayer, Ingrid. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud “Dr. C. G. Malbrán”; Argentina Fil: Símboli, Norberto Fabián. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud “Dr. C. G. Malbrán”; Argentina

Sig, Ali Korhan/0000-0003-2907-257X; Akbal, Ahmet Ugur/0000-0002-0627-5326 WOS: 000464730900003 PubMed: 30417212 Streptomycin (STR) and ethambutol (EMB) are important drugs used for the treatment of tuberculosis. There is a need for fast, reliable and inexpensive methods for detecting resistance to these drugs. The aim of this study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for the detection of STR and EMB resistance that is important drugs in tuberculosis treatment. In this study, drug susceptibility testing was performed on 140 Mycobacterium tuberculosis isolates provided from nine centers. Three tubes were used for each isolate. One of the tubes had a concentration of 2mg/L STR and the other 5mg/L EMB. The third was drug-free control tube. Sensitivity, specificity, positive predictive value (PPD), negative predictive value (NPD) and agreement for STR were found to be 81.8%, 94.6%, 87.8%, 91.5% and 90.57%, respectively. For EMB, sensitivity, specificity, PPD, NPD, and agreement were found to be 76%, 98.23%, 90.47%, 94.87% and 94.2%, respectively. The results were obtained in 11.3 +/- 2.7days (8-21days). CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of STR and EMB resistance, and it could be adapted for drug susceptibility testing.

BACKGROUND There are very few studies investigating metabolic biomarkers to predict acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). Metabolic models can provide a framework for analyzing the information-rich omics data sets in this setting. METHODS Four hundred and fifty-six samples from one hundred and fourteen consecutive patients who underwent HSCT from January 2012 to May 2014 were collected for this study. The changes in serum metabolite levels were investigated using a gas chromatography-mass spectrometry-based metabolomics approach and underwent statistical analysis. RESULTS Significant metabolic changes were observed on day 7. The stearic acid/palmitic acid (SA/PA) ratio was effective in the diagnosis of grade II-IV aGVHD. Multivariate analysis showed that patients with high SA/PA ratios on day 7 after HSCT were less likely to develop II-IV aGVHD than patients with low SA/PA ratios (odds ratio [OR] = 0.06, 95% CI 0.02-0.18, P < 0.001). After the adjustment for clinical characteristics, the SA/PA ratio had no significant effect on overall survival (hazard ratio [HR] = 1.95, 95% CI 0.92-4.14, P = 0.08), and patients in the high SA/PA ratio group were significantly more likely to relapse than those in the low ratio group (HR = 2.26, 95% CI 1.04-4.91, P = 0.04). CONCLUSION Our findings suggest that the SA/PA ratio on day 7 after HSCT is an excellent biomarker to predict both aGVHD and relapse. The serum SA/PA ratio measured on day 7 after transplantation may improve risk stratification for aGVHD and relapse after allogeneic stem cell transplantation. FUNDING National Natural Science Foundation of China (81470346, 81773361), Priority Academic Program Development of Jiangsu Higher Education Institutions, Jiangsu Natural Science Foundation (BK20161204), Innovation Capability Development Project of Jiangsu Province (BM2015004), Jiangsu Medical Junior Talent Person award (QNRC2016707), and NIH (AI129582 and NS106170).

Importance Universal tumor screening for Lynch syndrome (LS) in colorectal cancer (CRC) is recommended and involves up to 6 sequential tests. Somatic gene testing is performed on stage IV CRCs for treatment determination. The diagnostic workup for patients with CRC could be simplified and improved using a single up-front tumor next-generation sequencing test if it has higher sensitivity and specificity than the current screening protocol. Objective To determine whether up-front tumor sequencing (TS) could replace the current multiple sequential test approach for universal tumor screening for LS. Design, Setting, and Participants Tumor DNA from 419 consecutive CRC cases undergoing standard universal tumor screening and germline genetic testing when indicated as part of the multicenter, population-based Ohio Colorectal Cancer Prevention Initiative from October 2015 through February 2016 (the prospective cohort) and 46 patients with CRC known to have LS due to a germline mutation in a mismatch repair gene from January 2013 through September 2015 (the validation cohort) underwent blinded TS. Main Outcomes and Measures Sensitivity of TS compared with microsatellite instability (MSI) testing and immunohistochemical (IHC) staining for the detection of LS. Results In the 465 patients, mean age at diagnosis was 59.9 years (range, 20-96 years), and 241 (51.8%) were female. Tumor sequencing identified all 46 known LS cases from the validation cohort and an additional 12 LS cases from the 419-member prospective cohort. Testing with MSI or IHC, followed by BRAF p.V600E testing missed 5 and 6 cases of LS, respectively. Tumor sequencing alone had better sensitivity (100%; 95% CI, 93.8%-100%) than IHC plus BRAF (89.7%; 95% CI, 78.8%-96.1%; P = .04) and MSI plus BRAF (91.4%; 95% CI, 81.0%-97.1%; P = .07). Tumor sequencing had equal specificity (95.3%; 95% CI, 92.6%-97.2%) to IHC plus BRAF (94.6%; 95% CI, 91.9%-96.6%; P > .99) and MSI plus BRAF (94.8%; 95% CI, 92.2%-96.8%; P = .88). Tumor sequencing identified 284 cases with KRAS , NRAS, or BRAF mutations that could affect therapy for stage IV CRC, avoiding another test. Finally, TS identified 8 patients with germline DPYD mutations that confer toxicity to fluorouracil chemotherapy, which could also be useful for treatment selection. Conclusions and Relevance Up-front TS in CRC is simpler and has superior sensitivity to current multitest approaches to LS screening, while simultaneously providing critical information for treatment selection.

WOS: 000453760500001, PubMed ID: 30631600, Background and Objectives. Chronic venous insufficiency (CVI) is a common pathology of the circulatory system and is associated with a high morbidity for the patients and causes high costs for the healthcare systems. Arterial stiffness has been shown to be a predictor of cardiovascular events and mortality. The relationship between CVI and arterial stiffness using pulse wave velocity (PWV) and augmentation index (Aix) was evaluated in this study. Methods. Sixty-two patients with the stage of C3-C5 chronic venous disease (CVD) and 48 healthy subjects were enrolled in the study. To assess arterial stiffness, all cases were evaluated with I.E.M. Mobil-O-Graph brand ambulatory blood pressure monitor device. PWV and Aix were used to assess arterial stiffness in this study. Results. The mean age was 61.9 +/- 11.05 years and 54 % of the patient population was females. PWV and Aix were significantly higher in CVI patients than controls (8.92 +/- 1.65 vs. 8.03 +/- 1.43, p=0.001; 25.51 +/- 8.14 vs. 20.15 +/- 9.49, p=0.003, respectively) and also positive linear correlation was observed between CVI and all measured arterial stiffness parameters (r=0.675 for CVI and PWV, r=0.659 for CVI and Aix, respectively). A PWV value of > 9.2 has 88.9 % sensitivity and 71.4 % specificity to predict the presence of CVI. Conclusions. PWV and Aix are the most commonly used, easy, reproducible, reliable methods in the clinic to assess arterial stiffness. Logistic regression analysis showed that PWV and Aix were the independent predictors of CVI. PWV has the sensitivity of 88.9 % and specificity of 71.4 % to detect the presence of CVI.